It gives me immense pleasure to intro-
duce the revised second edition of this book
"Recent Trends in the Management of
Arshas/Haemorrhoids" This book deals
with detailed description regarding Arshas/
Haemorrhoids including aetiopathogenesis,
symptomatology and management. The author has taken
keen interest to discuss and evaluate the various modali-
ties of treatment with advantages and disadvantages of
each type of treatment. The author collected the various
research works on Arshas are conducted in different insti-
tutions in India and added multiple choice questions of
Arshas and Haemorrhoids in his book. This type of work
was really needed and is of great help for students, re-
search scholars as well as for clinicians. Precise description
in simple language is the special feature of the book. I hope
the author will keep his interest to bring out few more such
Ayurveda has immense potential to help in the solu-
tion of many challenging and unresolved problems of
medical science. The development of surgical and para
surgical procedures have remained neglected for long.
Arshas is considered as one of the Mahagada (difficult to
treat). It has been discussed in detail in Ayurvedic classics
specially the Sushruta Samhita considered to be special-
ized in surgical practice. Along with detailed surgical
technique, a parasurgical measures i.e. Kshara karma
(Caustic cautery), Kshara sutra (Caustic thread), Agnikarma
(Thermal cautery) and Raktamokshana (Blood letting)
has been highlighted. It is a Day-care and Ambulatory
procedure, which has wide range of acceptability
So, I felt it is berieficial to include the knowledge regarding
Ayurveda and Contemporary Sciences under one
book for students, clinicians, academicians, who can extract
information in a shortest possible time and with least
possible effort. The present book consists of critical analysis
and discussion on various aspects of Arshas/Haemorrhoids.
Here a sincere effort has been tried to apply the proposed
different treatment modalities would be better un-
derstood, how and when to institute the therapy The
visual illustrations of different types of Arshas/ Haemorr-
hoids with recent trends in the management are enlight-
ened. The various research works on Arshas are con-
ducted in different Institutions like Bananas Hindu Uni-
versity, Gujarat Ayurveda University etc. also mentioned.
All information of present medicaments of Arshas is described.
I believe that this publication highlighting an important
and pioneering work on surgical aspect of Ayurveda
will serve as a landmark in the development of Research.
It will also serve as a handbook for establishment of a spe-
cialty clinic for treatment of Piles. I added recent modali-
ties in the mangement of Arshas/Haemorrhoids and more
photos along with multiple-choice questions. I have at-
tempted to put before the students, research scholars and
practitioners a concise and comprehensive book related to
Ayurvedic and Modern aspects of Arshas.
I sincerely hope that this book will be useful to you.
I appeal to all my friends, students and readers that I
shall gratefully acknowledge any suggestions to further
improvement of this book.
Ayurveda is the science of life. Since time immemo-
rial, Ayurveda has been showing the ideal way of living,
which promises a disease-free, happy and long life. The
Ayurvedic branches are like that of ocean of knowledge
consisting of many newer concepts in concise form. The
Shalya Tantra a prime branch is rich in many aspects of
modern surgical concepts.
Piles or Haemorrhoids can affect anyone, anytime
and anywhere. Haemorrhoids have plagued humankind
since time immemorial, yet many misunderstandings re-
garding Haemorrhoidal complaints and disease still exist.
Many laypersons and physicians do not understand the
anorectal area and the common diseases associated with
it. Haemorrhoids or piles, one of the commonest disease
occurs in anorectal region. Its incidence increases with
advancing age; at least 50% of people over the age of 50
years have some degree of haemorrhoidal symptoms.
Recent statistics reveals that irrespective of age, sex, Socio
economic status, people suffer from piles. Nowadays every
person suffering from any one of the complaints of piles
during their lifetime. It is certainly one of the commonest
ailments that affect mankind. The disease Haemorrhoids
or piles is dealt rationally under the concept of Arshas,
however it includes some other fleshy masses like polyps,
warts etc., the food habits and sedentary life styles of
modern man increases the rate of incidence of Arshas.
Acharya Sushruta, the father of Indian Surgery
described about this disease in detail in his Sushruta
Samhita. The prime etiopathogenic factor of Arshas is
Mandagni ie., hypo function of digestive enzymes, which
in turn leads to constipation, prolonged contact of accu-
mulated Mala or excretory material to Gudavali causes
development of Arshas. It is one of the eight Mahagada
and difficult to cure.
Sushruta, the pioneer in the field of Surgery, de-
scribed four principal therapeutic measures in the man-
agement of Arshas ie. Bhesaja Chikitsa (Medical treat-
ment), Kshara karma (Caustic therapy), Agnikarma
(Thermal cautery) and Shastra karma (Surgery). These
measures in definite order are suggestive of similar meth-
ods to be preferred first. Among those the Parasurgical
procedures like Kshara karma, Kshara sutra (Caustic
thread), Agnikarma and Raktamokshana (Blood letting)
are minimal invasive procedures. These procedures are
simple, very safe, effective, ambulatory and minimal or no
complications, unhazardous and easily acceptable by the
patients. There is minimal interference in patient's routine
work. It is also effectively administered to aged patients
and those unfit for work.
The modern modalities of treatment in piles are Scle-
rotherapy, Rubber band ligation, Infrared Photocoagula-
tion, Cryosurgery and Haemorrhoidectomy and others.
Modern science has very little to offer in terms of medical
treatments of piles.
This attempt to review the concepts of Ayurveda and
modern science in all aspects i.e., Aetiology, Pathogenesis,
Classification, Prognosis, Complications, Management
and recent research works of Arshas/Haemorrhoids.
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