A Critical Analysis of Plihodara wsr to Portal Hypertension

Abstract

Plihodara is a distinct clinical condition described under Udara Roga in Ayurveda and is classified among the Ashta Mahagada signifying its chronic and challenging nature. It is primarily characterized by progressive enlargement of the spleen resulting from Agnimandya, Ama formation, vitiation of Rasa and Rakta Dhatu, and obstruction of Raktavaha Srotas. In contemporary medicine, portal hypertension is recognized as a major consequence of chronic liver disease and is characterized by persistent elevation of pressure within the portal venous system. This rise in pressure results primarily from increased resistance to blood flow within the liver along with hemodynamic alterations in the splanchnic circulation. Clinically, it presents with splenomegaly, ascites, development of portosystemic collateral vessels, hypersplenism, and multiple systemic complications. Owing to its progressive course and widespread physiological impact, portal hypertension significantly increases both morbidity and mortality. This review critically analyzes the Nidana Panchaka, Samprapti, Dosha-Dushya involvement, and Srotodushti of Plihodara based on classical texts including Charaka Samhita, Sushruta Samhita, and Ashtanga Hridaya, and systematically correlates them with the modern understanding of portal hypertension. The striking similarity in clinical presentation suggests a possible conceptual relation between Plihodara and portal hypertension. The conceptual parallels highlight the depth of Ayurvedic pathological understanding and provide a framework for integrative interpretation of hepatosplenic disorders.