Pulsating tumour, gradually taking the shape of a round mass, with pain and producing the features or pregnancy (like amenorrhoea, pigmented nipples, morning sickness etc). Often this produces this pain and burning sensation with the features of Pittaja Gulma.

1

NIDANA

1. Rutau Anahara – Avoiding food during menstruation

2. Bhaya, Rooksha, Vega Vinigraha: Fear, intake of excessively dry food and suppression of manifested natural urges:

3. Improper administration of Stambhana treatment (astringent, blocking treatment) and emetic therapies

4. Yoni dosha: Gynaecological disorder

2

LAKSHANA

Spandate – palpitates

Pindita – round mass

Sashoola – associated with colic-pain and

signs and symptoms suggestive of pregnancy.

This Rakthaja Gulma occurs only in women and is treated only after the passage of 10 months. [18- 19]

3

PRICIPAL OF CHIKITSA

The patient suffering from Rakta- Gulma, after 10th month, is given oleation and fomentation therapies followed by Sneha Virechana (purgation therapy with unctuous ingredients).

Two Patras of Palasha-Ksara (Alkali preparation of Palasa tree) and two Patras of oil and ghee is boiled together and administered to the patient in appropriate dose for with a view to suffering the Gulma. If the mass of Gulma does not break by the administration of this recipe, 1 of the following recipes is inserted into the vagina for the cleansing of Yoni (female genital tract)

1) Oil cake mixed with alkalies

2) Oil cake mixed with the milky latex of Sudha

3) Katuka- Maaatsya ( small fish called Saphari which is pungent in taste) impregnated with alkalies and milky later of Sudha

4) A peace of cloth well pergnated with the bile of Varaha or Matsya

5) A peace of cloth well impregnated with the drugs which cause vomiting or purgation and smeared with honey; and

6) Kinva (Yeast which is used for fermentation, Asavas and Aristas) mixed with Jaggery and Alkalies

If inspite of it, bleeding does not occur, then for breaking the Rakta Gulma,the patient may be given alkalies prescribed for the treatment of Raktha-Pitta ( A disease characterised by bleeding from different parts of the body) along with honey and ghee in the form of a linctus. She is given Lasuna, sharp type of Madira (variety of alcoholic drink) and fish. She may also be given medicated enema prepared without the decoction of Dasa-Mula mixed with milk, Cow’s urine and Alkalies.

After the occurrence of bleeding, the patient is given rice mixed with meat soup to it.

Ghee and oil is used for massage of her body, and for drinking; she is given freshly prepared Sura (a type of Alcoholic drink).

If there is excessive bleeding, then therapies prescribed for excessive pain is given, then she is given all therapies Avaseka (sprinkling of water), Tittiri, Charanayudha (cock), Sura alongwith its Manda (upper portion of the fermented liquid) and ghee prepared with sour drugs as food, drinks and regimens.

Ghee boiled with drugs belonging to Jivaniya group is used for Uttara Basti (douching the vaginal tract). If there is excessive bleeding then anuvasana type of medicated enema is administered by boiling with bitter – drugs [172-182]

4

PROGNOSIS OF GULMA

Tumor associated with the features of breathlessness, abdominal pain, thirst, anorexia, body ache, stiffness, and debility are critical; likewise, the tumor with the features of all the three Doshas is also incurable.

INCURABILITY AND COMPLICATIONS

When Gulma, gradually accumulated, surrounds a large area, deep-rooted, when it is engrossed with veins, when it is elevated like a tortoise and when it is associated with weakness, anorexia, Nausea, Cough, vomiting, Arati (Disliking for every thing), fever, morbid thirst, drowsiness as well as coryza, it becomes incurable.

Oedema in cardiac region, umbilical region and upper as well as lower limbs in a patient of Gulma who is afflicted with fever, dyspnoea, vomiting and diarrhoea drag him towards death.

5

MANAGEMENT OF GULMA (GASEOUS TUMOR)

All measures are undertaken to control Vata. To achieve this,

Snehana – oleation,

Swedana – sudation (sweating therapy),

Mild purgation,

Asthapana Basti – Decoction enema,

and sour mixed sweet eatables are recommended.

6

SINGLE DRUGS RECOMMENDED

1. Lashuna – garlic – Allium sativa Linn.

2. Hapusha – Juniperus communis Linn.

3. Hingu – asafetida – Ferula narthex Boiss.

4. Draksha – raisins – Vitis vinifera Linn.

5. Vacha – Acorus calamus Linn.

6. Eranda – castor- Ricinus communis Linn.

7. Ajamoda – Celery – Trachyspermum roxburghianum (DC.) Sprague.

8. Saindhava lavana – rock salt

9. Pippali-long pepper- Piper longum Linn.

10. Chavya- Piper chaba Hunter.

11. Danti – Baliospermum montanum (Willd.) Muell. Arg.

12. Haritaki – chebulic myrobalan – Terminalia chebula Retz.

13. Varuna – Crataeva nurvala Buch-Hem. etc

7

AYURVEDIC MEDICINES

1. Dashamoola kwatha

2. Hapushadi ghrita

3. Hingwadi choorna

4. Hingusauvarchala ghrita

5. Pippalyadi ghrita

6. Lashuna ksheerapaka

7. Shankha vati

8. Vaishwanara choorna

9. Agnimukha choorna

10. Dantiharitaki lehya

11. Chavikasava

12. Pravala Panchamrita rasa

13. Dashamoola ghrita

14. Varunadi kwatha

15. Kumaryasava

16. Ksheera Shatpala ghrita etc.

10 MONTH NO TREATMENT, THEN

UTTER BASTI

Dashmula kvatha 30ml +

go mutra 10ml +

Yavakshar 250mg-->utter basti

WHOLESOME DIET AND HABITS

1. Purana shali (old rice)

2. Kulattha (horse gram)

3. Jangala mamsa (desert animals)

4. Kooshmanada (ash gourd)

5. Amalaki (goose berry)

6. Dadima (pomegranate)

7. Eranda taila (castor oil)

8. Ardraka (ginger)

9. Jiraka (cumin seeds)

10. Hingu (asa foetida)

11. Deepana (easily digestible, carminative food) etc

UNWHOLESOME FOOD AND HABITS

1. Guru ahara (heavy food)

2. Viruddha Ahara (incompatible food)

3. Vishama Ahara (improper food)

4. Shushka shaka (dry vegetable)

5. Shushka mamsa (dried meat)

6. Kanda moola (tubers and roots)

7. Matsya (fish)

8. Vegadharana (suppression of the urges) etc.

GULMAHARA KASHAYAS

A. DASAMOOLADI KASHAYAM

Ref – Sahasrayogam, Kashaya Prakaranam,

Dashamula (Ten roots)

Ginger (Zingiber officinale)

Devadaru (Cedrus Deodara)

The decoction prepared with these ingredients should be served fresh

uses-1. Gulma – abdominal tumors

B. CHITRAKADI KASHAYAM

Ref – Sahasrayogam, Kashaya Prakaranam,

Chitraka (Plumbago zeylanica)

Pippali mula (Roots of Piper longum)

Eranda (Ricinus communis)

Ginger (Zingiber officinale)

The decoction prepared with these ingredients should be served fresh

uses- 1. Gulma – abdominal tumors

C. VARSHABVADI KASHAYAM

Ref – Sahasrayogam, Kashaya Prakaranam,

Rakta Punarnava (Boerhavia diffusa, red variety )

Bilwa (Aegle Marmelos)

Horse gram (Dolichos biflorus )

Castor (Ricinus communis )

Sahachara (Strobilanthes heynianus)

Ginger (Zingiber officinale )

Agnimantha (Clerodendrum phlomidis )

The decoction prepared with these ingredients should be served fresh with jaggery, rock salt, Piper longum and asafetida

uses-1. Constipation 2. Indigestion 3. Severe pain in vagina 4. Pain in the cardiac region 5. Pain in flanks 6. Backache 7. Pelvic pain 8. Enlargement of prostate gland 9. Abdominal tumors 10. Enlargement of spleen

D. KANADI KASHAYAM

Ref – Sahasrayogam, Kashaya Prakaranam,

Pippali (Piper longum)

Shatahva (Anethum graveolens)

Dwi Karanja (Pongamia pinnata & Caesalpinia crista)

Devadaru (Cedrus deodara)

Bharangi (Cerodendron serratum)

Horse gram (Dolichos biflorus)

Sesame (Sesamum indicum / sesame )

Garlic (Allium sativum)

The decoction prepared with these ingredients should be served fresh with powder of asafetida

uses-1. Abdominal tumor caused by vitiated blood

RASODHI/BHASMA/PISTI-(120-250MG WITH MADHU/USHNODAKA)

- Gulmakuthar rasa-(parad,gandhak,hartal,tamra,tankan,yavkshar,trikatu)

- Badvanal rasa-(parad,gandhak,tamra,abhrak,tankan,samundri lavana,yavakshar,vatsanabh,palashkshar,apamarga)

- Agnikumar rasa-(parad,gandhak,tankan,vatsanabh,raka bhasma,karpada bhasma)

- Kravyadi rasa-(parad,gandhak,tamra,loha,panchkola,tankan)

- Rasayanamrit loha-(triphala,trikatu,trimada,trivrita,danti,saindhav,abhrak)

- Praval panchamrit-(praval,mukta,shankh,sukti,varatika)

- Panchanan ras-(rakt gulma)(parad,gandhak,tuthya,jaypal,pippali,amaltas)

- Pranballabha rasa-(loha,tamra,varat,tuthya,hingu,triphala)

- Sarveshver rasa-(svarna,tamra,triphala,trikatu,loha)

VATI-(250-500MG WITH USHNA JALA)

- Hingvadi vati-(hing,ajmoda,amlaveta,vrikshamla,pippali)

- Kankayan gutika-(kacura,pushkarmula,dantimula,chitrak,sonth,vacha,nisoth,hinga)

CURNA-(3-6GM WITH MADHU/USHNODAKA)

- Hingvadi curna-(hing,trikatu,patha,haubera,harad,ajmoda)

- Shatyadi curna-(kachra,pushkermula,hing,amlavet,yavkshar,dhaniya)

- Nagaradi curna-(south,krishna tila,guda)

- Vachadi curna-(vacha,harad,hinga,saindhav,yavkshar,ajwain)

- Yamanyadi curna-(ajvain,hing,saindhav,yavkshar,sauvarchal,harad)

- Lavangadi curna-(lavang,danti,trivrit,yamani,sunthi,kutaj beej)

KVATHA/ASAV/ARISTHA-(20-30ML WITH JALA)

- Til kvath-(sonf,karanjchal,devdaru,bharangi)

- Panchmul kwatha-(brihat panchmoola)

- Draksha-triphala kvath-(draksha,triphala,guda)

- Lehsuna ksheera-(lehsun,guda)

- Varunadi kvatha-(varun,agatsya,bilvachal,apamarga,chitrak)

- Kumaryasava-(kumari,chitrak,triphala,loha,tamra)

GHRITA/TAILA-(15-20ML WITH USNA JALA/MILK)

- Triyushnadhya ghrita-(trikatu,triphala,guda,goghrita)

- Hingusouvarchladhya ghrita-(hing,souchar namak,jeera,anardana,ajvain)

- Pippaliyadhya ghrita-(pippali,anardana,dhaniya)

- Drakshadhya ghrita-(amla,ikshu,goghrita,harad)

- Vasa ghrita-(adusha)

- Dashamuladi ghrita-(dashmula,pipper,sunthi,yavakshar)