Garudapurana 1.161

The glorious Garuḍa Mahāpurāṇa — 161.
Dhanvantari said: / I shall declare the diagnosis of abdominal enlargements (*udara*); hear that, Suśruta: / All diseases occur when the digestive fire is weak, but abdominal enlargements especially so.

Other diseases also arise from indigestion through the accumulation of waste matter. / Wind, obstructed above and below, agitated, flowing incorrectly,

vitiating *prāṇa* and *apāna*, and reaching the muscle and joints, / distends the belly, causing abdominal enlargement, which is of eight types according to its divisions:

by each humor separately, by all together, by spleen, by intestinal perforation, and by water. / Afflicted thereby, their palate and lips dry up, their feet, hands, and belly swollen entirely,

their movements, strength, and appetite destroyed, their bellies blown up, / men take on the appearance of ghosts. The premonitory signs of this are:

loss of hunger, and everything is digested with a burning sensation, as if without appetite; / the man who does not know when food is digested indulges in unwholesome food;

the strength of the body wastes away; he breathes heavily even after slight exertion; / the mind turns away from sensual objects, and there are grief, wasting, and so on;

there is constant pain in the bladder-joint, even with light and small meals; / one suffering from belly disease is worn out by decrepitude and loses strength.

Drowsiness, lassitude, discharge of wastes, weak digestive fire, / burning, swelling, and distension in the bowels occur when water develops;

when water is present in all parts, death [occurs], and grieving there is useless; / the belly rumbles, covered with a network of veins like latticed windows.

Obstructing the navel and the intestines, causing an urge, it subsides. / When wind is involved, there is pain in the heart, waist, navel, anus, and groin;

wind is expelled with noise; urine flows in small amounts; / the man has excessive craving, and the mouth has an unpleasant taste.

In wind-induced abdominal enlargement, there is swelling in the hands, feet, face, and belly; / pain in the belly, flanks, abdomen, waist, and back, and breaking pain in the joints;

dry cough, body aches, heaviness below, retention of feces, / dusky and reddish skin and other parts, and an enhanced taste for flavors in the mouth;

the belly has pricking and piercing pains and is spread with bluish-black veins; / distended, it produces an extraordinary sound in the abdomen.

And the wind here moves in all directions with pain and sound. / In bile-induced abdominal enlargement, there is fever, fainting, burning sensation, bitterness in the mouth,

dizziness, diarrhea, yellowness of the skin and other parts, a greenish abdomen, / yellow and coppery veins, and it burns with sweat and heat;

it fumes, is soft to the touch, suppurates quickly, and causes pain. / In phlegm-induced abdominal enlargements, there is prostration, sweating, swelling, and heaviness;

sleepiness, distress, loss of appetite, dyspnea, cough, whiteness of the skin and other parts; / the abdomen is dark, glossy, and covered with white and black veins;

when fluid increases excessively, it is hard, cold to the touch, heavy, and firm. / In the provocation of all three humors by their respective wastes produced by the three humors,

vitiated by all corrupting agents, mixed with blood and accumulated, / reaching the abdomen and mutating, accompanied by wasting, fainting, and dizziness,

they produce abdominal enlargement having the symptoms of all three, suppurating quickly and very severe; / and it increases especially upon exposure to cold wind,

and from overeating, shaking, the exertion of riding and walking, / and unprescribed drinks, emesis, and emaciation from diseases.

Situated on the left flank, displaced from its seat, the spleen enlarges; / or swollen by blood, chyle, and the other [bodily elements], it produces pain.

It is like a stony swelling, exceedingly hard, elevated like a tortoise's shell; / and gradually growing, it brings about distension in the belly,

accompanied by dyspnoea, cough, thirst, bad taste in the mouth, tympanites, fever, / pallor, fainting, vomiting, burning of the skin, and stupor.

Reddish, mottled, or marked with blue and yellow lines; / with upward movement of wind, constipation, delusion, thirst, and deep fever;

with heaviness, anorexia, hardness, obstruction, and giddy agitation— / like the spleen, the displaced liver also produces [the same condition] from the right flank.

When the liver has become inflamed, with stool constantly blocked in the rectum, / one may be afflicted with piles, upward movement of wind, or other [ailments].

The vitiated wind blocks the stool, bile, and phlegm; / obstructed thereby in the belly, the apāna [wind] causes fever and pain,

cough, dyspnoea, weakness of the thighs, headache, pain at the navel and flanks, / retention of stool, anorexia, vomiting, and foul wind in the belly.

The belly is covered with a network of firm blue and reddish veins, / and above the navel it usually assumes the shape of a cow's tail.

And when the belly is pierced by foreign bodies such as bones and other [objects], / the liver and other [organs] suppurate, and flowing outward through those perforations,

the intestinal fluid oozes into the rectum; thence the faecal liquid comes out little by little, / and it may have an abnormal smell, slimy, yellow, and red.

Then, filling the remaining [parts of the] belly, it produces a dreadful [condition]; / that enlarges below the navel and quickly turns watery.

When the characteristics of the doṣas are aggravated and accompanied by dyspnoea, thirst, and vertigo, / they call this perforated abdomen; others call it weeping [abdomen].

In one who has taken drinks of unctuous substances and then suddenly consumes unwholesome foods, / or from drinking excessive water, with sluggish digestive fire, emaciated and exceedingly lean,

the wind, blocked from its path, and the phlegm, mixed with water, / increase that very water, dropping by dropping accumulated in measure.

From its irritation, the abdomen is attended by thirst, rectal discharge, and pain, / accompanied by cough, dyspnoea, anorexia, and covered with veins of various colours.

Full of water, soft to the touch, with agitation and trembling similar [to a water bag], / ascites develops, firm and smooth, enveloping the channels.

When all [forms of abdominal disease] are neglected, displaced from their seats, / the suppurations and fluidities liquefy even the joints and channel openings.

And when perspiration is obstructed, aggravated and situated inside, / filling that very abdomen, it causes the disease of the belly.

The abdomen is heavy, steady, round, and emits no sound when struck; / the person has diminished strength, and it is dreadful; when touched at the channel, it throbs.

The disappearance of the veins on the belly is said to be common to all. / Abdominal disease is of wind, bile, phlegm, spleen, combination of all three, and water.

When fluid is produced after a fortnight, accompanied by obstinate constipation and complications, / abdominal disease is regarded as mostly very difficult to cure from its very onset.

Thus ends the one hundred and sixty-first chapter in the Ācārakāṇḍa, designated as the first part in the first section of the glorious Garuḍa Purāṇa.