The present book on Piles (Arsas) gives an overview of the disease in its clinical and therapeutic approaches elucidated in Ayurveda. The present
book contains an Introduction; Historical Survey, Anatomy of Gnda; Etymology & Definition; Aetiopathogenesis; Types; Signs & Symptoms;
Diagnostic Procedure; Management of Arsas; Proctology & other specialities; Drug Review; Recent Research Trends; Conclusion. The book
includes Colour illustrations, Glossary, References, Abbreviations and an Index.
“Arsas” as conceived by Ayurvedists is not a local condition. All the six kinds of vata, pitta and kapha get vitiated and express themselves in the
form of fleshing masses can pedicles in all the three sphincters of rectum and anus.
“Arsas” or Haemorrhoids thus cannot be simply considered as the varicosity of haemorrhoidal plexus of veins though the apparent
pathology is in the haemorrhoidal veins or the portal systems into which they drain. One of the three major haemorrhoidal veins is connected to
the systemic venous circulation (inferior vena cava) which again gives us an im ression that the varicosity of haemorrhoidal plexus of veins has
got some bearing with the systemic circulation also. More over some physicians believe that microaneurysms of rectal vasculature are also
found in primary haemorrhoids (haemorrhoids MIR publishers). Thus haemorrhoidectomy alone which is being practiced very freely and
extensively by the modern surgeons is not solving the other problems which the patient of haemorrhoids is suffering from.
Keeping inn view of all such complicated issues in the treatment of haemorrhoids Dr. BHASKAR RAO in this Monograph has
ventured to integrate the two systems i.e., Ayurveda & Modern medicine with a holistic approach. The reader will be immensely benefited by
reading this Monograph carefully in between the lines. A tremendous practical trail with Ksara injection which he himself has prepared as a
instantaneous injectable drug has to be improved further and for this the modern pharmaceutical industry can come forward to patent this
injection. Such a practice of instantaneous preparations of injections was there until the end of 20th century. Morphing Emetine hydrochloride,
Milk etc., were being prepared by the general practitioners then and there in their clinics just before their usage.
Hence this practice of Dr. M. BHASKAR RAO is also quite logical and appreciable. The reader can also find an elaborate description
of Infrared - thermo coagulation for internal piles which was developed by R.J. Leicester, R.J. Nicholls and et. All. Apart from these two
wounderful techniques of treatment the Ksarasutra & Ksarakarma which are the unique contributions of Ayurveda are recognized even by W.H.O.
and the Modern surgeons. Apart from the description of “Arsas” and haemorrhoids which is the main scope of this paper, the reader can get
elaborate latest information about some fool-proof Ayurvedic medicines. Bhallataka prayoga, Manual dilatation of anus, Rubber band technique,
Cryosurgery, Injection therapy etc., as alternative methods of treatment. The description of other ano-rectal disorders the role of proctology and
other specialities which help in the diagnosis and treatment of several ano-rectal disorders. Para-surgical techniques like Jalauka application,
Agni karma etc., is also very much useful to the reader. Colour guide of this monograph, a decade work of compilation, is definitely a useful
diagnostic tool for general practitioners and students of Ayurveda in their clinical practice.
The author has taken immense pains in giving a categorical description of Purva karma, Pradhana karma and Pascat karma of the
surgery of “Arsas” both according to Ayurveda and Modern surgery. Western scholars can understand the technical terms of Ayurveda which are
used in this monograph are advised to see the Glossary, wherever needed.
My whole-hearted blessings and good wishes will always be there to my beloved student, the Author.
Ayurveda laid supreme foundation to the health for consideration of caturvidha purusartha. It has a primary objective for the preservation and
promotion of health and henceforth postulated two modes of treatments i.e., Samana cikitsa (palliative treatment) and Sodana cikitsa (curative
treatment). Samana cikitsa includes medical management and Sodana cikitsa includes ksarakarma, agnikarma, raktamoksana and sastrakarma.
In this regard, Susruta (800 B.C.), the father of ancient surgery, employed ‘fourfold treatment pattern’ in the management of arsas
(haemorrhoids) i.e., ausadha cikitsa, sastracikitsa, ksaracikitsa and agnikarma. This clearly denotes that he did not want to land up directly for
surgery though he was an eminent and proficient in the field of surgery. He was always employing safe, simpler and non-invasive measures for
the management of arsas (haemorrhoids) initially. If the disease is not amenable to these measures, then adopting other measures like
ksarakarma, agnikarma, sastrakarma and others. This clearly vindicts Susruta’s scientific insight of experience with a practical approach is in the
light of contemporary discovery. His astute observations and real experiences are capable to withstand the experimental and statistical
This monograph is an attempt to review the disease Arsas with regard to its basic clinical and therapeutic approaches elucidated in
Ayurveda, which befit and suit to the contemporary modern times. The first few chapters deal with the disease arsas in its historical aspects,
anatomy of anal canal, definition, aetiopathogenesis and types in the light of contemporary discoveries with a possible comparison to prove the
basic tenets of Ayurveda are true and for ever. Later chapters deal further on signs and symptoms, diagnostic procedures and management of
haemorrhoids with an overview of both Ayurveda and contemporary medical sciences. Final chapters are enlightened with drug review, recent
research trends and the importance of proctology amongst the other allied sciences along with a colour guide on the disease haemorrhoids. This
certainly paves a way in identifying the research prospects to improve the current status in the light of current scientific advances.
If this humble collection and compilation of different visual documents on haemorrhoids along with the review of the subject in the
light of contemporary scientific overview, creates interest in the diagnosis and therapeutic measures of Ayurveda, I feel, gratified greatly and the
aim of the book is fulfilled.
Back of the Book
Dr. M. Bhaskar Rao, M.D. (Ay.)., is an Assistant Professor at the S.V. Ayurvedic College & Hospital, Tirupati. He has had a brilliant academic
career with a University I Rank and also a receipient of Gold Medal. He was an awardee of ‘Young Scientist’ by the World Congress of Natural
Medicine, S.V. University, Tirupati, for his surgical skills and extensive service of Ksarsutra application in high anal fistuae. He has done his post
graduation from Govt. College of Indian Medicine, Bangalore. He has published many research articles in regional and international journals. He
has attended several conference both in India and abroad. He has been extensively trained on Geriatrics’ at the University of New South Wales,
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