The royal sage Dhanvan-tari, the foremost of all pious men who equalled in splendour and glory the lord of the celestials, thus blissfully discoursed on the Nidánam of Udara to Susruta, the son of the holy Visvámitra, who devoutly approached him for that purpose. 2.
This disease may be divided into eight different types, of which four are produced by the several actions of the three deranged Doshas of the body and their concerted action as well. Of the remaining types, two being known as Plihodara (including Yakritodara), and Vaddha-Gudodara (tympanites due to the constriction of the anus), the seventh Agantuka (traumatic or of extraneous origin), and the eighth Dakodara (Ascites proper). 3.
The deranged Doshas of a person of extremely impaired digestion, addicted to the habit of taking unwholesome food, or of eating dry, putrid food, or of violating the rules of conduct to be observed in connection with oleaginous measures etc. * are aggravated and find lodgment in the abdomen. Thus appearing in the shape of an abdomi-nal tumour (Gulma), they give rise to this dreadful disease, attended with all its characteristic symptoms. The lymph chyle formed out of the assimilated food gets vitiated, and, impelled by the aggravated Váyu, it percolates through the peritoneum in the same manner as a quantity of oil or clarified butter kept in a new earthen pot will transude through the pores of its sides. It thus gradually distends the skin (Tvak) of the abdomen. The process becomes general all through the abdominal region and the disease (Udara) Is produced in consequence. 4 - 5.
* These include purgative, emitic, A'stha'panam and Anuva'sanarn measures.
The precursory symptoms of the disease are loss of strength, complexion and appetite, emaciation of the muscles of the abdomen, appearance of veins on its surface, acid reaction of food closely following upon its digestion (Vidáha) pain in the bladder, and swelling of the lower extremities. The patient cannot ascertain whether his meal has been digested or not. 6.
A case of Udara in which the abdomen enlarges on its sides and posterior part, and is overspread with nets of black veins should be ascribed to the action of the deranged Váyu. A pain (Sula), suppression of the stool and urine (Anáha) and a cutting and piercing pain and flatulent rumbling in the intestines are the symptoms which likewise characterise this Vátaja form of Udara. A sucking pain in the abdomen, thirst, fever with a burning sensation, yellow colour of the swollen skin of the abdomen, on the surface of which yellow veins appear, yellow colour of the eyes, nails, face, stool and urine and the rapid increase of the dropsical swelling, are the characteristics of the Pittaja Udara. In a case of Kaphaja type the dropsical swelling is cold to the touch and becomes overspread with white-coloured veins. The abdomen seems heavy, hard, glossy and is extremely distended. The swelling slowly increases,-and the fingernails and face of the patient become white, and he complains of a general lassitude. 7 - 9.