Comparative clinical study on the effectiveness of jala yukta nimba pratisarneeya kshara and gomutra yukta nimba pratisarneeya kshara in the management of abhyantara arshas

The disease which gives maximum trouble to mankind like an enemy is Arshas (Haemorrhoids). Sedentary life style, busy schedule of work, stress and bad food habits gives arises to Arshas. The primary etiological factor for the same is Mandagni.

Arshas which is compared to Haemorrhoids in the contemporary science is the commonest Ano-rectal condition seen in the practice of proctology. The dilated veins within the anal canal in the sub-epithelial region formed by radicles of superior, middle and inferior rectal veins are called as Haemorrhoids. Incidence of this disease can be traced since Vedic period. Its incidence increases with advancing age, at least 50% of people over the age of 50 years have some degree of Haemorrhoidal symptoms. Nowadays most of the persons suffer from any one of the complaints of piles during their life time.

In India 75% of population is estimated to be suffering from Haemorrhoids. Among this almost half million’s population are experiencing condition’s that are related to Haemorrhoids. Usually many are not aware that they have a symptom associated to this condition.

According to modern surgery Haemorrhoids, which are not treated properly or neglected, may lead to complication such as strangulation, thrombosis, portal pyaemia, suppuration, haemorrhage etc. In modern medical sciences Haemorrhoids are treated with injection-Sclerosant therapy, Barron’s bandage, Cryosurgery, Infrared coagulation, DGHAL, Stapled haemorrhoidopexy second degree Haemorrhoids mainly treated with Barron’s band ligation and early second degree Haemorrhoids treated with injection therapy. Unfortunately, all these techniques have got one or the other types of limitation.

The ancient medical authorities like Acharya Charaka and Acharya Sushruta both have described four types of measures for the treatment of Arshas. These are Bheshaja, Kshara, Agni and Shastra. As per the available treatment modalities of Arshas, the Kshara Karma modality is the best one, taking into the consideration its convenience, easy adoptability, cost effectiveness and curative results.

While going through the chapter of treatment of the disease Arshas, it becomes quite evident that Kshara Karma has been indicated for all the varieties of Arshas, that even the pedunculated and Arshas of a very big size can also be successfully treated with the help of Kshara Karma. Hence the repeated advocacy of Kshara Karma by almost all the ancient Acharya in the disease Arshas

has given an inspiration to work on the disease Arshas with the help of Pratisarneeya Kshara, because of its simple technique and it has important properties like Chedana, Bhedna, Lekhana.

Nimba has Krimighna and Arshoghna properties and have chemical constituents like nimbidin, nimbidol, sodium-nimbinate which helps in antimicrobial action. Anal canal is prone to contamination during postoperative period because of which there will be delaying of Ksharadagdha Vrana Ropana. Nimba is abundantly available, with a single plant we can get a large amount of Kshara. So, Nimba is selected for the Pratisarneeya Kshara in Abhyantra Arshas.

Nimba Pratisarneeya Kshara having properties like Sheeta Veerya, Tikta and Kashaya Rasa acts on haemorrhoids by cauterising the pile mass, due to its Teekshna Kshara Guna and coagulates protein in haemorrhoidal plexus.

Gomutra is important part of Indian tradition. It is not only holy but also has various important medicinal uses. Classical treatises in Ayurveda that is Charaka, Sushruta and Vagbhata Samhita has described Ashta mutra (eight types of urine) along with their properties, indication and uses. Cow urine is one of them and considered as best. Cow urine is one of the five contents of Panchagavya which obtain from cow (urine, milk, ghee, curd and dung).

Wound infection is a common cause of wound chronicity. It prolongs the inflammatory phase by increasing the production of inflammatory cytokines which lead to additional tissue destruction as well as delays wound collagen synthesis. Therefore, preventing wound infection would hasten process by promoting collagen synthesis. Various studies have demonstrated that cow urine (Gomutra), as well as its distillate, has antibacterial and antifungal activity against various strains of pathogens .

Till now, studies have been carried out by the use of Jala Yukta Apamarga, Chitraka, Nimba, Aragwadha and Palasha Kshara in various centers in India but less attention has been paid to Gomutra Yukta Kshara.

So, considering the above points it is very much essential to conduct a comparative study on Jala Yukta and Gomutra Yukta Nimba Pratisarneeya Kshara Karma.