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Gulma Chikitsa (view source)

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→‎Five sites of gulma

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बस्तौ च ना भ्यां हृदि पार्श्वयोर्वा स्थानानि गुल्मस्य भवन्ति पञ्च|८|

पञ्चात्मकस्य प्रभवं तु तस्य वक्ष्यामि लिङ्गानि चिकित्सितं च||८||

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bastau ca nābhyāṁ hr̥di pārśvayōrvā sthānāni gulmasya bhavanti pañca|8|

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pañcātmakasya prabhavaṁ tu tasya vakṣyāmi liṅgāni cikitsitaṁ ca||8||

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bastau ca nAbhyAM hRudi pArshvayorvA sthAnAni gulmasya bhavanti pa~jca|8|

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pa~jcAtmakasya prabhavaM tu tasya vakShyAmi li~ggAni cikitsitaM ca||8||

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Five places of gulma are urinary bladder (hypogastric region), umbilical region (Nabhi), cardiac region (Hrudi) and two flanks (Parshva). Henceforth I will explain the causes, symptoms and the treatment of these five types of gulma (8).

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Causative factors of vata dominant gulma:

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Five places of gulma are urinary bladder (hypogastric region), umbilical region (Nabhi), cardiac region (Hrudi) and two flanks (Parshva). Henceforth I will explain the causes, symptoms and the treatment of these five types of gulma [8]

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==== Causative factors of vata dominant gulma ====

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रूक्षान्नपानं विषमातिमात्रं विचेष्टितं वेगविनिग्रहश्च|

शोकोऽभिघातोऽतिमलक्षयश्च निरन्नता चानिलगुल्महेतुः||९||

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shoko~abhighAto~atimalakShayashca nirannatA cAnilagulmahetuH||9||

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Excessive use of dry articles of food and drinks, excessive or wrong body activities, suppression of natural urges, excessive grief, too-much diminution of faeces, trauma and excessive fasting are the causes of vata-gulma (9).

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Excessive use of dry articles of food and drinks, excessive or wrong body activities, suppression of natural urges, excessive grief, too-much diminution of faeces, trauma and excessive fasting are the causes of vata-gulma [9]

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Symptoms of vata gulma:

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==== Symptoms of vata gulma ====

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यः स्थानसंस्थानरुजां विकल्पं विड्वातसङ्गं गलवक्त्रशोषम्|

श्यावारुणत्वं शिशिरज्वरं च हृत्कुक्षिपार्श्वांसशिरोरुजं च||१०||

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karoti jIrNe~abhyadhikaM prakopaM bhukte mRudutvaM samupaiti yashca|

vAtAt sa gulmo na ca tatra rUkShaM kaShAyatiktaM kaTu copashete||11||

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Frequent change in the site, shape and pain of the lump along with obstruction of faeces and flatus, dryness in throat and mouth, dusky-red colour of body, fever with chills, pain in the cardiac, umbilical, flanks and shoulder regions and headache are the sign and symptoms of vata gulma. The symptoms decrease on taking of food but increase on completion of digestion as well as by taking dry substances or having astringent, bitter and pungent tastes (10-11).

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Frequent change in the site, shape and pain of the lump along with obstruction of faeces and flatus, dryness in throat and mouth, dusky-red colour of body, fever with chills, pain in the cardiac, umbilical, flanks and shoulder regions and headache are the sign and symptoms of vata gulma. The symptoms decrease on taking of food but increase on completion of digestion as well as by taking dry substances or having astringent, bitter and pungent tastes [10-11]

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Causative factors and pathogenesis of pitta dominant gulma:

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==== Causative factors and pathogenesis of pitta dominant gulma ====

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कट्वम्लतीक्ष्णोष्णविदाहिरूक्षक्रोधातिमद्यार्कहुताशसेवा|

आमाभिघातो रुधिरं च दुष्टं पैत्तस्य गुल्मस्य निमित्तमुक्तम्||१२||

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AmAbhighAto [2] rudhiraM ca duShTaM paittasya gulmasya nimittamuktam||12||

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Taking of food articles having pungent and sour tastes and piercing, hot, irritant (vidahi) and dry properties; excessive wines; exposure to sun and heat; indulgence in anger, affliction by ama and vitiation of rakta are the causative factors of pitta-gulma (12).

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Taking of food articles having pungent and sour tastes and piercing, hot, irritant (vidahi) and dry properties; excessive wines; exposure to sun and heat; indulgence in anger, affliction by ama and vitiation of rakta are the causative factors of pitta-gulma [12]

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Symptoms of pitta-gulma:

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==== Symptoms of pitta-gulma ====

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ज्वरः पिपासा वदनाङ्गरागः शूलं महज्जीर्यति भोजने च|

स्वेदो विदाहो व्रणवच्च गुल्मः स्पर्शासहः पैत्तिकगुल्मरूपम्||१३||

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jvaraH pipAsA vadanA~ggarAgaH shUlaM mahajjIryati bhojane ca|

svedo vidAho vraNavacca gulmaH sparshAsahaH paittikagulmarUpam||13||

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Fever, thirst, redness of mouth and other organs, excessive pain during digestion, sweating, burning sensation and tenderness in the lesion like that of ulcer are the signs and symptoms of pitta-gulma (13).

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Fever, thirst, redness of mouth and other organs, excessive pain during digestion, sweating, burning sensation and tenderness in the lesion like that of ulcer are the signs and symptoms of pitta-gulma [13]

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Causative factors of kapha-gulma and nichaya-gulma:

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==== Causative factors of kapha-gulma and nichaya-gulma ====

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शीतं गुरु स्निग्धमचेष्टनं च सम्पूरणं प्रस्वपनं दिवा च|

गुल्मस्य हेतुः कफसम्भवस्य सर्वस्तु दिष्टो निचयात्मकस्य||१४||

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gulmasya hetuH kaphasambhavasya sarvastu diShTo nicayAtmakasya||14||

Excessive intake of food articles having cold, heavy and unctuous properties and excessive eating, sedentary life style and day-sleep are the causative factors of kapha-gulma.

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All the causative factors mentioned for all the above three types of dosha gulma are also of nichaya (tridosha)-gulma (14).

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All the causative factors mentioned for all the above three types of dosha gulma are also of nichaya (tridosha)-gulma [14]

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==== Symptoms of kapha dominant gulma ====

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~~Symptoms of kapha dominant gulma:~~

स्तैमित्यशीतज्वरगात्रसादहृल्लासकासारुचिगौरवाणि|

शैत्यं रुगल्पा कठिनोन्नतत्वं गुल्मस्य रूपाणि कफात्मकस्य||१५||

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staimityashItajvaragAtrasAdahRullAsakAsArucigauravANi|

shaityaM rugalpA kaThinonnatatvaM gulmasya rUpANi kaphAtmakasya||15||

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Feeling as covered by wet cloth, fever with chills, exhaustion of limbs, nausea, cough, anorexia, heaviness, cold and mild pain with palpable hard and protruded mass are the signs and symptoms of kaphaja-gulma.(15)

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Feeling as covered by wet cloth, fever with chills, exhaustion of limbs, nausea, cough, anorexia, heaviness, cold and mild pain with palpable hard and protruded mass are the signs and symptoms of kaphaja-gulma [15]

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Dvi-doshaja gulma:

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==== Dvi-doshaja gulma ====

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निमित्तलिङ्गान्युपलभ्य गुल्मे द्विदोषजे दोषबलाबलं च|

व्यामिश्रलिङ्गानपरांस्तु गुल्मांस्त्रीनादिशेदौषधकल्पनार्थम्||१६||

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nimittali~ggAnyupalabhya gulme dvidoShaje doShabalAbalaM ca|

vyAmishrali~ggAnaparAMstu gulmAMstrInAdishedauShadhakalpanArtham||16||

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Three types of dvi-doshaja gulma (vata-pitta, vata-kapha and kapha-pitta) are produced by the mixture of causative factors of two involved dosha. These gulma manifest the signs and symptoms of two involved dosha. These varieties are mentioned here for the purpose of the treatment which can be planned on the basis of degree of provocation of each dosha (16).

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Three types of dvi-doshaja gulma (vata-pitta, vata-kapha and kapha-pitta) are produced by the mixture of causative factors of two involved dosha. These gulma manifest the signs and symptoms of two involved dosha. These varieties are mentioned here for the purpose of the treatment which can be planned on the basis of degree of provocation of each dosha [16]

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Signs and symptoms of tri-doshaja gulma:

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==== Signs and symptoms of tri-doshaja gulma ====

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महारुजं दाहपरीतमश्मवद्घनोन्नतं शीघ्रविदाहि दारुणम्|

मनःशरीराग्निबलापहारिणं त्रिदोषजं गुल्ममसाध्यमादिशेत्||१७||

mahārujaṁ dāhaparītamaśmavadghanōnnataṁ śīghravidāhi dāruṇam|

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manaḥśarīrāgnibalāpahāriṇaṁ tridōṣajaṁ gulmamasādhyamādiśēt||17||

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manaḥśarīrāgnibalāpahāriṇaṁ tridōṣajaṁ gulmamasādhyamādiśēt||17||

mahArujaM dAhaparItamashmavadghanonnataM shIghravidAhi dAruNam|

manaHsharIrAgnibalApahAriNaM tridoShajaM gulmamasAdhyamAdishet||17||

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The symptoms of tri-dosha gulma are, agonizing pain and excessive burning sensation, elevated mass, stony hard and quick to mutilate. It is a very serious condition and leads to diminution of strength of body, mind and digestion. It is incurable (17).

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The symptoms of tri-dosha gulma are, agonizing pain and excessive burning sensation, elevated mass, stony hard and quick to mutilate. It is a very serious condition and leads to diminution of strength of body, mind and digestion. It is incurable [17]

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Causative factors of rakta gulma:

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==== Causative factors of rakta gulma ====

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ऋतावनाहारतया भयेन विरूक्षणैर्वेगविनिग्रहैश्च|

संस्तम्भनोल्लेखनयोनिदोषैर्गुल्मः स्त्रियं रक्तभवोऽभ्युपैति||१८||

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dRuShTvA~a~adau svedayedyuktyA svinnaM ca vilayedbhiShak|

If the gulma is hard and protruded accompanied with constipation and distension of abdomen then physician should give sudation locally to dissolve it (51).

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लङ्घनोल्लेखने स्वेदे कृतेऽग्नौ सम्प्रधुक्षिते||५२|| कफगुल्मी पिबेत् काले सक्षारकटुकं घृतम्|

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लङ्घनोल्लेखने स्वेदे कृतेऽग्नौ सम्प्रधुक्षिते||५२||

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कफगुल्मी पिबेत् काले सक्षारकटुकं घृतम्|

laṅghanōllēkhanē svēdē kr̥tē'gnau sampradhukṣitē||52||

kaphagulmī pibēt kālē sakṣārakaṭukaṁ ghr̥tam|

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सस्नेहैर्बस्तिभिर्वाऽपि शोधयेद्दाशमूलिकैः|

sthānādapasr̥taṁ jñātvā kaphagulmaṁ virēcanaiḥ||53||

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sasnēhairbastibhirvā'pi śōdhayēddāśamūlikaiḥ|

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sasnēhairbastibhirvā'pi śōdhayēddāśamūlikaiḥ|

sthAnAdapasRutaM j~jAtvA kaphagulmaM virecanaiH||53||

sasnehairbastibhirvA~api shodhayeddAshamUlikaiH|

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दोषप्रकृतिगुल्मर्तुयोगं बुद्ध्वा कफोल्बणे||५६||

बलदोषप्रमाणज्ञः क्षारं गुल्मे प्रयोजयेत्|

−

एकान्तरं द्व्यन्तरं वा त्र्यहं विश्रम्य वा पुनः||५७|| शरीरबलदोषाणां वृद्धिक्षपणकोविदः|

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एकान्तरं द्व्यन्तरं वा त्र्यहं विश्रम्य वा पुनः||५७||

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शरीरबलदोषाणां वृद्धिक्षपणकोविदः|

dōṣaprakr̥tigulmartuyōgaṁ buddhvā kaphōlbaṇē||56|| baladōṣapramāṇajñaḥ kṣāraṁ gulmē prayōjayēt|

ēkāntaraṁ dvyantaraṁ vā tryahaṁ viśramya vā punaḥ||57||

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Daha karma and rakta mokshana in kapha gulma:

लङ्घनोल्लेखनैः स्वेदैः सर्पिःपानैर्विरेचनैः||६०||

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बस्तिभिर्गुटिकाचूर्णक्षारारिष्टगणैरपि| श्लैष्मिकः कृतमूलत्वाद्यस्य गुल्मो न शाम्यति||६१||

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बस्तिभिर्गुटिकाचूर्णक्षारारिष्टगणैरपि|

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श्लैष्मिकः कृतमूलत्वाद्यस्य गुल्मो न शाम्यति||६१||

तस्य दाहो हृते रक्ते शरलोहादिभिर्हितः|

laṅghanōllēkhanaiḥ svēdaiḥ sarpiḥpānairvirēcanaiḥ||60|| bastibhirguṭikācūrṇakṣārāriṣṭagaṇairapi|

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योन्यर्शोग्रहणीदोषश्वासकासारुचिज्वरान्|

बस्तिहृत्पार्श्वशूलं च घृतमेतद्व्यपोहति||७३||

−

इति हपुषाद्यं घृतम् hapuṣāvyōṣapr̥thvīkācavyacitrakasaindhavaiḥ|

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इति हपुषाद्यं घृतम्

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hapuṣāvyōṣapr̥thvīkācavyacitrakasaindhavaiḥ|

sājājīpippalīmūladīpyakairvipacēdghr̥tam||71||

sakōlamūlakarasaṁ sakṣīradadhidāḍimam|

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tat paraṁ vātagulmaghnaṁ śūlānāhavimōkṣaṇam||72|| yōnyarśōgrahaṇīdōṣaśvāsakāsārucijvarān|

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tat paraṁ vātagulmaghnaṁ śūlānāhavimōkṣaṇam||72||

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yōnyarśōgrahaṇīdōṣaśvāsakāsārucijvarān|

bastihr̥tpārśvaśūlaṁ ca ghr̥tamētadvyapōhati||73||

iti hapuṣādyaṁ ghr̥tam

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Or prepare the suppositories and pills by impregnating the powders of the above drugs in the juice of pomelo (matulunga) and use them for providing relief in gulma, distension of abdomen and discomfort (78).

Hiṅgvadi churṇa and gutika:

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हिङ्गु त्रिकटुकं पाठां हपुषामभयां शटीम्|

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हिङ्गु त्रिकटुकं पाठां हपुषामभयां शटीम्|

अजमोदाजगन्धे च तिन्तिडीकाम्लवेतसौ||७९||

दाडिमं पुष्करं धान्यमजाजीं चित्रकं वचाम्|

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भावितं मातुलुङ्गस्य चूर्णमेतद्रसेन वा|

बहुशो गुटिकाः कार्याः कार्मुकाः स्युस्ततोऽधिकम्||८४||

−

इति हिङ्ग्वादिचूर्णं गुटिका च | hiṅgu trikaṭukaṁ pāṭhāṁ hapuṣāmabhayāṁ śaṭīm|

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इति हिङ्ग्वादिचूर्णं गुटिका च |

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hiṅgu trikaṭukaṁ pāṭhāṁ hapuṣāmabhayāṁ śaṭīm|

ajamōdājagandhē ca tintiḍīkāmlavētasau||79||

dāḍimaṁ puṣkaraṁ dhānyamajājīṁ citrakaṁ vacām|

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pibēttasya prayōgēṇa vātagulmāt pramucyatē||97||

iti śilājatuprayōgaḥ |

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pa~jcamUlIkaShAyeNa sakShAreNa [11] shilAjatu|

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pa~jcamUlIkaShAyeNa sakShAreNa [11] shilAjatu|

pibettasya prayogeNa vAtagulmAt pramucyate||97||

iti shilAjatuprayogaH

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vāṭyaṁ pippalīyūṣēṇa mūlakānāṁ rasēna vā|

bhuktvā snigdhamudāvartādvātagulmādvimucyatē||98||

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vATyaM pippalIyUSheNa mUlakAnAM rasena vA|

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vATyaM pippalIyUSheNa mUlakAnAM rasena vA|

bhuktvA snigdhamudAvartAdvAtagulmAdvimucyate||98||

Taking of barley meal mixed with unctuous substances along with soup of long pepper or juice of radish, provides relief in vata gulma and udavarta (98).

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śūlānāhavibandhārtaṁ svēdayēdvātagulminam|

svēdaiḥ svēdavidhāvuktairnāḍīprastarasaṅkaraiḥ||99||

−

shUlAnAhavibandhArtaM svedayedvAtagulminam|

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shUlAnAhavibandhArtaM svedayedvAtagulminam|

svedaiH svedavidhAvuktairnADIprastarasa~gkaraiH||99||

If the patient of vata gulma is also having the complaints of distension of abdomen and constipation then swedana therapy should be given in the form of nadi (cattle sudation), prastara (stone slab sudation) and sankara (mix sudation) sweda as described in chapter 14 of Sutra Sthana of Charaka Samhita (99)

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prayuktAnyAshu sidhyanti tailaM hyanilajitparam [12] ||103||

−

The various types of medicated oil useful for gulma will be described in the chapter on vata vyadhi (Charaka Chikitisa Sthana chapter28). The medicated oils are used for oral administration, massage and anuvasana basti. As oil is best therapy for vata therefore it cures vata gulma quickly (102-103).

+

The various types of medicated oil useful for gulma will be described in the chapter on vata vyadhi (Charaka Chikitisa Sthana chapter28). The medicated oils are used for oral administration, massage and anuvasana basti. As oil is best therapy for vata therefore it cures vata gulma quickly (102-103).

नीलिनीचूर्णसंयुक्तं पूर्वोक्तं घृतमेव|

समलाय प्रदातव्यं शोधनं वातगुल्मिने||१०४||

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कुक्कुटाश्च मयूराश्च तित्तिरिक्रौञ्चवर्तकाः|

शालयो मदिरा सर्पिर्वातगुल्मभिषग्जितम्||११०||

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हितमुष्णं द्रवं स्निग्धं भोजनं वातगुल्मिनाम्| समण्डवारुणीपानं पक्वं वा धान्यकैर्जलम्||१११|| kukkuṭāśca mayūrāśca tittirikrauñcavartakāḥ|

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हितमुष्णं द्रवं स्निग्धं भोजनं वातगुल्मिनाम्|

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समण्डवारुणीपानं पक्वं वा धान्यकैर्जलम्||१११||

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kukkuṭāśca mayūrāśca tittirikrauñcavartakāḥ|

śālayō madirā sarpirvātagulmabhiṣagjitam||110||

hitamuṣṇaṁ dravaṁ snigdhaṁ bhōjanaṁ vātagulminām|

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vairecanikasiddhena sarpiShA tiktakena [14] vA||114||

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Physician while dealing with pitta gulma should know that it requires immediate treatment (atyayika). Pitta gulma patient should be given ghee prepared with purgative and bitter drugs (114).

+

Physician while dealing with pitta gulma should know that it requires immediate treatment (atyayika). Pitta gulma patient should be given ghee prepared with purgative and bitter drugs (114).

Rohiṇyadya ghritam:

रोहिणीकटुकानिम्बमधुकत्रिफलात्वचः|

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jvarastRuShNA ca shUlaM ca bhramo mUrcchA~arucistathA||117||

iti rohiNyAdyaM ghRutam

−

Take 10 gm each of katuka, neem, liquorices, triphala and trayamana; 40 gm each of patola and trivrita; 80 gm of lentil (Masura) and add to it 8 times water; boil on low fire till it reduces to 160 ml. Add to it equal quantity of ghee i.e. 160 ml and administer it to the patient orally. It alleviates pitta gulma, fever, thirst, abdominal pain, giddiness, fainting and anorexia. Thus rohinyadi ghrita is described (117).

+

Take 10 gm each of katuka, neem, liquorices, triphala and trayamana; 40 gm each of patola and trivrita; 80 gm of lentil (Masura) and add to it 8 times water; boil on low fire till it reduces to 160 ml. Add to it equal quantity of ghee i.e. 160 ml and administer it to the patient orally. It alleviates pitta gulma, fever, thirst, abdominal pain, giddiness, fainting and anorexia. Thus rohinyadi ghrita is described (117).

Trayamaṇadi ghritam:

जले दशगुणे साध्यं त्रायमाणाचतुष्पलम्|

Line 1,137: Line 1,167:

Post operative measures:

तिलैरण्डातसीबीजसर्षपैः परिलिप्य च|

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श्लेष्मगुल्ममयःपात्रैः सुखोष्णैः स्वेदयेद्भिषक्||१४१|| tilairaṇḍātasībījasarṣapaiḥ parilipya ca|

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श्लेष्मगुल्ममयःपात्रैः सुखोष्णैः स्वेदयेद्भिषक्||१४१||

+

tilairaṇḍātasībījasarṣapaiḥ parilipya ca|

ślēṣmagulmamayaḥpātraiḥ sukhōṣṇaiḥ svēdayēdbhiṣak||141||

tilairaNDAtasIbIjasarShapaiH parilipya ca|

Line 1,145: Line 1,176:

सव्योषक्षारलवणं दशमूलीशृतं घृतम्|

कफगुल्मं जयत्याशु सहिङ्गुबिडदाडिमम्||१४२||

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इति दशमूलीघृतम्| savyōṣakṣāralavaṇaṁ daśamūlīśr̥taṁ ghr̥tam|

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इति दशमूलीघृतम्|

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savyōṣakṣāralavaṇaṁ daśamūlīśr̥taṁ ghr̥tam|

kaphagulmaṁ jayatyāśu sahiṅgubiḍadāḍimam||142||

iti daśamūlīghr̥tam |

Line 1,226: Line 1,258:

द्विगुणं तद्विरेकार्थं प्रयोज्यं कफगुल्मिनाम्||१५२||

सुधाक्षीरद्रवे चूर्णं त्रिवृतायाः सुभावितम्|

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कार्षिकं मधुसर्पिभ्यां लीढ्वा साधु विरिच्यते||१५३|| yaduktaṁ vātagulmaghnaṁ sraṁsanaṁ nīlinīghr̥tam|

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कार्षिकं मधुसर्पिभ्यां लीढ्वा साधु विरिच्यते||१५३||

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yaduktaṁ vātagulmaghnaṁ sraṁsanaṁ nīlinīghr̥tam|

dviguṇaṁ tadvirēkārthaṁ prayōjyaṁ kaphagulminām||152||

sudhākṣīradravē cūrṇaṁ trivr̥tāyāḥ subhāvitam|

Line 1,380: Line 1,413:

Make a semisolid preparation by heating 5 Kg of palasha-kshara with 5 Kg each of ghee and oil. Administer it in sufficient dose to make the gulma soft/loose.

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प्रभिद्येत न यद्येवं दद्याद्योनिविशोधनम् |

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प्रभिद्येत न यद्येवं दद्याद्योनिविशोधनम् | क्षारेण युक्तं पललं सुधाक्षीरेण वा पुनः||१७४||

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क्षारेण युक्तं पललं सुधाक्षीरेण वा पुनः||१७४||

आभ्यां वा भावितान् दद्याद्योनौ कटुकमत्स्यकान्|

वराहमत्स्यपित्ताभ्यां लक्तकान् वा सुभावितान्||१७५||

Line 1,403: Line 1,436:

Bile of hog or fish or emetic or purgative drugs or with honey

Or yeast mixed with jaggery and honey may be used for cleansing the vagina (174-176).

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रक्तपित्तहरं क्षारं लेहयेन्मधुसर्पिषा|

Line 1,420: Line 1,452:

Basti prepared with milk, cow’s urine, kshara and decoction of dashamula should be given. Even after all these treatments, if blood does not flow from vagina then surgical intervention is required (178).

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प्रवर्तमाने रुधिरे दद्यान्मांसरसौदनम्|

घृततैलेन चाभ्यङ्गं पानार्थं तरुणीं सुराम्||१७९|| pravartamānē rudhirē dadyānmāṁsarasaudanam|

Line 1,438: Line 1,469:

सुरां समण्डां पूर्वं च पानमम्लस्य सर्पिषः||१८१||

प्रयोजयेदुत्तरं वा जीवनीयेन सर्पिषा|

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अतिप्रवृत्ते रुधिरे सतिक्तेनानुवासनम्||१८२|| ghr̥tatailāvasēkāṁśca tittirīṁścaraṇāyudhān|

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अतिप्रवृत्ते रुधिरे सतिक्तेनानुवासनम्||१८२||

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ghr̥tatailāvasēkāṁśca tittirīṁścaraṇāyudhān|

surāṁ samaṇḍāṁ pūrvaṁ ca pānamamlasya sarpiṣaḥ||181||

prayōjayēduttaraṁ vā jīvanīyēna sarpiṣā|

Line 1,459: Line 1,491:

सर्पिर्बस्तिर्गुटिकाश्चूर्णमरिष्टाश्च सक्षाराः||१८६||

गुल्मस्यान्ते दाहः कफजस्याग्रेऽपनीतरक्तस्य|

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गुल्मस्य रौधिरस्य क्रियाक्रमः स्त्रीभवस्योक्तः||१८७|| पथ्यान्नपानसेवा हेतूनां वर्जनं यथास्वं च|

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गुल्मस्य रौधिरस्य क्रियाक्रमः स्त्रीभवस्योक्तः||१८७||

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पथ्यान्नपानसेवा हेतूनां वर्जनं यथास्वं च|

नित्यं चाग्निसमाधिः स्निग्धस्य च सर्वकर्माणि||१८८||

हेतुर्लिङ्गं सिद्धिः क्रियाक्रमः साध्यता न योगाश्च|

गुल्मचिकित्सितसङ्ग्रह एतावान् व्याहृतोऽग्निवेशस्य||१८९||

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tatra ślōkāḥ-

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tatra ślōkāḥ-

snēhaḥ svēdaḥ sarpirbastiścūrṇāni br̥ṁhaṇaṁ guḍikāḥ|

vamanavirēkau mōkṣaḥ kṣatajasya ca vātagulmavatām||183||

Line 1,509: Line 1,542:

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Tattva Vimarsha

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=== ''Tattva Vimarsha'' ===

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• Gulma occurs predominantly due to excessive excretion of faeces, kapha and pitta or due to pressure exerted by their excessive aggravation and other causes leading to vitiation of vata dosha.

• Cavities like that in urinary bladder (hypo gastric region), umbilical region (nabhi), cardiac region (hrudi) and two flanks (parshva) are susceptible sites for gulma.

Line 1,526: Line 1,560:

• Rakta gulma should be treated only after observation for 10 months. This waiting period is essential for achieving a stage suitable for intervention. The patient should be given unctuous virechana after preparing with snehana and swedana.

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Vidhi Vimarsha

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=== ''Vidhi Vimarsha'' ===

Contemporary understanding of gulma:

In Ayurveda, a comprehensive description is given for abdominal swellings. While the generalized swellings have been described under the heading of udara roga (ascites), localized inflammatory swellings are described under the heading of vidradhi. However, there are other varieties of localized abdominal lumps which are non inflammatory in nature and are considered primarily under the heading of gulma.

Line 1,562: Line 1,596:

(Right iliac)

Organs: Caecum, appendix, lower end of ileum, right ureter, right spermatic cord in male & right ovary in female 8. Basti ( Hypogastric)

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Organs: Ileum, bladder, gravid pregnant uterus 9. Vāma Adho Parshava

Line 1,599: Line 1,632:

Blood letting 100 to 150 ml

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=== Glossary ===

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Glossary

Agni-karma (अग्निकर्म) cauterization

Ānāha (आनाह) distension of abdomen

Line 1,615: Line 1,646:

Sthānasaṁsthānarujāṁ vikalpaṁ (स्थानसंस्थानरुजां विकल्पं) frequent change in the site, shape and pain of the lump

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References

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=== References ===

1. Bhāvaprakāsha: Bhāvaprakāsha . Published by Chaukhamba Sanskrit Series office Banaras. Cikitsa Prakarana

Pallavmishra

Bureaucrats, Administrators

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