Chapter 6.5: Abdominal Lump Treatment (Gulma Chikitsa / गुल्मचिकित्सा)
Management of five types of intra-abdominal swellings occurring between the cardiac and bladder regions, with detailed treatment protocols for each dosha type including medicated ghees, powders, surgical intervention, and dietary management.
Source: Astanga Hridaya Sutrasthan by Vagbhata
Chapter 5 covers the management of gulma — large abdominal swellings between the heart and bladder. Five types are described based on dosha predominance, with rakta gulma occurring exclusively in women. Treatment is dosha-specific: oleation and enema for vata, purgation and bloodletting for pitta, lightening and emesis for kapha. Over 15 medicated ghee preparations are detailed for different gulma types. The chapter emphasizes protecting digestive fire (agni) throughout treatment, as gulma aggravates with decreased digestion. Surgical intervention using negative pressure extraction is described for suppurated kapha gulma. Dietary management includes hot, liquid, unctuous foods for vata gulma and cooling, sweet foods for pitta gulma.