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Line 9: − + − + − + − That which excretes mala or stool is termed as guda.+ − + − (efaidnbmnnnibpcajpcglclefindmkaj/<nowiki>http://bulletinmonumental.com</nowiki>)+ + − == 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) − + − + − + − + − + − + − + + − + − + − (is corelated with haemorrhoids) − − − Also arshas are found in mukha(oral cavity), taalu(palate),nasa(nose), karna(ears) etc+ + − + + − + − + − 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) Line 73:
Line 65: + + − 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) ?+ + + + + + + − + + − Sharp cutting pain+ + + + + − Pain before and after defecation.+ + − Blood filled mucous discharge+ + − Discomfort in anal region+ + + + + + − + + Line 165:
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no edit summary
== Etymology ==
== Etymology ==
Guda
The term Guda is made up of and derived from 2 parts as below,
Gu- mala
Gu- mala (waste matter/ fecal matter)
Da – to give/excrete
Da - to give/ excrete
Therefore, 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)
Guda is also termed as an organ which is controlled by apana vata (a type of vata dosha responsible for excretion of stools among other functions) and is a channel through which along with the fecal matter, the accumulated bowel gas is also expelled out.
== Anatomy | ''rachana'' ==
Structure, development and function of Guda have been studied in detail in Ayurveda.
In the process of embryogenesis i.e. development of fetus in womb, guda is said to be originated from matruja bhava which means it has its roots in maternal factors.<ref>Sushruta Samhita (Sharirasthana Adhyaya 3 sutra 31)</ref>
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)
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. <ref>Sushruta Samhita (Nidanasthanam Adhyaya 3 Sutra 19-20)</ref>
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)
The total length of guda is four and half anguli pramana (anguli pramana is the length equal to the transverse length of one’s own middle phalanx of middle finger).<ref name=":1">Sushruta Samhita (Nidanasthanam Adhyaya 2 Sutra 5-8)</ref>
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.
Internally guda has three valis (Folds) 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)
Acharya sushruta states the colour of guda resembles gajataalu means the palate of an elephant which is reddish black in colour.<ref name=":1" />
Guda is mamsa(muscle) dominant marma.(sush.shar.6.7)
Guda is mamsa (muscle) dominant marma.<ref>Sushruta Samhita (Sharirasthanam Adhyaya 9 Sutra 12)</ref>
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)
Since it is one among the bahirmukha srotas, It is the root of purishavaha strotas (precisely a channel concerning with excretory pathway ).<ref>Sushruta Samhita (Sharirasthanam Adhyaya 9 Sutra 12)</ref>
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)
There are 8 siras (corelated with veins) present in the central area of shroni ( pelvic region), which supply blood to guda and two dhamani (corelated with arteries) supplying blood to the guda in the downward direction.<ref>Sushruta Samhita (Sharirasthana Adhyaya 7 sutra 7), Sushruta Samhita (Sharirasthana Adhyaya 9 sutra 7)</ref>
== Diseases pertaining to Guda | ''gudagata vikaras'' ==
== Diseases pertaining to Guda | ''gudagata vikaras'' ==
There are certain medical conditions that primarily affect guda or develop in guda. Arsha (Hemorrhoids/piles), Bhagandara (Fistula-in-ano), Parikartika (Fissure -in-ano) are the diseases primarily affect and develop in Guda. Other diseases like atisara (diarrhea), pravahika (Dysentery), Grahani (conditions like IBS or Ulcerative colitis etc) also affect guda as a organ to certain level and might lead to some signs and symptoms in this region. The diseases that primarily affect guda are described in brief here,
Arsha
=== Arsha ===
Arsha is corelated with haemorrhoids. When these are found in guda region they are known as gudarsha (hemorrhoids in ano) or piles described in western medicine. When in guda, Arshas are located in the guda valis (the three folds present in the guda region).<ref>Charaka Samhita (Chikitsasthanam Adhyaya 14 Sutra 6)</ref>
Arshas are located in the guda valaya(the three folds present in the guda region). (char.chik.14.6)
==== Location ====
Alike Guda region, arshas can also be found in mukha (oral cavity), talu (palate), nasa (nose), karna (ears) etc
Fundamentally arshas are of two types, (char.chik.14.5)
==== Types ====
Fundamentally arshas are of two types,<ref>Charaka Samhita (Chikitsasthanam Adhyaya 14 Sutra 5-25)</ref>
1. Sahaja(congenital)
1. Sahaja (congenital)
2. Kalaja (acquired)
2. Kalaja (acquired)
Arshas are classified again, on the basis of dominance of a single dosha.
1. Vataja arshas (due to aggravation of vata dosha)
1. Vataja arshas (due to aggravation of vata dosha)
4. Tridoshaja arshas(due to aggravation of all the three doshas at the same time)
4. Tridoshaja arshas(due to aggravation of all the three doshas at the same time)
==== Signs and symptoms ====
Clinical features of Gudarshas are described in brief below,
* 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.
* Kalaja arshas – Due to gudarshas, [[Agni in Ayurveda (आयुर्वेदे अग्निः)|agni]] is affected it becomes weak and that ultimately affects overall metabolism. Disturbed metabolism leads to emaciation, weakness, loss of energy, discharge through anus, difficulty in defecation and many other symptoms like coughing, breathlessness, vomiting, swelling, sneezing etc. Therefore gudarshas located in anal region have the potential to cause signs and symptoms across all body systems and have wide rage of signs and symptoms.
==== General management ====
Gudarshas treatment has been discussed in detail in Ayurveda.<ref>Charaka Samhita (Chikitsasthanam Adhyaya 14 Sutra 33-143)</ref> The different types of treatments applied here are discussed in brief here,
* Oil application locally on guda
* Pottali or application of medicated poultice as a method of fomentation after oil application
* Sechana or pouring of medicated decoction over the affected region
* Sitz bath with herbal decoction like triphala (a combination of three powders), or medicated buttermilk etc.
* Application of medicated ointments
* Raktamokshana (bloodletting procedure)
* Internal administration of medications like takrasrishta, pippalyadi ghrita, abhayaarishta etc
* Basti karma. (Panchakarma therapy wherein herbal decoction or oil is administered through anal region)
* Kshar karma (application of alkali) and agni karma (thermal cauterization)
=== Bhagandara ===
Bhagandara in guda region is a condition which can be 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).<ref name=":2">Sushruta Samhita (Nidanasthana Adhyaya 4 Sutra 1-9)</ref>
==== Types ====
There are five types of bhagandara<ref name=":2" />
# Vataja or shataponaka bhagandara
# Pittaja or ushtragreeva bhagandara
# Kaphaja or parisravani bhagandara
# Sannipataja or shambhukavarta bhagandara
# Agantuja or unmargini bhagandara
==== Premonitory symptom ====
Certain signs and symptoms that manifest before actual Bhagandara is developed are known as Purvarupas or premonitory symptoms of Bhaganadara and they are as below,<blockquote>‘तेषां पूर्वरूपं गुदकण्डूदाहशोफागुदायामश्चेति सर्वेषां सामान्यम्’ (sush.nida.4.4 gaydas vyakha)<ref name=":2" /></blockquote>Meaning: Itching, burning sensation, edema in the guda or anal region are the general premonitory symptoms of bhagandara.
Symptoms | ''rupa'' (char.sidd.6.61) (sush.uttr.40.103)
==== Symptoms ====
Symptoms or clinical features of Bhagandara according to dosha dominant types are listed in short below,
# 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.
# 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.
# Kaphaja or parisravani bhagandara – aggravated kapha dosha causes mild pain, and the blisters are hardened with dense and white discharge along with itching.
# Sannipataja or shambhukavarta bhagandara – aggravated three doshas causes various kinds of pain, heavy discharge of various colour etc.
# Agantuja or unmargini bhagandara – external injury leads to agantuja bhagandara, which if neglected can cause pain and build of microrganisms.
==== General management ====
[[Raktamokshana (रक्तमोक्षणम्)|Raktamokshana]](bloodletting), agnikarma(thermal cautery),kshara karma(alkali application) etc are certain general management protocols in the successful treatment of bhagandara.<ref>Sushruta Samhita (Chikitsasthana Adhyaya 8)</ref>
=== Parikartika ===
Parikartana means cutting. Thus parikartika refers to the cuts in the guda or anal region that are popularly known as anal fissures. Also, 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), [[Mansa Dhatu (मांस धातु)|mamsa]](muscle) and [[Rakta Dhatu (रक्त धातु)|rakta]](blood). (sush.nida.1.25-26) ?
==== Symptoms ====
Common signs and symptoms of parikartika are,<ref>Sushruta Samhita (Uttaratantra Adhyaya 40 Sutra 103)</ref> <ref>Charaka Samhita (Siddhisthanam Adhyaya 6 Sutra 61)</ref>
* 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.
==== Parikartika as a symptom of other diseases ====
Parikartika is found as a symptom in various disorders and as an ill effect of certain inappropriately done [[Panchakarmas (पञ्चकर्माणि)|panchakarma]] methods.
{| class="wikitable"
{| class="wikitable"
|In relation with Disease
|In relation with Disease
|-
|-
|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)
|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)
|Niruha basti vyapad – niruha [[Basti (बस्तिः )|basti]] is a type of basti method 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)
|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))
|Basti netra vyapad – [[Basti (बस्तिः )|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)
|Jwara – in jeerna jwara which is type of fever, wherein 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)
|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)
|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)
|As [[Virechana (विरेचनम्)|virechana]] vyapad - ill effect after inappropriately done 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)
|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)