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निमित्तलिङ्गान्युपलभ्य गुल्मे द्विदोषजे दोषबलाबलं च। व्यामिश्रलिङ्गानपरांस्तु गुल्मांस्त्रीनादिशेदौषधकल्पनार्थम् ॥१६॥
[Dvi-doshaja gulma] Three types of dvi-doshaja gulma (vata-pitta, vata-kapha and kapha-pitta) are produced by the mixture of causative factors of two involved dosha. These gulma manifest the signs and symptoms of two involved dosha. These varieties are mentioned here for the purpose of the treatment which can be planned on the basis of degree of provocation of each dosha
english translation
महारुजं दाहपरीतमश्मवद्घनोन्नतं शीघ्रविदाहि दारुणम्। मनःशरीराग्निबलापहारिणं त्रिदोषजं गुल्ममसाध्यमादिशेत् ॥१७॥
[Signs and symptoms of tri-doshaja gulma] The symptoms of tri-dosha gulma include agonizing pain and excessive burning sensation, elevated mass, stony hard and quick to mutilate. It is a very serious condition and leads to diminution of strength of body, mind and digestion. It is incurable
english translation
ऋतावनाहारतया भयेन विरूक्षणैर्वेगविनिग्रहैश्च। संस्तम्भनोल्लेखनयोनिदोषैर्गुल्मः स्त्रियं रक्तभवोऽभ्युपैति ॥१८॥
[Causative factors of rakta gulma] During ritu-kala (ovulation period) if a woman does fasting or takes dry food articles or indulges in fear and suppression of natural urges; or misuses styptic (stambhana) drugs i.e. try to stop the menstrual bleeding; improper conduction of vomiting therapy and disorders of genital organs, all these may lead to formation of rakta gulma in women
english translation
यः स्पन्दते पिण्डित एव नाङ्गैश्चिरात् सशूलः समगर्भलिङ्गः। स रौधिरः स्त्रीभव एव गुल्मो मासे व्यतीते दशमे चिकित्स्यः ॥१९॥
[Symptoms of rakta gulma] The lump slowly grows in the form of round mass which has pulsation as a whole but not in its part. It is associated with acute pain and signs and symptoms mimicking pregnancy. Raktaja gulma occurs only in women and should be treated after the completion of ten months
english translation
क्रियाक्रममतः सिद्धं गुल्मिनां गुल्मनाशनम्। प्रवक्ष्याम्यत ऊर्ध्वं च योगान् गुल्मनिबर्हणान् ॥२०॥
Now onward first the successful line of treatment shall be described for the cure of gulma. Thereafter, the remedies and recipes for its cure shall be described
english translation