Ksharasutra Purva Karma: Pre-Treatment Procedures

Article by Dr Raghuram Y.S. MD (Ay) and Dr Manasa BAMS

Purvakarma

Pre-treatment stage of Ksharasutra application includes –
Selection of patient and thorough examination of disease and diseased –
For this, an Ayurvedic doctor conducts thorough examination of the patient (rogi pareeksha) to determine
prakriti – Dosha body type
Vikriti – ailment, extent of disease
agni (digestion capacity and metabolism),
bala (strength and tolerance on the part of the patient),
satwa (strength of mind, the acceptability and preparedness of the patient to cooperate and undergo the treatment process with courage and confidence) etc factors so as to decide if the treatment shall be conducted or not over the patient.
Read related: KsharaSutra Treatment: Introduction, Indication, Contra Indications

Similarly the causes of the disease are tracked down and the disease too is examined in detail (roga pareeksha).

This screening of the patient will help the doctor to rule out complicated cases, anorectal diseases related with cancer, people with chronic diseases like anaemia, diabetes, hypertension etc and mentally weak patients who are not willing to undergo the treatment.
Read related: Ksharasutra Preparation Method: Detailed Explanation

Collection of equipments, medicines

Collection of medicines and equipments needed for the treatment –
This is an equally important step in the pre-treatment procedures. The doctor should make sure to have kept all the equipments and medicines needed to conduct the treatment. The helpers or nursing staff too should be kept ready and equipped. Below mentioned are the important equipments, instruments and medicines needed to carry over the Kshara Sutra treatment effectively –

• Kshara Sutra – threads smeared or processed or impregnated with herbal alkalis
• Anaesthesia
• Syringes
• Probe or Needle / needles for inserting kshara sutra
• Forceps, scissors, pile holding forceps etc
• Sterile cotton and bandage clothes
• Surgical gloves and mask
• Kidney trays, crucibles etc
• Hot water
• Jatyadi taila, Jatyadi ghrita, Yashtimadhu taila or ghrita etc for dressing
  Read related: Kshara: Properties, Types, Preparation Method As per Sushruta

 Preparation of the patient

• The patient is explained about the procedure and counselled.
• Written consent duly undersigned by the patient and primary attendant is taken.
• The patient is advised to evacuate bowel and bladder.
• The peri-anal hair will be shaved. The same area would be painted with antiseptic solution 1 day earlier.
• The patient would be kept nil orally for at least 6 hours before the procedure.
• Soap water enema would be given on the night prior to and 2 hours prior to the procedure.
• Injection TT (Tetanus Toxoid) – in the dose of 0.5ml would be administered intra-muscular.
• Sensitivity for anaesthesia (xylocaine sensitivity test) would be performed in each patient.
• On the night prior to the procedure, the patient would be given light diet. Later he or she is kept nil oral.

Click to consult Dr Raghuram MD (Ayu)