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Charak Samhita

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योज्यश्चाहारसंसर्गो भेषजैः कटुतिक्तकैः। सानाहं सविबन्धं च गुल्मं कठिनमुन्नतम् ॥५१॥

If the gulma is hard and protruded accompanied with constipation and distension of abdomen then physician should give sudation locally to dissolve it

english translation

दृष्ट्वाऽऽदौ स्वेदयेद्युक्त्या स्विन्नं च विलयेद्भिषक्। लङ्घनोल्लेखने स्वेदे कृतेऽग्नौ सम्प्रधुक्षिते ॥५२॥

After performing langhana, vamana and swedana therapies when digestion is improved, the patient of kapha gulma should be given ghee prepared with bitter substances and kshara (alkali preparation) at the proper time

english translation

कफगुल्मी पिबेत् काले सक्षारकटुकं घृतम्। स्थानादपसृतं ज्ञात्वा कफगुल्मं विरेचनैः ॥५३॥

By the above treatments when kapha gulma dislodges from its place, the patient should be given virechana for purification. Anuvasana basti with oil prepared with dashamula drugs can also be given for this purpose

english translation

सस्नेहैर्बस्तिभिर्वाऽपि शोधयेद्दाशमूलिकैः। मन्देऽग्नावनिले मूढे ज्ञात्वा सस्नेहमाशयम् ॥५४॥

In the condition when digestion is low and dysfunction of vata, after proper oleation of the affected site (ashaya), the drugs in the form of pills, powder or decoction are administered to the patient of kapha gulma

english translation

गुटिकाचूर्णनिर्यूहाः प्रयोज्याः कफगुल्मिनाम्। कृतमूलं महावास्तुं कठिनं स्तिमितं गुरुम् ॥५५॥

If kapha-gulma has a deep root and is large in size, hard in consistency and heavy, then the patient should be treated with alkali preparation-kshara, arishta and agni karma (cauterization)

english translation