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Thursday, July 4, 2024

Ashtanga Hridayam Nidanasthanam Chapter 11:  Vidradhi Vriddhi Gulma Nidanam Adhyaya (Analysis of abscess, hernia and stomach tumors)


The 11th chapter of Nidanasthanam of Ashtanga Hridayam is called as Vidradhi Vrddhi Gulma Nidanam Adhyayah. This chapter offers with the reason of ‘prognosis of abscess, hernia and stomach tumors’.

The subjects lined on this chapter embody –

  • Vidradhi Nidana and Samprapti (causes and pathogenesis of abscess)
  • Rupa (medical options)
  • Rakta Vidradhi Rupa (medical options of abscess brought on by blood)
  • Kshataja Vidradhi Rupa (medical options of abscess brought on by trauma)
  • Indicators of abscess as per its location
  • Expulsion of abscess contents in relation to their location with respect to umbilicus
  • Sadhyasadhyata (prognosis)
  • Sthana Vidradhi (Breast Abscess)
  • Vriddhi Nidana (prognosis of enlargement of scrotum)
  • Mutraja Vrddhi (hydrocele)
  • Antraja Vrddhi (hernia)
  • Gulma Nidana (prognosis of stomach tumors)
  • Vataja, Pittaja, Kaphaja and Raktaja Gulma
  • Distinction between Gulma and Vidradhi
  • Gulma situated inside and outside the alimentary tract
  • Anaha (bloating)
  • Asthila and Pratyathila
  • Tuni and Prathituni
  • Gulma Purvarupa (premonitory signs of tumors)

Pledge by the creator(s)

अथातो विद्रधिवृद्धिगुल्मनिदानं व्याख्यास्याम ।
इति ह स्माहुरात्रेयादयो महर्षय: ।
After having supplied prayers to the God, henceforth we’re going to clarify the chapter pertaining to the reason of ‘prognosis of abscess, hernia and stomach tumors’. Thus say (pledge) atreya and different sages.

Vidradhi Nidana and Samprapti (causes and pathogenesis of abscess)

भुक्तैः पर्युषितात्युष्णरूक्षशुष्कविदाहिभिः ।
जिह्मशय्याविचेष्टाभिस्तैस्तैश्चासृक्प्रदूषणैः ॥ १ ॥
दुष्टत्वङ्मांसमेदोऽस्थिस्नाय्वसृक्कण्डराश्रयः ।
यः शोफो बहिरन्तर्वा महामूलो महारुजः ॥ २ ॥
वृत्तः स्यादायतो यो वा स्मृतः षोढा स विद्रधिः ।
दोषैः पृथक्समुदितैः शोणितेन क्षतेन च ॥ ३ ॥
By indulgence in meals that are stale (saved in a single day), very popular, dry meals (with out moisture and fats), these inflicting burning sensation throughout digestion; mendacity on uneven mattress, improper motion of the physique components these (meals and actions) which trigger vitiation of blood; the Doshas getting aggravated trigger vitiation of the pores and skin, muscle, fats, bone, ligaments, blood and tendons and produce a swelling arising from them both exterior or inside (the physique) located deep inside accompanied with extreme ache; being both spherical or huge, this is named Vidradhi (abscess); it’s of six varieties; from every Dosha individually, from the mixture of all, from blood and from trauma.

Rupa (medical options)

बाह्योऽत्र तत्र तत्राङ्गे दारुणो ग्रथितोन्नतः ।
आन्तरो दारुणतरो गम्भीरो गुल्मवद्घनः ॥ ४ ॥
वल्मीकवत्समुच्छ्रायी शीघ्रघात्यग्निशस्त्रवत् ।
नाभिबस्तियकृत्प्लीहक्लोमहृत्कुक्षिवङ्क्षणे ॥ ५ ॥
स्याद्वृक्कयोरपाने च
The exterior one, happens right here and there (anyplace on the physique) tough to bear, exhausting and elevated; the interior one is harder to bear, deep seated, exhausting like a tumor, heavy, rising upwards like an anthill, causes fast demise like the hearth or weapon, manifests on (close to) the umbilicus, urinary bladder, liver, spleen, kloma (pancreas ) coronary heart, stomach (epigastrium), groins, kidneys and rectum.

Rupa (medical options)

Vataja Vidradhi: Medical options

वातात्तत्रातितीव्ररुक् ।
श्यावारुणश्चिरोत्थानपाको विषमसंस्थितिः ॥ ६ ॥
व्यधच्छेदभ्रमानाहस्पन्दसर्पणशब्दवान् ।
That arising from Vata has very extreme ache, brownish pink in shade, takes very long time to develop and suppurate; of irregular placement (uneven form), has pains similar to puncturing, excising, rotating ache, flatulent (as if crammed with air) throbbing; spreads to different components and produces sound.

Pittaja Vidradhi: Medical options

रक्तताम्रासितः पित्तात्तृण्मोहज्वरदाहवान् ॥ ७ ॥
क्षिप्रोत्थानप्रपाकश्च
That brought on by Pitta, is pink, coppery or black in shade ; produces thirst, delusion, fever and burning sensation, fast to develop and suppurate.

Kaphaja and Sannipataja Vidradhi: Medical options

पाण्डुः कण्डूयुतः कफात् ।
सोत्क्लेशशीतकस्तम्भजृम्भारोचकगौरवः ॥ ८ ॥
चिरोत्थानविपाकश्च सङ्कीर्णः सन्निपाततः ।
That brought on by Kapha is white, itching (irritating), accompanied with nausea, chilly, stiffness of the physique, extra yawning, lack of style and feeling of heaviness of the physique; gradual in progress and suppuration. All of the signs are current collectively, in that brought on by all of the Doshas.

Dedication of inner / exterior vidradhi

सामर्थ्याच्चात्र विभजेद्बाह्याभ्यन्तरलक्षणम् ॥ ९ ॥
Dedication whether or not it’s exterior or internalshould be made on capacity (severity) and relation with organs and so on. (of the signs)

Rakta Vidradhi Rupa (Medical options of abscess brought on by blood)

कृष्णस्फोटावृतः श्यावस्तीव्रदाहरुजाज्वरः ।
पित्तलिङ्गोऽसृजा बाह्यः स्त्रीणामेव तथान्तरः ॥ १० ॥
That brought on by blood is surrounded by black eruptions, brown in shade, accompanied with extreme burning sensation, ache and fever different signs of Pitta aggravation are seen in exterior Vidradhi. Inside Vidradhi is seen solely in girls (implying that it arises within the uterus).

Kshataja Vidradhi Rupa (Medical options of abscess brought on by trauma)

शस्त्राद्यैरभिघातेन क्षते वापथ्यकारिणः ।
क्षतोष्मा वायुविक्षिप्तः सरक्तं पित्तमीरयन् ॥ ११ ॥
पित्तासृग्लक्षणं कुर्याद्विद्रधिं भूर्युपद्रवम् ।
Vayu (Vata) getting aggravated by assault by weapons, and so on. by unsuitable meals and so on. and by displacing the warmth on the web site of trauma, results in the aggravation of Pitta and Rakta (blood) and offers rise to an abscess, presenting signs of Pitta and Rakta, producing extreme problems, secondary ailments.

Indicators of abscess as per its location

तेषूपद्रवभेदश्च स्मृतोऽधिष्ठानभेदतः ॥ १२ ॥
नाभ्यां हिध्मा भवेद्बस्तौ मूत्रं कृच्छ्रेण पूति च ।
श्वासो यकृति रोधस्तु प्लीह्न्युच्छ्वासस्य तृट् पुनः ॥ १३ ॥
गलग्रहश्च क्लोम्नि स्यात्सर्वाङ्गप्रग्रहो हृदि ।
प्रमोहस्तमकः कासो हृदये घट्टनं व्यथा ॥ १४ ॥
कुक्षिपार्श्वान्तरांसार्तिः कुक्षावाटोपजन्म च ।
सक्थ्नोर्ग्रहो वङ्क्षणयोर्वृक्कयोः कटिपृष्ठयोः ॥ १५ ॥
पार्श्वयोश्च व्यथा पायौ पवनस्य निरोधनम् ।
These problems relies upon upon the location (of the abscess and so on) similar to; hiccup if the abscess is close to the umbilicus; tough and foul smelling urine if the abscess is within the bladder; yspnoea, if within the liver; obstruction to expiration, if within the spleen; thirst and obstruction of the throat if within the Kloma (pancreas) catching ache (or rigidity) everywhere in the physique, profound delusion, darkness (unconsciousness), issue in respiration , friction and ache within the coronary heart manifest if the abscess is within the coronary heart; ache within the stomach (higher area), flanks and shoulders, gurgling noise within the epigastrium seem whether it is within the epigasrtium; stiffness of the thighs, whether it is within the groins; catching ache within the waist and again, ache within the flanks whether it is within the kidneys; obstruction of flatus whether it is within the rectum.

Expulsion of abscess contents in relation to their location with respect to umbilicus

आमपक्वविदग्धत्वं तेषां शोफवदादिशेत् ॥ १६ ॥
नाभेरूर्ध्वं मुखात्पक्वाः प्रस्रवन्त्यधरे गुदात् ।
गुदास्यान्नाभिजो विद्याद्दोषं क्लेदाच्च विद्रधौ ॥ १७ ॥
यथास्वं व्रणवत्
The unripe, Ripening and Ripened Phases are just like these of sopha (inflammatory edema). After ripening, the abscesses localized above the umbilicus expel their contents (pus, blood and so on) via the mouth, these localized beneath the umbilicus, although the rectum.These localized within the umbilicus expel their contents via each rectum and mouth. The options of the doshas and of the exudates in abscesses needs to be understood as just like these of an ulcer (natural ulcer and never traumatic wound).

Sadhyasadhyata (prognosis)

तत्र विवर्ज्यः सन्निपातजः ।
पक्वो हृन्नाभिबस्तिस्थो भिन्नोऽन्तर्बहिरेव वा ॥ १८ ॥
पक्वश्चान्तः स्रवन् वक्त्रात् क्षीणस्योपद्रवाऽन्वितः ।
These produced by all of the doshas collectively; these situated within the coronary heart, umbilicus and urinary bladder, which have burst after ripening both inside or exterior; these which have ripened / burst inside and have expelled their contents via their opening; these arising in debilitated individuals, these having problems/ secondary ailments needs to be rejected.

Sthana Vidradhi (Breast Abscess)

एवमेव स्तनसिरा विवृताः प्राप्य योषिताम् ॥ १९ ॥
सूतानां गर्भिणीनां वा सम्भवेच्छ्वयथुर्घनः ।
स्तने सदुग्धेऽदुग्धे वा बाह्यविद्रधिलक्षणः ॥ २० ॥
नाडीनां सूक्ष्मवक्त्रत्वात् कन्यानां न स जायते ।
In the identical method (the doshas) invading the open channels of the breasts in girls, in girls in publish partum interval or or pregnant produce a tough swelling within the breasts. Having the options of an exterior abscess; when the breasts are both having milk or not; that is Stana Vidradhi (breast abscess), it doesn’t occur in virgins (ladies who haven’t menstruated) as a result of the mouths of the breast channels are minute. Thus ends the prognosis of Vidradhi (abscess).

Vriddhi Nidana (Analysis of enlargement of scrotum)

क्रुद्धो रुद्धगतिर्वायुः शोफशूलकरश्चरन् ॥ २१ ॥
मुष्कौ वङ्क्षणतः प्राप्य फलकोशाभिवाहिनीः ।
प्रपीड्य धमनीर्वृद्धिं करोति फलकोशयोः ॥ २२ ॥
दोषास्रमेदोमूत्रान्त्रैः स वृद्धिः सप्तधा गदः ।
मूत्रान्त्रजावप्यनिलाद्धेतुभेदस्तु केवलम् ॥ २३ ॥
Vata getting aggravated from obstruction of its actions, begins to maneuver from the groins to the scrotum, producing swelling and ache, on reaching the vessels of the scrotum adopted by knocking down of the dhamani (blood vessels) going into vessels contained in the scrotum causes Vrddhi (enlargement) of the scrotum vriddhi is of seven kinds-viz from every of the dosha individually , by blood, by fats, by urine and by the intestines; these by urine and gut are (truly) brought on by vata itself however are designated in another way (to indicate the organs concerned).

Rupa (Medical options)

वातपूर्णदृतिस्पर्शो रूक्षो वातादहेतुरुक् ।
पक्वोदुम्बरसङ्काशः पित्ताद्दाहोष्मपाकवान् ॥ २४ ॥
कफाच्छीतो गुरुः स्निग्धः कण्डूमान् कठिनोऽल्परुक् ।
कृष्णस्फोटावृतः पित्तवृद्धिलिङ्गश्च रक्ततः ॥ २५ ॥
कफवन्मेदसा वृद्धिर्मृदुस्तालफलोपमः ।
In that (swelling of the scrotum) brought on by vata, the (scrotum) resembles a leather-based bag crammed with air for contact, is dry and painful with out another purpose in that brought on by pitta ( the scrotum) resembles a ripe fruits of udumbara (brownish pink in shade and small) and has burning sensation, warmth and suppuration; in Vruddhi brought on by kapha (the scrotum) is chilly, heavy, unctuous, itching, exhausting and with slight ache; in Vruddhi brought on by blood, scrotum is studded with black eruptions (boils) and has the signs of enhance of pitta; in that brought on by fats the swelling of scrotum is tender and resembles a ripe fruit of tala – Borassus flabellifer (blakish- blue) in shade and large in measurement and has signs of kapha swelling.

Mutraja Vrddhi (Hydrocele)

मूत्रधारणशीलस्य मूत्रजः स तु गच्छतः ॥ २६ ॥
अम्भोभिः पूर्णदृतिवत्क्षोभं याति सरुङ्मृदुः ।
मूत्रकृच्छ्रमधस्ताच्च वलयं फलकोशयोः ॥ २७ ॥
Vrddhi (scrotal enlargement) brought on by urine occurs in individuals who suppress the urge of urine habitually, the scrotum resembles a leather-based bag crammed with water,
producing irritation; is painful and tender, accompanied with tough urination and creating spherical rings beneath the scrotum.

Antraja Vrddhi (Hernia)

वातकोपिभिराहारैः शीततोयावगाहनैः ।
धारणेरणभाराध्वविषमाङ्गप्रवर्तनैः ॥ २८ ॥
क्षोभणैः क्षुभितोऽन्यैश्च क्षुद्रान्त्रावयवं यदा ।
पवनो विगुणीकृत्य स्वनिवेशादधो नयेत् ॥ २९ ॥
कुर्याद्वङ्क्षणसन्धिस्थो ग्रन्थ्याभं श्वयथुं तदा |
उपेक्ष्यमाणस्य च मुष्कवृद्धिमाध्मानरुक्स्तम्भवतीं स वायुः |
प्रपीडितोऽन्तः स्वनवान् प्रयाति प्रध्मापयन्नेति पुनश्च मुक्तः ॥ ३० ॥
By indulgence in meals which trigger enhance of vata, immersing the physique in chilly water, suppression or untimely initiation of the urges of the physique, carrying heavy hundreds, strolling lengthy distance, improper actions of the physique and such different acts, vata getting elevated, when pulls down the vitiated small gut from its place, then produces a tumor like swelling within the becoming a member of place of groin (inguinal hernia). By neglecting it, vata produces enlargement of the scrotum accompanied swelling (of the groin and of the scrotum), ache and stiffness, if pressed by the hand, it (gut) goes inside (the stomach)

accompanied with a sound and comes down once more (into the scrotum) when launched. This antravrddhi i.e. scrotal hernia is incurable It possesses signs just like scrotal enlargement brought on by vata,
Thus ends the prognosis of vrddhi (scrotal enlargement).

Notes: The time period ’vrddhi’ in its widespread use, earns a rise greater than the standard. It could after to quantity, qualities and so on, of drugs.

 Enhance within the measurement of the scrotum is called as vrddhi’ based mostly on this which means solely, however time period has someway gained a technical sense, to face for scrotal enlargement. Vrddhi can also be known as as Bradhna in mutraja vrddhi it’s not urine that collects within the scrotum however it’s a fluid secreted by the layers of the scrotum itself (hydrocele). Antraja vrddhi consists of each inguinal and scrotal hernia. Hernia happens on the umbilicus additionally particularly in weak youngsters (hiatus hernia)

अथ गुल्मनिदानम् ॥

Gulma Nidana (Analysis of stomach tumors)

रूक्षकृष्णारुणसिरातन्तुजालगवाक्षितः ।
गुल्मोऽष्टधा पृथग्दोषैः संसृष्टैर्निचयं गतैः ॥ ३२ ॥
आर्तवस्य च दोषेण नारीणां जायतेऽष्टमः ।
Coated with community of dry blackish pink threads of veins unfold throughout Gulma (tumors contained in the stomach) is of eight varieties viz, from every dosha individually, by the mixture of any two of them, by the mixture of all of them,the eighth in girls solely, as a result of issues of artava (menstrual blood).

Gulma Nidana (Causes of stomach tumors)

ज्वरच्छर्द्यतिसाराद्यैर्वमनाद्यैश्च कर्मभिः ॥ ३३ ॥
कर्शितो वातलान्यत्ति शीतं वाऽम्बु बुभुक्षितः ।
यः पिबत्यनु चान्नानि लङ्घनप्लवनादिकम् ॥ ३४ ॥
सेवते देहसङ्क्षोभिच्छर्दिं वा समुदीरयेत् ।
अनुदीर्णामुदीर्णान्वा वातादीन्न विमुञ्चति ॥ ३५ ॥
स्नेहस्वेदावनभ्यस्य शोधनं वा निषेवते ।
शुद्धो वाशु विदाहीनि भजते स्यन्दनानि वा ॥ ३६ ॥
वातोल्बणास्तस्य मलाः पृथक् क्रुद्धा द्विशोऽथवा ।
सर्वे वा रक्तयुक्ता वा महास्रोतोऽनुशायिनः ॥ ३७ ॥
ऊर्ध्वाधोमार्गमावृत्य कुर्वते शूलपूर्वकम् ।
स्पर्शोपलभ्यं गुल्माख्यमुत्प्लुतं ग्रन्थिरूपिणम् ॥ ३८ ॥
One that has turn into weak by fever, vomiting, diarrhea and so on. (different such debilitating ailments) or by therapies like emesis and so on, when individual eats meals which trigger enhance of vata, or drinks chilly water when hungry or take pleasure in leaping, swimming, and such different strenuous actions instantly after meals; or initiates the urge of vomiting which has not began or suppresses the urges of flatus and so on. that are manifest; who resorts to purifactory therapies (emesis, purgation and so on) with out oleation and sudation therapies or quickly after Panchakarma therapy, the individual begins to eat meals that trigger burning sensation or that causes extra secretions (moisture), instantly after purification therapies (with out following the weight-reduction plan schedule prescribed). By these causes, the malas (doshas) with the predominance of vata, bear will increase both individually, together of any two or all of the three Doshas collectively or get vitiated together with blood, invade the alimentary tract, unfold in each upward and downward paths, and provides rise to a palpable, elevated exhausting nodular mass, preceded by ache within the stomach; this is named Gulma – Stomach tumor.

Rupa (Medical options)

Vataja Gulma: Gulma of vata origin

कर्शनात् कफविट्पित्तैर्मार्गस्यावरणेन वा ।
वायुः कृताश्रयः कोष्ठे रौक्ष्यात्काठिन्यमागतः ॥ ३९ ॥
स्वतन्त्रः स्वाश्रये दुष्टः परतन्त्रः पराश्रये ।
पिण्डितत्वादमूर्तोऽपि मूर्तत्वमिव संश्रितः ॥ ४० ॥
गुल्म इत्युच्यते बस्तिनाभिहृत्पार्श्वसंश्रयः ।
वातान्मन्याशिरःशूलं ज्वरप्लीहान्त्रकूजनम् ॥ ४१ ॥
व्यधः सूच्येव विट्सङ्गः कृच्छ्रादुच्छ्वसनं मुहुः ।
स्तम्भो गात्रे मुखे शोषः कार्श्यं विषमवह्निता ॥ ४२ ॥
रूक्षकृष्णत्वगादित्वं चलत्वादनिलस्य च ।
अनिरूपितसंस्थानस्थानवृद्धिक्षयव्यथः ॥ ४३ ॥
पिपीलिकाव्याप्त इव गुल्मः स्फुरति तुद्यते ।
Both by weak point (as a result of loss or depletion of tissues) or by obstruction of its passage by kapha, vit (faeces) or pitta, vata will get aggravated, localized within the alimentary tract, as a result of dryness, turns into exhausting If the mass develops in its personal (of vata) seat, i.e. pakvasaya- massive gut, then the illness is major / impartial and if it develops within the seat of the opposite Doshas (pitta and kapha) then the illness is secondary / dependent. Although the mass isn’t having any form, nonetheless it’s thought-about to have a form due to aggregation at one place and forming a bolus / elevation. (aggregated at one place) forming an elevation. Therefore it’s known as gulma (tumor); it occupies the area of the urinary bladder, umbilicus, coronary heart and the flanks. Attributable to Vata Dosha. The gulma is related to ache within the sides of the neck, headache, fever enlargement of spleen gurgling sound within the intestines, ache as if being pricked by needles, constipation, frequent issue in respiration, rigidity of the physique, dryness of the mouth, emaciation, irregular digestion,due to unsteadiness of Vata, there can be dryness and black discoloration of pores and skin and so on. (nails, eyes, urine, faeces). The tumor mass is undefined in form, place, enhance or lower (in measurement) and nature of ache, there’s feeling as if (the tumor) is being swarmed by ants; throbbing and chopping ache

Pitta Gulma: Gulma of pitta origin

पित्ताद्दाहोऽम्लको मूर्छाविड्भेदस्वेदतृड्ज्वराः ॥ ४४ ॥
हारिद्रत्वं त्वगाद्येषु गुल्मश्च स्पर्शनासहः ।
दूयते दीप्यते सोष्मा स्वस्थानं दहतीव च ॥ ४५ ॥
In gulma of pitta origin, there’s (elevated) burning sensation, sourness (acidity), episodes of unconsciousness, Diarrhea, Sweating, thirst, fever, yellow discoloration of pores and skin and so on; the tumour space can be tender has burning sensation, hotness and elevated temperature as if burning its personal web site.

Kaphaja Gulma: Gulma of kapha origin

कफात्स्तैमित्यमरुचिः सदनं शिशिरज्वरः ।
पीनसालस्यहृल्लासकासशुक्लत्वगादिताः ॥ ४६ ॥
गुल्मोऽवगाढः कठिनो गुरुः सुप्तः स्थिरोऽल्परुक् ।
In gulma of kapha origin, there’s stiffness, anorexia, weak point, fever related to coldness, nasal catarrh, lassitude, nausea, cough, white discoloration of pores and skin, paleness and so on; the tumor is deep seated, exhausting, heavy, numb, lack of sensationstatic, secure and barely painful.

Traits of doshaja gulma

स्वदोषस्थानधामानः स्वे स्वे काले च रुक्कराः ॥ ४७ ॥
प्राय:
Tumors arising from every dosha are discovered to develop typically in their very own seats and produce ache at their on particular occasions

Traits of doshaja gulma

त्रयस्तु द्वन्द्वोत्था गुल्माः संसृष्टलक्षणाः ।
सर्वजस्तीव्ररुग्दाहः शीघ्रपाकी घनोन्नतः ॥ ४८ ॥
सोऽसाध्यो
The three sorts of gulma arising from the mixture of two doshas, have blended signs; Gulma arising from the mixture of all of the doshas has extreme ache, burning sensation suppurates quickly, exhausting and significantly elevated, that is incurable.

Rakta Gulma

रक्तगुल्मस्तु स्त्रिया एव प्रजायते ।
ऋतौ वा नवसूता वा यदि वा योनिरोगिणी ॥ ४९ ॥
सेवते वातलानि स्त्री क्रुद्धस्तस्याः समीरणः ।
निरुणद्ध्यार्तवं योन्यां प्रतिमासमवस्थितम् ॥ ५० ॥
कुक्षिं करोति तद्गर्भलिङ्गमाविष्करोति च ।
हृल्लासदौर्हृदस्तन्यदर्शनक्षामतादिकम् ॥ ५१ ॥
क्रमेण वायुसंसर्गात्पित्तयोनितया च तत् ।
शोणितं कुरुते तस्या वातपित्तोत्थगुल्मजान् ॥ ५२ ॥
रुक्स्तम्भदाहातीसारतृड्ज्वरादीनुपद्रवान् ।
गर्भाशये च सुतरां शूलं दुष्टासृगाश्रये ॥ ५३ ॥
योन्याश्च स्रावदौर्गन्ध्यतोदस्पन्दनवेदनाः ।
न चाङ्गैर्गर्भवद्गुल्मः स्फुरत्यपि तु शूलवान् ॥ ५४ ॥
पिण्डीभूतः स एवास्याः कदाचित्स्पन्दते चिरात्
न चास्या वर्धते कुक्षिर्गुल्म एव तु वर्धते ॥ ५५ ॥
Rakta Gulma – Stomach tumor arising from blood happens solely in girls. Ladies who throughout their menstrual interval, or quickly after supply or who’re having gynecological issues, take pleasure in meals and actions which worsen vata, in them Vata dosha will get aggravated, obstructs the artava (menstrual blood) popping out each month, throughout the yoni (uterus) and produces indicators and signs of being pregnant contained in the stomach, similar to nausea, longings which are widespread throughout being pregnant, look of breast milk, emaciation and so on., step by step the rakta (blood tissue) as a result of affiliation of Vata, and of pitta within the uterus, causes problems of vata-pittaja Gulma similar to ache, stiffness, burning sensation, diarrhea, thirst, fever and so on. extreme ache within the uterus by accumulation of vitiated blood, per vaginalexudation, foul odor, tearing and pulsating ache within the vagina. The tumor strikes contained in the uterus like a foetus, with out its components (head , legs and arms), such actions being painful, as a result of it’s a gathered mass; it generally pulsates slowly, there is no such thing as a progress of the stomach (steadily as in being pregnant). However there’s progress solely of the tumor.

Notes: Rakta gulma is in comparison with totally different sorts of tumor and cysts creating within the uterus, ovaries or fallopian tubes.

Distinction between Gulma and Vidradhi

स्वदोषसंश्रयो गुल्मः सर्वो भवति तेन सः ।
पाकं चिरेण भजते नैव वा विद्रधिः पुनः ॥ ५६ ॥
पच्यते शीघ्रमत्यर्थं दुष्टरक्ताश्रयत्वतः ।  
अतः शीघ्रविदाहित्वाद्विद्रधिः सोऽभिधीयते ॥ ५७ ॥
Gulma (tumors) have solely the causative dosha as their base and supporting materials and all gulmas are fashioned by these doshas, in order that they bear suppuration after a very long time, or by no means; whereas Vidhradhi (abscesses) undergoes suppuration shortly. As a result of their base (supporting materials) is the extremely vitiated blood. Due to their shortly suppuration, they’re known as as Vidradhi.

Gulma situated inside and outside the alimentary tract

गुल्मेऽन्तराश्रये बस्तिकुक्षिहृत्प्लीहवेदनाः ।
अग्निवर्णबलभ्रंशो वेगानां चाप्रवर्तनम् ॥ ५८ ॥
अतो विपर्ययो बाह्ये कोष्ठाङ्गेषु तु नातिरुक् ।
वैवर्ण्यमवकाशस्य बहिरुन्नतताधिकम् ॥ ५९ ॥
Gulma (tumors) located inside (the alimentary tract), produce ache within the areas of the urinary bladder, higher stomach (epigastric area), coronary heart and spleen; weak digestion energy, lack of shade, complexion and energy, non look of the urges (non elimination of urine, feces, flatus and so on); Gulma located exterior (the alimentary tract) and within the stomach organs, produce reverse signs similar to absence of extreme ache, discoloration, higher outward progress, occupying wider house. Thus ends Gulma nidana.

Anaha (Bloating)

साटोपमत्युग्ररुजमाध्मानमुदरे भृशम् ।
ऊर्ध्वाधोवातरोधेन तमानाहं प्रचक्षते ॥ ६० ॥
Extreme ache within the stomach accompanied with gurgling noise, and profound enlargement of the stomach, as a result of obstruction of the upward and downward motion of vata, it’s seen as Anaha – bloating (flatulence).

Asthila and Pratyathila

घनोऽष्ठीलोपमो ग्रन्थिरष्ठीलोर्ध्वं समुन्नतः ।
आनाहलिङ्गस्तिर्यक् तु प्रत्यष्ठीला तदाकृतिः ॥ ६१ ॥
A tough tumor resembling a cobblers stone, elevated upwards, presenting signs of anaha is named Asthila;if elevated sideward in identical form it’s pratyasthila.

Tuni and Prathituni

पक्वाशयाद्गुदोपस्थं वायुस्तीव्ररुजः प्रयान् ।
तूणी प्रतूणी तु भवेत्स एवातो विपर्यये ॥ ६२ ॥
Vata produces extreme ache, travelling from pakvasaya (massive occasion) to the Guda (rectum) and upastha (penis ) is named Tuni; travelling within the revere course (from rectum and penis) ache travelling to the massive gut is named pratituni.

Gulma Purvarupa (Premonitory signs of tumors)

उद्गारबाहुल्यपुरीषबन्धतृप्त्यक्षमत्वान्त्रविकूजनानि ।
आटोपमाध्मानमपक्तिशक्तिमासन्नगुल्मस्य वदन्ति चिह्नम् ॥ ६३ ॥
Extreme belching, obstructions to elimination of feces, constipation, pathological feeling of contentment, intolerance, intestinal gurgling, motion of gasoline contained in the intestines, flatulence, and poor digestion capability are the premonitory signs of gulma (stomach tumor).

इति श्री वैद्यपति सिंहगुप्तसूनु श्रीमद्वाग्भटविरचितायामष्टाङ्गहृदयसंहिताया तृतीये निदानस्थाने विद्रधिवृद्धिगुल्मनिदानं नामैकादशोऽध्याय: । ।।११॥
Thus ends the chapter Vidradhi – abscess-vrddhi-gulma nidana the eleventh in Nidanasthana of astangahrdaya samhita composed by srimad Vaghata, son of Sri Vaidyapati Simhaguta.



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