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=== Introduction ===
=== Introduction ===
The word gulma is derived from the Sanskrit root gud, literal meaning encircling or surrounding. Therefore the word gulma stands for an entity that encircles, envelops or covers something. According to mythological concepts described in this text, people fleeing from the wrath of Lord Shiva, when he was dismantling Daksha’s holy sacrifice, were afflicted with this disease. This legend is symbolic, since situations such as panic, stress, or grief, usually accompanying such a chaotic, cataclysmic event would lead to vitiation of vata causing the appearance of vata-dominant diseases like gulma, etc. In Ayurveda, gulma has been defined as large palpable, rounded, intra- abdominal swellings between hridaya (upper abdomen) and the basti (bladder) regions, which develop due to accumulation of doshas with predominance of vata. Such swellings are either transitory or static, and display the properties of spontaneous regression and reappearance. Gulmas are usually non-suppurative and are separate entities from other intra-abdominal swellings such as antar vidradhi (internal abscesses) where suppuration is often found.
The word ''gulma'' is derived from the Sanskrit root ''gud'', literal meaning encircling or surrounding. Therefore the word ''gulma'' stands for an entity that encircles, envelops or covers something. According to mythological concepts described in this text, people fleeing from the wrath of Lord Shiva, when he was dismantling Daksha’s holy sacrifice, were afflicted with this disease. This legend is symbolic, since situations such as panic, stress, or grief, usually accompanying such a chaotic, cataclysmic event would lead to vitiation of ''vata'' causing the appearance of ''vata''-dominant diseases like ''gulma'', etc. In [https://en.wikipedia.org/wiki/Ayurveda Ayurveda], ''gulma'' has been defined as large palpable, rounded, intra- abdominal swellings between ''hridaya'' (upper abdomen) and the ''basti'' (bladder) regions, which develop due to accumulation of ''doshas'' with predominance of ''vata''. Such swellings are either transitory or static, and display the properties of spontaneous regression and reappearance. ''Gulmas'' are usually non-suppurative and are separate entities from other intra-abdominal swellings such as ''antar vidradhi'' (internal abscesses) where suppuration is often found.
The vitiated vata, in conjunction with other doshas, gets into the mahasrotas and get lodged either in the amashaya (stomach), pittashaya (gallbladder), pakwashaya (cecum) or in other regions like hridaya (epigastric), basti (bladder) and nabhi (umblicus) leading to formation of deep-rooted shrub-like mass. Here a new term has been introduced i,e, mahasrotas, that could be explained as viscera including organs of the gastrointestinal tract. However, commentators have suggested that it stands for all of abdominal viscera, including the kidneys. Thus it is evident that under the definition of mahasrotas all the organs in abdomen are included. As mentioned earlier, gulma afflicts the gastrointestinal region between the heart and the bladder. Depending upon the region it afflicts, it can be classified into four general types common to males and females:
The vitiated ''vata'', in conjunction with other ''doshas'', gets into the ''mahasrotas'' and get lodged either in the ''amashaya'' (stomach), ''pittashaya'' (gallbladder), ''pakwashaya'' (cecum) or in other regions like ''hridaya'' (epigastric), ''basti'' (bladder) and ''nabhi'' (umblicus) leading to formation of deep-rooted shrub-like mass. Here a new term has been introduced i,e, ''mahasrotas'', that could be explained as viscera including organs of the gastrointestinal tract. However, commentators have suggested that it stands for all of abdominal viscera, including the kidneys. Thus it is evident that under the definition of ''mahasrotas'' all the organs in abdomen are included. As mentioned earlier, ''gulma'' afflicts the gastrointestinal region between the heart and the bladder. Depending upon the region it afflicts, it can be classified into four general types common to males and females:
*''Hridaya'' (epigastric region),
*''Basti'' (pelvic region),
*''Nabhi'' (periumbilical region) and
Besides these, there is a fifth type afflicting only women - shonitaja gulma of the yoni region i.e. in the garbhashaya or uterus region. Such gulma shows a progressive increase in size and thus requires a special attention to differentiate it from pregnancy.
*Both the ''parshva'' (both the flanks)
While there are gulma variants like paittika and kaphaja gulma caused by an excess of pitta and kapha respectively, it is essentially a vata disorder. Sannipatika gulma is caused due to the vitiation of all the three doshas. Since abdominal organs have mamsadhatu as the main component, all the siragranthi (glandular/tumorous) types of srotodushti (vitiation of channels carrying body components) of abdominal viscera have also been covered under gulma. This chapter also covers obstruction and inflammation of viscera having no swelling.
Besides these, there is a fifth type afflicting only women - ''shonitaja gulma'' of the ''yoni'' region i.e. in the ''garbhashaya'' or uterus region. Such ''gulma'' shows a progressive increase in size and thus requires a special attention to differentiate it from pregnancy.
While there are ''gulma'' variants like ''paittika'' and ''kaphaja gulma'' caused by an excess of ''pitta'' and ''kapha'' respectively, it is essentially a ''vata'' disorder. ''Sannipatika gulma'' is caused due to the vitiation of all the three ''doshas''. Since abdominal organs have ''mamsadhatu'' as the main component, all the ''siragranthi'' (glandular/tumorous) types of ''srotodushti'' (vitiation of channels carrying body components) of abdominal viscera have also been covered under ''gulma''. This chapter also covers obstruction and inflammation of viscera having no swelling.
===Sanskrit text, transliteration and english translation===
===Sanskrit text, transliteration and english translation===