Evil-natured women (with a view to win the affections of their husbands or lovers sometimes) mix with their food and drink such refuse matters of their bodies as nails, hair, faeces, urine, catamenial blood etc. (which are supposed to be possessed of talismanic virtues). The three Doshas of the body, vitiated by such food or drink, or through imbibing any sort of chemical poison (Gara) administered by one's enemy, or by taking poisonous waters, or Dushi-Visha (slow poison whose active properties have been destroyed by fire or any antipoisonous medicine), will vitiate the blood and give rise to a kind of dreadful dropsical swelling of the abdomen, marked by the specific symptoms of each of them The disease is aggravated in cold and cloudy days and a burning sensation is felt (in the inside of the abdomen). The patient becomes pale, yellow and emaciated, and is afflicted with thirst and dryness in the mouth, and loses consciousness at short intervals. This disease is also known as the dreadful Dushyodaram. 10. Plihodaram. - (Spleen with dropsy of the abdomen): - Now hear me describe the symptoms of Plihodaram. The blood and the Kapham of a person, deranged and aggravated through the ingestion of phlegma-gogic food, or of those which is followed by an acid digestionary reaction (Vidáha), often enlarge the spleen, (which gives rise to a swelling of the abdomen). This disease is called Plihodara by the experts. Plihodaram protrudes on the left side of the abdomen, its characteristic symptoms being lassitude, low fever, impaired digestion, loss of strength, jaundice, weakness, and other distressing symptoms peculiar to the deranged Pittam and Kapham. A similar enlargement of the liver through similar causes on the right side of the abdomen is called Jakriddályudaram. 11 - 12.
The fecal matter, mixed with the deranged Váyu, Pittam etc. of the body, lies stuffed in the rectum of a person whose intestines have been stuffed with slimy food (as pot herbs) or with stones and hair (enteritis). They give rise to a sort of abdominal dropsy by swelling the part between the heart and the umbilicus which is called Vaddha Gudodaram. Scanty stools are evacuated with the greatest pain and difficulty and the patient vomits a peculiar kind of matter with a distinctly fecal smell (scyabalous?). 13.
Now hear me describe the causes and symptoms of the type of Udaram which is called Parisrávi-udaram. Thorny or sharp-pointed substances (such as fish-bones etc.), carried down with the food in a slanting way from the stomach into the abdomen, sometimes scratch or burrow into the intestines. Causes other than the preceding ones, (such as a long yawn or over-eating etc.) may contribute to the perforation of the intestines, giving rise to a copious flow of a watery exudation which constantly oozes out of the anus and to a distension of the lower part of the abdomen situated below the umbilicus. This is called Parisrávyudaram which is marked by a cutting pain and a burning sensation. 14.
Dakodaram: - Now hear me describe the causes and symptoms of the type known as Dakodaram (ascites). The drinking of cold water immediately after the application of an Aunvásanam or Asthápanam enema, or closely following upon the exhibition of any purgative or emetic medicine, or just after the taking of a medicated oil or clarified butter, etc. tends to derange the water-carrying channels of the body. The same result may be produced by the drinking of oil, etc. in inordinate quantities The water, by percolating or transuding through the walls of these channels, as before described, inordinately enlarges the abdomen, which becomes glossy on the surface and is full of water, being rounded about the umbilicus and raised like a full-bloated water-drum. The simile is complete as it fluctuates under pressure, oscillates, and makes a peculiar sound like a water-drum under percussion. 15.
* Dropsical swelling of the abdomen with tympanites due to the constriction of the rectum known as intestinal obstruction.
Distension of the stomach, incapacity of locomotion, weakness, impaired digestion, œdematous swelling of the limbs, a general sense of lassitude and looseness in the limbs, suppression of flatus and stool, and a burning sensation and thirst arc among the general characteristics of the disease in its various forms. 16.
Prognosis: - All cases of Udaram after the lapse of considerable time develop into those of ascites, and a case arriving at such a stage should be given up as incurable. 16 - 17.
Thus ends the seventh Chapter of the Nidŕna Sihŕnam in the Susruta Samhitá which treats of the Nidánam of Udaram.