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=== ''Vidhi Vimarsha'' ===  

=== ''Vidhi Vimarsha'' ===  

==== Understanding concept of ''udavarta'' ====

Understanding concept of udavarta:

 

Udavarta involves obstruction to movement of vata leading to its vitiation and vimarga-gamana (movement in improper direction). The vitiated vata then locates to various sites and produces diseases at that site. The basic pathogenesis of udavarta takes place at pakvashaya (colon). Ap-ana vata is vitiated due to excess consumption of astringent, bitter and pungent, dried food items, suppression of natural urges, starvation and excess sexual intercourse. The vitiated apana itself obstructs its own functions and produces retention of feces, flatus and urine in pelvic re-gion. These events occur frequently to cause udavarta.  

''Udavarta'' involves obstruction to movement of ''vata'' leading to its vitiation and ''vimarga gamana'' (movement in improper direction). The vitiated ''vata'' then locates to various sites and produces diseases at that site. The basic pathogenesis of ''udavarta'' takes place at ''pakvashaya'' (colon). ''Apana vata'' is vitiated due to excess consumption of astringent, bitter and pungent, dried food items, suppression of natural urges, starvation and excess sexual intercourse. The vitiated ''apana'' itself obstructs its own functions and produces retention of feces, flatus and urine in pelvic region. These events occur frequently to cause ''udavarta''.  

 

This leads to increased intra-abdominal pressure, hampering functions of various organs. This results in frequent severe pain in urinary bladder, cardiac region, pelvis, flanks, back region, abdominal distension, nausea, fissure in ano, pricking pain, indigestion, cystitis, constipation, dryness, hardness in stool and delayed passage of stools.  

This leads to increased intra-abdominal pressure, hampering functions of various organs. This results in frequent severe pain in urinary bladder, cardiac region, pelvis, flanks, back region, abdominal distension, nausea, fissure in ano, pricking pain, indigestion, cystitis, constipation, dryness, hardness in stool and delayed passage of stools.  

These pathological events produce various disorders of vata at various sites.  

 

Therefore, management is targeted to remove the apana sanga by vitiated apana. Pacification of apana by various unctuous and purification enema, massage, fomentation therapies is indi-cated.  

These pathological events produce various disorders of ''vata'' at various sites.  

Anulomona (carminatives) for proper movement of vata and anal suppositories are indicated to facilitate the action of vata in pelvic region.  

 

Therapeutic purgation with castor oil with proper concoction is prescribed to remove obstruc-tion by excess meda, kapha, pitta and rakta. Obstruction by fat and excess unctuous substances indicates pathogenesis of dyslipidemia causing atherosclerosis and cerebro-vascular disease. This is dealt in more detail in context of pakshaghata  in vata vyadhi chapter.  

Therefore, management is targeted to remove the ''apana sanga'' by vitiated ''apana''. Pacification of ''apana'' by various unctuous and purification enema, massage, fomentation therapies is indicated.  

Examination: Clinical examination of palpation of abdomen for distension, assessment of ob-struction and per rectal examination is done.  

 

Investigations: Ultra sonography of abdomen and pelvis can reveal the exact nature of obstruc-tion.

''Anulomona'' (carminatives) for proper movement of ''vata'' and anal suppositories are indicated to facilitate the action of ''vata'' in pelvic region.  

Treatment: 

 

Disease specific therapy: 1. Niruha (enema with decoction for purification) 2. Anuvasana (unc-tuous enema) 3. Anulomana (carminative) 4. Varti (wicks/suppositories)  

Therapeutic purgation with castor oil with proper concoction is prescribed to remove obstruction by excess ''meda, kapha, pitta'' and ''rakta''. Obstruction by fat and excess unctuous substances indicates pathogenesis of dyslipidemia causing atherosclerosis and cerebro-vascular disease. This is dealt in more detail in context of ''pakshaghata'' in [[Vatavyadhi Chikitsa]].

Important medicines: 1. Haratala 2. Kuchala 3. Haritaki  

Medicines for oral intake:

Examination: Clinical examination of palpation of abdomen for distension, assessment of obstruction and per rectal examination is done.  

 

Investigations: Ultra sonography of abdomen and pelvis can reveal the exact nature of obstruction.

 

==== Treatment ====

 

===== Disease specific therapy =====

 

#''Niruha'' (enema with decoction for purification)  

#''Anuvasana'' (unctuous enema)  

#''Anulomana'' (carminative)  

#''Varti'' (wicks/suppositories)  

 

==== Important medicines ====

#Haratala  

#Kuchala  

#Haritaki  

 

===== Medicines for oral intake =====

 

Type Name Dose Time Anupana

Type Name Dose Time Anupana

1. Vata nirodhaja 1. Agnitundi rasa

1. Vata nirodhaja 1. Agnitundi rasa