Guda (गुदम्)

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Introduction

Guda literally is termed as anus. It is an organ entity in ayurvedic anatomy and one among the sadhyopranahara marma(a type of marma or vital point which if injured will cause death or serious deformities) (sush.shar.6.9). It is stated as bahyastrotas (a type of channel) or an external opening channel in the shareera.(sush.shar.5.10).  guda is also one among the dashapranayatana (ten seats of prana).(char.shar.7.9)

According to charaka acharya Guda is one the 15 koshtangas, which precisely means a part or an entity of koshta(a cabin like structure which precisely is corelated with abdominal cavity).(char.shar.7.10)

Etymology

Guda

Gu- mala

Da – to give/excrete

That which excretes mala or stool is termed as guda.

Guda is also termed as an organ which evacuates apana vata (a type of vata dosha responsible for excretion of stools among other functions)

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Anatomy | rachana

During the ayurveda embryogenesis, guda is originated from matraja bhava which means from the best part of maternal factors. (sush.shar.3.31)

Acharya Sushruta explained the location of the guda as in the gudasthivivara which is corelated with the pelvic cavity and near the paurusha(prostate) and bastishira which is the neck of the bladder. (sush.nida 3.19-20)

The total length of guda is four and half angula pramana (angula pramana is tee length equal to the transverse length of one’s own middle phalanx of middle finger) (sush.nida.2.5)

Internally guda has three valis which are corelated with folds, which are pravahani, visarjini and samvarini. These are situated one over the other with a distance of one and half angula.

Acharya sushruta states the colour of guda resembles gajataalu which means the palate of an elephant which is reddish black in colour. (sush.nida.2.5-8)

Guda is mamsa(muscle) dominant marma.(sush.shar.6.7)

Since it is one among the bahirmukha srotas, it is the root of purishavaha strotas(precisely a channel concerning with excretory pathway ).(sush.shar.9.12)

There are 8 siras(corelated with veins) present in the central area of shroni or the pelvic region, which supply blood to guda and two dhamani(corelated with arteries)s supplying blood to the guda in the downward direction.(sush.shae.7.7)(sush.shar.9.7)

Diseases pertaining to Guda | gudagata vikaras

Arsha

(is corelated with haemorrhoids)

Arshas are located in the guda valaya(the three folds present in the guda region). (char.chik.14.6)

Also arshas are found in mukha(oral cavity), taalu(palate),nasa(nose), karna(ears) etc

Fundamentally arshas are of two types, (char.chik.14.5)

1.     Sahaja(congenital)

2.     Kalaja (acquired)

Signs and symptoms (char.chik.14.8-9)

1.     Sahaja arshas – weakness , emaciation since birth, irregular bowel movements, pain in the stomach region, change in stool color(pale yellow, white, reddish etc), suffers from dysentery, constipation from time to time, frequent dizziness and laziness.

2.     Kalaja arshas – intake of excessvie sweet, heavy, cold food, viruddha anna (intake of food which are not compatible with each other), excess intake of meat of buffalo, fish, pig etc., excess intake of milk products, drinking polluted water,lack of exercise, excess indulgence in sexual activity etc

Arshas is classified again, due to excess aggravation of a single dosha. (char.chik.14.12-25)

1.     Vataja arshas (due to aggravation of vata dosha)

2.     Pittaja arshas(due to aggravation of pitta dosha)

3.     Kaphaja arshas(due to aggravation of kapha dosha)

4.     Tridoshaja arshas(due to aggravation of all the three doshas at the same time)

General management (char.chik.14.33-43) (char.chik.14.43-143)

1.     Oil application(medicated)

2.     Pottali or application of medicated poultice as a method of fomentation after oil application

3.     Sechana or pouring of medicated decoction over the affected region with vasa(), eranda(), bilva() etc

4.     Sitz bath with herbal decoction like triphala(a combination of three powders), or medicated buttermilk etc.

5.     Application of medicated ointments

6.     Raktamokshana (bloodletting procedure)

7.     Internal administration of medications like takrasrishta, pippalyadi ghrita, abhayaarishta etc

8.     Basti karma. (Panchakarma therapy wherein herbal decoction or oil is administered through anal region)

9.     Kshar karma (application of alkali) and agni karma (thermal cauterization)

Bhagandara

Disorder corelated with Fistula-in-ano

Bhagandara is a painful draining track or canal with one opening present in and around guda, vasti(urinary bladder), bhaga(genital region).(sush.nida.4)

There are five types of bhagandara (sush.nida.4.3)

1.     Vataja or shataponaka bhagandara

2.     Pittaja or ushtragreeva bhagandara

3.     Kaphaja or parisravani bhagandara

4.     Sannipataja or shambhukavarta bhagandara

5.     Agantuja or unmargini bhagandara

Premonitory symptom’s | purvarupa

‘तेषां पूर्वरूपं गुदकण्डूदाहशोफागुदायामश्चेति सर्वेषां सामान्यम्’ (sush.nida.4.4 gaydas vyakha)

Itching, burning sensation, oedema in the guda or anal region are the general premonitory symptoms of bhagandara.

Symptoms | lakshana

(sush.nida.4.5-9)

1.     Vataja or shataponaka bhagandara – Aggravated vata dosha causes severe pain, blisters with frothy and reddish discharge, multiple openings and oozing of urine, stools etc through it.

2.     Pittaja or ushtragreeva bhagandara – aggravated pitta dosha ripens the lesion faster, the shape of the blister resembles neck of the camel, foul smelling and ushna(heated)discharge is present.

3.     Kaphaja or parisravani bhagandara – aggravated kapha dosha causes mild pain, and the blisters are hardened with dense and white discharge along with itching.

4.     Sannipataja or shambhukavarta bhagandara – aggravated three doshas causes various kinds of pain, heavy discharge of various colour etc.

5.     Agantuja or unmargini bhagandara – external injury leads to agantuja bhagandara, which if neglected can cause pain and build of microrganisms.

General management

Raktamokshana(bloodletting), agnikarma(thermal cautery),kshara karma(alkali application) etc are certain general management protocols in the successful treatment of bhagandara. (sush.chik.8)

Parikartika

It is correlated with anal fissures. when there is cutting and piercing type of pain in the guda region region it is known as parikartika. It is a vata dosha dominant disorder of the guda, which affects dhatus like tvak(skin), mamsa(muscle) and rakta(blood). (sush.nida.1.25-26) ?

Symptoms | rupa (char.sidd.6.61) (sush.uttr.40.103)

Sharp cutting pain

Pain before and after defecation.

Blood filled mucous discharge

Discomfort in anal region

Parikartika is found as a symptom in various disorders and as an ill effect of certain ill panchakarma methods.

In relation with Disease	As side effect
Udawarta or purishaja udavarta which precisely means reverse movement or pathological movement of vata dosha. Fissure occurring due to injury to the guda region due to formation of hard stools. (sush.utta.55.8)	Niruha basti vyapad – niruha basti is a type of bastimethod which includes administration of medicated decoction through anal route, thus as an ill effect of the medication parikartika is seen.(sush.chik.36.37)
Atisaara – in vata dosha type of atisara, spasm of the sphincters occurs leading to fissures. (char.chik.19.5)	Basti netra vyapad – basti therapy is administered through a certain instrument which is conical and round with soft edges, thus if any defect in the mouth of the instrument can cause fissures or parikartika over the anal region. (char.sidd.5.5/comm))
Jwara – in jeerna jwara which is type of feverwherein due to unclear bowel, parikartika is seen as a symptom. (char.chik.3.186)	Excessive administration yapana basti(a type of basti therapy) therapy can cause parikartika along with other disorders. (char.siddh.12.30)
Arsha, certain kinds of arshas affects the guda vali or the anal spincters, leading to the formation of both arshas and parikartika. (sush.nida.2.9)	As virechana vyapad - ill effect after virechana or purgation procedure. (sush.chik.34.16/dalhana comm)
In grahani roga which is corelated with irritable bowel syndrome, wherein vata dosha is involved, parikartika is seen as a symptom. (char.chik.15.62)