Chapter CLXXXVIII - The Nidanam of Udavarta

Dhanvantari said:—Now hear me, O Sushruta, discourse on the Nidanam of Udavarta. Suppression of urgings towards sneezing, yawning, defecation, urination or of any other functions of the body, unnatural non-gratification of hunger, thirst, etc., should be regarded as the exciting factors of Udavarta. The type of Udavarta, ushered in through a voluntary retention of flatus, is marked by tympanites with suppression of stool and urine, lassitude and a pricking, aching pain in the intestines. A deranged and aggravated condition of the bodily Vayu should be regarded as one of the essential causes of Udavarta, and measures calculated to restore the deranged Vayu to its normal course and condition should be considered as the primary remedies in all types of this disease. In the type due to the voluntary retention of stool, an aching pain with a rumbling sound in the intestines, a cutting pain about the anus, suppression of stool and urine and rising of eructations are the symptoms which manifest themselves, and sometimes the fecal matter is found to be ejected though the mouth. The type of Udavarta, which originates from a voluntary retention of urine, is marked by an aching pain in the bladder and urethera, strangury, and a drawing pain in the inguinal regions. The body seems extremely painful and the patient finds relief only in a recumbent posture. In the type of Udavarta resulting from a voluntary suppression of an urging towards yawning, stiffness of the muscle of the neck (Manya) with a numbed pain in the throat, headache and a host of other diseases of the eyes, ears, nose and mouth are developed. Similarly, the type of Udavarta, which is brought on through a voluntary suppression of tears, is marked(?) by an excruciating headache, catarrh and affections of the eyes. Voluntary suppressions of urgings towards sneezing may bring on a type of Udavarta, which is marked by an excruciating headache, stiffness of the neck, faceal(?) paralysis, hemi-crania and impaired organic functions in general. The type of Udavarta, which is induced through voluntary suppressions of yawns, gives rise to a sense of fullness in the throat and mouth, an aching pain with a rumbling sound in the intestines, a croaking sound in the throat, indistinctness of speech, dyspnœa, hic-cough, and other disorders of the deranged Vayu. The type of Udavarta, which is caused through the voluntary suppression of vomitings, is marked by urticaria, itching eruptions on the skin, with a distate for food, cutaneous affections, nausea, and erysipelatous ulcers on the skin. In the type ushered in through a voluntary suppression of emission of semen, a cutting pain in the scrotum, rectum, penis and bladder, together with a swelling about any of these localities, dribbling of urine and semen, suppression of urine, and seminal concretions are the symptoms that are exhibited. Unappeased hunger brings on drowsiness, lassitude with a distate for food and an aching pain in the limbs and impaired faculty of sight. An ungratified thirst produces parchedness of the throat and mouth, pain about the cardiac region, and obstruction of the faculty of hearing. Suppression of sighs after a fatiguing physical labour or exhaustion may bring on diseases of the heart, loss of consciousness, intestinal glands, yawning, with an aching pain in the limbs, heaviness of the head and the eyes, and drowsiness.

The bodily Vayu, deranged and aggravated by the ingestion of bitter, astringent, or parchifying articles of fare, invades the digestive apparatus, and by taking recourse in the abdominal cavity, gives rise to Udavarta. The deranged Vayu, thus aggravated, by stuffing the vessels of blood, fat, stool and urine, etc., absorbs the humidity of the feces and makes them dry and hard as stone. The patient tosses about in agony, afflicted with nausea, pain about the heart, and an aching pain in the urinary bladder, and the flatus, stool and urine are emitted with the greatest difficulty. Dyspnœa, cough, catarrh with a burning sensation in the body, thirst, epileptic fits, fever, vomiting, hic-cough, mental aberrations, headache and other distempers, which originate from the deranged Vayu, gradually manifest themselves with the progress of the disease.

The feces and the undigested lymph-chyle gradually accumulated in the stomach and obstructed in their downward course by the deranged and aggravated Vayu, gives rise to Anaha, which is characterised by thirst, catarrh with, a burning sensation in the head, gastralgia and a sensation of a weight in the stomach, and suppression of eructations, etc. In the type due to the accumulation of fecal matter in the intestines a feeling of numbness at the back and sacrum, suppression of stool and urine, colic epileptic fits, vomiting of fecal matter, œdema, and other distempers of the obstructed Vayu are found to be manifest.