Changes

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'').  

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 ====

==== ''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.

#''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.

 

#''Prakopa''- Consumption of ''ruksha, khara'' and ''sheeta'' food for prolonged periods of time reduces the ''snigdha'' quality of '''strotas''' while stimulating excess ''vata'' to overflow from its ''sthana''.

b. Prakopa- Consumption of ruksha, khara and sheeta food for prolonged periods of time reduces the snigdha quality of strotas while stimulating excess vata to overflow from its sthana.

#''Prasara''-In this stage aggravated ''vata'' dislodges from its accumulated site and spreads all over the body.

 

#''Sthanasanshraya''- This is the stage in which the ''dosha'' stays at a particular locus and comes in contact with ''dushya''. In case of ''gulma'', the ''mahastrotas'' are the principal loci, with an absence of ''dushya'' in their formation. The vitiated ''vata'' and other ''doshas'' have an affinity towards specific loci such as ''hridaya, nabhi, basti'' etc. to get lodged there. Prodromal symptoms of ''gulma'' such as anorexia, aversion for food, weakness etc. also become apparent at this stage.

c. Prasara-In this stage aggravated vata dislodges from its accumulated site and spreads all over the body.

#Vyakti- Clinical features of different types of gulma manifest at this stage so management can be done depending upon specific dosha characteristics.

 

d. Sthanasanshraya- This is the stage in which the dosha stays at a particular locus and comes in contact with dushya. In case of gulma, the mahastrotas are the principal loci, with an absence of dushya in their formation. The vitiated vata and other doshas have an affinity towards specific loci such as hridaya, nabhi, basti etc. to get lodged there. Prodromal symptoms of gulma such as anorexia, aversion for food, weakness etc. also become apparent at this stage.

 

e. Vyakti- Clinical features of different types of gulma manifest at this stage so management can be done depending upon specific dosha characteristics.

f. Bheda-When the gulma is not treated at the fourth and fifth stage, complications like bradhna roga (inguinal swellig), jwara (fever), vidbheda (loose stools/diarrhoea), and suppuration (in case of pittaja gulma ) occur where surgical intervention could be necessary.  

f. Bheda-When the gulma is not treated at the fourth and fifth stage, complications like bradhna roga (inguinal swellig), jwara (fever), vidbheda (loose stools/diarrhoea), and suppuration (in case of pittaja gulma ) occur where surgical intervention could be necessary.