Ksharkarma in Ayurveda

Views shared by several Ayurveda professionals and non-Ayurveda people in discussion group:

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Next topic for discussion: Ksharkarma in Ayurveda

Ayulink: Besides kshar-sutra, where can I read or know more about Kshar karma? Any ref of it in any treatment?

Dr. Madhuri Patil Chaudhari: Pratisaarniy and Paniy kshar.1st 1 externl.2nd one internal

Ayulink: Yes. In theory we read this. But in practice? Only Kshar sutra is popular. Kshar as internal medicine? Narikel Lavan? apamarg Kshar? But what about Kshar karma? As an external application? Only kshar-sutra?

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Dr. Madhuri Patil Chaudhari: Warts,  polyps, external skin tags pedunculated, which hv base to hold the knot of kshar thread

Dr. Maheshbhai Maysore: Kshara lepa for internal haemorroids. First to sec degree

Dr. Madhuri Patil Chaudhari: tvagaarsh too, with ksharsutra. excellent results with no scars. must b sufficiently large and with  a base to hold the knot properly in place

Ayulink: Must go back to Sushrut Samhita to find more. There must be lot more applications - not only Kshar sutra that I believe. In the text it is described as Kshar karma and Agni karma. It must be more than kshar-sutra as they have mentioned the word `karma` with it. Alkaline cautery is the concept.

Dr. Madhuri Patil Chaudhari: yes. Kshar karma local application also internal use.

Dr. P S. Desai: Kshar Sutra is one of the external kshar preparation. In Samhita there are many reffences for internal use of kshar. In Shalya we are using pratisharniy kshar means paste like kshar for various conditions

Ayulink: Please give more details of that paste application.

Dr. P S. Desai:We are using in internal piles, Pilonidal sinus, Non healing ulcers.I have used kshar varti in pilonidal sinus along with excision of tract

Dr. Amrish A Shah: Good Results but Vd not Prefer because long Time Treatment

Dr. P S. Desai: It will give better result with no recurance of disease.In skin warts also if patient not ready for Elctro cauterization I use pratisharniy kshar

Dr. Devesh Kumar: Which kshara sir apamarga or else??

Dr. P S. Desai: Mridu kshar

Ayulink: Kshar karma = is it only cautery or else? Does it have any other action - reaction or mode of actions?

Dr. P S. Desai: Kshar means Phyto chemical Cauterisation. It necrosis the tissue by its highly alkaline property

Dr. Madhuri Patil Chaudhari: Kshar Lekhaniya.

Dr. P S. Desai: As standard kshar have pH around 10-12

Ayulink: Does it improve blood circulation or it reduced inflammation?

Dr. Amrish A Shah: Ksharsutra is best Teatment in Piles 
Dr. P S. Desai: For pratisharniy kshar as it first Co agulate the blood at local site and causes cell death

Then slough formation

Healthy wound formation

Healing

Fibrosis

Dr. P S. Desai: This mode of action we use in tonsil and piles. To reduce the venous engorgemnet locally

Dr. Amrish A Shah: 3rd 4th degree piles only

Dr. Sahaj Shah: 4th degree haemorrhoids??

Canada Nitin Shah: Paaniya kshara which is used in aqueous form for internal usage. There are many indications in the original texts but hardly used in daily practise now a days except apamarga and forgot the name but which has chemical structure is NaHCO3.External application of kshar or ksharasutra does coagulative necrosis of the tissue.

Vd. Jignesh Thakkar: We have frequent use of paniya kshar ....as previously it was kept in the form of liquid nowadays so many medicines contains kshar like

1) shivakshar pachan churna(carminative and digestive)

2) shankh vati(carminative and digestive)

3) kshar Parpati( diuretic and anti caliculi)

In panchkarma kshar is used as

1)kshar basti

2) vaitaran basti

Kshar is used in apamarg  kshar tailam in ear disorders

Dr. V B. Maheshwari: Kshara sutra best in external growth like warts, piles etc. It does necrosis with healing also.

Vd. Dhruti Kagrana: I have find kshar karma Ch. in shushruta Samhita and astang hridaya.Any reference for uses of kshara in charaka Samhita?

Dr. P S. Desai: Charak mentioned paniy kshar in Gulm chikitsa  And in fistula in Ano as a Ksharsutra in Shoth chepter

Dr. Navneeth Krishnan: Yava kshara is used in many prepration like indukanta kashaya, indukantha ghrta,guggulu tiktakam, kankayana vati etc

Dr. Madhuri Patil Chaudhari: Yavkshar best for intetnal. mutrakruchha esp with  burning.  Yavkshar with Takra along with just a pinch of trikatu. or without it. best alkaliser of urine where pH needs to b maintained.A H

Vd. Dhruti Kagrana: Effect of kshara  may related to factors including

* pH of the kshara

* Concentration of the drug

*Length of the contact time

* Volume of the off ending agent

* Physical form of the drug

Dr. P S. Desai: Exactly

Dr. Shantanandkumar: Kshara if mixed with Amla dravya like takra it not work because Amla dravya reduces it's properties

Aman patel:  26 types of kshara are mentioned in charak samhita. However description of individual kshara are not found except yavakshara. Yavakshara is useful in the treatment of hrdroga,pandu,grahani,pliha,kasa,kaphaja arsa. Different types of kshara mentioned in charak samhita are lavana. Based on the similarity in the appearance,smell,taste and touch of urine a subcategory of pittaja prameha has named as kshara meha.

Dr. Madhuri Patil Chaudhari: Takra though Amla taste on tongue, Vipak is not acidic. Ashtang Hruday Mutrakruchha chikitsa its listed Yavkshar with Takra. Charak Viman sthan 4th adhyay 15th shlok. Kshar Lavan Pippali. never to be used regularly. Lavan n kshar different based on end product after digestion, Vipaak. Lavan mostly Amla, Kshar mostly  Katu.

 विमानस्थानम् - १. रसविमानम्

अथ खलु त्रीणि द्रव्याणि नात्युपयुञ्जीताधिकमन्येभ्यो द्रव्येभ्यः; तद्यथा-पिप्पली, क्षारः, लवणमिति||१५|| आयुर्वेददीपिका व्याख्या (चक्रपाणिदत्त कृत)

अभ्यस्यद्रव्यंप्रभावोदाहरणार्थमभिधायानभ्यस्यानाहअथेत्यादि| अधिकमन्येभ्य इतिवचनादन्यदपिचित्रकभल्लातकाद्येवञ्जातीयंनात्युपयोक्तव्यं, पिप्पल्यादिद्रव्यंत्वन्येभ्योऽप्यधिकमत्युपयोगे वर्जनीयमितिदर्शयति||१५|| 

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Compiled by - Dr. Dhruti Kagrana