Introduction:

Owing to its complex and organized nature and owing to its deep – rooted adherent nature, it is termed as Gulma.

Gulma is so called because it has its root in confounded, Vaayu, originates from deep source like a shrub and has massive spread like an assemblage.

 

Saamaanya Chikitsaa

First line of treatment should comprise of oleation (Snehana) and fomentation (Svedana) for all types of Gulma. As it yields desired results, any modality if dry proves counter productive. This should be followed by other appropriate therapies.

During the course of treatment, precaution should be taken to maintain the Agnibala. As Mandaagnee leads to aggravation of symptoms while normally functioning Agni reduces the Sampraapti. It is imperative to avoid overeating during the course of treatment and to avoid prolonged fasting too.

During the course of treatment precaution should be taken not to aggravate Vaata Dosha, as Vaata Dosha is the main Dosha involved in the Sampraapti. The treatment should mainly aim at managing the predominant Dosha but during the entire course of management Vaata Dosha should be watched diligently as it is responsible for secretion and absorption of the other two.

 

Vis`hesha Chkitsaa:

Vaataja Gulma

Generally following treatment is indicated in Vaataja Gulma.

o       Snehana Bhojana, Abhyanga, Paana, Nirooha, Anuvaasana.

o       Svedana (Srotasa Maardava, Vibandha Bheda)

o       Vaataprakopaghna

o       Taila Yoga indicated in treatment of Vaata Vyaadhi could be used for Abhyanga, Anuvaasana Basti and orally.

 

Considering specific Avasthaa of Vaataja Gulma, following treatment should be done.

o       Gulma above umbilicus: Snehapaana.

o       Gulma in Pakvaas`hayaBasti.

o       Gulma occuping abdomen: Nirooha, Anuvaasana Basti.

o       Vaata Varcha VibandhaBrimhan`a Annaapaana, Snigdha, Ushn`a Annaapaana.

o       Kapha Vriddhi + Agnimaandya: Vamana

o       VedanaaSnehana, Svedana

o       Pitta VriddhiVirechana, Sasneha Anulomana

o       No response to any treatment: Raktamokshan`a

 

Vaatakaphaja Gulma

For Vaatakaphaja Gulma associated with S`hoola, Aanaaha and VibandhaKaphavaatahara Varti, Gut`eekaa and Choorn`a are indictaed.

 

 

Pittaja Gulma:

Generally Virechana is treatment for Pittaja Gulma. Also Ghrita Yoga mentioned for Pittaja Vidradhi are indicated. Considering specific Avasthaa of Pittaja Gulma,following treatment should be done.

o       Snigdha and Ushn`a Hetu: Sramsana

o       Rooksha and Ushn`aHetuGhritapaana

o       Pakvaas`hayasthitaTikta Ksheera Basti, Tikta Virechana Daaha Abhyanga or Lepa with S`heeta Dravya Siddha Ghrita

o       Vriddha Rakta Pitta + VidaahaS`hastrakarma

o       Aama + Kapha Vaata Anubandha Langhana followed by Yavaagoo and Khad`a Yoosha

o       Paakonmukha Gulma Treatment like Pittaja Vidradhi

o       Pakva GulmaS`hastrakarma + Antarvidradhi Chikitsaa

 

Kaphaja Gulma:

Langhana, Svedana, Vamana should be done in Kaphaja Gulma. Also, Ghrita mediacated with KshaaraKat`u Dravya are indicated. Also Arisht`a Yoga mentioned in treatment of Ars`ha, As`hmaree and Grahan`ee and Kshaara Yoga mentioned in treatment of Grahan`ee should be used. Considering specific Avasthaa of Kaphaja Gulma, following treatment should be done.

o       Madaagni + Avaamya Rugn`a: Langhana, Ushn`a Upachaara, Kat`u Tikta Sevana

o       Madaagni + Utkles`ha: Vamana

o       Kat`hina Unnata + Vibandha: Svedana

o       Kat`hina Stimita Guru Gulma + Good`hamaamsa: Pratisaaran`eeya and Paaneeya Kshaara, Agneekarma, Arisht`a.

o       Mandaagni + Aruchi: Saatmya Madya, Sasneha Aahaara and Aasava

 

Raktaja Gulma:

Generally it should be treated SnehanaSvedana, Sneha Virechana, Kshaara Prayoga

Yoni Vis`hodhanaGhrita Yoga, Mootra Yoga and Varti mentioned in Udara Chikitsaa and Lavan`a Yoga mentioned in Vaata Vyaadhi should be used. Management ofPittaja Gulma should be followed.

 

Rakta Gulma should be differentiated from pregnancy. It is advised to treat after 10 months, as it becomes Sukhasaadhya in old condition. However it could be treated after diagnosis and following management should be suggested.

o       Pravartamaana Rakta (Bleeding): treat as Raktapitta

o       Vaata Varcha Nirodha: Snehana, Svedana and Sransana. Then VimlaapanaAbhyangaAgnikarma and Saalvan`a Upanaaha.

o       AamadoshaLanghana then Peyaa Sevana and then treatment according to vitiated Dosha.

Pathya:

Rasa – Lavan`a

Gun`a/ Karma – Snigdha, Ushn`a, Laghu, Brihan`a

S`haaka – S`hun`t`hee, Rasona, Baala Moolaka, Jala Pippalee, Vaastuka, S`higru, Haritakee, Hingu, Maricha, Pippalee

Maamsa – Jaangala Maamsarasa, Kukkut`a, Mayoora, Harin`aadi Pas`hu Maamsarasa,

Dugdha – Ghrita, Godugdha, Ajaa Dugdha, Takra

Phala – Draakshaa, Parushaka, Kharjoora, Daad`ima, Amlavetasa, Maatulunga, Naagaranga

Kritaanna – Kulattha Yoosha, Kulmaasha

        Other – Madhu, Erand`a Tail, Gomootra, Prasanna, Suraa Mand`a, Suraa, Khand`a S`harkaraa, Vaataanulomaka Aahaara, Snehana, Svedana, Virechana, Basti, Siraavyadha Baahu, Langhana, Varti, Abhyanga

 

Vaataja Gulma:

Dhaanya – S`haalee

Maamsa – Tittira Pakshi, Mayoora, Kukkut`a, Vartika Pakshi Maamsarasa

Dugdha – Ghrita,

Drava – Prasanna, Madya, Suraamand`a

 

Pittaja Gulma:

S`hooka – S`haalee

S`haaka – Pat`ola, Atibalaa, Us`heera,

Dugdha – Godugdha, Ajaa Dugdha

Phala – Draakshaa, Parushaka, Aamalakee, Kharjoora, Daad`ima

        Other – Ghrita, S`harkaraa

 

Kaphaja Gulma:

Dhaanya – Jeern`a S`haalee, Shasht`ika S`haalee, Yava

S`himbee – Kulattha

Maamsa – Jaangala Pas`hu Maamsarasa

Drava – Ghrita, Taila, Takra, Madya

 

Apathya:

Rasa – Madhura

Gun`a – Avisht`hambhee, Guru, Rooksha

S`haaka – Puraan`a Moolaka, S`hushka S`haaka, Kanda – Aalooka

S`himbee – Dvidala Dhaanya, S`hamee Dhaanya

Maamsa – S`hushka Maamsa, Matsya

Phala – Madhura Phala

        Other – Adhovaata, Mala Mootra Avarodha, Chchhardi, Ati Jala Paana

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