The disease admits of being divided into four several types, such as the Vátaja, the Pittaja, the Kaphaja and the Sukraja (Seminal) concretions. An exuberance or preponderance of the deranged Kapham should be understood as the underlying cause of all invasions of this disease. 2.

General Aetiology

The Kaphah of a man, who neglects to cleanse (Sams'odhana) the internal channels of his organism, or is in the habit of taking unwholesome food, enraged and aggravated by its own exciting causes, is carried into the urinary bladder. Here it becomes saturated with the urine, and gives rise to the formation of concretions or gravels in its cavity. 3.

Premonitory Symptoms

An aching pain in the bladder, with a non-relish for food, difficulty in urination, an excruciating pain in the scrotum,penis, and the neck of the bladder, febrile symptoms, physical lassitude, and a goat-like smell in the urine are the symptoms, which indicate the formation of gravel in the bladder. 4.

Metrical Text

The deranged Doshas involved in a particular case respectively impart their specific colour to the urine, and determine the character of the accompanying pain. The urine becomes thick, turbid, and vitiated with the action of the aggravated Doshas, and micturition becomes extremely painful. 5.

Leading Indications

A sort of excruciating pain is experienced cither about the umbilicus, or in the bladder, or at the median rape of the perineum, or about the penis, during micturition when gravel is forming in the bladder. The urine is stopped at intervals in its out-flow, or becomes charged with blood, or flows out twisted and scattered like spray, leaving a sediment of clear, sandy, red or yellow particles of stone, which resembles a Gomedha gem in colour. Moreover a pain is experienced in the bladder at the time of running or jumping or in swimming, or while riding on horseback, or after a long journey. 6.

The Sleshmásmari

Stone or gravel, originated through the action of the deranged Kapham, saturated with an excessive quantity of that Dosha by the constant ingestion of phlegm-generating (Slesh-mala) substances, increases in size at the lower orifice of the bladder and ultimately obstructs the passage of the urine. The pressure and recoil of that incarcerated fluid on the walls of the urinary badder gives rise to a kind of crushing, bursting, pricking pain in that organ, which becomes cold and heavy. A Kapha-origincd stone or gravel is white and glossy, attains to a large size, to that of a hen's egg, and has the colour of the Madhuka flower. This type is called Sleshmásmari. 7.

The Pittaja Asmari

The Kapham charged (dried) with the deranged Pittam becomes hard (condensed) and large in the aforesaid way, and lying at the mouth of the bladder obstructs the passage of the urine. The bladder, on account of the flowing back of the obstructed urine into its cavity, seems as if it has been exposed to the heat of an adjacent fire, boiling with the energy of an alkaline solution. A kind of sucking, drawing and burning pain is experienced in the organ. This type of Asmari is further marked by symptoms which characterise Ushna-váta (stricture). The concretion is found to be of a reddish, yellowish black colour like the stone of the Bhallátaka fruit, or it is coloured like honey. This type is called Pittaja As'mari. 8.