Obstruction of flatus, dryness of the throat and mouth, shivering, fever, pain in heart and abdominal sides, shoulder and head, aggravates on empty stomach and relieved on ingestion of food; the condition is worsened by dry-astringent-bitter and pungent substances.

1

NIDANA

1. Rooksha annapanam: Intake of dry diet and drinks

2. Ati matra vichestitam: Excessive and abnormal physical behaviour

3. Vega vinigraha: Suppression of manifested natural urges

4. Shoka: Affliction by grief

5. Abhighata: Affliction by external injury

6. Ati mala: Excessive elimination of excreta and

7. Nirannata: Fasting for a long time.

2

LAKSHANA

1. Momentary changes in the location, shape and intensity of pain

2. Vit vata sanga: Obstruction to the passage of the feces and flatus

3. Gala vaktra shosham: Dryness in the throat and mouth,

4. Shyava aruna shareera: Grey and reddish coloration of body

5. Shishira jvara: Fever with cold

6. Hrut, kukshi, Parshva, Shiro rujam: Pain in the region of heart, abdomen, sides of the abdomen (parshva), scapula and head

7. Aggravation of the disease after food is digested and alleviation of ailment by the intake of food.

8. In Vataja Gulma, dry, astringent, bitter and pungent types of food are not wholesome.[10-11]

3

PRICIPAL OF CHIKITSA

VATAJA GULMA CHIKITSA SUTRA:

A patient suffering from Vataja Gulma, caused by dry food and excessive physical activities, associated with excruciating pain and obstruction to feces and flatus should, in the beginning be administered with-

Snehakarma – Oleation,

oil massage,

Oily foods and drinks,

Niruha basti(decoction enema) and

Anuvasana basti– Oil enema.

After this, Swedana – sweating treatment is adopted.

Sweating therapy causes-

Srotasam Mardava – softness of channels of circulation,

Jitva Marutam ulbanam – alleviates aggravated Vata Dosha

Bhitva Vibandham – relieves constipation,

as a result of which Gulma gets cured.

Administration of Snehapana (unctuous liquid) is useful in Gulma, especially when this disease is located above the umbilical region.

If Gulma is manifested either in Pakvashaya – colon or in Jatara, (other part of abdomen), then Niruha (decoction enema) and Anuvasana (fat enema) is useful.

The Vataja Gulma patient accompanied with constipation and bloating is given unctuous, hot and nourishing diet and drinks after his digestive-power is stimulated;

In Vata Gulma, Sneha Pana (oral administration of Sneha), Niruha (a type of medicated enema) and Anuvasana (another type of medicated enema) is administered very frequently. But care is taken against Kapha and Pitta. That is, it is ensured that these therapies do not aggravate Kapha and Pitta in any way. [20-26]

If, by the therapies for alleviation of Vayu, other Doshas – Pitta, Kapha and Rakta get vitiated, then carefully, treatment is done to pacify the aggravated Dosha, while taking extra precautions for Vata Dosha balance. [27-28]

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.

8

VATA GULMA AYURVEDIC MEDICINES

AYURVEDIC MEDICINES FOR GULMA:

TRAYUSHANADI GHRTA

HINGU SAUVARCHALADI GHRTA

PIPPALYADYA GHRTA

HINGVADI CHURNA, GUTIKA

HINGVADI YOGA

SHATYADI CHURNA, GUTIKA

NAGARADI YOGA

ADMINISTRATION OF CASTOR OIL

Erandataila – Castor oil is taken by a patient suffering from Vataja Gulma after mixing it with the Manda (upper portion) of Varuni (a type of alcoholic preparation) or milk.

It is taken with Manda of Varuni, if kapha is secondarily aggravated along with Vata Dosha.

It is taken with milk if Pitta is secondarily aggravated. [92-93]

LASHUNA KSHEERAPAKA

ADMINISTRATION OF SHILAJAT

Intake of Shilajatu along with the decoction of Panchamoola added with Kshara (alkali preparation) Yava – Barley – Hordeum vulgare Kshara cures Vataja Gulma. [97]

ADMINISTRATION OF BOILED BARLEY

Intake of Vatya (boiled barley) along with the soup of Pippali – Long pepper fruit – Piper longum or the juice of Mulaka – Radish – Raphanus sativus by adding Sneha (ghee) cures Udavarta (upward movement of Vata) and Vata-Gulma [98]

SWEDANA THERAPY

If the patient of Vata- Gulma has symptoms like-

Shula – colic pain,

Anaha – abdominal distension and

Vibandha – constipation, then he is given fomentation therapy with the help of Nadi, Prastara or Sankara type of fomentation as described in Sutra 14[99]

ENEMA THERAPY

Medicated enema is the best therapy for curing Gulma.

In the beginning, it overcomes Gulma. Therefore, Niruha and Anuvasana types of medicated enema is administered frequently for the cure.over Dosage or taking this medicine for longer period than prescribed may cause Vatika, Paittika and Kaphaja type of Gulma.

Different effective recipes of medicated enema for successful treatment of this disease are described in Siddhi section of this work. [100-101]

HERBAL OILS AND GHEE

Recipes of medicated oils in the chapter dealing with the treatment of Vata-Roga (Chikitsa 28) should be useful for Pana (oral intake), massage and Anuvasana type of medicated enema by a patient suffering from Vataja Gulma. Medicated oil is the best for overcoming Vata. Therefore, these recipes cure Gulma instantaneously.

GHEE FOR PURIFICATION OF BODY:

Recipes of medicated ghee described earlier in the chapter is administered along with the powder of Neelini – Indigofera tinctorea to the patient suffering from Vata Gulma for the elimination (Shodhana) of excreta (Mala) from his body.[102- 104]

NILINYADYA GHRITA

9

DIET FOR VATA GULMA

Meat Of Cook, Peacock, Tittiri, Kraunca and Vartaka, Different types of Shali Rice, Madira (alcoholic drink) and ghee, these are to be used in the treatment of Vata- Gulma. Hot, liquid ad unctuous food and drinks like Varunu(a type of alcoholic drink) along with its Manda (upper portion or water boiled by adding Dhanyaka – Coriander – Coriandrum sativum are useful for a patient suffering from Vata- Gulma.

If there is suppression of the power of digestion then Gulma gets aggravated, and if the power of digestion then Gulma gets aggravated, and if the power of digestion is stimulated then Gulma gets alleviated. Therefore, the patient should not eat in excess nor should he fast in excess. [110-112]

VATAJ GULMA

(KHALI PET ATIVEDANA,VIBANDHA,HRIDAYA KUKSHI SHOOLA,SHEETA PURVAK JVAR)

1-SNEHAPANA-Triphala ghrita20ml(sansamanarth)

2-snigdha bhojan sevana

SANSODHANA

1.SNEHAPANA-Triphala ghrita

2.Bahya snehan-svedan(sos)

3.MRIDU VIRECHANA KALP

Nisoth 20 gm +

Choti harad 20gm +

Amaltash 20gm-->kada + castor oil 40ml-->mridu virechana

4.BASTI

A. Anuvasana-Narayan taila-30ml

B.Niruha-Erdandmuladi basti/Madhu taila basti

(fir bhi thik na ho to raktmokshan karaye

RAKTMOKSHAN-same side hand se)

(Vata gulma me kapha ka anubandh ho to vaman bhi kara sakte h)

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)