Ksharsutra and Fistula

Fistula in ano is one of the most common diseases of the ano rectal region. Treatment of Fistula in ano has puzzled the medical fraternity due to its complex nature. Commonly prevalent surgical treatment for anal Fistula, that is “Fistulectomy” does not provide successful cure for the disease, post operative complications and recurrences being common. Acharya Sushruta an ancient Indian Surgeon has described in his text ‘ Sushruta Samhita’ about an ancient Ayurvedic technique of medicated thread called Ksharsutra treatment for Bhagandara ( Fistula in ano). Treatment of anal Fistula (Bhagandara)and Nadi-Vrana(Sinus) with Ksharsutra was practiced by Sushruta (1000-600B.C.)

The Kshar Sutra was a standard medicated thread smeared with Kshar of Apamarga (Achyranthus aspera), Shnuhi (Eforbia Nerrifolia) which has quality of cutting and Haridra(Curcuma Longa) which is used as a antiseptic. The ph value of the thread thus prepared was determined and its sterilization effected by ultraviolet radiation. The alkalinity of Kshar Sutra was 9.2ph

Ksharsutra is a popular treatment modality in India for the management of fistula-in-ano. It works by the action of excision, scraping, draining, penetrating, debridement, and sclerosing as well as healing simultaneously without a surgical excision. The conventional method to insert a ksharsutra by using a metallic probe through an external opening may cause pain and discomfort to the patients. In some cases, this intervention is not possible without general anaesthesia. The ksharsutra may be inserted through an external opening by using an infant feeding tube (no. 5 or 6) without causing pain as a day care procedure.

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Prakriti Parikshan

Swasthasy Swasthya Rakshnam is the basic principal of Ayurveda. i.e. Protecting the health of healthy person. Provide bliss for complete  happiness by maintaining total health called chaturvidha purushartha i.e. (Dharma(virtuous Acts)Artha((Possessing  appropriately required wealth with judicious means)Kama(Gratification of Desires)Moksha(Emancipation/Salvation).

As Roga(Disease)  is a  great obstacle in attainment of these objects the science of Ayurveda is meant to provide assistance  in the achievement of the basic goals  by providing absolute health to all creatures on the earth in general and  human in pericular. Fundamental concept of structural, functional and pharmacological branches of Ayurveda is based on pancha-mahabhutas, trgunasi  &  tridosas  According to Samkhya school prakriti  is the matrix of whole psycho-physical universe.

The present context of description of Prakriti(constitution) is in context to the body constitution i.e. Deha Prakriti(physical constitution). Ayurveda have put forth a strong foundation to make an understanding of human constitution. The Ayurvedic concept of Prakriti (constitution) is helpful in maintaining health, understanding disease and its management. Also, attainment of Purusharth Chatushtaya (Dharm-Artha-Kama-Mokha) which is only possible by an healthy individual.

Knowledge of one’s own prakriti (constitution) can be helpful in maintenance of one’s health by following appropriate life style , diet and regimen suitable in the particular environmental condition.

Despite of the fact of fundamental similarities in the mankind, dissimilitude from individual to individual is very common and natural. The factors responsible for these differences are multifarious and they together exert effect on constitutional, temperamental, psychological and spiritual make up of each individual.

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