SHASTRA-KSHARA-AGNI KARMA

IN SHALAKYA
DR. PREETI PATEL
ASSISTANT PROFESSOR
 INTRODUCTION
• Ashta Vidha Shastra Karma utilizes eight surgical
techniques for the management of surgical problems.
• Ashta Vidha Shastra Karma involve procedures such as;
– Chedana (Excision),
– Bhedana (Incision),
– Lekhana (Scrapping),
– Vyadhana (Puncturing),
– Visravana (Drainage),
– Eshana (Probbing),
– Aharana (Extraction) and
– Sivana (Suturing).
 Chhedana Karma
• Chhedana involve excision of part from the body using
mandalagra, karpatra, vrudhipatra, mudrika &
utpalpatraka etc.
• The diseases which can be treated by Chhedana are as
follows
– Kaphaja cyst
– Ulcer margin
– Mild tumors -vartmarbuda
– Enlarged uvula
– Adhimansa
– Necroses tissue.
 Eye
• Shirajala
• Shirapidika
• Shuksharsha
• Pavrni
• Arshovartma
• Arbuda
• Arma 5
 Bhedana Karma
• It involve incision procedure to open a cavity for draining
out tissue debris, rakta, pus & waste discharge using
vrudhipatra, nakhgashastra and utpalpatrak etc.
• The bhedana karma may be used for the management of
conditions like;
– Granthi-Cysts
– Vidradhi-Abscesses
– Talupupputa,
– Dantapupputa
– Gilayu
– Tundikeri
 Eye
• Bisavartma
• Lagana
• Anjanamika
• Krimiganthi
• Upanaha
• Kumbhika
• Alaji
 Vyadhana
• It involves puncturing of affected part using needle, kutharika & aara
etc.
• It may be used in case of
– Nadis
– Ulcers lodged with foreign matter.
• Eye:
– Vataviparyaya
– Shiritpata
– Shiraharsha
– Sashopha paka
– Ashopha paka]puyalasa
– Adhimantha
– Abhishyanda
 Lekhana
• This technique involves scrapping out
waste/debris/dead material from affected part with
the help of with the help of mandalagra, vridhipatra
and karapatra etc.
• The conditions which can be managed by lekhana are;
– Cyst
– Upajihvika
– Rohini
– Dantavaidarbha
– Adhijihvika
 Eye
• Vartma sharkara
• Vartma avabandhaka
• Kardam vartma
• Klista vartma
• Bahala vartma
• Pothaki
• Utsangini
• Kumbhika
• Shyava vartma
 Eshana
• It involves snooping of waste discharge, debris
and foreign body, etc. with the help of eshani
from affected body parts.
• The pathological conditions which are
associated with
– Sinuses,
– Wounds and
– Abscesses, etc. Are needs use of probing
 Aharana
• It involves extraction of waste from diseased
body parts using badish, dantashanku and
nakha etc.
• The conditions which can be managed by this
procedure are
• tartar of teeth,
• ear wax.
 Vistravana
• This involves use of needle, trikurchak, shararimukh and
aatimukh for the purpose of bloodletting or draining of pus.
• It is mainly employed for the conditions such as;
– Abscess
– Shaushira
– Kanthashaluka
– Krimidanta
– Dantavestha
– Upakusha
– Shitad
– Dantapupputa
 Sivana
• It is a para-surgical approach involves use of sutures,
needles and threads as post operative management.
• The sivana (suturing) applied on incised or scraped
lesions, operated tissue and spreadable wounds.
• Rhujugranthi, anuvellit, gofanika and tunnasevani are
various types of Seevan used in this therapy.
• Sivana prevent chances of recurring and provides
faster healing of affected tissue.
 Kshara and agnikarma
• Kshara Karma, Agni Karma is known as
Anushastra Karmas.
• The surgical disorders are managed with these
procedures with ease and comfort for both
surgeon and patients.
 classification
• Concentration- Mild,
Moderate and

Extreme

Administration - External
(Dosage-Size of nails) and
Internal(1 pala (40G))
• INDICATIONS
– Skin diseases,
– cysts / tumors non healing
– ulcers
– poisons
– 7 MUKHAROGAS
 NETRAROGA LAGANA
•Bedhana---- Kshara
karma
•Yavakshara,thutha,
gorochana & pippali
mixed with honey
(A.H)
 ARSOVARTHMA, SUSHKARSAS,
VARTMARBUDA
•Chedana ---Kshara
Application
•Erandabeeja Majja or
Vibhitaki kshara
•+ Honey (S. U)
 PAKSHMA KOPA
UPAPAKSHMAMALA
•Epilation -- Kshara
•application
•Gunja kshara + Honey
•(S.U)
 KRIMI DANTA
•Arka kshara application
• (A.H)
 DANTA SARKARA
• Remove sarkara - Apply Yavakshara +
Honey(Chikitsa manjari)
 DANTA SOOLA
DANTA HARSA

Saindava + Kshara
+ Honey 
Pratisarana
(Yogamruta)
Yavakshara + Tila
taila –
Kavala
Danta Vaidarba
janya– Ksara
lepa
(Chakradatta)
ADHI MAMSA

Chedana –
Swarjika
kshara + honey
(Chakradatta)

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 AD H IJIH WA
UPAJIHVA

Adhijihwa
Yava kshara + Ardraka
Swarasa Lepana(Yogamruta)
Upajihva
Pratisarana with Yava
Kshara (Chakradatta)
Gala Roga

Panchakola
kshara for
dharana
( chakradatta)
Kaphaja
Galaganda

Kodrava
prepared in
water mixed
with
amalaki
kshara +
gomutr
a
( chikits
a
manjari
)
26
 Darunaka

Kodravatruna
kshara +
waterfor
kshalana
( A.H)

27
ARUMSHIK
A

Kushta Kshara +
Madhu For
Lepana(S.U)
NASARSHAS

NASARBUD
A

Chedana 
kshara karma
gunja kshara
+
honey –
lepana(AH)

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NASANAHA

Application of
apamarga
kshara over the
hypertrophied
turbinate
 NASAGAT
A
RAKTAPIT
TA

Utpala Kshara +
Honey
Lepana(A.H)
KARNA NADA,
BADHIRYA

Apamarga
kshara jala +
apamarga
moola kalka 
taila –
karnapoorana

32
 • DISEASES Raktapitta, Praviddha, Jwara,
Trishna, Udararoga, Murchha, Hridroga,
Prameha, Shiroroga, Panduroga,
Sarvaanga
Shopha and Raktajagulma.
• STATE -Children, phobic persons, aged,
Aavoid Menstruating or pregnant, Durbala,
Ruksha persons, Shukra-ksheena
persons.
• SITES -Arteries, joints, vital parts,
cartilages,
veins, ligaments, throat, umbilicus, penis,
insufficient musculature, nailed, testis,
all parts of the eye except eye lid.
• SEASONS -Summer, autumn and
cloudy
weather.
PRADHANA
KARMA

34
 • Milk & milk products.
• Exposure to
cold & cold drinks
• Meat &
Masha
AVOI products
D
• Hot & Hard
food for 3
days
 • Luke warm water &
soft diet for 3 days
• Triphala kashaya +
Yasthimadhu for
gargling
ADOPT • Oral medicines
according to need
 ASSESSMENT
◦ Alleviation of disease
◦ Without any secretions

◦ Atiyoga
◦ Hinayoga
• Pricking pain
◦ Burning sensation
• Itching ◦ Redness/Suppuration
• Numbness ◦ Secretions
• Aggravation of disease ◦ Body ache /Thirst
◦ Faintness /death
AGNI KARMA
IN
SHALAKYA
TANTRA
CLASSICA
L
MATERIA
LS
 Pancha
loha
shalaka

Rajata shalaka
• h
DIATHERMY

48
MONOPOLAR
AND
BIPOLAR
DIATHERM
Y
 SHAPES
1. Circular ring
2. Pointed
3. Curved lines
4. Rubbing
5. Crescent
6. Swasthika
7. Eight
limbed
 Shiras – Shiro Roga,
Ardhavabhedaka
INDICATIONS
Mukha- Medoja osta Jalrabuda,
Shiro roga Krimidanta, Dantanadi, Danta
Mukha Vidradhi, Dalana,Vardahna, Medoja
Galaganda
roga
General- Shonita Atipravritta,
Granthi, Arnuda,
Katina-ucchrita Vrana
 Netraroga

1. Lagana – After Bedana

2. Shonitarshas After Cedana
3 Shushkarshas After Cedana
4 Arbuda After Cedana
5. Pakshmakopa After
Shastra Karma
6 . Alaji With Suchi Agra
Bhaga
7.Kaphaja Linganasha- If Pain Is
Not Subsiding After Vyadhana
Karma
8. Adhimantha - If Pain Is Not
Subsiding
 • Local action
EFFECTS OF
• Special
AGNI KARMA actions
 LOCAL It increases the Vasodilatation, rate of
EFFECTS metabolism, capillary permeability,
delivery of leukocyte, elasticity of
ligaments capsules, muscle and nerve
conduction.
2. Removal of metabolic waste.
3. It causes the analgesia and
Vaso dilatation sedation of Nerves
4.It decreases the edema formation,
Waste muscle tone, muscle spasm and
disposal perspiration

Analgesia
Inflammation
 • • Induction of pro-inflammation
theory
SYSTEMIC • • Application of thermodynamic
EFFECTS principle to biological system
• • Gate control theory of pain
• • Superficial nerve endings
response
• theory
• • Contact inhibition theory
• • Pain threshold theory
• • Pizo- electric current theory
• • Reflex theory
These effects will
depend upon…

• Duration of heating
• Method of
application
• Depth of absorption
of specific radiation
• Size of area
heated
 RAKTAMOKSHANA
• SHASTRAVISTRAVAN
– Prachana-Bloodletting through local multiple
incision. it can be applicable in diseases which are
having drushti of two or three Dosha over the area
of one angula.
– Siravedha-Venous puncture. it can be applicable
in diseases which are having drushti of tri Dosha
and Rakta Dosha .It can be done on entire body.
• ANUSHASTRAVISTRAVAN
– Jalaukvcharana-Application of Leech.It can be applicable
in diseases which are having drushti of pitta dosha over
the area of one Hasta(palm).
– Shrung-Sucking through coes horn. it can be applicable
in diseases which are having Drushti of Vata Dosha over
an area of ten anguli.
– Alabu-Vaccum extraction using vegetable called Alabu.
It can be applicable in diseases which are having Drushti
of Kapha Dosha over an area of twelve angul .
 INDICATION
1. Puyalasa(Acute Dacrocystitis)
2. Complicated condition of Arma(pterygium)
3. Savarna Shukla(Corneal ulcer)
4. Pittaj Timir(painless loss of vision e.g.macular edema)
5. Abhishanda of all type (Cunjunctivitis)
6. Adhimantha of all type (painful condition of eyes like
congestive glaucoma,uveitis)
7. Visarpa (Herpes zoster)
8. Daha (Burning sensation)
 CONTRAINDICATIONS
• 1. Very young ,old,emaciated,exhausted
• 2. Suffering from high fever,convulsion or
unconscious patients
• 3. General swelling in whole body
• 4. Wasting due to unhealthy diet
• 5.Anemia
• 6. Piles
• 7. Pregnant woman
 SITE
• Upanasika-near nose
• Lalata-vein of forehead vein
• Apanga-veins present at outer canthus of eye
 BEST TIME FOR RAKTAMOKSHAN
1. Cloudless day in rainy season
2. Cool day in summer
3. Noon in winter
 PROCEDURE OF SIRAVEDHA
• Purvakarma
– Prakupita Dosha Viprita Dravabahul Anna or
Yavagu pan.
– Sthanik and Sarvadhehik Snehan and Swedana.
– Ask patient lie or sit in comfortable position.
– Tie the Bandha with the help of Vastrapatta,
Charma, Antavalkal or Lata.
– The Bandha should not too tight or too loose.
 Pradhankarma
• -After desired Sira is seen properly then
puncture the Sira with the help of sterile 18G
needle or scalp.
• Blood is collected in a kidney tray.When the
sufficient quantity of blood is drawn (Uttam
matra-1 prastha (0.78ml),Madhyam matra-25
tole,Hine matra-12tole) Then needle is
withdrawn cotton swab pressed over the
wound and Bandha should be released.
 Pashyatkarma
• If the bleeding continous from punctured site
then the fine powder of Lodhra,Yashtimadhu,
Raktac handan etc are applied.
• The area is covered with wet cloth or a thin
paste of cooling Dravyas like chandana.
• Patient is asked to relax and rest for
10min.Then patient adviced to take light diet
or milk later.
 Netraroga
• In Puyalasa- Siromokshana should be done
followed by Upnaha and other measures
mentioned for Akshipaka.
• In Savarna Sukla-First Sarpipana than later
Siromokshana is done, followed by
Jaloukavcharana, if remnants are not cleared.
• In Pittaj Timir-After Sarpipana,Sira Vyadhan is
done
• In Kaphaj Timir-After Sarpipana,Sira Vyadhan is
done.
• In Vataj Abhishyanda-Sira mokshan is done
when pain is not subsided
• In Pittaj & Kaphaj Abhishyanda-Repeated
Shiravydha is done.
• Jaloukavacharan is also useful.
• In chronic diseases for eye (pilla rog)-
Shiravedhya and Virechan is done for complete
recovery.
• In Pothaki-Jaloukavcharan is recommended.