A History of Indian Medical Literature v1.c23.349

v1.c23.349

The subjects dealt with are: prognostic features of the various types of udara: the baddhaguda and parisrāvin types are incurable, while the remaining ones are curable with difficulty; the treatment should always be carried out without holding out hope of complete recovery; the first four (of the eight types of udara) should be treated by means of drugs, the last four require surgical treatment; udara of long standing, of whatever type, is either curable by surgery only or should be given up (14.3);145 dietary and behavioural rules for udara patients (14.4);146 the management of vātodara (14.5), pittodara (14.6), kaphodara (14.7), and dūṣyodara (14.8); an anulomana147 treatment is useful in all cases of udara (14.9); three purgative recipes148 for udara in general; their way of administration; the fourth general recipe to be employed for purgative purposes in udara and other diseases is tilvakaghṛta149 (14.10); the preparation of ā-nāhavarti, its administration and indications (14.11); a second kind of ānāhavarti (14.12); the treatment of plīhodara (14.13); the preparation of ṣatpalakasarpis, useful in plīhodara and other diseases (14.14); the treatment of yakṛddālyudara is the same as that of plīhodara; more specifically, phlebotomy of the right arm is useful (14.15); cauterization of the sirā near the left thumb may bring relief to a patient with plīhodara (14.16); patients with baddhagudodara and parisrāvyudara should undergo oleation, sudation and īnunction before being subjected to surgery; subsequently, their abdomen should be opened and the intestines brought out; in a case of baddhagudodara the objects or substances causing intestinal obstruction should be removed, the intestines put back, and the wound sutured; in a case of parisrāvyudara, one should remove the foreign body, cleanse the intestines, bring the edges of the rupture together, and join them firmly by the bites of black ants; the bodies of these ants can then be removed, but their heads should be left behind;150 the wound should be sutured, etc., as described already; the post-operative treatment should take place in a sheltered room, where the patient should be made to sit in a droṇī full of oil or ghee; he should be kept on a milk diet (14.17); the treatment of dakodara (ascites): the preparatory stages, the positioning of the patient, the puncturing of the abdomen by means of the instrument called vrīhimukha, the insertion of a canula (nāḍī), and the draining of the fluid accumulated in the abdominal cavity; this draining should be carried out little by little, with intervals of three, four, five, six, eight, ten, twelve or sixteen days; the wound should be bandaged; the patient should be kept on particular diets for the period of a year after the operation (14.18); boiled milk and broths of the flesh of jāṅgala animals are beneficial in all types of udara (14.19).