Changes

In  [[Chikitsa Sthana]], Charaka states that ''vata'' gets vitiated by two basic means i.e. ''dhatukshaya'' (tissue wasting) and ''margavarana'' (obstruction).  The etiology given in this chapter could also include excess consumption of food with ''ruksha guna'', trauma and faulty ''shodhana'' procedures, excessive loss of ''mala'' and ''dhatu'' responsible for ''dhatukshaya'' and various other factors that vitiate ''doshas'' and ''mala'' causing obstruction of different channels, further aggravating ''vata''.

In  [[Chikitsa Sthana]], Charaka states that ''vata'' gets vitiated by two basic means i.e. ''dhatukshaya'' (tissue wasting) and ''margavarana'' (obstruction).  The etiology given in this chapter could also include excess consumption of food with ''ruksha guna'', trauma and faulty ''shodhana'' procedures, excessive loss of ''mala'' and ''dhatu'' responsible for ''dhatukshaya'' and various other factors that vitiate ''doshas'' and ''mala'' causing obstruction of different channels, further aggravating ''vata''.

While analysing the definition given by various Acharyas regarding gulma it can be stated that it is the clinical condition in which only solidification of doshas give rise to gulma. It is believed that, for the development of any other disease, vitiated dosha(s), together with dushya need to accumulate at a specific site leading to development of the disease. Therefore for the development of any disease, a combination of dosha and dushya is critical. However for gulma, only vitiated doshas are responsible and there is no involvement of dushya. This is a unique feature of pathogenesis of gulma. Sushruta has explained further  that just as water bubbles appear and disappear when rain drops fall on water, gulmas appear and disappear. Also, in the absence of any dushya (dhatu and mala), these swellings are commonly non-suppurative in nature. There are, however, some cases where suppuration may take place. For example, in Chikitsasthana, Charaka has mentioned that suppuration may takes place in pittaja gulma and further elaborates the various stages of suppuration of gulma i.e. ama (immature or initial stage), pachyamana (intermediary stage) and pakwa awastha (final mature stage) etc. similar to the stages seen in various suppurative conditions like vidradhi. Chakrapani commented that when the pittagulma is not treated timely, pitta dosha and rakta dhatu get aggravated (together or separately), and involves the deeper structure (kritmulam).  

While analysing the definition given by various Acharyas regarding ''gulma'' it can be stated that it is the clinical condition in which only solidification of ''doshas'' give rise to ''gulma''. It is believed that, for the development of any other disease, vitiated ''dosha''(s), together with ''dushya'' need to accumulate at a specific site leading to development of the disease. Therefore for the development of any disease, a combination of ''dosha'' and ''dushya'' is critical. However for ''gulma'', only vitiated ''doshas'' are responsible and there is no involvement of ''dushya''. This is a unique feature of pathogenesis of ''gulma''. Sushruta has explained further  that just as water bubbles appear and disappear when rain drops fall on water, ''gulmas'' appear and disappear.  

Shadkriyakala (lifecycle) of Gulma:

 

Also, in the absence of any ''dushya'' (''dhatu'' and ''mala''), these swellings are commonly non-suppurative in nature. There are, however, some cases where suppuration may take place. For example, in [[Chikitsa Sthana]], Charaka has mentioned that suppuration may takes place in ''pittaja gulma'' and further elaborates the various stages of suppuration of ''gulma'' i.e. ''ama'' (immature or initial stage), ''pachyamana'' (intermediary stage) and ''pakwa awastha'' (final mature stage) etc. similar to the stages seen in various suppurative conditions like ''vidradhi''. Chakrapani commented that when the ''pitta gulma'' is not treated timely, ''pitta dosha'' and ''rakta dhatu'' get aggravated (together or separately), and involves the deeper structure (''kritmulam'').  

 

==== Shadkriyakala (lifecycle) of Gulma ====

 

a. Sanchaya- Vata accumulates in vatasthana (pakwashaya, or the intestines) with the consumption of vatika food and activities such as excessive exercise, suppressing emergent urges etc., further aggravating it.

a. Sanchaya- Vata accumulates in vatasthana (pakwashaya, or the intestines) with the consumption of vatika food and activities such as excessive exercise, suppressing emergent urges etc., further aggravating it.