[Pramāṇa](https://indike.org/pramana/) › [Indian literature](https://indike.org/pramana/in) › [Medicine](https://indike.org/pramana/in.med) › [Early and ascribed compendia](https://indike.org/pramana/in.med.samhita) › [The Compendium of Caraka](https://indike.org/pramana/in.med.samhita.caraka) › 2.3 # The Compendium of Caraka 2.3: tṛtīyo 'adhyāyaḥ/ Carakasaṃhitā 2.3 - **Language:** Sanskrit ### tṛtīyo 'adhyāyaḥ/ ### [2.3.1](https://indike.org/pramana/in.med.samhita.caraka.2.3.1) athāto gulmanidānaṃ vyākhyāsyāmaḥ// > Now we shall explain the etiology of abdominal swellings (gulma). > — English (machine translation) (machine translation) ### [2.3.2](https://indike.org/pramana/in.med.samhita.caraka.2.3.2) iti ha smāha bhagavānātreyaḥ// > Thus spoke the venerable Ātreya. > — English (machine translation) (machine translation) ### [2.3.3](https://indike.org/pramana/in.med.samhita.caraka.2.3.3) iha khalu pañca gulmā bhavanti; tadyathā---vātagulmaḥ, pittagulmaḥ, śleṣmagulmo, nicayagulmaḥ, śoṇitagulma iti// > Here, indeed, there are five abdominal swellings (gulma); they are as follows: wind gulma, bile gulma, phlegm gulma, gulma from accumulation \[of all three doshas\], and blood gulma. > — English (machine translation) (machine translation) ### [2.3.4](https://indike.org/pramana/in.med.samhita.caraka.2.3.4) evaṃvādinaṃ bhagavantamātreyamagniveśa uvāca---kathamiha bhagavan pañcānāṃ gulmānāṃ viśeṣamabhijānīmahe; nahyaviśeṣavidrogāṇāmauṣadhavidapi bhiṣak praśamanasamartho bhavatīti// > To the venerable Ātreya speaking thus, Agniveśa said: 'How, O venerable one, do we distinguish among the five gulmas here? For a physician, even if knowledgeable about remedies, is not capable of alleviating diseases if he does not know their distinguishing features.' > — English (machine translation) (machine translation) ### [2.3.5](https://indike.org/pramana/in.med.samhita.caraka.2.3.5) tamuvāca bhagavānātreyaḥ---samutthānapūrvarūpaliṅgavedanopaśayaviśeṣebhyo viśeṣavijñānaṃ gulmānāṃ bhavatyanyeṣāṃ ca rogāṇāmagniveśa! tattu &khalu gulmeṣūcyamānaṃ nibodha// > The venerable Ātreya said to him: 'O Agniveśa, the distinguishing knowledge of gulmas as well as of other diseases arises from the specific differences in their etiology, premonitory symptoms, signs, pains, and therapeutic suitability. Listen to that as it is declared regarding gulmas. > — English (machine translation) (machine translation) ### [2.3.6](https://indike.org/pramana/in.med.samhita.caraka.2.3.6) yadā puruṣo vātalo viśeṣeṇa jvaravamanavirecanātīsārāṇāmanyatamena darśanena karśito vātalamāhāramāharati, śītaṃ vā &viśeṣeṇātimātram, asnehapūrve vā vamanavirecane pibati, anudīrṇāṃ vā chardimudīrayati, udīrṇan vātamūtrapurīṣavegānniruṇaddhi, atyaśito vā pibati navodakamatimātram, atisaṃkṣobhiṇā vā yānena yāti, ativyavāyavyāyāmamadyaśokarucirvā, abhighātamṛcchati vā, &viṣamasanaśayanasthānacaṅkramaṇasevī vā bhavati, anyadvā kiṃcidevaṃvidhaṃ viṣamamatimātraṃ vyāyāmajātamārabhate, &tasyāpacārādvātaḥ prakopamāpadyate// > When a person of wind constitution, emaciated especially by any one manifestation among fever, vomiting, purgation, or diarrhea, takes wind-increasing food, or especially cold \[food\] in excessive quantity; or drinks emetics or purgatives without prior unction; or induces unprovoked vomiting, or suppresses the provoked urges of flatus, urine, and feces; or, having overeaten, drinks freshly drawn water in excessive quantity; or travels by an excessively jarring vehicle; or is fond of excessive sexual intercourse, exercise, wine, and grief; or sustains trauma; or is accustomed to improper sitting, lying, standing, and walking; or undertakes any other such improper and excessive form of physical exertion—from his improper conduct, the wind becomes provoked. > — English (machine translation) (machine translation) ### [2.3.7](https://indike.org/pramana/in.med.samhita.caraka.2.3.7) sa prakupito vāyurmahāsroto 'anupraviśya raukṣyāt &kaṭhinībhūtamāplutya piṇḍito 'avasthānaṃ karoti hṛdi bastau pārśvayornābhyāṃ vā; sa śūlamupajanayati granthīṃścānekavidhān, piṇḍitaścāvatiṣṭhate, sa piṇḍitatvād 'gulma' ityabhidhīyate; sa &muhurādhamati, muhuralpatvamāpadyate; aviyatavupulāṇuvedanaśca bhavati calatvādvāyoḥ, muhuḥ pipīlikāsaṃpracāra ivāṅgeṣu, todabhedasphuraṇāyāmasaṅkocasuptiharṣapralayodayabahulaḥ; tadāturaḥ sūcyeva śaṅkuneva cābhisaṃviddhamātmānaṃ manyate, api ca divasānte &jvaryate, śuṣyati cāsyāsyam, ucchvāsaścoparudhyate, hṛṣyanti cāsya romāṇi vedanāyāḥ prādurbhāve; plīhāṭopāntrakūjanāvipākodāvartāṅgamardamanyāśiraḥśaṅkhaśūlabradhnarogāścainamupadravanti; kṛṣṇāruṇaparuṣatvaṅnakhanayanavadanamūtrapurīṣaśca bhavati, nidānoktāni cāsya nopaśerate, viparītāni copaśerata iti vātagulmaḥ// > That provoked wind, having entered the great channel (mahāsrotas), having enveloped \[the part\] that has become hardened through dryness, becomes massed into a ball and establishes a seat in the heart, in the urinary bladder, in the flanks, or in the navel; it produces colic and diverse kinds of nodular lumps, and remains massed into a ball; because it is massed into a ball (piṇḍita), it is called "gulma"; it swells at one moment and subsides at another moment; its pain is indefinite, broad, or minute because of the instability of wind; it frequently feels as if ants are crawling over the limbs; it abounds in the sudden onset and disappearance of pricking, bursting, throbbing, stretching, constriction, numbness, horripilation, and fainting; the patient afflicted with it considers himself pierced as if with needles or stakes; moreover, at the end of the day he develops fever, his mouth becomes dry, his breathing is obstructed, and his body hair stands on end when the pain manifests; splenomegaly, abdominal distension with rumbling, intestinal gurgling, indigestion, upward movement of wind, body aches, stiffness of the neck, and pain in the head, temples, and groin afflict him; his skin, nails, eyes, face, urine, and feces become blackish-red and rough; things declared as its etiology do not suit him, and opposite things do suit him—thus is wind gulma. > — English (machine translation) (machine translation) ### [2.3.8](https://indike.org/pramana/in.med.samhita.caraka.2.3.8) taireva tu karśanaiḥ karśitasyāmlalavaṇakaṭukakṣāroṣṇatīkṣṇaśuktavyāpannamadyaharitakaphalāmlānāṃ vidāhināṃ ca śākadhānyamāṃsādīnāmupayogādajīrṇādhyaśanādraukṣyānugate cāmāśaye &vamanamativelaṃ saṃdhāraṇaṃ vātātapau cātisevamānasya pittaṃ saha mārutena prakopamāpadyate// > However, in one emaciated by those very same reducing factors, through the use of sour, salty, pungent, alkaline, hot, sharp, spoiled vinegar, wine, green vegetables, sour fruits, and burning foods such as greens, grains, meats, and the like; through eating before the previous meal is digested and overeating; and in one whose stomach has become dry, through excessively untimely vomiting, through suppression \[of urges\], and through excessive exposure to wind and sun—the bile becomes provoked along with the wind. > — English (machine translation) (machine translation) ### [2.3.9](https://indike.org/pramana/in.med.samhita.caraka.2.3.9) tat prakupitaṃ māruta āmāśayaikadeśe &saṃvartya tāneva vedanāprakārānupajanayati, ya uktā vātagulme; pittaṃ tvenaṃ vidahati kukṣau hṛdyurasi kaṇṭhe ca; sa vidahyamānaḥ sadhūmamivodgāramudgiratyamlānvitaṃ, gulmāvakāśaścāsya dahyate dūyate &dhūpyate ūṣmāyate svidyati klidyati &śithila iva sparśāsaho+&alparomāñcaśca bhavati; jvarabhramadavathupipāsāgalatālumukhaśoṣapramohaviḍbhedāścainamupadravanti; haritahāridratvaṅnakhanayanavadanamūtrapurīṣaśca bhavati; nidānoktāni cāsya nopaśerate, viparītānyupaśerata iti pittagulmaḥ// > That provoked wind, having gathered the bile in a portion of the stomach, produces those very varieties of pain that were described in wind gulma; but the bile burns him in the abdomen, in the heart, in the chest, and in the throat; being burnt, he belches a smoky-like eructation accompanied by sourness; the site of his gulma burns, aches, fumes, feels heated, perspires, becomes moist, feels relaxed, becomes intolerant to touch, and has slight horripilation; fever, dizziness, burning sensation, thirst, dryness of the throat, palate, and mouth, bewilderment, and loose stools afflict him; his skin, nails, eyes, face, urine, and feces become green or yellow; things declared as its etiology do not suit him, and opposite things do suit him—thus is bile gulma. > — English (machine translation) (machine translation) ### [2.3.10](https://indike.org/pramana/in.med.samhita.caraka.2.3.10) taireva tu karśanaiḥ karśitasyātyaśanādatisnigdhagurumadhuraśītāśanāt &piṣṭekṣukṣīratilamāṣaguḍavikṛtisevanānmandakamadyātipānāddharitakātipraṇanayādānūpaudakagrāmyamāṃsātibhakṣaṇāt &saṃdhāraṇādabubhukṣasya cātipragāḍhamudapānāt saṃkṣobhaṇādvā śarīrasya śleṣmā saha mārutena prakopamāpadyate// > However, in one emaciated by those very same reducing factors, through overeating; through eating foods that are excessively unctuous, heavy, sweet, and cold; through consuming flour products, sugarcane, milk, sesame, black gram, and molasses preparations; through excessive drinking of immature wine; through excessive consumption of fresh greens; through excessive eating of meat from marshland, aquatic, and domesticated animals; through suppression \[of urges\]; through excessive drinking of water when not hungry; or through violent agitation of the body—the phlegm becomes provoked along with the wind. > — English (machine translation) (machine translation) ### [2.3.11](https://indike.org/pramana/in.med.samhita.caraka.2.3.11) taṃ prakupitaṃ māruta āmāśayaikadeśe &saṃvartya tāneva vedanāprakārānupajanayati ya uktā vātagulme; śleṣmā tvasya śītajvararocakāvipākāṅgamardaharṣahṛdrogacchardinidrālasyastaimityagauravaśirobhitāpānupajanayati, api ca gulmasya sthairyagauravakāṭhinyāvagāḍhasuptatāḥ, tathā kāsaśvāsapratiśyāyān rājayakṣmāṇaṃ cātipravṛddhaḥ, śvaityaṃ tvaṅnakhanayanavadanamūtrapurīṣeṣūpajanayati, nidānoktāni cāsya nopaśerate, viparītāni copaśerata iti śleṣmagulmaḥ// > That provoked wind, having gathered the phlegm in a portion of the stomach, produces those very varieties of pain that were described in wind gulma; but the phlegm produces in him cold fever, anorexia, indigestion, body aches, horripilation, heart disease, vomiting, sleepiness, laziness, rigidity, heaviness, and burning headache; furthermore, stability, heaviness, hardness, deep-seatedness, and numbness of the gulma; likewise, when excessively increased, it produces cough, dyspnea, coryza, and consumption (rājayakṣmā); it produces whiteness in the skin, nails, eyes, face, urine, and feces; things declared as its etiology do not suit him, and opposite things do suit him—thus is phlegm gulma. > — English (machine translation) (machine translation) ### [2.3.12](https://indike.org/pramana/in.med.samhita.caraka.2.3.12) triḍoṣadetuliṅgasannipāte tu sānnipātikaṃ gulmamupadiśanti kuśalāḥ/ > However, upon the combination of the causes and signs of all three doshas, the experts designate it as a gulma born of all three doshas (sānnipātika). > — English (machine translation) (machine translation) ### [2.3.12\_1](https://indike.org/pramana/in.med.samhita.caraka.2.3.12_1) sa &vipratiṣiddhopakramatvādasādhyo nicayagulmaḥ// > That gulma from accumulation \[of all three doshas\] (nicayagulma) is incurable because its treatments are mutually contradictory. > — English (machine translation) (machine translation) ### [2.3.13](https://indike.org/pramana/in.med.samhita.caraka.2.3.13) śoṇitagulmastu khalu striyā eva bhavati na puruṣasya, garbhakoṣṭhārtavāgamanavaiśeṣyāt/ > Blood gulma, however, occurs only in a woman, not in a man, on account of the distinction of the womb and the flow of menstrual blood. > — English (machine translation) (machine translation) ### [2.3.13\_1](https://indike.org/pramana/in.med.samhita.caraka.2.3.13_1) pāratantryādavaiśāradyāt satatamupacārānurodhādvā vegānudīrṇānuparundhatyā āmagarbhe vā 'apyacirapatite 'athavā 'apyaciraprajātāyā ṛtau vā vātaprakopaṇānyāsevamānāyāḥ kṣipraṃ vātaḥ prakopamāpadyate// > In a woman who, out of dependence, lack of confidence, or constant deference to etiquette, suppresses provoked urges; or who, when an immature fetus has recently miscarried, or when she has recently given birth, or during menstruation, indulges in wind-provoking factors, the wind quickly becomes provoked. > — English (machine translation) (machine translation) ### [2.3.14](https://indike.org/pramana/in.med.samhita.caraka.2.3.14) sa prakupito yonimukhamanupraviśyārtavamuparuṇaddhi, māsi māsi tadārtavamuparudhyamānaṃ kukṣimabhivardhayati/ > That provoked wind, entering the mouth of the vagina, obstructs the menstrual blood; that menstrual blood, being obstructed month after month, enlarges the abdomen. > — English (machine translation) (machine translation) ### [2.3.14\_1](https://indike.org/pramana/in.med.samhita.caraka.2.3.14_1) tasyāḥ śūlakāsātīsāracchardyarocakāvipākāṅgamardanidrālasyastaimityakaphaprasekāḥ samupajāyante, stanayośca stanyam, auṣṭhayoḥ stanamaṇḍalayośca kārṣṇyam, atyarthaṃ glāniścakṣuṣoḥ, mūrccha, hṛllāsaḥ, dohadaḥ, śvayathuśca pādayoḥ, īṣaccodgamo romarājyāḥ, yonyāścāṭālatvam, api ca yonyā daurgandhyamāsrāvaścopajāyate, kevalaścāsyā gulmaḥ piṇḍita eva spandate, tāmagarbhāṃ garbhiṇīmityāgurmūḍhāḥ// > In her, colic, cough, diarrhea, vomiting, anorexia, indigestion, body aches, sleepiness, laziness, rigidity, and excessive salivation of phlegm arise; milk appears in the breasts; blackness of the lips and the areolas of the breasts; extreme fatigue of the eyes, fainting, nausea, pregnancy cravings, swelling of the feet, slight emergence of the abdominal line of hair, widening of the vaginal orifice, and also foul odor and discharge from the vagina arise; and her gulma throbs only as a solid mass; fools declare her, who is not pregnant, to be pregnant.' > — English (machine translation) (machine translation) ### [2.3.15](https://indike.org/pramana/in.med.samhita.caraka.2.3.15) eṣāṃ tu khalu pañcānāṃ gulmānāṃ prāgabhinievṛtterimāni pūrvarūpāṇi bhavanti; tadyathā---anannābhilaṣaṇam, arocakāvipākau, agnivaiṣamyaṃ, vidāho bhuktasya, pākakāle cāyuktyā chardyudgārau, vātamūtrapurīṣavegānāṃ cāprādurbhāvaḥ, prādurbhūtānāṃ cāpravṛttirīṣadāgamanaṃ vā, vātaśūlāṭopāntrakūjanāpariharṣaṇātivṛttapurīṣatāḥ, abubhukṣā, daurbalyaṃ, sauhityasya cāsahatvamiti// > Prior to the manifest appearance of these five gulmas, these premonitory symptoms arise; namely: lack of desire for food, anorexia and indigestion, irregularity of the digestive fire, burning of what has been eaten, untimely vomiting and eructation at the time of digestion, non-appearance of the urges of wind, urine, and feces, and non-passage or slight passage of those that have appeared, wind colic, abdominal distension, rumbling in the intestines, lack of erection, retention of feces, lack of hunger, debility, and intolerance of satiety. > — English (machine translation) (machine translation) ### [2.3.16](https://indike.org/pramana/in.med.samhita.caraka.2.3.16) sarveṣvapi khalveteṣu gulmeṣu na kaścidvātādṛte saṃbhavati gulmaḥ/ > In all these gulmas, indeed, no gulma arises without wind. > — English (machine translation) (machine translation) ### [2.3.16\_1](https://indike.org/pramana/in.med.samhita.caraka.2.3.16_1) teṣāṃ sānnipātikamasādhyaṃ jñātvā naivopakrameta, ekadoṣaje tu yathāsvamārambhaṃ praṇayet, saṃsṛṣṭāṃstu sādhāraṇena karmaṇopacaret/ > Among them, knowing one born of all three doshas to be incurable, he should not undertake its treatment at all; but in one born of a single dosha, he should apply the procedure specific to it, and he should treat those born of combined doshas with a combined measure. > — English (machine translation) (machine translation) ### [2.3.16\_2](https://indike.org/pramana/in.med.samhita.caraka.2.3.16_2) yaccānyadapyaviruddhaṃ manyeta tadapyavacārayedvibhajya gurulāghavamupadravāṇāṃ, gurūnupadravāṃstvaramāṇaścikitsejjaghanyamitarān/ > Whatever else he considers unopposed \[to the treatment\], that too he should administer, distinguishing the gravity and lightness of the complications; acting with urgency, he should treat the severe complications, and the others subsequently. > — English (machine translation) (machine translation) ### [2.3.16\_3](https://indike.org/pramana/in.med.samhita.caraka.2.3.16_3) tvaramāṇastu viśeṣamanupalabhamāno gulmeṣvātyayike karmaṇi vātacikitsitaṃ praṇayet, snehasvedau vātaharau snehopasaṃhitaṃ ca mṛdu virecanaṃ bastīṃśca; amlalavaṇamadhurāṃśca rasān yuktyā 'avacārayet/ > If acting with urgency and not discerning any particular \[dosha\], he should apply the treatment for wind in emergencies involving gulmas: unction and sudation which remove wind, mild purgation combined with unctuous substances, and enemata; and he should administer sour, salty, and sweet tastes with proper method. > — English (machine translation) (machine translation) ### [2.3.16\_4](https://indike.org/pramana/in.med.samhita.caraka.2.3.16_4) mārute hyupaśānte svalpenāpi prayatnena śakyo 'anyo 'api doṣo niyantuṃ gulmeṣviti// > For when wind has been pacified, any other dosha too can be controlled in gulmas with even slight effort. > — English (machine translation) (machine translation) ### [2.3.17](https://indike.org/pramana/in.med.samhita.caraka.2.3.17) bhavati cātra--- > And on this there is \[a verse\]: > — English (machine translation) (machine translation) ### [2.3.17\_1](https://indike.org/pramana/in.med.samhita.caraka.2.3.17_1) gulmināmanilaśāntirupāyaiḥ sarvaśo bidhivadācaritavyā/ mārute gyavajite 'anyamudīrṇaṃ doṣamalpamapi karma nihanyāt// > The pacification of wind in gulma patients must be carried out in every way according to rule by appropriate means; > for when wind is conquered, even a slight measure destroys any other aggravated dosha. > — English (machine translation) (machine translation) ### [2.3.18](https://indike.org/pramana/in.med.samhita.caraka.2.3.18) tatra ślokaḥ--- > There is a verse here: > — English (machine translation) (machine translation) ### [2.3.18\_1](https://indike.org/pramana/in.med.samhita.caraka.2.3.18_1) saṃkhyā nimittaṃ rūpāṇi pūrvarūpamathāpi ca/ diṣṭaṃ nidāne gulmānāmekadeśaśca karmaṇām// > The number, etiology, symptoms, and also the premonitory symptom, > and a part of the therapeutic measures for gulmas have been stated in \[this\] etiology section. > — English (machine translation) (machine translation) ### [2.3.18\_2](https://indike.org/pramana/in.med.samhita.caraka.2.3.18_2) ityagniveśakṛte tantre carakapratisaṃskṛte nidānasthāne gulmanidānaṃ nāma tṛtīyo 'adhyāyaḥ//3// > Thus ends the third chapter, named 'Etiology of Gulma', in the Section on Etiology in the compendium composed by Agniveśa and redacted by Caraka. 3. > — English (machine translation) (machine translation) ## Translations (1) - [English (machine translation)](https://indike.org/pramana/in.med.samhita.caraka~en-mt.2.3.1) — English, machine translation ## Commentaries (1) - [Jalpakalpataru](https://indike.org/pramana/in.med.samhita.caraka!gangadhara.3.2) — Gaṅgādhara Kaviratna 1860, Sanskrit --- Source: [https://indike.org/pramana/in.med.samhita.caraka.2.3](https://indike.org/pramana/in.med.samhita.caraka.2.3) · Pramāṇa