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According to Acharya Sushruta the treatment modality of Arsha are Bhesaja (use of medicines), Kshara (use of caustic alkalies) Agni (use of fire/branding) Shastra (use of sharp instruments/surgical).Arsha which are Mrudu(soft), Prasrita (broad), Avagada (deep), Uchritha (bulged) are treated with Kshara Karma.Aim: to see Effectiveness of Teekshna Palasha Pratisaraniya Kshara Karma in the management of Rakta-Arshas (Grade II internal haemorrhoids).Material and methods: under local anesthesia 2% lignocaine and adrenaline Teekshna Palasha Pratisaraniya Kshara Karma over the grade to internal haemorrhoids at 7 oclock position and wait for Shatamatra Kala (100 seconds) or pile mass getting Pakvajambuphalavarna, followed by normal saline wash and later neutralize with Nimboo Swarasa.Thereafter anal canal is packed
A 2024 study studied this question.