Indian Medicine (Medicin), translated by C. G. Kashikar c12.38

Language: English

c12.38.1

Ailments similar to the first four gulmas fall partly under the conception of udara. Persons particularly suffering from weak digestion (*mandāgni*) are attacked by udara in which the saturated dosas penetrate between the skin and the flesh and severely blow up the belly as a result of unsuitable diet and other injurious causes. There are eight kinds of udara with the following signs: loss of appetite, sweet taste, oily and fat-containing food is slowly digested, one does not perceive whether the digestion is complete or not, does not endure oversaturation, the feet are swollen, the bladder ails, one becomes void of strength and breathes heavily even with small exertions, the faeces are retained, the belly is blown up even by light and sparing diet, veins appear on it and the wrinkles disappear and so on. Further common symptoms are: flatulence, inability to walk, feebleness, weak digestion, swelling of hands and feet, giddiness in limbs, constipation and retention of urine, heat, looseness and getting lean. 1-4. The special symptoms of the first three udaras which are derived from the dosas are distinguished chiefly (cf. gulma) by dark, yellow or white colour of the skin and veins on the belly. In the derangement of all dosas the patient becomes pale, lean and suffers from thirst. The derangement of all dosas can also be caused by poison or by an incantation of love consisting of food mixed with nails, hair, urine, faeces or menstrual blood of women. 5. plīhodara.

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This is caused by prolapse and enlargement of spleen which becomes hard as stone and pushed like the back of a tortoise and fills the left side of the belly with violent troubles. Similar symptoms on the right side are called yakṛddālyudara. 6. baddhaguda. This is caused by constipating food or by hair or stone in the food. The symptom is that the faeces accumulate in the anus and come out only in small quantity with troubles. There is also thirst, heat etc. and formation of a swelling between the navel and the heart. 7. parisrāvyudara or chirodara. This is caused by fish-bones, bones, wood, grass and other foreign bodies (*śalya*) in the food which wound the intestines and cause a flow of fluid from the anus with faeces and a swelling below the navel, with indigestion and other troubles. 8. udakodara, dakodara, jalodara. This is caused by untimely drinking of cold water. The belly is severely pushed as if filled with water so that it is felt and heard as a filled water-leatherbag. There is thirst, loss of appetite, prolapse and pain in the anus, feebleness, cough, breathlessness, swelling on the feet, etc. This is the ascitis coming already in the Vedas as thrown on the sinners by Varuna, the god of waters. It comes also in Manu 8.82 as "the fetters of Varuna" with which he fastens the perjurers. In other *udara*s also water can be produced and then they, as a rule, are incurable. Congenital *udara* is similarly incurable.

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In *baddhaguda* and *chidrodara* the patient dies mostly after 14 days. Of the remaining *udara*s, those caused by *vāta*, *pitta*, *kapha*, spleen, all *dosa*s and water are in succession more dangerous than the former. Fatal symptoms are the encroachment of the disease complicating all the vital spots in the body, the skin gets wet and thin, there is pain in the sides, loss of strength, swollen eyes, diarrhoea and vomiting etc. If the light remedies are ineffective, then, in the case of *udara* caused by all *dosa*s, the patient should be given poison mixed with drink or food, or in a fruit in which an excited serpent has bitten. For this, however, the physician must secure permission of the friends, relatives or wife of the patient, or of the Brāhmaṇas or the king or the *guru*. In the case of *baddhaguda* or *chidrodara* the surgeon should, after obtaining permission, take an incision (laparotomy) in the belly with a correspondingly big knife, four *angula*s below the navel on the left side, should open the intestines four *angula*s broad and pull them out. He should then examine them, remove the hair, faeces, stone etc. stuck inside. In *chidrodara* he should likewise take out the foreign bodies, wipe off the excretion, and should cause black ants to bite the wounded place whereupon he should pull off their bodies, the heads being stuck inside.

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Thereupon he should smear the bowels with honey and butter, lay them again in their place and sew up the external wound of the belly (Car, Su, AS, AHr). In *dakodara* the surgeon should, of course with permission, take an incision on the patient while friends have held him fast and have covered his body with cloth upto the arm-pits, on the left side, four *angula*s below the naval with *vrīhimukha* (trocar), as deep as the broad part of the thumb, then place inside a tube of tin or other material or a quill and tap the water of dropsy, not at one sitting lest it may cause thirst, fever and other complications, but gradually within 16 days. The wound should be rubbed with oil and salt and bandaged and a cloth should be covered around the body. The diet should be limited to milk for six months and eating should be resumed after an year (Car 6.13; Su 2.7; 4.14; AS 3.12; 4.17; AHr 3.12; 4.15; MN 236-242; Bhav 2.3.78-86; Vang 535-561).