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Arśa (piles/hemorrhoids) is a common anorectal disorder described extensively in Ayurvedic
classics. Yogaratnakara recommends Tiladi Modaka as a therapeutic formulation for Arśa, yet systematic
academic evaluation integrating classical rationale and modern research design remains limited. Objective: To
critically review the classical basis, pharmacological rationale, and contemporary evidence for Tiladi Modaka in
Arśa, and to propose a clinical research methodology. Methods: Classical references from Yogaratnakara and
allied Ayurvedic texts were reviewed. Available modern pharmacological and clinical literature on Tiladi Modaka
and its constituent drugs was synthesized. A prospective randomized pilot clinical trial protocol is proposed,
including standard operating procedures (SOPs) for drug preparation and quality control. Results: Classical texts
indicate Tiladi Modaka as Arśaghna through doṣa-śamana, śothahara, raktastambhana, and vranaropaṇa actions.
Modern studies on individual constituents suggest anti-inflammatory, venotonic, wound-healing, antimicrobial,
and laxative effects. Hypothetical pilot data presentation demonstrates potential reductions in pain, bleeding,
discharge, and pile mass size.

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