The 14th chapter of Chikitsasthana of Sushruta Samhita is called as Udara Cikitsitam Adhyaya. This chapter offers with Enlargement of the stomach.
अथातउदराणांचिकित्सतंव्याख्यास्यामः।।१।।
यथोवाचभगवान्धन्वन्तरिः।।२।।
We’ll now expound the Udara chikitsa- remedy 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 forms of Udara are curable with problem.
The doctor ought to deal with all forms of Udara after intimating about their incurability (prognosis) to the affected person (and his attendants / household).
The primary 4 forms of Udara i.e. Vataja Udara, Pittaja Udara, Kaphaja Udara and Dusivisaja Udara will be handled with medicines.
The opposite 4 forms of Udara are treatable with surgical therapies.
All types of Udara change into treatable by surgical procedure or match to be refused (remedy 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।।
Under talked about must 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 / bathtub or immersing in water
The affected person ought to take the beneath talked about issues each day –
– sāli,
– șașţika,
– yava,
– godhūma and
– nīvāra
Vātodara Cikitsā
तत्रवातोदरिणंविदारिगन्धादिसिद्धेनसर्पिषास्नेहयित्वा,तिल्वकविपक्वेनानुलोम्य,चित्राफलतैलप्रगाढेनविदारिगन्धादिकषायेणास्थापयेदनुवासयेच्च,साल्वणेनचोपनाहयेदुदरं,भोजयेच्चैनंविदारिगन्धादिसिद्धेनक्षीरेणजाङ्गलरसेनच,स्वेदयेच्चाभीक्ष्णम्।।५।।
Under talked about therapies must be thought of and executed 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 must be given fomentation / poultice following Salvana Upanaha technique
– Eating regimen – Meals processed with herbs belonging to Vidārigañdhādi Gaña must be administered to the vataja udara affected person together with milk, soup of meat of animals dwelling in arid areas
– Sudation – The Vataja Udara affected person must be made to sweat profusely.
Pittodara Cikitsā
पित्तॊदरिणंतुमधुरगणविपक्वेनसर्पिषास्नेहयित्वा,श्यामात्रिफलानिवृद्वि-
पक्वेनानुलोम्य,शर्करामधुघृतप्रगाढेनन्यग्रोधादिकषायेणास्थापयेदनुवासयेच्च,पायसेनोपनाहगेदुदरं,भोजयेच्चैनंविदारिगन्धादिसिद्धेनपयसा।।६।।
Under talked about therapies must be thought of and executed to the affected person of Pittodara –
Oleation – must be given utilizing medicated ghee ready from herbs belonging to Madhura Gaña (kākolyādi gaņa),
Purgation – must be administered utilizing ghee boiled and ready with śyāmā, triphalā and trivrt,
Enema – Medicated enema within the type of decoction enema and oil enema must 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 must be executed utilizing Payasa – milk pudding.
Eating regimen – 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।।
Under talked about therapies must be thought of and executed to the affected person of Slesmodara –
– Oleation – must be given to the affected person affected by Kaphaja or Slesma Udara utilizing ghee processed with decoction of herbs belonging to Pippalyādi Gana
– Purgation – must be given utilizing purgative boiled with Snuhi Ksira
– Enema – Medicated enema within the type of decoction enema and oil enema must be given with decoction of herbs belonging to Muskakādi Gana after having added extra amount of Trikatu, Gomutra, Yava Ksara and Taila
– Fomentation / poultice – must be given to the stomach of the affected person with poultice comprised of Sana, Atasi, Dhataki, Kinva, Sarsapa and seeds of Mulaka.
– Eating regimen – 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 must be made to perspire continuously.
Düşyodara Cikitsā
दूष्योदरिणंतुप्रत्याख्यायसप्तलाशङ्खिनीस्वरससिद्धेनसर्पिषाविरेचयेन्मासमर्थमासंवा,महावृक्षक्षीरसुरागोमूत्रसिद्धेनवा.शुद्धकोष्ठंतुमद्येनाश्वमारकगुञ्जाकाकादनीमूलकल्कपाययेत्.इक्षुकाण्डानिवाकृष्णसर्पणदंशयित्वाभक्षयेद्वल्लीफलानिवा,मूलजंकन्दजंवाविषमासेवयेत्तेनागदोभवत्यन्यंवाभावमापद्यते।।८।।
Under talked about therapies must be thought of and executed to the affected person of Dusyodara –
The affected person of Dusyodara must be handled solely after being knowledgeable concerning the incurable nature of the illness and having taken his consent.
Purgation – The affected person of Dusyodara must be given purgation each day for a month or a fortnight time. For this objective, ghee boiled with contemporary juice of Saptala and Sankhini must 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 must be given wine combined with paste of Aśvamāra, Guñja and Kākādanīmūla to drink.
Administering poison – A chunk of sugarcane or a Valliphala – i.e. gourds like cucumber, melon, snake gourd and so forth. must be taken. These gourds must 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 remedy is named Visa Prayoga i.e. administering poisons. It acts as an anti-poisonous recipe or might also give the opposite type of end result i.e. dying.
भवतिचात्र
One verse right here
कुपितानिलमूलत्वात्संचितत्वान्मलस्यच।।
सर्वोदरेषुशंसन्तिबहुशस्त्वनुलोमनम्।।९।।
Within the remedy of Udara Roga, skilled physicians reward the advantages of administering extra of purgative remedy for the reason that illness is attributable to Vata and by accumulation of malas (doshas) within the physique (which have to be flushed out by administering virechana – purgation).
Sāmanya yoga – frequent 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 frequent recipes for every kind of udara – stomach enlargements shall be described, as enlisted beneath –
Eranda Taila i.e. castor oil must be administered for oral consumption combined with Gomutra – urine of cow or milk. This recipe must be consumed by the affected person day by day 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 devour buffalo urine combined with milk for a interval of seven days. He mustn’t take another meals throughout this era. Alternatively he ought to devour solely camel’s milk as meals whereas avoiding other forms of meals and water for a interval of fortnight.
He ought to devour Pippali – Piper longum following the strategy of consuming Vardhamana Pippali beforehand defined in chapter 5, for a interval of 1 month.
He ought to devour 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 must be consumed.
Alternatively the beneath talked about recipes must be given –
– Milk boiled with juice of Srngavera or
– Paste of Cavya and Srngavera combined 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 combined with two elements of Guda – jaggery
The affected person ought to devour one thousand Pippali – Piper longum soaked in Snuhi Ksira as a course in stipulated time interval, as a lot as potential (Vardhamana Pippali).
Utkarika – pan cake ready by cooking powder of Pathya and Krsna (Pippali) soaked in milky sap of Snuhi must 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 stored 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 must 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 elements –
– 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 elements 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 must be used. When used, they’re useful in curing the beneath talked about circumstances / illnesses –
– 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 must be combined 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 stated elements 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 elements are cooked over a gentle hearth. Whereas cooking, the elements are stirred on a regular basis, not permitting the paste to get charred.
Later, it’s taken out of the oven. After the elements 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 retaining in view the energy of the particular person. It must be taken for a interval of three or 4 months.
These tablets / dragees are specifically utilized in treating mahāvyadhis i.e. dreadful illnesses. In addition they destroy the intestinal worms.
They’re used to treatment the beneath talked about illnesses –
– cough,
– dyspnoea,
– worms,
– leprosy / pores and skin illnesses,
– nasal catarrh,
– anorexia,
– dyspnoea and
– upward motion of vayu (upward peristalsis)
Madanādi gudavarti – rectal suppositories
मदनफलमज्जकुटजजीमूतकेक्ष्वाकुधामार्गवत्रिवृत्रिकटुकसर्षपलवणनिमहावृक्षश्मीरमूत्रयोरन्यतरेणपिष्टवाऽङ्गुष्ठमात्रांवर्तिकृत्वोदरिणआनाहेतैललवणाभ्यक्तगुदस्यैकांद्वेनिस्न्नॊवापायौनिदध्यात्,एषाऽऽनाहवर्तिक्रियावातमूत्रपुरीषोदावर्तामानानाहेषुविधेया।।१२।।
Under talked about elements are macerated within the milky sap of Mahavrksa (snuhi), mutra (urines) or any comparable liquids and made into wicks of the scale of the thumb –
– Madanaphala majja,
– Kutaja,
– Jimutaka,
– Iksvāku,
– Dhāmārgava,
– Trivrt,
– Trikatu,
– Sarsapa and
– Lavana (salts)
Anus is lubricated with a mix 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 circumstances –
– obstruction of flatus, urine and faeces,
– reverse peristalsis,
– tympanitis and
– flatulence
Plīhodara Cikitsā – remedy of splenomegaly
प्लीहोदरिणःस्निग्धस्विन्नस्यदध्नाभुक्तवतोवामबाहौकूर्पराभ्यन्तरतःसिरांविध्येत्,विमर्दयेच्चपाणिनाप्लीहानंरुधिरस्यन्दनार्थःततःसंशुद्धदेहंसमुद्रशुक्तिकाक्षारंपयसापाययेत,हिमुसौवर्चिकेवाक्षीरेण,स्रुतेनपलाशक्षारेणवायवक्षारं,किंशुकक्षारोदकेनवाबहुशःस्रुतेनयवक्षारं,पारिजातकेक्षुरकापामार्गक्षारंवा,तैलसंसृष्टंशोभाञ्जनकयूषंपिप्पलीसैन्धवचित्रकयुक्तं,पूतिकरञ्जक्षारंवाऽम्लत्रुतंबिडलवणपिप्पलीप्रगाढम्।।१३।।
In Plihodara, there’s enlargement of stomach because of enlargement of Pliha (spleen). Sufferers of Plihodara must be first given with oleation and sudation therapies.
Following this, he must be served with meals combined 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 move out.
After purification, the affected person must 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 instances within the resolution 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 stated elements are cooked collectively in order to organize medicated ghee. This medicated ghee is understood by the identify Satpalaka Ghrta.
Advantages – This ghrta cures the beneath talked about circumstances –
– 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 must be utilized by the sufferers who’ve weak digestive hearth.
मणिबन्धंसकृन्नाम्यवामाङ्गुष्ठसमीरिताम्।।
दहेत्सिरांशरेणाशुप्लीह्नोवैद्यःप्रशान्तये।।१६।।
The left wrist of the affected person must be bent inwards intently 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 crimson sizzling arrow or by a crimson sizzling iron rod with the intention of decreasing the scale of the enlarged spleen (in plihodara).
यकृहाल्येऽप्येषएवक्रियाविभागः।
विशेषतस्तुदक्षिणबाहौसिराव्यधः।।१५।।
The identical remedy (as defined for Plihodara) must be executed in case of Yakrddalyodara / Yakrtodara (hepatomegaly / enlargement of liver) however the vein puncture must be executed on the fitting arm (as an alternative of on the left).
Baddhagudodara Cikitsā – remedy 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 must be executed first. The stomach must be anointed after which the stomach is minimize open. For this, the incision must 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 by means of 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 mix 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 (international physique inflicting the puncture) is eliminated in the identical means as described above, the intestinal exudate cleaned (eliminated), the minimize ends of gut are introduced shut and acquired bitten by massive 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 minimize off). Afterwards the stomach must be sutured as described earlier.
A paste is ready by mixing black mud with Yastimadhu – licorice powder. This paste must 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 must be prescribed an excellent routine of meals and actions. The attendants must be defined about their duties in the direction of the affected person. The affected person must 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 – remedy of Ascitis
दकोदरिणस्तुवातहरतैलाभ्यक्तस्योष्णोदकस्विन्नस्यस्थितस्याप्तैःसुपरिगृहीतस्याकक्षात्परिवेष्टितस्याधोनाभेर्वामतश्चतुरङ्गुलमपहायरोमराज्याव्रीहिमुखेनाङ्गुष्ठोदरप्रमाणमवगार्डविध्येत्,तत्रत्रप्वादीनामन्यतमस्यनाडीद्विद्वारांपक्षनाडीवासंयोज्यदोषोदकमवसिञ्चेत्,ततोनाडीमपहृत्यतैललवणेनाभ्यज्यव्रणंबन्धेनोपचरेत्,नचैकस्मिन्नेवदिवसेसर्वदोषोदकमपहरेत्,सहसाह्यपहृतेतृष्णाज्वराङ्गमर्दातीसारश्वासकासपाददाहाउत्पद्येरन्नापूर्यतेवाभृशतरमुदरमसञ्जातप्राणस्य,तस्मात्तृतीयचतुर्थपञ्चमषष्ठाष्टमदशमद्वादशषोडशरात्राणामन्यतममन्तरीकृत्यदोषोदकमल्पाल्पमवसिञ्चत्निःस्तेचदोषेगाढतरमाविककौशेयचर्मणामन्यतमेनपरिवेष्टयेदुदरं,तथानाध्मापयतिवायुः.षण्मासांश्चपयसाभोजयेज्जाङ्गलरसेनवा,ततस्त्रीन्मासान ? दकेनपयसाफलाम्लेनजाङ्गलरसेनवा,अवशिष्टंमासत्रयमन्नंलघुहितंवासेवेत,एवंसंवत्सरेणागदोभवति।।१८।।
The stomach of the affected person of Dakodara (ascites) must be given anointment / therapeutic massage with vata mitigating oils. After this, fomentation must be given by utilizing sizzling water (pads soaked in sizzling water or pouring sizzling 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 peak). He must be held tight in place by his effectively wishers i.e. kin or attendants, wrapped with fabric bands from armpit downwards.
Subsequent, the stomach of the affected person must 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 must be executed 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 accrued 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 combined with saindhava lavana – rock salt and is bandaged. The doctor / surgeon mustn’t take away all of the vitiated fluid in a single sitting itself i.e. it shouldn’t be eliminated in in the future itself. If the fluid is eliminated without delay, it might give rise to thirst, fever, body-aches, diarrhoea, dyspnoea, cough and burning sensation within the soles. Additionally, the fluid might 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 must be eliminated at intervals of three, 4, 5, six, eight, ten, twelve, sixteen or such different days. The fluid must be eliminated in much less portions.
After eradicating the vitiated fluids, the stomach must 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 dwelling in arid lands for a interval of first six months. Meals must be taken with milk added with half its amount of water or juice of bitter fruits or meat soup of animals dwelling in arid lands through the subsequent three months. Within the remaining three months he ought to devour boiled rice which is gentle and appropriate.
On this method, the particular person would get cured of ascites in a single yr time by adhering strictly to the routine.
भवतिचात्र
आस्थापनेचैवविरेचनेचपानेतथाऽऽहारविधिक्रियासु।।
सर्वोदरिभ्यःकुशलैःप्रयोज्यंक्षीरंशृतंजाङ्गलजोरसोवा।।१९।।
One verse right here,
Within the remedy 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.
