Indian Medicine (Medicin), translated by C. G. Kashikar c12.37

c12.37

By gulma is meant a round, growthlike swelling hardness in the intestines between the heart and the navel. It is either firm or movable. Generally five kinds of gulma are distinguished which are known from the following symptoms : frequent eructation, constipation, a feeling of saturation, noise and unrest in the intestines, flatulence, weak digestion, retention of urine and the wind, going up of the wind. According to Caraka the vāta deranged by injurious or excessive food etc. causes pain in the heart, bladder, sides and the navel and even growths (swellings) of different kinds in vātagulma. The growth is sometimes larger, sometimes smaller, ails sometimes severely, sometimes only a little, by virtue of the activity of the wind it is felt as if ants crawl on the body, the patient has the feeling as if he were pricked severely with a needle or a nail, gets fever in the evening, his mouth becomes dry, his breathing is difficult, his hair bristle, the spleen swells, he suffers from flatulence, unrest in bowels, indigestion, pain in the limbs, in the head and in the temple; his skin, nails, eyes and mouth, his urine and stools become dark-brown etc. When caused by pitta the tumour burns and is weak and sensitive to pressure; skin, nails etc. becomes green-yellow, the patient suffers from fever, diarrhoea etc. When caused by kapha the tumour is firm and hard; the skin, nails etc. become white, the patient suffers from cold fever, gout in the joints, cough and sneezing, consumption etc. In the case of all doṣas an incurable combination of all symptoms occurs. A gulma which is particularly greater, pervading the whole body or is spherical like a tortoise is also incurable. Raktagulma occurs in women only as a result of retained amenorrhoea, particularly after an abortion or child-birth and is easily misunderstood for pregnancy by the ignorant. The symptoms of the first four gulmas partly appear to be connected with hyperamia of liver and spleen, partly with enlargement of the belly and tumour in the belly, partly with floating kidney, floating spleen and similar conditions. The enlargement of spleen (plīhā) appears also as a particular disease. The treatment of gulma is to be directed especially towards the removal of the deranged vāta; so nutritional and perspiring remedies are to be applied, then mild purgative, enemata, lemon-juice and other juices of sour, salt and sweet taste, ghee with various additions etc. are to be given (MN 202-208; Car 2.3; 6.5; Su 6.42; AS 4.16; AHr 4.14; Vr 30; Vang 471-487; Bhāv 2.3.19.).