Kshaarakarma

Dr. R.B.Gogte
GFAM, AVP

S.Su.11-4

Kshaara is a medicine which when given internally or applied externally produces the result in removing the unwanted – life threatening things or helpful in curing the disease. These two things are called Ksharan`a or Kshan`ana

Ksharan`a is nothing but debridementof the infected, sloughed material in relation to the tissue like skin, adipose tissue, muscles etc. Kshan`ana means shedding of the old tissue or growth of the new.

Pradhaanatva (Superiority)-

S.Su. 11-3

Kshaara is superior to Surgical excision, cauteryby heat or application of leeches as it possesses the property of Chhedana (excision), Bhedana (Incision) and is Tridoshaghna. When surgical procedure is risky, Kshaarais the choice of treatment.

Types of KshaaraS.Su. 11-6 and 11,12,13

Paaneeya to be given orally
Pratisaarn`eeya to be applied externally. This Pratisaaran`eeya is again sub-classifiedas:

1. Mrudu Only Kshaara– Soft.
2. Madhyama Kshaarawith Addition of Aavaapa – Medium
3. Teekshn`a Kshaarawith Aavaapa and Prativaapa – Powerful

Application of Kshaaraexternally removes unwanted and degenerated tissue by its corrosive action and thus is useful when used as Kshaarasutra, which results in dissolution, cutting and also healing in the case of Fistula in Anoas well as for the excision of tissue e.g. warts, piles (external) etc.

Paribhaashaa S.Su. 11-11 (and D`alhan`a and Chakrapaan`i.)

1. One S`hukti = Pala = 24 grams
2. One Kud`ava = 8 Pala = 384 grams
3. One Pala = 4 Tola_s = 48 grams
4. One Dron`a = 256 Pala = 12288 grams = 12.288

• Sudhaas`harkaraa: means raw limestone
• Kat`as`harkaraa: means raw limestone
• Bhasmas`harkaraa: means when un-driedbark of a tree is burnt, there is oozing of juice from the bark. It crystallizes due to heat, so that this crystallized juice is described as Bhasmashakaraa. Some clinicians wrongly take BhaskmaKshaara as heated limestone.
• Aavaapa: Is nothing but dipping of red-hot Katas`harkaraa, Bhasmas`harkaraa, S`hankhanaabhee or Kshaarapaaka in the Kshaarodaka.
• Prativaapa: Is nothing but addition of Choorn`a_s of Dantee, Dravantee etc.

Materials that are required for preparation of Kshaara: (Kshaara Paaka method.)

Sudhaa S`harkaraa, Tilamoola, S`hankhanaabhee, Dantee, Dravantee, Chitraka, water, Mootra, Lohakumbha, Agni.

S.Su.11-11 and 12

1. Make a heap of chopped Panchaanaga_s (i.e. leaves, roots, stem, flowers and fruit), which are chopped on the base of a raw limestone. On the heap of Panchaanga_s put the Tila Naala Kaasht`ha_s and burn it. After total burning of the heap of the tree parts and Tila Naala, allow it to cool.
2. Now, separate the ash from the heated limestone.
3. Now, take one Dron`a of Bhasma (Ash) about 12.250 Kgs. And mix it with 6 Dron`a of Water or cows urine (Gomootra) – about 15 Kgs. And strain it through a cloth 21 times.
4. Now, take this strained water in a flat iron vessel (Kat`aaha) and boil it till it becomes clear, reddish, and irritating to skin and slimy. Strain it again and separate the water. The material that is left on the clothafter straining is called Khaarapaaka. From this Ksharodaka, take out 11/2 Kud`ava of Kshaarodaka get to it red hot 2 Pala_s and Kat`abhas`harkaraa, Bhasmas`harkaraa, Kshaarapaaka and S`hankhanaabhee and again heat altogether till it becomes semisolid and then cool it down. Now put this Kshaaraapaka in an iron vessel (Loha Kumbha) which is buriedin the soil and close the mouth; this is Madhyama Kshaara.

Kut`aja (Holeinhena Antidysentrica) Palaasha (Butea Monosperma), Paaribhadra (Azadira Dhla India). Bibheetaka (Termialiabelerica), Aaragavadha (Casssia Fistuala) Bilvaka(Sxmplocas racemes), Arka (Calatropis Procera) Snuni (Euphorbia Nerifolia) Apaamaarga (Achyranthes Aspera)  at`ala (Stereo Spermum) Naktamaala – (Pongamia Glabra), Kadalee (Musa paradisiacal) Chitraka (Plumbagao Zeylanica) Pootika (Holoptele Itegripholia) Sapta Erand`a (papaya) Agnimantha (Premaintegrifoia) Kos`haatakee – (Luffa Acutangulala) Samudra Phala (Babingtonia Acutangulata) adhuka (Glxcyihiza Glabra).

Teekshn`a Kshaara: (Activated Kshaaracan be prepared by adding Dantee, Dravantee, Chitraka etc. (each 02 Tolaa_s)

Now, the softness or Teekshn`atva (Powerful action) could be tested by applicationofthis Kshaarato castor stem. After the application of Kshaara, count, 1 to 100. If the appearances of burn starts appearing before the completion of 100 count, it indicates that it is (Teekshn`a) strong in action, Kshaara; if not, it is taken that it is Mridu Kshaara.

Qualities of the best Kshaara:

S.Su. 11-15

It shouldnot be too strong or too weak.
It should be soft to the touch, sticky and should not be watery [Hygroscopic]. Acting speedily, but without much irritation on the body part.
Vaagbhat`a has added two more properties-

1. S`hikharee means it must produce a vertical flame on heating
2. Its irritating property must subside by the application of Kaanjee (Sukhaneervaapya)

Bad [unwanted] Qualities of Kshaara:

S.Su. 11-16 and 17 and A.H.Su.30-24-25 the one which does not soften or has strong irritating action, more whiteness of color, quick hot to touch, does not spread, but penetrates briskly, catches abundant moisture, or does not get dissolved quickly, is therapeutically unwanted one.

Action of Kshaaraon different Tissues and Dhaatu: –

S.Su 11-17, D`alhan`a.

1. As it contains many herbs, it becomes Tridoshaghna
2. As it tends towards whiteness, it has less irritation and corrosive action
3. It burns, it helps to digest, it opens up what was closed
4. It has Agnigun`a domination, as it possesses:

• Gun`a_s like Kat`u, Ushn`a, Teekshn`a
• It helps in maturation of Vran`as`hotha and Amaajeern`a
• It reduces inflammation
• It cleanses the infected wounds
• It also promotes the healing of non-infected wounds
• It reduces discharge from the wounds
• It is Haemostatic (Paachana)
• It has a scrubbing action on infected wounds and Medodhaatu
• It kills both the bacteria / maggots in the wounds when applied externally and cleans up the infection when given internally
• It normalizes Aama, Kapha, Visha, Medodhaatu, and also cures Kusht`ha when gives in proper dosage.
• It also causes sterility when given excessively.
• D`alhan`a says that it should not be used in a clean wound as a clean wound heals naturally and Ropan`a activity is an indirect effect of Kshaara.

How the KshaaraActs?

A.H.Su. 30-25,26.

When the Kshaarais applied on the skin or tissue, first there is irritation followed by inflammatory process resulting Edema, dragging pain and pressure finally resulting in separation of Dusht`a Dosha and all signs and symptoms of Kshaaradisappear.
As per Modern medicine, its action is alkaline in nature acquired through the lime

Diseases cured by Kshaarawhen applied externally:

Kusht`ha, Kit`abha, Dadru, Mand`ala, Kilaas, Bhagandara, Arbuda, Ars`ha, Dusht`a, Vran`a, Charmakeela, Tilkaalaka, Nyachchha, Vyanga, Mashaka, External Vidradhi, Kreemi, Visha. In the Mukharoga_s Upajeevhaa, Adhijeevhaa, Upakus`ha, Dantavaidarbha, and three types of Rohin`i.

When given internally, the curing action of Kshaarais on Gulma, Udara, Vaata Kaphaja Grahan`i, Visoochikaa, Alasaka, Vilambikaa, Agnimaandya, Ajeern`a, Arochaka, Aanaaha, Mutras`harkaraa, As`hmaree, Antarvidradhi, Krumi, Visha and Ars`ha

Contradictions for Kshaaratherapy:

Raktapitta, Jvara, Pittavikaaree, children and older people, emaciated or weak patients, patientshaving attacks of fainting Timeera or black outs.

It is also contraindicated in the patients having generalized Oedema, Ascitis, pregnancy, and menstruation phase of a lady, diabetics, painful conditions, recently traumatized patients, and sterility, Udvritta or Apavritta Phalayoni.

It should not be applied on Marma, Siraa, Snaayu, Sandhi, Tarun`aasthi, Sevani, Dhamani, Gala, Naabhi, and edges of nails, Med`hra and Alpamaamsa. Except the eyelids not anywhere on the eye.

Even though, the condition is an absolute pointer to Kshaarakarma, it should not be used in paralytic conditions, patients with Asthishoola, having severe anorexia, and pain in Precordial region

Method of Application of Kshaara:
S.Su. 11-18, 19 to 22, and A.H.Su. 30- 27, 28, 30.

With all the things prepared, the physician must inspect the area where the Kshaarakarma is to be carried out. If there is Pittadusht`i, scrub a little, if there is Vaatadusht`i, perform a deep scrapping, if Kaphadusht`i is there, make blood letting by taking superficial incisions. Apply Kshaaraby means of Kaarpaasakritoshn`eesha S`halaakaa and count upto100.

1. In case of piles, keep Ars`ho Yantra as it is with its mouth closed.
2. If it is to be applied on eyelids, fold the lid, cover the other parts of eye with a swab dipped in cold water and apply Kshaaraof a breadth of kamala Parn`a.
3. If it is to be applied for Naasaarbuda, place the patient so he is facing the sun, elevate the tip of the nose and apply Kshaara for a period, counting up to 50.
4. In case of auralpolyp, apply Kshaaratillthe area becomes blackish. After the application of Kshaara, and keeping it for the time mentioned or development of signs as said, wash the Kshaarawith Kaanjee or any of the Amla substance, and then apply honey and ghee. If there is no response to the Kshaaratherapy, apply Kaanjeekaa, Mahalunga Rasa, Sesum indicum, and honey.

Tilakalka, Yasht`imadhu (Glyceriza Gabia) and ghee are the best mixture for Vran`a Ropan`a after Kshaara Karma.

Why the Kshaarashould be washed with sour substances?

S.Su. 11-2225.

Kshaara has Ushn`a and Teekshn`a properties, thus application of Amla substance due to its S`heeta Gun`alowers the Ushna Gun`a of Kshaara.

Salt taste predominates in Kshaara, while sour taste predominates in the Amla Rasa when both these Rasa_s are mixed together, they produce Madhura Rasa, which is Saumya. It is nothing but a neutralization process.

Kshaara is hot to the touch while Amla substance is S`heeta to the touch. So that this or instantaneous contact is limitation of further action of Kshaaraon the tissues.

Signs and symptoms of Samyak Dagdha, Heena Dagdha and Atidagdha: by Kshaara.

S.Su.11-26, 27 and A.H.Su. 30-34,35.

1. Samyaka Dagdha Immediate relief in the sings and symptoms of the disease. Immediate stoppage of discharge, if any. The color of the area looks like a ripened Jambhoola (Eugeina jambolana), which is shrunken in appearance.
2. Atidagdha S.Su. 11-27 and A.H.Su. 30-34, 35.
   This produces thickened redness, inflammation, increased discharge, body ache, fatigue, thirst, fainting and heavy bleeding. It also produces contracturesin discharging sinuses like fistula in Anoat the anus.
3. Durdagdha There is redness, itching and dragging sensation. In the Atidagdha, treat symptomatically. If there is excessive burning due to sensation due to Kshaara, the following results are seen: –

Rectal area stagnation of Faecesor urine or

• Diarrohea, Polyuria, sterility and death
• Oedema at Perianlregion unable to hold the act of defecation or urination
• if it is a nasal condition, it leads to narrowing of nostrils, and loss of smell
• if it is an ear condition, it can result in narrowing of the lumen of ear and loss of hearing

In cases of Atidagdha (excess action of Kshaara):
Use Amla Lepa, cold application; apply Madhu Ghrita, Tilakalka and all Vaatapittaghna treatment. If there is bleeding, use all Raktastambhana measures. Excessive action of Kshaaraanywhere on the body produces Jvara, Diarrhea, Thirst, Fainting, Giddiness and Precordialpain.

Dr. R.B.Gogte
Ex – Professor and H.O.D. Department of Shalya,
Tilak Ayurved Mahavidyalaya and Hospital, Pune.

Last updated on March 2nd, 2021 at 02:58 pm