AGNIKARMA

Dr. Vaibhav WavhalJR III, Shalyatantra

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Introduction

History

Classification

Indications and Contra-indications

Steps in Agnikarma

Overview

Mechanism of action

Prospective of Agnikarma

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Introduction

Agnikarma means application of

Agni directly or indirectly with

the help of different materials

to relieve the patient from disease.

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Synonyms of Agni karma

i) Agni chikitsaii) Agni karmaiii) Vahni dagdhaiv) Dagdhakarma

v) Dahan karmavi) Dagdha chikitsavii) Dambha kriyaviii) Pachana kriya

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History(Vedic period)

According to the verses of Rigveda the Agni is capable of destroying the invading parasites and demons in the vagina and uterus of the women and to save the foetus from the infections.

This signifies the idea about the utilization of Agni karma as a disinfectant.

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History(Vedic period)

Atharva veda has identified Agni as God and treatment for diseases. from the verses it becomes clear that Agni was used to protect the body from the invading microorganisms.

It is also mentioned in Atharva veda as ‘Rakshoha agni’.

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Samhita Period

Charaka Described Agni in

ShastraPranidhana As a Chikitsa of many clinical and

surgical diseases like- Kaphaja Gulma, shvayathu, bhagandara, arsha, grahani, granthi visarpa, Gridhrasi roga chikitsa, Ardhavbhedhaka,

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Samhita period

Sushruta- -

Maharshi Sushruta told Agnikarma as a parasurgical procedure and it is superior to all parasurgical procedures.

Described it as a Upayantra. For management of various surgical

diseases like Arsha, bhagandar, ashmari , granthi, apachi etc

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Samhita period Sangraha kala-

Vriddha vagbhatta and Vagbhatta Mentioned Agnikarma as superior therapy for pain management and also described it’s surgical use in various surgical disorders.

likewise agnikarma was also mentioned in laghutrayi and many ancient ayurveda literature.

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Agnikarma in mughal period The status of treatment in mughal

period was described by Italian author, Nicalia Manuci in his book “Mughal India”. Nicalia Manuci was physician of Shah Alam

and Aurangzeb. He had also advised to do cauterization on

the heal in case of Cholera.

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Agnikarma in Unani Chikitsa ‘Unani Chikitsa Sara’ book of unani

chikitsa also has same reference regarding management of cholera. Hot iron piece should be kept at a little

distance from the forehead Lemon drop should be squeezed on hot

piece, so that lemon drops being hot will fall on forehead

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Important referenes in context of Agnikarma स्रवात्�ऽश्र्मभवा�न्र्म�त्रं� य� चा�न्य� रक्तवा�हि"�# ||

हि�#शे�षच्छि'न्नसंन्ध्)श्च सं�धय�दग्नि��कृर्म�णा� ||s.c.1/89||

सप्ता�हा�दूर्ध्वं� पु�नर्य�दा� व्रणा�न�मसन्धा�न�न म�त्रं� स्�म�र्गं न प्रतितापुद्यता� तादा���ग्नि�नन� दाहा�ता!(dalhan)

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भर्गंन्दारा�र्श�स�दार्य& पु�� स्विस्�द्यन्ता�, पुश्चा�त्ते�षु� र्शस्त्रंम�चा�र्य�ता�; �� स्��दाग्रहाणा� भ�षुजो.पुलक्षणा�, भ�षुजो�र्शक्तौ2 र्शस्त्रं��चा�राणा�, र्शस्त्रं�र्शक्तौ��र्श�षुव्या�धि5र्शमन�र्य ,क्ष�रा&, क्ष�रा�र्शक्र्य�ऽ�र्गं�ढम�ल� व्या�5��ग्नि�नरिरातिता||(s.s.12/3.dalhana)

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Agnikarma in present Era Agnikarma is also practiced by the

modern physician in same or other forms.1) Cauterization

To check bleeding in surgeries. cauterization in cervical erosion

2) Laser in medical use Angioplasty Lithotripsy Laser photocoagulation, correcting vision

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Agnikarma in present Era

Skin diseases Prostatectomy Close small blood vessels to reduce blood loss Remove warts, moles, sunspots, and tattoos Reduce the appearance of skin wrinkles,

scars, and other skin blemishes Remove dilated blood vessels from the face Remove hair Remove precancerous lesions (actinic

keratoses)

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Work done in the departmentYear Topic Work done by

1968

A scientific study on agnikarma Dr. S.D. Vaishnava

1993

Evaluation of immunological behavior in cancer patients by agnikarma

Dr. Poonam Kesarwani

2009

Critical analysis of Agnikarma in pain management

Dr. Deepak poman

2011

Biochemical analysis of Jalaukaavacharan and agnikarma in pain management

Dr. Jitendra Chaubey(still in progress)

PHD thesis

1994

Role of Agnikarma in malignancy Dr. P. N. Rao

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Material used for Dahana karma

Pippali Godant Ajashakrit Shara Shalaka- ArdhenduvaktraKolasthidaltulya Jambvosta

Dhatu Madhu

Madhuschista Gud Vasaa Ghrita Majja Varti Suryakanta Nadiyantra Suchi

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Classification On the basis of

Types

Names

Dravya used

2 1. Snigdha-to treat diseases situated in Sira, Snayu, Sandhi, Asthi.

2. Ruksha-to treat diseases situated in Twak and Mamsa dhatu.

Site 2 1. Sthanik-)-As in vicharchika, kadara, arsha2. Stsanantariya-)-As in visuchika, apachi, gridhrasi

etc

Akriti 7 1. Valaya 2. Bindu 3. Vilekha 4. Pratisarana 5. Ardhachandra

6. Swast ika 7. Ashtapada

Dhatus 4 1. Twak 2. Mamsa 3.Sira Snayu 4. Sandhi Asthi

Pramad Dagdha(Itartha)

4 i)Plustha(Tuttha) dagdha ii) Durdagdha iii)Samyaka dagdha iv) Ati dagdha

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Agnikarma kala Can be done in all seasons except Grishma and sharad.

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Agnikarma kala But again Acharya advices to perform Agni

karma in emergency conditions in these ritus also, provided appropriate counter measures are adopted.

Dalhan mentioned the counter methods to mitigate effect of Agni karma as covering the part with moist cloth use of cold foods and applying cooling paste over the part.

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Indications

In all types of Pain especially Vataja disease like Sciatica, Heal Pain.

After excision of Cyst, Mass, Warts, Tumour, Piles, Fistula etc.

Migrane, Trachoma, Sinusitis and other type of Shiroroga

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Indications

In case of Hernia -first toe of leg of opposite side of the body

All types of joint pain like Sandhitgatvata, Amavata, Frozen shoulder, Cervical Spondylosis etc.

Bleeding disorder along with convulsive disorder like Epilepsy, Hysteria and also useful Psychosomatic disease.

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Pitta Prakriti Daurbalya Vriddha Paandu, Madhumeha, Raktapitta Bhinna Kostha Antah Sonita Anuddhruta Shalya Bala, Bhiru Multiple Vrana

CONTRAINDICATIONS

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Those who are contraindicated for Swedana.

Vrana of Snayu, Marma, Netra, Kustha and Vrana with Visa and Shalya (Charak)

Marmasthaana is the absolute contraindication for Agnikarma. 

S.Su.12-4 (Dalhana)

In confusion state

CONTRAINDICATIONS

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Medical contraindication include- Insensitive skin- Acute trauma- Venous obstruction- Arterial insufficiency

CONTRAINDICATIONS

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Agnikarma shreshtata

1. Apunarbhavaa 2. Sterlization property 3. Haemostatic action4. Curative property 5. Kaphavatagna

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Agnikarma practised in OPDs

Panchavalkala kwatha for Praksalana of the local part of patient.

Yashtimadhu ChurnaSmall pieces of

Kumari Patra

Swab holding forcepGauze pieceCotton, Adhesive

tape, Cotton bandage Gas stovePancadhatu

Shalaka.

MATERIAL USED

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Poorvakarma

Confirmation of site of Agni Karma and marking the site of Maximum tenderness.

Proper Positioning of the patient

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Poorvakarma The area is covered with sterile drap. The selected site is isolated and cleaned with

Triphala kashaya. (Spirit should not be applied) Heating of the Shalaka till red hot.

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Pradhan Karma

Make Samyaka Dagdha Vrana : After carefully considering the symptoms of the disease, the vital spots and the strength of the patient, disease and seasons, the physician should undertake samyak dagdha.(Su. Su. 12/12).

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Pradhan Karma

The number of the Samyak Dagdha Vrana may be 5-30 according to the extent of the diseased area.

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Pradhan Karma

During the procedure the patient may feel pain so he should be taken in confidence and assistant may be required to hold them so that heat burns can be performed at appropriate site.

If the patient is non co-operative the pain caused due to heat burn will make the patient restless and will lead to heat burns on wrong places which can cause wounds.

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Complications Complication

Causes treatment

Plustha Dagdha

If the Shalaka is not properly heated- Inadequate burn.

Durdagdha Unskilled physician or un cooperative patient- Durdagdha may occur.

Ati-Dagdha This complication is produced due to more heat which is transferred from the red hot Shalaka to the diseased part.

Daha (burning) More or less burning pain is experienced by each and every patient who uses to take Agnikarma Chikitsa.

Ghritakumari Patra Swarasa.

Dushtha Vranata (Sepsis of wound)

Due to ignorance of agnikarma wound Wound management

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Paschat karma

Application of Cooling agents :

To subside burning pain.

Small pieces of Kumari Patra after crushing with swab holding forceps.

दुहिषत् रक्त हि/त्तय�: प्रसं�द�य , वा�द�� उ/शेर्म�य चा ।

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Paschat karma

Yashtimadhu ghrita, Shatadhauata ghrita, Raktachandan siddha ghrita or lepa of ghrita mixed with honey can also be applied

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Paschat karma

(These medicines help to reduces the burning sensation and pain caused by heat burns , also they help in healing procedure)

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Mechanism of action Ushna guna of agnikrma acts as

vatagna, in this way it acts as a pain releiver.

Ushna guna improves dhatwagni and thus helps to remove toxins(aama-pachana). This improves local nourishment of the tissue and thus reduces pain by decreasing local inflammatory process.

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Mechanism of action According to scientist Dr. Ven Hanff,

the place where heat burns the local tissue metabolism is improved and thus it leads to increased demand of oxygen and nutrient of the tissues.

This causes enhanced delivery of nutrients and more efficient removal of waste products, hence speeding up the natural process of repair.

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Mechanism of action(Pain pathway)

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Mechanism of action Presumed Action of agnikarma in

pain pathway Heat Thermal receptors Stimulation of

Lateral Spinothalamic Tract Stimulation of Descending Pain Inhibitory fibres Release of endogenous Opoid peptide which bind with opioid receptors at Substantia Gelatinosa Rolandi Inhibition of release of P-substance blockade of pain sensation.

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Mechanism of action Pain receptors of skin and motor end plate

stimulated at 450C. Pathway for pain and thermal signals run parallel and ends into same area but only stronger one can felt. Therefore complete exclusion of pain impulse by heat occurs.

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Prospective of agnikarma Agnikarma is the

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18% of Elderly PersonsTake Analgesic Medications Regularly

(daily or more than 3 times a week)

71 % take prescription analgesics 63% for more than 6 months

72% take OTC analgesics Median duration more than 5 years

26% report side-effects 10% were hospitalized 41% take medications for side-effects

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Non-Drug Strategies for pain management

Exercise PT, OT, stretching,

strengthening general

conditioning

Physical methods ice, heat, massage

Chiropracty Acupuncture TENS Alternative

therapies Relaxation herbals

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Thank you…