अथातो गुल्मचिकित्सितं व्याख्यास्यामः । इतिह स्माहुरात्रेयादयो महर्षयः || १ ||
We will now expound- Gulma chikitsa- treatment of tumors of the abdomen; thus said Atreya and other great sages. (1)
गुल्मो हि वातादृते न सम्भवति। तस्मात्तेषु सर्वेष्वपि प्रथमं स्नेहस्वेदौ वातहरौ। स्नेहोपसंहितं मृदु विरेचनं तद्विधांश्च बहुशो बस्तीनम्ललवणमधुरांश्च रसान्युक्त्यावचारयेत् । मारुते हि विजितेऽल्पेनापि यत्नेनशक्योऽन्योऽपि दोषो गुल्मेषु नियन्तुम् || २ ||
Gulma, (abdominal tumors) do not arise without (aggravation of) vata, hence in all of them, the first treatment shall be oleation and sudation therapies which subdue vata, mild purgatives mixed with fatty material, similar kinds of enema therapies in great numbers, using liquids which are (prepared with drugs having) sour, salt and sweet tastes and added with juices of meat. If maruta (vata) is controlled then the other doshas can easily be controlled by even simple methods. (2)
Vataja gulma chikitsa
अथ वातोत्तरे रूक्षं बद्धमरुच्छकृतमातुरं तीव्ररुजमाननिलव्याधिविहितमन्यतम तैलं पाययेत् । अथवा विडङ्गपञ्चकोलमरिचत्रिफलाधान्यकगर्भं सपयस्सर्पिर्विपक्वम् । अनेनैव वा कल्केन दशमूलक्काथोपहितम् । राजयक्ष्मविहितं वा षट्पलम् । हिङ्गुधानकाम्लवेतससौवर्चलैलाबिडशठीदाडिमयवक्षारत्रिकटुकाजगन्धाजमोदाजाजीपुष्करमूलवचाचित्रकसुरसैर्वा दधिसंयुक्तम् ।।३।।
In that (tumor) with the predominance of vata, if the patient is having dryness, obstruction of the movement of flatus, and faeces, and other disease of vata, he should be made to drink one of the (medicated) oils described in the treatment of vatavyadhi (disease caused by aggravated vata) or the medicated ghee prepared from vidanga, panchakol, maricha, triphala, dhanyaka, milk and ghee; or that prepared from the decoction of dashamoola mixed with the paste of the above drugs; or with satpala (ghrta) described in the treatment of rajayaksma (pulmonary tuberculosis); or that prepared from hingu, dhanaka, amlavetasa, ajagandha, ajamoda, ajaji, puskaramula, vacha, chitraka and surasa and added with dadhi. (3)
हपुषामरिचबाष्पिकासैन्धवदीप्यकाजाजीपञ्चकोलकैः कोलमूलकदाडिमरसदधिक्षीरवत् सर्पिः सिद्धं सिद्धं शूलविबन्धहिध्माध्मानप्लीहहृद्रोगग्रहणीहतनामकृमिवर्मपाण्डुक्षयश्वासकास योनिरोगोदरज्वरारोचकेषु । शुण्ठीपलं पिप्पलीपलमध्यर्धं धानकाकुडवं दाडिमद्विकुडवं घृतपलानि विंशतिः क्षीरं चैकध्यं विपचेत् । एतत्सर्पिः समानं पूर्वेण ॥४॥
Medicated ghee prepared with hapusa, maricha, baspika, saindhava, dipyaka, ajaji, panchakola, juices of kola, mulaka and dadima, dadhi (curds), kshira (milk) is a sure remedy for pain in the abdomen, constipation, hiccup, flatulence, disease of the spleen, heart disease, duodenal disease, haemorrhoids, worms, scrotal enlargement, anaemia, consumption, dyspnoea, cough, enlargement of abdomen, fevers and anorexia.
One pala of sunthi, and one and half pala of pippali, one kudava of dhanaka, two kudava of dadima, twenty pala each of ghee and milk all are cooked together; this medicated ghee is similar in action) to the earlier. (4)
Lasunadi ghrita
लशुनस्य विगतत्वचस्तुलां प्रत्येकं पञ्चपलिकं च महापञ्चमूलमष्टगुणेऽम्भसि साधयेत् ।
तेन क्वाथेन तदर्धांशैश्च पृथक सुरादधिमस्तुधान्याम्लदाडिमरसैः यवानीदीप्यकाम्लवेतसहिङ्गुचविकासैन्धवत्र्यूषणत्रिफलामरदारुभिश्चार्धपलिकैः प्रस्थोन्मितं घृतं शृतं पीतं समानं पूर्वेण ॥५॥
One tula of dehusked lasuna, five pala each of the drugs of mahapanchamula are boiled in eight times their quantity of water (decoction reduced to quarter), to this decoction are added sura (beer) dadhi-mastu (water of curds), dhanyamla (fermented soup of pulses) and juice of dadima- each half of the quantity of the decoction, paste of half pala each of yavani, dipyaka, amlavetasa, hingu, cavika saindhava, tryusana, triphala and amaradaru, and one prastha of ghee- are cooked in the usual way and medicated ghee prepared: this ghee consumed acts the same way as the earlier. (5)
Dadhika ghrita
वर्षाभूद्वयदशमूलाश्वगन्धासुषवीच्छिन्नरुहाभार्ङ्गरास्नैरण्डबलाकालाशठीपुष्करमूलगन्धपलाशान् द्वपलांशान् प्रस्थं प्रस्थं च यवमाषकोलकुलत्थानां जलद्रोणे पादावशिष्टं विपचेत् । तेन पृथक् समं मातुलुङ्गदाडिमाम्रातकरसशुक्ततुषोदकारनालं घृतप्रस्थं दध्याढकोपेतं व चाकारवीशताह्लाद्विक्षारत्रिलवणत्रिकटुकरास्त्राकुम्भनिकुम्भयवानीयवानकहिंस्राम्लवेतसनीलिनीफलविडङ्गदाडिमहिङ्गुषाषाणभेदकोषकवृषकहपुषाभाश्वदंष्ट्रात्रपुसैर्वारुबीजाजाजीसारिवोपकुञ्चिकाग्रन्थिककुस्तुम्बरीतुम्बुरुफलमूर्वाचित्रकसुरसागजपिप्पलीगर्भं साधयेत्। दाधिकाख्यमेतत् सर्पि: समानं पूर्वेण । मूत्राघातोन्मादापस्मारवातव्याधिहरं च । पिबेद्वा व्योषषड्ग्रन्थाकृमिघ्नकटुकाचित्रकसौवर्चलाभयायवक्षारैर्दशांशक्षीरसंयुक्तं साधितं सर्पिः । क्षीरायोग्याय च सुरामदिरामस्तुदधिसरदाडिमरसानामन्यतमं विदध्यात् ॥ ६ ॥
One pala each of the two varsabhu, dashamoola, ashwagandha, susavi, chinnaruha, bharangi, rasna, eranda, bala, kala (nilini) sathi, puskaramula, gandhapalasa, one prastha each of yava, masa, kola and kulattha- are boiled in one drona of water, decoction reduced to a quarter. To this, are added equal quantity of juice of each of matulunga, dadima, amra and amrataka, sukta, tusodaka and aranala, one prastha of ghee, one adhaka of dadhi (curds), karavi and a paste of (equal quantity of each of) vacha, satahva, the two kshara, the three lavana, trikatuka, rasna, kumbha, nikumbha, yavani, yavanaka (another variety of yavani), himsra, amlavetasa, niliniphala, vidanga, dadima, hingu, paasanabhedaka, usuaka, vrsaka (atarusa), hapusa, bharangi, svadamstra, trapusa, eravarubija, ajaji, sariva, upakunchika, granthika, kustumburu, tumburuphala, murva, chitraka, surasa and gajapippaliare all cooked into a medicated ghee. This recipe known as Dadhikaghrta, is similar in action to the earlier and also cures retention of urine, insanity, epilepsy and vatavyadhi (diseases caused by aggravated vata).
Or drink the ghee prepared with vyosa, sadgrantha, krimighna, katuka, chitraka, sauvarchala, abhaya and yavakshara and ten parts of milk.
For those who are unsuited for the use of milk, this medicated ghee may be prepared by using either sura, madira, mastu, dadhisara or the juice of dadima instead of milk. (6)
अभ्यङ्गपूर्वं चैनं सदा स्वेदयेत् । स्नेहस्वेदौ हि सम्यक् प्रयुक्तौ स्त्रोतसांमार्दवमुपजनय्यानिलं जित्वा भित्वाच विबन्धमाशुगुल्ममपकर्षतः ।।७।।
He (the patient) should always be administered svedana (sudation therapy) preceded by abhaynga (oil massage); oleation and sudation therapies properly done produce softness of the channels, subdue vata, remove the obstruction and by all these, cure abdominal tumors quickly. (7)
तत्र हृदयजेविशेषेण स्नेहपानमिच्छन्ति। बस्तिजेबस्तिमुभयंनाभिपार्श्वाश्रये। विबद्धानिलवर्चसश्च दीप्ताग्नेः स्निग्धोष्णानि बृंहणानि चान्नपानानिपुन: पुनश्च स्नेहपाननिरूहानुवासनानि कफपित्तानुरक्षिणा योज्यानि ॥८॥
When the tumor is in (localised in the region of) the heart, drinking of oil (internal oleation therapy) is specially desired; when (localised in the region of) the urinary bladder, enemas (both kinds of enema therapy) are especially desired; when (localised in) the region of the umbilicus and the flanks, both (internal oleation therapy and enema therapy) are desired.
For those who have obstruction to the movement of flatus and faeces, who have strong digestive activity, use of foods and drinks which are unctous (fatty), hot (in potency) and causing stoutness of the body should be resorted; so also repeated administration of internal oleation, decoction-enema and oil-enema therapies; protecting kapha and pitta (not allowing them to increase) in the mean time. (8)
कुर्यात् । तमुल्लिखेत् । तत्कृतेषु च कोलदाडिममातुलुङ्गसुरामण्डअन्यथा कफो विवृद्धस्तन्द्रागौरवारुचिल्लासाग्निसादान् शूलानाहविबन्धेष्वनन्तरोक्तानां घृतानामौषधैश्चूर्णगुटिकाक्काथान् तक्रमस्तुधान्याम्लोष्णोदकानामन्यतमेनप्रकल्पयेत् । अपिच ॥ ९ ॥
Otherwise, kapha, undergoing great increase will cause stupor, feeling of heaviness of the body, anorexia, oppression in the chest, and weakness of digestive function; then that (kapha) should be expelled out by upward route (vomiting); having done it, he should be administered medicated ghee, powders, pills, decoction etc, of drugs mentioned in the treatment of pain in the abdomen, distention, constipation etc, along with any one of juice of kola, dadima, matulunga, suramanda, takra, mastu dhanyamla or usnodaka. (9)
त्रिलवणहपुषाजमोदाजगन्धावचाहिङ्गुपाठोपकुञ्चीशठीजीरकाजाजिकुस्तुम्बरीबाष्पिकाकारवी – तुम्बुरुस्वर्जिका यावशूको जटापौष्करी दाडिमं तिन्तिणीकं विडङ्गानि भाङ्ग वरो वेतसाम्लो मिशिर्मरिचगजकणाभय / पञ्चकोलानि कुम्भो निकुम्भो विशाला यवानी सुराह्वं च तत्सर्वमेकत्र चूर्णीकृतंबीजपूराद्रसेनासकृत् भावितं यः पिबेत् प्रातराहारकालेऽथवा मासमात्रंहिताशी नरः सादरम् । । प्लुतमशिशिरवारिणा जीर्णमद्येन मूत्रेण तक्रेण कोलाम्भसा मस्तुना पेयया सर्पिषौष्ट्रेण दुग्धेन कौलत्थयूषेण वा क्षारनिश्च्योततोयेन वा. दाडिमाद्वा रसेनात्मवानेभिरेवौषधैः साधितं वा घृतं हृदयगुदकटीयकृत्प्लीहगुह्याश्रितं तस्य शूलं प्रणश्येत् तथा गुल्मविष्टम्भदुर्नामकृच्छ्रोदराध्मानहिमाविबन्धाः सवर्ध्यारुचिश्वासकासाः प्रपक्तुं च शक्तो भवेत् पावकः प्राश्यमानानि पाषाणचूर्णान्यपि ॥ १० ॥
The three lavana, hapusa, ajamoda, ajagandha, vacha, hingu, patha upakunci, sathi, jiraka, ajaji, kustumburi, baspika, karavi, tumburu, svarjika, yavasuka, pauskarija (puskaramula), dadima, tintinika, vidanga, bharangi, vara, sindhuvara, vetasamla (amlavetasa), misi, maricha, gajakana abhaya, panchakola, kumbha, nikumbha, visala, yavani and surahva- all these are powdered, soaked and macerated many times in the juice of bijapura; he who, consuming suitable foods, only drinks this powder mixed with either hot water, old wine, cowsurine, buttermilk, juice of kola, mastu, peya (gruel) sarpi (ghee), camels milk, yusa (soup) of kulattha water in which alkali ( or ash) has been dissolved (and then decanted) or juice of dadima etc, every morning or during the time of meals, for one month, faithfully; or in the same manner makes use of medicated ghee prepared with these drugs, will get relieved of pain of the tumor localised in the region of the heart, rectum, waist, liver, spleen, and genitals (pelvis) and also diseases such as abdominal tumor, long stasis of food without digestion, piles, dysuria, enlargement of abdomen, flatulence, hiccup, constipation, enlargement of scrotum, anorexia, dyspnoea and cough, his digestive fire (activity) will be able to digest even pieces of stone if ingested. (10)
अभयापलद्वयमम्लवेतसपलद्वयंपालिकान् वचाविश्वभेषजत्रिवृद्दन्तीचित्रकशठीपुष्करजटायावशूकान्कार्षिकान्मरिचाजाजीसैन्धवोपकुञ्चिकाशितिवारकयवानीधातकीपुष्पविडङ्गाहिङ्गुन्त्रिक चचूर्णितं पूर्ववद्भावितं पीतं च समानं तेन ।। ११ ।।
Two pala of abhaya, two pala of amlavetas, one pala each of vacha, visvabhesaja, trivrit, danti, chitraka, sathi, puskarajata and yavasuka, one karsa each of maricha, ajaji, saindhava, upakunchika, sitivaraka, yavani, dhatakipushpa and vidanga, three karsa of hingu- all are powdered and macerated as before and used as drink; is similar (in action) to it (the earlier one). (11)
यवानीशतपुष्पानागकेसरवचामुस्तव्योषपाठागुग्गुलुत्रिवृतागजपिप्पलीतालीसैलापामार्गद्रवन्ती – निदिग्धिकामूलानां भागो भागश्चाम्लवेतसस्य तत्सूक्ष्मरजीकृतं मातुलुङ्गदाडिमबदररसशीधुसुरोष्णसलिलान्यतमेन पीतं शूलगुल्मवर्ष्मानाहोदरकोष्ठस्तैमित्यार्शोश्मरीमूत्रग्रहकटीपृष्ठग्रहोन्मादापस्मार – स्कन्नशुक्रताग्निसादानपनयति ॥ १२ ॥
Equal quantity of yavani, satapushpa, nagakesara, vacha, musta, vyosapatha, guggulu, trivrit, gajapippali, talisa, ela, apamarga, dravanti and roots of nidigdhika together making one part, nice powder of amlavetasa of equal quantity, forming another part- are powdered together nicely, consumed mixed with either juice of matulunga, dadima or badara or Sidhu, sura or hot water, wards off colic, tumors of the abdomen, scrotal enlargement, distention of abdomen, enlargement of abdomen, sluggishness of the alimentary tract, piles, urinary calculii, difficulty of micturition, catching pain of the waist and back, insanity epilepsy thickening of the semen and weakness of the digestive activity. (12)
तिलकुन्तलपलाशसर्षपयवनालमूलकबीजानामन्तर्धूमदग्धानां क्षारंगोजाविमहिषीखरहस्तिमूत्रैर्बहुकृत्वो गालयेत् । ततस्तदच्छंशुण्ठीसैन्धवकुष्ठकृमिघ्नचूर्णप्रतीवापमधिशृत्य लेहीभूतमाददीत । तत्तैलयुक्तं समानंपूर्वेण ॥ १३ ॥
The stem and leaves of tila, sarsapa, yavanala (stem of yava plant) and seeds of mulaka are converted into ash inside a pot and the ash is dissolved in urine of the cow, goat, sheep, buffalo, ass and elephant (seperately); solution stirred well many times and the clear supernatent, fluid decanted. To this, is added the powder of sunthi, saindhava, kustha and krimighna and cooked to the constistence of the confection. This if, consumed mixed with oil acts similar to the earlier one. (13)
Ksharagada
महौषधदेवदारुदन्तीत्रिवृत्पाठाक्षारद्वयत्रिफलोपकुञ्चिकाचविकाद्वीपिपिप्पलीद्वयपिप्पलीमूलसर्पसुगन्धा कुष्टकटुरोहिणीनामर्धपलिकान् भागान् पलं पलं च पञ्चानां लवणानामेकत्र चूर्णयित्वा दना त्रिवृतेन चाप्लाव्यं कलशोदरेऽन्तर्धूमं पाचयेत् । अग्निवर्णं च कलशमपनीय क्षारमाददीत | एष क्षारागदो भेलविहितः समान: पूर्वेण सर्पमूषिकदष्टगरापस्मारोन्मादाश्मरीयोनिशुक्रदोषांश्च समयति ॥१४॥
Halfpala each of mahausadha, devadaru, danti, trivit, patha, the two ksharas, triphala, upakunchika, cavika, dvipi (chitraka), the twopippalh, pippalimula, sarpasugandha, kustha, and katurohinı; one pala each of the five salts- are all powdered, soaked in dadhi (curds) and trivrit (mixture of three fats) inside a pot and cooked by closing the mouth of the pot tight, when the pot becomes red by the heat, it is removed from the oven, and the ash/alkali collected after cooling, this recipe known as Ksharagada, formulated by Bhela, is similar (in action) to the earlier one and in addition of cures snake bite, rat bite, artificial poison, epilepsy, insanity, urinary calculii, disorders of the uterus vagina and semen. (14)
पित्तं च विवृद्धमन्तः सन्तापं जनयेत् । तत्रैरण्डतैलं सपयस्कं विरेचनाथं पिबेत् । सकफस्तु वारुणीमण्डमिश्रम् । अत्युद्रिक्तपित्तस्त्रिफलां त्रायमाणां वा क्षीरेण पिबेत् । विरिक्तस्यापि सन्तापानुवृत्तौरक्तमवसेचयेत् ॥ १५ ॥
Pitta getting increased (during the course of vata gulma) produces burning sensation inside; then in order to induce purgation, eranda, taila mixed with milk should be given to drink, if associated with kapha, it ( eranda taila) should be taken along with varuni manda (scum of liquor), if the increase of pitta is very profound triphala and trayamana should be taken mixed with milk; if even after purgation burning sensation continues, then blood letting should be done. (15)
विविबन्धे चोदावर्तक्रमंकुर्यात्। लुञ्चिततिलपलद्वयं शुण्ठ्यर्धपलं च पिष्टंगुडपलोपेतमुष्णेन पयसा पिबेत् । तद्वातगुल्मोदावर्तयोनिशूलानपोहतितथाक्षीरभृतेन महापञ्चमूलेनशिलाह्वयम् । लशुनंतु क्षीरसिद्धपीत्वा गुल्मोदावर्तगृध्रसीहृद्रोगविद्रधिशोषविषमज्वरान्जयति ।।१६।।
In case of obstruction of facces, treatment prescribed for duavarta (upward movement of vata) should be done. Two pala of dehusked tila, half-pala of sunthi, are converted to a paste, mixed with one pala of guda (jaggery) and consumed along with hot milk; this will relieve abdominal tumor of vata origin, upward movement of vata, and pain of the vagina. So also silajatu, and maha panchamula boiled in milk (and consuned); consuming of lasuna cooked in milk cures abdominal tumors, upward movement of vata, sciatica, heart disease, abscess, consumption, intermittant fevers. (16)
बृहतीद्वयबिल्वगोक्षुरकैरण्डमातुलुङ्गीमूलपाषाण भेदक्वाथः सयावशूको गुल्मशूलहरः । माषपर्णीमुद्द्रपर्णीसहदेवाहस्वपञ्चमूलैरण्डेक्षुवालिकानिर्यूहो यवक्षारोपेतः सर्वगुल्मकोष्ठशूलघ्नः । देवदारुनागरैरण्डपुष्करमूलानां क्वाथः सर्वगुल्मशूलघ्नः । पुष्करमूलदुरालभायवशुण्ठीनां वा । तैलारनालमूत्रमदिरायावशूकाश्चैकत्र पीता गुल्मोदरानाहप्लीहहराः । स्वेदांश्च विविधान् पुनः पुनर्योजयेत् ॥ ॥१७॥
Decoction of the two brihati, bilva, goksuraka, eranda, root of matulungi, pashanabheda and yavasuka cures tumor of abdomen and abdominal pain. Decoction of masparni, mudgaparni, sahadevi, hrasvapanchamula, eranda and iksuvalika, along with yavakshara cures all varieties of abdominal tumors and pain of the alimentary tract. Decoction of devadaru, nagara, eranda and puskaramula cures all varieties of abdominal tumors. Or that of puskaramula, duralabha, yava (kshara) and sunthi. Taila (oil), aranala, mutra (urine of cow), madira and yavasuka, taken together as drink cures abdominal tumors, enlargement of abdomen and disease of the spleen. Different kinds of sudation therapies should be done again and again. (17)
स्रंसनार्थीनीलिनीफलचूर्णयुक्तानिपूर्वोक्तानिहवषिपिबेत् । अथवा रामठस्यैको भाग: सैन्धवस्य त्रयो नवैरण्डतैलस्य सप्तविंशतिर्लशुनस्वरसस्य तदैकघ्यं कृत्वा पीतमुदरगरगुल्मवमंप्लीहशूलहरम् । नीलिनीबला-व्याघ्रीकटुकाफलतालपत्रिकारास्त्राकृमिघ्नानि पालिकान्यपामाढके साधयित्वाष्टभागावशिष्टमवतारयेत् । तेन स्रुहीक्षीरपलप्रतीवापं दधिसमं सर्पिःप्रस्थं पचेत् । तत्पेयामण्डेन सह रसाशिना नीलिनीघृतं पलमात्रया पीतं गुल्मप्लीहकुष्ठश्वित्रजठरव्यङ्गशोफज्वरपाण्डुरोगोन्मादापस्मारानपकर्षति । दुर्विरेच्यो हि सर्व एव गुल्मी मारुताभिभूतकोष्ठत्वात्। तस्मात्सुस्रिग्धमेनंस्त्रेहविरेकैर्वा शोधयेत् ।।१८।।
To have soft movement of bowels, the patient should drink any one of the medicated ghee described earlier, mixed with powder of niliniphala. Or one part of ramatha, three parts of saindhava, nine parts of eranda taila and twenty seven parts of fresh juice of lasuna- are all cooked together and used. This cures enlargement of the abdomen, artificial poison, abdominal tumor, enlargement of the scrotum, splenic enlargement and pain of the abdomen.
Nilini ghrita
One pala of each of nilini, bala, vyaghri, katuka, talaphala, tala patraka, rasna, krimighna- are boiled with one adhaka of water, decoction reduced to one-eighth, to this are added, one pala of snuhi-kshira (milky sap of snuhi), dadhi (curds) equal in quantity (of the decoction) and one prastha of ghee and cooked (in the usual way). This recipe known as Nilinighrta- taken along with peya, manda (thin gruel) and juice of meat, in the dose of one pala (per time) wards off abdominal tumor, splenic disorders, leprosy (and other skin diseases), leucoderma, enlargement of abdomen, pigmented patches on the face, dropsy anaemea, insanity and epilepsy.
It is very difficult to produce purgation in patients of abdominal tumors because of predominance of vata in their alimentary tract; hence they should be administered purgations only after internal oleation therapy properly done or by the use of fatty purgative recipes. (18)
Pitta gulma chikitsa
पित्तगुल्मे तु स्निग्धोष्णेन जाते स्स्रंसनार्थं मधुना कम्पिल्लकमवलिह्यात् । द्राक्षाभयारसं वा सगुडं पिबेत् । कल्पोदितानिवाविरेचनानिप्रयुञ्जीत ।।१९।।
In pitta gulma (abdominal tumor caused by pitta) a confection of kampillaka should be licked mixed with honey in order to produce easy movements of the bowels; or drink the juice of draksa and abhaya mixed with guda (jaggery) or purgative recipes enumerated in kalpasthana (chapter 2) may be administered. (19)
रूक्षोष्णसमुद्भूते पुनः संशमनार्थं तिक्तकं वासाघृतं वा पिबेत् । अथवा तृणपञ्चमूलक्काथेन जीवनीयकल्केन च सिद्धं सर्पिः । तथा न्यग्रोधादिगणेन तृणपञ्चमूलादिभिर्वा पृथक् साधितं क्षीरम् ॥ २० ॥
In that arising from indulgence in dry and hot things (foods and drinks) drinking of tiktaka ghrta or vasaghrta should be consumed to mitigate (the dosha); or medicated ghee prepared from the decoction of trnapanchamula and paste of drugs of jivaniya gana; likewise drinking of milk boiled either with drugs of nyagrodhadigana (chapter 16 of sutrasthana) or of trnapanchamula should be adopted. (20)
रूक्षोष्णजेऽपि चात्ययिके सामान्यतो वा समुत्पन्ने विद्रधिविहितानां त्रिफलादिक्वाथत्रायमाणाधृतद्राक्षाघृतानामन्यतमं पिबेत् । क्षीरंवात्रायमाणा शृतं कोष्णंपीत्वा क्षीरमेव सुखोष्णमनु- पिबेत् २१ ॥
पक्वाशयस्थे वा गुल्म क्षीरबस्तिभिः सतिक्तैः संशोधयेत् । शीतद्रव्यसिद्धैश्च स्त्रैहैरभ्यञ्जयेत् । मणिकनकरजतताम्रभाजनानि च शिशिरवारिपूर्णानि गुल्मदेशस्योपरि धारयेन्मुक्तावलीश्च सुशीताः । एवमसिद्धौ विदाहपूर्वरूपेषु चासृक् स्त्रावयेत् । स्स्रुतरक्तं च जाङ्गलरसैर्लब्धबलमर्तिशेषनाशाय पुनः सर्पिरभ्यासयेत् ||२२ ॥
Though arising from induglence of dry and hot things, if there is urgency (due to severe pain and other distress) or even in that arising from ordinary causes, drinking any one of triphaladi ghrta, trayamana ghrta or draksa ghrta described in the treatment of vidardhi (chapter 15 of chikitsasthana) should be adopted; or milk boiled with trayamana taken warm followed by milk only as an after-drink ( is also suitable).
If the abdominal tumor is localised in the pakvasaya (large intestine) purification should be done with administration of kshirabasti; anointing massaging of the body with oil processed with drugs of cold potency, vessels of precious stones, gold, silver or copper filled with very cold water, or garland of pearls which is cold should be placed on the area of the tumor; if these do not succeed and if there is burning sensation even from the prodromal stage, then blood should be let out; after blood letting, strength should be gained by the use of juice of meat of animals of desert-like regions; using medicated ghee should be continued again to get relief from residual pain. (21-22)
विद्रधिवच्चविदह्यमानमुपनाहयेत् । पर्यागतमपितद्वदुपलक्ष्य तथैव सर्वथोपचरेत् ॥ २३ ॥
If the tumor is found to undergo ripening just like abscess, it should then be fomented with hot poultices and bandages, after carefully nothing the signs of ripened stage, it should be treated in the same manner (as a ripe abscess is treated). ( 23 )
Kaphaja gulma chikitsa
लेष्मगुल्मिनंप्रागेवविधिवद्वामयेदवाम्यमुपवासयेत्। लङ्घितस्योष्णकटुतिक्तदीपनंसंसर्ग – माचरेत् । तथा स्वेदान् वातगुल्मोक्तानि चघृतादीनि द्विगुणहिङ्गुक्षाराम्लवेतानि ॥२४॥
The patient of slesmagulma (tumor arising from kapha) should be administered vamana (emesis) in the beginning itself; he who is unsuitable for the emesis therapy should be made to fast; afterwards the regimen of diet should be followed, with foods which are processed with drugs having properties like hot (potency), pungent, bitter taste, and of increasing hunger/digestion. Similarly, sudation therapies and use of medicated ghee recipes described for vata gulma prepared with double the quantity of hingu, kshara and amlavetasa- should be adopted. ( 24 )
•दशमूलक्काथे व्योषदाडिमहिङ्ग्यवक्षारबिडसैन्धवयुक्तं सर्पिः सिद्धं लेष्मगुल्मघ्नम्। भल्लातकपलद्वयं लघुपञ्चमूलं च पालिकमुदकाढके प्रस्थावशेषं पाचयेत् । तस्मिन् क्षीरप्रस्थे च सर्पिःप्रस्थं हिङ्गुविडङ्गशठीबिडसैन्धवक्षाररास्नानागरपिप्पलीषड्ग्रन्थामधुकचित्रकैः काषिकैर्विपचेत् । एतद् भल्लातकघृतं कफगुल्मप्लीहकासश्वासग्रहणीपाण्डुरोगघ्नम् । षट्पलं वा द्विगुणाएं क्षीररहितं मस्तुदधिकाञ्जिकार्द्रकरसाढकद्वयोपेतं साधयित्वा प्रयुञ्जीत। हिङ्ग्रहरीतकीपुष्करमूलशुण्ठीसैन्धवबिडश्यामायवक्षारतुम्बुरुचूर्णोयवक्वाथाप्लुतः सर्पिर्भृष्टो भक्षितः शूलगुल्मकाठियघ्नः ||२५||
Medicated ghee prepared from decoction of dashamoola, along with the paste of vyosa, dadima, hingu, yavakshara, bida and saindhava cures kaphagulma (abdominal tumor of kapha origin).
Bhallataka ghrita
Two pala of bhallataka and one pala of laghu panchamula are boiled in one adhaka of water, decoction reduced to one prastha; to this are added two prastha of milk, one prastha of ghee and paste of one karsa each fo hingu, vidanga, Sathi, bida, saindhava, yavakshara, rasna, nagara, pippali, sadgrantha, madhuka and chitraka and medicated ghee prepared. This recipe Bhallataka ghrta cures abdominal tumor arising from kapha, enlargement of spleen, cough, dyspnoea, diseases of the duodenum and anaemia.
Or Satpala (ghrita) described in the treatment of rajayaksma ( chapter 7 of chikitsasthana) prepared with double the quantity of kshara, without milk, but with the addition of two adhaka of mastu, dadhi, kanjika and juice of ardraka put together-should be made use of.
Powder ofhingu, haritaki, puskaramula, sunthi, saindhava, bida, syama, yavakshara and tumburu, soaked in the decoction of yava, dried and fried in ghee and consumed (daily); this cures abdominal pain and hardness of the abdominal tumors. ( 25 )
ततोऽस्य सर्वमङ्गं गुल्मं च साध्मानं सविबन्धं कठिनमुन्नतं गूढमांसं स्थिरं महावस्तुं च बहुधा बहुशश्चस्वेदयेत् ।स्निग्धस्विन्नशरीरस्य शिथिलतांगतेगुल्मे यथोक्तांघटिकांलागयेत् । तया सगृहीते चगुल्मेघटीमपनयेत्भिन्द्याद्वा ॥ २६ ॥
If the tumor is found o be enlarged, having obstruction inside, hard, bulging out, covered with muscles, immoveable and occupying wide area, then the entire body of the patient and also the tumor should be given sudation therapy, in many ways and many times. When by such oleation and sudation therapies the tumor becomes loose, a ghata (pot/sucking apparatu’;), should be applied over it. (chapter 35 of sutrasthana) when it has caught (the tumor) well it should be pulled out (forecebly) or broken open and removed. (26)
ततो हृदयमान्त्रं च वर्जयन् गुल्मं विमार्गाजपदादर्शान्यतमेन वस्त्रान्तरितं प्रपीडयेत् प्रमृज्यात् । ततः साल्वलादिभिः सुखोष्णैर्लेपयित्वा लोहपात्रैः स्वेदयेत् । एवममुना क्रमेण स्थानादपसृते शिथिलीभूतेचगुल्मेविरेकान्स्नेहवतोदाशमूलिकांश्चबस्तीन्विदध्यात् । नीलिनीघृतमेनं द्विगुणप्रमाणं पाययेत् । उदरोक्तानिचसपीषि ॥२७॥
Avoiding the heart and the intestine, the abdominal tumor should be covered with a cloth, held tight by using either a vimarga (wooden calipers used by cobblers) ajapada (another kind of forceps) or a mirror (the circular metallic rim of a round mirror) and squeezed hard from all the sides; then it should be smeared with comfortably warm paste of salvala etc (described as a method of sudation in chapter 24 of sutrasthana) and given fomentation with vessels of iron. By these procedures, when the tumor is found to have been slowly displaced and become loose, then administration of purgatives of fatty nature and enemas containing dashamoola (described in bastikalpa, chapter 4 of kalpasthana) should be resorted to. Nilinighrta is given to him in double the dose and also the medicated ghee described in the treatment of udara (chapter 17 of chikitsasthana). (27)
Misraka sneha
त्रिफलाकुम्भनिकुम्भदशमूलानां षोडशांशावशिष्टं क्वाथं घृतमेरण्डतैलं क्षीरं चैकतः साधयेत् । अयंमिश्रकस्त्रेहः कफगुल्मवातविड्विबन्धोदावर्तप्लीहोदरयोनिशूलान्यपकर्षति ॥ २८ ॥
Triphala, kumbha, nikurmbha, dasanmula – are boiled in water and decoction reduced to one-sixteenth part; this decoction is mixed with ghee, eranda taila and milk and cooked suitably. This mixture known as Misrakasneha- relieves abdominal tumor of kapha origin, obstruction of flatus and faeces, upward movement of vata, enlargement of spleen enlargement of the abdomen and vaginal pain. (28)
पिप्पल्यामलकद्राक्षाश्यामाद्यैः पालिकैरेरण्डतैलहविषोः प्रस्थौषड्गुणे पयसिपचेदयं मिश्रकस्त्रहो गुल्मिनां स्त्रसनो वृद्धिविद्रधिगुल्मवातव्याधिषुचपरममृतम् ॥ २९ ॥
One pala each of pippali, amalaka, draksa and kasmarya- are converted into a decoction, to which are added, one prastha each of eranda taila and ghee and boiled with six times their quantity of milk. This (second) misraka sneha is srarnsana ( laxative) in patients of abdominal tumor and acts like nector in enlargement of scrotum, abscess, abdominal tumor and disease caused by vata. (29)
Dantiharitaki avaleha
दन्त्याः पलानि पञ्चविंशतिस्तावन्त्येव चित्रकस्य तावत्य एव हरीतक्यः सर्वमेकत्र सलिलकलशेऽष्टांशावशिष्टं साधयित्वा पूते च तस्मिन् रसे ताश्च हरीतकीः पञ्चविंशतिं गुडपलानि तैलार्धकुडवं चूर्णीकृतं त्रिवृताकुडवमर्धपलोन्मितां मागधिकां महौषधं च प्रक्षिपेत् । ततो मृद्वग्निना लेहीभूतेऽवतारिते शीते च तैलसमं मधु कर्षांशं च चतुर्जातकचूर्णं मिश्रयेत् । एता दन्तीहरीतक्यः सावलेहाः पञ्चविंशत्यहोभिर्भक्ष्यमाणागुल्मार्शःश्वयथुकुष्ठकामलारोचकग्रहणीपाण्डुहृद्रोगोत्क्लेशप्लीहोदरविषमज्वरानपोहन्ति । हृद्यं सुखंचविरेचनम् ॥ ३० ॥
Fruits of danti twentyfive pala, the same number of chitraka and also of haritaki- all are boiled in one kalasa (drona) of water, decoction reduced to one-eighth part and filtered. To this are added, the haritaki, twentyfive pala of guda (jaggery) half kudava of taila, one kudava of powder of trivrit and one pala of each of magadhika and mahausadhaall are cooked over mild fire into a confection, removed from the oven and allowed to cool. After it cools, honey equal in quantity of oil and one karsa of powder of caturjataka are added. This recipe Dantiharitaki avaleha consumed, cures within twentyfive days, abdominal tumors, haemorrhoids, swelling, leprosy and other skin diseases, jaundice, anorexia, disease of duodenum, heart disease, nausea diseases of spleen, enlargement of abdomen, intermittant fevers, it is pleasant and easy (good) purgative also. (30)
गुडाक्षीरभावितं वा त्रिवृताचूर्णं सर्पिर्मधुभ्यामवलिह्यात् । गुग्गुलं वा गोमूत्रेण पिबेत् । तेन वा श्यामात्रिवृत्कुष्ठदन्तीगुग्गुलुक्षारहरीतकी: पीलुरसंवा समधुसर्पिर्लवणम् ।।३१ ॥
Powder of trivit macerated with the milky sap of guda (snuhi) should be licked with ghee and honey; or guggulu mixed with cows urine should be drunk; or with it (cows urine) the powder of Syamatrivirt, kustha, danti, guggulu, kshara (yavakshara) and haritaki mixed with honey, ghee and salt (saindhava); or the juice of pilu (mixed with honey, ghee and saindhava (should be consumed). (31)
मूत्रबस्तिक्षारांश्च तांस्तांस्तत्र तत्रोक्तान् क्षीररसस्निग्धाहारो व्यहमेकाहं वा विश्राम्य प्रयुञ्जीत । क्षारो हि श्रेष्माणं स्निग्धस्थिरं मधुरमाशयात् छिन्दन् क्षरयति ॥ ३२ ॥
Administration of cows urine, enema therapy and alkalies, described at many places (in the course of treatment of many diseases) should be resorted to, in the same manner as described therein, with intervals of two days or one day, for the patient who partakes milk, meat juice, and fatty foods only as diet. Alkalies themselves scrape the unctous, solidified and sweetish kapha sticking to the organs and expels it out. (32)
कफरुद्धमार्गशुध्यर्थं विविधांश्च चूर्णलवणतक्रारिष्टासवानवचारयेत् । पिप्पलीपिप्पलीमूलसैन्धवाजाजीचित्रकचूर्णयुक्तांचजीर्णसुराम् अपिच ॥ ३३ ॥
In order to clear the passages obstructed by kapha, different kinds of medicinal powders, salts, takraristas ( fermented buttermilk ) and asavas ( fermented infusions ) should be administered. Old sura (beer) mixed with the powder of pippali, pippalimula, sairndhava, ajaji and chitraka may also be used. (33)
Further on –
वमनैर्लङ्घनैः स्वेदैः सर्पिष्पानैर्विरेचनैः । बस्तिभिर्गुटिकाचूर्णक्षारारिष्टासवैरपि ॥३४॥ शैष्मिकः कृतमूलत्वाद्यदि गुल्मो नशाम्यति । तस्य दाहं हृते रक्ते कुर्यादन्ते शरादिभिः ॥ ३५ ॥
Abdominal tumor of kapha origin, being deep rooted, if does not get cured even after therapies such as emesis, fasting, sudation, drinking of ghee, purgation, enemas, use of pills, powders, alkalies, fermented decoction and infusion and blood letting, then as a last measure, it should be burnt by touching with red hot arrow etc. (34-35 )
Agnikarma- thermal cautery
अथ वस्त्रान्तरितं सपर्यन्तं गुल्मनिचयं प्रदीप्तेन शरलोहाग्निमन्थतिन्दुककाष्ठानामन्यतमेन नाभिबस्तिहृदयान्त्ररोमराजीः परिहरन् नातिगाढं परामृशेत् । ततः कषायस्वादुशीतैरग्निवेगप्रुपशमय्य व्रणोपक्रमंकुर्वीत ||३६ ॥
The tumor mass, covered with cloth all around, should be touched by red hot iron arrow, or a burning piece of wood of either agnimantha or tinduka, avoiding injury to the umbilicus, urinary bladder, heart, intestines and lines of hairs (on the abdom burning rod entering inside but not very deep; afterwards, the degree of heat reduced by application of astringent, sweet, cold liquids, and then treatment of th adopted. (36)
व्यामिश्रदोषे तु व्यामिश्रमिदमेव यथोक्तं विदध्यात् ||३७ |
In case of combination of doshas causing the abdominal tumor appropriate combined therapies should be adopted. (37)
रक्तगुल्मेपुनरतीतप्रसवकालायायोषितः स्नेहस्वेदपूर्वकंस्त्रेहविरेचनंवितरेत् । पलाश – क्षारोदकसिद्धं चयमकम् । गुल्मभेदनाय तीक्ष्णोष्णं च विधिम् ॥ ३८ ॥
For Raktagulma (tumor in women caused by vitiated blood) the treatment should start only after the lapse of period of delivery (10 months ). The woman should be administered oleation and sudation therapies first, followed by oily purgatives, then a mixture of two fats (ghee and oil) boiled along with palasakshara (ash of leaves of palasa), and adoption of remedial measures which cause bursting of the tumor, use of (drugs of possessing) penetrating and heat producing properties. (38)
एवमभिद्यमाने योनौ योनिविरेचनार्थं क्षारेण महावृक्षक्षीरेण वा युक्तं पललम् । ताभ्यां वा भावितान् कटुकमत्स्यांस्तत्पित्तभावितान् वा वराहपित्तभावितान् वा नक्तकानूर्ध्वाधोभागिकद्रव्यभावितान् वा । सगुडक्षारं किण्वं वा । बस्तिं च सक्षारक्षीरमूत्रं दाशमूलिकमुत्तरबस्तिं च योजयेत् ।।३९ ।। –
If by these methods, the tumor does not burst, then palala (paste of tila) mixed with yavakshara or with milky sap of mahavriksha (snuhi) should be placed in the vagina, in order to produce purgins from the vagina; or katuka matsya (fish which are bitter in taste) or piece of cloth (diaper) soaked in them (yavakshara and sap of sudha) or soaked in its own bile (fish bile) or soaked in bile of a boar, or soaked in the juice (or decoction) of drugs which cause purgations both in upward (emetics) and downward (purgative) routes; or kinva (yeast) mixed with guda (jaggery) and kshara (yavakshara) (may be placed in the vagina); enema with decoction of dashamoola mixed with kshara (yavakshara) and milk and (cows) urine, should be administered both through the rectum and also through the vaginal tract. (39)
प्रवृत्तंतु रक्तं रसौदनाशिन्या उपेक्षेत । अतिप्रवृत्तंतु रक्तं रक्तपित्तोपक्रमेणसाधयेत् ।।४० ।।
When it starts bleeding it should be neglected (not controlled) and the woman should be supplied with food along with meat juice. If the bleeding is copious, it should be controlled by methods of treatment prescribed for raktapitta (bleeding disease). (40)
सर्वेषु चान्नपानस्वरूपज्ञोगुल्मेष्वाहारमग्निबलापेक्षीप्रयुञ्जीत ।। ४१ ।।
In all varieties of abdominal tumor, the physician conversant with the nature of foods should prescribe them considering the strength of the digestive fire of the patient. (41)
आनाहादिष्वप्यामशुद्धवातोदावर्तानुरोधेन गुल्मवत्प्रतिकुर्यादिति । भवतिचात्र । ॥ ४२ ॥
anaha (distention of the abdomen) and others (symptoms) should be treated similar to gulma (abdominal tumors) considering (without giving rise to) ama (undigested food), suddhavata (vata unassociated with other doshas) and udavarta (upward movement of vata). (42)
Some verses are
मन्देऽग्नौ वर्धते गुल्मः प्रदीप्ते तुप्रशाम्यति । शमप्रकोपौ दोषाणां
सर्वेषां यत्तदाश्रयौ ॥४३ ।।
Abdominal tumor gets exacerbated by mandagni (weak digestive activity) and subsides by strong digestive activity, the alleviation (decrease to normal), and the aggravation (increase) of all the doshas, also depend on this (digestive activity).
Chapter 16
।। इतिषोडशोऽध्यायः ॥
Thus ends the Sixteenth chapter.
