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→Prognosis and general principles of management
tvaramANastu visheShamanupalabhamAno gulmeShvAtyayike karmaNi VatacikitsitaM praNayet, snehasvedau Vataharau snehopasaMhitaM ca mRudu virecanaM bastIMshca; amlalavaNamadhurAMshca rasAn yuktyA~avacArayet| mArute hyupashAnte svalpenApi prayatnena shakyo~anyo~api doSho niyantuM gulmeShviti||16||
tvaramANastu visheShamanupalabhamAno gulmeShvAtyayike karmaNi VatacikitsitaM praNayet, snehasvedau Vataharau snehopasaMhitaM ca mRudu virecanaM bastIMshca; amlalavaNamadhurAMshca rasAn yuktyA~avacArayet| mArute hyupashAnte svalpenApi prayatnena shakyo~anyo~api doSho niyantuM gulmeShviti||16||
As is evident from the descriptions of gulma, no variant is caused without vitiation of vata. Amongst these variants, sannipatika gulma is incurable and should not be treated. The variant caused by just one dosha, should be treated with suitable therapeutics prescribed for respective dosha. Those caused by a combination of two doshas (vata – pitta or vata – kapha) should be managed with the general therapeutic measures applicable to dwidoshic ailments. The measures that are not contrary to the dosha can be applied according to severity of complications. In case of emergency situations, the measures applicable in treatment of vata gulma, such as vata-alleviating unction, fomentation, mild unctuous purgation, enema, and use of sweet, sour and salty substances should be administered. If vata is pacified, then the disease can be cured even with little efforts and other types of gulma can also be treated. [16]
As is evident from the descriptions of ''gulma'', no variant is caused without vitiation of ''vata''. Amongst these variants, ''sannipatika'' ''gulma'' is incurable and should not be treated. The variant caused by just one ''dosha'', should be treated with suitable therapeutics prescribed for respective ''dosha''. Those caused by a combination of two ''doshas'' (''vata – pitta'' or ''vata – kapha'') should be managed with the general therapeutic measures applicable to ''dwidoshic'' ailments. The measures that are not contrary to the ''dosha'' can be applied according to severity of complications. In case of emergency situations, the measures applicable in treatment of ''vata gulma'', such as ''vata''-alleviating unction, fomentation, mild unctuous purgation, enema, and use of sweet, sour and salty substances should be administered. If ''vata'' is pacified, then the disease can be cured even with little efforts and other types of ''gulma'' can also be treated. [16]
भवति चात्र-
भवति चात्र-
hyavajite~anyamudIrNaM doShamalpamapi karma nihanyAt||17||
hyavajite~anyamudIrNaM doShamalpamapi karma nihanyAt||17||
In the case of gulma, all the measures for pacification of vata should be administered properly because after vayu is controlled over, other aggravated doshas can be alleviated even with small remedies. (17)
In the case of ''gulma'', all the measures for pacification of ''vata'' should be administered properly because after ''vayu'' is controlled over, other aggravated ''doshas'' can be alleviated even with small remedies. [17]
Summary:
==== Summary ====
तत्र श्लोकः-
तत्र श्लोकः-
सङ्ख्या निमित्तं रूपाणि पूर्वरूपमथापि च|
सङ्ख्या निमित्तं रूपाणि पूर्वरूपमथापि च|
दिष्टं निदाने गुल्मानामेकदेशश्च कर्मणाम्||१८||
दिष्टं निदाने गुल्मानामेकदेशश्च कर्मणाम्||१८||
tatra ślōkaḥ- saṅkhyā nimittaṁ rūpāṇi pūrvarūpamathāpi ca|
tatra ślōkaḥ- saṅkhyā nimittaṁ rūpāṇi pūrvarūpamathāpi ca|
diṣṭaṁ nidānē gulmānāmēkadēśaśca karmaṇām||18||
diṣṭaṁ nidānē gulmānāmēkadēśaśca karmaṇām||18||
Tatra shlokaH-
sa~gkhyA nimittaM rUpANi pUrvarUpamathApi ca| diShTaM
sa~gkhyA nimittaM rUpANi pUrvarUpamathApi ca| diShTaM
nidAne gulmanAmekadeshashca karmaNAm||18||
Now, to summarize:
Now, to summarize:
In the chapter on diagnosis of gulma the number, causative factor, symptoms and prodromal symptoms along with a portion of treatment of gulmas have been described.(18)
In the chapter on diagnosis of ''gulma'' the number, causative factor, symptoms and prodromal symptoms along with a portion of treatment of ''gulmas'' have been described.[18]
इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृते निदानस्थाने गुल्मनिदानं
इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृते निदानस्थाने गुल्मनिदानं
नाम तृतीयोऽध्यायः||३||
नाम तृतीयोऽध्यायः||३||
ityagnivēśakr̥tē tantrē carakapratisaṁskr̥tē nidānasthānē gulmanidānaṁ nāma tr̥tīyō'dhyāyaḥ||3||
ityagnivēśakr̥tē tantrē carakapratisaṁskr̥tē nidānasthānē gulmanidānaṁ nāma tr̥tīyō'dhyāyaḥ||3||
ityagniveshakRute tantre tantre carakapratisaMskRute nidAnasthAne gulmanidAnaM nAma tRutIyo~adhyAyaH||3||
ityagniveshakRute tantre tantre carakapratisaMskRute nidAnasthAne gulmanidAnaM nAma tRutIyo~adhyAyaH||3||
Thus ends the third chapter on the diagnosis of gulma in the treatise composed by Agnivesha and redacted by Charaka.
Thus ends the third chapter on the diagnosis of ''gulma'' in the treatise composed by Agnivesha and redacted by Charaka.
=== ''Tattva Vimarsha'' ===
• Gulma is a disease of the mahastrotas (gastro-intestinal tract/abdomen) and is caused due to predominance of vata. It is of five types depending upon its location (limited to the gastro-intestinal region between the heart and the bladder). Four types of gulma are common to both males and females while the fifth, raktaja gulma, is a condition limited to females.
• Gulma is a disease of the mahastrotas (gastro-intestinal tract/abdomen) and is caused due to predominance of vata. It is of five types depending upon its location (limited to the gastro-intestinal region between the heart and the bladder). Four types of gulma are common to both males and females while the fifth, raktaja gulma, is a condition limited to females.
• Gulmas also vary by the vitiation of other doshas besides vata. The Sannipitak gulma, caused by vitiation of all three doshas, is said to be incurable.
• Gulmas also vary by the vitiation of other doshas besides vata. The Sannipitak gulma, caused by vitiation of all three doshas, is said to be incurable.