The fundamental principles of the body, deranged and aggravated by their respective or specific exciting causes and factors tend to accumulate in the cavity of the abdomen (Koshtha) and help the formations of balllike tumours or Gulmas (internal tumours inculsive of those known as the phantom tumours) somewhere inside the body lying between the extreme confine of the regions of the heart and of the bladder (Vasti). The Gulma is of five kinds and found to be round or spheroid in shape and may be either fixed or mobile (lit. shifting) in their character and subject to variations in their mass and size. 2.
They have five locations inside the abdominal cavity, viz. the two sides, the region of the heart, the bladder (Vasti) and the region of the umbilicus). The Gulmas are so named because their root or base cannot be exactly localised as well as their cause cannot be exactly ascertained owing to the fact of their having their origin in the aggravated condition of the local bodily Vayu, or because of their being but a agglomeration of the deranged bodily Uoshas in the affected locality and the shrub-like large converse outline of the surface (Gulma-shrub). Since a Gulma, like a bubble of water, is a self-contained agglomeration of the deranged bodily Doshas and freely moves about in the cavity of its growth, it is not marked by the advent of any suppurative process in its mass or body. The Gulmas are the products of either the several or concerted actions of the three Doshas, while in females a separate class of tumours (such as the ovarian or uterine tumours) intimately connected with the deranged or vitiated condition of the blood (catamenial fluid, etc) is also recognised. 3 - 5.
A sense of lassitude, dulness of appetite, pain and rumbling in the intestines, suppression of stool, urine and flatus, incapacity to take food to the full, aversion to food, and an upward coursing of the internal Vayu are the indications which may be set down as the premonitory symptoms of Gulma. 6.
Pain (Sula) in the region of the heart and the belly (Kukshi), dryness of the throat and of the mouth, suppression of Vayu (flatus), irregularity of digestion and all other symptoms which specifically indicate the deranged condition of the bodily Vayu arc the characteristics of the Vataja-Gulma. Fever, perspiration, defective digestion, burning sensation, thirst, redness of the body (Anga-raga), bitter taste in the mouth and all other specific symptoms of the deranged Pitta mark the Pittaja type of the disease. A sensation of wetness all over the body, an aversion to food, lassitude, vomiting, water-brash, sweet taste in the mouth and all other specific indications of the deranged Kapha arc exhibited in the Kaphaja type of the disease. The Tri-doshaja type exhibits the symptoms specifically belonging to each of the preceding ones and should be regarded as incurable. 7 - 9.