This is defined as accumulation of fluid in the peritoneal cavity. In Ayurveda it is called as Udara.
Low digestive fire, production of ama, obstructions in sweat ad water carrying systems, and vitiation of Prana and Apana are the basic pathological factors in this disease.
It has been divided in two major types: without accumulation or with accumulation of fluid in the abdominal peritoneal cavity. Eight other types are due to vitiation of Vata, Pitta, Kapha, due to vitiation of duel doshas, and due to liver and spleen disorders.
Ascites can be due to ifection of tubercular bacilli, neoplasm, Hodgkin’s disease, portl hypertension, or cirrhosis f liver. It maybe due to C.C.F.or diseases of the kidney.
Vata type- is associated with indigestion, gas in abdomen, edema on feet, abdominal pain, sudden increase or decrease in the size of abdominal edema.
Pitta type- Diarrhoea, fever, thirst, sweating, quick accumulations of fluid in abdomen are present.
Kapha type- Heaviness in the body, whitish colored edema on feet and abdomen, loss of appetite are present. Due to disorder of liver and spleen, liver and spleen are enlarged. There is also varicosity of veins on the abdominal wall along with accumulation of fluid in the abdomen.
In the early stage, before abdominal fluid is accumulated the disease is curable. In this stage, herbs for increasing digestive fire and detoxification of ama should be given. Trikatu, cayenine, cinnamon, fennel, an plant alkalies help increase the digestive fire. They can be given in dose of 500 mgm, twice a day for 15 days. While mixture of asafetida, cyperus, and cumin seeds 1 gm. Twice a day for 7 days are useful to detoxify the ama.
When there is fluid in abdomen, treatment of choice is daily purgation. Stronger purgatives like seeds of croton tiglium 50 mgm, or arka-ksheera can be used.
Many prepared medicines from these herbs are available I the market. These herbs remove the abdominal fluid by purgation (This is better than giving diuretics, which tax the kidney). According to requirement, one can choose any one preparation from ashvakanchuki, icchabhedi, naracharasa or abhayadi modaka in dose of 125 mgm, twice a day for 1 month.
During this treatment, it is also necessary to apply tight cloth belt over the abdomen to prevent the accumulation of fluid in the abdomen. Light abdominal massage with castor oil s advised. This prevents enlargement of abdomen by gas. Because as the abdominal fluid is drained out by purgation, there is every chance that in this place Vatagets accumulated quickly.
If the cause of as cites is some kidney problem, use herbs to improve kidney function along with diuretic action such as dandelion leaf or gravel root. Herbs of choice are boerrhavia diffusa and tribulus terestris. They can be given in dose of 1 to 3 gms, a day for 15 days.
In western countries, herbs like, rhubarb root, bark of walnut or butternut, cascara, buckthorn, senna, and aloe can be used for this purpose.
Since this disease originates due to low digestive fire, preserving the power of digestion is the most important aspect. Hence avoid food and drinks that are too cold, heavy, fried foods, meat, and cheese.
As long as there is fluid in the abdomen, patient should be asked to remain only on a milk diet. He should not drink water nor take any solid food. When the fluid disappears and the digestive power increases, then he can start light diet with vegetable soup. Afterwards he can take whole wheat or millet (bajari) bread with little amount of castor oil, garlic, and ginger to increase the digestive fire.