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Introduction

Agnikarma :

Agni-Fire

Karma-Procedure

Agnikarma can be explained as the procedure done with the help of Agni for treating a disease.(1)

Historical View:

The oldest testimony of knowledge is the classical books called VEDAS which are most ehical,trustworthy and ever available source of recorded knowledge history is a part of any subject.there are four Vedas,namely Saamveda,Yajurveda,Rigveda and Atharveda in which detail explination of Agnikarma given.

Saamveda2-it is found the wide description of agni in special khand i.e ‘Agneya khandam’.according to this veda, importance was given to Agni by mentioning special names like Parmeshwar,Atma and Vaiswanar.

Yajurveda3-Yajurveda again emphasized the use of Agni as remedy for sheet(hima) induced disease.

Rigveda4-in Rigveda application of agni is indicated for the gynaecological and obstetrical diseases also gives idea about the utilization of Agni as disinfectant.

Atharveda5-Has identified Agni as god and used for various diseases.

Ayurvedic views Samhita periods-

• Charak: Acharya Charak explained AgnikarmaChikitsa in the treatment of Vrana(6), KaphajGulma(7), Bhagandar(8),Plihodara(9), Arshachikitsa(10) ,Visarpachikitsa(11), Arditchikitsa (12)  and many more.
• Sushruta: Acharya Sushruta described Agnikarmavidhiin a separate chapter(13). He mentioned Agnikarma as supreme in all parasurgical procedures(14).He explained AgnikarmaChikitsa in various diseases like  Arsha, Ashmari, Bhagandar,Arbuda, Kshudraroga, Granthi.
• Other Acharya:

• Vagabhata in AshtangHridaya explained Agnikarma in Sutrasthana Chapter 30.
• Chakradatta and Yogaratnakar mentioned Agnikarma inthe context of Vatavyadhi regarding Gridhrasi disease.
• Harita mentioned Agnikarmaas one of the eight important types of treatment.(15)

MATERIALS AND METHODS:

Various materials or Dahnopakarana have been decribed by Sushruta in Sushrutasamhita which are as follows:

Pippali, Ajashakrut, Godanta, Shara, Shalaka, Jambavastha,Dhatu, Madhu, madhuchista, Guda, vasa, Ghrita, Taila, Yashtimadhu, Suchi, Varti, Suryakanta and many more.These Dahnopkaranaare used according to the site of Agnikarma:

1) For Twakgatavikara- Pippali, Ajashakrut, Godanta, Shara, Shalaka

2) For Maansgatavikara- Jaamavastha, Lauha, Tamra, Rajat                        

3) For Sira, Snayu, Sandhi, Asthi- Madhu, Guda, Taila(13)

Agnikarma procedure-methods-

It should be done under following manner-

Purva karma-16

1)Agnikarma Indications:

• Sushruta-Pain caused by Vataprakopa in twacha, maans, sira, snayu, asthi, sandhi; Arsha, Arbuda, Bhagandara, Apachi, Shleepada, Charmakila, Tilakalak, Antravriddhi, Nadivrana, Atiraktastrava(severe bleeding).

2)Agnikarma Contraindications:

• Pittaprakriti, Bhinnakoshtha, Daurbalya, Vriddha, Antahshonita, Bhiru, Anekavranapidita, Balaka, Aswedya, Garbhavati, Raktapittarogi, Trishna, Jwar, Nirabalastri, Vishayuktavrana,Netravrana, Kushthavrana, etc.

3)Dahan Kala( Suitable time for Agnikarma):(17)

• Agnikarma can be done in all seasons except Sharada and Grishma. But in case of emergency,Agnikarma can be performed in these seasons also but with proper precautions according to the condition of the patient

4)Proper instruments(Agropaharaniyani)

• The Agnikarma room should be well prepared with all required instruments described by Sushruta.
• Take Written informed consent.
• Patient is adviced to take pichhila and singdha diet.
• Prepare Triphala kashay for prakshalana of local part of patients.
• Yashtimadhu churna,small pieces of kumara,plot,pichu,gas stove,shalaka etc,are kept ready for use.
• Shalaka is heated upto become red hot on fire.

Pradhan karma-18

• Position of patient on the table is depends upon the disease.
• Disease area is cleaned with triphala kwath.
• Drap the local part with sterile sheet
• Marke the area on which you want to do agnikarma.
• Shalaka is kept on marked area for samyak dagdha .
• Immediately apply kumara pulp on dagdha area.
• Apply yashtimadhu churna over dagdha area.
• Proper patta bandhana  applied.

Paschyat karma-.(19)

• Madhu and Ghrita should be applied over the Agnikarmasite for proper healing
• SamyakaDagdhaLakshana of Dhatu:(20)
• 1] Twakadagdha- Shabdapradurbhava (sound production), Durgandhta (bad odour), Twakasankocha (Skin contraction).
• 2] Maansdagdha- Kapotavarnata (Pigeon-coloured), Alpashawathu (mild swelling), alpavedana (mild pain), Shushkasankuchitavrana (contracted wound).
• 3] Sira-snayudagdha- Krishnavarnata (Black colour), Unnatavranata (elevated wound), Stravasannirodha (stoppage of discharge).
• 4] Sandhi-asthi-Rukshata (Dryness), arunata(Redness), Karkasha (Roughness), Sthira (Stability).

Agnikarma Classification:

1] According to Akriti:(21)

AcharyaSushruta mentioned four types:

a) Valaya (Circular)

b )Bindu (Dot shaped)

c) Vilekha (Linear lines)

d )Pratisaran (Agnikarma done by rubbing of heated shalaka over indicated site)

   These are also called ‘Dahanvishesh’ by Acharyasushruta.

 AcharyaVagbhata has added three more types which are as follows:(22)

a)  Ardhachandra( Half moon like shape)

b)  Swastika

c) Ashtapada (shape like eight limbs in different directions)

2] According to Dravya type:

1. SnigdhaAgnikarma:Madhu,Ghrita, Tailaare used for the Agnikarma of Sira,Snayu, Asthi, Sandhi.
2. RukshaAgnikarma: Pippali, Shalaka, Godanta are used for the Agnikarma of Twaka, Maans.

3] According to Disease :

• In Arsha, Kadar etc. Agnikarmais done after Chedan karma.
• In Bhagandar, Nadivrana etc. Agnikarma is done after Bhedan karma.
• In Krimidanta disease, Agnikarma is done with the help of Guda.

4] According to Dhatus:(23)

1. Twakadagdha
2. Maansdagdha
3. Sira-Snayudagdha
4. Asthidagdha

Ashtang Hridaya –Shiroroga, Shlishta Vartma, Alaji, Arbuda, Puyalasa, Lagana, Medojaoshtharoga, Dantanadi, Adhidanta, Nasarsha, yoniarsha,Kadar, Sarpadansh, Alarkvisha, Lutavisha, Gulma, Unmada, Plihodara,etc.

• Charak–Atiraktapravritti, Kaphajgranthi, Galaganda,Vatastambh, Vatajanyapida, Gambhir-sthirvrana, Ashmari,etc.

Discussion

Agnikarma can perform tissue cuttin, coagulation, blending, fulguration, or wound healing in an instant. The medical community is still unsure about the precise mode of action of agnikarma. To describe these mechanisms, some hypotheses can be used, however they work differently depending on the situation. According to the proinflammatory idea, the presence of chronic inflammation at the site can be corrected by causing an acute inflammation that attracts additional lymphocytes, neutrophils, histamines, and prostaglandins to the area.  

According to the application of thermodynamics to biological systems, when thermal energy is transferred from an object to a tissue, the tissue's internal energy increases and the heat energy is sent to the cells. The body's thermostatic centre is quickly triggeredin order to spread the body's localised temperature increase and blood flow rises. 

According to the Vant Hoff principle (https://en.m.wikipedia.org>wiki>Vant Hoff Equationthe body's basal metabolism increases by a specific proportion for every 10°C rise in body temperature. Increased body temperature causes muscles to relax, which lessens muscle spasms, inflammation, and pain. Warm tissues facilitate muscle relaxation, which in turn lessens spasms.

The probable mode of the action is as follows.

1.Physical heat (red hot shalaka)-ushna, tiksha, ashukari,sikshma guna of Agni transfer to twak dhatu

2. Removes strovarodha increase dhatwagni

3.incease the circulation metabolism of dhatu neutralise the sita guna of vata.

4.digest the sama dosha

5.flush away the pain

6.patient free from symptoms.

Conclusion

Agnikarma results in instant relief of chronic pain, severe bleeding, tissue cutting and wound healing. Agnikarma causes vasoconstriction due to heat and thus stops the bleeding. It is said to be the superior treatment because there is no reoccurrence of disease after Agnikarma. Now-a-days modern procedure like Cauterization is nothing but the modified Agnikarma procedure only. Its applications are widely practiced and thus open the gates for many researchers to work on this for the betterment of the society in the field of health and well being.