🔺 CASE STUDY NO : 55 🔺 PART NO :2 🔺 JALODHARA /ASCITIES 🔺DIFFERENTIAL DIAGNOSIS (MODERN CONCEPT OF ASCITES) 📌Liver Cirrhosis : Most common; signs of portal hypertension. 📌Congestive Heart Failure (CHF) :Raised JVP, hepatomegaly, pleural effusion. 📌Budd-Chiari Syndrome :Hepatic vein thrombosis, painful hepatomegaly. 📌Nephrotic Syndrome : Generalized edema, proteinuria. 📌Tuberculous Peritonitis :Fever, weight loss, lymphocytes in ascitic fluid. 📌Peritoneal Carcinomatosis : Bloody/turbid ascitic fluid, high protein content. 📌Pancreatic Ascites :History of pancreatitis, high amylase in ascitic fluid. 📌Serositis (SLE) :Ascites with other autoimmune manifestations. 🔺 SAMPRAPTI (PATHOGENESIS) -Doshas: Predominantly Kapha and Pitta, with Vata vitiation -Dushyas: Rasa, Rakta, Mamsa, -Medas, Udaka -Srotas: Udakavaha and -Annavaha srotas *Process: -Due to nidana, doshas get vitiated and enter the Udara (abdominal cavity), disturbing the Udakavaha Srotas. This leads to accumulation of fluid (Udaka) in the abdominal cavity. * In modern terms, this can be correlated with portal hypertension, liver cirrhosis, or hypoproteinemia. 🔺 UPASHAYA (FACTORS THAT RELIEVE SYMPTOMS) -Langhana (fasting) in initial stage -Use of light and drying food -Mild purgation (Mridu Virechana) -Use of diuretic herbs (e.g., Punarnava, Gokshura) -Tikta, Kashaya rasa medicines 🔺 ANUPASHAYA (FACTORS THAT AGGRAVATE SYMPTOMS) -Intake of Guru (heavy) and Snigdha (unctuous) food -Day-sleep -Alcohol -Sedentary lifestyle -Suppression of natural urges 🔺 SAMANYA CHIKITSA (GENERAL TREATMENT) - Agnideepana (Stimulating Digestive Fire) -Trikatu, Chitrakadi Vati - Shodhana (Purificatory Measures) -Virechana (Purgation) with drugs like Trivrit, Avipattikar -Niruha Basti with Tikta Kashaya -Anuvasana Basti with drugs like Eranda Taila * Shamana (Palliative Treatment) -Use of Punarnavadi Kashaya, Gokshuradi Guggulu -Pippalyadi Yoga, Gulma Kuthara Rasa 🔺 VISHESHA CHIKITSA (SPECIFIC TREATMENT FOR JALODHARA) -Nitya Virechana with Trivrit / Aragvadha -Tikta Ghrita – to pacify Pitta and Kapha -Basti Karma – to correct Vata *Important Formulations: -Punarnavadi Mandura -Gokshuradi Guggulu -Jalodarari Rasa -Pippalyasavam -Abhayarishta *External Therapies: -Udwartana (dry massage) -Lepa with drying herbs -Abhyanga with Kapha-Vata hara oils 📌Shodhana Chikitsa (Purification Therapy) To eliminate the root cause: *Snehapana: Internal oleation with medicated ghee (e.g., Triphala Ghrita or Tiktaka Ghrita) – 5–10 ml increasing dose daily for 3–7 days. *Vamana (Therapeutic emesis) – if Kapha is dominant and patient is fit. *Virechana (Therapeutic purgation) – using Trivrit Lehya, Avipattikara Churna, or Nimbamrutadi Eranda Taila – 10–15 ml with warm water or milk. *Niruha Basti (Medicated decoction enema) and Anuvasana Basti (Oil enema) – using Dashamoola Kwatha and Eranda Taila alternately. 📌 Shamana Chikitsa (Palliative Therapy) Herbs and formulations to balance Doshas and manage symptoms. *Punarnavadi Kashayam / Kwath 15–30 ml twice daily With equal water before food Reduces fluid retention, diuretic *Varunadi Kwatha 15–30 ml twice daily Before meals For liver function and ascites *Gokshuradi Guggulu 1–2 tablets twice daily After food with warm water Diuretic, anti-inflammatory *Punarnava Manduram 1–2 tablets twice daily With honey or warm water Improves hemoglobin, reduces swelling *Kakamachi Ghrita 5–10 ml once or twice daily With warm water or milk Liver protector *Guduchi Satva 250–500 mg twice daily With honey or warm water Immunity booster, reduces inflammation *Arogyavardhini Vati 1–2 tablets twice daily After meals For liver detox, digestion *Jalodarari Rasa (Classical) 125–250 mg twice daily With Punarnava Kashaya Specific for ascites (to be used under supervision) 🛑https://chat.whatsapp.com/KLufxKFrXwbIIAXLxXDqOB