KSHARA KARMA - CAUSTIC THERAPY

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KSHARA KARMA - CAUSTIC THERAPY IN HAEMORRHOIDS
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Dr. P. Hemantha Kumar
M. S .(Ay) Dip.Yoga, (Phd) Prof. HOD Dept. of
Shalya Tantra in P.G. Studies S.D.M.College of
Ayurveda Hospital, Hassan, Karnataka,
INDIA Mobile [phone] Email
phk4uster_at_gmail.co phk4u_at_redifmail.co
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Piles / Haemorrhoids can affect anyone, anytime,
anyplace and anywhere. Commonest disease in
Anorectal region. Recent statistics reveals
that irrespective of age, sex, socio-economic
status, people suffer from piles. Now a days
every person suffered from any one of the
complaint of piles during their life time.
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• Kshara is a caustic chemical, alkaline
• in nature obtained from the ashes of
• medicinal plants.
• It is a milder procedure compared to surgery
• and thermal cautery.
• It is the superior most among the sharp and
• subsidiary instruments because of
• performing excision, incision and scraping.
• Used safely on the patients who are afraid of
• surgery.

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CLASSIFICATION OF KSHARA
On the basis of Administration 1.
Pratisaaraneeya Kshara External application 2.
Paaneeya Kshara Internal application
According to Preparation 1.
Uttama - Best 2. Madhyama - Moderate
3. Adhama - Poor
On the basis of Concentration 1. Mridu
- Mild 2. Madhyama - Moderate 3. Teekshana -
High
On the basis of Origin 1. Herbal 2.
Mineral 3. Animal
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INGREDIENTS OF KSHARA
APAMARGA Achyranthes aspera
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Sukti Lime stone
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Chitraka - Plumbago gelanica
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METHOD OF PREPARATION OF PRATISARANEEYA TEEKSHANA
KSHARA (High concentration Kshara)

• Dried Apamarga plant (Achyranthes aspera) (5 kg)
• Burnt
• 500 gms of Achyranthes aspera Ash
• 
  Add 6 times of water (3 liters)
• Filtered 21 times through cloth
• To get clean and clear solution Cows urine
  colour
• 
  (slight reddish)

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• Filtrate Solution was boiled and evaporated
• 
  
• 
  Heating up to 2/3 remains
• Add Red-hot Lime stone 1/10th (50 gms) into the
  boiled Apamarga (Achyranthes aspera) filtrate
  solution
  
• 
  Continuous mild heating
• Liquid evaporates to 1/3rd of its original
  quantity
  
• Add 1/10th (5gms) of Chitraka Kalka
  
  (Plumbago gelanica)
• PRATISARANIYA TEEKSHANA KSHARA
• (High concentration Kshara)

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PREPARED KSHARA
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PROPERTIES OF KSHARA

• It is having pungent, hot, sharp and digestive
  property.
• It does cauterizing, digesting and splitting
  actions.
• Externally it has Cleansing, Heating, Absorbent
  and Scraping properties.
• PH value of Teekshna Apamarga Kshara is 13.5.

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• INDICATIONS OF KSHARA IN PILES
• Soft, spread out,
• deep rooted
• elevated type of Piles
• Internal Haemorrhoids First degree, Second
  degree and Third degree.

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APPLICATION OF KSHARA

• Pre-operative
• Required instruments - Proctoscopes, Prepared
  Kshara, Lemon juice, Allis tissue forceps, Artery
  forceps etc.
• Night prior to procedure, the patient is advised
  to have light diet afterwards nil orally.
• Part preparation and soap water enema.

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INSTRUMENTS
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Operative

• Patient is in lithotomy position
• 
  L. A. / S. A.
• Part cleaned with aseptic
  solutions
• Introduce lubricated slit Proctoscope
• into the anus and pile masses bulges in
• 
  
• Pile mass should be scraped or rubbed with cloth
  or a cotton swab with warm water

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• Kshara applied on internal piles
• Wait for 1- 2 min
• Pile mass turns to the colour of Pakva
• Jambhuphala (ripened black berry
  fruit) - Reddish black in colour
• Pile mass washed with Lemon juice
• Apply
  Yashtimadhu Ghrita
• 
  Proctoscope is removed
• Rectal pack with Anu taila or Mahanarayana
  taila

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• Post operative
• Orally liquid diet after 4 to 6 hours
• Packing removed after 6 hours
• Sitz bath -Triphala decoction
• 10 ml Anu taila / Mahanarayana taila per
• rectally twice daily

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BEFORE
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KSHARA KARMA CAUSTIC CAUTERY
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Before Application
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During Application
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After Application
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MECHANISM OF ACTION OF KSHARA IN HAEMORRHOIDS
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HISTOPATHOLOGICAL SLIDE OF SLOUGH COLLECTED
AFTER KSHARA KARMA
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ADVANTAGES

• Mild postoperative pain
• No bleeding
• Minimum hospitalization
• No scope for recurrence
• No stricture formation
• (if correct procedure is followed)
• Kshara Karma - treating all the pile mass in one
  sitting.

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COMPLICATIONS

• Bleeding - Negligible
• Pain Mild to moderate pain - relieved by hot
  sitz bath and oil enema.
• Discharge Blackish brown discharge will be
  occur 5 to 7 days postoperatively.
• Anal stricture Improper technique
• Recurrence Improper technique

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Dr P. Hemantha Kumar www.proctocure.com