Sushruta Samhita Chapter 11 Ksharapaka Adhyaya

This text explains Sushruta Samhita Sutrasthana Chapter 11 “Ksharapaka Adhyaya”- Preparation of Caustic alkali.

We are going to now broaden the chapter, by title Ksharapakavidhi – preparation of caustic alkali; as revealed by the venerable Dhanvantari.

Kshara Mahatva

Significance of Alkali
Among the many shastra (sharp devices) and anushastra (accent devices) – kshara (caustic alkali) is an important one as a result of –

• It serves the features like chedana – excision (eradicating), bhedana – slicing (dividing) and lekhana – scraping,
• It’s ready by many herbs,
• It mitigates all of the three doshas and
• It’s appropriate for being utilized in many particular procedures
  Learn – Kshara: Properties, Varieties, Preparation Methodology, Advantages

Nirukti

Definition
It’s known as Kshara, because it does ksharana (destroys the vitiated tissues and makes them fall off) or because it does kshanana (torments the tissues).

Ksharaguna

Properties of Alkali
The kshara is ready by the mix of many herbs / medicine. Subsequently, it mitigates tridoshas. (Alkali is ready utilizing many herbs that are helpful in destroying the morbid tridoshas and therefore helpful in aggravation of all three doshas).

Since kshara is white in coloration, it’s cool in nature. Despite being cool it could protect its actions together with burning, ripening, and bursting.

Kshara is ready utilizing medicine / herbs that are predominant in Agneya guna (having fiery nature). Subsequently, it’s pungent in style and scorching in efficiency. (As a result of identical qualities) it’s deep penetrating and causes ripening (of swelling round wounds – vrana sotha and so on), liquefaction (of gulma – tumors and so on., purification / cleaning (of contaminated wounds and ulcers), therapeutic (of unpolluted wounds – shuddha vrana), absorption (of fluids – dampness or extreme moistness of wounds / ulcers), withholding (stops bleeding – checks extreme bleeding), and scarification (of arduous and elevated tissues together with muscle groups). It destroys worms (micro organism, virus and so on.), ama (undigested supplies), and kapha. It additionally cures kushta (pores and skin ailments, leprosy), poisons and extreme accumulation of fat (weight problems). If alkali is taken in extra, it destroys masculinity (sexual powers in male).
Learn – Kshara Agnikarma Vidhi – Cauterization- Astanga Hridaya Sutrasthana 30

Vidha- Varieties

Kshara is of two varieties, viz,

1. Pratisaraniya Kshara – meant for exterior software and
2. Paniya Kshara – meant for inside administration i.e., to be drunk (inside potion)

Pratisaraniya Kshara

Pratisaraniya Kshara i.e., software of caustic alkali externally is indicated within the under talked about circumstances –

• Kustha – leprosy
• Kitibha, Dadrumandala – minor pores and skin ailments  
• Kilasa – leucoderma
• Bhagandara – fistula-in-ano
• Arbuda – malignant tumors
• Arsha – piles / hemorrhoids
• Dusta vrana – vitiated (septic) ulcers
• Nadi – sinus ulcers
• Charmakila – pores and skin warts
• Tilakalaka – pinheads
• Nyaccha – pigmented patches on the physique and face
• Vyanga – pigmented patches on the face
• Mashaka – moles on the pores and skin
• Bahya Vidradhi – exterior abscess
• Krumi – worms (micro organism and so on.)
• Visha – ailments produced by poisons / poisoning
• Seven ailments of the mouth together with – Upajihva, Adhijihva, Upakusha, Dantavaidarbha and three sorts of Rohini / Kantarohini (Vataja Rohini, Pittaja Rohini and Kaphaja Rohini)
• Eteshu anushastra pranidanam uktam – in all these ailments whereby use of accent devices has been indicated
  Learn – Ksharasutra Preparation Methodology: Detailed Clarification

Paniya Kshara

Paniya Kshara i.e., ingesting of the answer of alkalies is indicated within the under talked about circumstances –

• Gara visha – synthetic poisons
• Gulma – stomach tumors
• Udara – enlargement of stomach
• Agnisanga – diminished digestive energy (irregularities or impairment of digestive capability and issues ensuing from the identical)
• Ajirna – indigestion
• Arochaka – lack of style / anorexia
• Anaha – flatulence / distension of stomach
• Sharkara – urinary gravel
• Ashmari – urinary calculi
• Abhyantara vidradhi – inside abscess
• Krumi – worms
• Visha – poisons
• Arsha – hemorrhoids
  Learn – Administration of Kshara Sutra in Arshas (piles, haemorrhoids)

Contraindications for administration of Paniya Kshara

Paniya Kshara is contraindicated within the under talked about circumstances and other people (since it’s dangerous in these circumstances) –

• Raktapitta – bleeding issues
• Jwarita – fevers
• Pitta prakruti – these belonging to pitta structure / physique kind
• Balaka – kids
• Vrddha – outdated aged individuals
• Durbala – debilitated individuals
• Bhrama – giddiness / these affected by dizziness
• Mada – intoxication
• Murcha – fainting
• Timira – blindness
• and related illnesses

Methodology of preparation of Paniya Kshara
Paniya Kshara ought to be ready by burning (incinerating) the medicine and making an answer of it. Its technique of preparation is identical as that of different ksharas, the small print of which will likely be described elsewhere.

Kshara nirmana

Preparation of Alkali
The opposite Kshara i.e., Pratisaraniya Kshara – meant for exterior software is of three varieties viz –

• Mrudu – alkali having delicate energy
• Madhyama – alkali having medium power
• Tikshna – alkali which is highly effective / of immense power

The individual (doctor) who wishes to arrange kshara ought to observe the under talked about procedures –
He ought to select an auspicious day throughout Sharad Rtu – autumn season. He ought to cleanse himself and observe fasting. Later he ought to attain the peaks (slopes) of the mountain on the chosen day. He shall seek for a Kala Mushkaka tree grown within the auspicious areas of those peaks. This tree ought to be of center age (enriched with style and efficiency) and massive in dimension. The facility (impact) of its efficiency shouldn’t have been destroyed by the impact of chilly, rains, hearth, poisons and bugs (worms and so on.). On the primary day the doctor ought to provide worship and oblations to the tree (enchant hymns in favor of the tree and induce energy in the identical). On the second day (subsequent day) the tree ought to be de-rooted. Its stem and branches ought to be minimize into small items with the assistance of an axe and saved within the type of a heap in a spot devoid of breeze. On this heap one ought to add some amount of small items of sudha sharkara i.e., lime stones (some limestones shall be positioned beneath the heap and a few within the between). This heap ought to be placed on hearth (burnt) with the assistance of dried reeds of Tila (sesame) plant. Ashes of the tree shall be collected in a separate vessel and that of the limestone in a separate one, after the hearth will get extinguished all by itself.

In the identical method, the under talked about vegetation / timber together with their roots, stem, branches, leaves and fruits shall be burnt and their as collected –

• Kutaja
• Palasham
• Ashvakarna
• Paribhadraka
• Bibhitaka
• Aragvadha
• Tilvaka
• Arka
• Snuhi
• Apamarga
• Patala
• Naktamala
• Vrusa
• Kadali
• Chitraka
• Putika
• Indravruksha
• Asphota
• Ashvamaraka
• Saptachchada
• Agnimantha
• Gunja
• 4 sorts of Koshataki

The ash of the above stated shall be taken within the amount of 1 drona (10.24 kg), put and combined in six drona (61.44kg) of water. If robust alkali is required, the ash is combined within the urine of cows and so on. (as a substitute of water). This ash combined water shall be filtered by means of fabric for twenty-one occasions.
This filtered water is now put in a big iron cauldron and boiled. Whereas boiling, the liquid ought to be slowly and always stirred with a ladle.

Through the technique of boiling, when the liquid turns into clear, pink coloured, sharp and slimy, the vessel ought to be faraway from the hearth. This could once more be filtered by means of a thick fabric into one other (iron) vessel and the filtrate (liquid) ought to be cooked once more. Earlier than heating, one or one and half kudava (160 or 240 grams) of the answer of ash (alkaline water) ought to be eliminated and saved individually, saved in a distinct vessel.
After that, the ash of Katasarkara, Bhasmasarkara (ash of limestone), Kshirapaka (oyster shell) and Sankha Nabhi (conch shell) ate burnt on hearth and made pink scorching and put into iron vessel containing the answer of ash (alkali) and stirred properly. Then eight pala (320 grams) of ash of Sankhanabhi and so on. are macerated in two drones (20-84 kg) of the identical resolution (taken out individually as defined earlier), made into paste can also be added (as prativapa). Cooking is sustained whereas stirring the contents all by means of until the mass turns into neither too stable nor too liquid (skinny). When the cooking is nearly full, the liquid is then poured into the iron vessel, closed with a lid and preserved rigorously. That is the tactic of getting ready Madhyama Kshara (alkali of reasonable power and efficiency).

This Kshara (Alkali) itself if ready with out Prativapa (including paste of different medicine) known as as Samvyuhima Kshara or Mrdu Kshara (Alkali of delicate efficiency).

Within the prativapa of Katasharkaradi herbs, the high quality powder of equal amount of every of Danti, Dravanti, Chitraka, Langali, Putikapravala, Tadapatri, Bida lavana, Suvarchika, Kanakakshiri, Vacha and Ativisha – all or as many as out there are added in amount of 1 shukti (20 grams). On this manner if prativapa (including further medicine to reinforce the properties) of Katasharkara and so on. is added with prativapa of Danti and so on. and cooked, it’s known as as (the resultant alkali) Tikshna Kshara (alkali of robust efficiency). Additionally it is known as as Pakya Kshara.

These (two sorts of Alkali – Mrdu and Tikshna) ought to be used in keeping with the power of the illness. If the Alkali is weak (delicate efficiency) it ought to be soaked (for a short while) within the resolution of Alkali to reinforce its power.

Kshara Guna Dosha

Good Properties and demerits of Caustic Alkali

Kshara Ashta Guna – The eight good properties of alkali are –

1. Naiva Atitikshna – Not very robust,
2. Na Mruduh – not very delicate
3. Shuklah – white in coloration
4. Shlakshna – clean
5. Pichchila – slimy
6. Avishyandi – not spreading
7. Shiva – good appearing
8. Shighrah – fast appearing

Kshara Ashta Dosha – The eight demerits of alkali are –

1. Ati mardava – very delicate / weak,
2. Ati shvaitya – an excessive amount of white in coloration
3. Ati ushna – highly regarded (warmth producing)
4. Ati tikshna – extremely penetrating
5. Ati pichchila – very slimy
6. Ati sarpitah – enormously spreading
7. Ati sandrata – very thick (liquid
8. Apakvata – not properly cooked, and
9. Hina dravyata – missing in medicine (talked about within the classics) required to arrange the

Pratisaraniya Kshara prayoga

Process of Making use of caustic Alkali externally
The affected person, who’s affected by a illness which is curable with software of alkali, ought to be made to sit down in a spot devoid of breeze and daylight. The place ought to be broad (not slender). All the mandatory equipments and issues required for conducting kshara karma shall be collected beforehand and saved prepared, as defined in agropaharaniya chapter (chapter 5).

 Subsequent, the place (website) for the applying of the Alkali, within the affected person match to bear alkali remedy, ought to be noticed (inspected properly) correctly. Later the location ought to be scrubbed, scrapped or minimize (incised). Then the Alkali held in a salaka yantra – rod like instrument (specifically meant for this objective described in chapter 8) ought to be smeared on the place (website of the illness). After making use of, a time period required for saying 100 letters ought to be allowed to elapse (the doctor ought to anticipate a time interval of hundred counts).
Learn – Sushruta Samhita Chapter 8 Shastravacharaniya Adhyaya

Kshara Dagdha Lakshana

Indicators of fine burning by alkali (cauterization)

The indicators of fine burning by alkali (cauterization by alkali) are –

• disappearance of the illness following the applying of kshara / falling off of the diseased half following the applying of kshara and
• improvement of black coloration on the website 

As soon as this seems, the medicine of the ‘bitter tasting group – amla varga’ are combined (processed, boiled) with ghee and powder of licorice is utilized. This relieves burning sensation, ache and discomfort.

If the diseased half (vitiated muscle and so on tissues) doesn’t fall off despite being burnt by the alkali, the world ought to be smeared with paste of all of the medicine that are talked about henceforth.
Equal portions of amla kanjika bija (the stable half settled on the backside of amla kanjika – bitter gruel), sesame and madhuka – licorice ought to be floor collectively and the resultant paste be utilized on the half burnt by alkali.
For additional therapeutic of the ulcer ignored after software of the above stated formulation, paste of tila – sesame and madhuka added with ghee is utilized on the website.

Amlarasa Karma

Motion of the bitter style
Lord (Grasp) Dhanwantari stated to Sushruta ‘Pricey son, when you opine – how does amla rasa (bitter style) which possesses penetrating property, scorching efficiency and hearth like actions, having hearth like motion, mitigate the impact of kshara – alkali, which additionally has related properties as these of fireplace, then take heed to what I’m going to say now (my reply)’.

In Kshara (alkali), all tastes (candy, salt, pungent, bitter and astringent) are current, besides bitter style.
Amongst these 5 tastes, pungent is the predominant style and salt is the secondary style. When these pungent and salt tastes mix with the bitter style, they turn into predominantly candy.

When salt having penetrating high quality will get combined with bitter style it could purchase extreme sweetness and solid off its penetrating high quality and in addition will get subsided by (mitigated) the sweetness, identical to the hearth subsides when water is poured on it (results of burning by alkali will get mitigated).
Learn – Amla Advantages, Dose, How To Use, Facet Results, Dwelling Cures

Dagdha Lakshana

Indicators of burning (cauterization)
Samyak Dagdha Lakshanas (indicators of correct cauterization) –

• Mitigation of the ailments (subsiding of signs like ache, swelling, bleeding and so on.),
• Feeling of lightness (of the diseased half) and
• Stoppage of exudations

Hina Dagdha Lakshanas (indicators of insufficient cauterization) –

• pricking ache,
• itching,
• lack of motion and
• improve of the illness (aggravation of signs)

 Ati Dagdha Lakshanas (indicators of extreme / over burning) –

• burning sensation,
• suppuration (ulceration),
• redness,
• discharges / exudation,
• ache within the physique elements,
• exhaustion,
• extreme thirst,
• fainting and
• even demise

The ulcer produced by burning (cauterization)by Alkali ought to be handled suitably in keeping with the aggravated Dosa and the illness.
Learn – How To Make Natural Oil To Take away Burn Scars

Kshara Anarha

Contraindications for Alkali Cautery: –
Cauterization by Alkali shouldn’t be performed for individuals resembling

• the debilitated,
• kids,
• outdated aged,
• fearful,
• these affected by swelling everywhere in the physique, enlargement of the stomach, bleeding ailments,
• pregnant woman,
• lady throughout menstruation,
• these in whom the depth of the fever has abnormally elevated (superior stage of fever),
• these affected by diabetes, those that are emaciated because of damage to the chest (lungs), thirst, fainting
• these impotent,
• girls whose uterus has been displaced downwards or upwards

So additionally, alkali shall not be administered in locations resembling important spots, veins, ligaments, joints, cartilages, sinews (raphae, sutures), arteries, throat, umbilicus, nail-bed, penis, channels, locations of the physique with much less muscle groups and eyes, besides ailments of the eyelids

Even in these ailments that are curable with using alkali, administration of kshara (alkali) won’t profit (yield good outcomes) in sufferers having swelling everywhere in the physique, ache within the bones, aversion in direction of meals, ache within the coronary heart and joints.

Limitations of administration of kshara – alkali
Alkali (cauterization) administered by an individual of poor intelligence will likely be like (the impact of) poison, hearth, sharp weapon, thunderbolt and demise. Quite the opposite, if alkali is run correctly by an clever individual (doctor, surgeon) it could possibly treatment even dreadful ailments in fast time.
Thus finish the eleventh chapter by title Ksharapakavidhi in Sutra Sthana of Sushruta Samhita.