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.
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)
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.