रक्तं वातकफाद्दुष्टं बस्तिद्वारे सुदारुणम्| ग्रन्थिं कुर्यात् स कृच्छ्रेण सृजेन्मूत्रं तदावृतम्||४१||
[Raktagranthi (nodular swelling in bladder)] Rakta getting vitiated by vata and kapha, produces a grievous nodular swelling (granthi) which obstructs the mutra and as a result the mutra is eliminated with difficulty and pain similar to urinary calculus.
The condition is called raktagranthi. [Vid vighata (feces coming through urine)] In a ruksha (emaciated) and durbala (weak) person, due to aggravated vata when shakrita (stool matter) becomes udavarta (moves into other pathway)
and enters the channels of mutra, the person passes mutra admixed with stool matter bearing a fecal odor with difficulty. The condition is called vidvighata.
[Basti kundala (circular distension of bladder) Due to factors such as fast walking, fasting, exhaustion, injury and compression, the basti is displaced upwards giving the appearance of distended gravid uterus.
The patient manifests with shula (severe pain), spandana (involuntary contractions or spasms) and daha (burning) and passes urine drop by drop. On straining there is streamed urine with samstambha (griping pain), udvestana (twisting pain) or arti (simple pain).