Changes

The clinical condition of peritonitis is comparable to the ''udara roga'' in general. Clinically this is categorized into primary or secondary, acute or chronic and localized or diffuse. These are comparable to the ''doshaja udara'' that includes ''vataja, pittaja, kaphaja'' and ''sannipataja udara roga''. Splenomegaly and hepatomegaly refers to plihodara and ''yakritodara'' respectively. Intestinal obstruction is said by the ''baddhagudodara'' (enlargement of abdomen due to gastrointestinal obstruction) and ''chhidrodara'' (abdominal enlargement due to intestinal perforation) refers to the intestinal perforation. [22]

The clinical condition of peritonitis is comparable to the ''udara roga'' in general. Clinically this is categorized into primary or secondary, acute or chronic and localized or diffuse. These are comparable to the ''doshaja udara'' that includes ''vataja, pittaja, kaphaja'' and ''sannipataja udara roga''. Splenomegaly and hepatomegaly refers to plihodara and ''yakritodara'' respectively. Intestinal obstruction is said by the ''baddhagudodara'' (enlargement of abdomen due to gastrointestinal obstruction) and ''chhidrodara'' (abdominal enlargement due to intestinal perforation) refers to the intestinal perforation. [22]

Peritonitis caused without an apparent source of contamination of peritoneal cavity is regarded as primary peritonitis. The spontaneous peritonitis caused due to hematogenous spread of bacterial infection into the peritoneum causing inflammation. Chronic liver disease is the most common cause of such infection. This can even happen without any underlying disease. 80% of the patients present with fever. Acute onset of abdominal pain is characteristic and malaise, fatigue, or encephalopathy is the other co-morbidity. The primary peritonitis caused by gram negative bacteria matches with the symptom of ''vataja udara''. Sub acute manifestation with non pyogenic exudation causing ascites points towards the diagnosis of ''vatodara''. Microbiology study of ascitic fluid will reveal pathogens like Escherichia coli and enterococci<ref>Agnivesha. Charaka Samhita, elaborated by Charaka & Dridabala with Ayurveda Deepika commentary by Chakrapani Datta, Vaidya Jadavaji Trikamji ed., 2009 Edition, Varanasi, Chaukhambha Orientalia, Pp 738, Pg no 492</ref>[25].

Peritonitis caused without an apparent source of contamination of peritoneal cavity is regarded as primary peritonitis. The spontaneous peritonitis caused due to hematogenous spread of bacterial infection into the peritoneum causing inflammation. Chronic liver disease is the most common cause of such infection. This can even happen without any underlying disease. 80% of the patients present with fever. Acute onset of abdominal pain is characteristic and malaise, fatigue, or encephalopathy is the other co-morbidity.<ref name="ref21">Anthony S. Fauci, et al Editor. Harrison’s principles of internal medicine. 17th edition. New York. McGraw-Hills. 2008. p 2739.Pg no 1912</ref> The primary peritonitis caused by gram negative bacteria matches with the symptom of ''vataja udara''. Sub acute manifestation with non pyogenic exudation causing ascites points towards the diagnosis of ''vatodara''. Microbiology study of ascitic fluid will reveal pathogens like Escherichia coli and enterococci<ref name=ref21" />[25].

Image 01: Patient suffering from ''udara roga''

Image 01: Patient suffering from ''udara roga''

Again, based on the etiology ''udara roga'' is further segregated into ''nija'' (endogenous) and ''agantuja'' (exogenous) type. Among the different types of ''udara roga''; the types of ''udara'' caused due to erroneous food and habits and mediated through morbidity of ''dosha'' and ''dushya'' is considered as ''nija'' type of ''udara''. ''Plihodara'' (enlargement of the spleen) and ''jalodara'' (enlargement of abdomen due to collection of fluid) are segregated as ''nija udara'' in the list of ''dushya'' dominant ''udara''. All the four types of ''dosha'' dominant ''udara'' fall under the category of ''nija udara'' (distension of abdomen due to endogenous causes). Contrary to this the ''baddhodara'' (enlargement of abdomen due to gastrointestinal obstruction) and ''chidrodara'' (abdominal enlargement due to intestinal perforation) caused by injury of intestines due to external factors are regarded as ''agantu udara'' (distension of abdomen caused due to exogenous causes)<ref>Agnivesha. Charaka Samhita, elaborated by Charaka & Dridabala with Ayurveda Deepika commentary by Chakrapani Datta, Vaidya Jadavaji Trikamji ed., 2009 Edition, Varanasi, Chaukhambha Orientalia, Pp 738, Pg no 492</ref> [22].

Again, based on the etiology ''udara roga'' is further segregated into ''nija'' (endogenous) and ''agantuja'' (exogenous) type. Among the different types of ''udara roga''; the types of ''udara'' caused due to erroneous food and habits and mediated through morbidity of ''dosha'' and ''dushya'' is considered as ''nija'' type of ''udara''. ''Plihodara'' (enlargement of the spleen) and ''jalodara'' (enlargement of abdomen due to collection of fluid) are segregated as ''nija udara'' in the list of ''dushya'' dominant ''udara''. All the four types of ''dosha'' dominant ''udara'' fall under the category of ''nija udara'' (distension of abdomen due to endogenous causes). Contrary to this the ''baddhodara'' (enlargement of abdomen due to gastrointestinal obstruction) and ''chidrodara'' (abdominal enlargement due to intestinal perforation) caused by injury of intestines due to external factors are regarded as ''agantu udara'' (distension of abdomen caused due to exogenous causes)[22].

==== ''Vatodara'' ====

==== ''Vatodara'' ====