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 andarsha(haemorrhoid).
In his book Chakradutta explains the method that by smearing a sutra (thread)
repeatedly in the latex of snuhi() andharidra(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.
Method of preparation
The standard kshar sutra is prepared by repeated coatings of snuhi ksheera (latex of Euphorbia Nerrifolia), apamarg
kshara (ash ofAchyranthus 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.
Mode of Action
Kshar Sutra is now a popular treatment modality in India for the
management of fistula in ano, piles, fissure tag, pilo-nodal sinus. 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 Seton 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 without 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.,paniya kshara act
through changing internal environment of body (prakit vighata concept of
ayurveda).
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
Disclaimer : "Kshar Sutra" (क्षारसूत्र) is a very special Ayurvedic procedure requiring proper guidance from a highly trained and skillful Ayurvedic practitioner. This should not be undertaken just from information in this article. One should consult with an Ayurvedic physician.
Disclaimer : "Kshar Sutra" (क्षारसूत्र) is a very special Ayurvedic procedure requiring proper guidance from a highly trained and skillful Ayurvedic practitioner. This should not be undertaken just from information in this article. One should consult with an Ayurvedic physician.
