Aardra Arshahara Kashaya – Ingredients, Preparation, Ayurvedic Properties, Indications & Dosages

Introduction

Aardra Arshahara Kashaya is a classical Ayurvedic formulation indicated for the management of Aardra Arsha, which corresponds to bleeding hemorrhoids (bleeding piles). The term Aardra denotes moistness or bleeding, indicating piles associated with fresh bleeding, inflammation, burning sensation, and tenderness. According to Ayurveda, Arsha develops due to impaired digestive fire (Mandagni), chronic constipation, improper dietary habits, suppression of natural urges, sedentary lifestyle, and vitiation of the Vata, Pitta, and Kapha Doshas. In Aardra Arsha, Pitta dosha and Rakta dhatu (blood tissue) predominate, resulting in inflamed hemorrhoidal veins that bleed during or after defecation. The classical text describes two simple decoctions under Aardra Arshahara Kashaya. The first is prepared from Patha (Cissampelos pareira) and administered with Madhu (Honey). The second is prepared using Kutaja seeds (Holarrhena pubescens) along with Musta (Cyperus rotundus). Both formulations possess Grahi (absorbent), Stambhana (haemostatic), Deepana (digestive stimulant), Pachana (digestive), and anti-inflammatory properties, making them beneficial in controlling bleeding, improving digestion, and reducing anorectal inflammation. The simplicity of these formulations highlights the Ayurvedic principle that carefully selected herbs, even in small combinations, can effectively correct the underlying pathology when administered appropriately.

Classical Reference

अर्शेषु पाठासंसिद्धः क्वाथो मधुसमन्वितः।
प्रशस्तः कौटजैर्बीजैः सिद्धो वा सह मुस्तया।। (Sahasrayogam)

For the treatment of bleeding hemorrhoids, a decoction prepared from Patha (Cissampelos pareira) and administered with Honey is considered beneficial. Alternatively, a decoction prepared using Kutaja (Holarrhena pubescens) seeds together with Musta (Cyperus rotundus) is also highly effective in relieving the condition.

Kashaya 1: Patha Kashaya

Ingredients

1. Patha (Cissampelos pareira) – Velvetleaf, False Pareira Root – 1 part
2. Water – 16 parts

Adjuvant

• Madhu (Honey) – Apis mellifera honey – added after filtration as required.

Method of Preparation

• Prepare a coarse powder of Patha (Cissampelos pareira).
• Add 16 parts of water (for example, 16 litres (L) of water for 1 kilogram (kg) of coarse powder or 1600 ml for 100 g of coarse powder).
• Boil gently until the volume is reduced to one-eighth of the original quantity.
• Filter through a clean cotton cloth.
• Allow the decoction to become lukewarm.
• Add an appropriate quantity of honey before administration.

Dose

48–96 ml of freshly prepared decoction, administered twice daily or as directed by an Ayurvedic physician.

Ayurvedic Properties of the Ingredient

Patha (Cissampelos pareira) – Velvetleaf

• Rasa (Taste): Tikta (Bitter), Kashaya (Astringent)
• Guna (Qualities): Laghu (Light), Ruksha (Dry)
• Virya (Potency): Ushna (Hot)
• Vipaka (Post-digestive effect): Katu (Pungent)

Patha is well known for its Deepana, Pachana, Grahi, Shothahara (anti-inflammatory), and Raktashodhaka (blood-purifying) actions. It helps arrest bleeding while correcting impaired digestion, which is considered the root cause of Arsha (piles).

Therapeutic Action

The Patha decoction primarily reduces inflammation of hemorrhoidal veins while improving digestion and bowel function. Honey acts as a Yogavahi (catalytic carrier) and promotes wound healing. The formulation also helps reduce mucous discharge, burning sensation, and minor bleeding associated with inflamed piles.

Kashaya 2: Kutaja Bija-Musta Kashaya

Ingredients

1. Kutaja Bija (Holarrhena pubescens) – Kurchi Seeds – 1 part
2. Musta (Cyperus rotundus) – Nut Grass – 1 part
3. Water – 16 parts

Method of Preparation

• Prepare a coarse powder of Kutaja (Holarrhena pubescens) seeds and Musta (Cissampelos pareira).
• Add 16 parts water (for example, 16 litres (L) for 1 kilogram (kg) of the combined coarse powder or 1600 ml for 100 g).
• Boil until the liquid is reduced to one-eighth.
• Filter through a clean cloth.
• Administer the freshly prepared decoction while lukewarm.

Dose

48–96 ml, twice daily or as advised by an Ayurvedic physician.

Ayurvedic Properties of the Ingredients

Kutaja (Holarrhena pubescens) – Kurchi

• Rasa: Tikta (Bitter), Kashaya (Astringent)
• Guna: Laghu (Light), Ruksha (Dry)
• Virya: Sheeta (Cold)
• Vipaka: Katu (Pungent)

Kutaja (Holarrhena pubescens) is highly regarded for its Grahi, Stambhana, Krimighna (anthelmintic), and anti-inflammatory properties. It is particularly useful in conditions involving bleeding and excessive intestinal secretions.

Musta (Cyperus rotundus) – Nut Grass

• Rasa: Tikta (Bitter), Katu (Pungent), Kashaya (Astringent)
• Guna: Laghu (Light), Ruksha (Dry)
• Virya: Sheeta (Cold)
• Vipaka: Katu (Pungent)

Musta (Cyperus rotundus) improves digestion, reduces Ama (endotoxins), pacifies Pitta and Kapha dosha, and relieves inflammation and discomfort associated with anorectal disorders.

Therapeutic Actions

The combined action of Kutaja (Holarrhena pubescens) and Musta (Cyperus rotundus) helps:

• Arrest bleeding from hemorrhoids.
• Reduce inflammation and oedema.
• Improve digestive fire (Agni).
• Relieve burning sensation and irritation.
• Reduce mucous discharge.
• Support healthy bowel movements.
• Prevent recurrence associated with indigestion.

Indications

Aardra Arshahara Kashaya is traditionally indicated in:

• Bleeding hemorrhoids (Bleeding piles)
• Inflamed internal hemorrhoids
• Burning sensation during defecation
• Rectal bleeding associated with piles
• Mucous discharge from hemorrhoids
• Mild constipation associated with piles
• Pitta-dominant Arsha
• Digestive weakness contributing to anorectal disorders

Mode of Action According to Ayurveda

Ayurveda considers Mandagni (poor digestive fire) and Ama formation to be the primary causes of Arsha. These lead to vitiation of Doshas and congestion within the anal veins. Both formulations work by improving Agni, digesting Ama, and balancing Pitta, Kapha, and Vata. Their Kashaya Rasa provides Stambhana (haemostatic) action, while Deepana and Pachana properties remove the root cause of disease rather than merely controlling symptoms. The formulations also support healing of inflamed anorectal tissues and restore normal bowel function.

Modern Pharmacological Perspective

Modern phytopharmacological studies have demonstrated that the herbs included in these formulations possess several activities relevant to hemorrhoidal disease.

• Patha (Cissampelos pareira) exhibits anti-inflammatory, antimicrobial, antioxidant, analgesic, and wound-healing properties.
• Kutaja (Holarrhena pubescens) possesses anti-inflammatory, antimicrobial, anti-diarrhoeal, antioxidant, and astringent activities that support tissue repair.
• Musta (Cyperus rotundus) has documented anti-inflammatory, analgesic, antioxidant, digestive stimulant, antimicrobial, and gastroprotective effects.

Collectively, these pharmacological properties may help reduce inflammation, control microbial contamination, support healing of damaged mucosa, improve gastrointestinal function, and reduce symptoms associated with bleeding hemorrhoids.

Conclusion

Aardra Arshahara Kashaya is a valuable classical Ayurvedic formulation comprising two distinct decoctions intended for the management of bleeding hemorrhoids. The Patha Kashaya with Honey primarily promotes haemostasis, tissue healing, and digestive correction, whereas the Kutaja-Musta Kashaya combines astringent, digestive, and anti-inflammatory actions to reduce bleeding, inflammation, and recurrence. Both formulations emphasize the Ayurvedic principle of addressing the underlying impairment of digestion and Doshic imbalance while promoting local healing. When administered under the guidance of a qualified Ayurvedic physician, these decoctions can serve as effective supportive therapies in the comprehensive management of Aardra Arsha (bleeding piles).