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Journey of Agnikarma

chikitsa

Presented by:
Dr. Danish Javed
Clinical Registrar (shalya)
CBPACS, New Delhi

AIM & OBJECTIVE


To project the importance of Agnikarma in our daily clinical

practice and try to show that it may have potency to treat various
diseases.
Common indication of agnikarma
Limitation of agnikarma
To understand the efficacy of Agnikarma at a specific condition,
stage and applicability at its best level.
study and involvement to ensure the reliability of Agnikarma as a
minimal invasive technique.
Try to expose the Agnikarma in ayurvedic text to provide
platform for scientific research.
Journey of Agnikarma chikitsa

Introduction
Ayurveda is a science of life which has active

role in treating various diseases.


Shalya tantra is the surgical discipline in Ayurveda & its

uniqueness is that it have dual treatment procedures i. Shastrakarma(surgical procedure) &


ii. Anushstrakarma(parasurgical procedure).

Journey of Agnikarma chikitsa

Among parasurgical procedures one of them is

Agnikarma chikitsa in which therapeutically heat applied


locally with the help of shalaka(red hot rods having
specific points made of dhatus like tamra, lauha etc),
sneha, madhu etc. and it produced positive effect.
Can be performed at OPD(outdoor)

basis.
Primarily apply in diseases produced by vata and
kapha doshas.

Journey of Agnikarma chikitsa

Agnikarma
The term Agnikarma is made up of 2 words- Agni & karma

Agni derived from the root agigatau agyati

i.e. it gives the rebirth, is


utilized to cure and prevent the diseases.
Karma - Action
Agni + Karma i.e. Agninakritwa
yatkarma,agne sambaandh va yatkarma
tad agnikarma(Dalhan on S.Sutra 12/02)
agnayamna prapyanti

Journey of Agnikarma chikitsa

Agnikarma is intentional therapeutic heat


burn(I.T.H.B.).

It was broadly described by Acharya

Sushruta, Charak, Vagbhatta and many


others.
In Sushrut samhita under Anushastra
karma(Sushruta Sutra.12).
Journey of Agnikarma chikitsa

Superiority of
Agnikarma(Agnikarma Sresthata)
The agni karma are more superior than kshara as disease treated with

agnikarma never happen again and the diseases that not cured by
bhesaj(medicines), shastra, kshara are may treated by agnikarma.(A.H.sutra
30, S.Sutra 12)

InMMx G
Ji:, iqMvx
Mh{x
VIvx iivi
c **(S. Sutra.12/3)
Agnitapten shastren chinddyat, Anyatha ataptashastrachedane
Paakbhayam shyat,(Dalhan), it prevent sepsis,(concept of sterlization) on
S.Chikitsa 2/46
urney of Agnikarma chikitsa

History & evolution


ANCIENT METHODS TO PRODUCE FIRE
STONE METHOD

HAND DRILL METHOD

THE CONTROL OF FIRE BY EARLY HUMANS

The control of fire by early humans was a turning point.


Heat to cook plant and animals.

To clear forest for planting and farming.


To heat stones for making tools.
To burn clay for ceramic objects.
#

AGNI
# Agni (: ) is a , one of the most important Devta. He is the god
of fire.
# The word agni is for "fire" (noun), cognate with ignis (the root
of English ignite)

# Agni has three forms: FIRE, LIGHTNING, SUN.


SUN
According to Ayurvedic Ethics before 2350BC Agni
Karma was well establish and well developed in Ayurveda.
It also described in Ayurvedic text and in Vedas also.

Vedas
Rigveda Agni is the first word of the first hymn of the

Rigveda-

It is mention in context to obstetric diseases
(Rigveda 10/62/1-4) .
Yaajurveda In context to sita (yajurveda 23/10/1)
Saamveda- a separate Agneya kanda described.
Atharvaveda It described agni as a God & Bhesaj in

context to Krimi (Atharvaveda


-5/23/1,3,5)
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In Charak samhita
C.Sutra11/55-shastrapranidhana.
C.Chikitsa 25/101-103-dwivraniya chapter

in treatment of vrana
In treatment of Kaphaj gulma, granthi &
bhagandara treatment, arsha, pleehodara,
yakrutodara , ardhavbhedak , visharpa etc

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Sushruta Samhita
Anushastra karma(parasurgical procedures)
S.Sutra-12, Agnikarmavidhi adhyaya,

mention detail of agnikarma


As upyantra,
shalyanirharan method,
one of the 60 procedures in vrana chikitsa.
Treating variety of diseases.
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Astanga Samgraha A.S.sutra 40,

Agnikarmavidhi chapter
Astanga Hridaya A.H.Sutra-30-

Agnikarma vidhi chapter


Harita samhita one of the 8 treatment
procedure.
Cakradatta- In Gridhrishi chikitsa
Yogratnakar - In Gridhrishi chikitsa
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Sharangadhara,
Gadnigraha,
Vangasen,
Bhavaprakash,
Bhavaprakash
Latest Shalya tantra books
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TYPES OF CAUTERIZATION
# Electric cautery.
# Cryosurgery (cryotherapy)
@ liquid nitrogen
@ Carbon dioxide
@ Argon
@ Dimethyl ether

# Diathermy cautery Diathermy was used for the first


time on gynecology by the spanish doctor Celedonio
Calatayud in 1910
#

chemical cautery.

# Cautery is described in the Hippocratic Corpus.The cautery was


employed for almost every possible purpose in ancient times:
as a haemostatic,
as a bloodless knife,
as a means of destroying tumours, etc.
cauterize arteries.

Classification of Agnikarma
1.According to dravya
Snigdha Agni karma - Mahdhu ,Ghrita, Tail in Sira , Snayu, Sandhi,

Asthi
Ruksha Agni Karma Pippali, Salaka, Godanta in Twaka, Mamsa

2.According to Akriti (as per dahan visesa)


Valaya,, Bindu,, Vilekha. Pratisarana,
Ardhachandrakar, swastika, Ashtapadi,

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Dahanopkaran
(Material for agnikarma)
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Journey of Agnikarma chikitsa

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19

05 June,2014

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Agnikarma Kaal
Agnikarma done in every seasons but one

should must take additional safety measure


in sharad & greeshma season (Sushruta sutra 12) .

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Material and Method


Generally in Agni karma the red hot shalaka

/dahanopkarana used.
Triphala kwath/ Panchvalkal kwath.
Heat source,
Shalaka/ghrita/taila etc.material use for agnikarma
Ghritkumari pulp
Yastimadhu churna
Bandage
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4
1- Heat source and agnikarma shalaka
3 & 4- equipments needed in therapy

(A) Pre proceduresDone according to site, vyadhi , strength of

patient and ritu


Explain about procedure to patient, take consent
Give picchila anna before therapy.
Clean the surface by triphala
kwatha/panchvalkal kwath and prepare the part
for treatment
Drapped unnecessary exposed part of patient.
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(B) Main procedures With the help of certain things (e.g. cuppor,

panchdhatu etc rod which are designed in specific


form-agnikarma shalaka, oil, pippli, madhu etc),
after red hot applied locally in form of circle, dot,
line, rubbing etc shape properly.
Burn by red hot shalaka etc as per need.
The Shalaka of various dhatu used in patient.

By panchdhatu Shalaka Samyaka Dagdha could

be made satisfactory.
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(C) Post operative procedures After doing therapeutic burn, applied locally

ghritakumari swarasa, yastimadhu churn ,


shaalimooladi sheetal lepa etc on burn site act as a
cooling/healing agent. Loose bandaging with yashti
madhu churna, for next 24 hour.

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Indication of Agnikarma
therapy
Pain(vividh vatavedana, severe pain d/t vayu entrapped

at twak mamsha sira snayu asthi, sandhi etc.),


Stambha(Stiffness) ,
Arsh / adhimamsha.
Granthi,
Apchi,
Vrana -Chronic ulcer, nonhealing ulcer and the wound
who are elevated, senseless and hard
Sirachheda/ raktatishrava = Post amputation hemorrhage/
siracheda etc in form of cautry. Which are more
beneficial.
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Arbuda
Naadivrana(sinus tract)
Bhagandara ,
Charmakeel ,
Goiter(galganda),
Sleepad(filariasis),
Antravriddhi(inguinal hernia)
Siro roga
Adhimantha(netra roga)
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Contraindication
It should be contraindicated or done with caution in condition
of
Excess weak person, childrens, old age,
madhumeha,
In which swedana are contraindicated.
Pittaja diseases, pittaprakriti
Raktapitti rogi
Atisara
Retaining shalya(foreign bodies) inside
Having multiple wound
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Pain OR conditions in which


Agnikarma indicated
Lower Back Pain

Elbow Pain
Elbow pain is most often the result of

tendinitis, which can affect the inner or


outer elbow. e.g.

Tennis elbow(lateral epicondylitis)


pain and tenderness at the lateral epicondyle
of the humerus d/t non specific inflammation
at the origin of the extensor muscles of the
forearm.
Golfers elbow(medial epicondylitis).

Achillis tendinitis

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Agnikarma done especially in

idiopathic pain
in chronic post- traumatic pain.

Ankle/ plantar Pain


Chronic pain at ankle is commonly due to Vatakantak (Ankle sprain or tendinitis)

Calcanean spur
Plantar fascitis
The agnikarma in this cases are effective for

subsiding pain

Kadar (Corn and callosity)


Corn are horny induration and thickening of the skin that

may be hard or soft.

Sciatica (Gridhrishi)

Sandhivata Osteoarthritis/
Knee pain(
Osteoarthritis is a type of arthritis caused

by inflammation, breakdown, and eventual


loss of cartilage in the joints.

Kampwata (Tremors and palsy)


Twakgata vata peripheral neuritis
Mamshagata vata - Myopathy
Manyastambha Torticolis or neck
rigidity

Hanugraha Lock jaw


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Charmkeel (Warts)
Mashak (elevated moles)
Tilkalak(non elevated mole)
Jatumani (congenital mole)
Valmik (Madura foot, Actinomycosis)
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Charmkeel ----Warts

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Hypertrophic wound scar

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Complications & Its


Management
1) Plustha Dagdha When shalaka not properly
heated- Ushna chikitsa

2) Durdagdha d/t unskilled physician/ shaking of


body parts by patient d/t fear. both warm and cold
therapy.

3) Atidagdha d/t more heat transferred by shalaka


Tt madhuyashtyadi lepa

4) Daha (burning) may possible.Tt- Ghritkumari


patra swarasha.

5) Dushta vranata if sepsis develop, treat


accordingly.

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Discussion on probable
mode of action1. Vata and kapha doshas have been considered the
important factors for causation of shoth (inflammation)
and shoola (pain) in the body. To treat such condition,
Agnikarma chikitsa is indicated as a best treatment
modality. As stiffness(stabdhata), pain, movement
disorders, granthi etc are mainly due to vataj and kaphaj
roga so it can treated by agnikarma which having
ushnaguna and are kaphavatashamak, aampachan(remove
toxins), improves local tissue nourishment. It is
contraindicated in pittaja roga.(S. sutra 12/14).
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2. As there is no any established mode of action

described for agnikarma therapy that how this


act.
It prevent sepsis as there is sterilization due to high

temperature while doing agnikarma.

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3.

Hypothetically it can be assumed that agnikarma


stimulate pain & touch sensations-- (gate control
theory for pain).

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4. Ushna gunaincrease dhatwagni


remove toxins
Improve local nourishment - reduce
pain & decrease inflammatory process.

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