अर्शोमूले ततः शोफः कण्डूदाहादिमान् भवेत् । स शीघ्रं पक्वभिन्नोऽस्य क्लेदयन् मूलमर्शसः ॥ १६ ॥
give rise to swelling, itching and burning sensation at the roots of the pile masses, very soon ripens, forms a fistula by softening, the roots of the pile mass
स्रवत्यजस्रं गतिभिरयमर्शोभगन्दरः । सर्वजः शम्बुकावर्तः शम्बूकावर्तसन्निभः ॥ १७ ॥
begins to eliminate constantly through its sinuses. This condition is Arshobhagandara. Shambukavarta is caused by all the doshas and resembles the shell of a snail in its sinuses,
causing severe pain and laceration of the rectum by its multiple sinuses. In a person who eats meat with great relish, small pieces of bone swallowed along with it, while passing out of the rectum in an obliquely
क्षिणोति तिर्यङ्निर्गच्छन्नुन्मार्गं क्षततो गतिः । स्यात्ततः पूयदीर्णायां मांसकोथेन तत्र च ॥ १९ ॥
abnormal course, causes tear and this injury gives rise to sinuses in its passage. Later there is discharge of pus and decaying of muscles in the passage of the rectum.
जायन्ते कृमयस्तस्य खादन्तः परितो गुदम् । विदारयन्ति न चिरादुन्मार्गी क्षतजश्च सः ॥ २० ॥
This leads to growth of worms (bacteria etc.) in it and they eat away the rectum and cause tears therein soon, this is known as Unmargi or Kshataja (Bhagandara).