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दाहाविपाकदौर्बल्यसदनारुचिकर्षितः। कामला बहुपित्तैषा कोष्ठशाखाश्रया मता॥३६॥
complexion develops a color similar to that of a frog (found in rainy season); the senses get impaired; has burning sensation, indigestion, weakness, prostration and anorexia. This kamala is caused by excess of pitta is known as koshthashakhashrita
english translation
कालान्तरात् खरीभूता कृच्छ्रा स्यात् कुम्भकामला। कृष्णपीतशकृन्मूत्रो [१] भृशं शूनश्च मानवः॥३७॥
[Kumbha kamala] With the due course of time the disease (kamala) becomes deep seated (kharibhuta) resulting in excessive dryness of the body or afflicted tissue and thus becomes difficult to cure. This condition is called kumbha kamala [Bad prognostic symptoms of kamala] If the stool and urine of the patient (of kamala) become black and yellow;
english translation
सरक्ताक्षिमुखच्छर्दिविण्मूत्रो यश्च ताम्यति। दाहारुचितृषानाहतन्द्रामोहसमन्वितः॥३८॥
develops excessive edema; eyes and face becomes red colored; vomit, stool and urine are mixed with blood; the patient feels like going in darkness; has burning sensation, anorexia, morbid thirst, constipation, drowsiness and fainting;
english translation
नष्टाग्निसञ्ज्ञः क्षिप्रं हि कामलावान् विपद्यते। साध्यानामितरेषां तु प्रवक्ष्यामि चिकित्सितम्॥३९॥
such patient may succumb to death quickly. [Principles of treatment] Now, the treatment for the curable types of pandu roga is being described here:
english translation
तत्र पाण्ड्वामयी स्निग्धस्तीक्ष्णैरूर्ध्वानुलोमिकैः। संशोध्यो मृदुभिस्तिक्तैः कामली तु विरेचनैः॥४०॥
The patient suffering from the pandu should first be given strong (tikshna) emetic and purgation therapies after the administration of internal oleation (snehana) for cleansing of the body (shodhana).
english translation