The unripe stage is called as Pitika (Bhagandara Pitika) and the ripe stage as Bhagandara; the Pitika (eruptions) which is deep seated, having great swelling, severe pain and increased (recurring) even after healing,
भगन्दरकरीं विद्यात्पिटिकां न त्वतोऽन्यथा । तत्र श्यावारुणा तोदभेदस्फुरणरुक्करी ॥ ७ ॥
should be recognised as causing Bhagandara (rectal fistula) whereas without this feature as a difficult disease. The Pitika (Bhagandra Pitika) caused by Vata, is blackish red, with pricking, puncturing and throbbing kinds of pain;
पिटिका मारुतात्पित्तादुष्ट्रग्रीवावदुच्छ्रिता । रागिणी तनुरूष्माढ्या ज्वरधूमायनान्विता ॥ ८ ॥
that caused by Pitta is raised up like the neck of the camel, red, thin (small) with great warmth accompanied with fever and feeling of hot fumes coming out;
that caused by Kapha is static, unctuous, deep rooted, pale yellow and has itching; that caused by Vata and Pitta is black, coppery with burning sensation, has great warmth and severe pain;
पाण्डुरा किञ्चिदाश्यावा कृच्छ्रपाका कफानिलात् । पादाङ्गुष्ठसमा सर्वैर्दोषैर्नानाविधव्यथा ॥ १० ॥
those caused by Kapha and Vata is pale, slightly bluish and ripens with difficulty; that caused by all the doshas together resembles the big toe, has different kinds of pain,