Charaka-Samhita — trans. Kaviraj Avinash Chandra Kaviratna

In that ‘Gulma’ which is born of two faults, the physician, after ascertaining its causes and symptoms, as also the (comparative) strength and weakness of the two faults, should, for prescribing (propâV) medicaments, take into consideration the three other varieties of ‘Gulma’ {viz., the simple or unmixed ones', whose symptoms have been combined in the case that confronts him.# 15

* I have rendered the original as nearly as possible. The reader will have some idea, from this, of the terseness of Sanskrit. What is said hare is this : there are some ‘Gulmas’ which are born of two faults, such as wind and bile, bile and phlegm, and wind and phlegm.

CHARAKA-SA MHITA .

p. 1170

‘Gulma’ born of all the three faults is characterised by. intense pain, is accompanied by a burning sensation, and is hard and elevated, like a ball of stone. It quickly ripens, and assumes a virulent type. It is deprivative of strength of mind, body, and digestive fire. The physician should regard it as incurable. 16

In consequence of abstention from food during the menstrual period, of fear, of food and drink that are dry, of suppression of the urgings of stools and urine, of indulgence in food, &c., that are con¬ stipating, as also in things that attenuate the system by promoting: copious secretions, and of faults of the generative organ, ‘Gulma’ born of blood afflicts women. *7

That ‘Gulma’, of a globular form, which stirs at long intervals without any of its parts stirring, which is accompanied by pain, and whose symptoms resemble those of conception, is bl6od;born. It afflicts women only ; and it should never be treated before at least ten months of its appearance.* ^

I shall now expound what the course of treatment, whose success has been ascertained by experience, is that should be followed for the cure of ‘Gulma’ of persons afflicted by them. I shall then lay down what those combinations are (of drugs, &c.) that are alleviative of ‘Gulmas.’f 19

When the phystcian finds such a case, how is he to treat it ? He should consider what the treatment is of the simple varieties of ‘Gulma’, that is, of the wind-born, the bile-bqrr?, and the phlegm-born ones, respectively. Having ascertained which of the two faults have produced the ‘Gulma’ and in what proportion each of them has been excited, he will be able to adopt the proper course of treatment by combining the courses of treatment followed in those two simple varieties whose symptoms are jointly manifested in the case that confronts him. Thus, if the ‘Gulma’ be the result of wind and bile, its treatment should be a combination of the courses of treatment followed in the wind-bom and the bile-born varieties respectively. — T.

* There is great resemblance between a blood-born ‘Gulma’* and an embryo in the womb. There is this difference : when the embryo moves, its parts may be felt to move. But in the case of a ‘Gulma’, it stirs bodily, for it has no parts (like the limbs of an embryo) which can move or stir. Then, again, a ‘Gulma’ stirs in this way at long intervals. But an embryo stirs often. Other symptoms of conception, such as stoppage of the menstrual flow, paleness of complexion, &c., appear. Hence, a ‘Gulma’ of this kind should not be treated before ten months which an embryo takes in developing and coming out. — T.

+ It is difficult to understand what the difference is which the Rishi contemplates between ‘kriyakrama’ (course of treatment) and ‘Gulmanivarhanan yogan’ (combination of drugs

CHARAKA-SAMHITA.

H7l

A ‘Gulma’ that is wind-born, that has arisen from dry food and drink and severe physical exercise, that is accompanied by intense pain, and that causes a stoppage of stools and the downward wind, should, from the outset, be treated with oils. 20

To one who has been (properly) oiled by means of (oily) food and unguents, (oily) drinks, enemata (dry and oily), the physician should administer ‘sweda’ (fomentation) for the relief of his ‘Gulma.’ ai • The ‘sweda’ that is administered unto a person who has been properly oiled, having softened the ducts and subdued the excited wind and removed the constipation of the bowels, destroys the 'Gulma.’ 22

The drinking of oils is especially beneficial in a ‘Gulma’ that appears in any region above the navel.

In the case of ‘Gulma’ that appears in the ‘pakkafaya’ (or that part of the stomach where digestion goes on), the administration of enemata is beneficial.

In a ‘Gulma’ that appears in the abdortien, both {vis., the drinking of oils and the administration of enemata) are beneficial. 23

If in wind-born ‘Gulma’, the digestive fire be enkindled, and the (downward) wind and the stools be constipated, then food and drink that are ‘Vringhaniya’ (that is, which promote nutrition and corpu¬ lency), should be administered, as also food and drink that are oily and heating. 24

In all varieties of wind-born ‘Gulma’, frequent drinking of (medi¬ cated) oils, as also the administration of enemata both dry and oily, is prescribable by the physician who should, however, seek to keep the phlegm and the bile in their normal condition. 25