The Sushruta Samhita — trans. Bhishagratna
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The patient cannot ascertain whether his meal has been digested or not. 6.
The Vataja, Pittaja, and Kaphaja
Types : — A case of Udara in which the abdomen enlarges on its sides and posterior part, and is overspread with nets of black veins should be ascribed to the action of the deranged Vdyu. A pain (Sula), suppression of the stool and urine (Andha) and a cutting and piercing pain and flatulent rumbling in the intestines are the symptoms which likewise characterise this Va'taja form of Udara. A sucking pain in the abdomen, thirst, fever with a burning sensation, yellow colour of the swollen skin of the abdomen, on the surface of which yellow veins appear, yellow colour of the eyes, nails, face, stool and urine and the rapid increase of the dropsical swelling, are the characteristics of the Pittaja Udara. In a case of Kaphaja type the dropsical swelling is cold to the touch and becomes overspread with white-coloured, veins. The abdomen seems heavy , hard, glossy and is extremely distended. The swelling slowly increases, and the fingernails and face of the patient become white, and he complains of a general lassitude. 7 — 9.
52 THE SUSHRDTA SAMHITA. tChap. VIl.
The abdomen seems heavy , hard, glossy and is extremely distended. The swelling slowly increases, and the fingernails and face of the patient become white, and he complains of a general lassitude. 7 — 9.
52 THE SUSHRDTA SAMHITA. tChap. VIl.
The TridOShaja Type :— Evil-natured women (with a view to win the affections of their husbands or lovers sometimes) mix with their food and drink such refuse matters of their bodies as nails, hair, faeces, urine, catamenial blood etc. (which are supposed to be possessed of talismanic virtues). The three Doshas of the body, vitiated by such food or drink, or through imbibing any sort of chemical poison (Gara) administered by one's enemy, or by taking poisonous waters, or Dushi-Visha (slow poison whose active properties have been destroyed by fire or any antipoisonous medicine), will vitiate the blood and give rise to a kind of dreadful dropsical swelling of the abdomen, marked by the specific symptoms of each of them The disease is aggravated in cold and cloudy days and a burning sensation is felt (in the inside of the abdomen\ The patient becomes pale, yellow and emaciated, and is afflicted with thirst and dryness in the mouth, and loses consciousness at short intervals. This disease is also known as the dreadful Dushyodaram. lo. Plihodaram. — (Spleen with dropsy of the abdomen) : — -Now hear me describe the symptoms of Plihodaram. The blood and the Kapham of a person, deranged and aggravated through the ingestion of phlegmagogic food, or of those which is followed by an acid digestionary reaction (Viddha), often enlarge the spleen, (which gives rise to a swelling of the abdomen). This disease is called Plihodara by the experts. Plihodaram protrudes on theleft sideof the abdomen, its characteristic symptoms being lassitude, low fever, impaired digestion, loss of strength, jaundice, weakness, and other distressing symptoms peculiar to the deranged Pittam and Kapham. A similar enlargement of the liver through similar causes on the right side of the abdomen is called Jakriddfitly udarani. 1 1 — 1 2.
Chap. Vll.] NIDANA SfHAJSTAM. ^3
A similar enlargement of the liver through similar causes on the right side of the abdomen is called Jakriddfitly udarani. 1 1 — 1 2.
Chap. Vll.] NIDANA SfHAJSTAM. ^3
Vaddha-gUdOdaram* :— The fecal matter, mixed with the deranged Vayu, Pittam etc. of the body, lies stuffed in the rectum of a person whose intestines have been stuffed with slimy food (as pot herbs) or with stones and hair (enteritis). They give rise to a sort of abdominal dropsy by swelling the part between the heart and the umbilicus which is called Vaddha Gudodaram. Scanty stools are evacuated with the greatest pain and difficulty and the patient vomits a peculiar kind of matter with a distinctly fecal smell (scyabalous ?). 13.
Parisravi-Udaram : — Now hear me describe the causes and symptoms of the type of Udaram which is called Parisratvi-udaram. Thorny or sharp-pointed substances (such as fish-bones etc.), carried down with the food in a slanting way from the stomach into the abdomen, sometimes scratch or burrow into the intestines. Causes other than the preceding ones, (such as a long yawn or over-eating etc.) may contribute to the perforation of the intestines, giving rise to a copious flow of a watery exudation which constantly oozes out of the anus and to a distension of the lower part of the abdomen situated below the , umbilicus. This is called Parisravy udaram which is marked by a cutting pain and a burning sensation. 14.
Dakodaram : — Now hear me describe the causes and symptoms of the type known as Dakodaram (ascites). The drinking of cold water immediately after the application of an Aunvdsanam or Asthapanam enema, or closely following upon the exhibition of any purgative or emetic medicine, or just after the taking of a medicated oil or clarified butter, etc. tends to derangep. 54 the water-carrying channels of the body. The same result may be produced by the drinkmg of oil, etc. in inordinate quantities The water, by percolating or transuding through the walls of these channels, as before described, inordinately enlarges the abdomen, which becomes glossy on the surface and is full of water, being rounded about the umbilicus and raised like a fullbloated water-drum. The simile is complete as it fluctuates under pressure, oscillates, and makes a peculiar sound like a water-drum under percussion. 15.
* Dropsical swelling of the abdomen with tympanites due to the constriction of the rectum known as intestinal obstruction.