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Charak Samhita

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स प्रकुपितो वायुर्महास्रोतोऽनुप्रविश्य रौक्ष्यात् कठिनीभूतमाप्लुत्य पिण्डितोऽवस्थानं करोति हृदि बस्तौ पार्श्वयोर्नाभ्यां वा; स शूलमुपजनयति ग्रन्थींश्चानेकविधान्, पिण्डितश्चावतिष्ठते, स पिण्डितत्वाद् ‘गुल्म’ इत्यभिधीयते; स मुहुराधमति मुहुरल्पत्वमापद्यते; अनियतविपुलाणुवेदनश्च भवति चलत्वाद्वायोः, मुहुः पिपीलिकासम्प्रचार इवाङ्गेषु, तोदभेदस्फुरणायामसङ्कोचसुप्तिहर्षप्रलयोदयबहुलः; तदातुरः सूच्येव शङ्कुनेव चाभिसंविद्धमात्मानं मन्यते, अपि च दिवसान्ते ज्वर्यते शुष्यति चास्यास्यम्, उच्छ्वासश्चोपरुध्यते, हृष्यन्ति चास्य रोमाणि वेदनायाः प्रादुर्भावे;प्लीहाटोपान्त्रकूजनाविपाकोदावर्ताङ्गमर्दमन्याशिरःशङ्खशूलब्रध्नरोगाश्चैनमुपद्रवन्ति; कृष्णारुणपरुषत्वङ्नखनयनवदनमूत्रपुरीषश्च भवति, निदानोक्तानि चास्य नोपशेरते, विपरीतानि चोपशेरत इति वातगुल्मः ॥७॥

Such vitiated vata, on entering the mahasrotas, hardens due to dryness forming a mass or swelling localised in the regions of heart, urinary bladder, sides and the navel. The condition, gulma (or vata gulma), is painful and can take the shape of a single swelling or multiple nodules of various types. It sometimes gets aggravated and enlarged, sometimes diminished, and causes mild or severe pain due to instability of vayu. Sometimes there are tingling sensations like ants crawling on body and frequent onset and diminution of various types of painful sensations such as piercing, breaking, twitching, extension, contraction, numbness, hyperaesthesia, etc. These sensations could be accompanied by a rise in temperature usually in the evenings, dryness of mouth, difficulty in expiration, horripilation at the onset of pain and complications such as spleen (enlargement), distension and gurgling sound in the abdomen, indigestion, udavarta (upward movement of vata), bodyache, pain in the lateral side of the neck, head and temple regions and bradhana (swellings of the inguinal region) with appearance of blackness, reddishness and roughness in skin, nails, eyes, face, urine and feces. The disease aggravates due to these etiological factors and pacifies due to opposite factors. These are characteristic features of vata gulma.

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