Medoja Arvuda (fat origined tumour) should be first fomented and then incised. The blood in its inside having been cleansed it should be quickly sutured and then plastered over with a compound composed of Haridrá, Griha-dhuma (soot of a room), Rodhra, Pattanga, Manah s'ilá and Haritála pounded together and mixed with a proper quantity of honey After its purification, thus produced, it should be treated with the application of Karanja-Taila (prescribed before in cases of Vidradhi). Even the least particle of Doshas (pus, etc.) in a tumour, left unremoved, would lead to a fresh growth of the excrescence and bring on death just like the least particle of an unextinguished fire. Hence it should be destroyed in its entirety. 32-33.
A case of the Vátaja type of Gala-ganda (goitre) should be treated with fomentations of the vapours of the decoctions of tender leaves of the Váyu-subduing drugs prepared by boiling them with Kánjika, various kinds of urine and milk as well as with minced meat and oil, and should be applied in the manner of a Nádisveda. After this fomentation, the contents should be carefully drained (from inside the goitre). Then after having duly purified (the incidental ulcer, it should be plastered with a medicinal compound composed of (the seeds of) the S'aria, Atasi, Mulaka, S'igru and sesamum and Kinva and the piths of the Piyála, or with that composed of Kálá, Amritá, S'igru, Punarnavá, Arka, Gaja-pippali, Karaháta . Madana) and Kushtha, or with that composed of Ekaishiká, Vrikshaka and Tilvaka. All of them should be pasted with Sura and Kánjika and applied hot to the affected part. The internal use of a medicated oil, cooked * with Amritá Nimba, Hamsáhvá, Vrikshaka, Pippali, Valá, Ati-valá, and Deva-dáru, always proves efficacious in a case of goitre. 34-56.
- A case of the Kaphaja type of goitre should be treated with applications of fomentation and poultice and should be duly drained (Visráva). Then a medicinal plaster composed of Aja-gandhá, Ati-vishá, Vis'alyá, Vishániká, Kushtha, S'ukáhvayá, Gunjá (taken in equal parts) and pasted with the alkaline water prepared from the ashes of the Palás'a wood should be applied hot to the affected part. A medicated oil cooked with the drugs of the Pippalyádi group and mixed with the five officinal kinds of salt should be taken by the patient. Emetics, errhines and inhalations of Vairechanika-dhuma are beneficial in such cases. In the Va'taja and the Kaphaja types of goitre (Gala-ganda), the skilful physician should employ suppurating measures in partially suppurated cases. The patient's diet should consist of rice, barley and Mudga soup and should be taken with honey, Trikatu, cow's urine, fresh ginger, Patola and Nimba. 37-39.
* Some say that the oil should be prepared with the decoction as well as with Kalka of the said drugs. Others, however, hold that water should be used in the preparation of the oil and the said drugs should be used only as a Kalka.