Case series of karam (kshara / corrosive gauze) application on Chronic ulcers

Abstract

Karam acts as natural chemical cauterization and removes the debris from the wound. Among all the yantrams, upayantrams, sastrams, anusastrams (Instruments) and medicines, the karam has the supreme action, because it is most effective and acts immediately. There are many diseases which are not curable with medicine or drugs or are not so much effectively treated such as skin diseases, some allergic condition, Bhagandram (Fistula in ano), Nadi Viranam (Sinuses), Arbuda (Cancer), Moolam (piles), Dustra Viranam (Chronic or non-healing ulcers), warts, melanomas, external abscess, diseases of mouth, some tumor of oral cavity. This diseased portion should be removed or killed, but it is observed that many time drugs fail to work. Surgery is always feared by even those who advocate it. Many times, patients are physically or mentally not fit to undergo surgical operation. Under such condition the alternative measure for advancing the result of surgery is always welcomed. During pre- anesthetic age such alternative procedure was one of the main armamentaria for surgery and it was used in the place of surgery under certain conditions, among such para surgical measures. Karam occupied a prominent place as armamentarium tool of surgery in the ancient era. The external application of karam is used in various diseases, further it can bring about the same result as a surgical operation without its pain agony, modifying tissue by less degree may give rise to less effusion of blood and less agony than operation. Karam can also be used in the dangerous condition of disease. Karam are more effective than other methods of treatment because they can be administered both internally as paneeyam karam and externally as pratisaraneeya karam. Karam is a single drug, it acts on all the three dosha. The great Siddha sage “Akasthiyar” narrated in kara techniques for the wound healing. Several corrosive gauzes (Karam) are named based on its colour. Thus green, yellow, black and blue corrosive plasters were mentioned in Siddha Medicine for effective wound healing.