Kshara and Kshara Karma (Caustic Therapy)

Abstract

To every disease the management is prioritized on the basis of the  least invasion it makes to the body and its  least side effects . Ayurveda too follows the same principles. It believes in guarding the healthy body by various preventive measures (following Sadvrutta, dincharya, Ritucharya) that can be undertaken, by taking medicine (Sanshaman aushadhi) or detoxification therapy (Panchkarma)  for the diseased conditions and by the use of invasive Surgical  procedures such as Kshara , Agni karma, Jaloka avcharan, Raktavsechan etc ( which cannot be subsided by internal medication ). These  surgical procedures act harshly over the affected area and subside the pathology completely. Little is known to the modern world about this  amazing ancient method of healing. Probably modern correlation of these procedures could be made to Electrical cauterization, Chemical cauterization, Thermal cauterization erc. This article  discusses what actually the concept of Kshara and Kshara Karma is and its significance in various untreatable pathological conditions.

Introduction

Kshara(alkaline extract of a plant) is something that is capable of separating the vitiated twak and mamsa from the body. Kshara karma is considered the best operative procedure of all the surgical procedures. This works very effectively both via external application  and  internal consumption (Tridosha ghana).

Types

Kshara on the basis of its mode of application could be divided into two types:

• Pratisarniye kshara (for external application) this further is of three types mils, moderate and strong.
• Panniye kshara (for internal application)

Application

1. Panniye kshara (the one meant for consumption) is effective against the disorders such as Krtrim vish, gulm (abdominal tumour), udar (enlargement of abdomen), Agnisang (dyspepsia), Ajeern(indigestion), Arochak(anorexia), Anaah, Ashmari, Abhyantar vidhradhi, Krimi, Arsh(Haemorrhoids) etc.
2. Pratisaarniye kshara (meant for the external application) is effective against kushat, kitibh, dadru, mandal, kilas, Bhangadar, Arbud(tumor), Arsh(haemorrhoids), Dushatvrana, Naasi, Charkeel, vyang, Mashak (moles), Bahyavidridi, Krimi etc.

Contraindication

The consumption of kshara is contraindicated to Jawar, Raktpitt,  pitta prakriti, Children, Elderly, bhrum, mad, murcha (loss of consciousness), timir etc.

Kshara in general is contraindicated to  weak, emaciated, children, elderly, fearful, with generalised edema,udar, raktapitta, pregnant women, menstruating women, fever, diabatic, thirsty, unconscious, infertile, women with prolapsed uterus etc.

Method of Preparation

Pratisarniye kshara

• The panch of the herb ( such as Apamarg) is collected auspiciously in Sharad ritu( in between October and November) and burnt.
• Ash of the burnt plant is collected and is mixed with the water in 1: 6 proportion.
• For a stronger alkali cow urine is considered in place of plain water.
• This mixture is filtered via cloth for 21 times.
• There after this mixture is stirred over the low flame.
• When the mixture appears red, dirtless and viscous , it is indicative that the kshara has been prepared.
• On separating 1 part of the filtered mixture and the rest of the mixture, mridhu( mild) kshara is obtained.
• Madhyam Kshara -In this the kshaara is diluted by katsharkara, ksheerpaak, shankhnabhi etc.
• Tikshan kshara- Tn this the kshara is concentrated via adding danti, dravanti, chitrak, langli, vidlavan, hing, ativisha, etc.
• The prepared kshara is tested for its Organoleptic Characters such as Colour, Taste, Odour, Appearance
• Physico-chemical parameters
  •  Loss on drying
  •  PH analysis
  •  Total Ash
  •  Acid Insoluble ash
  •  Water soluble ash
  •  Refractive Index
  •  Specific gravity
• Physical tests
• Chemical test Qualitative analysis & Quantitative analysis- Percentage of Sodium, Potassium, Magnesium, Calcium, Sulphate, Alkalinity CaC03, Carbonate Bicarbonate
• Elemental Analysis etc.

Panniye kshara

The reference of preparation of this kind of kshara is given in Uttaratantra chapter Gulmadyaadhyaya. Sesame ,talmakhana, Plash, mustard, yav naal, mulak is burnt and made into an ash. There after this ash is mixed into the urine of cow, goat, sheep, ass, elephant, buffalo etc. Thereafter it is filtered and mixed with licorice, dried ginger, ajwain powder along with salt and is heated until it gets a vicious thickened paste. The paste can be consumed along ghee, curd, warm water etc.

Dose: For application the strongest dose is given in Vataj vyadhi and the mildest dose is given in Pittaj vyadhi.

Procedure of Kshara Use

• Prior proceeding with this procedure the local area must be cleaned and all the necessary things should accordingly be arranged.
• Vata vitiation must be given Lekhan( scratching),Pitta vitiation must be given gharshan(rubbing) and kapha vitiation must be given Prashan karma.
• After the kshara karma the lepana (paste application) of liquorice and sesame is done over the affected area.
• Kshara is of katu ras and lavan anuras. It has all five rasas mentioned in ayurveda except for amla ras
• When kshara is given amla ras gets changed into an overall madhur ras which numbs the cauterisation done by kshara
  • Symptoms of Adequate Kshara Karma- The wound appears of a blackish discolouration, with no exudation along with improved signs of healing.
  • Inadequate Kshara Karma- This brings symptoms such as pricking sensations, itching, stiffness, pallor, etc. In this condition a sequel of kshara karma is advised.
  • Overburnt Kshara Karma- Burnt appearance, burning sensations, fever, pus accumulation, unconsciousness and may be even death if it gets more severe.

Properties (Guna) of Kshara

According to acharya Sushurut the properties mentioned  of kshara are-

• Na ati tikshan (not too intense)
• Na ati mridhu (not too soft)
• Shuklvarni (white coloured)
• Shalakshan (Smooth)
• Pichchila (slimy)
• Na Avishansdi (Does not produce moisture or exudation)
• Shiv (Pleasant or mild nature)
• Shighar (fast acting)

Along with the above mentioned properties acharya Vagbhata also mentioned  two more qualities which are –

• Shikhari- (at the side of application, it remains like a mountain peak)
• Na ati ruk (doesn’t cause much pain)

Doshas of Kshara

Acharya Sushurut has considered 9 doshas of Kshara-

• Atimrudhu (too soft)
• Atishveta (too white )
• Atiushna (too hot)
• Atitikshan (too intense)
• Ati pichchila (too slimy)
• Atisarpita (That spreads too much)
• Atisandhra (Too dense)
• Apakva (Not formed effectively)
• Heendravyata (of inferior raw material)

Duration of Use

According to Acharya Vagbhata the Kshara made should be used uptil 7 days.

Attestation of the Kshara Prepared

• The kshara hence prepared must be applied over the affected area by the means of an errand stalk and must be awaited for around 100 matra kaal ( 32 seconds).
• If the prepared kshara manages to show its action in the said period then it is an adequate kshara
• If the kshara shows its action quicker then it is theekshana (too intense) kshara.
• If the kshara fails to act in this duration then it is mild or soft kshara.

Contraindicated Areas for Kshara Karma

The areas that are contraindicated for kshara karma are-marmasthan(vital points), Sira( veins), Dhamni(arteries), penis, tarunaisathi(vulnerable bones), sanayu(cartilages), sensitive areas such as eyes etc. Also the patients suffering from edema, swellings, Joint ache, heart ailments and the ones that disrespect food  are not benefited by kshara karma.

Kshara in Various Forms

Kshara can be made into use by its various different forms such as-

• Kshara Varti- This can be used for hollow pathological sites such as fistulas, cavities etc.
• Kshara Tail- It is very effective for its use against earache, discharge from the ear, deafness etc.
• Kshara pichu-This used in vaginal granulation tissues and slough .
• Kshara Sutra- It has a wide application in fistulas, internal piles, warts, Pilonidal sinus etc.

Conclusion

Kshara is a very useful ancient  medicinal formula. Despite its amazing medicinal properties it has not yet  been used up to its full potential . The detailed description, discussion and elaboration of this topic along with modern integration can prove to be very useful in this context.