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Astanga Hrudaya

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प्रवाहिणीं वलीं प्राप्तं सेवनीं वा समाश्रितम् । अथास्य पिटिकामेव तथा यत्नादुपाचरेत् ॥ २२ ॥

so also, if the fistula is in the pravahini layer of the rectum or if it is in the sevani (vesico-rectal raphae). During the Pitika (eruption) stage only, effective treatment should be done with effort

english translation