Gulma chikitsa according to Charaka Samhitha and its probable modern science correlation

1. गु म च क सा
CORRELATION WITH MODERN
SCIENCE CONDITIONS
Dr. K. Malathi
Second year MD Scholar
Dept.of. Kaya Chikitsa
Dr. N.R.S. Govt.Ayurvedic College
Vijayawada.

2. OBJECTIVES
Introduction
Common causes
Pathogenesis
Location and types
Correlation with Modern Science
Gulma Chikitsa
Yogas for Gulma
Summery
Dr. K. Malathi
MD(Ayu)
2

3. Introduction
 Charak Samhita 5th chapter of Chikitsa Sthan deals with
Gulma Chikitsa – Treatment of different types of
Abdominal Tumor.
 GULMA – bush/ shrub/ cluster or clump of trees
 Name is based on the shape –Akrthi
 It is Vatapradhana vyadhi, Rakta pradosaja vikara(Ch. Su.
28), Samanyaja vikaras(Ch.Su.18), Ekadesiya
shota(Ch.Su. 18).
3

4. Common causes
4
 व ले म प ा तप र वा वा तैरेव वृ धैः प रपीडना वा|
वेगै द ण वहतैरधो वा बा य भघातैर तपीडनैवा||४||
ा नपानैर तसे वतैवा शोक
े न म या तकमणा वा|
वचेि टतैवा वषमा तमा ैः को ठे कोपं समुपै त वायुः||५||
• Excess intake of vata aggravating foods ( dry, light, rough, spicy )
• Constipation or improper bowel habit
• Pressure exerted by external causes like injury, hit, compression etc
• Excess food intake
• Grief / stress
• Improperly carried panchakarma treatment

5. Common Pathogenesis
5
Vata vardhak nidan sevana
This vitiated Vayu provokes either kapha or pitta or both
Vitiated kapha, pitta or both obstruct the channels of circulation
Its causes pain in the region of heart, umbilicus, side of the chest,
abdomen and urinary bladder
Dosha are eliminated to pakvashaya, pittasaya or kaphasaya either
independently or associated
It becomes palpable and because of its shape its called gulma.
Depending upon the doshas involved in manifestation its classified in
several categories.

6. Location and Types
6
ब तौ च ना यां द पा वयोवा थाना न गु म य भवि त प च|८|
प चा मक य भवं तु त य व या म ल गा न च कि सतं च||८||
वा तक
पै तक
कफज
वदोषज
सि नपातज
र तज
Types:

7. Vataja gulma
7
यः थानसं थान जां वक पं Momentary changes in the location , shape and
intensity of pain
- व वातस गं Obstruction to the passage of the feces and flatus
- गलव शोषम ्Dryness in the throat and mouth
- यावा ण वं Grey and reddish coloration of body
- श शर वरं Fever with cold
- क
ु पा वास शरो जं Pain in the region of heart, abdomen, sides of the
abdomen, scapula and head
- जीणऽ य धक
ं कोपं भु ते मृदु वं समुपै त य च Aggravation of the disease after
food is digested and alleviation of aliment by the intake of food
- वातात ्स गु मो न च त ं कषाय त तं कटु चोपशेते
In vataj gulma dry, astringent, bitter and pungent types of food are not
wholesome

8. Correlation with:
8
Intestinal Tuberculosis
Chronic Intussusseption
Umblical or Epigastric Herniation
Appendicular Lump
Phantom Tumour

9. Vata gulma chikitsa
9
 नेहपानं हतं गु मे वशेषेणो वना भजे|
प वाशयगते बि त भयं जठरा ये||२४||
If gulma is located above the part of umbilical region than
give internal sneha and if gulma is located in pakvashaya
than sneha given by anuvasana or asthapana basti.
 Vataj gulma patient having constipation and bloating so
these patients given unctuous, hot and nourishing diet and
drinks after digestive power is stimulated.

10. Pitta Gulma
- वरः पपासा Fever and excessive thirst
- वदना गरागः Redness of face and limbs
- शूलं मह जीय त भोजने च Excruciating pain during digestion of
food
- वेदो वदाहो णव च Sweating and burning sensation
- पशासहः Tenderness of the affected part as if it is wounded
10

11. Correlation with:
 Lumps – Regional Ileitis
 Appendicular Abscess
 Psoas Abscess
 Empyema of Gall bladder
 Hepatic Abscess
 Cholecystitis
11

12. Pittaja Gulma Chikitsa
12
ि न धो णेनो दते गु मे पै क
े ंसनं हतम ्|
ो णेन तु स भूते स पः शमनं परम ्||३३||
-If paitika gulma is caused by unctuous and hot
things then administration of sramsana (mild
moderate laxative) is given.
-If it is caused by dry and hot things then
administration of ghee is best

13. Kaphaja Gulma
- तै म य Numbness or a feeling as if covered with wet cloth
- शीत वर Fever associated with feeling of cold
- गा साद लासकासा चगौरवा ण Body stiffness, nausea, cough,
anorexia and heaviness
- शै यं ग पा क ठनो नत वं The affected part of the body is hard to
touch and is elevated
- It is cold in touch and there is less pain
13

14. Correlation with:
Tumours connected with Liver, Spleen etc.,
Polycystic Ovarian Syndrome
Poly cystic Kidney Disease
Painless Grandular TB
Ovarian cyst
14

15. Kaphaja Gulma Chikitsa
15
थानादपसृतं ा वा कफगु मं वरेचनैः||५३||
स नेहैबि त भवाऽ प शोधये दाशमू लक
ै ः|
- If Gulma are subside after Vamana and other therapy than Virechana and Basti
given (53)
- Kshara karma
- Langhana
- Ghrita pana
- Agnikarma
- Hot therapy

16. Gulma -Correlation as
16
Intestinal TB
Chronic intussuseption
Umblical/epigastric hernia
Phantom tumour
Molar pregnancy
Cryptomenorrhea
Amenorrhea
Ovarian tumours
Uterine
fibromyomas/tumours
Raktaja
Appendicular abscess
Psoas Abscess
Hepatic Abscess
Cholecystitis
Pittaja
Palpable mass with severe
pain
Suppuration
Dissappearance of
strength, mind, body,
digestion
Sannipathaja
Tumours of liver, spleen etc
PCOS
PKD
Ovarian Cyst
Kaphaja
Vataja
Others
Abdominal Aortic
Aneurisms
Divertyiculitis
Bladder distention
Bowel Obstruction
Chrons’disease etc.,

17. Diagnostic Tools
 Physical Examination
 Medical History
 Blood tests -
S.Creatinine
BUN
LFT
S.Amylase
Total Bilirubin
 CAT
 Abdomen X-RAY
 Abdomen USG
 Colonoscopy
 TransVaginal USG 17

18. गु मनाशक योग
यु णा द घृत (64)
षटपल घृत (67)
ह गुसौवरचला द घृत (69-70)
हपुषा द घृत (71-73)
पप या द घृत (74-75)
ह वा द चूण (79-84)
मातुलु गरस योग (78)
शटया द चूण (86-90)
18
नागरा द योग (91)
लशुन ीर (94)
तैल प चक (93)
न लनी घृत (105)
न ल या द घृत (106-109)
रो ह या द घृत (115-117)
ायमाणा द घृत (118-121)
आमलका द घृत (122)
ा ा द घृत (123-125)
वासा द घृत (127)

19. Summary
19
शम कोपौ दोषाणां सवषामि नसं तौ|
त मादि नं सदा र ेि नदाना न च वजयेत ्||१३६||
- In all types of Gulma treatment are based on Agni.
- In all types of Gulma Vata is pradhana so in all
gulma snehana and swedana are main treatment.
र तज गु म च क सासू
गु म य रौ धर य या मः ीभव यो तः||१८७||

20. • It is defined as a mass in between the region of the heart
and the umbilicus, either moving ( from place to place ) or
stationary, round in shape and undergoing increase or
decrease in size.
• Sadhyasadhyata :
• Tumor associated with the features of breathlessness,
abdominal pain, thirst, anorexia, body ache, stiffness and
debility are critical; likewise the tumor with the features of
all the three doshas is also incurable.
20

21. Reference
• Charaka Samhita. Chikitsa Sthana Chapter 5. Chaukhambha Prakashan;
Reprint 2013.Varanasi,
• Sushruta Samhita. Uttaratantra Chapter.42.
• Charaka Samhita. Suthra Sthana Chapter 28. Chaukhambha Prakashan;
Reprint 2013. Varanasi
• Katru P, Sharma R, Porte S, Sharma A. An Overview of Gulma and its Relation to
Gallbladder Cancer
https://www.researchgate.net/profile/Priyanka-
Katru/publication/367499313_An_Overview_of_Gulma_and_its_Relation_to_Gall
bladder_Cancer/links/63d4d5a8c97bd76a82422f41/An-Overview-of-Gulma-
and-its-Relation-to-Gallbladder-Cancer.pdf Volume 8, Issue 1, January – 2023
International Journal of Innovative Science and Research Technology ISSN
No:-2456-2165
• Mishra BR, Katre VS. Raktaja Gulma in correlation with modern science conditions.
Journal of Ayurveda and Integrated Medical Sciences. 2018 Apr 30;3(02):73-7. 21

22. Thank you