The Diagnosis of Abscess and Abdominal Tumors (Vidradhi and Gulma)

Verse 1 (garuda.1.160.1)

धन्वन्तरिरुवाच । निदानं विद्रधेर्वक्ष्ये गुल्मस्य शृणु शुश्रुत । भुक्तैः पर्युषितात्युष्णशुष्करूक्षविदाहिभिः

dhanvantariruvāca nidānaṁ vidradhervakṣye gulmasya śṛṇu śuśruta bhuktaiḥ paryuṣitātyuṣṇaśuṣkarūkṣavidāhibhiḥ

Dhanvantari said: O Sushruta, I shall now declare the diagnosis of Vidradhi, deep abscess, and Gulma, abdominal tumor; listen. From eating stale, excessively hot, dry, rough, and burning food —

Verse 2 (garuda.1.160.2)

जिह्मशय्याविचेष्टाभिस्तैस्तैश्चासृक्प्रदूषणैः । दुष्टसत्वङ्मांसमेदोऽस्थिमदामृष्टोदराश्रयः

jihmaśayyāviceṣṭābhistaistaiścāsṛkpradūṣaṇaiḥ duṣṭasatvaṅmāṁsamedo'sthimadāmṛṣṭodarāśrayaḥ

from lying crookedly and improper movements, and from various forms of blood-corruption, a swelling lodges in the abdomen, having corrupted the skin, flesh, fat, bone, and marrow —

Verse 3 (garuda.1.160.3)

यः शोथो बहिरन्तश्च महाशूलो महारुजः । वृत्तः स्यादायतो यो वा स्मृतो रोगः स विद्रधिः

yaḥ śotho bahirantaśca mahāśūlo mahārujaḥ vṛttaḥ syādāyato yo vā smṛto rogaḥ sa vidradhiḥ

which, inside or outside, causes great pain and great agony, whether round or elongated in shape — this disease is called Vidradhi.

Verse 4 (garuda.1.160.4)

दोषैः पृथक्समुदितैः शोणितेन स्त्रतेन च । वहते तत्र तत्राङ्गे दारुणे ग्रथितोऽस्त्रुतः

doṣaiḥ pṛthaksamuditaiḥ śoṇitena stratena ca vahate tatra tatrāṅge dāruṇe grathito'strutaḥ

caused by the humors, separately or combined, and by extravasated blood, it spreads through the body's various parts, terrible, knotted, without discharge —

Verse 5 (garuda.1.160.5)

अन्तरा दारुणश्चैव गम्भीरो गुल्मवर्धनः । वल्मीकवत्समुत्स्त्रावी ह्यग्निमान्द्यञ्च जायते

antarā dāruṇaścaiva gambhīro gulmavardhanaḥ valmīkavatsamutstrāvī hyagnimāndyañca jāyate

internally too it is equally terrible and deep-seated, growing into a Gulma, a tumor; it discharges like an anthill, and weakness of the digestive fire also arises —

Verse 6 (garuda.1.160.6)

नाभिबस्तियकृत्प्लीहक्लोमहृत्कुक्षिवङ्क्षणि । हृदये वेपमाने तु तत्रतत्रातितीव्ररुक्

nābhibastiyakṛtplīhaklomahṛtkukṣivaṅkṣaṇi hṛdaye vepamāne tu tatratatrātitīvraruk

at the navel, bladder, liver, spleen, lungs, heart, flank, and groin, and, when the heart trembles, extremely intense pain occurs in each of these places —

Verse 7 (garuda.1.160.7)

श्यामारुणशिरोत्थानपाको विषमसंस्थितिः । संज्ञाच्छेदभ्रमानाहस्यन्दसर्पणशब्दवान्

śyāmāruṇaśirotthānapāko viṣamasaṁsthitiḥ saṁjñācchedabhramānāhasyandasarpaṇaśabdavān

a dark-reddish elevation forms and suppurates, irregular in position; there is loss of consciousness, a cutting sensation, giddiness, distension, and a sound as of flowing or spreading —

Verse 8 (garuda.1.160.8)

रक्तताम्रासितः पित्तात्तृण्मोहज्वरदाहवान् । क्षिप्तोत्थानप्रपाकश्च पाण्डुः कण्डूयुतः कफात्

raktatāmrāsitaḥ pittāttṛṇmohajvaradāhavān kṣiptotthānaprapākaśca pāṇḍuḥ kaṇḍūyutaḥ kaphāt

from Pitta, the color is reddish-copper-black, with thirst, confusion, fever, and burning; from Kapha, it rises suddenly and suppurates, pale in color and itchy —

Verse 9 (garuda.1.160.9)

संक्लेशशीतकस्तम्भजृम्भारोचकगौरवाः । चिरोत्थानोऽविपाकश्च संकीर्णः सन्निपातजः

saṁkleśaśītakastambhajṛmbhārocakagauravāḥ cirotthāno'vipākaśca saṁkīrṇaḥ sannipātajaḥ

with great distress, chills, stiffness, yawning, loss of appetite, and heaviness; slow to arise, with poor digestion, and mixed — this is the tridoshic type.

Verse 10 (garuda.1.160.10)

सामर्थ्याच्चात्र विड्भेदो बाह्याभ्यन्तरलक्षणम् । कृष्णस्फोटावृतश्यामस्तीव्रदाहरुजाज्वरः

sāmarthyāccātra viḍbhedo bāhyābhyantaralakṣaṇam kṛṣṇasphoṭāvṛtaśyāmastīvradāharujājvaraḥ

here, depending on the cause, diarrhea may also occur, along with external and internal signs; covered with black blisters, blackish, with intense burning, pain, and fever —

Verse 11 (garuda.1.160.11)

पित्तलिङ्गोऽसृजा बाह्ये स्त्रीणामेव तथान्तरम् । शस्त्राद्यैरभिघातोत्थरक्तैश्च रोगकारणम्

pittaliṅgo'sṛjā bāhye strīṇāmeva tathāntaram śastrādyairabhighātottharaktaiśca rogakāraṇam

showing the signs of Pitta and blood, this is the external type, while the internal type occurs only in women. This disease arises from injury by weapons and the like, and from the blood arising from such injury —

Verse 12 (garuda.1.160.12)

क्षतोत्थो वायुना क्षिप्तः स रक्तः पित्तमीरयन् । पित्तासृग्लक्षणं कुर्याद्विद्रधिं भूर्युपद्रवम्

kṣatottho vāyunā kṣiptaḥ sa raktaḥ pittamīrayan pittāsṛglakṣaṇaṁ kuryādvidradhiṁ bhūryupadravam

arising from injury and driven by Vata, that blood, stirring up Pitta, shows the signs of a blood-Pitta condition, producing Vidradhi with many complications.

Verse 13 (garuda.1.160.13)

तेनोपद्रवभेदश्च स्मृतोऽधिष्ठानभेदतः । नाभौ हि ध्मातं चेद्बस्तौ मूत्रकृच्छ्रञ्चजायते

tenopadravabhedaśca smṛto'dhiṣṭhānabhedataḥ nābhau hi dhmātaṁ cedbastau mūtrakṛcchrañcajāyate

the distinction of complications is likewise remembered according to the location's difference: if there is swelling at the navel, painful urination arises at the bladder —

Verse 14 (garuda.1.160.14)

श्वासप्रश्वासरोधश्च प्लीहायामतितृट्परम् । गलरोधश्च क्लोम्नि स्यात्सर्वाङ्गप्ररुजा हृदि

śvāsapraśvāsarodhaśca plīhāyāmatitṛṭparam galarodhaśca klomni syātsarvāṅgaprarujā hṛdi

if at the spleen, obstruction of inhalation and exhalation occurs, along with intense thirst; if in the lungs, obstruction of the throat; if in the heart, pain throughout all the limbs —

Verse 15 (garuda.1.160.15)

प्रमोहस्तमकः कासौ हृदयोद्धट्टनन्तथा । कुक्षिपार्श्वान्तरे चैव कुक्षौ दोषोपजन्म च

pramohastamakaḥ kāsau hṛdayoddhaṭṭanantathā kukṣipārśvāntare caiva kukṣau doṣopajanma ca

confusion, obstructed breathing, and cough, along with palpitation of the heart; between the flank and the side, and in the flank too, a further humor arises —

Verse 16 (garuda.1.160.16)

तथा चेदूरुसन्धौ च वङ्क्षणे कटिपृष्ठयोः । पार्श्वयोश्च व्यथा पायौ पवनस्य निरोधनम्

tathā cedūrusandhau ca vaṅkṣaṇe kaṭipṛṣṭhayoḥ pārśvayośca vyathā pāyau pavanasya nirodhanam

and likewise at the hip-joint, in the groin, in the waist and back, and in the sides there is pain, and at the anus, obstruction of wind —

Verse 17 (garuda.1.160.17)

आमपक्वविदग्धत्वं तेषां शोथवदादिशेत् । नाभेरूर्ध्वमुखात्पक्वात्प्रद्रवन्त्यपरे गुदात्

āmapakvavidagdhatvaṁ teṣāṁ śothavadādiśet nābherūrdhvamukhātpakvātpradravantyapare gudāt

one should recognize, as with swelling, the unripe, ripe, and over-ripe stages; those ripening upward from the navel discharge upward, others discharge through the anus —

Verse 18 (garuda.1.160.18)

गुदास्तनाभिजे विद्याद्दोषक्लेदोच्चविद्रधौ । कुरुते स्वाधिष्ठानस्य विवर्तं सन्निपातजः

gudāstanābhije vidyāddoṣakledoccavidradhau kurute svādhiṣṭhānasya vivartaṁ sannipātajaḥ

one should recognize that Vidradhi arising near the anus, breast, or navel has an excess of humor and moisture; the tridoshic type causes a transformation at its own location —

Verse 19 (garuda.1.160.19)

पक्वो हि नाभिवस्तिस्थो भिन्नोऽन्तर्बहिरेव वा । पाकश्चान्तः प्रवृद्धस्य क्षीणस्योपद्रवार्दितः

pakvo hi nābhivastistho bhinno'ntarbahireva vā pākaścāntaḥ pravṛddhasya kṣīṇasyopadravārditaḥ

the ripe Vidradhi located at the navel or bladder, once it ruptures, opens either internally or externally; and one whose vitality first increased and then diminished, afflicted with complications, suppurates internally —

Verse 20 (garuda.1.160.20)

विद्रधिश्च भवेत्तत्र पापानां पापयोषिताम् । मृते तु गर्भगे चैव सम्भवेच्छ्वयथर्घनः

vidradhiśca bhavettatra pāpānāṁ pāpayoṣitām mṛte tu garbhage caiva sambhavecchvayatharghanaḥ

Vidradhi can arise there in women of sinful, ill conduct; and when the fetus dies within the womb, a dense swelling can also arise —

Verse 21 (garuda.1.160.21)

स्तने समत्थे दुःखं वा बाह्यविद्रधिलक्षणम् । नारीणां सूक्ष्मरक्तत्वात्कन्यायान्तु न जायते

stane samatthe duḥkhaṁ vā bāhyavidradhilakṣaṇam nārīṇāṁ sūkṣmaraktatvātkanyāyāntu na jāyate

or it may similarly arise in the breast, causing pain — this is the sign of the external type. Because of the subtlety of an unmarried girl's blood, it does not arise in her —

Verse 22 (garuda.1.160.22)

क्रुद्धो रुद्धगतिर्वायुः शेफमूलकरो?हि सः । मुष्कवङ्क्षणतः प्राप्य फलकोषातिवाहिनीम्

kruddho ruddhagatirvāyuḥ śephamūlakaro?hi saḥ muṣkavaṅkṣaṇataḥ prāpya phalakoṣātivāhinīm

aggravated Vata, its movement obstructed, affects the root of the penis; passing through the testicles and groin, it enters excessively into the vessel of the scrotal sac —

Verse 23 (garuda.1.160.23)

आपीड्य धमनीवृद्धिं करोति फलकोषयोः । दोषो मेदःसु तत्रास्ते सवृद्धिः सप्तधा गदः

āpīḍya dhamanīvṛddhiṁ karoti phalakoṣayoḥ doṣo medaḥsu tatrāste savṛddhiḥ saptadhā gadaḥ

and, compressing it, causes enlargement of the vessels of the scrotal sac; there the vitiated humor lodges in the fat tissue — this swelling-disease is of seven kinds.

Verse 24 (garuda.1.160.24)

मूत्रन्तयोरप्यनिलाद्बाह्ये वाभ्यन्तरे तथा । वातपूर्णः खरस्पर्शो रूक्षो वाताच्च दाहकृत्

mūtrantayorapyanilādbāhye vābhyantare tathā vātapūrṇaḥ kharasparśo rūkṣo vātācca dāhakṛt

in the urinary passages too, from Vata, externally or internally; the Vata type is filled with wind, rough to the touch, dry, and produces burning —

Verse 25 (garuda.1.160.25)

पक्वोदुम्बरसङ्काशः पित्ताद्दाहोष्मपाकवान् । कफात्तीव्रो गुरुः स्निग्धः कण्डूमान्कठिनोऽल्परुक्

pakvodumbarasaṅkāśaḥ pittāddāhoṣmapākavān kaphāttīvro guruḥ snigdhaḥ kaṇḍūmānkaṭhino'lparuk

from Pitta it resembles a ripe fig, with burning heat and suppuration; from Kapha it is intense, heavy, unctuous, itchy, hard, and causes little pain —

Verse 26 (garuda.1.160.26)

कृष्णः स्फोटावृतः पिण्डों वृद्धिलिङ्गश्च रक्ततः । कफवन्मेदसां वृद्धिर्मृदुतालफलोपमः

kṛṣṇaḥ sphoṭāvṛtaḥ piṇḍoṁ vṛddhiliṅgaśca raktataḥ kaphavanmedasāṁ vṛddhirmṛdutālaphalopamaḥ

black, blister-covered, and lumpy — these are the signs of the blood-caused swelling; the fat-caused swelling, resembling Kapha, is soft like the fruit of the palm tree —

Verse 27 (garuda.1.160.27)

मूत्रधारणशीलस्य मूत्रजस्तत्र गच्छतः । अलोभः पूर्णधृतिमान्क्षोभं याति सरन्मृदु

mūtradhāraṇaśīlasya mūtrajastatra gacchataḥ alobhaḥ pūrṇadhṛtimānkṣobhaṁ yāti saranmṛdu

in one habituated to retaining urine, the urine-caused type arises while walking; in one free of desire and full of self-restraint, it becomes agitated and flows softly —

Verse 28 (garuda.1.160.28)

मूत्रकृच्छ्रमधस्ताच्च वलयः फलकोषयोः । वातकोपिभिसहारैः शीततोयावगाहनैः

mūtrakṛcchramadhastācca valayaḥ phalakoṣayoḥ vātakopibhisahāraiḥ śītatoyāvagāhanaiḥ

below there is painful urination and rings form around the scrotal sac. From Vata-aggravating foods, from bathing in cold water —

Verse 29 (garuda.1.160.29)

विण्मूत्रधारणाच्चैव विषमाङ्गविचेष्टनैः । क्षोभितैः क्षोभितौजाश्च क्षीणान्तर्देहिनो यदा

viṇmūtradhāraṇāccaiva viṣamāṅgaviceṣṭanaiḥ kṣobhitaiḥ kṣobhitaujāśca kṣīṇāntardehino yadā

from suppressing stool and urine, and from irregular bodily movements, when the vital energy, thus disturbed, becomes agitated in one whose inner body has grown weak —

Verse 30 (garuda.1.160.30)

पवनो विगुणीभूय शोणितं तदधोनयेत् । कुर्यात्तत्क्षणसन्धिस्थो ग्रन्थ्याभः श्वयथुस्तदा

pavano viguṇībhūya śoṇitaṁ tadadhonayet kuryāttatkṣaṇasandhistho granthyābhaḥ śvayathustadā

then the deranged Vata draws the blood downward; at that moment a knot-like swelling forms at the nearby joint —

Verse 31 (garuda.1.160.31)

उपेक्ष्यमाणस्य च गुल्मवृद्धिमाध्मानरुग्वै विविधाश्च रोगाः । सुपीडितोऽन्तः स्वनवान् प्रयाति प्रध्मापयन्नेति पुनश्च मूर्ध्नि

upekṣyamāṇasya ca gulmavṛddhimādhmānarugvai vividhāśca rogāḥ supīḍito'ntaḥ svanavān prayāti pradhmāpayanneti punaśca mūrdhni

if neglected, the Gulma grows further, with distension, pain, and various diseases; greatly compressed within, making a sound, it moves about, causing more distension, and again rises upward.

Verse 32 (garuda.1.160.32)

रक्तवृद्धिरसाध्येऽयं वातवृद्धिसमाकृतिः । रूक्षकृष्णारुणशिरा ऊर्णावृतगवाक्षवत्

raktavṛddhirasādhye'yaṁ vātavṛddhisamākṛtiḥ rūkṣakṛṣṇāruṇaśirā ūrṇāvṛtagavākṣavat

this incurable blood-caused swelling resembles the Vata-caused swelling in appearance — its veins dry, dark-reddish, as if wool were wrapped over a lattice window —

Verse 33 (garuda.1.160.33)

वातोऽष्टधा पृथदौषैः संस्पृष्टैर्निचयं गतः । आर्तवस्य च दोषेण नारीणां जायतेऽष्टमः

vāto'ṣṭadhā pṛthadauṣaiḥ saṁspṛṣṭairnicayaṁ gataḥ ārtavasya ca doṣeṇa nārīṇāṁ jāyate'ṣṭamaḥ

Vata, combined with the other separate humors when accumulated, produces eight kinds; and, through disorder of the menstrual flow, an eighth type arises in women.

Verse 34 (garuda.1.160.34)

ज्वरमूर्छातिसारैश्च वमनाद्यैश्च कर्मभिः । कर्शितो बलवान्याति शीतार्तश्च बुभुक्षितः

jvaramūrchātisāraiśca vamanādyaiśca karmabhiḥ karśito balavānyāti śītārtaśca bubhukṣitaḥ

one made weak by fever, fainting, diarrhea, and vomiting and similar procedures, then, afflicted by cold and hunger, eats forcefully —

Verse 35 (garuda.1.160.35)

यः पिबत्यन्नपानानि लङ्घनप्लावनादिकम् । सेवते हीनसंज्ञाभिरर्दितः समुदीरयन्

yaḥ pibatyannapānāni laṅghanaplāvanādikam sevate hīnasaṁjñābhirarditaḥ samudīrayan

one who drinks food and drink improperly, and undertakes fasting, bathing, and the like; afflicted, with impaired awareness, worsens his own condition —

Verse 36 (garuda.1.160.36)

स्नेहस्वेदावनभ्यस्य शोषणं वा निषेवयेत् । शुद्धो वा सुद्धिहानिर्वा भजेत स्पन्दनानि वा

snehasvedāvanabhyasya śoṣaṇaṁ vā niṣevayet śuddho vā suddhihānirvā bhajeta spandanāni vā

one who resorts to drying treatments without first properly undergoing oleation and sudation; or, whether purified or having failed to be purified, experiences throbbing sensations —

Verse 37 (garuda.1.160.37)

वातोल्बणास्तस्य मलाः पृथक्चैव हि तेऽथवा । सर्वो रक्तयुतो वाताद्देहस्नोतोऽनुसारिणः

vātolbaṇāstasya malāḥ pṛthakcaiva hi te'thavā sarvo raktayuto vātāddehasnoto'nusāriṇaḥ

in such a person, the excretions become predominantly Vata-aggravated, whether separately or combined; all, mixed with blood through Vata, follow along the body's channels —

Verse 38 (garuda.1.160.38)

ऊर्ध्वाधोमार्गमावृत्य वायुः शूलं करोति वै । स्पर्शोपलभ्यं गुल्मोत्थमुष्णं ग्रन्थिस्वरूपिणम्

ūrdhvādhomārgamāvṛtya vāyuḥ śūlaṁ karoti vai sparśopalabhyaṁ gulmotthamuṣṇaṁ granthisvarūpiṇam

obstructing the upward and downward passages, Vata produces cramping pain; a knot-shaped Gulma arises, perceptible to touch, warm —

Verse 39 (garuda.1.160.39)

कर्षणात्कफविड्घातैर्मार्गस्यावरणेन वा । वायुः कृताश्रयः कोष्ठे रौक्ष्यात्काठिन्यमागतः

karṣaṇātkaphaviḍghātairmārgasyāvaraṇena vā vāyuḥ kṛtāśrayaḥ koṣṭhe raukṣyātkāṭhinyamāgataḥ

from wasting, from obstruction by kapha and stool, or from blockage of the passage; Vata, taking up residence in the abdomen, becomes hardened through dryness —

Verse 40 (garuda.1.160.40)

स्वतन्त्रः स्वाश्रये दुष्टः परतन्त्रः पराश्रये । ततः पिण्डकवच्छ्लेष्मा मलसंसृष्ट एव च

svatantraḥ svāśraye duṣṭaḥ paratantraḥ parāśraye tataḥ piṇḍakavacchleṣmā malasaṁsṛṣṭa eva ca

independent when vitiated in its own site, dependent when in another's site; then kapha, mixed with waste-matter, becomes lump-shaped —

Verse 41 (garuda.1.160.41)

गुलम इत्युच्यते बस्तिनाभिहृत्पार्श्वसंश्रयः । वातजन्ये शिरः शूलज्वर प्लीहान्त्रकूजनम्

gulama ityucyate bastinābhihṛtpārśvasaṁśrayaḥ vātajanye śiraḥ śūlajvara plīhāntrakūjanam

and this is called Gulma, located in the bladder, navel, heart, or side. In the Vata-caused type: headache, fever, an enlarged spleen, and rumbling of the intestines —

Verse 42 (garuda.1.160.42)

वेधः सूच्येव विड्भ्रंशः कृच्छ्रे मूत्रं प्रवर्तते । गात्रे मुखे पदे शोथः ह्यग्निमान्द्यं तथैव च

vedhaḥ sūcyeva viḍbhraṁśaḥ kṛcchre mūtraṁ pravartate gātre mukhe pade śothaḥ hyagnimāndyaṁ tathaiva ca

pain as if pierced by a needle, loose stools, and painful urination occur; there is swelling of the body, face, and feet, and likewise weakness of digestion —

Verse 43 (garuda.1.160.43)

रूक्षकृष्णत्वगादित्वं चलत्वादनिलस्यच । अनिरूपितसंस्थानो विविधाञ्जनयेद्व्यथाम्

rūkṣakṛṣṇatvagāditvaṁ calatvādanilasyaca anirūpitasaṁsthāno vividhāñjanayedvyathām

dry, dark skin and the like; and because of Vata's mobility, its shape remains unfixed, producing various kinds of pain —

Verse 44 (garuda.1.160.44)

पिपीलिकाव्याप्त इव गुल्मः स्फुरति नुद्यते । पित्ताद्दाहाम्लकौ मूर्छा विड्भेदः स्वेदतृड्ज्वराः

pipīlikāvyāpta iva gulmaḥ sphurati nudyate pittāddāhāmlakau mūrchā viḍbhedaḥ svedatṛḍjvarāḥ

the Gulma throbs and shifts as if crawling with ants. In the Pitta-caused type: burning and acidity, fainting, diarrhea, sweating, thirst, and fever —

Verse 45 (garuda.1.160.45)

हारिद्रयं सर्वगात्रेषु गुल्माच्छोथस्य दर्शनम् । हीयते दीप्यते श्लेष्मा स्वस्थानं दहतीवच

hāridrayaṁ sarvagātreṣu gulmācchothasya darśanam hīyate dīpyate śleṣmā svasthānaṁ dahatīvaca

a yellow tinge appears throughout the body, and the swelling of the Gulma becomes visible; kapha diminishes as if the fire begins to blaze, seeming to burn its own seat —

Verse 46 (garuda.1.160.46)

कफात्स्तैमित्यमरुचिः सदनं शिरसि ज्वरः । पीनसालस्यहृल्लासौ शुक्लकृष्णत्वगादिता

kaphātstaimityamaruciḥ sadanaṁ śirasi jvaraḥ pīnasālasyahṛllāsau śuklakṛṣṇatvagāditā

in the Kapha-caused type there is heaviness, loss of appetite, weakness, fever in the head, catarrh, lassitude, and nausea; the skin turns whitish-dark —

Verse 47 (garuda.1.160.47)

गुल्मो गभीरः कठिनो गुरुर्गर्भस्थबालवत् । स्वस्थानस्था अधावन्तस्तत एवात्र मारकाः

gulmo gabhīraḥ kaṭhino gururgarbhasthabālavat svasthānasthā adhāvantastata evātra mārakāḥ

the Gulma is deep-seated, hard, and heavy, like a child within the womb; those types that remain fixed in their own place, not spreading, are for that very reason the most fatal.

Verse 48 (garuda.1.160.48)

प्रायस्तु यत्तद्द्वन्द्वोत्था गुल्माः संसृष्टमैथुनाः । सर्वजस्तीव्ररुग्दाहः शीघ्रपाकी घनोन्नतः

prāyastu yattaddvandvotthā gulmāḥ saṁsṛṣṭamaithunāḥ sarvajastīvrarugdāhaḥ śīghrapākī ghanonnataḥ

for the most part, Gulmas arising from two combined humors are usually associated with sexual intercourse. The tridoshic Gulma causes intense pain and burning, ripens quickly, and is dense and raised —

Verse 49 (garuda.1.160.49)

सोऽसाध्यो रक्तगुल्मस्तु स्त्रिया एव प्रजायते । ऋतौ या चैव शूलार्ता यति वा योनिरोगिणी

so'sādhyo raktagulmastu striyā eva prajāyate ṛtau yā caiva śūlārtā yati vā yonirogiṇī

this is incurable. Raktagulma, the blood-tumor, arises only in a woman — one who, during her menstrual period, is afflicted with cramping pain, or who suffers from a genital disorder —

Verse 50 (garuda.1.160.50)

सेवते वानिलांश्च स्त्री क्रुद्धस्तस्याः समीरणः । निरुध्यात्यार्तवं योन्यां प्रतिमासं व्यवस्थितम्

sevate vānilāṁśca strī kruddhastasyāḥ samīraṇaḥ nirudhyātyārtavaṁ yonyāṁ pratimāsaṁ vyavasthitam

or who indulges in Vata-aggravating conduct — her aggravated Vata then obstructs the menstrual flow that is normally regular each month in the womb —

Verse 51 (garuda.1.160.51)

सुक्षौ करोति तद्गर्भे लिङ्गमाविष्करोति च । हृल्लासदौहृदस्तन्यदर्शनं कामचारिता

sukṣau karoti tadgarbhe liṅgamāviṣkaroti ca hṛllāsadauhṛdastanyadarśanaṁ kāmacāritā

it produces something resembling a womb-mass, and manifests its false signs — nausea, pregnancy-like cravings, the appearance of breast-milk, and capricious desires —

Verse 52 (garuda.1.160.52)

क्रमेण वायोः संसर्गात्पित्तं योनिषु सञ्चयम् । रक्तस्य कुरुते तस्या वातपित्तोक्तगुल्मजान्

krameṇa vāyoḥ saṁsargātpittaṁ yoniṣu sañcayam raktasya kurute tasyā vātapittoktagulmajān

gradually, through Vata's influence, Pitta accumulates in the womb, and, combining with blood, produces in her the previously described signs of Vata-Pitta Gulma —

Verse 53 (garuda.1.160.53)

गर्भाशये च सुतरां शूलांश्चैवासृगाश्रये । योनिस्त्रावश्च दौर्गन्ध्यं भूयः स्यन्दनवेदने

garbhāśaye ca sutarāṁ śūlāṁścaivāsṛgāśraye yonistrāvaśca daurgandhyaṁ bhūyaḥ syandanavedane

especially severe cramping pain in the womb, and in the blood's seat as well; vaginal discharge, foul odor, and again a sensation of flowing pain occur —

Verse 54 (garuda.1.160.54)

कदापि गर्भवद्गुल्मः सर्वे ते रतिसम्भवाः । पाकञ्चिरेण भजते नैधते विद्रधिः पुनः

kadāpi garbhavadgulmaḥ sarve te ratisambhavāḥ pākañcireṇa bhajate naidhate vidradhiḥ punaḥ

sometimes the Gulma resembles a pregnancy; all these arise from excessive sexual activity. It ripens only slowly, whereas Vidradhi, unlike it, does not linger —

Verse 55 (garuda.1.160.55)

पच्यते शीघ्रमत्यर्थं दुष्टरक्ताश्रयस्तु सः । अतः शीघ्रं विदाहित्वाद्वद्रधिः सोऽभीधीयते

pacyate śīghramatyarthaṁ duṣṭaraktāśrayastu saḥ ataḥ śīghraṁ vidāhitvādvadradhiḥ so'bhīdhīyate

being lodged in vitiated blood, it ripens very quickly; because of this rapid suppuration, it is called Vidradhi.

Verse 56 (garuda.1.160.56)

गुल्मान्तारश्रये बस्तिदाहश्च प्लीहवेदना । अग्निवर्णबलभ्रंशो वेगानां वा प्रवर्तनम्

gulmāntāraśraye bastidāhaśca plīhavedanā agnivarṇabalabhraṁśo vegānāṁ vā pravartanam

when Gulma is located internally, there is burning in the bladder and pain in the spleen; digestive fire, complexion, and strength decline, or the natural urges become disturbed —

Verse 57 (garuda.1.160.57)

अतो विपर्यये बाह्यकोष्ठाङ्गेषु च नातिरुक् । वैवर्ण्यमथ वा कासो बहिरुन्नतताधिकम्

ato viparyaye bāhyakoṣṭhāṅgeṣu ca nātiruk vaivarṇyamatha vā kāso bahirunnatatādhikam

conversely, in the external type, there is not much pain in the abdomen and limbs; there may be discoloration or cough, along with a more pronounced external protrusion —

Verse 58 (garuda.1.160.58)

साटोपमत्युग्ररुजमाध्मानमुदरे भृशम् । ऊर्ध्वाधो वातरोधेन तमानाहं प्रचक्षते

sāṭopamatyugrarujamādhmānamudare bhṛśam ūrdhvādho vātarodhena tamānāhaṁ pracakṣate

with rumbling and extremely severe pain, and intense distension of the abdomen, caused by obstruction of Vata both upward and downward — this they call Anaha.

Verse 59 (garuda.1.160.59)

धनश्चाष्ठ्युपमो ग्रन्थिलोऽष्ठीलातु समुन्नता । समस्तालिङ्गसंयुक्तः प्रत्यष्ठीला तदाकृतिः

dhanaścāṣṭhyupamo granthilo'ṣṭhīlātu samunnatā samastāliṅgasaṁyuktaḥ pratyaṣṭhīlā tadākṛtiḥ

the dense, knotted, raised mass resembling a stone is called Ashthila; when combined with all the signs together and of similar shape, it is called Pratyashthila —

Verse 60 (garuda.1.160.60)

पक्वशयोद्भवोऽप्येवं वायुस्तीव्ररुजाश्रयात् । उद्गारबाहुल्यपुरीषबन्धतृप्त्यक्षमत्वान्त्रविकूजनानि

pakvaśayodbhavo'pyevaṁ vāyustīvrarujāśrayāt udgārabāhulyapurīṣabandhatṛptyakṣamatvāntravikūjanāni

similarly arising from the stomach, through severe pain-causing Vata; frequent belching, retention of stool, intolerance of satiety, and rumbling of the intestines —

Verse 61 (garuda.1.160.61)

आचोपमाध्मानमपक्तिशक्तिः आसन्नगुल्मस्य भवेच्च चिह्नम्

ācopamādhmānamapaktiśaktiḥ āsannagulmasya bhavecca cihnam

and rumbling-like distension along with an inability to digest — these are the signs indicating that Gulma is imminent.