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Line 20: − + − + − + + + + + + + + + + − + + + + + − === Abstract ===+ − ''Gulma'' is defined as large palpable, rounded, intra- abdominal swellings between ''hridaya'' (cardiac region) and the ''basti'' (bladder) regions, which develop due to excess accumulation of ''doshas'' with predominance of ''vata''. Such swellings are either transitory or static, and display the properties of spontaneous regression and reappearance. This chapter on the treatment of ''gulma'' (abdominal lumps) first describes its general etiological factors and pathogenesis along with five places in the abdomen where the swelling occurs. The treatment of ''vata gulma'' includes ''snehana'' (oleation), ''swedana'' (sudation), ''brimhana'' (repletion), ''basti'' with ''ghee'', ''virechana'', ''vamana'' and preparations in the form of powders, pills and medicated ''ghrita'' and as a last resort bloodletting. For the treatment of ''pitta gulma'', the ''ghrita'' prepared with bitter (''tikta'') drugs, ''virechana'', recipes for ''niruha basti'', blood-letting (''rakta-mokshana''), use of milk, counseling (''ashvasana'') and oral recipes have been elaborated. ''Upanaha'' (poultice), ''shodhana'' and surgical measures for suppurated and internally ruptured ''gulma'' have also been described. − For ''kapha gulma snehana'', ''swedana'', ''bhedana'' (puncturing), ''langhana'' (lightening therapy), ''vamana'', ''virechana'', medicated ''ghee'', ''basti'', pills, powder, ''arishta'', and ''kshara'' are described. Bloodletting followed by cauterization of the ''gulma'' as a last resort is explained. A surgical procedure for ''rakta gulma'', which occurs only in women is also described. − Wholesome (''pathya'') food and drinks, avoidance of etiological factors, continuous protection of digestive power (''agni'') and the instructions for a patient who undergoes ''snehana'' are discussed in detail. − + + + − === Introduction ===+ − The word ''gulma'' stands for an entity that encircles, envelops or covers something. Situations such as panic, stress, or grief, usually associated with chaotic, cataclysmic event would lead to vitiation of ''vata'' causing the appearance of ''vata''-dominant diseases like ''gulma'', etc. The vitiated ''vata'', in conjunction with other ''doshas'', gets into the ''mahasrotas'' and get lodged either in the ''amashaya'' (stomach), ''pittashaya'' (gall bladder), ''pakwashaya'' (cecum) or in other regions like ''hridaya'' (epigastric), ''basti'' (bladder) and ''nabhi'' (umblicus) leading to formation of deep-rooted shrub-like mass. As mentioned earlier, ''gulma'' afflicts the gastrointestinal region between the heart and the bladder. Depending upon the region it afflicts, it can be classified into four general types common to males and females: ''vata gulma'', ''pitta gulma'', ''kapha gulma'', and ''sannipatik gulma''.+ − Since ''gulma'' can occur as complication of ''raktapitta'' (bleeding disorders) Charaka describes this chapter after the ''raktapitta'' chapter. ''Jwara'' is the disease of ''rasavah srotas'' whereas, ''raktapitta'' is a disease of ''raktavah srotas'', in that sequence ''gulma'' is a disease of ''mansavah srotas'' and further ''prameha'' is of ''medavah srotas''. However, this chapter seems to be designed with greater implication and term ''mahasrotasa'' has been used because manifestation of disease is in the viscera/ organs up to uterus. Even then the involvement of ''vata dosha'' and ''mamsa dhatu'' is predominant in final manifestation of disease ''gulma''.+ + + − It should also be noted that the same pathogenesis route and treatment procedure should be kept in mind for the disease of the ''mahasrotasa'' occurring without the true manifestation of growth/tumor. Hence peptic ulcer and ulcer dyspepsia should be treated like ''pitta gulma'' etc.+ − + − ''Gulma'' is defined as a palpable round compact lump in the abdomen. Thus, all the localized palpable masses in the abdomen are classified under ''gulma'', but they are named depending upon the dominance of ''dosha'' or the place. Its four types belong to ''dosha'' i.e. three of single ''dosha'' and one of a combination of all the three ''dosha'' and the fifth one is ''rakta gulma'' which occurs only in females in uterine cavity (''garbhashayashroni''). ''Sannipata Gulma'' has been given synonym as ''nichaya-gulma''. − − ===Sanskrit text, Transliteration and English Translation=== − − ==== Management of ''Gulma'' (abdominal lumps) ==== + Line 48:
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Line 87: − + + − + − ==== Etio-pathogenesis of ''gulma'' ====+ + Line 74:
Line 101: + Line 90:
Line 118: − + + − + Line 102:
Line 131: − + − + − ==== General Pathogenesis of ''gulma'' ====+ + + Line 117:
Line 148: + + + − The provoked ''vata'' takes out ''kapha'' and ''pitta'' from their sites and in turn gets blocked its own passage by them. Thus, blocked ''vata'' is unable to move properly leading to pain in the regions of heart, umbilicus, both sides of abdomen and urinary bladder [6]+ − + − ==== Cardinal Signs of ''Gulma'' ==== + Line 133:
Line 167: + − + − ==== Five sites of ''gulma'' ====+ + + Line 149:
Line 186: + − ==== Causative factors of ''vata'' dominant ''gulma'' ====+ + + Line 165:
Line 205: + − + − ==== Symptoms of ''vata gulma'' ====+ + Line 177:
Line 219: + Line 193:
Line 236: + − + − ==== Causative factors and pathogenesis of ''pitta'' dominant ''gulma'' ====+ + + Line 209:
Line 255: + − + − ==== Symptoms of ''pitta-gulma'' ====+ + + Line 225:
Line 274: + − + − ==== Causative factors of ''kapha-gulma'' and ''nichaya-gulma'' ====+ + + Line 241:
Line 293: + − + − + − ==== Symptoms of ''kapha'' dominant ''gulma'' ====+ + + Line 259:
Line 314: + − ==== ''Dvi-doshaja gulma'' ====+ + + Line 275:
Line 333: + − + − ==== Signs and symptoms of ''tri-doshaja gulma'' ====+ + + Line 291:
Line 352: + − + − ==== Causative factors of ''rakta gulma'' ====+ + + Line 307:
Line 371: + − + − ==== Symptoms of ''rakta gulma'' ====+ + + Line 323:
Line 390: + + + Line 337:
Line 407: + − ==== Treatment of ''vata-gulma'' ====+ + + Line 353:
Line 426: + − + − ==== ''Snehana'' for ''vata-gulma'' ====+ + + Line 369:
Line 445: + − + − ==== Benefit of ''swedana'' therapy for ''vata-gulma'' ====+ + + Line 385:
Line 464: + − + − ==== Mode of Administration of ''sneha'' according to sites of ''vata gulma'' ====+ + + Line 401:
Line 483: + − + + + Line 415:
Line 500: + − + − ==== Repeated ''basti'' in ''vata gulma'' ====+ + + Line 431:
Line 519: + − + + Line 441:
Line 531: + Line 457:
Line 548: + − + − ==== ''Vamana'' in ''vata gulma'' ====+ + + Line 473:
Line 567: + − + + + Line 487:
Line 584: + − + − ==== ''Virechana'' in ''vata gulma'' ====+ + + Line 503:
Line 603: + − + − ==== Blood-letting in ''vata gulma''====+ + + Line 519:
Line 622: + − + − ==== Treatment of ''pitta'' dominant ''gulma'' ====+ + + Line 535:
Line 641: + − + + Line 545:
Line 653: + Line 561:
Line 670: + − + − ==== Blood-letting in ''pitta'' dominant ''gulma'' ====+ + + Line 577:
Line 689: + − + + + Line 591:
Line 706: + − + − ==== Diet after blood-letting ====+ + + Line 607:
Line 725: + + + Line 621:
Line 742: + − + − ==== ''Apakva gulma'' (intial non-suppurative stage) ====+ + + Line 637:
Line 761: + − ==== Symptoms of suppurating (''vidahamana'') ''gulma'' ====+ + + Line 653:
Line 780: + − ==== Symptoms of suppurated ''gulma'' ====+ + Line 665:
Line 794: + Line 681:
Line 811: + + + Line 695:
Line 828: + + + Line 709:
Line 845: + − ==== Management of pus discharging ''gulma'' ====+ + Line 719:
Line 857: + Line 731:
Line 870: + + + Line 745:
Line 887: + − + − ==== Management of ''kaphaja gulma'' ====+ − ===== Indications of ''langhana'' =====+ + + Line 763:
Line 908: + − + − ===== Indications of vamana =====+ + + Line 779:
Line 927: + − + + + Line 793:
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Line 1,058: + − + + + Line 903:
Line 1,075: + − + + + Line 917:
Line 1,092: + − + − ==== ''Daha karma'' and ''rakta mokshana'' in ''kapha gulma'' ====+ + Line 929:
Line 1,106: + Line 945:
Line 1,123: + − + + + Line 959:
Line 1,140: + − + + + Line 973:
Line 1,157: + + + + − + + + + − ===== ''Tryushanadi-ghritam'' =====+ + + Line 1,005:
Line 1,198: + − + − ==== ''Parama trayushanadighritam'' ====+ + + Line 1,021:
Line 1,217: + + + + + + Line 1,043:
Line 1,245: + − + − ==== ''Hingusauvarchaladya ghrita'' ====+ + Line 1,057:
Line 1,261: + Line 1,077:
Line 1,282: + − + − ==== ''Hapushadya ghritam'' ====+ + Line 1,095:
Line 1,302: + Line 1,123:
Line 1,331: + − + − ==== ''Pippalyadyam ghritam'' ====+ + Line 1,137:
Line 1,347: + Line 1,157:
Line 1,368: + − + + + Line 1,171:
Line 1,385: + − ==== ''Peya'' (liquid gruel) ====+ + + Line 1,187:
Line 1,404: + + + Line 1,201:
Line 1,421: + − ==== ''Hingvadi churna'' and ''gutika'' ====+ + Line 1,231:
Line 1,453: + Line 1,283:
Line 1,506: + Line 1,288:
Line 1,512: − + + + Line 1,303:
Line 1,529: + − + − ==== ''Shatyadi churnam'' and ''gutika'' ====+ + Line 1,327:
Line 1,555: + Line 1,366:
Line 1,595: + Line 1,371:
Line 1,601: − ==== ''Nagara'' preparation ====+ + Line 1,378:
Line 1,609: + Line 1,390:
Line 1,622: + − + + Line 1,398:
Line 1,632: + Line 1,410:
Line 1,645: + − + − ==== ''Lashuna-kshiram'' ====+ + Line 1,424:
Line 1,661: + Line 1,444:
Line 1,682: + − + − ==== ''Taila panchakam'' ====+ + Line 1,454:
Line 1,694: + Line 1,466:
Line 1,707: + − ==== ''shilajatu-prayoga'' ====+ + Line 1,476:
Line 1,719: + Line 1,488:
Line 1,732: + − + − ==== ''Vatyam'' or barley preparation ====+ + + Line 1,504:
Line 1,751: + − + − ==== ''Swedana'' ====+ + + Line 1,520:
Line 1,770: + − + − ==== ''Basti karma'' ====+ + Line 1,534:
Line 1,786: + Line 1,554:
Line 1,807: + − + − ==== Medicated oils ====+ + Line 1,564:
Line 1,819: + Line 1,576:
Line 1,832: + − + + + Line 1,590:
Line 1,849: + − + − ==== ''Nilinyadyam ghritam'' ====+ + + Line 1,606:
Line 1,868: + − + − ==== ''Nilinyadyam ghritam'' ====+ + Line 1,628:
Line 1,892: + Line 1,664:
Line 1,929: + − + − ==== ''Pathya'' in ''vata gulma'' ====+ + Line 1,678:
Line 1,945: + Line 1,694:
Line 1,962: + − + − ==== Protection of ''agni'' ====+ + + Line 1,712:
Line 1,983: + − ==== Oleation therapy ====+ + + Line 1,728:
Line 2,002: + − + − ==== Management of ''pitta gulma'' ====+ + + Line 1,744:
Line 2,021: + − + − ==== ''Rohiṇyadya ghritam'' ====+ + Line 1,762:
Line 2,041: + Line 1,790:
Line 2,070: + − + − ==== ''Trayamaṇadi ghritam'' ====+ + Line 1,812:
Line 2,094: + Line 1,848:
Line 2,131: + − + − ==== ''Amalakadi ghritam'' ====+ + Line 1,858:
Line 2,143: + Line 1,870:
Line 2,156: + − ==== ''Drakshadi ghritam'' ====+ + Line 1,888:
Line 2,176: + Line 1,916:
Line 2,205: + − + − ==== ''Vasaghr̥itam'' ====+ + Line 1,930:
Line 2,221: + Line 1,950:
Line 2,242: + − + + Line 1,960:
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Line 2,271: + − + + + Line 1,990:
Line 2,288: + − + − ==== Massage ====+ + + Line 2,006:
Line 2,307: + − ==== ''Kshira-basti'' for ''pitta gulma'' ====+ + + Line 2,022:
Line 2,326: + − + − ==== ''Pathya'' for ''pitta gulma'' ====+ + Line 2,034:
Line 2,340: + Line 2,050:
Line 2,357: + − + − ==== Management of ''ama'' associated ''gulma'' ====+ + + Line 2,066:
Line 2,376: + − + − ==== Importance of ''agni'' ====+ + + Line 2,082:
Line 2,395: + − + − ==== Treatment of ''kaphaja gulma'' ====+ − ===== ''Vamana'' in ''kaphaja gulma'' =====+ + + + − + − ===== Surgical treatment of ''kapha gulma'' =====+ + + + + + + + + Line 2,124:
Line 2,449: + + + + − + − − ==== Post operative measures ==== − + + + + + + + + + − + − ==== ''Dashamuli ghrita'' ====+ + + + + Line 2,162:
Line 2,501: + + − + − ==== ''Bhallatakadi ghritam'' ====+ + + + + − + + + + + + + Line 2,199:
Line 2,550: + + − + + + + − + − ==== ''Kshiraṣhaṭpalaka ghritam'' ====+ + + + + + + Line 2,233:
Line 2,595: + + + − + − + − ==== ''Mishraka sneha'' ====+ + + + + + + + + Line 2,267:
Line 2,640: + + + + − + − ==== ''Virechana'' in ''kapha gulma'' ====+ + + + + + + + + + − + − + − ==== ''Danti-haritaki'' ====+ + + + + + + + + + + + + + + + + Line 2,352:
Line 2,754: + + + + + + + + − + − + − ==== ''Basti'' in ''kapha gulma'' ====+ + + + + + + − + − ==== Powders and pills ====+ + + + + + + − + − ==== ''Kshara'' and ''daha karma'' ====+ + + + + + + + + − ''Kshara'' preparations mentioned in [[Grahani Chikitsa]] are also beneficial for ''kapha gulma'' without any side effect. If above mentioned treatment does not cure ''kapha gulma'' then cauterization should be done as a last resort [163]+ − + − ==== ''Pathya'' for ''kapha gulma'' ==== + + + + + + + + − + + + + + − + + + − + + + + + + + − + + + + + + + + + − Taking of butter milk mixed with ''yavani'' (''ajwain'') and salted with bid-salt acts as a digestive stimulant and the regulator of flatus, urine and ''kapha'' [168]+ − + − ==== Signs and symptoms of incurable ''gulma'' ==== + + + + − + + + + + − + − ==== Signs and symptoms of bad prognosis ====+ + + + + + + − ==== Treatment of ''rakta gulma'' ====+ + + + + + − + + + + + − + + + + − + + + + + + + + + + + + − + − + + + + + + + − + + + + + + + − + + + + + + + + + + + + + − + + + + + + + + + + − + − ==== Summary ====+ + + + + + + + + + + + + + + + + − + + + + + + + + + − + − + − + − + + + + + + + − + − + − + − + − + − + − + − + − + − + − + − + − + − ==== Contemporary understanding of ''gulma'' ====+ − + − + Line 2,759:
Line 3,315: − + Line 2,767:
Line 3,323: − + − ==== Sites of ''gulma'' ====+ − ===== Table1. Nine divisions of the abdomen, according to Ayurveda and allopathic medicine =====+ Line 2,812:
Line 3,368: − ==== Differential diagnosis of ''gulma'' ====+ − + − + − ==== ''Chikitsa sutra'' (principles of management) of ''gulma'' ====+ − + Line 2,830:
Line 3,386: − ===== Internal Medicines =====+ Line 2,840:
Line 3,396: − + Line 2,856:
Line 3,412: − + Line 2,872:
Line 3,428: − + Line 2,888:
Line 3,444: − + Line 2,906:
Line 3,462: − ===== [[Panchakarma]] =====+ Line 2,916:
Line 3,472: − + Line 2,922:
Line 3,478: − + − | 20-40 ml − | Morning, one time − | Milk − |- − | rowspan="2"| ''Virechana'' − | Castor Oil Line 2,937:
Line 3,487: − + Line 2,943:
Line 3,493: − + Line 2,952:
Line 3,502: − + − + − + − + − #Agni-karma (अग्निकर्म) cauterization + − #Ānāha (आनाह) distension of abdomen + − + − + − + − + − + − #Kṣira-Basti (क्षीरबस्ति) Basti prepared with milk+ − + − #Nicaya Gulma (निचय गुल्म) Tridoṣaja Gulma + − #Sparśāsahaḥ (स्पर्शासहः) tenderness + − #Sthānasaṁsthānarujāṁ vikalpaṁ (स्थानसंस्थानरुजां विकल्पं) frequent change in the site, shape and pain of the lump+ + + − + − #Bhāvaprakāsha: Bhāvaprakāsha . Published by Chaukhamba Sanskrit Series office Banaras. Cikitsa Prakarana − #Charaka: Charaka Samhita, Edited by Yadavaji T. Acharya. Niranaya sagar Press, Bombay. − #Madhava: Madhava Nidana; published by Chaukhamba Samskrit series office, Varanasi, − #Sushruta: Sushruta Samhita. Edited by Yadavaji T. Acharya. Niranaya sagar Press, Bombay. − #Vagbhata Junior: Ashtanga Hridaya with Sarvanga-Sundra commentry by Arunadatta, published by Chaukhamba Samskrit series office, Varanasi, − #Warner E. C. (1964): Savills System of clinical medicine. Orient Longmans Ltd.New Delhi, 14th Edition p.341
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{{CiteButton}}
{{#seo:
|title=Gulma Chikitsa
|titlemode=append
|keywords=Gulma (abdominal lumps), Pathya (whole some), Rakta Mokshana (bloodletting), Apathya (unwholesome), Ayurveda, charak samhita, Indian system of medicine.
|description=Chikitsa Sthana Chapter 5.Management of Gulma(abdominal lumps and other diseases)
|image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg
|image_alt=charak samhita
|type=article
}}
<big>'''[[Chikitsa Sthana]] Chapter 5.Management of Gulma '''</big>
{{Infobox
{{Infobox
|title = Gulma Chikitsa
|title = Gulma Chikitsa
|label5 = Other Sections
|label5 = Other Sections
|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]
|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]
|label6 = Translator and commentator
|header3 =
|data6 = Singh G.
|label7 = Reviewer
|data7 = Bhagwat M., Tripathi J.S., Gadgil D.
|label8 = Editors
|data8 = Baghel M.S., Deole Y.S., Basisht G.
|label9 = Year of publication
|data9 = 2020
|label10 = Publisher
|data10 = [[Charak Samhita Research, Training and Skill Development Centre]]
|label11 = DOI
|data11 = [https://doi.org/10.47468/CSNE.2020.e01.s06.006 10.47468/CSNE.2020.e01.s06.006]
}}
}}
==[[Chikitsa Sthana]] Chapter 5, Chapter on the treatment of ''Gulma'', or Abdominal Lumps ==
<big>'''Abstract'''</big>
<p style="text-align:justify;">''Gulma'' is defined as large palpable, rounded, intra- abdominal swellings between ''hridaya'' (cardiac region) and the ''basti'' (bladder) regions, which develop due to excess accumulation of ''[[dosha]]s'' with predominance of ''[[vata]]''. Such swellings are either transitory or static, and display the properties of spontaneous regression and reappearance. This chapter on the treatment of ''gulma'' (abdominal lumps) first describes its general etiological factors and pathogenesis along with five places in the abdomen where the swelling occurs. The treatment of ''[[vata]] gulma'' includes ''[[snehana]]'' (oleation), ''[[swedana]]'' (sudation), ''[[brimhana]]'' (repletion), ''[[basti]]'' with ''ghee'', ''[[virechana]]'', ''[[vamana]]'' and preparations in the form of powders, pills and medicated ''ghrita'' and as a last resort bloodletting. For the treatment of ''[[pitta]] gulma'', the ''ghrita'' prepared with bitter (''tikta'') drugs, ''[[virechana]]'', recipes for ''niruha [[basti]]'', blood-letting (''[[raktamokshana]]''), use of milk, counseling (''ashvasana'') and oral recipes have been elaborated. ''Upanaha'' (poultice), ''[[shodhana]]'' and surgical measures for suppurated and internally ruptured ''gulma'' have also been described.
<br/>For ''[[kapha]] gulma [[snehana]]'', ''[[swedana]]'', ''bhedana'' (puncturing), ''[[langhana]]'' (lightening therapy), ''[[vamana]]'', ''[[virechana]]'', medicated ''ghee'', ''[[basti]]'', pills, powder, ''arishta'', and ''kshara'' are described. Bloodletting followed by cauterization of the ''gulma'' as a last resort is explained. A surgical procedure for ''[[rakta]] gulma'', which occurs only in women is also described.
<br/>Wholesome (''pathya'') food and drinks, avoidance of etiological factors, continuous protection of digestive power (''agni'') and the instructions for a patient who undergoes ''[[snehana]]'' are discussed in detail.
</p>
'''Keywords''': ''Gulma'' (abdominal lumps), ''Pathya'' (whole some), ''[[Raktamokshana]]'' (bloodletting), ''Apathya'' (unwholesome)
'''Keywords''': ''Gulma'' (abdominal lumps), ''Pathya'' (whole some), ''Rakta Mokshana'' (bloodletting), ''Apathya'' (unwholesome)
== Introduction ==
<div style="text-align:justify;">
The word ''gulma'' stands for an entity that encircles, envelops or covers something. Situations such as panic, stress, or grief, usually associated with chaotic, cataclysmic event would lead to vitiation of ''[[vata]]'' causing the appearance of ''[[vata]]''-dominant diseases like ''gulma'', etc. The vitiated ''[[vata]]'', in conjunction with other ''[[dosha]]s'', gets into the ''mahasrotas'' and get lodged either in the ''amashaya'' (stomach), ''pittashaya'' (gall bladder), ''pakwashaya'' (cecum) or in other regions like ''hridaya'' (epigastric), ''basti'' (bladder) and ''nabhi'' (umblicus) leading to formation of deep-rooted shrub-like mass. As mentioned earlier, ''gulma'' afflicts the gastrointestinal region between the heart and the bladder. Depending upon the region it afflicts, it can be classified into four general types common to males and females: ''[[vata]] gulma'', ''[[pitta]] gulma'', ''[[kapha]] gulma'', and ''sannipatik gulma''.
Since ''gulma'' can occur as complication of ''raktapitta'' (bleeding disorders) Charak describes this chapter after the ''raktapitta'' chapter. ''[[Jwara]]'' is the disease of ''rasavah srotas'' whereas, ''raktapitta'' is a disease of ''raktavah srotas'', in that sequence ''gulma'' is a disease of ''mansavah srotas'' and further ''prameha'' is of ''medavah srotas''. However, this chapter seems to be designed with greater implication and term ''mahasrotasa'' has been used because manifestation of disease is in the viscera/ organs up to uterus. Even then the involvement of ''[[vata dosha]]'' and ''[[mamsa dhatu]]'' is predominant in final manifestation of disease ''gulma''.
It should also be noted that the same pathogenesis route and treatment procedure should be kept in mind for the disease of the ''mahasrotasa'' occurring without the true manifestation of growth/tumor. Hence peptic ulcer and ulcer dyspepsia should be treated like ''[[pitta]] gulma'' etc.
''Gulma'' is defined as a palpable round compact lump in the abdomen. Thus, all the localized palpable masses in the abdomen are classified under ''gulma'', but they are named depending upon the dominance of ''[[dosha]]'' or the place. Its four types belong to ''[[dosha]]'' i.e. three of single ''[[dosha]]'' and one of a combination of all the three ''[[dosha]]'' and the fifth one is ''[[rakta]] gulma'' which occurs only in females in uterine cavity (''garbhashayashroni''). ''Sannipata Gulma'' has been given synonym as ''nichaya-gulma''.
</div>
== Sanskrit text, Transliteration and English Translation ==
=== Management of ''Gulma'' (abdominal lumps) ===
<div class="mw-collapsible mw-collapsed">
अथातो गुल्मचिकित्सितं व्याख्यास्यामः||१||
अथातो गुल्मचिकित्सितं व्याख्यास्यामः||१||
इति ह स्माह भगवानात्रेयः||२||
इति ह स्माह भगवानात्रेयः||२||
<div class="mw-collapsible-content">
athātō gulmacikitsitaṁ vyākhyāsyāmaḥ||1||
athātō gulmacikitsitaṁ vyākhyāsyāmaḥ||1||
iti ha smAha bhagavAnAtreyaH||2||
iti ha smAha bhagavAnAtreyaH||2||
</div></div>
Now we will expound the chapter entitled [[Gulma Chikitsa]] . Thus said Lord Atreya [1-2]
<div style="text-align:justify;">
Now we shall expound the chapter "Gulma Chikitsa" (Management of abdominal lumps and other diseases) . Thus said Lord Atreya. [1-2]
</div>
<div class="mw-collapsible mw-collapsed">
सर्वप्रजानां पितृवच्छरण्यः पुनर्वसुर्भूतभविष्यदीशः|
सर्वप्रजानां पितृवच्छरण्यः पुनर्वसुर्भूतभविष्यदीशः|
चिकित्सितं गुल्मनिबर्हणार्थं प्रोवाच सिद्धं वदतां वरिष्ठः||३||
चिकित्सितं गुल्मनिबर्हणार्थं प्रोवाच सिद्धं वदतां वरिष्ठः||३||
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sarvaprajānāṁ pitr̥vaccharaṇyaḥ punarvasurbhūtabhaviṣyadīśaḥ|
sarvaprajānāṁ pitr̥vaccharaṇyaḥ punarvasurbhūtabhaviṣyadīśaḥ|
cikitsitaM gulmanibarhaNArthaM provAca siddhaM vadatAM variShThaH||3||
cikitsitaM gulmanibarhaNArthaM provAca siddhaM vadatAM variShThaH||3||
</div></div>
<div style="text-align:justify;">
Punarvasu the fatherly figure for all, who has knowledge of past and future, who is the best among the exponents, describes the treatment for the complete eradication of ''gulma'' [3]
Punarvasu the fatherly figure for all, who has knowledge of past and future, who is the best among the exponents, describes the treatment for the complete eradication of ''gulma'' [3]
</div>
=== Etio-pathogenesis of ''gulma'' ===
<div class="mw-collapsible mw-collapsed">
विट्श्लेष्मपित्तातिपरिस्रवाद्वा तैरेव वृद्धैः परिपीडनाद्वा|
विट्श्लेष्मपित्तातिपरिस्रवाद्वा तैरेव वृद्धैः परिपीडनाद्वा|
विचेष्टितैर्वा विषमातिमात्रैः कोष्ठे प्रकोपं समुपैति वायुः||५||
विचेष्टितैर्वा विषमातिमात्रैः कोष्ठे प्रकोपं समुपैति वायुः||५||
<div class="mw-collapsible-content">
viṭślēṣmapittātiparisravādvā tairēva vr̥ddhaiḥ paripīḍanādvā|
viṭślēṣmapittātiparisravādvā tairēva vr̥ddhaiḥ paripīḍanādvā|
viceShTitairvA viShamAtimAtraiH koShThe prakopaM samupaiti vAyuH||5||
viceShTitairvA viShamAtimAtraiH koShThe prakopaM samupaiti vAyuH||5||
</div></div>
<div style="text-align:justify;">
Following are the general causative factors of ''gulma'':
Following are the general causative factors of ''gulma'':
*Excessive excretion of feces, ''kapha'' and ''pitta'' or due to pressure exerted by their excessive aggravation,
*Excessive excretion of feces, ''[[kapha]]'' and ''[[pitta]]'' or due to pressure exerted by their excessive aggravation,
*Suppression of downward natural urges (like feces, flatus and urine),
*Suppression of downward natural urges (like feces, flatus and urine),
*Physical trauma,
*Physical trauma,
*Excessive wrongful body activities,
*Excessive wrongful body activities,
Due to the above mentioned factors ''vata'' gets aggravated in ''koshtha'' i.e. thoraco-abdominal cavity [4-5]
Due to the above mentioned factors ''[[vata]]'' gets aggravated in ''koshtha'' i.e. thoraco-abdominal cavity [4-5]
</div>
=== General Pathogenesis of ''gulma'' ===
<div class="mw-collapsible mw-collapsed">
कफं च पित्तं च स दुष्टवायुरुद्धूय मार्गान् विनिबद्ध्य ताभ्याम्|
कफं च पित्तं च स दुष्टवायुरुद्धूय मार्गान् विनिबद्ध्य ताभ्याम्|
हृन्नाभिपार्श्वोदरबस्तिशूलं करोत्यथो याति न बद्धमार्गः||६||
हृन्नाभिपार्श्वोदरबस्तिशूलं करोत्यथो याति न बद्धमार्गः||६||
<div class="mw-collapsible-content">
kaphaṁ ca pittaṁ ca sa duṣṭavāyuruddhūya mārgān vinibaddhya tābhyām|
kaphaṁ ca pittaṁ ca sa duṣṭavāyuruddhūya mārgān vinibaddhya tābhyām|
hRunnAbhipArshvodarabastishUlaM karotyatho yAti na baddhamArgaH||6||
hRunnAbhipArshvodarabastishUlaM karotyatho yAti na baddhamArgaH||6||
</div></div>
<div style="text-align:justify;">
The provoked ''[[vata]]'' takes out ''[[kapha]]'' and ''[[pitta]]'' from their sites and in turn gets blocked its own passage by them. Thus, blocked ''[[vata]]'' is unable to move properly leading to pain in the regions of heart, umbilicus, both sides of abdomen and urinary bladder [6]
=== Cardinal Signs of ''Gulma'' ===
<div class="mw-collapsible mw-collapsed">
पक्वाशये पित्तकफाशये वा स्थितः स्वतन्त्रः परसंश्रयो वा|
पक्वाशये पित्तकफाशये वा स्थितः स्वतन्त्रः परसंश्रयो वा|
स्पर्शोपलभ्यः परिपिण्डितत्वाद्गुल्मो यथादोषमुपैति नाम||७||
स्पर्शोपलभ्यः परिपिण्डितत्वाद्गुल्मो यथादोषमुपैति नाम||७||
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pakvāśayē pittakaphāśayē vā sthitaḥ sVātantraḥ parasaṁśrayō vā|
pakvāśayē pittakaphāśayē vā sthitaḥ sVātantraḥ parasaṁśrayō vā|
sparshopalabhyaH paripiNDitatvAdgulmo yathAdoShamupaiti nAma||7||
sparshopalabhyaH paripiNDitatvAdgulmo yathAdoShamupaiti nAma||7||
</div></div>
Formation of a palpable mass in colon, gall-bladder or stomach which may be independent or associated with other dosha is known as ''gulma''. It is named according to the ''dosha'' involved. [7]
Formation of a palpable mass in colon, gall-bladder or stomach which may be independent or associated with other dosha is known as ''gulma''. It is named according to the ''[[dosha]]'' involved. [7]
=== Five sites of ''gulma'' ===
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बस्तौ च ना भ्यां हृदि पार्श्वयोर्वा स्थानानि गुल्मस्य भवन्ति पञ्च|
बस्तौ च ना भ्यां हृदि पार्श्वयोर्वा स्थानानि गुल्मस्य भवन्ति पञ्च|
पञ्चात्मकस्य प्रभवं तु तस्य वक्ष्यामि लिङ्गानि चिकित्सितं च||८||
पञ्चात्मकस्य प्रभवं तु तस्य वक्ष्यामि लिङ्गानि चिकित्सितं च||८||
<div class="mw-collapsible-content">
bastau ca nābhyāṁ hr̥di pārśvayōrvā sthānāni gulmasya bhavanti pañca|8|
bastau ca nābhyāṁ hr̥di pārśvayōrvā sthānāni gulmasya bhavanti pañca|8|
pa~jcAtmakasya prabhavaM tu tasya vakShyAmi li~ggAni cikitsitaM ca||8||
pa~jcAtmakasya prabhavaM tu tasya vakShyAmi li~ggAni cikitsitaM ca||8||
</div></div>
Five places of ''gulma'' are urinary bladder (hypogastric region), umbilical region (''nabhi''), cardiac region (''hridi'') and two flanks (''parshva''). Henceforth I will explain the causes, symptoms and the treatment of these five types of ''gulma'' [8]
Five places of ''gulma'' are urinary bladder (hypogastric region), umbilical region (''nabhi''), cardiac region (''hridi'') and two flanks (''parshva''). Henceforth I will explain the causes, symptoms and the treatment of these five types of ''gulma'' [8]
=== Causative factors of ''[[vata]]'' dominant ''gulma'' ===
<div class="mw-collapsible mw-collapsed">
रूक्षान्नपानं विषमातिमात्रं विचेष्टितं वेगविनिग्रहश्च|
रूक्षान्नपानं विषमातिमात्रं विचेष्टितं वेगविनिग्रहश्च|
शोकोऽभिघातोऽतिमलक्षयश्च निरन्नता चानिलगुल्महेतुः||९||
शोकोऽभिघातोऽतिमलक्षयश्च निरन्नता चानिलगुल्महेतुः||९||
<div class="mw-collapsible-content">
rūkṣānnapānaṁ viṣamātimātraṁ vicēṣṭitaṁ vēgavinigrahaśca|
rūkṣānnapānaṁ viṣamātimātraṁ vicēṣṭitaṁ vēgavinigrahaśca|
shoko~abhighAto~atimalakShayashca nirannatA cAnilagulmahetuH||9||
shoko~abhighAto~atimalakShayashca nirannatA cAnilagulmahetuH||9||
</div></div>
Excessive use of dry articles of food and drinks, excessive or wrong body activities, suppression of natural urges, excessive grief, too-much diminution of feces, trauma and excessive fasting are the causes of ''vata-gulma'' [9]
Excessive use of dry articles of food and drinks, excessive or wrong body activities, suppression of natural urges, excessive grief, too-much diminution of feces, trauma and excessive fasting are the causes of ''[[vata]]-gulma'' [9]
=== Symptoms of ''[[vata]] gulma'' ===
<div class="mw-collapsible mw-collapsed">
यः स्थानसंस्थानरुजां विकल्पं विड्वातसङ्गं गलवक्त्रशोषम्|
यः स्थानसंस्थानरुजां विकल्पं विड्वातसङ्गं गलवक्त्रशोषम्|
वातात् स गुल्मो न च तत्र रूक्षं कषायतिक्तं कटु चोपशेते||११||
वातात् स गुल्मो न च तत्र रूक्षं कषायतिक्तं कटु चोपशेते||११||
<div class="mw-collapsible-content">
yaḥ sthānasaṁsthānarujāṁ vikalpaṁ viḍvātasaṅgaṁ galavaktraśōṣam|
yaḥ sthānasaṁsthānarujāṁ vikalpaṁ viḍvātasaṅgaṁ galavaktraśōṣam|
vAtAt sa gulmo na ca tatra rUkShaM kaShAyatiktaM kaTu copashete||11||
vAtAt sa gulmo na ca tatra rUkShaM kaShAyatiktaM kaTu copashete||11||
</div></div>
Frequent change in the site, shape and pain of the lump along with obstruction of feces and flatus, dryness in throat and mouth, dusky-red color 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]
Frequent change in the site, shape and pain of the lump along with obstruction of feces and flatus, dryness in throat and mouth, dusky-red color 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]
=== Causative factors and pathogenesis of ''[[pitta]]'' dominant ''gulma'' ===
<div class="mw-collapsible mw-collapsed">
कट्वम्लतीक्ष्णोष्णविदाहिरूक्षक्रोधातिमद्यार्कहुताशसेवा|
कट्वम्लतीक्ष्णोष्णविदाहिरूक्षक्रोधातिमद्यार्कहुताशसेवा|
आमाभिघातो रुधिरं च दुष्टं पैत्तस्य गुल्मस्य निमित्तमुक्तम्||१२||
आमाभिघातो रुधिरं च दुष्टं पैत्तस्य गुल्मस्य निमित्तमुक्तम्||१२||
<div class="mw-collapsible-content">
kaṭvamlatīkṣṇōṣṇavidāhirūkṣakrōdhātimadyārkahutāśasēvā|
kaṭvamlatīkṣṇōṣṇavidāhirūkṣakrōdhātimadyārkahutāśasēvā|
AmAbhighAto [2] rudhiraM ca duShTaM paittasya gulmasya nimittamuktam||12||
AmAbhighAto [2] rudhiraM ca duShTaM paittasya gulmasya nimittamuktam||12||
</div></div>
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]
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]
=== Symptoms of ''[[pitta]]-gulma'' ===
<div class="mw-collapsible mw-collapsed">
ज्वरः पिपासा वदनाङ्गरागः शूलं महज्जीर्यति भोजने च|
ज्वरः पिपासा वदनाङ्गरागः शूलं महज्जीर्यति भोजने च|
स्वेदो विदाहो व्रणवच्च गुल्मः स्पर्शासहः पैत्तिकगुल्मरूपम्||१३||
स्वेदो विदाहो व्रणवच्च गुल्मः स्पर्शासहः पैत्तिकगुल्मरूपम्||१३||
<div class="mw-collapsible-content">
jvaraḥ pipāsā vadanāṅgarāgaḥ śūlaṁ mahajjīryati bhōjanē ca|
jvaraḥ pipāsā vadanāṅgarāgaḥ śūlaṁ mahajjīryati bhōjanē ca|
svedo vidAho vraNavacca gulmaH sparshAsahaH paittikagulmarUpam||13||
svedo vidAho vraNavacca gulmaH sparshAsahaH paittikagulmarUpam||13||
</div></div>
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]
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]
=== Causative factors of ''[[kapha]]-gulma'' and ''nichaya-gulma'' ===
<div class="mw-collapsible mw-collapsed">
शीतं गुरु स्निग्धमचेष्टनं च सम्पूरणं प्रस्वपनं दिवा च|
शीतं गुरु स्निग्धमचेष्टनं च सम्पूरणं प्रस्वपनं दिवा च|
गुल्मस्य हेतुः कफसम्भवस्य सर्वस्तु दिष्टो निचयात्मकस्य||१४||
गुल्मस्य हेतुः कफसम्भवस्य सर्वस्तु दिष्टो निचयात्मकस्य||१४||
<div class="mw-collapsible-content">
śītaṁ guru snigdhamacēṣṭanaṁ ca sampūraṇaṁ prasvapanaṁ divā ca|
śītaṁ guru snigdhamacēṣṭanaṁ ca sampūraṇaṁ prasvapanaṁ divā ca|
gulmasya hetuH kaphasambhavasya sarvastu diShTo nicayAtmakasya||14||
gulmasya hetuH kaphasambhavasya sarvastu diShTo nicayAtmakasya||14||
</div></div>
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''.
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''.
All the causative factors mentioned for all the above three types of ''dosha gulma'' are also of ''nichaya'' (''tridosha'')-''gulma'' [14]
All the causative factors mentioned for all the above three types of ''[[dosha]] gulma'' are also of ''nichaya'' (''tridosha'')-''gulma'' [14]
=== Symptoms of ''[[kapha]]'' dominant ''gulma'' ===
<div class="mw-collapsible mw-collapsed">
स्तैमित्यशीतज्वरगात्रसादहृल्लासकासारुचिगौरवाणि|
स्तैमित्यशीतज्वरगात्रसादहृल्लासकासारुचिगौरवाणि|
शैत्यं रुगल्पा कठिनोन्नतत्वं गुल्मस्य रूपाणि कफात्मकस्य||१५||
शैत्यं रुगल्पा कठिनोन्नतत्वं गुल्मस्य रूपाणि कफात्मकस्य||१५||
<div class="mw-collapsible-content">
staimityaśītajvaragātrasādahr̥llāsakāsārucigauravāṇi|
staimityaśītajvaragātrasādahr̥llāsakāsārucigauravāṇi|
shaityaM rugalpA kaThinonnatatvaM gulmasya rUpANi kaphAtmakasya||15||
shaityaM rugalpA kaThinonnatatvaM gulmasya rUpANi kaphAtmakasya||15||
</div></div>
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]
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]
=== ''Dvi-doshaja gulma'' ===
<div class="mw-collapsible mw-collapsed">
निमित्तलिङ्गान्युपलभ्य गुल्मे द्विदोषजे दोषबलाबलं च|
निमित्तलिङ्गान्युपलभ्य गुल्मे द्विदोषजे दोषबलाबलं च|
व्यामिश्रलिङ्गानपरांस्तु गुल्मांस्त्रीनादिशेदौषधकल्पनार्थम्||१६||
व्यामिश्रलिङ्गानपरांस्तु गुल्मांस्त्रीनादिशेदौषधकल्पनार्थम्||१६||
<div class="mw-collapsible-content">
nimittaliṅgānyupalabhya gulmē dvidōṣajē dōṣabalābalaṁ ca|
nimittaliṅgānyupalabhya gulmē dvidōṣajē dōṣabalābalaṁ ca|
vyAmishrali~ggAnaparAMstu gulmAMstrInAdishedauShadhakalpanArtham||16||
vyAmishrali~ggAnaparAMstu gulmAMstrInAdishedauShadhakalpanArtham||16||
</div></div>
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]
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]
=== Signs and symptoms of ''tri-doshaja gulma'' ===
<div class="mw-collapsible mw-collapsed">
महारुजं दाहपरीतमश्मवद्घनोन्नतं शीघ्रविदाहि दारुणम्|
महारुजं दाहपरीतमश्मवद्घनोन्नतं शीघ्रविदाहि दारुणम्|
मनःशरीराग्निबलापहारिणं त्रिदोषजं गुल्ममसाध्यमादिशेत्||१७||
मनःशरीराग्निबलापहारिणं त्रिदोषजं गुल्ममसाध्यमादिशेत्||१७||
<div class="mw-collapsible-content">
mahārujaṁ dāhaparītamaśmavadghanōnnataṁ śīghravidāhi dāruṇam|
mahārujaṁ dāhaparītamaśmavadghanōnnataṁ śīghravidāhi dāruṇam|
manaHsharIrAgnibalApahAriNaM tridoShajaM gulmamasAdhyamAdishet||17||
manaHsharIrAgnibalApahAriNaM tridoShajaM gulmamasAdhyamAdishet||17||
</div></div>
The symptoms of ''tri-dosha gulma'' include 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]
The symptoms of ''tri-[[dosha]] gulma'' include 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]
=== Causative factors of ''[[rakta]] gulma'' ===
<div class="mw-collapsible mw-collapsed">
ऋतावनाहारतया भयेन विरूक्षणैर्वेगविनिग्रहैश्च|
ऋतावनाहारतया भयेन विरूक्षणैर्वेगविनिग्रहैश्च|
संस्तम्भनोल्लेखनयोनिदोषैर्गुल्मः स्त्रियं रक्तभवोऽभ्युपैति||१८||
संस्तम्भनोल्लेखनयोनिदोषैर्गुल्मः स्त्रियं रक्तभवोऽभ्युपैति||१८||
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r̥tāvanāhāratayā bhayēna virūkṣaṇairvēgavinigrahaiśca|
r̥tāvanāhāratayā bhayēna virūkṣaṇairvēgavinigrahaiśca|
saMstambhanollekhanayonidoShairgulmaH striyaM raktabhavo~abhyupaiti||18||
saMstambhanollekhanayonidoShairgulmaH striyaM raktabhavo~abhyupaiti||18||
</div></div>
During ''ritu-kala'' (ovulation period) if a woman does fasting or takes dry food articles or indulges in fear and suppression of natural urges; or misuses styptic (''stambhana'') drugs i.e. try to stop the menstrual bleeding; improper conduction of vomiting therapy and disorders of genital organs, all these may lead to formation of ''rakta gulma'' in women [18]
During ''ritu-kala'' (ovulation period) if a woman does fasting or takes dry food articles or indulges in fear and suppression of natural urges; or misuses styptic (''[[stambhana]]'') drugs i.e. try to stop the menstrual bleeding; improper conduction of vomiting therapy and disorders of genital organs, all these may lead to formation of ''[[rakta]] gulma'' in women [18]
=== Symptoms of ''[[rakta]] gulma'' ===
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यः स्पन्दते पिण्डित एव नाङ्गैश्चिरात् सशूलः समगर्भलिङ्गः|
यः स्पन्दते पिण्डित एव नाङ्गैश्चिरात् सशूलः समगर्भलिङ्गः|
स रौधिरः स्त्रीभव एव गुल्मो मासे व्यतीते दशमे चिकित्स्यः||१९||
स रौधिरः स्त्रीभव एव गुल्मो मासे व्यतीते दशमे चिकित्स्यः||१९||
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yaḥ spandatē piṇḍita ēva nāṅgaiścirāt saśūlaḥ samagarbhaliṅgaḥ|
yaḥ spandatē piṇḍita ēva nāṅgaiścirāt saśūlaḥ samagarbhaliṅgaḥ|
sa raudhiraH strIbhava eva gulmo mAse vyatIte dashame cikitsyaH||19||
sa raudhiraH strIbhava eva gulmo mAse vyatIte dashame cikitsyaH||19||
</div></div>
The lump slowly grows in the form of round mass which has pulsation as a whole but not in its part. It is associated with acute pain and signs and symptoms mimicking pregnancy. ''Raktaja gulma'' occurs only in women and should be treated after the completion of ten months [19]
The lump slowly grows in the form of round mass which has pulsation as a whole but not in its part. It is associated with acute pain and signs and symptoms mimicking pregnancy. ''Raktaja gulma'' occurs only in women and should be treated after the completion of ten months [19]
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क्रियाक्रममतः सिद्धं गुल्मिनां गुल्मनाशनम्|
क्रियाक्रममतः सिद्धं गुल्मिनां गुल्मनाशनम्|
प्रवक्ष्याम्यत ऊर्ध्वं च योगान् गुल्मनिबर्हणान्||२०||
प्रवक्ष्याम्यत ऊर्ध्वं च योगान् गुल्मनिबर्हणान्||२०||
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kriyākramamataḥ siddhaṁ gulmināṁ gulmanāśanam|
kriyākramamataḥ siddhaṁ gulmināṁ gulmanāśanam|
pravakShyAmyata UrdhvaM ca yogAn gulmanibarhaNAn||20||
pravakShyAmyata UrdhvaM ca yogAn gulmanibarhaNAn||20||
</div></div>
Now onward first the successful line of treatment shall be described for the cure of ''gulma''. Thereafter, the remedies and recipes for its cure shall be described [20]
Now onward first the successful line of treatment shall be described for the cure of ''gulma''. Thereafter, the remedies and recipes for its cure shall be described [20]
=== Treatment of ''[[vata]]-gulma'' ===
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रूक्षव्यायामजं गुल्मं वातिकं तीव्रवेदनम्|
रूक्षव्यायामजं गुल्मं वातिकं तीव्रवेदनम्|
बद्धविण्मारुतं स्नेहैरादितः समुपाचरेत्||२१||
बद्धविण्मारुतं स्नेहैरादितः समुपाचरेत्||२१||
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rūkṣavyāyāmajaṁ gulmaṁ vātikaṁ tīvravēdanam|
rūkṣavyāyāmajaṁ gulmaṁ vātikaṁ tīvravēdanam|
baddhaviNmArutaM snehairAditaH samupAcaret||21||
baddhaviNmArutaM snehairAditaH samupAcaret||21||
</div></div>
As ''vata gulma'' is produced due to excessive dryness and exercise and is associated with severe pain and retention of feces and flatus, therefore in the beginning ''snehana'' (unctuous) therapy should be prescribed [21]
As ''[[vata]] gulma'' is produced due to excessive dryness and exercise and is associated with severe pain and retention of feces and flatus, therefore in the beginning ''[[snehana]]'' (unctuous) therapy should be prescribed [21]
=== ''[[Snehana]]'' for ''[[vata]]-gulma'' ===
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भोजनाभ्यञ्जनैः पानैर्निरूहैः सानुवासनैः|
भोजनाभ्यञ्जनैः पानैर्निरूहैः सानुवासनैः|
स्निग्धस्य भिषजा स्वेदः कर्तव्यो गुल्मशान्तये||२२||
स्निग्धस्य भिषजा स्वेदः कर्तव्यो गुल्मशान्तये||२२||
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bhōjanābhyañjanaiḥ pānairnirūhaiḥ sānuvāsanaiḥ|
bhōjanābhyañjanaiḥ pānairnirūhaiḥ sānuvāsanaiḥ|
snigdhasya bhiShajA svedaH kartavyo gulmashAntaye||22||
snigdhasya bhiShajA svedaH kartavyo gulmashAntaye||22||
</div></div>
''Snehana'' is performed by administration of unctuous substances in the form of food and drink, oil massage and ''anuvasana basti'' along with ''niruha basti''. After proper ''snehana'', physician should subject the patient to ''swedana'' therapy [22]
''[[Snehana]]'' is performed by administration of unctuous substances in the form of food and drink, oil massage and ''anuvasana [[basti]]'' along with ''niruha [[basti]]''. After proper ''[[snehana]]'', physician should subject the patient to ''[[swedana]]'' therapy [22]
=== Benefit of ''[[swedana]]'' therapy for ''[[vata]]-gulma'' ===
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स्रोतसां मार्दवं कृत्वा जित्वा मारुतमुल्बणम्|
स्रोतसां मार्दवं कृत्वा जित्वा मारुतमुल्बणम्|
भित्त्वा विबन्धं स्निग्धस्य स्वेदो गुल्ममपोहति||२३||
भित्त्वा विबन्धं स्निग्धस्य स्वेदो गुल्ममपोहति||२३||
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srōtasāṁ mārdavaṁ kr̥tvā jitvā mārutamulbaṇam|
srōtasāṁ mārdavaṁ kr̥tvā jitvā mārutamulbaṇam|
bhittvA vibandhaM snigdhasya svedo gulmamapohati||23||
bhittvA vibandhaM snigdhasya svedo gulmamapohati||23||
</div></div>
''Swedana'' therapy administered to a patient who has already undergone oil massage produces softness in the channels leading to alleviation of ''vata''. Thus by breaking the obstruction and opening the channels the ''vata-gulma'' is cured [23]
''[[Swedana]]'' therapy administered to a patient who has already undergone oil massage produces softness in the channels leading to alleviation of ''[[vata]]''. Thus by breaking the obstruction and opening the channels the ''[[vata]]-gulma'' is cured [23]
=== Mode of Administration of ''sneha'' according to sites of ''[[vata]] gulma'' ===
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स्नेहपानं हितं गुल्मे विशेषेणोर्ध्वनाभिजे|
स्नेहपानं हितं गुल्मे विशेषेणोर्ध्वनाभिजे|
पक्वाशयगते बस्तिरुभयं जठराश्रये||२४||
पक्वाशयगते बस्तिरुभयं जठराश्रये||२४||
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snēhapānaṁ hitaṁ gulmē viśēṣēṇōrdhvanābhijē|
snēhapānaṁ hitaṁ gulmē viśēṣēṇōrdhvanābhijē|
pakvAshayagate bastirubhayaM jaTharAshraye||24||
pakvAshayagate bastirubhayaM jaTharAshraye||24||
</div></div>
Oral administration of unctuous substances is beneficial in ''vata gulma'' particularly if it is situated above the umbilicus i.e. in stomach. ''Anuvasana'' (unctuous) ''basti'' is beneficial if ''gulma'' is situated in colon and both oral administration of unctuous substances and unctuous ''basti'' are beneficial if it is situated in the middle of ''jathara'' i.e. in small intestine [24]
Oral administration of unctuous substances is beneficial in ''[[vata]] gulma'' particularly if it is situated above the umbilicus i.e. in stomach. ''Anuvasana'' (unctuous) ''[[basti]]'' is beneficial if ''gulma'' is situated in colon and both oral administration of unctuous substances and unctuous ''[[basti]]'' are beneficial if it is situated in the middle of ''jathara'' i.e. in small intestine [24]
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दीप्तेऽग्नौ वातिके गुल्मे विबन्धेऽनिलवर्चसोः|
दीप्तेऽग्नौ वातिके गुल्मे विबन्धेऽनिलवर्चसोः|
बृंहणान्यन्नपानानि स्निग्धोष्णानि प्रयोजयेत्||२५||
बृंहणान्यन्नपानानि स्निग्धोष्णानि प्रयोजयेत्||२५||
<div class="mw-collapsible-content">
dīptē'gnau vātikē gulmē vibandhē'nilavarcasōḥ|
dīptē'gnau vātikē gulmē vibandhē'nilavarcasōḥ|
bRuMhaNAnyannapAnAni snigdhoShNAni prayojayet||25||
bRuMhaNAnyannapAnAni snigdhoShNAni prayojayet||25||
</div></div>
In ''vata gulma'' if the retention of feces and flatus is present but digestion is good then unctuous, hot and nourishing (''brimhana'') diet and drinks should be given [25]
In ''[[vata]] gulma'' if the retention of feces and flatus is present but digestion is good then unctuous, hot and nourishing (''[[brimhana]]'') diet and drinks should be given [25]
=== Repeated ''[[basti]]'' in ''[[vata]] gulma'' ===
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पुनः पुनः स्नेहपानं निरूहाः सानुवासनाः|
पुनः पुनः स्नेहपानं निरूहाः सानुवासनाः|
प्रयोज्या वातगुल्मेषु कफपित्तानुरक्षिणा||२६||
प्रयोज्या वातगुल्मेषु कफपित्तानुरक्षिणा||२६||
<div class="mw-collapsible-content">
punaḥ punaḥ snēhapānaṁ nirūhāḥ sānuvāsanāḥ|
punaḥ punaḥ snēhapānaṁ nirūhāḥ sānuvāsanāḥ|
prayojyA vAtagulmeShu kaphapittAnurakShiNA||26||
prayojyA vAtagulmeShu kaphapittAnurakShiNA||26||
</div></div>
In ''vata gulma'' repeated use of unctuous drink and alternative use of ''anuvasana'' (unctuous) and ''niruha'' (un-unctuous) ''basti'' are advised in taking care of ''kapha'' and ''pitta'' [26]
In ''[[vata]] gulma'' repeated use of unctuous drink and alternative use of ''anuvasana'' (unctuous) and ''niruha'' (un-unctuous) ''[[basti]]'' are advised in taking care of ''[[kapha]]'' and ''[[pitta]]'' [26]
<div class="mw-collapsible mw-collapsed">
कफो वाते जितप्राये पित्तं शोणितमेव वा|
कफो वाते जितप्राये पित्तं शोणितमेव वा|
आदावन्ते च मध्ये च मारुतं परिरक्षता||२८||
आदावन्ते च मध्ये च मारुतं परिरक्षता||२८||
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kaphō vātē jitaprāyē pittaṁ śōṇitamēva vā|
kaphō vātē jitaprāyē pittaṁ śōṇitamēva vā|
AdAvante ca madhye ca mArutaM parirakShatA||28||
AdAvante ca madhye ca mArutaM parirakShatA||28||
</div></div>
During the treatment when ''vata'' has almost subsided but ''kapha, pitta'' or ''rakta'' gets provoked, then routine treatment of these provoked ''dosha'' should be done. In this condition, the treatment should be according to the predominance of ''dosha'' but care should be taken to protect ''vata'' in the beginning, middle and at the end of the treatment [27-28]
During the treatment when ''[[vata]]'' has almost subsided but ''[[kapha]], [[pitta]]'' or ''[[rakta]]'' gets provoked, then routine treatment of these provoked ''[[dosha]]'' should be done. In this condition, the treatment should be according to the predominance of ''[[dosha]]'' but care should be taken to protect ''[[vata]]'' in the beginning, middle and at the end of the treatment [27-28]
=== ''[[Vamana]]'' in ''[[vata]] gulma'' ===
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वातगुल्मे कफो वृद्धो हत्वाऽग्निमरुचिं यदि|
वातगुल्मे कफो वृद्धो हत्वाऽग्निमरुचिं यदि|
हृल्लासं गौरवं तन्द्रां जनयेदुल्लिखेत्तु तम्||२९||
हृल्लासं गौरवं तन्द्रां जनयेदुल्लिखेत्तु तम्||२९||
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vātagulmē kaphō vr̥ddhō hatvā'gnimaruciṁ yadi|
vātagulmē kaphō vr̥ddhō hatvā'gnimaruciṁ yadi|
hRullAsaM gauravaM tandrAM janayedullikhettu tam||29||
hRullAsaM gauravaM tandrAM janayedullikhettu tam||29||
</div></div>
In ''vata gulma'' if ''kapha'' gets increased, it causes diminution in digestion leading to anorexia, nausea, heaviness and sleepiness; such condition should be treated with ''vamana'' therapy [29]
In ''[[vata]] gulma'' if ''[[kapha]]'' gets increased, it causes diminution in digestion leading to anorexia, nausea, heaviness and sleepiness; such condition should be treated with ''[[vamana]]'' therapy [29]
<div class="mw-collapsible mw-collapsed">
शूलानाहविबन्धेषु गुल्मे वातकफोल्बणे|
शूलानाहविबन्धेषु गुल्मे वातकफोल्बणे|
वर्तयो गुटिकाश्चूर्णं कफवातहरं हितम्||३०||
वर्तयो गुटिकाश्चूर्णं कफवातहरं हितम्||३०||
<div class="mw-collapsible-content">
śūlānāhavibandhēṣu gulmē vātakaphōlbaṇē|
śūlānāhavibandhēṣu gulmē vātakaphōlbaṇē|
vartayo guTikAshcUrNaM kaphavAtaharaM hitam||30||
vartayo guTikAshcUrNaM kaphavAtaharaM hitam||30||
</div></div>
In ''vata-kapha'' dominant ''gulma'' if there is acute pain, distension of abdomen and constipation then it should be treated with suppositories, pills and powders which are prepared from ''vata'' and ''kapha'' pacifying drugs [30]
In ''[[vata]]-[[kapha]]'' dominant ''gulma'' if there is acute pain, distension of abdomen and constipation then it should be treated with suppositories, pills and powders which are prepared from ''[[vata]]'' and ''[[kapha]]'' pacifying drugs [30]
=== ''[[Virechana]]'' in ''[[vata]] gulma'' ===
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पित्तं वा यदि संवृद्धं सन्तापं वातगुल्मिनः|
पित्तं वा यदि संवृद्धं सन्तापं वातगुल्मिनः|
कुर्याद्विरेच्यः स भवेत् सस्नेहैरानुलोमिकैः||३१||
कुर्याद्विरेच्यः स भवेत् सस्नेहैरानुलोमिकैः||३१||
<div class="mw-collapsible-content">
pittaṁ vā yadi saṁvr̥ddhaṁ santāpaṁ vātagulminaḥ|
pittaṁ vā yadi saṁvr̥ddhaṁ santāpaṁ vātagulminaḥ|
kuryAdvirecyaH sa bhavet sasnehairAnulomikaiH||31||
kuryAdvirecyaH sa bhavet sasnehairAnulomikaiH||31||
</div></div>
In ''vata gulma'' if increased ''pitta'' causes burning sensation then ''virechana'' should be done with laxative drugs mixed with unctuous substances [31]
In ''[[vata]] gulma'' if increased ''[[pitta]]'' causes burning sensation then ''[[virechana]]'' should be done with laxative drugs mixed with unctuous substances [31]
=== Blood-letting in ''[[vata]] gulma''===
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गुल्मो यद्यनिलादीनां कृते सम्यग्भिषग्जिते|
गुल्मो यद्यनिलादीनां कृते सम्यग्भिषग्जिते|
न प्रशाम्यति रक्तस्य सोऽवसेकात् प्रशाम्यति||३२||
न प्रशाम्यति रक्तस्य सोऽवसेकात् प्रशाम्यति||३२||
<div class="mw-collapsible-content">
gulmō yadyanilādīnāṁ kr̥tē samyagbhiṣagjitē|
gulmō yadyanilādīnāṁ kr̥tē samyagbhiṣagjitē|
na prashAmyati raktasya so~avasekAt prashAmyati||32||
na prashAmyati raktasya so~avasekAt prashAmyati||32||
</div></div>
If ''gulma'' does not subside even after proper treatment of ''vata'' etc. mentioned above then bloodletting is advised to cure it [32]
If ''gulma'' does not subside even after proper treatment of ''[[vata]]'' etc. mentioned above then bloodletting is advised to cure it [32]
=== Treatment of ''[[pitta]]'' dominant ''gulma'' ===
<div class="mw-collapsible mw-collapsed">
स्निग्धोष्णेनोदिते गुल्मे पैत्तिके स्रंसनं हितम्|
स्निग्धोष्णेनोदिते गुल्मे पैत्तिके स्रंसनं हितम्|
रूक्षोष्णेन तु सम्भूते सर्पिः प्रशमनं परम्||३३||
रूक्षोष्णेन तु सम्भूते सर्पिः प्रशमनं परम्||३३||
<div class="mw-collapsible-content">
snigdhōṣṇēnōditē gulmē paittikē sraṁsanaṁ hitam|
snigdhōṣṇēnōditē gulmē paittikē sraṁsanaṁ hitam|
rUkShoShNena tu sambhUte sarpiH prashamanaM param||33||
rUkShoShNena tu sambhUte sarpiH prashamanaM param||33||
</div></div>
If ''pitta gulma'' is caused by indulging in unctuous and hot substances then ''virechana'' is beneficial. But if it is caused by indulging in dry and hot substances then ghee is a choice of drug [33]
If ''[[pitta]] gulma'' is caused by indulging in unctuous and hot substances then ''[[virechana]]'' is beneficial. But if it is caused by indulging in dry and hot substances then ghee is a choice of drug [33]
<div class="mw-collapsible mw-collapsed">
पित्तं वा पित्तगुल्मं वा ज्ञात्वा पक्वाशयस्थितम्|
पित्तं वा पित्तगुल्मं वा ज्ञात्वा पक्वाशयस्थितम्|
भिषगग्निबलापेक्षी सर्पिषा तैल्वकेन वा||३५||
भिषगग्निबलापेक्षी सर्पिषा तैल्वकेन वा||३५||
<div class="mw-collapsible-content">
pittaṁ vā pittagulmaṁ vā jñātvā pakvāśayasthitam|
pittaṁ vā pittagulmaṁ vā jñātvā pakvāśayasthitam|
bhiShagagnibalApekShI sarpiShA tailvakena vA||35||
bhiShagagnibalApekShI sarpiShA tailvakena vA||35||
</div></div>
If ''pitta'' or ''pitta-gulma'' is situated in colon, the physician expert in proper and timely treatment should eliminate it by giving ''kshira-basti'' mixed with bitter drugs immediately. The physician aiming to increase the digestive power should perform ''virechana'' with milk mixed with bitter drugs or with ''tilvaka ghrita'' [34-35]
If ''[[pitta]]'' or ''[[pitta]]-gulma'' is situated in colon, the physician expert in proper and timely treatment should eliminate it by giving ''kshira-[[basti]]'' mixed with bitter drugs immediately. The physician aiming to increase the digestive power should perform ''[[virechana]]'' with milk mixed with bitter drugs or with ''tilvaka ghrita'' [34-35]
=== Blood-letting in ''[[pitta]]'' dominant ''gulma'' ===
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तृष्णाज्वरपरीदाहशूलस्वेदाग्निमार्दवे|
तृष्णाज्वरपरीदाहशूलस्वेदाग्निमार्दवे|
गुल्मिनामरुचौ चापि रक्तमेवावसेचयेत्||३६||
गुल्मिनामरुचौ चापि रक्तमेवावसेचयेत्||३६||
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tr̥ṣṇājvaraparīdāhaśūlasvēdāgnimārdavē|
tr̥ṣṇājvaraparīdāhaśūlasvēdāgnimārdavē|
gulminAmarucau cApi raktamevAvasecayet||36||
gulminAmarucau cApi raktamevAvasecayet||36||
</div></div>
The patient of ''pitta-gulma'' if having thirst, fever, burning sensation, pain, perspiration, impaired digestion and anorexia is treated with bloodletting [36]
The patient of ''[[pitta]]-gulma'' if having thirst, fever, burning sensation, pain, perspiration, impaired digestion and anorexia is treated with bloodletting [36]
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छिन्नमूला विदह्यन्ते न गुल्मा यान्ति च क्षयम्|
छिन्नमूला विदह्यन्ते न गुल्मा यान्ति च क्षयम्|
रक्तं हि व्यम्लतां याति, तच्च नास्ति न चास्ति रुक्||३७||
रक्तं हि व्यम्लतां याति, तच्च नास्ति न चास्ति रुक्||३७||
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chinnamūlā vidahyantē na gulmā yānti ca kṣayam|
chinnamūlā vidahyantē na gulmā yānti ca kṣayam|
raktaM hi vyamlatAM yAti, tacca nAsti na cAsti ruk||37||
raktaM hi vyamlatAM yAti, tacca nAsti na cAsti ruk||37||
</div></div>
Provoked ''rakta'' is responsible for inflammation (''vidaha'') which is removed by bloodletting; thus when root-cause is removed then there will be no inflammation resulting in vanishing of swelling and pain [37]
Provoked ''[[rakta]]'' is responsible for inflammation (''vidaha'') which is removed by bloodletting; thus when root-cause is removed then there will be no inflammation resulting in vanishing of swelling and pain [37]
=== Diet after blood-letting ===
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हृतदोषं परिम्लानं जाङ्गलैस्तर्पितं रसैः|
हृतदोषं परिम्लानं जाङ्गलैस्तर्पितं रसैः|
समाश्वस्तं सशेषार्तिं सर्पिरभ्यासयेत् पुनः||३८||
समाश्वस्तं सशेषार्तिं सर्पिरभ्यासयेत् पुनः||३८||
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hr̥tadōṣaṁ parimlānaṁ jāṅgalaistarpitaṁ rasaiḥ|
hr̥tadōṣaṁ parimlānaṁ jāṅgalaistarpitaṁ rasaiḥ|
samAshvastaM sasheShArtiM sarpirabhyAsayet punaH||38||
samAshvastaM sasheShArtiM sarpirabhyAsayet punaH||38||
</div></div>
The patient may become weak due to elimination of vitiated blood; hence he should be nourished by the diet comprising of meat soup of wild animals and comforted. To pacify the remaining complaints, he should be prescribed the medicated ghee again [38]
The patient may become weak due to elimination of vitiated blood; hence he should be nourished by the diet comprising of meat soup of wild animals and comforted. To pacify the remaining complaints, he should be prescribed the medicated ghee again [38]
<div class="mw-collapsible mw-collapsed">
रक्तपित्तातिवृद्धत्वात् क्रियामनुपलभ्य च|
रक्तपित्तातिवृद्धत्वात् क्रियामनुपलभ्य च|
यदि गुल्मो विदह्येत शस्त्रं तत्र भिषग्जितम्||३९||
यदि गुल्मो विदह्येत शस्त्रं तत्र भिषग्जितम्||३९||
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raktapittātivr̥ddhatvāt kriyāmanupalabhya ca|
raktapittātivr̥ddhatvāt kriyāmanupalabhya ca|
yadi gulmo vidahyeta shastraM tatra bhiShagjitam||39||
yadi gulmo vidahyeta shastraM tatra bhiShagjitam||39||
</div></div>
In case of excessive increase of ''pitta'' and ''rakta'' or due to unavailability of proper treatment, if suppuration occurs then surgery should be performed by the surgeon [39]
In case of excessive increase of ''[[pitta]]'' and ''[[rakta]]'' or due to unavailability of proper treatment, if suppuration occurs then surgery should be performed by the surgeon [39]
=== ''Apakva gulma'' (intial non-suppurative stage) ===
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गुरुः कठिनसंस्थानो गूढमांसान्तराश्रयः|
गुरुः कठिनसंस्थानो गूढमांसान्तराश्रयः|
अविवर्णः स्थिरश्चैव ह्यपक्वो गुल्म उच्यते||४०||
अविवर्णः स्थिरश्चैव ह्यपक्वो गुल्म उच्यते||४०||
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guruḥ kaṭhinasaṁsthānō gūḍhamāṁsāntarāśrayaḥ|
guruḥ kaṭhinasaṁsthānō gūḍhamāṁsāntarāśrayaḥ|
avivarNaH sthirashcaiva hyapakvo gulma ucyate||40||
avivarNaH sthirashcaiva hyapakvo gulma ucyate||40||
</div></div>
Immovable lump of ''gulma'' which is deeply situated under the flesh and hard and heavy to palpate and whose color remains unchanged is considered as ''apakva'' i.e. non-suppurative [40]
Immovable lump of ''gulma'' which is deeply situated under the flesh and hard and heavy to palpate and whose color remains unchanged is considered as ''apakva'' i.e. non-suppurative [40]
=== Symptoms of suppurating (''vidahamana'') ''gulma'' ===
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दाहशूलार्तिसङ्क्षोभस्वप्ननाशारतिज्वरैः|
दाहशूलार्तिसङ्क्षोभस्वप्ननाशारतिज्वरैः|
विदह्यमानं जानीयाद्गुल्मं तमुपनाहयेत्||४१||
विदह्यमानं जानीयाद्गुल्मं तमुपनाहयेत्||४१||
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dāhaśūlārtisaṅkṣōbhasvapnanāśāratijvaraiḥ|
dāhaśūlārtisaṅkṣōbhasvapnanāśāratijvaraiḥ|
vidahyamAnaM jAnIyAdgulmaM tamupanAhayet||41||
vidahyamAnaM jAnIyAdgulmaM tamupanAhayet||41||
</div></div>
The ''gulma'' with symptoms of burning sensation, much pain, very much irritation and discomfort, loss of sleep and fever indicates that it is about to suppurate. In this condition ''upanaha'' (poultice) is indicated. [41]
The ''gulma'' with symptoms of burning sensation, much pain, very much irritation and discomfort, loss of sleep and fever indicates that it is about to suppurate. In this condition ''upanaha'' (poultice) is indicated. [41]
=== Symptoms of suppurated ''gulma'' ===
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विदाहलक्षणे गुल्मे बहिस्तुङ्गे समुन्नते|
विदाहलक्षणे गुल्मे बहिस्तुङ्गे समुन्नते|
तत्रैव पिण्डिते शूले सम्पक्वं गुल्ममादिशेत्||४३||
तत्रैव पिण्डिते शूले सम्पक्वं गुल्ममादिशेत्||४३||
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vidāhalakṣaṇē gulmē bahistuṅgē samunnatē|
vidāhalakṣaṇē gulmē bahistuṅgē samunnatē|
tatraiva piNDite shUle sampakvaM gulmamAdishet||43||
tatraiva piNDite shUle sampakvaM gulmamAdishet||43||
</div></div>
If ''gulma'' protrudes pointing toward outside and skin over the lesion becomes stiff and numb and its color changes to dusky with red margins. On palpation, the lump resembles as bladder filled with water, pitting on pressure, but on pressing from side the mass becomes tense with mild pain, otherwise it feels compressed mass with acute pain; all these signs and symptoms indicate that the ''gulma'' has suppurated [42-43]
If ''gulma'' protrudes pointing toward outside and skin over the lesion becomes stiff and numb and its color changes to dusky with red margins. On palpation, the lump resembles as bladder filled with water, pitting on pressure, but on pressing from side the mass becomes tense with mild pain, otherwise it feels compressed mass with acute pain; all these signs and symptoms indicate that the ''gulma'' has suppurated [42-43]
<div class="mw-collapsible mw-collapsed">
तत्र धान्वन्तरीयाणामधिकारः क्रियाविधौ|
तत्र धान्वन्तरीयाणामधिकारः क्रियाविधौ|
वैद्यानां कृतयोग्यानां व्यधशोधनरोपणे||४४||
वैद्यानां कृतयोग्यानां व्यधशोधनरोपणे||४४||
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tatra dhānvantarīyāṇāmadhikāraḥ kriyāvidhau|
tatra dhānvantarīyāṇāmadhikāraḥ kriyāvidhau|
vaidyAnAM kRutayogyAnAM vyadhashodhanaropaNe||44||
vaidyAnAM kRutayogyAnAM vyadhashodhanaropaNe||44||
</div></div>
The suppurated ''gulma'' requires surgical intervention such as incision, cleansing and healing therefore it should be treated by a surgeon [44]
The suppurated ''gulma'' requires surgical intervention such as incision, cleansing and healing therefore it should be treated by a surgeon [44]
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अन्तर्भागस्य चाप्येतत् पच्यमानस्य लक्षणम्|
अन्तर्भागस्य चाप्येतत् पच्यमानस्य लक्षणम्|
हृत्क्रोडशूनताऽन्तःस्थे [५] बहिःस्थे पार्श्वनिर्गतिः||४५||
हृत्क्रोडशूनताऽन्तःस्थे [५] बहिःस्थे पार्श्वनिर्गतिः||४५||
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antarbhāgasya cāpyētat pacyamānasya lakṣaṇam|
antarbhāgasya cāpyētat pacyamānasya lakṣaṇam|
hRutkroDashUnatA~antaHsthe [5] bahiHsthe pArshvanirgatiH||45||
hRutkroDashUnatA~antaHsthe [5] bahiHsthe pArshvanirgatiH||45||
</div></div>
The above mentioned symptoms also occur in suppurating (''pachyamana'') internal ''gulma''. Only difference is that in the internal ''gulma'' there is swelling in cardiac region of the abdomen while exterior ''gulma'' protrudes towards sides of abdomen [45]
The above mentioned symptoms also occur in suppurating (''pachyamana'') internal ''gulma''. Only difference is that in the internal ''gulma'' there is swelling in cardiac region of the abdomen while exterior ''gulma'' protrudes towards sides of abdomen [45]
=== Management of pus discharging ''gulma'' ===
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पक्वः स्रोतांसि सङ्क्लेद्य व्रजत्यूर्ध्वमधोऽपि वा|
पक्वः स्रोतांसि सङ्क्लेद्य व्रजत्यूर्ध्वमधोऽपि वा|
दशाहं द्वादशाहं वा रक्षन् भिषगुपद्रवान्|
दशाहं द्वादशाहं वा रक्षन् भिषगुपद्रवान्|
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pakvaḥ srōtāṁsi saṅklēdya vrajatyūrdhvamadhō'pi vā|
pakvaḥ srōtāṁsi saṅklēdya vrajatyūrdhvamadhō'pi vā|
dashAhaM dvAdashAhaM vA rakShan bhiShagupadravAn|
dashAhaM dvAdashAhaM vA rakShan bhiShagupadravAn|
</div></div>
Suppurated ''gulma'' on softening of the passage discharges the pus upwards or downwards. In case of ''gulma'' starts discharging at its own then the physician should wait and watch for ten or twelve days while taking care that no complication occurs [46]
Suppurated ''gulma'' on softening of the passage discharges the pus upwards or downwards. In case of ''gulma'' starts discharging at its own then the physician should wait and watch for ten or twelve days while taking care that no complication occurs [46]
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अत ऊर्ध्वं हितं पानं सर्पिषः सविशोधनम्||४७||
अत ऊर्ध्वं हितं पानं सर्पिषः सविशोधनम्||४७||
शुद्धस्य तिक्तं सक्षौद्रं प्रयोगे सर्पिरिष्यते|४८|
शुद्धस्य तिक्तं सक्षौद्रं प्रयोगे सर्पिरिष्यते|४८|
<div class="mw-collapsible-content">
ata ūrdhvaṁ hitaṁ pānaṁ sarpiṣaḥ saviśōdhanam||47||
ata ūrdhvaṁ hitaṁ pānaṁ sarpiṣaḥ saviśōdhanam||47||
shuddhasya tiktaM sakShaudraM prayoge sarpiriShyate|48|
shuddhasya tiktaM sakShaudraM prayoge sarpiriShyate|48|
</div></div>
Oral administration of ghee with cleansing of the discharging ulcer with ''shodhana'' drugs are beneficial. After the cleansing, medicated ghee prepared with bitter drugs should be given with honey [48]
Oral administration of ghee with cleansing of the discharging ulcer with ''[[shodhana]]'' drugs are beneficial. After the cleansing, medicated ghee prepared with bitter drugs should be given with honey [48]
=== Management of ''kaphaja gulma'' ===
==== Indications of ''[[langhana]]'' ====
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शीतलैर्गुरुभिः स्निग्धैर्गुल्मे जाते कफात्मके||४८||
शीतलैर्गुरुभिः स्निग्धैर्गुल्मे जाते कफात्मके||४८||
अवम्यस्याल्पकायाग्नेः कुर्याल्लङ्घनमादितः|
अवम्यस्याल्पकायाग्नेः कुर्याल्लङ्घनमादितः|
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śītalairgurubhiḥ snigdhairgulmē jātē kaphātmakē||48||
śītalairgurubhiḥ snigdhairgulmē jātē kaphātmakē||48||
avamyasyAlpakAyAgneH kuryAlla~gghanamAditaH|
avamyasyAlpakAyAgneH kuryAlla~gghanamAditaH|
</div></div>
''Kapha-gulma'' if caused by indulgence in cold, heavy and unctuous diet and in those not eligible for ''vamana, langhana'' (depletion) therapy should be prescribed in the beginning. [48]
''[[Kapha]]-gulma'' if caused by indulgence in cold, heavy and unctuous diet and in those not eligible for ''[[vamana]], [[langhana]]'' (depletion) therapy should be prescribed in the beginning. [48]
==== Indications of [[vamana]] ====
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मन्दोऽग्निर्वेदना मन्दा गुरुस्तिमितकोष्ठता||४९||
मन्दोऽग्निर्वेदना मन्दा गुरुस्तिमितकोष्ठता||४९||
सोत्क्लेशा चारुचिर्यस्य स गुल्मी वमनोपगः|
सोत्क्लेशा चारुचिर्यस्य स गुल्मी वमनोपगः|
<div class="mw-collapsible-content">
mandō'gnirvēdanā mandā gurustimitakōṣṭhatā||49||
mandō'gnirvēdanā mandā gurustimitakōṣṭhatā||49||
sotkleshA cAruciryasya sa gulmI vamanopagaH|
sotkleshA cAruciryasya sa gulmI vamanopagaH|
</div></div>
''Vamana'' is indicated in a patient of ''gulma'' who is having low digestion, anorexia, nausea and mild pain, heaviness and stiffness in abdomen [49]
''[[Vamana]]'' is indicated in a patient of ''gulma'' who is having low digestion, anorexia, nausea and mild pain, heaviness and stiffness in abdomen [49]
<div class="mw-collapsible mw-collapsed">
उष्णैरेवोपचर्यश्च कृते वमनलङ्घने||५०||
उष्णैरेवोपचर्यश्च कृते वमनलङ्घने||५०||
योज्यश्चाहारसंसर्गो भेषजैः कटुतिक्तकैः|
योज्यश्चाहारसंसर्गो भेषजैः कटुतिक्तकैः|
<div class="mw-collapsible-content">
uṣṇairēvōpacaryaśca kr̥tē vamanalaṅghanē||50||
uṣṇairēvōpacaryaśca kr̥tē vamanalaṅghanē||50||
yojyashcAhArasaMsargo bheShajaiH kaTutiktakaiH|
yojyashcAhArasaMsargo bheShajaiH kaTutiktakaiH|
</div></div>
After the treatment with ''vamana'' and ''langhana'', the patient should be given hot (''ushna'') therapy and food mixed with pungent and bitter substances [50]
After the treatment with ''[[vamana]]'' and ''[[langhana]]'', the patient should be given hot (''ushna'') therapy and food mixed with pungent and bitter substances [50]
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सानाहं सविबन्धं च गुल्मं कठिनमुन्नतम्||५१||
सानाहं सविबन्धं च गुल्मं कठिनमुन्नतम्||५१||
दृष्ट्वाऽऽदौ स्वेदयेद्युक्त्या स्विन्नं च विलयेद्भिषक्|
दृष्ट्वाऽऽदौ स्वेदयेद्युक्त्या स्विन्नं च विलयेद्भिषक्|
<div class="mw-collapsible-content">
sānāhaṁ savibandhaṁ ca gulmaṁ kaṭhinamunnatam||51||
sānāhaṁ savibandhaṁ ca gulmaṁ kaṭhinamunnatam||51||
dRuShTvA~a~adau svedayedyuktyA svinnaM ca vilayedbhiShak|
dRuShTvA~a~adau svedayedyuktyA svinnaM ca vilayedbhiShak|
</div></div>
If the ''gulma'' is hard and protruded accompanied with constipation and distension of abdomen then physician should give sudation locally to dissolve it [51]
If the ''gulma'' is hard and protruded accompanied with constipation and distension of abdomen then physician should give sudation locally to dissolve it [51]
<div class="mw-collapsible mw-collapsed">
लङ्घनोल्लेखने स्वेदे कृतेऽग्नौ सम्प्रधुक्षिते||५२||
लङ्घनोल्लेखने स्वेदे कृतेऽग्नौ सम्प्रधुक्षिते||५२||
कफगुल्मी पिबेत् काले सक्षारकटुकं घृतम्|
कफगुल्मी पिबेत् काले सक्षारकटुकं घृतम्|
<div class="mw-collapsible-content">
laṅghanōllēkhanē svēdē kr̥tē'gnau sampradhukṣitē||52||
laṅghanōllēkhanē svēdē kr̥tē'gnau sampradhukṣitē||52||
kaphagulmI pibet kAle sakShArakaTukaM ghRutam|
kaphagulmI pibet kAle sakShArakaTukaM ghRutam|
</div></div>
After performing ''langhana, vamana'' and ''swedana'' therapies when digestion is improved, the patient of ''kapha gulma'' should be given ghee prepared with bitter substances and ''kshara'' (alkali preparation) at the proper time [52]
After performing ''[[langhana]], [[vamana]]'' and ''[[swedana]]'' therapies when digestion is improved, the patient of ''[[kapha]] gulma'' should be given ghee prepared with bitter substances and ''kshara'' (alkali preparation) at the proper time [52]
<div class="mw-collapsible mw-collapsed">
स्थानादपसृतं ज्ञात्वा कफगुल्मं विरेचनैः||५३||
स्थानादपसृतं ज्ञात्वा कफगुल्मं विरेचनैः||५३||
सस्नेहैर्बस्तिभिर्वाऽपि शोधयेद्दाशमूलिकैः|
सस्नेहैर्बस्तिभिर्वाऽपि शोधयेद्दाशमूलिकैः|
<div class="mw-collapsible-content">
sthānādapasr̥taṁ jñātvā kaphagulmaṁ virēcanaiḥ||53||
sthānādapasr̥taṁ jñātvā kaphagulmaṁ virēcanaiḥ||53||
sasnehairbastibhirvA~api shodhayeddAshamUlikaiH|
sasnehairbastibhirvA~api shodhayeddAshamUlikaiH|
</div></div>
By the above treatments when ''kapha gulma'' dislodges from its place, the patient should be given ''virechana'' for purification. ''Anuvasana basti'' with oil prepared with ''dashamula'' drugs can also be given for this purpose [53]
By the above treatments when ''[[kapha]] gulma'' dislodges from its place, the patient should be given ''[[virechana]]'' for purification. ''Anuvasana [[basti]]'' with oil prepared with ''dashamula'' drugs can also be given for this purpose [53]
<div class="mw-collapsible mw-collapsed">
मन्देऽग्नावनिले मूढे ज्ञात्वा सस्नेहमाशयम्||५४||
मन्देऽग्नावनिले मूढे ज्ञात्वा सस्नेहमाशयम्||५४||
गुटिकाचूर्णनिर्यूहाः प्रयोज्याः कफगुल्मिनाम्|
गुटिकाचूर्णनिर्यूहाः प्रयोज्याः कफगुल्मिनाम्|
<div class="mw-collapsible-content">
mandē'gnāvanilē mūḍhē jñātvā sasnēhamāśayam||54||
mandē'gnāvanilē mūḍhē jñātvā sasnēhamāśayam||54||
guTikAcUrNaniryUhAH prayojyAH kaphagulminAm|
guTikAcUrNaniryUhAH prayojyAH kaphagulminAm|
</div></div>
In the condition when digestion is low and dysfunction of ''vata'', after proper oleation of the affected site (''ashaya''), the drugs in the form of pills, powder or decoction are administered to the patient of ''kapha gulma'' [54]
In the condition when digestion is low and dysfunction of ''[[vata]]'', after proper oleation of the affected site (''ashaya''), the drugs in the form of pills, powder or decoction are administered to the patient of ''[[kapha]] gulma'' [54]
<div class="mw-collapsible mw-collapsed">
कृतमूलं महावास्तुं कठिनं स्तिमितं गुरुम्||५५||
कृतमूलं महावास्तुं कठिनं स्तिमितं गुरुम्||५५||
जयेत्कफकृतं गुल्मं क्षारारिष्टाग्निकर्मभिः||
जयेत्कफकृतं गुल्मं क्षारारिष्टाग्निकर्मभिः||
<div class="mw-collapsible-content">
kr̥tamūlaṁ mahāvāstuṁ kaṭhinaṁ stimitaṁ gurum||55||
kr̥tamūlaṁ mahāvāstuṁ kaṭhinaṁ stimitaṁ gurum||55||
jayetkaphakRutaM gulmaM kShArAriShTAgnikarmabhiH|56|
jayetkaphakRutaM gulmaM kShArAriShTAgnikarmabhiH|56|
</div></div>
If ''kapha-gulma'' has a deep root and is large in size, hard in consistency and heavy, then the patient should be treated with alkali preparation-''kshara, arishta'' and ''agni karma'' (cauterization) [55]
If ''[[kapha]]-gulma'' has a deep root and is large in size, hard in consistency and heavy, then the patient should be treated with alkali preparation-''kshara, arishta'' and ''agni karma'' (cauterization) [55]
<div class="mw-collapsible mw-collapsed">
दोषप्रकृतिगुल्मर्तुयोगं बुद्ध्वा कफोल्बणे||५६||
दोषप्रकृतिगुल्मर्तुयोगं बुद्ध्वा कफोल्बणे||५६||
शरीरबलदोषाणां वृद्धिक्षपणकोविदः|
शरीरबलदोषाणां वृद्धिक्षपणकोविदः|
<div class="mw-collapsible-content">
dōṣaprakr̥tigulmartuyōgaṁ buddhvā kaphōlbaṇē||56||
dōṣaprakr̥tigulmartuyōgaṁ buddhvā kaphōlbaṇē||56||
sharIrabaladoShANAM vRuddhikShapaNakovidaH|
sharIrabaladoShANAM vRuddhikShapaNakovidaH|
</div></div>
A physician expert in assessing the degree of strength of patient as well as of ''dosha'' should prescribe alkali preparation–''kshara'' to the patient of ''kapha gulma'' by considering its ''dosha'' and nature as well as prevailing season. The expert physician should use ''kshara'' treatment on alternate day or at the interval of two or three days depending on the increase or decrease in the strength of the body and ''dosha'' [56-57]
A physician expert in assessing the degree of strength of patient as well as of ''[[dosha]]'' should prescribe alkali preparation–''kshara'' to the patient of ''[[kapha]] gulma'' by considering its ''[[dosha]]'' and nature as well as prevailing season. The expert physician should use ''kshara'' treatment on alternate day or at the interval of two or three days depending on the increase or decrease in the strength of the body and ''[[dosha]]'' [56-57]
<div class="mw-collapsible mw-collapsed">
श्लेष्माणं मधुरं स्निग्धं मांसक्षीरघृताशिनः||५८||
श्लेष्माणं मधुरं स्निग्धं मांसक्षीरघृताशिनः||५८||
छित्त्वा छित्त्वाऽऽशयात् क्षारः क्षरत्वात क्षारयत्यधः|
छित्त्वा छित्त्वाऽऽशयात् क्षारः क्षरत्वात क्षारयत्यधः|
<div class="mw-collapsible-content">
ślēṣmāṇaṁ madhuraṁ snigdhaṁ māṁsakṣīraghr̥tāśinaḥ| |58||
ślēṣmāṇaṁ madhuraṁ snigdhaṁ māṁsakṣīraghr̥tāśinaḥ| |58||
chittvA chittvA~a~ashayAt kShAraH kSharatvAta kShArayatyadhaH|
chittvA chittvA~a~ashayAt kShAraH kSharatvAta kShArayatyadhaH|
</div></div>
''Kapha'' is sweet and unctuous, so it is increased by indulging in the diet comprising of excessive meat, milk and ghee. Alkali preparation-''kshara'' has an action of erosion (''ksharana'') due to which it erodes the ''gulma'' and tickles it down from its habitat [58]
''[[Kapha]]'' is sweet and unctuous, so it is increased by indulging in the diet comprising of excessive meat, milk and ghee. Alkali preparation-''kshara'' has an action of erosion (''ksharana'') due to which it erodes the ''gulma'' and tickles it down from its habitat [58]
<div class="mw-collapsible mw-collapsed">
मन्देऽग्नावरुचौ सात्म्ये मद्ये सस्नेहमश्नताम्||५९||
मन्देऽग्नावरुचौ सात्म्ये मद्ये सस्नेहमश्नताम्||५९||
प्रयोज्या मार्गशुद्ध्यर्थमरिष्टाः कफगुल्मिनाम्||
प्रयोज्या मार्गशुद्ध्यर्थमरिष्टाः कफगुल्मिनाम्||
<div class="mw-collapsible-content">
mandē'gnāvarucau sātmyē madyē sasnēhamaśnatām||59||
mandē'gnāvarucau sātmyē madyē sasnēhamaśnatām||59||
prayojyA mArgashuddhyarthamariShTAH kaphagulminAm|60|
prayojyA mArgashuddhyarthamariShTAH kaphagulminAm|60|
</div></div>
The diminution in digestion and loss of appetite occur in a patient of ''kapha gulma'' due to excessive indulgence in unctuous diet, therefore for the purification of the channels medicated fermented preparation-''arishta'' should be given provided the patient is habituated of taking alcohol [59]
The diminution in digestion and loss of appetite occur in a patient of ''[[kapha]] gulma'' due to excessive indulgence in unctuous diet, therefore for the purification of the channels medicated fermented preparation-''arishta'' should be given provided the patient is habituated of taking alcohol [59]
=== ''Daha karma'' and ''[[raktamokshana]]'' in ''[[kapha]] gulma'' ===
<div class="mw-collapsible mw-collapsed">
लङ्घनोल्लेखनैः स्वेदैः सर्पिःपानैर्विरेचनैः||६०||
लङ्घनोल्लेखनैः स्वेदैः सर्पिःपानैर्विरेचनैः||६०||
तस्य दाहो हृते रक्ते शरलोहादिभिर्हितः|
तस्य दाहो हृते रक्ते शरलोहादिभिर्हितः|
<div class="mw-collapsible-content">
laṅghanōllēkhanaiḥ svēdaiḥ sarpiḥpānairvirēcanaiḥ||60||
laṅghanōllēkhanaiḥ svēdaiḥ sarpiḥpānairvirēcanaiḥ||60||
tasya dAho hRute rakte sharalohAdibhirhitaH|
tasya dAho hRute rakte sharalohAdibhirhitaH|
</div></div>
If the ''kapha gulma'' does not subside by ''langhana, vamana, swedana,'' oral administration of medicated ghee, ''virechana, basti'', pills, powder, ''kshara'' and ''arishta'' due to its firm root in the body, then first bloodletting should be done and then cauterization with such means as arrow head should be done [61]
If the ''[[kapha]] gulma'' does not subside by ''[[langhana]], [[vamana]], [[swedana]],'' oral administration of medicated ghee, ''[[virechana]], [[basti]]'', pills, powder, ''kshara'' and ''arishta'' due to its firm root in the body, then first bloodletting should be done and then cauterization with such means as arrow head should be done [61]
<div class="mw-collapsible mw-collapsed">
औष्ण्यात्तैक्ष्ण्याच्च शमयेदग्निर्गुल्मे कफानिलौ||६२||
औष्ण्यात्तैक्ष्ण्याच्च शमयेदग्निर्गुल्मे कफानिलौ||६२||
तयोः शमाच्च सङ्घातो गुल्मस्य विनिवर्तते|
तयोः शमाच्च सङ्घातो गुल्मस्य विनिवर्तते|
<div class="mw-collapsible-content">
auṣṇyāttaikṣṇyācca śamayēdagnirgulmē kaphānilau||62||
auṣṇyāttaikṣṇyācca śamayēdagnirgulmē kaphānilau||62||
tayoH shamAcca sa~gghAto gulmasya vinivartate|
tayoH shamAcca sa~gghAto gulmasya vinivartate|
</div></div>
The fire heat due to its hot and sharp properties relieves ''kapha'' and ''vata'' in ''gulma'', which in turn leads to dissolving the mass of ''gulma'' [62]
The fire heat due to its hot and sharp properties relieves ''[[kapha]]'' and ''[[vata]]'' in ''gulma'', which in turn leads to dissolving the mass of ''gulma'' [62]
<div class="mw-collapsible mw-collapsed">
दाहे धान्वन्तरीयाणामत्रापि भिषजां बलम्||६३||
दाहे धान्वन्तरीयाणामत्रापि भिषजां बलम्||६३||
क्षारप्रयोगे भिषजां क्षारतन्त्रविदां बलम्||
क्षारप्रयोगे भिषजां क्षारतन्त्रविदां बलम्||
<div class="mw-collapsible-content">
dāhē dhānvantarīyāṇāmatrāpi bhiṣajāṁ balam||63||
dāhē dhānvantarīyāṇāmatrāpi bhiṣajāṁ balam||63||
kShAraprayoge bhiShajAM kShAratantravidAM balam|64|
kShAraprayoge bhiShajAM kShAratantravidAM balam|64|
</div></div>
Cauterization comes under the purview of the surgeon and the use of ''kshara'' is the field of specialist in ''kshara karma'' [63]
Cauterization comes under the purview of the surgeon and the use of ''kshara'' is the field of specialist in ''kshara karma'' [63]
<div class="mw-collapsible mw-collapsed">
व्यामिश्रदोषे व्यामिश्र एष एव क्रियाक्रमः||६४||
व्यामिश्रदोषे व्यामिश्र एष एव क्रियाक्रमः||६४||
<div class="mw-collapsible-content">
vyāmiśradōṣē vyāmiśra ēṣa ēva kriyākramaḥ||64||
vyāmiśradōṣē vyāmiśra ēṣa ēva kriyākramaḥ||64||
vyAmishradoShe vyAmishra eSha eva kriyAkramaH||64||
vyAmishradoShe vyAmishra eSha eva kriyAkramaH||64||
</div></div>
If the ''gulma'' is due to two ''dosha'' then the mix treatment of the involved two ''dosha'' should be done [64]
If the ''gulma'' is due to two ''[[dosha]]'' then the mix treatment of the involved two ''[[dosha]]'' should be done [64]
<div class="mw-collapsible mw-collapsed">
सिद्धानतः प्रवक्ष्यामि योगान् गुल्मनिबर्हणान्|
सिद्धानतः प्रवक्ष्यामि योगान् गुल्मनिबर्हणान्|
<div class="mw-collapsible-content">
siddhānataḥ pravakṣyāmi yōgān gulmanibarhaṇān|
siddhānataḥ pravakṣyāmi yōgān gulmanibarhaṇān|
siddhAnataH pravakShyAmi yogAn gulmanibarhaNAn|
siddhAnataH pravakShyAmi yogAn gulmanibarhaNAn|
</div></div>
Now the specific preparations for the cure of ''gulma'' will be described [64 ½]
Now the specific preparations for the cure of ''gulma'' will be described [64 ½]
==== ''Tryushanadi-ghritam'' ====
<div class="mw-collapsible mw-collapsed">
त्र्यूषणत्रिफलाधान्यविडङ्गचव्यचित्रकैः||६५||
त्र्यूषणत्रिफलाधान्यविडङ्गचव्यचित्रकैः||६५||
कल्कीकृतैर्घृतं सिद्धं सक्षीरं वातगुल्मनुतिति त्र्यूषणादिघृतम् |
कल्कीकृतैर्घृतं सिद्धं सक्षीरं वातगुल्मनुतिति त्र्यूषणादिघृतम् |
<div class="mw-collapsible-content">
tryūṣaṇatriphalādhānyaviḍaṅgacavyacitrakaiḥ||65||
tryūṣaṇatriphalādhānyaviḍaṅgacavyacitrakaiḥ||65||
kalkIkRutairghRutaM siddhaM sakShIraM vAtagulmanutiti tryUShaNAdighRutam |
kalkIkRutairghRutaM siddhaM sakShIraM vAtagulmanutiti tryUShaNAdighRutam |
</div></div>
Ghee prepared with a paste of ''trayushna'' (dry ginger, black and long pepper), ''triphala'', coriander, ''vidanga, chavya'' and ''chitraka'' by adding milk is known as ''tryushanadighritam''. It is curative of ''vata gulma''; thus described ''trayushanadighritam'' [65]
Ghee prepared with a paste of ''trayushna'' (dry ginger, black and long pepper), ''triphala'', coriander, ''vidanga, chavya'' and ''chitraka'' by adding milk is known as ''tryushanadighritam''. It is curative of ''[[vata]] gulma''; thus described ''trayushanadighritam'' [65]
=== ''Parama trayushanadighritam'' ===
<div class="mw-collapsible mw-collapsed">
एत एव च कल्काः स्युः कषायः पाञ्चमूलिकः ||६६||
एत एव च कल्काः स्युः कषायः पाञ्चमूलिकः ||६६||
द्विपञ्चमूलिको वाऽपि तद्घृतं गुल्मनुत् परमिति त्र्यूषणादिघृतमपरम्
द्विपञ्चमूलिको वाऽपि तद्घृतं गुल्मनुत् परमिति त्र्यूषणादिघृतमपरम्
<div class="mw-collapsible-content">
ēta ēva ca kalkāḥ syuḥ kaṣāyaḥ pāñcamūlikaḥ ||66||
ēta ēva ca kalkāḥ syuḥ kaṣāyaḥ pāñcamūlikaḥ ||66||
dvipa~jcamUliko vA~api tadghRutaM gulmanut paramiti tryUShaNAdighRutamaparam
dvipa~jcamUliko vA~api tadghRutaM gulmanut paramiti tryUShaNAdighRutamaparam
</div></div>
Above mentioned paste if prepared with decoction of ''brihat panchamula'' or ''dashamula'' is known as ''parama tryushanadighritama''. It is very much effective in curing ''gulma''; thus described ''parama tryushanadighritama'' [66]
Above mentioned paste if prepared with decoction of ''brihat panchamula'' or ''dashamula'' is known as ''parama tryushanadighritama''. It is very much effective in curing ''gulma''; thus described ''parama tryushanadighritama'' [66]
<div class="mw-collapsible mw-collapsed">
(षट्पलं वा पिबेत् सर्पिर्यदुक्तं राजयक्ष्मणि)||६७||
(षट्पलं वा पिबेत् सर्पिर्यदुक्तं राजयक्ष्मणि)||६७||
<div class="mw-collapsible-content">
(ṣaṭpalaṁ vā pibētsarpiryaduktaṁ rājayakṣmaṇi)||67||
(ṣaṭpalaṁ vā pibētsarpiryaduktaṁ rājayakṣmaṇi)||67||
(ShaTpalaM vA pibetsarpiryaduktaM rAjayakShmaNi)||67||
(ShaTpalaM vA pibetsarpiryaduktaM rAjayakShmaNi)||67||
</div></div>
(''shatpalam ghrita'' described for the treatment of ''rajayakshma'' may also be used orally) [67]
(''shatpalam ghrita'' described for the treatment of ''rajayakshma'' may also be used orally) [67]
<div class="mw-collapsible mw-collapsed">
प्रसन्नया वा क्षीरार्थं सुरया दाडिमेन वा|
प्रसन्नया वा क्षीरार्थं सुरया दाडिमेन वा|
दध्नः सरेण वा कार्यं घृतं मारुतगुल्मनुत्||६८||
दध्नः सरेण वा कार्यं घृतं मारुतगुल्मनुत्||६८||
<div class="mw-collapsible-content">
prasannayā vā kṣīrārthaṁ surayā dāḍimēna vā|
prasannayā vā kṣīrārthaṁ surayā dāḍimēna vā|
dadhnaH sareNa vA kAryaM ghRutaM mArutagulmanut||68||
dadhnaH sareNa vA kAryaM ghRutaM mArutagulmanut||68||
</div></div>
In place of milk in above preparation of ''tryushanadighritam, ghrita'' can also be prepared with ''prasanna'' wine, ''sura'' wine, pomegranate juice or cream of yogurt (curd). It also cures ''vata gulma'' [68]
In place of milk in above preparation of ''tryushanadighritam, ghrita'' can also be prepared with ''prasanna'' wine, ''sura'' wine, pomegranate juice or cream of yogurt (curd). It also cures ''[[vata]] gulma'' [68]
=== ''Hingusauvarchaladya ghrita'' ===
<div class="mw-collapsible mw-collapsed">
हिङ्गुसौवर्चलाजाजीबिडदाडिमदीप्यकैः|
हिङ्गुसौवर्चलाजाजीबिडदाडिमदीप्यकैः|
इति हिङ्गुसौवर्चलाद्यं घृतम्
इति हिङ्गुसौवर्चलाद्यं घृतम्
<div class="mw-collapsible-content">
hiṅgusauvarcalājājībiḍadāḍimadīpyakaiḥ|
hiṅgusauvarcalājājībiḍadāḍimadīpyakaiḥ|
iti hi~ggusauvarcalAdyaM ghRutam
iti hi~ggusauvarcalAdyaM ghRutam
</div></div>
A ''ghrita'' prepared with paste of asafoetida, rock salt, cumin, Vit-salt, pomegranate, ''ajwan, pushkaramula, trikatu,'' coriander, ''vetas, yavakshara, chitraka, shati, vacha, ajagandha,'' cardamom and holy basil by adding curd/yogurt is known as ''hingusauvarchaladyam ghritam''. It cures ''vata gulma'', acute pain and distension of abdomen due to retention of gases (''anaha''). Thus ''hiṅgusauvarchaladyam ghritam'' is described [69-70]
A ''ghrita'' prepared with paste of asafoetida, rock salt, cumin, Vit-salt, pomegranate, ''ajwan, pushkaramula, trikatu,'' coriander, ''vetas, yavakshara, chitraka, shati, vacha, ajagandha,'' cardamom and holy basil by adding curd/yogurt is known as ''hingusauvarchaladyam ghritam''. It cures ''[[vata]] gulma'', acute pain and distension of abdomen due to retention of gases (''anaha''). Thus ''hiṅgusauvarchaladyam ghritam'' is described [69-70]
=== ''Hapushadya ghritam'' ===
<div class="mw-collapsible mw-collapsed">
हपुषाव्योषपृथ्वीकाचव्यचित्रकसैन्धवैः|
हपुषाव्योषपृथ्वीकाचव्यचित्रकसैन्धवैः|
इति हपुषाद्यं घृतम्
इति हपुषाद्यं घृतम्
<div class="mw-collapsible-content">
hapuṣāvyōṣapr̥thvīkācavyacitrakasaindhavaiḥ|
hapuṣāvyōṣapr̥thvīkācavyacitrakasaindhavaiḥ|
iti hapuShAdyaM ghRutam
iti hapuShAdyaM ghRutam
</div></div>
Ghee prepared with a paste of ''hapusha, trikatu,'' cardamom, ''chavya, chitraka,'' rock salt, cumin, root of long pepper and ''ajwain'' along with juice of jujubes, radish and pomegranate, by adding milk and curd is known as ''hapushadyam ghritam''. It is best drug to cure ''vata gulma'', abdominal pain and distension of abdomen. It also provides relief in gynecological disorders, piles, ''grahani'' (assimilation disorders), dyspnea, cough, anorexia, fever and pain in hypogastric, epigastric and flanks regions of the abdomen. Thus, ''hapushadyam ghritam'' is described [71-73]
Ghee prepared with a paste of ''hapusha, trikatu,'' cardamom, ''chavya, chitraka,'' rock salt, cumin, root of long pepper and ''ajwain'' along with juice of jujubes, radish and pomegranate, by adding milk and curd is known as ''hapushadyam ghritam''. It is best drug to cure ''[[vata gulma]]'', abdominal pain and distension of abdomen. It also provides relief in gynecological disorders, piles, ''grahani'' (assimilation disorders), dyspnea, cough, anorexia, fever and pain in hypogastric, epigastric and flanks regions of the abdomen. Thus, ''hapushadyam ghritam'' is described [71-73]
=== ''Pippalyadyam ghritam'' ===
<div class="mw-collapsible mw-collapsed">
पिप्पल्या पिचुरध्यर्धो दाडिमाद्द्विपलं पलम्|
पिप्पल्या पिचुरध्यर्धो दाडिमाद्द्विपलं पलम्|
इति पिप्पल्याद्यं घृतम्
इति पिप्पल्याद्यं घृतम्
<div class="mw-collapsible-content">
pippalyā picuradhyardhō dāḍimāddvipalaṁ palam|
pippalyā picuradhyardhō dāḍimāddvipalaṁ palam|
iti pippalyAdyaM ghRutam
iti pippalyAdyaM ghRutam
</div></div>
Ghee prepared with paste of one and half part of long pepper, eight parts of pomegranate seeds, four parts of coriander and one part of dry ginger in 20 parts of ghee and 80 parts of milk is known as ''pippalyadyam ghritam''. It provides quick relief in ''vata gulma'', pain in vagina, headache, piles and irregular fever. Thus ''pippalyadyam ghritam'' is described [74-75]
Ghee prepared with paste of one and half part of long pepper, eight parts of pomegranate seeds, four parts of coriander and one part of dry ginger in 20 parts of ghee and 80 parts of milk is known as ''pippalyadyam ghritam''. It provides quick relief in ''[[vata]] gulma'', pain in vagina, headache, piles and irregular fever. Thus ''pippalyadyam ghritam'' is described [74-75]
<div class="mw-collapsible mw-collapsed">
घृतानामौषधगणा य एते परिकीर्तिताः|
घृतानामौषधगणा य एते परिकीर्तिताः|
ते चूर्णयोगा वर्त्यस्ताः कषायास्ते च गुल्मिनाम्||७६||
ते चूर्णयोगा वर्त्यस्ताः कषायास्ते च गुल्मिनाम्||७६||
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ghr̥tānāmauṣadhagaṇā ya ētē parikīrtitāḥ|
ghr̥tānāmauṣadhagaṇā ya ētē parikīrtitāḥ|
te cUrNayogA vartyastAH kaShAyAste ca gulminAm||76||
te cUrNayogA vartyastAH kaShAyAste ca gulminAm||76||
</div></div>
The drugs mentioned in the above ''ghrita'' preparations may also be used in form of powders, suppositories or decoctions for the treatment of ''gulma'' [76]
The drugs mentioned in the above ''ghrita'' preparations may also be used in form of powders, suppositories or decoctions for the treatment of ''gulma'' [76]
=== ''Peya'' (liquid gruel) ===
<div class="mw-collapsible mw-collapsed">
कोलदाडिमघर्माम्बुसुरामण्डाम्लकाञ्जिकैः|
कोलदाडिमघर्माम्बुसुरामण्डाम्लकाञ्जिकैः|
शूलानाहहरी पेया बीजपूररसेन वा||७७||
शूलानाहहरी पेया बीजपूररसेन वा||७७||
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kōladāḍimagharmāmbusurāmaṇḍāmlakāñjikaiḥ|
kōladāḍimagharmāmbusurāmaṇḍāmlakāñjikaiḥ|
shUlAnAhaharI peyA bIjapUrarasena vA||77||
shUlAnAhaharI peyA bIjapUrarasena vA||77||
</div></div>
The liquid gruel prepared from jujube, pomegranate, warm water, supernatant liquid of ''sura''(wine) (''sura manda''), sour ''kanji'' or citron juice relieves abdominal pain and distension of abdomen [77]
The liquid gruel prepared from jujube, pomegranate, warm water, supernatant liquid of ''sura''(wine) (''sura manda''), sour ''kanji'' or citron juice relieves abdominal pain and distension of abdomen [77]
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चूर्णानि मातुलुङ्गस्य भावितानि रसेन वा|
चूर्णानि मातुलुङ्गस्य भावितानि रसेन वा|
कुर्याद्वर्तीः सगुटिका गुल्मानाहार्तिशान्तये||७८||
कुर्याद्वर्तीः सगुटिका गुल्मानाहार्तिशान्तये||७८||
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cūrṇāni mātuluṅgasya bhāvitāni rasēna vā|
cūrṇāni mātuluṅgasya bhāvitāni rasēna vā|
kuryAdvartIH saguTikA gulmAnAhArtishAntaye||78||
kuryAdvartIH saguTikA gulmAnAhArtishAntaye||78||
</div></div>
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]
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]
=== ''Hingvadi churna'' and ''gutika'' ===
<div class="mw-collapsible mw-collapsed">
हिङ्गु त्रिकटुकं पाठां हपुषामभयां शटीम्|
हिङ्गु त्रिकटुकं पाठां हपुषामभयां शटीम्|
इति हिङ्ग्वादिचूर्णं गुटिका च |
इति हिङ्ग्वादिचूर्णं गुटिका च |
<div class="mw-collapsible-content">
hiṅgu trikaṭukaṁ pāṭhāṁ hapuṣāmabhayāṁ śaṭīm|
hiṅgu trikaṭukaṁ pāṭhāṁ hapuṣāmabhayāṁ śaṭīm|
iti hi~ggvAdicUrNaM guTikA ca
iti hi~ggvAdicUrNaM guTikA ca
</div></div>
Make fine powder of equal parts of asafoetida, ''trikatu, patha, hapusha, haritaki, shati, ajamoda, ajagandha, tintidika, amlavetas,'' pomegranate, ''pushkaramula,'' coriander, ''cumin, chitraka, vacha,'' two types of kshara, two types of salt and ''chavya''. It is known as ''hingvadichurnam''.
Make fine powder of equal parts of asafoetida, ''trikatu, patha, hapusha, haritaki, shati, ajamoda, ajagandha, tintidika, amlavetas,'' pomegranate, ''pushkaramula,'' coriander, ''cumin, chitraka, vacha,'' two types of kshara, two types of salt and ''chavya''. It is known as ''hingvadichurnam''.
This powder is to be given with food and drinks or it may be taken before meal as drink mixed with wine or hot water. This has no harmful effect.
This powder is to be given with food and drinks or it may be taken before meal as drink mixed with wine or hot water. This has no harmful effect.
It is useful in ''vata-kapha gulma,'' pain in hypogastric, epigastric and hypochondric regions of the abdomen, distension of abdomen, dysuria, pain in anus and vagina, assimilation disorders, piles, spleen disorders, anemia, anorexia, tightness of chest, hiccup, cough, dyspnoea and sore-throat.
It is useful in ''[[vata]]-[[kapha]] gulma,'' pain in hypogastric, epigastric and hypochondric regions of the abdomen, distension of abdomen, dysuria, pain in anus and vagina, assimilation disorders, piles, spleen disorders, anemia, anorexia, tightness of chest, hiccup, cough, dyspnoea and sore-throat.
The pills may also be prepared by repeatedly impregnating the above mentioned powders in juice of citron, which is more effective than administration of the simple powders. Thus ''hingvadichurnam'' and ''gutika'' have been described [79-84]
The pills may also be prepared by repeatedly impregnating the above mentioned powders in juice of citron, which is more effective than administration of the simple powders. Thus ''hingvadichurnam'' and ''gutika'' have been described [79-84]
<div class="mw-collapsible mw-collapsed">
मातुलुङ्गरसो हिङ्गु दाडिमं बिडसैन्धवे|
मातुलुङ्गरसो हिङ्गु दाडिमं बिडसैन्धवे|
सुरामण्डेन पातव्यं वातगुल्मरुजापहम्||८५||
सुरामण्डेन पातव्यं वातगुल्मरुजापहम्||८५||
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mātuluṅgarasō hiṅgu dāḍimaṁ biḍasaindhavē|
mātuluṅgarasō hiṅgu dāḍimaṁ biḍasaindhavē|
surAmaNDena pAtavyaM vAtagulmarujApaham||85||
surAmaNDena pAtavyaM vAtagulmarujApaham||85||
</div></div>
Mix asafoetida, pomegranate and bid and rock salts in juice of citron and take with supernatant fluid of ''surā'' wine. It cures pain of ''vata gulma'' [85]
Mix asafoetida, pomegranate and bid and rock salts in juice of citron and take with supernatant fluid of ''surā'' wine. It cures pain of ''[[vata]] gulma'' [85]
=== ''Shatyadi churnam'' and ''gutika'' ===
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शटीपुष्करहिङ्ग्वम्लवेतसक्षारचित्रकान्|
शटीपुष्करहिङ्ग्वम्लवेतसक्षारचित्रकान्|
पार्श्वहृद्बस्तिशूलं च गुटिकैषा व्यपोहति||९०||
पार्श्वहृद्बस्तिशूलं च गुटिकैषा व्यपोहति||९०||
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śaṭīpuṣkarahiṅgvamlavētasakṣāracitrakān|
śaṭīpuṣkarahiṅgvamlavētasakṣāracitrakān|
pArshvahRudbastishUlaM ca guTikaiShA vyapohati||90||
pArshvahRudbastishUlaM ca guTikaiShA vyapohati||90||
</div></div>
Mix fine powders of ''shati, pushkaramula,'' asafoetida, ''amlavetasa, kshara, chitraka,'' coriander, ''ajwain'' (''yavani''), ''vidanga'', rock-salt, ''vacha, chavya, pippalimula, ajagandha,'' pomegranate, ''ajaji'' and ''ajamoda''. It may be used in powder form or in the form of pills made of size of jujube by impregnating these powders in juice of citron or vinegar of honey by rubbing well.
Mix fine powders of ''shati, pushkaramula,'' asafoetida, ''amlavetasa, kshara, chitraka,'' coriander, ''ajwain'' (''yavani''), ''vidanga'', rock-salt, ''vacha, chavya, pippalimula, ajagandha,'' pomegranate, ''ajaji'' and ''ajamoda''. It may be used in powder form or in the form of pills made of size of jujube by impregnating these powders in juice of citron or vinegar of honey by rubbing well.
This pill cures ''gulma'', spleen disorders, distension of abdomen, dyspnea, anorexia, hiccup, heart diseases, piles, various types of headache, anemia, excessive of secretions (''kaphotklesha''), all types of dysenteries and pain in hypogastric, epigastric and hypochondric regions of the abdomen [86-90]
This pill cures ''gulma'', spleen disorders, distension of abdomen, dyspnea, anorexia, hiccup, heart diseases, piles, various types of headache, anemia, excessive of secretions (''kaphotklesha''), all types of dysenteries and pain in hypogastric, epigastric and hypochondric regions of the abdomen [86-90]
=== ''Nagara'' preparation ===
<div class="mw-collapsible mw-collapsed">
नागरार्धपलं पिष्ट्वा द्वे पले लुञ्चितस्य च|
नागरार्धपलं पिष्ट्वा द्वे पले लुञ्चितस्य च|
वातगुल्ममुदावर्तं योनिशूलं च नाशयेत्|
वातगुल्ममुदावर्तं योनिशूलं च नाशयेत्|
<div class="mw-collapsible-content">
nāgarārdhapalaṁ piṣṭvā dvē palē luñcitasya ca|
nāgarārdhapalaṁ piṣṭvā dvē palē luñcitasya ca|
vAtagulmamudAvartaM yonishUlaM ca nAshayet|
vAtagulmamudAvartaM yonishUlaM ca nAshayet|
</div></div>
Make paste of 25 gm of dried ginger, 100 gm pealed sesame and 50 gm of jaggery and administer to the patient with warm milk. It cures ''vata gulma, udavarta'' ( disorder due to improper direction of ''vata'') and pain in vagina [91½]
Make paste of 25 gm of dried ginger, 100 gm pealed sesame and 50 gm of jaggery and administer to the patient with warm milk. It cures ''[[vata]] gulma, udavarta'' ( disorder due to improper direction of ''[[vata]]'') and pain in vagina [91½]
<div class="mw-collapsible mw-collapsed">
पिबेदेरण्डजं तैलं वारुणीमण्डमिश्रितम्||९२||
पिबेदेरण्डजं तैलं वारुणीमण्डमिश्रितम्||९२||
श्लेष्मण्यनुबले पूर्वं हितं पित्तानुगे परम्||९३||
श्लेष्मण्यनुबले पूर्वं हितं पित्तानुगे परम्||९३||
<div class="mw-collapsible-content">
pibēdēraṇḍajaṁ tailaṁ vāruṇīmaṇḍamiśritam||92||
pibēdēraṇḍajaṁ tailaṁ vāruṇīmaṇḍamiśritam||92||
shleShmaNyanubale pUrvaM hitaM pittAnuge param||93||
shleShmaNyanubale pUrvaM hitaM pittAnuge param||93||
</div></div>
The patient of ''vata gulma'' associated with ''kapha'' dominance, then should take castor oil with supernatant of ''varuni'' wine and if ''pitta'' is associated then take castor oil with milk [92-93]
The patient of ''[[vata]] gulma'' associated with ''[[kapha]]'' dominance, then should take castor oil with supernatant of ''varuni'' wine and if ''[[pitta]]'' is associated then take castor oil with milk [92-93]
=== ''Lashuna-kshiram'' ===
<div class="mw-collapsible mw-collapsed">
साधयेच्छुद्धशुष्कस्य लशुनस्य चतुष्पलम्|
साधयेच्छुद्धशुष्कस्य लशुनस्य चतुष्पलम्|
इति लशुनक्षीरम् |
इति लशुनक्षीरम् |
<div class="mw-collapsible-content">
sādhayēcchuddhaśuṣkasya laśunasya catuṣpalam|
sādhayēcchuddhaśuṣkasya laśunasya catuṣpalam|
iti lashunakShIram
iti lashunakShIram
</div></div>
Take 160 gm of dried and peeled garlic, add to it 640 ml of milk and 640 ml of water and boil on slow fire till only milk remains. It is known as ''lashuna kshiram'' and its oral administration provides quick relief in ''vata gulma, udavarta,'' sciatica, irregular fever, heart disease, abscess and inflammation [94-95]
Take 160 gm of dried and peeled garlic, add to it 640 ml of milk and 640 ml of water and boil on slow fire till only milk remains. It is known as ''lashuna kshiram'' and its oral administration provides quick relief in ''[[vata]] gulma, udavarta,'' sciatica, irregular fever, heart disease, abscess and inflammation [94-95]
=== ''Taila panchakam'' ===
<div class="mw-collapsible mw-collapsed">
तैलं प्रसन्ना गोमूत्रमारनालं यवाग्रजम्|
तैलं प्रसन्ना गोमूत्रमारनालं यवाग्रजम्|
इति तैलपञ्चकम् |
इति तैलपञ्चकम् |
<div class="mw-collapsible-content">
tailaṁ prasannā gōmūtramāranālaṁ yavāgrajam|
tailaṁ prasannā gōmūtramāranālaṁ yavāgrajam|
iti tailapa~jcakam
iti tailapa~jcakam
</div></div>
The mixture of castor oil, ''prasanna'' wine, cow’s urine, ''aranala'' (sour ''kanji'') and ''yavakshara'' is known as ''tailapanchakam''. Its oral administration cures ''gulma'', gastric disorders and distension of abdomen [96]
The mixture of castor oil, ''prasanna'' wine, cow’s urine, ''aranala'' (sour ''kanji'') and ''yavakshara'' is known as ''tailapanchakam''. Its oral administration cures ''gulma'', gastric disorders and distension of abdomen [96]
=== ''shilajatu-prayoga'' ===
<div class="mw-collapsible mw-collapsed">
पञ्चमूलीकषायेण सक्षारेण शिलाजतु|
पञ्चमूलीकषायेण सक्षारेण शिलाजतु|
इति शिलाजतुप्रयोगः |
इति शिलाजतुप्रयोगः |
<div class="mw-collapsible-content">
pañcamūlīkaṣāyēṇa sakṣārēṇa śilājatu|
pañcamūlīkaṣāyēṇa sakṣārēṇa śilājatu|
iti shilAjatuprayogaH
iti shilAjatuprayogaH
</div></div>
Taking of ''shilajatu'' with ''kshara'' and decoction of ''panchamula'' cures ''vata gulma''. Thus administration of ''shilajatu'' is described [97]
Taking of ''shilajatu'' with ''kshara'' and decoction of ''panchamula'' cures ''[[vata]] gulma''. Thus administration of ''shilajatu'' is described [97]
=== ''Vatyam'' or barley preparation ===
<div class="mw-collapsible mw-collapsed">
वाट्यं पिप्पलीयूषेण मूलकानां रसेन वा|
वाट्यं पिप्पलीयूषेण मूलकानां रसेन वा|
भुक्त्वा स्निग्धमुदावर्ताद्वातगुल्माद्विमुच्यते||९८||
भुक्त्वा स्निग्धमुदावर्ताद्वातगुल्माद्विमुच्यते||९८||
<div class="mw-collapsible-content">
vāṭyaṁ pippalīyūṣēṇa mūlakānāṁ rasēna vā|
vāṭyaṁ pippalīyūṣēṇa mūlakānāṁ rasēna vā|
bhuktvA snigdhamudAvartAdvAtagulmAdvimucyate||98||
bhuktvA snigdhamudAvartAdvAtagulmAdvimucyate||98||
</div></div>
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]
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]
=== ''[[Swedana]]'' ===
<div class="mw-collapsible mw-collapsed">
शूलानाहविबन्धार्तं स्वेदयेद्वातगुल्मिनम्|
शूलानाहविबन्धार्तं स्वेदयेद्वातगुल्मिनम्|
स्वेदैः स्वेदविधावुक्तैर्नाडीप्रस्तरसङ्करैः||९९||
स्वेदैः स्वेदविधावुक्तैर्नाडीप्रस्तरसङ्करैः||९९||
<div class="mw-collapsible-content">
śūlānāhavibandhārtaṁ svēdayēdvātagulminam|
śūlānāhavibandhārtaṁ svēdayēdvātagulminam|
svedaiH svedavidhAvuktairnADIprastarasa~gkaraiH||99||
svedaiH svedavidhAvuktairnADIprastarasa~gkaraiH||99||
</div></div>
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 [[Swedadhyaya]] [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 [[Swedadhyaya]] [99]
=== ''[[Basti]] karma'' ===
<div class="mw-collapsible mw-collapsed">
बस्तिकर्म परं विद्याद्गुल्मघ्नं तद्धि मारुतम्|
बस्तिकर्म परं विद्याद्गुल्मघ्नं तद्धि मारुतम्|
गुल्मघ्ना विविधा दिष्टाः सिद्धाः सिद्धिषु बस्तयः|
गुल्मघ्ना विविधा दिष्टाः सिद्धाः सिद्धिषु बस्तयः|
<div class="mw-collapsible-content">
bastikarma paraṁ vidyādgulmaghnaṁ taddhi mārutam|
bastikarma paraṁ vidyādgulmaghnaṁ taddhi mārutam|
gulmaghnA vividhA diShTAH siddhAH siddhiShu bastayaH|
gulmaghnA vividhA diShTAH siddhAH siddhiShu bastayaH|
</div></div>
''Basti Karma'' is the best treatment of ''gulma'' because it first conquers ''vata'' at its natural site and then cures ''gulma'' quickly. Therefore ''niruha'' and ''anuvasana basti'' should be administered repeatedly for cure of ''vata, pitta'' and ''kapha gulma''. Various types of ''basti'' for the cure of ''gulma'' shall be described in [[Basti Siddhi]] [100-101]
''[[Basti]] Karma'' is the best treatment of ''gulma'' because it first conquers ''[[vata]]'' at its natural site and then cures ''gulma'' quickly. Therefore ''niruha'' and ''anuvasana [[basti]]'' should be administered repeatedly for cure of ''[[vata]], [[pitta]]'' and ''[[kapha]] gulma''. Various types of ''[[basti]]'' for the cure of ''gulma'' shall be described in [[Basti Siddhi]] [100-101]
=== Medicated oils ===
<div class="mw-collapsible mw-collapsed">
गुल्मघ्नानि च तैलानि वक्ष्यन्ते वातरोगिके||१०२||
गुल्मघ्नानि च तैलानि वक्ष्यन्ते वातरोगिके||१०२||
प्रयुक्तान्याशु सिध्यन्ति तैलं ह्यनिलजित्परम् [१२] ||१०३||
प्रयुक्तान्याशु सिध्यन्ति तैलं ह्यनिलजित्परम् [१२] ||१०३||
<div class="mw-collapsible-content">
gulmaghnāni ca tailāni vakṣyantē vātarōgikē||102||
gulmaghnāni ca tailāni vakṣyantē vātarōgikē||102||
prayuktAnyAshu sidhyanti tailaM hyanilajitparam [12] ||103||
prayuktAnyAshu sidhyanti tailaM hyanilajitparam [12] ||103||
</div></div>
The various types of medicated oil useful for ''gulma'' will be described in [[Vatavyadhi Chikitsa]]. 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 [[Vatavyadhi Chikitsa]]. 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]
<div class="mw-collapsible mw-collapsed">
नीलिनीचूर्णसंयुक्तं पूर्वोक्तं घृतमेव|
नीलिनीचूर्णसंयुक्तं पूर्वोक्तं घृतमेव|
समलाय प्रदातव्यं शोधनं वातगुल्मिने||१०४||
समलाय प्रदातव्यं शोधनं वातगुल्मिने||१०४||
<div class="mw-collapsible-content">
nīlinīcūrṇasaṁyuktaṁ pūrvōktaṁ ghr̥tamēva|
nīlinīcūrṇasaṁyuktaṁ pūrvōktaṁ ghr̥tamēva|
samalAya pradAtavyaM shodhanaM vAtagulmine||104||
samalAya pradAtavyaM shodhanaM vAtagulmine||104||
</div></div>
Accumulated feces of the patient of ''vata gulma'' should be eliminated by giving earlier mentioned ''ghrita'' mixed with powder ''nilini''.[104]
Accumulated feces of the patient of ''[[vata]] gulma'' should be eliminated by giving earlier mentioned ''ghrita'' mixed with powder ''nilini''.[104]
=== ''Nilinyadyam ghritam'' ===
<div class="mw-collapsible mw-collapsed">
नीलिनीत्रिवृतादन्तीपथ्याकम्पिल्लकैः सह|
नीलिनीत्रिवृतादन्तीपथ्याकम्पिल्लकैः सह|
शोधनार्थं घृतं देयं सबिडक्षारनागरम्||१०५||
शोधनार्थं घृतं देयं सबिडक्षारनागरम्||१०५||
<div class="mw-collapsible-content">
nīlinītrivr̥tādantīpathyākampillakaiḥ saha|
nīlinītrivr̥tādantīpathyākampillakaiḥ saha|
shodhanArthaM ghRutaM deyaM sabiDakShAranAgaram||105||
shodhanArthaM ghRutaM deyaM sabiDakShAranAgaram||105||
</div></div>
The ghee prepared with ''nilini, trivrita, danti, haritaki'' and ''kampillaka'' along with bid-salt and ''kshara'' should be given for ''shodhana'' [105]
The ghee prepared with ''nilini, trivrita, danti, haritaki'' and ''kampillaka'' along with bid-salt and ''kshara'' should be given for ''[[shodhana]]'' [105]
=== ''Nilinyadyam ghritam'' ===
<div class="mw-collapsible mw-collapsed">
नीलिनीं त्रिफलां रास्नां बलां कटुकरोहिणीम्|
नीलिनीं त्रिफलां रास्नां बलां कटुकरोहिणीम्|
इति नीलिन्याद्यं घृतम्
इति नीलिन्याद्यं घृतम्
<div class="mw-collapsible-content">
nīlinīṁ triphalāṁ rāsnāṁ balāṁ kaṭukarōhiṇīm|
nīlinīṁ triphalāṁ rāsnāṁ balāṁ kaṭukarōhiṇīm|
iti nIlinyAdyaM ghRutam
iti nIlinyAdyaM ghRutam
</div></div>
Take 50 gm each of ''nilini, triphala, rasna, bala, katuki, vidanga'' and ''kantakari'' and add to it 2.5 litres of water and prepare the decoction by reducing it to one-fourth. Add to it 640 ml of ghee, 640 ml of curd and 50 ml of latex of ''snuhi'' and prepare ghee as per method of ''sneha-paka''. Its 40 ml mixed with ''manda'' (liquid obtained by filtering the boiled rice) should be given for ''virechana''. When the patient is well purged and the drug is digested then meat soup is given in diet.
Take 50 gm each of ''nilini, triphala, rasna, bala, katuki, vidanga'' and ''kantakari'' and add to it 2.5 litres of water and prepare the decoction by reducing it to one-fourth. Add to it 640 ml of ghee, 640 ml of curd and 50 ml of latex of ''snuhi'' and prepare ghee as per method of ''sneha-paka''. Its 40 ml mixed with ''manda'' (liquid obtained by filtering the boiled rice) should be given for ''[[virechana]]''. When the patient is well purged and the drug is digested then meat soup is given in diet.
This ''ghrita'' cures ''gulma, kushtha, udara roga, vyanga'' (freckles), swellings, anemia, fever, leukoderma, splenomegaly and psychic disorders (''unmada''). Thus ''nilinyadi ghritam'' is described [106-109]
This ''ghrita'' cures ''gulma, kushtha, udara roga, vyanga'' (freckles), swellings, anemia, fever, leukoderma, splenomegaly and psychic disorders (''unmada''). Thus ''nilinyadi ghritam'' is described [106-109]
=== ''Pathya'' in ''[[vata]] gulma'' ===
<div class="mw-collapsible mw-collapsed">
कुक्कुटाश्च मयूराश्च तित्तिरिक्रौञ्चवर्तकाः|
कुक्कुटाश्च मयूराश्च तित्तिरिक्रौञ्चवर्तकाः|
समण्डवारुणीपानं पक्वं वा धान्यकैर्जलम्||१११||
समण्डवारुणीपानं पक्वं वा धान्यकैर्जलम्||१११||
<div class="mw-collapsible-content">
kukkuṭāśca mayūrāśca tittirikrauñcavartakāḥ|
kukkuṭāśca mayūrāśca tittirikrauñcavartakāḥ|
samaNDavAruNIpAnaM pakvaM vA dhAnyakairjalam||111||
samaNDavAruNIpAnaM pakvaM vA dhAnyakairjalam||111||
</div></div>
Hot, liquid and unctuous diet is beneficial for the patient of ''vata gulma''. Red rice, wine and ghee; meats of chicken, peacock, partridge (''tittara''), ''krauncha'' (demoiselle) and quail (''vartaka'') are beneficial for the patient of ''vata gulma''.
Hot, liquid and unctuous diet is beneficial for the patient of ''[[vata]] gulma''. Red rice, wine and ghee; meats of chicken, peacock, partridge (''tittara''), ''krauncha'' (demoiselle) and quail (''vartaka'') are beneficial for the patient of ''[[vata]] gulma''.
Similarly a potion of ''varuni'' wine with ''manda'' (supernatant fluid of boiled rice) or water boiled with coriander is beneficial [110-111]
Similarly a potion of ''varuni'' wine with ''manda'' (supernatant fluid of boiled rice) or water boiled with coriander is beneficial [110-111]
=== Protection of ''agni'' ===
<div class="mw-collapsible mw-collapsed">
मन्देऽग्नौ वर्धते गुल्मो दीप्ते चाग्नौ प्रशाम्यति|
मन्देऽग्नौ वर्धते गुल्मो दीप्ते चाग्नौ प्रशाम्यति|
तस्मान्ना नातिसौहित्यं कुर्यान्नातिविलङ्घनम्||११२||
तस्मान्ना नातिसौहित्यं कुर्यान्नातिविलङ्घनम्||११२||
<div class="mw-collapsible-content">
mandē'gnau vardhatē gulmō dīptē cāgnau praśāmyati|
mandē'gnau vardhatē gulmō dīptē cāgnau praśāmyati|
tasmAnnA nAtisauhityaM kuryAnnAtivila~gghanam||112||
tasmAnnA nAtisauhityaM kuryAnnAtivila~gghanam||112||
</div></div>
With decrease in digestive-power (''agni'') the ''gulma'' is aggravated, while on augmentation of the digestion (''agni'') the ''gulma'' is pacified. Therefore, to the patient of ''gulma'' neither excessive nutritional food nor excessive fasting or light food/treatment should be prescribed [112]
With decrease in digestive-power (''agni'') the ''gulma'' is aggravated, while on augmentation of the digestion (''agni'') the ''gulma'' is pacified. Therefore, to the patient of ''gulma'' neither excessive nutritional food nor excessive fasting or light food/treatment should be prescribed [112]
=== Oleation therapy ===
<div class="mw-collapsible mw-collapsed">
सर्वत्र गुल्मे प्रथमं स्नेहस्वेदोपपादिते|
सर्वत्र गुल्मे प्रथमं स्नेहस्वेदोपपादिते|
या क्रिया क्रियते सिद्धिं सा याति न विरूक्षिते||११३||
या क्रिया क्रियते सिद्धिं सा याति न विरूक्षिते||११३||
<div class="mw-collapsible-content">
sarvatra gulmē prathamaṁ snēhasvēdōpapāditē|
sarvatra gulmē prathamaṁ snēhasvēdōpapāditē|
yA kriyA kriyate siddhiM sA yAti na virUkShite||113||
yA kriyA kriyate siddhiM sA yAti na virUkShite||113||
</div></div>
In all types of ''gulma'', only that successive treatment is fruitful which is given after subjecting first the patient to ''snehana'' and then ''swedana'', but it never success if given after un-unctuous (''ruksha'') treatment [113]
In all types of ''gulma'', only that successive treatment is fruitful which is given after subjecting first the patient to ''[[snehana]]'' and then ''[[swedana]]'', but it never success if given after un-unctuous (''ruksha'') treatment [113]
=== Management of ''[[pitta]] gulma'' ===
<div class="mw-collapsible mw-collapsed">
भिषगात्ययिकं बुद्ध्वा पित्तगुल्ममुपाचरेत्|
भिषगात्ययिकं बुद्ध्वा पित्तगुल्ममुपाचरेत्|
वैरेचनिकसिद्धेन सर्पिषा तिक्तकेन वा||११४||
वैरेचनिकसिद्धेन सर्पिषा तिक्तकेन वा||११४||
<div class="mw-collapsible-content">
bhiṣagātyayikaṁ buddhvā pittagulmamupācarēt|
bhiṣagātyayikaṁ buddhvā pittagulmamupācarēt|
vairecanikasiddhena sarpiShA tiktakena [14] vA||114||
vairecanikasiddhena sarpiShA tiktakena [14] vA||114||
</div></div>
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'' ===
<div class="mw-collapsible mw-collapsed">
रोहिणीकटुकानिम्बमधुकत्रिफलात्वचः|
रोहिणीकटुकानिम्बमधुकत्रिफलात्वचः|
इति रोहिण्याद्यं घृतम्
इति रोहिण्याद्यं घृतम्
<div class="mw-collapsible-content">
rōhiṇīkaṭukānimbamadhukatriphalātvacaḥ|
rōhiṇīkaṭukānimbamadhukatriphalātvacaḥ|
iti rohiNyAdyaM ghRutam
iti rohiNyAdyaM ghRutam
</div></div>
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'' ===
<div class="mw-collapsible mw-collapsed">
जले दशगुणे साध्यं त्रायमाणाचतुष्पलम्|
जले दशगुणे साध्यं त्रायमाणाचतुष्पलम्|
इति त्रायमाणाद्यं घृतम्
इति त्रायमाणाद्यं घृतम्
<div class="mw-collapsible-content">
jalē daśaguṇē sādhyaṁ trāyamāṇācatuṣpalam|
jalē daśaguṇē sādhyaṁ trāyamāṇācatuṣpalam|
iti trAyamANAdyaM ghRutam
iti trAyamANAdyaM ghRutam
</div></div>
Make decoction by adding 10 times of water to 160 gm of ''trayamana'' and reducing it to one fifth. To this decoction add 10 gm paste of ''katuka, mustaka, trayamana'' and ''duralabha''; 10 gm paste of ''tamalaki, veera, jivanti, chandana'' and lotus; add to it 320 ml juice of ''amalaki,'' milk and ghee. From all these, prepare ghrita as per method of ''sneha pāka''. It is best ''ghrita'' to cure ''pitta'' and ''rakta-gulma, visarpa, pitta jwara,'' heart disease, jaundice and ''kushtha''. Thus ''trayamanadi ghritam'' is described [118-121]
Make decoction by adding 10 times of water to 160 gm of ''trayamana'' and reducing it to one fifth. To this decoction add 10 gm paste of ''katuka, mustaka, trayamana'' and ''duralabha''; 10 gm paste of ''tamalaki, veera, jivanti, chandana'' and lotus; add to it 320 ml juice of ''amalaki,'' milk and ghee. From all these, prepare ghrita as per method of ''sneha pāka''. It is best ''ghrita'' to cure ''pitta'' and ''[[rakta]]-gulma, visarpa, [[pitta]] jwara,'' heart disease, jaundice and ''kushtha''. Thus ''trayamanadi ghritam'' is described [118-121]
=== ''Amalakadi ghritam'' ===
<div class="mw-collapsible mw-collapsed">
रसेनामलकेक्षूणां घृतपादं विपाचयेत्|
रसेनामलकेक्षूणां घृतपादं विपाचयेत्|
इत्यामलकाद्यं घृतम्
इत्यामलकाद्यं घृतम्
<div class="mw-collapsible-content">
rasēnāmalakēkṣūṇāṁ ghr̥tapādaṁ vipācayēt|
rasēnāmalakēkṣūṇāṁ ghr̥tapādaṁ vipācayēt|
ityAmalakAdyaM ghRutam
ityAmalakAdyaM ghRutam
</div></div>
Prepare ''ghrita'' with four parts of juice of ''amalaki'' and sugarcane juice, one-fourth part of paste of ''haritaki'' and one part of ghee. It is to be taken orally to cure pitta ''gulma''. Thus ''amalakadyam ghritam'' is described [122]
Prepare ''ghrita'' with four parts of juice of ''amalaki'' and sugarcane juice, one-fourth part of paste of ''haritaki'' and one part of ghee. It is to be taken orally to cure pitta ''gulma''. Thus ''amalakadyam ghritam'' is described [122]
=== ''Drakshadi ghritam'' ===
<div class="mw-collapsible mw-collapsed">
द्राक्षां मधूकं खर्जूरं विदारीं सशतावरीम्|
द्राक्षां मधूकं खर्जूरं विदारीं सशतावरीम्|
इति द्राक्षाद्यं घृतम्
इति द्राक्षाद्यं घृतम्
<div class="mw-collapsible-content">
drākṣāṁ madhūkaṁ kharjūraṁ vidārīṁ saśatāvarīm|
drākṣāṁ madhūkaṁ kharjūraṁ vidārīṁ saśatāvarīm|
iti drAkShAdyaM ghRutam
iti drAkShAdyaM ghRutam
</div></div>
Take 40 gm each of raisin, ''madhuka'' (mahva), date, ''vidari, shatavari, parushaka'' and ''triphala'' and add to it 2560 ml of water and boil till reduced to one-fourth. To this decoction add 640 gm each of ghee, sugar-cane juice, juice of ''amalaki'' and milk and its one fourth part of paste of ''haritaki''; and prepare ''ghrita'' as per method of ''sneha-paka''. Take this ghee by adding one fourth quantities of sugar and honey. It cures ''pitta-gulma'' and all types of pitta disorders. Thus ''drakshdyam ghritam'' is described [123-125]
Take 40 gm each of raisin, ''madhuka'' (mahva), date, ''vidari, shatavari, parushaka'' and ''triphala'' and add to it 2560 ml of water and boil till reduced to one-fourth. To this decoction add 640 gm each of ghee, sugar-cane juice, juice of ''amalaki'' and milk and its one fourth part of paste of ''haritaki''; and prepare ''ghrita'' as per method of ''sneha-paka''. Take this ghee by adding one fourth quantities of sugar and honey. It cures ''[[pitta]]-gulma'' and all types of pitta disorders. Thus ''drakshdyam ghritam'' is described [123-125]
=== ''Vasaghr̥itam'' ===
<div class="mw-collapsible mw-collapsed">
वृषं समूलमापोथ्य पचेदष्टगुणे जले|
वृषं समूलमापोथ्य पचेदष्टगुणे जले|
इति वासाघृतम्
इति वासाघृतम्
<div class="mw-collapsible-content">
vr̥ṣaṁ samūlamāpōthya pacēdaṣṭaguṇē jalē|
vr̥ṣaṁ samūlamāpōthya pacēdaṣṭaguṇē jalē|
iti vAsAghRutam
iti vAsAghRutam
</div></div>
Take whole plant of ''vasa'' including its root and make decoction by adding to it eight times water and reducing to one-eighth. Add to the decoction, paste of its flower and ghee and prepare the ''ghrita''. It is to be taken with honey which cures ''pitta gulma'', piles, fever, dyspnea, cough and heart disease. Thus ''vasaghritam'' is described [126-127]
Take whole plant of ''vasa'' including its root and make decoction by adding to it eight times water and reducing to one-eighth. Add to the decoction, paste of its flower and ghee and prepare the ''ghrita''. It is to be taken with honey which cures ''[[pitta]] gulma'', piles, fever, dyspnea, cough and heart disease. Thus ''vasaghritam'' is described [126-127]
<div class="mw-collapsible mw-collapsed">
द्विपलं त्रायमाणाया जलद्विप्रस्थसाधितम्|
द्विपलं त्रायमाणाया जलद्विप्रस्थसाधितम्|
तेन निर्हृतदोषस्य गुल्मः शाम्यति पैत्तिकः||१२९||
तेन निर्हृतदोषस्य गुल्मः शाम्यति पैत्तिकः||१२९||
<div class="mw-collapsible-content">
dvipalaṁ trāyamāṇāyā jaladviprasthasādhitam|
dvipalaṁ trāyamāṇāyā jaladviprasthasādhitam|
tena nirhRutadoShasya gulmaH shAmyati paittikaH||129||
tena nirhRutadoShasya gulmaH shAmyati paittikaH||129||
</div></div>
Take 80 gm of ''trayamana'' and make decoction by adding 1.280 litre of water and reducing to one-eighth and filter it. Take it by adding equal quantity of warm milk and thereafter take as much milk as one can digest. This preparation eliminates the toxic substances and thus cures ''pitta gulma'' [128-129]
Take 80 gm of ''trayamana'' and make decoction by adding 1.280 litre of water and reducing to one-eighth and filter it. Take it by adding equal quantity of warm milk and thereafter take as much milk as one can digest. This preparation eliminates the toxic substances and thus cures ''[[pitta]] gulma'' [128-129]
<div class="mw-collapsible mw-collapsed">
द्राक्षाभयारसं गुल्मे पैत्तिके सगुडं पिबेत्|
द्राक्षाभयारसं गुल्मे पैत्तिके सगुडं पिबेत्|
लिह्यात्कम्पिल्लकं वाऽपि विरेकार्थं मधुद्रवम्||१३०||
लिह्यात्कम्पिल्लकं वाऽपि विरेकार्थं मधुद्रवम्||१३०||
<div class="mw-collapsible-content">
drākṣābhayārasaṁ gulmē paittikē saguḍaṁ pibēt|
drākṣābhayārasaṁ gulmē paittikē saguḍaṁ pibēt|
lihyAtkampillakaM vA~api virekArthaM madhudravam||130||
lihyAtkampillakaM vA~api virekArthaM madhudravam||130||
</div></div>
In patient of ''pitta gulma'' the ''virechana'' can be performed by administration of decoction of raisins and ''haritaki'' with jaggery or by licking powder of ''kampillaka'' with honey [130]
In patient of ''[[pitta]] gulma'' the ''[[virechana]]'' can be performed by administration of decoction of raisins and ''haritaki'' with jaggery or by licking powder of ''kampillaka'' with honey [130]
=== Massage ===
<div class="mw-collapsible mw-collapsed">
दाहप्रशमनोऽभ्यङ्गः सर्पिषा पित्तगुल्मिनाम्|
दाहप्रशमनोऽभ्यङ्गः सर्पिषा पित्तगुल्मिनाम्|
चन्दनाद्येन तैलेन तैलेन मधुकस्य वा||१३१||
चन्दनाद्येन तैलेन तैलेन मधुकस्य वा||१३१||
<div class="mw-collapsible-content">
dāhapraśamanō'bhyaṅgaḥ sarpiṣā pittagulminām|
dāhapraśamanō'bhyaṅgaḥ sarpiṣā pittagulminām|
candanAdyena tailena tailena madhukasya vA||131||
candanAdyena tailena tailena madhukasya vA||131||
</div></div>
For relieving burning sensation in the patient of ''gulma'', massage with ghee or ''chandanadi taila'' or medicated oil prepared with ''madhuka'' should be done [131]
For relieving burning sensation in the patient of ''gulma'', massage with ghee or ''chandanadi taila'' or medicated oil prepared with ''madhuka'' should be done [131]
=== ''Kshira-[[basti]]'' for ''[[pitta]] gulma'' ===
<div class="mw-collapsible mw-collapsed">
ये च पित्तज्वरहराः सतिक्ताः क्षीरबस्तयः|
ये च पित्तज्वरहराः सतिक्ताः क्षीरबस्तयः|
हितास्ते पित्तगुल्मिभ्यो वक्ष्यन्ते ये च सिद्धिषु||१३२||
हितास्ते पित्तगुल्मिभ्यो वक्ष्यन्ते ये च सिद्धिषु||१३२||
<div class="mw-collapsible-content">
yē ca pittajvaraharāḥ satiktāḥ kṣīrabastayaḥ|
yē ca pittajvaraharāḥ satiktāḥ kṣīrabastayaḥ|
hitAste pittagulmibhyo vakShyante ye ca siddhiShu||132||
hitAste pittagulmibhyo vakShyante ye ca siddhiShu||132||
</div></div>
''Kshira-basti'' comprising of bitter drugs described for ''pitta'' fever as well as which will be described in [[Siddhi Sthana]] are also beneficial for curing ''pitta gulma'' [132]
''Kshira-[[basti]]'' comprising of bitter drugs described for ''[[pitta]]'' fever as well as which will be described in [[Siddhi Sthana]] are also beneficial for curing ''[[pitta]] gulma'' [132]
=== ''Pathya'' for ''[[pitta]] gulma'' ===
<div class="mw-collapsible mw-collapsed">
शालयो जाङ्गलं मांसं गव्याजे पयसी घृतम्|
शालयो जाङ्गलं मांसं गव्याजे पयसी घृतम्|
बलाविदारीगन्धाद्यैः पित्तगुल्मचिकित्सितम्||१३४||
बलाविदारीगन्धाद्यैः पित्तगुल्मचिकित्सितम्||१३४||
<div class="mw-collapsible-content">
śālayō jāṅgalaṁ māṁsaṁ gavyājē payasī ghr̥tam|
śālayō jāṅgalaṁ māṁsaṁ gavyājē payasī ghr̥tam|
balAvidArIgandhAdyaiH pittagulmacikitsitam||134||
balAvidArIgandhAdyaiH pittagulmacikitsitam||134||
</div></div>
Red rice, meat of wild animals, milk and ghee of cow and goat, dates, grapes, pomegranates, ''amalaki'' and ''parushaka'' are wholesome diet articles for eating and water boiled with ''bala-vidarigandhadi'' drugs for drinking for the patient of ''pitta gulma'' [133-134]
Red rice, meat of wild animals, milk and ghee of cow and goat, dates, grapes, pomegranates, ''amalaki'' and ''parushaka'' are wholesome diet articles for eating and water boiled with ''bala-vidarigandhadi'' drugs for drinking for the patient of ''[[pitta]] gulma'' [133-134]
=== Management of ''ama'' associated ''gulma'' ===
<div class="mw-collapsible mw-collapsed">
आमान्वये पित्तगुल्मे सामे वा कफवातिके|
आमान्वये पित्तगुल्मे सामे वा कफवातिके|
यवागूभिः खडैर्यूषैः सन्धुक्ष्योऽग्निर्विलङ्घिते||१३५||
यवागूभिः खडैर्यूषैः सन्धुक्ष्योऽग्निर्विलङ्घिते||१३५||
<div class="mw-collapsible-content">
āmānvayē pittagulmē sāmē vā kaphavātikē|
āmānvayē pittagulmē sāmē vā kaphavātikē|
yavAgUbhiH khaDairyUShaiH sandhukShyo~agnirvila~gghite||135||
yavAgUbhiH khaDairyUShaiH sandhukShyo~agnirvila~gghite||135||
</div></div>
''Pitta gulma'' or ''kapha-vata gulma'' if associated with ''ama'', first it should be subjected to ''langhana'' and then given cooked rice (''yavagu'') and vegetable or pulse soup to enhance the digestion [135]
''[[Pitta]] gulma'' or ''[[kapha]]-[[vata]] gulma'' if associated with ''ama'', first it should be subjected to ''[[langhana]]'' and then given cooked rice (''yavagu'') and vegetable or pulse soup to enhance the digestion [135]
=== Importance of ''agni'' ===
<div class="mw-collapsible mw-collapsed">
शमप्रकोपौ दोषाणां सर्वेषामग्निसंश्रितौ|
शमप्रकोपौ दोषाणां सर्वेषामग्निसंश्रितौ|
तस्मादग्निं सदा रक्षेन्निदानानि च वर्जयेत्||१३६||
तस्मादग्निं सदा रक्षेन्निदानानि च वर्जयेत्||१३६||
<div class="mw-collapsible-content">
śamaprakōpau dōṣāṇāṁ sarvēṣāmagnisaṁśritau|
śamaprakōpau dōṣāṇāṁ sarvēṣāmagnisaṁśritau|
tasmAdagniM sadA rakShennidAnAni ca varjayet||136||
tasmAdagniM sadA rakShennidAnAni ca varjayet||136||
</div></div>
Equilibrium or provocation of all the ''dosha'' depend upon the condition of ''agni'' (digestion and metabolism), hence one should always take its care and avoid such causes which disturb it [136]
Equilibrium or provocation of all the ''[[dosha]]'' depend upon the condition of ''agni'' (digestion and metabolism), hence one should always take its care and avoid such causes which disturb it [136]
=== Treatment of ''kaphaja gulma'' ===
==== ''Vamana'' in ''kaphaja gulma'' ====
<div class="mw-collapsible mw-collapsed">
वमनं वमनार्हाय प्रदद्यात् कफगुल्मिने|
वमनं वमनार्हाय प्रदद्यात् कफगुल्मिने|
<div class="mw-collapsible-content">
vamanaṁ vamanārhāya pradadyāt kaphagulminē|
vamanaṁ vamanārhāya pradadyāt kaphagulminē|
vamanaM vamanArhAya pradadyAt kaphagulmine|
vamanaM vamanArhAya pradadyAt kaphagulmine|
</div></div>
''Vamana karma'' should be done in ''kapha gulma'' provided the patient is fit for it [136½]
''[[Vamana]] karma'' should be done in ''[[kapha]] gulma'' provided the patient is fit for it [136½]
==== Surgical treatment of ''[[kapha]] gulma'' ====
<div class="mw-collapsible mw-collapsed">
स्निग्धस्विन्नशरीराय गुल्मे शैथिल्यमागते||१३७||
स्निग्धस्विन्नशरीराय गुल्मे शैथिल्यमागते||१३७||
परिवेष्ट्य प्रदीप्तांस्तु बल्वजानथवा कुशान्|
परिवेष्ट्य प्रदीप्तांस्तु बल्वजानथवा कुशान्|
भिषक्कुम्भे समावाप्य गुल्मं घटमुखे न्यसेत्||१३८||
भिषक्कुम्भे समावाप्य गुल्मं घटमुखे न्यसेत्||१३८||
सङ्गृहीतो यदा गुल्मस्तदा घटमथोद्धरेत्|
सङ्गृहीतो यदा गुल्मस्तदा घटमथोद्धरेत्|
वस्त्रान्तरं ततः कृत्वा भिन्द्याद्गुल्मं प्रमाणवित्||१३९||
वस्त्रान्तरं ततः कृत्वा भिन्द्याद्गुल्मं प्रमाणवित्||१३९||
विमार्गाजपदादर्शैर्यथालाभं प्रपीडयेत्|
विमार्गाजपदादर्शैर्यथालाभं प्रपीडयेत्|
मृद्नीयाद्गुल्ममेवैकं न त्वन्त्रहृदयं स्पृशेत्||१४०||
मृद्नीयाद्गुल्ममेवैकं न त्वन्त्रहृदयं स्पृशेत्||१४०||
<div class="mw-collapsible-content">
snigdhasvinnaśarīrāya gulmē śaithilyamāgatē||137||
snigdhasvinnaśarīrāya gulmē śaithilyamāgatē||137||
parivēṣṭya pradīptāṁstu balvajānathavā kuśān|
parivēṣṭya pradīptāṁstu balvajānathavā kuśān|
bhiṣakkumbhē samāvāpya gulmaṁ ghaṭamukhē nyasēt||138||
bhiṣakkumbhē samāvāpya gulmaṁ ghaṭamukhē nyasēt||138||
saṅgr̥hītō yadā gulmastadā ghaṭamathōddharēt|
saṅgr̥hītō yadā gulmastadā ghaṭamathōddharēt|
vastrāntaraṁ tataḥ kr̥tvā bhindyādgulmaṁ pramāṇavit||139||
vastrāntaraṁ tataḥ kr̥tvā bhindyādgulmaṁ pramāṇavit||139||
vimārgājapadādarśairyathālābhaṁ prapīḍayēt|
vimārgājapadādarśairyathālābhaṁ prapīḍayēt|
mr̥dnīyādgulmamēvaikaṁ na tvantrahr̥dayaṁ spr̥śēt||140||
mr̥dnīyādgulmamēvaikaṁ na tvantrahr̥dayaṁ spr̥śēt||140||
pariveShTya pradIptAMstu balvajAnathavA kushAn|
pariveShTya pradIptAMstu balvajAnathavA kushAn|
bhiShakkumbhe samAvApya gulmaM ghaTamukhe nyaset||138||
bhiShakkumbhe samAvApya gulmaM ghaTamukhe nyaset||138||
sa~ggRuhIto [17] yadA gulmastadA ghaTamathoddharet|
sa~ggRuhIto [17] yadA gulmastadA ghaTamathoddharet|
vastrAntaraM tataH kRutvA bhindyAdgulmaM [18] pramANavit||139||
vastrAntaraM tataH kRutvA bhindyAdgulmaM [18] pramANavit||139||
vimArgAjapadAdarshairyathAlAbhaM prapIDayet|
vimArgAjapadAdarshairyathAlAbhaM prapIDayet|
mRudnIyAdgulmamevaikaM na tvantrahRudayaM [19] spRushet||140||
mRudnIyAdgulmamevaikaM na tvantrahRudayaM [19] spRushet||140||
</div></div>
First make the ''kapha gulma'' loose (''shaithilya'') by ''snehana'' and ''swedana'' therapies then following operation should be performed on the patient:
First make the ''[[kapha]] gulma'' loose (''shaithilya'') by ''[[snehana]]'' and ''[[swedana]]'' therapies then following operation should be performed on the patient:
Cover the brim of ''gulma'' with a piece of cloth and on the inner portion of the brim put an earthen lid containing ignited ''balvaja'' or small sacrificial grass (''kusha''). Then place the mouth of an inverted empty pot on it in such a way so that it covers and fit on the brim. Due to negative pressure produced inside the pot by the fire, the mouth of the pot will strongly adhere to the brim and the lump will be pulled into the pot. Then remove the pot and tightly tie the bottom of this bulged portion of the ''gulma'' and then puncture it. Thereafter, with the help of any available instruments such as ''vimarga, ajapada'' and ''adarsha'', only the ''gulma'' part is squeezed or compressed, without touching the intestines and heart. This operation should be done only by the expert surgeon in the technique [137-140]
Cover the brim of ''gulma'' with a piece of cloth and on the inner portion of the brim put an earthen lid containing ignited ''balvaja'' or small sacrificial grass (''kusha''). Then place the mouth of an inverted empty pot on it in such a way so that it covers and fit on the brim. Due to negative pressure produced inside the pot by the fire, the mouth of the pot will strongly adhere to the brim and the lump will be pulled into the pot. Then remove the pot and tightly tie the bottom of this bulged portion of the ''gulma'' and then puncture it. Thereafter, with the help of any available instruments such as ''vimarga, ajapada'' and ''adarsha'', only the ''gulma'' part is squeezed or compressed, without touching the intestines and heart. This operation should be done only by the expert surgeon in the technique [137-140]
तिलैरण्डातसीबीजसर्षपैः परिलिप्य च|
=== Post-operative measures ===
<div class="mw-collapsible mw-collapsed">
तिलैरण्डातसीबीजसर्षपैः परिलिप्य च|
श्लेष्मगुल्ममयःपात्रैः सुखोष्णैः स्वेदयेद्भिषक्||१४१||
श्लेष्मगुल्ममयःपात्रैः सुखोष्णैः स्वेदयेद्भिषक्||१४१||
<div class="mw-collapsible-content">
tilairaṇḍātasībījasarṣapaiḥ parilipya ca|
tilairaṇḍātasībījasarṣapaiḥ parilipya ca|
ślēṣmagulmamayaḥpātraiḥ sukhōṣṇaiḥ svēdayēdbhiṣak||141||
ślēṣmagulmamayaḥpātraiḥ sukhōṣṇaiḥ svēdayēdbhiṣak||141||
tilairaNDAtasIbIjasarShapaiH parilipya ca|
tilairaNDAtasIbIjasarShapaiH parilipya ca|
shleShmagulmamayaHpAtraiH sukhoShNaiH svedayedbhiShak||141||
shleShmagulmamayaHpAtraiH sukhoShNaiH svedayedbhiShak||141||
</div></div>
After the above operation apply the paste made from sesame, castor seed, linseeds and mustard seeds on the ''gulma'' and do its sudation through bearable hot iron pot [141]
After the above operation apply the paste made from sesame, castor seed, linseeds and mustard seeds on the ''gulma'' and do its sudation through bearable hot iron pot [141]
=== ''Dashamuli ghrita'' ===
<div class="mw-collapsible mw-collapsed">
सव्योषक्षारलवणं दशमूलीशृतं घृतम्|
सव्योषक्षारलवणं दशमूलीशृतं घृतम्|
कफगुल्मं जयत्याशु सहिङ्गुबिडदाडिमम्||१४२||
कफगुल्मं जयत्याशु सहिङ्गुबिडदाडिमम्||१४२||
इति दशमूलीघृतम्|
इति दशमूलीघृतम्|
<div class="mw-collapsible-content">
savyōṣakṣāralavaṇaṁ daśamūlīśr̥taṁ ghr̥tam|
savyōṣakṣāralavaṇaṁ daśamūlīśr̥taṁ ghr̥tam|
kaphagulmaṁ jayatyāśu sahiṅgubiḍadāḍimam||142||
kaphagulmaṁ jayatyāśu sahiṅgubiḍadāḍimam||142||
savyoShakShAralavaNaM dashamUlIshRutaM ghRutam|
savyoShakShAralavaNaM dashamUlIshRutaM ghRutam|
kaphagulmaM jayatyAshu sahi~ggubiDadADimam||142||
kaphagulmaM jayatyAshu sahi~ggubiDadADimam||142||
iti dashamUlIghRutam
iti dashamUlIghRutam
</div></div>
Prepare a medicated ghee with decoction of ''dashamula,'' paste of ''trikatu, yavakshara,'' salt, asafoetida, bid-salt and pomegranate, and ghee. Its oral use quickly subsides ''kapha gulma''. Thus ''dashamuli-ghritam'' is described. [142]
Prepare a medicated ghee with decoction of ''dashamula,'' paste of ''trikatu, yavakshara,'' salt, asafoetida, bid-salt and pomegranate, and ghee. Its oral use quickly subsides ''[[kapha]] gulma''. Thus ''dashamuli-ghritam'' is described. [142]
=== ''Bhallatakadi ghritam'' ===
<div class="mw-collapsible mw-collapsed">
भल्लातकानां द्विपलं पञ्चमूलं पलोन्मितम्|
भल्लातकानां द्विपलं पञ्चमूलं पलोन्मितम्|
साध्यं विदारीगन्धाद्यमापोथ्य सलिलाढके||१४३||
साध्यं विदारीगन्धाद्यमापोथ्य सलिलाढके||१४३||
पादशेषे रसे तस्मिन् पिप्पलीं नागरं वचाम्|
पादशेषे रसे तस्मिन् पिप्पलीं नागरं वचाम्|
विडङ्गं सैन्धवं हिङ्गु यावशूकं बिडं शटीम्||१४४||
विडङ्गं सैन्धवं हिङ्गु यावशूकं बिडं शटीम्||१४४||
चित्रकं मधुकं रास्नां पिष्ट्वा कर्षसमं भिषक्|
चित्रकं मधुकं रास्नां पिष्ट्वा कर्षसमं भिषक्|
प्रस्थं च पयसो दत्त्वा घृतप्रस्थं विपाचयेत्||१४५||
प्रस्थं च पयसो दत्त्वा घृतप्रस्थं विपाचयेत्||१४५||
एतद्भल्लातकघृतं कफगुल्महरं परम्|
एतद्भल्लातकघृतं कफगुल्महरं परम्|
प्लीहपाण्ड्वामयश्वासग्रहणीरोगकासनुत्||१४६||
प्लीहपाण्ड्वामयश्वासग्रहणीरोगकासनुत्||१४६||
इति भल्लातकाद्यं घृतम्
इति भल्लातकाद्यं घृतम्
<div class="mw-collapsible-content">
bhallātakānāṁ dvipalaṁ pañcamūlaṁ palōnmitam|
bhallātakānāṁ dvipalaṁ pañcamūlaṁ palōnmitam|
sādhyaṁ vidārīgandhādyamāpōthya salilāḍhakē||143||
sādhyaṁ vidārīgandhādyamāpōthya salilāḍhakē||143||
pādaśēṣē rasē tasmin pippalīṁ nāgaraṁ vacām|
pādaśēṣē rasē tasmin pippalīṁ nāgaraṁ vacām|
viḍaṅgaṁ saindhavaṁ hiṅgu yāvaśūkaṁ biḍaṁ śaṭīm||144||
viḍaṅgaṁ saindhavaṁ hiṅgu yāvaśūkaṁ biḍaṁ śaṭīm||144||
citrakaṁ madhukaṁ rāsnāṁ piṣṭvā karṣasamaṁ bhiṣak|
citrakaṁ madhukaṁ rāsnāṁ piṣṭvā karṣasamaṁ bhiṣak|
prasthaṁ ca payasō dattvā ghr̥taprasthaṁ vipācayēt||145||
prasthaṁ ca payasō dattvā ghr̥taprasthaṁ vipācayēt||145||
ētadbhallātakaghr̥taṁ kaphagulmaharaṁ param|
ētadbhallātakaghr̥taṁ kaphagulmaharaṁ param|
plīhapāṇḍvāmayaśvāsagrahaṇīrōgakāsanut||146||
plīhapāṇḍvāmayaśvāsagrahaṇīrōgakāsanut||146||
bhallAtakAnAM dvipalaM pa~jcamUlaM palonmitam|
bhallAtakAnAM dvipalaM pa~jcamUlaM palonmitam|
sAdhyaM vidArIgandhAdyamApothya salilADhake||143||
sAdhyaM vidArIgandhAdyamApothya salilADhake||143||
pAdasheShe rase tasmin pippalIM nAgaraM vacAm|
pAdasheShe rase tasmin pippalIM nAgaraM vacAm|
viDa~ggaM saindhavaM hi~ggu yAvashUkaM biDaM shaTIm||144||
viDa~ggaM saindhavaM hi~ggu yAvashUkaM biDaM shaTIm||144||
citrakaM madhukaM rAsnAM piShTvA karShasamaM bhiShak|
citrakaM madhukaM rAsnAM piShTvA karShasamaM bhiShak|
prasthaM ca payaso dattvA ghRutaprasthaM vipAcayet||145||
prasthaM ca payaso dattvA ghRutaprasthaM vipAcayet||145||
etadbhallAtakaghRutaM kaphagulmaharaM param|
etadbhallAtakaghRutaM kaphagulmaharaM param|
plIhapANDvAmayashvAsagrahaNIrogakAsanut||146||
plIhapANDvAmayashvAsagrahaNIrogakAsanut||146||
iti bhallAtakAdyaM ghRutam
iti bhallAtakAdyaM ghRutam
</div></div>
Take coarse powder of 80 gm of ''bhallataka,'' 40 gm of ''laghu panchamula'' and 40 gm of ''vidarigandhadi'' and prepare a decoction by adding 2.5 liters of water and reducing to one-fourth. To this decoction add paste made of 10 gm each of long pepper, dry ginger, ''vacha, vidanga,'' rock and bid salts, asafoetida, ''yavakshara, chitraka, shati,'' liquorices and ''rasna''; 640 ml each of milk and ghee and make ''ghrita'' as per method of ''sneha paka''. Oral use of ''bhallatakadyam ghritam'' is best for providing cure to ''kapha gulma''. It also provides relief in spleen disorders, anemia, asthma, assimilation disorders and cough. Thus ''bhallatakadyam ghritam'' is described [143-146]
Take coarse powder of 80 gm of ''bhallataka,'' 40 gm of ''laghu panchamula'' and 40 gm of ''vidarigandhadi'' and prepare a decoction by adding 2.5 liters of water and reducing to one-fourth. To this decoction add paste made of 10 gm each of long pepper, dry ginger, ''vacha, vidanga,'' rock and bid salts, asafoetida, ''yavakshara, chitraka, shati,'' liquorices and ''rasna''; 640 ml each of milk and ghee and make ''ghrita'' as per method of ''sneha paka''. Oral use of ''bhallatakadyam ghritam'' is best for providing cure to ''[[kapha]] gulma''. It also provides relief in spleen disorders, anemia, asthma, assimilation disorders and cough. Thus ''bhallatakadyam ghritam'' is described [143-146]
=== ''Kshiraṣhaṭpalaka ghritam'' ===
<div class="mw-collapsible mw-collapsed">
पिप्पलीपिप्पलीमूलचव्यचित्रकनागरैः|
पिप्पलीपिप्पलीमूलचव्यचित्रकनागरैः|
पलिकैः सयवक्षारैर्घृतप्रस्थं विपाचयेत्||१४७||
पलिकैः सयवक्षारैर्घृतप्रस्थं विपाचयेत्||१४७||
क्षीरप्रस्थं च तत् सर्पिहन्ति गुल्मं कफात्मकम्|
क्षीरप्रस्थं च तत् सर्पिहन्ति गुल्मं कफात्मकम्|
ग्रहणीपाण्डुरोगघ्नं प्लीहकासज्वरापहम्||१४८||
ग्रहणीपाण्डुरोगघ्नं प्लीहकासज्वरापहम्||१४८||
इति क्षीरषट्पलकं घृतम्
इति क्षीरषट्पलकं घृतम्
<div class="mw-collapsible-content">
pippalīpippalīmūlacavyacitrakanāgaraiḥ|
pippalīpippalīmūlacavyacitrakanāgaraiḥ|
palikaiḥ sayavakṣārairghr̥taprasthaṁ vipācayēt||147||
palikaiḥ sayavakṣārairghr̥taprasthaṁ vipācayēt||147||
kṣīraprasthaṁ ca tat sarpirhanti gulmaṁ kaphātmakam|
kṣīraprasthaṁ ca tat sarpirhanti gulmaṁ kaphātmakam|
grahaṇīpāṇḍurōgaghnaṁ plīhakāsajvarāpaham||148||
grahaṇīpāṇḍurōgaghnaṁ plīhakāsajvarāpaham||148||
pippalIpippalImUlacavyacitrakanAgaraiH|
pippalIpippalImUlacavyacitrakanAgaraiH|
palikaiH sayavakShArairghRutaprasthaM vipAcayet||147||
palikaiH sayavakShArairghRutaprasthaM vipAcayet||147||
kShIraprasthaM ca tat sarpihanti gulmaM kaphAtmakam|
kShIraprasthaM ca tat sarpihanti gulmaM kaphAtmakam|
grahaNIpANDurogaghnaM plIhakAsajvarApaham||148||
grahaNIpANDurogaghnaM plIhakAsajvarApaham||148||
iti kShIraShaTpalakaM ghRutam
iti kShIraShaTpalakaM ghRutam
</div></div>
Make a paste of 40 gm each of fruits and roots of long pepper, ''chavya'' and ''chitraka, yavakshara'' and dried ginger and add to it 640 gm each of ghee and milk, and prepare a medicated ghee. This ''ghrita'' cures ''kapha gulma, grahani'' (chronic assimilation disorders), anemia, spleen disorders, cough and fever. Thus ''kshirashatpalakam ghritam'' is described [147-148]
Make a paste of 40 gm each of fruits and roots of long pepper, ''chavya'' and ''chitraka, yavakshara'' and dried ginger and add to it 640 gm each of ghee and milk, and prepare a medicated ghee. This ''ghrita'' cures ''[[kapha]] gulma, grahani'' (chronic assimilation disorders), anemia, spleen disorders, cough and fever. Thus ''kshirashatpalakam ghritam'' is described [147-148]
=== ''Mishraka sneha'' ===
<div class="mw-collapsible mw-collapsed">
त्रिवृतां त्रिफलां दन्तीं दशमूलं पलोन्मितम्|
त्रिवृतां त्रिफलां दन्तीं दशमूलं पलोन्मितम्|
जले चतुर्गुणे पक्त्वा चतुर्भागस्थितं रसम्||१४९||
जले चतुर्गुणे पक्त्वा चतुर्भागस्थितं रसम्||१४९||
सर्पिरेरण्डजं तैलं क्षीरं चैकत्र साधयेत्|
सर्पिरेरण्डजं तैलं क्षीरं चैकत्र साधयेत्|
स सिद्धो मिश्रकस्नेहः सक्षौद्रः कफगुल्मनुत्||१५०||
स सिद्धो मिश्रकस्नेहः सक्षौद्रः कफगुल्मनुत्||१५०||
कफवातविबन्धेषु कुष्ठप्लीहोदरेषु च|
कफवातविबन्धेषु कुष्ठप्लीहोदरेषु च|
प्रयोज्यो मिश्रकः स्नेहो योनिशूलेषु चाधिकम्||१५१||
प्रयोज्यो मिश्रकः स्नेहो योनिशूलेषु चाधिकम्||१५१||
इति मिश्रकः स्नेहः
इति मिश्रकः स्नेहः
<div class="mw-collapsible-content">
trivr̥tāṁ triphalāṁ dantīṁ daśamūlaṁ palōnmitam|
trivr̥tāṁ triphalāṁ dantīṁ daśamūlaṁ palōnmitam|
jalē caturguṇē paktvā caturbhāgasthitaṁ rasam||149||
jalē caturguṇē paktvā caturbhāgasthitaṁ rasam||149||
sarpirēraṇḍajaṁ tailaṁ kṣīraṁ caikatra sādhayēt|
sarpirēraṇḍajaṁ tailaṁ kṣīraṁ caikatra sādhayēt|
sa siddhō miśrakasnēhaḥ sakṣaudraḥ kaphagulmanut||150||
sa siddhō miśrakasnēhaḥ sakṣaudraḥ kaphagulmanut||150||
kaphavātavibandhēṣu kuṣṭhaplīhōdarēṣu ca|
kaphavātavibandhēṣu kuṣṭhaplīhōdarēṣu ca|
prayōjyō miśrakaḥ snēhō yōniśūlēṣucādhikam||151||
prayōjyō miśrakaḥ snēhō yōniśūlēṣucādhikam||151||
trivRutAM triphalAM dantIM dashamUlaM palonmitam|
trivRutAM triphalAM dantIM dashamUlaM palonmitam|
jale caturguNe paktvA caturbhAgasthitaM rasam||149||
jale caturguNe paktvA caturbhAgasthitaM rasam||149||
sarpireraNDajaM tailaM kShIraM caikatra sAdhayet|
sarpireraNDajaM tailaM kShIraM caikatra sAdhayet|
sa siddho mishrakasnehaH sakShaudraH kaphagulmanut||150||
sa siddho mishrakasnehaH sakShaudraH kaphagulmanut||150||
kaphavAtavibandheShu kuShThaplIhodareShu ca|
kaphavAtavibandheShu kuShThaplIhodareShu ca|
prayojyo mishrakaH sneho yonishUleShu cAdhikam||151||
prayojyo mishrakaH sneho yonishUleShu cAdhikam||151||
iti mishrakaH snehaH
iti mishrakaH snehaH
</div></div>
Prepare a decoction of 40 gm each of ''trivrita, triphala, danti'' and ''dashamula'' by adding four times of water and reducing to one-fourth. In this decoction add ghee, castor oil and milk and prepare medicated ghee. This ''mishraka sneha'' taken orally by adding honey cures ''kapha gulma''. It also provides relief in constipation due to ''kapha'' and ''vata, kushtha'' (chronic skin disorders), spleen disorders and ''udara-roga'' (generalized enlargement of abdomen) and especially useful in vaginal pain. Thus ''mishraka sneha'' is described [149-151]
Prepare a decoction of 40 gm each of ''trivrita, triphala, danti'' and ''dashamula'' by adding four times of water and reducing to one-fourth. In this decoction add ghee, castor oil and milk and prepare medicated ghee. This ''mishraka sneha'' taken orally by adding honey cures ''[[kapha]] gulma''. It also provides relief in constipation due to ''[[kapha]]'' and ''[[vata]], kushtha'' (chronic skin disorders), spleen disorders and ''udara-roga'' (generalized enlargement of abdomen) and especially useful in vaginal pain. Thus ''mishraka sneha'' is described [149-151]
=== ''[[Virechana]]'' in ''[[kapha]] gulma'' ===
<div class="mw-collapsible mw-collapsed">
यदुक्तं वातगुल्मघ्नं स्रंसनं नीलिनीघृतम्|
यदुक्तं वातगुल्मघ्नं स्रंसनं नीलिनीघृतम्|
द्विगुणं तद्विरेकार्थं प्रयोज्यं कफगुल्मिनाम्||१५२||
द्विगुणं तद्विरेकार्थं प्रयोज्यं कफगुल्मिनाम्||१५२||
सुधाक्षीरद्रवे चूर्णं त्रिवृतायाः सुभावितम्|
सुधाक्षीरद्रवे चूर्णं त्रिवृतायाः सुभावितम्|
कार्षिकं मधुसर्पिभ्यां लीढ्वा साधु विरिच्यते||१५३||
कार्षिकं मधुसर्पिभ्यां लीढ्वा साधु विरिच्यते||१५३||
<div class="mw-collapsible-content">
yaduktaṁ vātagulmaghnaṁ sraṁsanaṁ nīlinīghr̥tam|
yaduktaṁ vātagulmaghnaṁ sraṁsanaṁ nīlinīghr̥tam|
dviguṇaṁ tadvirēkārthaṁ prayōjyaṁ kaphagulminām||152||
dviguṇaṁ tadvirēkārthaṁ prayōjyaṁ kaphagulminām||152||
sudhākṣīradravē cūrṇaṁ trivr̥tāyāḥ subhāvitam|
sudhākṣīradravē cūrṇaṁ trivr̥tāyāḥ subhāvitam|
kārṣikaṁ madhusarpibhyāṁ līḍhvā sādhu viricyatē||153||
kārṣikaṁ madhusarpibhyāṁ līḍhvā sādhu viricyatē||153||
yaduktaM vAtagulmaghnaM sraMsanaM nIlinIghRutam|
yaduktaM vAtagulmaghnaM sraMsanaM nIlinIghRutam|
dviguNaM tadvirekArthaM prayojyaM kaphagulminAm||152||
dviguNaM tadvirekArthaM prayojyaM kaphagulminAm||152||
sudhAkShIradrave cUrNaM trivRutAyAH subhAvitam|
sudhAkShIradrave cUrNaM trivRutAyAH subhAvitam|
kArShikaM madhusarpibhyAM lIDhvA [20] sAdhu viricyate||153||
kArShikaM madhusarpibhyAM lIDhvA [20] sAdhu viricyate||153||
</div></div>
''Nilini-ghrita'' already described as laxative for the cure of ''vata gulma'' should be used in double the dose for ''virechana'' in the patient of ''kapha gulma''.
''Nilini-ghrita'' already described as laxative for the cure of ''[[vata]] gulma'' should be used in double the dose for ''[[virechana]]'' in the patient of ''[[kapha]] gulma''.
10 gm powder of ''trivrita'' well impregnated with latex of ''snuhi'' taken with ghee and honey may also be used to produce a good ''virechana'' [152-153]
10 gm powder of ''trivrita'' well impregnated with latex of ''snuhi'' taken with ghee and honey may also be used to produce a good ''[[virechana]]'' [152-153]
=== ''Danti-haritaki'' ===
<div class="mw-collapsible mw-collapsed">
जलद्रोणे विपक्तव्या विंशतिः पञ्च चाभयाः|
जलद्रोणे विपक्तव्या विंशतिः पञ्च चाभयाः|
दन्त्याः पलानि तावन्ति चित्रकस्य तथैव च||१५४||
दन्त्याः पलानि तावन्ति चित्रकस्य तथैव च||१५४||
अष्टभागावशेषं तु रसं पूतमधिक्षिपेत्|
अष्टभागावशेषं तु रसं पूतमधिक्षिपेत्|
दन्तीसमं गुडं पूतं क्षिपेत्तत्राभयाश्च ताः||१५५||
दन्तीसमं गुडं पूतं क्षिपेत्तत्राभयाश्च ताः||१५५||
तैलार्धकुडवं चैव त्रिवृतायाश्चतुष्पलम्|
तैलार्धकुडवं चैव त्रिवृतायाश्चतुष्पलम्|
चूर्णितं पलमेकं तु पिप्पलीविश्वभेषजम्||१५६||
चूर्णितं पलमेकं तु पिप्पलीविश्वभेषजम्||१५६||
तत् साध्यं लेहवच्छीते तस्मिंस्तैलसमं मधु|
तत् साध्यं लेहवच्छीते तस्मिंस्तैलसमं मधु|
क्षिपेच्चूर्णपलं चैकं त्वगेलापत्रकेशरात्||१५७||
क्षिपेच्चूर्णपलं चैकं त्वगेलापत्रकेशरात्||१५७||
ततो लेहपलं लीढ्वा जग्ध्वा चैकां हरीतकीम्|
ततो लेहपलं लीढ्वा जग्ध्वा चैकां हरीतकीम्|
सुखं विरिच्यते स्निग्धो दोषप्रस्थमनामयम्||१५८||
सुखं विरिच्यते स्निग्धो दोषप्रस्थमनामयम्||१५८||
गुल्मं श्वयथुमर्शांसि पाण्डुरोगमरोचकम्|
गुल्मं श्वयथुमर्शांसि पाण्डुरोगमरोचकम्|
हृद्रोगं ग्रहणीदोषं कामलां विषमज्वरम्||१५९||
हृद्रोगं ग्रहणीदोषं कामलां विषमज्वरम्||१५९||
कुष्ठं प्लीहानमानाहमेषा हन्युपसेविता|
कुष्ठं प्लीहानमानाहमेषा हन्युपसेविता|
निरत्ययः क्रमश्चास्या द्रवो मांसरसौदनः||१६०||
निरत्ययः क्रमश्चास्या द्रवो मांसरसौदनः||१६०||
इति दन्तीहरीतकी
इति दन्तीहरीतकी
<div class="mw-collapsible-content">
jaladrōṇē vipaktavyā viṁśatiḥ pañca cābhayāḥ|
jaladrōṇē vipaktavyā viṁśatiḥ pañca cābhayāḥ|
dantyāḥ palāni tāvanti citrakasya tathaiva ca||154||
dantyāḥ palāni tāvanti citrakasya tathaiva ca||154||
aṣṭabhāgāvaśēṣaṁ tu rasaṁ pūtamadhikṣipēt|
aṣṭabhāgāvaśēṣaṁ tu rasaṁ pūtamadhikṣipēt|
dantīsamaṁ guḍaṁ pūtaṁ kṣipēttatrābhayāśca tāḥ||155||
dantīsamaṁ guḍaṁ pūtaṁ kṣipēttatrābhayāśca tāḥ||155||
tailārdhakuḍavaṁ caiva trivr̥tāyāścatuṣpalam|
tailārdhakuḍavaṁ caiva trivr̥tāyāścatuṣpalam|
cūrṇitaṁ palamēkaṁ [21] tu pippalīviśvabhēṣajam||156||
cūrṇitaṁ palamēkaṁ [21] tu pippalīviśvabhēṣajam||156||
tat sādhyaṁ lēhavacchītē tasmiṁstailasamaṁ madhu|
tat sādhyaṁ lēhavacchītē tasmiṁstailasamaṁ madhu|
kṣipēccūrṇapalaṁ caikaṁ tvagēlāpatrakēśarāt||157||
kṣipēccūrṇapalaṁ caikaṁ tvagēlāpatrakēśarāt||157||
tatō lēhapalaṁ līḍhvā jagdhvā caikāṁ harītakīm|
tatō lēhapalaṁ līḍhvā jagdhvā caikāṁ harītakīm|
sukhaṁ viricyatē snigdhō dōṣaprasthamanāmayam||158||
sukhaṁ viricyatē snigdhō dōṣaprasthamanāmayam||158||
gulmaṁ śvayathumarśāṁsi pāṇḍurōgamarōcakam|
gulmaṁ śvayathumarśāṁsi pāṇḍurōgamarōcakam|
hr̥drōgaṁ grahaṇīdōṣaṁ kāmalāṁ viṣamajvaram||159||
hr̥drōgaṁ grahaṇīdōṣaṁ kāmalāṁ viṣamajvaram||159||
kuṣṭhaṁ plīhānamānāhamēṣā hanyupasēvitā|
kuṣṭhaṁ plīhānamānāhamēṣā hanyupasēvitā|
niratyayaḥ kramaścāsyā dravō māṁsarasaudanaḥ||160||
niratyayaḥ kramaścāsyā dravō māṁsarasaudanaḥ||160||
jaladroNe vipaktavyA viMshatiH pa~jca cAbhayAH|
jaladroNe vipaktavyA viMshatiH pa~jca cAbhayAH|
dantyAH palAni tAvanti citrakasya tathaiva ca||154||
dantyAH palAni tAvanti citrakasya tathaiva ca||154||
aShTabhAgAvasheShaM tu rasaM pUtamadhikShipet|
aShTabhAgAvasheShaM tu rasaM pUtamadhikShipet|
dantIsamaM guDaM pUtaM kShipettatrAbhayAshca tAH||155||
dantIsamaM guDaM pUtaM kShipettatrAbhayAshca tAH||155||
tailArdhakuDavaM caiva trivRutAyAshcatuShpalam|
tailArdhakuDavaM caiva trivRutAyAshcatuShpalam|
cUrNitaM palamekaM [21] tu pippalIvishvabheShajam||156||
cUrNitaM palamekaM [21] tu pippalIvishvabheShajam||156||
tat sAdhyaM lehavacchIte tasmiMstailasamaM madhu|
tat sAdhyaM lehavacchIte tasmiMstailasamaM madhu|
kShipeccUrNapalaM caikaM tvagelApatrakesharAt||157||
kShipeccUrNapalaM caikaM tvagelApatrakesharAt||157||
tato lehapalaM lIDhvA jagdhvA caikAM harItakIm|
tato lehapalaM lIDhvA jagdhvA caikAM harItakIm|
sukhaM viricyate snigdho doShaprasthamanAmayam||158||
sukhaM viricyate snigdho doShaprasthamanAmayam||158||
gulmaM shvayathumarshAMsi pANDurogamarocakam|
gulmaM shvayathumarshAMsi pANDurogamarocakam|
hRudrogaM grahaNIdoShaM kAmalAM viShamajvaram||159||
hRudrogaM grahaNIdoShaM kAmalAM viShamajvaram||159||
kuShThaM plIhAnamAnAhameShA hanyupasevitA|
kuShThaM plIhAnamAnAhameShA hanyupasevitA|
niratyayaH kramashcAsyA dravo mAMsarasaudanaH||160||
niratyayaH kramashcAsyA dravo mAMsarasaudanaH||160||
iti dantIharItakI
iti dantIharItakI
</div></div>
Prepare a decoction of 25 ''haritaki'' and 50 gm each of ''danti'' and ''chitraka'' in 10 liters of water by reducing it to one-eighth. Add jaggery equal to quantity of ''danti'' to the decoction and filter again and add to it ''haritaki'', 80 ml of sesame oil, 160 gm of ''trivrita'' powder and 40 gm each of long pepper and dry ginger and by heating made into constituency of the jam. On cooling add 80 gm of honey, 40 gm powder of cinnamon, cardamom, ''tamalapatra'' and ''keshara''. Administer its 40 gm with one ''haritaki'' daily to a person who has already been prepared with ''snehana'' and ''swedana'' for a good ''virechana''. It will remove 640 gm of morbid material (''dosha prastha'') without producing any side effect.
Prepare a decoction of 25 ''haritaki'' and 50 gm each of ''danti'' and ''chitraka'' in 10 liters of water by reducing it to one-eighth. Add jaggery equal to quantity of ''danti'' to the decoction and filter again and add to it ''haritaki'', 80 ml of sesame oil, 160 gm of ''trivrita'' powder and 40 gm each of long pepper and dry ginger and by heating made into constituency of the jam. On cooling add 80 gm of honey, 40 gm powder of cinnamon, cardamom, ''tamalapatra'' and ''keshara''. Administer its 40 gm with one ''haritaki'' daily to a person who has already been prepared with ''[[snehana]]'' and ''[[swedana]]'' for a good ''[[virechana]]''. It will remove 640 gm of morbid material (''[[dosha]] prastha'') without producing any side effect.
This decoction for ''virechana'' will cure ''gulma'', swellings, piles, anemia, anorexia, heart disease, chronic assimilation disorders, jaundice, irregular fever, ''kushtha'', spleen disorders and distension of abdomen. The therapy does not produce any complication. During this therapy liquid diet and rice with meat soup are given to eat. Thus ''dantiharitaki'' is described [154-160]
This decoction for ''[[virechana]]'' will cure ''gulma'', swellings, piles, anemia, anorexia, heart disease, chronic assimilation disorders, jaundice, irregular fever, ''kushtha'', spleen disorders and distension of abdomen. The therapy does not produce any complication. During this therapy liquid diet and rice with meat soup are given to eat. Thus ''dantiharitaki'' is described [154-160]
=== ''[[Basti]]'' in ''[[kapha]] gulma'' ===
<div class="mw-collapsible mw-collapsed">
सिद्धाः सिद्धिषु वक्ष्यन्ते निरूहाः कफगुल्मिनाम्|
सिद्धाः सिद्धिषु वक्ष्यन्ते निरूहाः कफगुल्मिनाम्|
अरिष्टयोगाः सिद्धाश्च ग्रहण्यर्शश्चिकित्सिते||१६१||
अरिष्टयोगाः सिद्धाश्च ग्रहण्यर्शश्चिकित्सिते||१६१||
<div class="mw-collapsible-content">
siddhāḥ siddhiṣu vakṣyantē nirūhāḥ kaphagulminām|
siddhāḥ siddhiṣu vakṣyantē nirūhāḥ kaphagulminām|
ariṣṭayōgāḥ siddhāśca grahaṇyarśaścikitsitē||161||
ariṣṭayōgāḥ siddhāśca grahaṇyarśaścikitsitē||161||
siddhAH siddhiShu vakShyante nirUhAH kaphagulminAm|
siddhAH siddhiShu vakShyante nirUhAH kaphagulminAm|
ariShTayogAH siddhAshca grahaNyarshashcikitsite||161||
ariShTayogAH siddhAshca grahaNyarshashcikitsite||161||
</div></div>
The most effective ''niruha basti'' for ''kapha gulma'' will be described in [[Siddhi Sthana]] and most effective medicated wines (''arishta'') will be described in the chapter on [[Grahani Chikitsa]] and [[Arsha Chikitsa]] [161]
The most effective ''niruha [[basti]]'' for ''[[kapha]] gulma'' will be described in [[Siddhi Sthana]] and most effective medicated wines (''arishta'') will be described in the chapter on [[Grahani Chikitsa]] and [[Arsha Chikitsa]] [161]
=== Powders and pills ===
<div class="mw-collapsible mw-collapsed">
यच्चूर्णं गुटिका याश्च विहिता वातगुल्मिनाम्|
यच्चूर्णं गुटिका याश्च विहिता वातगुल्मिनाम्|
द्विगुणक्षारहिङ्ग्वम्लवेतसास्ताः कफे हिताः||१६२||
द्विगुणक्षारहिङ्ग्वम्लवेतसास्ताः कफे हिताः||१६२||
<div class="mw-collapsible-content">
yaccūrṇaṁ guṭikā yāśca vihitā vātagulminām|
yaccūrṇaṁ guṭikā yāśca vihitā vātagulminām|
dviguṇakṣārahiṅgvamlavētasāstāḥ kaphē hitāḥ||162||
dviguṇakṣārahiṅgvamlavētasāstāḥ kaphē hitāḥ||162||
yaccUrNaM guTikA yAshca vihitA vAtagulminAm|
yaccUrNaM guTikA yAshca vihitA vAtagulminAm|
dviguNakShArahi~ggvamlavetasAstAH kaphe hitAH||162||
dviguNakShArahi~ggvamlavetasAstAH kaphe hitAH||162||
</div></div>
Powder and pills which are described for the treatment of ''vata gulma'' should also be used for ''kapha gulma'' but added with double the quantity of mixture of ''kshara,'' asafoetida and ''amlavetasa'' [162]
Powder and pills which are described for the treatment of ''[[vata]] gulma'' should also be used for ''[[kapha]] gulma'' but added with double the quantity of mixture of ''kshara,'' asafoetida and ''amlavetasa'' [162]
=== ''Kshara'' and ''daha karma'' ===
<div class="mw-collapsible mw-collapsed">
य एव ग्रहणीदोषे क्षारास्ते कफगुल्मिनाम्|
य एव ग्रहणीदोषे क्षारास्ते कफगुल्मिनाम्|
सिद्धा निरत्ययाः शस्ता दाहस्त्वन्ते प्रशस्यते||१६३||
सिद्धा निरत्ययाः शस्ता दाहस्त्वन्ते प्रशस्यते||१६३||
<div class="mw-collapsible-content">
ya ēva grahaṇīdōṣē kṣārāstē kaphagulminām|
ya ēva grahaṇīdōṣē kṣārāstē kaphagulminām|
siddhā niratyayāḥ śastā dāhastvantē praśasyatē||163||
siddhā niratyayāḥ śastā dāhastvantē praśasyatē||163||
ya eva grahaNIdoShe kShArAste kaphagulminAm|
ya eva grahaNIdoShe kShArAste kaphagulminAm|
siddhA niratyayAH shastA dAhastvante prashasyate||163||
siddhA niratyayAH shastA dAhastvante prashasyate||163||
</div></div>
''Kshara'' preparations mentioned in [[Grahani Chikitsa]] are also beneficial for ''[[kapha]] gulma'' without any side effect. If above mentioned treatment does not cure ''[[kapha]] gulma'' then cauterization should be done as a last resort [163]
=== ''Pathya'' for ''[[kapha]] gulma'' ===
<div class="mw-collapsible mw-collapsed">
प्रपुराणानि धान्यानि जाङ्गला मृगपक्षिणः|
प्रपुराणानि धान्यानि जाङ्गला मृगपक्षिणः|
कौलत्थो मुद्गयूषश्च पिप्पल्या नागरस्य च||१६४||
कौलत्थो मुद्गयूषश्च पिप्पल्या नागरस्य च||१६४||
शुष्कमूलकयूषश्च बिल्वस्य वरुणस्य च|
शुष्कमूलकयूषश्च बिल्वस्य वरुणस्य च|
चिरबिल्वाङ्कुराणां च यवान्याश्चित्रकस्य च||१६५||
चिरबिल्वाङ्कुराणां च यवान्याश्चित्रकस्य च||१६५||
<div class="mw-collapsible-content">
prapurāṇāni dhānyāni jāṅgalā mr̥gapakṣiṇaḥ|
prapurāṇāni dhānyāni jāṅgalā mr̥gapakṣiṇaḥ|
kaulatthō mudgayūṣaśca pippalyā nāgarasya ca||164||
kaulatthō mudgayūṣaśca pippalyā nāgarasya ca||164||
śuṣkamūlakayūṣaśca bilvasya varuṇasya ca|
śuṣkamūlakayūṣaśca bilvasya varuṇasya ca|
cirabilvāṅkurāṇāṁ ca yavānyāścitrakasya ca||165||
cirabilvāṅkurāṇāṁ ca yavānyāścitrakasya ca||165||
prapurANAni dhAnyAni jA~ggalA mRugapakShiNaH|
prapurANAni dhAnyAni jA~ggalA mRugapakShiNaH|
kaulattho mudgayUShashca pippalyA nAgarasya ca||164||
kaulattho mudgayUShashca pippalyA nAgarasya ca||164||
shuShkamUlakayUShashca bilvasya varuNasya [22] ca|
shuShkamUlakayUShashca bilvasya varuNasya [22] ca|
cirabilvA~gkurANAM ca yavAnyAshcitrakasya ca||165||
cirabilvA~gkurANAM ca yavAnyAshcitrakasya ca||165||
</div></div>
More than one year old grains, meat of wild animals and birds, soup of horse-gram (''kulattha'') or green gram (''mudga''), long pepper, dry ginger, dry radish, ''bilva, varuna,'' sprouts of ''chirabilva, yavani'' and ''chitraka'' are beneficial diet articles for the patient of ''kapha gulma'' [165]
More than one year old grains, meat of wild animals and birds, soup of horse-gram (''kulattha'') or green gram (''mudga''), long pepper, dry ginger, dry radish, ''bilva, varuna,'' sprouts of ''chirabilva, yavani'' and ''chitraka'' are beneficial diet articles for the patient of ''[[kapha]] gulma'' [165]
<div class="mw-collapsible mw-collapsed">
बीजपूरकहिङ्ग्वम्लवेतसक्षारदाडिमैः|
बीजपूरकहिङ्ग्वम्लवेतसक्षारदाडिमैः|
तक्रेण तैलसर्पिर्भ्यां व्यञ्जनान्युपकल्पयेत्||१६६||
तक्रेण तैलसर्पिर्भ्यां व्यञ्जनान्युपकल्पयेत्||१६६||
<div class="mw-collapsible-content">
bījapūrakahiṅgvamlavētasakṣāradāḍimaiḥ|
bījapūrakahiṅgvamlavētasakṣāradāḍimaiḥ|
takrēṇa tailasarpirbhyāṁ vyañjanānyupakalpayēt||166||
takrēṇa tailasarpirbhyāṁ vyañjanānyupakalpayēt||166||
bIjapUrakahi~ggvamlavetasakShAradADimaiH|
bIjapUrakahi~ggvamlavetasakShAradADimaiH|
takreNa tailasarpirbhyAM vya~jjanAnyupakalpayet||166||
takreNa tailasarpirbhyAM vya~jjanAnyupakalpayet||166||
</div></div>
Citron, asafoetida, ''amlavetas, kshara,'' pomegranate, butter milk, oil and ghee preparations are also wholesome for ''kapha gulma'' [166]
Citron, asafoetida, ''amlavetas, kshara,'' pomegranate, butter milk, oil and ghee preparations are also wholesome for ''[[kapha]] gulma'' [166]
<div class="mw-collapsible mw-collapsed">
पञ्चमूलीशृतं तोयं पुराणं वारुणीरसम्|
पञ्चमूलीशृतं तोयं पुराणं वारुणीरसम्|
कफगुल्मी पिबेत्काले जीर्णं माध्वीकमेव वा||१६७||
कफगुल्मी पिबेत्काले जीर्णं माध्वीकमेव वा||१६७||
<div class="mw-collapsible-content">
pañcamūlīśr̥taṁ tōyaṁ purāṇaṁ vāruṇīrasam|
pañcamūlīśr̥taṁ tōyaṁ purāṇaṁ vāruṇīrasam|
kaphagulmī pibētkālē jīrṇaṁ mādhvīkamēva vā||167||
kaphagulmī pibētkālē jīrṇaṁ mādhvīkamēva vā||167||
pa~jcamUlIshRutaM toyaM purANaM vAruNIrasam|
pa~jcamUlIshRutaM toyaM purANaM vAruNIrasam|
kaphagulmI pibetkAle jIrNaM mAdhvIkameva vA||167||
kaphagulmI pibetkAle jIrNaM mAdhvIkameva vA||167||
</div></div>
Water boiled in ''laghu panchamula'' or old ''varuni'' or old honey wine should be given to drink on getting the thirst to the patient of ''kapha gulma'' [167]
Water boiled in ''laghu panchamula'' or old ''varuni'' or old honey wine should be given to drink on getting the thirst to the patient of ''[[kapha]] gulma'' [167]
<div class="mw-collapsible mw-collapsed">
यवानीचूर्णितं तक्रं बिडेन लवणीकृतम्|
यवानीचूर्णितं तक्रं बिडेन लवणीकृतम्|
पिबेत् सन्दीपनं वातकफमूत्रानुलोमनम् ||१६८||
पिबेत् सन्दीपनं वातकफमूत्रानुलोमनम् ||१६८||
<div class="mw-collapsible-content">
yavānīcūrṇitaṁ takraṁ biḍēna lavaṇīkr̥tam|
yavānīcūrṇitaṁ takraṁ biḍēna lavaṇīkr̥tam|
pibēt sandīpanaṁ vātakaphamūtrānulōmanam [23] ||168||
pibēt sandīpanaṁ vātakaphamūtrānulōmanam [23] ||168||
yavAnIcUrNitaM takraM biDena lavaNIkRutam|
yavAnIcUrNitaM takraM biDena lavaNIkRutam|
pibet sandIpanaM vAtakaphamUtrAnulomanam [23] ||168||
pibet sandIpanaM vAtakaphamUtrAnulomanam [23] ||168||
</div></div>
Taking of butter milk mixed with ''yavani'' (''ajwain'') and salted with bid-salt acts as a digestive stimulant and the regulator of flatus, urine and ''[[kapha]]'' [168]
=== Signs and symptoms of incurable ''gulma'' ===
<div class="mw-collapsible mw-collapsed">
सञ्चितः क्रमशो गुल्मो महावास्तुपरिग्रहः|
सञ्चितः क्रमशो गुल्मो महावास्तुपरिग्रहः|
कृतमूलः सिरानद्धो यदा कूर्म इवोन्नतः||१६९||
कृतमूलः सिरानद्धो यदा कूर्म इवोन्नतः||१६९||
दौर्बल्यारुचिहृल्लासकासवम्यरतिज्वरैः |
दौर्बल्यारुचिहृल्लासकासवम्यरतिज्वरैः |
तृष्णातन्द्राप्रतिश्यायैर्युज्यते न स सिध्यति||१७०||
तृष्णातन्द्राप्रतिश्यायैर्युज्यते न स सिध्यति||१७०||
<div class="mw-collapsible-content">
sañcitaḥ kramaśō gulmō mahāvāstuparigrahaḥ|
sañcitaḥ kramaśō gulmō mahāvāstuparigrahaḥ|
kr̥tamūlaḥ sirānaddhō yadā kūrma ivōnnataḥ||169||
kr̥tamūlaḥ sirānaddhō yadā kūrma ivōnnataḥ||169||
daurbalyārucihr̥llāsakāsavamyaratijvaraiḥ |
daurbalyārucihr̥llāsakāsavamyaratijvaraiḥ |
tr̥ṣṇātandrāpratiśyāyairyujyatē na sa sidhyati||170||
tr̥ṣṇātandrāpratiśyāyairyujyatē na sa sidhyati||170||
sa~jcitaH kramasho gulmo mahAvAstuparigrahaH|
sa~jcitaH kramasho gulmo mahAvAstuparigrahaH|
kRutamUlaH sirAnaddho yadA kUrma ivonnataH||169||
kRutamUlaH sirAnaddho yadA kUrma ivonnataH||169||
daurbalyArucihRullAsakAsavamyaratijvaraiH [24] |
daurbalyArucihRullAsakAsavamyaratijvaraiH [24] |
tRuShNAtandrApratishyAyairyujyate na sa sidhyati||170||
tRuShNAtandrApratishyAyairyujyate na sa sidhyati||170||
</div></div>
The gulma which gradually goes on increasing, spreading over a large area, has taken firm root, is covered by veins, has convex surface like that of tortoise, and which is accompanied with weakness, anorexia, thirst, nausea, vomiting, fever, cough, coryza and drowsiness is considered as incurable [169-170]
The ''gulma'' which gradually goes on increasing, spreading over a large area, has taken firm root, is covered by veins, has convex surface like that of tortoise, and which is accompanied with weakness, anorexia, thirst, nausea, vomiting, fever, cough, coryza and drowsiness is considered as incurable [169-170]
=== Signs and symptoms of bad prognosis ===
<div class="mw-collapsible mw-collapsed">
गृहीत्वा सज्वरश्वासं वम्यतीसारपीडितम्|
गृहीत्वा सज्वरश्वासं वम्यतीसारपीडितम्|
हृन्नाभिहस्तपादेषु शोफः कर्षति गुल्मिनम्||१७१||
हृन्नाभिहस्तपादेषु शोफः कर्षति गुल्मिनम्||१७१||
<div class="mw-collapsible-content">
gr̥hītvā sajvaraśvāsaṁ vamyatīsārapīḍitam|
gr̥hītvā sajvaraśvāsaṁ vamyatīsārapīḍitam|
hr̥nnābhihastapādēṣu śōphaḥ karṣati gulminam||171||
hr̥nnābhihastapādēṣu śōphaḥ karṣati gulminam||171||
gRuhItvA sajvarashvAsaM vamyatIsArapIDitam|
gRuhItvA sajvarashvAsaM vamyatIsArapIDitam|
hRunnAbhihastapAdeShu shophaH karShati gulminam||171||
hRunnAbhihastapAdeShu shophaH karShati gulminam||171||
</div></div>
The patient of ''gulma'' accompanied with fever, dyspnea, vomiting and diarrhea along with edema in the epigastric and umbilical regions and on hands and feet indicate that the patient is approaching to death [171]
The patient of ''gulma'' accompanied with fever, dyspnea, vomiting and diarrhea along with edema in the epigastric and umbilical regions and on hands and feet indicate that the patient is approaching to death [171]
=== Treatment of ''[[rakta]] gulma'' ===
<div class="mw-collapsible mw-collapsed">
रौधिरस्य तु गुल्मस्य गर्भकालव्यतिक्रमे|
रौधिरस्य तु गुल्मस्य गर्भकालव्यतिक्रमे|
स्निग्धस्विन्नशरीरायै दद्यात् स्नेहविरेचनम्||१७२||
स्निग्धस्विन्नशरीरायै दद्यात् स्नेहविरेचनम्||१७२||
<div class="mw-collapsible-content">
raudhirasya tu gulmasya garbhakālavyatikramē|
raudhirasya tu gulmasya garbhakālavyatikramē|
snigdhasvinnaśarīrāyai dadyāt snēhavirēcanam||172||
snigdhasvinnaśarīrāyai dadyāt snēhavirēcanam||172||
raudhirasya tu gulmasya garbhakAlavyatikrame|
raudhirasya tu gulmasya garbhakAlavyatikrame|
snigdhasvinnasharIrAyai dadyAt snehavirecanam||172||
snigdhasvinnasharIrAyai dadyAt snehavirecanam||172||
</div></div>
The treatment of ''rakta gulma'' should be under taken only after completion of normal period of gestation i.e. 10 months. The patient should be given unctuous ''virechana'' after preparing with ''snehana'' and ''swedana'' [172]
The treatment of ''[[rakta]] gulma'' should be under taken only after completion of normal period of gestation i.e. 10 months. The patient should be given unctuous ''[[virechana]]'' after preparing with ''[[snehana]]'' and ''[[swedana]]'' [172]
<div class="mw-collapsible mw-collapsed">
पलाशक्षारपात्रे द्वे द्वे पात्रे तैलसर्पिषोः|
पलाशक्षारपात्रे द्वे द्वे पात्रे तैलसर्पिषोः|
गुल्मशैथिल्यजननीं पक्त्वा मात्रां प्रयोजयेत्||१७३||
गुल्मशैथिल्यजननीं पक्त्वा मात्रां प्रयोजयेत्||१७३||
<div class="mw-collapsible-content">
palāśakṣārapātrē dvē dvē pātrē tailasarpiṣōḥ|
palāśakṣārapātrē dvē dvē pātrē tailasarpiṣōḥ|
gulmaśaithilyajananīṁ paktvā mātrāṁ prayōjayēt||173||
gulmaśaithilyajananīṁ paktvā mātrāṁ prayōjayēt||173||
palAshakShArapAtre dve dve pAtre tailasarpiShoH|
palAshakShArapAtre dve dve pAtre tailasarpiShoH|
gulmashaithilyajananIM paktvA mAtrAM prayojayet||173||
gulmashaithilyajananIM paktvA mAtrAM prayojayet||173||
</div></div>
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. [173]
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. [173]
<div class="mw-collapsible mw-collapsed">
प्रभिद्येत न यद्येवं दद्याद्योनिविशोधनम् |
प्रभिद्येत न यद्येवं दद्याद्योनिविशोधनम् |
क्षारेण युक्तं पललं सुधाक्षीरेण वा पुनः||१७४||
क्षारेण युक्तं पललं सुधाक्षीरेण वा पुनः||१७४||
आभ्यां वा भावितान् दद्याद्योनौ कटुकमत्स्यकान्|
आभ्यां वा भावितान् दद्याद्योनौ कटुकमत्स्यकान्|
वराहमत्स्यपित्ताभ्यां लक्तकान् वा सुभावितान्||१७५||
वराहमत्स्यपित्ताभ्यां लक्तकान् वा सुभावितान्||१७५||
अधोहरैश्चोर्ध्वहरैर्भावितान् वा समाक्षिकैः|
अधोहरैश्चोर्ध्वहरैर्भावितान् वा समाक्षिकैः|
किण्वं वा सगुडक्षारं दद्याद्योनिविशोधनम्||१७६||
किण्वं वा सगुडक्षारं दद्याद्योनिविशोधनम्||१७६||
<div class="mw-collapsible-content">
prabhidyēta na yadyēvaṁ dadyādyōniviśōdhanam |
prabhidyēta na yadyēvaṁ dadyādyōniviśōdhanam |
kṣārēṇa yuktaṁ palalaṁ sudhākṣīrēṇa vā punaḥ||174||
kṣārēṇa yuktaṁ palalaṁ sudhākṣīrēṇa vā punaḥ||174||
ābhyāṁ vā bhāvitān dadyādyōnau kaṭukamatsyakān|
ābhyāṁ vā bhāvitān dadyādyōnau kaṭukamatsyakān|
varāhamatsyapittābhyāṁ laktakān vā subhāvitān||175||
varāhamatsyapittābhyāṁ laktakān vā subhāvitān||175||
adhōharaiścōrdhvaharairbhāvitān vā samākṣikaiḥ|
adhōharaiścōrdhvaharairbhāvitān vā samākṣikaiḥ|
kiṇvaṁ vā saguḍakṣāraṁ dadyādyōniviśōdhanam||176||
kiṇvaṁ vā saguḍakṣāraṁ dadyādyōniviśōdhanam||176||
prabhidyeta na yadyevaM dadyAdyonivishodhanam [25] |
prabhidyeta na yadyevaM dadyAdyonivishodhanam [25] |
kShAreNa yuktaM palalaM sudhAkShIreNa vA punaH||174||
kShAreNa yuktaM palalaM sudhAkShIreNa vA punaH||174||
AbhyAM vA bhAvitAn dadyAdyonau kaTukamatsyakAn|
AbhyAM vA bhAvitAn dadyAdyonau kaTukamatsyakAn|
varAhamatsyapittAbhyAM laktakAn vA subhAvitAn||175||
varAhamatsyapittAbhyAM laktakAn vA subhAvitAn||175||
adhoharaishcordhvaharairbhAvitAn vA samAkShikaiH|
adhoharaishcordhvaharairbhAvitAn vA samAkShikaiH|
kiNvaM vA saguDakShAraM dadyAdyonivishodhanam||176||
kiNvaM vA saguDakShAraM dadyAdyonivishodhanam||176||
</div></div>
If the above mentioned treatments do not break the ''rakta gulma'' then the preparations which cleans vagina should be used locally.
If the above mentioned treatments do not break the ''[[rakta]] gulma'' then the preparations which cleans vagina should be used locally.
A swab well saturated with one of the following pastes may be inserted in the vagina:
A swab well saturated with one of the following pastes may be inserted in the vagina:
*Sesame paste mixed with ''kshaara'' or latex of ''snuhi'' or
*Sesame paste mixed with ''kshara'' or latex of ''snuhi'' or
*Pungent fish impregnated with both ''kshara'' and latex of ''snuhi''
*Pungent fish impregnated with both ''kshara'' and latex of ''snuhi''
*Bile of hog or fish or emetic or purgative drugs or with honey
*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]
Or yeast mixed with jaggery and honey may be used for cleansing the vagina [174-176]
<div class="mw-collapsible mw-collapsed">
रक्तपित्तहरं क्षारं लेहयेन्मधुसर्पिषा|
रक्तपित्तहरं क्षारं लेहयेन्मधुसर्पिषा|
लशुनं मदिरां तीक्ष्णां मत्स्यांश्चास्यै प्रदापयेत्||१७७||
लशुनं मदिरां तीक्ष्णां मत्स्यांश्चास्यै प्रदापयेत्||१७७||
<div class="mw-collapsible-content">
raktapittaharaṁ kṣāraṁ lēhayēnmadhusarpiṣā|
raktapittaharaṁ kṣāraṁ lēhayēnmadhusarpiṣā|
laśunaṁ madirāṁ tīkṣṇāṁ matsyāṁścāsyai pradāpayēt||177||
laśunaṁ madirāṁ tīkṣṇāṁ matsyāṁścāsyai pradāpayēt||177||
raktapittaharaM kShAraM lehayenmadhusarpiShA|
raktapittaharaM kShAraM lehayenmadhusarpiShA|
lashunaM madirAM tIkShNAM matsyAMshcAsyai pradApayet||177||
lashunaM madirAM tIkShNAM matsyAMshcAsyai pradApayet||177||
</div></div>
Kshara which cures raktapitta may be licked with honey and ghee. Or garlic mixed with strong wine and fish may be given in diet [177]
''Kshara'' which cures ''raktapitta'' may be licked with honey and ghee. Or garlic mixed with strong wine and fish may be given in diet [177]
<div class="mw-collapsible mw-collapsed">
बस्तिं सक्षीरगोमूत्रं सक्षारं दाशमूलिकम्|
बस्तिं सक्षीरगोमूत्रं सक्षारं दाशमूलिकम्|
अदृश्यमाने रुधिरे दद्याद्गुल्मप्रभेदनम्||१७८||
अदृश्यमाने रुधिरे दद्याद्गुल्मप्रभेदनम्||१७८||
<div class="mw-collapsible-content">
bastiṁ sakṣīragōmūtraṁ sakṣāraṁ dāśamūlikam|
bastiṁ sakṣīragōmūtraṁ sakṣāraṁ dāśamūlikam|
adr̥śyamānē rudhirē dadyādgulmaprabhēdanam||178||
adr̥śyamānē rudhirē dadyādgulmaprabhēdanam||178||
bastiM sakShIragomUtraM sakShAraM dAshamUlikam|
bastiM sakShIragomUtraM sakShAraM dAshamUlikam|
adRushyamAne rudhire dadyAdgulmaprabhedanam||178||
adRushyamAne rudhire dadyAdgulmaprabhedanam||178||
</div></div>
''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]
''[[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]
<div class="mw-collapsible mw-collapsed">
प्रवर्तमाने रुधिरे दद्यान्मांसरसौदनम्|
प्रवर्तमाने रुधिरे दद्यान्मांसरसौदनम्|
घृततैलेन चाभ्यङ्गं पानार्थं तरुणीं सुराम्||१७९||
घृततैलेन चाभ्यङ्गं पानार्थं तरुणीं सुराम्||१७९||
<div class="mw-collapsible-content">
pravartamānē rudhirē dadyānmāṁsarasaudanam|
pravartamānē rudhirē dadyānmāṁsarasaudanam|
ghr̥tatailēna cābhyaṅgaṁ pānārthaṁ taruṇīṁ surām||179||
ghr̥tatailēna cābhyaṅgaṁ pānārthaṁ taruṇīṁ surām||179||
pravartamAne rudhire dadyAnmAMsarasaudanam|
pravartamAne rudhire dadyAnmAMsarasaudanam|
ghRutatailena cAbhya~ggaM pAnArthaM taruNIM surAm||179||
ghRutatailena cAbhya~ggaM pAnArthaM taruNIM surAm||179||
</div></div>
When blood starts flowing through vagina then rice with meat soup should be given to eat. Massage with ghee or oil is done and for drink new wine may be given [179]
When blood starts flowing through vagina then rice with meat soup should be given to eat. Massage with ghee or oil is done and for drink new wine may be given [179]
<div class="mw-collapsible mw-collapsed">
रुधिरेऽतिप्रवृत्ते तु रक्तपित्तहरीः क्रियाः|
रुधिरेऽतिप्रवृत्ते तु रक्तपित्तहरीः क्रियाः|
कार्या वातरुगार्तायाः सर्वा वातहरीः पुनः||१८०||
कार्या वातरुगार्तायाः सर्वा वातहरीः पुनः||१८०||
<div class="mw-collapsible-content">
rudhirē'tipravr̥ttē tu raktapittaharīḥ kriyāḥ|
rudhirē'tipravr̥ttē tu raktapittaharīḥ kriyāḥ|
kāryā vātarugārtāyāḥ sarvā vātaharīḥ punaḥ||180||
kāryā vātarugārtāyāḥ sarvā vātaharīḥ punaḥ||180||
rudhire~atipravRutte tu raktapittaharIH kriyAH|
rudhire~atipravRutte tu raktapittaharIH kriyAH|
kAryA vAtarugArtAyAH sarvA vAtaharIH punaH||180||
kAryA vAtarugArtAyAH sarvA vAtaharIH punaH||180||
</div></div>
In case of excessive bleeding, the measures curative of ''raktapitta'' should be prescribed. If the patient gets ''vata'' type of pains then all the remedies curative of ''vata'' are given [180]
In case of excessive bleeding, the measures curative of ''raktapitta'' should be prescribed. If the patient gets ''[[vata]]'' type of pains then all the remedies curative of ''[[vata]]'' are given [180]
<div class="mw-collapsible mw-collapsed">
घृततैलावसेकांश्च तित्तिरींश्चरणायुधान्|
घृततैलावसेकांश्च तित्तिरींश्चरणायुधान्|
सुरां समण्डां पूर्वं च पानमम्लस्य सर्पिषः||१८१||
सुरां समण्डां पूर्वं च पानमम्लस्य सर्पिषः||१८१||
प्रयोजयेदुत्तरं वा जीवनीयेन सर्पिषा|
प्रयोजयेदुत्तरं वा जीवनीयेन सर्पिषा|
अतिप्रवृत्ते रुधिरे सतिक्तेनानुवासनम्||१८२||
अतिप्रवृत्ते रुधिरे सतिक्तेनानुवासनम्||१८२||
<div class="mw-collapsible-content">
ghr̥tatailāvasēkāṁśca tittirīṁścaraṇāyudhān|
ghr̥tatailāvasēkāṁśca tittirīṁścaraṇāyudhān|
surāṁ samaṇḍāṁ pūrvaṁ ca pānamamlasya sarpiṣaḥ||181||
surāṁ samaṇḍāṁ pūrvaṁ ca pānamamlasya sarpiṣaḥ||181||
prayōjayēduttaraṁ vā jīvanīyēna sarpiṣā|
prayōjayēduttaraṁ vā jīvanīyēna sarpiṣā|
atipravr̥ttē rudhirē satiktēnānuvāsanam||182||
atipravr̥ttē rudhirē satiktēnānuvāsanam||182||
ghRutatailAvasekAMshca tittirIMshcaraNAyudhAn|
ghRutatailAvasekAMshca tittirIMshcaraNAyudhAn|
surAM samaNDAM pUrvaM ca pAnamamlasya sarpiShaH||181||
surAM samaNDAM pUrvaM ca pAnamamlasya sarpiShaH||181||
prayojayeduttaraM vA jIvanIyena sarpiShA|
prayojayeduttaraM vA jIvanIyena sarpiShA|
atipravRutte rudhire satiktenAnuvAsanam||182||
atipravRutte rudhire satiktenAnuvAsanam||182||
</div></div>
Effusion with ghee and oil should be performed. Meat of partridge (''tittara'') and rooster (''charanayudha''), ''sura'' (wine) along with its upper fluid (''manda'') and ghee prepared with sour drugs may be given in diet.
Effusion with ghee and oil should be performed. Meat of partridge (''tittara'') and rooster (''charanayudha''), ''sura'' (wine) along with its upper fluid (''manda'') and ghee prepared with sour drugs may be given in diet.
''Uttara basti'' with ghee prepared with ''jivaniya'' drugs should be given. In case of the excessive blood flow, ''anuvasana basti'' with ghee/oil prepared with bitter drugs should be given [181-182]
''Uttara basti'' with ghee prepared with ''jivaniya'' drugs should be given. In case of the excessive blood flow, ''anuvasana [[basti]]'' with ghee/oil prepared with bitter drugs should be given [181-182]
=== Summary ===
<div class="mw-collapsible mw-collapsed">
तत्र श्लोकाः-
तत्र श्लोकाः-
स्नेहः स्वेदः सर्पिर्बस्तिश्चूर्णानि बृंहणं गुडिकाः|
स्नेहः स्वेदः सर्पिर्बस्तिश्चूर्णानि बृंहणं गुडिकाः|
वमनविरेकौ मोक्षः क्षतजस्य च वातगुल्मवताम्||१८३||
वमनविरेकौ मोक्षः क्षतजस्य च वातगुल्मवताम्||१८३||
सर्पिः सतिक्तसिद्धं क्षीरं प्रस्रंसनं निरूहाश्च|
सर्पिः सतिक्तसिद्धं क्षीरं प्रस्रंसनं निरूहाश्च|
रक्तस्य चावसेचनमाश्वासनसंशमनयोगाः||१८४||
रक्तस्य चावसेचनमाश्वासनसंशमनयोगाः||१८४||
उपनाहनं सशस्त्रं पक्वस्याभ्यन्तरप्रभिन्नस्य|
उपनाहनं सशस्त्रं पक्वस्याभ्यन्तरप्रभिन्नस्य|
संशोधनसंशमने पित्तप्रभवस्य गुल्मस्य||१८५||
संशोधनसंशमने पित्तप्रभवस्य गुल्मस्य||१८५||
स्नेहः स्वेदो भेदो लङ्घनमुल्लेखनं विरेकश्च|
स्नेहः स्वेदो भेदो लङ्घनमुल्लेखनं विरेकश्च|
सर्पिर्बस्तिर्गुटिकाश्चूर्णमरिष्टाश्च सक्षाराः||१८६||
सर्पिर्बस्तिर्गुटिकाश्चूर्णमरिष्टाश्च सक्षाराः||१८६||
गुल्मस्यान्ते दाहः कफजस्याग्रेऽपनीतरक्तस्य|
गुल्मस्यान्ते दाहः कफजस्याग्रेऽपनीतरक्तस्य|
गुल्मस्य रौधिरस्य क्रियाक्रमः स्त्रीभवस्योक्तः||१८७||
गुल्मस्य रौधिरस्य क्रियाक्रमः स्त्रीभवस्योक्तः||१८७||
पथ्यान्नपानसेवा हेतूनां वर्जनं यथास्वं च|
पथ्यान्नपानसेवा हेतूनां वर्जनं यथास्वं च|
नित्यं चाग्निसमाधिः स्निग्धस्य च सर्वकर्माणि||१८८||
नित्यं चाग्निसमाधिः स्निग्धस्य च सर्वकर्माणि||१८८||
हेतुर्लिङ्गं सिद्धिः क्रियाक्रमः साध्यता न योगाश्च|
हेतुर्लिङ्गं सिद्धिः क्रियाक्रमः साध्यता न योगाश्च|
गुल्मचिकित्सितसङ्ग्रह एतावान् व्याहृतोऽग्निवेशस्य||१८९||
गुल्मचिकित्सितसङ्ग्रह एतावान् व्याहृतोऽग्निवेशस्य||१८९||
<div class="mw-collapsible-content">
tatra ślōkāḥ-
tatra ślōkāḥ-
snēhaḥ svēdaḥ sarpirbastiścūrṇāni br̥ṁhaṇaṁ guḍikāḥ|
snēhaḥ svēdaḥ sarpirbastiścūrṇāni br̥ṁhaṇaṁ guḍikāḥ|
vamanavirēkau mōkṣaḥ kṣatajasya ca vātagulmavatām||183||
vamanavirēkau mōkṣaḥ kṣatajasya ca vātagulmavatām||183||
sarpiḥ satiktasiddhaṁ kṣīraṁ prasraṁsanaṁ nirūhāśca|
sarpiḥ satiktasiddhaṁ kṣīraṁ prasraṁsanaṁ nirūhāśca|
raktasya cāvasēcanamāśvāsanasaṁśamanayōgāḥ||184||
raktasya cāvasēcanamāśvāsanasaṁśamanayōgāḥ||184||
upanāhanaṁ saśastraṁ pakvasyābhyantaraprabhinnasya|
upanāhanaṁ saśastraṁ pakvasyābhyantaraprabhinnasya|
saṁśōdhanasaṁśamanē pittaprabhavasya gulmasya||185||
saṁśōdhanasaṁśamanē pittaprabhavasya gulmasya||185||
snēhaḥ svēdō bhēdō laṅghanamullēkhanaṁ virēkaśca|
snēhaḥ svēdō bhēdō laṅghanamullēkhanaṁ virēkaśca|
sarpirbastirguṭikāścūrṇamariṣṭāśca sakṣārāḥ||186||
sarpirbastirguṭikāścūrṇamariṣṭāśca sakṣārāḥ||186||
gulmasyāntē dāhaḥ kaphajasyāgrē'panītaraktasya|
gulmasyāntē dāhaḥ kaphajasyāgrē'panītaraktasya|
gulmasya raudhirasya kriyākramaḥ strībhavasyōktaḥ||187||
gulmasya raudhirasya kriyākramaḥ strībhavasyōktaḥ||187||
pathyānnapānasēvā hētūnāṁ varjanaṁ yathāsvaṁ ca|
pathyānnapānasēvā hētūnāṁ varjanaṁ yathāsvaṁ ca|
nityaṁ cāgnisamādhiḥ snigdhasya ca sarvakarmāṇi||188||
nityaṁ cāgnisamādhiḥ snigdhasya ca sarvakarmāṇi||188||
hēturliṅgaṁ siddhiḥ kriyākramaḥ sādhyatā na yōgāśca|
hēturliṅgaṁ siddhiḥ kriyākramaḥ sādhyatā na yōgāśca|
gulmacikitsitasaṅgraha ētāvān vyāhr̥tō'gnivēśasya||189||
gulmacikitsitasaṅgraha ētāvān vyāhr̥tō'gnivēśasya||189||
tatra shlokAH-
tatra shlokAH-
snehaH svedaH sarpirbastishcUrNAni bRuMhaNaM guDikAH|
snehaH svedaH sarpirbastishcUrNAni bRuMhaNaM guDikAH|
vamanavirekau mokShaH kShatajasya ca vAtagulmavatAm||183||
vamanavirekau mokShaH kShatajasya ca vAtagulmavatAm||183||
sarpiH satiktasiddhaM kShIraM prasraMsanaM nirUhAshca|
sarpiH satiktasiddhaM kShIraM prasraMsanaM nirUhAshca|
raktasya cAvasecanamAshvAsanasaMshamanayogAH||184||
raktasya cAvasecanamAshvAsanasaMshamanayogAH||184||
upanAhanaM sashastraM pakvasyAbhyantaraprabhinnasya|
upanAhanaM sashastraM pakvasyAbhyantaraprabhinnasya|
saMshodhanasaMshamane pittaprabhavasya gulmasya||185||
saMshodhanasaMshamane pittaprabhavasya gulmasya||185||
snehaH svedo bhedo la~gghanamullekhanaM virekashca|
snehaH svedo bhedo la~gghanamullekhanaM virekashca|
sarpirbastirguTikAshcUrNamariShTAshca sakShArAH||186||
sarpirbastirguTikAshcUrNamariShTAshca sakShArAH||186||
gulmasyAnte dAhaH kaphajasyAgre~apanItaraktasya|
gulmasyAnte dAhaH kaphajasyAgre~apanItaraktasya|
gulmasya raudhirasya kriyAkramaH strIbhavasyoktaH||187||
gulmasya raudhirasya kriyAkramaH strIbhavasyoktaH||187||
pathyAnnapAnasevA hetUnAM varjanaM yathAsvaM ca|
pathyAnnapAnasevA hetUnAM varjanaM yathAsvaM ca|
nityaM cAgnisamAdhiH snigdhasya ca sarvakarmANi||188||
nityaM cAgnisamAdhiH snigdhasya ca sarvakarmANi||188||
heturli~ggaM siddhiH kriyAkramaH sAdhyatA na yogAshca|
heturli~ggaM siddhiH kriyAkramaH sAdhyatA na yogAshca|
gulmacikitsitasa~ggraha etAvAn vyAhRuto~agniveshasya||189||
gulmacikitsitasa~ggraha etAvAn vyAhRuto~agniveshasya||189||
</div></div>
In this chapter, ''sneha, sweda, sarpi-basti, churna, brimhana, gudika, vamana, virechana'' and ''rakta mokshana'' for the patient suffering from ''vata-gulma'' have been described.
In this chapter, ''sneha, sweda, sarpi-[[basti]], churna, [[brimhana]], gudika, [[vamana]], [[virechana]]'' and ''[[raktamokshana]]'' for the patient suffering from ''[[vata]]-gulma'' have been described.
For the treatment of ''pitta gulma'', ''sarpi'' prepared with ''tikta'' drugs, ''kshira, samshamana-niruha basti'', bloodletting, counseling (''ashvasana''), ''samshamana''(preparations) have been described.
For the treatment of ''[[pitta]] gulma'', ''sarpi'' prepared with ''tikta'' drugs, ''kshira, samshamana-niruha [[basti]]'', bloodletting, counseling (''ashvasana''), ''samshamana''(preparations) have been described.
For ''pakva'' (suppurated) ''gulma'', surgical procedure and poultice (''upanaha'') are described and for that which is ruptured internally the purification (''samshodhana'') and palliative (''samshamana'') treatments are mentioned.
For ''pakva'' (suppurated) ''gulma'', surgical procedure and poultice (''upanaha'') are described and for that which is ruptured internally the purification (''samshodhana'') and palliative (''samshamana'') treatments are mentioned.
For ''kapha gulma, snehana, swedana, bhedana, langhana, vamana, virechana, sarpirbasti, gutika, churna, arishta, kshara,'' bloodletting followed by cauterization of the ''gulma'' as a last resort have been described. Line of treatment for ''rakta-guma'' occurring in women has also been described.
For ''[[kapha]] gulma, [[snehana]], [[swedana]], bhedana, [[langhana]], [[vamana]], [[virechana]], sarpir[[basti]], gutika, churna, arishta, kshara,'' bloodletting followed by cauterization of the ''gulma'' as a last resort have been described. Line of treatment for ''[[]rakta]]-guma'' occurring in women has also been described.
Use of wholesome (''pathya'') eats and drinks, avoidance of the respective etiological factors, continuously protection of digestive power (''agni''), the instruction for the patient who has undergone ''snehana'' are described.
Use of wholesome (''pathya'') eats and drinks, avoidance of the respective etiological factors, continuously protection of digestive power (''agni''), the instruction for the patient who has undergone ''[[snehana]]'' are described.
Etiological factors, signs and symptoms, successful line of treatment, curability and otherwise and therapeutic measures are described in concise form in this chapter of [[Gulma Chikitsa]] as described by Agnivesha [183-189]
Etiological factors, signs and symptoms, successful line of treatment, curability and otherwise and therapeutic measures are described in concise form in this chapter of [[Gulma Chikitsa]] as described by Agnivesha [183-189]
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इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृते चिकित्सितस्थाने
इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृते चिकित्सितस्थाने
गुल्मचिकित्सितं नाम पञ्चमोऽध्यायः||५||
गुल्मचिकित्सितं नाम पञ्चमोऽध्यायः||५||
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ityagnivēśakr̥tē tantrē carakapratisaṁskr̥tē cikitsitasthānē
ityagnivēśakr̥tē tantrē carakapratisaṁskr̥tē cikitsitasthānē
gulmacikitsitaṁ nāma pañcamō'dhyāyaḥ||5||
gulmacikitsitaṁ nāma pañcamō'dhyāyaḥ||5||
ityagniveshakRute tantre carakapratisaMskRute cikitsitasthAne
ityagniveshakRute tantre carakapratisaMskRute cikitsitasthAne
gulmacikitsitaM nAma pa~jcamo~adhyAyaH||5||
gulmacikitsitaM nAma pa~jcamo~adhyAyaH||5||
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Thus fifth chapter named [[Gulma Chikitsa]] in [[Chikitsa Sthana]] in the treatise compiled by Agnivesha and revised by Charaka is completed [5]
Thus fifth chapter named [[Gulma Chikitsa]] in [[Chikitsa Sthana]] in the treatise compiled by Agnivesha and revised by Charak is completed [5]
=== ''Tattva Vimarsha'' ===
== Tattva Vimarsha (Fundamental Principles) ==
*''Gulma'' occurs predominantly due to excessive excretion of feces, ''kapha'' and ''pitta'' or due to pressure exerted by their excessive aggravation and other causes leading to vitiation of ''vata dosha''.
*''Gulma'' occurs predominantly due to excessive excretion of feces, ''[[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 (''hridi'') and two flanks (''parshva'') are susceptible sites for ''gulma''.
*Cavities like that in urinary bladder (hypo gastric region), umbilical region (''nabhi''), cardiac region (''hridi'') and two flanks (''parshva'') are susceptible sites for ''gulma''.
*All ''gulma'' are treated after consideration of ''dosha'' dominance, stage, site and strength of patient.
*All ''gulma'' are treated after consideration of ''[[dosha]]'' dominance, stage, site and strength of patient.
*Internal administration of ''sneha'' (unctuous substance) in various modes like oral administration, massage, unctuous enema is the principle of management of ''vata'' dominant ''gulma''.
*Internal administration of ''sneha'' (unctuous substance) in various modes like oral administration, massage, unctuous enema is the principle of management of ''[[vata]]'' dominant ''gulma''.
*If ''pitta gulma'' is caused due to unctuous and hot substances, then ''virechana'' shall be administered. If it is caused by dry and hot substances, then ghee shall be administered.
*If ''[[pitta]] gulma'' is caused due to unctuous and hot substances, then ''[[virechana]]'' shall be administered. If it is caused by dry and hot substances, then ghee shall be administered.
*If ''kapha-gulma'' is caused by indulgence in cold, heavy and unctuous diet and in those not eligible for ''vamana, langhana'' (depletion) therapy should be prescribed in the beginning. ''Vamana'' is indicated in a patient of ''gulma'' who is having low digestion, anorexia, nausea and mild pain, heaviness and stiffness in abdomen.
*If ''[[kapha]]-gulma'' is caused by indulgence in cold, heavy and unctuous diet and in those not eligible for ''[[vamana]], [[langhana]]'' (depletion) therapy should be prescribed in the beginning. ''[[Vamana]]'' is indicated in a patient of ''gulma'' who is having low digestion, anorexia, nausea and mild pain, heaviness and stiffness in abdomen.
*''Kapha gulma'' is treated with ''langhana, agni dipana, swedana, vamana, snehana, kshara karma'' and ''agni karma.''
*''[[Kapha]] gulma'' is treated with ''[[langhana]], agni [[dipana]], [[swedana]], [[vamana]], [[snehana]], kshara karma'' and ''agni karma.''
*If ''kapha-gulma'' has a deep root and is large in size, hard in consistency and heavy, then the patient should be treated with alkali preparation-''kshara, arishta'' and ''agni karma'' (cauterization).
*If ''[[kapha]]-gulma'' has a deep root and is large in size, hard in consistency and heavy, then the patient should be treated with alkali preparation-''kshara, arishta'' and ''agni karma'' (cauterization).
*With decrease in digestive-power (''agni'') the ''gulma'' is aggravated, while on augmentation of the digestion (''agni'') the ''gulma'' is pacified. Therefore, to the patient of ''gulma'' neither excessive nutritional food nor excessive fasting or light food/treatment should be prescribed (112).
*With decrease in digestive-power (''agni'') the ''gulma'' is aggravated, while on augmentation of the digestion (''agni'') the ''gulma'' is pacified. Therefore, to the patient of ''gulma'' neither excessive nutritional food nor excessive fasting or light food/treatment should be prescribed (112).
*''Pitta gulma'' requires immediate treatment (''atyayika'') and the patient should be given ghee prepared with purgative and bitter drugs (114).
*''Pitta gulma'' requires immediate treatment (''atyayika'') and the patient should be given ghee prepared with purgative and bitter drugs (114).
*Equilibrium or provocation of all the ''dosha'' depend upon the condition of ''agni'' (digestion and metabolism), hence one should always take its care and avoid such causes which disturb it.
*Equilibrium or provocation of all the ''[[dosha]]'' depend upon the condition of ''agni'' (digestion and metabolism), hence one should always take its care and avoid such causes which disturb it.
*''Vamana karma'' should be done in ''kapha gulma'' provided the patient is fit for it.
*''[[Vamana]] karma'' should be done in ''[[kapha]] gulma'' provided the patient is fit for it.
*The excessively increased stage of ''gulma'' needs surgical intervention.
*The excessively increased stage of ''gulma'' needs surgical intervention.
*The ''gulma'' which gradually goes on increasing, spreading over a large area, has taken firm root, is covered by veins, has convex surface like that of tortoise, and which is accompanied with weakness, anorexia, thirst, nausea, vomiting, fever, cough, coryza and drowsiness is considered malignant and as incurable.
*The ''gulma'' which gradually goes on increasing, spreading over a large area, has taken firm root, is covered by veins, has convex surface like that of tortoise, and which is accompanied with weakness, anorexia, thirst, nausea, vomiting, fever, cough, coryza and drowsiness is considered malignant and as incurable.
*''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''.
*''[[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]]''.
=== ''Vidhi Vimarsha'' ===
== Vidhi Vimarsha (Applied Inferences ) ==
=== 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''.
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''.
On analyzing the features described by Charaka, it appears that the ''vataja gulma'' are irregular, mobile swellings of waxing and waning nature and are associated with pain of different characters. Such features can be seen in conditions like chronic intestinal obstructions of various etiology, intestinal tuberculosis, pyloric stenosis, mobile caecum etc. The treatment modalities like ''snehana, swedana'' and ''basti/vamana'' help in alleviating the symptoms by elimination of feces and flatus as well as improving the gut motility.
On analyzing the features described by Charak, it appears that the ''vataja gulma'' are irregular, mobile swellings of waxing and waning nature and are associated with pain of different characters. Such features can be seen in conditions like chronic intestinal obstructions of various etiology, intestinal tuberculosis, pyloric stenosis, mobile caecum etc. The treatment modalities like ''[[snehana]], [[swedana]]'' and ''[[basti]]/[[vamana]]'' help in alleviating the symptoms by elimination of feces and flatus as well as improving the gut motility.
''Pittaja gulma'' have been described as tender abdominal lumps associated with fever, thirst, burning sensation etc. which usually progress through various stages of inflammation i.e. ''ama-avastha'' and ''pachyamana avastha'' and finally suppurate.
''Pittaja gulma'' have been described as tender abdominal lumps associated with fever, thirst, burning sensation etc. which usually progress through various stages of inflammation i.e. ''ama-avastha'' and ''pachyamana avastha'' and finally suppurate.
The other variants of ''gulma'' that is ''bahistha'' (externally located) may present with a visible swelling over the surface of abdomen usually in the flanks. These inflammatory pathologies seem to be located extraperitoneally or in the wall of abdomen. Ileopsoas or iliac abscess, perinephric abscess are some of the examples. Some other clinical conditions like infected urachal cyst or infected vitellointestinal duct cysts may also resemble with ''bahistha pittaja gulma''.
The other variants of ''gulma'' that is ''bahistha'' (externally located) may present with a visible swelling over the surface of abdomen usually in the flanks. These inflammatory pathologies seem to be located extraperitoneally or in the wall of abdomen. Ileopsoas or iliac abscess, perinephric abscess are some of the examples. Some other clinical conditions like infected urachal cyst or infected vitellointestinal duct cysts may also resemble with ''bahistha pittaja gulma''.
The features described in ''kaphaja gulma'' like a firm, fixed, elevated, non-tender lump are comparable to solid mass lesions of the abdomen. Charaka has also added that these lumps can be treated surgically and a detailed surgical procedure has been described as under.
The features described in ''kaphaja gulma'' like a firm, fixed, elevated, non-tender lump are comparable to solid mass lesions of the abdomen. Charak has also added that these lumps can be treated surgically and a detailed surgical procedure has been described as under.
An earthen pitcher (''ghati'') of suitable size is taken and fire is put inside for a while. Once the fire is extinguished, the pitcher is placed over the ''gulma'' in upside down position. This creates a negative pressure inside the earthen pitcher resulting a part of the ''gulma'' to gradually move inside the pitcher. The pitcher is separated after a while. As the mass has risen above rest of the surface of abdominal wall sufficiently, a tourniquet is tied firmly at the narrow part i.e. the base of the ''gulma'' for further surgical procedure. Tying of tourniquet at the base of ''gulma'' facilitate proper holding as well as minimize bleeding during surgical procedure. An incision is made and the ''gulma'' is compressed firmly by ''vimarga yantra'' (a wooden instrument to apply pressure). The contents of ''gulma'' are removed by scrapping with the help of other ''yantras'' like ''ajpada'' and ''adarsha'' (ref. commentary by Yogindranath Sen). During this procedure, he has cautioned not to injure ''aantra'' (gut) or ''hridaya'' (vital organ).
An earthen pitcher (''ghati'') of suitable size is taken and fire is put inside for a while. Once the fire is extinguished, the pitcher is placed over the ''gulma'' in upside down position. This creates a negative pressure inside the earthen pitcher resulting a part of the ''gulma'' to gradually move inside the pitcher. The pitcher is separated after a while. As the mass has risen above rest of the surface of abdominal wall sufficiently, a tourniquet is tied firmly at the narrow part i.e. the base of the ''gulma'' for further surgical procedure. Tying of tourniquet at the base of ''gulma'' facilitate proper holding as well as minimize bleeding during surgical procedure. An incision is made and the ''gulma'' is compressed firmly by ''vimarga yantra'' (a wooden instrument to apply pressure). The contents of ''gulma'' are removed by scrapping with the help of other ''yantras'' like ''ajpada'' and ''adarsha'' (ref. commentary by Yogindranath Sen). During this procedure, he has cautioned not to injure ''aantra'' (gut) or ''hridaya'' (vital organ).
In addition to above varieties of ''gulma'', a ''tridoshaja gulma'' is also described which is considered as incurable. The features described like an elevated, stony hard lump with excessive pain and burning sensation and loss of vitality suggest more towards a malignant tumor of the abdomen. Moreover, the bad prognostic characters defined for an incurable ''gulma'' viz. a gradually increasing, deep rooted, elevated hard mass like a turtle shell which is associated with visibly engorged vessels and poor general condition like generalized edema, loss of appetite, cough, vomiting, persistent fever etc. point more towards an advanced malignant lesion of abdomen e.g. hepatoma or the metastatic involvement of liver or other solid malignant tumors of abdominal organs.
In addition to above varieties of ''gulma'', a ''tridoshaja gulma'' is also described which is considered as incurable. The features described like an elevated, stony hard lump with excessive pain and burning sensation and loss of vitality suggest more towards a malignant tumor of the abdomen. Moreover, the bad prognostic characters defined for an incurable ''gulma'' viz. a gradually increasing, deep rooted, elevated hard mass like a turtle shell which is associated with visibly engorged vessels and poor general condition like generalized edema, loss of appetite, cough, vomiting, persistent fever etc. point more towards an advanced malignant lesion of abdomen e.g. hepatoma or the metastatic involvement of liver or other solid malignant tumors of abdominal organs.
In conclusion, ''vataja gulma'' are mobile swellings of waxing and waning nature due to partial obstructive lesions of gut lumen. ''Pittaja gulma'' are intraperitoneal or extraperitoneal inflammatory or suppurative lesions of abdomen whereas ''kaphaja gulma'' are non inflammatory benign lesions of abdominal wall. ''Tridoshaja gulma'' seems to be malignant intra-abdominal lesions with poor prognosis.
In conclusion, ''[[vata]]ja gulma'' are mobile swellings of waxing and waning nature due to partial obstructive lesions of gut lumen. ''[[Pitta]]ja gulma'' are intraperitoneal or extraperitoneal inflammatory or suppurative lesions of abdomen whereas ''[[kapha]]ja gulma'' are non inflammatory benign lesions of abdominal wall. ''Tridoshaja gulma'' seems to be malignant intra-abdominal lesions with poor prognosis.
=== Sites of ''gulma'' ===
Five regions of the abdomen where ''gulma'' occurs are ''hrid'' (epigastric), ''nabhi'' (umbilical), ''basti'' (hypogastric) and two ''parshva'' (right and left flanks). If both flanks are further subdivided into three ''urdhva'' (upper), ''madhya'' (middle) and ''adho'' (lower), then whole abdomen is divided into 9 parts which is similar to the modern clinical method where abdomen is also divided into nine parts as shown in Table-1. Some of the organs situated in these regions as mentioned by Warner (1964) are also depicted therein and on that basis exact location of the Gulma can be traced.
Five regions of the abdomen where ''gulma'' occurs are ''hrid'' (epigastric), ''nabhi'' (umbilical), ''basti'' (hypogastric) and two ''parshva'' (right and left flanks). If both flanks are further subdivided into three ''urdhva'' (upper), ''madhya'' (middle) and ''adho'' (lower), then whole abdomen is divided into 9 parts which is similar to the modern clinical method where abdomen is also divided into nine parts as shown in Table-1. Some of the organs situated in these regions as mentioned by Warner (1964) are also depicted therein and on that basis exact location of the Gulma can be traced.
==== Table1. Nine divisions of the abdomen, according to [[Ayurveda]] and allopathic medicine ====
{| class="wikitable"
{| class="wikitable"
|-
|-
|}
|}
=== Differential diagnosis of ''gulma'' ===
Ayurveda is a clinical science; therefore, the diseases are classified in such a way so that they can be systematically diagnosed on the basis of the symptoms. ''Gulma'' is a good example for it.
[[Ayurveda]] is a clinical science; therefore, the diseases are classified in such a way so that they can be systematically diagnosed on the basis of the symptoms. ''Gulma'' is a good example for it.
Mainly three resembling diseases occur in the abdominal cavity viz. ''udara roga, gulma'' and ''pliha dosha'' which require differential diagnosis. ''Udararoga'' comprises of eight diseases which cause general enlargement of the abdomen. Five types of ''gulma'' have protruding and palpable localized swellings related to the abdominal organs and appendages. Under ''pliha dosha'' benign enlargement of spleen or liver occurs (''Bhavaprakasha Chikitsa-Prakarana'' chapter 33). Therefore, on the basis of these clear demarcations, it may not be difficult to differentiate these three kinds of diseases clinically.
Mainly three resembling diseases occur in the abdominal cavity viz. ''udara roga, gulma'' and ''pliha dosha'' which require differential diagnosis. ''Udararoga'' comprises of eight diseases which cause general enlargement of the abdomen. Five types of ''gulma'' have protruding and palpable localized swellings related to the abdominal organs and appendages. Under ''pliha dosha'' benign enlargement of spleen or liver occurs <ref>Bhavamishra. Bhavaprakasha -Volume I.Chikitsa-Prakarana chapter 33, Translated from Sanskrit by K.R. Srikantha Murthy. 1st ed. Varanasi: Krishnadas academy;2000.pp.-</ref>. Therefore, on the basis of these clear demarcations, it may not be difficult to differentiate these three kinds of diseases clinically.
=== ''Chikitsa sutra'' (principles of management) of ''gulma'' ===
'''Principles''':
'''Principles''':
#''Anulomana''
#''Anulomana''
#''Pachana''
#''[[Pachana]]''
'''Main drugs''':
'''Main drugs''':
#''Tamra bhasma''
#''Tamra bhasma''
==== Internal Medicines ====
{| class="wikitable"
{| class="wikitable"
! scope="col"| ''Anupana''
! scope="col"| ''Anupana''
|-
|-
| rowspan="3"| ''Vata'' dominant
| rowspan="3"| ''[[Vata]]'' dominant
| ''Lashunadi Vati''
| ''Lashunadi Vati''
| 500 to 1000 mg
| 500 to 1000 mg
| Milk
| Milk
|-
|-
| rowspan="3"| ''Pitta'' dominant
| rowspan="3"| ''[[Pitta]]'' dominant
| ''Praval panchamritam''
| ''Praval panchamritam''
| 250 to 500 mg
| 250 to 500 mg
| Milk
| Milk
|-
|-
| rowspan="3"| ''Kapha'' dominant
| rowspan="3"| ''[[Kapha]]'' dominant
| ''Svarna vasant''
| ''Svarna vasant''
| 250 to 500 mg
| 250 to 500 mg
| ''Kumaryasava''
| ''Kumaryasava''
|-
|-
| rowspan="2"| ''Raktaja''
| rowspan="2"| ''[[Rakta]]ja''
| ''Shatavari-truna panchamula decoction ''
| ''Shatavari-truna panchamula decoction ''
| 20 to 40 ml
| 20 to 40 ml
|}
|}
==== [[Panchakarma]] ====
{| class="wikitable"
{| class="wikitable"
! scope="col"| ''Anupana''
! scope="col"| ''Anupana''
|-
|-
| rowspan="2"| ''Virechana''
| rowspan="2"| ''[[Virechana]]''
| Castor Oil
| Castor Oil
| 20-40 ml
| 20-40 ml
| Milk
| Milk
|-
|-
| ''Virechana'' decoction
| ''[[Virechana]]'' decoction
| 20-40 ml
| 20-40 ml
| Morning, one time
| Morning, one time
| 320 ml
| 320 ml
| Morning, one time
| Morning, one time
|
| ''-''
|-
|-
| ''Anuvasana''
| ''Anuvasana''
| 40 to 70 ml
| 40 to 70 ml
| Morning, one time
| Morning, one time
|
| ''-''
|-
|-
| ''Anulomana''
| ''Anulomana''
|-
|-
| Blood Letting
| Blood Letting
|
| ''-''
| 100 to 150 ml
| 100 to 150 ml
|
| ''-''
|
| ''-''
|}
|}
=== Glossary ===
=== Related Chapter ===
* [[Gulma Nidana]]
#Apakva Gulma (अपक्व गुल्म) non-suppurate Gulma
#Gulma (गुल्म) palpable mass in abdomen, abdominal lump
=== Further reading ===
#Kriyākramaḥ (क्रियाक्रमः) management
#Kṣāra karma (क्षारकर्म) application of special alkali preparation
#Charak. Charak Samhita. Edited by Jadavaji Trikamji Aacharya. 1st ed. Varanasi: Krishnadas Academy;2000. p.--.
#Kṣaratva (क्षरत्व) erosion
#Madhavakara. Madhava Nidanam (Roga vinischaya). Translated from Sanskrit by K. R. Srikantha Murthy. 8th ed. Varanasi: Chaukhambha orientalia;2007.pp--
#Sushruta. Sushruta Samhita. Edited by Jadavaji Trikamji Aacharya. 8th ed. Varanasi: Chaukhambha Orientalia;2005. p.--.
#Mahāvāstuṁ (महावास्तुं) involving extensive area
#Vagbhata. Ashtanga Hridayam. Edited by Harishastri Paradkar Vaidya. 1st ed. Varanasi: Krishnadas Academy;2000.p.--.
#Bhavamishra. Bhavaprakasha -Volume I. Translated from Sanskrit by K.R. Srikantha Murthy. 1st ed. Varanasi: Krishnadas academy;2000.pp.-
#Warner E. C. (1964): Savill's System of clinical medicine. Orient Longmans Ltd.New Delhi, 14th Edition p.341
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