Piles in Ayurveda is called as ARSHA. It is defined as”arivat pranan shrinoti hinasti iti arshah” A disease which tortures patient’s vital force (prana) as enemy is called as Arsha. Neglect of proper diet and lifestyle habits ends in reducing digestive fire (Agni) or making it abnormal called mandagni. It means inability to digest food material with proper pace and time leading to accumulation or stagnation of half digested food material (Aama) in the form of stool inside, or expelling it before time in watery or semisolid form, which disturbs doshas at anorectal region.
Asam. : Kechumuri, Arsha
Beng. : Arsha
Dogr. : Bavaseer, Mesiyama
Guj. : Harasa, Masa
Hind. : Bavashir
Kan. : Mulavyadhi
Maly. : Mulakkuru
Mra. : Mulavyadha
Tam. : Mulnoy, Mulam
Tel. : Mula Vyadhi, Arisamolalu
Eng. : Haemorrhoid, piles
Arsha (piles) is a condition in which a fleshy mass of variable size, shape and colour appears (due to varicosity of veins) in the anus. From the treatment point of view, Arsha may be divided into two groups viz. Shushkarsh (Dry piles) and sravi Arsh (exudating piles).
Signs and Symptoms
Appearance of fleshy swelling (Mansaankura) in the anus, obstruction to the passage of gases, pain particularly on defecation, diminished appetite and constipation are the general signs and symptoms of Arsha. In addition to these, following are the specific symptoms of shushkarsha(Dry piles) and Sravi Arsha .
a. shushkarsha: The piles which generally do not bleed is known as shushkarsha. This type of piles occur due to the dominance of Vāyu and Kapha.
b. Sravi Arsha (Raktarsha): Sravi Arsha is piles which occur due to the dominance of Pitta and Rakta. In this condition patient passes suddenly streaks of bright red blood with the stool. Sometimes it may bleed profusely leading to the complications like anaemia.
(A) Shushkarsha Management
Common home remedies (Single Drugs)
1. Powdered root of Citraka (lead-wort-Plumbago geylenica) – 1 g., to be taken with 100 ml. Takra (butter milk) twice a day.
2. Fruit of Yavani-Ajawain (ptycotis) – 1 g. and Kala namak(Black salt) – 1 g. to be taken with Takra (butter milk) twice a day.
3. Fruit rind of Hareetaki-Hrad (chebulic myrobalan) kept overnight in Gomutra (cow’s urine) is to be taken in the dose of 6 to 12 g. with Guda (jaggery), twice a day.
1. 16 g. powder of wood of Rakta Chandana (red sandal) is to be kept in 400 ml. of water and to be taken twice a day after filtering with thin cloth.
2. Powder of equal part of fruit pulp of Bilva (bel)-Eagle marmelous, shunthi-shonth (dried ginger), fruit of Yavani-ajwain (ptycotis) and root of Citraka (lead-wort), to be taken in 3 g. dose with Takra (butter milk) twice a day.
3. Prepare Surana Kanda-Jimi kanda (amorophallus-elephant’s foot) by Puṭapāka method(Tuber of surana is wrapped in wet soil and placed in fire till the soil gets red .Remove from fire and allow to cool on its own, powder it after removing the wrapped soil) and it is to be taken 12 to 25 g.by mixing with 6 to 12 ml. of sarsapa-sarson Taila (mustard oil) and 1 g. of Lavana (common salt), twice a day.
Compound oral formulations
1. Vijaya churna: 3 to 6 g., to be taken with 50 ml. warm water twice a day.
2. Pathyadi kwatha: 14 to 28 ml., to be taken twice a day before meals.
External application for allaying pain
Lepa (Paste) prepared from the leaves of bhang (cannabis) to be applied over the anus.
(B) sravi Arsha Management
Common home Remedies (Single Drugs)
1. Fresh juice obtained from the fruit of Dadima-Anar (pomegranate) – 14 ml., to be taken with 5 to 10 g. Sharkara (raw sugar) twice a day.
2. Powdered fruit rind of Haritaki (chebulic myrobalan) – 1 to 3 g., to be taken with 50 ml. warm water, twice a day.
3. Pericarp of Dadima-Anar (pomegranate) – 12 g., to be taken with equal part of sharkara (raw sugar) twice a day.
4. Kamal keshara (lotus stamen) – 5 g., to be taken with 5 g. butter in the morning.
5. Cream of curd – 50 g., churned in 250 ml. water is to be taken once a day.
6. Powdered fruit pulp of Bilva (bel) – 1 to 2 g. and Shunthi (dried ginger) – 1 g., to be taken with 50 ml. water twice a day.
1. Powder of Nagkeshara (flower stamen of iron wood tree) – 6 g., butter – 25 g. and Sharkara (raw sugar) – 10 g., to be taken once in the morning.
2. Grind the root of Apamarga (prickly chaff) – 25 g. in Tandulodaka ( Water obtained after decantation of washed rice). Add 250 ml. of goat’s milk and 1 g. powdered root of Shatavari ( asparagus) in it. To be taken twice a day.
Compound Ethical Formulations
1. Samasharkara churna: 5 to 12 g., to be taken with 50 ml. water twice a day.
2. Vijaya churna Cūrṇa: 3 to 6 g., to be taken with 50 ml. water twice a day.
3. Arshakuthar Rasa: 1 to 2 pills, to be taken with 50 ml. water twice a day.
4. Nityodita Rasa: 250 mg., to be taken with 5 to 10 g. ghee twice a day.
5. Candraprabhā Vaṭī (Arśadhikāra): 1 to 2 pills, to be taken with 50 ml. water twice a day.
6. Take fruit of small variety of Harītakī (chebulic myrobalan), whole plant of Dūrvā (doob grass), root of Pippalī (long pepper) and Nāgakeśara (stamen of Indian iron wood tree) in equal parts and make pills of 8 g. by adding Svarasa (fresh juice) or decoction prepared from fruit rind of Āmalakī (embelic myrobalan). Such 1 to 2 pills are to be taken with Takra (butter milk) twice a day
7 Pranadavati,Abhayarishta,Duralabharishta,Vidangarishta,Chitrakadi vati,Sukumarghrita,Dantyarishta,Usheerasasava,KumaryasavaMridwikarishta,Rodhrasava,Kalyanaka guda,Chitrka hreetaki,Danti Hareetaki,Snuhi rasayana,Manibhadra guda.Yavani sandhava are some of the common ethical formulations used in piles and can be taken under the supervision of institutionally qualified Ayurveda physicians
1. Kāsīsādi Taila: to be applied in the anus in the morning after defecation.
2. Give fomentation to the anus with a pottalika (bag) prepared from the powder of equal part of leaf of Bhanga (cannabis) and Haridrā (turmeric)
3. Lepa prepared from the powdered rhizome ofHaldi (turmeric) and fruit ofKatukarohini in Sarsapa-Sarso Taila (mustard oil) is to be applied on the anus.
Godhuma-Genhu (wheat), Shali variety of rice, seeds of Yava (barley) and Kulattha-kulathi (dolichos bean);Aja dugdha( goat’s milk), Navneeta(butter); fruit of Kapittha (wood apple), leaf and fruit of Patola (a variety of small cucumber), root of Punarnava pigweed), Suraṇa Kanda (tuber of amorophallus-elephant’s foot), leaf of Vastuka (a variety of chenopodium), fruit rind of Āmalakī (embelic myrobalan) are the useful articles of diet for the patient of Arśa (piles).
Masha-urad (balck phaseolus bean), seed of Tila (sesame), Piṇyaka (oil cake), Pishamaya Dravya (dishes prepared through pashna(Grinding on stone)); fried, constipating and difficult to digest articles of food are harmful for the patient of Arsha (piles). Excessive use of water, sun bath, heat and riding; and suppression of natural urges of urination and defecation should be avoided.