Abstract

There are many things in Ayurvedic science which are not fully known to the world. For them it is just as a magic or miracle but things are different with the Ayurvedic science. Ayurveda is the science which is considered as fifth veda according to some references and on the other hand some references suggest that it is the part of the atharva veda. As mentioned before, many things in Ayurveda are not fully known, for example Rasaushadhi, Which are still misunderstood as toxic for the body but their intake gives impressive results in many chronic conditions and even acts as immunomodulatory in cases of cancer and some viral infections. Like Rasaushadhi there is one more thing mentioned in Ayurvedic texts whose benefits are not known much but is of great therapeutic use. This thing is called Kshara and in this article we will discuss Tikshana Kshara along with its therapeutic importance in detail.

Introduction

Starting with the introduction of the topic, we must understand that

What is Kshara?

Kshara or ksharas are the alkaline substance that is obtained from the water soluble ashes of the herbal plants. In Ayurvedic texts there are a variety of kshara which are mentioned. Discussing specifically about Tikshan Kshara, it is a highly alkaline and caustic concentrated solution which contains non metallic elements like potassium and sodium. The hydroxides of these elements are used to destroy the growths like warts etc. The concentrated solution of alkali has the capacity to destroy the superficial skin and deeper tissues. A Crust of dead tissues is formed, which separates shortly leaving a deep ulcer. This is a strong caustic penetrates and liquifies the deeper issues.

Though such destructive action is unwanted. Weak caustics like silver nitrate, copper sulphate, phenol etc are used for treatment of warts, ulcers, dental caries, follicular conjunctivitis and dog or snake bites.

Similarly Acharya Sushruta has mentioned manufacturing techniques and therapeutic use of Tikshna kshar in various types of surgical disorders. It is used in the treatment of haemorrhoids, fistula in ano, anal fissure, non healing and unhealthy wounds, sinuses, moles and warts. It is specially for external use and is contraindicated in internal administration.

Kshara Preparation

The preparation of Kshara is only done in sharad kala or Autumn season. Autumn season is considered between October and november. The preparation should be done near a hilly area.

Before the preparation of kshara, mangacharna is guided. Manglacharna is holistic and devotional rituals which are to be conducted. After this a healthy mushkaka plant or Elaeodendron glaucum should be taken along with its roots. The plant is made into small parts and subjected to boiling till it is covered into total ash. After the separation of burned lime stones from the ashes it is collected in a sterile jar. It is to be noted that ash must not have any type of contamination or it should not be exposed to moisture. The kshara collected from this method is called prathamika kshara or primary Kshara.

This is one of the examples given by Sushruta, later he had mentioned some set of herbs from which kshara or alkali can be extracted and further can be used for medicinal purposes.

After the collection of ashes in a sterile container it is to be prepared as kshara. For that it is to be mixed in 4 times water and stirred well and then left for three hours. The solution should be filtered through three layered cloth. The obtained material is then taken in an iron vessel. Now heat the material till the water is completely evaporated. Once it becomes free from water content then it should be powdered and stored in the airtight glass jar.

List of Plants for Kshara Preparation

Following are the Plants that can be used for preparing kshara:

• Kutaja (Holarrhena antidysenterica)
• Palasha (Butea monosperma)
• Gunja (Abrus precatorius)
• Ashwakarna (Dipterocarpus turbinatus)
• Agnimantha (Premna integrifolia)
• Paaribhadraka (Erythrina variegata)
• Saptachanda (Alstonia scholaris)
• Bibhitaki (Terminalia bellerica)
• Ashwamarka (Nerium indicum)
• Aaragwadha – (Cassia fistula)
• Asphota – (Hemidesmus indicus)
• Tilwaka – (Symplocos racemosa)
• Putika – (Holoptelea integrifolia)
• Arka – (Calotropis procera)
• Snuhi – (Euphorbia neriifolia)
• Chitraka – (Plumbago zeylanica)
• Apamarga – (Achyranthes aspera)
• Kadail – (Musa sapientum)
• Paatala – (Stereospermum suaveolens)
• Vrusha – (Adhatoda vasica)
• Naktamaala – (Pongamia Pinnata)

Selection of herbs for Kshara Preparation according to dosha dominance

The herbs for kshara preparation are also selected on the basis of dosha dominance. Some of the examples are as follows:

• Kadali – Vata Alleviating Property
• Aragwadha, Krutavedana, Kutaja etc – Pittaghna property or pitta alleviating property
• Palasha, Karanja, Tilwaka, vasa, Agnimantha, snuhi, apamarga, putika, Nimab, ashwakarna, karavira, bibhitaki, Arka, Krishnamushkaka, Saptachchada – Kapha alleviation property or kapha ghana
• Patala, sariva, Gunja – Tridosha pacification property

Types Of Kshara

Ayurveda mentions two types of Kshara. The types are as following:

1. Paneeya Kshara
2. Pratisarana Kshara

1. Paneeya Kshara

The paneeya kshara are the alkalis which can be consumed through the mouth. This type of kshara are to be used in conditions like Arsha (haemorrhoids), Agnisada (indigestion causing dyspepsia), Ashma (Urinary stones), Gulma (Abdominal tumours) & Udara (Enlarged abdomen, abdominal disorders and ascites).

2. Pratisarana Kshara

Pratisarana kshara are the alkalis which are to be applied externally. This type of kshara is used in management of mashaka (Moles), Shwitra (leucoderma), Bahya arsha (External piles), Kushta (Skin diseases), Supti (Anaesthetic patches), bhagandara (fistula in ano), Arbuda (tumours or cancer), granthi (tumours or fibroids) and dushta nadi vrana (Contaminated or foul sinus ulcers).

Pratisarnnaya kshara is further subdivided into three categories. These three are as follows:

• Mridu kshar (Mild)
• Madhyam (Moderate)
• Tikshana (Intense)

Type on the basis of season of preparation

1. Uttamn (best) – Prepared in Greeshma (Summer season)
2. Madhyam (better) – Prepared in sharad (Autum season)
3. Adhama (Bad) – Prepared in Varsha ritu (Rainy season)

Classification of Kshara on the basis of their numbers

After knowing and gaining so much knowledge about kshara, we already know that kshara has therapeutic value. Moving further in the article we will discuss the therapeutic utilisation of kshara.

Qualities of Kshara

• Tridohsa ghana – pacifies tridosha
• Soumaya – Pleasant and mild nature
• Dahana – Burns, Corrodes
• Pachana – Ripens the Wound
• Darana – bursts open wounds
• Katuka – Pungent
• Ushna – Hot potency
• Teekshna – Intense action
• Vilayana – Liquifies
• Shodhana – Cleansing Property
• Ropana – Has healing effect/Improving granulation
• Shoshana – Drying or absorbing property
• Stambhana – Arrests or stops oozing
• Lekhana – Scraping nature
• Krimighana – Kills microbes
• Shukra ghana – Causes sterility

Standard properties of Kshara (Ashtanga Hridaya Sutrasthana 30)

• Na aati Teekshana – Not too strong
• Na aati Mridu – Not too mild
• Shalkshna – Smooth
• Pichchila – Slimy or smooth
• Sheeghraga – Spreads Quickly
• Sita – White in Colour
• Shikari – Remaining Like a mountain peak at the site of application
• Sukha nirvapya – Easy removable
• Na vishyandi – Don’t produce much moistness
• Na ati ruk – Doesn’t cause much pain

Therapeutic Utilisation Of Kshara

If we look into the above mentioned types of kshara then it's already understood that kshara has various categories. After going through basic details of kshara now let's discuss the therapeutic application of tikshna kshara.

Kshar karma was very popular in Ancient India for the treatment of various surgical disorders and physicians who are having speciality in kshara therapy were known as kshara vaidya. The surgical value of kshara due to its therapeutic utility in various diseases is excellent. Acharya Sushruta has mentioned this para surgical tool for the various surgical ailments.

Because of its action of chedya (excision of the tissues), Bhedya (Penetration into deeper tissues), lekhya (Scraping of tissues), it is used in many conditions in which major surgical procedure is not possible. Although agni karma (Thermal cauterization) which is mentioned by Sushruta, is superior to kshara karma as the disease managed by agni karma do not relapse. In Addition scope of mridu kshar in internal Administration orally for the treatment of various types of abdominal disorders, which proves its superiority than other forms of para surgical procedures.

Indications of Kshara

As mentioned before kshara is used in various type of conditions the major indications of kshara are as following:

• Mridu kshara is indicated for internal use like in abdominal disorders or gastrointestinal disorders. Mostly works for indigestion, dyspepsia, constipation, worms and hyperacidity
• Tikshana kshara is used externally for the treatment of various types of ailments like ringworm, leucoderma, piles, fistula, sinus, tumour, small warty growths, unhealthy or infected wounds, Abscess along with various types of skin diseases, oral and dental diseases, ear, nasal and ocular diseases.

Method of kshara application

The Application of kshara is done after Purva karma (Pre operative procedure), its application of kshara is Pradahan karma (operative procedure) and After its application patient has to follow Pashchat Karma (Post operative procedure).

Purva Karma (Pre- operative Procedure)

• Patient should visit his/her doctor with a free mind and should not have fear, anxiety, tension or doubts in mind.
• Patients are also advised to take light meals before kshara karma.
• The area where procedure is to be done should be properly ventilated.

Pradhan karma (Operative procedure)

• The patient is placed on the operation table.
• The diseased part is exposed, cleaned and examined carefully.
• Before the application of kshara Lekhan, visravan or scraping, scrapping of the diseased part is to be done till the blood oozes out.
• In case of raised lesion, its excision is to be done.
• Now the kshara is applied on the affected area with a probe mounted with a cotton swab.
• The lekhan, visravan and excision is only done in the lesions which have hard tissues. This results in penetration of kshara into deeper tissues.
• The kshara is applied on the skin till the counting of 100 but can vary according to the type of the kshara, soft or hard tissues, mucosal or cutaneous tissues. In addition one can wait till the time symptoms of proper cauterization appear on the skin.

Paschat Karma (Post operative procedure)

• As soon as the signs of samyak dagdha appear that are signs of proper cauterization, the kshara is immediately or rapidly neutralised by acidic fluid like kanji mastu.
• Later on the cauterised part is completely washed out with distilled water  and application of Jatyadi or Yasti Ghrita is done on the  cauterised lesion.
• Finally dressing is done.
• Techniques may vary according to site and kshara karma in case of ear, eye, nose and oral diseases is to be done very carefully.
• In case of haemorrhoids, the kshara application is done by visualising the lesions by Proctoscope.

As mentioned above samyak dagdha lakshan or appearance of proper cauterization are to be watched. So, following are the symptoms of proper, improper or extensive cauterization.

Smyak Dagdha (Proper Cauterization)

After 30-60 seconds of kshar application the tissues of the disease part becomes purple or dark black in colour and cauterised lesions is shrinked, pain and discharge relieved. Patients also feel easiness with relief of prominent symptoms.

Heena Dagdha (Improper Cauterization)

The colour of the Treated area looks reddish with aggravated pain and itching.

Ati Dagdha (Extensive Cauterization)

It is followed by burning and severe pain, along with burning of the cauterised area, ulcerations with purulent discharge and fever. Along with these symptoms it also has generalised pain in the body, intense thirst and shock and even death may occur.

Above mentioned points are to be kept in mind whenever you are doing kshar karma. Kshar karma especially with tikshan kshara is really helpful in various types of diseases and other types of kshara are also really beneficial in many types of diseases. Kshara karma is also done in Pilonidal sinus, Chronic dacryocystitis, chronic trachoma and warts.

Conclusion

The kshara Karma is one of the best gems of Ayurveda which can be used successfully in the conditions where major surgical procedures are not possible. As mentioned above Ayurveda has many hidden secrets, such secrets can be enlightened for the benefit of mankind and other kinds as well. The above article has entire information about the kshara, Its definition, preparation, herbs which are used for kshara preparation, various types of kshara and how it can be utilised. Moreover, it also has information regarding the entire procedure of kshara karma and also about its therapeutic utilities. In case of any queries kindly visit www.PlanetAyurveda.com