Charaka-Samhita — trans. Kaviraj Avinash Chandra Kaviratna

Thus ends Lesson IV, on Blood-Bile, in the Division called Chikitsa (Treatment), of -the treatise of Agnivega as revised by Charaka.

LESSON V.

TREATMENT OF GULMA (TUMOURS).

We shall now expound the Lesson on the treatment of Gulma (tumours).

Thus said the illustrious son of Atari. 1

That refuge, as a father, of all creatures, that lord of the past and the future, that foremost of speakers, viz., Punarvasu, inculcated the treatment whose results had been tested by experience and which had for its object the cure of tumours. 2

From excessive loss of stools, phlegm, and bile, or oppressed by these increased excessively, or by the suppression of the pronounced urgings (of urine and stools),.

or by excessive shocks caused by external wounds,

* The correct reading is ‘samjna’, meaning . nomenclature, and not ‘sankhya’ which implies number or'varieties. — T,

148 ' .

CHA RA KA-SA MHITA.

p. 1168

or by excessive indulgence in dry food and drink, or by grief, or by injudicious application of correetives (such as purgatives, emetics, enemata), or .by indulgence, at once irregular and excessive, in acts and exertions that are injurious, the wind becomes excited in the stomach. 3-4

Vitiating the phlegm a nd the bile, bearing them upwards, and obstructing thereby its own paths, the excited wind causes (deepseated) pains in the chest, the spleen, the flanks, the abdomen, and the bladder. Its passage being obstructed, it becomes incapable of moving downwards. It then stays independently or in dependance on others, in the ‘Pakkagaya’, or in the seat of the bile, or of the phlegm ; perceivable by touch, it becomes solidified into a globular form and obtains the name, ‘Gulma’ (round or ball-like), and is called after the particular fault that predominates.* 5-6

The bladder, the navel, the chest, and the two flanks are the five seats of ‘Gulma.’

I sh^ll now lay down the origin, the symptoms, and the treatment of ‘Gulma’ which is of five varieties.-]- 7

Food and drink that are dry, exertions (both mental and physical) that are irregular and that involve an excessive strain, suppression of the urgings (of stools and urine), grief, shocks due to wounds and acts of violence, excessive loss of stools, and abstention from food, are the causes of wind-born ‘Gulma.’ 8

That ‘Gulma’ which is characterised by irregularity in respect of its seat, size, and the pain it causes, which brings about an obstruct¬ ion in respect of both stools and wind, which causes a dryness of both the mouth and the throat, which produces a complexion that is

• What is said here is this : the wind, becoming obstructed, becomes solidified into a ball-like substance ; hence, it comes to be called ‘Gulma’, which literally means a ball-like or globular thing. Having obtained the name of ‘Gulma’ it comes again to be called after the particular fault that predominates, viz., ‘wind-gulma„ ‘bile-gulma’, ‘phlegm-gulma’, or ‘s3 nnipa tika-gulma. ’ — T.

t The five varieties, which are mentioned in the following verses, are I. wind-bom, 4. bile-bom, 3. phlegm-born, 4. that born of all the three faults, and 5. that bom of irregular menstruation. — T.

CHARAKA-SAMH1TA.

p. 1169

dark and red, which brings about a cold fever as also pains in the chest, the abdomen, the flanks, the shoulders, and the head, which gains in intensity (as regards the pains it causes) when digestion has taken place of the food that has been eaten, and which becomes milder when the stomach is stuffed with some food, should be known as having sprung from the wind. When one is afflicted by such a ‘Gulma’, one should not take food or drink that is dry, or astringent, or bitter, or acrid. 9-m

Food and drink that are acrid, or sour, or keen, or hot, or burning, or dry, wrath, excessive indulgence in alcoholic wines, exposure to the sun and fire, generation in the stomach of ‘ama’ (mucus) in an excessive measure, and vitiated blood, have been said to be the originating causes of bile-born ‘Gulma.’ “

Fever," thirst, redness of the whole body, especially of the face, excessive pain while the food taken is in course of digestion, perspi¬ ration, and a burning sensation of the skin, are the symptoms of this variety of ‘Gulma.’ Besides, this kind of ‘Gulma’ becomes as untouch¬ able as an inflammatory boil. 12

Food and drink that are cold, and heavy, and oily, absence of all exertion, gorging the stomach with food, and sleep at daytime, are the causes of phlegm-born ‘Gulma.’

All the causes mentioned above bring about that ‘Gulma’ which is born of all the three faults. 13

Of ‘Gulma’ that is 'phlegm-born, the symptoms are a sensation of wetness (as if the body is covered with a piece of wet cloth), cold fever, langour of limbs, nausea, bronchites, disgust for food, heaviness of limbs, sensation of cold, mildness of pains, hardness, . and elevation (swelling^. 14