Asuri chikitsā in Arshas: An Ayurvedic perspective with modern correlations: A review

 Corresponding author: MANJUNATH BHAT Copyright © 2025 Author(s) retain the copyright of this article. This article is published under the terms of the Creative Commons Attribution License 4.0. Asuri chikitsā in Arshas: An Ayurvedic perspective with modern correlations: A review AMAR GAJAKOSH R, YADAV KRISHNAKUMAR and MANJUNATHA BHAT * Department Of Shalya Tantra, Alva’s Ayurveda Medical College and Hospital, Moodubidrie, D.K.(Dist.), Karnataka-574227. World Journal of Advanced Research and Reviews, 2025, 28(01), 1301-1305 Publication history: Received on 07 September 2025; revised on 12 October 2025; accepted on 15 October 2025 Article DOI: https://doi.org/10.30574/wjarr.2025.28.1.3312 Abstract Asuri Chikitsa, an esoteric branch of Ayurveda, involves mystical and ritualistic therapies used primarily for diseases of divine or supernatural origin. This review examines the application of Asuri Chikitsa in the management of Arshas (haemorrhoids), an ailment described in Ayurvedic texts as a condition arising from imbalances in the body's Doshas, particularly Vata. The article explores the historical and cultural significance of Asuri Chikitsa, with a focus on its use in Arshas when conventional treatments failed. It details the therapeutic methods, including the use of Mantras, Yantras, herbal combinations, and rituals, all aimed at restoring balance in the body and mind. Additionally, the review draws parallels between traditional Ayurvedic surgical procedures (Chedana Karma, Kṣārakarma, and Agnikarma) and their modern counterparts in proctology, such as haemorrhoidectomy, sclerotherapy, and infrared coagulation. The article also highlights how modern technological advancements, such as laser therapy and Doppler-guided haemorrhoidal artery ligation, are aligning with Ayurvedic principles. The integration of modern techniques with Ayurvedic wisdom underscores the relevance of Asuri Chikitsa in contemporary healthcare, offering a holistic approach to treating Arshas. Further research is essential to validate the efficacy of Ayurvedic treatments in modern medical practice. Keywords: Arshas; Ashuri Chikista; Advanced Technology; Hemorrhoids; Ayurvedic principles 1. Introduction Ayurveda, the ancient science of life, encompasses a wide range of treatment modalities, including Daivavyapāśraya (divine therapies), Yuktivyapāśraya (rational therapies), and Satvāvajaya (psychological therapies). Among these, Asuri Chikitsa is a less explored branch that primarily deals with ritualistic, occult, or esoteric healing methods. This method was often applied when conventional therapeutic measures failed or when a condition was considered to have a divine or supernatural origin. Arshas (hemorrhoids) is a condition well-documented in Ayurvedic classics, described as a fleshy growth that obstructs the anal channel and eliminates the existence like enemy1 While modern medicine categorizes haemorrhoids as vascular structures2,3 in the anal canal that become swollen due to various reasons, The primary causes of Arshas are binge eating and a sedentary lifestyle, which decreases the activity of digestive enzymes and causes constipation, itchiness, burning, and pain near the Guda, which eventually results in bleeding4 (Guda area), which is unquestionably a Marma (essential portion), is where Arshas takes place. The disease manifess because of a variety of circumstances, such as an incorrect diet, prolonged standing or sitting, bad defecation habits, etc., which deranges the Jatharagni and vitiates the Tridosha, primarily the Vata dosha. The localisation of these vitiated Doshas in Gudavali and Pradhana Dhamani further vitiates Twak. Due to Annavahasrotodushti, Mansa, and Meda Dhatus result in the creation of Arshas 5 Among the various treatments available for Arshas, surgical interventions (Śastrakarma) and para-surgical measures (Kṣharakarma and Agnikarma) hold a crucial place, which can be linked to modern advancements in proctology. World Journal of Advanced Research and Reviews, 2025, 28(01), 1301-1305 1302 2. Materials and methods All sorts of references have been collected from our ancient Ayurvedic texts viz., Sushruta Samhita, Charaka Samhita, Ashtanga Hridaya, Bhaisajya Ratnavali. Modern books like Bailey and Loves’s, Short Practice of Surgery, Surgery of the Anus Rectum and Colon, Atlas of General Surgery Jaypee Brothers medical publishers etc are used as literary source. Aim To explore the role and relevance of Asuri Chikitsa in the management of Arshas from an Ayurvedic perspective, and to correlate its traditional therapeutic approaches with modern surgical and technological advancements. Objectives • To review the concepts, principles, and historical applications of Asuri Chikitsa, with a specific focus on its role in the treatment of Arshas as described in classical Ayurvedic texts. • To identify and analyze the Ayurvedic surgical and para-surgical procedures such as Chedana Karma, Kṣharakarma, and Agnikarma in the management of Arshas. • To correlate traditional Ayurvedic approaches for Arshas with modern proctological techniques like haemorrhoidectomy, sclerotherapy, and infrared coagulation. • To explore the integration of advanced medical technologies (e.g., laser therapy, Doppler-guided procedures) with Ayurvedic principles, and to highlight the need for further research in combining traditional and modern practices for enhanced clinical outcomes. 2.1. Definition of Asuri chikitsa Asuri Chikitsa refers to a specialized form of therapy involving mystical, ritualistic, and supernatural elements, often performed to remove or alleviate diseases believed to have a divine, karmic, or metaphysical origin. The word Asuri is derived from Asura, signifying a connection to spiritual forces that are beyond human control. Asuri Chikitsa involves the use of Mantras, Yantras, Herbs, and rituals to neutralize negative influences affecting the body and mind.      23  Types of chikista6 Chikista is of three types viz. Asuri, Manusi and Daivi. The treatment with surgery is know as Asuri. 2.2. Application of asuri chikitsain arshas In the context of Arshas, Asuri Chikitsa was employed when conventional treatments failed. Various Ayurvedic texts mention the use of: ● Mantras (Sacred chants) to reduce pain and inflammation. ● Herbal combinations to counteract supernatural influences. ● Yantras and talismans to ward off negative energies. ● Rituals and oblations to pacify Doshic imbalances believed to be influenced by planetary forces. Although such practices might not align with modern scientific principles, their psychological impact on the patient cannot be ignored, as belief and faith play an essential role in healing. 2.3. Historical significance The use of Asuri Chikitsa is rooted in the Atharva Veda, which describes various esoteric therapies7 for different ailments. Ayurvedic texts like Susruta Saṃhita and Caraka Saṃhita mention divine and mystical interventions when describing treatment approaches. Caraka Saṃhita 8 emphasizes Daivavyapasraya Chikitsa, which includes Asuri Chikitsa, for diseases where the cause is uncertain or spiritual factors are suspected. Susruta Saṃhita 9 highlights certain offerings in treating of Arshas. World Journal of Advanced Research and Reviews, 2025, 28(01), 1301-1305 1303 Aṣṭanga Hṛdaya highlights the importance of rituals and chants in specific cases where diseases do not respond to traditional therapies. This suggests that Asuri Chikitsa was an integral part of disease management in ancient times, particularly for conditions perceived as having metaphysical causes. 2.4. Surgical interventions for Arshas When non-surgical measures failed, Sastrakarma (surgical procedures) were performed. Susruta, the father of surgery, describes the following surgical techniques for Arshas: ● Chedana Karma (Excision) – Surgical removal of haemorrhoidal masses using specialized instruments. ● Kshara Karma (Caustic Therapy) 10 – Application of alkaline preparations (Kṣhara) to burn and shrink the haemorrhoidal tissue. ● Agnikarma (Cauterization)11 – Use of heat or fire-based instruments to coagulate and destroy pathological tissue. 2.5. Modern correlation of surgical methods The ancient methods of treating Arshas correlate closely with modern proctology: ● Chedana Karma → Haemorrhoidectomy (Surgical removal of haemorrhoids) ● Kshara karma → Chemical Cauterization (Sclerotherapy using chemical agents) ● Agnikarma → Infrared Coagulation (Infrared or laser therapy for haemorrhoid shrinkage) These interventions highlight how ancient Ayurveda's surgical wisdom finds application in modern medical advancements. 2.6. Advanced technology and Ayurveda With technological evolution, Ayurveda has adapted to modern innovations, enhancing treatment outcomes for Arshas. Some notable advancements include: ● Laser Haemorrhoidoplasty (LHP) – A modern equivalent of Agnikarma, utilizing laser beams for precise coagulation and tissue removal. ● Doppler-Guided Haemorrhoidal Artery Ligation (DG-HAL) – Advanced diagnostic tools combined with targeted intervention, aligning with Ayurveda’s principles of pinpointing Doshic imbalance. ● Kṣhara Sutra Therapy with Standardized Techniques – Integration of scientific precision in herbal caustic therapy to enhance efficacy and minimize complications. ● Biofeedback and Neuromodulation12– These modern techniques resemble ancient Ayurvedic approaches focusing on the nervous system’s role in anorectal disorders. The fusion of Ayurveda with Biotechnology, Artificial intelligence (AI), and advanced diagnostics continues to refine treatment protocols, making them more effective and accessible. 3. Discussion The management of Arshas through Asuri Chikitsa reflects a unique blend of spiritual healing, ritual practices, and therapeutic intervention rooted in Ayurveda. Traditionally part of Daivavyapasraya Chikitsa, it was employed in cases believed to have metaphysical causes or where conventional treatments failed. Ancient texts like the Atharva Veda, Caraka Saṃhita, and Susruta Saṃhita describe the use of mantras, yantras, and rituals—methods that may offer psychosomatic benefits even today. When such divine methods proved insufficient, Ayurvedic surgeons utilized Sastrakarma, Kṣharakarma, and Agnikarma, which correlate closely with modern proctological procedures like haemorrhoidectomy, sclerotherapy, and infrared coagulation. Recent innovations such as laser therapy and Dopplerguided interventions align with Ayurvedic principles, demonstrating the system’s adaptability. However, the mystical basis of Asuri Chikitsa lacks empirical validation, limiting its acceptance in modern medicine. Further interdisciplinary research is essential to integrate its psychosomatic strengths with contemporary clinical protocols, enriching holistic care. World Journal of Advanced Research and Reviews, 2025, 28(01), 1301-1305 1304 4. Conclusion Asuri Chikitsa in Arshas represents an intersection of spiritual, ritualistic, and therapeutic interventions in Ayurveda. While modern medicine has moved away from mystical approaches, the psychological and faith-based impact of such treatments cannot be disregarded. The surgical principles outlined in ancient texts continue to inspire contemporary proctology, demonstrating Ayurveda's timeless relevance. With the integration of modern technology and scientific validation, Ayurvedic principles for Arshas management are undergoing a transformation, making them more evidence-based and patient-friendly. Future research and clinical trials will further solidify Ayurveda’s role in holistic proctology, ensuring a balance between tradition and innovation in healthcare Compliance with ethical standards Acknowledgments The authors express their heartfelt gratitude to Alva’s Ayurveda Medical College and Hospital, Moodubidri, for providing the necessary facilities. We extend our sincere thanks to the Department of Shalya Tantra, for their constant guidance and encouragement. We are especially grateful to our respected teachers and mentors for their valuable inputs and insights, which greatly enhanced the quality of this work. Disclosure of conflict of interest No conflict of interest to be disclosed. References [1] Shastri AD. SushrutaSamhita Vol-I. Ayurveda Tatwa Sandeepika Hindi Commentary. 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