Changes

Intra abdominal malignancy spreading into the peritoneum causes malignant ascites. Usually it is the endometrial, colonic, gastric and pancreatic carcinoma, which may progress into peritoneal carcinomatosis. Even extra gastro intestinal malignancies like carcinoma of the breast, melanoma and lung carcinoma can cause peritoneal spread. Characteristically ascites happens in this condition in the absence of portal hypertension, tuberculosis, or right heart failure. Diagnostic paracentesis is confirmatory in this condition. More to add, the development of malignant ascites is always indicator of poor prognosis. This peritoneal carcinomatosis presenting with plethora of symptoms that matches with the symptoms pathognomonic of morbid vāta, pitta and kapha dosha, and its prognosis substantiates the consideration of sannipātodara in such cases27 [33-34].

Intra abdominal malignancy spreading into the peritoneum causes malignant ascites. Usually it is the endometrial, colonic, gastric and pancreatic carcinoma, which may progress into peritoneal carcinomatosis. Even extra gastro intestinal malignancies like carcinoma of the breast, melanoma and lung carcinoma can cause peritoneal spread. Characteristically ascites happens in this condition in the absence of portal hypertension, tuberculosis, or right heart failure. Diagnostic paracentesis is confirmatory in this condition. More to add, the development of malignant ascites is always indicator of poor prognosis. This peritoneal carcinomatosis presenting with plethora of symptoms that matches with the symptoms pathognomonic of morbid vāta, pitta and kapha dosha, and its prognosis substantiates the consideration of sannipātodara in such cases27 [33-34].

==== Plihodara and Yakritodara ====

==== ''Plihodara'' and ''Yakritodara'' ====

The etiology, pathology and treatment of plihodara and yakritodara are identical. Thus, for the descriptive purposes these two conditions are collectively called as Yakrit-plihodara.

The etiology, pathology and treatment of ''plihodara'' and ''yakritodara'' are identical. Thus, for the descriptive purposes these two conditions are collectively called as ''Yakrita-plihodara''.

Among the above said list of etiological factors; variety of dietary factors like sweet and greasy foods that cause affliction of rakta dhātu is the cause of achyuta plihavriddhi. All the other etiological factors are of chyuta plihavriddhi28 [35].

Among the above said list of etiological factors; variety of dietary factors like sweet and greasy foods that cause affliction of ''rakta dhatu'' is the cause of ''achyuta plihavriddhi''. All the other etiological factors are of ''chyuta plihavriddhi'' 28 [35].

The Sanskrit term chyuta refers to the act to descend and the vriddhi implies abdominal enlargement. Descent of the spleen is said to happen due to the violent jerk that happens during different physical activities. Descended spleen causes abdominal enlargement. Further this is of four types based on causative morbidity of dosha as vataj, pittaja, kaphaja and sannipataja29.

The Sanskrit term ''chyuta'' refers to the act to descend and the ''vriddhi'' implies abdominal enlargement. Descent of the spleen is said to happen due to the violent jerk that happens during different physical activities. Descended spleen causes abdominal enlargement. Further this is of four types based on causative morbidity of ''dosha'' as ''vataja, pittaja, kaphaja'' and ''sannipataja''29.

In Sanskrit the word Achyuta refers to lack of downward displacement. Vriddhi refers to the abdominal enlargement. Put together, the word achyuta plihavriddhi refers to the abdominal enlargement due to splenic causes without its descending. The morbidity of the rakta dhātu causes enlargement of the spleen which in turn is responsible for the abdominal distension. Thus, the chyuta and achyuta type of plihodara together forms five types of plihodara29 [36].

In Sanskrit, the word ''Achyuta'' refers to lack of downward displacement. ''Vriddhi'' refers to the abdominal enlargement. Put together, the word ''achyuta plihavriddhi'' refers to the abdominal enlargement due to splenic causes without its descending. The morbidity of the ''rakta dhatu'' causes enlargement of the spleen which in turn is responsible for the abdominal distension. Thus, the ''chyuta'' and ''achyuta'' type of ''plihodara'' together forms five types of ''plihodara''29 [36].

Febrile illness of mild degree is the symptom of plihodara. Habitual consumption of food habits that cause burning sensation leads to the morbidity of rakta as well as pitta dosha. Morbid pitta dosha and rakta dhātu cause mild fever. Further loss of appetite is a clinical symptom of plihodara. Habitual consumption of abhishyandi foods causes morbidity of kapha which in turn is responsible for the impairment of agni30 [37-38].

Febrile illness of mild degree is the symptom of ''plihodara''. Habitual consumption of food habits that cause burning sensation leads to the morbidity of ''rakta'' as well as ''pitta dosha''. Morbid ''pitta dosha'' and ''rakta dhatu'' cause mild fever. Further loss of appetite is a clinical symptom of ''plihodara''. Habitual consumption of ''abhishyandi'' foods causes morbidity of ''kapha'' which in turn is responsible for the impairment of ''agni''30 [37-38].

==== Baddhagudodara ====

==== Baddhagudodara ====