सूत्रस्थानम् - १२ अग्निकर्मविध्यध्यायः

अग्निना कृ त्वा यत् कर्म, अग्नेः सम्बन्धि वा यत् कर्म

तदग्निकर्म

•First half of the sentence means direct contact of

agni to the body –bindu dagdha by shalaka in
sandhigata vata
•Second half means indirect heat transfer to the
body- like fomentation , sitz bath etc
 AGNIKARMA

We can understand the word Agni in two ways-

Accordind to swaroop-which spread
Accordind to swabhav –which moves in upward direction
Karma means-Action
MODERN POINT OF VIEW-Agnikarma therapy can be
termed as –Therapeutic heat burn, Peripheral Nerve
Stimulation With Thermal Microcautery. In this procedure
heat is transferred to deeper structures by producing
superficial burn on skin. It has been defined as an effective
and superior among all para surgical procedures.
 IMPORTANCE
क्षारादग्निर्गरीयान् क्रियासु व्याख्यातः,तद्दग्धानां
रोगाणामपुनर्भावाद्भेषजशस्त्रक्षारैरसाध्यानां
तत्साध्यत्वाच्च
• According to Acharya Sushruta Agnikarma
treatment has been described to be superior to
the caustics, as the disease treated by it do not
relapse and more over those incurable by
medicines, operations and caustics.
 Modern point of view
• In modern surgery the principles of Agnikarma
has been adopted with advance technology
like
Radiation therapy

Cauterization

Diathermy

Infrared hot lamp

Laser

Hot needling
 Dahan upkaranas
(Instruments for applying cautery)
पिप्पल्यजाशकृ द्गोदन्तशरशलाकास्त्वग्गतानां, जाम्बवौष्ठेतरलौहा मांसगतानां,
गुडस्नेहाः सिरास्नायुसन्ध्यस्थिगतानाम् ||Su.su 12/4||

Twaka dagdha Sira Snayu

MAMS DAGDHA जाम्बवौष्ठे Sandhi Asthi gata
पिप्पल्य Pippali जम्बूफलसदृशमुखाग्राकृ ष्णपाषाणरचितावर्तिः-A
शर Arrow wick Shaped instrument • क्षौद्रगुडस्नेहाश्च- Honey
शलाका Rod
made of stone , Jaggery, Fatty
इतरलौहाः-Other metals like iron
गोदंत-Cow teeth copper silver substance
अजाशकृ द-Goat’s feces
 Dahan upakarana

• Why different Dahana upakarna ?

Because it possesses different temperature

7
• ACCORDING TO DALHAN-

• अजाशकृ त -छागपुरीषं;
• जाम्बवौष्टं-जम्बूफलसदृशमुखाग्रा कृ ष्णपाषाणरचिता वर्तिः
• इतरलोहास्ताम्ररजतादयः, तेषां विकारा लौहाः
• क्षौद्रगुडस्नेहाश्चेति सर्जरस मधूच्छिष्टादयः|
• त्वग्गतानाम मांसगतानां वातकफकृ तानां सुप्त्यादिविकाराणाम्
• सिरास्नायुसन्ध्यस्थिच्छेदाद्रक्तातिप्रवृत्तौ व्यापत्प्रतीकाराय- अग्निकर्मोक्तं ,
9
 Panchadhatu Shalaka
• Tamra (Copper) - 40%
• Loha (Iron) - 30%
• Yashada ( Zinc) - 10%
• Rajata ( Silver) - 10%

• Vanga (Tin) - 10%

• Panchadhatu Shalaka takes 15 min to get red hot and
maximum temperature noted was 240 degree centigrade
up to 45 sec after that decrease in temp starts.
* Agnikarma technological innovations (treatment by therapeutic burning) by prof P.D Gupta Prabha publications Nagpur

10
 Types of Agnikarma
• अत ऊर्ध्वमितरथादग्धलक्षणं वक्ष्यामः |
तत्र, स्निग्धं रूक्षं वाऽऽ(चा)श्रित्य द्रव्यमग्निर्दहति; अग्नि Accordin
g to
सन्तप्तोहि स्नेहः सूक्ष्मसिरानुसारित्वात्त्वगादीननुप्रविश्या
Dravya
शु दहति; तस्मात् स्नेहदग्धेऽधिका रुजो भवन्ति ||
Su.Su 12/15|| Ruksha Snigdha

Twacha Sirasnayuasth
Mamsa i
Pippli
Jambavoshta, sandhi
Godant
Loha shalaka Ghrita, Taila,
Ajashkrut Kshaudra

11
 SUITABLE SEASONS FOR AGNIKARMA

• Agnikarma should be done during all the

seasons except autumn and summer .Even in
these seasons, during emergency states
amneable only to agnikarma, may be used
after taking appropriate counter measures
against them.
 Dietary regimen for the patient
सर्वव्याधिष्वृतुषु च पिच्छिलमन्नं भुक्तवतःकर्म कु र्वीत

• शीतमृदुपिच्छिलानां वीर्याणां --- पित्तघ्नत्वात्

• Due to agnikarma because of its ushna guna pattika symptoms aggravates in
body .to subside these slimy light soft nourishing diet to be given prior this kind
of minor procedure

• प्राक् शस्त्रकर्मणश्चेष्टं भोजयेदातुरं भिषक् -surgeon should advise appropriate diet before
procedure

• न मूर्च्छत्यन्नसंयोगान्मत्तः शस्त्रं न बुध्यते तस्मादवश्यं भोक्तव्यं रोगेषूक्ते षु – i.e. where ever it is indicated
the patients should be advise for light diet to prevent fainting hypotension etc.

• प्राणो ह्याभ्यन्तरो नॄणां बाह्यप्राणगुणान्वितःधारयत्यविरोधेन शरीरं पाञ्चभौतिकम् |

i.e. the vitality with in the human being augmented by the force of vitality from
out side is able to maintain the body made up of five primary elements as the
food both being complimentary to each other.
 Acc to Ayurved
Indications of - nil by mouth –in surgery
•मूढगर्भोदरार्शोऽश्मरीभगन्दरमुखरोगेष्व - अभुक्तवतः कर्म कु र्वीत

•एषु भोजने कृ ते ऊर्ध्वाधोवेगाभ्यां कर्मविघातः स्यात्

•मु॒ढगर्भादिषु षट्स्व अन्नपूर्णकोष्ठत्वाद्यन्त्रदानादिभिः कष्टं मरणं वा प्राप्नोत्यातुरः, अनिलश्च प्रकोपमेति;

•मुखरोगेष्वाहारोऽङ्गुल्यादिपीडनेन घृणया च निष्काशितः कर्मघातं करोति

•तद‘अर्शोधिकारे त्वनिलप्रशमनार्थं ‘स्निग्धमुष्णमल्पमन्नं द्रवप्रायं भुक्तवन्तं’

• MODERN CONCEPT
• For major operations ,patients should be kept empty
stomach prior to surgery. This helps to clear intestine
• under Anesthesia, body and all its functions are “put to
sleep” making normal reactions, like swallowing,
impossible.
• Since body is unable to control reflexes, if anyone eat
something before surgery stomach contents could
regurgitate into airways, causing complications such as
pulmonary aspiration which, in severe cases, can be fatal.
• In emergencies, special precautions are taken to reduce
the risk of aspiration, but elective surgery will be
cancelled if fasting instructions are not followed.
 Types of Dagdha

कपोतवर्णता कृ ष्णोन्नतव्रणता रूक्षरुणता

शब्दप्रादुर्भाव दुर्गन्धता
त्वक्सङ्कोचश्च अल्पश्वयथुवेदना स्रावसन्निरोधश्च कर्क शस्थिरव्रणताच
Twaka dagdha शुष्कसङ्कु चितव्रणता Sira -snayu Sandhi- Asthi
Mamsa dagdha dagdha dagdha

Grey Blackish Dryness

Production color discolorati redness
of audible wound on , hardness
sound bad , mild swelling, and fixity
odor and inflam cessation of lesion
contraction mantio of
of skin n pai discharge
Indications of Agnikarma
त्वङ्मांससिरास्नायुसन्ध्यस्थिस्थितेऽत्युग्ररुजि वायावुच्छ्रि त-It should be done when
vitiated vayu has afflicted skin, muscles vessels ligaments joints and bone
and is associated severe pain

कठिनसुप्तमांसे,व्रणे-Wound with excessive granulations

ग्रन्थ्यर्शोऽर्बुदभगन्दरापचीश्लीपदचर्मकीलतिलकालकान्त्रवृद्धिसन्धि-Mentioned
diseased conditions

सिराच्छेदनादिषुनाडीशोणितातिप्रवृत्तिषु –In excessive bleeding

cauterization is done
General conditions treated with
Agnikarma
• Painful conditions of bones and joints.
• Joint stiffness
• Muscle spasm
• Calcaneal spur
• Osteoarthritis
• Sciatica
• To remove warts
• To excise corn
• To excise the external piles
• Excision of fistulous track
• Low back pain
• Excision of abnormal growth
CONTRAINDICATION OF AGNIKARMA

अथेमानग्निना परिहरेत्- पित्तप्रकृ ति

अन्तःशोणितं-(Internal bleeding)
भिन्नकोष्ठम-(ruptured viscera)
अनुद्धृतशल्यं-(un extracted foreign body)
दुर्बलं बालं वृद्धं भीरु-(weak very young ,very old)
अनेकव्रणपीडित-(pts having multiple lesions)
अस्वेद्यांश्चेति-(in whom the fomentation treatment is
contraindicated)
Contraindications of Agnikarma(Ayogya): aswedya
1 Pitta prakriti 7. Antah shonita
2. Bhinna koshtha 8. Anuddhrata shalya
3. Daurbalya 9. Bhiru
4. Vruddha 10. Multiple vrana
5. Balaka
6. Aswedya
• Pandu • Kruddha • Guda bhramsha • Garbhini
• Kshaya • Adhya rogi • Nasta sangya • Raksha
• Udara roga • Prameha • Shochita • Shranta
• Chhardi • Daurbalya • Oja kshaya • Kshudha
• Alcohol drinker • Visha • Rakta pitta • kshata
• Vidagdha • Timir • Ajirna
• Sthula • Atisara • Trishana

20
 Contraindication as individual treatment modality -
Agnikarma Ayogya

• बालदुर्बलवृद्धानां गर्भिण्या रक्तपित्तिनाम्| तृष्णाज्वरपरीतानामबलानां विषादिनाम्||१०५||
नाग्निकर्मोपदेष्टव्यं स्नायुमर्मव्रणेषु च| सविषेषु च शल्येषु नेत्रकु ष्ठव्रणेषु च||१०६|| (Ch.
Chi 25)
• HIV, HBsAg, Uncontrolled DM and HTN, Hepatitis,
Anemia, pregnancy, alcoholism, peptic ulcer
• Painful acute inflammatory conditions

21
 PRE ASSESSMENT

रोगस्य संस्थानमवेक्ष्य सम्यङ्नरस्य मर्माणि बलाबलं च |

व्याधिं तथर्तुं च समीक्ष्य सम्यक् ततोऽव्यवस्येद्भिषगग्निकर्म

• रोगस्य -रोगस्य ग्रन्थ्यादेः

• संस्थानमवेक्ष्य- संस्थानम् आयताद्याकारम्| एतेन वलयाद्यारम्भहेतुः

• सम्यङ्नरस्य मर्माणि -परिहार्याणि

• बलाबलं च- बलवत्यातुरे कर्माधिकारः, अबलवति परिहारः
• व्याधिं -व्याधिं वातकफात्मकं , तत्राग्निकर्माधिकारः, परिहारस्तु रक्तपित्तादौ|
• ॠर्तुं च- ऋतुमिति हेमन्तादिप्रवृत्तिविषयम्, अप्रवृत्तिस्तु शरद्ग्रीष्मयोः
• समीक्ष्य सम्यक् ततोऽव्यवस्येद्भिषगग्निकर्म
 Method: sites of Agnikarma according to
diseases

Medorbuda: after applying tila kalka at site then burning the

whole kala with shalaka- pravhhana
Twacha: Charma kila, mashaka, pakshmakopa- bindu akriti at
site. Vicharchika- vilekha
Bhagandara: vilekha
Remote site:
• Vrudhi roga: Agnikarma with Ardhendu vakra in same side
and on incised skin between the 1 st and 2nd toe opposite site
• तत्र या वङ्क्षणस्था तां दहेदर्धेन्दुवक्त्रया ||Su. Su.12/21||
सम्यङ्मार्गावरोधार्थं कोशप्राप्तां तु वर्जयेत् |
त्वचं भित्त्वाऽङ्गुष्ठमध्ये दहेच्चाङ्गविपर्ययात् ||Su. Su.12/22||
23
 Method: sites of Agnikarma according to diseases

7. Apachi: in the gulf after

excision of sirajala
8. Sadhya Vrana, Shonita
sthapana- at the site of
bleeding
• तत्र शिरोरोगाधिमन्थयोर्भ्रूललाटशङ्खप्रदेशेषु दहेत्, वर्त्मरोगेष्वार्द्रालक्तकप्रतिच्छन्नां

 दृष्टिं कृ त्वा वर्त्मरोमकू पान् ||९||

24
 Method- Pradhan karma
• अथ दाहार्हमातुरं कृ तस्वस्त्ययनमुपहृतसर्वोपकरणं प्राक्शिरः संविष्टमाप्तावलम्बितं कृ त्वा वैद्यो निर्धूमबृहत्स्थिरदीप्तख़दिरबदराद्यङ्गारैरयोग़ट
नप्रकारेण भस्त्रानिलाध्मातैर्व्यजनेन चोर्ध्वानिर्गच्छज्ज्वालतयापादितापाद्यमानभासुराग्निवर्णैर्जाम्बवौष्ठादिभिर्व्याधिप्रदेशवशाद्वलयार्धचन्द्रस्व
स्तिकाष्टापदबिन्दुरेख़ाप्रतिसारणविकल्पेन मुहुर्मुहुर्हितोपहिताभिर्वाग्भिरद्भिश्चातुरमाश्वासयन् दहेदासम्यग्दाहलिङ्गोत्पत्तेः|
उच्छू नसुषिरप्रलूनदन्तनाडीसजन्तुदुष्टव्रणेषु तु स्नेहमधूच्छिष्टमधुगुडैः पूरयित्वा दहेत्|
सम्यग्दग्धे च मधुसर्पिषी दद्याच्छीतस्निग्धांश्च प्रदेहान्||५|| A Sa. Su. 40/5

Sprinkling of Haridra Agnikarma marks after

Red hot shalaka Agnikarma procedure Samyaka Dagdha vrana churna one month

25
 Patterns of agnikarma (THERAPEUTIC BURN
AND MANAGEMENT)
• r बिंदु
विळेखा तिर्यग
शलाकाग्र प्रतिसारण
वळय व्याधिमूले ऋजुवक्रा विविधा तप्तशलाकाप्रभृति
वलयमिव वलयं निर्मितबिन्दुइव
लेखा विलेखा भिरवघर्षणं
बिन्दुः
(circle) Parallel प्रतिसारणं
(dot)
corn lines) superficial
sandhivat rubbing

After proper therapeutic burn honey and ghrita should be

applied on wound.Acc to dalhan honey n ghrita is for
purification of agnidooshit rakta and for pain

.अग्निकर्मदूषितरक्तपित्तयोः प्रसादाय वेदनोपशमाय च||

 Method/ procedure
Dahana(Akriti) vishesha

Ardhachandra
Valaya
Ashtapada
Bindu
Swastika
Vilekha

Pratisarana

27
. Method- Pradhan karma

28
 Method- Paschat karma

• तत्र सम्यग्दग्धे मधुसर्पिर्भ्यामभ्यङ्गः ||Su. Su.12/13|
अग्निकर्मदूषितरक्तपित्तयोः प्रसादाय वेदनोपशमाय च(dalhana)
• Apply kumari patra majja on the site of
agnikarma
• Then gently mop the site
• Apply Haridra and yastimadhu ghrita
• Loosely cover the site
29
 Method- Paschat karma
• Pathya- Apathya
• Doés:
• Do not apply water for 24 hours
• Do not apply soap for 7 days
• Do not rub the site to wipe off, simply mop it gently with smooth soft cloth
• Apply a mixture of ghrita and madhu or medicated ghrita 2 times a day for 5
days
• Avoid strenuous exercise
Don’ts for food:
• New rice, potatoes, big sized pulses, black gram, groundnut, brinjal, fermented
food, stale, fried, spicy, curd, jaggery, extra salt, shigru, cluster beans, pishtanna
(fine floor).

30
 Complications of procedure (Itaratha Dagdha)

तत्र प्लुष्टं दुर्दग्धं सम्यग्दग्धमतिदग्धं चेति चतुर्विधमग्निदग्धम् |

तत्र यद्विवर्णं प्लुष्यतेऽतिमात्रं तत् प्लुष्टं; यत्रोत्तिष्ठन्ति स्फोटास्तीव्राश्चोषदाहरागपाकवेदनाश्चिराच्चोपशाम्य
न्ति तद्दुर्दग्धं; सम्यग्दग्धमनवगाढं तालवर्णं सुसंस्थितं पूर्वलक्षणयुक्तं  च; अतिदग्धे मांसावलम्बनं गात्रविश्
लेषः सिरास्नायुसन्ध्यस्थिव्यापादनमतिमात्रं ज्वरदाहपिपासामूर्च्छाश्चोपद्रवा भवन्ति, व्रणश्चास्य चिरेण
 रोहति, रूढश्च विवर्णो भवति |
तदेतच्चतुर्विधमग्निदग्धलक्षणमात्मकर्मप्रसाधकं  भवति ||Su. Su.12/16||
तत्राग्निदग्धं वैद्यदोषात् प्रमादाद्वा चतुर्विधं(dalhana)
• In harita samhiata the classification is: ishat, madhya
• Burning sensation
• Wound infection

31
BURN(caused otherwise than therapeutic)
• SUSRUTA mentioned this as Itartha dagdha,Vagbhata as
Pramaad dagdha.Itis of two types snigdha and rooksha
dagdha ‘इतरथेति वलयादि परित्यज्य स्नेहादिदाहेनान्यथादाहः’ इति चक्रः
इरथादग्धलक्षणं-

तत्र, स्निग्धं रूक्षं वाऽऽ(चा)श्रित्य द्रव्यमग्निर्दहति;

अग्निसन्तप्तो हि स्नेहः सूक्ष्मसिरानुसारित्वात्त्वगादीननुप्रविश्याशु दहति; तस्मात्
स्नेहदग्धेऽधिका रुजो भवन्ति |

• Heat produces burn either through dry or wet media.The

liquids at high temperature burns the skin etc rapidly as they
penitrates along the minute pores,that is why burn caused by
liquid media is more painful.
 प्लुष्ट
first degree burn
According to ayurveda
• यद्विवर्णं-discoloration
• प्लुष्यतेऽतिमात्रं excessive burning
• तत् प्लुष्टं
• न च स्फोटोत्पत्तिःBlisters are not formed
चिकित्सा-प्लुष्टस्याग्निप्रतपनं कार्यमुष्णं तथौषधम् |
•उष्णक्रिया पुना रक्तविलयनकरी भवति, अत ऊष्मनिःसरणवातानुलोमहेतुः साऽतिसुखयति
द्दुर्दग्धं
second degree burn
• स्फोटास्तीव्रा blisters formed
• श्चोषदाहरागपाकवेदना- Sucking pain,
• Burning sensation,
• Redness
• Inflammation
• चिरात्-उपशाम्यति Long time to subside
• चिकित्सा-
• शीतामुष्णां च दुर्दग्धे क्रियां कु र्याद्भिषक पुनःघृतालेपनसेकांस्तु शीतानेवास्य कारयेत्
• Both heating and cooling treatment, but anointing of ghrita
and liquid should be done in cold state only
 SAMYAKA DAGDHA AND ITS
TREATMENT
• सम्यग्दग्धमनवगाढं तालवर्णं सुसंस्थितं पूर्वलक्षणयुक्तं च
सुसंस्थितम् अत्युन्नतावनतादिदोषवर्जितम्| पूर्वलक्षणयुक्तं  चेति त्वङ्मांससिरास्नायुसन्ध्यस्थिदाहलिङ्गयुक्तम्| 

• Burn not very deep ,i.e. up to bones

• Is of the color of the palm fruit
Treatment -तुगाक्षीरीप्लक्षचन्दनगैरिकैः |
सामृतैः सर्पिषा स्निग्धैरालेपं
-ग्राम्यानूपौदकै श्चैनं पिष्टैर्मांसैः प्रलेपयेत् |
पित्तविद्रधिवच्चैनं सन्ततोष्माणमाचरेत्

• i.e. demulcent ointment made by sheetveerya plants and ghrita

and crushed flesh of domestic animals is applied

• If there is severe intense burning the management should be

done as for abscess(pattika vidradhi)
ATIDAGDHA
मांसावलम्बनं-hanging of muscles
गात्रविश्लेषः-disorganization of
affected body part
सिरास्नायुसन्ध्यस्थिव्यापाद destruction of
vessels nerves joints etc
उपद्रव-
ज्वरदाहपिपासामूर्च्छाcomplication
s like fever thirst
unconsciousness
व्रणश्चास्य चिरेण रोहति prolonged
healing
रूढश्च विवर्णो भवति discolored
scar
FOURTH DEGREE There is also
technically a fourth-degree burn. In this
type, the damage of third-degree burns
extends beyond the skin into tendons
and bones and associated with severe
complication
COMPLICATIONS such as infections,
blood loss, and shock.
•Tetanus is another possible complication
with burns of all levels.
•Severe burns also carry the risk of
hypothermia and hypovolemia
•Scars are a complication of all burns.
Severe burns may cause keloids, which
are discolored areas of scar tissue on the
skin. 
 Treatment Of Atidagdha
•अतिदग्धे विशीर्णानि मांसान्युद्धृत्य शीतलाम् क्रियां कु र्याद्भिषक् - irst we should excise
withered tissue, cooling treatment is carried out

•पश्चाच्छालितण्डु लकण्डनैःFine strained powder of rice +ghrita

•तिन्दुकीत्वक्कपालैर्वा घृतमिश्रैः प्रलेपयेत्Or ghrita+pieces of bark of tinduka is

applied

•व्रणं गुडू चीपत्रैर्छादयेदथवौदकैःWound should be kept covered with guduchi

patra or aquatic plants leaves

•क्रियां च निखिलां कु र्याद्भिषक् पित्तविसर्पवत् |Entire treatment should be done as

for pittaj visarp ie sheetal pralepa ,application of gauryadi ghrita
 Mode of action
• According to Ayurveda, any musculoskeletal pain, that is, Ruja is caused due to
vitiation of VataDosha. In various conditions, such as chronic plantar fasciitis,
sciatica, osteoarthritis, calcaneal spur, cervical spondylosis, and frozen shoulder, there
is a predominant involvement of Vata and KaphaDosha. In the procedure of
Agnikarma, Agni is given at the site of pain, which acts by its Ushna (hot),
Tikshna(penetrating), Sukshma (minute), Vyavayi (quick acting), and Vikasi (quickly
spreading) Guna. This Guna acts against Vata and KaphaDosha, thereby relieving
pain and inflammation at that site.
• According to modern science, the heat therapy, which is given at the local or affected
area increases the blood circulation with metabolism by causing vasodilation, increase
in the elasticity of connective tissue, and exudation of fluid with increase in white
blood cells and antibodies.
• Local tissue metabolism rate is increased by warming, which helps in healing. As
there is an increase in local metabolism, the waste products that are generated get
excreted, which normalize the blood circulation, resulting in decreased intensity of
pain..
 AGNIKARMA

Application of Ushna,Tiksna,Suksma, Ashukari Guna

to Asthi Sandhi through Twaka Dhatu

Dhatu Kshaya Janya Marga Avarodha Janya

Samprapti Samprapti

Direct impact On Marmasthi

Sandhi Gata Mahabhutgni PROBABLE Removes Avarana of Vikruta
MODE OF Shleshma on Vyana Vayu
ACTION OF
AGNIKARMA
Stops Dhatu Kshaya process by Improves of Rasa Rakta
establishing Agni Samatva Samvahana to Sandhi

Establish the Prakrut Vata

Prakruta Vatadosha functions .
Dosha function
Elimination of Stambhaadi Lakshana
(Gati, Vibhajana etc)
by Ushnadi Guna

40
 Gate Control Mechanism of 2nd
Pain

Ronald Melzack and Patrick Wall

* introduced their "gate control"
theory of pain in the 1965 most
widely accepted hypothesis for
pain.
*En.wikipedia.org/wiki/
Ronald_Melzach

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