The disease admits of being divided into four several types, such as the Vataja, the Pittaja, the Kaphaja and the Sukraja (Seminal) concretions. An exuberance or preponderance of the deranged Kapha should be understood as the underlying cause of all invasions of this disease.
General aetiology:—The Kapha of a man, who neglects to cleanse (Samshodhana) 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.
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 arc the symptoms, which indicate the formation of gravel in the bladder.
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.
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, sand)’, 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.
The Sleshma-asmari:—Stone or gravel, originated through the action of the deranged Kapha, 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 bladder gives rise to a kind of crushing, bursting, pricking pain in that organ, which becomes cold and heavy. A Kapha-origined 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 Sleshma-asmari.
The Pittaj-asmari: —The Kapha charged (dried) with the deranged Pitta 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 Ashmari is further marked by symptoms which characterize Ushna-vata (stricture). The concretion is found to be of a reddish, yellowish black colour like the stone of the Bhallataka fruit, or it is coloured like honey. This type is called Pitta;ja As man
The Vata-ashmari .—The deranged Kapham (mucus) inordinately saturated with the bodily Vata, acquires hardness and gains in dimensions, and these lying at the mouth of the bladder obstructs the passage of the urine. The incarcerated fluid causes extreme pain in the organ. The patient constantly under severe pain gnashes his teeth or presses his umbilical region, or rubs his penis, or fingers his rectum (Payu) and loudly screams. A burning sensation is experienced in the penis, and urination, belching and defecation become difficult and painful.* The concretions in this type of Ashmari are found to be of a dusky colour, rough, uneven in shape, hard, facetted and nodular like a Kadamva flower. This type is called Vata-ashmari.
Infants arc more susceptible to an attack of any of the three preceding types of Ashmari, inasmuch as they are fond of day sleep or of food composed of both whole-some and unwholesome ingredients, and are in the habit of eating before the digestion of a previous meal, or of taking heavy, sweet, emollient and demulcent food. In children the bladder is of diminished size and poor in muscular structure. These facts conti ibutc to the easy possibility of the organ being grappled (with a surgical instrument) and of the stone being extracted with the greatest ease in cases of infantile Ashmari.
The Sukra-ashmari :—Sukra-ashmaris or seminal concretions arc usually formed in adults owing to the germination of semen in their organisms. A sudden or abrupt stoppage of a sexual act or excessive coition tends to dislodge the semen from its natural receptacle * Stool and urine can be voided only with the greatest straining in the body. The fluid thus dislodged, but not emitted, finds a wrong passage. The Vata gathers up the fluid (semen), thus led astray, and deposits it (in a round or oval shape) at a place lying about the junction of the penis and the scrotum and dries up the humidity with which it is charged. The matter, thus formed, condensed, and hardened, is called the seminal stone (SukrAshmari), which then obstructs the passage of the urine, giving rise to pain in the bladder, painful micturition, and swelling of the scrotum. The stone vanishes under pressure in its seat.
Here only the introduction of Ashmari is given with their types. The treatment portion shall be discussed on another post.