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AYANAACADEMYby Dr Vijaya Dwarampudi
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௭. உதரநிதாநம்

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Adhikarana ௧ (௧-௨) · Śloka ௨

அதாத உதராணாஂ நிதாநஂ வ்யாக்யாஸ்யாமஃ ||௧|| யதோவாச பகவாந் தந்வந்தரிஃ ||௨||

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अथात उदराणां निदानं व्याख्यास्यामः ||१|| यथोवाच भगवान् धन्वन्तरिः ||२||

Meaning of the śloka

Now the diagnosis of udara disorders will be explained, as taught by the revered Dhanvantari.

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அதாத இத்யாதி||௧-௨||

Meaning of the commentary

The commentary gives only the conventional opening and adds no separate explanation.

Key terms

udara
A classical group of disorders characterized especially by abdominal enlargement.
nidAna (nidāna)
An account of causes and diagnostic features.

Adhikarana ௨ (௩) · Śloka ௩

தந்வந்தரிர்தர்மபதாஂ வரிஷ்டோ ராஜர்ஷிரிந்த்ரப்ரதிமோऽபவத்யஃ | ப்ரஹ்மர்ஷிபுத்ரஂ விநயோபபந்நஂ ஶிஷ்யஂ ஶுபஂ ஸுஶ்ருதமந்வஶாத் ஸஃ ||௩||

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धन्वन्तरिर्धर्मभृतां वरिष्ठो राजर्षिरिन्द्रप्रतिमोऽभवद्यः | ब्रह्मर्षिपुत्रं विनयोपपन्नं शिष्यं शुभं सुश्रुतमन्वशात् सः ||३||

Meaning of the śloka

Dhanvantari, foremost among those who uphold dharma, a royal sage comparable to Indra, instructed his worthy and disciplined student Sushruta, the son of a Brahmarṣi.

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யோ தந்வந்தரிரபவத் ஸ ஸுஶ்ருதமந்வஶாதிதி ஸம்பந்தஃ, ஶிக்ஷிதவாநித்யர்தஃ| தர்மபதாஂ தார்மிகாணாஂ மத்யே| இந்த்ரப்ரதிமோ ஜ்ஞாநைஶ்வர்யாதிபிஃ| ப்ரஹ்மர்ஷிர்விஶ்வாமித்ரஃ, ராஜர்ஷிரபி தபஸா ப்ரஹ்மர்ஷித்வஂ ப்ராப்தவாந்| விநயோபபந்நஂ ஜிதேந்த்ரியம்| ஶுபமிதி பூர்வோக்தைரந்வயவயஃஶீலாதிகுணைருபேதம்||௩||

Meaning of the commentary

The commentary connects the sentence as: Dhanvantari instructed Sushruta. 'Foremost' means foremost among righteous people, and comparable to Indra refers to knowledge, sovereignty, and similar qualities. The Brahmarṣi is Viśvāmitra, who, though originally a royal sage, attained the status of Brahmarṣi through austerity. Sushruta is described as disciplined because he has mastered his senses and as worthy because he possesses the previously stated qualities of lineage, age, character, and others.

Key terms

rAjarShi (rājarṣi)
A royal sage.
brahmarShi (brahmarṣi)
A sage of the Brahmarṣi rank; identified here as Viśvāmitra.
vinayopapanna
Endowed with discipline and self-restraint.
anvashAt (anvaśāt)
Instructed or taught.

Adhikarana ௩ (௪) · Śloka ௪

பதக் ஸமஸ்தைரபி சேஹ தோஷைஃ ப்லீஹோதரஂ பத்தகுதஂ ததைவ | ஆகந்துகஂ ஸப்தமமஷ்டமஂ ச தகோதரஂ சேதி வதந்தி தாநி ||௪||

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पृथक् समस्तैरपि चेह दोषैः प्लीहोदरं बद्धगुदं तथैव | आगन्तुकं सप्तममष्टमं च दकोदरं चेति वदन्ति तानि ||४||

Meaning of the śloka

Eight udara disorders are enumerated: one from each doṣa separately, one from all the doṣas together, plīhodara, baddhaguda, an externally caused form, and dakodara.

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உதராணாஂ ஸங்க்யாமாஹ- பதகித்யாதி| பதக்தோஷைஸ்த்ரீணி, ஸமஸ்தைர்தோஷைரேகம்; ஏதேந சத்வாரி தோஷப்ரதாநாநி| இஹேதி அஸ்மிஞ்சாஸ்த்ரே| தாநீதி உதராணீத்யர்தஃ| ப்லீஹோதராதீநி சத்வாரி தூஷ்யப்ரதாநாநி| அஷ்டமமிதி ஸங்க்யோக்த்யா ப்லீஹோதரயகத்தால்யுதரயோரைக்யமேவ ஜ்ஞாதவ்யம்||௪||

Meaning of the commentary

The commentary counts three forms caused by the individual doṣas and one caused by all of them, making four in which doṣas predominate. Plīhodara and the remaining three are described as forms in which affected bodily structures or materials predominate. Because the verse explicitly says there are eight, plīhodara and yakṛddālyudara are to be understood as a single category rather than counted separately.

Key terms

plIhodara (plīhodara)
An udara form associated with the spleen; linked by the commentary with yakṛddālyudara.
baddhaguda
An udara form associated with obstruction of the lower bowel or rectal passage.
Agantuka (āgantuka)
An externally caused or acquired form.
dakodara
A fluid-associated abdominal enlargement category.
dUShyapradhAna (dūṣya-pradhāna)
A form classified chiefly by the affected bodily structure or material.

Adhikarana ௪ (௫) · Śloka ௬

ஸுதுர்பலாக்நேரஹிதாஶநஸ்ய ஸஂஶுஷ்கபூத்யந்நநிஷேவணாத்வா | ஸ்நேஹாதிமித்யாசரணாச்ச ஜந்தோர்வத்திஂ கதாஃ கோஷ்டமபிப்ரபந்நாஃ ||௫|| குல்மாகதிவ்யஞ்ஜிதலக்ஷணாநி குர்வந்தி கோராண்யுதராணி தோஷாஃ |௬|

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सुदुर्बलाग्नेरहिताशनस्य संशुष्कपूत्यन्ननिषेवणाद्वा | स्नेहादिमिथ्याचरणाच्च जन्तोर्वृद्धिं गताः कोष्ठमभिप्रपन्नाः ||५|| गुल्माकृतिव्यञ्जितलक्षणानि कुर्वन्ति घोराण्युदराणि दोषाः |६|

Meaning of the śloka

In a person whose digestive fire is extremely weak, disturbed doṣas are said to increase, enter the abdominal cavity, and produce severe udara disorders with signs resembling gulma. The stated causes include unsuitable eating, repeated consumption of thoroughly dried or spoiled food, and incorrect performance of oleation and related procedures.

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உதராணாஂ ஹேதுஂ தர்ஶயந்நாஹ- ஸுதுர்பலாக்நேரிதாதி துர்பலாக்நேஃ அத்யந்தநஷ்டாக்நேஃ| அஹிதாஶநஸ்யேதி விருத்தஸமஶநாத்யஶநவிஷமாஶநஸ்ய| ஸ்நேஹாதீத்யாதிஶப்தாத்வமநவிரேசநாஸ்தாபநாநுவாஸநபரிக்ரஹஃ| மித்யாசரணஂ யதோக்தாநுஷ்டாநபரித்யாகஃ| ஜந்தோஃ ப்ராணிநஃ| அபிப்ரபந்நாஃ ப்ராப்தா இத்யர்தஃ| கிஂவிஶிஷ்டாந்யுதரணி குர்வந்தி? குல்மாகதிவ்யஞ்ஜிதலக்ஷணாநி குல்மாகத்யா குல்மரூபேண வ்யஞ்ஜிதாநி ப்ரகடிதாநி லக்ஷணாநி யேஷாஂ தாநி ததா| புநரபி கிஂவிஶிஷ்டாநி? கோராணி கச்ச்ரதமாநி||௫||-

Meaning of the commentary

The commentary explains very weak agni as digestive fire that is almost completely lost. Unsuitable eating includes incompatible combinations, eating equal mixtures regarded as improper, eating again before digestion, and irregular eating. 'Oleation and so forth' includes emesis, purgation, decoction enema, and oil enema. Incorrect performance means abandoning or deviating from the prescribed method. The doṣas reach the abdominal cavity and create very difficult disorders whose signs are expressed in a form resembling gulma.

Key terms

sudurbalAgni (sudurbalāgni)
Extremely weak digestive activity in the classical framework.
ahitAshana (ahitāśana)
Eating regarded as unsuitable or harmful by the source.
pUtyanna (pūtyanna)
Spoiled, putrid, or decomposed food.
snehAdimithyAcaraNa (snehādi-mithyācaraṇa)
Incorrect performance of oleation and related classical procedures.
gulma
A classical abdominal mass or swelling disorder used here as a resemblance.

Adhikarana ௫ (௬) · Śloka ௭

கோஷ்டாதுபஸ்நேஹவதந்நஸாரோ நிஃஸத்ய துஷ்டோऽநிலவேகநுந்நஃ ||௬|| த்வசஃ ஸமுந்நம்ய ஶநைஃ ஸமந்தாத்விவர்தமாநோ ஜடரஂ கரோதி |௭|

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कोष्ठादुपस्नेहवदन्नसारो निःसृत्य दुष्टोऽनिलवेगनुन्नः ||६|| त्वचः समुन्नम्य शनैः समन्ताद्विवर्धमानो जठरं करोति |७|

Meaning of the śloka

Disturbed nutritive essence is said to leave the digestive cavity through minute pathways, like moisture seeping through a new earthen pot. Driven by vāta, it raises or distends the skin and gradually increases in all directions, producing the abdominal disorder called jaṭhara.

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ஸம்ப்ராப்தி தர்ஶயந்நாஹ- கோஷ்டாதித்யாதி| உபஸ்நேஹவதிதி நவகடாத்யுபஸ்நேஹோ யதாऽணுதமஸ்ரோதோபிர்பஹிஃஸ்ரவத் தஶ்யதே தத்வத் கோஷ்டாதந்நஸாரோऽந்நரஸோ நிஃஸத்ய, ஶநைஃ க்ரமேண, ஜடரமுதராக்யஂ ரோகஂ கரோதீதி ஸம்பந்தஃ| கோஷ்டஶப்தேநாத்ராஹாரபாகாதார உச்யதே| கிம்பூதோऽந்நஸாரஃ? துஷ்டஃ| புநஃ கிம்பூதஃ? அநிலவேகநுந்நோ வாதவேகப்ரேரிதஃ| கிஂ கத்வா? த்வசஃ ஸமுந்நம்ய ஆநத்தாஃ கத்வா| புநஃ கிம்பூதோ ரஸஃ? ஸமந்தாத்விவர்தமாநஃ ஸமந்தாத் ஸர்வதோ வத்திஂ கச்சந்||௬||-

Meaning of the commentary

The commentary presents this as the pathogenic sequence. Koṣṭha here is the receptacle of food and digestion, and annasāra or annarasa is the nutritive essence of food. Its passage outward is compared with moisture emerging through extremely fine pores of a new pot. The essence is disturbed, propelled by the force of vāta, and makes the skin tense or distended. It then gradually enlarges throughout the abdomen and creates the disease called udara or jaṭhara.

Key terms

annasAra (anna-sāra)
The nutritive essence derived from food in the classical framework.
koShTha (koṣṭha)
The internal cavity that holds food and digestion in this passage.
anilaveganunna (anila-vega-nunna)
Driven or propelled by the force of vāta.
jaThara (jaṭhara)
An abdominal enlargement disorder, used here as another name for udara.

Adhikarana ௬ (௭) · Śloka ௮

தத்பூர்வரூபஂ பலவர்ணகாங்க்ஷாவலீவிநாஶோ ஜடரே ஹி ராஜ்யஃ ||௭|| ஜீர்ணாபரிஜ்ஞாநவிதாஹவத்யோ பஸ்தௌ ருஜஃ பாதகதஶ்ச ஶோபஃ |௮|

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तत्पूर्वरूपं बलवर्णकाङ्क्षावलीविनाशो जठरे हि राज्यः ||७|| जीर्णापरिज्ञानविदाहवत्यो बस्तौ रुजः पादगतश्च शोफः |८|

Meaning of the śloka

Prodromal features include loss of strength, complexion, desire for food, and the natural abdominal folds, with lines appearing on the abdomen. The person may be unable to determine whether food has digested, may experience burning and pain in the bladder region, and may develop swelling of the feet.

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பூர்வரூபமாஹ- ததித்யாதி| விநாஶஶப்தோ பலாதிபிஃ ப்ரத்யேகஂ ஸம்பத்யதே| காங்க்ஷா அந்நாபிலாஷஃ| வலீ த்வக்ஸங்கோசஃ| ராஜ்யோ ரேகாஃ ‘பவந்தி’ இதி ஶேஷஃ| ஜீர்ணாபரிஜ்ஞாநவிதாஹவத்யோ பஸ்தௌ ருஜ இதி ஜீர்ணாபரிஜ்ஞாநவிதாஹௌ வித்யேதே யாஸு பஸ்திருஜாஸு தாஸ்ததா| ஜீர்ணாபரிஜ்ஞாநமந்நபரிணாமாநிஶ்சயஃ; ஜீர்ணாபரிஜ்ஞாநஂ து யதாஸம்பவத்வாத் புருஷஸ்யைவ ஜ்ஞேயம்||௭||-

Meaning of the commentary

The commentary applies 'loss' separately to strength, complexion, appetite, and the abdominal folds. Kāṅkṣā means desire for food; valī means skin folds; and rāji means lines, for which the verb 'appear' is supplied. The bladder-region pains are accompanied by uncertainty about whether food has digested and by burning. The uncertainty about digestion is more properly understood as a feature experienced by the person, as context allows.

Key terms

pUrvarUpa (pūrvarūpa)
A prodromal feature before the disorder is fully manifest.
jIrNAparij~jAna (jīrṇāparijñāna)
Uncertainty about whether a meal has been digested.
vidAha (vidāha)
A burning or corrosive digestive sensation in the classical account.
pAdashopha (pāda-śopha)
Swelling of the feet.
rAjI (rājī)
A line or streak appearing on the abdomen.

Adhikarana ௭ (௮) · Śloka ௯

ஸங்கஹ்ய பார்ஶ்வோதரபஷ்டநாபீர்யத்வர்ததே கஷ்ணஸிராவநத்தம் ||௮|| ஸஶூலமாநாஹவதுக்ரஶப்தஂ ஸதோதபேதஂ பவநாத்மகஂ தத் |௯|

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सङ्गृह्य पार्श्वोदरपृष्ठनाभीर्यद्वर्धते कृष्णसिरावनद्धम् ||८|| सशूलमानाहवदुग्रशब्दं सतोदभेदं पवनात्मकं तत् |९|

Meaning of the śloka

The abdominal condition that constricts the flanks, abdomen, back, and navel, enlarges with dark visible veins, and is accompanied by pain, distension, loud abdominal sounds, pricking, and splitting sensations is described as vāta-origin udara.

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வாதோதரமாஹ- ஸங்கஹ்யேத்யாதி||௮||-

Meaning of the commentary

The commentary identifies these verses as the description of vātodara and provides no additional gloss.

Key terms

vAtodara (vātodara)
A classical abdominal enlargement syndrome attributed predominantly to vāta.
kRuShNasirAvanaddha (kṛṣṇa-sirā-vanaddha)
Covered or bound with dark-appearing veins.
AnAha (ānāha)
Abdominal distension or obstruction.
todabheda (toda-bheda)
Pricking and splitting kinds of pain.

Adhikarana ௮ (௯) · Śloka ௧௦

யச்சோஷதஷ்ணாஜ்வரதாஹயுக்தஂ பீதஂ ஸிரா பாந்தி ச யத்ர பீதாஃ ||௯|| பீதாக்ஷிவிண்மூத்ரநகாநநஸ்ய பித்தோதரஂ தத்த்வசிராபிவத்தி |௧௦|

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यच्चोषतृष्णाज्वरदाहयुक्तं पीतं सिरा भान्ति च यत्र पीताः ||९|| पीताक्षिविण्मूत्रनखाननस्य पित्तोदरं तत्त्वचिराभिवृद्धि |१०|

Meaning of the śloka

An abdominal condition accompanied by a drawing or burning sensation, thirst, fever, and heat, yellow in appearance with yellow visible veins, and occurring in a person whose eyes, stool, urine, nails, and face are yellow is called pittodara. It is described as enlarging rapidly.

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பித்தோதரமாஹ- யதித்யாதி| அசிராபிவத்தி ஶீக்ரவர்தநஶீலம்||௯||-

Meaning of the commentary

The commentary identifies this as pittodara and explains acirābhivṛddhi as having a tendency to enlarge quickly.

Key terms

pittodara
A classical abdominal enlargement syndrome attributed predominantly to pitta.
coSha (coṣa)
A drawing, drying, or suction-like discomfort in this symptom group.
pItasirA (pīta-sirā)
Yellow-appearing visible veins.
acirAbhivRuddhi (acirābhivṛddhi)
Increasing or enlarging rapidly.

Adhikarana ௯ (௧௦) · Śloka ௧௧

யச்சீதலஂ ஶுக்லஸிராவநத்தஂ குரு ஸ்திரஂ ஶுக்லநகாநநஸ்ய ||௧௦|| ஸ்நிக்தஂ மஹச்சோபயுதஂ ஸஸாதஂ கபோதரஂ தத்து சிராபிவத்தி |௧௧|

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यच्छीतलं शुक्लसिरावनद्धं गुरु स्थिरं शुक्लनखाननस्य ||१०|| स्निग्धं महच्छोफयुतं ससादं कफोदरं तत्तु चिराभिवृद्धि |११|

Meaning of the śloka

An abdominal condition that is cold, covered with pale visible veins, heavy, firm, unctuous, greatly enlarged, associated with swelling and bodily fatigue, and occurring in a person with pale nails and face is called kaphodara. It is described as enlarging slowly.

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ஶ்லேஷ்மோதரமாஹ- யச்சீதலமித்யாதி| ஸ்திரஂ கடிநம்| ஸஸாதமங்கக்லாநியுக்தம்||௧௦||-

Meaning of the commentary

The commentary identifies this as śleṣmodara. Sthira means hard or firm, and sa-sāda means accompanied by fatigue or weakness of the limbs.

Key terms

kaphodara
A classical abdominal enlargement syndrome attributed predominantly to kapha.
shuklasirAvanaddha (śukla-sirā-vanaddha)
Covered or bound with pale-appearing veins.
sthira
Firm or hard according to the commentary.
sAda (sāda)
Bodily or limb fatigue.
cirAbhivRuddhi (cirābhivṛddhi)
Increasing slowly over a prolonged period.

Adhikarana ௧௦ (௧௧-௧௩) · Śloka ௧௪

ஸ்த்ரியோऽந்நபாநஂ நகரோமமூத்ரவிடார்தவைர்யுக்தமஸாதுவத்தாஃ ||௧௧|| யஸ்மை ப்ரயச்சந்த்யரயோ கராஂஶ்ச துஷ்டாம்புதூஷீவிஷஸேவநாத்வா | தேநாஶு ரக்தஂ குபிதாஶ்ச தோஷாஃ குர்வந்தி கோரஂ ஜடரஂ த்ரிலிங்கம் ||௧௨|| தச்சீதவாதாப்ரஸமுத்பவேஷு விஶேஷதஃ குப்யதி தஹ்யதே ச ஸ சாதுரோ மூர்ச்சதி ஸம்ப்ரஸக்தஂ பாண்டுஃ கஶஃ ஶுஷ்யதி தஷ்ணயா ச ||௧௩|| ப்ரகீர்திதஂ தூஷ்யுதரஂ து கோரஂ ... |௧௪|

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स्त्रियोऽन्नपानं नखरोममूत्रविडार्तवैर्युक्तमसाधुवृत्ताः ||११|| यस्मै प्रयच्छन्त्यरयो गरांश्च दुष्टाम्बुदूषीविषसेवनाद्वा | तेनाशु रक्तं कुपिताश्च दोषाः कुर्वन्ति घोरं जठरं त्रिलिङ्गम् ||१२|| तच्छीतवाताभ्रसमुद्भवेषु विशेषतः कुप्यति दह्यते च स चातुरो मूर्च्छति सम्प्रसक्तं पाण्डुः कृशः शुष्यति तृष्णया च ||१३|| प्रकीर्तितं दूष्युदरं तु घोरं ... |१४|

Meaning of the śloka

The passage attributes a severe three-doṣa abdominal disorder to ingestion of food or drink contaminated with nails, hair, urine, stool, menstrual blood, deliberately administered artificial poisons, contaminated water, or dūṣīviṣa. Blood and all three doṣas are said to become rapidly aggravated, producing a grave abdominal condition with their combined signs. It becomes especially aggravated during cold, wind, and cloudy weather. The affected person experiences burning and recurrent fainting and is described as pale, thin, wasting, and afflicted by thirst. This severe condition is called dūṣyudara.

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ஸந்நிபாதோதரமாஹ- ஸ்த்ரிய இத்யாதி| ஸ்த்ரியோऽந்நபாநஂ நகரோமமூத்ரவிடார்தவயுக்தஂ யஸ்மை புருஷாய ப்ரயச்சந்தி தததி| கிம்பூதாஃ ஸ்த்ரியஃ? அஸாதுவத்தா துராசாராஃ| ஸ்த்ரீக்ரஹணமத்ரோபலக்ஷணஂ, தேநாந்யேऽபி ஸந்நிஹிதா அவிவேகிநோ க்ராஹ்யாஃ| அரயஃ ஶத்ரவஃ| கராந் கத்ரிமவிஷாணி யஸ்மை ப்ரயச்சந்தி| துஷ்டாம்பு ஸவிஷமத்ஸ்யாதிஸம்பந்தாத்| விஷமேவ தாவாக்நிவாதாதபாத்யபிபவேந மந்ததாஂ கதஂ விஷபீதஸ்ய வா விஷஂ தூஷீவிஷஂ; தேந நகரோமாதிநா விஷகல்பேந கரேண தூஷீவிஷேண வாऽऽஶு ஶீக்ரஂ ரக்தஂ குபிதமிதி போத்தவ்யம்| த்ரிலிங்கஂ வாதபித்தஶ்லேஷ்மலிங்கம்| ஸம்ப்ரஸக்தஂ நிரந்தரம்| தூஷ்யுதரமிதி யதேவ ஸாந்நிபாதிகோதரஂ ததேவ தூஷ்யுதரம், ஏதேந ந ஸங்க்யாதிரேகஃ| கோரஂ பயாநகஂ, புநர்கோரஂ கஷ்டகாரி||௧௧-௧௩||-

Meaning of the commentary

The commentary calls this sannipātodara. It reproduces a historical narrative in which persons described pejoratively as behaving badly contaminate a man’s food or drink; it then clarifies that the reference is illustrative and includes any nearby person acting without judgment. Enemies may administer gara, an artificially prepared poison. Duṣṭāmbu is water contaminated through contact with poisonous fish or similar causes. Dūṣīviṣa is explained either as poison weakened by forest fire, wind, sunlight, and other exposure or as residual poison in someone previously poisoned. Nails, hair, and the other materials are treated as poison-like contaminants. Triliṅga means signs of vāta, pitta, and kapha; samprasakta means continuous. Dūṣyudara is said to be the same condition as sannipātodara, so it does not add another type to the count. Ghora is repeated to mean both alarming and distressing.

Key terms

sannipAtodara (sannipātodara)
A classical abdominal syndrome displaying signs of all three doṣas.
dUShyudara (dūṣyudara)
The same three-doṣa abdominal condition framed here as arising from contamination or poison.
gara
An artificially compounded poison in the historical account.
dUShIviSha (dūṣīviṣa)
Weakened or residual poison according to two explanations in the commentary.
trili~gga (tri-liṅga)
Possessing signs attributed to all three doṣas.

Adhikarana ௧௧ (௧௪-௧௫) · Śloka ௧௬

... ப்லீஹோதரஂ கீர்தயதோ நிபோத | விதாஹ்யபிஷ்யந்திரதஸ்ய ஜந்தோஃ ப்ரதுஷ்டமத்யர்தமஸக் கபஶ்ச ||௧௪|| ப்லீஹாபிவத்திஂ ஸததஂ கரோதி ப்லீஹோதரஂ தத் ப்ரவதந்தி தஜ்ஜ்ஞாஃ | வாமே ச பார்ஶ்வே பரிவத்திமேதி விஶேஷதஃ ஸீததி சாதுரோऽத்ர ||௧௫|| மந்தஜ்வராக்நிஃ கபபித்தலிங்கைருபத்ருதஃ க்ஷீணபலோऽதிபாண்டுஃ |௧௬|

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... प्लीहोदरं कीर्तयतो निबोध | विदाह्यभिष्यन्दिरतस्य जन्तोः प्रदुष्टमत्यर्थमसृक् कफश्च ||१४|| प्लीहाभिवृद्धिं सततं करोति प्लीहोदरं तत् प्रवदन्ति तज्ज्ञाः | वामे च पार्श्वे परिवृद्धिमेति विशेषतः सीदति चातुरोऽत्र ||१५|| मन्दज्वराग्निः कफपित्तलिङ्गैरुपद्रुतः क्षीणबलोऽतिपाण्डुः |१६|

Meaning of the śloka

The text next describes plīhodara. In a person habitually consuming foods that produce burning or abhiṣyanda, severely affected blood and kapha are said continually to enlarge the spleen; specialists call this plīhodara. Enlargement occurs particularly on the left side, and the person develops marked fatigue. The condition is associated with low fever, weak digestive fire, signs of kapha and pitta, diminished strength, and pronounced pallor.

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நிபோத ஜாநீஹி| அபிஷ்யந்தி தோஷதாதுமலஸ்ரோதஸாஂ க்லேதப்ராப்திஜநகம்| அஸக் கபஶ்சேதி அஸக்க்ரஹணேந பித்தஸ்யாபி க்ரஹணம்| ப்லீஹா உதரஸ்ய வாமபார்ஶ்வஸ்திதஃ| ஏதி கச்சதி| ஸீததி அங்கக்லாநியுக்தோ பவதி| அத்ர ப்லீஹோதரே||௧௪-௧௫||-

Meaning of the commentary

The commentary explains abhiṣyandin as producing moisture or obstruction in the channels of doṣas, dhātus, and wastes. Mention of blood also includes pitta. The spleen is located on the left side of the abdomen. Sīdati means becoming fatigued or weak in the limbs, specifically in plīhodara.

Key terms

plIhodara (plīhodara)
A classical abdominal syndrome centered on enlargement of the spleen.
abhiShyandin (abhiṣyandin)
Considered to promote moisture or obstruction in bodily channels.
plIhAbhivRuddhi (plīhābhivṛddhi)
Enlargement of the spleen.
mandajvara (manda-jvara)
Low-grade or mild fever.
atipANDu (ati-pāṇḍu)
Marked pallor.

Adhikarana ௧௨ (௧௬) · Śloka ௧௬

ஸவ்யேதரஸ்மிந் யகதி ப்ரதுஷ்டே ஜ்ஞேயஂ யகத்தால்யுதரஂ ததேவ ||௧௬||

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सव्येतरस्मिन् यकृति प्रदुष्टे ज्ञेयं यकृद्दाल्युदरं तदेव ||१६||

Meaning of the śloka

When the corresponding condition occurs on the right side in an affected liver, it is to be recognized as yakṛddālyudara.

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யகத்தால்யுதரஸ்ய ப்லீஹோதரே ஏவாவரோதஂ தர்ஶயந்நாஹ- ஸவ்யேதரஸ்மிந்நித்யாதி| ஸவ்யேதரஸ்மிந் தக்ஷிணபார்ஶ்வே| ததேவ ப்லீஹோதரஂ யகத்தால்யுதரஂ ஜ்ஞேயம்| க்வ ஜ்ஞேயமித்யாஹ- யகதி காலகண்டே; கிம்பூதே? ப்ரதுஷ்டே; ஏதேந ந ஸங்க்யாதிரேகஃ||௧௬||

Meaning of the commentary

The commentary includes yakṛddālyudara within the preceding discussion of plīhodara rather than treating it as an additional numbered type. ‘The side other than the left’ means the right side. The same pattern called plīhodara is termed yakṛddālyudara when it involves the affected liver, described as the dark organ.

Key terms

yakRuddAlyudara (yakṛddālyudara)
A classical abdominal syndrome corresponding to plīhodara but centered on the liver and right side.
savyetara
The side other than the left, interpreted as the right side.
yakRut (yakṛt)
The liver.
kAlakhaNDa (kāla-khaṇḍa)
The dark-coloured organ, used here as a gloss for the liver.

Adhikarana ௧௩ (௧௭-௧௮) · Śloka ௧௯

யஸ்யாந்த்ரமந்நைருபலேபிபிர்வா பாலாஶ்மபிர்வா ஸஹிதைஃ பதக்வா | ஸஞ்சீயதே தத்ர மலஃ ஸதோஷஃ க்ரமேண நாட்யாமிவ ஸங்கரோ ஹி ||௧௭|| நிருத்யதே சாஸ்ய குதே புரீஷஂ நிரேதி கச்ச்ராதபி சால்பமல்பம் | ஹந்நாபிமத்யே பரிவத்திமேதி த(ய)ச்சோதரஂ விட்ஸமகந்திகஂ ச ||௧௮|| ப்ரச்சர்தயந் பத்தகுதீ விபாவ்யஃ, ... |௧௯|

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यस्यान्त्रमन्नैरुपलेपिभिर्वा बालाश्मभिर्वा सहितैः पृथग्वा | सञ्चीयते तत्र मलः सदोषः क्रमेण नाड्यामिव सङ्करो हि ||१७|| निरुध्यते चास्य गुदे पुरीषं निरेति कृच्छ्रादपि चाल्पमल्पम् | हृन्नाभिमध्ये परिवृद्धिमेति त(य)च्चोदरं विट्समगन्धिकं च ||१८|| प्रच्छर्दयन् बद्धगुदी विभाव्यः, ... |१९|

Meaning of the śloka

When the intestine is obstructed by coating foods, small stones or hard particles, either together or separately, stool associated with the doshas is said to accumulate gradually like debris in a channel. Feces then becomes obstructed at the rectum and passes only with difficulty and in small amounts. The abdomen enlarges between the heart region and navel, develops an odor like feces, and vomiting occurs; this condition is identified as baddhaguda. The supplied passage ends incompletely.

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பத்தகுதஂ தர்ஶயந்நாஹ- யஸ்யேத்யாதி| யஸ்ய புருஷஸ்ய அந்த்ரஂ நிருத்யத இதி ஸம்பந்தஃ| கைர்நிருத்யத இத்யாஹ- அந்நைரித்யாதி| உபலேபிபிஃ பிச்சிலாதிபிஃ| வா அத்ர ஸமுச்சயே| ஸஹிதைரிதி ஏகத்ர மிலிதைஃ ஸமுதிதைரித்யர்தஃ| பதக்வேதி ஏகைகைரித்யர்தஃ| மலஃ புரீஷம்| ஸதோஷோ தோஷத்ரயஸஹிதஃ| நாட்யாஂ ப்ரணாலிகாயாம்| ஸங்கரோऽவகரஃ, ப்ரசுரதணாதிஸமூஹ இத்யர்தஃ| நிரேதி நிஃஸரதி| பத்தகுதீ விபாவ்யஃ ஸ புருஷோ பத்தகுதீ ஜ்ஞேயஃ||௧௭-௧௮||-

Meaning of the commentary

The commentary defines baddhaguda through intestinal obstruction. Upalepin foods are sticky or slimy. Sahita means the obstructing materials are combined, while prithak means each may act separately; va is interpreted cumulatively. Mala here means feces accompanied by all three doshas. The accumulation is likened to a mass of grass and other refuse blocking a pipe. Nireti means that stool comes out, and the affected person is thereby recognized as having baddhaguda. The commentary and source are incomplete after the verses explained.

Key terms

baddhaguda
A classical abdominal disorder characterized here by intestinal and rectal obstruction.
upalepin anna
Food described as coating, sticky, or slimy.
bAlAshman (balashman)
Small stones or hard particles; the precise referent requires review.
sa~gkara (sankara)
Accumulated debris, compared with a mass blocking a channel.
kRucchrAt (krichhrat)
With difficulty.

Adhikarana ௧௪ (௧௯-௨௦) · Śloka ௨௧

...ததஃ பரிஸ்ராவ்யுதரஂ நிபோத | ஶல்யஂ யதந்நோபஹிதஂ ததந்த்ரஂ பிநத்தி யஸ்யாகதமந்யதா வா ||௧௯|| தஸ்மாத் ஸ்ருதோऽந்த்ராத் ஸலிலப்ரகாஶஃ ஸ்ராவஃ ஸ்ரவேத்வை குததஸ்து பூயஃ | நாபேரதஶ்சோதரமேதி வத்திஂ நிஸ்துத்யதேऽதீவ விதஹ்யதே ச ||௨௦|| ஏதத் பரிஸ்ராவ்யுதரஂ ப்ரதிஷ்டஂ... |௨௧|

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...ततः परिस्राव्युदरं निबोध | शल्यं यदन्नोपहितं तदन्त्रं भिनत्ति यस्यागतमन्यथा वा ||१९|| तस्मात् स्रुतोऽन्त्रात् सलिलप्रकाशः स्रावः स्रवेद्वै गुदतस्तु भूयः | नाभेरधश्चोदरमेति वृद्धिं निस्तुद्यतेऽतीव विदह्यते च ||२०|| एतत् परिस्राव्युदरं प्रदिष्टं... |२१|

Meaning of the śloka

The text describes parisravyudara as arising when a foreign object swallowed with food enters crosswise and pierces the intestine. Watery discharge then repeatedly flows from the injured intestine through the rectum; the abdomen enlarges below the navel and has intense pricking and burning pain. The supplied passage is incomplete at both its beginning and end.

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பரிஸ்ராவ்யுதரமாஹ- தத இத்யாதி| யச்சல்யமந்நோபஹிதமந்நஸம்பத்தஂ புக்தஂ, ததந்த்ரஂ பிநத்தி விதாரயதி| யஸ்ய புருஷஸ்ய| ஶல்யஂ ஶர்கராகாஷ்டாஸ்திகண்டகாதிகம்| ஆகதமந்யதா வேதி வாஶப்தோऽவதாரணே, தேநாந்யதைவ விலோமேந திர்யகேவாகதஂ, நத்வநுலோமேந| ஸ்ருதோ கலிதஃ||௧௯-௨௦||-

Meaning of the commentary

The commentary explains shalya as a foreign object associated with swallowed food, such as gravel, wood, bone, or a thorn. It tears the intestine. In 'agatam anyatha va,' va is taken as emphasizing that the object entered abnormally, crosswise or contrary to the normal course. Sruta means fluid that has leaked or flowed from the injured intestine.

Key terms

parisrAvyudara (parisravyudara)
A classical abdominal disorder involving intestinal injury and discharge.
shalya
A swallowed foreign object, exemplified by gravel, wood, bone, or a thorn.
antrabheda
Piercing or tearing of the intestine.
pratiloma/tiryak Agata (pratiloma/tiryak agata)
Entering contrary to the normal direction or crosswise.
srAva (srava)
Watery discharge or leakage.

Adhikarana ௧௫ (௨௧-௨௩) · Śloka ௨௩

... தகோதரஂ கீர்தயதோ நிபோத | யஃ ஸ்நேஹபீதோऽப்யநுவாஸிதோ வா வாந்தோ விரிக்தோऽப்யதவா நிரூடஃ ||௨௧|| பிபேஜ்ஜலஂ ஶீதலமாஶு தஸ்ய ஸ்ரோதாஂஸி துஷ்யந்தி ஹி தத்வஹாநி | ஸ்நேஹோபலிப்தேஷ்வதவாऽபி தேஷு தகோதரஂ பூர்வவதப்யுபைதி ||௨௨|| ஸ்நிக்தஂ மஹத் ஸம்பரிவத்தநாபி பஶோந்நதஂ பூர்ணமிவாம்புநா ச | யதா ததிஃ க்ஷுப்யதி கம்பதே ச ஶப்தாயதே சாபி தகோதரஂ தத் ||௨௩||

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... दकोदरं कीर्तयतो निबोध | यः स्नेहपीतोऽप्यनुवासितो वा वान्तो विरिक्तोऽप्यथवा निरूढः ||२१|| पिबेज्जलं शीतलमाशु तस्य स्रोतांसि दुष्यन्ति हि तद्वहानि | स्नेहोपलिप्तेष्वथवाऽपि तेषु दकोदरं पूर्ववदभ्युपैति ||२२|| स्निग्धं महत् सम्परिवृत्तनाभि भृशोन्नतं पूर्णमिवाम्बुना च | यथा दृतिः क्षुभ्यति कम्पते च शब्दायते चापि दकोदरं तत् ||२३||

Meaning of the śloka

The passage asks the reader to understand dakodara or udakodara. It says that rapidly drinking cold water after oleation, an oil enema, vomiting therapy, purgation, or a decoction enema impairs the water-carrying channels; it may also arise when these channels are coated with unctuous material. The abdomen is described as smooth, greatly enlarged, prominently raised, with a displaced or protruding navel, and as if filled with water; like a leather water bag, it moves, trembles, and makes sound. The supplied text begins incompletely.

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உதகோதரமாஹ- தகோதரமித்யாதி| தகோதரம் உதகோதரமித்யர்தஃ| தத்வஹாநி தோயவஹாநி| ஸ்நேஹோபலிப்தேஷ்வதவாऽபி தேஷ்விதி ஸ்நேஹாதிபாநஂ விநாऽபி தேஷு ஸ்ரோதஃஸு ஸ்நேஹோபலிப்தேஷு யதா ஶீதலஂ ஜலஂ பிபேத்ததாऽபீத்யர்தஃ| பூர்வவதிதி க்ஷதாந்த்ரோதரே யதா ஸலிலஸ்யாதோகாமித்வாததோ நாபேருதரோத்பத்திர்யதா ச குதாதாஸ்ராவஸ்தத்வதிதி; ஜேஜ்ஜடேந புநஃ ‘பூர்வவதித்யத்ராந்யாந்யுதராணி யதா பவந்தி ததேதமபி’ இதி வ்யாக்யாதஂ, தந்நேச்சதி கயீ| பரிவத்தநாபி| உச்சலிதநாபி| ததிஃ கல்லா| க்ஷுப்யதி சலதி| கம்பதே சேதி கம்பநமதிஶயேந சலநம்||௨௧-௨௩||

Meaning of the commentary

The commentary identifies dakodara with udakodara and the relevant channels as water-carrying. It states that even without immediately preceding oleation or the other procedures, drinking cold water when the channels are coated with unctuous material may produce the condition. In its preferred explanation, 'as before' refers to the earlier injured-intestine abdominal disorder: fluid descends, swelling develops below the navel, and discharge occurs from the rectum. Jejjata instead takes it to mean that this develops like the other abdominal disorders; Gayi rejects that explanation. Parivrittanabhi is glossed as a protruding navel, driti as a leather bag, and kampate as especially marked movement.

Key terms

udakodara/dakodara
A classical abdominal condition described as containing mobile fluid.
toyavaha srotas
Channels described as carrying water.
snehopalipta
Coated with unctuous material.
parivRuttanAbhi (parivrittanabhi)
A displaced or protruding navel according to the commentary.
dRuti (driti)
A leather water bag used as a comparison.

Adhikarana ௧௬ (௨௪) · Śloka ௨௪

ஆத்மாநஂ கமநேऽஶக்திர்தௌர்பல்யஂ துர்பலாக்நிதா | ஶோபஃ ஸதநமங்காநாஂ ஸங்கோ வாதபுரீஷயோஃ | தாஹஸ்தஷ்ணா ச ஸர்வேஷு ஜடரேஷு பவந்தி ஹி ||௨௪||

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आध्मानं गमनेऽशक्तिर्दौर्बल्यं दुर्बलाग्निता | शोफः सदनमङ्गानां सङ्गो वातपुरीषयोः | दाहस्तृष्णा च सर्वेषु जठरेषु भवन्ति हि ||२४||

Meaning of the śloka

Distension, inability to walk, weakness, weak agni, swelling, exhaustion of the limbs, obstruction of flatus and stool, burning, and thirst are said to occur in all forms of jathara described here.

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தேஷாமஷ்டாநாமபி ஸாமாந்யஂ லிங்கஂ தர்ஶயந்நாஹ- ஆத்மாநமித்யாதி| ஜேஜ்ஜடேந புநரேதே உபத்ரவா வ்யாக்யாதாஃ; தந்நேச்சதி கயீ||௨௪||

Meaning of the commentary

The commentary treats these as common signs of all eight abdominal disorders. Jejjata instead explains them as complications, an interpretation Gayi does not accept.

Key terms

AdhmAna (adhmana)
Abdominal distension.
durbalAgni (durbalagni)
Weak digestive fire in the classical account.
vAtapurIShasa~gga (vatapurishasanga)
Obstruction or retention of flatus and feces.
jaThara (jathara)
An abdominal disorder category in this passage.
upadrava
A complication, as Jejjata interprets these features.

Adhikarana ௧௭ (௨௫) · Śloka ௨௫

அந்தே ஸலிலபாவஂ ஹி பஜந்தே ஜடராணி து | ஸர்வாண்யேவ பரீபாகாத்ததா தாநி விவர்ஜயேத் ||௨௫||

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अन्ते सलिलभावं हि भजन्ते जठराणि तु | सर्वाण्येव परीपाकात्तदा तानि विवर्जयेत् ||२५||

Meaning of the śloka

The text says that, in their final stage, all jathara disorders develop a fluid state through maturation; at that point they should be left aside as unsuitable for curative treatment.

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ஸாத்யாஸாத்யவிபாகமாஹ- அந்த இத்யாதி| பரிபாகாத் பரிணாமேந தகோதரதா ஸர்வேஷாமேவ; அந்யாந்யுதராணி பரிபாகாதுதகபாவஂ பஜந்தே, தகோதரஂ ப்ராகேவேதி விஶேஷஃ||௨௫||

Meaning of the commentary

The commentary gives a classical division of prognosis. Through progression, all the other abdominal disorders eventually take on the state of dakodara or fluid accumulation; dakodara differs in having this state from the outset.

Key terms

salilabhAva (salilabhava)
A fluid-filled state.
paripAka (paripaka)
Maturation or advanced progression of the disorder.
dakodaratA (dakodarata)
The state of dakodara, characterized here by fluid accumulation.
vivarjayet
Should leave aside, expressing an unfavorable historical prognosis.

Adhikarana புஷ்பிகா · Śloka ௭

இதி ஸுஶ்ருதஸஂஹிதாயாஂ நிதாநஸ்தாநே உதரநிதாநஂ நாம ஸப்தமோऽத்யாயஃ ||௭||

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इति सुश्रुतसंहितायां निदानस्थाने उदरनिदानं नाम सप्तमोऽध्यायः ||७||

Meaning of the śloka

Thus ends the seventh chapter of the Nidanasthana in the Sushruta Samhita, entitled Udaranidana, the diagnosis of abdominal disorders.

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இதி ஶ்ரீடல்ஹ(ஹ்ல)ணவிரசிதாயாஂ நிபந்தஸங்க்ரஹாக்யாயாஂ ஸுஶ்ருதவ்யாக்யாயாஂ நிதாநஸ்தாநே ஸப்தமோऽத்யாயஃ||௭||

Meaning of the commentary

The commentary colophon states that the seventh chapter of the Nidanasthana is complete in Shri Dalhana's explanation of Sushruta entitled Nibandhasangraha.

Key terms

udaranidAna (Udaranidana)
The chapter on causes and diagnostic description of abdominal disorders.
nidAnasthAna (Nidanasthana)
The division concerned with causes and diagnostic descriptions.
saptama adhyAya (saptama adhyaya)
The seventh chapter.
nibandhasa~ggraha (Nibandhasangraha)
The title of Dalhana's commentary.
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