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- The procedure by which Vilayana or Dravikaran`a (liquefaction) of Dusht`a Tvak and Maamsa and also removal of the same is achieved with the help of Kshaara is called as Kshaarakarma.
- It becomes imperative in certain conditions to physically remove the sloughs, Dusht`a Tvak (contaminated) skin or hypertrophic muscles from a wound or a lump, at such places Kshaarakarma should be done.
- Prtisaaran`eeya Kshaara is again divided into three types viz.
- Madhyama and
- Madhu, Kaanjee, Dadhi, Dadhi Mastu, Lepa of S`heetaveerya Dravya, Tila Kalka, Yasht`i, Ghrita, Amla Varga, Sauveeraka, Tushodaka, Dhaanyaamla
- The procedure should be conducted inside a room free from excessive wind flow and sunlight.
- The person should be given a position according to the disease.
- The area around the site of Kshaarakarma should be covered by a cloth.
- For Pittaja diseases Gharshan`a (rubbing), for Vaataja diseases, Kathin`a and Supta Tvak Lekhana (scrapping) for Kaphaja diseases and when excessive Kan`d`oo and S`hotha is present then Prachchhaana Karma should be done before application of Kshaara.
- Then Kshaara should be applied with the help of S`halaakaa.
- Kshaara should be washed off after a time required calculating 100 numbers. (For Kshaara karma at Mridu organs the time should be that equal to calculate 50 numbers.)
- The site should be covered by a Plota / palm.
- The site of Kshaarakarma should be flushed with drugs from Amlavarga.
- Then Lepa of solid part from Sauveeraka, Tushodaka etc. or Tila, Yasht`i should be applied at the site of Kshaarakarma.
- The patient should be given Abhishyandi Aahaara e.g. Dadhi, Maasha. Due to this there is formation of Kleda at the site of Kshaarakarma and Vilayana of Maamsaadi Dhaatu resulting in Ksharan`a (destruction) of Dhaatu.
- Pratisaaran`eeya Kshaara should not be used at the region of Marma, Siraa, Snaayu, Sandhi, Tarun`aasthi, Sevanee, Dhamanee, Gala, Naabhee, Nakhaanta, Med`hra, Srotasaagra, Netra, Kan`t`ha and the region where small amount of Maamsa is present.
- This procedure has effect on Kleda.
- This procedure should not be done when the patient is having multiple wounds.
- After S`hastrakarma, Kshaarakarma should be done over Vartmaars`ha, S`hushkaars`ha (Netra Roga) and Arbuda Netra Roga.
Following is the procedure performed particularly in the treatment of Ars`ha:
- S`halaakaa Yantra
- The patient should eat light diet having Anulomana effect in small amount on the previous night.
- The patient is not allowed to eat anything on the day of procedure till the end of the procedure.
- He should be asked to evacuate bowel and pass urine prior to the procedure.
- The patient should have bath. (The area should be cleaned thoroughly before Kshaarakarma.)
- Svastivaachana to stabilize the patient psychologically.
- Pratisaaran`eeya Kshaara – Mridu Kshaara should be used for Kshaarakarma of Raktapittaja Ars`ha.
- Yantranaa – positioning – The position should lie down in a supine position on a bed or a table with legs spread to expose the anus for better view and to facilitate Kshaarakarma.
- In case of a child or a serious patient, the patient should lie on the lap of the assistant (in such a manner that the patient’s body above waist, lies on the lap of assistant.)
- The patient’s anus should face east.
- His waist should be elevated by keeping a pillow below his waist.
- The patient should be asked to raise his legs and should be given lithotomic position.
- Then the assistant should apply lubrication to anus and insert lubricated Ars`ha Veekshan`a Yantra, slowly and steadily through the anal opening.
- Then the patient is asked to do Pravaahan`a (straining).
- Due to this the Ars`ha will be visible in the Ars`ha Veekshan`a Yantra.
- The Kshaara should be taken over a Jambvosht`ha S`halaakaa Yantra which is covered by the cloth at one end.
- The physician should pull the Ars`ha slightly upwards or press the upper part of Ars`ha so that the root of the Ars`ha is visible and apply the Kshaara at the root of Ars`ha.
- After application of Kshaara the Ars`ha Veekshan`a Yantra should be closed with hand for a time required to count 100 numbers.
- Then the Kshaara is applied again till the symptoms of proper Kshaarakarma are achieved.
- When the Ars`ha looks like ripe Jambu or Avasanna (shrinked) or slightly Nata (bent), Kshaara should be washed off with Kaanji, Dadhimastu, S`hukta or Phalaamla Rasa. Then ghee and Yasht`imadhu should be applied.
- Then the Ars`ho Yantra should be removed gently.
- Kshaara karma should be done for one Ars`ha at one time. After 7 days Kshaara should be applied to another Ars`ha and so.
- The Kshaara should be applied to Ars`ha on right side initially then to that on left side, then back and then front.
- In case of prolapsed piles the Kshaara should be applied without using any instrument.
- Abhyanga should be done over anus and the area around anus.
- Avagaaha should be done with hot water and Parisheka with cold water. (According to some Parisheka with hot water should be done.)
- Then the patient should be asked to rest for a while.
Last updated on April 30th, 2021 at 05:43 am