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.
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.
Generally following treatment is indicated in Vaataja Gulma.
o Snehana Bhojana, Abhyanga, Paana, Nirooha, Anuvaasana.
o Svedana (Srotasa Maardava, Vibandha Bheda)
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`haya: Basti.
o Gulma occuping abdomen: Nirooha, Anuvaasana Basti.
o Vaata Varcha Vibandha: Brimhan`a Annaapaana, Snigdha, Ushn`a Annaapaana.
o Kapha Vriddhi + Agnimaandya: Vamana
o Vedanaa: Snehana, Svedana
o Pitta Vriddhi: Virechana, Sasneha Anulomana
o No response to any treatment: Raktamokshan`a
For Vaatakaphaja Gulma associated with S`hoola, Aanaaha and Vibandha, Kaphavaatahara Varti, Gut`eekaa and Choorn`a are indictaed.
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`aHetu: Ghritapaana
o Pakvaas`hayasthita: Tikta Ksheera Basti, Tikta Virechana Daaha Abhyanga or Lepa with S`heeta Dravya Siddha Ghrita
o Vriddha Rakta Pitta + Vidaaha: S`hastrakarma
o Aama + Kapha Vaata Anubandha Langhana followed by Yavaagoo and Khad`a Yoosha
o Paakonmukha Gulma Treatment like Pittaja Vidradhi
o Pakva Gulma: S`hastrakarma + Antarvidradhi Chikitsaa
Langhana, Svedana, Vamana should be done in Kaphaja Gulma. Also, Ghrita mediacated with Kshaara, Kat`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
Generally it should be treated Snehana, Svedana, Sneha Virechana, Kshaara Prayoga
Yoni Vis`hodhana. Ghrita 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 Vimlaapana, Abhyanga, Agnikarma and Saalvan`a Upanaaha.
o Aamadosha: Langhana then Peyaa Sevana and then treatment according to vitiated Dosha.
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
Dhaanya – S`haalee
Maamsa – Tittira Pakshi, Mayoora, Kukkut`a, Vartika Pakshi Maamsarasa
Dugdha – Ghrita,
Drava – Prasanna, Madya, Suraamand`a
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
Dhaanya – Jeern`a S`haalee, Shasht`ika S`haalee, Yava
S`himbee – Kulattha
Maamsa – Jaangala Pas`hu Maamsarasa
Drava – Ghrita, Taila, Takra, Madya
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