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तृष्णाज्वरपरीदाहशूलस्वेदाग्निमार्दवे। गुल्मिनामरुचौ चापि रक्तमेवावसेचयेत् ॥३६॥
[Blood-letting in pitta dominant gulma] The patient of pitta-gulma if having thirst, fever, burning sensation, pain, perspiration, impaired digestion and anorexia is treated with bloodletting
english translation
छिन्नमूला विदह्यन्ते न गुल्मा यान्ति च क्षयम्। रक्तं हि व्यम्लतां याति, तच्च नास्ति न चास्ति रुक् ॥३७॥
Provoked rakta is responsible for inflammation (vidaha) which is removed by bloodletting; thus when root-cause is removed then there will be no inflammation resulting in vanishing of swelling and pain
english translation
हृतदोषं परिम्लानं जाङ्गलैस्तर्पितं रसैः। समाश्वस्तं सशेषार्तिं सर्पिरभ्यासयेत् पुनः ॥३८॥
[Diet after blood-letting] The patient may become weak due to elimination of vitiated blood; hence he should be nourished by the diet comprising of meat soup of wild animals and comforted. To pacify the remaining complaints, he should be prescribed the medicated ghee again
english translation
रक्तपित्तातिवृद्धत्वात् क्रियामनुपलभ्य च। यदि गुल्मो विदह्येत शस्त्रं तत्र भिषग्जितम् ॥३९।
In case of excessive increase of pitta and rakta or due to unavailability of proper treatment, if suppuration occurs then surgery should be performed by the surgeon
english translation
गुरुः कठिनसंस्थानो गूढमांसान्तराश्रयः। अविवर्णः स्थिरश्चैव ह्यपक्वो गुल्म उच्यते ॥४०॥
[Apakva gulma (intial non-suppurative stage)] Immovable lump of gulma which is deeply situated under the flesh and hard and heavy to palpate and whose color remains unchanged is considered as apakva i.e. non-suppurative
english translation