Reference:
S.Ni.4, A H.U.28, M.N.46
Introduction:
Bhagandara is laceration of anal region (fistula). According to Sus`hruta it is one of the Mahaavyaadhi.
Nirukti:
- Te Tu Bhaga Guda Basti Prades`ha Daaran`aat Cha Bhagandaraa Iti Uchyante |
- Bhagam Parisamantaat Cha Gudam Bastim Tathaa Eva Cha |
- Bhagam Daarayati Tasmaat Tat Dnyeyo Bhagandarah || M. N. 46/1 Madhukos`ha
Whenever an Pid`akaa (abscess) formed at the sites like perineal region(Bhaga), anal region(Guda) and bladder region(Basti) bursts out after suppuration, it causes tearing of the skin making an opening on the surface of skin, this is called as Bhagandara.
Manifestation of Bhagandara:
Due to Krimi, Asthi, Kshan`ana, Vyavaaya, Pravaahan`a, Utkat`akaasana, there is manifestation of abscess (Pid`akaa) with excessive pain (Bhris`ha Arti) at the anal region. This Pid`akaa gets suppurated and bursts out, which leads to Bhagandara. After suppuration, the Pid`akaa is called as Bhaagandaree Pid`akaa.
Types:T
here are 5 types of Bhagandara according to Sus`hrita.
- S`hataponaka
- Usht`ragreeva
- Parisraavee
- S`hambookaavarta
- Unmaargee
Doshabhedena:
- Vaataja
- Pittaja
- Kaphaja
- Vaatapittaja
- Vaatakaphaja
- Kaphapittaja
- Saannipaatika
- Aagantu
If the Pid`akaa is not treated at proper time, this leads to formation of Bhagandara. Bhaga, Basti and Guda, these areas get lacerated. There is secretion of Vaata, Mootra, S`hukra in succession.
Sampraapti:
S`hataponaka:
S`hataponaka Chaalanikaa, Sahasra Dhaaraa Iti Anye |
S`hataponakavad Anekamukhaakaara Bhagandarah | M. N. 46/2 Madhukos`ha
- In a person who is consuming unwholesome diet, aggravated Vaayu residing at the periphery of anal region 2 to 3 Angula in length, vitiates Rakta and Maamsa. It causes Arun`a Varn`ee Pid`akaa of (reddish colour).
- Due to this Pid`akaa, a person suffers from pain. If this is not treated then it gets suppurated.
- As it is near the urinary bladder, it gets vitiated (Praklinna).
- This Pid`akaa may have hundreds of (many) small openings.
- These openings discharge with continuous frothy secretions.
- At the site of Vran`a, there are different types of pain like Taad`ana, Bhedana, Chhedana, Todana.
- Ultimately, the anal region gets lacerated. At this stage also if at all it remains untreated, then Vaata, Pureesha, Retas may get secreted through these openings.
- This type of Bhagandara is called as S`hataponaka.
Usht`ragreeva:
Atra Pid`akaavasthaagatagalavaktratvena Usht`ragreevaakaaratvam, Tena Usht`ragreeva Samdnyaa | M. N. 46/3, 4 Madhukos`ha
- Aggravated Pitta is carried towards the anal region by Vaayu.
- It gets resided around the anal region in the periphery.
- It manifests with a Pid`akaa which is red colored, thin, elevated and resembles to Usht`ragreevaa. (neck of the camel)
- It causes different types of pains. It remains untreated, it gets suppurated.
- There is a burning sensation as if the wound is being burnt by fire or alkali (Agni and Kshaara)
- There is discharge having the foul smell and hot property.
- Then also, if remains untreated, it may secrete Vaata, Mootra, Pureesha and Retas.
- This type of Bhagandara is called as Usht`ragreevaa.
Parisraavee:
Ghanasraava Yogaat Parisraavee | M. N. 46/5 Madhukos`ha
- Aggravated Kapha is carried by the Vaayu towards anal region.
- It gets resided around the anal region in the periphery.
- It manifests with a Pid`akaa which is white (S`hukla), Sthira, Kan`d`oomatee (with itching).
- It remains untreated, it gets suppurated.
- The wound becomes hard (Kat`hina) and Samrambhee, more with itching.
- It discharges with the sticky secretions (Pichchhila).
- Then also, if remains untreated, it may secrete Vaata, Mootra, Pureesha and Retas.
- This type of Bhagandara is called as Parisraavee.
S`hambookaavarta:|
Poorn`a Nadyaavarta S`hambookaavartaakaaren`a Avagatvaad Avagaad`ha Vedanaa Bhavanti | S. Ni. 4/8 D`alhan`a
S`hambookaavartavad Aavartam Vedanaa Doshagati Vis`heshaad Bhavanti Iti S`hambookaavartah | M. N. 46/6
- Aggravated Pitta and Kapha are carried towards the anal region by Vaayu.
- They cause a Pid`akaa similar in size of thumb of foot.
- This Pid`akaa gets manifested with the symptoms by all the three Dosha.
- It causes different types of pain like Toda, Daaha, Kan`d`oo etc.
- The wound secretes different types of secretions in color.
- The pains in this type of Bhagandara are as severe as the whirlpool of the fully flooded river.
- Therefore, it is called as S`hambookaavarta.
Unmaargee:
Unmaargen`a Vikrita Gati Maargen`a Pureeshaadigamanaat Unmaargee Samdnyaa | M. N. 46/7 Madhukos`ha
- When a stupefied person consumes meat with bones, then this Asthi (bone) passes with the stools which causes tear in the anal region and causes putrefaction in the wound.
- In this vitiated wound where Maamsa is putrefied with Rakta and pus, maggots (Krimi) are formed. They eat the region causing tears.
- Through this wound created by Krimi, Vaata, Mootra and Pureesha, Retas are secreted.
- This type of Bhagandara is called as Unmaargee.
Parikshepee:
This Bhagandara is manifested around the anus like a trench round a town or fort.
This is caused due to Vaata and Pitta.
Riju:
This type of Bhagandara is caused due to Vaata and Kapha.
This Bhagandara tears anus in a straight direction towards anus.
Ars`hobhagandara:
There is S`hotha at the root of the Ars`ha. There is Kan`d`oo and Daaha. Here, Kapha and Pitta gets aggravated. This S`hotha bursts out causing wetness at the root of the Ars`ha. This is called Ars`hobhagandara.
Difference between Pid`akaa and Bhaagandaree Pid`akaa:
Pid`akaa | Bhaagandaree Pid`akaa |
Alpa Vedanaa Pid`akaa | With severe Vedanaa (Rug Aad`hya) |
S`hotha pacifies earlier | S`hotha does not pacifies easily |
Not so close to the anal region | They are near to anal region around anus of 2 to 3 Angula in diameter |
Not so deeply rooted | Deeply rooted (Good`hamoolaa) with inflammation. Itvitiates after healing also. |
Vaataja Pit`ikaa:
It is S`hyaava, Arun`a in color.
There is Toda, Bheda, Sphuran`a and Rujaa.
Pittaja Pit`ikaa:
This is thin Pit`ikaa elevated like Usht`ragreeva.
There is redness at the site (Raaga). Temperature is elevated at the site (Ushmaad`hyaa).
Other signs are Jvara and Dhoomaayana.
Kaphaja Pit`ikaa:
Sthira (stable not increasing or decreasing in size)
Snigdha
Deeply rooted (Mahaamoola)
Whitish in color(Paan`d`u)
Vaata Pittaja Pit`ikaa:
Paan`d`ura
Dark brownin color(Kinchid S`hyaava)
It does not suppurate easily (Krichchhrapaaki).
Sarva Doshajaa Pit`ikaa:
It resembles to the shape and size of thumb of foot.
It manifests with different pains.
There is S`hoola, Arochaka, Trishn`aa, Daaha, Jvara, Chhardi.
All these types of Pit`ikaa get suppurated if remain untreated.
Correlation of types of Pit`ikaa and Bhagandara:
Type of Pit`ikaa | Type of Bhagandara |
Vaataja Pit`ikaa | S`hataponaka |
Pittaja Pit`ikaa | Usht`ragreeva |
Kaphaja Pit`ikaa | Parisraavee |
Vaatapittaja Pit`ikaa | Parikshepee |
Vaatakaphaja Pit`ikaa | Riju |
Kaphapittaja Pit`ikaa | Ars`hobhagandara |
Sarva Doshaja | S`hambookaavarta |
Aagantu (Kshataja Unmaargee) | Kshataja |
Asaadhya Criteria:
- Vaata Sraavee Bhagandara
- Mootra Sraavee Bhagandara
- Pureesha Sraavee Bhagandara
Comparative study of Bhagandara
Bhagandara | S`hataponaka | Usht`ragreeva | Parisraavee | S`hambookaavarta | Kshataja(S`halya nimittaja) | |
Rogamaarga | Madhyama | |||||
Svabhaava | MahaavyaadhiGhora | |||||
Avayava | GudaBhagaBasti | |||||
Krichchhra | Kasht`asaadhya | SukumaaraBheeru | ||||
Asaadhya*** | Sevanee Praapta BhagandaraValee Praapta Bhagandara | Asaadhya | Asaadhya | |||
Dosha | Vaata Prakopa | Pitta Prakopa | Kapha Prakopa | Vaata PrakopaPitta PrakopaKapha Prakopa | ||
Dhaatu | Maamsa Dusht`iRakta Dusht`i | Maamsa Dusht`iRakta Dusht`i | Maamsa Dusht`iRakta Dusht`i | Maamsa Dusht`iRakta Dusht`i | ||
Srotas | MaamsavahaRaktavahaPureeshavaha | MaamsavahaRaktavaha | MaamsavahaRaktavaha | MaamsavahaRaktavaha | ||
Avayava | GudaBhagaBasti |
*** As per Vaagbhat`a, Saannipaatika and Aagantu (Kshataja)are Asaadhya.
Last updated on March 2nd, 2021 at 08:16 am