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→Jalodara
==== ''Jalodara'' ====
==== ''Jalodara'' ====
''Udaka'' in Sanskrit translates as fluid and ''udara'' refers to the distension of the abdomen, put together the term ''udakodara'' means distension of the abdomen due to accumulation of the fluid. According to Sanskrit literature, the word ''dakodara'' is formed by the removal of initial letter u from the word ''udakodara''. Thus, formed word ''dakodara'' also give the same meaning of ''udakodara''<ref>Vagbhata. Astanga hridayam, elaborated by Vagbhata, with joint commentaries Ayurveda Rasayana by Hemadri and Sarvangasundara by Arunadatta, Pt. Harisadashiva Shastri Paradakara Ed., 2010 Edition, Varanasi, Chaukhambha Sanskrit Sansthan, Pp 956, Pg 516.</ref>.
''Udaka'' in Sanskrit translates as fluid and ''udara'' refers to the distension of the abdomen, put together the term ''udakodara'' means distension of the abdomen due to accumulation of the fluid. According to Sanskrit literature, the word ''dakodara'' is formed by the removal of initial letter u from the word ''udakodara''. Thus, formed word ''dakodara'' also give the same meaning of ''udakodara''.<ref>Agnivesha. Charaka Samhita, elaborated by Charaka & Dridabala with jalpakalpataru commentary by gangadhara, 3rd part, kaviraja shri narendranathasen gupta; kaviraja shri balayichandrasen gupta, ed., 1st Edition, Culcutta , C.K.Sen and company ltd, Pp3828, Pg no 2825</ref>
Image 02: ''Sira janma'' in ''udara''
Image 02: ''Sira janma'' in ''udara''
Water intoxication and edema are the two distinct clinical implications of over hydration. Excessive intake of plain water without adequate solutes causes abnormal increase in extracellular fluid with deficient sodium. This in turn causes movement of fluid into the cell to maintain the salt balance. Thus, resulting in cellular edema which in turn causes the clinical manifestation of water intoxication and it is a fatal condition. Contrary to this over hydration with adequate intake of sodium leads to increase in the fluid within the interstitial compartment due to excess of isotonic volume excess. The water does not diffuse into the cells as the solutes hold the water in the interstitial fluid compartment. Thus this will result in the edema. This edema is due to over hydration and is comparable to ''jalodara''.
Water intoxication and edema are the two distinct clinical implications of over hydration. Excessive intake of plain water without adequate solutes causes abnormal increase in extracellular fluid with deficient sodium. This in turn causes movement of fluid into the cell to maintain the salt balance. Thus, resulting in cellular edema which in turn causes the clinical manifestation of water intoxication and it is a fatal condition. Contrary to this over hydration with adequate intake of sodium leads to increase in the fluid within the interstitial compartment due to excess of isotonic volume excess. The water does not diffuse into the cells as the solutes hold the water in the interstitial fluid compartment. Thus this will result in the edema. This edema is due to over hydration and is comparable to ''jalodara''.
Over hydration is observed in different clinical situations. As fluid supplementation is recommended in patients suffering from gastroenteritis, an excess of fluid intake may lead to over hydration. Identical to this, excessive fluid intake after any of the purification procedure may have similar sequel. Psychogenic polydipsia characterized by compulsive water drinking may sometimes lead to over hydration. This is also true in mentally challenged children. Individuals are likely to take large amount of fluids following long bouts of intensive exercise and will have the similar consequences of over hydration. Marathon runners are susceptible to excessive fluid intake while running and may prove incriminatory. Any physical activity leading to profuse sweating like working in extreme heat or humidity; may be followed by intake of excessive fluid to replace the loss. These situations with excessive fluid supplementation with adequate addition of salt and other solutes lead to edema<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 493</ref>.
Over hydration is observed in different clinical situations. As fluid supplementation is recommended in patients suffering from gastroenteritis, an excess of fluid intake may lead to over hydration. Identical to this, excessive fluid intake after any of the purification procedure may have similar sequel. Psychogenic polydipsia characterized by compulsive water drinking may sometimes lead to over hydration. This is also true in mentally challenged children. Individuals are likely to take large amount of fluids following long bouts of intensive exercise and will have the similar consequences of over hydration. Marathon runners are susceptible to excessive fluid intake while running and may prove incriminatory. Any physical activity leading to profuse sweating like working in extreme heat or humidity; may be followed by intake of excessive fluid to replace the loss. These situations with excessive fluid supplementation with adequate addition of salt and other solutes lead to edema.<ref>Agnivesha. Charaka Samhita, elaborated by Charaka & Dridabala with jalpakalpataru commentary by gangadhara, 3rd part, kaviraja shri narendranathasen gupta; kaviraja shri balayichandrasen gupta, ed., 1st Edition, Culcutta , C.K.Sen and company ltd, Pp3828, Pg no 2825</ref>
Edema due to isotonic volume excess is characterized by weight gain, dependent edema, pitting edema, engorged neck vein, ascites, pericardial effusion, pleural effusion, increased blood pressure and congestive cardiac failure. [47]
Edema due to isotonic volume excess is characterized by weight gain, dependent edema, pitting edema, engorged neck vein, ascites, pericardial effusion, pleural effusion, increased blood pressure and congestive cardiac failure. [47]
As the inflammation continues gradually the fluid starts accumulating. The features of gaseous distension are going to be masked by the fluid accumulation. This phase of peritonitis is indicative of ''picchavastha'' of ''udara''.
As the inflammation continues gradually the fluid starts accumulating. The features of gaseous distension are going to be masked by the fluid accumulation. This phase of peritonitis is indicative of ''picchavastha'' of ''udara''.
Further as the fluid accumulates, the patient develops the complete symptoms of ascites that include horse shoe dullness, shifting dullness and fluid thrill. This stage of peritonitis is considered as ''jatodakavastha'' of ''udara''<ref>Tadataka Yamada, textbook of gastroenterology, 5th edition, volume 1, part 2, 2009 Blackwell Publishing. ISBN: pages 3413, chapter 100 2509</ref> [48-49].
Further as the fluid accumulates, the patient develops the complete symptoms of ascites that include horse shoe dullness, shifting dullness and fluid thrill. This stage of peritonitis is considered as ''jatodakavastha'' of ''udara''<ref name="ref21" /> [48-49].
===== Current management =====
===== Current management =====