At some point of medical evolution we seem to have forgotten the basic contribution that was made by the Vedic Literature to make the documentation. After Vedas the Susruta samhita is only available text of Vedic surgical skill. Many more references are also available in other Ayurvedic texts. In different Puranas these examples are quoted in the forms of stories. Vagbhatta samhita is another milestone in this field. Our understanding of the ancient Vedic medical skill is limited due to lack of Vedic textual knowledge. In this consideration review of the Ayurvedic Literature is necessary for the better outcome.
A number of examples are available in different texts about the zenith of surgical skill at that time. Susruta has taken the lead in this regard to deal with numerous surgical procedures. From incision and drainage operation of an abscess to reconstructive surgery Susruta passed a very long way. His command over all the branches of surgery is remarkable. Surgical and para surgical procedures are discussed extensively in the text. Apart from this he described surgical instruments, wound management, importance of blood in surgery and principles of plastic surgery. It can be observed from this sort of description that the Indian surgery is scientific outcome of the vast manual experience of the surgical practitioners during thousands of year.
Utility / Properties of Kshara-
Indications of Pratisaraneeya Teekshna Kshara –
The patient is in lithotomy position, the part is cleaned with aseptic solutions and draping was done after Local Anaesthesia / Spinal Anaesthesia. Lubricated Slit Proctoscope is to be introduced and Kshara applied at lower most all around healthy mucosa of 3 cm area of anal canal and wait for 2 minutes or until it turns to the colour of Reddish black. After this process, the mucosa must be washed with Lemon juice to neutralize the Kshara after proper burning of mucosa. Later the rectal pack with Yashtimadhu Taila is applied and bandaging was done and shifted to the postoperative ward.
After Kshara application in rectal prolapse, the burned part heals and anal canal become fibrosed and narrowed. Then prolapse of rectum is stopped completely.
The process of Kshara sutra application in the cases of sinuses has also been elaborated which is also applicable in fistula-in ano. Repeated use of Kshara sutra is necessary in the management of sinus, because single application of Kshara sutra was not found sufficient for the complete cure of the disease. So the technique of successive changes of Kshara sutra as often as necessary has also been depicted. In Susruta samhita, a comprehensive procedure including primary application and successive changes of Kshara sutra has been clearly detuned.