Easy Ayurveda

Article by Dr Raghuram Y.S. MD (Ay) and Dr Manasa BAMS
Kshara is considered superior to all the shastra karma (surgical measures) and anu-shastra karma (para-surgical measures) because Ksharas or alkalis perform the work of incision, puncture, and scarification so as to relieve the derangements of Tridosha. They uniformly affect the diseased part or parts to which they are applied.

Kshara qualities as per Sushruta

According to Sushruta, Kshara possesses the below mentioned qualities:

• Tridoshaghna – pacifies or destroys all the morbid (vitiated) doshas (because of being made up of various herbs)
• Soumyata – pleasant or mild nature (owing to their white colour)
• Dahana – burns, corrodes (owing to its burning nature)
• Pachana – brings about maturity, ripens the wounds (owing to its digestive capability)
• Darana – bursts or breaks open the wounds (owing to the agneya or fiery nature of the herbs used in the composition)
• Katuka – pungent (owing to its pungent taste)
• Ushna – hot (owing to its heat producing nature)
• Teekshna – intense (because of its irritant nature)
• Vilayana – liquifies (because of its liquefaction property)
• Shodhana – cleanses (owing to its cleansing property)
• Ropana – heals, improves granulation (owing to its healing property)
• Shoshana – dries (owing to its nature of absorption)
• Stambhana – arrests, stops (owing to its arresting or stoping nature)
• Lekhana – scraps (owing to its scraping nature)
• Krimighna – kills microbes and germs (owing to its antimicrobial action)
• Shukraghna – causes sterility when used in excess

Apart from this, kshara:

• Expels and destroys ama (metabolic toxins)
• Destroys morbid kapha
• Destroys visha or poisons
• Destroys meda (excess, morbid fat)
• Cures kushta (skin diseases, leprosy)
• Laghu – light in nature (Charaka)
• Bhedana – splits open (Charaka)

Use of Kshara is also mentioned to be one of the important anu-shastra vidhi or para-surgical measures in Ayurveda.

Kshara qualities by Ashtanga Hrudaya

Kshara Guna (Properties of Kshara or alkali)

• Na ati teekshna – not too strong
• Na ati mrudu – not too mild
• Shlakshna – smooth
• Pichchila – slimy
• Sheeghraga – spreads quickly
• Sita – white in colour
• Shikhari – remaining like a mountain peak at the site of application
• Sukha nirvapya – easily removable
• Na vishyandi – doesn’t produce much exudation or moistness
• Na ati ruk – doesn’t cause much pain

Kshaara or alkali by the virtue of its 10 above mentioned properties; will render all the functions of shastra (sharp surgical instruments) and agni (fire, cauterization). Bu the virtue of its actions like sucking quickly (aachooshana), healing effect over the body, spreading everywhere, it pulls out all the doshas by their roots. After such actions when the diseases disappear, kshara also subsides on its own accord.

Kshara preparation

Preparation of Kshara as per Sushruta
Kshara shall be prepared only in Sharad Kala (in between October and November) of a calendar year. It shall be prepared nearby a hilly area.

Before preparation of Kshara, Mangalacharana (holistic and devotional rituals) shall be conducted. After this, the healthy Mushkaka plant or Elaeodendron glaucum shall be taken along with its roots. The plant is made into small parts and subjected to boiling till it is converted into total ash. After the separation of burnt lime-stones, the ash is collected in a sterile vessel. Care is taken that the ash is not contaminated or exposed to moisture. This is called Prathamika Kshara or basic (primary kshara). This is one example given by Sushruta. Later he gives a set of herbs from which kshara or alkali can be extracted and later used for medicinal purposes. The list of source plants for kshara preparation is as mentioned below –

• Kutaja – Holarrhena antidysenterica
• Palasha – Butea monosperma
• Gunja – Abrus precatorius
• Ashwakarna – Dipterocarpus turbinatus
• Agnimantha – Premna integrifolia
• Paaribhadraka – Erythrina variegate
• Saptachada – Alstonia scholaris
• Bibhitaka – Terminalia bellerica
• Ashwamaraka – Nerium indicum
• Aaragwadha – Cassia fistula
• Asphota – Hemidesmus indicus
• Tilwaka – Symplocos racemosa
• Putika – holoptelia integrifolia
• Arka – Calotropis procera
• Snuhi – Euphorbia neriifolia
• Chitraka – Plumbago zeylanica
• Apamarga – Achyranthes aspera
• Kadali – Musa sapientum
• Paatala – Stereospermum suaveolens
• Vrusha – Adhatoda vasica
• Naktamaala – Pongamia pinnata

The herbs can also be selected based on their doshagnatva or dosha mitigating property. Example:
Kadali – Vata alleviating property (Vataghna)
Aragwadha, Krutavedana, Kutaja etc – Pitta alleviating property (Pittagna)
Palasha, Karanja, Tilwaka, Vasa, Agnimantha, Apamarga, Snuhi, Putika, Ashwakarna, Nimba, Bibhitaka, Karavira, Arka, Saptachchada, Chitraka, Krishnamushkaka – Kapha alleviating property (Kaphagna)
Patala, Sariva, Gunja – Tridosha alleviating property (Tridoshagna)
Read related: KsharaSutra Treatment: Introduction, Indication, Contra Indications

Types of Kshara

Types of Kshara used for medicinal purposes:
Kshara can be used internally and applied externally.

Paneeya kshara

Paaneeya kshara (alkalis which can be consumed through mouth) – This type of kshara is used in treating the conditions like:

• Arsha – haemorrhoids
• Agnisada – dyspepsia, indigestion
• Ashma – urinary stones (urinary calculus)
• Gulma – abdominal tumours
• Udara – enlargement of abdomen, abdominal disorders, ascites etc
• Garavisha – chronic poisoning etc

Pratisarana kshara

Pratisarana Kshara (alkalis externally applied) – This type of kshara is used in the treatment of:

• Mashaka – moles, warts etc
• Shwitra – leucoderma
• Bahya arsha – external piles
• Kushta – skin diseases
• Supti – anaesthetic patches
• Bhagandara – fistula-in-ano
• Arbuda – tumours, cancers
• Granthi – tumour, fibroids etc
• Dushta nadi vrana – contaminated or foul sinus ulcers etc.

The kshara used in kshara sutra is Pratisarana type of kshara because it is applied externally on ano-rectal diseases.
Click to consult Dr Raghuram MD (Ayu)