Abdominal and Intestinal Disorders

Udara is the anatomical name used in the texts for the abdomen. The term also signifies generalized abdominal disease manifested by enlargement. Most of the Udara disorders are ascribed to bad eating habits or to eating spoiled or poisonous food. A few conditions, however, can be understood by modern medicine. Among them is enlargement of the left side of the abdomen because of a large spleen. The symptoms associated with this condition suggest splenomegaly resulting from malaria or filariasis. Enlargement of the right side of the abdomen was the result of involvement of the liver and at times must have indicated cirrhosis. A particularly ominous situation resulted when all three dosas were disturbed: The patient turned yellow and suffered from pain, ascites, and emaciation. This could have been either advanced hepatic cirrhosis with liver failure or liver or pancreatic cancer.

A disease called Dakodara was clearly ascites. The abdomen enlarged with fluid that could be palpated, the umbilicus was flattened out or everted, and there were enlarged blue veins in the thin abdominal wall. Another abdominal distension arose from obstruction of the large bowel, and was manifested by progressive constipation, gaseous swelling of the abdomen, and crampy pains, all of which provides a picture of left colonic cancer or, less commonly, progressive anal stenosis. The latter was ascribed to sharp pieces of food perforating the gut and causing continuous thin and liquid anal discharge associated with vomiting, anorexia, abdominal distension, and pain. The condition could well have been acute gastroenteritis, which was, and is still, a common disease in the Indian subcontinent.

Among the discernible intestinal disorders are dyspepsia, acute diarrhea, and dysentery with some symptoms of the latter suggestive of amebic dysentery. Clearly discernible is cholera, or Vishuchika -the Ayurvedic term for cholera. The patient vomits, trembles, has continuous watery diarrhea, severe abdominal pain, and hiccoughs. In agonal stages there is tingling all over the body, and the patient loses consciousness and becomes cyanotic. The voice becomes weak, the muscles and joints become lax, and the eyes retract into the orbital cavity. In a variant termed Alashaka, diarrhea is not prominent, the abdomen distends, the patient has severe cramps and is very thirsty and nauseated. These symptoms parallel those of cholera sicca.

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