Gulma- Abdominal Tumor- A Unique Disease In Ayurveda

Article by Prof. MS Krishnamurthy. MD (Ayu)., PhD.
We get the reference of various kinds of abdominal lumps with different names like cysts, tumour, herniation, fibroid, inflamed conditions, abscess etc. According to the site of manifestation and specific features they are termed Granthi, Arbuda, Vriddhi, Abhyantara Shopha, Vidradhi etc in Ayurvedic system of medicine.
Ayurveda refers one more specific kind of disease with the term – Gulma.
Ayurvedic scholars define it as the abdominal lump which is caused due to aggravation and encapsulation of Vata Dosha (kupita Anila moodhatwat) which does not give clue about its site of origin (Goodha Gulmodaya) which spreads widely like the shrubs (Gulmavat vishalatwaat). It is usually known as gaseous tumour of abdomen.

Causative factors

1. Excess intake of Vata aggravating foods (dry, light, rough, spicy)
2. Constipation or improper bowel habit
3. Suppression of natural urges
4. Pressure exerted by external causes like injury, hit, compression etc
5. Excess food intake
6. Grief / stress
7. Improperly carried Panchakarma treatment

Origin of the disease

The causative factors lead to severe aggravation of Vatadosha at the level of abdomen. This further vitiates Pitta and Kapha in the localized area and obstruct the passage of the channels. Due to the blockage of the morbid factor, they are stagnated and localized in abdominal organs like intestines, liver. According to the site and Dosha involvement, the features are exhibited. Usually, the condition is manifested in epigastrium, umbilicus, pelvic cavity and in lumbar/iliac regions.

Types

1. Vataja
2. Pittaja
3. Kaphaia
4. Tridoshic
5. Raktaja(in female, refers to uterine fibroids)

Stages of Gulma

1. Immature (recent onset) tumours:
Tumours are heavy, hard, situated beneath the muscles, without change or colour and fixed firmly.
2. Maturing tumours:
The Tumours are burning, painful, causing agony, loss of sleep, irritation, and fever.
3. Matured (suppurated) gaseous tumors:
The tumors are burning, bluish red in colour, palpable like bladder and severe painful in nature.

Specific features

1. Vatic Gulma

Obstruction of flatus, dryness of the throat and mouth, shivering, fever, pain in heart and abdominal sides, shoulder and head, aggravates on empty stomach and relieved on ingestion of food; the condition is worsened by dry-astringent-bitter and pungent substances.

2. Pittaja gulma

In the condition, fever, thirst, redness of the face, pain, sweating, burning and tenderness are complained by the patients.

3. Kaphaja gulma

This produces inertia, shivering, fever, body ache, nausea, cough, tastelessness, heaviness, and hard elevated non inflammatory masses.

4. Dwidoshaja and sannipataja

According to the dosha involvement mixed features are observed.

5. Raktaja gulma

Menstruating women indulging in fasting or using excess of dry food, facing the fearsome events, suppressing the natural urges, subjecting to therapies which arrest the free outgoing of blood and vomiting, suffering from uterine dysfunction etc, cause the vitiation of menstrual blood. This, in turn lead to the occurrence of Raktaja gulma (fibroid).
Here, pulsating tumour, gradually taking the shape of a round mass, with pain and producing the features or pregnancy (like amenorrhoea, pigmented nipples, morning sickness etc).
Often this produces this pain and burning sensation with the features of Pittaja Gulma.

Prognosis of Gulma

Tumor associated with the features of breathlessness, abdominal pain, thirst, anorexia, body ache, stiffness, and debility are critical; likewise, the tumor with the features of all the three Doshas is also incurable.

Management of Gulma (gaseous tumor)

All measures are undertaken to control Vata. To achieve this,
Snehana – oleation,
Swedana – sudation (sweating therapy),
Mild purgation,
Asthapana Basti – Decoction enema,
and sour mixed sweet eatables are recommended.

Single drugs recommended

1. Lashuna – garlic – Allium sativa Linn.
2. Hapusha – Juniperus communis Linn.
3. Hingu – asafetida – Ferula narthex Boiss.
4. Draksha – raisins – Vitis vinifera Linn.
5. Vacha – Acorus calamus Linn.
6. Eranda – castor- Ricinus communis Linn.
7. Ajamoda – Celery – Trachyspermum roxburghianum (DC.) Sprague.
8. Saindhava lavana – rock salt
9. Pippali-long pepper- Piper longum Linn.
10. Chavya- Piper chaba Hunter.
11. Danti – Baliospermum montanum (Willd.) Muell. Arg.
12. Haritaki – chebulic myrobalan – Terminalia chebula Retz.
13. Varuna – Crataeva nurvala Buch-Hem. etc

Ayurvedic medicines

1. Dashamoola kwatha
2. Hapushadi ghrita
3. Hingwadi choorna
4. Hingusauvarchala ghrita
5. Pippalyadi ghrita
6. Lashuna ksheerapaka
7. Shankha vati
8. Vaishwanara choorna
9. Agnimukha choorna
10. Dantiharitaki lehya
11. Chavikasava
12. Pravala Panchamrita rasa
13. Dashamoola ghrita
14. Varunadi kwatha
15. Kumaryasava
16. Ksheera Shatpala ghrita etc.

Wholesome diet and habits

1. Purana shali (old rice)
2. Kulattha (horse gram)
3. Jangala mamsa (desert animals)
4. Kooshmanada (ash gourd)
5. Amalaki (goose berry)
6. Dadima (pomegranate)
7. Eranda taila (castor oil)
8. Ardraka (ginger)
9. Jiraka (cumin seeds)
10. Hingu (asa foetida)
11. Deepana (easily digestible, carminative food) etc.

According to Yogaratnakara

One year old red rice, sugar candy, horse gram soup, soup of meat of animals living in desert areas, alcohol, goat milk, cow milk, raisins, falsa fruit, buttermilk, castor oil, garlic, tender radish, pattura vegetable, Mexican tea, drumstick, citron fruit, chebulic myrobalan and substances that help in downward movement of vata dosha.

Unwholesome food and habits

1. Guru ahara (heavy food)
2. Viruddha Ahara (incompatible food)
3. Vishama Ahara (improper food)
4. Shushka shaka (dry vegetable)
5. Shushka mamsa (dried meat)
6. Kanda moola (tubers and roots)
7. Matsya (fish)
8. Vegadharana (suppression of the urges) etc.

According to yogaratnakara

Black gram etc. pulses, barley etc. grains, dried meat, radish, fish, sweet fruits, suppressing the urges of flatus, feces, urine, deep breath after exercise and tears, emesis, excessive intake of water etc.

Gaseous tumor (Gulma) is a condition which is very difficult to equate any particular disease kind of modern medicinal system. Often this is found as a feature in so many acute and chronic diseased conditions. But it is commonly found in the patients who often indulge in unwholesome diet and take multiple medicaments or food varieties at a time. So, one should be careful while making the combination of medicines and food and beverages.

Addition By Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S

Effective Decoctions For Abdominal Tumors From Sahasrayogam

1. Gulmahara Kashayas

a. Dasamooladi Kashayam

Ref – Sahasrayogam, Kashaya Prakaranam, 43a

Ingredients	Botanical Name	Method of using	Indications
Dashamula	Ten roots	The decoction prepared with these ingredients should be served fresh	1. Gulma – abdominal tumors
Ginger	Zingiber officinale
Devadaru	Cedrus Deodara

Read – Kashayam (Kwath) – Herbal Teas Preparation [Video], Benefits, Usage

b. Chitrakadi Kashayam

Ref – Sahasrayogam, Kashaya Prakaranam, 43a

Ingredients	Botanical Name	Method of using	Indications
Chitraka	Plumbago zeylanica	The decoction prepared with these ingredients should be served fresh	1. Gulma – abdominal tumors
Pippali mula	Roots of Piper longum
Eranda	Ricinus communis
Ginger	Zingiber officinale

Read – 50 Great Decoctions Explained By Master Charaka – Maha Kashaya

c. Varshabvadi Kashayam

Ref – Sahasrayogam, Kashaya Prakaranam, 43b

Ingredients	Botanical Name	Method of using	Indications
Rakta Punarnava	Boerhavia diffusa, red variety	The decoction prepared with these ingredients should be served fresh with jaggery, rock salt, Piper longum and asafetida	1. Constipation 2. Indigestion 3. Severe pain in vagina 4. Pain in the cardiac region 5. Pain in flanks 6. Backache 7. Pelvic pain 8. Enlargement of prostate gland 9. Abdominal tumors 10. Enlargement of spleen
Bilwa	Aegle Marmelos
Horse gram	Dolichos biflorus
Castor	Ricinus communis
Sahachara	Strobilanthes heynianus
Ginger	Zingiber officinale
Agnimantha	Clerodendrum phlomidis

Read – Should Kashayams Be Given Necessarily Before Food?

d. Kanadi Kashayam

Ref – Sahasrayogam, Kashaya Prakaranam, 43c

Ingredients	Botanical Name	Method of using	Indications
Pippali	Piper longum	The decoction prepared with these ingredients should be served fresh with powder of asafetida	1. Abdominal tumor caused by vitiated blood
Shatahva	Anethum graveolens
Dwi Karanja	Pongamia pinnata & Caesalpinia crista
Devadaru	Cedrus deodara
Bharangi	Cerodendron serratum
Horse gram	Dolichos biflorus
Sesame	Sesamum indicum / sesame
Garlic	Allium sativum

Read – Sesame and Sesame Oil Benefits – Total Ayurveda Details

2. Vidaryadi Kashayam (Swasa-Kasahara Kashaya)– Read more here

3. Varunadi Gana Siddha Kashayam (Vidradhihara Kashayam)

Ref – Sahasrayogam, Kashaya Prakaranam, 41

Ingredients	Botanical Name	Method of using	Indications
Varuna	Crateva nurvula	The decoction prepared with these ingredients should be served fresh	1. Abdominal tumors 2. Kapha disorders 3. Cures indigestion, gout, headache, internal abscesses
Saireyaka yugma	Two types of Barleria prionitis
Shatavari	Asparagus racemosus
Chitraka	Plumbago zeylanica
Murva	Marsdenia tenacissima
Bilwa	Aegle marmelos
Karkatashringi	Pistacia chinensis
Brihati	Solanum indicum
Kantakari	Solanum xanthocarpum
Karanja	Pongamia pinnata
Chirabilva	Holoptelea integrifolia
Agnimantha	Clerodendrum phlomidis / Premna integrifolia
Haritaki	Terminalia chebula
Shigru	Moringa oleifera
Darbha	Desmostachya bipinnata
Rujakara	Barleria prionitis / Semicarpus anacardium /

Read – Ayurvedic Liquid Remedies In The Management of Shwasa, Dyspnoea

4. Chiruvilvadi Kashayam (Arshohara Kashaya)–Read more here

Ref – Sahasrayogam, Kashaya Prakaranam, 35b

Read – Chirabilva- Holoptelea integrifolia, Uses, Research, Remedies, Side Effects

5. Vidal Chitramooladi Kashayam

Ref – Sahasrayogam, Parishishta Prakaranam, 65

Ingredients	Botanical Name	Method of using	Indications
Roots of Vidanga	Embelia ribes	The decoction prepared with these ingredients should be served fresh with rock salt and asafetida	1. Cures abdominal tumors
Roots of Chitraka	Plumbago zeylanica
Ginger	Zingiber officinale
Sesame	Sesamum indicum
Bark of Palasha	Bark of Butea monosperma
Bark of Paribhadra	Bark of Erythrina indica

Read – Palasha – Butea monosperma Uses, Dose, Research

6. Plasintoladi Kashayam

Ref – Sahasrayogam, Parishishta Prakaranam, 69

Ingredients	Botanical Name	Method of using	Indications
Bark of Palasa	Butea monosperma – 24 grams	The decoction prepared with these ingredients should be served fresh with rock salt	1. Painful abdominal tumors (relieves pain) 2. Swelling
Punarnava	Boerhavia diffusa – 16 grams
Ginger	Zingiber officinale – 8 grams

Read – 10 Punarnava Remedies: Urinary Calculi, Pedal Edema, UTI

7. Pacchotri Kuvaladi Kashayam

Ref – Sahasrayogam, Parishishta Prakaranam, 70

Ingredients	Botanical Name	Method of using	Indications
Roots of Lodhra	Symplocos racemosa	The decoction prepared with these ingredients should be served fresh	1. Pain during menstruation 2. Abdominal tumors
Roots of Bilwa moola	Aegle marmelos
Licorice	Glycyrrhiza glabra
Bharangi	Clerodendron serratum
Sesame	Sesamum indicum

8. Trayantyadi Kashayam – Read more

Ref – Sahasrayogam, Parishishta Prakaranam, 111

Read – Daha Prashamana Gana – Burning Sensation Relieving Group Of Herbs

9. Pathyadi Kashayam (Mahodarahara Kashaya)

Ref – Sahasrayogam, Kashaya Prakaranam, 45

Ingredients	Botanical Name	Method of using	Indications
Haritaki	Terminalia chebula	The decoction prepared with these ingredients should be served fresh with alkali of barley and asafetida	1. Cures Abdominal tumors 2. Cures piles, enlargement of spleen, indigestion, enlargement of prostate, flatulence, colic caused by vata and kapha, ascites
Putikaranja	Pongamia pinnata / Holoptelea integrifolia
Ginger	Zingiber officinale
Chitraka	Plumbago zeylanica
Pippali	Piper longum
Roots of Pippali	Piper longum
Chavya	Piper retrofractum
Ajagandha	Cleome gynandra
Rakta Punarnava	Boerhavia diffusa, red variety
Bilwa	Aegle marmelos
Horse gram	Dolichos biflorus
Castor	Ricinus communis
Sahachara	Strobilanthes heynianus
Ginger	Zingiber officinale
Agnimantha	Clerodendrum phlomidis

Other Yogas from Sahasra Yoga Text Book
Gulmahara Kashaya
Swasakasahara Kashaya
Arsohara Kashaya
Tiktaka Ghrita
Mahatiktaka Ghrita
Panchatiktaka Guggulu Ghrita
Indukanta Ghrita
Sukumara Ghrita
Dathryadi Ghrita
Vrisha Ghrita
Dasanga Ghrita
Sasa vasadi Ghrita
Patha Karanjadi Ghrita
Dhanvantari Ghrita
Varunadi Ghrita
Kusmanda Ghrita
Mahakusmanda Ghrita
Dhanvantara Taila
Amrutottara Taila
Sahacharadi Taila
Ashta Choorna
Lavangadi Choorna
Maha Khandava Choorna
Trikatwadi Choorna
Naracha Choorna
Hapushadi Choorna
Nilini Choorna
Patoladi Choorna
Chukkilirattyadi Choorna
Trilavana pasugandhadi Choorna
Abhraka Gandhadi Choorna
Nimbadi Choorna
Hinguvachadi Choorna
Yogaraja Choorna
Guggulu Panchapala Choorna
Karpooradi Choorna
Bala soolari Choorna
Kukkuta Choorna
Kalyana Kshara
Vidangadi Kshara
Sudha Khandadi Kshara
Pippalyasava
Punarnavasava
Lohasava
Kumaryasava
Manibhadra Guda
Madhu snuhi Rasayana
Pulim Kuzhambu
Agasthya Rasayana
Danti Haritakyavaleha
Gandhaka Rasayana
Vyaghryadi Leha
Dasamoolahareetaki Lehya
Chitraka Guda
Gudardraka
Matala Rasayana (Dadima)
Kaisora Guggulu
Yogaraja Guggulu
Chandabhaskara Rasa
Neelakantha Rasa
Gulmakulantaka Rasa
Sankhapani Rasa
Marichadi Gutika
Anthrakuthara Rasa
Madhukadi Ghrita

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