[Complication of parikartika (fissure in ano) and its management] If potent (purification) medicine is given in properly oleated patients, with guru koshtha(heavy bowel), in cases of ama dosha, body being lean with mridu koshtha (soft bowel), fatigued and less strength,
then doshas reach guda (rectum) in sama condition and get expelled out immediately. It results in parikartika (fissure in ano) with severe pain, mucous and bloody secretions.
In amadosha or sama conditions, fasting (langhana), digestive (pachana), drying (rukshana), should be done and easily digestible (light) and hot food must be taken. For those whose body is emaciated, every brimhana (nourishing) measure like food with madhura rasa (sweet taste) dominance must be taken.
आमे जीर्णेऽनुबन्धश्चेत् क्षाराम्लं लघु शस्यते| पुष्पकासीसमिश्रं वा क्षारेण लवणेन वा||६४||
If parikartika continues even if the ama got digested, light food added with kshara (alkalizing) and amla (sour) is good. For aggravated vayu, ghee medicated with pomegranate juice, puspa-kaaseesa (green vitriol- Ferrous sulphate), kshara (alkalies), lavana(salts) and dadima (Punica granatum) can be used.