In a case of the Khaphaja type of the disease, the Doshas should be first eliminated from the system with the regular and successive measures. † The affected part (Granthi) should then be fomented and firmly pressed (Vimlápana) and rubbed with either the thumb, or a piece of iron rod, or stone, or with a bamboo rod in order to bring about its resolution. A plaster composed of the roots of the Vikamkata, ‡ Aragvad/ia, Káananti (Gunjá), Kákádani (Váyasa-tinduka), and Tápasa-Vriksha (Ingudi) and with Pinda-phala (Tiktálávu). Arka, § Bhárgi, Karanja, Kálá and Madana, pasted together, should be applied to it by an erudite physician. A glandular swelling Kaphaja Granthi) on any part of the body other than a vital and vulnerable one (Marma) and not (otherwise) resolved and absorbed should be cut open even in its non-suppurated stage and the glands removed. The expert surgeon should then cauterize the incidental wound after the cessation of the bleeding and treat it in the manner * of the Sadyo-Vrana treatment. These remedies should be employed by the experienced physician, where the swelling would be found to have assumed a large, stiff, elevated and fleshy aspect (bulging from the deeper tissues of the flesh). A Kaphaja Granthi should be opened with an incision as soon as it becomes fully suppurated and should then be washed with a decoction of appropriate medicinal drugs. The incidental ulcer should be purified (disinfected) with a purifying remedy prepared with a profuse quantity of Yava-kshara, honey and clarified butter; and finally it should be healed up by the application of an oil, cooked with Vidanga, Páthá and Rohini. 7-9.
* The Vanaspati class consists of Vata, Plaksha, As'vattha and Udumbara trees.
† These are the applications of Sneha, fomentation, emetics, pur-gatives, Asthápana, S'iro-virechana and bloodletting.
‡ Dallana explains "Vikamkata" as "Kanta-káriká," but it means Sruvá (called Vainch in Bengal) and S'ivadása also explains it as such. - Ed.
§ Chakradatta does not read "Arka" in the list.
In a case of Medoja Granthi (originated from the vitiated condition of the bodily fat) a plaster of pasted sesamum, placed inside the folds of a piece of linen, should be applied to the seat of the affected part and fomentations with hot iron-rods should be frequently applied, inasmuch as application of heat (lit. - fire) is efficacious in such cases. As an alternative, the affected part should be fomented with a ladle, pasted with heated shellac (Lákshá). The Granthi (in its non-suppurated stage) should be opened by an incision and the fat removed; the incidental ulcer should then be (actually) cauterized. On the other hand, the Granthi, when fully suppurated, should be incised and washed with the urine (of a cow). Then a paste, composed of sesamum, Suvarchiká, Haritála and rock-salt, pounded together and mixed with honey, clarified butter and an abundant quantity of Yava-kshara, should be applied to the incidental wound for purifying purposes. Oil, cooked with the two kinds of Karanja, Gunjá, the green scrapings of bamboo, Ingudi and the urine * of a cow, should be used to heal the ulcer. 10-11.
* Applications of honey, clarified butter, etc.