🔘 Gulma Roga

Gulma

👉🏻Classification of Gulma -

इह खलु पञ्च गुल्मा भवन्ति; तद्यथा-

वातगुल्मः, पित्तगुल्मः, श्लेष्मगुल्मो,

निचयगुल्म:, शोणितगुल्म इति  ||

There are five types of gulma-

vata dominant gulma, pitta

dominant gulma, shleshma/

kapha dominant gulma, nichaya

(tridosha dominant) gulma, and

shonita gulma.

👉🏻Etio-Pathogenesis of Vata Dominant Gulma-

यदा पुरुषो वातलो विशेषेण

ज्वरवमनविरेचनातीसाराणामन्यतमेन

कर्शनेन कर्शितो वातलमाहारमाहरति,

शीतं वा विशेषेणातिमात्रम् अस्नेहपूर्वे

वा वमनविरेचने पिबति, अनुदीर्णां

वा छर्दिमुदीरयति, उदीर्णान्

वातमूत्रपुरीषवेगान्निरुणद्धि, अत्यशितो

वा पिबति नवोदकमतिमात्रम्,

अतिसङ्क्षोभिणा वा यानेन याति,

अतिव्यवायव्यायाममद्यशोकरुचिर्वा,

अभिघातमृच्छति वा,

विषमासनशयनस्थानचङ्क्रमणसेवी

वा भवति, अन्यद्वा किञ्चिदेवंविधं

विषममतिमात्रं व्यायामजातमारभते,

तस्यापचाराद्वातः प्रकोपमापद्यते||६||

When a person of vatika

constitution, particularly

emaciated due to one of

the debilitating factors like fever, emesis, purgation and

diarrhoea, consumes vata-aggravating food or excessively

cold food, in excessive

quantities, or is administered

emesis or purgation without prior unction, he vomits profusely and holds up impelling

urges of flatus, urine, bowel movement. Or if such a person,after consuming a heavy meal,drinks a lot of fresh water or

travels by an excessively jerking vehicle, indulges in excessive sexual intercourse, intensive

physical exercise, or drinks alcoholic drinks, or suffers from excessive anxiety, or is subjected to injury or uses uneven postures in sitting,sleeping,standing and walking, or starts

some other similar sort of irregular and excessive physical

exercises -vata gets vitiated or aggravated. 

स प्रकुपितो वायुर्महास्रोतोऽनुप्रविश्य

रौक्ष्यात् कठिनीभूतमाप्लुत्य

पिण्डितोऽवस्थानं करोति हदि बस्तौपार्श्वयोर्नाभ्यां वा; स शूलमुपजनयतिग्रन्थींश्चानेकविधान्, पिण्डितश्चावतिष्ठते,स पिण्डितत्वाद् 'गुल्म'इत्यभिधीयते;

समुहुराधमतिमुहुरल्पत्वमापद्यते;

अनियतविपुलाणुवेदनश्च भवति

चलत्वाद्वायोः,मुहुःपिपीलिकासम्प्रचारइवाङ्गेषु,तोदभेदस्फुरणायामसङ्कोचसुप्तिहर्षप्रलयोदयबहुलः; तदातुरःसूच्येव शङ्कुनेव चाभिसंविद्धमात्मानंमन्यते, अपि च दिवसान्ते ज्वर्यते शुष्यति

चास्यास्यम्,उच्छवासश्चोपरुध्यते, हृष्यन्तिचास्य रोमाणि वेदनायाः प्रादुर्भावे;प्लीहाटोTনकजनातिाकोटात्ताळमर्टशिपान्त्रकूजनाविपाकोदावत्ताङ्गमर्दमन्याशि

र:शङ्खशूलब्रध्नरोगाश्चैनमुपद्रवन्ति;कृष्णारुणपरुषत्वङ्नखनयनवदनमूत्रपुरीषश्चभवति, निदानोक्तानि चास्य नोपशेरते,विपरीतानि चोपशेरत इति वातगुल्मः|| ||

Such vitiated vata, on entering the mahasrotas, hardens due to dryness forming a mass or

swelling localised in the regions of 

-heart

-urinary bladder

- sides and the navel.

 Thecondition,gulma (or vatagulma),is painful and can take the shape of a single swelling or multiplenodules of various types. It sometimes gets aggravated and enlarged, sometimes diminished, and causes mild or severe pain due to instability of vayu. Sometimes there are

tingling sensations like -ants crawling on body  -frequent onset and diminution of various

types of painful sensations such

as 

-piercing

-breaking 

-twitching

-extension

-contraction

-numbness

-hyperaesthesia,etc.

 These sensations could be accompanied bv a rise intemperature usually in the evenings, dryness of mouth,

difficulty in expiration,

horripilation at the onset of pain and complications such

as 

-spleen (enlargement),

-distension 

-gurgling sound in the abdomen

-indigestion

-udavarta (upward movement of vata), -bodyache

-pain in the lateral side of the neck

- head and temple regions and bradhana (swellings of the inguinal region) with appearance of blackness, reddishness and roughness in

skin, nails, eyes, face, urine and feces. 

The disease aggravates

due to these etiological factors and pacifies due to opposite factors. These are characteristic

features of vata gulma.

👉🏻Pitta Dominant Gulma -

तैरेवतुकर्शनैःकर्शितस्याम्ललवणकटुकक्षारोष्ण तीक्ष्णशुक्तव्यापन्न मद्यहरितकफलाम्लानां

विदाहिनां च शाकधान्य मांसादीनामुपयो

गादजीर्णाध्यशनाद्रौक्ष्यानुगते चामाशयेवमनमतिवेलं सन्धारणं वातातपौचातिसेवमानस्य पित्तं सह मारुतेनप्रकोपमापद्यते|| ||

If a person, weakened by ailments or various etiological factors , uses 

-sour

-salty

-pungent

- alkaline substances with hot and sharp potency

- vinegar

-improperly prepared or denatured alcoholic

drinks

-salads

-sour fruits 

- acidic vegetables, grains,meat etc., takes food during indigestion, is administered

emesis when amashaya is dry (or not properly oleated),suppresses natural urges for

long, or is exposed excessively to the sun and wind, his pitta

along with vata gets vitiated or aggravated.

तत्प्रकुपितंमारुतआमाशयैकदेशे

संवत्त्यतानेववेदनाप्रकारानुपजनयति,य उक्ता वातगुल्मे; पित्तं त्वेनं विदहतिकुक्षौ हृद्युरसि कण्ठे च; स विदह्यमानः

सधूममिवोद्गारमुद्गिरत्यम्लान्वितं,

गुल्मावकाशश्चास्य दह्यते दूयते धूप्यतेऊष्मायते स्विद्यति क्लिद्यति शिथिल

इव स्पर्शासहोऽल्परोमाञ्चश्च भवति;ज्वरभ्रमदवथुपिपासागलतालुमुखशोषप्रमोहविड्भेदाश्चैनमुपद्रवन्ति;

हरितहारिद्रत्वङ्नखनयनवदनमूत्रपुरीषश्चभवति; निदानोक्तानि चास्य नोपशेरते,

विपरीतान्युपशेरतइतिपित्तगुल्मः||

Aggravated vata, along with vitiated pitta, gets (completely or partially) collected in the amashaya and produces the same types of pain as mentioned for vata gulma.Due to aggravation of pitta in certain cases, the patient feels a burning sensation (with

hyperacidity) in the belly, cardiac region, chest and throat while letting out smoky and sour eructations at the same time. In the location of gulma, there is 

-burning sensation

-pain

-sensations of fuming

-sweating  

-moistening

-laxity

-tenderness 

- slight horripilation. 

The patient could exhibit symptoms such as

- fever

-giddiness

-burning pain

-thirst

-dryness of throat, palate and mouth, -fainting 

- diarrhea 

- develops greenish or yellowish discoloration of skin,nails, eyes, face, urine and feces.

The disease aggravates due to these etiological factors and pacifies due to opposite factors.

This variant of gulma is called pitta gulma.

👉🏻Kapha Dominant Gulma -

तैरेव तु कर्शनैः कर्शितस्यात्यश

नादतिस्निग्धगुरुमधुरशीताशनात्

पिष्टेक्षुक्षीरतिलमाषगुडविकृतिसेवनान्मन्दकमद्यातिपानाद्धरितकातिप्रणनयादानूपौदकग्राम्यमांसातिभक्षणात्सन्धारणादबुभुक्षस्य चातिप्रगाढमुदपानात्

सङ्क्षोभणाद्वा शरीरस्य श्लेष्मा सहमारुतेन प्रकोपमापद्यते||

If a person weakened by

diseases or aforesaid factors takes

- too muchunctuous -heavy

-sweet 

-cold things

-habitually takes

preparations of (rice) flour, sugarcane, milk, sesame, black

gram andsugar (jaggery)

-uses excessive

immature curd -alcoholic drinks

-salads

- eats meat of marshy,

aquatic and domesticated

animals in excessive quantities

-suppresses natural urges

-drinks too much water when hungry, or is subjected to excessive shaking of the body (caused by travellingon rough roads, etc.), his kapha

along with vata gets vitiated or aggravated. 

तं प्रकुपितं मारुत आमाशयैकदेशे

संवत्त्य तानेव वेदनाप्रकारानुपजनयति

य उक्ता वातगुल्मे; श्लेष्मा त्वस्य

शीतज्वरारोचकाविपाकाङ्गमर्द

हर्षहृद्रोगच्छर्दिनिद्रालस्यस्तैमित्यगौरवशिरोभितापानुपजनयति, अपि चगुल्मस्यस्थैर्यगौरवकाठिन्यावगाढसुप्तताः,

तथाकासश्वासप्रतिश्यायान्

राजयक्ष्माणं चातिप्रवृद्धः, श्वैत्यं

त्वङ्नखनयनवदनमूत्रपुरीषेषूपजनयति,

निदानोक्तानि चास्य नोपशेरते, विपरीतानिचोपशेरत इति श्लेष्मगुल्मः||

Such aggravated vata along with vitiated kapha, when

accumulated in the amashaya

(upper part of abdomen)

region or a part of it, causes the same types of painful symptoms as mentioned for vata gulma. Kapha causes

fever accompanied with -cold sensation -anorexia

-indigestion

-bodyache

-horripilation

- heartdisease

-vomiting

-excess sleep

-lassitude

-sweating

- feeling of heaviness 

-distress in the head. 

In the region where the gulma is located, there is fixity, heaviness, hardness, and numbness. Complications could occur such as

- cough

-dyspnoea

-coryza 

 -tuberculosis

 in much advanced stages. In terms of physical appearance, thepatient develops whiteness in skin, nails, face, urine and feces.

The disease aggravates due to these etiological factors and pacifies due to opposite factors.

This variant of gulma is called kapha gulma. 

👉🏻Tridosha Dominant Gulma -

त्रिदोषहेतुलिङ्गसन्निपाते तु

सान्निपातिकं गुल्ममुपदिशन्ति कुशलाः|

स विप्रतिषिद्धोपक्रमत्वादसाध्यो

निचयगुल्म: ||

When the symptoms of three doshas are exhibited, a gulma patient is said to be ailing from sannipatika gulma. This condition is incurable. 

👉🏻Shonita Gulma

शोणितगुल्मस्तु खलु स्त्रिया एव

भवति न पुरुषस्य, गर्भकोष्ठार्तवागमन

वैशेष्यात् पारतन्त्र्यादवैशारद्यात्

सततमुपचारानुरोधाद्वा

वेगानुदीर्णानुपरुन्धत्या आमगर्भे

वाऽप्यचिरपतितेऽथवाऽप्यचिरप्रजातायाऋतौवावातप्रकोपणान्यासेवमानायाःक्षिप्रंवातः प्रकोपमापद्यते|| ||

Shonita or raktagulma occurs specifically only in women and not in men because of presence of uterus and menstrual flow in the former. In woman, who suppress their natural urges

because of dependence,ignorance or a constant attendance to service of others or uses vata aggravating substances soon after abortion, delivery or during menstruation,

vata gets vitiated or aggravated quickly.

👉🏻Prodormal Symptoms -

एषां तु खलु पञ्चानां गुल्मानां

प्रागभिनिर्वृत्तेरिमानि पूर्वरूपाणि

भवन्ति; तद्यथा-अनन्नाभिलषणम्,

अरोचकाविपाकौ, अग्निवैषम्यं, विदाहोभुक्तस्य, पाककाले चायुक्त्याछट्टुद्गारौ,वातमूत्रपुरीषवेगानां चाप्रादुर्भावप्रादुर्भूतानां चाप्रवृत्तिरीषदागमनं वा,वातशूलाटोपान्त्रकूजनापरिहर्षणातिवृत्तपुरीषताः, अबुभुक्षा, दौर्बल्यं,सौहित्यस्यचासहत्वमिति || ||

These five types of gulma have the following prodormal

symptoms just prior to

occurring: 

-aversion to food -anorexia 

- indigestion

-disturbed metabolism

-burning sensation after taking meals

-vomiting and 

-unusual eructations

-reduced urge for flatus urine and bowel

movements

-pain 

-distension

-gurgling sound 

-horripilation

-diarrhea due to vata 

-loss of appetite debility 

-inability to endure satiety.