Ayurveda is well known for curing and treating people since ages. There’s no disease that this Vedic science cannot treat. Ayurveda has left no stone untouched when it comes to pave a way to healthy lifestyle, treat any disease or find best suited management to any chronic ailment like diabetes. Ayurveda is a prestigious yet most underrated science. This science is not much known for its surgical procedures despite of the fact that Acharya Sushruta, a renowned Ayurveda Acharya has been called as father of surgery in ancient texts.

There are some Para-surgical methods that are operated in Ayurveda – Shastra karma, Agni karm and Kshara karma. In the past few years, these methods are more imbibed in practice by the Ayurveda practitioners due to the accountable and time tested results of these procedures in clinical practice. A huge number of people suffering with diseases like piles, fistula, warts, fissure, Pilonidal sinus and other anorectal diseases are often told that surgery is the only way out. But Ayurveda offers less harming, cost effective and faster healing alternative with least complication than general surgery through Kshara Karma.

Kshara karma is a Para-surgical approach for treating anorectal diseases and other sinus diseases. This method is widely imbibed and practiced in our county today. The standard approach of preparing Kshara sutra involves 2 basic steps which are detailed below-

1. Preparation of Kshara

2. Preparation of Kshara Sutra

1. Preparation of Kshara –

The word Kshara literally means ‘Alkali’. There’s no strict plant or plant part that one has to choose for the preparation of kshara. A specialized Ayurveda physician selects the medicinal plant for the purpose of preparing kshara according to the disease and likewise, part of the plant to be used is also selected. Most commonly, Kshara of medicinal plants like Apamarga (Achyranthes aspera), Palasha (Butea monosperma), Kutaj ( Wrightia antidysentrica), etc are taken into clinical practice. Plant chosen varies in accordance with type of disease, severity of disease and extent and type of vitiation of Dosha.

After selecting the plant successfully, usually the entire plant is taken into use while for some plants only roots or stems and leaves are taken in use. Likewise, after the collection of the required plant part, the plant is cut to small pieces and dried well under the roof. Later, the dried plant parts are kept in an earthen pot and burnt to ash. Afterwards, the ash is made to dissolve in water 6 times the quantity of the ash. Now, this solution is made to pass through a filter paper or a cloth with minutest pores for 3-4 times till visibly clear water is obtained. The obtained clear water is now set to boil on mild flame till the entire water evaporates. This leaves behind a white powdery salty substance named Kshara.

2. Preparation of Kshara Sutra –

Sutra literally means ‘thread’. Sutra is the main surgical device through which the entire process is carried out. For the preparation of kshara sutra one requires a thread of 20 number that is attached in the thread stand for better handling. On this sutra total 21 coatings are done in 3 steps. In the first step, 11 coatings of Snuhi sheera (Latex of Euphorbia nerifolia) are done on the thread. In second step, 7 coatings of Snuhi latex along with the above prepared plant Kshara is coated. In third step, 3 coatings of Snuhi latex with Haridra (Turmeric) are coated on the thread. Some may use Guggulu in place of Snuhi latex. The pH of the Kshara is usually from 9 to 10, which is basic in nature. Snuhi latex and Guggulu both are used for the purpose of binding the other essentials on the Sutra successfully. Kshara is coated on the thread for its medical properties. Turmeric is coated on the thread in order to sterilize and avoid the microbial growth and sepsis at the affected area. Also, it aggravates the process of healing. This 21 times coated Kshara Sutra is now ready to be used. It is widely indicated in diseases like Fistula-in-ano, pilonidal sinus, rectal or anal polyps, genital warts, sentinel piles etc.

Kshara aims to cut, curette, drain and heal the extra outgrowth of the skin. It removes the unwanted and septic unhealthy tissues and debris over the skin. Sutra does not create major wounds at the site of infection which decreases the exposure of the affected area, thus inhibiting the extra microbial growth. The minimal chances of recurrence of the disease and no major complications like stenosis, incontinence and strictures often makes this para-surgical process more patient friendly.

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