In a case of a Medoja goitre (due to the deranged fat), the patient should be first made to use oleaginous substances (internally and externally) and venesection should then be resorted to, as advised before (Sárira-Sthana, Ch VIII). A hot plaster composed of S'yámá (Trivrit), Sudhá, Mandurá, Danti and Rasánjana pasted together should be applied to the seat of the disease. Powders of the essential parts (Sara) of a S'ála tree mixed with cow's urine may be given every morning with advantage
As an alternative, the Goitre (Gala-ganda) should be opened, its fatty contents fully removed and the wound then sutured. Or it should be cauterised with the application of heated animal marrow, clarified butter, lard, or honey; after which it should be lubricated with clarified butter and honey (mixed together), and a pulverised compound of Kásisa, Tuttha, and Gorochaná, should be applied to it; or after lubricating it with oil, it should be dusted with the ashes of cow-dung and of S'ála-sára. Daily washings with the decoction of Triphalá, hard bandaging and a diet of barley, prove efficacious (in cases of goitre). 40.