Causes : - A wise man valuing his life shall never repress any natural urging of his body, whether upward or downward, e. g. that of Vayu, etc. Udavarta is so called from its origin from the repression of any natural urging such as Vata (flatus), evacuation of bowels, micturition, yawning, lacrimation, sneezing, eructation, vomiting and discharge of semen when it makes its appearance (Udita) and urges a person to answer its call. Udavarta is also brought on by the repression of hunger, thirst, respiration and sleep. I shall now fully describe its symptoms and the mode of medical treatment to be pursued therein. It is of thirteen different types and are brought about through the aforesaid causes, over and above the one incidental to the habitual use of unwholesome food and drink (Apathyaja). 2-4.
The vital Apana-Vayu (at the anus) anyhow obstructed in its passage gives rise to distension and cramps in the abdomen, oppression and a constricted feeling at the heart, headache, laboured breathing, hiccough, cough, catarrh, catching pain at the throat which makes speaking and Deglutition difficult (Gala-graha), violent movement of deranged Pitta and Kapha all through the body and suppression of stools or emission of fecal matter through the mouth. 5.
A repressed urging for stool is followed by the exhibition of such symptoms, as rumbling in the intestines, severe pain (in the abdomen), cutting pain in the anus, upward coursing of the flatus, suppression of stool or even emission of feces through the mouth. 6.
A repression of the desire of making water is followed by scanty emission of urine which is often given out by painful drops producing distension of the bladder and an excruciating pain in the urethra, anus, scrotum and the inguinal regions and about the umbilicus, and sometimes even in the head, accompanied with distortion of features in consequence. 7.
A repression of yawning leads to wry-neck (numbness of the Manya and of the neck) as well as troubles of the head due to the incarcerated local Vayu and violent diseases affecting the eyes, nose, ears and the mouth. Tears born of any mental condition of grief or joy and voluntarily repressed without being given free vent to, give rise to severe distempers of the eyes, heaviness of the head and catarrh (Pinasa). 8-9.
A repression of sneezing is followed by acute diseases of the head, eyes, nose and cars. A sense of fulness in the throat as well as the suppression and croaking of the incarcerated Vayu (wind) arc also exhibited in this case.* The voluntary repression of any natural urging towards eructation gives rise to diseases peculiar to the derangement of the bodily Vayu. 10 - 11.
A repression of vomiting is followed by cutaneous affections (Kushtha) due to the bodily Doshas which, being vitiated, had interfered with the gastric digestion with reactionary acidity and produced the vomiting. Painful swelling of the bladder and of the scrotum, and about the anus as well as suppression of urine, formation of gravels in the bladder and involuntary emission of semen are the symptoms which manifest themselves in a case of repressed seminal discharge. 12-13.
* The symptoms mentioned in this sentence (which comprises a line in the verse) is taken by Madhava with the following line which enumerates the symptoms of Udavarta due to the voluntary repression of eructation.
Ungratified hunger brings on drowsiness, aching pain in the limbs, disrelish for food, sense of exhaustion, and weakness of eye-sight. An ungratified thirst brings on dryness of the throat and mouth, dulness of hearing and pain at the heart. A suppression of breath, in an exhausted person brings on cardiac troubles, fainting fits and an attack of Gulma. An unindulged sleep produces yawning, aching pain in the limbs, and a sense of heaviness in the limbs as well as in the head and the eyes. It may also bring on drowsiness. 14-17.
An Uddvarta-patient afflicted with thirst and cramps (Sula), vomiting fecal matter and suffering from weakness and a distressing exhaustion should be given up by a wise physician. 18.
in all forms of Udavarta the preliminary treatment generally consists in restoring the deranged and incarcerated bodily Vayu to its normal course and direction. Now hear me again describe the specific medicinal remedies to be separately employed in each case. 19.
In a case of Va'taja Udavartathe patient should be first treated with a Sneha and Sveda (fomentation) after which medicinal injections should be made into the rectum after the manner of an Asthapana-vasti. In a case due to the incarceration of feces in the intestines (Purishaja), the remedial measures and medicines laid down in connection with the treatment of Anaha should be employed. 20 - 21.
Wine charged with a large quantity of Souvarchala-salt should be administered in a case due to the retention of urine. Milk or Eld should also be taken in combination with wine. The expressed juice of Dhatri diluted with water should be taken for three successive days; or the expressed liquid of the dung of a horse or of an ass should be taken ; or wine made from treacle (Goudika) should be taken with honey and cooked meat should beitaken by biting at intervals. One Tola weight of the compound consisting of Bhadra-daru, Musta, Murva, Haridra and Yashti-madhu should be dissolved in an adequate quantity of rain-water and then be taken. The expressed juice of Duspars'a (Dura-labha) or an infusion of Kum-kuma (D. R. - decoction of Kakubha i. e. Arjuna' should be taken, or Ervaruka seeds mixed with a little salt should also be taken with water. Milk duly cooked with Pancha-mula* or the expressed juice of Draksha should be prescribed. The medicinal remedies previously described as possessed of the efficacy of disintegrating gravels, (As'mari)† should be administered. Similarly, all the measures to be mentioned hereafter in connection with the medical treatment of Mutra-krichchhra ‡ (strangury) and of Mutraghata § (obstruction of urine) which I shall have occasion to deal with later on should also be adopted in this case. 22.
A case of Udavarta due to the suppression of yawning should be conquered with the applications of Sneha and of Sveda (fomentation). The patient should be treated with Sneha and then fomented and lachrymation should then be induced (with appropriate remedies)* in a case where the flow of tears has been suddenly checked. Sneezing should be induced with the help of strong Anjanas and Avapidas, or by the application of Vartis, or by holding any strong smell at his nose or by blowing any strong medicinal powder into the nose (Pradhamna) or by making the patient look towards the sun (or such like luminous body) in a case of Udavarta due to the suppression of sneezing. 23 - 24.
* Both Dallana and S'ivadasa recommend the use of minor Pancha-inula, but S'rikantha rccomnicdb the Trina-I'ancha-mula. † For Ab'mari - See Chiktisila sthana, Chapter VII (Sounds Of A (Medicated) Drum, Etc., Possessed Of Anti-Venomous Virtues (Dundhubhi-Svaniya)). ‡ For Mutra-Kuchchhra - Sec ch. LIX., Uttara-Tantra. § For Mutraghata - See ch, LVIII, Uttara-Tantra
In a case of Udavarta due to suppressed eructation. the patient should be made to inhale the fumes of oily or lardaceous articles in due order † or to take draught of wine surcharged with Souvarchala-salt. and the expressed juice of Vija-pura. A case of Udavarta due to suppressed vomiting should be duly conquered with emulsive measures (treating with a Sneha), etc., according to the nature of the deranged bodily Dosha involved in each case. In the alternative unguents with (Saindhava) salt and (Yava-) Ks'hara should be applied. 25 - 26.
Milk should be duly cooked with the admixture of four times as much water and with the drugs of bladder-cleansing virtues ‡ and boiled until all the water is evaporated. Draughts of this medicated milk should be prescribed in copious quantities in a case of Udavarta due to the retention of seminal fluid and the patient should be advised to have sexual intercourse with lovely women. 27.
* These are the applications of strong Anjanas and Avapida-Nasyas.
‡ These are the drugs of the Trina-pancha-mula as well as of the Viratarvadi groups (Chapter XXXVIII (General Classification Of Drugs According To Their Therapeutical Properties (Dravya-Sangra-Haniya-Madhyayam)), Sutra Sthana).
Fatty (Snigdha) things should be taken lukewarm and in small quantities in a case of Udavarta due to ungratified hunger- Cold Manthas or Yavagus should be given to the patient in a case of Udavarta due to the suppression of thirst. Food with meat-soup should be given to the patient after sufficient rest in a case of Udavarta originated from the suppression of breath in a tired state of the body. Milk* should be given in a case of Udavarta due to the suppression of sleep and the patient should be made to sleep with the help of sweet discourses. 28.
Cases of Adhmaua (distension of the abodomen), etc., which are the supervening symptoms of Udavarta) should be remedied with appropriate medicines and other measures with an eye to the nature and intensity of the deranged Dosha or Doshas involved in each case underlying at the root. 29.