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धूमैर्विरेकैः शिरसः पूर्वोक्तैर्गुल्मभेदनैः । अयोलवणपाषाणहेमताम्रप्रपीडनैः ॥१३१॥
Dhuma, shirovirechana, measures described to break the gulma in Gulma Chikitsa chapter, as well as iron, salt, stone, gold and copper should be used for prapidana (compression) of granthi.
english translation
आभिः क्रियाभिः सिद्धाभिर्विविधाभिर्बली स्थिरः । ग्रन्थिः पाषाणकठिनो यदा नैवोपशाम्यति ॥१३२॥
If granthi is strong, firm and stony hard and not responding to all these proven methods of treatment then it is better to be cauterized with kshara (medicinal alkali)
english translation
अथास्य दाहः क्षारेण शरैर्हेम्नाऽथ वा हितः । पाकिभिः पाचयित्वा वा पाटयित्वा समुद्धरेत् ॥१३३॥
or hot metal arrow or hot gold or after making it suppurate by applying suitable suppurative medications one should open and extract.
english translation
मोक्षयेद्बहुशश्चास्य रक्तमुत्क्लेशमागतम् । पुनश्चापहृते रक्ते वातश्लेष्मजिदौषधम् ॥१३४॥
Besides, vitiated blood should be eliminated, frequently followed administration of vata and kapha pacifying medicines,
english translation
धूमो विरेकः शिरसः स्वेदनं परिमर्दनम् । अप्रशाम्यति दोषे च पाचनं वा प्रशस्यते ॥१३५॥
dhuma (fumigation therapy), shirovechana (errhine therapy), swedana(sudation) and parimardana (pressure method). If dosha do not pacify, pachana (suppuration) treatment is beneficial.
english translation