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Text replacement - "Ayurveda" to "Ayurveda"
==== Contemporary understanding of ''gulma'' ====
==== Contemporary understanding of ''gulma'' ====
In Ayurveda, a comprehensive description is given for abdominal swellings. While the generalized swellings have been described under the heading of ''udara roga'' (ascites), localized inflammatory swellings are described under the heading of ''vidradhi''. However, there are other varieties of localized abdominal lumps which are non inflammatory in nature and are considered primarily under the heading of ''gulma''.
In [[Ayurveda]], a comprehensive description is given for abdominal swellings. While the generalized swellings have been described under the heading of ''udara roga'' (ascites), localized inflammatory swellings are described under the heading of ''vidradhi''. However, there are other varieties of localized abdominal lumps which are non inflammatory in nature and are considered primarily under the heading of ''gulma''.
On analyzing the features described by Charak, it appears that the ''vataja gulma'' are irregular, mobile swellings of waxing and waning nature and are associated with pain of different characters. Such features can be seen in conditions like chronic intestinal obstructions of various etiology, intestinal tuberculosis, pyloric stenosis, mobile caecum etc. The treatment modalities like ''snehana, swedana'' and ''basti/vamana'' help in alleviating the symptoms by elimination of feces and flatus as well as improving the gut motility.
On analyzing the features described by Charak, it appears that the ''vataja gulma'' are irregular, mobile swellings of waxing and waning nature and are associated with pain of different characters. Such features can be seen in conditions like chronic intestinal obstructions of various etiology, intestinal tuberculosis, pyloric stenosis, mobile caecum etc. The treatment modalities like ''snehana, swedana'' and ''basti/vamana'' help in alleviating the symptoms by elimination of feces and flatus as well as improving the gut motility.
Five regions of the abdomen where ''gulma'' occurs are ''hrid'' (epigastric), ''nabhi'' (umbilical), ''basti'' (hypogastric) and two ''parshva'' (right and left flanks). If both flanks are further subdivided into three ''urdhva'' (upper), ''madhya'' (middle) and ''adho'' (lower), then whole abdomen is divided into 9 parts which is similar to the modern clinical method where abdomen is also divided into nine parts as shown in Table-1. Some of the organs situated in these regions as mentioned by Warner (1964) are also depicted therein and on that basis exact location of the Gulma can be traced.
Five regions of the abdomen where ''gulma'' occurs are ''hrid'' (epigastric), ''nabhi'' (umbilical), ''basti'' (hypogastric) and two ''parshva'' (right and left flanks). If both flanks are further subdivided into three ''urdhva'' (upper), ''madhya'' (middle) and ''adho'' (lower), then whole abdomen is divided into 9 parts which is similar to the modern clinical method where abdomen is also divided into nine parts as shown in Table-1. Some of the organs situated in these regions as mentioned by Warner (1964) are also depicted therein and on that basis exact location of the Gulma can be traced.
===== Table1. Nine divisions of the abdomen, according to Ayurveda and allopathic medicine =====
===== Table1. Nine divisions of the abdomen, according to [[Ayurveda]] and allopathic medicine =====
{| class="wikitable"
{| class="wikitable"
|-
|-
==== Differential diagnosis of ''gulma'' ====
==== Differential diagnosis of ''gulma'' ====
Ayurveda is a clinical science; therefore, the diseases are classified in such a way so that they can be systematically diagnosed on the basis of the symptoms. ''Gulma'' is a good example for it.
[[Ayurveda]] is a clinical science; therefore, the diseases are classified in such a way so that they can be systematically diagnosed on the basis of the symptoms. ''Gulma'' is a good example for it.
Mainly three resembling diseases occur in the abdominal cavity viz. ''udara roga, gulma'' and ''pliha dosha'' which require differential diagnosis. ''Udararoga'' comprises of eight diseases which cause general enlargement of the abdomen. Five types of ''gulma'' have protruding and palpable localized swellings related to the abdominal organs and appendages. Under ''pliha dosha'' benign enlargement of spleen or liver occurs (''Bhavaprakasha Chikitsa-Prakarana'' chapter 33). Therefore, on the basis of these clear demarcations, it may not be difficult to differentiate these three kinds of diseases clinically.
Mainly three resembling diseases occur in the abdominal cavity viz. ''udara roga, gulma'' and ''pliha dosha'' which require differential diagnosis. ''Udararoga'' comprises of eight diseases which cause general enlargement of the abdomen. Five types of ''gulma'' have protruding and palpable localized swellings related to the abdominal organs and appendages. Under ''pliha dosha'' benign enlargement of spleen or liver occurs (''Bhavaprakasha Chikitsa-Prakarana'' chapter 33). Therefore, on the basis of these clear demarcations, it may not be difficult to differentiate these three kinds of diseases clinically.