The 14th chapter of Chikitsasthana of Sushruta Samhita is known as as Udara Cikitsitam Adhyaya. This chapter offers with Enlargement of the stomach.
अथातउदराणांचिकित्सतंव्याख्यास्यामः।।१।।
यथोवाचभगवान्धन्वन्तरिः।।२।।
We are going to now expound the Udara chikitsa- therapy of stomach enlargements as revealed by the venerable Dhañvañtari.
Sadhyāsādhyata – prognosis
अष्टावुदराणिपूर्वमुद्दिष्टानि।तेष्वसाध्यंबद्धगुदंपरिस्राविच.अवशिष्टानिकृच्छ्रसाध्यानि.सर्वाण्येवप्रत्याख्यायोपक्रमेत।तेष्वाद्यश्चतुर्वर्गोभेषजसाध्यः,उत्तरःशस्त्रसाध्यः,कालप्रकर्षात्सर्वाण्येवशस्त्रसाध्यानिवर्जयितव्यानिवा।।३।।
Earlier i.e. in Nidana Sthana part, chapter 7, eight sorts of Udara Roga have been described. Amongst these eight varieties, Baddhaguda Udara and Parisrāvi Udara are incurable. The remaining six varieties of Udara are curable with issue.
The doctor ought to deal with all varieties of Udara after intimating about their incurability (prognosis) to the affected person (and his attendants / household).
The primary 4 varieties of Udara i.e. Vataja Udara, Pittaja Udara, Kaphaja Udara and Dusivisaja Udara may be handled with medicines.
The opposite 4 varieties of Udara are treatable with surgical therapies.
Every kind of Udara change into treatable by surgical procedure or match to be refused (therapy shall be refused because of its dangerous prognosis) with lapse of time i.e. if not handled at correct time.
Pathyāpathya – appropriate and unsuitable issues in Udara
उदरीतुगुर्वभिष्यन्दिरूक्षविदाहिस्निग्धपिशितपरिषेकावगाहान्परिहरेत.शालिषष्टिकयवगोधूमनीवारान्नित्यमश्नीयात्।।४।।
Beneath talked about ought to be prevented by the sufferers affected by Udara i.e. stomach enlargement –
– meals that are heavy i.e. laborious to digest,
– meals which trigger moisture contained in the tissues,
– meals which trigger dryness within the physique,
– meals which produce burning sensation throughout digestion and
– meats wealthy in fats and
– taking bathe / tub or immersing in water
The affected person ought to take the beneath talked about issues every day –
– sāli,
– șașţika,
– yava,
– godhūma and
– nīvāra
Vātodara Cikitsā
तत्रवातोदरिणंविदारिगन्धादिसिद्धेनसर्पिषास्नेहयित्वा,तिल्वकविपक्वेनानुलोम्य,चित्राफलतैलप्रगाढेनविदारिगन्धादिकषायेणास्थापयेदनुवासयेच्च,साल्वणेनचोपनाहयेदुदरं,भोजयेच्चैनंविदारिगन्धादिसिद्धेनक्षीरेणजाङ्गलरसेनच,स्वेदयेच्चाभीक्ष्णम्।।५।।
Beneath talked about remedies ought to be thought of and performed to the affected person of Vatodara –
– Oleation – with ghee ready from herbs belonging to Vidārigañdhadi Gaņa,
– Purgation – with ghee processed with Tilvaka,
– Enema – within the type of decoction enema and oil enema utilizing the decoction of herbs belonging to Vidārigañdhādi Gana after including extra amount of Citraphala (Dantiphala) oil
– Poultice fomentation – The stomach of the affected person of Vataja Udara ought to be given fomentation / poultice following Salvana Upanaha technique
– Food plan – Meals processed with herbs belonging to Vidārigañdhādi Gaña ought to be administered to the vataja udara affected person together with milk, soup of meat of animals residing in arid areas
– Sudation – The Vataja Udara affected person ought to be made to sweat profusely.
Pittodara Cikitsā
पित्तॊदरिणंतुमधुरगणविपक्वेनसर्पिषास्नेहयित्वा,श्यामात्रिफलानिवृद्वि-
पक्वेनानुलोम्य,शर्करामधुघृतप्रगाढेनन्यग्रोधादिकषायेणास्थापयेदनुवासयेच्च,पायसेनोपनाहगेदुदरं,भोजयेच्चैनंविदारिगन्धादिसिद्धेनपयसा।।६।।
Beneath talked about remedies ought to be thought of and performed to the affected person of Pittodara –
Oleation – ought to be given utilizing medicated ghee ready from herbs belonging to Madhura Gaña (kākolyādi gaņa),
Purgation – ought to be administered utilizing ghee boiled and ready with śyāmā, triphalā and trivrt,
Enema – Medicated enema within the type of decoction enema and oil enema ought to be given with decoction ready from herbs belonging to Nyagrodhadi Gana. It shall be given after including and mixing completely extra portions of sugar, honey and ghee.
Fomentation / Poultice – to the stomach area ought to be performed utilizing Payasa – milk pudding.
Food plan – The affected person ought to eat meals together with milk boiled with herbs belonging to Vidārigañdhadi Gana.
Kaphodara Cikitsā
श्लेष्मोदरिणंतुपिप्पल्यादिकषायसिद्धेनसर्पिषोपस्नेह्य,स्नुहीक्षीरविपक्वेनानुलोम्य,त्रिकटुकमूत्रक्षारतैलप्रगाढेनमुष्ककादिकषायेणास्थापयेदनुवासयेच्च,शणातसीधातकीकिण्वसर्षपमूलकबीजकल्कैश्चोपनाहयेदुदरं,भोजयेच्चैनंत्रिकटुकप्रगाढेनकुलत्थयूषेणपायसेनवा,स्वेदयेच्चाभीक्ष्णम्।।७।।
Beneath talked about remedies ought to be thought of and performed to the affected person of Slesmodara –
– Oleation – ought to be given to the affected person affected by Kaphaja or Slesma Udara utilizing ghee processed with decoction of herbs belonging to Pippalyādi Gana
– Purgation – ought to be given utilizing purgative boiled with Snuhi Ksira
– Enema – Medicated enema within the type of decoction enema and oil enema ought to be given with decoction of herbs belonging to Muskakādi Gana after having added extra amount of Trikatu, Gomutra, Yava Ksara and Taila
– Fomentation / poultice – ought to be given to the stomach of the affected person with poultice constituted of Sana, Atasi, Dhataki, Kinva, Sarsapa and seeds of Mulaka.
– Food plan – The affected person ought to take meals together with Kulattha (horse gram) soup or Payasa (milk pudding) including extra amount of Trikatu.
– Swedana – The affected person of Slesmodara ought to be made to perspire always.
Düşyodara Cikitsā
दूष्योदरिणंतुप्रत्याख्यायसप्तलाशङ्खिनीस्वरससिद्धेनसर्पिषाविरेचयेन्मासमर्थमासंवा,महावृक्षक्षीरसुरागोमूत्रसिद्धेनवा.शुद्धकोष्ठंतुमद्येनाश्वमारकगुञ्जाकाकादनीमूलकल्कपाययेत्.इक्षुकाण्डानिवाकृष्णसर्पणदंशयित्वाभक्षयेद्वल्लीफलानिवा,मूलजंकन्दजंवाविषमासेवयेत्तेनागदोभवत्यन्यंवाभावमापद्यते।।८।।
Beneath talked about remedies ought to be thought of and performed to the affected person of Dusyodara –
The affected person of Dusyodara ought to be handled solely after being knowledgeable concerning the incurable nature of the illness and having taken his consent.
Purgation – The affected person of Dusyodara ought to be given purgation every day for a month or a fortnight time. For this objective, ghee boiled with recent juice of Saptala and Sankhini ought to be used. Alternatively, ghee boiled with sap of Mahāvrkșa (snuhī), Surā (beer) and Gomūtra.
Drink – As soon as the stomach of the affected person is cleansed by administering purgation as defined above, he ought to be given wine blended with paste of Aśvamāra, Guñja and Kākādanīmūla to drink.
Administering poison – A bit of sugarcane or a Valliphala – i.e. gourds like cucumber, melon, snake gourd and so forth. ought to be taken. These gourds ought to be bitten by a black serpent. This gourd ought to now be given to the affected person for consuming. Alternatively, a root or stem of toxic vegetation could also be given for consuming. This therapy is named Visa Prayoga i.e. administering poisons. It acts as an anti-poisonous recipe or can also give the opposite sort of end result i.e. loss of life.
भवतिचात्र
One verse right here
कुपितानिलमूलत्वात्संचितत्वान्मलस्यच।।
सर्वोदरेषुशंसन्तिबहुशस्त्वनुलोमनम्।।९।।
Within the therapy of Udara Roga, skilled physicians reward the advantages of administering extra of purgative remedy for the reason that illness is brought on by Vata and by accumulation of malas (doshas) within the physique (which must be flushed out by administering virechana – purgation).
Sāmanya yoga – widespread recipes
अतऊर्ध्वंसामान्ययोगान्वक्ष्यामः।तद्यथा-एरण्डतैलमहरहर्मासंद्वौवा केवलंमूत्रयुक्तंक्षीरयुक्तंवासेवेतोदकवर्जी,माहिषंवामूत्रंक्षीरेणनिराहारःसप्तरात्रम्,उष्ट्रीक्षीराहारोवाऽन्नवारिवर्जीपक्षं,पिप्पलीवामासंपूर्वोक्तेनविधानेनासेवेत,सैन्धवाजमोदायुक्तंवानिकुम्भतैलम्,आर्द्रश्शृङ्गवेररसपात्रशतसिद्धंवावातशूलेऽवचार्य,शृङ्गवेररसविपक्वंक्षीरमासेवेत,चव्यशृङ्गवेरकल्कंवापयसासरलदेवदारुचित्रकमेववा,मुरङ्गीशालपर्णीश्यामापुनर्नवाकल्कंवाज्योतिष्कफलतैलंवाक्षीरेणस्वर्जिकाहिङ्गमिश्रंपिबेत्,गुडद्वितीयांवाहरीतकीभक्षयेत्,स्नुहीक्षीरभावितानांवापिप्पलीनांसहस्रंकालेन,पथ्याकृष्णाचूर्णंवास्नुहीक्षीरभावितमुत्कारिकांपक्वांदापयेत्हरीतकीचूर्णंप्रस्थमाढकेघृतस्यावाप्याङ्गारेष्वभिविलाप्यखजेनाभिमथ्यानुगुप्तंकृत्वाऽर्धमासंयवपल्लेवासयेत्,ततश्चोद्धृत्यपरिस्राव्यहरीतकीक्वाथाम्लदधीन्यावाप्यविपचेत्,तद्यथायोगंमासमर्धमासंवापाययेत्.गव्येपयसिमहावृक्षक्षीरमावाप्यविपचेत्,विपक्वंचावतार्यशीतीभूतमन्थानेनाभिमथ्यनवनीतमादायभूयोमहावृक्षक्षीरेणैवविपचेत्,तद्यथायोगंमासंमासार्धंवापाययेत्चव्यचित्रकदन्त्यतिविषाकुष्ठसारिवात्रिफलाजमोदहरिद्राशङ्गिनीत्रिवृत्रिकदुकानामर्धकार्षिकाभागा,राजवृक्षफलमज्झामष्टौकर्षाः,महावृक्षक्षीरपलेद्वे,गवांक्षीरमूत्रयोरष्टावष्टौपलानि,एतत्सर्वंघृतप्रस्थेसमावाप्यविपचेत्,तद्यथायोगंमासमर्धमासंवापाययेत्।एतानितिल्वकघृतचतुर्थानिसीष्युदरगुल्मविद्रध्यष्ठीलानाहकुष्ठोन्मादापस्मारेषूपयोज्यानिविरेचनार्थं.मूत्रासवारिष्टसुराश्चाभीक्ष्णंमहावृक्षक्षीरसंभृताःसेवेत.विरेचनद्रव्यकषायंवाशृङ्गवेरदेवदारुप्रगाढम्।।१०।।
Additional, some widespread recipes for every kind of udara – stomach enlargements shall be described, as enlisted beneath –
Eranda Taila i.e. castor oil ought to be administered for oral consumption blended with Gomutra – urine of cow or milk. This recipe ought to be consumed by the affected person on daily basis for a interval of 1 or two months. Whereas taking this recipe, one ought to keep away from ingesting water.
The affected person ought to eat buffalo urine blended with milk for a interval of seven days. He shouldn’t take another meals throughout this era. Alternatively he ought to eat solely camel’s milk as meals whereas avoiding other forms of meals and water for a interval of fortnight.
He ought to eat Pippali – Piper longum following the tactic of consuming Vardhamana Pippali beforehand defined in chapter 5, for a interval of 1 month.
He ought to eat Nikumba Taila i.e. oil of Danti added with Saindhava and Ajamoda. Alternatively, Nikumbha Taila processed with 300 patra (adhaka – 2.5 kg) of Srngavera juice ought to be consumed.
Alternatively the beneath talked about recipes ought to be given –
– Milk boiled with juice of Srngavera or
– Paste of Cavya and Srngavera blended with milk or
– Paste of Sarala, Devadaru and Citraka with milk or
– Paste of Murangi, Salaparni, Syama and Punarnava with milk or
– Oil of Jyotismati with milk, added with Svarjika and Hingu or
– Haritaki – Terminalia chebula added and blended with two components of Guda – jaggery
The affected person ought to eat one thousand Pippali – Piper longum soaked in Snuhi Ksira as a course in stipulated time interval, as a lot as attainable (Vardhamana Pippali).
Utkarika – pan cake ready by cooking powder of Pathya and Krsna (Pippali) soaked in milky sap of Snuhi ought to be consumed.
One prastha amount (640 grams) of Haritaki – Terminalia chebula powder is taken. This powder is cooked in a single adhaka (2.56 kg) of ghee on burning coal. It’s churned with a churner and put right into a pot. This pot is saved hidden in a heap of Yava – barley for half a month. After one month, the pot is eliminated and the contents are filtered. To this, decoction of Haritaki – Terminalia chebula and bitter curd is added and cooked. This recipe ought to be consumed for a time interval of 1 fortnight or one month.
Firstly the milk sap is obtained from Mahavrksa (Snuhi). Milk is added to this sap and cooked. After it will get cooled, it’s churned with a churner and butter is extracted from it. To that is added milky sap of Mahavrksa and cooked. Ghee is obtained from it and consumed for a time interval of 1 month or half of a month.
Half karsa (5mg) every of the beneath talked about herbs are taken –
– Cavya,
– Citarka,
– Dañtī,
– Ativişā,
– Kuştha,
– Sărivā,
– Triphalā,
– Ajamodā,
– Haridrā,
– Sankhinī,
– Trivít and
– Trikațuka
Different components –
– eight karsa (80 grams) of phala majja (pulp / resin of fruit) of Rajavrksa
– two pala (80 grams) of milky sap of Mahavrksa (Snuhi),
– eight pala (320 grams) of go kshira – cow milk
– eight pala (320 grams) of gomutra – cow urine and
– one prastha (640 grams) of ghee
All of the above talked about components are cooked collectively and medicated ghee ready. This ghee is consumed for one month or half month in appropriate doses.
For purgation, the above-mentioned recipes or the 4 Tilvaka Ghrta described in chapter 4 ought to be used. When used, they’re useful in curing the beneath talked about situations / ailments –
– stomach enlargement,
– stomach tumour,
– abscess,
– enlarged prostate,
– flatulence,
– leprosy,
– madness and
– epilepsy
Or, the beneath talked about could also be consumed with milky sap of Mahavrksa (Snuhi) –
– asava – fermented infusion,
– arista – fermented decoction or
– sura – beer
Or extra amount of powder of Srngavera and Devadaru ought to be blended within the decoction of purgative medicine (vide chp.39 of sūtrasthāna) and consumed.
Virecana guţikal / Ānāhahara varti
वमनविरेचनशिरोविरेचनद्रव्याणांपालिकाभागाःपिप्पल्यादिवचादिहरिद्रादिपरिपठितानांचद्रव्याणांश्लक्ष्णपिष्टानांयथोक्तानांचलवणानांतत्सर्वंमूत्रगणेप्रक्षिप्यमहावृक्षक्षीरप्रस्थंचमृद्वग्निनाऽवघडयन्विपचेदप्रदग्धकल्क,तत्साधुसिद्धमत्रतार्यशीतीभूतमक्षमात्रागुटिकावर्तयेत्,तासामेकांद्वेतिस्रोवागुटिकाबलापेक्षयामासांस्त्रींश्चतुरोवासेवेत,एषाऽऽनाहवर्तिक्रियाविशेषेणमहाव्याधिषूपयुज्यते(विशेषण),कोष्ठजांश्चकृमीनपहन्तिकासश्र्वासकृमिकुष्टप्रतिश्यायारॊचकाविपाकादावर्तांश्र्चनाशयति॥११॥
Elements –
– one pala (40 grams) every of – herbs talked about below vamana (emetics), virecana (purgatives), sirovirecana (head purging) group of herbs
– one pala (40 grams) every of herbs talked about in Pippalyadi, Vacadi and Haridradi Gana
– one pala of all of the lavanas (salts)
The above mentioned components are made into paste and soaked in combination of all of the mutras i.e. urines of animals talked about in mutravarga (chapter 45 of Sutra Sthana part of the identical treatise).
To this, one prastha (640 grams) of milky sap of Mahavrksa (Snuhi) can also be added.
These components are cooked over a light hearth. Whereas cooking, the components are stirred on a regular basis, not permitting the paste to get charred.
Later, it’s taken out of the oven. After the components get cooled it’s made into dragees / tablets of 1 aksa (10 grams) in amount.
One, two or three numbers of those medicine / tablets are consumed protecting in view the energy of the particular person. It ought to be taken for a interval of three or 4 months.
These tablets / dragees are specifically utilized in treating mahāvyadhis i.e. dreadful ailments. Additionally they destroy the intestinal worms.
They’re used to treatment the beneath talked about ailments –
– cough,
– dyspnoea,
– worms,
– leprosy / pores and skin ailments,
– nasal catarrh,
– anorexia,
– dyspnoea and
– upward motion of vayu (upward peristalsis)
Madanādi gudavarti – rectal suppositories
मदनफलमज्जकुटजजीमूतकेक्ष्वाकुधामार्गवत्रिवृत्रिकटुकसर्षपलवणनिमहावृक्षश्मीरमूत्रयोरन्यतरेणपिष्टवाऽङ्गुष्ठमात्रांवर्तिकृत्वोदरिणआनाहेतैललवणाभ्यक्तगुदस्यैकांद्वेनिस्न्नॊवापायौनिदध्यात्,एषाऽऽनाहवर्तिक्रियावातमूत्रपुरीषोदावर्तामानानाहेषुविधेया।।१२।।
Beneath talked about components are macerated within the milky sap of Mahavrksa (snuhi), mutra (urines) or any comparable liquids and made into wicks of the dimensions of the thumb –
– Madanaphala majja,
– Kutaja,
– Jimutaka,
– Iksvāku,
– Dhāmārgava,
– Trivrt,
– Trikatu,
– Sarsapa and
– Lavana (salts)
Anus is lubricated with a combination of oil and salt. After this, one, two or three of those wicks are launched into the rectum.
These rectal suppositories would relieve flatulence when utilized in sufferers of stomach enlargements. Due to this fact they’re advocated for utilization within the beneath talked about situations –
– obstruction of flatus, urine and faeces,
– reverse peristalsis,
– tympanitis and
– flatulence
Plīhodara Cikitsā – therapy of splenomegaly
प्लीहोदरिणःस्निग्धस्विन्नस्यदध्नाभुक्तवतोवामबाहौकूर्पराभ्यन्तरतःसिरांविध्येत्,विमर्दयेच्चपाणिनाप्लीहानंरुधिरस्यन्दनार्थःततःसंशुद्धदेहंसमुद्रशुक्तिकाक्षारंपयसापाययेत,हिमुसौवर्चिकेवाक्षीरेण,स्रुतेनपलाशक्षारेणवायवक्षारं,किंशुकक्षारोदकेनवाबहुशःस्रुतेनयवक्षारं,पारिजातकेक्षुरकापामार्गक्षारंवा,तैलसंसृष्टंशोभाञ्जनकयूषंपिप्पलीसैन्धवचित्रकयुक्तं,पूतिकरञ्जक्षारंवाऽम्लत्रुतंबिडलवणपिप्पलीप्रगाढम्।।१३।।
In Plihodara, there may be enlargement of stomach because of enlargement of Pliha (spleen). Sufferers of Plihodara ought to be first given with oleation and sudation therapies.
Following this, he ought to be served with meals blended with curds (yoghurt).
After this, the doctor ought to puncture the vein of the left arm, contained in the elbow joint of the affected person. On the identical time, the spleen of the affected person is pressed with the hand to allow extra blood to circulation out.
After purification, the affected person ought to be given one of many beneath talked about recipes –
– heat milk added with samudra sukti (shells of sea oysters) or
– heat milk with hingu – asafoetida and sauvarcika ksara or
– with palasa ksara or yava ksara filtered many occasions within the answer of ash of kimsuka or
– ash of parijata, iksuraka and apamarga or
– ingesting of yusa – soup ready from sobhanjana added with oil and powder of pippali, saindhava lavana and citraka or
– ash of putikaranja dissolved in any bitter juice including extra amount of powder of bida lavana and pippali n any bitter juice including extra of powder or bida lavana and pippali.
Satpala Ghrta
पिप्पलीपिप्पलीमूलचव्यचित्रकशृङ्गवेरयवक्षारसैन्धवानांपालिकाभागाः,घृतप्रस्थंतत्तुल्यंचक्षीरंतदैकध्यंविपाचयेत्,एतत्षट्पलकंनामसर्पिःप्लीहाग्निसङ्गगुल्मोदरोदावर्तश्वयथुपाण्डुरोगकासश्वासप्रतिश्यायोर्ध्ववातविषमज्वरानपहन्ति।मन्दाग्निर्वाहिङ्ग्वादिकंचूर्णमुपयुञ्जीत।।१४।।
Elements –
One pala (40 grams) every of –
– Pippali,
– Pippalīmāla,
– Cavya,
– Citarka,
– Srñgavera,
– Yavakşāra and
– Saindhava
One prastha (640 gm) of – ghrta (ghee) and
Equal amount of i.e. one prastha (640 gm) of – milk
All of the above mentioned components are cooked collectively in order to arrange medicated ghee. This medicated ghee is understood by the identify Satpalaka Ghrta.
Advantages – This ghrta cures the beneath talked about situations –
– enlargement of spleen,
– weak digestive energy,
– stomach tumour,
– enlargement of stomach,
– reverse peristalsis,
– dropsy,
– anaemia,
– cough,
– dyspnoea,
– nasal catarrh,
– extreme belching and
– intermittent fever
Hiñgvādi Cūrņa ought to be utilized by the sufferers who’ve weak digestive hearth.
मणिबन्धंसकृन्नाम्यवामाङ्गुष्ठसमीरिताम्।।
दहेत्सिरांशरेणाशुप्लीह्नोवैद्यःप्रशान्तये।।१६।।
The left wrist of the affected person ought to be bent inwards carefully in order to bulge the vein. The vein arising close to the left thumb ought to now be burnt (cauterized) with the assistance of a pink scorching arrow or by a pink scorching iron rod with the intention of lowering the dimensions of the enlarged spleen (in plihodara).
यकृहाल्येऽप्येषएवक्रियाविभागः।
विशेषतस्तुदक्षिणबाहौसिराव्यधः।।१५।।
The identical therapy (as defined for Plihodara) ought to be performed in case of Yakrddalyodara / Yakrtodara (hepatomegaly / enlargement of liver) however the vein puncture ought to be performed on the precise arm (as a substitute of on the left).
Baddhagudodara Cikitsā – therapy of intestinal obstruction
बद्धगुदेपरिस्राविणीचस्निग्धस्विन्नस्याभ्यक्तस्याधोनामेमतश्चतुरङ्गुलमपहायरोमराज्याउदरंपाटयित्वाचतुरङ्गुलप्रमाणमन्त्राणिनिष्कृष्यनिरीक्ष्यबद्धगुदस्यान्त्रप्रतिरोधकरमश्मानंबालंवाऽपोह्यमलजातंवाततोमधुसर्पिभ्या॑मभ्यज्यान्त्राणियथास्थानंस्थापयित्वाबाह्यव्रणमुदरस्यसीव्येत्।
In Baddhagudodara, the stomach of the affected person is enlarged because of intestinal obstruction. On this situation oleation and sudation therapies ought to be performed first. The stomach ought to be anointed after which the stomach is lower open. For this, the incision ought to be made beneath the umbilicus permitting 4 angula (8 cm) house from the road of hairs located within the central line of the stomach. After placing the incision, the gut is gently pulled out via the wound (opening). The pulled out gut is examined for the presence of stone, hair, faeces or another materials which is inflicting obstruction of the gut. As soon as they’re discovered, they need to be eliminated. Following this, the gut is anointed with a combination of honey and ghee and later positioned in its regular place by pushing it inside. After this, the exterior wound of the stomach is sutured.
Parisrāviudara cikitsā
परित्राविण्यप्येवमेवशल्यमुद्धृत्यान्त्रनावान्संशोध्य,तच्छिद्रमान्नंसमाधायकालपिपीलिकाभिदंशयेत्,दष्टेचतासांकायानपहरेन्नशिरांसि,ततःपूर्ववत्सीव्येत्,संधानचयथोक्तंकारयेत्,यष्टीमधुकमिश्रयाचकृष्णमृदाऽवलिप्यबन्धेनोपचरेत्,ततोनिवातमागारप्रवेश्याचारिकमुपदिशेत्,वासयेच्चैनंतैलद्रोण्यांसर्पिोण्यांवापयोवृत्तिमिति।।१७।।
In Parisraviudara (stomach enlargement because of intestinal puncture) the the Salya (overseas physique inflicting the puncture) is eliminated in the identical approach as described above, the intestinal exudate cleaned (eliminated), the lower ends of gut are introduced shut and received bitten by huge black ants. When the ants have correctly bitten the ends of the gut their heads are chopped off from their our bodies (our bodies are lower off). Afterwards the stomach ought to be sutured as described earlier.
A paste is ready by mixing black mud with Yastimadhu – licorice powder. This paste ought to be utilized on the stomach of the affected person as a plaster after which bandaged correctly.
After this, the affected person is made to enter a room devoid of breeze and allowed to remain there. Whereas staying there he ought to be prescribed an excellent routine of meals and actions. The attendants ought to be defined about their duties in direction of the affected person. The affected person ought to be made to lie down in a bath full of oil or ghee (medicated) for some days. He ought to maintain on milk solely as meals throughout this era.
Dakodara Cikitsā – therapy of Ascitis
दकोदरिणस्तुवातहरतैलाभ्यक्तस्योष्णोदकस्विन्नस्यस्थितस्याप्तैःसुपरिगृहीतस्याकक्षात्परिवेष्टितस्याधोनाभेर्वामतश्चतुरङ्गुलमपहायरोमराज्याव्रीहिमुखेनाङ्गुष्ठोदरप्रमाणमवगार्डविध्येत्,तत्रत्रप्वादीनामन्यतमस्यनाडीद्विद्वारांपक्षनाडीवासंयोज्यदोषोदकमवसिञ्चेत्,ततोनाडीमपहृत्यतैललवणेनाभ्यज्यव्रणंबन्धेनोपचरेत्,नचैकस्मिन्नेवदिवसेसर्वदोषोदकमपहरेत्,सहसाह्यपहृतेतृष्णाज्वराङ्गमर्दातीसारश्वासकासपाददाहाउत्पद्येरन्नापूर्यतेवाभृशतरमुदरमसञ्जातप्राणस्य,तस्मात्तृतीयचतुर्थपञ्चमषष्ठाष्टमदशमद्वादशषोडशरात्राणामन्यतममन्तरीकृत्यदोषोदकमल्पाल्पमवसिञ्चत्निःस्तेचदोषेगाढतरमाविककौशेयचर्मणामन्यतमेनपरिवेष्टयेदुदरं,तथानाध्मापयतिवायुः.षण्मासांश्चपयसाभोजयेज्जाङ्गलरसेनवा,ततस्त्रीन्मासान ? दकेनपयसाफलाम्लेनजाङ्गलरसेनवा,अवशिष्टंमासत्रयमन्नंलघुहितंवासेवेत,एवंसंवत्सरेणागदोभवति।।१८।।
The stomach of the affected person of Dakodara (ascites) ought to be given anointment / therapeutic massage with vata mitigating oils. After this, fomentation ought to be given by utilizing scorching water (pads soaked in scorching water or pouring scorching water on the stomach).
The affected person is now made to take a seat on a chair or cot of the peak of his knee (knee top). He ought to be held tight in place by his properly wishers i.e. kinfolk or attendants, wrapped with fabric bands from armpit downwards.
Subsequent, the stomach of the affected person ought to be punctured with the assistance of vrihimukha sastra i.e trocar, permitting an area of 4 angulas (8cm) from the midline of the stomach, on the left aspect of the stomach and beneath the umbilicus. The puncture ought to be performed to a depth of thickness of the centre of the thumb. A tube (cannula) manufactured from tin and so forth (metallic tube) or feather of birds having openings at each ends is mounted to the trocar and the vitiated fluid amassed within the stomach is drained out.
After draining the fluid, the tube i.e. trocar and cannula is eliminated. The wound is anointed with oil blended with saindhava lavana – rock salt and is bandaged. The doctor / surgeon shouldn’t take away all of the vitiated fluid in a single sitting itself i.e. it shouldn’t be eliminated in someday itself. If the fluid is eliminated directly, it could give rise to thirst, fever, body-aches, diarrhoea, dyspnoea, cough and burning sensation within the soles. Additionally, the fluid could as soon as once more accumulate within the stomach in extra even earlier than the energy (of the stomach and affected person) is regained. Due to this fact, the vitiated fluids ought to be eliminated at intervals of three, 4, 5, six, eight, ten, twelve, sixteen or such different days. The fluid ought to be eliminated in much less portions.
After eradicating the vitiated fluids, the stomach ought to be bandaged tightly utilizing bands of wool, silk or leather-based such that the air doesn’t trigger stomach bloating.
The affected person shall take meals both with milk or meat soup of animals residing in arid lands for a interval of first six months. Meals ought to be taken with milk added with half its amount of water or juice of bitter fruits or meat soup of animals residing in arid lands throughout the subsequent three months. Within the remaining three months he ought to eat boiled rice which is gentle and appropriate.
On this method, the particular person would get cured of ascites in a single 12 months time by adhering strictly to the routine.
भवतिचात्र
आस्थापनेचैवविरेचनेचपानेतथाऽऽहारविधिक्रियासु।।
सर्वोदरिभ्यःकुशलैःप्रयोज्यंक्षीरंशृतंजाङ्गलजोरसोवा।।१९।।
One verse right here,
Within the therapy of every kind of Udara i.e. stomach enlargement, an clever and skilled doctor ought to plan and administer the therapies like decoction enema, purgation, routine of meals, drinks, boiled milk and meat soup.
इतिसुश्रुतसंहितायांचिकित्सास्थानेउदरचिकित्सितंनाम चतुर्दशोऽध्यायः।।१४।।
Thus ends the fourteenth chapter by identify Udara cikitsita in Cikitsā Sthāna of Susruta Samhita.
