Charaka-Samhita — trans. Kaviraj Avinash Chandra Kaviratna

If when the (excited) phlegm and the wind are almost subdued, the bile, or the blood, be provoked during the continuance of the treatment then medicine should be administered, agreeably to the fault that is aggravated, by the physician who should, at the outset, in the the middle, and at the end, seek to keep the wind in its normal condition. 27

If in wind-born ‘Gulma’, the phlegm, becoming aggravated, and quenching the digestive fire, brings about disgust for food, nausea, alleviative of ‘Gulmas.’) If there is any difference, it will appear from the verses that follow.— T.

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CH ARAKA- SAM HIT A.

heaviness of the limbs, and drowsiness, the physician should tear out {expel) the phlegm (by administering emetics). 28

If in ‘Gulma’ caused by excited wind and phlegm, ‘£ula’ (deepseated pains), epistasis, and constipation occur, the administration of sticks, pills, and powders, that are alleviative of phlegm and wind, is regarded beneficial. 29

If of a person who is afflicted with wind-born ‘Gulma’, the bile, becoming excited, causes great heat or burning of the body, that person should be purged by administering such medicated oils as are calculated to restore to the vitiated faults their normal condition. 3° If a ‘Gulma’ does not abate notwithstanding the administration of proper medicines for checking wind and the rest, it becomes alleviated by letting the blood of the patient out. 31

If in consequence of indulgence in oily and heating food and drink, bile-born ‘Gulma’ becomes aggravated, purgatives, called ‘Srangsana’, are regarded beneficial.*

If by indulgence in food and drink that ar% dry and heating, bileborn Gulma’ becomes aggravated, (medicated) ghees are regarded as the foremost of alleviatives. 32

If bile, in bile-born ‘Gulma’, be ascertained to be located in the ‘pakkagaya’, then the physician,, conversant with considerations of time, should promptly expel it by administering enemata composed of milk and astringent drugs. 33

Or, he should purge the patient by milk boiled with bitters and administered in a lukewarm, state.

Or, carefully ascertaining the strength of the patient’s digestive fire, the physician should purge him by administering (medicated) ghees or oils. 34

In thirst, fever, excessive burning, ‘£ula’, perspiration, mildness of the digestive fire, and disgust for food, manifested in persons afflicted with bile-born ‘Gulma’, the physician should let the patient’s blood out (by opening the veins, &c). 35

If their very roots be torn up, ‘Gulmas’ do not ripen (suppurate)*

* ‘Virechaka’ or purgatives are described under three heads, viz. , ‘Srangsana’, ‘Bhedana, and ‘Rechaka.’ Those medicines which hurry the chyle or materials for digestion, without allowing them to be properly digested, are called ‘Srangsana,’ as, for example, pulv of Cassia fistula. ‘Bhedana’ ate those which expel the scybalae, &c’, without liquefying them. •Rechaka’ indude those which first liquefy the scybalae, &c., and then expel theip. — T.

CM A RAKA- SAM HIT A ,

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On the other hand, their roots torn, they perish or disappear. It is the blood that becomes vitiated and transformed into pus. There being no blood, there can be no disease.* 3$

When the faults {viz., blood and bile) have been expelled, the person afflicted with ‘Gulma’ becomes strengthless. He should be nourished with meat-juice prepared from the flesh of wild animals.

When the patient has become assured of recovery, the ailments that remain should be treated with ghee. 37

If in consequence of the excessive aggravation of blood and bile, and of want of proper treatment, a ‘Gulma’ (born of blood) ripens (suppurates), the lancet is the proper remedy. 38

A ‘Gulma’ that is heavy, of hard form, with the deep-seated flesh for its subsequent refuge, without discolouration, and immovable, is said to be raw (or unripe). 39

By these indications, viz., burning, ‘£ula’, disturbance of the digestive fire, loss of sleep, cheerlessness, and fever, a ‘Gulma’ should be known as ripening. Such a ‘Gulma’ should be treated with poultices. 4° -

When in a ‘Gulma’ that is about to ripen, the following indications are observable, it should then be regarded as having ripened: swell¬ ing outwards, uniform elevation, darkness of complexion with redness of the borders, resemblance with a leathern bag when touched, elasti¬ city (i. e., going down when pressed and rising up when the pressure is withdrawn), numbness, appearance in the form of a ball on that side on which the patient lies down, and ‘£ula’ pains. 41 24

In the treatment of such a case, those physicians who are wellskilled in the operations of opening or piercing, dressing, and plastering, and who are followers of Dhanwantari, are regarded as concerned. 43 If the inner portion of a ‘Gulma’ undergoes the process of ripen¬ ing, the following symptom appears :

Swelling of the chest and the abdomen.

This, when ripening, goes on internally. When it goes on exter¬ nally, the ‘Gulma’ comes out on the (right or the left) side. 44