৭. উদরনিদানম্

Meaning of the śloka

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

Key terms

udara

A classical group of disorders characterized especially by abdominal enlargement.

nidAna (nidāna)

An account of causes and diagnostic features.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

Meaning of the śloka

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

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

Meaning of the śloka

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

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.