Chapter 19 - The Eight Abdominal affections (udara-roga)

1. We shall now expound the chapter entitled “The Eight Abdominal Affections (udara-roga).”

2. Thus declared the worshipful Atreya.

The Enumeration of Diseases

3-(1.) There are eight varieties of abdominal affections (Udararoga—udara-roga), eight of the disorders of the urinary system (Mutraghata—mūtrāghāta), eight of galactic disorders (Kshira-dosha—kṣīradoṣa), eight of seminal disorders (Retas-dosha—retodoṣa), seven of dermatosis (Kushtha—kuṣṭha), seven of inflammatory swellings (Pidaka—piḍaka), seven of acute spreading affections (visarpa), six of diarrhea (atisāra), six of misperistalsis (Udavarta—udāvarta);

3-(2). Five of gulma, five of splenic disorder (Pliha-dosha—plīhadoṣa), five of cough (Kasa—kāsa), five of dyspnea (Shvasa—śvāsa), five of hiccup (Hikka—hikkā), five of thirst (Trishna—tṛṣṇā), five of vomiting (chardaya), five of loss of appetite (Bhakta-anashana—bhaktānaśana), five of the disease of the head (Shiras-roga—śiroroga), five of cardiac disorder (Hrid-roga—hṛdroga), five of anemia (Pandu-roga—pāṇḍuroga), five of insanity (Unmada—unmāda);

3-(3). Four of epilepsy (Apasmara—apasmāra), four of eye-disease (Akshi-roga—akṣiroga), ear-disease (Karna-roga—karṇaroga), four of coryza (Pratishyaya—pratiśyāya), four of assimilation disorder [? Mukha-roga—mukharoga |OR| Grahani-dosha—grahaṇīdoṣa ?], four of intoxication (Mada-roga—madaroga), four of fainting (Murccha/Murcchaya—mūrcchā/mūrcchāyā), four of consumption (Shosha—śoṣa), four of impotency (klaibya);

3-(4). Three of edema (Shopha—śopha), three of leprosy (Kilasa—kilāsa), three varieties of hemothermia (Lohita-pitta—lohitapitta), two of fever (jvara), two of wounds (Vrana—vraṇa), two of convulsions (Ayama—āyāma), two of sciatica (Gridhrasi—gṛdhrasi), two of jaundice (Kamala—kāmala), two of chyme disorder (Ama—āma), two of rheumatic condition (Vatarakta—vātarakta), two of piles (Arsha—arśa);

3. One of spastic paraplegia (Urustambha—ūrustambha), one of syncope (Sannyasa—saṃnyāsa), one of magnum morbus (Mahagada—mahāgada), twenty varieties of worms (Krimi-jataya—krimijātaya), twenty of anomalies of urinary secretion (prameha), twenty of gynecic disorders (Yoni-vyapada—yonivyāpada):—thus in this enumeration are given forty-eight varieties of diseases.

Abdominal Diseases (udara-roga) and Urinary Disorders (mutraghata)

4-(1a). We shall explain them in the order of enumeration. The eight varieties of abdominal disease (udara-roga) are those caused by (1) Vata, (2) Pitta, (3) Kapha, (4) tridiscordance, (5) splenic disorder, (6) intestinal obstruction, (7) gastrointestinal perforation and (8) ascites. The eight varieties of disorders of the urinary system (Mutraghata—mūtrāghāta) are caused by (1) Vata (2) Pitta, (3) Kapha, (4) tridiscordance, (5) formation of stone, (6) formation of sand, (7) seminal disorder and (8) vitiation of blood.

Galactic and Seminal Disorders

4-(1). The eight varieties of galactic disorders are—(1) discoloration, (2) stink, (3) distaste (4) sliminess, (5) frothiness, (6) absence of unctuousness, (7) heaviness and (8) excessive unctuousness. The eight varieties of seminal disorders are—(1) thinness, (2) dryness, (3) frothiness, (4) lack of whiteness, (5) stink, (6) hyper-sliminess, (7) mixture with other elements and (8) loss of buoyancy.

Dermatosis, inflammatory swellings and Acute Spreading Affections

4-(2). The seven varieties of dermatosis are—(1) Kapala (kapāla), (2) Udumbara (3) Mandala (maṇḍala), (4) Rishyajihva (ṛṣyajihva), (5) Pundarika (puṇḍarīka), (6) Sidhma and (7) Kakana (kākaṇa). The seven various inflammatory swellings are:—(1) crateriform ulcer, (2) carbuncle, (3) cribriform swelling, (4) boils, (5) dry gangrene, (6) moist gangrene and (7) abscess. The seven varieties of acute spreading affections are—(1) Vata type, (2) Pitta type, (3) Kapha type (4) erysipelas (5) spreading moist gangrene, (6) a,cute lymphadenitis and (7) tridiscordance type.

Diarrhea and Misperistalsis

4-(3). The six varieties of diarrhea are those of (1) Vata, (2) Pitta, (3) Kapha, (4) tridiscordance, (5) fear and (6) grief. The six varieties of misperistalsis are those of (1) flatus, urine, (3) feces, (4) semen, (5) vomiting and (6) sternutation.

Gulma

4-(4a). The five varieties of Gulma are those due to (1) Vata, (2) Pitta, (3) Kapha (4) tridiscordance and (5) vitiated blood. The varieties of splenic disorders are the same as described in Gulma.

Cough, Dyspnea and Hiccup

4-(4b.). The five varieties of cough-disorder are those due to (1) Vata, (2) Pitta, (3) Kapha, (4) ulcerations in the respiratory tract and (5) wasting. The five varieties of dyspnea are (1) major, (2) respiratory, (3) spasmodic, (4) asthma and (5) minor. The five varieties of hiccup are—(1) Mahati (mahatī) or the major (2) Gambhira (gambhīra) or the deep, Vyapeta or intermittent. (4) Ksudra (kṣudra) or the minor and (5) the alimental.

Dipsosis, Vomiting and anorexia

4-(4c.) The five varieties of thirst are those due to (1) Vata, (2) Pitta, (3) chyme-disorder, (4) wasting and (5) secondary complications. The Five varieties of vomiting are those due to (1) contact of repulsive articles, (2) provoked Vata, (3) Pitta, (4) Kapha, (5) and tridiscordance. The five varieties of disinclination for food are those due to (1) Vata, (2) Pitta, (3) Kapha, (4) tridiscordance and (5) repulsion.

Head-Diseases and Cardiac Diseases

4-(4d). The five varieties of the diseases of the head, as previously described, are those due to (1) Vata, (2) Pitta, (3) Kapha, (4) tridiscordance and (5) Parasitic infection. The five varieties of cardiac disorders are to be understood to be caused like “The diseases of the head.”

Anemia and insanity

4-(4). The five varieties of anemia are those due to (1) Vata, (2) Pitta, (3) Kapha, (4) tridiscordance and (5) geophagism. The five varieties of insanity are those due to (1) Vata, (2) Pitta, (3) Kapha, (4) tridiscordance and (5) exogenous causes.

Epilepsy, Eye Disease, Ear Disease, Coryza and Mouth Disease

4 (5a.) The four varieties of epilepsy are those due to (1) Vata, (2) Pitta, (3) Kapha and (4) tridiscordance. So also the four varieties of eye-disease, of ear-diseases, of coryza and of mouth-diseases.

Assimilation Disorders, intoxication and Fainting

4-(5b) The four varieties of. assimilation-disorders, the four of intoxication and the four of fainting are caused by the same factors as those inducing epilepsy.

Consumption and Impotency

4-(5). The four varieties of consumption are due to (1) overstrain, (2) suppression of natural urges, (3) wasting and (4) irregularity of diet. The four varieties of impotency are due to (1) atonic, (2) organic, (3) senile and (4) oligospermatic conditions.

Edema, Leprosy and hemothermia

4-(6). The three varieties of edema are those due to (1) Vata, (2) Pitta and (3) Kapha. The three varieties of leprosy are those that are (1) red, (2) coppery and (3) white. The three varieties of hemothermia are those (1) affecting the upper channels (2) affecting the lower channels and (3) affecting both the channels.

Fever, Wounds, tonic Spasms and Sciatica

4-(7a). The two varieties of fever are those caused by (1) cold accompanied with a craving for hot things and (2) heat accompanied with a craving for cold things. The two varieties of wounds are those due to (1) endogenous and 2) exogenous causes. The two varieties of tonic spasms are (1) external or opisthotonos and (2) internal or emprosthotonos. The two varieties, of sciatica are those due to (1) Vata and (2) Vata-cum-kapha.

Jaundice, Chyme-Disorder, Rheumatic Condition and Piles

(4-7). The two varieties of jaundice are (1) central and (2) peripheral. The two varieties of chyme-disorders are of (1) intestinal torpor and (2) intestinal irritation. The two varieties of rheumatic condition are (1) the deep and (2) the superficial. The two varieties of piles are (1) the bleeding one aud (2) the non bleeding ones.

Paraplegia, Syncope and Magnum Morbus

4-8 Spastic paraplegia is of one kind and is due to the disorder of chyme and tridiscordance. Similarly, syncope which is also of one kind is due to symptosis of all the three humors, and is of a psycho-somatic nature. Magnum Morbus is due to mental and moral perversion

Worms

4-(9a). The twenty varieties of worms are (1) lice (2) mites residing in the body-excretion, six varieties residing in the blood viz,. (1) Kesada (keśāda), (2) Lomada (lomāda), (3) Lomadvipa (lomadvīpa), (4) Saurasa, (5) Audumbara and (6) Jantumatara (jantumātara).

4-(9b). Seven varieties residing in the mucus viz., (1) Antrada (antrāda), (2) Udaraveshta (udarāveṣṭa), (3) Hridayada (hṛdayāda), (4) Curu, (5) Darbhapushpa (darbhapuṣpa), (6) Saugandhika aud (7) Mahaguda (mahāguda).

4-(9c). Five varieties residing in the feces viz., (1) Kakeruka, (2) Makeruka, (3) Leliha, (4) Sashulaka (saśūlaka) and (5) Sausurada (sausurāda).

Urinary Disorders

4-(9d). The twenty varieties of the anomalies of urinary secretion are (1) Udakameha or hydruria (2) Ikshuvalikarasameha (ikṣuvālikārasameha) or glycosuria (3) Sandrameha (sāndrameha) or lymphuria (4) Sandraprasadameha (sāndraprasādameha) or chyluria, (5) Shuklameha (śuklameha) or bacteriuria (8) Shukrameha (śukrameha) or spermaturia. 7) Shitameha (śītameha) or phosphaturia (8) Shanairmeha (śanairmeha) or slow micturition, (9) Sikatameha (sikatāmeha) or Ethuria and (10) Lalameha (lālāmeha) or pyuria are the ten that are caused by kapha.

4-(9e) (1) Ksharameha (kṣārameha) or alkalinuria. (2) Kalameha (kālameha) or melanuria (3) Nilameha (nīlameha) or indicanuria, (4) Lohitameha or hematuria, (5) Manjishthameha (mañjiṣṭhāmeha) or hemoglobinuria aud (6) Haridrameha (haridrāmeha) or coliuria are the six caused by Pitta.

4-(9f). (1) Vasameha (vasāmeha) or lipuria, (2) Majjameha (majjāmeha) or Myelopathic albuminuria, (3) Hastimeha or incontinence of urine and (4) Madhumeha or diabetes are the four caused by Vata. These are the twenty varieties of the anomalies of urinary secretion.

Gynecic Diseases

4-(9g). There are twenty varieties of gynecic diseases; of them four are born of the morbid humors i.e. (1) Vata (2) Pitta (3) Kapha and (4) tridiscordance.

4-(9). The remaining sixteen are designated in the light of associated morbid humors and causative factors. They are (1) Raktayoni or menorrhagia, (2) Arajaska or amenorrhea, (3) Acarana (acaraṇā/ācaraṇā[?]) or colpitis mycotica. (4) Aticarana (aticaraṇā) or chronic vaginitis, (5) Prakcarana (prākcaraṇā) or deflorative vaginitis, (6) Upapluta (upaplutā) or leucorrhea, (7) Paripluta (pariplutā) or acute vaginitis, (8) Udavartini (udāvartin) or dysmenorrhea, (9) Karnini (karṇin/karṇinī[?]) or endocervicitis, (10) Putraghni (putraghnī) or abortive tendency, (11) Antarmukhi (antarmukhī) or inversion of uterus, (12) Sucimukhi (sūcīmukhī) or colpo stenosis (13) Shushka (śuṣkā) or colpoxerosis, (14) Vamini (vāminī) or profluvium seminis, (15) Shandhayoni (ṣaṇḍhayoni) or pseudo uterus and (16) Mahayoni (mahāyoni) or prolapse of the uterus—these are the twenty varieties of gynecic diseases.

4. Thus has been the whole subject described according to the order of numeration.

All Diseases Are Referable to Vata, Pitta and Kapha

5-(1). All endogenous diseases manifest the discordance of Vata, Pitta and Kapha. Just as a bird, though it fly throughout the day, cannot yet overtake its own shadow, similarly, all the disorders born of the vitiation of humors, cannot escape falling into the categories of Vata, Pitta and Kapha.

5. Again, after investigating carefully the characteristics of the seat of affection, symptoms and causes of these conditions produced by morbidity of Vata, Pitta and Kapha, the learned physician classifies all diseases caused by them, in accordance with all these factors.

Here are two verses again—

6. There are many classes of disorders affecting the body, that are caused by the discordance of body-elements; but they are none of them independent of the three factors Pitta, Kapha and Vata; only the disorders produced by the exogenous causes are different.

Inter-Relation Between Endogenous and Exogenous Diseases

7. Exogenous affections may occur consequent upon endogenous disorders and similarly, increased endogenous morbidity may combine with exogenous affections. Under such circumstances, the physician should carefully investigate the primary causes and secondary complications before he begins the treatment.

Summary

Here are the two recapitulatory verses—

3-9. The scores, the monads[?], the three triads, the eight dyads, the ten tetrads, the twelve pentads, the four octads, the two hexads, and the three heptads of the classes of diseases are described in this chapter on “The Eight abdominal affections.”

19. Thus, in the section on General Principles in the treatise compiled by Agnivesha and revised by Caraka, the nineteenth chapter entitled, “The Eight Abdominal affections” is completed.