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|title=Udara Chikitsa

|title=Udara Chikitsa

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<big>'''[[Chikitsa Sthana]] Chapter 13. Management of Udara (Generalized enlargement of Abdomen)</big>'''

<big>'''[[Chikitsa Sthana]] Chapter 13. Management of Udara (Generalized enlargement of Abdomen)</big>'''

{{Infobox

{{Infobox

|data7  = Goyal M.

|data7  = Goyal M.

|label8 = Editors

|label8 = Editors

|data8  = Singh G., Goyal M., Deole Y.S., Basisht G.

|data8  = Singh G., Goyal M., [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]]

|label9 = Year of publication  

|label9 = Year of publication  

|data9 =  2020

|data9 =  2020

<big>'''Abstract </big>'''

<big>'''Abstract </big>'''

<div style="text-align:justify;">

<p style="text-align:justify;">The diseases presenting with cardinal symptom of generalized enlargement of abdomen is regarded as ''udara roga''. Emaciation, loss of appetite, pedal edema, inability to perform any physical activity are its other characteristic features. Extreme impairment of ''agni'' (digestion and metabolism) is the basic pathology of ''udara roga'' in general, which is regarded as one among the ''mahagada'' (major illness). It is classified into eight types viz. four types of ''[[dosha]]ja udara roga'' (''[[vata]]ja, [[pitta]]ja, [[kapha]]ja'' and ''sannipataja''), ''plihodara'' (splenomegaly), ''kshatodara/chhidrodara'' (abdominal enlargement due to intestinal perforation), ''baddhagudodara'' (enlargement of abdomen due to gastrointestinal obstruction) and ''jalodara/udakodara'' (ascites). ''Yakritodara'' (hepatomegaly) is also a distinct type of ''udara roga'' but incorporated in the ''plihodara'' since the etiology and treatment of these two conditions are similar.  

The diseases presenting with cardinal symptom of generalized enlargement of abdomen is regarded as ''udara roga''. Emaciation, loss of appetite, pedal edema, inability to perform any physical activity are its other characteristic features. Extreme impairment of ''agni'' (digestion and metabolism) is the basic pathology of ''udara roga'' in general, which is regarded as one among the ''mahagada'' (major illness). It is classified into eight types viz. four types of ''[[dosha]]ja udara roga'' (''[[vata]]ja, [[pitta]]ja, [[kapha]]ja'' and ''sannipataja''), ''plihodara'' (splenomegaly), ''kshatodara/chhidrodara'' (abdominal enlargement due to intestinal perforation), ''baddhagudodara'' (enlargement of abdomen due to gastrointestinal obstruction) and ''jalodara/udakodara'' (ascites). ''Yakritodara'' (hepatomegaly) is also a distinct type of ''udara roga'' but incorporated in the ''plihodara'' since the etiology and treatment of these two conditions are similar.  

 

Each type of ''udara roga'' has distinct etiology, pathology and symptomatology. ''[[Vata]]ja, [[pitta]]ja, [[kapha]]ja'' and ''sannipataja udara roga'' are comparable to the primary peritonitis based on the similarity of the symptoms. ''Plihodara'' (enlargement of the spleen) can be compared by the description of splenomegaly for different reasons. Symptoms of ''yakritodara'' resembles with that of hepatomegaly of varied pathology. Intestinal obstruction for different reasons causes ''baddhagudodara'' (enlargement of abdomen due to gastrointestinal obstruction).  Intestinal perforation is explained under the name of ''chhidrodara/kshatodara'' (abdominal enlargement due to intestinal perforation). ''Udara roga'' in general develops in three distinct stages. Conditions of ''ajatodaka'' is initial phase of generalized enlargement of abdomen without fluid accumulation, ''pichcha'' is generalized enlargement of abdominal distention due to liquefying state of ''[[dosha]]'' and ''jatodaka'' is generalized enlargement of abdomen with fluid accumulation. All the types of ''udara roga'' end up in ''jalodara'' (enlargement of abdomen due to collection of fluid) in the terminal phases. Among the different types of ''udara roga'', the later one in the list is more difficult to cure than its previous one. Presence of complication in ''udara roga'' is indicative of incurability. ''[[Virechana]]'' (therapeutic purgation), ''niruha [[basti]]'' (decoction enema), ''anuvasana [[basti]]'' (unctuous enema), intake of milk and buttermilk and surgical interventions (tapping) form the crux of treatment of ''udara roga''.

Each type of ''udara roga'' has distinct etiology, pathology and symptomatology. ''[[Vata]]ja, [[pitta]]ja, [[kapha]]ja'' and ''sannipataja udara roga'' are comparable to the primary peritonitis based on the similarity of the symptoms. ''Plihodara'' (enlargement of the spleen) can be compared by the description of splenomegaly for different reasons. Symptoms of ''yakritodara'' resembles with that of hepatomegaly of varied pathology. Intestinal obstruction for different reasons causes ''baddhagudodara'' (enlargement of abdomen due to gastrointestinal obstruction).  Intestinal perforation is explained under the name of ''chhidrodara/kshatodara'' (abdominal enlargement due to intestinal perforation). ''Udara roga'' in general develops in three distinct stages. Conditions of ''ajatodaka'' is initial phase of generalized enlargement of abdomen without fluid accumulation, ''pichcha'' is generalized enlargement of abdominal distention due to liquefying state of ''[[dosha]]'' and ''jatodaka'' is generalized enlargement of abdomen with fluid accumulation. All the types of ''udara roga'' end up in ''jalodara'' (enlargement of abdomen due to collection of fluid) in the terminal phases. Among the different types of ''udara roga'', the later one in the list is more difficult to cure than its previous one. Presence of complication in ''udara roga'' is indicative of incurability. ''[[Virechana]]'' (therapeutic purgation), ''niruha [[basti]]'' (decoction enema), ''anuvasana [[basti]]'' (unctuous enema), intake of milk and buttermilk and surgical interventions (tapping) form the crux of treatment of ''udara roga''.

 

'''Keywords''': ''Udara roga, vatodara, pittodara, kaphodara, sannipatodara, plihodara, yakritodara, baddhodara, chidrodara, kshatodara, jalodara,'' intestinal perforation, splenomegaly, hepatomegaly, intestinal obstruction, ascites, ''ajatodakavastha, picchavastha, jatodakavastha, virechana,'' tapping </div>

'''Keywords''': ''Udara roga, vatodara, pittodara, kaphodara, sannipatodara, plihodara, yakritodara, baddhodara, chidrodara, kshatodara, jalodara,'' intestinal perforation, splenomegaly, hepatomegaly, intestinal obstruction, ascites, ''ajatodakavastha, picchavastha, jatodakavastha, virechana,'' tapping </p>

== Introduction ==

== Introduction ==

*In order to prevent recurrence, ''udara'' should be treated by regular ''[[virechana]]'' (frequent therapeutic purgation). After purgation, milk is advised to improve the physical strength and to relieve the strain of purgation.  

*In order to prevent recurrence, ''udara'' should be treated by regular ''[[virechana]]'' (frequent therapeutic purgation). After purgation, milk is advised to improve the physical strength and to relieve the strain of purgation.  

*''Asthapana'' (decoction enema) and ''anuvasana'' (unctuous enema) is advised to remove obstruction.  

*''Asthapana'' (decoction enema) and ''anuvasana'' (unctuous enema) is advised to remove obstruction.  

*Physically strong patients suffering from ''pittodara'' should be treated by ''[[virechana]] karma'' (therapeutic purgation) first. *Physically weak patients should be treated by purification by adapting ''kshirabasti'' (decoction enema consisting of milk as predominant ingredient). After they regain physical strength and digestive power improves, the patient should be treated with ''[[virechana]]'' (therapeutic purgation).

*Physically strong patients suffering from ''pittodara'' should be treated by ''[[virechana]] karma'' (therapeutic purgation) first.

*Physically weak patients should be treated by purification by adapting ''kshirabasti'' (decoction enema consisting of milk as predominant ingredient). After they regain physical strength and digestive power improves, the patient should be treated with ''[[virechana]]'' (therapeutic purgation).

*In patients suffering from ''kaphodara, shodhana'' (eliminative therapy) is done after preparing with oleation and sudation. In ''samsarjana krama'' (gradual diet schedule) pungent, ''kshara'' and anti ''[[kapha]]'' diet is prescribed.

*In patients suffering from ''kaphodara, shodhana'' (eliminative therapy) is done after preparing with oleation and sudation. In ''samsarjana krama'' (gradual diet schedule) pungent, ''kshara'' and anti ''[[kapha]]'' diet is prescribed.

*''Plihodara'' should be treated by measures like oral medication of ''sneha'' (medicated unctuous substance), sudation, ''[[virechana]]'' (therapeutic purgation), ''niruha'' (decoction enema) and ''anuvasana [[basti]]'' (oil enema) and ''[[raktamokshana]]'' (blood-letting) by sectioning the vein located in the left arm. The ''[[vata]]'' and ''[[kapha]]'' dominated ''plihodara'' should be treated by ''agnikarma'' (cauterization).

*''Plihodara'' should be treated by measures like oral medication of ''sneha'' (medicated unctuous substance), sudation, ''[[virechana]]'' (therapeutic purgation), ''niruha'' (decoction enema) and ''anuvasana [[basti]]'' (oil enema) and ''[[raktamokshana]]'' (blood-letting) by sectioning the vein located in the left arm. The ''[[vata]]'' and ''[[kapha]]'' dominated ''plihodara'' should be treated by ''agnikarma'' (cauterization).

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== References ==

== References ==