Kshar-Karma Vidhi

 KSHARA SRESTHATA (ADVANTAGES OF ALKALINE CAUTERY)-

Kshara is an effective Ayurvedic medicine for healing wound.Of all the sharp instruments and accessory instruments, Kshara (caustic alkali) is the best. Kshara performs many functions like incising, excising . It can be used even in impassable places. Success can be obtained by it can be used even in the form of a drink and its very useful  in diseases which are very difficult to treat .

INDICATIONS-

• Paneeya Kshara Yogya(drinkable alkali Indications) –

• Arsha – haemorrhoids,
• Agnisada – dyspepsia,
• Ashma – renal calculus,
• Gulma – Tumors of the abdomen
• Udara – ascites, enlargement of the abdomen
• Garavisha – chronic poisoning etc.

• Pratisarana Kshara Yogya (alkali applicationIndications)-

• Mashaka – moles – warts,
• Shvitra – leucoderma,
• Bahya Arsha – external piles
• Kushta – skin diseases
• Supti – anesthetic patches,
• Bhagandara – rectal fistula,
• Arbuda – cancerous growth,
• Granthi – tumour, fibroid
• Dushta Nadi vrana – foul and sinus ulcers etc.

Ksharaguna-

 There are the ten ideal qualities of the caustic alkali which are mentioned below:

• Naati teekshna – Not too strong
• Shlakshna – smooth
• Na vishyandi –doesn’t  produce too much of exudation or moistness
• Sheeghraga – quick in spreading
• Sita – white in colour
• Sukha nirvapya – easy to remove
• Na ati ruk –it does not cause much pain
• Na ati mrudu – not too mild
• Shikhari –Kshara Like a mountain peak
• Picchila – slimy

Ksharakarma-

• Kshara  does all the functions of the sharp surgical instrument (Shastra karma) and also the fire (Agni karma).
• By actions such as sucking quickly
• Very good healing effect over the body
• kshara spreads everywhere because of it’sheeghraga ghuna. 
• Kshara pulls out all the Doshas (vitiating materials) by their root.

KSHARA NIRMANA – PREPARATION OF CAUSTIC ALKALI:-

• The whole plant (panchanga) of Achyranthes aspera ( Apamarga) 5 kgs should be collected, dried up and burnt.
• The whole ash 500 gms were collected and mixed with 6 times (3 litters) of plain water and filters 21 times. The filtrate is clear and clean like color of cow’s urine (gaumutra).
• Then filtered water is kept on mild fire and liquid evaporates to 1/3rd of its original quantity. 
• This is known as Mrudu (mild potency) comncentrate kshara. 
• Then add 50 gms of red hot shukti (Limestone) to the filtrate solution and continuously stirred well until it’s evaporates to 1/3rd of its original quantity.
• This is known as Madhyama or moderate kshara. 
• Moderate/Madhyama Kshara should be further heated up by admixture 5 gms of Chitraka kalka (Plumbago gelanica).
• When  this dense solution is obtained which is known as Pratisaraneeya Teekshana kshara (highly concentrate kshara).
• At the end of Kshara preparation process it should be collected and stored in air tight container.

KSHARA NISEDHA (CONTRAINDICATION)-

• When Pitta and Rakta are aggravated 
• Manda  Vata
• Atisara – diarrhoea, dysentery
• Hrut Murdha Roga – diseases of the heart and head,
• Pandu – anemia
• Aruchi – anorexia,
• Timira – blindness
• Fever-jwara
• Bheeru-who are fearful, coward.
• The pregnant, the menstruating woman, woman who has difficult menstrual flow, or woman who has displacement of either vagina or uterus
• children and old persons
• Places which are poor of muscles, the testes, penis, orifices, passages, interior of the nails
• In eye diseases except the eyelids.
• During cold, rainy and hot seasons (Sadharana kala)  and on days when sun in not seen.
• Aama – indigestion condition
• Kruta samshuddha – in those who have been recently administered Panchakarma therapies 
• Sarvagshotha – who have swelling of the entire body

 INDICATIONS OF THREE KINDS OF ALKALI-

Mrudu Kshara/Mild Potency Alkali – Mild alkali is used In diseases

arising from  Asra/Rakta and Pitta Doshas – Rakta and heamorrhoids, 

Madhyama Kshara – alkali of medium potency is useful in those diseases which are not very difficult to treat. 

Teekshna Kshara (Strong Potency Alkali)– 

Alkali of strong potency should be used in diseases which are arising from Vata Dosha, Kapha Doshas, and Medas (fat) and also used in Arbuda (Cancerous or non-cancerous growth) etc. 

PROCEDURE FOR KSHARA KARMA-The patient anaesthetized with small dose of anesthesia to relax the muscles and to put in a sleep like state so that no pain and discomfort is experienced during the kshara karma therapy.

•  Lubricated proctoscope should be introduced into the anus and Kshara applied over the internal pile mass and wait until the pile mass turns to the color of reddish black and burning of it.
• Next, the pile mass is washed with lemon juice to neutralize the Kshara and a rectal pack is applied.
• Kshara cuts and drains the pus from fistula in ano and fissure in ano or hemorrhoids and also preserves the continence of anal canal.
• Kshara karma helps for quick healing and reduces the chance of recurrence.

ADVANTAGE OF KSHARA KARMA-

• Postoperative pain is mild in intensity
• No  bleeding
• Minimum hospitalization – only one day care.
• Systemic diseases are also undergoing this procedure.
• No surgical complications such as stenosis,incontinence, and stricture
• Cost-effective and ambulatory.
• Faster healing and recovery
• No scope for infection and recurrence 

Precautions After Kshara Karma Therapy-

• A physician customized diet plan for patients who have undergone Kshara karma therapy. 
• This should be followed strictly to avoid constipation and to clear the bowel regularly.
• The diet plan incorporates fibre rich foods with lots of vegetables and fruits along with plenty of water. 
• All fried and spicy food items should be avoided because they disturbed proper functioning of the digestive system.
•  For improve the blood circulation to all extremities of the body regular physical activity (with less strain) like walking is required.
• Avoid prolonged sitting that can apply pressure on the area.