KSHAR AND KSHARSUTRA

Kshara

Kshara is a kind of medication described in Ayurveda Texts for the management of various disorders . The word Kshara(क्षार) is derived from the root Kshar(क्षर्), means to melt away or to perish (क्षर् स्यन्दने). Acharya Sushruta defines as the material which destroys or cleans the excessive/the morbid doshas (Kshyaranat Kshyananat va Kshara). According to the preparation we can consider it to be caustic materials, obtained from the ashes after distillation and are mostly alkaline in nature.

Contents

            1 Types of Kshara

• 2 Drugs Used
• 3 Method of Preparation
• 4 Kshara Sutra
  • 4.1 Method of preparation
• 5 Mode of Action
• 6 Types of Kshar Sutra
• 7 References

Types of Kshara

According to the administration it is of two type 1. Paniya Kshara(for internal Medication) and 2.Pratisaraniya Kshara'(external application). The Paniya Kshara is mostly used for the treatment of diseases like artificial poison, abdominal lump, indigestion, calculus etc. The Pratisaraniya Ksara is used to apply on tumors, piles, fistula in ano, skin diseases etc.

1. ^ Sabda Kalpadrima
2. ^ Susruta Samhita 3/11
3. ^ Susruta Samhita 11

 Drugs Used

Many drugs have been advised by Sushruta and other Ayurvedic texts for the preparation of Kshara. The important among them are - Palasa- Butea monosperma, Erythrina indica, Terminalia belerica, Cassia fistula , Plumbago zeylanica, Holarrhena antidysenterica etc.

 Method of Preparation

According to the three types of Ksharas are prepared on the basis of their strength. 1. Mild - Mridu, 2. Moderate - Madhyama and 3. Strong - Tikshna .The general procedure can be narrated as - 'Mridu'Bhașmīkaraņa (conversion to ash) Adding to water(1:6 ratio) Filtration(21 times) Distillation(boiling the ksarajala still all water evaporates) collection (process called lixiviation) 'Madhyama' Here the procedure is same some extra powders of Katasarkara Bhasma sarkara Ksheerapaka, Samkhanabhi( gravels of lime and ash,oyester-shell & core of conch-shell) are added to the boiling ksharajala before distilling it. 'Tikshna' Similar to madhyama kshara here added is the powders of drugs like Chitraka, danti, vacha etc. inplace of the lime stones.

Kshara Sutra

"Kshar Sutra" (क्षारसूत्र) is a sanskrit phrase in which Kshar (क्षार) refers to anything that is corrosive or caustic; while Sutra(सूत्र) means a thread.It is described by many Ayurvedic texts which originated and flourished in India. It is one among popular Ayurvedic treatment modality in the branch of Salyatantra followed by Susruta.

The Ksharsutra was first mentioned by the "Father of Surgery" Sushruta in his text named SUSHRUT - SAMHITA for the treatment of Nadi Vrana(sinus), Bhagandara (fistula- in - ano), arbuda(excision of small benign tumour) etc..Although Brihattrayi- the chief three texts of Ayurveda mention the use of kshara sutra,there is no description of their preparation properly. It was Chakrapani Dutta in late eleventh century in his book Chakradatta ,first mentioned the method of preparation with a clear-cut indication of its use in bhagandara and arsha(haemorrhoid). In his book Chakradutta explains the method that by smearing a sutra (thread) repeatedly in the latex of snuhi() and haridra(turmeric) powder makes the kshara sutra. Later authors like Bhavamishra, Bhaisajyaratnavali etc. also mention the same method. But because of brevity of preparation and inadequate explanation of procedure of application, it lost its popularity among Ayurvedic surgeons. Later in Rasatarangini a better preparation procedure was introduced still the credit of making it practically in use goes to Prof. P.J.Deshpandey and his coworkers. They rediscovered and standardized the ksharasutra in the present era . The Dept. of Shalya- Shalakya, Faculty of Ayurveda, IMS, BHU should be credited for the abundant use and popularization of this technique.

1. ^ A hand book of Anorectal Disorders and their Ayurvedic Management, Dept. of Salyatantra , GAC, Tripunithura, Kerala

Method of preparation

The standard kshar sutra is prepared by repeated coatings of snuhi ksheera (latex of Euphorbia Nerrifolia), apamarg kshara (ash of Achyranthus aspera) and haridra powder over a surgical linen thread no. 20. This thread is spread throughout lengthwise in hangers. Each thread on the hanger is then smeared with snuhi latex with the help of gauze piece soaked in the latex. This wet hanger is transferred in kshara sutra cabinet.

The same process is repeated next day. Eleven such coatings with snuhi ksheera alone should be accomplished. The twelfth coating is done by first smearing the thread with ksheera and in wet condition thread is passed through the apamarg kshar. It is again transfer into the cabinet for drying. This process is repeated till seven coatings of snuhi ksheer and apamarg kshara are achieved. The final three coatings are completed with snuhi ksheera and fine powder of turmeric in the same fashion. Thus twenty-one coatings over the thread are completed.,

1. ^ A Handbook of Anorectal Disorders and their Ayurvedic Management, Dept. of Salyatantra, GAC, Tripunithura, Kerala
2. ^ Anal Fistula and KST, Pathak S.N., Chawkhamba Krishnadash Academy, Varanasi

 Mode of Action

Kshar Sutra is now a popular treatment modality in India for the management of fistula in ano. Many Clinical trials have done all over in different institutes to evaluate the action. In countries like Srilanka and Japan also many clinical trial has already done and established it. Precisely the action of Kshara sutra is thought to be due to its healing and cleansing effect according to Ayurveda. It can be suggested that due to the anti microbial action, and as a saton it allows the proper drainage of pus from the fistula, that leads to a proper healing. On the other hand the cutting effect of thread incises the skin gradually with out a surgical incision. Many studies confirms that it is more effective in the way of reducing hospital stay and less infection than the conventional seton therapy.Researches suggests that it is having the action of Excision, Scrapping, Draining Penetrating, Debridement , Sclerosing and Healing.it is Bactericidal and Bacteriostatic.

Types of Kshar Sutra

In the textual reference of Chakradatta and Rasatarangini we get only indication of the thread made up of Snuhi, apamarga and Turmeric. Susruta describes about many kind of Kshars like Karaveera, Palasa, Kadali etc. in Susruta Samhita. So many studies have already carried out with variations in the Kshara and the latex. The most remarkable are Guggulu Ksharasutra, Udumbara KS, Gomutra KS, Papaya KS, KS with Ficus carica latex etc.

1. ^ Shukla, N.K. Narang, R. Nair, N.G.K., Radhakrishna, S., Satyavati, G.V.: Multicentric randomized controlled clinical studies of Kshara-sootra in management of fistula-in-ano. Indi J. Med. Res. (B), 177-185, 1994
2. ^ Thakur abhiram at al , Kshara sutra therapy a new dimension, souvenir-Anusastra 2008, Dept. of Salyatantra, GAC, Tripunitura, Kerala
3. ^ Ghanekar BG , Susruta Samhita, Sutra sthana 11, ML Publication, New Delhi,1998

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medical director,chief ayurveda consultant,ayurmangalam hospital ·Jul 2003 to present · Jhansi

ayurmangalam hospital and research centre,

• specialist of ayurved chikitsa, yoga ,panchakarma and naturopathy

9795330300

Arthritis And Diet..

About one in seven peoples suffers from some type of arthritis,joint inflammation,stiffness,swelling and pain.The most common types are osteoarthritis,a painful condition in which joint cartilage gradually breaks down and rheumatoid arthritis ,a systemic disease that can cause severe pain and crippling...

Doctors do not understand why some individuals develop arthritis and others do not,but a combination of factors plays a role.People with Osteoarthritis may have inherently defective cartilage that makes it vulnerable  to normal wear and tear.Rheumatoid Arthritis(RA)develops when an overactive immune system attacks connective tissue in the joints and other organs,causing inflammation and pain...

There are some dietary measures which can fight with Arthritis..By some researches it is proved that with some types of foods,food elements,Arthritis can be prevented,or can be fought with..Until recently doctors generally dismissed dietary treatments for arthritis,but new research shows that for some patients diet can make a difference..Studies have shown that patients with RA can experience a marked reduction in swelling ,pain,and redness of joints by ADDING OMEG-3 FATTY ACIDS to their diet.The OMEGA-3 FATTY ACIDS have anti inflammatory properties,where as the more common OMEGA-6 FATTY ACIDS are pro inflammatory..

So..Some Important Dietary Tips:...

1..It is necessary to Watch the levels of OMEGA-6 FATTY ACIDS in your diet ...

OMEGA 6 FATTY ACIDS tend to weight gain,reduce the powe of immune system,resultant of Cardiac disease and even Cancer...So just keep watch on the level of OMEGA 6 FATTY ACIDS..which are found in sunflower oil,corns,soya-bin,safola oil..

2...Eat more Vitamin C rich foods...

Vitamin C is important for the manufacture of Collagen..Collagen is a type of protein. Fibrous in nature, it connects and supports other bodily tissues, such as skin, bone, tendons, muscles, and cartilage. It also supports the internal organs and is even present in teeth. There are more than 25 types of collagens that naturally occur in the body.Eating Vitamin C enriched foods may help slow the progression of Osteo Arthritis(OA)...Best food sources of Vitamin C are citrus fruits,berries,melons,many other fruits,cabbage,potatoes..many other vegetables..

3...Antioxidants:..

There are evidences that antioxidanats such as Vitmin C,beta carotene and Vitamin E will fight the effects of free radicals ,which are generated by inflammatory compounds and are thought to cause tissue damage in people with RA...So addition of Anti oxidants in diet will be helpful..

Antioxidant.                            Function                                                            Food Sources..

Vitamin C           Protects against HEART DISEASE,macular              Citrus fruits,Tomatoes,Melon etc...

                            degeneration,some types of Cancer     

Vitamin E     May help prevent tissue damage by fighting with        Nuts,seeds,oils,fruits,vegetables...

                    free radicals

Carotenoids               Same As Vitamin E Function                      Orange,dark green vegetables like

Beta carotene                                                                             carrots,spinach,sweet potatoes etc.

4...Food Allergies...

Some evidence show that a small % of people with arthritis have food allergies that exacerbate joint symptoms.Like wheat,soy,corn,coffee,possibly certain food additives..Researches have found that for these people removing the allergy causing foods from the diet has resulted in less pain ..It is helpful if you think a certain food is triggering your pain ,remove it from your diet for 2 weeks and pay attention to any symptom changes.Then add it back and see if your symptom worsens...

5...Weight Factor..

Obesity greatly increases the risk and severity of OA..Even a little extra weight strains the knees and hips.Losing weight and increasing exercise improve symptoms..

Patient of RA often have the opposite problem,they may be too thin due to appetite loss,chronic pain,or depression.So by having calorie and nutrient enriched liquid supplements it will be helpful..

6..Vegetarian Diet...

Researches have found that a strict vegetarian diet can bring about significant symptoms relief.The strict diet have a benefit from fruits,vegetables, and grains which contribute important anti oxidants that can help counter some of the inflammation..The diet is also low in or free of animal fats,which may promote the production of inflammatory immune compounds..Vegetarian diet with proper nutrition will be helpful...

7...Top Foods That Fight Arthritis...

A..Fish:..

Fish rich in Omega 3 fatty Acids....

B..Vegetables:..

Eat 5 to 10 servings of dark green or bright orange vegetables every day to provide beta carotene.(sources given in the chart)

C..Fruits:..

Eat daily:..yellow,orange colored fruits for beta carotene,citrus fruits,berries,melons etc..

D..Nuts & Whole Grains:...

Eat nuts,seeds and whole grains regularly,for Vitamin E,a potent antioxidant that helps relieve inflammation and stiffness...

I have tried to cover this important issue by the point of Dietary means...In the next doc file will try to cover Blood Pressure.....

References:..

1...Foods That Heal Foods That Harm...

2..The Nutrition Source..Vegetables and Fruits

3..Family medicine and Diseases..

4...Healthy Eating..Harvard School Of Public Health

5..Beilin LJ. Vegetarian and other complex diets, fats, fiber, and hypertension..

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DrAmita Kulkarni Purohit

Shatavari

Shatavari is considered to be the most helpful herb for women as it helps in balancing the female hormonal system. The main herbal rejuvenative for women, Shatavari nourishes and cleanses the blood and the female reproductive organs thus supporting the body's natural fertility. It nourishes the womb and ovum and supports the female organs for pregnancy. It also promotes body's natural lactation. Shatavari contains phyto-estrogens, the precursors of estrogen and is very useful for women who suffer from low natural estrogen levels as a result of menopause.

Botanical Name : ASPARAGUS RACEMOSUS

Family Name : LILIACEAE

Common Name : ASPARAGUS, WILD ASPARAGUS, ASPARAGUS ROOT, SHATAVARI

Shatavari is a climbing plant which grows in low forests throughout India. It is mainly the roots of the plant that are used for medicinal purposes. The roots are bitter, sweet, emollient, cooling, nervine, tonic, constipating, opthalimic, anobyne, aphrodisiac.

Shatavari has been mentioned in Ayurvedic texts like the Charak Samhita, Susruta Samhita, and Astanga Samgraha. Pandit Hem Raj Sharma, in the Kashyap Samhita, has clearly stated that shatavari promotes maternal health and noted its particular use as a galactagogue (enhances breast milk secretion in lactating mothers).

Ayurveda has called Shatavari the Queen of herbs and is the foremost herb recommended for female health. Among the three Ayurveda Doshas of ‘Vata’, ‘Pitta’ and ‘Kapha’ , Shatavari helps in balancing 'Pitta Dosha'. Shatavari's rasas are sweet "madhura" and bitter "tikta". It is a natural coolant.

Shatavari nourishes the female reproductive organs and prepares them for conception. It also prevents miscarriages and is useful as a post partum tonic. A clinical study performed in the Dept. of Gynecology & Obstetrics, Ayurveda Hospital, Nepal on The Effect of Shatavari in Threatened Abortion and High Risk Pregnancy, showed 90% of the mothers had successful, healthy pregnancies and deliveries when using shatavari..

Rashmi Chaturvedi
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AYURVEDIC RHEUMATOLOGY

Rheumatological  disorders  described  in Ayurvedic texts, as ‘Ama-vata’, is a popular Ayurvedic term for any inflammatory disorder that causes pain and stiffness, in joints, muscles and connective tissues, including minor aches and twinges as well as disorders like rheumatoid arthritis, osteoarthritis etc.. In many texts, ‘Ama-vata’ has been referred as an  “auto-immune disorder” and “exogenous non-compatibility”  & “endogenous intoxication” as its main aetiological factors.

Due to complete abstinence from food, indigestion, over eating, irregular dietary  habits,  indulgence  in  incompatible articles of food, excessive consumption of cold substances, ill-effects of  ‘Virechana’(purgation), ‘Vamana’ (disgorgation), ‘Snehan’ (oleation), the wasting of tissues, states induced  by  faults or changes in place, climate & season, suppression of natural urges, impaired  ‘Pachak-pitta’ (digestive heat),  excessive  use  of dehydrated, over-hydrated or ‘Guru-Madhur-Amal’ (heavy, sweet & alkaline) food; physical stresses like excessive exercises, over indulgence in sexual pleasures, swimming etc.; mental stresses like rage, grief & hunger; and due to accumulation of ‘Mala’ (body’s waste products), ‘Ama’(unassimilated or undigested food juice) is  produced  &  collected in the gastrointestinal tract. A part  of it may be absorbed in the system causing systemic manifestations of certain ‘Ama’ related diseases. 

The already vitiated ‘Vata’ transports this ‘Ama’ to all parts of the body and carries it to the sites of‘Shleshak-kapha’ which has a common resemblance with ‘Ama’. With the effect of place, climate & season, the ‘Ama’ is motivated by vitiated ‘Vata’ and established at the already vitiated site of ‘Shleshak-kapha’. This ‘Ama’ associated with vitiated ‘doshas’, gets localised in a particular ‘Dhatu’ (tissue) to produce several types of endog­enous diseases like ‘Ama-vata’. In this disease, ‘Ama’ observed from the gastrointestinal tract reaches to ‘Kapha-sthana’ (site of ‘Kapha’) through the respective channels and gets modified and recirculated in the system causing capillaritis and synovitis. Probably some immunological mechanisms are also involved in this process.

General langour or debility of the body, disgust for food, thirst, lethargy, heaviness of the limbs, fever, indigestion and swellings are the common symptoms of ‘Ama-vata’ or rheumatism. The acute phase of‘Ama-vata’ is generally very painful with appearance of swellings in the hands, feet, head, ankles, waist, knees, thighs, and generally , in all the joints. These places, in  which the vitiated ‘Ama’ accumulates, become subject to piercing pains. Loss of appetite, watery secretions from the mouth & nose, loss of energy, loss of taste in the mouth, burning of  the  skin, copious or scanty urine, deep-seated pain and hardness of the abdomen, sleep at day-time but want of it at night, thirst, vomiting, vertigo, swoons, pain in the chest, constipation, dullness  of  the  body,  rumbling noise in the stomach, obstruction of the intestines or a sluggish condition of bowels; are the associated symptoms.

The excited ‘doshas’ according to their characteristics cause particular symptoms like excited ‘Vata’ causes excessive pains; excited ‘Pitta’ causes burning of the skin and redness of the complexion; excited ‘Kapha’causes wet sensation, heaviness of the limbs and continuous itching manifestations; besides the other symptoms. If the disease be due to the vitiation of two of the ‘doshas’, or all the three of them, the specific symptoms of each of the ‘dosha’ appear collectively.

There are many remedies prescribed in Ayurveda, some of which are:

1. Yograj Guggulu: ‘Guggulu’ processed with 27 extremely useful herbs, it nourishes the ‘Dhatus’, corrects vitiated ‘Vata’, destroys ‘Ama’, enkindles the ‘Agni’ (Ayur.Sars. pp-521-22); cures acute rheumatism, pain in the bones & joints, paraple­gia, acts as a tonic and enhances strength & vigour (Sen Gupta N.N.,1984); is well tolerated and shows marked im­provement in cases of morning stiffness, hotness, feverish­ness & tenderness of joints (Antarkar D.S., 1993).

2. Trayodashang Guggulu: ‘Guggulu’ processed with 12 extremely useful herbs, it is esteemed in all kinds of ‘Vata-vyadhi’ (neurological disorders) by correcting the  vitiated ‘Vata’ and used in colic-neuritis, gouty arthritis, paraplegia, hemiplagia, sciatica & other neuralgias (Ayur.Sars., p-516); cures the pains in the arms, back, knees, calves, waist, bones & the bone-joints and also relieves dislocation of the cheek bone and other ailments caused by the vitiated ‘Vata’ (Sen Gupta N.N. 1984).

3. Vyosadi Guggulu: ‘Guggulu’ processed with 9 extremely useful herbs, it corrects the vitiated ‘Kapha & Vata’ and destroys ‘Ama’; regarded to cure ‘Medoroga’ (Obesity), & ‘Ama-vata’ (Rheumatological disorders) (A.F.I., 5:9, p-59).

4. Haritkyadi Guggulu: ‘Guggulu’ processed with 3 extremely useful herbs, it nourishes the ‘Dhatus’, corrects vitiated ‘Vata’, stimulates ‘Pachak-pitta’, destroys ‘Ama’, enkindles the ‘Agni’, to relieve from ‘Vata-vyadhi’, low back pain, lumbago, constipation,  & ‘Ama-vata’ (Ayur. Sars. p-524).

5. Lakshadi Guggulu: ‘Guggulu’ processed with 5 extremely useful herbs & minerals, it nourishes the‘Asthis’ (bones) & dhatus’ and is  useful in  osteoarthritis,  lumbago and rheumatism. It also enhances healing  of fractured bones and decreases inflammation from the fractured part. (Ayur. Sars. p-523; Bhar.Ay.Yog Sang. Part-I, 1984).

6. Maharasnadi Kwath: Maharasnadi Kwath is a decoction (obtained from of 50 parts of Vanda roxburghii, and one part each of Ricinus communis, Adhatoda vasica, Pinus deodara, Curcuma zerumbet, Hedysarum alhagi, Cyperus rotundus, Zingiber officinalis, Sida cordifolia, Aconitum heterophyllum, Terminalia chebula, Tribulus lanuginosus, Cassia  fistula,  Foeniculum  vulgare,  Coriandrum  sativum, Boerhaavia diffusa, Physalis flexuosa, Tinospora cordifolia, Piper longum, Lettsomia nervosa, Asparagus racemosus, Acorus calamus, Barleria cristata, Piper chaba, Solanum indicum and  Solanum xanthocarpum). To make its Kwath (decoction):

• all these herbs are crushed & added to water taken 8 times w/v,
• boiled to evaporate to obtain 1/8 decoction v/v under controlled heat at  optimum  temperatures;
• strained & mixed  with  finely  pulverised  dried  extract  of Sonth (Zingiber officinalis).

Maharasnadi Kwath  is esteemed in all kinds of ‘Vata-vyadhi’ by correcting the  vitiated ‘Vata’ and destroying ‘Ama’. It is useful in generalised pains, hemiplagia, lumbago, sciatica, elephantiasis (A.F.I. 4:28, p-51); highly esteemed to alleviate all symptoms and  problems associated with rheumatism, lock-jaw, paralysis, facial paralysis and the diseases produced by vitiated wind (Sen Gupta N.N. 1984).

In Ayurveda this plant is used to cure inflammations, rheumatic pains (Dr.Kaushik,P., 1983),and in Greek system of medicines this orchid plant is given to lessen inflammation & heal fractures (Kirtikar & Basu 1975).

Maharasnadi kwath  a good long term Ayurvedic agent helping the patients to manage their chronic illness in osteoarthritis (Dr Pai Dhungat, M.D., 1993). This kwatha is fairly effective in the treatment of ‘Ama-vata’ (Kishore & Basu 1988).

Ayurvedacharya P NaGrath

 

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