Charak Samhita - Nidana Sthana - Chapter 3 (Gulma)
Charak Samhita is a Ayurvedic treatise which explains about the diseases, their causes, their pathology, Management and complications as per ayurveda. Charak samhita was written by acharya charaka and is completed by drdhbala. It consists of 8 Sthana which is sutra sthana, Nidana sthana, Vimana sthana, Sharira sthana, Indriya sthana, Chikitsa sthana, kalp sthana, siddhi sthana. In this article we will discuss the 3rd chapter of the Nidana sthana named Gulma.
In this chapter acharya charaka has explained about the Aetiology, Pre symptoms, symptoms, Chief Complaint and Therapeutic Stability and types of gulma Roga. Gulma is considered as the chronic disease in which the anna vaha srotas is disturbed, It is caused by all doshas but significantly due to the vitiation of the vata dosha. It can be termed as the Palpable, large, Round swelling between the cardiac region and the Bladder. The symptoms of these vary according to the involvement of the Doshas.
Types Of Gulma
- Vataja Gulma
- Pitta gulma
- Kapha gulma
- Sannipata gulma
- Rakta Gulma
- A person who is having the vata prakriti is emaciated because of these reasons such as Fever, Emesis, Pugration and Diarrhea.
- Intake of food which aggravates vata dosha or takes cold items in excess,
- Takes the procedures of emesis and purgation without prior function etc.
- Propels un impelled vomiting, the one that holds up the urge of the Flatus, Urine or intake of fresh water after having a heavy meal.
- The person travels by a jerking vehicle excessively,
- Excessive sexual intercourse,
- Physical Exercise, Intake of the alcohol and Anxiety,
- Subjected to injury,
- Have uneven Sitting Posture,sleeping posture, Standing and Walking.
- Does the excessive Physical exercise due to which the vata gets Vitiated.
The Vayu which is vitiated enters the MahaSrotas (Gastrointestinal tract) hardens because of roughness. It formed into a mass and got localized in the region of the Heart, Urinary bladder, Flanks and Navel. It causes the Pain and various types of nodules. Because of massification it remains massified, and known as Gulma.
- The mass or the Gulma, sometimes aggravates and sometimes gets Diminished.
- The Patient may have Severe, Unstable and Mild Pain.
- There might be a tingling sensation in which It senses like ants crawling in the organs
- Pains might be Piercing, Twitching, Breaking, Twitching, Extension, Contraction, Numbness, Oversensitivity.
- The patient Feels like it has been Pierced by a needle or a nail.
- Rise in Temperature in Evening
- Dryness in the mouth
- Respiratory Trouble
- Spleen Enlargement
- Distension of the Abdomen
- Gurgling Sounds in Abdomen
- Upward movement of Vayu
- Pain in Sterno mastoid, Head and Temporal Region
- Swelling of Inguinal Glands
- Appearance of the Black, Redishness and Roughness in The skin, nails, face, eyes, Urine and Faeces.
- Unsuitability of the Causative factors.
The person gets emaciated with the same factors and uses the Sour, Saline, Alkaline, Sour, Hot and Sharp Things, Vinegar, Salads and Sour fruits, the acid Possessing Vegetables, Meat, Grains etc. Intake of food during Indigestion, Ingestion of the Emesis when the Stomach is rough, Suppresses the Natural Urges, Excessive sun exposure.
The Vayu starts getting Collecting in vitiated Pitta in amasaya produces the same pains as vata gulma. Due to pitta dosha, the patient may feel the burning sensation in the Belly, Heart region, Throat and Chest, The person emits out the Smokey and sour eructations. At the site of the Gulma, there is Heat, Burning Sensation and Heating pain. Sweating, laxity, tenderness, Moistening is present.
- Burning pain
- Dryness of Throat, Palate and Mouth
- Yellowishness and Greenishness of the Nails, Skin, Eyes, Face, Urine and Faeces.
If the person is emaciated due to the above said reducing factors and does the intake of the Unctuous, Heavy, sweet and Cold things, Intake Preparations of the Rice flour, Sugarcane, Milk, Sesamum, Black Gram and Jaggery. Excessive use of the Immature curd and Wines, Excessive Intake of meat of the marshey, Aquatic and Domesticated animals, Suppresses the natural urges, indulges in salads, the one while hungry takes too much water or subjected to the jerking of the body.
- Heart Diseases
- Cold Sensation
- Distress in Head
- Whiteness in the Skin, Nails, Eyes, Face, Urine and Feces
- Unsuitability of the Aetiological factors and suitability to the contrary ones
When all the symptoms of the Dosa's etiology combined, it is known as the Sannipatika Gulma. It can be termed as incurable due to mutually conflicting therapeutic measures.
It occurs only in the women and not in the men because the females have uterus and menstrual flow. Those women who suppress their natural urges because of dependence, constant attendance to others or Does the vata aggravating things after delivery, abortion or the menses.
This vitiated vata enters into the mouth of the uterus and Checks the flow of menses. Every month, the menstrual bleeding is not seen and enlarges the Abdomen.
- Cold sensation
- Excessive salivation
- Milk in breasts
- Blackness in breasts and in lips
- Longing for certain things
- Swelling of the Feet
- Slight appearance of small hairs
- Dilation of vagina with foul smell and Discharge
- Pregnancy Symptoms
- Pulsation in mass of Gulma
Prodromal Symptoms Of All Types Of Gulma
- Aversion towards the food
- Irregularity in Digestion
- Non emergence urge of flatus, urine and faeces
- No proper elimination or slight elimination
- Pain, Distension, Gurgling Sound, Malaise, Diarrhoea, due to vata
- Loss of Appetite
- Intolerance to the food saturation
For all types of Gulma, it Doesn't arise without vata. Among them, The sanni pathika is considered as Incurable and is not treatable.
The gulma which is caused by one dosha, the management should be taken according to the Dosa. The gulma which arises due to combination of the dosha, should be managed by the General treatment. Whatever is non-contradictory, it may be Administered according to the Severity or the mildness of the complication.
The complications should be treated quickly. If the physician is in hurry or is unable to differentiate between the types of Gulma. He should administer the therapeutic measures as prescribed for vata such as application of vata alleviating snehana (Unction) and Swedana (Fomentation), mild unctuous purgation and enema which has amla, lavan and Madhura ras. Pacification of the vata is must because when the vata gets pacified, the other Dosa can also be controlled with minimal efforts.
In the Third chapter of charaka samhita, it has explained about Gulma roga which is of five types, its causes, Symptoms and management. The Sadhya Asadhya (Curability) has also been described by acharya. It has been said that the pacification of the vayu should be done correctly because if the Vayu gets managed then the small remedies can also manage the other Doshas.