In Ayurveda, Samprapti Vighatana—the reversal of disease pathogenesis—is considered the prime goal of Chikitsa, achieved by correcting Dosha–Dushya Sammurchana to restore balance. Arshas (hemorrhoids), a common Annavaha Srotas Vyadhi, arises from Mandagni and vitiated Doshas by Nidana like Viruddhashan, Adhyashana, Atistriprasanga etc. The Chikitsa of arshas includes Bheshaja, Kshara, Agni, and Shastra Karma, selected according to the lakshana of ankura. This study interprets the Chikitsa Sutra of Arshas in the context of Samprapti Vighatana, emphasizing Ekamoolika Prayoga (single-drug therapy) using Pippali and Kupilu, and the significance of Pathya–Apathya. Classical texts and modern commentaries were reviewed to correlate their pharmacodynamics with Shushka and Sravi Arshas. Pippali, with Deepana, Vatanulomana, and Kaphahara actions, is beneficial in Shushka Arshas, while Kupilu, possessing Tikta-Katu Rasa, Ushna Virya, and Kapha-Vatahara properties, suits Sravi Arshas. Pathya–Apathya supports Agni maintenance, bowel regulation, and relapse prevention. Thus, Ekamoolika Prayoga of Pippali and Kupilu with dietary discipline offers an economical and effective approach to Arshas management through Samprapti Vighatana, particularly beneficial in early stages with preventive potential and severity.