Dr. Kamathe Piles Hospital

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Kshara is an alkaline, caustic substance derived from the ashes of medicinal plants. It represents a gentler alternative to both surgery and thermal cautery. Standing out as the foremost among sharp and subsidiary instruments, Kshara excels in performing excisions, incisions, and scrapings. Its versatility shines through, as it can effectively address challenging locations that may be difficult to approach through conventional means. Kshara Karma serves as a valuable substitute for surgical instruments, offering a safe option for patients averse to surgery due to its ease of performance, cost-effectiveness, absence of complications, proven efficacy over time, and the convenience of not requiring hospital admission.


  • On the basis of Administration –
  • Pratisaaraneeya Kshara – External application
  • Paneeya Kshara – Internal administration
  • On the basis of Concentration – Mild, Moderate and High


Gather 5 kilograms of the entire plants of Apamarga (Achyranthes aspera), Palash, Kutaj, Aragwadh, Arka, Snuhi, Patala, Chitrak, Karveer, Saptaparna, Agnimanth, Ashwakarna, Tilvak, Paribhadra, Kadali, Nimb (Azadirakta indica), etc., dry them, and then burn them. Collect 500 grams of the resulting ash and mix it with approximately 3 liters of water, filtering the mixture 21 times.

The resulting filtrate is clear, resembling the color of cow’s urine. It is then heated gently until the liquid reduces to one-third of its original quantity, creating what is known as Mridu or mild concentrate Kshara. Next, introduce 50 grams of red-hot Shukti (Limestone) to the filtrate, stirring continuously until it evaporates again to one-third of its original volume. This stage is termed Madhyama or moderate Kshara.

Further heating is done by adding 5 grams of Chitraka moola Kalka (Plumbago gelanica). This process yields a thick solution, referred to as Pratisaraneeya Teekshana or highly concentrated Kshara. Collect this solution and store it in an airtight container.

Microscopy features of prepared Kshara

Fibrous and sclereidal tissues, along with polygonal crystals of varying sizes, were uncovered through the examination. After decanting the supernatant liquid, the Kshara paste exhibited loss on drying. The Kshara powder, devoid of moisture, was analyzed for total ash and acid insoluble ash. Additionally, the pH of the supernatant liquid was measured and found to be 13.3.


Following are the possibilities behind the development of hemorrhoids.

Paneeya Kshara – Mild concentrate Kshara is used internally in worms, indigestion, urinary calculus, skin diseases, obesity etc.

Pratisaraneeya Kshara – Highly concentrate Kshara is used in internal haemorrhoids ( Piles) , after fistulectomy, rectal prolapse, after excision of pilonidal sinus, after incision and drainage of anorectal abscess, infected wounds , fissures etc

Advantages of Kshara Therapy

  • Postoperative pain is mild in intensity
  • Fast recovery
  • No bleeding/ minimal bleeding
  • Minimum hospitalization – one day care
  • Routine activity can start earlier
  • No wound
  • Less follow up
  • No scope for recurrencey
  • Systemic diseases are also undergoing this procedure.
  • No scope for recurrencey
  • No surgical complications like incontinence, stenosis and stricture.

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