Changes

=== ''Tattva Vimarsha'' ===

=== ''Tattva Vimarsha'' ===

*Abnormalities of jatharagni (digestive power) leads to the morbid accumulation of the mala (dosha and excreta- waste) and in turn tend to cause multiple diseases and particularly udara roga.

*Abnormalities of ''jatharagni'' (digestive power) leads to the morbid accumulation of the ''mala'' (''dosha'' and excreta- waste) and in turn tend to cause multiple diseases and particularly ''udara roga''.

*Affliction of prana vata, agni as well as apana vata are main culprits leading to accumulation of morbid dosha. This in turn obliterates the channels of sweda (sweat) and udaka (body fluid) tending upwards and downwards.  

*Affliction of ''prana vata, agni'' as well as ''apana vata'' are main culprits leading to accumulation of morbid ''dosha''. This in turn obliterates the channels of ''sweda'' (sweat) and ''udaka'' (body fluid) tending upwards and downwards.  

*The causes of gross enlargement of abdomen include consumption of foods that lead to vitiation of pitta like hot, salty, kshara (alkali), that cause burning sensation, sour, ruksha (dry), slow poisons, erroneous dietary management following purification treatments, viruddha ahara (combination of foods having mutually contradictory properties), unhealthy foods, emaciation due to splenic enlargement, arshas (mass per rectum), emaciation due to grahani roga (malabsorption), improper  administration of panchakarma, ignorance of persistent illness without treatment, dryness of the body, withholding the naturally manifesting urges, morbidity of body channels, illness of ama (undigested food), psychological irritation, excessive consumption of foods, obstruction of the ano-rectal canal by the arshas (mass per rectum), impaction of hair within the lumen of the intestines, impaction of hardened stools within the intestines, perforation or rupture of intestines, excessive accumulation of morbidity, indulging in sinful activities.  

*The causes of gross enlargement of abdomen include consumption of foods that lead to vitiation of ''pitta'' like hot, salty, ''kshara'' (alkali), that cause burning sensation, sour, ''ruksha'' (dry), slow poisons, erroneous dietary management following purification treatments, ''viruddha ahara'' (combination of foods having mutually contradictory properties), unhealthy foods, emaciation due to splenic enlargement, ''arshas'' (mass per rectum), emaciation due to ''grahani roga'' (malabsorption), improper  administration of [[Panchakarma]], ignorance of persistent illness without treatment, dryness of the body, withholding the naturally manifesting urges, morbidity of body channels, illness of ''ama'' (undigested food), psychological irritation, excessive consumption of foods, obstruction of the ano-rectal canal by the ''arshas'' (rectal mass, or piles), impaction of hair within the lumen of the intestines, impaction of hardened stools within the intestines, perforation or rupture of intestines, excessive accumulation of morbidity, indulging in sinful activities.  

*Apart from accumulation of morbid dosha in abdomen, splenomegaly, gastrointestinal obstruction, intestinal perforation, collection of fluid are the other causes of udara  

*Apart from accumulation of morbid ''dosha'' in abdomen, splenomegaly, gastrointestinal obstruction, intestinal perforation, collection of fluid are the other causes of ''udara''.

*Liver and spleen are affected by morbid dosha leading to enlargement in size and udara.

*Liver and spleen are affected by morbid ''dosha'' leading to enlargement in size and ''udara''.

*The pathogenic factors in vata dominant udara are located at kukshi (lower abdomen), hridaya (heart), basti (bladder and urinary system), guda (ano-rectal canal).  

*The pathogenic factors in ''vata'' dominant ''udara'' are located at ''kukshi'' (lower abdomen), ''hridaya'' (heart), ''basti'' (bladder and urinary system), ''guda'' (ano-rectal canal).  

*The pathogenic factors in pitta dominant udara are located at amashaya (stomach and upper GI tract).  

*The pathogenic factors in ''pitta'' dominant ''udara'' are located at ''amashaya'' (stomach and upper GI tract).  

*The pathogenic factors in kapha dominant udara are located at bahirantra (outer side of intestine i.e. peritoneal cavity).   

*The pathogenic factors in ''kapha'' dominant ''udara'' are located at ''bahirantra'' (outer side of intestine i.e. peritoneal cavity).   

*Collection of ascitic fluid is due to affliction of kapha dosha and udaka. (body fluids).  

*Collection of ascitic fluid is due to affliction of ''kapha dosha'' and ''udaka''. (body fluids).  

*Treatment protocol for vatodara includes administration of unctuous medications, abhyanga   (unctuous massage), sweda (sudation), sneha virechana (purgation with unctuous purgatives) and pattabandhana (tight bandage on abdomen).  

*Treatment protocol for ''vatodara'' includes administration of unctuous medications, ''abhyanga'' (unctuous massage), ''sweda'' (sudation), ''sneha virechana'' (purgation with unctuous purgatives)and ''pattabandhana'' (tight bandage on abdomen).  

*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).

*The treatment of baddhodara (enlargement of abdomen due to gastrointestinal obstruction) includes sudation followed by niruha basti (decoction enema) consisting of potent medicines, cow’s urine, saindhava (rock salt) and oil. After niruha basti (decoction enema), oil processed with same drugs should be given in the form of anuvasana basti (unctuous enema).

*The treatment of ''baddhodara'' (enlargement of abdomen due to gastrointestinal obstruction) includes sudation followed by ''niruha basti'' (decoction enema) consisting of potent medicines, cow’s urine, ''saindhava'' (rock salt) and oil. After ''niruha basti'' (decoction enema), oil processed with same drugs should be given in the form of ''anuvasana basti'' (unctuous enema).

*Chhidrodara (enlargement of abdomen due to intestinal perforation) is treated by all measures of kaphodara except sudation. The patient should be maintained by repeated aspiration of the abdominal fluid as and when it gets collected.

*''Chhidrodara'' (enlargement of abdomen due to intestinal perforation) is treated by all measures of ''kaphodara'' except sudation. The patient should be maintained by repeated aspiration of the abdominal fluid as and when it gets collected.

*All types of udara (enlargement of abdomen) are mostly due to tri discordance of dosha, hence treatment that alleviates all three dosha should be adapted in all types of udara.

*All types of ''udara'' (enlargement of abdomen) are mostly due to tri-discordance of ''dosha'', hence treatment that alleviates all three ''dosha'' should be adapted in all types of ''udara''.

=== ''Vidhi Vimarsha'' ===

=== ''Vidhi Vimarsha'' ===