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{{#seo:
|title=Udara Chikitsa
|titlemode=append
|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, Ayurveda, charak samhita, Indian system of medicine.
|description=Chikitsa Sthana Chapter 13. Management of Udara (Generalized enlargement of Abdomen)
|image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg
|image_alt=charak samhita
|type=article
}}
<big>'''[[Chikitsa Sthana]] Chapter 13. Management of Udara (Generalized enlargement of Abdomen)</big>'''
{{Infobox
{{Infobox
|title = Udara Chikitsa
|title = Udara Chikitsa
|label5 = Other Sections
|label5 = Other Sections
|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]
|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]
|label6 = Translator and commentator
|header3 =
|data6 = Acharya G.S.
|label7 = Reviewer
|data7 = Goyal M.
|label8 = Editors
|data8 = Singh G., Goyal M., [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]]
|label9 = Year of publication
|data9 = 2020
|label10 = Publisher
|data10 = [[Charak Samhita Research, Training and Skill Development Centre]]
|label11 = DOI
|data11 = [https://doi.org/10.47468/CSNE.2020.e01.s06.014 10.47468/CSNE.2020.e01.s06.014]
}}
}}
== [[Chikitsa Sthana]] Chapter 13, Chapter on management of ''Udara'' (Generalized enlargement of Abdomen) ==
<big>'''Abstract </big>'''
<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.
<br/>
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''.
<br/>
'''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>
=== Abstract ===
== Introduction ==
<div style="text-align:justify;">
Generalized enlargement of the abdomen is ''udara roga'' and due to similarity of this symptom i.e. bulging (''utsedha''), this chapter follows the chapter on ''shvayathu'' (edema). Out of eight types of ''udara roga'' viz. ''[[vata]]ja, [[pitta]]ja, [[kapha]]ja'' and ''sannipataja'' are regarded as ''dosha'' dominant ''udara roga''. In contrast to this ''plihodara'' (splenomegaly), ''baddhodara'' (enlargement of abdomen due to gastrointestinal obstruction), ''kshatodara'' (abdominal enlargement due to intestinal perforation) and ''jalodara'' (enlargement of abdomen due to collection of fluid) are regarded as ''[[dushya]]'' dominant ''udara roga''. Again, ''baddhodara'' and ''chhidrodara'' are considered as ''agantuja'' (exogenous disease) and the remaining six types of ''udara roga'' are enlisted as ''nija'' (endogenous disease). Vitiation of morbid ''[[dosha]]'' obstructing the channels in the abdomen and leading to fluid accumulation are the predominant features of pathogenesis of ''udara roga''. Various purification treatments including therapeutic purgation, enema and surgical intervention to remove excess fluid are described in the chapter. The medications to pacify morbid ''[[dosha]]'' with strict dietary guidelines are treatment measures of ''udara roga''.
</div>
== Sanskrit text, Transliteration and English Translation ==
<div class="mw-collapsible mw-collapsed">
Generalized enlargement of the abdomen is ''udara roga'' and due to similarity of this symptom i.e. bulging (''utsedha''), this chapter follows the chapter on ''shvayathu'' (edema). Out of eight types of ''udara roga'' viz. ''vataja, pittaja, kaphaja'' and ''sannipataja'' are regarded as ''dosha'' dominant ''udara roga''. In contrast to this ''plihodara'' (splenomegaly), ''baddhodara'' (enlargement of abdomen due to gastrointestinal obstruction), ''kshatodara'' (abdominal enlargement due to intestinal perforation) and ''jalodara'' (enlargement of abdomen due to collection of fluid) are regarded as ''dushya'' dominant ''udara roga''. Again, ''baddhodara'' and ''chhidrodara'' are considered as ''agantuja'' (exogenous disease) and the remaining six types of ''udara roga'' are enlisted as ''nija'' (endogenous disease). Vitiation of morbid ''dosha'' obstructing the channels in the abdomen and leading to fluid accumulation are the predominant features of pathogenesis of ''udara roga''. Various purification treatments including therapeutic purgation, enema and surgical intervention to remove excess fluid are described in the chapter. The medications to pacify morbid ''dosha'' with strict dietary guidelines are treatment measures of ''udara roga''.
अथात उदरचिकित्सितं व्याख्यास्यामः||१||
अथात उदरचिकित्सितं व्याख्यास्यामः||१||
इति ह स्माह भगवानात्रेयः||२||
इति ह स्माह भगवानात्रेयः||२||
<div class="mw-collapsible-content">
athāta Udara cikitsitaṁ vyākhyāsyāmaḥ||1||
athāta Udara cikitsitaṁ vyākhyāsyāmaḥ||1||
iti ha smAha bhagavAnAtreyaH||2||
iti ha smAha bhagavAnAtreyaH||2||
</div></div>
<div style="text-align:justify;">
Now we shall expound the chapter "Udara chikitsa" (Management of generalized enlargement of abdomen). Thus said Lord Atreya [1-2]
</div>
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सिद्धविद्याधराकीर्णे कैलासे नन्दनोपमे| <br />
तप्यमानं तपस्तीव्रं साक्षाद्धर्ममिव स्थितम्||३|| <br />
सिद्धविद्याधराकीर्णे कैलासे नन्दनोपमे|
तप्यमानं तपस्तीव्रं साक्षाद्धर्ममिव स्थितम्||३||
==== Description of patient of ''udara roga'' ====
आयुर्वेदविदां श्रेष्ठं भिषग्विद्याप्रवर्तकम्| <br />
पुनर्वसुं जितात्मानमग्निवेशोऽब्रवीद्वचः||४|| <br />
<div class="mw-collapsible-content">
siddhavidyādharākīrṇē kailāsē nandanōpamē| <br />
tapyamānaṁ tapastīvraṁ sākṣāddharmamiva sthitam||3|| <br />
āyurvēdavidāṁ śrēṣṭhaṁ bhiṣagvidyāpravartakam| <br />
punarvasuṁ jitātmānamagnivēśō'bravīdvacaḥ||4|| <br />
siddhavidyAdharAkIrNe kailAse nandanopame| <br />
tapyamAnaM tapastIvraM sAkShAddharmamiva sthitam||3|| <br />
[[Ayurveda]]vidAM shreShThaM bhiShagvidyApravartakam| <br />
punarvasuM jitAtmAnamagnivesho~abravIdvacaH||4|| <br />
</div></div>
<div style="text-align:justify;">
Sage Punarvasu was residing in Mount Kailasa (which is similar to ''Nandana Vana'') and was accompanied with ''Siddha'' (a group of highly skilled individuals possessing eight supernatural faculties) and ''Vidhyadara'' (the possessor of knowledge of science/super human personality is termed ''Vidyadhara''). In Mount Kailasa, Sage Punarvasu was seated like very embodiment of ''dharma'' (righteousness) and was engaged in practicing austerity. Sage Punarvasu is the foremost among those who are proficient in the knowledge of [[Ayurveda]] and involved in promulgating the science of medicine. Agnivesha spoke addressing to such self controlled great sage Punarvasu. [3-4]
</div>
=== Description of patient of ''udara roga'' ===
<div class="mw-collapsible mw-collapsed">
भगवन्नुदरैर्दुःखैर्दृश्यन्ते ह्यर्दिता नराः| <br />
शुष्कवक्त्राः कृशैर्गात्रैराध्मातोदरकुक्षयः||५|| <br />
प्रनष्टाग्निबलाहाराः सर्वचेष्टास्वनीश्वराः| <br />
दीनाः प्रतिक्रियाभावाज्जहतोऽसूननाथवत्||६||<br />
तेषामायतनं सङ्ख्यां प्राग्रूपाकृतिभेषजम्| <br />
यथावच्छ्रोतुमिच्छामि गुरुणा सम्यगीरितम्||७|| <br />
<div class="mw-collapsible-content">
bhagavannUdara irduḥkhairdr̥śyantē hyarditā narāḥ| <br />
śuṣkavaktrāḥ kr̥śairgātrairādhmātōdarakukṣayaḥ||5|| <br />
pranaṣṭāgnibalāhārāḥ sarvacēṣṭāsvanīśvarāḥ| <br />
dīnāḥ pratikriyābhāvājjahatō'sūnanāthavat||6|| <br />
tēṣāmāyatanaṁ saṅkhyāṁ prāgrūpākr̥tibhēṣajam| <br />
yathāvacchrōtumicchāmi guruṇā samyagīritam||7|| <br />
bhagavannudarairduHkhairdRushyante hyarditA narAH| <br />
shuShkavaktrAH kRushairgAtrairAdhmAtodarakukShayaH||5|| <br />
pranaShTAgnibalAhArAH sarvaceShTAsvanIshvarAH| <br />
dInAH pratikriyAbhAvAjjahato~asUnanAthavat||6|| <br />
teShAmAyatanaM sa~gkhyAM prAgrUpAkRutibheShajam| <br />
yathAvacchrotumicchAmi guruNA samyagIritam||7|| <br />
</div></div>
<div style="text-align:justify;">
Sage Agnivesha addressing Punarvasu, said “Oh Lord!” it is observed that the patient of ''udara'' suffers from dryness of the mouth, emaciation of body, distension of abdomen and flanks, impaired digestion, loss of physical strength, inability to consume food, inability to perform any physical activities and depression; such patients sooner or later die due to the illness in the absence of treatment just like an orphan. I wish to hear the proper description of this disease from my teacher Lord Punarvasu in regards to its etiology, the number, the premonitory symptoms, clinical presentation and treatment. [5-7] </div>
<div class="mw-collapsible mw-collapsed">
सर्वभूतहितायर्षिः शिष्येणैवं प्रचोदितः| <br />
सर्वभूतहितं वाक्यं व्याहर्तुमुपचक्रमे||८||<br />
<div class="mw-collapsible-content">
sarvabhūtahitāyarṣiḥ śiṣyēṇaivaṁ pracōditaḥ| <br />
sarvabhūtahitaṁ vākyaṁ vyāhartumupacakramē||8||<br />
sarvabhUtahitAyarShiH shiShyeNaivaM pracoditaH| <br />
sarvabhUtahitaM vAkyaM vyAhartumupacakrame||8||<br />
</div></div>
<div style="text-align:justify;">
Enthused by the student’s questioning, Lord Punarvasu spoke about the beneficial topics for the well being of human. [8]
</div>
=== Pathogenesis of ''udara roga'' ===
<div class="mw-collapsible mw-collapsed">
अग्निदोषान्मनुष्याणां रोगसङ्घाः पृथग्विधाः| <br />
मलवृद्ध्या प्रवर्तन्ते विशेषेणोदराणि तु||९|| <br />
मन्देऽग्नौ मलिनैर्भुक्तैरपाकाद्दोषसञ्चयः| <br />
प्राणाग्न्यपानान् सन्दूष्य मार्गान्रुद्ध्वाऽधरोत्तरान्||१०|| <br />
त्वङ्मांसान्तरमागम्य कुक्षिमाध्मापयन् भृशम्| <br />
जनयत्युदरं तस्य हेतुं शृणु सलक्षणम् ||११||<br />
<div class="mw-collapsible-content">
agnidōṣānmanuṣyāṇāṁ rōgasaṅghāḥ pr̥thagvidhāḥ| <br />
malavr̥ddhyā pravartantē viśēṣēṇōdarāṇi tu||9|| <br />
mandē'gnau malinairbhuktairapākāddōṣasañcayaḥ| <br />
prāṇāgnyapānān sandūṣya mārgānruddhvā'dharōttarān||10|| <br />
tvaṅmāṁsāntaramāgamya kukṣimādhmāpayan bhr̥śam| <br />
janayatyUdara ṁ tasya hētuṁ śr̥ṇu salakṣaṇam||11||<br />
agnidoShAnmanuShyANAM rogasa~gghAH pRuthagvidhAH| <br />
malavRuddhyA pravartante visheSheNodarANi tu||9|| <br />
mande~agnau malinairbhuktairapAkAddoShasa~jcayaH| <br />
prANAgnyapAnAn sandUShya mArgAnruddhvA~adharottarAn||10|| <br />
Abnormalities of ''jatharagni'' (digestive power) leads to the morbid accumulation of the ''mala'' (''dosha'' and bodily wastes) and in turn tend to cause multiple diseases and particularly ''udara roga''. In the state of impaired ''jatharagni'' consumption of unhealthy foods further leads to indigestion and eventually causes accumulation of morbid substances. Thus formed morbidity afflicts the functioning of ''prana vata, agni'' as well as ''apana vata'' which in turn obliterates the channels tending upwards and downwards. Due to this obliteration of channels, finally the morbid ''dosha'' tend to divulge and penetrate the space between the skin and flesh and gets accumulated there. This accumulation leads severe distention of the abdomen and causes serious disease ''udara roga''. Hereafter etiology and clinical symptoms of the same have been narrated [9-11]
tva~gmAMsAntaramAgamya kukShimAdhmApayan bhRusham| <br />
janayatyudaraM tasya hetuM shRuNu salakShaNam||11||<br />
</div></div>
<div style="text-align:justify;">
Abnormalities of ''jatharagni'' (digestive power) leads to the morbid accumulation of the ''[[mala]]'' (''[[dosha]]'' and bodily wastes) and in turn tend to cause multiple diseases and particularly ''udara roga''. In the state of impaired ''jatharagni'' consumption of unhealthy foods further leads to indigestion and eventually causes accumulation of morbid substances. Thus formed morbidity afflicts the functioning of ''prana vata, agni'' as well as ''apana vata'' which in turn obliterates the channels tending upwards and downwards. Due to this obliteration of channels, finally the morbid ''[[dosha]]'' tend to divulge and penetrate the space between the skin and flesh and gets accumulated there. This accumulation leads severe distention of the abdomen and causes serious disease ''udara roga''. Hereafter etiology and clinical symptoms of the same have been narrated. [9-11] </div>
=== Etiology of ''udara roga'' ===
<div class="mw-collapsible mw-collapsed">
अत्युष्णलवणक्षारविदाह्यम्लगराशनात्|
अत्युष्णलवणक्षारविदाह्यम्लगराशनात्| <br />
मिथ्यासंसर्जनाद्रूक्षविरुद्धाशुचिभोजनात्||१२||
मिथ्यासंसर्जनाद्रूक्षविरुद्धाशुचिभोजनात्||१२|| <br />
प्लीहार्शोग्रहणीदोषकर्शनात् कर्मविभ्रमात्|
प्लीहार्शोग्रहणीदोषकर्शनात् कर्मविभ्रमात्| <br />
क्लिष्टानामप्रतीकाराद्रौक्ष्याद्वेगविधारणात्||१३||
क्लिष्टानामप्रतीकाराद्रौक्ष्याद्वेगविधारणात्||१३|| <br />
स्रोतसां दूषणादामात् सङ्क्षोभादतिपूरणात्|
स्रोतसां दूषणादामात् सङ्क्षोभादतिपूरणात्| <br />
अर्शोबालशकृद्रोधादन्त्रस्फुटनभेदनात्||१४||
अर्शोबालशकृद्रोधादन्त्रस्फुटनभेदनात्||१४|| <br />
अतिसञ्चितदोषाणां पापं कर्म च कुर्वताम्|
अतिसञ्चितदोषाणां पापं कर्म च कुर्वताम्| <br />
उदराण्युपजायन्ते मन्दाग्नीनां विशेषतः||१५||
उदराण्युपजायन्ते मन्दाग्नीनां विशेषतः||१५||<br />
<div class="mw-collapsible-content">
atyuṣṇalavaṇakṣāravidāhyamlagarāśanāt|
atyuṣṇalavaṇakṣāravidāhyamlagarāśanāt| <br />
mithyāsaṁsarjanādrūkṣaviruddhāśucibhōjanāt||12||
mithyāsaṁsarjanādrūkṣaviruddhāśucibhōjanāt||12|| <br />
plīhārśōgrahaṇīdōṣakarśanāt karmavibhramāt|
plīhārśōgrahaṇīdōṣakarśanāt karmavibhramāt| <br />
kliṣṭānāmapratīkārādraukṣyādvēgavidhāraṇāt||13||
kliṣṭānāmapratīkārādraukṣyādvēgavidhāraṇāt||13|| <br />
srōtasāṁ dūṣaṇādāmāt saṅkṣōbhādatipūraṇāt|
srōtasāṁ dūṣaṇādāmāt saṅkṣōbhādatipūraṇāt| <br />
arśōbālaśakr̥drōdhādantrasphuṭanabhēdanāt||14||
arśōbālaśakr̥drōdhādantrasphuṭanabhēdanāt||14|| <br />
atisañcitadōṣāṇāṁ pāpaṁ karma ca kurvatām|
atisañcitadōṣāṇāṁ pāpaṁ karma ca kurvatām| <br />
udarāṇyupajāyantē mandāgnīnāṁ viśēṣataḥ||15||
udarāṇyupajāyantē mandāgnīnāṁ viśēṣataḥ||15||<br />
atyuShNalavaNakShAravidAhyamlagarAshanAt|
atyuShNalavaNakShAravidAhyamlagarAshanAt| <br />
mithyAsaMsarjanAdrUkShaviruddhAshucibhojanAt||12||
mithyAsaMsarjanAdrUkShaviruddhAshucibhojanAt||12|| <br />
plIhArshograhaNIdoShakarshanAt karmavibhramAt|
plIhArshograhaNIdoShakarshanAt karmavibhramAt| <br />
kliShTAnAmapratIkArAdraukShyAdvegavidhAraNAt||13||
kliShTAnAmapratIkArAdraukShyAdvegavidhAraNAt||13|| <br />
srotasAM dUShaNAdAmAt sa~gkShobhAdatipUraNAt|
srotasAM dUShaNAdAmAt sa~gkShobhAdatipUraNAt| <br />
arshobAlashakRudrodhAdantrasphuTanabhedanAt||14||
arshobAlashakRudrodhAdantrasphuTanabhedanAt||14|| <br />
atisa~jcitadoShANAM pApaM karma ca kurvatAm|
atisa~jcitadoShANAM pApaM karma ca kurvatAm| <br />
udarANyupajAyante mandAgnInAM visheShataH||15||
udarANyupajAyante mandAgnInAM visheShataH||15||<br />
</div></div>
<div style="text-align:justify;">
Consumption of foods that are excessively hot in property, excessive consumption of salty foods, excessive intake of foods containing solutions of ''kshara'' (alkali obtained from ash of herbs), excessive intake of foods that cause burning sensation on digestion, excessive consumption of foods that are sour in taste, consumption of ''garavisha'' (intentional application of poison or poison synthesized by combination of nontoxic substances), erroneous dietary management following ''[[shodhana]]'' treatment, excessive consumption of foods having ''ruksha'' (dry) property, intake of ''viruddha ahara'' (combination of foods having mutually contradictory properties), consumption of unhealthy foods, emaciation due to splenic enlargement, emaciation due to ''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, these causes will lead to development of ''udara roga'' and among these more particularly the impairment of ''jatharagni''. [12-15] </div>
=== Premonitary symptoms ===
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क्षुन्नाशः स्वाद्वतिस्निग्धगुर्वन्नं पच्यते चिरात्| <br />
भुक्तं विदह्यते सर्वं जीर्णाजीर्णं न वेत्ति च||१६|| <br />
सहते नातिसौहित्यमीषच्छोफश्च पादयोः| <br />
शश्वद्बलक्षयोऽल्पेऽपि व्यायामे श्वासमृच्छति||१७|| <br />
वृद्धिः पुरीषनिचयो रूक्षोदावर्तहेतुका| <br />
बस्तिसन्धौ रुगाध्मानं वर्धते पाट्यतेऽपि च||१८|| <br />
आतन्यते च जठरमपि लघ्वल्पभोजनात्| <br />
राजीजन्म वलीनाश इति लिङ्गं भविष्यताम्||१९||<br />
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kṣunnāśaḥ svādvatisnigdhagurvannaṁ pacyatē cirāt| <br />
bhuktaṁ vidahyatē sarvaṁ jīrṇājīrṇaṁ na vētti ca||16|| <br />
sahatē nātisauhityamīṣacchōphaśca pādayōḥ| <br />
śaśvadbalakṣayō'lpē'pi vyāyāmē śvāsamr̥cchati||17|| <br />
vr̥ddhiḥ purīṣanicayō rūkṣōdāvartahētukā| <br />
bastisandhau rugādhmānaṁ vardhatē pāṭyatē'pi ca||18|| <br />
ātanyatē ca jaṭharamapi laghvalpabhōjanāt| <br />
rājījanma valīnāśa iti liṅgaṁ bhaviṣyatām||19||<br />
ātanyatē ca jaṭharamapi laghvalpabhōjanāt|
rājījanma valīnāśa iti liṅgaṁ bhaviṣyatām||19||
kShunnAshaH svAdvatisnigdhagurvannaM pacyate cirAt|
kShunnAshaH svAdvatisnigdhagurvannaM pacyate cirAt|
bhuktaM vidahyate sarvaM jIrNAjIrNaM na vetti ca||16||
bhuktaM vidahyate sarvaM jIrNAjIrNaM na vetti ca||16||
sahate nAtisauhityamIShacchophashca pAdayoH|
sahate nAtisauhityamIShacchophashca pAdayoH| <br />
shashvadbalakShayo~alpe~api vyAyAme shvAsamRucchati||17||
shashvadbalakShayo~alpe~api vyAyAme shvAsamRucchati||17|| <br />
vRuddhiH purIShanicayo [1] rUkShodAvartahetukA|
vRuddhiH purIShanicayo [1] rUkShodAvartahetukA| <br />
bastisandhau rugAdhmAnaM vardhate pATyate~api ca||18||
bastisandhau rugAdhmAnaM vardhate pATyate~api ca||18||<br />
Atanyate ca jaTharamapi [2] laghvalpabhojanAt|
Atanyate ca jaTharamapi [2] laghvalpabhojanAt| <br />
rAjIjanma valInAsha iti li~ggaM bhaviShyatAm||19||
rAjIjanma valInAsha iti li~ggaM bhaviShyatAm||19||<br />
</div></div>
<div style="text-align:justify;">
Loss of appetite, delayed digestion of foods that are sweet, greasy and heavy for digestion, food consumed causing burning sensation, inability to appreciate the digestion and indigestion of the food, intolerance to over eating, slight edema in the feet, constant reduction in the physical strength, breathlessness even on slight exertion, abdominal distension due to accumulation of fecal matter resulting due to dryness or ''udavarta'' (abnormal upward course of ''[[vata]]''), abdominal pain, fullness of the abdomen, distension of the abdomen or bursting type of abdominal pain at the site where bladder meets the surrounding, distension of the stomach even after small meals, appearance of distended veins and loss of normal skin folds are the premonitory symptoms of ''udara roga''. [16-19] </div>
=== General pathogenesis of ''udara roga'' ===
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==== General pathogenesis of ''udara roga'' ====
रुद्ध्वा स्वेदाम्बुवाहीनि दोषाः स्रोतांसि सञ्चिताः| <br />
प्राणाग्न्यपानान् सन्दूष्य जनयन्त्युदरं नृणाम्||२०|| <br />
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ruddhvā svēdāmbuvāhīni dōṣāḥ srōtāṁsi sañcitāḥ| <br />
prāṇāgnyapānān sandūṣya janayantyUdaraṁ nr̥ṇām||20|| <br />
ruddhvA svedAmbuvAhIni doShAH srotAMsi sa~jcitAH| <br />
prANAgnyapAnAn sandUShya janayantyudaraM nRuNAm||20||<br />
</div></div>
<div style="text-align:justify;">
Morbid ''[[dosha]]'' by obstructing the channels of ''sweda'' (sweat) and ''udaka'' (body fluid) and afflicting the ''prana vata, agni'' and ''apana vata'' causes ''udara roga''. [20] </div>
=== General Symptoms of ''udara roga'' ===
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कुक्षेराध्मानमाटोपः शोफः पादकरस्य च| <br />
मन्दोऽग्निः श्लक्ष्णगण्डत्वं कार्श्यं चोदरलक्षणम्||२१|| <br />
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kukṣērādhmānamāṭōpaḥ śōphaḥ pādakarasya ca| <br />
mandō'gniḥ ślakṣṇagaṇḍatvaṁ kārśyaṁ cōdaralakṣaṇam||21|| <br />
kukSherAdhmAnamATopaH shophaH pAdakarasya ca| <br />
mando~agniH shlakShNagaNDatvaM kArshyaM codaralakShaNam||21|| <br />
</div></div>
<div style="text-align:justify;">
Distension and gurgling sound in the abdomen, edema of hands and feet, impaired digestion, smooth shiny cheeks and emaciation are the common symptoms of ''udara roga''. [21] </div>
=== Classification of ''udara roga'' ===
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पृथग्दोषैः समस्तैश्च प्लीहबद्धक्षतोदकैः| <br />
सम्भवन्त्युदराण्यष्टौ तेषां लिङ्गं पृथक् शृणु||२२||<br />
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pr̥thagdōṣaiḥ samastaiśca plīhabaddhakṣatōdakaiḥ| <br />
sambhavantyudarāṇyaṣṭau tēṣāṁ liṅgaṁ pr̥thak śr̥ṇu||22||<br />
==== Classification of ''udara roga'' ====
pRuthagdoShaiH samastaishca plIhabaddhakShatodakaiH| <br />
sambhavantyudarANyaShTau teShAM li~ggaM pRuthak shRuNu||22||<br />
</div></div>
<div style="text-align:justify;">
Three types of ''udara'' caused by each morbid ''[[dosha]]'', one type of ''udara'' caused by morbidity of all three ''[[dosha]], plihodara'' (splenomegaly), ''baddhodara'' (enlargement of abdomen due to gastrointestinal obstruction), ''kshatodara'' (abdominal enlargement due to intestinal perforation) and ''udakodara'' (enlargement of abdomen due to collection of fluid) are the eight types of ''udara''. Listen to the characteristic symptoms each of these types of ''udara roga''. [22]. </div>
=== Etiology of ''vatodara'' ===
<div class="mw-collapsible mw-collapsed">
रूक्षाल्पभोजनायासवेगोदावर्तकर्शनैः|
रूक्षाल्पभोजनायासवेगोदावर्तकर्शनैः|
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rūkṣālpabhōjanāyāsavēgōdāvartakarśanaiḥ|
rūkṣālpabhōjanāyāsavēgōdāvartakarśanaiḥ|
rUkShAlpabhojanAyAsavegodAvartakarshanaiH|
rUkShAlpabhojanAyAsavegodAvartakarshanaiH|
</div></div>
Among the etiological factors of ''udara roga'' is intake of dry food articles, consumption of inadequate amount of food, exertion, suppression of naturally manifesting urges, abnormal upward course of ''vata'' and weight reducing activities like walking or lifting weight causes ''vatodara'' [23]
<div style="text-align:justify;">
Among the etiological factors of ''udara roga'' is intake of dry food articles, consumption of inadequate amount of food, exertion, suppression of naturally manifesting urges, abnormal upward course of ''[[vata]]'' and weight reducing activities like walking or lifting weight causes ''vatodara''. [23]
</div>
=== Pathogenesis of ''vatodara'' ===
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वायुः प्रकुपितः कुक्षिहृद्बस्तिगुदमार्गगः||२३||
वायुः प्रकुपितः कुक्षिहृद्बस्तिगुदमार्गगः||२३||
हत्वाऽग्निं कफमुद्धूय तेन रूद्धगतिस्ततः|
हत्वाऽग्निं कफमुद्धूय तेन रूद्धगतिस्ततः| <br />
आचिनोत्युदरं जन्तोस्त्वङ्मांसान्तरमाश्रितः||२४||
आचिनोत्युदरं जन्तोस्त्वङ्मांसान्तरमाश्रितः||२४|| <br />
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vāyuḥ prakupitaḥ kukṣihr̥dbastigudamārgagaḥ||23||
vāyuḥ prakupitaḥ kukṣihr̥dbastigudamārgagaḥ||23||
hatvā'gniṁ kaphamuddhūya tēna rūddhagatistataḥ|
hatvā'gniṁ kaphamuddhūya tēna rūddhagatistataḥ| <br />
ācinōtyUdara ṁ jantōstvaṅmāṁsāntaramāśritaḥ||24||
ācinōtyUdara ṁ jantōstvaṅmāṁsāntaramāśritaḥ||24||<br />
vAyuH prakupitaH kukShihRudbastigudamArgagaH||23||
vAyuH prakupitaH kukShihRudbastigudamArgagaH||23||
hatvA~agniM kaphamuddhUya tena rUddhagatistataH|
hatvA~agniM kaphamuddhUya tena rUddhagatistataH| <br />
AcinotyudaraM jantostva~gmAMsAntaramAshritaH||24||
AcinotyudaraM jantostva~gmAMsAntaramAshritaH||24|| <br />
</div></div>
Due to the etiological factors ''vata'' gets aggravated which assumes abnormal course and reaches the ''kukshi'' (lower abdomen), ''hridaya'' (chest), ''basti'' (pelvis) and ''gudamarga'' (rectum). Again the morbid ''vata'' further impairs the ''agni'' (digestive enzymes) and draws out the ''kapha''. Thus morbid ''kapha'' in turn obstructs the morbid ''vata''. Eventually the obstructed ''vata'' gets diverged in to the space between the skin and visceral tissues in the abdomen leading to distension of the abdomen and ''udara roga'' [23-24]
<div style="text-align:justify;">
Due to the etiological factors ''[vata]]'' gets aggravated which assumes abnormal course and reaches the ''kukshi'' (lower abdomen), ''hridaya'' (chest), ''basti'' (pelvis) and ''gudamarga'' (rectum). Again the morbid ''[[vata]]'' further impairs the ''agni'' (digestive enzymes) and draws out the ''[[kapha]]''. Thus morbid ''[[kapha]]'' in turn obstructs the morbid ''[[vata]]''. Eventually the obstructed ''[[vata]]'' gets diverged in to the space between the skin and visceral tissues in the abdomen leading to distension of the abdomen and ''udara roga''. [23-24]
</div>
=== Symptoms of ''vatodara'' ===
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तस्य रूपाणि- कुक्षिपाणिपादवृषणश्वयथुः, उदरविपाटनम्, अनियतौ च वृद्धिह्रासौ,कुक्षिपार्श्वशूलोदावर्ताङ्गमर्दपर्वभेदशुष्ककासकार्श्यदौर्बल्यारोचकाविपाकाः, अधोगुरुत्वं, वातवर्चोमूत्रसङ्गः, श्यावारुणत्वं चनखनयनवदनत्वङ्मूत्रवर्चसाम्, अपि चोदरं तन्वसितराजीसिरासन्ततम्, आहतमाध्मातदृतिशब्दवद्भवति,वायुश्चोर्ध्वमधस्तिर्यक् च सशूलशब्दश्चरति, एतद्वातोदरमिति विद्यात्||२५||
तस्य रूपाणि- कुक्षिपाणिपादवृषणश्वयथुः, उदरविपाटनम्, अनियतौ च वृद्धिह्रासौ,कुक्षिपार्श्वशूलोदावर्ताङ्गमर्दपर्वभेदशुष्ककासकार्श्यदौर्बल्यारोचकाविपाकाः, अधोगुरुत्वं, वातवर्चोमूत्रसङ्गः, श्यावारुणत्वं चनखनयनवदनत्वङ्मूत्रवर्चसाम्, अपि चोदरं तन्वसितराजीसिरासन्ततम्, आहतमाध्मातदृतिशब्दवद्भवति,वायुश्चोर्ध्वमधस्तिर्यक् च सशूलशब्दश्चरति, एतद्वातोदरमिति विद्यात्||२५||
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tasya rūpāṇi-kukṣipāṇipādavr̥ṣaṇaśvayathuḥ, Udara vipāṭanam, aniyatau ca vr̥ddhihrāsau,kukṣipārśvaśūlōdāvartāṅgamardaparvabhēdaśuṣkakāsakārśyadaurbalyārōcakāvipākāḥ, adhōgurutvaṁ,vātavarcōmūtrasaṅgaḥ, śyāvāruṇatvaṁ ca nakhanayanavadanatvaṅmūtravarcasām, api cōdaraṁtanvasitarājīsirāsantatam, āhatamādhmātadr̥tiśabdavadbhavati, vāyuścōrdhvamadhastiryak casaśūlaśabdaścarati, ētadvātōdaramiti vidyāt||25||
tasya rūpāṇi-kukṣipāṇipādavr̥ṣaṇaśvayathuḥ, Udara vipāṭanam, aniyatau ca vr̥ddhihrāsau,kukṣipārśvaśūlōdāvartāṅgamardaparvabhēdaśuṣkakāsakārśyadaurbalyārōcakāvipākāḥ, adhōgurutvaṁ,vātavarcōmūtrasaṅgaḥ, śyāvāruṇatvaṁ ca nakhanayanavadanatvaṅmūtravarcasām, api cōdaraṁtanvasitarājīsirāsantatam, āhatamādhmātadr̥tiśabdavadbhavati, vāyuścōrdhvamadhastiryak casaśūlaśabdaścarati, ētadvātōdaramiti vidyāt||25||
tasya rUpANi- kukShipANipAdavRuShaNashvayathuH, udaravipATanam, aniyatau ca vRuddhihrAsau,kukShipArshvashUlodAvartA~ggamardaparvabhedashuShkakAsakArshyadaurbalyArocakAvipAkAH,adhogurutvaM, vAtavarcomUtrasa~ggaH, shyAvAruNatvaM ca nakhanayanavadanatva~gmUtravarcasAm,api codaraM tanvasitarAjIsirAsantatam, AhatamAdhmAtadRutishabdavadbhavati,vAyushcordhvamadhastiryak ca sashUlashabdashcarati, etadvAtodaramiti vidyAt||25||
tasya rUpANi- kukShipANipAdavRuShaNashvayathuH, udaravipATanam, aniyatau ca vRuddhihrAsau,kukShipArshvashUlodAvartA~ggamardaparvabhedashuShkakAsakArshyadaurbalyArocakAvipAkAH,adhogurutvaM, vAtavarcomUtrasa~ggaH, shyAvAruNatvaM ca nakhanayanavadanatva~gmUtravarcasAm,api codaraM tanvasitarAjIsirAsantatam, AhatamAdhmAtadRutishabdavadbhavati,vAyushcordhvamadhastiryak ca sashUlashabdashcarati, etadvAtodaramiti vidyAt||25||
</div></div>
<div style="text-align:justify;">
The symptoms of ''vatodara'' include distension of abdomen, edema of the hands, legs and scrotum, splitting type of pain in abdomen, undue increase and decrease of abdominal distension, abdominal pain, pain in the sides of the abdomen, abnormal upward course of ''[[vata]]'' within abdomen, body ache, pain in phalangeal joints, dry cough, emaciation, debility, lack of taste in mouth, indigestion, heaviness in the lower abdomen, obstructed flatus, constipation, retention of the urine, brown or reddish black discoloration of the nails, brown or reddish black discoloration of the conjunctiva, buccal mucosa, dermis, urine and fecal matter; abdominal wall possessing thin, blackish stretch lines and vessels, tympanic note on percussion similar to the sound produced on tapping air filled leather bag or bladder and upward, downward and lateral painful movement of ''[[vata]]'' with gurgling sound within the abdomen. [25]
</div>
=== Etiology of ''pittodara'' ===
<div class="mw-collapsible mw-collapsed">
कट्वम्ललवणात्युष्णतीक्ष्णाग्न्यातपसेवनैः| <br />
विदाह्यध्यशनाजीर्णैश्चाशु पित्तं समाचितम्||२६|| <br />
<div class="mw-collapsible-content">
kaṭvamlalavaṇātyuṣṇatīkṣṇāgnyātapasēvanaiḥ| <br />
vidāhyadhyaśanājīrṇaiścāśu pittaṁ samācitam||26|| <br />
kaTvamlalavaNAtyuShNatIkShNAgnyAtapasevanaiH| <br />
vidAhyadhyashanAjIrNaishcAshu pittaM samAcitam||26|| <br />
</div></div>
<div style="text-align:justify;">
Etiological factors of ''pittodara'' are excessive consumption of foods having pungent taste ans sour taste, salty foods, foods having ''ushna'' (hot) and ''tikshna'' (sharply acting) properties, exposure the heat of fire place, exposure to sunshine, consumption of foods that cause burning sensation whilst getting digested, pre-digestion meals and indigestion. [26]
</div>
=== Pathogenssis of ''pittodara'' ===
<div class="mw-collapsible mw-collapsed">
प्राप्यानिलकफौ रुद्ध्वा मार्गमुन्मार्गमास्थितम्| <br />
निहन्त्यामाशये वह्निं जनयत्युदरं ततः||२७|| <br />
<div class="mw-collapsible-content">
prāpyānilakaphau ruddhvā mārgamunmārgamāsthitam| <br />
nihantyāmāśayē vahniṁ janayatyUdaraṁ tataḥ||27|| <br />
prApyAnilakaphau ruddhvA mArgamunmArgamAsthitam| <br />
nihantyAmAshaye vahniM janayatyudaraM tataH||27|| <br />
</div></div>
<div style="text-align:justify;">
Due to the etiological factors [[pitta]] gets aggravated, which assumes abnormal upward course and obstructs the ''[[vata]]'' and ''[[kapha]]''. Further the morbid ''[[pitta]]'' by suppressing the ''agni'' situated in stomach causes ''pittodara''. [27]
</div>
=== Symptoms of ''pittodara'' ===
<div class="mw-collapsible mw-collapsed">
prApyAnilakaphau ruddhvA mArgamunmArgamAsthitam|
nihantyAmAshaye vahniM janayatyudaraM tataH||27||
Due to the etiological factors pitta gets aggravated, which assumes abnormal upward course and obstructs the ''vata'' and ''kapha''. Further the morbid ''pitta'' by suppressing the ''agni'' situated in stomach causes ''pittodara'' [27]
तस्य रूपाणि- दाहज्वरतृष्णामूर्च्छातीसारभ्रमाः, कटुकास्यत्वं, हरितहारिद्रत्वं [१] च नखनयनवदनत्वङ्मूत्रवर्चसाम्, अपि चोदरंनीलपीतहारिद्रहरितताम्रराजीसिरावनद्धं, दह्यते, दूयते, धूप्यते, ऊष्मायते, स्विद्यते, क्लिद्य, मृदुस्पर्शं क्षिप्रपाकं चभवति; एतत् पित्तोदरमिति विद्यात्||२८||
तस्य रूपाणि- दाहज्वरतृष्णामूर्च्छातीसारभ्रमाः, कटुकास्यत्वं, हरितहारिद्रत्वं [१] च नखनयनवदनत्वङ्मूत्रवर्चसाम्, अपि चोदरंनीलपीतहारिद्रहरितताम्रराजीसिरावनद्धं, दह्यते, दूयते, धूप्यते, ऊष्मायते, स्विद्यते, क्लिद्य, मृदुस्पर्शं क्षिप्रपाकं चभवति; एतत् पित्तोदरमिति विद्यात्||२८||
<div class="mw-collapsible-content">
tasya rūpāṇi- dāhajvaratr̥ṣṇāmūrcchātīsārabhramāḥ, kaṭukāsyatvaṁ, haritahāridratvaṁ [1] canakhanayanavadanatvaṅmūtravarcasām, api cōdaraṁ nīlapītahāridraharitatāmrarājīsirāvanaddhaṁ,dahyatē, dūyatē, dhūpyatē, ūṣmāyatē, svidyatē, klidyatē, mr̥dusparśaṁ kṣiprapākaṁ ca bhavati; ētatpittōdaramiti vidyāt||28||
tasya rūpāṇi- dāhajvaratr̥ṣṇāmūrcchātīsārabhramāḥ, kaṭukāsyatvaṁ, haritahāridratvaṁ [1] canakhanayanavadanatvaṅmūtravarcasām, api cōdaraṁ nīlapītahāridraharitatāmrarājīsirāvanaddhaṁ,dahyatē, dūyatē, dhūpyatē, ūṣmāyatē, svidyatē, klidyatē, mr̥dusparśaṁ kṣiprapākaṁ ca bhavati; ētatpittōdaramiti vidyāt||28||
tasya rUpANi- dAhajvaratRuShNAmUrcchAtIsArabhramAH, kaTukAsyatvaM, haritahAridratvaM [1] canakhanayanavadanatva~gmUtravarcasAm, api codaraM nIlapItahAridraharitatAmrarAjIsirAvanaddhaM,dahyate, dUyate, dhUpyate, UShmAyate, svidyate, klidyate, mRudusparshaM kShiprapAkaM ca bhavati;etat pittodaramiti vidyAt||28||
tasya rUpANi- dAhajvaratRuShNAmUrcchAtIsArabhramAH, kaTukAsyatvaM, haritahAridratvaM [1] canakhanayanavadanatva~gmUtravarcasAm, api codaraM nIlapItahAridraharitatAmrarAjIsirAvanaddhaM,dahyate, dUyate, dhUpyate, UShmAyate, svidyate, klidyate, mRudusparshaM kShiprapAkaM ca bhavati;etat pittodaramiti vidyAt||28||
</div></div>
<div style="text-align:justify;">
The symptoms of ''pittodara'' are burning sensation, fever, excessive thirst, transient loss of consciousness, diarrhea, giddiness, abnormal pungent taste in mouth, abnormal green or yellowish discoloration of nails, conjunctiva, mouth, dermis, urine and feces, abdominal wall covered with bluish, yellowish, greenish or coppery stretch marks and distended veins, burning sensation of the abdominal wall, abdomen becoming warm, subjective symptoms of smoke emitting from the abdomen, subjective feeling of abdominal warmth as if fire in near place, abdominal sweating, moistening of the abdomen, abdomen appears soft on palpation and the illness rapidly progressing to ascites. [28]
</div>
=== Etiology of ''kaphodara'' ===
<div class="mw-collapsible mw-collapsed">
अव्यायामदिवास्वप्नस्वाद्वतिस्निग्धपिच्छिलैः| <br />
दधिदुग्धौदकानूपमांसैश्चाप्यतिसेवितैः||२९|| <br />
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अव्यायामदिवास्वप्नस्वाद्वतिस्निग्धपिच्छिलैः|
दधिदुग्धौदकानूपमांसैश्चाप्यतिसेवितैः||२९||
avyāyāmadivāsvapnasvādvatisnigdhapicchilaiḥ| <br />
dadhidugdhaudakānūpamāṁsaiścāpyatisēvitaiḥ||29|| <br />
avyAyAmadivAsvapnasvAdvatisnigdhapicchilaiH| <br />
dadhidugdhaudakAnUpamAMsaishcApyatisevitaiH||29|| <br />
</div></div>
<div style="text-align:justify;">
Indulgence in the factors such as lack of physical exercise, day sleep, excessive consumption of sweet, greasy and slimy foods, curds, milk, liquids and meat of wet land animals causes ''kaphodara''. [29]
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=== Pathogenesis of ''kaphodara'' ===
<div class="mw-collapsible mw-collapsed">
क्रुद्धेन श्लेष्मणा स्रोतःस्वावृतेष्वावृतोऽनिलः| <br />
तमेव पीडयन् कुर्यादुदरं बहिरन्त्रगः [१] ||३०|| <br />
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kruddhēna ślēṣmaṇā srōtaḥsvāvr̥tēṣvāvr̥tō'nilaḥ| <br />
tamēva pīḍayan kuryādUdaraṁ bahirantragaḥ [1] ||30|| <br />
==== Symptoms of ''kaphodara'' ====
kruddhena shleShmaNA srotaHsvAvRuteShvAvRuto~anilaH| <br />
tameva pIDayan kuryAdudaraM bahirantragaH [1] ||30||<br />
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<div style="text-align:justify;">
The etiological factors lead to the morbidity of ''[[kapha]]'' which obstructs the body channels that include obliteration of the passage of ''[[vata]]''. Thus obstructed ''[[vata]]'' expels the morbid ''[[kapha]]'' out of the intestines causing distension of the abdomen. [30]
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=== Symptoms of ''kaphodara'' ===
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तस्य रूपाणि- गौरवारोचकाविपाकाङ्गमर्दाः, सुप्तिः, पाणिपादमुष्कोरुशोफः, उत्क्लेशनिद्राकासश्वासाः, शुक्लत्वं चनखनयनवदनत्वङ्मूत्रवर्चसाम्; अपि चोदरं शुक्लराजीसिरासन्ततं, गुरु, स्तिमितं, स्थिरं, कठिनं च भवति;एतच्छ्लेष्मोदरमिति विद्यात्||३१||
तस्य रूपाणि- गौरवारोचकाविपाकाङ्गमर्दाः, सुप्तिः, पाणिपादमुष्कोरुशोफः, उत्क्लेशनिद्राकासश्वासाः, शुक्लत्वं चनखनयनवदनत्वङ्मूत्रवर्चसाम्; अपि चोदरं शुक्लराजीसिरासन्ततं, गुरु, स्तिमितं, स्थिरं, कठिनं च भवति;एतच्छ्लेष्मोदरमिति विद्यात्||३१||
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tasya rūpāṇi-gauravārōcakāvipākāṅgamardāḥ, suptiḥ, pāṇipādamuṣkōruśōphaḥ, utklēśanidrākāsaśvāsāḥ,śuklatvaṁ ca nakhanayanavadanatvaṅmūtravarcasām; api cōdaraṁ śuklarājīsirāsantataṁ, guru, stimitaṁ,sthiraṁ, kaṭhinaṁ ca bhavati; ētacchlēṣmōdaramiti vidyāt||31||
tasya rūpāṇi-gauravārōcakāvipākāṅgamardāḥ, suptiḥ, pāṇipādamuṣkōruśōphaḥ, utklēśanidrākāsaśvāsāḥ,śuklatvaṁ ca nakhanayanavadanatvaṅmūtravarcasām; api cōdaraṁ śuklarājīsirāsantataṁ, guru, stimitaṁ,sthiraṁ, kaṭhinaṁ ca bhavati; ētacchlēṣmōdaramiti vidyāt||31||
tasya rUpANi- gauravArocakAvipAkA~ggamardAH, suptiH, pANipAdamuShkorushophaH,utkleshanidrAkAsashvAsAH, shuklatvaM ca nakhanayanavadanatva~gmUtravarcasAm; api codaraMshuklarAjIsirAsantataM, guru, stimitaM, sthiraM, kaThinaM ca bhavati; etacchleShmodaramiti vidyAt||31||
tasya rUpANi- gauravArocakAvipAkA~ggamardAH, suptiH, pANipAdamuShkorushophaH,utkleshanidrAkAsashvAsAH, shuklatvaM ca nakhanayanavadanatva~gmUtravarcasAm; api codaraMshuklarAjIsirAsantataM, guru, stimitaM, sthiraM, kaThinaM ca bhavati; etacchleShmodaramiti vidyAt||31||
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<div style="text-align:justify;">
The symptoms of ''kaphodara'' are heaviness of the body, lack of taste in the mouth, indigestion, body ache, numbness, edema of the hands, feet, scrotum and thighs, nausea due to morbid ''[[dosha]]'' located in the chest, sleepiness, cough, dyspnea, whitish discoloration of nails, conjunctiva, mouth, skin, urine and feces, abdominal wall covered with whitish stretch marks, whitish distended veins, subjective feeling of heaviness and stillness of the abdomen, unwavering abdomen with hardness of the abdomen. [31]
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=== Etiology of ''sannipatodara'' ===
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दुर्बलाग्नेरपथ्यामविरोधिगुरुभोजनैः| <br />
स्त्रीदत्तैश्च रजोरोमविण्मूत्रास्थिनखादिभिः||३२|| <br />
दुर्बलाग्नेरपथ्यामविरोधिगुरुभोजनैः|
स्त्रीदत्तैश्च रजोरोमविण्मूत्रास्थिनखादिभिः||३२||
विषैश्च मन्दैर्वाताद्याः कुपिताः सञ्चयं त्रयः|
विषैश्च मन्दैर्वाताद्याः कुपिताः सञ्चयं त्रयः|
<div class="mw-collapsible-content">
durbalāgnērapathyāmavirōdhigurubhōjanaiḥ|
durbalāgnērapathyāmavirōdhigurubhōjanaiḥ| <br />
strīdattaiśca rajōrōmaviṇmūtrāsthinakhādibhiḥ||32||
strīdattaiśca rajōrōmaviṇmūtrāsthinakhādibhiḥ||32|| <br />
viṣaiśca mandairvātādyāḥ kupitāḥ sañcayaṁ trayaḥ|
viṣaiśca mandairvātādyāḥ kupitāḥ sañcayaṁ trayaḥ|
durbalAgnerapathyAmavirodhigurubhojanaiH|
durbalAgnerapathyAmavirodhigurubhojanaiH| <br />
strIdattaishca rajoromaviNmUtrAsthinakhAdibhiH||32||
strIdattaishca rajoromaviNmUtrAsthinakhAdibhiH||32|| <br />
viShaishca mandairvAtAdyAH kupitAH sa~jcayaM trayaH|
viShaishca mandairvAtAdyAH kupitAH sa~jcayaM trayaH|
</div></div>
The etiological factors such as person with impaired ''agni'' (digestive power) indulging in unhealthy food habits and consuming foods that are inadequately cooked, taking food articles having mutually contradictory properties, eating foods that are heavy for digestion, consumption of food adulterated with dust, hair, feces, urine, bone and nails which is offered by a wicked lady and slow poisoning by the intake of ''dushivisha'' (chronic poisoning) cause ''sannipatodara'' [32].
<div style="text-align:justify;">
The etiological factors such as person with impaired ''agni'' (digestive power) indulging in unhealthy food habits and consuming foods that are inadequately cooked, taking food articles having mutually contradictory properties, eating foods that are heavy for digestion, consumption of food adulterated with dust, hair, feces, urine, bone and nails which is offered by a wicked lady and slow poisoning by the intake of ''dushivisha'' (chronic poisoning) cause ''sannipatodara''. [32]
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=== Pathogenesis of ''sannipatodara'' ===
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शनैः कोष्ठे प्रकुर्वन्तो जनयन्त्युदरं नृणाम्||३३||
शनैः कोष्ठे प्रकुर्वन्तो जनयन्त्युदरं नृणाम्||३३||
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śanaiḥ kōṣṭhē prakurvantō janayantyUdaraṁ nr̥ṇām||33||
śanaiḥ kōṣṭhē prakurvantō janayantyUdaraṁ nr̥ṇām||33||
shanaiH koShThe prakurvanto janayantyudaraM nRuNAm||33||
shanaiH koShThe prakurvanto janayantyudaraM nRuNAm||33||
</div></div>
Exposure to the etiological factors lead to morbidity of all three ''dosha'', which gradually accumulates in the abdomen causing ''sannipatodara'' [33]
<div style="text-align:justify;">
Exposure to the etiological factors lead to morbidity of all three ''[[dosha]]'', which gradually accumulates in the abdomen causing ''sannipatodara''. [33]
</div>
=== Symptoms of ''sannipatodara'' ===
<div class="mw-collapsible mw-collapsed">
तस्य रूपाणि-सर्वेषामेव दोषाणां समस्तानि लिङ्गान्युपलभ्यन्ते, वर्णाश्च सर्वे नखादिषु, उदरमपि नानावर्णराजीसिरासन्ततंभवति; एतत् सन्निपातोदरमिति विद्यात्||३४||
तस्य रूपाणि-सर्वेषामेव दोषाणां समस्तानि लिङ्गान्युपलभ्यन्ते, वर्णाश्च सर्वे नखादिषु, उदरमपि नानावर्णराजीसिरासन्ततंभवति; एतत् सन्निपातोदरमिति विद्यात्||३४||
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tasya rūpāṇi- sarvēṣāmēva dōṣāṇāṁ samastāni liṅgānyupalabhyantē, varṇāśca sarvē nakhādiṣu,Udara mapi nānāvarṇarājīsirāsantataṁ bhavati; ētat sannipātōdaramiti vidyāt||34||
tasya rūpāṇi- sarvēṣāmēva dōṣāṇāṁ samastāni liṅgānyupalabhyantē, varṇāśca sarvē nakhādiṣu,Udara mapi nānāvarṇarājīsirāsantataṁ bhavati; ētat sannipātōdaramiti vidyāt||34||
tasya rUpANi- sarveShAmeva doShANAM samastAni li~ggAnyupalabhyante, varNAshca sarve nakhAdiShu,udaramapi nAnAvarNarAjIsirAsantataM bhavati; etat sannipAtodaramiti vidyAt||34||
tasya rUpANi- sarveShAmeva doShANAM samastAni li~ggAnyupalabhyante, varNAshca sarve nakhAdiShu,udaramapi nAnAvarNarAjIsirAsantataM bhavati; etat sannipAtodaramiti vidyAt||34||
</div></div>
<div style="text-align:justify;">
The symptoms of ''sannipatodara'' are manifestation of symptoms pathognomonic of all three ''[[dosha]]'', variegated abnormal coloration of nails and other body parts pathognomonic of all three ''[[dosha]]'' and appearance of stretch marks and veins having variegated color pathognomonic of morbidity of all three ''[[dosha]]''. This illness is regarded as ''sannipatodara''. [34]
</div>
=== Etiology of ''plihodara'' ===
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अशितस्यातिसङ्क्षोभाद्यानयानातिचेष्टितैः| <br />
अतिव्यवायभाराध्ववमनव्याधिकर्शनैः||३५|| <br />
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aśitasyātisaṅkṣōbhādyānayānāticēṣṭitaiḥ| <br />
ativyavāyabhārādhvavamanavyādhikarśanaiḥ||35|| <br />
aśitasyātisaṅkṣōbhādyānayānāticēṣṭitaiḥ|
ativyavāyabhārādhvavamanavyādhikarśanaiḥ||35||
ashitasyAtisa~gkShobhAdyAnayAnAticeShTitaiH| <br />
ativyavAyabhArAdhvavamanavyAdhikarshanaiH||35|| <br />
</div></div>
<div style="text-align:justify;">
The ''plihodara'' is caused by activities like travelling excessively in vibrating vehicle, heavy exercises that involve violent jerky movements of the body and are done immediately after the meals, excessive sex, lifting heavy objects, indulging in heavy walking, excessive vomiting and emaciation due to chronic illness [35].
The ''plihodara'' is caused by activities like travelling excessively in vibrating vehicle, heavy exercises that involve violent jerky movements of the body and are done immediately after the meals, excessive sex, lifting heavy objects, indulging in heavy walking, excessive vomiting and emaciation due to chronic illness [35].
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=== ''Samprapti'' of ''plihodara'' ===
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वामपार्श्वाश्रितः प्लीहा च्युतः स्थानात् प्रवर्धते| <br />
शोणितं वा रसादिभ्यो विवृद्धं तं विवर्धयेत्||३६|| <br />
वामपार्श्वाश्रितः प्लीहा च्युतः स्थानात् प्रवर्धते|
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शोणितं वा रसादिभ्यो विवृद्धं तं विवर्धयेत्||३६||
vāmapārśvāśritaḥ plīhā cyutaḥ sthānāt pravardhatē| <br />
śōṇitaṁ vā rasādibhyō vivr̥ddhaṁ taṁ vivardhayēt||36|| <br />
Afflicted by the jerky movements of the body etc, the spleen located in the left side(flank or left hypochondriac region) enlarges and descends to cause enlargement of the abdomen; or else, a variety of dietary factors leading to increment and morbidity of ''rasa, rakta'' etc. which in turn causes enlargement of the spleen. Enlarged spleen distends the abdomen causing ''plihodara'' [36].
vAmapArshvAshritaH plIhA cyutaH sthAnAt pravardhate| <br />
shoNitaM vA rasAdibhyo vivRuddhaM taM vivardhayet||36|| <br />
</div></div>
<div style="text-align:justify;">
Afflicted by the jerky movements of the body etc, the spleen located in the left side(flank or left hypochondriac region) enlarges and descends to cause enlargement of the abdomen; or else, a variety of dietary factors leading to increment and morbidity of ''[[rasa]], [[rakta]]'' etc. which in turn causes enlargement of the spleen. Enlarged spleen distends the abdomen causing ''plihodara'' [36].
</div>
=== Symptoms of ''plihodara'' and ''yakritodara'' ===
<div class="mw-collapsible mw-collapsed">
तस्य प्लीहा कठिनोऽष्ठीलेवादौ वर्धमानः कच्छपसंस्थान उपलभ्यते; स चोपेक्षितः क्रमेण कुक्षिं जठरमग्न्यधिष्ठानं चपरिक्षिपन्नुदरमभिनिर्वर्तयति||३७||
तस्य प्लीहा कठिनोऽष्ठीलेवादौ वर्धमानः कच्छपसंस्थान उपलभ्यते; स चोपेक्षितः क्रमेण कुक्षिं जठरमग्न्यधिष्ठानं चपरिक्षिपन्नुदरमभिनिर्वर्तयति||३७||
दौर्बल्यारोचकाविपाकवर्चोमूत्रग्रहतमःप्रवेशपिपासाङ्गमर्दच्छर्दिमूर्च्छाङ्गसाद-कासश्वासमृदुज्वरानाहाग्निनाशकार्श्यास्यवैरस्यपर्वभेदकोष्ठवातशूलानि, अपि चोदरमरुणवर्णं विवर्णं वानीलहरितहारिद्रराजिमद्भवति; एवमेव यकृदपि दक्षिणपार्श्वस्थं कुर्यात्, तुल्यहेतुलिङ्गौषधत्वात्तस्य प्लीहजठर एवावरोधइति; एतत् प्लीहोदरमिति विद्यात्||३८||
दौर्बल्यारोचकाविपाकवर्चोमूत्रग्रहतमःप्रवेशपिपासाङ्गमर्दच्छर्दिमूर्च्छाङ्गसाद-कासश्वासमृदुज्वरानाहाग्निनाशकार्श्यास्यवैरस्यपर्वभेदकोष्ठवातशूलानि, अपि चोदरमरुणवर्णं विवर्णं वानीलहरितहारिद्रराजिमद्भवति; एवमेव यकृदपि दक्षिणपार्श्वस्थं कुर्यात्, तुल्यहेतुलिङ्गौषधत्वात्तस्य प्लीहजठर एवावरोधइति; एतत् प्लीहोदरमिति विद्यात्||३८||
<div class="mw-collapsible-content">
tasya plīhā kaṭhinō'ṣṭhīlēvādau vardhamānaḥ kacchapasaṁsthāna upalabhyatē; sa cōpēkṣitaḥ kramēṇakukṣiṁ jaṭharamagnyadhiṣṭhānaṁ ca parikṣipannUdara mabhinirvartayati||37||
tasya plīhā kaṭhinō'ṣṭhīlēvādau vardhamānaḥ kacchapasaṁsthāna upalabhyatē; sa cōpēkṣitaḥ kramēṇakukṣiṁ jaṭharamagnyadhiṣṭhānaṁ ca parikṣipannUdara mabhinirvartayati||37||
daurbalyArocakAvipAkavarcomUtragrahatamaHpraveshapipAsA~ggamardacchardimUrcchA~ggasAda-kAsashvAsamRudujvarAnAhAgninAshakArshyAsyavairasyaparvabhedakoShThavAtashUlAni, apicodaramaruNavarNaM vivarNaM vA nIlaharitahAridrarAjimadbhavati; evameva yakRudapidakShiNapArshvasthaM kuryAt, tulyahetuli~ggauShadhatvAttasya plIhajaThara evAvarodha iti; etatplIhodaramiti vidyAt||38||
daurbalyArocakAvipAkavarcomUtragrahatamaHpraveshapipAsA~ggamardacchardimUrcchA~ggasAda-kAsashvAsamRudujvarAnAhAgninAshakArshyAsyavairasyaparvabhedakoShThavAtashUlAni, apicodaramaruNavarNaM vivarNaM vA nIlaharitahAridrarAjimadbhavati; evameva yakRudapidakShiNapArshvasthaM kuryAt, tulyahetuli~ggauShadhatvAttasya plIhajaThara evAvarodha iti; etatplIhodaramiti vidyAt||38||
</div></div>
<div style="text-align:justify;">
Patient suffers from progressive enlargement of the spleen. Initially the enlarged spleen is palpable as a hard mass identical to the oval metal ball used by blacksmiths. The surface of the spleen appears smooth similar to the dorsum of the tortoise. If left untreated the enlarging spleen encroach the whole abdomen including the abode of ''agni'' [37].
Patient suffers from progressive enlargement of the spleen. Initially the enlarged spleen is palpable as a hard mass identical to the oval metal ball used by blacksmiths. The surface of the spleen appears smooth similar to the dorsum of the tortoise. If left untreated the enlarging spleen encroach the whole abdomen including the abode of ''agni'' [37].
The symptoms of ''plihodara'' include debility, lack of taste in mouth, indigestion, constipation, retention of urine, darkness in front of the eyes, excessive thirst, body ache, vomiting, transient loss of consciousness, tiredness in the body parts, cough, dyspnea, mild fever, flatulence, loss of appetite, emaciation, abnormal taste in the mouth, pain in joint of the digits, abdominal pain due to morbid ''vata'', abnormal pinkish coloration of the abdomen, discoloration of the abdominal wall and the abdominal wall shows bluish greenish yellowish linear stretch marks.
The symptoms of ''plihodara'' include debility, lack of taste in mouth, indigestion, constipation, retention of urine, darkness in front of the eyes, excessive thirst, body ache, vomiting, transient loss of consciousness, tiredness in the body parts, cough, dyspnea, mild fever, flatulence, loss of appetite, emaciation, abnormal taste in the mouth, pain in joint of the digits, abdominal pain due to morbid ''[[vata]]'', abnormal pinkish coloration of the abdomen, discoloration of the abdominal wall and the abdominal wall shows bluish greenish yellowish linear stretch marks.
In the similar manner the enlarged liver located at right flank(hypochondriac) region causes distention of the abdomen. As the etiology symptoms and treatment of enlarged liver is identical to the ''plihodara, yakritodara'' is included in the ''plihodara''. This is regarded as ''plihodara'' [38].
In the similar manner the enlarged liver located at right flank(hypochondriac) region causes distention of the abdomen. As the etiology symptoms and treatment of enlarged liver is identical to the ''plihodara, yakritodara'' is included in the ''plihodara''. This is regarded as ''plihodara'' [38].
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=== Etiology of ''baddhodara'' ===
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==== Etiology of ''baddhodara'' ====
पक्ष्मबालैः सहान्नेन भुक्तैर्बद्धायने गुदे| <br />
उदावर्तैस्तथाऽर्शोभिरन्त्रसम्मूर्च्छनेन वा||३९|| <br />
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pakṣmabālaiḥ sahānnēna bhuktairbaddhāyanē gudē| <br />
udāvartaistathā'rśōbhirantrasammūrcchanēna vā||39|| <br />
pakShmabAlaiH sahAnnena bhuktairbaddhAyane gude| <br />
udAvartaistathA~arshobhirantrasammUrcchanena vA||39|| <br />
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<div style="text-align:justify;">
''Baddhodara'' is caused by the obliteration of the passage of stools due to consumption of the food admixed with feathers of birds or human hair, ''udavarta'' (reversed course of ''[[vata]]'' in abdomen), due to ''arshas'' (ano-rectal mass lesion) and intussusception of the intestines [39].
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=== Pathogenesis of ''baddhagudodara'' ===
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अपानो मार्गसंरोधाद्धत्वाऽग्निं कुपितोऽनिलः| <br />
वर्चःपित्तकफान् रुद्ध्वा जनयत्युदरं ततः||४०|| <br />
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apānō mārgasaṁrōdhāddhatvā'gniṁ kupitō'nilaḥ| <br />
varcaḥpittakaphān ruddhvā janayatyUdara ṁ tataḥ||40|| <br />
apānō mārgasaṁrōdhāddhatvā'gniṁ kupitō'nilaḥ|
varcaḥpittakaphān ruddhvā janayatyUdara ṁ tataḥ||40||
apAno mArgasaMrodhAddhatvA~agniM kupito~anilaH|
apAno mArgasaMrodhAddhatvA~agniM kupito~anilaH| <br />
varcaHpittakaphAn ruddhvA janayatyudaraM tataH||40||
varcaHpittakaphAn ruddhvA janayatyudaraM tataH||40|| <br />
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Obliteration of the passage of colon leads to morbidity of ''apana vata'' which in turn impairs the functioning of the agni as well as obstructs the excretion of stools and obliterates the movement of ''pitta'' and ''kapha''. Eventually the patient suffers from the ''baddhagudodara'' [40].
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Obliteration of the passage of colon leads to morbidity of ''apana vata'' which in turn impairs the functioning of the agni as well as obstructs the excretion of stools and obliterates the movement of ''[[pitta]]'' and ''[[kapha]]''. Eventually the patient suffers from the ''baddhagudodara'' [40].
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=== Symptoms of ''baddhagudodara'' ===
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तस्य रूपाणि-
तस्य रूपाणि-
तृष्णादाहज्वरमुखतालुशोषोरुसादकासश्वासदौर्बल्यारोचकाविपाक-वर्चोमूत्रसङ्गाध्मानच्छर्दिक्षवथुशिरोहृन्नाभिगुदशूलानि, अपि चोदरं मूढवातं स्थिरमरुणं नीलराजि सिरावनद्धराजिकं वा प्रायोनाभ्युपरि गोपुच्छवदभिनिर्वर्तत इति; एतद्बद्धगुदोदरमिति विद्यात्||४१||
तृष्णादाहज्वरमुखतालुशोषोरुसादकासश्वासदौर्बल्यारोचकाविपाक-वर्चोमूत्रसङ्गाध्मानच्छर्दिक्षवथुशिरोहृन्नाभिगुदशूलानि, अपि चोदरं मूढवातं स्थिरमरुणं नीलराजि सिरावनद्धराजिकं वा प्रायोनाभ्युपरि गोपुच्छवदभिनिर्वर्तत इति; एतद्बद्धगुदोदरमिति विद्यात्||४१||
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tasya rūpāṇi-
tasya rūpāṇi-
tRuShNAdAhajvaramukhatAlushoShorusAdakAsashvAsadaurbalyArocakAvipAka-varcomUtrasa~ggAdhmAnacchardikShavathushirohRunnAbhigudashUlAni, api codaraM mUDhavAtaMsthiramaruNaM nIlarAji sirAvanaddharAjikaM vA prAyo nAbhyupari gopucchavadabhinirvartata iti;etadbaddhagudodaramiti vidyAt||41||
tRuShNAdAhajvaramukhatAlushoShorusAdakAsashvAsadaurbalyArocakAvipAka-varcomUtrasa~ggAdhmAnacchardikShavathushirohRunnAbhigudashUlAni, api codaraM mUDhavAtaMsthiramaruNaM nIlarAji sirAvanaddharAjikaM vA prAyo nAbhyupari gopucchavadabhinirvartata iti;etadbaddhagudodaramiti vidyAt||41||
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Symptoms of ''baddhagudodara'' are excessive thirst, burning sensation, fever, dryness of the mouth, dryness of the palate, tiredness in the thighs, cough, breathlessness, debility, lack of taste in mouth, indigestion, constipation, retention of the urine, abdominal distention, vomiting, sneezing, headache, chest pain, pain in the umbilical region and rectum, absence of gurgling sound in the abdomen, abdominal wall covered with pinkish and bluish stretch marks, visible veins, probably the stretch marks and visible veins occur above the umbilicus in the shape of cow tail, or else there may not be any stretch marks [41].
Symptoms of ''baddhagudodara'' are excessive thirst, burning sensation, fever, dryness of the mouth, dryness of the palate, tiredness in the thighs, cough, breathlessness, debility, lack of taste in mouth, indigestion, constipation, retention of the urine, abdominal distention, vomiting, sneezing, headache, chest pain, pain in the umbilical region and rectum, absence of gurgling sound in the abdomen, abdominal wall covered with pinkish and bluish stretch marks, visible veins, probably the stretch marks and visible veins occur above the umbilicus in the shape of cow tail, or else there may not be any stretch marks [41].
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=== Causes of ''chhidrodara'' ===
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==== Causes of ''chhidrodara'' ====
शर्करातृणकाष्ठास्थिकण्टकैरन्नसंयुतैः| <br />
भिद्येतान्त्रं यदा भुक्तैर्जृम्भयाऽत्यशनेन वा||४२|| <br />
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śarkarātr̥ṇakāṣṭhāsthikaṇṭakairannasaṁyutaiḥ| <br />
bhidyētāntraṁ yadā bhuktairjr̥mbhayā'tyaśanēna vā||42|| <br />
śarkarātr̥ṇakāṣṭhāsthikaṇṭakairannasaṁyutaiḥ|
bhidyētāntraṁ yadā bhuktairjr̥mbhayā'tyaśanēna vā||42||
sharkarAtRuNakAShThAsthikaNTakairannasaMyutaiH| <br />
bhidyetAntraM yadA bhuktairjRumbhayA~atyashanena vA||42|| <br />
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<div style="text-align:justify;">
Consumption of food contaminated with sand particles, straw, pieces of wood, bone and thorn, or else yawing with stretching of the body as well as excessive intake of food causes injury to intestine lead to ''chhidrodara'' [42].
Consumption of food contaminated with sand particles, straw, pieces of wood, bone and thorn, or else yawing with stretching of the body as well as excessive intake of food causes injury to intestine lead to ''chhidrodara'' [42].
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=== Pathogenesis of ''chhidrodara'' ===
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पाकं गच्छेद्रसस्तेभ्यश्छिद्रेभ्यः प्रस्रवद्बहिः| <br />
पूरयन् गुदमन्त्रं च जनयत्युदरं ततः||४३|| <br />
पाकं गच्छेद्रसस्तेभ्यश्छिद्रेभ्यः प्रस्रवद्बहिः|
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पूरयन् गुदमन्त्रं च जनयत्युदरं ततः||४३||
pākaṁ gacchēdrasastēbhyaśchidrēbhyaḥ prasravadbahiḥ| <br />
pūrayan gudamantraṁ ca janayatyUdara ṁ tataḥ||43|| <br />
pAkaM gacchedrasastebhyashchidrebhyaH prasravadbahiH| <br />
pUrayan gudamantraM ca janayatyudaraM tataH||43|| <br />
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<div style="text-align:justify;">
Contaminated food causes perforation of the intestines, which undergoes suppuration. Or else the suppuration of the intestines may happen due to yawing or excessive food which in turn leads to perforation. Perforation of the intestines further causes leaking out of the chyle from the intestines, which tends to move into the dependent parts of the abdomen filling the intestinal and rectal parts. Eventually the accumulation of the fluids in the lower abdomen manifests in ''chhidrodara'' [43].
Contaminated food causes perforation of the intestines, which undergoes suppuration. Or else the suppuration of the intestines may happen due to yawing or excessive food which in turn leads to perforation. Perforation of the intestines further causes leaking out of the chyle from the intestines, which tends to move into the dependent parts of the abdomen filling the intestinal and rectal parts. Eventually the accumulation of the fluids in the lower abdomen manifests in ''chhidrodara'' [43].
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=== Symptoms of ''chhidrodara'' ===
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तस्य रूपाणि-तदधो नाभ्याः प्रायोऽभिवर्धमानमुदकोदरं भवति, यथाबलं च दोषाणां रूपाणि दर्शयति, अपि चातुरः सलोहितनीलपीतपिच्छिलकुणपगन्ध्यामवर्च उपवेशते, हिक्काश्वासकासतृष्णाप्रमेहारोचकाविपाकदौर्बल्यपरीतश्च भवति;एतच्छिद्रोदरमिति विद्यात्||४४||
तस्य रूपाणि-तदधो नाभ्याः प्रायोऽभिवर्धमानमुदकोदरं भवति, यथाबलं च दोषाणां रूपाणि दर्शयति, अपि चातुरः सलोहितनीलपीतपिच्छिलकुणपगन्ध्यामवर्च उपवेशते, हिक्काश्वासकासतृष्णाप्रमेहारोचकाविपाकदौर्बल्यपरीतश्च भवति;एतच्छिद्रोदरमिति विद्यात्||४४||
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tasya rūpāṇi- tadadhō nābhyāḥ prāyō'bhivardhamānamudakōdaraṁ bhavati, yathābalaṁ ca dōṣāṇāṁrūpāṇi darśayati, api cāturaḥ salōhitanīlapītapicchilakuṇapagandhyāmavarca upavēśatē,hikkāśvāsakāsatr̥ṣṇāpramēhārōcakāvipākadaurbalyaparītaśca bhavati; ētacchidrōdaramiti vidyāt||44||
tasya rūpāṇi- tadadhō nābhyāḥ prāyō'bhivardhamānamudakōdaraṁ bhavati, yathābalaṁ ca dōṣāṇāṁrūpāṇi darśayati, api cāturaḥ salōhitanīlapītapicchilakuṇapagandhyāmavarca upavēśatē,hikkāśvāsakāsatr̥ṣṇāpramēhārōcakāvipākadaurbalyaparītaśca bhavati; ētacchidrōdaramiti vidyāt||44||
tasya rUpANi- tadadho nAbhyAH prAyo~abhivardhamAnamudakodaraM bhavati, yathAbalaM cadoShANAM rUpANi darshayati, api cAturaH salohitanIlapItapicchilakuNapagandhyAmavarca upaveshate,hikkAshvAsakAsatRuShNApramehArocakAvipAkadaurbalyaparItashca bhavati; etacchidrodaramitividyAt||44||
tasya rUpANi- tadadho nAbhyAH prAyo~abhivardhamAnamudakodaraM bhavati, yathAbalaM cadoShANAM rUpANi darshayati, api cAturaH salohitanIlapItapicchilakuNapagandhyAmavarca upaveshate,hikkAshvAsakAsatRuShNApramehArocakAvipAkadaurbalyaparItashca bhavati; etacchidrodaramitividyAt||44||
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<div style="text-align:justify;">
The symptoms include distension of the abdomen mostly below the umbilicus due to accumulation of the fluids. Patient may suffer from a variety of symptoms according to the degree of morbidity of each ''[[dosha]]''. Patient excretes reddish, bluish, yellowish, mucous mixed with foul smelling and unformed stools. Patient suffers from hiccough, cough, breathlessness, thirst, altered state of consciousness, tastelessness in mouth, indigestion and debility. These are indicative of ''chhidrodara'' [44].
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=== Etiopathogenesis of ''jalodara'' ===
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स्नेहपीतस्य मन्दाग्नेः क्षीणस्यातिकृशस्य वा| <br />
अत्यम्बुपानान्नष्टेऽग्नौ मारुतः क्लोम्नि संस्थितः||४५|| <br />
स्नेहपीतस्य मन्दाग्नेः क्षीणस्यातिकृशस्य वा|
अत्यम्बुपानान्नष्टेऽग्नौ मारुतः क्लोम्नि संस्थितः||४५||
स्रोतःसु रुद्धमार्गेषु कफश्चोदकमूर्च्छितः| <br />
वर्धयेतां तदेवाम्बु स्वस्थानादुदराय तौ||४६|| <br />
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snēhapītasya mandāgnēḥ kṣīṇasyātikr̥śasya vā| <br />
atyambupānānnaṣṭē'gnau mārutaḥ klōmni saṁsthitaḥ||45|| <br />
srōtaḥsu ruddhamārgēṣu kaphaścōdakamūrcchitaḥ| <br />
vardhayētāṁ tadēvāmbu svasthānādudarāya tau||46|| <br />
snehapItasya mandAgneH kShINasyAtikRushasya vA| <br />
atyambupAnAnnaShTe~agnau mArutaH klomni saMsthitaH||45|| <br />
srotaHsu ruddhamArgeShu kaphashcodakamUrcchitaH| <br />
vardhayetAM tadevAmbu svasthAnAdudarAya tau||46|| <br />
</div></div>
<div style="text-align:justify;">
Excessive consumption of water on occasions like oral medication with medicated ghee, impaired state of ''agni'', debility and emaciation causes destruction of digestive power and vitiation of ''[[vata]]'' situated at ''kloma''. [45].
These vitiated factors obliterate ''udaka-vaha-srotas''. Thus obliterated ''[[kapha]]'' mixed water further increases the fluid contents which by disloging from its site and accumulating in abdomen produce ''jalodara'' [46].
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=== Symptoms of ''udakodara'' ===
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तस्य रूपाणि-
तस्य रूपाणि-
अनन्नकाङ्क्षापिपासागुदस्रावशूलश्वासकासदौर्बल्यानि, अपि चोदरंनानावर्णराजिसिरासन्ततमुदकपूर्णदृतिक्षोभसंस्पर्शं भवति, एतदुदकोदरमिति विद्यात्||४७||
अनन्नकाङ्क्षापिपासागुदस्रावशूलश्वासकासदौर्बल्यानि, अपि चोदरंनानावर्णराजिसिरासन्ततमुदकपूर्णदृतिक्षोभसंस्पर्शं भवति, एतदुदकोदरमिति विद्यात्||४७||
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tasya rūpāṇi-
tasya rūpāṇi-
anannakA~gkShApipAsAgudasrAvashUlashvAsakAsadaurbalyAni, api codaraMnAnAvarNarAjisirAsantatamudakapUrNadRutikShobhasaMsparshaM bhavati, etadudakodaramitividyAt||47||
anannakA~gkShApipAsAgudasrAvashUlashvAsakAsadaurbalyAni, api codaraMnAnAvarNarAjisirAsantatamudakapUrNadRutikShobhasaMsparshaM bhavati, etadudakodaramitividyAt||47||
</div></div>
<div style="text-align:justify;">
The symptoms of ''udakodara'' (''jalodara'') includes lack of interest to take food, excessive thirst, mucus discharge from anus, abdominal pain, breathlessness, cough, debility, abdomen with stretch marks and distended variegated veins, fluid thrill and dull percussion note identical to the one seen in leather bag filled with water [47].
The symptoms of ''udakodara'' (''jalodara'') includes lack of interest to take food, excessive thirst, mucus discharge from anus, abdominal pain, breathlessness, cough, debility, abdomen with stretch marks and distended variegated veins, fluid thrill and dull percussion note identical to the one seen in leather bag filled with water [47].
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=== Consequences of not treating ''jalodara'' at early stage ===
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तत्र अचिरोत्पन्नमनुपद्रवमनुदकमप्राप्तमुदरं त्वरमाणश्चिकित्सेत्; उपेक्षितानां ह्येषां दोषाः स्वस्थानादपवृत्तापरिपाकाद्द्रवीभूताः सन्धीन् स्रोतांसि चोपक्लेदयन्ति, स्वेदश्च बाह्येषु स्रोतःसुप्रतिहतगतिस्तिर्यगवतिष्ठमानस्तदेवोदकमाप्याययति; तत्र पिच्छोत्पत्तौ मण्डलमुदरं गुरु स्तिमितमाकोठितमशब्दंमृदुस्पर्शमपगतराजीकमाक्रान्तं नाभ्यामेवोपसर्पति| ततोऽनन्तरमुदकप्रादुर्भावः|
तत्र अचिरोत्पन्नमनुपद्रवमनुदकमप्राप्तमुदरं त्वरमाणश्चिकित्सेत्; उपेक्षितानां ह्येषां दोषाः स्वस्थानादपवृत्तापरिपाकाद्द्रवीभूताः सन्धीन् स्रोतांसि चोपक्लेदयन्ति, स्वेदश्च बाह्येषु स्रोतःसुप्रतिहतगतिस्तिर्यगवतिष्ठमानस्तदेवोदकमाप्याययति; तत्र पिच्छोत्पत्तौ मण्डलमुदरं गुरु स्तिमितमाकोठितमशब्दंमृदुस्पर्शमपगतराजीकमाक्रान्तं नाभ्यामेवोपसर्पति| ततोऽनन्तरमुदकप्रादुर्भावः|
तदाऽऽतुरमुपद्रवाः स्पृशन्तिछर्द्यतीसारतमकतृष्णाश्वासकासहिक्कादौर्बल्यपार्श्वशूलारुचिस्वरभेदमूत्रसङ्गादयः;तथाविधमचिकित्स्यं विद्यादिति||४९||
तदाऽऽतुरमुपद्रवाः स्पृशन्तिछर्द्यतीसारतमकतृष्णाश्वासकासहिक्कादौर्बल्यपार्श्वशूलारुचिस्वरभेदमूत्रसङ्गादयः;तथाविधमचिकित्स्यं विद्यादिति||४९||
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tatra acirōtpannamanupadravamanudakamaprāptamUdara ṁ tvaramāṇaścikitsēt; upēkṣitānāṁ hyēṣāṁdōṣāḥ svasthānādapavr̥ttā paripākāddravībhūtāḥ sandhīn srōtāṁsi cōpaklēdayanti, svēdaśca bāhyēṣusrōtaḥsu pratihatagatistiryagavatiṣṭhamānastadēvōdakamāpyāyayati; tatra picchōtpattaumaṇḍalamUdara ṁ guru stimitamākōṭhitamaśabdaṁ mr̥dusparśamapagatarājīkamākrāntaṁnābhyāmēvōpasarpati| tatō'nantaramudakaprādurbhāvaḥ|
tatra acirōtpannamanupadravamanudakamaprāptamUdara ṁ tvaramāṇaścikitsēt; upēkṣitānāṁ hyēṣāṁdōṣāḥ svasthānādapavr̥ttā paripākāddravībhūtāḥ sandhīn srōtāṁsi cōpaklēdayanti, svēdaśca bāhyēṣusrōtaḥsu pratihatagatistiryagavatiṣṭhamānastadēvōdakamāpyāyayati; tatra picchōtpattaumaṇḍalamUdara ṁ guru stimitamākōṭhitamaśabdaṁ mr̥dusparśamapagatarājīkamākrāntaṁnābhyāmēvōpasarpati| tatō'nantaramudakaprādurbhāvaḥ|
chardyatIsAratamakatRuShNAshvAsakAsahikkAdaurbalyapArshvashUlArucisvarabhedamUtrasa~ggAdayaH;tathAvidhamacikitsyaM vidyAditi||49||
chardyatIsAratamakatRuShNAshvAsakAsahikkAdaurbalyapArshvashUlArucisvarabhedamUtrasa~ggAdayaH;tathAvidhamacikitsyaM vidyAditi||49||
</div></div>
''Udara roga'' of recent origin having no complications and without signs of fluid accumulation should be immediately treated. If left untreated, the morbid ''dosha'' gets displaced and liquefied, moistens the joints as well as body channels, obstructs the external channels and thus mobilizes the fluid into the abdomen.
<div style="text-align:justify;">
''Udara roga'' of recent origin having no complications and without signs of fluid accumulation should be immediately treated. If left untreated, the morbid ''[[dosha]]'' gets displaced and liquefied, moistens the joints as well as body channels, obstructs the external channels and thus mobilizes the fluid into the abdomen.
The accumulated fluid in the abdomen thus become turbid and leads to the symptoms like globular distension of the abdomen, subjective feeling of heaviness in the abdomen, still abdomen with absence of gurgling sound, dull note on percussion, soft abdomen on palpation, disappearance of stretch marks and distended veins spreading around the umbilicus.
The accumulated fluid in the abdomen thus become turbid and leads to the symptoms like globular distension of the abdomen, subjective feeling of heaviness in the abdomen, still abdomen with absence of gurgling sound, dull note on percussion, soft abdomen on palpation, disappearance of stretch marks and distended veins spreading around the umbilicus.
On appearance of the fluid the patient may suffer several complications that include vomiting, diarrhea, asthma, excessive thirst, breathlessness, cough, hiccough, debility, pain in the sides of the abdomen, tastelessness in mouth, hoarseness of voice and retention of urine and in this state it is incurable [48-49].
On appearance of the fluid the patient may suffer several complications that include vomiting, diarrhea, asthma, excessive thirst, breathlessness, cough, hiccough, debility, pain in the sides of the abdomen, tastelessness in mouth, hoarseness of voice and retention of urine and in this state it is incurable [48-49].
</div>
=== Prognosis of ''udara roga'' ===
<div class="mw-collapsible mw-collapsed">
भवन्ति चात्र-
भवन्ति चात्र-
वातात्पित्तात्कफात् प्लीह्नः सन्निपातात्तथोदकात्|
वातात्पित्तात्कफात् प्लीह्नः सन्निपातात्तथोदकात्| <br />
परं परं कृच्छ्रतरमुदरं भिषगादिशेत्||५०||
परं परं कृच्छ्रतरमुदरं भिषगादिशेत्||५०|| <br />
पक्षाद्बद्धगुदं तूर्ध्वं सर्वं जातोदकं तथा|
पक्षाद्बद्धगुदं तूर्ध्वं सर्वं जातोदकं तथा| <br />
प्रायो भवत्यभावाय च्छिद्रान्त्रं चोदरं नृणाम्||५१||
प्रायो भवत्यभावाय च्छिद्रान्त्रं चोदरं नृणाम्||५१|| <br />
शूनाक्षं कुटिलोपस्थमुपक्लिन्नतनुत्वचम्|
शूनाक्षं कुटिलोपस्थमुपक्लिन्नतनुत्वचम्| <br />
बलशोणितमांसाग्निपरिक्षीणं च वर्जयेत्||५२||
बलशोणितमांसाग्निपरिक्षीणं च वर्जयेत्||५२|| <br />
श्वयथुः सर्वमर्मोत्थः श्वासो हिक्काऽरुचिः सतृट्|
श्वयथुः सर्वमर्मोत्थः श्वासो हिक्काऽरुचिः सतृट्| <br />
मूर्च्छा च्छर्दिरतीसारो निहन्त्युदरिणं नरम्||५३||
मूर्च्छा च्छर्दिरतीसारो निहन्त्युदरिणं नरम्||५३|| <br />
जन्मनैवोदरं सर्वं प्रायः कृच्छ्रतमं मतम्|
जन्मनैवोदरं सर्वं प्रायः कृच्छ्रतमं मतम्| <br />
बलिनस्तदजाताम्बु यत्नसाध्यं नवोत्थितम्||५४||
बलिनस्तदजाताम्बु यत्नसाध्यं नवोत्थितम्||५४||<br />
<div class="mw-collapsible-content">
bhavanti cātra-
bhavanti cātra-
vātātpittātkaphāt plīhnaḥ sannipātāttathōdakāt|
vātātpittātkaphāt plīhnaḥ sannipātāttathōdakāt| <br />
paraṁ paraṁ kr̥cchrataramUdara ṁ bhiṣagādiśēt||50||
paraṁ paraṁ kr̥cchrataramUdara ṁ bhiṣagādiśēt||50|| <br />
pakṣādbaddhagudaṁ tūrdhvaṁ sarvaṁ jātōdakaṁ tathā|
pakṣādbaddhagudaṁ tūrdhvaṁ sarvaṁ jātōdakaṁ tathā| <br />
prāyō bhavatyabhāvāya cchidrāntraṁ cōdaraṁ nr̥ṇām||51||
prāyō bhavatyabhāvāya cchidrāntraṁ cōdaraṁ nr̥ṇām||51||<br />
śūnākṣaṁ kuṭilōpasthamupaklinnatanutvacam|
śūnākṣaṁ kuṭilōpasthamupaklinnatanutvacam| <br />
balaśōṇitamāṁsāgniparikṣīṇaṁ ca varjayēt||52||
balaśōṇitamāṁsāgniparikṣīṇaṁ ca varjayēt||52|| <br />
śvayathuḥ sarvamarmōtthaḥ śvāsō hikkā'ruciḥ satr̥ṭ|
śvayathuḥ sarvamarmōtthaḥ śvāsō hikkā'ruciḥ satr̥ṭ| <br />
mūrcchā cchardiratīsārō nihantyudariṇaṁ naram||53||
mūrcchā cchardiratīsārō nihantyudariṇaṁ naram||53|| <br />
janmanaivōdaraṁ sarvaṁ prāyaḥ kr̥cchratamaṁ matam|
janmanaivōdaraṁ sarvaṁ prāyaḥ kr̥cchratamaṁ matam| <br />
balinastadajātāmbu yatnasādhyaṁ navōtthitam||54||
balinastadajātāmbu yatnasādhyaṁ navōtthitam||54||<br />
bhavanti cAtra-
bhavanti cAtra-
vAtAtpittAtkaphAt plIhnaH sannipAtAttathodakAt|
vAtAtpittAtkaphAt plIhnaH sannipAtAttathodakAt| <br />
paraM paraM kRucchrataramudaraM bhiShagAdishet||50||
paraM paraM kRucchrataramudaraM bhiShagAdishet||50|| <br />
pakShAdbaddhagudaM tUrdhvaM sarvaM jAtodakaM tathA|
pakShAdbaddhagudaM tUrdhvaM sarvaM jAtodakaM tathA| <br />
prAyo bhavatyabhAvAya cchidrAntraM codaraM nRuNAm||51||
prAyo bhavatyabhAvAya cchidrAntraM codaraM nRuNAm||51||<br />
shUnAkShaM kuTilopasthamupaklinnatanutvacam|
shUnAkShaM kuTilopasthamupaklinnatanutvacam| <br />
balashoNitamAMsAgniparikShINaM ca varjayet||52||
balashoNitamAMsAgniparikShINaM ca varjayet||52|| <br />
shvayathuH sarvamarmotthaH shvAso hikkA~aruciH satRuT|
shvayathuH sarvamarmotthaH shvAso hikkA~aruciH satRuT| <br />
mUrcchA cchardiratIsAro nihantyudariNaM naram||53||
mUrcchA cchardiratIsAro nihantyudariNaM naram||53|| <br />
janmanaivodaraM sarvaM prAyaH kRucchratamaM matam| <br />
balinastadajAtAmbu yatnasAdhyaM navotthitam||54||<br />
</div></div>
<div style="text-align:justify;">
Among the list of ''vatodara, pittodara, kaphodara, plihodara, sannipatodara'' and ''jalodara'' (ascites); the later ones are more and more difficult to cure. After a fortnight the ''baddhodara'' (enlargement of abdomen due to gastrointestinal obstruction) and ''udara'' that presents with accumulation of fluid are incurable. Mostly ''chhidrodara'' (enlargement of abdomen due to intestinal perforation) is fatal. The treatment should be avoided in patients of ''udara'' presenting with peri-orbital edema, distorted genitalia, moistening and thinning of the skin, severe reduction in the physical strength, severe depletion in the blood, severe wasting of the body flesh and severe impairment in the ''agni''.
Among the list of ''vatodara, pittodara, kaphodara, plihodara, sannipatodara'' and ''jalodara'' (ascites); the later ones are more and more difficult to cure. After a fortnight the ''baddhodara'' (enlargement of abdomen due to gastrointestinal obstruction) and ''udara'' that presents with accumulation of fluid are incurable. Mostly ''chhidrodara'' (enlargement of abdomen due to intestinal perforation) is fatal. The treatment should be avoided in patients of ''udara'' presenting with peri-orbital edema, distorted genitalia, moistening and thinning of the skin, severe reduction in the physical strength, severe depletion in the blood, severe wasting of the body flesh and severe impairment in the ''agni''.
The ''udara'' is difficult to cure from the very onset itself but if the patient is physically strong, in state of ''ajatodaka'' (initial phase of distension of abdomen with slight fluid accumulation) and the ''udara'' of recent onset can be managed only with energetic treatment [50-54].
The ''udara'' is difficult to cure from the very onset itself but if the patient is physically strong, in state of ''ajatodaka'' (initial phase of distension of abdomen with slight fluid accumulation) and the ''udara'' of recent onset can be managed only with energetic treatment [50-54].
</div>
=== Symptoms of ''ajatodaka udara roga'' ===
<div class="mw-collapsible mw-collapsed">
अजातशोथमरुणं सशब्दं नातिभारिकम्| <br />
सदा गुडगुडायच्च सिराजालगवाक्षितम्||५५|| <br />
नाभिं विष्टभ्य पायौ तु वेगं कृत्वा प्रणश्यति| <br />
हृन्नाभिवङ्क्षणकटीगुदप्रत्येकशूलिनः||५६|| <br />
कर्कशं सृजतो वातं नातिमन्दे च पावके| <br />
लोलस्याविरसे चास्ये मूत्रेऽल्पे संहते विषि||५७|| <br />
अजातोदकमित्येतैर्लिङ्गैर्विज्ञाय तत्त्वतः| <br />
उपाक्रमेद्भिषग्दोषबलकालविशेषवित्||५८||<br />
<div class="mw-collapsible-content">
ajātaśōthamaruṇaṁ saśabdaṁ nātibhārikam| <br />
sadā guḍaguḍāyacca sirājālagavākṣitam||55|| <br />
nābhiṁ viṣṭabhya pāyau tu vēgaṁ kr̥tvā praṇaśyati|<br />
hr̥nnābhivaṅkṣaṇakaṭīgudapratyēkaśūlinaḥ||56|| <br />
karkaśaṁ sr̥jatō vātaṁ nātimandē ca pāvakē| <br />
lōlasyāvirasē cāsyē mūtrē'lpē saṁhatē viṣi||57|| <br />
ajātōdakamityētairliṅgairvijñāya tattVātaḥ| <br />
upākramēdbhiṣagdōṣabalakālaviśēṣavit||58||<br />
ajAtashothamaruNaM [1] sashabdaM nAtibhArikam| <br />
sadA guDaguDAyacca [2] sirAjAlagavAkShitam||55|| <br />
nAbhiM viShTabhya pAyau [3] tu vegaM kRutvA praNashyati| <br />
hRunnAbhiva~gkShaNakaTIgudapratyekashUlinaH||56|| <br />
karkashaM sRujato vAtaM nAtimande ca pAvake| <br />
lolasyAvirase [4] cAsye mUtre~alpe saMhate viShi||57|| <br />
ajAtodakamityetairli~ggairvij~jAya tattvataH| <br />
upAkramedbhiShagdoShabalakAlavisheShavit||58||<br />
</div></div>
<div style="text-align:justify;">
State of ''ajatodaka'' (initial phase of distension of abdomen without fluid accumulation) of the ''udara'' is presents with symptoms such as pink coloration of distended abdomen, increased gurgling sound, comparatively less heaviness of the abdomen, persistent gurgling sound, abdomen covered with network of distended veins, the flatus frequently generates urges to pass with distention of the umbilical region and then fades away with of farting, pain in the cardiac region, umbilical region, groin, sacral region and anal part, passing of flatus with loud sound, less severe impairment of digestion, tastelessness in the mouth, reduced urination and constipation. This state of ''ajatodaka'' should be treated with the due consideration of degree of morbidity of ''[[dosha]]'' as well as time [55-58].
</div>
=== Treatment of ''vatodara'' ===
<div class="mw-collapsible mw-collapsed">
वातोदरं बलमतः पूर्वं स्नेहैरुपाचरेत्| <br />
स्निग्धाय स्वेदिताङ्गाय दद्यात् स्नेहविरेचनम्||५९|| <br />
हृते दोषे परिम्लानं वेष्टयेद्वाससोदरम्| <br />
तथाऽस्यानवकाशत्वाद्वायुर्नाध्मापयेत् पुनः||६०|| <br />
<div class="mw-collapsible-content">
vātōdaraṁ balamataḥ pūrvaṁ snēhairupācarēt| <br />
snigdhāya svēditāṅgāya dadyāt snēhavirēcanam||59|| <br />
hr̥tē dōṣē parimlānaṁ vēṣṭayēdvāsasōdaram| <br />
tathā'syānavakāśatvādvāyurnādhmāpayēt punaḥ||60||<br />
vAtodaraM balamataH pUrvaM snehairupAcaret| <br />
snigdhAya sveditA~ggAya dadyAt snehavirecanam||59|| <br />
hRute doShe parimlAnaM veShTayedvAsasodaram| <br />
tathA~asyAnavakAshatvAdvAyurnAdhmApayet punaH||60|| <br />
</div></div>
<div style="text-align:justify;">
Patient of ''vatodara'' who is physically strong should be initially treated with unctuous medications. Then after the ''[[snehana]]'' is completed, ''abhyanga'' (unctuous massage) and ''sweda'' (sudation) is done. Then the ''sneha [[virechana]]'' (purgation with unctuous purgatives) should be given. After elimination of ''[[dosha]]'' with ''[[shodhana]]'' (purification procedure) the abdomen should be tightly bandaged so that no space is left in the abdomen for the morbid ''[[vata]]'' to cause distension of the abdomen again [59-60].
</div>
=== Post ''[[virechana]]'' regimen ===
<div class="mw-collapsible mw-collapsed">
दोषातिमात्रोपचयात् स्रोतोमार्गनिरोधनात्| <br />
सम्भवत्युदरं तस्मान्नित्यमेव विरेचयेत्||६१|| <br />
शुद्धं संसृज्य च क्षीरं बलार्थं पाययेत्तु तम्| <br />
प्रागुत्क्लेशान्निवर्त्यं च बले लब्धे क्रमात् पयः||६२|| <br />
शुद्धं संसृज्य च क्षीरं बलार्थं पाययेत्तु तम्|
प्रागुत्क्लेशान्निवर्त्यं च बले लब्धे क्रमात् पयः||६२||
यूषै रसैर्वा मन्दाम्ललवणैरेधितानलम्|
यूषै रसैर्वा मन्दाम्ललवणैरेधितानलम्|
<div class="mw-collapsible-content">
dōṣātimātrōpacayāt srōtōmārganirōdhanāt|
dōṣātimātrōpacayāt srōtōmārganirōdhanāt| <br />
sambhavatyUdaraṁ tasmānnityamēva virēcayēt||61||
sambhavatyUdaraṁ tasmānnityamēva virēcayēt||61|| <br />
śuddhaṁ saṁsr̥jya ca kṣīraṁ balārthaṁ pāyayēttu tam|
śuddhaṁ saṁsr̥jya ca kṣīraṁ balārthaṁ pāyayēttu tam| <br />
prāgutklēśānnivartyaṁ ca balē labdhē kramāt payaḥ||62||
prāgutklēśānnivartyaṁ ca balē labdhē kramāt payaḥ||62|| <br />
yūṣai rasairvā mandāmlalavaṇairēdhitānalam|
yūṣai rasairvā mandāmlalavaṇairēdhitānalam|
doShAtimAtropacayAt srotomArganirodhanAt|
doShAtimAtropacayAt srotomArganirodhanAt| <br />
sambhavatyudaraM tasmAnnityameva virecayet||61||
sambhavatyudaraM tasmAnnityameva virecayet||61|| <br />
shuddhaM saMsRujya ca kShIraM balArthaM pAyayettu tam|
shuddhaM saMsRujya ca kShIraM balArthaM pAyayettu tam| <br />
prAgutkleshAnnivartyaM ca bale labdhe kramAt payaH||62||
prAgutkleshAnnivartyaM ca bale labdhe kramAt payaH||62|| <br />
yUShai rasairvA mandAmlalavaNairedhitAnalam|
yUShai rasairvA mandAmlalavaNairedhitAnalam|
</div></div>
<div style="text-align:justify;">
''Udara'' is caused due to the obliteration of the body channels leading to accumulation of morbid ''[[dosha]]''. Hence ''udara'' should be treated by regular ''[[virechana]]'' (therapeutic purgation). After the purgation, with an intention to improve the physical strength and to relieve the strain of purgation, the patient should be given milk. Gradually as the patient regains strength by the intake of milk, his functioning of the ''agni'' should be improved by giving ''yusha'' (cereal soup) or meat soup added with little salt [61-62].
</div>
=== Role of ''asthapana [[basti]]'' ===
<div class="mw-collapsible mw-collapsed">
सोदावर्तं पुनः स्निग्धं स्विन्नमास्थापयेन्नरम्||६३||
सोदावर्तं पुनः स्निग्धं स्विन्नमास्थापयेन्नरम्||६३||
स्फुरणाक्षेपसन्ध्यस्थिपार्श्वपृष्ठत्रिकार्तिषु|
स्फुरणाक्षेपसन्ध्यस्थिपार्श्वपृष्ठत्रिकार्तिषु|
<div class="mw-collapsible-content">
sōdāvartaṁ punaḥ snigdhaṁ svinnamāsthāpayēnnaram||63||
sōdāvartaṁ punaḥ snigdhaṁ svinnamāsthāpayēnnaram||63||
sphuraNAkShepasandhyasthipArshvapRuShThatrikArtiShu|
sphuraNAkShepasandhyasthipArshvapRuShThatrikArtiShu|
</div></div>
If the patient has ''udavarta'' (reversed course of ''vata'' in the abdomen), ''sphurana'' (fasciculation), ''akshepa'' (involuntary movements), pain in the joints, bone, sides of the abdomen, back and sacral region; then again after performing oleation and sudation ''asthapana basti'' (decoction enema) is given [63].
<div style="text-align:justify;">
If the patient has ''udavarta'' (reversed course of ''[[vata]]'' in the abdomen), ''sphurana'' (fasciculation), ''akshepa'' (involuntary movements), pain in the joints, bone, sides of the abdomen, back and sacral region; then again after performing oleation and sudation ''asthapana [[basti]]'' (decoction enema) is given [63].
</div>
=== Role of ''anuvasana [[basti\\'' ===
<div class="mw-collapsible mw-collapsed">
दीप्ताग्निं बद्धविड्वातं रूक्षमप्यनुवासयेत्||६४||
दीप्ताग्निं बद्धविड्वातं रूक्षमप्यनुवासयेत्||६४||
<div class="mw-collapsible-content">
dīptāgniṁ baddhaviḍvātaṁ rūkṣamapyanuvāsayēt||64||
dīptāgniṁ baddhaviḍvātaṁ rūkṣamapyanuvāsayēt||64||
dIptAgniM baddhaviDvAtaM rUkShamapyanuvAsayet||64||
dIptAgniM baddhaviDvAtaM rUkShamapyanuvAsayet||64||
</div></div>
If the patient has strong digestive power and suffers from obstructed bowel movement and flatus as well as with dryness of the body; then he should be treated by ''anuvasana basti'' (oily enema) [64]
<div style="text-align:justify;">
If the patient has strong digestive power and suffers from obstructed bowel movement and flatus as well as with dryness of the body; then he should be treated by ''anuvasana [[basti]]'' (oily enema) [64]
</div>
=== ''Dashamula niruha basti'' ===
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तीक्ष्णाधोभागयुक्तोऽस्य निरूहो दाशमूलिकः|
तीक्ष्णाधोभागयुक्तोऽस्य निरूहो दाशमूलिकः|
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tīkṣṇādhōbhāgayuktō'sya nirūhō dāśamūlikaḥ|
tīkṣṇādhōbhāgayuktō'sya nirūhō dāśamūlikaḥ|
tIkShNAdhobhAgayukto~asya nirUho dAshamUlikaH|
tIkShNAdhobhAgayukto~asya nirUho dAshamUlikaH|
</div></div>
<div style="text-align:justify;">
''Niruha basti'' (decoction enema) prepared with ''dashamula'' (''bilva'' (Aegle marmelos Corr), ''agnimantha'' (Clerodendrum phlomidis Linn. f), ''shyonaka'' (Oroxylum indicum Vent), ''kashmari'' (Gmelina arborea), ''patala'' (Stereospermum suaveolens), ''shalaparni'' (Desmodium gangeticum DC), ''prishniparni'' (Uraria picta Desv), ''brihati'' (Solanum indicum Linn), ''kantakari'' (Solanum surattense Burm. f) and g''okshura'' (Tribulus terrestris Linn)) added with potent purgatives should be given to the patients.[65]
''Niruha basti'' (decoction enema) prepared with ''dashamula'' (''bilva'' (Aegle marmelos Corr), ''agnimantha'' (Clerodendrum phlomidis Linn. f), ''shyonaka'' (Oroxylum indicum Vent), ''kashmari'' (Gmelina arborea), ''patala'' (Stereospermum suaveolens), ''shalaparni'' (Desmodium gangeticum DC), ''prishniparni'' (Uraria picta Desv), ''brihati'' (Solanum indicum Linn), ''kantakari'' (Solanum surattense Burm. f) and g''okshura'' (Tribulus terrestris Linn)) added with potent purgatives should be given to the patients.[65]
</div>
<div class="mw-collapsible mw-collapsed">
वातघ्नाम्लशृतैरण्डतिलतैलानुवासनम्||६५||
वातघ्नाम्लशृतैरण्डतिलतैलानुवासनम्||६५||
<div class="mw-collapsible-content">
vātaghnāmlaśr̥tairaṇḍatilatailānuvāsanam||65||
vātaghnāmlaśr̥tairaṇḍatilatailānuvāsanam||65||
vAtaghnAmlashRutairaNDatilatailAnuvAsanam||65||
vAtaghnAmlashRutairaNDatilatailAnuvAsanam||65||
</div></div>
<div style="text-align:justify;">
''Anuvasana [[basti]]'' (oily enema) should be given with ''eranda taila'' (castor oil) or ''tila taila'' (sesame oil) processed with sour and anti ''[[vata]]'' drugs [65].
</div>
=== Indications for palliative (''shamana'') treatment ===
<div class="mw-collapsible mw-collapsed">
अविरेच्यं तु यं विद्याद्दुर्बलं स्थविरं शिशुम्| <br />
सुकुमारं प्रकृत्याऽल्पदोषं वाऽथोल्बणानिलम्||६६|| <br />
अविरेच्यं तु यं विद्याद्दुर्बलं स्थविरं शिशुम्|
सुकुमारं प्रकृत्याऽल्पदोषं वाऽथोल्बणानिलम्||६६||
तं भिषक् शमनैः सर्पिर्यूषमांसरसौदनैः| <br />
बस्त्यभ्यङ्गानुवासैश्च क्षीरैश्चोपाचरेद्बुधः||६७||<br />
<div class="mw-collapsible-content">
avirēcyaṁ tu yaṁ vidyāddurbalaṁ sthaviraṁ śiśum| <br />
sukumāraṁ prakr̥tyā'lpadōṣaṁ vā'thōlbaṇānilam||66|| <br />
taṁ bhiṣak śamanaiḥ sarpiryūṣamāṁsarasaudanaiḥ| <br />
bastyabhyaṅgānuvāsaiśca kṣīraiścōpācarēdbudhaḥ||67||<br />
avirecyaM tu yaM vidyAddurbalaM sthaviraM shishum| <br />
sukumAraM prakRutyA~alpadoShaM vA~atholbaNAnilam||66|| <br />
The patient who is debilitated, aged, children, having delicate constitution, minimal morbidity of ''dosha'' and dominant vitiation of ''vata'' and unfit for ''virechana karma'' (therapeutic purgation) should be treated by palliative (''shamana'') measures. ''Shamana'' treatment comprises use of medicated ghee, meat soup, rice, oil massage and milk. Such patients may also be given ''anuvasana basti'' (oily enema).[66-67]
taM bhiShak shamanaiH sarpiryUShamAMsarasaudanaiH| <br />
bastyabhya~ggAnuvAsaishca kShIraishcopAcaredbudhaH||67||<br />
</div></div>
<div style="text-align:justify;">
The patient who is debilitated, aged, children, having delicate constitution, minimal morbidity of ''[[dosha]]'' and dominant vitiation of ''[[vata]]'' and unfit for ''[[virechana]] karma'' (therapeutic purgation) should be treated by palliative (''shamana'') measures. ''Shamana'' treatment comprises use of medicated ghee, meat soup, rice, oil massage and milk. Such patients may also be given ''anuvasana [[basti]]'' (oily enema).[66-67]
</div>
=== Treatment of ''pittodara'' ===
<div class="mw-collapsible mw-collapsed">
पित्तोदरे तु बलिनं पूर्वमेव विरेचयेत्|
पित्तोदरे तु बलिनं पूर्वमेव विरेचयेत्|
<div class="mw-collapsible-content">
pittōdarē tu balinaṁ pūrvamēva virēcayēt|
pittōdarē tu balinaṁ pūrvamēva virēcayēt|
pittodare tu balinaM pUrvameva virecayet|
pittodare tu balinaM pUrvameva virecayet|
</div></div>
Physically strong patients suffering from ''pittodara'' should be treated by ''virechana karma'' (therapeutic purgation) at the outset [68].
<div style="text-align:justify;">
Physically strong patients suffering from ''pittodara'' should be treated by ''[[virechana]] karma'' (therapeutic purgation) at the outset [68].
</div>
<div class="mw-collapsible mw-collapsed">
दुर्बलं त्वनुवास्यादौ शोधयेत् क्षीरबस्तिना||६८||
दुर्बलं त्वनुवास्यादौ शोधयेत् क्षीरबस्तिना||६८||
सञ्जातबलकायाग्निं पुनः स्निग्धं विरेचयेत्|
सञ्जातबलकायाग्निं पुनः स्निग्धं विरेचयेत्|
<div class="mw-collapsible-content">
durbalaṁ tvanuvāsyādau śōdhayēt kṣīrabastinā||68||
durbalaṁ tvanuvāsyādau śōdhayēt kṣīrabastinā||68||
sa~jjAtabalakAyAgniM punaH snigdhaM virecayet|
sa~jjAtabalakAyAgniM punaH snigdhaM virecayet|
</div></div>
If the patient of ''pittodara'' is physically weak then he should be treated by purification by adapting ''kshirabasti'' (decoction enema consisting of milk as predominant ingredient). By this treatment when the patient regains physical strength, and improved digestive power, once again the patient should be treated by ''virechana'' (therapeutic purgation) [68-69]
<div style="text-align:justify;">
If the patient of ''pittodara'' is physically weak then he should be treated by purification by adapting ''kshirabasti'' (decoction enema consisting of milk as predominant ingredient). By this treatment when the patient regains physical strength, and improved digestive power, once again the patient should be treated by ''[[virechana]]'' (therapeutic purgation) [68-69]
</div>
<div class="mw-collapsible mw-collapsed">
पयसा सत्रिवृत्कल्केनोरुबूकशृतेन वा||६९||
पयसा सत्रिवृत्कल्केनोरुबूकशृतेन वा||६९||
सातलात्रायमाणाभ्यां शृतेनारग्वधेन वा|
सातलात्रायमाणाभ्यां शृतेनारग्वधेन वा| <br />
सकफे वा समूत्रेण सवाते तिक्तसर्पिषा||७०||
सकफे वा समूत्रेण सवाते तिक्तसर्पिषा||७०|| <br />
<div class="mw-collapsible-content">
payasā satrivr̥tkalkēnōrubūkaśr̥tēna vā||69||
payasā satrivr̥tkalkēnōrubūkaśr̥tēna vā||69||
sātalātrāyamāṇābhyāṁ śr̥tēnāragvadhēna vā|
sātalātrāyamāṇābhyāṁ śr̥tēnāragvadhēna vā| <br />
sakaphē vā samūtrēṇa savātē tiktasarpiṣā||70||
sakaphē vā samūtrēṇa savātē tiktasarpiṣā||70|| <br />
payasA satrivRutkalkenorubUkashRutena vA||69||
payasA satrivRutkalkenorubUkashRutena vA||69||
sAtalAtrAyamANAbhyAM shRutenAragvadhena vA|
sAtalAtrAyamANAbhyAM shRutenAragvadhena vA| <br />
sakaphe vA samUtreNa savAte tiktasarpiShA||70||
sakaphe vA samUtreNa savAte tiktasarpiShA||70|| <br />
</div></div>
''Virechana'' be performed by administering paste of ''trivrita'' (Operculina turpethum) with milk; decoction of ''urubuka'' (Ricinus communis), decoction of ''satala'' (Euphorbia Tirucalli) and ''trayamana'' (Gentiana kurrhoa) or decoction of ''aragvadha'' (Cassia fistula). Again, if the dominance of ''kapha'' is present then in the above preparation cow’s urine may be added. If the dominance of ''vata'' is present, then in the above medicines for ''virechana'' (therapeutic purgation) medicated ghee prepared with bitter herbs should be given [69-70]
<div style="text-align:justify;">
''Virechana'' be performed by administering paste of ''trivrita'' (Operculina turpethum) with milk; decoction of ''urubuka'' (Ricinus communis), decoction of ''satala'' (Euphorbia Tirucalli) and ''trayamana'' (Gentiana kurrhoa) or decoction of ''aragvadha'' (Cassia fistula). Again, if the dominance of ''[[kapha]]'' is present then in the above preparation cow’s urine may be added. If the dominance of ''[[vata]]'' is present, then in the above medicines for ''[[virechana]]'' (therapeutic purgation) medicated ghee prepared with bitter herbs should be given [69-70]
</div>
<div class="mw-collapsible mw-collapsed">
पुनः क्षीरप्रयोगं च बस्तिकर्म विरेचनम्| <br />
क्रमेण ध्रुवमातिष्ठन् युक्तः पित्तोदरं जयेत्||७१||<br />
<div class="mw-collapsible-content">
punaḥ kṣīraprayōgaṁ ca bastikarma virēcanam| <br />
kramēṇa dhruvamātiṣṭhan yuktaḥ pittōdaraṁ jayēt||71||<br />
Oral treatment with milk, ''basti karma'' (medicated enema) and ''virechana'' (therapeutic purgation) should be repeated in ''pittodara''; by this patient is gradually stabilized and the illness gets cured [71].
punaH kShIraprayogaM ca bastikarma virecanam| <br />
krameNa dhruvamAtiShThan yuktaH pittodaraM jayet||71||<br />
</div></div>
<div style="text-align:justify;">
Oral treatment with milk, ''[[basti]] karma'' (medicated enema) and ''[[virechana]]'' (therapeutic purgation) should be repeated in ''pittodara''; by this patient is gradually stabilized and the illness gets cured [71].
</div>
=== Treatment of ''kaphodara'' ===
<div class="mw-collapsible mw-collapsed">
==== Treatment of ''kaphodara'' ====
स्निग्धं स्विन्नं विशुद्धं तु कफोदरिणमातुरम्| <br />
संसर्जयेत् कटुक्षारयुक्तैरन्नैः कफापहैः||७२|| <br />
<div class="mw-collapsible-content">
snigdhaṁ svinnaṁ viśuddhaṁ tu kaphōdariṇamāturam| <br />
saṁsarjayēt kaṭukṣārayuktairannaiḥ kaphāpahaiḥ||72|| <br />
snigdhaM svinnaM vishuddhaM tu kaphodariNamAturam| <br />
saMsarjayet kaTukShArayuktairannaiH kaphApahaiH||72||<br />
</div></div>
<div style="text-align:justify;">
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 [72].
</div>
<div class="mw-collapsible mw-collapsed">
गोमूत्रारिष्टपानैश्च चूर्णायस्कृतिभिस्तथा| <br />
सक्षारैस्तैलपानैश्च शमयेत्तु कफोदरम्||७३||<br />
<div class="mw-collapsible-content">
gōmūtrāriṣṭapānaiśca cūrṇāyaskr̥tibhistathā| <br />
sakṣāraistailapānaiśca śamayēttu kaphōdaram||73||<br />
gōmūtrāriṣṭapānaiśca cūrṇāyaskr̥tibhistathā|
sakṣāraistailapānaiśca śamayēttu kaphōdaram||73||
gomUtrAriShTapAnaishca cUrNAyaskRutibhistathA| <br />
sakShAraistailapAnaishca shamayettu kaphodaram||73||<br />
</div></div>
<div style="text-align:justify;">
''Shamana'' (palliative) treatment is done in ''kaphodara'' by oral intake of ''gomutra'' (cow’s urine), ''arishta'' (fermented decoctions), drug powder, ''ayaskriti'' (medically processed iron) and sesame oil added with ''kshara'' (alkali obtained from ash of herbs) [73].
''Shamana'' (palliative) treatment is done in ''kaphodara'' by oral intake of ''gomutra'' (cow’s urine), ''arishta'' (fermented decoctions), drug powder, ''ayaskriti'' (medically processed iron) and sesame oil added with ''kshara'' (alkali obtained from ash of herbs) [73].
</div>
=== Treatment of ''sannipatodara'' ===
<div class="mw-collapsible mw-collapsed">
==== Treatment of ''sannipatodara'' ====
सन्निपातोदरे सर्वा यथोक्ताः कारयेत् क्रियाः|<br />
सोपद्रवं तु निर्वृत्तं प्रत्याख्येयं विजानता|७४|<br />
<div class="mw-collapsible-content">
sannipātōdarē sarvā yathōktāḥ kārayēt kriyāḥ| <br />
sōpadravaṁ tu nirvr̥ttaṁ pratyākhyēyaṁ vijānatā|74|<br />
sannipātōdarē sarvā yathōktāḥ kārayēt kriyāḥ|
sōpadravaṁ tu nirvr̥ttaṁ pratyākhyēyaṁ vijānatā|74|
sannipAtodare sarvA yathoktAH kArayet kriyAH| <br />
sopadravaM tu nirvRuttaM pratyAkhyeyaM vijAnatA|74|<br />
</div></div>
<div style="text-align:justify;">
''Sannipatodara'' should be treated by the combination of treatment mentioned for ''doshaja udara'' depending upon the requirement [74].
''Sannipatodara'' should be treated by the combination of treatment mentioned for ''doshaja udara'' depending upon the requirement [74].
If the patient presents with all the complications of ''udara'' then the physician should avoid treating such patients considering it as ''pratyakhyeya'' (near death) [74].
If the patient presents with all the complications of ''udara'' then the physician should avoid treating such patients considering it as ''pratyakhyeya'' (near death) [74].
</div>
=== Predominant symptoms of ''[[dosha]]'' in ''plihodara'' (splenomegaly) ===
<div class="mw-collapsible mw-collapsed">
उदावर्तरुजानाहैर्दाहमोहतृषाज्वरैः| <br />
गौरवारुचिकाठिन्यैश्चानिलादीन् यथाक्रमम्||७५|| <br />
उदावर्तरुजानाहैर्दाहमोहतृषाज्वरैः|
गौरवारुचिकाठिन्यैश्चानिलादीन् यथाक्रमम्||७५||
लिङ्गैः प्लीह्न्यधिकान् [१] दृष्ट्वा रक्तं चापि स्वलक्षणैः| <br />
चिकित्सां सम्प्रकुर्वीत यथादोषं यथाबलम्||७६|| <br />
<div class="mw-collapsible-content">
udāvartarujānāhairdāhamōhatr̥ṣājvaraiḥ| <br />
gauravārucikāṭhinyaiścānilādīn yathākramam||75|| <br />
liṅgaiḥ plīhnyadhikān [1] dr̥ṣṭvā raktaṁ cāpi svalakṣaṇaiḥ| <br />
cikitsāṁ samprakurvīta yathādōṣaṁ yathābalam||76|| <br />
udAvartarujAnAhairdAhamohatRuShAjvaraiH| <br />
gauravArucikAThinyaishcAnilAdIn yathAkramam||75|| <br />
li~ggaiH plIhnyadhikAn [1] dRuShTvA raktaM cApi svalakShaNaiH| <br />
cikitsAM samprakurvIta yathAdoShaM yathAbalam||76|| <br />
</div></div>
<div style="text-align:justify;">
Association of symptoms like ''udavarta'' (anti peristalsis), abdominal pain and flatulence indicate dominance of ''[[vata]]'' in the ''plihodara''. Symptoms like burning sensation, delirious state, excessive thirst and fever suggests dominance of ''[[pitta]]''.
Predominance of ''[[kapha]]'' is judged by the symptoms like heaviness, lack of taste in the mouth and hardness of the abdomen. Presence of symptoms indicative of morbidity of ''[[rakta]]'' as mentioned in [[Vidhishonitiya Adhyaya]] point towards the dominance of morbid ''[[rakta]]'' in the pathogenesis of ''plihodara''. Hence, ''plihodara'' should be treated according to the dominance of ''[[dosha]]'' involved [75-76].
</div>
=== Treatment of ''plihodara'' ===
<div class="mw-collapsible mw-collapsed">
स्नेहं स्वेदं विरेकं च निरूहमनुवासनम्|
स्नेहं स्वेदं विरेकं च निरूहमनुवासनम्| <br />
समीक्ष्य कारयेद्बाहौ वामे वा व्यधयेत् सिराम्||७७||
समीक्ष्य कारयेद्बाहौ वामे वा व्यधयेत् सिराम्||७७||<br />
<div class="mw-collapsible-content">
snēhaṁ svēdaṁ virēkaṁ ca nirūhamanuvāsanam|
snēhaṁ svēdaṁ virēkaṁ ca nirūhamanuvāsanam| <br />
samīkṣya kārayēdbāhau vāmē vā vyadhayēt sirām||77||
samīkṣya kārayēdbāhau vāmē vā vyadhayēt sirām||77|| <br />
snehaM svedaM virekaM ca nirUhamanuvAsanam|
snehaM svedaM virekaM ca nirUhamanuvAsanam| <br />
samIkShya kArayedbAhau vAme vA vyadhayet sirAm||77||
samIkShya kArayedbAhau vAme vA vyadhayet sirAm||77|| <br />
</div></div>
<div style="text-align:justify;">
With the due analysis of the pathogenesis, ''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 [77].
</div>
<div class="mw-collapsible mw-collapsed">
षट्पलं पाययेत् सर्पिः पिप्पलीर्वा प्रयोजयेत्| <br />
सगुडामभयां वाऽपि क्षारारिष्टगणांस्तथा||७८|| <br />
<div class="mw-collapsible-content">
ṣaṭpalaṁ pāyayēt sarpiḥ pippalīrvā prayōjayēt| <br />
saguḍāmabhayāṁ vā'pi kṣārāriṣṭagaṇāṁstathā||78|| <br />
ṣaṭpalaṁ pāyayēt sarpiḥ pippalīrvā prayōjayēt|
saguḍāmabhayāṁ vā'pi kṣārāriṣṭagaṇāṁstathā||78||
ShaTpalaM pAyayet sarpiH pippalIrvA prayojayet| <br />
saguDAmabhayAM vA~api kShArAriShTagaNAMstathA||78|| <br />
</div></div>
<div style="text-align:justify;">
Patient of plihodara is treated by oral medication of ''shatpala ghrita, pippali'' (Piper longum), combination of molasses and ''haritaki'' (Emblica officinalis), ''kshara'' (alkali obtained from ash of herbs) or ''arishta'' (fermented decoctions)[78]
Patient of plihodara is treated by oral medication of ''shatpala ghrita, pippali'' (Piper longum), combination of molasses and ''haritaki'' (Emblica officinalis), ''kshara'' (alkali obtained from ash of herbs) or ''arishta'' (fermented decoctions)[78]
</div>
<div class="mw-collapsible mw-collapsed">
एष क्रियाक्रमः प्रोक्तो योगान् संशमनाञ्छृणु|
एष क्रियाक्रमः प्रोक्तो योगान् संशमनाञ्छृणु|
<div class="mw-collapsible-content">
ēṣa kriyākramaḥ prōktō yōgān saṁśamanāñchr̥ṇu|
ēṣa kriyākramaḥ prōktō yōgān saṁśamanāñchr̥ṇu|
eSha kriyAkramaH prokto yogAn saMshamanA~jchRuNu|
eSha kriyAkramaH prokto yogAn saMshamanA~jchRuNu|
</div></div>
<div style="text-align:justify;">
Thus is the description of principles of treatment of ''plihodara''; now listen to the medications [79]
Thus is the description of principles of treatment of ''plihodara''; now listen to the medications [79]
</div>
=== ''Pippalyadi churna'' ===
<div class="mw-collapsible mw-collapsed">
पिप्पली नागरं दन्ती चित्रकं द्विगुणाभयम्||७९||
पिप्पली नागरं दन्ती चित्रकं द्विगुणाभयम्||७९||
विडङ्गांशयुतं चूर्णमेतदुष्णाम्बुना पिबेत्|
विडङ्गांशयुतं चूर्णमेतदुष्णाम्बुना पिबेत्|
<div class="mw-collapsible-content">
pippalī nāgaraṁ dantī citrakaṁ dviguṇābhayam||79||
pippalī nāgaraṁ dantī citrakaṁ dviguṇābhayam||79||
viDa~ggAMshayutaM cUrNametaduShNAmbunA pibet|
viDa~ggAMshayutaM cUrNametaduShNAmbunA pibet|
</div></div>
<div style="text-align:justify;">
Take one part each of the fine sieved powder of ''pippali'' (Piper longum), ''nagara'' (Zingiber officinale), ''danti'' (Baliospermum montanum), ''chitraka'' (Plumbago zeylanica) and ''vidanga'' (Embelia ribes), and add it to two parts of ''abhaya'' (Terminalia chebula). It is to be orally given with warm water [79]
Take one part each of the fine sieved powder of ''pippali'' (Piper longum), ''nagara'' (Zingiber officinale), ''danti'' (Baliospermum montanum), ''chitraka'' (Plumbago zeylanica) and ''vidanga'' (Embelia ribes), and add it to two parts of ''abhaya'' (Terminalia chebula). It is to be orally given with warm water [79]
</div>
=== ''Vidangadi kshara'' ===
<div class="mw-collapsible mw-collapsed">
विडङ्गं चित्रकं शुण्ठीं सघृतां सैन्धवं वचाम्||८०||
विडङ्गं चित्रकं शुण्ठीं सघृतां सैन्धवं वचाम्||८०||
दग्ध्वा कपाले पयसा गुल्मप्लीहापहं पिबेत्|
दग्ध्वा कपाले पयसा गुल्मप्लीहापहं पिबेत्|
<div class="mw-collapsible-content">
viḍaṅgaṁ citrakaṁ śuṇṭhīṁ saghr̥tāṁ saindhavaṁ vacām||80||
viḍaṅgaṁ citrakaṁ śuṇṭhīṁ saghr̥tāṁ saindhavaṁ vacām||80||
dagdhvA kapAle payasA gulmaplIhApahaM pibet|
dagdhvA kapAle payasA gulmaplIhApahaM pibet|
</div></div>
<div style="text-align:justify;">
Take powder of ''vidanga'' (Embelia ribes), ''chitraka'' (Plumbago zeylanica), ''shunthi'' (Zingiber officinale Rosc), ''saindhava'' (rock salt) and ''vacha'' (Acorus calamus) and fry with ghee in an earthen pan and administer orally. This is curative of ''gulma'' (abdominal lump) and ''plihodara'' [80]
Take powder of ''vidanga'' (Embelia ribes), ''chitraka'' (Plumbago zeylanica), ''shunthi'' (Zingiber officinale Rosc), ''saindhava'' (rock salt) and ''vacha'' (Acorus calamus) and fry with ghee in an earthen pan and administer orally. This is curative of ''gulma'' (abdominal lump) and ''plihodara'' [80]
</div>
=== ''Rohitakadi yoga'' ===
<div class="mw-collapsible mw-collapsed">
रोहीतकलतानां तु काण्डकानभयाजले||८१||
रोहीतकलतानां तु काण्डकानभयाजले||८१||
मूत्रे वा सुनुयात्तच्च सप्तरात्रस्थितं पिबेत्|
मूत्रे वा सुनुयात्तच्च सप्तरात्रस्थितं पिबेत्| <br />
कामलागुल्ममेहार्शःप्लीहसर्वोदरक्रिमीन्||८२||
कामलागुल्ममेहार्शःप्लीहसर्वोदरक्रिमीन्||८२|| <br />
स हन्याज्जाङ्गलरसैर्जीर्णे स्याच्चात्र भोजनम्|
स हन्याज्जाङ्गलरसैर्जीर्णे स्याच्चात्र भोजनम्|
<div class="mw-collapsible-content">
rōhītakalatānāṁ tu kāṇḍakānabhayājalē||81||
rōhītakalatānāṁ tu kāṇḍakānabhayājalē||81||
mūtrē vā sunuyāttacca saptarātrasthitaṁ pibēt|
mūtrē vā sunuyāttacca saptarātrasthitaṁ pibēt|<br />
kāmalāgulmamēhārśaḥplīhasarvōdarakrimīn||82||
kāmalāgulmamēhārśaḥplīhasarvōdarakrimīn||82|| <br />
sa hanyājjāṅgalarasairjīrṇē syāccātra bhōjanam|
sa hanyājjāṅgalarasairjīrṇē syāccātra bhōjanam|
rohItakalatAnAM tu kANDakAnabhayAjale||81||
rohItakalatAnAM tu kANDakAnabhayAjale||81||
mUtre vA sunuyAttacca saptarAtrasthitaM pibet|
mUtre vA sunuyAttacca saptarAtrasthitaM pibet| <br />
kAmalAgulmamehArshaHplIhasarvodarakrimIn||82||
kAmalAgulmamehArshaHplIhasarvodarakrimIn||82|| <br />
sa hanyAjjA~ggalarasairjIrNe syAccAtra bhojanam|
sa hanyAjjA~ggalarasairjIrNe syAccAtra bhojanam|
</div></div>
<div style="text-align:justify;">
The course powder of stem of ''rohitaka'' (Tecomella undulate) is soaked in a decoction of ''abhaya'' (Terminalia chebula) or cow’s urine for seven days and given to the patient to drink. Once the medicine gets digested the patient is asked to have meat soup of dry land animals in meals. This regimen cures ''kamala'' (jaundice), ''gulma'' (abdominal lump), ''prameha'' (frequent turbid urination), ''arsha'' (mass per rectum), ''plihodara'', all types of ''udara roga'' and ''krimi'' (worm infestation) [81-82].
The course powder of stem of ''rohitaka'' (Tecomella undulate) is soaked in a decoction of ''abhaya'' (Terminalia chebula) or cow’s urine for seven days and given to the patient to drink. Once the medicine gets digested the patient is asked to have meat soup of dry land animals in meals. This regimen cures ''kamala'' (jaundice), ''gulma'' (abdominal lump), ''prameha'' (frequent turbid urination), ''arsha'' (mass per rectum), ''plihodara'', all types of ''udara roga'' and ''krimi'' (worm infestation) [81-82].
</div>
=== ''Rohitaka ghrita'' ===
<div class="mw-collapsible mw-collapsed">
रोहीतकत्वचः कृत्वा पलानां पञ्चविंशतिम्||८३||
रोहीतकत्वचः कृत्वा पलानां पञ्चविंशतिम्||८३||
कोलद्विप्रस्थसंयुक्तं कषायमुपकल्पयेत्|
कोलद्विप्रस्थसंयुक्तं कषायमुपकल्पयेत्| <br />
पलिकैः पञ्चकोलैस्तु तैः सर्वैश्चापि तुल्यया||८४||
पलिकैः पञ्चकोलैस्तु तैः सर्वैश्चापि तुल्यया||८४|| <br />
रोहीतकत्वचा पिष्टैर्घृतप्रस्थं विपाचयेत्|
रोहीतकत्वचा पिष्टैर्घृतप्रस्थं विपाचयेत्| <br />
प्लीहाभिवृद्धिं शमयत्येतदाशु प्रयोजितम्||८५||
प्लीहाभिवृद्धिं शमयत्येतदाशु प्रयोजितम्||८५|| <br />
तथा गुल्मोदरश्वासक्रिमिपाण्डुत्वकामलाः|
तथा गुल्मोदरश्वासक्रिमिपाण्डुत्वकामलाः|
<div class="mw-collapsible-content">
rōhītakatvacaḥ kr̥tvā palānāṁ pañcaviṁśatim||83||
rōhītakatvacaḥ kr̥tvā palānāṁ pañcaviṁśatim||83||
kōladviprasthasaṁyuktaṁ kaṣāyamupakalpayēt|
kōladviprasthasaṁyuktaṁ kaṣāyamupakalpayēt| <br />
palikaiḥ pañcakōlaistu taiḥ sarvaiścāpi tulyayā||84||
palikaiḥ pañcakōlaistu taiḥ sarvaiścāpi tulyayā||84|| <br />
rōhītakatvacā piṣṭairghr̥taprasthaṁ vipācayēt|
rōhītakatvacā piṣṭairghr̥taprasthaṁ vipācayēt| <br />
plīhābhivr̥ddhiṁ śamayatyētadāśu prayōjitam||85||
plīhābhivr̥ddhiṁ śamayatyētadāśu prayōjitam||85|| <br />
tathā gulmōdaraśvāsakrimipāṇḍutvakāmalāḥ|
tathā gulmōdaraśvāsakrimipāṇḍutvakāmalāḥ|
rohItakatvacaH kRutvA palAnAM pa~jcaviMshatim||83||
rohItakatvacaH kRutvA palAnAM pa~jcaviMshatim||83||
koladviprasthasaMyuktaM kaShAyamupakalpayet|
koladviprasthasaMyuktaM kaShAyamupakalpayet| <br />
palikaiH pa~jcakolaistu taiH sarvaishcApi tulyayA||74||
palikaiH pa~jcakolaistu taiH sarvaishcApi tulyayA||74|| <br />
rohItakatvacA piShTairghRutaprasthaM vipAcayet|
rohItakatvacA piShTairghRutaprasthaM vipAcayet| <br />
plIhAbhivRuddhiM shamayatyetadAshu prayojitam||85||
plIhAbhivRuddhiM shamayatyetadAshu prayojitam||85|| <br />
tathA gulmodarashvAsakrimipANDutvakAmalAH|
tathA gulmodarashvAsakrimipANDutvakAmalAH|
</div></div>
<div style="text-align:justify;">
Twenty five ''pala'' (1200g) of bark of ''rohitaka'' (Tecomella Undulate) and two ''prastha'' (1536g) of ''kola'' (jujube) are added in eight times water and boiled to get the decoction. Then the paste prepared from 48g each of fruit and root of ''pippali'' (Piper longum), ''chavya'' (Piper retrofractum), ''chitraka'' (Plumbago zeylanica), ''nagara'' (Zingiber officinale) and equal to this 240g of bark of ''rohitaka'' and to this mixture 768g of cow’s ghee is added and boiled to get the medicated ghee. Oral medication with this medicated ghee will immediately cure ''plihodara, gulma'' (abdominal lump), ''udara roga'', dyspnea, ''krimi'' (worm infestation), anemia and jaundice [83-85].
Twenty five ''pala'' (1200g) of bark of ''rohitaka'' (Tecomella Undulate) and two ''prastha'' (1536g) of ''kola'' (jujube) are added in eight times water and boiled to get the decoction. Then the paste prepared from 48g each of fruit and root of ''pippali'' (Piper longum), ''chavya'' (Piper retrofractum), ''chitraka'' (Plumbago zeylanica), ''nagara'' (Zingiber officinale) and equal to this 240g of bark of ''rohitaka'' and to this mixture 768g of cow’s ghee is added and boiled to get the medicated ghee. Oral medication with this medicated ghee will immediately cure ''plihodara, gulma'' (abdominal lump), ''udara roga'', dyspnea, ''krimi'' (worm infestation), anemia and jaundice [83-85].
</div>
=== ''Agnikarma'' (cauterization) ===
<div class="mw-collapsible mw-collapsed">
अग्निकर्म च कुर्वीत भिषग्वातकफोल्बणे||८६||
अग्निकर्म च कुर्वीत भिषग्वातकफोल्बणे||८६||
<div class="mw-collapsible-content">
agnikarma ca kurvīta bhiṣagvātakaphōlbaṇē||86||
agnikarma ca kurvīta bhiṣagvātakaphōlbaṇē||86||
agnikarma ca kurvIta bhiShagvAtakapholbaNe||86||
agnikarma ca kurvIta bhiShagvAtakapholbaNe||86||
</div></div>
<div style="text-align:justify;">
The ''[[vata]]'' and ''[[kapha]]'' dominated ''plihodara'' should be treated by ''agnikarma'' (cauterization)[86].
</div>
=== Treatment of ''[[pitta]]'' dominated ''plihodara''(splenomegaly) ===
<div class="mw-collapsible mw-collapsed">
पैत्तिके जीवनीयानि सर्पींषि क्षीरबस्तयः| <br />
रक्तावसेकः संशुद्धिः क्षीरपानं च शस्यते||८७|| <br />
पैत्तिके जीवनीयानि सर्पींषि क्षीरबस्तयः|
रक्तावसेकः संशुद्धिः क्षीरपानं च शस्यते||८७||
यूषैर्मांसरसैश्चापि दीपनीयसमायुतैः|
यूषैर्मांसरसैश्चापि दीपनीयसमायुतैः| <br />
यकृति प्लीहवत् सर्वं तुल्यत्वाद्भेषजं मतम्||८८||
यकृति प्लीहवत् सर्वं तुल्यत्वाद्भेषजं मतम्||८८|| <br />
लघून्यन्नानि संसृज्य दद्यात् प्लीहोदरे भिषक्|
लघून्यन्नानि संसृज्य दद्यात् प्लीहोदरे भिषक्|
<div class="mw-collapsible-content">
paittikē jīvanīyāni sarpīṁṣi kṣīrabastayaḥ|
paittikē jīvanīyāni sarpīṁṣi kṣīrabastayaḥ| <br />
raktāvasēkaḥ saṁśuddhiḥ kṣīrapānaṁ ca śasyatē||87||
raktāvasēkaḥ saṁśuddhiḥ kṣīrapānaṁ ca śasyatē||87|| <br />
yūṣairmāṁsarasaiścāpi dīpanīyasamāyutaiḥ|
yūṣairmāṁsarasaiścāpi dīpanīyasamāyutaiḥ| <br />
yakr̥ti plīhavat sarvaṁ tulyatvādbhēṣajaṁ matam||88||
yakr̥ti plīhavat sarvaṁ tulyatvādbhēṣajaṁ matam||88|| <br />
laghūnyannāni saṁsr̥jya dadyāt plīhōdarē bhiṣak|
laghūnyannāni saṁsr̥jya dadyāt plīhōdarē bhiṣak|
paittike jIvanIyAni sarpIMShi kShIrabastayaH|
paittike jIvanIyAni sarpIMShi kShIrabastayaH| <br />
raktAvasekaH saMshuddhiH kShIrapAnaM ca shasyate||87||
raktAvasekaH saMshuddhiH kShIrapAnaM ca shasyate||87|| <br />
yUShairmAMsarasaishcApi dIpanIyasamAyutaiH|
yUShairmAMsarasaishcApi dIpanIyasamAyutaiH| <br />
yakRuti plIhavat sarvaM tulyatvAdbheShajaM matam||88||
yakRuti plIhavat sarvaM tulyatvAdbheShajaM matam||88|| <br />
laghUnyannAni saMsRujya dadyAt plIhodare bhiShak|
laghUnyannAni saMsRujya dadyAt plIhodare bhiShak|
</div></div>
''Plihodara'' with dominance of ''pitta'' is treated by oral administration of ghee medicated with ''jivaniya'' herbs (''Jeevaka'' (Malaxis acuminta), ''rishbhaka'' (Microstylis muscifera), ''meda'' (Polygonatum verticillatum), ''mahameda'' (Polygonatum cirrhifolium), ''kakoli'' (Roscoea procera), ''kshirakakoli'' (Lilium polphyllum), ''riddhi'' (Habenaria edgeworthii), ''vriddhi'' (Habenaria intermedia), ''kshara'' ''basti'' (decoction enema consisting of alkali obtained from ash of herbs), ''raktavaseka'' (blood letting), ''shodhana'' (purification measures) and oral intake of milk. Patient is asked to take ''yusha'' (cereal soup) or meat soup processed with ''dipaniya'' (herbs augmenting the digestive power) drugs and light food. Since the etiology and symptomatology of ''plihodara'' (splenomegaly) and ''yakritodara'' (hepatomegaly) are same, so all the treatment mentioned for ''plihodara'' should be adopted in ''yakritodara'' [87-88].
<div style="text-align:justify;">
''Plihodara'' with dominance of ''[[pitta]]'' is treated by oral administration of ghee medicated with ''jivaniya'' herbs (''Jeevaka'' (Malaxis acuminta), ''rishbhaka'' (Microstylis muscifera), ''meda'' (Polygonatum verticillatum), ''mahameda'' (Polygonatum cirrhifolium), ''kakoli'' (Roscoea procera), ''kshirakakoli'' (Lilium polphyllum), ''riddhi'' (Habenaria edgeworthii), ''vriddhi'' (Habenaria intermedia), ''kshara'' ''basti'' (decoction enema consisting of alkali obtained from ash of herbs), ''raktavaseka'' (blood letting), ''shodhana'' (purification measures) and oral intake of milk. Patient is asked to take ''yusha'' (cereal soup) or meat soup processed with ''dipaniya'' (herbs augmenting the digestive power) drugs and light food. Since the etiology and symptomatology of ''plihodara'' (splenomegaly) and ''yakritodara'' (hepatomegaly) are same, so all the treatment mentioned for ''plihodara'' should be adopted in ''yakritodara'' [87-88].
</div>
=== Treatment of ''baddhagudodara'' ===
<div class="mw-collapsible mw-collapsed">
स्विन्नाय बद्धोदरिणे मूत्रतीक्ष्णौषधान्वितम्||८९||
स्विन्नाय बद्धोदरिणे मूत्रतीक्ष्णौषधान्वितम्||८९||
सतैललवणं दद्यान्निरूहं सानुवासनम्|
सतैललवणं दद्यान्निरूहं सानुवासनम्| <br />
परिस्रंसीनि चान्नानि तीक्ष्णं चैव विरेचनम्||९०||
परिस्रंसीनि चान्नानि तीक्ष्णं चैव विरेचनम्||९०|| <br />
उदावर्तहरं कर्म कार्यं वातघ्नमेव च|
उदावर्तहरं कर्म कार्यं वातघ्नमेव च|
<div class="mw-collapsible-content">
svinnāya baddhōdariṇē mūtratīkṣṇauṣadhānvitam||89||
svinnāya baddhōdariṇē mūtratīkṣṇauṣadhānvitam||89||
satailalavaṇaṁ dadyānnirūhaṁ sānuvāsanam|
satailalavaṇaṁ dadyānnirūhaṁ sānuvāsanam| <br />
parisraṁsīni cānnāni tīkṣṇaṁ caiva virēcanam||90||
parisraṁsīni cānnāni tīkṣṇaṁ caiva virēcanam||90|| <br />
udāvartaharaṁ karma kāryaṁ vātaghnamēva ca|
udāvartaharaṁ karma kāryaṁ vātaghnamēva ca| <br />
svinnAya baddhodariNe mUtratIkShNauShadhAnvitam||89||
svinnAya baddhodariNe mUtratIkShNauShadhAnvitam||89|| <br />
satailalavaNaM dadyAnnirUhaM sAnuvAsanam|
satailalavaNaM dadyAnnirUhaM sAnuvAsanam| <br />
parisraMsIni cAnnAni tIkShNaM caiva virecanam||90||
parisraMsIni cAnnAni tIkShNaM caiva virecanam||90|| <br />
udAvartaharaM karma kAryaM vAtaghnameva ca|
udAvartaharaM karma kAryaM vAtaghnameva ca|
</div></div>
Patient suffering from ''baddhodara'' (enlargement of abdomen due to gastrointestinal obstruction) should be initially treated by 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). Food that induces laxation should be given. Strong purgation is also indicated in the ''baddhodara''. All measures that cure ''udavarta'' as well as morbidity of ''vata'' should be done in ''baddhodara'' [89-90].
<div style="text-align:justify;">
Patient suffering from ''baddhodara'' (enlargement of abdomen due to gastrointestinal obstruction) should be initially treated by 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). Food that induces laxation should be given. Strong purgation is also indicated in the ''baddhodara''. All measures that cure ''udavarta'' as well as morbidity of ''[[vata]]'' should be done in ''baddhodara'' [89-90].
</div>
=== Treatment of ''Chhidrodara'' ===
<div class="mw-collapsible mw-collapsed">
छिद्रोदरमृते स्वेदाच्छ्लेष्मोदरवदाचरेत्||९१||
छिद्रोदरमृते स्वेदाच्छ्लेष्मोदरवदाचरेत्||९१||
जातं जातं जलं स्राव्यमेवं तद्यापयेद्भिषक्|
जातं जातं जलं स्राव्यमेवं तद्यापयेद्भिषक्| <br />
तृष्णाकासज्वरार्तं तु क्षीणमांसाग्निभोजनम्||९२||
तृष्णाकासज्वरार्तं तु क्षीणमांसाग्निभोजनम्||९२|| <br />
वर्जयेच्छ्वासिनं तद्वच्छूलिनं दुर्बलेन्द्रियम्|
वर्जयेच्छ्वासिनं तद्वच्छूलिनं दुर्बलेन्द्रियम्|
<div class="mw-collapsible-content">
chidrōdaramr̥tē svēdācchlēṣmōdaravadācarēt||91||
chidrōdaramr̥tē svēdācchlēṣmōdaravadācarēt||91||
jātaṁ jātaṁ jalaṁ srāvyamēvaṁ tadyāpayēdbhiṣak|
jātaṁ jātaṁ jalaṁ srāvyamēvaṁ tadyāpayēdbhiṣak| <br />
tr̥ṣṇākāsajvarārtaṁ tu kṣīṇamāṁsāgnibhōjanam||92||
tr̥ṣṇākāsajvarārtaṁ tu kṣīṇamāṁsāgnibhōjanam||92|| <br />
varjayēcchvāsinaṁ tadvacchūlinaṁ durbalēndriyam|
varjayēcchvāsinaṁ tadvacchūlinaṁ durbalēndriyam|
chidrodaramRute svedAcchleShmodaravadAcaret||91||
chidrodaramRute svedAcchleShmodaravadAcaret||91||
jAtaM jAtaM jalaM srAvyamevaM tadyApayedbhiShak|
jAtaM jAtaM jalaM srAvyamevaM tadyApayedbhiShak| <br />
tRuShNAkAsajvarArtaM tu kShINamAMsAgnibhojanam||92||
tRuShNAkAsajvarArtaM tu kShINamAMsAgnibhojanam||92|| <br />
varjayecchvAsinaM tadvacchUlinaM durbalendriyam|
varjayecchvAsinaM tadvacchUlinaM durbalendriyam|
</div></div>
<div style="text-align:justify;">
''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. The treatment should be avoided in patient of ''chhidrodara'' if he suffers from symptoms like excessive thirst, cough, fever, emaciation, impairment of ''agni'', reduced food intake, dyspnea, abdominal pain and week cognition [91-92]
''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. The treatment should be avoided in patient of ''chhidrodara'' if he suffers from symptoms like excessive thirst, cough, fever, emaciation, impairment of ''agni'', reduced food intake, dyspnea, abdominal pain and week cognition [91-92]
</div>
=== Treatment of ''jalodara'' ===
<div class="mw-collapsible mw-collapsed">
अपां दोषहराण्यादौ प्रदद्यादुदकोदरे||९३||
अपां दोषहराण्यादौ प्रदद्यादुदकोदरे||९३||
द्रवेभ्यश्चोदकादिभ्यो नियच्छेदनुपूर्वशः|
द्रवेभ्यश्चोदकादिभ्यो नियच्छेदनुपूर्वशः|
<div class="mw-collapsible-content">
apāṁ dōṣaharāṇyādau pradadyādudakōdarē||93||
apāṁ dōṣaharāṇyādau pradadyādudakōdarē||93||
dravebhyashcodakAdibhyo niyacchedanupUrvashaH|
dravebhyashcodakAdibhyo niyacchedanupUrvashaH|
</div></div>
Initially all measure to eliminate the effect of fluid should be done in the treatment of ''jalodara'' (enlargement of abdomen due to collection of fluid). Oral administration of different strong ''kshara'' (alkali obtained from ash of herbs) added with cow’s urine should be done. Foods that alleviate ''kapha'' and augments digestion should be given to the patient. Patient should gradually reduce the intake of fluids [93-94].
<div style="text-align:justify;">
Initially all measure to eliminate the effect of fluid should be done in the treatment of ''jalodara'' (enlargement of abdomen due to collection of fluid). Oral administration of different strong ''kshara'' (alkali obtained from ash of herbs) added with cow’s urine should be done. Foods that alleviate ''[[kapha]]'' and augments digestion should be given to the patient. Patient should gradually reduce the intake of fluids [93-94].
</div>
<div class="mw-collapsible mw-collapsed">
सर्वमेवोदरं प्रायो दोषसङ्घातजं मतम्||९५||
सर्वमेवोदरं प्रायो दोषसङ्घातजं मतम्||९५||
तस्मात्त्रिदोषशमनीं क्रियां सर्वत्र कारयेत्|
तस्मात्त्रिदोषशमनीं क्रियां सर्वत्र कारयेत्|
<div class="mw-collapsible-content">
sarvamēvōdaraṁ prāyō dōṣasaṅghātajaṁ matam||95||
sarvamēvōdaraṁ prāyō dōṣasaṅghātajaṁ matam||95||
tasmAttridoShashamanIM kriyAM sarvatra kArayet|
tasmAttridoShashamanIM kriyAM sarvatra kArayet|
</div></div>
<div style="text-align:justify;">
All types of ''udara'' (enlargement of abdomen) are mostly due to the imbalance of all the three ''doshas'', hence treatment that alleviate all three ''dosha'' should be adapted in all types of udara [95].
All types of ''udara'' (enlargement of abdomen) are mostly due to the imbalance of all the three ''doshas'', hence treatment that alleviate all three ''dosha'' should be adapted in all types of udara [95].
</div>
<div class="mw-collapsible mw-collapsed">
दोषैः कुक्षौ हि सम्पूर्णे वह्निर्मन्दत्वमृच्छति||९६||
दोषैः कुक्षौ हि सम्पूर्णे वह्निर्मन्दत्वमृच्छति||९६||
तस्माद्भोज्यानि भोज्यानि दीपनानि लघूनि च|
तस्माद्भोज्यानि भोज्यानि दीपनानि लघूनि च|
<div class="mw-collapsible-content">
dōṣaiḥ kukṣau hi sampūrṇē vahnirmandatvamr̥cchati||96||
dōṣaiḥ kukṣau hi sampūrṇē vahnirmandatvamr̥cchati||96||
tasmAdbhojyAni bhojyAni dIpanAni laghUni ca|
tasmAdbhojyAni bhojyAni dIpanAni laghUni ca|
</div></div>
Accumulation of the ''dosha'' in the abdomen lowers digestive power (''agnimandya''), hence light foods that augments the digestion (''agni'') should be given to the patient [96].
<div style="text-align:justify;">
Accumulation of the ''[[dosha]]'' in the abdomen lowers digestive power (''agnimandya''), hence light foods that augments the digestion (''agni'') should be given to the patient [96].
</div>
=== Healthy diet for ''udara roga'' ===
<div class="mw-collapsible mw-collapsed">
रक्तशालीन् यवान्मुद्गाञ्जाङ्गलांश्च मृगद्विजान्||९७||
रक्तशालीन् यवान्मुद्गाञ्जाङ्गलांश्च मृगद्विजान्||९७||
पयोमूत्रासवारिष्टान्मधुसीधुं तथा सुराम्|
पयोमूत्रासवारिष्टान्मधुसीधुं तथा सुराम्| <br />
यवागूमोदनं वाऽपि यूषैरद्याद्रसैरपि||९८||
यवागूमोदनं वाऽपि यूषैरद्याद्रसैरपि||९८|| <br />
मन्दाम्लस्नेहकटुभिः पञ्चमूलोपसाधितैः|
मन्दाम्लस्नेहकटुभिः पञ्चमूलोपसाधितैः|
<div class="mw-collapsible-content">
raktaśālīn yavānmudgāñjāṅgalāṁśca mr̥gadvijān||97||
raktaśālīn yavānmudgāñjāṅgalāṁśca mr̥gadvijān||97||
payōmūtrāsavāriṣṭānmadhusīdhuṁ tathā surām|
payōmūtrāsavāriṣṭānmadhusīdhuṁ tathā surām| <br />
yavāgūmōdanaṁ vā'pi yūṣairadyādrasairapi||98||
yavāgūmōdanaṁ vā'pi yūṣairadyādrasairapi||98|| <br />
mandāmlasnēhakaṭubhiḥ pañcamūlōpasādhitaiḥ|
mandāmlasnēhakaṭubhiḥ pañcamūlōpasādhitaiḥ|
raktashAlIn yavAnmudgA~jjA~ggalAMshca mRugadvijAn||97||
raktashAlIn yavAnmudgA~jjA~ggalAMshca mRugadvijAn||97||
payomUtrAsavAriShTAnmadhusIdhuM tathA surAm|
payomUtrAsavAriShTAnmadhusIdhuM tathA surAm| <br />
yavAgUmodanaM vA~api yUShairadyAdrasairapi||98||
yavAgUmodanaM vA~api yUShairadyAdrasairapi||98|| <br />
mandAmlasnehakaTubhiH pa~jcamUlopasAdhitaiH|
mandAmlasnehakaTubhiH pa~jcamUlopasAdhitaiH|
</div></div>
<div style="text-align:justify;">
Food comprising ''rakta shali'' (Oryza sativa), ''yava'' (Hordeum vulgare), ''mudga'' (Phaseolus radiatus), meat soup of dry land animals, milk, cow’s urine, ''asava'' (fermented infusions), ''arishtha'' (fermented decoctions), honey, ''sidhu'' (alcoholic preparation from sugarcane juice) and ''sura'' (alcoholic preparation made by fermenting a mixture of water, flour of rice and jaggery). ''Yavagu'' (rise gruel) and ''odana'' (rice) should be given along with cereal soup, or meat soup that are prepared by adding mild sour tasting drugs, small amount of ghee, pungent tasting drugs and ''panchamula'' (''bilva'' (Aegle marmelos), ''agnimantha'' (Clerodendrum phlomidis), ''shyonaka'' (Oroxylum indicum), ''kashmari'' (Gmelina arborea) and ''patala'' (Stereospermum suaveolens).[97-98]
</div>
===Do’s and Don’ts ===
<div class="mw-collapsible mw-collapsed">
औदकानूपजं मांसं शाकं पिष्टकृतं तिलान्||९९||
औदकानूपजं मांसं शाकं पिष्टकृतं तिलान्||९९||
व्यायामाध्वदिवास्वप्नं यानयानं च वर्जयेत्|
व्यायामाध्वदिवास्वप्नं यानयानं च वर्जयेत्| <br />
तथोष्णलवणाम्लानि विदाहीनि गुरूणि च||१००||
तथोष्णलवणाम्लानि विदाहीनि गुरूणि च||१००|| <br />
नाद्यादन्नानि जठरी तोयपानं च वर्जयेत्|
नाद्यादन्नानि जठरी तोयपानं च वर्जयेत्|
<div class="mw-collapsible-content">
audakānūpajaṁ māṁsaṁ śākaṁ piṣṭakr̥taṁ tilān||99||
audakānūpajaṁ māṁsaṁ śākaṁ piṣṭakr̥taṁ tilān||99||
vyāyāmādhvadivāsvapnaṁ yānayānaṁ ca varjayēt|
vyāyāmādhvadivāsvapnaṁ yānayānaṁ ca varjayēt| <br />
tathōṣṇalavaṇāmlāni vidāhīni gurūṇi ca||100||
tathōṣṇalavaṇāmlāni vidāhīni gurūṇi ca||100|| <br />
nādyādannāni jaṭharī tōyapānaṁ ca varjayēt|
nādyādannāni jaṭharī tōyapānaṁ ca varjayēt|
audakAnUpajaM mAMsaM shAkaM piShTakRutaM tilAn||99||
audakAnUpajaM mAMsaM shAkaM piShTakRutaM tilAn||99||
vyAyAmAdhvadivAsvapnaM yAnayAnaM ca varjayet|
vyAyAmAdhvadivAsvapnaM yAnayAnaM ca varjayet| <br />
tathoShNalavaNAmlAni vidAhIni gurUNi ca||100||
tathoShNalavaNAmlAni vidAhIni gurUNi ca||100|| <br />
nAdyAdannAni jaTharI toyapAnaM ca varjayet|
nAdyAdannAni jaTharI toyapAnaM ca varjayet|
</div></div>
<div style="text-align:justify;">
Patient of ''udara'' (enlargement of abdomen) should avoid meat of aquatic and wetland animals, leafy vegetables, ''pishtakrita'' (cake and pastries made of flour; dough of rice flour), ''tila'' (Sesamum indicum), exercise, prolonged walking, day sleep, traveling, ''ushna ahara'' (hot foods), salty and sour foods, ''vidahi'' foods (foods that cause burning sensation on consumption), foods that are heavy for digestion and water [99-100].
Patient of ''udara'' (enlargement of abdomen) should avoid meat of aquatic and wetland animals, leafy vegetables, ''pishtakrita'' (cake and pastries made of flour; dough of rice flour), ''tila'' (Sesamum indicum), exercise, prolonged walking, day sleep, traveling, ''ushna ahara'' (hot foods), salty and sour foods, ''vidahi'' foods (foods that cause burning sensation on consumption), foods that are heavy for digestion and water [99-100].
</div>
=== Therapeutic use of ''takra'' (buttermilk) in ''udara roga'' ===
<div class="mw-collapsible mw-collapsed">
नातिसान्द्रं हितं पाने स्वादु तक्रमपेलवम्||१०१||
नातिसान्द्रं हितं पाने स्वादु तक्रमपेलवम्||१०१||
त्र्यूषणक्षारलवणैर्युक्तं तु निचयोदरी|
त्र्यूषणक्षारलवणैर्युक्तं तु निचयोदरी| <br />
वातोदरी पिबेत्तक्रं पिप्पलीलवणान्वितम्||१०२||
वातोदरी पिबेत्तक्रं पिप्पलीलवणान्वितम्||१०२|| <br />
शर्करामधुकोपेतं स्वादु पित्तोदरी पिबेत्|
शर्करामधुकोपेतं स्वादु पित्तोदरी पिबेत्| <br />
यवानीसैन्धवाजाजीव्योषयुक्तं कफोदरी||१०३||
यवानीसैन्धवाजाजीव्योषयुक्तं कफोदरी||१०३|| <br />
पिबेन्मधुयुतं तक्रं कवोष्णं नातिपेलवम्|
पिबेन्मधुयुतं तक्रं कवोष्णं नातिपेलवम्| <br />
मधुतैलवचाशुण्ठीशताह्वाकुष्ठसैन्धवैः||१०४||
मधुतैलवचाशुण्ठीशताह्वाकुष्ठसैन्धवैः||१०४|| <br />
युक्तं प्लीहोदरी जातं सव्योषं तूदकोदरी|
युक्तं प्लीहोदरी जातं सव्योषं तूदकोदरी| <br />
बद्धोदरी तु हपुषायवान्यजाजिसैन्धवैः ||१०५||
बद्धोदरी तु हपुषायवान्यजाजिसैन्धवैः ||१०५|| <br />
पिबेच्छिद्रोदरी तक्रं पिप्पलीक्षौद्रसंयुतम्|
पिबेच्छिद्रोदरी तक्रं पिप्पलीक्षौद्रसंयुतम्| <br />
गौरवारोचकार्तानां समन्दाग्न्यतिसारिणाम्||१०६||
गौरवारोचकार्तानां समन्दाग्न्यतिसारिणाम्||१०६|| <br />
तक्रं वातकफार्तानाममृतत्वाय कल्पते|
तक्रं वातकफार्तानाममृतत्वाय कल्पते|
<div class="mw-collapsible-content">
nātisāndraṁ hitaṁ pānē svādu takramapēlavam||101||
nātisāndraṁ hitaṁ pānē svādu takramapēlavam||101||
tryūṣaṇakṣāralavaṇairyuktaṁ tu nicayōdarī|
tryūṣaṇakṣāralavaṇairyuktaṁ tu nicayōdarī| <br />
vātōdarī pibēttakraṁ pippalīlavaṇānvitam||102||
vātōdarī pibēttakraṁ pippalīlavaṇānvitam||102|| <br />
śarkarāmadhukōpētaṁ svādu pittōdarī pibēt|
śarkarāmadhukōpētaṁ svādu pittōdarī pibēt| <br />
yavānīsaindhavājājīvyōṣayuktaṁ kaphōdarī||103||
yavānīsaindhavājājīvyōṣayuktaṁ kaphōdarī||103|| <br />
pibēnmadhuyutaṁ takraṁ kavōṣṇaṁ nātipēlavam|
pibēnmadhuyutaṁ takraṁ kavōṣṇaṁ nātipēlavam| <br />
madhutailavacāśuṇṭhīśatāhvākuṣṭhasaindhavaiḥ||104||
madhutailavacāśuṇṭhīśatāhvākuṣṭhasaindhavaiḥ||104|| <br />
yuktaṁ plīhōdarī jātaṁ savyōṣaṁ tūdakōdarī|
yuktaṁ plīhōdarī jātaṁ savyōṣaṁ tūdakōdarī| <br />
baddhōdarī tu hapuṣāyavānyajājisaindhavaiḥ ||105||
baddhōdarī tu hapuṣāyavānyajājisaindhavaiḥ ||105|| <br />
pibēcchidrōdarī takraṁ pippalīkṣaudrasaṁyutam|
pibēcchidrōdarī takraṁ pippalīkṣaudrasaṁyutam| <br />
gauravārōcakārtānāṁ samandāgnyatisāriṇām||106||
gauravārōcakārtānāṁ samandāgnyatisāriṇām||106|| <br />
takraṁ vātakaphārtānāmamr̥tatvāya kalpatē|<br />
nAtisAndraM hitaM pAne svAdu takramapelavam||101||
nAtisAndraM hitaM pAne svAdu takramapelavam||101||
tryUShaNakShAralavaNairyuktaM tu nicayodarI|
tryUShaNakShAralavaNairyuktaM tu nicayodarI| <br />
vAtodarI pibettakraM pippalIlavaNAnvitam||102||
vAtodarI pibettakraM pippalIlavaNAnvitam||102|| <br />
sharkarAmadhukopetaM [1] svAdu pittodarI pibet|
sharkarAmadhukopetaM [1] svAdu pittodarI pibet| <br />
yavAnIsaindhavAjAjIvyoShayuktaM kaphodarI||103||
yavAnIsaindhavAjAjIvyoShayuktaM kaphodarI||103|| <br />
pibenmadhuyutaM takraM kavoShNaM [2] nAtipelavam|
pibenmadhuyutaM takraM kavoShNaM [2] nAtipelavam| <br />
madhutailavacAshuNThIshatAhvAkuShThasaindhavaiH||104||
madhutailavacAshuNThIshatAhvAkuShThasaindhavaiH||104|| <br />
yuktaM plIhodarI jAtaM savyoShaM tUdakodarI|
yuktaM plIhodarI jAtaM savyoShaM tUdakodarI| <br />
baddhodarI tu hapuShAyavAnyajAjisaindhavaiH [3] ||105||
baddhodarI tu hapuShAyavAnyajAjisaindhavaiH [3] ||105|| <br />
pibecchidrodarI takraM pippalIkShaudrasaMyutam|
pibecchidrodarI takraM pippalIkShaudrasaMyutam| <br />
gauravArocakArtAnAM samandAgnyatisAriNAm||106||
gauravArocakArtAnAM samandAgnyatisAriNAm||106|| <br />
takraM vAtakaphArtAnAmamRutatvAya kalpate|
takraM vAtakaphArtAnAmamRutatvAya kalpate|
</div></div>
Patient of ''sannipatodara'' (abdominal enlargement due to morbidity of all three ''dosha'') should drink butter milk which is neither excessively thick, nor fatty, and while drinking it should be added with ''triushana'' (combination of three pungent elements that include ''pippali'' (Piper longum), ''shunthi'' (Zingiber officinale) and ''maricha'' (Piper nigrum)], ''kshaira'' (alkali obtained from ash of herbs) and rock salt.
<div style="text-align:justify;">
Patient of ''sannipatodara'' (abdominal enlargement due to morbidity of all three ''[[dosha]]'') should drink butter milk which is neither excessively thick, nor fatty, and while drinking it should be added with ''triushana'' (combination of three pungent elements that include ''pippali'' (Piper longum), ''shunthi'' (Zingiber officinale) and ''maricha'' (Piper nigrum)], ''kshaira'' (alkali obtained from ash of herbs) and rock salt.
Patient suffering from ''vatodara'' should drink buttermilk added with ''pippali'' (Piper longum) and rock salt.
Patient suffering from ''vatodara'' should drink buttermilk added with ''pippali'' (Piper longum) and rock salt.
Patient suffering from ''baddhodara'' (enlargement of abdomen due to gastrointestinal obstruction) should take buttermilk added with ''hapusha'' (Juniperus communis), ''yavani'' (Trachyspermum ammi), ''ajaji'' (Cuminum cyminum) and rock salt.
Patient suffering from ''baddhodara'' (enlargement of abdomen due to gastrointestinal obstruction) should take buttermilk added with ''hapusha'' (Juniperus communis), ''yavani'' (Trachyspermum ammi), ''ajaji'' (Cuminum cyminum) and rock salt.
Patient suffering from ''chidrodara'' (enlargement of abdomen due to perforation in gastro-intestinal tract) should drink buttermilk added with ''pippali'' (Piper longum) and honey. Further, in patient suffering from ''udara'' (enlargement of abdomen) having morbidity of ''vata'' and ''kapha'' and who develops heaviness in the abdomen, loss of taste in the mouth, ''agnimandya'' (impairment of gastric fire) and diarrhea; intake of ''takra'' (buttermilk) is beneficial and its effect is identical to the nectar [103-106].
Patient suffering from ''chidrodara'' (enlargement of abdomen due to perforation in gastro-intestinal tract) should drink buttermilk added with ''pippali'' (Piper longum) and honey. Further, in patient suffering from ''udara'' (enlargement of abdomen) having morbidity of ''[[vata]]'' and ''[[kapha]]'' and who develops heaviness in the abdomen, loss of taste in the mouth, ''agnimandya'' (impairment of gastric fire) and diarrhea; intake of ''takra'' (buttermilk) is beneficial and its effect is identical to the nectar [103-106].
</div>
=== Use of milk in ''udara roga'' ===
<div class="mw-collapsible mw-collapsed">
शोफानाहार्तितृण्मूर्च्छापीडिते कारभं पयः||१०७||
शोफानाहार्तितृण्मूर्च्छापीडिते कारभं पयः||१०७||
शुद्धानां क्षामदेहानां गव्यं छागं समाहिषम्|
शुद्धानां क्षामदेहानां गव्यं छागं समाहिषम्|
<div class="mw-collapsible-content">
śōphānāhārtitr̥ṇmūrcchāpīḍitē kārabhaṁ payaḥ||107||
śōphānāhārtitr̥ṇmūrcchāpīḍitē kārabhaṁ payaḥ||107||
shuddhAnAM kShAmadehAnAM gavyaM chAgaM samAhiSham|
shuddhAnAM kShAmadehAnAM gavyaM chAgaM samAhiSham|
</div></div>
The patient of ''udara'' (enlargement of abdomen) if develops symptoms like edema, distension of abdomen, abdominal pain and transient loss of consciousness then camel’s milk should be given to drink. If the patient’s physique reduces after the ''shodhana'' (purification measures) then he should be given cow’s milk, goat’s milk or buffalo’s milk to drink.[107]
<div style="text-align:justify;">
The patient of ''udara'' (enlargement of abdomen) if develops symptoms like edema, distension of abdomen, abdominal pain and transient loss of consciousness then camel’s milk should be given to drink. If the patient’s physique reduces after the ''[[shodhana]]'' (purification measures) then he should be given cow’s milk, goat’s milk or buffalo’s milk to drink.[107]
</div>
=== Application of paste on abdomen ===
<div class="mw-collapsible mw-collapsed">
देवदारुपलाशार्कहस्तिपिप्पलिशिग्रुकैः||१०८||
देवदारुपलाशार्कहस्तिपिप्पलिशिग्रुकैः||१०८||
साश्वगन्धैः सगोमूत्रैः प्रदिह्यादुदरं समैः|
साश्वगन्धैः सगोमूत्रैः प्रदिह्यादुदरं समैः|
<div class="mw-collapsible-content">
dēvadārupalāśārkahastiPippaliśigrukaiḥ||108||
dēvadārupalāśārkahastiPippaliśigrukaiḥ||108||
sAshvagandhaiH sagomUtraiH pradihyAdudaraM samaiH|
sAshvagandhaiH sagomUtraiH pradihyAdudaraM samaiH|
</div></div>
<div style="text-align:justify;">
The paste prepared from ''devadaru'' (Cedrus deodara), ''palasha'' (Butea monosperma), ''arka'' (Calotropis procera), ''hastipippali'' (Scindapsus officinalis), ''shigru'' (Moringa oleifera) and ''ashvagandha'' (Withania somnifera) added with cow’s urine should be applied on the abdomen as ''pradeha'' (paste) [108].
The paste prepared from ''devadaru'' (Cedrus deodara), ''palasha'' (Butea monosperma), ''arka'' (Calotropis procera), ''hastipippali'' (Scindapsus officinalis), ''shigru'' (Moringa oleifera) and ''ashvagandha'' (Withania somnifera) added with cow’s urine should be applied on the abdomen as ''pradeha'' (paste) [108].
</div>
=== ''Parisheka'' in ''udara roga'' ===
<div class="mw-collapsible mw-collapsed">
वृश्चिकालीं वचां कुष्ठं पञ्चमूलीं पुनर्नवाम्||१०९||
वृश्चिकालीं वचां कुष्ठं पञ्चमूलीं पुनर्नवाम्||१०९||
मूत्राण्यष्टावुदरिणां सेके पाने च योजयेत्|
मूत्राण्यष्टावुदरिणां सेके पाने च योजयेत्|
<div class="mw-collapsible-content">
vr̥ścikālīṁ vacāṁ kuṣṭhaṁ pañcamūlīṁ punarnavām||109||
vr̥ścikālīṁ vacāṁ kuṣṭhaṁ pañcamūlīṁ punarnavām||109||
mUtrANyaShTAvudariNAM seke pAne ca yojayet|
mUtrANyaShTAvudariNAM seke pAne ca yojayet|
</div></div>
<div style="text-align:justify;">
Abdomen should be treated with ''parisheka'' (pouring medicated liquids on body parts) by using decoction prepared from ''vrishchikali'' (Tragia involucrata), ''vacha'' (Acorus calamus), ''kushtha'' (Saussurea lappa), ''bilva'' (Aegle marmelos), ''agnimantha'' (Clerodendrum phlomidis), ''shyonaka'' (Oroxylum indicum), ''kashmari'' (Gmelina arborea), ''patala'' (Stereospermum suaveolens), ''punarnava'' (Boerhaavia diffusa), ''bhutika'' (Cymbopogon jvarancusha), ''nagara'' (Zingiber officinale) and ''dhanyaka'' (Coriandrum sativum). In the same way the decoction prepared from ''palasha'' (Butea monosperma), ''kattruna'' (Cymbopogon citratus) and ''rasna'' (Pluchea lanceolata) may be used for ''parisheka'' (pouring medicated liquids on body parts). In general the eight types of urine (urine of human being, cow, goat, sheep, camel and buffalo) may be used in the form of drink or ''parisheka'' (pouring medicated liquids on body parts) in patients suffering from ''udara'' (enlargement of abdomen tending ascites) [109-110].
Abdomen should be treated with ''parisheka'' (pouring medicated liquids on body parts) by using decoction prepared from ''vrishchikali'' (Tragia involucrata), ''vacha'' (Acorus calamus), ''kushtha'' (Saussurea lappa), ''bilva'' (Aegle marmelos), ''agnimantha'' (Clerodendrum phlomidis), ''shyonaka'' (Oroxylum indicum), ''kashmari'' (Gmelina arborea), ''patala'' (Stereospermum suaveolens), ''punarnava'' (Boerhaavia diffusa), ''bhutika'' (Cymbopogon jvarancusha), ''nagara'' (Zingiber officinale) and ''dhanyaka'' (Coriandrum sativum). In the same way the decoction prepared from ''palasha'' (Butea monosperma), ''kattruna'' (Cymbopogon citratus) and ''rasna'' (Pluchea lanceolata) may be used for ''parisheka'' (pouring medicated liquids on body parts). In general the eight types of urine (urine of human being, cow, goat, sheep, camel and buffalo) may be used in the form of drink or ''parisheka'' (pouring medicated liquids on body parts) in patients suffering from ''udara'' (enlargement of abdomen tending ascites) [109-110].
</div>
<div class="mw-collapsible mw-collapsed">
रूक्षाणां बहुवातानां तथा संशोधनार्थिनाम्||१११||
रूक्षाणां बहुवातानां तथा संशोधनार्थिनाम्||१११||
दीपनीयानि सर्पींषि जठरघ्नानि चक्ष्महे|११२|
दीपनीयानि सर्पींषि जठरघ्नानि चक्ष्महे|११२|
<div class="mw-collapsible-content">
rūkṣāṇāṁ bahuvātānāṁ tathā saṁśōdhanārthinām||111||
rūkṣāṇāṁ bahuvātānāṁ tathā saṁśōdhanārthinām||111||
dIpanIyAni sarpIMShi jaTharaghnAni cakShmahe|
dIpanIyAni sarpIMShi jaTharaghnAni cakShmahe|
</div></div>
From here onward, the medicated ghee will be discussed that are curative of ''udara'' (enlargement of abdomen) and indicated in patients who exhibit dryness of the body, who have dominance of morbid ''vata'' and also the patients who will undergo ''shodhana'' (purification measures) [111-112].
<div style="text-align:justify;">
From here onward, the medicated ghee will be discussed that are curative of ''udara'' (enlargement of abdomen) and indicated in patients who exhibit dryness of the body, who have dominance of morbid ''[[vata]]'' and also the patients who will undergo ''[[shodhana]]'' (purification measures) [111-112].
</div>
=== ''Panchakola ghrita'' ===
<div class="mw-collapsible mw-collapsed">
पिप्पलीपिप्पलीमूलचव्यचित्रकनागरैः||११२||
पिप्पलीपिप्पलीमूलचव्यचित्रकनागरैः||११२||
श्वयथुं वातविष्टम्भं गुल्मार्शांसि च नाशयेत्||११४||
श्वयथुं वातविष्टम्भं गुल्मार्शांसि च नाशयेत्||११४||
<div class="mw-collapsible-content">
pippalīpippalīmūlacavyacitrakanāgaraiḥ||112||
pippalīpippalīmūlacavyacitrakanāgaraiḥ||112||
shvayathuM vAtaviShTambhaM gulmArshAMsi ca nAshayet||114||
shvayathuM vAtaviShTambhaM gulmArshAMsi ca nAshayet||114||
</div></div>
<div style="text-align:justify;">
Take powder of ''pippali'' (Piper longum Linn), ''pippali mula'' (Piper longum), ''chavya'' (Piper retrofractum), ''chitraka'' (Plumbago zeylanica), ''nagara'' (Zingiber officinale) and ''kshara'' (alkali obtained from ash of herbs) half ''pala'' (24g) of each in quantity. This is added with ''ardha-tula'' (2400g) decoction of ''dashamula'' (roots of 10 drugs) and two ''prastha'' (1536g) of cow’s ghee and processed to get the medicated ghee. This ghee when orally administered along with ''dadhi manda'' (watery portion of curds) cures all types of ''udara, shvayathu'' (''anasaraka'') ''vata vishtambha'' (obstructed ''[[vata]]'' in the abdomen), ''gulma'' (abdominal lump) and ''arshas'' (mass per rectum) [112-114].
</div>
=== ''Nagaraadi ghrita'' ===
<div class="mw-collapsible mw-collapsed">
नागरत्रिफलाप्रस्थं घृततैलात्तथाऽऽढकम्| <br />
मस्तुनः साधयित्वैतत् पिबेत् सर्वोदरापहम्||११५|| <br />
नागरत्रिफलाप्रस्थं घृततैलात्तथाऽऽढकम्|
मस्तुनः साधयित्वैतत् पिबेत् सर्वोदरापहम्||११५||
कफमारुतसम्भूते गुल्मे चैतत् प्रशस्यते|
कफमारुतसम्भूते गुल्मे चैतत् प्रशस्यते|
<div class="mw-collapsible-content">
nāgaratriphalāprasthaṁ ghr̥tatailāttathā''ḍhakam|
nāgaratriphalāprasthaṁ ghr̥tatailāttathā''ḍhakam| <br />
mastunaḥ sādhayitvaitat pibēt sarvōdarāpaham||115||
mastunaḥ sādhayitvaitat pibēt sarvōdarāpaham||115|| <br />
kaphamārutasambhūtē gulmē caitat praśasyatē|
kaphamārutasambhūtē gulmē caitat praśasyatē|
nAgaratriphalAprasthaM ghRutatailAttathA~a~aDhakam|
nAgaratriphalAprasthaM ghRutatailAttathA~a~aDhakam| <br />
mastunaH sAdhayitvaitat pibet sarvodarApaham||115||
mastunaH sAdhayitvaitat pibet sarvodarApaham||115|| <br />
kaphamArutasambhUte gulme caitat prashasyate|
kaphamArutasambhUte gulme caitat prashasyate|
</div></div>
One ''prastha'' (768g) of powder of ''nagara'' (Zingiber officinale), ''haritaki'' (Terminalia chebula), ''vibhitaki'' (Terminalia belerica) and ''amalaki'' (Emblica officinalis) is added with 1/2 ''adhaki'' (1536g) of cow’s ghee, 1/2 ''adhaki'' (1536g) of ''taila'' (oil extracted from seeds of Sesamum indicum) and 1 ''adhaki'' (3073g) of ''mastu'' (liquid separated from curd ). This combination is processed in to medicated ghee. Oral administration of this ghee is effective in all types of ''udara'' (enlargement of abdomen) as well as ''kapha vataja gulma'' (abdominal lump) [115].
<div style="text-align:justify;">
One ''prastha'' (768g) of powder of ''nagara'' (Zingiber officinale), ''haritaki'' (Terminalia chebula), ''vibhitaki'' (Terminalia belerica) and ''amalaki'' (Emblica officinalis) is added with 1/2 ''adhaki'' (1536g) of cow’s ghee, 1/2 ''adhaki'' (1536g) of ''taila'' (oil extracted from seeds of Sesamum indicum) and 1 ''adhaki'' (3073g) of ''mastu'' (liquid separated from curd ). This combination is processed in to medicated ghee. Oral administration of this ghee is effective in all types of ''udara'' (enlargement of abdomen) as well as ''[[kapha]] [[vata]]ja gulma'' (abdominal lump) [115].
</div>
=== ''Chitraka ghrita'' ===
<div class="mw-collapsible mw-collapsed">
चतुर्गुणे जले मूत्रे द्विगुणे चित्रकात् पले||११६||
चतुर्गुणे जले मूत्रे द्विगुणे चित्रकात् पले||११६||
कल्के सिद्धं घृतप्रस्थं सक्षारं जठरी पिबेत्|
कल्के सिद्धं घृतप्रस्थं सक्षारं जठरी पिबेत्|
<div class="mw-collapsible-content">
caturguṇē jalē mūtrē dviguṇē citrakāt palē||116||
caturguṇē jalē mūtrē dviguṇē citrakāt palē||116||
kalke siddhaM ghRutaprasthaM sakShAraM jaTharI pibet|
kalke siddhaM ghRutaprasthaM sakShAraM jaTharI pibet|
</div></div>
<div style="text-align:justify;">
The powder prepared from each 1 ''pala'' (48g) of ''chitraka'' (Plumbago zeylanica) and ''kshara'' (alkali obtained from ash of herbs) is added with 1 ''prastha'' (768g) cow’s ghee, 2 ''prastha'' (1536 g) of cow’s urine and 4 ''prastha'' (3073g) of water. The combination is processed into medicated ghee and is orally administered in patients suffering from ''udara'' (enlargement of abdomen). [116]
The powder prepared from each 1 ''pala'' (48g) of ''chitraka'' (Plumbago zeylanica) and ''kshara'' (alkali obtained from ash of herbs) is added with 1 ''prastha'' (768g) cow’s ghee, 2 ''prastha'' (1536 g) of cow’s urine and 4 ''prastha'' (3073g) of water. The combination is processed into medicated ghee and is orally administered in patients suffering from ''udara'' (enlargement of abdomen). [116]
</div>
=== ''Yavadi ghrita'' ===
<div class="mw-collapsible mw-collapsed">
यवकोलकुलत्थानां पञ्चमूलरसेन च||११७||
यवकोलकुलत्थानां पञ्चमूलरसेन च||११७||
सुरासौवीरकाभ्यां च सिद्धं वाऽपि पिबेद्घृतम्|
सुरासौवीरकाभ्यां च सिद्धं वाऽपि पिबेद्घृतम्|
<div class="mw-collapsible-content">
yavakōlakulatthānāṁ pañcamūlarasēna ca||117||
yavakōlakulatthānāṁ pañcamūlarasēna ca||117||
surAsauvIrakAbhyAM ca siddhaM vA~api pibedghRutam|
surAsauvIrakAbhyAM ca siddhaM vA~api pibedghRutam|
</div></div>
<div style="text-align:justify;">
The powders of ''yava'' (Hordeum vulgare), ''kola'' (Zizypus jujuba) and ''kulattha'' (Vigna unquiculata) is added with decoction of ''brihat panchamula'' (roots of five big plants), ''sura'' (alcoholic preparation made by fermenting a mixture of water, flour of rice and jaggery) and ''sauviraka'' (alcoholic beverage prepared from dehusked barley either raw or cooked) and ghee. This combination is processed into medicated ghee and is orally given in patients suffering from ''udara roga'' [117].
The powders of ''yava'' (Hordeum vulgare), ''kola'' (Zizypus jujuba) and ''kulattha'' (Vigna unquiculata) is added with decoction of ''brihat panchamula'' (roots of five big plants), ''sura'' (alcoholic preparation made by fermenting a mixture of water, flour of rice and jaggery) and ''sauviraka'' (alcoholic beverage prepared from dehusked barley either raw or cooked) and ghee. This combination is processed into medicated ghee and is orally given in patients suffering from ''udara roga'' [117].
</div>
=== ''[[Virechana]]'' ===
<div class="mw-collapsible mw-collapsed">
एभिः स्निग्धाय सञ्जाते बले शान्ते च मारुते||११८||
एभिः स्निग्धाय सञ्जाते बले शान्ते च मारुते||११८||
स्रस्ते दोषाशये दद्यात् कल्पदिष्टं विरेचनम्|११९|
स्रस्ते दोषाशये दद्यात् कल्पदिष्टं विरेचनम्|११९|
<div class="mw-collapsible-content">
ēbhiḥ snigdhāya sañjātē balē śāntē ca mārutē||118||
ēbhiḥ snigdhāya sañjātē balē śāntē ca mārutē||118||
sraste doShAshaye dadyAt kalpadiShTaM virecanam|119|
sraste doShAshaye dadyAt kalpadiShTaM virecanam|119|
</div></div>
After the oral medication of this medicated ghee, once the patient regains the physical strength, morbid ''vata'' gets alleviated and ''dosha'' has been mobilized into the ''koshtha''; the patient is treated with ''virechana'' (therapeutic purgation) by administering purgatives mentioned in the [[Kalpa Sthana]]. [118-119]
<div style="text-align:justify;">
After the oral medication of this medicated ghee, once the patient regains the physical strength, morbid ''[[vata]]'' gets alleviated and ''[[dosha]]'' has been mobilized into the ''koshtha''; the patient is treated with ''[[virechana]]'' (therapeutic purgation) by administering purgatives mentioned in the [[Kalpa Sthana]]. [118-119]
</div>
=== ''Patoāldi churna'' ===
<div class="mw-collapsible mw-collapsed">
पटोलमूलं रजनीं विडङ्गं त्रिफलात्वचम्||११९||
पटोलमूलं रजनीं विडङ्गं त्रिफलात्वचम्||११९||
कम्पिल्लकं नीलिनीं च त्रिवृतां चेति चूर्णयेत्|
कम्पिल्लकं नीलिनीं च त्रिवृतां चेति चूर्णयेत्| <br />
षडाद्यान् कार्षिकानन्त्यांस्त्रींश्च द्वित्रिचतुर्गुणान्||१२०||
षडाद्यान् कार्षिकानन्त्यांस्त्रींश्च द्वित्रिचतुर्गुणान्||१२०|| <br />
कृत्वा चूर्णमतो मुष्टिं गवां मूत्रेण ना पिबेत्|
कृत्वा चूर्णमतो मुष्टिं गवां मूत्रेण ना पिबेत्| <br />
विरिक्तो मृदु भुञ्जीत भोजनं जाङ्गलै रसैः||१२१||
विरिक्तो मृदु भुञ्जीत भोजनं जाङ्गलै रसैः||१२१|| <br />
मण्डं पेयां च पीत्वा ना सव्योषं षडहं पयः|
मण्डं पेयां च पीत्वा ना सव्योषं षडहं पयः| <br />
शृतं पिबेत्ततश्चूर्णं पिबेदेवं पुनः पुनः||१२२||
शृतं पिबेत्ततश्चूर्णं पिबेदेवं पुनः पुनः||१२२|| <br />
हन्ति सर्वोदराण्येतच्चूर्णं जातोदकान्यपि|
हन्ति सर्वोदराण्येतच्चूर्णं जातोदकान्यपि| <br />
कामलां पाण्डुरोगं च श्वयथुं चापकर्षति||१२३||
कामलां पाण्डुरोगं च श्वयथुं चापकर्षति||१२३|| <br />
पटोलाद्यमिदं चूर्णमुदरेषु प्रपूजितम्|
पटोलाद्यमिदं चूर्णमुदरेषु प्रपूजितम्|
<div class="mw-collapsible-content">
paṭōlamūlaṁ rajanīṁ viḍaṅgaṁ triphalātvacam||119||
paṭōlamūlaṁ rajanīṁ viḍaṅgaṁ triphalātvacam||119||
kampillakaṁ nīlinīṁ ca trivr̥tāṁ cēti cūrṇayēt|
kampillakaṁ nīlinīṁ ca trivr̥tāṁ cēti cūrṇayēt| <br />
ṣaḍādyān kārṣikānantyāṁstrīṁśca dvitricaturguṇān||120||
ṣaḍādyān kārṣikānantyāṁstrīṁśca dvitricaturguṇān||120|| <br />
kr̥tvā cūrṇamatō muṣṭiṁ gavāṁ mūtrēṇa nā pibēt|
kr̥tvā cūrṇamatō muṣṭiṁ gavāṁ mūtrēṇa nā pibēt| <br />
viriktō mr̥du bhuñjīta bhōjanaṁ jāṅgalai rasaiḥ||121||
viriktō mr̥du bhuñjīta bhōjanaṁ jāṅgalai rasaiḥ||121|| <br />
maṇḍaṁ pēyāṁ ca pītvā nā savyōṣaṁ ṣaḍahaṁ payaḥ|
maṇḍaṁ pēyāṁ ca pītvā nā savyōṣaṁ ṣaḍahaṁ payaḥ| <br />
śr̥taṁ pibēttataścūrṇaṁ pibēdēvaṁ punaḥ punaḥ||122||
śr̥taṁ pibēttataścūrṇaṁ pibēdēvaṁ punaḥ punaḥ||122|| <br />
hanti sarvōdarāṇyētaccūrṇaṁ jātōdakānyapi|
hanti sarvōdarāṇyētaccūrṇaṁ jātōdakānyapi| <br />
kāmalāṁ pāṇḍurōgaṁ ca śvayathuṁ cāpakarṣati||123||
kāmalāṁ pāṇḍurōgaṁ ca śvayathuṁ cāpakarṣati||123|| <br />
paṭōlādyamidaṁ cūrṇamudarēṣu prapūjitam|
paṭōlādyamidaṁ cūrṇamudarēṣu prapūjitam|
paTolamUlaM rajanIM viDa~ggaM triphalAtvacam||119||
paTolamUlaM rajanIM viDa~ggaM triphalAtvacam||119||
kampillakaM nIlinIM ca trivRutAM ceti cUrNayet|
kampillakaM nIlinIM ca trivRutAM ceti cUrNayet| <br />
ShaDAdyAn kArShikAnantyAMstrIMshca dvitricaturguNAn||120||
ShaDAdyAn kArShikAnantyAMstrIMshca dvitricaturguNAn||120|| <br />
kRutvA cUrNamato muShTiM gavAM mUtreNa nA pibet|
kRutvA cUrNamato muShTiM gavAM mUtreNa nA pibet| <br />
virikto mRudu bhu~jjIta bhojanaM jA~ggalai rasaiH||121||
virikto mRudu bhu~jjIta bhojanaM jA~ggalai rasaiH||121|| <br />
maNDaM peyAM ca pItvA nA savyoShaM ShaDahaM payaH|
maNDaM peyAM ca pItvA nA savyoShaM ShaDahaM payaH| <br />
shRutaM pibettatashcUrNaM pibedevaM punaH punaH||122||
shRutaM pibettatashcUrNaM pibedevaM punaH punaH||122|| <br />
hanti sarvodarANyetaccUrNaM jAtodakAnyapi|
hanti sarvodarANyetaccUrNaM jAtodakAnyapi| <br />
kAmalAM pANDurogaM ca shvayathuM cApakarShati||123||
kAmalAM pANDurogaM ca shvayathuM cApakarShati||123|| <br />
paTolAdyamidaM cUrNamudareShu prapUjitam|
paTolAdyamidaM cUrNamudareShu prapUjitam|
</div></div>
<div style="text-align:justify;">
The powder is prepared from each one ''karsha'' (12g) each powder of root of ''patola'' (Trichosanthes dioica), ''rajani'' (Curcuma longa), ''vidanga'' (Embelia ribes.), barks of ''haritaki'' (Terminalia chebula), ''vibhitaki'' (Terminalia belerica) and ''amalaki'' (Emblica officinalis), two ''karsha'' (24g) of ''kampilla'' (Mallotus philippinensis), three ''karsha'' (36g) of ''nilini'' (Indigofera tinctoria) and four ''karsha'' (48g) of ''trivrita'' (Operculina turpethum). This powder is orally administered in a dose of one ''pala'' (48g) along with cow’s urine to induce purgation. After the purgation, the patient is advised to have light food consisting of meat soup of dry land animals. Or else, after the intake of ''manda'' (gruel water) and ''peya'' (liquid rice gruel), the patient is given milk processed with ''pippali'' (Piper longum), ''shunthi'' (Zingiber officinale) and ''maricha'' (Piper nigrum) for six days. The repeated administration of this regimen cures all the types of ''udara'' including the stage of ''jatodaka'' (enlargement of abdomen with fluid accumulation), jaundice, anemia and ''anasaraka''. This powder named as ''patoladi churna'' is well appreciated for the cure of ''udara'' (enlargement of abdomen) [119-123]
The powder is prepared from each one ''karsha'' (12g) each powder of root of ''patola'' (Trichosanthes dioica), ''rajani'' (Curcuma longa), ''vidanga'' (Embelia ribes.), barks of ''haritaki'' (Terminalia chebula), ''vibhitaki'' (Terminalia belerica) and ''amalaki'' (Emblica officinalis), two ''karsha'' (24g) of ''kampilla'' (Mallotus philippinensis), three ''karsha'' (36g) of ''nilini'' (Indigofera tinctoria) and four ''karsha'' (48g) of ''trivrita'' (Operculina turpethum). This powder is orally administered in a dose of one ''pala'' (48g) along with cow’s urine to induce purgation. After the purgation, the patient is advised to have light food consisting of meat soup of dry land animals. Or else, after the intake of ''manda'' (gruel water) and ''peya'' (liquid rice gruel), the patient is given milk processed with ''pippali'' (Piper longum), ''shunthi'' (Zingiber officinale) and ''maricha'' (Piper nigrum) for six days. The repeated administration of this regimen cures all the types of ''udara'' including the stage of ''jatodaka'' (enlargement of abdomen with fluid accumulation), jaundice, anemia and ''anasaraka''. This powder named as ''patoladi churna'' is well appreciated for the cure of ''udara'' (enlargement of abdomen) [119-123]
</div>
=== ''Gavakshyadi churna'' ===
<div class="mw-collapsible mw-collapsed">
गवाक्षीं शङ्खिनीं दन्तीं तिल्वकस्य त्वचं वचाम्||१२४||
गवाक्षीं शङ्खिनीं दन्तीं तिल्वकस्य त्वचं वचाम्||१२४||
पिबेद्द्राक्षाम्बुगोमूत्रकोलकर्कन्धुसीधुभिः|
पिबेद्द्राक्षाम्बुगोमूत्रकोलकर्कन्धुसीधुभिः|
<div class="mw-collapsible-content">
gavākṣīṁ śaṅkhinīṁ dantīṁ tilvakasya tvacaṁ vacām||124||
gavākṣīṁ śaṅkhinīṁ dantīṁ tilvakasya tvacaṁ vacām||124||
pibeddrAkShAmbugomUtrakolakarkandhusIdhubhiH|
pibeddrAkShAmbugomUtrakolakarkandhusIdhubhiH|
</div></div>
<div style="text-align:justify;">
Powder prepared from equal amounts of ''gavakshi'' (Citrullus colocynthis), ''shankhini'' (Clitoria terneata), ''danti'' (Baliospermum montanum), bark of ''tilvaka'' (Symplocos cochinchinensis/Jatropha curcas) and ''vacha'' (Acorus calamus) is orally administered with juice of grapes, cow’s urine, decoction of ''kola'' (Zizypus jujuba), decoction of ''karkandhu'' (Zizyphus sativa) and ''sidhu'' (alcoholic preparation from unboiled/boiled sugarcane juice) [124]
Powder prepared from equal amounts of ''gavakshi'' (Citrullus colocynthis), ''shankhini'' (Clitoria terneata), ''danti'' (Baliospermum montanum), bark of ''tilvaka'' (Symplocos cochinchinensis/Jatropha curcas) and ''vacha'' (Acorus calamus) is orally administered with juice of grapes, cow’s urine, decoction of ''kola'' (Zizypus jujuba), decoction of ''karkandhu'' (Zizyphus sativa) and ''sidhu'' (alcoholic preparation from unboiled/boiled sugarcane juice) [124]
</div>
=== ''Narayana churna'' ===
<div class="mw-collapsible mw-collapsed">
यवानी हपुषा धान्यं त्रिफला चोपकुञ्चिका||१२५||
यवानी हपुषा धान्यं त्रिफला चोपकुञ्चिका||१२५||
कारवी पिप्पलीमूलमजगन्धा शटी वचा|
कारवी पिप्पलीमूलमजगन्धा शटी वचा| <br />
शताह्वा जीरकं व्योषं स्वर्णक्षीरी सचित्रका||१२६||
शताह्वा जीरकं व्योषं स्वर्णक्षीरी सचित्रका||१२६|| <br />
द्वौ क्षारौ पौष्करं मूलं कुष्ठं लवणपञ्चकम्|
द्वौ क्षारौ पौष्करं मूलं कुष्ठं लवणपञ्चकम्| <br />
विडङ्गं च समांशानि दन्त्या भागत्रयं तथा||१२७||
विडङ्गं च समांशानि दन्त्या भागत्रयं तथा||१२७|| <br />
त्रिवृद्विशाले द्विगुणे सातला स्याच्चतुर्गुणा|
त्रिवृद्विशाले द्विगुणे सातला स्याच्चतुर्गुणा| <br />
एतन्नारायणं नाम चूर्णं रोगगणापहम्||१२८||
एतन्नारायणं नाम चूर्णं रोगगणापहम्||१२८|| <br />
नैनत् प्राप्यातिवर्तन्ते रोगा विष्णुमिवासुराः|
नैनत् प्राप्यातिवर्तन्ते रोगा विष्णुमिवासुराः| <br />
तक्रेणोदरिभिः पेयं गुल्मिभिर्बदराम्बुना||१२९||
तक्रेणोदरिभिः पेयं गुल्मिभिर्बदराम्बुना||१२९|| <br />
आनद्धवाते सुरया वातरोगे प्रसन्नया|
आनद्धवाते सुरया वातरोगे प्रसन्नया| <br />
दधिमण्डेन विट्सङ्गे दाडिमाम्बुभिरर्शसैः||१३०||
दधिमण्डेन विट्सङ्गे दाडिमाम्बुभिरर्शसैः||१३०|| <br />
परिकर्ते सवृक्षाम्लमुष्णाम्बुभिरजीर्णके|
परिकर्ते सवृक्षाम्लमुष्णाम्बुभिरजीर्णके| <br />
भगन्दरे पाण्डुरोगे श्वासे कासे गलग्रहे||१३१||
भगन्दरे पाण्डुरोगे श्वासे कासे गलग्रहे||१३१|| <br />
हृद्रोगे ग्रहणीदोषे कुष्ठे मन्देऽनले ज्वरे|
हृद्रोगे ग्रहणीदोषे कुष्ठे मन्देऽनले ज्वरे| <br />
दंष्ट्राविषे मूलविषे सगरे कृत्रिमे विषे||१३२||
दंष्ट्राविषे मूलविषे सगरे कृत्रिमे विषे||१३२|| <br />
यथार्हं स्निग्धकोष्ठेन पेयमेतद्विरेचनमिति नारायणचूर्णम्
यथार्हं स्निग्धकोष्ठेन पेयमेतद्विरेचनमिति नारायणचूर्णम्
<div class="mw-collapsible-content">
yavānī hapuṣā dhānyaṁ triphalā cōpakuñcikā||125||
yavānī hapuṣā dhānyaṁ triphalā cōpakuñcikā||125||
kāravī pippalīmūlamajagandhā śaṭī vacā|
kāravī pippalīmūlamajagandhā śaṭī vacā| <br />
śatāhvā jīrakaṁ vyōṣaṁ svarṇakṣīrī sacitrakā||126||
śatāhvā jīrakaṁ vyōṣaṁ svarṇakṣīrī sacitrakā||126|| <br />
dvau kṣārau pauṣkaraṁ mūlaṁ kuṣṭhaṁ lavaṇapañcakam|
dvau kṣārau pauṣkaraṁ mūlaṁ kuṣṭhaṁ lavaṇapañcakam| <br />
viḍaṅgaṁ ca samāṁśāni dantyā bhāgatrayaṁ tathā||127||
viḍaṅgaṁ ca samāṁśāni dantyā bhāgatrayaṁ tathā||127|| <br />
trivr̥dviśālē dviguṇē sātalā syāccaturguṇā|
trivr̥dviśālē dviguṇē sātalā syāccaturguṇā| <br />
ētannārāyaṇaṁ nāma cūrṇaṁ rōgagaṇāpaham||128||
ētannārāyaṇaṁ nāma cūrṇaṁ rōgagaṇāpaham||128|| <br />
nainat prāpyātivartantē rōgā viṣṇumivāsurāḥ|
nainat prāpyātivartantē rōgā viṣṇumivāsurāḥ| <br />
takrēṇōdaribhiḥ pēyaṁ gulmibhirbadarāmbunā||129||
takrēṇōdaribhiḥ pēyaṁ gulmibhirbadarāmbunā||129|| <br />
ānaddhavātē surayā vātarōgē prasannayā|
ānaddhavātē surayā vātarōgē prasannayā| <br />
dadhimaṇḍēna viṭsaṅgē dāḍimāmbubhirarśasaiḥ||130||
dadhimaṇḍēna viṭsaṅgē dāḍimāmbubhirarśasaiḥ||130|| <br />
parikartē savr̥kṣāmlamuṣṇāmbubhirajīrṇakē|
parikartē savr̥kṣāmlamuṣṇāmbubhirajīrṇakē| <br />
bhagandarē pāṇḍurōgē śvāsē kāsē galagrahē||131||
bhagandarē pāṇḍurōgē śvāsē kāsē galagrahē||131||<br />
hr̥drōgē grahaṇīdōṣē kuṣṭhē mandē'nalē jvarē|
hr̥drōgē grahaṇīdōṣē kuṣṭhē mandē'nalē jvarē| <br />
daṁṣṭrāviṣē mūlaviṣē sagarē kr̥trimē viṣē||132||
daṁṣṭrāviṣē mūlaviṣē sagarē kr̥trimē viṣē||132|| <br />
yathārhaṁ snigdhakōṣṭhēna pēyamētadvirēcanamiti nārāyaṇacūrṇam
yathārhaṁ snigdhakōṣṭhēna pēyamētadvirēcanamiti nārāyaṇacūrṇam
yavAnI hapuShA dhAnyaM triphalA copaku~jcikA||125||
yavAnI hapuShA dhAnyaM triphalA copaku~jcikA||125||
kAravI pippalImUlamajagandhA shaTI vacA|
kAravI pippalImUlamajagandhA shaTI vacA| <br />
shatAhvA jIrakaM vyoShaM svarNakShIrI sacitrakA||126||
shatAhvA jIrakaM vyoShaM svarNakShIrI sacitrakA||126|| <br />
dvau kShArau pauShkaraM mUlaM kuShThaM lavaNapa~jcakam|
dvau kShArau pauShkaraM mUlaM kuShThaM lavaNapa~jcakam| <br />
viDa~ggaM ca samAMshAni dantyA bhAgatrayaM tathA||127||
viDa~ggaM ca samAMshAni dantyA bhAgatrayaM tathA||127|| <br />
trivRudvishAle dviguNe sAtalA syAccaturguNA|
trivRudvishAle dviguNe sAtalA syAccaturguNA| <br />
etannArAyaNaM nAma cUrNaM rogagaNApaham||128||
etannArAyaNaM nAma cUrNaM rogagaNApaham||128|| <br />
nainat prApyAtivartante rogA viShNumivAsurAH|
nainat prApyAtivartante rogA viShNumivAsurAH| <br />
takreNodaribhiH peyaM gulmibhirbadarAmbunA||129||
takreNodaribhiH peyaM gulmibhirbadarAmbunA||129|| <br />
AnaddhavAte surayA vAtaroge prasannayA|
AnaddhavAte surayA vAtaroge prasannayA| <br />
dadhimaNDena viTsa~gge dADimAmbubhirarshasaiH||130||
dadhimaNDena viTsa~gge dADimAmbubhirarshasaiH||130|| <br />
parikarte savRukShAmlamuShNAmbubhirajIrNake|
parikarte savRukShAmlamuShNAmbubhirajIrNake| <br />
bhagandare pANDuroge shvAse kAse galagrahe||131||
bhagandare pANDuroge shvAse kAse galagrahe||131|| <br />
hRudroge grahaNIdoShe kuShThe mande~anale jvare|
hRudroge grahaNIdoShe kuShThe mande~anale jvare| <br />
daMShTrAviShe mUlaviShe sagare kRutrime viShe||132||
daMShTrAviShe mUlaviShe sagare kRutrime viShe||132|| <br />
yathArhaM snigdhakoShThena peyametadvirecanamiti nArAyaNacUrNam
yathArhaM snigdhakoShThena peyametadvirecanamiti nArAyaNacUrNam
</div></div>
Take one part each of ''yavani'' (Trachyspermum ammi), ''hapusha'' (Juniperus communis), ''dhanyaka'' (Coriandrum sativum), ''haritaki'' (Terminalia chebula Retz), ''vibhitaki'' (Terminalia belerica), ''amalaki'' (Emblica officinalis), ''upakunchika'' (Nigella sativa), ''kaavi'' (Apium leptophyllum), root of ''pippali'' (Piper longum), ''ajagandha'' (Withania somnifera), ''shati'' (Hedychium spicatum), ''vacha'' (Acorus calamus), ''shatahva'' (Anethum sowa), ''jiraka'' (Cuminum cyminum), ''pippali'' (Piper longum), ''shunthi'' (Zingiber officinale), ''maricha'' (Piper nigrum), ''svarnakshiri'' (Argemone mexicana), ''chitraka'' (Plumbago zeylanica), ''sarjakshara'' (Sodii carbonas impura), ''yava kshara'' (alkali from awns of barley), ''pushkaramula'' (Inula racemosa), ''kushtha'' (Saussurea lappa), rock salt (saindhava), ''sauvarchala lavana'' (Unaqua sodium chloride), ''vida lavana'' (ammonium salt; salt obtained from animal’s excreta-feces/ urine), ''samudra lavana'' (Sodi muris), ''audbida lavana'' (salt obtained from earth) and ''vidanga'' (Embelia ribes). To this, three parts of ''danti'' (Baliospermum montanum), two parts of ''trivrita'' (Operculina turpethum), two parts of ''vishala'' (Citrulus colocynthis) and four parts of ''satala'' (Euphorbia tirucalli) are added and powdered. This powder is known as ''narayana churna'' and is effective in curing horde of diseases. Quite similar to the Lord Vishnu killing the demon; this ''churna'' on consumption kills the diseases. Patient suffering from ''udara roga'' should take this powder with butter milk. The patients suffering from ''gulma'' (abdominal lump) should be prescribed with decoction of ''badara'' (Ziziphus zizyphus). In case of ''anaddha vata'' (obstructed ''vata'' in the abdomen) this ''narayana churna'' should be given with ''sura'' (alcoholic preparation made by fermenting a mixture of water, flour of rice, jaggery). ''Vata roga'' is treated by administering this powder with ''prasanna'' (supernatant clear portion of alcoholic preparation; upper portion of ''madya''). Constipation is treated by giving this ''churna'' with ''dadhi manda'' (watery portion of curds). ''Arsha'' (piles) is treated by administering this powder with juice of ''dadima'' (Punica granatum). ''Parikartka'' (cutting pain in the anal region) may be treated by giving this medicine with ''vrikshamla'' (Garcinia indica). This powder, if given with lukewarm water cures indigestion. Also this powder is orally administered with relevant ''anupana'' (liquid adjunct) after oral oleation measure and to induce ''virechana'' (therapeutic purgation) in patients suffering from diseases like bhagandara (fistula in ano), anaemia, dyspnea, cough, throat irritation, cardiac disease, ''grahanidosha'' (malabsorption), ''kushtha'' (obstinate skin diseases), impaired appetite, fever, venomous bite, toxic tubers, ''garavisha'' (mild poisoning) and ''kritrima visha'' (poisoning with synthesized poison)[125-132]
<div style="text-align:justify;">
Take one part each of ''yavani'' (Trachyspermum ammi), ''hapusha'' (Juniperus communis), ''dhanyaka'' (Coriandrum sativum), ''haritaki'' (Terminalia chebula Retz), ''vibhitaki'' (Terminalia belerica), ''amalaki'' (Emblica officinalis), ''upakunchika'' (Nigella sativa), ''kaavi'' (Apium leptophyllum), root of ''pippali'' (Piper longum), ''ajagandha'' (Withania somnifera), ''shati'' (Hedychium spicatum), ''vacha'' (Acorus calamus), ''shatahva'' (Anethum sowa), ''jiraka'' (Cuminum cyminum), ''pippali'' (Piper longum), ''shunthi'' (Zingiber officinale), ''maricha'' (Piper nigrum), ''svarnakshiri'' (Argemone mexicana), ''chitraka'' (Plumbago zeylanica), ''sarjakshara'' (Sodii carbonas impura), ''yava kshara'' (alkali from awns of barley), ''pushkaramula'' (Inula racemosa), ''kushtha'' (Saussurea lappa), rock salt (saindhava), ''sauvarchala lavana'' (Unaqua sodium chloride), ''vida lavana'' (ammonium salt; salt obtained from animal’s excreta-feces/ urine), ''samudra lavana'' (Sodi muris), ''audbida lavana'' (salt obtained from earth) and ''vidanga'' (Embelia ribes). To this, three parts of ''danti'' (Baliospermum montanum), two parts of ''trivrita'' (Operculina turpethum), two parts of ''vishala'' (Citrulus colocynthis) and four parts of ''satala'' (Euphorbia tirucalli) are added and powdered. This powder is known as ''narayana churna'' and is effective in curing horde of diseases. Quite similar to the Lord Vishnu killing the demon; this ''churna'' on consumption kills the diseases. Patient suffering from ''udara roga'' should take this powder with butter milk. The patients suffering from ''gulma'' (abdominal lump) should be prescribed with decoction of ''badara'' (Ziziphus zizyphus). In case of ''anaddha vata'' (obstructed ''[[vata]]'' in the abdomen) this ''narayana churna'' should be given with ''sura'' (alcoholic preparation made by fermenting a mixture of water, flour of rice, jaggery). ''[[Vata]] roga'' is treated by administering this powder with ''prasanna'' (supernatant clear portion of alcoholic preparation; upper portion of ''madya''). Constipation is treated by giving this ''churna'' with ''dadhi manda'' (watery portion of curds). ''Arsha'' (piles) is treated by administering this powder with juice of ''dadima'' (Punica granatum). ''Parikartka'' (cutting pain in the anal region) may be treated by giving this medicine with ''vrikshamla'' (Garcinia indica). This powder, if given with lukewarm water cures indigestion. Also this powder is orally administered with relevant ''anupana'' (liquid adjunct) after oral oleation measure and to induce ''[[virechana]]'' (therapeutic purgation) in patients suffering from diseases like bhagandara (fistula in ano), anaemia, dyspnea, cough, throat irritation, cardiac disease, ''grahanidosha'' (malabsorption), ''kushtha'' (obstinate skin diseases), impaired appetite, fever, venomous bite, toxic tubers, ''garavisha'' (mild poisoning) and ''kritrima visha'' (poisoning with synthesized poison)[125-132]
</div>
=== ''Hapushadya churna'' ===
<div class="mw-collapsible mw-collapsed">
हपुषां काञ्चनक्षीरीं त्रिफलां कटुरोहिणीम्||१३३||
हपुषां काञ्चनक्षीरीं त्रिफलां कटुरोहिणीम्||१३३||
नीलिनीं त्रायमाणां च सातलां त्रिवृतां वचाम्|
नीलिनीं त्रायमाणां च सातलां त्रिवृतां वचाम्| <br />
सैन्धवं काललवणं पिप्पलीं चेति चूर्णयेत्||१३४||
सैन्धवं काललवणं पिप्पलीं चेति चूर्णयेत्||१३४|| <br />
दाडिमत्रिफलामांसरसमूत्रसुखोदकैः|
दाडिमत्रिफलामांसरसमूत्रसुखोदकैः| <br />
पेयोऽयं सर्वगुल्मेषु प्लीह्नि सर्वोदरेषु च||१३५||
पेयोऽयं सर्वगुल्मेषु प्लीह्नि सर्वोदरेषु च||१३५|| <br />
श्वित्रे कुष्ठे सरुजके सवाते विषमाग्निषु|
श्वित्रे कुष्ठे सरुजके सवाते विषमाग्निषु| <br />
शोथार्शःपाण्डुरोगेषु कामलायां हलीमके||१३६||
शोथार्शःपाण्डुरोगेषु कामलायां हलीमके||१३६|| <br />
वातं पित्तं कफं चाशु विरेकात् सम्प्रसाधयेतिति
वातं पित्तं कफं चाशु विरेकात् सम्प्रसाधयेतिति <br />
हपुषाद्यं चूर्ण
हपुषाद्यं चूर्ण <br />
<div class="mw-collapsible-content">
hapuṣāṁ kāñcanakṣīrīṁ triphalāṁ kaṭurōhiṇīm||133||
hapuṣāṁ kāñcanakṣīrīṁ triphalāṁ kaṭurōhiṇīm||133||
nīlinīṁ trāyamāṇāṁ ca sātalāṁ trivr̥tāṁ vacām|
nīlinīṁ trāyamāṇāṁ ca sātalāṁ trivr̥tāṁ vacām| <br />
saindhavaṁ kālalavaṇaṁ pippalīṁ cēti cūrṇayēt||134||
saindhavaṁ kālalavaṇaṁ pippalīṁ cēti cūrṇayēt||134|| <br />
dāḍimatriphalāmāṁsarasamūtrasukhōdakaiḥ|
dāḍimatriphalāmāṁsarasamūtrasukhōdakaiḥ| <br />
pēyō'yaṁ sarvagulmēṣu plīhni sarvōdarēṣu ca||135||
pēyō'yaṁ sarvagulmēṣu plīhni sarvōdarēṣu ca||135|| <br />
śvitrē kuṣṭhē sarujakē savātē viṣamāgniṣu|
śvitrē kuṣṭhē sarujakē savātē viṣamāgniṣu| <br />
śōthārśaḥpāṇḍurōgēṣu kāmalāyāṁ halīmakē||136||
śōthārśaḥpāṇḍurōgēṣu kāmalāyāṁ halīmakē||136|| <br />
vātaṁ pittaṁ kaphaṁ cāśu virēkāt samprasādhayētiti
vātaṁ pittaṁ kaphaṁ cāśu virēkāt samprasādhayētiti <br />
hapuṣādyaṁ cūrṇam
hapuṣādyaṁ cūrṇam <br />
hapuShAM kA~jcanakShIrIM triphalAM kaTurohiNIm||133||
hapuShAM kA~jcanakShIrIM triphalAM kaTurohiNIm||133||
nIlinIM trAyamANAM ca sAtalAM trivRutAM vacAm|
nIlinIM trAyamANAM ca sAtalAM trivRutAM vacAm| <br />
saindhavaM kAlalavaNaM pippalIM ceti cUrNayet||134||
saindhavaM kAlalavaNaM pippalIM ceti cUrNayet||134|| <br />
dADimatriphalAmAMsarasamUtrasukhodakaiH|
dADimatriphalAmAMsarasamUtrasukhodakaiH| <br />
peyo~ayaM sarvagulmeShu plIhni sarvodareShu ca||135||
peyo~ayaM sarvagulmeShu plIhni sarvodareShu ca||135|| <br />
shvitre kuShThe sarujake savAte viShamAgniShu|
shvitre kuShThe sarujake savAte viShamAgniShu| <br />
shothArshaHpANDurogeShu kAmalAyAM halImake||136||
shothArshaHpANDurogeShu kAmalAyAM halImake||136|| <br />
vAtaM pittaM kaphaM cAshu virekAt samprasAdhayetiti
vAtaM pittaM kaphaM cAshu virekAt samprasAdhayetiti <br />
hapuShAdyaM cUrNam
hapuShAdyaM cUrNam <br />
</div></div>
Prepare fine powder from ''hapusha'' (Juniperus communis), ''svarnakshiri'' (Argemone mexicana), ''haritaki'' (Terminalia chebula), ''vibhitaki'' (Terminalia belerica), ''amalaki'' (Emblica officinalis), ''katurohini'' (Picrorhiza kurroa), ''nilini'' (Indigofera tinctoria), ''trayamana'' (Gentiana kurrhoa), ''satala'' (Euphorbia Tirucalli), ''trivrita'' (Operculina turpethum), ''vacha'' (Acorus calamus), rock salt, ''kala lavana'' (black salt) and ''pippali'' (Piper longum). This powder should be orally given with juice of ''dadima'' (Punica granatum), decoction of ''triphala'' (three fruits), meat soup, cow’s urine or warm water. This medication induces purgation, eliminates ''vata, pitta and kapha''; and is effective in curing diseases that include ''shvitra'' (leukoderma), ''kushtha'' (obstinate skin diseases), pain due to morbid ''vata, vishamagni'' (irregular digestion), ''anasaracha'', ''arshas'' (piles), anemia, jaundice and ''halimaka'' (chlorosis) [133-136]
<div style="text-align:justify;">
Prepare fine powder from ''hapusha'' (Juniperus communis), ''svarnakshiri'' (Argemone mexicana), ''haritaki'' (Terminalia chebula), ''vibhitaki'' (Terminalia belerica), ''amalaki'' (Emblica officinalis), ''katurohini'' (Picrorhiza kurroa), ''nilini'' (Indigofera tinctoria), ''trayamana'' (Gentiana kurrhoa), ''satala'' (Euphorbia Tirucalli), ''trivrita'' (Operculina turpethum), ''vacha'' (Acorus calamus), rock salt, ''kala lavana'' (black salt) and ''pippali'' (Piper longum). This powder should be orally given with juice of ''dadima'' (Punica granatum), decoction of ''triphala'' (three fruits), meat soup, cow’s urine or warm water. This medication induces purgation, eliminates ''[[vata]], [[pitta]] and [[kapha]]''; and is effective in curing diseases that include ''shvitra'' (leukoderma), ''kushtha'' (obstinate skin diseases), pain due to morbid ''[[vata]], vishamagni'' (irregular digestion), ''anasaracha'', ''arshas'' (piles), anemia, jaundice and ''halimaka'' (chlorosis) [133-136]
</div>
=== ''Nilinyadi churna'' ===
<div class="mw-collapsible mw-collapsed">
नींलिनीं निचुलं व्योषं द्वौ क्षारौ लवणानि च||१३७||
नींलिनीं निचुलं व्योषं द्वौ क्षारौ लवणानि च||१३७||
चित्रकं च पिबेच्चूर्णं सर्पिषोदरगुल्मनुतिति नीलिन्याद्यं चूर्णम्||
चित्रकं च पिबेच्चूर्णं सर्पिषोदरगुल्मनुतिति नीलिन्याद्यं चूर्णम्||
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nīlinīṁ niculaṁ vyōṣaṁ dvaukṣārau lavaṇāni ca||137||
nīlinīṁ niculaṁ vyōṣaṁ dvaukṣārau lavaṇāni ca||137||
citrakaM ca pibeccUrNaM sarpiShodaragulmanutiti nIlinyAdyaM cUrNam
citrakaM ca pibeccUrNaM sarpiShodaragulmanutiti nIlinyAdyaM cUrNam
</div></div>
<div style="text-align:justify;">
The ''nililnyadi churna'' is prepared from the powders of ''nilini'' (Indigofera tinctoria), ''nichula'' (Barringtonia acutangula), pippali (Piper longum), ''shunthi'' (Zingiber officinale), ''maricha'' (Piper nigrum), ''svarajika kshara'' (Sodii carbonas impura), ''yava kshara'' (alkali from awns of barley), ''sauvarchala lavana'' (unaqua sodium chloride), ''vida lavana'' (ammonium salt), ''audbhida lavana'' (salt obtained from earth), rock salt (''saindhava''), ''samudra lavana'' (Sodi muris) and ''chitraka'' (Plumbago zeylanica). This powder is orally administered with ghee and is curative of all types ''udara roga'' as well as ''gulma'' (abdominal lump) [137]
The ''nililnyadi churna'' is prepared from the powders of ''nilini'' (Indigofera tinctoria), ''nichula'' (Barringtonia acutangula), pippali (Piper longum), ''shunthi'' (Zingiber officinale), ''maricha'' (Piper nigrum), ''svarajika kshara'' (Sodii carbonas impura), ''yava kshara'' (alkali from awns of barley), ''sauvarchala lavana'' (unaqua sodium chloride), ''vida lavana'' (ammonium salt), ''audbhida lavana'' (salt obtained from earth), rock salt (''saindhava''), ''samudra lavana'' (Sodi muris) and ''chitraka'' (Plumbago zeylanica). This powder is orally administered with ghee and is curative of all types ''udara roga'' as well as ''gulma'' (abdominal lump) [137]
</div>
=== ''Snuhi kshira ghrita'' ===
<div class="mw-collapsible mw-collapsed">
क्षीरद्रोणं सुधाक्षीरप्रस्थार्धसहितं दधि||१३८||
क्षीरद्रोणं सुधाक्षीरप्रस्थार्धसहितं दधि||१३८||
जातं विमथ्य तद्युक्त्या त्रिवृत्सिद्धं पिबेद्घृतम्|
जातं विमथ्य तद्युक्त्या त्रिवृत्सिद्धं पिबेद्घृतम्| <br />
तथा सिद्धं घृतप्रस्थं पयस्यष्टगुणे पिबेत्||१३९||
तथा सिद्धं घृतप्रस्थं पयस्यष्टगुणे पिबेत्||१३९|| <br />
स्नुक्क्षीरपलकल्केन त्रिवृताषट्पलेन च|
स्नुक्क्षीरपलकल्केन त्रिवृताषट्पलेन च| <br />
गुल्मानां गरदोषाणामुदराणां च शान्तये||१४०||
गुल्मानां गरदोषाणामुदराणां च शान्तये||१४०|| <br />
इति स्नुहीक्षीरघृतम्
इति स्नुहीक्षीरघृतम्
<div class="mw-collapsible-content">
kṣīradrōṇaṁ sudhākṣīraprasthārdhasahitaṁ dadhi||138||
kṣīradrōṇaṁ sudhākṣīraprasthārdhasahitaṁ dadhi||138||
jātaṁ vimathya tadyuktyā trivr̥tsiddhaṁ pibēdghr̥tam|
jātaṁ vimathya tadyuktyā trivr̥tsiddhaṁ pibēdghr̥tam| <br />
tathā siddhaṁ ghr̥taprasthaṁ payasyaṣṭaguṇē pibēt||139||
tathā siddhaṁ ghr̥taprasthaṁ payasyaṣṭaguṇē pibēt||139|| <br />
snukkṣīrapalakalkēna trivr̥tāṣaṭpalēna ca|
snukkṣīrapalakalkēna trivr̥tāṣaṭpalēna ca| <br />
gulmānāṁ garadōṣāṇāmudarāṇāṁ ca śāntayē||140||
gulmānāṁ garadōṣāṇāmudarāṇāṁ ca śāntayē||140|| <br />
iti snuhīkṣīraghr̥tam
iti snuhīkṣīraghr̥tam
kShIradroNaM sudhAkShIraprasthArdhasahitaM dadhi||138||
kShIradroNaM sudhAkShIraprasthArdhasahitaM dadhi||138||
jAtaM vimathya tadyuktyA trivRutsiddhaM pibedghRutam|
jAtaM vimathya tadyuktyA trivRutsiddhaM pibedghRutam| <br />
tathA siddhaM ghRutaprasthaM payasyaShTaguNe pibet||139||
tathA siddhaM ghRutaprasthaM payasyaShTaguNe pibet||139|| <br />
snukkShIrapalakalkena trivRutAShaTpalena ca|
snukkShIrapalakalkena trivRutAShaTpalena ca| <br />
gulmAnAM garadoShANAmudarANAM ca shAntaye||140||
gulmAnAM garadoShANAmudarANAM ca shAntaye||140|| <br />
iti snuhIkShIraghRutam
iti snuhIkShIraghRutam
</div></div>
<div style="text-align:justify;">
Curd is prepared from the mixture of one ''drona'' (12228g) of milk and half ''prastha'' (384g) of ''snuhi kshira'' (latex of Euphorbia neriifolia). This curd is churned properly to extract the butter. Thus obtained butter is boiled to get the ghee. Further this ghee is processed with ''trivrita'' (Operculina turpethum) to get the ''snuhi kshira ghrita''. Alternatively one can take one ''prastha'' (768g) of cow’s ghee, mixed with eight ''prastha'' (6144g) of milk; and to this paste prepared from one ''pala'' (48g) of ''snuhi kshira'' (latex of Euphorbia neriifolia) and eight ''pala'' (384g) of ''trivrita'' (Operculina turpethum) is added. This is then processed to get the medicated ghee. This ''snuhi kshira ghrita'' is effective in alleviating the ''gulma'' (abdominal lump), ''garadosha'' (poison synthesized by combination of non toxic substances) and all types of ''udara''. Thus is described ''snuhi kshira ghrita'' [138-140].
Curd is prepared from the mixture of one ''drona'' (12228g) of milk and half ''prastha'' (384g) of ''snuhi kshira'' (latex of Euphorbia neriifolia). This curd is churned properly to extract the butter. Thus obtained butter is boiled to get the ghee. Further this ghee is processed with ''trivrita'' (Operculina turpethum) to get the ''snuhi kshira ghrita''. Alternatively one can take one ''prastha'' (768g) of cow’s ghee, mixed with eight ''prastha'' (6144g) of milk; and to this paste prepared from one ''pala'' (48g) of ''snuhi kshira'' (latex of Euphorbia neriifolia) and eight ''pala'' (384g) of ''trivrita'' (Operculina turpethum) is added. This is then processed to get the medicated ghee. This ''snuhi kshira ghrita'' is effective in alleviating the ''gulma'' (abdominal lump), ''garadosha'' (poison synthesized by combination of non toxic substances) and all types of ''udara''. Thus is described ''snuhi kshira ghrita'' [138-140].
</div>
<div class="mw-collapsible mw-collapsed">
दधिमण्डाढके सिद्धात् स्नुक्क्षीरपलकल्कितात्|
दधिमण्डाढके सिद्धात् स्नुक्क्षीरपलकल्कितात्| <br />
घृतप्रस्थात् पिबेन्मात्रां तद्वज्जठरशान्तये||१४१||
घृतप्रस्थात् पिबेन्मात्रां तद्वज्जठरशान्तये||१४१|| <br />
एषां चानु पिबेत् पेयां पयो वा स्वादु वा रसम्|
एषां चानु पिबेत् पेयां पयो वा स्वादु वा रसम्|
<div class="mw-collapsible-content">
dadhimaṇḍāḍhakē siddhāt snukkṣīrapalakalkitāt|
dadhimaṇḍāḍhakē siddhāt snukkṣīrapalakalkitāt| <br />
ghr̥taprasthāt pibēnmātrāṁ tadvajjaṭharaśāntayē||141||
ghr̥taprasthāt pibēnmātrāṁ tadvajjaṭharaśāntayē||141|| <br />
ēṣāṁ cānu pibēt pēyāṁ payō vā svādu vā rasam|
ēṣāṁ cānu pibēt pēyāṁ payō vā svādu vā rasam|
dadhimaNDADhake siddhAt snukkShIrapalakalkitAt|
dadhimaNDADhake siddhAt snukkShIrapalakalkitAt| <br />
ghRutaprasthAt pibenmAtrAM tadvajjaTharashAntaye||141||
ghRutaprasthAt pibenmAtrAM tadvajjaTharashAntaye||141|| <br />
eShAM cAnu pibet peyAM payo vA svAdu vA rasam|
eShAM cAnu pibet peyAM payo vA svAdu vA rasam|
</div></div>
<div style="text-align:justify;">
Take one ''adhaka'' (3073g) of ''dadhi manda'' (liquid portion of curds), one ''pala'' (48g) paste of ''snuhi kshara'' (latex of Euphorbia neriifolia) and one ''prastha'' (768g) of ghee and process it into medicated ''ghrita''. Its oral administeration in a proper dose to patients suffering from ''udara roga'' with ''peya'' (liquid rice gruel), sweetened milk or sweet tasting meat soup cures ''udara roga'' [141].
Take one ''adhaka'' (3073g) of ''dadhi manda'' (liquid portion of curds), one ''pala'' (48g) paste of ''snuhi kshara'' (latex of Euphorbia neriifolia) and one ''prastha'' (768g) of ghee and process it into medicated ''ghrita''. Its oral administeration in a proper dose to patients suffering from ''udara roga'' with ''peya'' (liquid rice gruel), sweetened milk or sweet tasting meat soup cures ''udara roga'' [141].
</div>
=== Management following ''[[virechana]]'' ===
<div class="mw-collapsible mw-collapsed">
घृते जीर्णे विरिक्तस्तु कोष्णं नागरकैः शृतम्||१४२||
घृते जीर्णे विरिक्तस्तु कोष्णं नागरकैः शृतम्||१४२||
पिबेदम्बु ततः पेयां यूषं कौलत्थकं ततः|
पिबेदम्बु ततः पेयां यूषं कौलत्थकं ततः| <br />
पिबेद्रूक्षस्त्र्यहं त्वेवं भूयो [१] वा प्रतिभोजितः||१४३||
पिबेद्रूक्षस्त्र्यहं त्वेवं भूयो [१] वा प्रतिभोजितः||१४३|| <br />
पुनः पुनः पिबेत् सर्पिरानुपूर्व्या तयैव च|
पुनः पुनः पिबेत् सर्पिरानुपूर्व्या तयैव च| <br />
घृतान्येतानि सिद्धानि विदध्यात् कुशलो भिषक्||१४४||
घृतान्येतानि सिद्धानि विदध्यात् कुशलो भिषक्||१४४|| <br />
गुल्मानां गरदोषाणामुदराणां च शान्तये|
गुल्मानां गरदोषाणामुदराणां च शान्तये|
<div class="mw-collapsible-content">
ghr̥tē jīrṇē viriktastu kōṣṇaṁ nāgarakaiḥ śr̥tam||142||
ghr̥tē jīrṇē viriktastu kōṣṇaṁ nāgarakaiḥ śr̥tam||142||
pibēdambu tataḥ pēyāṁ yūṣaṁ kaulatthakaṁ tataḥ|
pibēdambu tataḥ pēyāṁ yūṣaṁ kaulatthakaṁ tataḥ| <br />
pibēdrūkṣastryahaṁ tvēvaṁ bhūyō [1] vā pratibhōjitaḥ||143||
pibēdrūkṣastryahaṁ tvēvaṁ bhūyō [1] vā pratibhōjitaḥ||143|| <br />
punaḥ punaḥ pibēt sarpirānupūrvyā tayaiva ca|
punaḥ punaḥ pibēt sarpirānupūrvyā tayaiva ca| <br />
ghr̥tānyētāni siddhāni vidadhyāt kuśalō bhiṣak||144||
ghr̥tānyētāni siddhāni vidadhyāt kuśalō bhiṣak||144|| <br />
gulmānāṁ garadōṣāṇāmudarāṇāṁ ca śāntayē|
gulmānāṁ garadōṣāṇāmudarāṇāṁ ca śāntayē| <br />
ghRute jIrNe viriktastu koShNaM nAgarakaiH shRutam||142||
ghRute jIrNe viriktastu koShNaM nAgarakaiH shRutam||142|| <br />
pibedambu tataH peyAM yUShaM kaulatthakaM tataH|
pibedambu tataH peyAM yUShaM kaulatthakaM tataH| <br />
pibedrUkShastryahaM tvevaM bhUyo [1] vA pratibhojitaH||143||
pibedrUkShastryahaM tvevaM bhUyo [1] vA pratibhojitaH||143|| <br />
punaH punaH pibet sarpirAnupUrvyA tayaiva ca|
punaH punaH pibet sarpirAnupUrvyA tayaiva ca| <br />
ghRutAnyetAni siddhAni vidadhyAt kushalo bhiShak||144||
ghRutAnyetAni siddhAni vidadhyAt kushalo bhiShak||144|| <br />
gulmAnAM garadoShANAmudarANAM ca shAntaye|
gulmAnAM garadoShANAmudarANAM ca shAntaye|
</div></div>
''Virechana karma'' (therapeutic purgation) should be undertaken after the digestion of the orally administrated medicated ghee. After the ''virechana'', the patient is advised to take decoction of ''nagaraa'' (Zingiber officinale). Then the patient is given ''peya'' (liquid rice gruel) and ''yusha'' (cereal soup) prepared of ''kulattha'' (Vigna unquiculata). If the patient suffers from the state of dryness in his body then he should be given rice with milk for three days. On regaining the physical strength the patient should be repeatedly and alternatively treated with medicated ghee and nourishing diet. In this way ''gulma'' (abdominal lump), ''garavisha'' (poison synthesized by combination of nontoxic substances) and ''udara'' (enlargement of abdomen tending ascites) should be treated [142-144].
<div style="text-align:justify;">
''[[Virechana]] karma'' (therapeutic purgation) should be undertaken after the digestion of the orally administrated medicated ghee. After the ''[[virechana]]'', the patient is advised to take decoction of ''nagaraa'' (Zingiber officinale). Then the patient is given ''peya'' (liquid rice gruel) and ''yusha'' (cereal soup) prepared of ''kulattha'' (Vigna unquiculata). If the patient suffers from the state of dryness in his body then he should be given rice with milk for three days. On regaining the physical strength the patient should be repeatedly and alternatively treated with medicated ghee and nourishing diet. In this way ''gulma'' (abdominal lump), ''garavisha'' (poison synthesized by combination of nontoxic substances) and ''udara'' (enlargement of abdomen tending ascites) should be treated [142-144].
</div>
<div class="mw-collapsible mw-collapsed">
पीलुकल्कोपसिद्धं वा घृतमानाहभेदनम्||१४५||
पीलुकल्कोपसिद्धं वा घृतमानाहभेदनम्||१४५||
गुल्मघ्नं नीलिनीसर्पिः स्नेहं वा मिश्रकं पिबेत्|
गुल्मघ्नं नीलिनीसर्पिः स्नेहं वा मिश्रकं पिबेत्|
<div class="mw-collapsible-content">
pīlukalkōpasiddhaṁ vā ghr̥tamānāhabhēdanam||145||
pīlukalkōpasiddhaṁ vā ghr̥tamānāhabhēdanam||145||
gulmaghnaM nIlinIsarpiH snehaM vA mishrakaM pibet|
gulmaghnaM nIlinIsarpiH snehaM vA mishrakaM pibet|
</div></div>
<div style="text-align:justify;">
The patient suffering from ''anaha'' (distented abdomen) should be treated with ghee processed with paste of ''pilu'' (Salvadora persica). The medicated ghee prepared from ''nilini'' (Indigofera tinctoria) or ''mishraka ghrita'' which is curative of ''gulma'' (abdominal lump) may also be prescribed to cure ''udara roga'' [145]
The patient suffering from ''anaha'' (distented abdomen) should be treated with ghee processed with paste of ''pilu'' (Salvadora persica). The medicated ghee prepared from ''nilini'' (Indigofera tinctoria) or ''mishraka ghrita'' which is curative of ''gulma'' (abdominal lump) may also be prescribed to cure ''udara roga'' [145]
</div>
=== ''Shamana'' (palliative) treatment ===
<div class="mw-collapsible mw-collapsed">
क्रमान्निर्हृतदोषाणां जाङ्गलप्रतिभोजिनाम् ||१४६||
क्रमान्निर्हृतदोषाणां जाङ्गलप्रतिभोजिनाम् ||१४६||
दोषशेषनिवृत्त्यर्थं योगान् वक्ष्याम्यतः परम्|
दोषशेषनिवृत्त्यर्थं योगान् वक्ष्याम्यतः परम्|
<div class="mw-collapsible-content">
kramānnirhr̥tadōṣāṇāṁ jāṅgalapratibhōjinām ||146||
kramānnirhr̥tadōṣāṇāṁ jāṅgalapratibhōjinām ||146||
doShasheShanivRuttyarthaM yogAn vakShyAmyataH param|
doShasheShanivRuttyarthaM yogAn vakShyAmyataH param|
</div></div>
After the methodical elimination of ''dosha'' followed by proper nutrition by the intake of meat soup of dry land animals; the patient should be treated with oral medications to alleviate the remaining ''dosha''. Such medications are discussed here onwards [146]
<div style="text-align:justify;">
After the methodical elimination of ''[[dosha]]'' followed by proper nutrition by the intake of meat soup of dry land animals; the patient should be treated with oral medications to alleviate the remaining ''[[dosha]]''. Such medications are discussed here onwards [146]
</div>
<div class="mw-collapsible mw-collapsed">
चित्रकामरदारुभ्यां कल्कं क्षीरेण ना पिबेत्||१४७||
चित्रकामरदारुभ्यां कल्कं क्षीरेण ना पिबेत्||१४७||
मासं युक्तस्तथा हस्तिपिप्पली विश्वभेषजम्|
मासं युक्तस्तथा हस्तिपिप्पली विश्वभेषजम्|
<div class="mw-collapsible-content">
citrakāmaradārubhyāṁ kalkaṁ kṣīrēṇa nā pibēt||147||
citrakāmaradārubhyāṁ kalkaṁ kṣīrēṇa nā pibēt||147||
mAsaM yuktastathA hastipippalI vishvabheShajam|
mAsaM yuktastathA hastipippalI vishvabheShajam|
</div></div>
The fine powder of ''chitraka'' (Plumbago zeylanica) and ''devadaru'' (Cedrus deodara) should be orally given with milk for one month. Or else the powder of ''hastipippali'' and ''shunthi'' (Zingiber officinale) should be given orally with milk for one month [147].
<div style="text-align:justify;">
The fine powder of ''chitraka'' (Plumbago zeylanica) and ''devadaru'' (Cedrus deodara) should be orally given with milk for one month. Or else the powder of ''hastipippali'' and ''shunthi'' (Zingiber officinale) should be given orally with milk for one month [147]. </div>
<div class="mw-collapsible mw-collapsed">
विडङ्गं चित्रकं दन्ती चव्यं व्योषं च तैः पयः||१४८||
विडङ्गं चित्रकं दन्ती चव्यं व्योषं च तैः पयः||१४८||
कल्कैः कोलसमैः पीत्वा प्रवृद्धमुदरं जयेत्|
कल्कैः कोलसमैः पीत्वा प्रवृद्धमुदरं जयेत्|
<div class="mw-collapsible-content">
viḍaṅgaṁ citrakaṁ dantī cavyaṁ vyōṣaṁ ca taiḥ payaḥ||148||
viḍaṅgaṁ citrakaṁ dantī cavyaṁ vyōṣaṁ ca taiḥ payaḥ||148||
kalkaiH kolasamaiH pItvA pravRuddhamudaraM jayet|
kalkaiH kolasamaiH pItvA pravRuddhamudaraM jayet|
</div></div>
Take one ''kola'' (12g) each of ''vidanga'' (Embelia ribes), ''chitraka'' (Plumbago zeylanica), ''danti'' (Baliospermum montanum), ''chavya'' (Piper retrofractum), ''pippali'' (Piper longum), ''shunthi'' (Zingiber officinale) and ''maricha'' (Piper nigrum) and powder. This powder is added with milk and processed. The patient should take this medicated milk to cure of ''udara roga'' [148]
<div style="text-align:justify;">
Take one ''kola'' (12g) each of ''vidanga'' (Embelia ribes), ''chitraka'' (Plumbago zeylanica), ''danti'' (Baliospermum montanum), ''chavya'' (Piper retrofractum), ''pippali'' (Piper longum), ''shunthi'' (Zingiber officinale) and ''maricha'' (Piper nigrum) and powder. This powder is added with milk and processed. The patient should take this medicated milk to cure of ''udara roga'' [148] </div>
<div class="mw-collapsible mw-collapsed">
पिबेत् कषायं त्रिफलादन्तीरोहितकैः शृतम्||१४९||
पिबेत् कषायं त्रिफलादन्तीरोहितकैः शृतम्||१४९||
व्योषक्षारयुतं जीर्णे रसैरद्यात्तु जाङ्गलैः|
व्योषक्षारयुतं जीर्णे रसैरद्यात्तु जाङ्गलैः|
<div class="mw-collapsible-content">
pibēt kaṣāyaṁ triphalādantīrōhitakaiḥ śr̥tam||149||
pibēt kaṣāyaṁ triphalādantīrōhitakaiḥ śr̥tam||149||
vyoShakShArayutaM jIrNe rasairadyAttu jA~ggalaiH|
vyoShakShArayutaM jIrNe rasairadyAttu jA~ggalaiH|
</div></div>
Decoction is prepared from drugs taken in equal amounts that includes ''haritaki'' (Terminalia chebula), ''vibhitaki'' (Terminalia belerica), ''amalaki'' (Emblica officinalis), ''danti'' (Baliospermum montanum) and ''rohitaka'' (Tecomella Undulate). This is added with powder of ''pippali'' (Piper longum), ''shunthi'' (Zingiber officinale), ''maricha'' (Piper nigrum) and ''kshara'' (alkali obtained from ash of herbs). Patient is asked to take this medicine, and on its digestion meat soup of dry land animals is given [149].
<div style="text-align:justify;">
Decoction is prepared from drugs taken in equal amounts that includes ''haritaki'' (Terminalia chebula), ''vibhitaki'' (Terminalia belerica), ''amalaki'' (Emblica officinalis), ''danti'' (Baliospermum montanum) and ''rohitaka'' (Tecomella Undulate). This is added with powder of ''pippali'' (Piper longum), ''shunthi'' (Zingiber officinale), ''maricha'' (Piper nigrum) and ''kshara'' (alkali obtained from ash of herbs). Patient is asked to take this medicine, and on its digestion meat soup of dry land animals is given [149]. </div>
<div class="mw-collapsible mw-collapsed">
मांसं वा भोजनं भोज्यं सुधाक्षीरघृतान्वितम्||१५०||
मांसं वा भोजनं भोज्यं सुधाक्षीरघृतान्वितम्||१५०||
क्षीरानुपानां गोमूत्रेणाभयां वा प्रयोजयेत्|
क्षीरानुपानां गोमूत्रेणाभयां वा प्रयोजयेत्| <br />
सप्ताहं माहिषं मूत्रं क्षीरं चानन्नभुक् पिबेत्||१५१||
सप्ताहं माहिषं मूत्रं क्षीरं चानन्नभुक् पिबेत्||१५१|| <br />
मासमौष्ट्रं पयश्छागं त्रीन्मासान् व्योषसंयुतम्|
मासमौष्ट्रं पयश्छागं त्रीन्मासान् व्योषसंयुतम्| <br />
हरीतकीसहस्रं वा क्षीराशी वा शिलाजतु||१५२||
हरीतकीसहस्रं वा क्षीराशी वा शिलाजतु||१५२|| <br />
शिलाजतुविधानेन गुग्गुलुं वा प्रयोजयेत्|
शिलाजतुविधानेन गुग्गुलुं वा प्रयोजयेत्| <br />
शृङ्गवेरार्द्रकरसः पाने क्षीरसमो हितः||१५३||
शृङ्गवेरार्द्रकरसः पाने क्षीरसमो हितः||१५३|| <br />
तैलं रसेन तेनैव सिद्धं दशगुणेन वा|
तैलं रसेन तेनैव सिद्धं दशगुणेन वा| <br />
दन्तीद्रवन्तीफलजं तैलं दूष्योदरे हितम्||१५४||
दन्तीद्रवन्तीफलजं तैलं दूष्योदरे हितम्||१५४|| <br />
शूलानाहविबन्धेषु मस्तुयूषरसादिभिः|
शूलानाहविबन्धेषु मस्तुयूषरसादिभिः|<br />
सरलामधुशिग्रूणां बीजेभ्यो मूलकस्य च||१५५||
सरलामधुशिग्रूणां बीजेभ्यो मूलकस्य च||१५५|| <br />
तैलान्यभ्यङ्गपानार्थं शूलघ्नान्यनिलोदरे|
तैलान्यभ्यङ्गपानार्थं शूलघ्नान्यनिलोदरे| <br />
स्तैमित्यारुचिहृल्लासे मन्देऽग्नौ मद्यपाय च||१५६||
स्तैमित्यारुचिहृल्लासे मन्देऽग्नौ मद्यपाय च||१५६|| <br />
अरिष्टान् दापयेत् क्षारान् कफस्त्यानस्थिरोदरे|
अरिष्टान् दापयेत् क्षारान् कफस्त्यानस्थिरोदरे|
<div class="mw-collapsible-content">
māṁsaṁ vā bhōjanaṁ bhōjyaṁ sudhākṣīraghr̥tānvitam||150||
māṁsaṁ vā bhōjanaṁ bhōjyaṁ sudhākṣīraghr̥tānvitam||150||
kṣīrānupānāṁ gōmūtrēṇābhayāṁ vā prayōjayēt|
kṣīrānupānāṁ gōmūtrēṇābhayāṁ vā prayōjayēt| <br />
saptāhaṁ māhiṣaṁ mūtraṁ kṣīraṁ cānannabhuk pibēt||151||
saptāhaṁ māhiṣaṁ mūtraṁ kṣīraṁ cānannabhuk pibēt||151|| <br />
māsamauṣṭraṁ payaśchāgaṁ trīnmāsān vyōṣasaṁyutam|
māsamauṣṭraṁ payaśchāgaṁ trīnmāsān vyōṣasaṁyutam| <br />
harītakīsahasraṁ vā kṣīrāśī vā śilājatu||152||
harītakīsahasraṁ vā kṣīrāśī vā śilājatu||152|| <br />
śilājatuvidhānēna gugguluṁ vā prayōjayēt|
śilājatuvidhānēna gugguluṁ vā prayōjayēt| <br />
śr̥ṅgavērārdrakarasaḥ pānē kṣīrasamō hitaḥ||153||
śr̥ṅgavērārdrakarasaḥ pānē kṣīrasamō hitaḥ||153|| <br />
tailaṁ rasēna tēnaiva siddhaṁ daśaguṇēna vā|
tailaṁ rasēna tēnaiva siddhaṁ daśaguṇēna vā| <br />
dantīdravantīphalajaṁ tailaṁ dūṣyōdarē hitam||154||
dantīdravantīphalajaṁ tailaṁ dūṣyōdarē hitam||154|| <br />
śūlānāhavibandhēṣu mastuyūṣarasādibhiḥ|
śūlānāhavibandhēṣu mastuyūṣarasādibhiḥ| <br />
saralāmadhuśigrūṇāṁ bījēbhyō mūlakasya ca||155||
saralāmadhuśigrūṇāṁ bījēbhyō mūlakasya ca||155|| <br />
tailānyabhyaṅgapānārthaṁ śūlaghnānyanilōdarē|
tailānyabhyaṅgapānārthaṁ śūlaghnānyanilōdarē| <br />
staimityārucihr̥llāsē mandē'gnau madyapāya ca||156||
staimityārucihr̥llāsē mandē'gnau madyapāya ca||156|| <br />
ariṣṭān dāpayēt kṣārān kaphastyānasthirōdarē|
ariṣṭān dāpayēt kṣārān kaphastyānasthirōdarē| <br />
mAMsaM vA bhojanaM bhojyaM sudhAkShIraghRutAnvitam||150|| <br />
kShIrAnupAnAM gomUtreNAbhayAM vA prayojayet| <br />
saptAhaM mAhiShaM mUtraM kShIraM cAnannabhuk pibet||151|| <br />
mAsamauShTraM payashchAgaM trInmAsAn vyoShasaMyutam| <br />
harItakIsahasraM vA kShIrAshI vA shilAjatu||152|| <br />
shilAjatuvidhAnena gugguluM vA prayojayet| <br />
shRu~ggaverArdrakarasaH pAne kShIrasamo hitaH||153|| <br />
tailaM rasena tenaiva siddhaM dashaguNena vA| <br />
dantIdravantIphalajaM tailaM dUShyodare hitam||154|| <br />
tailAnyabhya~ggapAnArthaM shUlaghnAnyanilodare|
shUlAnAhavibandheShu mastuyUSharasAdibhiH| <br />
staimityArucihRullAse mande~agnau madyapAya ca||156||
saralAmadhushigrUNAM bIjebhyo mUlakasya ca||155|| <br />
tailAnyabhya~ggapAnArthaM shUlaghnAnyanilodare| <br />
staimityArucihRullAse mande~agnau madyapAya ca||156|| <br />
ariShTAn dApayet kShArAn kaphastyAnasthirodare|
ariShTAn dApayet kShArAn kaphastyAnasthirodare|
</div></div>
<div style="text-align:justify;">
Or the patient is given medicated ghee prepared with snuhikshira (latex of Euphorbia neriifolia) along with meat in food. The combination of ''abhaya'' (Terminalia chebula) and cow’s urine may be orally administered with milk. Patient may be treated with buffalo urine for one week along with milk as food avoiding rice.
Or the patient is given medicated ghee prepared with snuhikshira (latex of Euphorbia neriifolia) along with meat in food. The combination of ''abhaya'' (Terminalia chebula) and cow’s urine may be orally administered with milk. Patient may be treated with buffalo urine for one week along with milk as food avoiding rice.
The camel’s milk and goat’s milk may be orally given for three months added with ''pippali'' (Piper longum), ''shunthi'' (Zingiber officinale) and ''maricha'' (Piper nigrum). One course of ''haritaki'' (Terminalia chebula Retz) consisting a thousand numbers may be administered along with milk diet. ''Shilajatu'' (asphaltum) may be administerd orally along with milk diet. Similarly, ''guggulu'' (Commiphora wightii) may be orally administered. Juice of ''ardraka'' (Zingiber officinale) or decoction of ''shringavera'' (Zingiber officinale) is given orally with equal amounts of milk. Alternatively one can take 10 parts of oil processed with one part of ''ardraka'' (Zingiber officinale Rosc) with milk. Oral administration of oil extracted from the seeds of ''danti'' (Baliospermum montanum) and ''dravanti'' (Jatropha glandulifera) along with ''mastu'' (liquid separated from curd ), ''yusha'' (soup) and ''mamsarasa'' (meat soup) is effective in ''dushyodara'' (enlargement of abdomen tending ascites), ''shula'' (abdominal pain), ''anaha'' (flatulence) as well as ''vibandha'' (constipation). The combination of ''sarala'' (Pinus roxburghii), ''madhushigru'' (Moringa oleifera) and oil extracted from seeds of ''mulaka'' (Raphanus sativus) should be given orally and for oil massage in patients suffering from abdominal pain due to vātodara. Patient of kaphodara having the habit of consuming alcohol and suffering from symptoms like abdominal rigidity, ''staimitya'' (subjective feeling as if the body is covered by wet cloth), abdominal heaviness, lack of taste, nausea and impaired digestion should be treated with ''arishta'' (fermented decoctions) or ''kshara'' (alkali obtained from ash of herbs) [150-156]
The camel’s milk and goat’s milk may be orally given for three months added with ''pippali'' (Piper longum), ''shunthi'' (Zingiber officinale) and ''maricha'' (Piper nigrum). One course of ''haritaki'' (Terminalia chebula Retz) consisting a thousand numbers may be administered along with milk diet. ''Shilajatu'' (asphaltum) may be administerd orally along with milk diet. Similarly, ''guggulu'' (Commiphora wightii) may be orally administered. Juice of ''ardraka'' (Zingiber officinale) or decoction of ''shringavera'' (Zingiber officinale) is given orally with equal amounts of milk. Alternatively one can take 10 parts of oil processed with one part of ''ardraka'' (Zingiber officinale Rosc) with milk. Oral administration of oil extracted from the seeds of ''danti'' (Baliospermum montanum) and ''dravanti'' (Jatropha glandulifera) along with ''mastu'' (liquid separated from curd ), ''yusha'' (soup) and ''mamsarasa'' (meat soup) is effective in ''dushyodara'' (enlargement of abdomen tending ascites), ''shula'' (abdominal pain), ''anaha'' (flatulence) as well as ''vibandha'' (constipation). The combination of ''sarala'' (Pinus roxburghii), ''madhushigru'' (Moringa oleifera) and oil extracted from seeds of ''mulaka'' (Raphanus sativus) should be given orally and for oil massage in patients suffering from abdominal pain due to vātodara. Patient of kaphodara having the habit of consuming alcohol and suffering from symptoms like abdominal rigidity, ''staimitya'' (subjective feeling as if the body is covered by wet cloth), abdominal heaviness, lack of taste, nausea and impaired digestion should be treated with ''arishta'' (fermented decoctions) or ''kshara'' (alkali obtained from ash of herbs) [150-156] </div>
=== ''Pippalyadi lavana'' ===
<div class="mw-collapsible mw-collapsed">
श्लेष्मणो विलयार्थं तु दोषं वीक्ष्य भिषग्वरः||१५७||
श्लेष्मणो विलयार्थं तु दोषं वीक्ष्य भिषग्वरः||१५७||
पिप्पलीं तिल्वकं हिङ्गु नागरं हस्तिपिप्पलीम्|
पिप्पलीं तिल्वकं हिङ्गु नागरं हस्तिपिप्पलीम्| <br />
भल्लातकं शिग्रुफलं त्रिफलां कटुरोहिणीम्||१५८||
भल्लातकं शिग्रुफलं त्रिफलां कटुरोहिणीम्||१५८|| <br />
देवदारु हरिद्रे द्वे सरलातिविषे वचाम् |
देवदारु हरिद्रे द्वे सरलातिविषे वचाम् | <br />
कुष्ठं मुस्तं तथा पञ्च लवणानि प्रकल्प्य च||१५९||
कुष्ठं मुस्तं तथा पञ्च लवणानि प्रकल्प्य च||१५९|| <br />
दधिसर्पिर्वसामज्जतैलयुक्तानि दाहयेत्|
दधिसर्पिर्वसामज्जतैलयुक्तानि दाहयेत्| <br />
अन्नादूर्ध्वमतः क्षाराद्बिडालकपदं पिबेत्||१६०||
अन्नादूर्ध्वमतः क्षाराद्बिडालकपदं पिबेत्||१६०|| <br />
मदिरादधिमण्डोष्णजलारिष्टसुरासवैः|
मदिरादधिमण्डोष्णजलारिष्टसुरासवैः| <br />
हृद्रोगं श्वयथुं गुल्मं प्लीहार्शोजठराणि च||१६१||
हृद्रोगं श्वयथुं गुल्मं प्लीहार्शोजठराणि च||१६१||<br />
विसूचिकामुदावर्तं वाताष्ठीलां च नाशयेत्|
विसूचिकामुदावर्तं वाताष्ठीलां च नाशयेत्|
<div class="mw-collapsible-content">
ślēṣmaṇō vilayārthaṁ tu dōṣaṁ vīkṣya bhiṣagvaraḥ||157||
ślēṣmaṇō vilayārthaṁ tu dōṣaṁ vīkṣya bhiṣagvaraḥ||157||
pippalīṁ tilvakaṁ [3] hiṅgu nāgaraṁ hastipippalīm|
pippalīṁ tilvakaṁ [3] hiṅgu nāgaraṁ hastipippalīm| <br />
bhallātakaṁ śigruphalaṁ triphalāṁ kaṭurōhiṇīm||158||
bhallātakaṁ śigruphalaṁ triphalāṁ kaṭurōhiṇīm||158||<br />
dēvadāru haridrē dvē saralātiviṣē vacām [4] |
dēvadāru haridrē dvē saralātiviṣē vacām [4] | <br />
kuṣṭhaṁ mustaṁ tathā pañca lavaṇāni prakalpya ca||159||
kuṣṭhaṁ mustaṁ tathā pañca lavaṇāni prakalpya ca||159|| <br />
dadhisarpirvasāmajjatailayuktāni dāhayēt|
dadhisarpirvasāmajjatailayuktāni dāhayēt| <br />
annādūrdhvamataḥ kṣārādbiḍālakapadaṁ pibēt||160||
annādūrdhvamataḥ kṣārādbiḍālakapadaṁ pibēt||160|| <br />
madirādadhimaṇḍōṣṇajalāriṣṭasurāsavaiḥ|
madirādadhimaṇḍōṣṇajalāriṣṭasurāsavaiḥ| <br />
hr̥drōgaṁ śvayathuṁ gulmaṁ plīhārśōjaṭharāṇi ca||161||
hr̥drōgaṁ śvayathuṁ gulmaṁ plīhārśōjaṭharāṇi ca||161|| <br />
visūcikāmudāvartaṁ vātāṣṭhīlāṁ ca nāśayēt|
visūcikāmudāvartaṁ vātāṣṭhīlāṁ ca nāśayēt| <br />
shleShmaNo vilayArthaM tu doShaM vIkShya bhiShagvaraH||157|| <br />
pippalIM tilvakaM [3] hi~ggu nAgaraM hastipippalIm| <br />
bhallAtakaM shigruphalaM triphalAM kaTurohiNIm||158|| <br />
devadAru haridre dve saralAtiviShe vacAm [4] | <br />
kuShThaM mustaM tathA pa~jca lavaNAni prakalpya ca||159|| <br />
madirAdadhimaNDoShNajalAriShTasurAsavaiH|
dadhisarpirvasAmajjatailayuktAni dAhayet| <br />
hRudrogaM shvayathuM gulmaM plIhArshojaTharANi ca||161||
annAdUrdhvamataH kShArAdbiDAlakapadaM pibet||160|| <br />
madirAdadhimaNDoShNajalAriShTasurAsavaiH| <br />
hRudrogaM shvayathuM gulmaM plIhArshojaTharANi ca||161|| <br />
visUcikAmudAvartaM vAtAShThIlAM ca nAshayet|
visUcikAmudAvartaM vAtAShThIlAM ca nAshayet|
</div></div>
<div style="text-align:justify;">
With the due consideration of morbid ''[[dosha]]'', the physician should prescribe ''pippalyadi lavana'' for liquefying the ''[[kapha]]''. The ingredients of ''pippalyadi lavana'' are ''pippali'' (Piper longum), ''tilvaka'' (Symplocos cochinchinensis/Jatropha curcas), ''hingu'' (Ferula foetida), ''nagaraa'' (Zingiber officinale), ''hastipippali'' (Scindapsus officinalis), ''bhallataka'' (Semecarpus anacardium), fruits of ''shigru'' (Moringa oleifera), ''haritaki'' (Terminalia chebula), ''vibhitaki'' (Terminalia belerica), ''amalaki'' (Emblica officinalis), ''katukarohini'' (Picrorhiza kurroa Royle), ''devadaru'' (Cedrus deodara), ''haridra'' (Curcuma longa), ''daruharidra'' (Berberis aristata), ''sarala'' (Pinus roxburghii), ''ativisha'' (Aconitum heterophyllum), ''vacha'' (Acorus calamus), ''kushtha'' (Saussurea lappa), ''musta'' (Cyperus rotundus), ''sauvarchala lavana'' (unaqua sodium chloride), ''vida lavana'' (ammonium salt), ''audbida lavana'' (salt obtained from earth), rock salt (''saindhava'') and ''samudra lavana'' (Sodi muris). The course powder of these drugs is added with curd/yogurt, cow’s ghee, ''vasa'' (animal fat), ''majja'' (bone marrow) and ''taila'' (oil extracted from seeds of Sesamum indicum) and then is burnt to get the ''kshara'' (alkali obtained from ash of herbs). This ''kshara'' is orally administered after the meals in a dose of one ''karsha'' (12g). The ''anupana'' (adjunct) for it is any one of madirā (alcoholic beverage), dadhimanda (liquid portion of curds), warm water, arishta (fermented decoctions), surā (alcoholic preparation made by fermenting a mixture of water, flour of rice, jaggery) and ''asava'' (fermented infusions). This medication effectively cures ''hridroga'' (cardiac disease), ''anasaraka, gulma'' (abdominal lump), ''plihodara'' (splenomegaly), ''arshas'' (piles), ''udara roga, visuchika'' (illness characterized by vomiting and diarrhea), ''udavarta'' (reversed course of ''[[vata]]'' in the abdomen) and ''vatashtila'' (mass obliterating the urinary and rectal passage)[157-161]. </div>
=== ''Kshara vatika'' ===
<div class="mw-collapsible mw-collapsed">
क्षारं चाजकरीषाणां स्रुतं मूत्रैर्विपाचयेत्||१६२||
क्षारं चाजकरीषाणां स्रुतं मूत्रैर्विपाचयेत्||१६२||
कार्षिकं पिप्पलीमूलं पञ्चैव लवणानि च|
कार्षिकं पिप्पलीमूलं पञ्चैव लवणानि च| <br />
पिप्पलीं चित्रकं शुण्ठीं त्रिफलां त्रिवृतां वचाम्||१६३||
पिप्पलीं चित्रकं शुण्ठीं त्रिफलां त्रिवृतां वचाम्||१६३|| <br />
द्वौ क्षारौ सातलां दन्तीं स्वर्णक्षीरीं विषाणिकाम्|
द्वौ क्षारौ सातलां दन्तीं स्वर्णक्षीरीं विषाणिकाम्| <br />
कोलप्रमाणां वटिकां पिबेत् सौवीरसंयुताम्||१६४||
कोलप्रमाणां वटिकां पिबेत् सौवीरसंयुताम्||१६४|| <br />
श्वयथावविपाके च प्रवृद्धे च दकोदरे|
श्वयथावविपाके च प्रवृद्धे च दकोदरे|
<div class="mw-collapsible-content">
kṣāraṁ cājakarīṣāṇāṁ srutaṁ mūtrairvipācayēt||162||
kṣāraṁ cājakarīṣāṇāṁ srutaṁ mūtrairvipācayēt||162||
kārṣikaṁ pippalīmūlaṁ pañcaiva lavaṇāni ca|
kārṣikaṁ pippalīmūlaṁ pañcaiva lavaṇāni ca|<br />
pippalīṁ citrakaṁ śuṇṭhīṁ triphalāṁ trivr̥tāṁ vacām||163||
pippalīṁ citrakaṁ śuṇṭhīṁ triphalāṁ trivr̥tāṁ vacām||163|| <br />
dvau kṣārau sātalāṁ dantīṁ svarṇakṣīrīṁ viṣāṇikām| <br />
kōlapramāṇāṁ vaṭikāṁ pibēt sauvīrasaṁyutām||164|| <br />
śvayathāvavipākē ca pravr̥ddhē ca dakōdarē| <br />
kShAraM cAjakarIShANAM srutaM mUtrairvipAcayet||162|| <br />
kShAraM cAjakarIShANAM srutaM mUtrairvipAcayet||162||
kArShikaM pippalImUlaM pa~jcaiva lavaNAni ca|
kArShikaM pippalImUlaM pa~jcaiva lavaNAni ca| <br />
pippalIM citrakaM shuNThIM triphalAM trivRutAM vacAm||163||
pippalIM citrakaM shuNThIM triphalAM trivRutAM vacAm||163|| <br />
dvau kShArau sAtalAM dantIM svarNakShIrIM viShANikAm|
dvau kShArau sAtalAM dantIM svarNakShIrIM viShANikAm| <br />
kolapramANAM vaTikAM pibet sauvIrasaMyutAm||164||
kolapramANAM vaTikAM pibet sauvIrasaMyutAm||164|| <br />
shvayathAvavipAke ca pravRuddhe ca dakodare|
shvayathAvavipAke ca pravRuddhe ca dakodare|
</div></div>
<div style="text-align:justify;">
''Kshara'' is prepared by burning goat’s dung processed with cow’s urine and it is added with 1 karsha (12g) each of root of ''pippali'' (Piper longum), ''sauvarchala lavana'' (unaqua sodium chloride), ''vida lavana'' (ammonium salt), ''audbida lavana'' (salt obtained from earth), ''saindhava'' (Sodi chloriduium), ''samudra lavana'' (Sodi muris), ''pippali'' (Piper longum), ''chitraka'' (Plumbago zeylanica), ''shunthi'' (Zingiber officinale), ''haritaki'' (Terminalia chebula), ''vibhitaki'' (Terminalia belerica), ''amalaki'' (Emblica officinalis), ''trivrita'' (Operculina turpethum), ''vacha'' (Acorus calamus), ''sarjikashara'' (Sodii carbonas impura), ''yava kshara'' (alkali from awns of barley), ''satala'' (Euphorbia Tirucalli), ''danti'' (Baliospermum montanum), ''svarnakshiri'' (Argemone mexicana ) and ''vishanika'' (Euphorbia fusiformis). This formulation is rolled into a pill of the size one ''kola'' (6g). This is orally administered in a dose of one ''kola'' (6g) with ''sauvira'' (alcoholic beverage prepared from dehusked barley either raw or cooked) and is effective in ''shvayathu'' (''anasaraka''), ''avipaka'' (indigestion) and advanced stage of ''udara roga'' [162-164].
''Kshara'' is prepared by burning goat’s dung processed with cow’s urine and it is added with 1 karsha (12g) each of root of ''pippali'' (Piper longum), ''sauvarchala lavana'' (unaqua sodium chloride), ''vida lavana'' (ammonium salt), ''audbida lavana'' (salt obtained from earth), ''saindhava'' (Sodi chloriduium), ''samudra lavana'' (Sodi muris), ''pippali'' (Piper longum), ''chitraka'' (Plumbago zeylanica), ''shunthi'' (Zingiber officinale), ''haritaki'' (Terminalia chebula), ''vibhitaki'' (Terminalia belerica), ''amalaki'' (Emblica officinalis), ''trivrita'' (Operculina turpethum), ''vacha'' (Acorus calamus), ''sarjikashara'' (Sodii carbonas impura), ''yava kshara'' (alkali from awns of barley), ''satala'' (Euphorbia Tirucalli), ''danti'' (Baliospermum montanum), ''svarnakshiri'' (Argemone mexicana ) and ''vishanika'' (Euphorbia fusiformis). This formulation is rolled into a pill of the size one ''kola'' (6g). This is orally administered in a dose of one ''kola'' (6g) with ''sauvira'' (alcoholic beverage prepared from dehusked barley either raw or cooked) and is effective in ''shvayathu'' (''anasaraka''), ''avipaka'' (indigestion) and advanced stage of ''udara roga'' [162-164].
</div>
=== ''Yavagu'' for treatment of ''udara roga'' ===
<div class="mw-collapsible mw-collapsed">
भावितानां गवां मूत्रे षष्टिकानां तु तण्डुलैः||१६५||
भावितानां गवां मूत्रे षष्टिकानां तु तण्डुलैः||१६५||
यवागूं पयसा सिद्धां प्रकामं भोजयेन्नरम्|
यवागूं पयसा सिद्धां प्रकामं भोजयेन्नरम्| <br />
पिबेदिक्षुरसं चानु जठराणां निवृत्तये||१६६||
पिबेदिक्षुरसं चानु जठराणां निवृत्तये||१६६||<br />
स्वं स्वं स्थानं व्रजन्त्येवं तथा पित्तकफानिलाः|
स्वं स्वं स्थानं व्रजन्त्येवं तथा पित्तकफानिलाः|
<div class="mw-collapsible-content">
bhāvitānāṁ gavāṁ mūtrē ṣaṣṭikānāṁ tu taṇḍulaiḥ||165||
bhāvitānāṁ gavāṁ mūtrē ṣaṣṭikānāṁ tu taṇḍulaiḥ||165||
yavāgūṁ payasā siddhāṁ prakāmaṁ bhōjayēnnaram|
yavāgūṁ payasā siddhāṁ prakāmaṁ bhōjayēnnaram| <br />
pibēdikṣurasaṁ cānu jaṭharāṇāṁ nivr̥ttayē||166||
pibēdikṣurasaṁ cānu jaṭharāṇāṁ nivr̥ttayē||166|| <br />
svaṁ svaṁ sthānaṁ vrajantyēvaṁ tathā pittakaphānilāḥ|
svaṁ svaṁ sthānaṁ vrajantyēvaṁ tathā pittakaphānilāḥ| <br />
yavAgUM payasA siddhAM prakAmaM bhojayennaram|
bhAvitAnAM gavAM mUtre ShaShTikAnAM tu taNDulaiH||165|| <br />
pibedikShurasaM cAnu jaTharANAM nivRuttaye||166||
yavAgUM payasA siddhAM prakAmaM bhojayennaram| <br />
pibedikShurasaM cAnu jaTharANAM nivRuttaye||166|| <br />
svaM svaM sthAnaM vrajantyevaM tathA pittakaphAnilAH|
svaM svaM sthAnaM vrajantyevaM tathA pittakaphAnilAH|
</div></div>
The rice that grows in 60 days is processed with cow’s urine and is used for the preparation of ''yavagu'' (rice gruel) added with milk. Patient is allowed to consume stomach full of this ''yavagu'' followed along with ample intake of sugar cane juice. This will cure the ''udara roga'' and the morbid ''vata, pitta'' as well ''kapha'' and help in regaining their natural abode [165-66].
<div style="text-align:justify;">
The rice that grows in 60 days is processed with cow’s urine and is used for the preparation of ''yavagu'' (rice gruel) added with milk. Patient is allowed to consume stomach full of this ''yavagu'' followed along with ample intake of sugar cane juice. This will cure the ''udara roga'' and the morbid ''[[vata]], [[pitta]]'' as well ''[[kapha]]'' and help in regaining their natural abode [165-66].
</div>
=== Treatment of constipation ===
<div class="mw-collapsible mw-collapsed">
शङ्खिनीस्नुक्त्रिवृद्दन्तीचिरबिल्वादिपल्लवैः||१६७||
शङ्खिनीस्नुक्त्रिवृद्दन्तीचिरबिल्वादिपल्लवैः||१६७||
शाकं गाढपुरीषाय प्राग्भक्तं दापयेद्भिषक् |
शाकं गाढपुरीषाय प्राग्भक्तं दापयेद्भिषक् | <br />
ततोऽस्मै शिथिलीभूतवर्चोदोषाय शास्त्रवित्||१६८||
ततोऽस्मै शिथिलीभूतवर्चोदोषाय शास्त्रवित्||१६८|| <br />
दद्यान्मूत्रयुतं क्षीरं दोषशेषहरं शिवम्|
दद्यान्मूत्रयुतं क्षीरं दोषशेषहरं शिवम्|
<div class="mw-collapsible-content">
śaṅkhinīsnuktrivr̥ddantīcirabilvādipallavaiḥ||167||
śaṅkhinīsnuktrivr̥ddantīcirabilvādipallavaiḥ||167||
śākaṁ gāḍhapurīṣāya prāgbhaktaṁ dāpayēdbhiṣak |
śākaṁ gāḍhapurīṣāya prāgbhaktaṁ dāpayēdbhiṣak | <br />
tatō'smai śithilībhūtavarcōdōṣāya śāstravit||168||
tatō'smai śithilībhūtavarcōdōṣāya śāstravit||168|| <br />
dadyānmūtrayutaṁ kṣīraṁ dōṣaśēṣaharaṁ śivam| <br />
sha~gkhinIsnuktrivRuddantIcirabilvAdipallavaiH||167||
sha~gkhinIsnuktrivRuddantIcirabilvAdipallavaiH||167||
shAkaM gADhapurIShAya prAgbhaktaM dApayedbhiShak [5] |
shAkaM gADhapurIShAya prAgbhaktaM dApayedbhiShak [5] | <br />
tato~asmai shithilIbhUtavarcodoShAya shAstravit||168||
tato~asmai shithilIbhUtavarcodoShAya shAstravit||168|| <br />
==== Treatment of ''parshva shula'' ====
dadyAnmUtrayutaM kShIraM [6] doShasheShaharaM shivam| <br />
</div></div>
<div style="text-align:justify;">
The knowledgeable physician should give the patients the food prepared with adding leaves of ''shankhini'' (Clitoria terneata), ''snuhi'' (Euphorbia neriifolia), ''trivrita'' (Operculina turpethum), ''danti'' (Baliospermum montanum) and ''chirabilva'' (Holoptelea integrifolia). This will soften the fecal matter and helps in emptying the bowels. If some amount of ''[[dosha]]'' is left unexpeled, then the patient is allowed to drink milk added with cow’s urine [167-168]
</div>
=== Treatment of ''parshva shula'' ===
<div class="mw-collapsible mw-collapsed">
पार्श्वशूलमुपस्तम्भं हृद्ग्रहं चापि मारुतः||१६९||
पार्श्वशूलमुपस्तम्भं हृद्ग्रहं चापि मारुतः||१६९||
जनयेद्यस्य तं तैलं बिल्वक्षारेण पाययेत्|
जनयेद्यस्य तं तैलं बिल्वक्षारेण पाययेत्|
<div class="mw-collapsible-content">
pārśvaśūlamupastambhaṁ hr̥dgrahaṁ cāpi mārutaḥ||169||
pārśvaśūlamupastambhaṁ hr̥dgrahaṁ cāpi mārutaḥ||169||
janayēdyasya taṁ tailaṁ bilvakṣārēṇa pāyayēt|
janayēdyasya taṁ tailaṁ bilvakṣārēṇa pāyayēt|
pArshvashUlamupastambhaM hRudgrahaM cApi mArutaH||169||
pArshvashUlamupastambhaM hRudgrahaM cApi mArutaH||169||
janayedyasya taM tailaM bilvakShAreNa pAyayet|
janayedyasya taM tailaM bilvakShAreNa pAyayet|
</div></div>
Patient of ''udara'' if develops ''parshvashula'' (pain in the sides), ''upastambha'' (paresis and ''paresthesia'' of lower limbs due to entrapment of ''vata''), ''hridgraha'' (congestion in cardiac region) due to morbidity of ''vata'', it should be treated by oral administration of ''taila'' (oil extracted from seeds of Sesamum indicum), added with ''bilva kshāra'' (alkali obtained from ash of Aegle marmelos) [169].
<div style="text-align:justify;">
Patient of ''udara'' if develops ''parshvashula'' (pain in the sides), ''upastambha'' (paresis and ''paresthesia'' of lower limbs due to entrapment of ''[[vata]]''), ''hridgraha'' (congestion in cardiac region) due to morbidity of ''[[vata]]'', it should be treated by oral administration of ''taila'' (oil extracted from seeds of Sesamum indicum), added with ''bilva kshāra'' (alkali obtained from ash of Aegle marmelos) [169].
</div>
=== ''Kshara taila'' ===
<div class="mw-collapsible mw-collapsed">
तथाऽग्निमन्थस्योनाकपलाशतिलनालजैः||१७०||
तथाऽग्निमन्थस्योनाकपलाशतिलनालजैः||१७०||
बलाकदल्यपामार्गक्षारैः प्रत्येकशः स्रुतैः|
बलाकदल्यपामार्गक्षारैः प्रत्येकशः स्रुतैः| <br />
तैलं पक्त्वा भिषग्दद्यादुदराणां प्रशान्तये||१७१||
तैलं पक्त्वा भिषग्दद्यादुदराणां प्रशान्तये||१७१|| <br />
निवर्तते चोदरिणां हृद्ग्रहश्चानिलोद्भवः|१७२|
निवर्तते चोदरिणां हृद्ग्रहश्चानिलोद्भवः|१७२|
<div class="mw-collapsible-content">
tathā'gnimanthasyōnākapalāśatilanālajaiḥ||170||
tathā'gnimanthasyōnākapalāśatilanālajaiḥ||170||
balākadalyapāmārgakṣāraiḥ pratyēkaśaḥ srutaiḥ|
balākadalyapāmārgakṣāraiḥ pratyēkaśaḥ srutaiḥ| <br />
tailaṁ paktvā bhiṣagdadyādudarāṇāṁ praśāntayē||171||
tailaṁ paktvā bhiṣagdadyādudarāṇāṁ praśāntayē||171|| <br />
nivartatē cōdariṇāṁ hr̥dgrahaścānilōdbhavaḥ|172|
nivartatē cōdariṇāṁ hr̥dgrahaścānilōdbhavaḥ|172|
tathA~agnimanthasyonAkapalAshatilanAlajaiH||170||
tathA~agnimanthasyonAkapalAshatilanAlajaiH||170||
balAkadalyapAmArgakShAraiH pratyekashaH srutaiH|
balAkadalyapAmArgakShAraiH pratyekashaH srutaiH| <br />
tailaM paktvA bhiShagdadyAdudarANAM prashAntaye||171||
tailaM paktvA bhiShagdadyAdudarANAM prashAntaye||171|| <br />
nivartate codariNAM hRudgrahashcAnilodbhavaH|172|
nivartate codariNAM hRudgrahashcAnilodbhavaH|172|
</div></div>
Oil is prepared successively with each of the ''kshara'' of ''agnimantha'' (Clerodendrum phlomidis), ''shyonaka'' (Oroxylum indicum), ''palasha'' (Butea monosperma), stalk of ''tila'' (Sesamum indicum), ''bala'' (Sida cordifolia), ''kadali'' (Musa paradisiaca) and ''apamarga'' (Achyranthes aspera). This is orally given to cure the ''udara roga''. This medicated oil also relieves cardiac arrest (''hridgraha'') caused by morbid ''vata'' in patient of ''udara'' [170-172]
<div style="text-align:justify;">
Oil is prepared successively with each of the ''kshara'' of ''agnimantha'' (Clerodendrum phlomidis), ''shyonaka'' (Oroxylum indicum), ''palasha'' (Butea monosperma), stalk of ''tila'' (Sesamum indicum), ''bala'' (Sida cordifolia), ''kadali'' (Musa paradisiaca) and ''apamarga'' (Achyranthes aspera). This is orally given to cure the ''udara roga''. This medicated oil also relieves cardiac arrest (''hridgraha'') caused by morbid ''[[vata]]'' in patient of ''udara'' [170-172]
</div>
=== ''Eranda taila'' in ''avarana'' ===
<div class="mw-collapsible mw-collapsed">
कफे वातेन पित्तेन ताभ्यां वाऽप्यावृतेऽनिले||१७२||
कफे वातेन पित्तेन ताभ्यां वाऽप्यावृतेऽनिले||१७२||
बलिनः स्वौषधयुतं तैलमेरण्डजं हितम्|
बलिनः स्वौषधयुतं तैलमेरण्डजं हितम्| <br />
सुविरिक्तो नरो यस्तु पुनराध्मापितो भवेत्||१७३||
सुविरिक्तो नरो यस्तु पुनराध्मापितो भवेत्||१७३|| <br />
सुस्निग्धैरम्ललवणैर्निरूहैस्तमुपाचरेत्|
सुस्निग्धैरम्ललवणैर्निरूहैस्तमुपाचरेत्| <br />
सोपस्तम्भोऽपि वा वायुराध्मापयति यं नरम्||१७४||
सोपस्तम्भोऽपि वा वायुराध्मापयति यं नरम्||१७४|| <br />
तीक्ष्णैः सक्षारगोमूत्रैर्बस्तिभिस्तमुपाचरेत्|१७५|
तीक्ष्णैः सक्षारगोमूत्रैर्बस्तिभिस्तमुपाचरेत्|१७५|
<div class="mw-collapsible-content">
kaphē vātēna pittēna tābhyāṁ vā'pyāvr̥tē'nilē||172||
kaphē vātēna pittēna tābhyāṁ vā'pyāvr̥tē'nilē||172||
balinaḥ svauṣadhayutaṁ tailamēraṇḍajaṁ hitam|
balinaḥ svauṣadhayutaṁ tailamēraṇḍajaṁ hitam| <br />
suviriktō narō yastu punarādhmāpitō bhavēt||173||
suviriktō narō yastu punarādhmāpitō bhavēt||173|| <br />
susnigdhairamlalavaṇairnirūhaistamupācarēt|
susnigdhairamlalavaṇairnirūhaistamupācarēt| <br />
sōpastambhō'pi vā vāyurādhmāpayati yaṁ naram||174||
sōpastambhō'pi vā vāyurādhmāpayati yaṁ naram||174|| <br />
tīkṣṇaiḥ sakṣāragōmūtrairbastibhistamupācarēt|175|
tīkṣṇaiḥ sakṣāragōmūtrairbastibhistamupācarēt|175|
kaphe vAtena pittena tAbhyAM vA~apyAvRute~anile||172||
kaphe vAtena pittena tAbhyAM vA~apyAvRute~anile||172||
balinaH svauShadhayutaM tailameraNDajaM hitam|
balinaH svauShadhayutaM tailameraNDajaM hitam| <br />
suvirikto naro yastu punarAdhmApito bhavet||173||
suvirikto naro yastu punarAdhmApito bhavet||173|| <br />
susnigdhairamlalavaNairnirUhaistamupAcaret|
susnigdhairamlalavaNairnirUhaistamupAcaret| <br />
sopastambho~api vA vAyurAdhmApayati yaM naram||174||
sopastambho~api vA vAyurAdhmApayati yaM naram||174|| <br />
tIkShNaiH sakShAragomUtrairbastibhistamupAcaret|175|
tIkShNaiH sakShAragomUtrairbastibhistamupAcaret|175|
</div></div>
<div style="text-align:justify;">
In condition where ''[[kapha]]'' is afflicted with morbid ''[[vata]]'' and ''[[pitta]]'' or where ''[[vata]]'' is overlaid by ''[[kapha]]'' and ''[[pitta]]'', it should be treated by oral medication of ''eranda taila'' (oil of Ricinus communis) processed with relevant herbs that cure the morbid ''[[dosha]]''.
After the proper elimination of the morbid ''[[dosha]]'', if the abdominal distension recurs then it should be treated by ''niruha [[basti]]'' (decoction enema) consisting adequate amount of ''sneha'' (dietary fat), sour tasting drugs and ''saindhava lavana'' (Sodi chloriduium).
After the proper elimination of the morbid ''dosha'', if the abdominal distension recurs then it should be treated by ''niruha basti'' (decoction enema) consisting adequate amount of ''sneha'' (dietary fat), sour tasting drugs and ''saindhava lavana'' (Sodi chloriduium).
If morbid ''vata'' causes intestinal stasis and abdominal distension then it should be treated by administration of ''niruha'' (decoction enema) consisting of strong medicines such as ''kshara'' (alkali obtained from ash of herbs) and cow’s urine [172-75].
If morbid ''[[vata]]'' causes intestinal stasis and abdominal distension then it should be treated by administration of ''niruha'' (decoction enema) consisting of strong medicines such as ''kshara'' (alkali obtained from ash of herbs) and cow’s urine [172-75].
</div>
=== Use of ''venum'' in the treatment of ''sannipatodara'' ===
<div class="mw-collapsible mw-collapsed">
क्रियातिवृत्ते जठरे त्रिदोषे चाप्रशाम्यति||१७५||
क्रियातिवृत्ते जठरे त्रिदोषे चाप्रशाम्यति||१७५||
ज्ञातीन् ससुहृदो दारान् ब्राह्मणान्नृपतीन् गुरून्|
ज्ञातीन् ससुहृदो दारान् ब्राह्मणान्नृपतीन् गुरून्| <br />
अनुज्ञाप्य भिषक् कर्म विदध्यात् संशयं ब्रुवन्||१७६||
अनुज्ञाप्य भिषक् कर्म विदध्यात् संशयं ब्रुवन्||१७६|| <br />
अक्रियायां ध्रुवो मृत्युः क्रियायां संशयो भवेत्|
अक्रियायां ध्रुवो मृत्युः क्रियायां संशयो भवेत्| <br />
एवमाख्याय तस्येदमनुज्ञातः सुहृद्गणैः||१७७||
एवमाख्याय तस्येदमनुज्ञातः सुहृद्गणैः||१७७|| <br />
पानभोजनसंयुक्तं विषमस्मै प्रयोजयेत्|
पानभोजनसंयुक्तं विषमस्मै प्रयोजयेत्| <br />
यस्मिन् वा कुपितः सर्पो विसृजेद्धि फले विषम्||१७८||
यस्मिन् वा कुपितः सर्पो विसृजेद्धि फले विषम्||१७८|| <br />
भोजयेत्तदुदरिणं प्रविचार्य भिषग्वरः|
भोजयेत्तदुदरिणं प्रविचार्य भिषग्वरः| <br />
तेनास्य दोषसङ्घातः स्थिरो लीनो विमार्गगः||१७९||
तेनास्य दोषसङ्घातः स्थिरो लीनो विमार्गगः||१७९|| <br />
विषेणाशुप्रमाथित्वादाशु भिन्नः प्रवर्तते|
विषेणाशुप्रमाथित्वादाशु भिन्नः प्रवर्तते| <br />
विषेण हृतदोषं तं शीताम्बुपरिषेचितम्||१८०||
विषेण हृतदोषं तं शीताम्बुपरिषेचितम्||१८०|| <br />
पाययेत भिषग्दुग्धं यवागूं वा यथाबलम्|
पाययेत भिषग्दुग्धं यवागूं वा यथाबलम्| <br />
त्रिवृन्मण्डूकपर्ण्योश्च शाकं सयववास्तुकम्||१८१||
त्रिवृन्मण्डूकपर्ण्योश्च शाकं सयववास्तुकम्||१८१|| <br />
भक्षयेत् कालशाकं वा स्वरसोदकसाधितम् |
भक्षयेत् कालशाकं वा स्वरसोदकसाधितम् | <br />
निरम्ललवणस्नेहं स्विन्नास्विन्नमनन्नभुक्||१८२||
निरम्ललवणस्नेहं स्विन्नास्विन्नमनन्नभुक्||१८२|| <br />
मासमेकं ततश्चैव तृषितः स्वरसं पिबेत्|
मासमेकं ततश्चैव तृषितः स्वरसं पिबेत्| <br />
एवं विनिर्हृते दोषे शाकैर्मासात् परं ततः||१८३||
एवं विनिर्हृते दोषे शाकैर्मासात् परं ततः||१८३|| <br />
दुर्बलाय प्रयुञ्जीत प्राणभृत् कारभं पयः|१८४|
दुर्बलाय प्रयुञ्जीत प्राणभृत् कारभं पयः|१८४|
<div class="mw-collapsible-content">
kriyātivr̥ttē jaṭharē tridōṣē cāpraśāmyati||175||
kriyātivr̥ttē jaṭharē tridōṣē cāpraśāmyati||175||
jñātīn sasuhr̥dō dārān brāhmaṇānnr̥patīn gurūn|
jñātīn sasuhr̥dō dārān brāhmaṇānnr̥patīn gurūn| <br />
anujñāpya bhiṣak karma vidadhyāt saṁśayaṁ bruvan||176||
anujñāpya bhiṣak karma vidadhyāt saṁśayaṁ bruvan||176|| <br />
akriyāyāṁ dhruvō mr̥tyuḥ kriyāyāṁ saṁśayō bhavēt|
akriyāyāṁ dhruvō mr̥tyuḥ kriyāyāṁ saṁśayō bhavēt| <br />
ēvamākhyāya tasyēdamanujñātaḥ suhr̥dgaṇaiḥ||177||
ēvamākhyāya tasyēdamanujñātaḥ suhr̥dgaṇaiḥ||177|| <br />
pānabhōjanasaṁyuktaṁ viṣamasmai prayōjayēt|
pānabhōjanasaṁyuktaṁ viṣamasmai prayōjayēt| <br />
yasmin vā kupitaḥ sarpō visr̥jēddhi phalē viṣam||178||
yasmin vā kupitaḥ sarpō visr̥jēddhi phalē viṣam||178|| <br />
bhōjayēttadudariṇaṁ pravicārya bhiṣagvaraḥ|
bhōjayēttadudariṇaṁ pravicārya bhiṣagvaraḥ| <br />
tēnāsya dōṣasaṅghātaḥ sthirō līnō vimārgagaḥ||179||
tēnāsya dōṣasaṅghātaḥ sthirō līnō vimārgagaḥ||179|| <br />
viṣēṇāśupramāthitvādāśu bhinnaḥ pravartatē|
viṣēṇāśupramāthitvādāśu bhinnaḥ pravartatē| <br />
viṣēṇa hr̥tadōṣaṁ taṁ śītāmbupariṣēcitam||180||
viṣēṇa hr̥tadōṣaṁ taṁ śītāmbupariṣēcitam||180|| <br />
pāyayēta bhiṣagdugdhaṁ yavāgūṁ vā yathābalam|
pāyayēta bhiṣagdugdhaṁ yavāgūṁ vā yathābalam| <br />
trivr̥nmaṇḍūkaparṇyōśca śākaṁ sayavavāstukam||181||
trivr̥nmaṇḍūkaparṇyōśca śākaṁ sayavavāstukam||181|| <br />
bhakṣayēt kālaśākaṁ vā svarasōdakasādhitam |
bhakṣayēt kālaśākaṁ vā svarasōdakasādhitam | <br />
niramlalavaṇasnēhaṁ svinnāsvinnamanannabhuk||182||
niramlalavaṇasnēhaṁ svinnāsvinnamanannabhuk||182|| <br />
māsamēkaṁ tataścaiva tr̥ṣitaḥ svarasaṁ pibēt|
māsamēkaṁ tataścaiva tr̥ṣitaḥ svarasaṁ pibēt| <br />
ēvaṁ vinirhr̥tē dōṣē śākairmāsāt paraṁ tataḥ||183||
ēvaṁ vinirhr̥tē dōṣē śākairmāsāt paraṁ tataḥ||183|| <br />
durbalāya prayuñjīta prāṇabhr̥t kārabhaṁ payaḥ|184|
durbalāya prayuñjīta prāṇabhr̥t kārabhaṁ payaḥ|184| <br />
kriyAtivRutte jaThare tridoShe cAprashAmyati||175||
kriyAtivRutte jaThare tridoShe cAprashAmyati||175|| <br />
j~jAtIn sasuhRudo dArAn brAhmaNAnnRupatIn gurUn|
j~jAtIn sasuhRudo dArAn brAhmaNAnnRupatIn gurUn| <br />
anuj~jApya bhiShak karma vidadhyAt saMshayaM bruvan||176||
anuj~jApya bhiShak karma vidadhyAt saMshayaM bruvan||176|| <br />
akriyAyAM dhruvo mRutyuH kriyAyAM saMshayo bhavet|
akriyAyAM dhruvo mRutyuH kriyAyAM saMshayo bhavet| <br />
evamAkhyAya tasyedamanuj~jAtaH suhRudgaNaiH||177||
evamAkhyAya tasyedamanuj~jAtaH suhRudgaNaiH||177|| <br />
pAnabhojanasaMyuktaM viShamasmai prayojayet|
pAnabhojanasaMyuktaM viShamasmai prayojayet| <br />
yasmin vA kupitaH sarpo visRujeddhi phale viSham||178||
yasmin vA kupitaH sarpo visRujeddhi phale viSham||178|| <br />
bhojayettadudariNaM pravicArya bhiShagvaraH|
bhojayettadudariNaM pravicArya bhiShagvaraH| <br />
tenAsya doShasa~gghAtaH sthiro lIno vimArgagaH||179||
tenAsya doShasa~gghAtaH sthiro lIno vimArgagaH||179|| <br />
viSheNAshupramAthitvAdAshu bhinnaH pravartate|
viSheNAshupramAthitvAdAshu bhinnaH pravartate| <br />
viSheNa hRutadoShaM taM shItAmbupariShecitam||180||
viSheNa hRutadoShaM taM shItAmbupariShecitam||180|| <br />
pAyayeta bhiShagdugdhaM yavAgUM vA yathAbalam|
pAyayeta bhiShagdugdhaM yavAgUM vA yathAbalam| <br />
trivRunmaNDUkaparNyoshca shAkaM sayavavAstukam||181||
trivRunmaNDUkaparNyoshca shAkaM sayavavAstukam||181|| <br />
bhakShayet kAlashAkaM vA svarasodakasAdhitam [2] |
bhakShayet kAlashAkaM vA svarasodakasAdhitam [2] | <br />
niramlalavaNasnehaM svinnAsvinnamanannabhuk||182||
niramlalavaNasnehaM svinnAsvinnamanannabhuk||182|| <br />
mAsamekaM tatashcaiva tRuShitaH svarasaM pibet|
mAsamekaM tatashcaiva tRuShitaH svarasaM pibet| <br />
evaM vinirhRute doShe shAkairmAsAt paraM tataH||183||
evaM vinirhRute doShe shAkairmAsAt paraM tataH||183|| <br />
durbalAya prayu~jjIta prANabhRut kArabhaM payaH|184|
durbalAya prayu~jjIta prANabhRut kArabhaM payaH|184| <br />
</div></div>
<div style="text-align:justify;">
If patient suffering from ''udara'' does not respond to usual treatment due to morbidity of three ''[[dosha]]'', then the physician should inform the critical state to the relative of the patient and start treating with venom of cobra after obtaining consent from the patients friends, spouse, brahmins, king as well as teacher. The physician should win the confidence of these people after clearly stating that the patient will not survive if the treatment with venom is not made, and patient may survive if this treatment is done. After obtaining the consent, the physician should mix the venom in food and drink and administer it to the patient.
Alternatively the angry serpent is made to release the venom while biting the fruit. Patient is allowed to consume this venomous fruit after proper analysis by the physician. This treatment immediately liquefies the infiltrating displaced morbid ''[[dosha]]'' by virtue of its ''pramathi'' (clearing the channels adhered with ''[[dosha]]'') property and eliminates from the body. Once the ''[[dosha]]'' is cleared from the body by the action of venom patient is treated with cold water ''parishechana'' (pouring of medicated liquids on body parts). Depending upon the physical strength, the patient is allowed to drink milk or yavāgu (rice gruel). The food prepared from leafy vegetables that include ''trivrita'' (Operculina turpethum), ''mandukaparni'' (Centella asiatica), ''yava'' (Hordeum vulgare), ''vastuka'' (Chenopodium murale) and ''kalashaka'' (Corchorus capsularis) processed with juice of same leafy vegetables should be given to the patient but without adding ''amla'' (sour), ''lavana'' (salty) and ''sneha'' (unctuous substance). This food may be served with or without steaming and during this food rice is avoided. This regimen should be continued for one month. During this course if the patient is thirsty then the juice extracted from these leafy vegetables should be given to the patient. By this method once in one month all the morbid ''[[dosha]]'' is cleared from the body and the patient is advised to drink milk to improve the physical strength [175-184]
</div>
Alternatively the angry serpent is made to release the venom while biting the fruit. Patient is allowed to consume this venomous fruit after proper analysis by the physician. This treatment immediately liquefies the infiltrating displaced morbid ''dosha'' by virtue of its ''pramathi'' (clearing the channels adhered with ''dosha'') property and eliminates from the body. Once the ''dosha'' is cleared from the body by the action of venom patient is treated with cold water ''parishechana'' (pouring of medicated liquids on body parts). Depending upon the physical strength, the patient is allowed to drink milk or yavāgu (rice gruel). The food prepared from leafy vegetables that include ''trivrita'' (Operculina turpethum), ''mandukaparni'' (Centella asiatica), ''yava'' (Hordeum vulgare), ''vastuka'' (Chenopodium murale) and ''kalashaka'' (Corchorus capsularis) processed with juice of same leafy vegetables should be given to the patient but without adding ''amla'' (sour), ''lavana'' (salty) and ''sneha'' (unctuous substance). This food may be served with or without steaming and during this food rice is avoided. This regimen should be continued for one month. During this course if the patient is thirsty then the juice extracted from these leafy vegetables should be given to the patient. By this method once in one month all the morbid ''dosha'' is cleared from the body and the patient is advised to drink milk to improve the physical strength [175-184]
=== Surgical measures ===
<div class="mw-collapsible mw-collapsed">
इदं तु शल्यहर्तॄणां कर्म स्याद्दृष्टकर्मणाम्||१८४||
इदं तु शल्यहर्तॄणां कर्म स्याद्दृष्टकर्मणाम्||१८४||
वामं कुक्षिं मापयित्वा नाभ्यधश्चतुरङ्गुलम्|
वामं कुक्षिं मापयित्वा नाभ्यधश्चतुरङ्गुलम्| <br />
मात्रायुक्तेन शस्त्रेण पाटयेन्मतिमान् भिषक्||१८५||
मात्रायुक्तेन शस्त्रेण पाटयेन्मतिमान् भिषक्||१८५|| <br />
विपाट्यान्त्रं ततः पश्चाद्वीक्ष्य बद्धक्षतान्त्रयोः|
विपाट्यान्त्रं ततः पश्चाद्वीक्ष्य बद्धक्षतान्त्रयोः| <br />
सर्पिषाऽभ्यज्य केशादीनवमृज्य विमोक्षयेत्||१८६||
सर्पिषाऽभ्यज्य केशादीनवमृज्य विमोक्षयेत्||१८६|| <br />
मूर्च्छनाद्यच्च सम्मूढमन्त्रं तच्च विमोक्षयेत्|
मूर्च्छनाद्यच्च सम्मूढमन्त्रं तच्च विमोक्षयेत्| <br />
छिद्राण्यन्त्रस्य तु स्थूलैर्दंशयित्वा पिपीलिकैः||१८७||
छिद्राण्यन्त्रस्य तु स्थूलैर्दंशयित्वा पिपीलिकैः||१८७|| <br />
बहुशः सङ्गृहीतानि ज्ञात्वा च्छित्वा पिपीलिकान्|
बहुशः सङ्गृहीतानि ज्ञात्वा च्छित्वा पिपीलिकान्| <br />
प्रतियोगैः [२] प्रवेश्यान्त्रं प्रेयैः [३] सीव्येद्व्रणं ततः||१८८||
प्रतियोगैः [२] प्रवेश्यान्त्रं प्रेयैः [३] सीव्येद्व्रणं ततः||१८८||<br />
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idaṁ tu śalyahartr̥̄ṇāṁ karma syāddr̥ṣṭakarmaṇām||184||
idaṁ tu śalyahartr̥̄ṇāṁ karma syāddr̥ṣṭakarmaṇām||184||
vāmaṁ kukṣiṁ māpayitvā nābhyadhaścaturaṅgulam|
vāmaṁ kukṣiṁ māpayitvā nābhyadhaścaturaṅgulam| <br />
mātrāyuktēna śastrēṇa pāṭayēnmatimān bhiṣak||185||
mātrāyuktēna śastrēṇa pāṭayēnmatimān bhiṣak||185|| <br />
vipāṭyāntraṁ tataḥ paścādvīkṣya baddhakṣatāntrayōḥ|
vipāṭyāntraṁ tataḥ paścādvīkṣya baddhakṣatāntrayōḥ| <br />
sarpiṣā'bhyajya kēśādīnavamr̥jya vimōkṣayēt||186||
sarpiṣā'bhyajya kēśādīnavamr̥jya vimōkṣayēt||186|| <br />
mūrcchanādyacca sammūḍhamantraṁ tacca vimōkṣayēt|
mūrcchanādyacca sammūḍhamantraṁ tacca vimōkṣayēt| <br />
chidrāṇyantrasya tu sthūlairdaṁśayitvā pipīlikaiḥ||187||
chidrāṇyantrasya tu sthūlairdaṁśayitvā pipīlikaiḥ||187|| <br />
bahuśaḥ saṅgr̥hītāni jñātvā cchitvā pipīlikān|
bahuśaḥ saṅgr̥hītāni jñātvā cchitvā pipīlikān| <br />
pratiyōgaiḥ [2] pravēśyāntraṁ prēyaiḥ [3] sīvyēdvraṇaṁ tataḥ||188||
pratiyōgaiḥ [2] pravēśyāntraṁ prēyaiḥ [3] sīvyēdvraṇaṁ tataḥ||188||<br />
idaM tu shalyahartRUNAM karma syAddRuShTakarmaNAm||184||
idaM tu shalyahartRUNAM karma syAddRuShTakarmaNAm||184|| <br />
vAmaM kukShiM mApayitvA nAbhyadhashcatura~ggulam|
vAmaM kukShiM mApayitvA nAbhyadhashcatura~ggulam| <br />
mAtrAyuktena shastreNa pATayenmatimAn bhiShak||185||
mAtrAyuktena shastreNa pATayenmatimAn bhiShak||185|| <br />
vipATyAntraM tataH pashcAdvIkShya baddhakShatAntrayoH|
vipATyAntraM tataH pashcAdvIkShya baddhakShatAntrayoH| <br />
sarpiShA~abhyajya keshAdInavamRujya vimokShayet||186||
sarpiShA~abhyajya keshAdInavamRujya vimokShayet||186|| <br />
mUrcchanAdyacca sammUDhamantraM tacca vimokShayet|
mUrcchanAdyacca sammUDhamantraM tacca vimokShayet| <br />
chidrANyantrasya tu sthUlairdaMshayitvA pipIlikaiH||187||
chidrANyantrasya tu sthUlairdaMshayitvA pipIlikaiH||187|| <br />
bahushaH sa~ggRuhItAni j~jAtvA cchitvA pipIlikAn| <br />
pratiyogaiH [2] praveshyAntraM preyaiH [3] sIvyedvraNaM tataH||188||<br />
</div></div>
<div style="text-align:justify;">
Surgical intervention should be done by an expert surgeon. A proper incision is made on the left side of the abdomen about fpur figure (7.8cm) below the umbilicus by an efficient surgeon. From this incision intestinal loops are drawn out and carefully looked for foreign substances causing ''chidrodara'' or ''baddhodara''. Ghee is applied on the affected loop of the intestines. Then the foreign substances like hair and others are then removed from the intestinal loop. Any torsion or intussusception of the loops of intestines if present is opened. By the surgical procedure if large rend happens in the intestines then edges of rend is anchored by making the small ants to bite and hold the edges together. Once the ants properly anchor the opposing edges of rend, the body of the ants is separated and thrown. Intestinal loops are then properly inserted into the abdomen and the incised area is sutured. Then wound management is done [184-188].
Surgical intervention should be done by an expert surgeon. A proper incision is made on the left side of the abdomen about fpur figure (7.8cm) below the umbilicus by an efficient surgeon. From this incision intestinal loops are drawn out and carefully looked for foreign substances causing ''chidrodara'' or ''baddhodara''. Ghee is applied on the affected loop of the intestines. Then the foreign substances like hair and others are then removed from the intestinal loop. Any torsion or intussusception of the loops of intestines if present is opened. By the surgical procedure if large rend happens in the intestines then edges of rend is anchored by making the small ants to bite and hold the edges together. Once the ants properly anchor the opposing edges of rend, the body of the ants is separated and thrown. Intestinal loops are then properly inserted into the abdomen and the incised area is sutured. Then wound management is done [184-188].
</div>
=== Surgical Intervention in ''jalodara'' ===
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तथा जातोदकं सर्वमुदरं व्यधयेद्भिषक्| <br />
वामपार्श्वे त्वधो नाभेर्नाडीं दत्त्वा च गालयेत्||१८९|| <br />
विस्राव्य च विमृद्यैतद्वेष्टयेद्वाससोदरम्| <br />
तथा बस्तिविरेकाद्यैर्म्लानं सर्वं च वेष्टयेत्||१९०|| <br />
निःस्रुते लङ्घितः पेयामस्नेहलवणां पिबेत्| <br />
अतः परं तु षण्मासान् क्षीरवृत्तिर्भवेन्नरः||१९१|| <br />
त्रीन् मासान् पयसा पेयां पिबेत्त्रींश्चापि भोजयेत्| <br />
श्यामाकं कोरदूषं वा क्षीरेणालवणं लघु||१९२|| <br />
नरः संवत्सरेणैवं जयेत् प्राप्तं जलोदरम्| <br />
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tathā jātōdakaṁ sarvamUdaraṁ vyadhayēdbhiṣak| <br />
vāmapārśvē tvadhō nābhērnāḍīṁ dattvā ca gālayēt||189|| <br />
visrāvya ca vimr̥dyaitadvēṣṭayēdvāsasōdaram| <br />
tathā bastivirēkādyairmlānaṁ sarvaṁ ca vēṣṭayēt||190|| <br />
niḥsrutē laṅghitaḥ pēyāmasnēhalavaṇāṁ pibēt| <br />
ataḥ paraṁ tu ṣaṇmāsān kṣīravr̥ttirbhavēnnaraḥ||191|| <br />
trīn māsān payasā pēyāṁ pibēttrīṁścāpi bhōjayēt| <br />
śyāmākaṁ kōradūṣaṁ vā kṣīrēṇālavaṇaṁ laghu||192|| <br />
naraḥ saṁvatsarēṇaivaṁ jayēt prāptaṁ jalōdaram| <br />
tathA jAtodakaM sarvamudaraM vyadhayedbhiShak| <br />
vAmapArshve [1] tvadho nAbhernADIM dattvA ca gAlayet||189|| <br />
visrAvya ca vimRudyaitadveShTayedvAsasodaram| <br />
tathA bastivirekAdyairmlAnaM sarvaM ca veShTayet||190|| <br />
niHsrute la~gghitaH peyAmasnehalavaNAM pibet| <br />
ataH paraM tu ShaNmAsAn kShIravRuttirbhavennaraH||191|| <br />
trIn mAsAn payasA peyAM pibettrIMshcApi bhojayet| <br />
shyAmAkaM [2] koradUShaM vA kShIreNAlavaNaM laghu||192|| <br />
naraH saMvatsareNaivaM jayet prAptaM jalodaram| <br />
</div></div>
<div style="text-align:justify;">
naraH saMvatsareNaivaM jayet prAptaM jalodaram|
In all conditions of ''udara'' with accumulation of fluid, the fluid should be aspirated by inserting a cannula into the abdomen just below the umbilicus on the left side. While aspirating, compress the abdomen and after the aspiration the abdomen is tightly wrapped with a cloth. This wrapping should also be done in cases where reduction of the abdomen is achieved by other methods like ''niruha [[basti]]'' (decoction enema) and ''[[virechana]]'' (therapeutic purgation). After the removal of the fluid patient is treated with ''[[langhana]]'' (reducing regimen) and is given ''peya'' (liquid rice gruel) with little or no addition of ''sneha'' (dietary fat) and salt. After this the patient is kept on only milk diet for six months. For another three months patient is allowed to take ''peya'' (liquid rice gruel) along with milk. Following this for another three months the patients is given rice prepared with shyāmaka (Echinochloa frumentacea) or ''koradusha'' (Paspalum scorbiculatum) added with milk. This light diet should be without salt altogether. By managing the patient in this manner for one year one can get cured of ''jalodara'' [189-192]
</div>
In all conditions of ''udara'' with accumulation of fluid, the fluid should be aspirated by inserting a cannula into the abdomen just below the umbilicus on the left side. While aspirating, compress the abdomen and after the aspiration the abdomen is tightly wrapped with a cloth. This wrapping should also be done in cases where reduction of the abdomen is achieved by other methods like ''niruha basti'' (decoction enema) and ''virechana'' (therapeutic purgation). After the removal of the fluid patient is treated with ''langhana'' (reducing regimen) and is given ''peya'' (liquid rice gruel) with little or no addition of ''sneha'' (dietary fat) and salt. After this the patient is kept on only milk diet for six months. For another three months patient is allowed to take ''peya'' (liquid rice gruel) along with milk. Following this for another three months the patients is given rice prepared with shyāmaka (Echinochloa frumentacea) or ''koradusha'' (Paspalum scorbiculatum) added with milk. This light diet should be without salt altogether. By managing the patient in this manner for one year one can get cured of ''jalodara'' [189-192]
=== Importance of milk diet ===
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प्रयोगाणां च सर्वेषामनु क्षीरं प्रयोजयेत्||१९३||
प्रयोगाणां च सर्वेषामनु क्षीरं प्रयोजयेत्||१९३||
दोषानुबन्धरक्षार्थं बलस्थैर्यार्थमेव च|
दोषानुबन्धरक्षार्थं बलस्थैर्यार्थमेव च|
प्रयोगापचिताङ्गानां हितं ह्युदरिणां पयः|
प्रयोगापचिताङ्गानां हितं ह्युदरिणां पयः| <br />
सर्वधातुक्षयार्तानां देवानाममृतं यथा||१९४||
सर्वधातुक्षयार्तानां देवानाममृतं यथा||१९४||<br />
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prayōgāṇāṁ ca sarvēṣāmanu kṣīraṁ prayōjayēt||193||
prayōgāṇāṁ ca sarvēṣāmanu kṣīraṁ prayōjayēt||193||
dōṣānubandharakṣārthaṁ balasthairyārthamēva ca|
dōṣānubandharakṣārthaṁ balasthairyārthamēva ca|
prayōgāpacitāṅgānāṁ hitaṁ hyudariṇāṁ payaḥ|
prayōgāpacitāṅgānāṁ hitaṁ hyudariṇāṁ payaḥ| <br />
sarvadhātukṣayārtānāṁ dēvānāmamr̥taṁ yathā||194||
sarvadhātukṣayārtānāṁ dēvānāmamr̥taṁ yathā||194||<br />
prayogANAM ca sarveShAmanu kShIraM prayojayet||193||
prayogANAM ca sarveShAmanu kShIraM prayojayet||193||
doShAnubandharakShArthaM balasthairyArthameva ca|
doShAnubandharakShArthaM balasthairyArthameva ca|
prayogApacitA~ggAnAM hitaM hyudariNAM payaH|
prayogApacitA~ggAnAM hitaM hyudariNAM payaH| <br />
sarvadhAtukShayArtAnAM devAnAmamRutaM yathA||194||
sarvadhAtukShayArtAnAM devAnAmamRutaM yathA||194||<br />
</div></div>
To prevent the perpetuation of morbid ''dosha'' and to regain the physical strength, milk should be included in all prescriptions for the patients suffering from ''udara''. The physique of the patients of ''udara'' which is reduced due to medications is best recuperated by milk diet, and milk is regarded as best remedy identical to the nectar for gods in all patients suffering from depletion of all ''dhatu'' [193-194]
<div style="text-align:justify;">
To prevent the perpetuation of morbid ''[[dosha]]'' and to regain the physical strength, milk should be included in all prescriptions for the patients suffering from ''udara''. The physique of the patients of ''udara'' which is reduced due to medications is best recuperated by milk diet, and milk is regarded as best remedy identical to the nectar for gods in all patients suffering from depletion of all ''[[dhatu]]'' [193-194]
</div>
=== Summary of the chapter ===
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तत्र श्लोकौ-
तत्र श्लोकौ-
हेतुं प्राग्रूपमष्टानां लिङ्गं व्याससमासतः|
हेतुं प्राग्रूपमष्टानां लिङ्गं व्याससमासतः| <br />
उपद्रवान् गरीयस्त्वं साध्यासाध्यत्वमेव च||१९५||
उपद्रवान् गरीयस्त्वं साध्यासाध्यत्वमेव च||१९५|| <br />
जाताजाताम्बुलिङ्गानि चिकित्सां चोक्तवानृषिः|
जाताजाताम्बुलिङ्गानि चिकित्सां चोक्तवानृषिः| <br />
समासव्यासनिर्देशैरुदराणां चिकित्सिते||१९६||
समासव्यासनिर्देशैरुदराणां चिकित्सिते||१९६||<br />
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tatra ślōkau-
tatra ślōkau-
hētuṁ prāgrūpamaṣṭānāṁ liṅgaṁ vyāsasamāsataḥ|
hētuṁ prāgrūpamaṣṭānāṁ liṅgaṁ vyāsasamāsataḥ| <br />
upadravān garīyastvaṁ sādhyāsādhyatvamēva ca||195||
upadravān garīyastvaṁ sādhyāsādhyatvamēva ca||195|| <br />
jātājātāmbuliṅgāni cikitsāṁ cōktavānr̥ṣiḥ|
jātājātāmbuliṅgāni cikitsāṁ cōktavānr̥ṣiḥ| <br />
samāsavyāsanirdēśairudarāṇāṁ cikitsitē||196||
samāsavyāsanirdēśairudarāṇāṁ cikitsitē||196||<br />
tatra shlokau-
tatra shlokau-
hetuM prAgrUpamaShTAnAM li~ggaM vyAsasamAsataH|
hetuM prAgrUpamaShTAnAM li~ggaM vyAsasamAsataH| <br />
upadravAn garIyastvaM sAdhyAsAdhyatvameva ca||195||
upadravAn garIyastvaM sAdhyAsAdhyatvameva ca||195|| <br />
jAtAjAtAmbuli~ggAni cikitsAM coktavAnRuShiH| <br />
samAsavyAsanirdeshairudarANAM cikitsite||196||<br />
</div></div>
<div style="text-align:justify;">
Thus the etiology, premonitory symptoms, general and individual symptoms of eight types of ''udara'', complications of ''udara'', seriousness of the illness, prognosis, symptoms of stages of ''udara'' as non accumulation and accumulation of fluid, and the specific as well as general treatment of ''udara roga'' are described by the sage Punarvasu in this chapter of [[Chikitsa Sthana]] [195-196].
Thus the etiology, premonitory symptoms, general and individual symptoms of eight types of ''udara'', complications of ''udara'', seriousness of the illness, prognosis, symptoms of stages of ''udara'' as non accumulation and accumulation of fluid, and the specific as well as general treatment of ''udara roga'' are described by the sage Punarvasu in this chapter of [[Chikitsa Sthana]] [195-196].
=== ''Tattva Vimarsha'' ===
== Tattva Vimarsha (Fundamental Principles) ==
*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'' (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.
*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.
*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.
*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).
*''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).
*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.
*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).
*''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).
*''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 (Applied Inferences ) ==
=== Etiopathogenesis ===
Impairment of ''jatharagni'' leads to morbidity of all the three ''dosha''. ''Mala'' in the present context refers to morbid ''vata'', ''pitta'' and ''kapha'', the metabolic bi-products formed during ''dhatu'' metabolism i.e. during tissue formation as well as the wastes like excreta<ref name="ref1">Agnivesha. Charaka Samhita, elaborated by Charaka & Dridabala with Ayurveda Deepika commentary by Chakrapani Datta, Vaidya Jadavaji Trikamji ed., 2009 Edition, Varanasi, Chaukhambha Orientalia, Pp 738, Pg no 491</ref>. Impairment of ''agni'' leads to excess formation of metabolic bi products (''mala'') and less formation of quality products. This leads to accumulation of the waste at micro-cellular circulation, which causes multiple diseases. More specifically, this accumulation of wastes at various visceral organs like liver, spleen etc. leads to distension of abdomen<ref name="ref13">Agnivesha. Charaka Samhita, elaborated by Charaka & Dridabala with jalpakalpataru commentary by gangadhara, 3rd part, kaviraja shri narendranathasen gupta; kaviraja shri balayichandrasen gupta, ed., 1st Edition, Culcutta, C.K.Sen and company ltd, Pp3828, Pg no 2815</ref>.
Impairment of ''jatharagni'' leads to morbidity of all the three ''[[dosha]]''. ''[[Mala]]'' in the present context refers to morbid ''[[vata]]'', ''[[pitta]]'' and ''[[kapha]]'', the metabolic bi-products formed during ''[[dhatu]]'' metabolism i.e. during tissue formation as well as the wastes like excreta<ref name="ref1">Chakrapani, Charak. In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita. 1st ed. Varanasi: Chaukhambha Orientalia;2009.p.738,491</ref>. Impairment of ''agni'' leads to excess formation of metabolic bi products (''[[mala]]'') and less formation of quality products. This leads to accumulation of the waste at micro-cellular circulation, which causes multiple diseases. More specifically, this accumulation of wastes at various visceral organs like liver, spleen etc. leads to distension of abdomen<ref name="ref13">Gangadhara, Charak. In: Kaviraja shri Narendranathasen Gupta; kaviraja shri Balayichandrasen Gupta, Editor. Charak Samhita. 1st ed. Calcutta: C.K.Sen and company ltd;??.p.3828,2815.</ref>.
''Malina ahara'' meaning unhealthy food refers to all food articles that cause morbidity of ''dosha'' in the body when consumed<ref name="ref1" />. ''Malina ahara'' also includes unclean vegetable and other food articles<ref name="ref13" />
''Malina ahara'' meaning unhealthy food refers to all food articles that cause morbidity of ''[[dosha]]'' in the body when consumed<ref name="ref1" />. ''Malina ahara'' also includes unclean vegetable and other food articles<ref name="ref13" />
Excessive dryness of the body in the absence of counteracting the same by proper measures leads to the ''udara roga''. The disease ''ama'' causing ''udara'' refers to the chronic perpetuation ''ama'' leads to ''udara roga''.<ref name="ref12">Agnivesha. Charaka Samhita, elaborated by Charaka & Dridabala with Ayurveda Deepika commentary by Chakrapani Datta, Vaidya Jadavaji Trikamji ed., 2009 Edition, Varanasi, Chaukhambha Orientalia, Pp 738, Pg no 492</ref>
Excessive dryness of the body in the absence of counteracting the same by proper measures leads to the ''udara roga''. The disease ''ama'' causing ''udara'' refers to the chronic perpetuation ''ama'' leads to ''udara roga''.<ref name="ref12">Chakrapani, Charak. In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita, 2009 Edition, Varanasi, Chaukhambha Orientalia, Pp 738, Pg no 492</ref>
''Ama'' as a cause of ''udara'' also refers to the consumption of uncooked foods.<ref name="ref13" />
''Ama'' as a cause of ''udara'' also refers to the consumption of uncooked foods.<ref name="ref13" />
Listing of sinful acts as etiology indicates the serious unrighteousness as the potent etiology of ''udara roga''<ref name="ref12" /> [12-13].
Listing of sinful acts as etiology indicates the serious unrighteousness as the potent etiology of ''udara roga''<ref name="ref12" /> [12-13].
All the foods that are greasy, heavy for digestion or light for digestion and dry causes ''vidaha'' (burning sensation in the abdomen during the digestion of foods) or else the patient develops ''vidaghdajirna''(intermediate state of digestion that caused burning)<ref>Agnivesha. Charaka Samhita, elaborated by Charaka & Dridabala with Jalpakalpataru commentary by gangadhara, 3rd part, kaviraja shri narendranathasen gupta; kaviraja shri balayichandrasen gupta, ed., 1st Edition, Culcutta, C.K.Sen and company ltd, Pp3828, Pg no 2816</ref>[12-15] .
All the foods that are greasy, heavy for digestion or light for digestion and dry causes ''vidaha'' (burning sensation in the abdomen during the digestion of foods) or else the patient develops ''vidaghdajirna''(intermediate state of digestion that caused burning)<ref>Gangadhara, Charak. .In:Kaviraja shri narendranathasen gupta; kaviraja shri balayichandrasen gupta,1st Edition, Culcutta, C.K.Sen and company ltd,??? Pp 3828, Pg no 2816</ref>[12-15] .
The pathogenesis mentioned earlier in the text is of all types of ''udara roga''. The pathogenesis described here is that of the four types of ''udara'' caused by ''morbid dosha'' viz ''vatodara, pittodara, kaphodara'' and ''sannipatodara''<ref name="ref12" />[20].
The pathogenesis mentioned earlier in the text is of all types of ''udara roga''. The pathogenesis described here is that of the four types of ''udara'' caused by ''morbid [[dosha]]'' viz ''vatodara, pittodara, kaphodara'' and ''sannipatodara''<ref name="ref12" />[20].
Two tier impairment of ''jatharagni'' is mentioned as the cause of ''udara roga''. In a patient with impaired ''jatharagni'' (digestive juices), consumption of unhealthy foods further impairs the functioning of ''jatharagni''. This indicates extreme impairment of ''jatharagni'' is involved in the pathogenesis of ''udara roga''.
Two tier impairment of ''jatharagni'' is mentioned as the cause of ''udara roga''. In a patient with impaired ''jatharagni'' (digestive juices), consumption of unhealthy foods further impairs the functioning of ''jatharagni''. This indicates extreme impairment of ''jatharagni'' is involved in the pathogenesis of ''udara roga''.
Impairment of ''agni'' is the initial state that causes indigestion and morbidity of ''dosha''. Morbid ''dosha'' in turn further impairs the functioning of ''agni'' thus forming a vicious cycle.
Impairment of ''agni'' is the initial state that causes indigestion and morbidity of ''[[dosha]]''. Morbid ''[[dosha]]'' in turn further impairs the functioning of ''agni'' thus forming a vicious cycle.
Morbid ''dosha'' formed by the indigestion afflicts the ''srotas''. Constriction and dilatation are the two varieties of pathology of ''srotas''. Dilatation leads to excessive circulation and constriction leads to decreased circulation. In the pathology of ''udara, srotas'' are obliterated due to morbid ''dosha''. This obliteration at ''swedavaha srotas'' leads to impairment of sweating. The fluid within the ''sweda-vaha-srotas'' is deviated to ''udaka-vaha-srotas'' thereby adding to the body fluids.<ref name="ref9" /> <ref name="ref12" />
Morbid ''[[dosha]]'' formed by the indigestion afflicts the ''srotas''. Constriction and dilatation are the two varieties of pathology of ''srotas''. Dilatation leads to excessive circulation and constriction leads to decreased circulation. In the pathology of ''udara, srotas'' are obliterated due to morbid ''[[dosha]]''. This obliteration at ''swedavaha srotas'' leads to impairment of sweating. The fluid within the ''sweda-vaha-srotas'' is deviated to ''udaka-vaha-srotas'' thereby adding to the body fluids.<ref name="ref9" /> <ref name="ref12" />
''Udakavaha srotas'' that are coursing upwards and downwards are also being obliterated by the morbid ''dosha''. The body fluid increased in the ''srotas'' is then deviated to the abdomen between the ''tvacha'' (skin) and ''mamsa'' (visceral tissues) causing ''udara roga'' <ref>Vagbhata. Astanga hridayam elaborated by Vagbhata, with joint commentaries Ayurveda Rasayana by Hemadri and Sarvangasundara by Arunadatta, Pt. Harisadashiva Shastri Paradakara Ed., 2010 Edition, Varanasi, Chaukhambha Sanskrit Sansthan, Pp 956, Pg 513.</ref>
''Udakavaha srotas'' that are coursing upwards and downwards are also being obliterated by the morbid ''[[dosha]]''. The body fluid increased in the ''srotas'' is then deviated to the abdomen between the ''tvacha'' (skin) and ''[[mamsa]]'' (visceral tissues) causing ''udara roga'' <ref>Vagbhata. Astanga hridayam elaborated by Vagbhata, with joint commentaries [[Ayurveda]] Rasayana by Hemadri and Sarvangasundara by Arunadatta, Pt. Harisadashiva Shastri Paradakara Ed., 2010 Edition, Varanasi, Chaukhambha Sanskrit Sansthan, Pp 956, Pg 513.</ref>
The divergence of fluids is not restricted to ''sweda-vaha-srotas'' and ''udaka-vaha srotas'', rather ''rasa-vaha srotas'' is also obstructed. ''Rasa dhatu'' is another source of fluid in the body. This fluid is also deviated to the space between the ''kala'' (mucus membrane) and visceral tissues in the abdomen. Thus, the fluid from the ''udaka-vaha srotas, sweda-vaha-srotas, rasa-vaha srotas'' and ''annavaha srotas'' deviates into the abdominal cavity <ref name="ref9">Sushrut, Sushruta samhita, with nibandha sangraha commentary of dhallahan & Nyayachandrika commentary of of gayadasa, yadavji trikamji , nirnaya sagar press, 1915, P713, Pgno 236</ref>
The divergence of fluids is not restricted to ''sweda-vaha-srotas'' and ''udaka-vaha srotas'', rather ''[[rasa]]-vaha srotas'' is also obstructed. ''[[Rasa dhatu]]'' is another source of fluid in the body. This fluid is also deviated to the space between the ''kala'' (mucus membrane) and visceral tissues in the abdomen. Thus, the fluid from the ''udaka-vaha srotas, sweda-vaha-srotas, [[rasa]]-vaha srotas'' and ''annavaha srotas'' deviates into the abdominal cavity <ref name="ref9">Dalhana,Gayadasa,Sushruta, Sushruta samhita In:yadavji trikamji, Editors,Mumbai:nirnaya sagar press,1915, P713, Pgno 236</ref>
Fluid is diverged from the ''koshtha'' into the space between the ''kala'' (mucus membrane) and visceral tissues in the abdomen. In the present context, the word ''koshtha'' refers to the intestines wherein digestion as well as separation of nutrient from the waste and assimilation of nutrients takes place. To be clearer the chyle formed in the intestines is diverted to the abdominal space between the ''kala'' (mucus membrane) and visceral tissue. The accumulation of the fluid in the abdominal space is due to the diversion of fluids from the intestines, ''rasa, udaka''(fluid) as well as ''sweda'' (sweat)<ref name="ref9" />.
Fluid is diverged from the ''koshtha'' into the space between the ''kala'' (mucus membrane) and visceral tissues in the abdomen. In the present context, the word ''koshtha'' refers to the intestines wherein digestion as well as separation of nutrient from the waste and assimilation of nutrients takes place. To be clearer the chyle formed in the intestines is diverted to the abdominal space between the ''kala'' (mucus membrane) and visceral tissue. The accumulation of the fluid in the abdominal space is due to the diversion of fluids from the intestines, ''[[rasa]], udaka''(fluid) as well as ''sweda'' (sweat)<ref name="ref9" />.
Diversion of fluids from the ''sweda-vaha, udaka-vaha,'' and ''rasa-vaha srotas'' is mobilized by the morbid ''vata''. In this pathology, the ''prana vata'' acts in the upper part of the trunk whereas the ''apana vata'' acts at the lower part of the trunk.
Diversion of fluids from the ''sweda-vaha, udaka-vaha,'' and ''[[rasa]]-vaha srotas'' is mobilized by the morbid ''[[vata]]''. In this pathology, the ''prana vata'' acts in the upper part of the trunk whereas the ''apana vata'' acts at the lower part of the trunk.
Since the fluid is diverted, the other body parts exhibit emaciation. Contrary to this the abdomen shows distention as the diverted fluid accumulates in the abdomen<ref name="ref9" />.
Since the fluid is diverted, the other body parts exhibit emaciation. Contrary to this the abdomen shows distention as the diverted fluid accumulates in the abdomen<ref name="ref9" />.
No visible ''srotas'' is involved in the diversion of fluids into the abdomen. Rather it is from the minute pores present in the intestine, fluid oozes into the abdominal space between the ''kala'' and visceral tissues. This can be best understood by the allegory of oozing of the water stored in the new earthen pot through the invisible minute pores.<ref name="ref9" /> Thus, in ''udara'', the distension of abdomen is due to the accumulation of the fluids within the space between the ''kala'' and visceral tissues in the abdomen<ref>Vriddhavagbhata. Astanga Sangraha, elaborated by Vriddha Vaghbata, with commentary Sasilekha by Indu, Dr Shivaprasad Sharma ed., 2006 Edition, Varanasi, Chowkhamba Sanskrit Sansthan, Pp965, Pg 385</ref> [9-11].
No visible ''srotas'' is involved in the diversion of fluids into the abdomen. Rather it is from the minute pores present in the intestine, fluid oozes into the abdominal space between the ''kala'' and visceral tissues. This can be best understood by the allegory of oozing of the water stored in the new earthen pot through the invisible minute pores.<ref name="ref9" /> Thus, in ''udara'', the distension of abdomen is due to the accumulation of the fluids within the space between the ''kala'' and visceral tissues in the abdomen<ref> Indu,Vriddhavagbhata. Astanga Sangraha, translated by Dr Shivaprasad Sharma , Varanasi, Chowkhamba Sanskrit Sansthan,2006 , Pp 965, Pg 385</ref> [9-11].
=== Types of ''udara roga'' ===
The clinical condition of peritonitis is comparable to the ''udara roga'' in general. Clinically this is categorized into primary or secondary, acute or chronic and localized or diffuse. These are comparable to the ''doshaja udara'' that includes ''[[vata]]ja, [[pitta]]ja, [[kapha]]ja'' and ''sannipataja udara roga''. Splenomegaly and hepatomegaly refers to plihodara and ''yakritodara'' respectively. Intestinal obstruction is said by the ''baddhagudodara'' (enlargement of abdomen due to gastrointestinal obstruction) and ''chhidrodara'' (abdominal enlargement due to intestinal perforation) refers to the intestinal perforation. [22]
==== Types of ''udara roga'' ====
Peritonitis caused without an apparent source of contamination of peritoneal cavity is regarded as primary peritonitis. The spontaneous peritonitis caused due to hematogenous spread of bacterial infection into the peritoneum causing inflammation. Chronic liver disease is the most common cause of such infection. This can even happen without any underlying disease. 80% of the patients present with fever. Acute onset of abdominal pain is characteristic and malaise, fatigue, or encephalopathy is the other co-morbidity.<ref name="ref21">Anthony S. Fauci, et al Editor. Harrison’s principles of internal medicine. 17th edition. New York. McGraw-Hills. 2008. p 2739.Pg no 1912</ref> The primary peritonitis caused by gram negative bacteria matches with the symptom of ''[[vata]]ja udara''. Sub acute manifestation with non pyogenic exudation causing ascites points towards the diagnosis of ''vatodara''. Microbiology study of ascitic fluid will reveal pathogens like Escherichia coli and enterococci<ref name="ref21" />[25].
'''Image 01: Patient suffering from ''udara roga'''''
[[File:300px-Udara1 modified.jpg|200px|thumb]]
Again, based on the etiology ''udara roga'' is further segregated into ''nija'' (endogenous) and ''agantuja'' (exogenous) type. Among the different types of ''udara roga''; the types of ''udara'' caused due to erroneous food and habits and mediated through morbidity of ''dosha'' and ''dushya'' is considered as ''nija'' type of ''udara''. ''Plihodara'' (enlargement of the spleen) and ''jalodara'' (enlargement of abdomen due to collection of fluid) are segregated as ''nija udara'' in the list of ''dushya'' dominant ''udara''. All the four types of ''dosha'' dominant ''udara'' fall under the category of ''nija udara'' (distension of abdomen due to endogenous causes). Contrary to this the ''baddhodara'' (enlargement of abdomen due to gastrointestinal obstruction) and ''chidrodara'' (abdominal enlargement due to intestinal perforation) caused by injury of intestines due to external factors are regarded as ''agantu udara'' (distension of abdomen caused due to exogenous causes)<ref name="ref9" />[22].
Again, based on the etiology ''udara roga'' is further segregated into ''nija'' (endogenous) and ''agantuja'' (exogenous) type. Among the different types of ''udara roga''; the types of ''udara'' caused due to erroneous food and habits and mediated through morbidity of ''[[dosha]]'' and ''[[dushya]]'' is considered as ''nija'' type of ''udara''. ''Plihodara'' (enlargement of the spleen) and ''jalodara'' (enlargement of abdomen due to collection of fluid) are segregated as ''nija udara'' in the list of ''[[dushya]]'' dominant ''udara''. All the four types of ''[[dosha]]'' dominant ''udara'' fall under the category of ''nija udara'' (distension of abdomen due to endogenous causes). Contrary to this the ''baddhodara'' (enlargement of abdomen due to gastrointestinal obstruction) and ''chidrodara'' (abdominal enlargement due to intestinal perforation) caused by injury of intestines due to external factors are regarded as ''agantu udara'' (distension of abdomen caused due to exogenous causes)<ref name="ref9" />[22].
=== ''Vatodara'' ===
Initial morbidity of ''vata'' caused by aggravated ''kapha'' during the pathogenesis of ''vatodara'' indicates that the morbidity of ''kapha'' is secondary. Thus, this secondary morbidity of ''kapha'' distinguishes the ''vatodara'' and ''kaphodara''<ref name="ref12" /> [23-24].
Initial morbidity of ''[[vata]]'' caused by aggravated ''[[kapha]]'' during the pathogenesis of ''vatodara'' indicates that the morbidity of ''[[kapha]]'' is secondary. Thus, this secondary morbidity of ''[[kapha]]'' distinguishes the ''vatodara'' and ''kaphodara''<ref name="ref12" /> [23-24].
Since the lower part of the abdomen is the normal location of ''vata'', distention of the abdomen initially occur in its lower parts.<ref name="ref12" /> Blackish and reddish discoloration of nails, conjunctiva, mouth and dermis is pathognomonic of morbid ''vata''<ref name="ref12" />. [25]
Since the lower part of the abdomen is the normal location of ''[[vata]]'', distention of the abdomen initially occur in its lower parts.<ref name="ref12" /> Blackish and reddish discoloration of nails, conjunctiva, mouth and dermis is pathognomonic of morbid ''[[vata]]''<ref name="ref12" />. [25]
=== ''Pittodara'' ===
In this pathogenesis, the morbidity of ''pitta'' is most predominant than that of ''vata'' and ''kapha''. It is worth mentioning here that suppression of the ''agni'' in this context implies the suppression of ''dhatvagni''<ref name="ref12" /> [27].
In this pathogenesis, the morbidity of ''[[pitta]]'' is most predominant than that of ''[[vata]]'' and ''[[kapha]]''. It is worth mentioning here that suppression of the ''agni'' in this context implies the suppression of ''dhatvagni''<ref name="ref12" /> [27].
The primary peritonitis caused by pyogenic gram positive bacteria like streptococci, and pneumococci matches with the symptom of ''pittaja udara''. Acute presentation of the illness with rapid progression into prominently exudative ascites justifies the contention of ''pittodara''. Microbiology study of ascitic fluid will reveal pathogens and will clinch the diagnosis<ref name="ref21" />[28]
The primary peritonitis caused by pyogenic gram positive bacteria like streptococci, and pneumococci matches with the symptom of ''[[pitta]]ja udara''. Acute presentation of the illness with rapid progression into prominently exudative ascites justifies the contention of ''pittodara''. Microbiology study of ascitic fluid will reveal pathogens and will clinch the diagnosis<ref name="ref21" />[28]
=== ''Kaphodara'' ===
Peritoneal tuberculosis is comparable to ''kaphodara''. Chronic perpetuation of the illness with the co-morbidity of the respiratory illness justifies the same. Infection of peritoneum with Mycobacterium tuberculosis also causes peritonitis. Fever, anorexia, weakness, malaise, and weight loss are the initial constitutional manifestations. Abdominal distention then develops either because of partial intestinal obstruction or ascites. Doughy abdomen is regarded as most classic sign of tubercular peritonitis. In most of the cases it is possible to detect the primary focus of infection in the lungs. Abdominal tenderness associates the abdominal pain. Analysis of ascitic fluid confirms exudative ascites.<ref name="ref21" />[31]
Peritoneal tuberculosis is comparable to ''kaphodara''. Chronic perpetuation of the illness with the co-morbidity of the respiratory illness justifies the same. Infection of peritoneum with Mycobacterium tuberculosis also causes peritonitis. Fever, anorexia, weakness, malaise, and weight loss are the initial constitutional manifestations. Abdominal distention then develops either because of partial intestinal obstruction or ascites. Doughy abdomen is regarded as most classic sign of tubercular peritonitis. In most of the cases it is possible to detect the primary focus of infection in the lungs. Abdominal tenderness associates the abdominal pain. Analysis of ascitic fluid confirms exudative ascites.<ref name="ref21" />[31]
=== ''Sannipatodara'' ===
''Dushyodara'' is another name of ''sannipatodara''. This is not the ninth type of ''udara'' and the total number of ''udara'' remains eight<ref>Sushruta, sushruta samhita with nabandha sangraha commentary by dhallahana, edited by yadavaji trikamji , nirnaya sagar press, 1915, p 711, pg no 236</ref>.
''Dushyodara'' is another name of ''sannipatodara''. This is not the ninth type of ''udara'' and the total number of ''udara'' remains eight<ref>Dalhana, Sushruta. In: Jadavaji Trikamji Aacharya, Editors. Sushruta Samhita.? ed.Mumbai:Nirnaya sagar press, 1915, p 711, pg no 236</ref>.
Literally the term ''dushya'' refers to the pathology of affliction. Since the illness occurs due to the affliction of ''rakta''; it is termed as ''dushyodara''. Or else, the mutual affliction of ''dosha'' is characteristic of ''sannipatodara'' hence is termed as ''dushyodara''<ref>Madhavakara, Madhavanidham with Madhukosha Sanskrit comantary of Vijayarakshitha and Shrikantadutta, edited by vaidya yadavaji trikamji, Pandurang jawaji, nirnayasagar press, Page no. 495 with page 269</ref>.
Literally the term ''dushya'' refers to the pathology of affliction. Since the illness occurs due to the affliction of ''[[rakta]]''; it is termed as ''dushyodara''. Or else, the mutual affliction of ''[[dosha]]'' is characteristic of ''sannipatodara'' hence is termed as ''dushyodara''<ref> Vijayarakshitha,Shrikantadutta,Madhavakara, Madhavanidana translated by vaidya yadavaji trikamji, Pandurang jawaji, Mumbai: Nirnayasagar press, Page no. 495 with page 269</ref>.
Wicked ladies with an intention of subjugating male partners or winning love, likely to offer food mixed with poison treated substances like menstrual blood, body dirt, hair, excreta, urine bone and nails. Person unaware of the mischief of ladies likely to consume the adulterated food offered by them and suffer from ''sannipatodara''. Even enemies may practice adulterating the food with poison treated substances. Unknowingly, consuming such food also leads to the ''sannipatodara''<ref>Agnivesha. Charaka Samhita, elaborated by Charaka & Dridabala with Jalpakalpataru commentary by gangadhara, 3rd part, kaviraja shri narendranathasen gupta; kaviraja shri balayichandrasen gupta, ed., 1st Edition, Culcutta, C.K.Sen and company ltd, Pp3828, Pg no. 2820</ref>.
Wicked ladies with an intention of subjugating male partners or winning love, likely to offer food mixed with poison treated substances like menstrual blood, body dirt, hair, excreta, urine bone and nails. Person unaware of the mischief of ladies likely to consume the adulterated food offered by them and suffer from ''sannipatodara''. Even enemies may practice adulterating the food with poison treated substances. Unknowingly, consuming such food also leads to the ''sannipatodara''<ref> Gangadhara, Charaka,3rd part In: Kaviraja shri narendra natha sengupta; kaviraja shri balayichandra sengupta, ed., 1st Edition, Culcutta, C.K.Sen and company ltd, Pp3828, Pg no. 2820</ref>.
Probably the slow poisoning is attempted by the enemies. The poisons having reduced potency due to the act of environmental factors is known as ''dushivisha''. The enemies may contaminate the food with such ''dushivisha''. Person consuming such contaminated food suffers from ''sannipatodara''<ref name="ref12" /> [32].
Probably the slow poisoning is attempted by the enemies. The poisons having reduced potency due to the act of environmental factors is known as ''dushivisha''. The enemies may contaminate the food with such ''dushivisha''. Person consuming such contaminated food suffers from ''sannipatodara''<ref name="ref12" /> [32].
Intra-abdominal malignancy spreading into the peritoneum causes malignant ascites. Usually it is the endometrial, colonic, gastric and pancreatic carcinoma, which may progress into peritoneal carcinomatosis. Even extra gastro intestinal malignancies like carcinoma of the breast, melanoma and lung carcinoma can cause peritoneal spread. Characteristically ascites happens in this condition in the absence of portal hypertension, tuberculosis, or right heart failure. Diagnostic paracentesis is confirmatory in this condition. More to add, the development of malignant ascites is always indicator of poor prognosis. This peritoneal carcinomatosis presenting with plethora of symptoms that matches with the symptoms pathognomonic of morbid ''vata, pitta'' and ''kapha dosha'', and its prognosis substantiates the consideration of ''sannipatodara'' in such cases<ref name="ref21" />[33-34].
Intra-abdominal malignancy spreading into the peritoneum causes malignant ascites. Usually it is the endometrial, colonic, gastric and pancreatic carcinoma, which may progress into peritoneal carcinomatosis. Even extra gastro intestinal malignancies like carcinoma of the breast, melanoma and lung carcinoma can cause peritoneal spread. Characteristically ascites happens in this condition in the absence of portal hypertension, tuberculosis, or right heart failure. Diagnostic paracentesis is confirmatory in this condition. More to add, the development of malignant ascites is always indicator of poor prognosis. This peritoneal carcinomatosis presenting with plethora of symptoms that matches with the symptoms pathognomonic of morbid ''[[vata]], [[pitta]]'' and ''[[kapha]] [[dosha]]'', and its prognosis substantiates the consideration of ''sannipatodara'' in such cases<ref name="ref21" />[33-34].
=== ''Plihodara'' and ''Yakritodara'' ===
The etiology, pathology and treatment of ''plihodara'' and ''yakritodara'' are identical. Thus, for the descriptive purposes these two conditions are collectively called as ''Yakrita-plihodara''.
The etiology, pathology and treatment of ''plihodara'' and ''yakritodara'' are identical. Thus, for the descriptive purposes these two conditions are collectively called as ''Yakrita-plihodara''.
Among the above said list of etiological factors; variety of dietary factors like sweet and greasy foods that cause affliction of ''rakta dhatu'' is the cause of ''achyuta plihavriddhi''. All the other etiological factors are of ''chyuta plihavriddhi'' <ref name="ref31" /> [35].
Among the above said list of etiological factors; variety of dietary factors like sweet and greasy foods that cause affliction of ''[[rakta dhatu]]'' is the cause of ''achyuta plihavriddhi''. All the other etiological factors are of ''chyuta plihavriddhi'' <ref name="ref31" /> [35].
The Sanskrit term ''chyuta'' refers to the act to descend and the ''vriddhi'' implies abdominal enlargement. Descent of the spleen is said to happen due to the violent jerk that happens during different physical activities. Descended spleen causes abdominal enlargement. Further this is of four types based on causative morbidity of ''[[dosha]]'' as ''[[vata]]ja, [[pitta]]ja, [[kapha]]ja'' and ''sannipataja''. <ref name="ref31"> Chakrapani, Charak. In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.1st ed. Varanasi: Krishnadas Academy;2009.p.4.Pp 738, Pg no 493</ref>
In Sanskrit, the word ''Achyuta'' refers to lack of downward displacement. ''Vriddhi'' refers to the abdominal enlargement. Put together, the word ''achyuta plihavriddhi'' refers to the abdominal enlargement due to splenic causes without its descending. The morbidity of the ''[[rakta dhatu]]'' causes enlargement of the spleen which in turn is responsible for the abdominal distension. Thus, the ''chyuta'' and ''achyuta'' type of ''plihodara'' together forms five types of ''plihodara''<ref name="ref31" /> [36].
Febrile illness of mild degree is the symptom of ''plihodara''. Habitual consumption of food habits that cause burning sensation leads to the morbidity of ''rakta'' as well as ''pitta dosha''. Morbid ''pitta dosha'' and ''rakta dhatu'' cause mild fever. Further loss of appetite is a clinical symptom of ''plihodara''. Habitual consumption of ''abhishyandi'' foods causes morbidity of ''kapha'' which in turn is responsible for the impairment of ''agni''<ref name="ref9" /> [37-38].
Febrile illness of mild degree is the symptom of ''plihodara''. Habitual consumption of food habits that cause burning sensation leads to the morbidity of ''[[rakta]]'' as well as ''[[pitta dosha]]''. Morbid ''[[pitta dosha]]'' and ''[[rakta dhatu]]'' cause mild fever. Further loss of appetite is a clinical symptom of ''plihodara''. Habitual consumption of ''abhishyandi'' foods causes morbidity of ''[[kapha]]'' which in turn is responsible for the impairment of ''agni''<ref name="ref9" /> [37-38].
=== ''Baddhagudodara'' ===
Acute or chronic intestinal obstruction due to variety of causes is comparable to ''baddhodara'' (enlargement of abdomen due to gastrointestinal obstruction). Sudden development of intestinal obstruction in an otherwise healthy person may be due to strangulation, paralytic ileus, and intussusception. Even the simple of malignant stricture of the colon, diverticulitis and pressure by a tumor can cause obstruction. Impaction of masses of roundworms, too much cellulose like orange peel, hair balls and other foreign substances can also cause intestinal obstruction.
Acute or chronic intestinal obstruction due to variety of causes is comparable to ''baddhodara'' (enlargement of abdomen due to gastrointestinal obstruction). Sudden development of intestinal obstruction in an otherwise healthy person may be due to strangulation, paralytic ileus, and intussusception. Even the simple of malignant stricture of the colon, diverticulitis and pressure by a tumor can cause obstruction. Impaction of masses of roundworms, too much cellulose like orange peel, hair balls and other foreign substances can also cause intestinal obstruction.
Clinical presentations include absolute constipation, no passing of the flatus. This is true even after repeated enemata. Abdominal pain initially referred to umbilicus. Eventually the abdominal pain turns into colicky in nature due to strong peristalsis trying to overcome the obstruction. Tenderness is little. Since the beginning the patient will have projectile vomiting. Vomitus consists of food particles initially and then bile follows and finally stercoraceous with fecal odor. Abdominal distention is noticed, more in the flanks in colonic obstruction and will be seen in the central abdomen if, the obstruction is in the intestines. Peristalsis may be visible. Gradually the patient develops the constitutional symptoms like prostration, thready rapid pulse. Urine is diminished. Obstruction located in proximal intestines may cause tetany [39-41].
Clinical presentations include absolute constipation, no passing of the flatus. This is true even after repeated enemata. Abdominal pain initially referred to umbilicus. Eventually the abdominal pain turns into colicky in nature due to strong peristalsis trying to overcome the obstruction. Tenderness is little. Since the beginning the patient will have projectile vomiting. Vomitus consists of food particles initially and then bile follows and finally stercoraceous with fecal odor. Abdominal distention is noticed, more in the flanks in colonic obstruction and will be seen in the central abdomen if, the obstruction is in the intestines. Peristalsis may be visible. Gradually the patient develops the constitutional symptoms like prostration, thready rapid pulse. Urine is diminished. Obstruction located in proximal intestines may cause tetany [39-41].
=== ''Kshatodara'' ===
The word ''kshatodara'' is formed by the component terms ''kshata'' and ''udara''. The Sanskrit term ''kshata'' refers to the perforation caused by substances like sand particles. ''Kshatodara'' is caused by perforation of the intestines due entangling of the foreign substances that are consumed along with the food. Thus, the distension of the abdomen caused by the perforation of the intestines is termed as ''kshatodara''<ref>Raja radha kanta deva, Shabdakalpadruma, part 2 chaukhambha Sanskrit siries, varanasi 3rd edition 1967, P555; Pg no 226</ref>.
The word ''kshatodara'' is formed by the component terms ''kshata'' and ''udara''. The Sanskrit term ''kshata'' refers to the perforation caused by substances like sand particles. ''Kshatodara'' is caused by perforation of the intestines due entangling of the foreign substances that are consumed along with the food. Thus, the distension of the abdomen caused by the perforation of the intestines is termed as ''kshatodara''<ref>Raja radha kanta deva, Shabdakalpadruma, part 2 chaukhambha Sanskrit siries, varanasi 3rd edition 1967, P555; Pg no 226</ref>.
=== ''Parisravi udara'' ===
''Parisravi'' and ''udara'' are the component terms of ''parisraavi udara''. ''Parisraavi'' is again formed by the verb ''sraai'' with the addition of the prefix ''pari''. The prefix ''pari'' gives the meaning of extensive from all the sides. The verb ''sraavi'' refers to the secretion. Thus the term ''parisraavi'' refers to the pathology of morbid flow or extensive secretion from all sides.
''Parisravi'' and ''udara'' are the component terms of ''parisraavi udara''. ''Parisraavi'' is again formed by the verb ''sraai'' with the addition of the prefix ''pari''. The prefix ''pari'' gives the meaning of extensive from all the sides. The verb ''sraavi'' refers to the secretion. Thus the term ''parisraavi'' refers to the pathology of morbid flow or extensive secretion from all sides.
Pathologically this illness is characterized by intestinal contents oozing into the abdomen and the abdominal contents in turn oozing into the rectum. Hence the illness is called as ''parisraavi udara''<ref>Raja radha kanta deva, Shabdakalpadruma, part 5 chaukhambha Sanskrit siries, varanasi 3rd edition 1967, P555; Pg no 466</ref>.
Pathologically this illness is characterized by intestinal contents oozing into the abdomen and the abdominal contents in turn oozing into the rectum. Hence the illness is called as ''parisraavi udara''<ref>Raja radha kanta deva, Shabdakalpadruma, part 5 chaukhambha Sanskrit siries, varanasi 3rd edition 1967, P555; Pg no 466</ref>.
=== ''Chhidrodara'' ===
The component terms ''chhidra'' and ''udara'' together forms ''chhidrodara''. '''Chhidra''' refers to perforation and ''udara'' refers to distension of the abdomen. Thus, the illness characterized by the perforation of the intestines is known as ''chhidrodara''<ref>Raja radha kanta deva, Shabdakalpadruma, part 2 chaukhambha Sanskrit siries, varanasi 3rd edition 1967, P937; Pg no 482 </ref>[42-43].
The component terms ''chhidra'' and ''udara'' together forms ''chhidrodara''. '''Chhidra''' refers to perforation and ''udara'' refers to distension of the abdomen. Thus, the illness characterized by the perforation of the intestines is known as ''chhidrodara''<ref>Raja radha kanta deva, Shabdakalpadruma, part 2 chaukhambha Sanskrit siries, varanasi 3rd edition 1967, P937; Pg no 482 </ref>[42-43].
The foreign substances consumed with the food may traverse along the length of intestines without hurting it. At times these foreign substances may traverse across the length and hurt the intestines leading to perforation. Thus, if the foreign substances traverse along the length of the intestines without hurting, then the patient do not suffer from ''chhidrodara''.<ref name="ref9" />
The foreign substances consumed with the food may traverse along the length of intestines without hurting it. At times these foreign substances may traverse across the length and hurt the intestines leading to perforation. Thus, if the foreign substances traverse along the length of the intestines without hurting, then the patient do not suffer from ''chhidrodara''.<ref name="ref9" />
Foreign substances consumed along with food causes perforation of the intestines. Even consumption of excessive food and yawing with excessive stretching of the body may lead to perforation.<ref name="ref9" /> The intestines contain liquid chyle consisting of both nutrients and waste. This liquid leaks out of the intestines through the rent caused by the perforation into the space between the abdominal skin and flesh. Note that, fluids also leak into the abdomen in ''doshaja udara'' but not through the rent, but by the method of diffusion.<ref name="ref9" />
Foreign substances consumed along with food causes perforation of the intestines. Even consumption of excessive food and yawing with excessive stretching of the body may lead to perforation.<ref name="ref9" /> The intestines contain liquid chyle consisting of both nutrients and waste. This liquid leaks out of the intestines through the rent caused by the perforation into the space between the abdominal skin and flesh. Note that, fluids also leak into the abdomen in ''[[dosha]]ja udara'' but not through the rent, but by the method of diffusion.<ref name="ref9" />
The fluid leaked out of the intestines again re-enters into the rectum. Over filled fluid with the space between the skin and viscera may re-enter into the intestines through the end of perforation. Or else the fluid may seep into the rectum. Thus, the rectum gets filled with the undigested food consisting of nutrients and waste which is defecated out<ref name="ref9" />.
The fluid leaked out of the intestines again re-enters into the rectum. Over filled fluid with the space between the skin and viscera may re-enter into the intestines through the end of perforation. Or else the fluid may seep into the rectum. Thus, the rectum gets filled with the undigested food consisting of nutrients and waste which is defecated out<ref name="ref9" />.
The accumulation of the chyle within the abdomen that does not diffuse into the rectum causes ''jalodara''. This ''jalodara'' of ''chhidrodara'' is different from the ''jalodara''. ''Jalodara'' as type of ''udara'' is caused by distinct causes as an independent disease and the fluid accumulates by the process of diffusion. ''Jalodara'' is a phase in ''chhidrodara'' and is due to the leakage of fluids form the perforated intestines.<ref>Vagbhata. Astanga hridayam, elaborated by Vagbhata, with joint commentaries Ayurveda Rasayana by Hemadri and Sarvangasundara by Arunadatta, Pt. Harisadashiva Shastri Paradakara Ed., 2010 Edition, Varanasi, Chaukhambha Sanskrit Sansthan, Pp 956, Pg 516.</ref>
The accumulation of the chyle within the abdomen that does not diffuse into the rectum causes ''jalodara''. This ''jalodara'' of ''chhidrodara'' is different from the ''jalodara''. ''Jalodara'' as type of ''udara'' is caused by distinct causes as an independent disease and the fluid accumulates by the process of diffusion. ''Jalodara'' is a phase in ''chhidrodara'' and is due to the leakage of fluids form the perforated intestines.<ref>Arunadatta, Vagbhata. Sutra Sthana. In: Pt. Harisadashiva Shastri Paradakara Ed., Varanasi: Chaukhambha Sanskrit Sansthan,2010, Pp 956, Pg 516.</ref>
Since the fluid tends to occupy the dependent parts, the accumulation of the chyle in the abdomen causes distention of the lower part of the abdomen below the umbilicus.<ref name="ref31" />
Since the fluid tends to occupy the dependent parts, the accumulation of the chyle in the abdomen causes distention of the lower part of the abdomen below the umbilicus.<ref name="ref31" />
Paralytic ileus supervenes in the pathology of peritonitis. Ileus is characterized by diminishing of the bowel sounds. Percussion note becomes tympanitic. Further as the disease advances the tachycardia progressively worsens and temperature gradually falls indicating impending peritoneal shock from bacterial toxemia and septicemia. Investigation may reveal leukocytosis. Free air under the diaphragm may be seen in an upright chest radiograph if a ruptured viscus is the cause.<ref>Tadataka Yamada, textbook of gastroenterology, 5th edition, volume 1, part 2, 2009 Blackwell Publishing. ISBN: pages 3413, chapter 100 2509</ref>
Paralytic ileus supervenes in the pathology of peritonitis. Ileus is characterized by diminishing of the bowel sounds. Percussion note becomes tympanitic. Further as the disease advances the tachycardia progressively worsens and temperature gradually falls indicating impending peritoneal shock from bacterial toxemia and septicemia. Investigation may reveal leukocytosis. Free air under the diaphragm may be seen in an upright chest radiograph if a ruptured viscus is the cause.<ref>Tadataka Yamada, textbook of gastroenterology, 5th edition, volume 1, part 2, 2009 Blackwell Publishing. ISBN: pages 3413, chapter 100 2509</ref>
=== ''Jalodara'' ===
''Udaka'' in Sanskrit translates as fluid and ''udara'' refers to the distension of the abdomen, put together the term ''udakodara'' means distension of the abdomen due to accumulation of the fluid. According to Sanskrit literature, the word ''dakodara'' is formed by the removal of initial letter u from the word ''udakodara''. Thus, formed word ''dakodara'' also give the same meaning of ''udakodara''.<ref name="ref34">Gangadhara, Charak. 3rd part, In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.1st ed. Varanasi:kaviraja shri narendranathasen gupta; kaviraja shri balayichandrasen gupta, ed., 1st Edition, Culcutta , C.K.Sen and company ltd, Pp3828, Pg no 2825</ref>
''Udaka'' in Sanskrit translates as fluid and ''udara'' refers to the distension of the abdomen, put together the term ''udakodara'' means distension of the abdomen due to accumulation of the fluid. According to Sanskrit literature, the word ''dakodara'' is formed by the removal of initial letter u from the word ''udakodara''. Thus, formed word ''dakodara'' also give the same meaning of ''udakodara''.<ref name="ref34">Agnivesha. Charaka Samhita, elaborated by Charaka & Dridabala with jalpakalpataru commentary by gangadhara, 3rd part, kaviraja shri narendranathasen gupta; kaviraja shri balayichandrasen gupta, ed., 1st Edition, Culcutta , C.K.Sen and company ltd, Pp3828, Pg no 2825</ref>
'''Image 02: ''Sira janma'' in ''udara'''''
[[File:Udara2.jpg|300px|thumb]]
Water intoxication and edema are the two distinct clinical implications of over hydration. Excessive intake of plain water without adequate solutes causes abnormal increase in extracellular fluid with deficient sodium. This in turn causes movement of fluid into the cell to maintain the salt balance. Thus, resulting in cellular edema which in turn causes the clinical manifestation of water intoxication and it is a fatal condition. Contrary to this over hydration with adequate intake of sodium leads to increase in the fluid within the interstitial compartment due to excess of isotonic volume excess. The water does not diffuse into the cells as the solutes hold the water in the interstitial fluid compartment. Thus this will result in the edema. This edema is due to over hydration and is comparable to ''jalodara''.
Water intoxication and edema are the two distinct clinical implications of over hydration. Excessive intake of plain water without adequate solutes causes abnormal increase in extracellular fluid with deficient sodium. This in turn causes movement of fluid into the cell to maintain the salt balance. Thus, resulting in cellular edema which in turn causes the clinical manifestation of water intoxication and it is a fatal condition. Contrary to this over hydration with adequate intake of sodium leads to increase in the fluid within the interstitial compartment due to excess of isotonic volume excess. The water does not diffuse into the cells as the solutes hold the water in the interstitial fluid compartment. Thus this will result in the edema. This edema is due to over hydration and is comparable to ''jalodara''.
Edema due to isotonic volume excess is characterized by weight gain, dependent edema, pitting edema, engorged neck vein, ascites, pericardial effusion, pleural effusion, increased blood pressure and congestive cardiac failure. [47]
Edema due to isotonic volume excess is characterized by weight gain, dependent edema, pitting edema, engorged neck vein, ascites, pericardial effusion, pleural effusion, increased blood pressure and congestive cardiac failure. [47]
Image03: ''Raji janma'' in ''udara''
'''Image03: ''Raji janma'' in ''udara'''''
[[File:Udara3.jpg|200px|thumb]]
Image 04: ''Parivritta nabhi'' in ''udara''
'''Image 04: ''Parivritta nabhi'' in ''udara'''''
[[File:Udara4.jpg|200px|thumb]]
Image 05: ''Kutilopastha'' in ''udara''
'''Image 05: ''Kutilopastha'' in ''udara'''''
All types of ''udara'' are characterized by distension of the abdomen. Accumulation of the fluid in the abdomen is the common pathology in these conditions. But in the initial phases the collection of the fluid in the abdomen is due to the diffusion of chyle. This chyle is little as the impairment of ''agni'' is less severe. Also the little accumulation of the fluid is not detected clinically. In this state, in the absence of immediate effective treatment; morbid ''dosha'' tend to obliterate the external body channels that maintain the homeostasis of fluid in the body. The chyle is more liquefied. And more and more fluid is poured into the abdomen causing huge accumulation of the fluid in the abdomen. At this stage, accumulation of the fluid is clinically detected. Accordingly, the ''udara roga'' is distinguished into three stages. Identification of these stages is important and immediate energetic treatment should be planned lest all ''udara'' finally land in ''jalodara''. Condition of ''ajatodaka, piccha'' and ''jatodaka'' are the three stages of ''udara'' .
[[File:Udara5.jpg|200px|thumb]]
All types of ''udara'' are characterized by distension of the abdomen. Accumulation of the fluid in the abdomen is the common pathology in these conditions. But in the initial phases the collection of the fluid in the abdomen is due to the diffusion of chyle. This chyle is little as the impairment of ''agni'' is less severe. Also the little accumulation of the fluid is not detected clinically. In this state, in the absence of immediate effective treatment; morbid ''[[dosha]]'' tend to obliterate the external body channels that maintain the homeostasis of fluid in the body. The chyle is more liquefied. And more and more fluid is poured into the abdomen causing huge accumulation of the fluid in the abdomen. At this stage, accumulation of the fluid is clinically detected. Accordingly, the ''udara roga'' is distinguished into three stages. Identification of these stages is important and immediate energetic treatment should be planned lest all ''udara'' finally land in ''jalodara''. Condition of ''ajatodaka, piccha'' and ''jatodaka'' are the three stages of ''udara'' .
The course of primary as well as secondary peritonitis exhibits a typical progression. Initially the peritoneum gets inflamed and is characterized by abdominal pain and associated symptoms. This inflammation of the peritoneum is supervened by paralytic ileus. This paralytic ileus is responsible for the diminishing bowel sounds, gaseous distention of the abdomen and tympanic percussion note. This stage of peritonitis is the ''ajatodakavastha'' of ''udara''.
The course of primary as well as secondary peritonitis exhibits a typical progression. Initially the peritoneum gets inflamed and is characterized by abdominal pain and associated symptoms. This inflammation of the peritoneum is supervened by paralytic ileus. This paralytic ileus is responsible for the diminishing bowel sounds, gaseous distention of the abdomen and tympanic percussion note. This stage of peritonitis is the ''ajatodakavastha'' of ''udara''.
Further as the fluid accumulates, the patient develops the complete symptoms of ascites that include horse shoe dullness, shifting dullness and fluid thrill. This stage of peritonitis is considered as ''jatodakavastha'' of ''udara''<ref name="ref21" /> [48-49].
Further as the fluid accumulates, the patient develops the complete symptoms of ascites that include horse shoe dullness, shifting dullness and fluid thrill. This stage of peritonitis is considered as ''jatodakavastha'' of ''udara''<ref name="ref21" /> [48-49].
==== Current Clinical Management ====
{| class="wikitable"
Type Medicine Dose Time Anupana
|-
Vata dominant Dashamula kwatha 20-40 ml Apana kala (before meals) two times Water
! scope="col"| Type
! scope="col"| Medicine
Pitta dominant Suvarna shekhara 50-100 mg Apana kala Water
! scope="col"| Dosage
! scope="col"| Time
Kapha dominant Aarogyavardhini 250-500 mg Morning Milk
! scope="col"| ''Anupana''
|-
| rowspan="2"|''[[Vata]]'' dominant
| ''Dashamula kwatha''
Tridoshaja Suvarna vasanta 200-400 mg Apana kala Honey
| 20-40 ml
| ''Apana kala'' (between meals)
| Water
Chhidrodara Surgery -- -- --
|-
| ''Surya Kshara''
| 800-1200 mg
| Morning
| Water
|-
| rowspan="2"|''[[Pitta]]'' dominant
| ''Suvarna Shekhara''
| 50-100 mg
| ''Apana kala''
| Water
|-
| ''Apamarga Kshara''
| 800-1200 mg
| Morning
| Water
|-
| rowspan="2"|''[[Kapha]]'' dominant
| ''Arogyavardhini''
| 250-500 mg
| Morning
| Milk
|-
| ''Vajra Kshara''
| 800-1200 mg
| Morning
| Honey
|-
| rowspan="2"|''Yakritodara-Plihodara''
| ''Tamra Kalpa''
| 200-800 mg
| Morning
| Honey
|-
| ''Gomutra''
| 50-100 ml
| Morning
| Honey
|-
| rowspan="3"|''Tridoshaja''
| ''Suvarna Vasanta''
| 200-400 mg
| ''Apana Kala''
| Honey
|-
| ''Kumari Asava''
| 10-20 ml
| ''Apana Kala''
| Water
|-
| ''Bhallatakasava''
| 5-10 ml
| ''Samana Kala''
| Water
|-
| ''Chhidrodara''
| Surgery
| ''-''
| ''-''
| ''-''
|}
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== References ==
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