Changes

==== Etiopathogenesis ====

==== Etiopathogenesis ====

Impairment of jatharāgni leads to morbidity of all the three dosha. Mala in the present context refers to morbid vāta, pitta and kapha, the metabolic bi-products formed during dhātu metabolism i.e. during tissue formation as well as the wastes like excreta1. Impairment of agni leads to excess formation of metabolic bi products (mala) and less formation of quality products. This leads to accumulation of the waste at micro-cellular circulation, which causes multiple diseases. More specifically, this accumulation of wastes at various visceral organs like liver, spleen etc. leads to distension of abdomen2.  

Impairment of ''jatharagni'' leads to morbidity of all the three ''dosha''. ''Mala'' in the present context refers to morbid ''vata'', ''pitta'' and ''kapha'', the metabolic bi-products formed during ''dhatu'' metabolism i.e. during tissue formation as well as the wastes like excreta1. Impairment of ''agni'' leads to excess formation of metabolic bi products (''mala'') and less formation of quality products. This leads to accumulation of the waste at micro-cellular circulation, which causes multiple diseases. More specifically, this accumulation of wastes at various visceral organs like liver, spleen etc. leads to distension of abdomen2.  

Malina ahāra meaning unhealthy food refers to all food articles that cause morbidity of dosha in the body when consumed3. Malina ahāra also includes unclean vegetable and other food articles4.

''Malina ahara'' meaning unhealthy food refers to all food articles that cause morbidity of ''dosha'' in the body when consumed3. ''Malina ahara'' also includes unclean vegetable and other food articles4.

Excessive dryness of the body in the absence of counteracting the same by proper measures leads to the udara roga5. The disease ama causing udara refers to the chronic perpetuation ama leads to udara roga5.  

Excessive dryness of the body in the absence of counteracting the same by proper measures leads to the ''udara roga''5. The disease ''ama'' causing ''udara'' refers to the chronic perpetuation ''ama'' leads to ''udara roga''5.  

Āma as a cause of udara also refers to the consumption of uncooked foods6.  

''Āma'' as a cause of ''udara'' also refers to the consumption of uncooked foods6.  

Severe suffering of diseases like pliha here refers to the suffering due to non availability of proper treatment predisposes to udara roga7.  

Severe suffering of diseases like ''pliha'' here refers to the suffering due to non availability of proper treatment predisposes to ''udara roga''7.  

Morbidity of srotas refers to the mutravaha and purishavaha srotas and others that lead to the manifestation of udara roga7.

Morbidity of ''srotas'' refers to the ''mutravaha'' and ''purishavaha srotas'' and others that lead to the manifestation of ''udara roga''7.

Travelling and other physical activities immediately after the meals are referred as irritation after the meals and are the cause of udara roga6.

Traveling and other physical activities immediately after the meals are referred as irritation after the meals and are the cause of ''udara roga''6.

Listing of sinful acts as etiology indicates the serious unrighteousness as the potent etiology of udara roga5 [12-13].

Listing of sinful acts as etiology indicates the serious unrighteousness as the potent etiology of ''udara roga''5 [12-13].

All the foods that are greasy, heavy for digestion or light for digestion and dry causes vidāha (burning sensation in the abdomen during the digestion of foods) or else the patient develops vidaghdājirna8 (intermediate state of digestion that caused burning)[12-15] .

All the foods that are greasy, heavy for digestion or light for digestion and dry causes ''vidaha'' (burning sensation in the abdomen during the digestion of foods) or else the patient develops ''vidaghdajirna''8 (intermediate state of digestion that caused burning)[12-15] .

The pathogenesis mentioned earlier in the text is of all types of udara roga. The pathogenesis described here is that of the four types of udara caused by morbid dosha viz vātodara, pittodara, kaphodara and sannipātodara9 [20].

The pathogenesis mentioned earlier in the text is of all types of ''udara roga''. The pathogenesis described here is that of the four types of ''udara'' caused by ''morbid dosha'' viz ''vatodara, pittodara, kaphodara'' and ''sannipatodara''9 [20].

Two tier impairment of jatharāgni is mentioned as the cause of udara roga. In a patient with impaired jatharagni (digestive juices), consumption of unhealthy foods further impairs the functioning of jatharāgni. This indicates extreme impairment of jatharagni is involved in the pathogenesis of udara roga.

Two tier impairment of ''jatharagni'' is mentioned as the cause of ''udara roga''. In a patient with impaired ''jatharagni'' (digestive juices), consumption of unhealthy foods further impairs the functioning of ''jatharagni''. This indicates extreme impairment of ''jatharagni'' is involved in the pathogenesis of ''udara roga''.

Impairment of agni is the initial state that causes indigestion and morbidity of dosha. Morbid dosha in turn further impairs the functioning of agni thus forming a vicious cycle.

Impairment of ''agni'' is the initial state that causes indigestion and morbidity of ''dosha''. Morbid ''dosha'' in turn further impairs the functioning of ''agni'' thus forming a vicious cycle.

Morbid dosha formed by the indigestion afflicts the srotas. Constriction and dilatation are the two varieties of pathology of srotas. Dilatation leads to excessive circulation and constriction leads to decreased circulation. In the pathology of udara, srotas are obliterated due to morbid dosha. This obliteration at swedavaha srotas leads to impairment of sweating. The fluid within the sweda-vaha-srotas is deviated to udaka-vaha-srotas thereby adding to the body fluids 10-11.

Morbid ''dosha'' formed by the indigestion afflicts the ''srotas''. Constriction and dilatation are the two varieties of pathology of ''srotas''. Dilatation leads to excessive circulation and constriction leads to decreased circulation. In the pathology of ''udara, srotas'' are obliterated due to morbid ''dosha''. This obliteration at ''swedavaha srotas'' leads to impairment of sweating. The fluid within the ''sweda-vaha-srotas'' is deviated to ''udaka-vaha-srotas'' thereby adding to the body fluids 10-11.

Udakavaha srotas that are coursing upwards and downwards are also being obliterated by the morbid dosha. The body fluid increased in the srotas is then deviated to the abdomen between the tvacha [skin] and māmsa [visceral tissues] causing udara roga 12.   

''Udakavaha srotas'' that are coursing upwards and downwards are also being obliterated by the morbid ''dosha''. The body fluid increased in the ''srotas'' is then deviated to the abdomen between the ''tvacha'' (skin) and ''mamsa'' (visceral tissues) causing ''udara roga'' 12.   

The divergence of fluids is not restricted to sweda-vaha-srotas and udaka-vaha srotas, rather rasa-vaha srotas is also obstructed. Rasa dhātu is another source of fluid in the body. This fluid is also deviated to the space between the kalā (mucus membrane) and visceral tissues in the abdomen. Thus, the fluid from the udaka-vaha srotas, sweda-vaha-srotas, rasa-vaha srotas and annavaha srotas deviates into the abdominal cavity 13.

The divergence of fluids is not restricted to ''sweda-vaha-srotas'' and ''udaka-vaha srotas'', rather ''rasa-vaha srotas'' is also obstructed. ''Rasa dhatu'' is another source of fluid in the body. This fluid is also deviated to the space between the ''kala'' (mucus membrane) and visceral tissues in the abdomen. Thus, the fluid from the ''udaka-vaha srotas, sweda-vaha-srotas, rasa-vaha srotas'' and ''annavaha srotas'' deviates into the abdominal cavity 13.

Fluid is diverged from the koshtha into the space between the kalā (mucus membrane) and visceral tissues in the abdomen. In the present context, the word koshtha refers to the intestines wherein digestion as well as separation of nutrient from the waste and assimilation of nutrients takes place. To be clearer the chyle formed in the intestines is diverted to the abdominal space between the kalā (mucus membrane) and visceral tissue. The accumulation of the fluid in the abdominal space is due to the diversion of fluids from the intestines, rasa, udaka(fluid) as well as sweda (sweat)13.

Fluid is diverged from the ''koshtha'' into the space between the ''kala'' (mucus membrane) and visceral tissues in the abdomen. In the present context, the word ''koshtha'' refers to the intestines wherein digestion as well as separation of nutrient from the waste and assimilation of nutrients takes place. To be clearer the chyle formed in the intestines is diverted to the abdominal space between the ''kala'' (mucus membrane) and visceral tissue. The accumulation of the fluid in the abdominal space is due to the diversion of fluids from the intestines, ''rasa, udaka''(fluid) as well as ''sweda'' (sweat)13.

Diversion of fluids from the sweda-vaha, udaka-vaha, and rasa-vaha srotas is mobilized by the morbid vāta. In this pathology, the prāna vāta acts in the upper part of the trunk whereas the apāna vāta acts at the lower part of the trunk.

Diversion of fluids from the ''sweda-vaha, udaka-vaha,'' and ''rasa-vaha srotas'' is mobilized by the morbid ''vata''. In this pathology, the ''prana vata'' acts in the upper part of the trunk whereas the ''apana vata'' acts at the lower part of the trunk.

Since the fluid is diverted, the other body parts exhibit emaciation. Contrary to this the abdomen shows distention as the diverted fluid accumulates in the abdomen13.

Since the fluid is diverted, the other body parts exhibit emaciation. Contrary to this the abdomen shows distention as the diverted fluid accumulates in the abdomen13.

No visible srotas is involved in the diversion of fluids into the abdomen. Rather it is from the minute pores present in the intestine, fluid oozes into the abdominal space between the kalā and visceral tissues. This can be best understood by the allegory of oozing of the water stored in the new earthen pot through the invisible minute pores14. Thus, in udara, the distension of abdomen is due to the accumulation of the fluids within the space between the kalā and visceral tissues in the abdomen15 [9-11].

No visible ''srotas'' is involved in the diversion of fluids into the abdomen. Rather it is from the minute pores present in the intestine, fluid oozes into the abdominal space between the ''kala'' and visceral tissues. This can be best understood by the allegory of oozing of the water stored in the new earthen pot through the invisible minute pores14. Thus, in ''udara'', the distension of abdomen is due to the accumulation of the fluids within the space between the ''kala'' and visceral tissues in the abdomen15 [9-11].

==== Types of udara roga ====

==== Types of udara roga ====