Agnikarma1

CONCEPT OF AGNIKARMAAND IT’S
CLINICAL APPLICATION IN
ARSHAS
Presenter
Dr. Shalini U.A. BAMS.
2nd
year PG Scholar
Dept. of PG studies in Shalya Tantra
JSSAMC&H
Mysore -21
Guided by
Dr.Siddesh Aradhyamath MS, Ph.D
Reader and Head
Dept. of PG studies in Shalya Tantra
JSSAMC&H
Mysore -21

CONTENTS
1. Introduction
2. Derivation and definition
3. Synonyms
4. Importance of agnikarma
5. History
6. Classification
7. Indications
8. Contraindications
9. Poorvakarma
10. Pradhanakarma
11. Paschath karma
12. Mode of action acc. to ayurveda
13. Cauterization
14. Mode of action of cauterization
15. Discussion
16. Conclusion

INTRODUCTION TO AGNI KARMA
Agni karma is one among the Parasurgical
procedure, anushastra and upayantra.
In present time it is used and it is termed as
therapeutic burns or cauterization.
3

DEFINITION
;- +
– derived from the root word
i. e. – it gives rebirth, is utilized to cure and prevent the
diseases.
– +
karma is an operation employed in an organism or living
being.
“, ||
Treatment performed by the use of different sources of
heat is agnikarma.
. . . . .. . /-.
4

SYNONYMS
1.
2.
3.
4.
5.
6. .
5

IMPORTANCE OF AGNIKARMA;-
 : : II
( . . /)
Agni karma is elective and employed for such cases where medicines,
surgery and kshara karma fail to bring about desired results.
Hippocrates says ;- “Those diseases which medicine do not cure, the knife
cures, those which iron can not cure, fire cures, and those which fire can
not cure, are to be reckoned wholly incurable’’.
 , ()
The wound created by agnikarma is infection free as the heat destroys
infection causing micro organisms.
6

IN VEDAS AND SAMHITAS
A. In Rig Veda application of agni has mentioned in context of
obstetric and gynecological disorders to get rid of micro organisms
in genital areas.(10/162/1-4)
B. In Atharva veda- worshipped agni as God. They mentioned as
Rakshoha.( Ath. 5/23/1,3,5)
C. In Yajur veda – agni has been used to treat sheeta related
disorders(23/10/1)
D. Sama veda – a separate adhyaya as Agnneya khanda – elaborate
description of agni is cited.
E. Charaka- Shastra Pranidhana chikitsa for Granti, gridrasi, apachi,
bhagandara etc.
F. Sushruta- parasurgical procedure, upayantra for the management
of arsha, bhagandara, granti etc.
G. Vagbhata- mainly for pain management and surgical procedures.
7

ANCIENT VIEW OF AGNI
1. From the dawn of history, man admired fire and its power.
2. Ancient cultures, especially the Persians worshiped fire.
3. Cautery is called Kaiy in Arabic.
4. The Arab cautery is similar in concept to the Chinese therapy of
Moxibustion.
5. The surgical book, Al-Tasrfi liman ‘ajaza’ an al –ta lif written by the Arab
Andalusian surgeon, Abul Qasi Al Zahrawi(Albucasis d. 1013 A.D)
recommended cautery.
6. The use of cauterization as a counter irritant in joint disorders, According
to Jame Syme(1862) it was introduced in Great britain about 1830.
7. In Mughal era, cauterization of heels in a patients suffering with
Cholera.
8. In modern era- Hippocratic Corpus- Haemostatic-a bloodless knife
4. https://www.takingcharge.csh.umn.edu/explore-healing-practices/moxibustion
https://en.wikipedia.org/wiki/Moxibustion
8

AGNIKARMA VS. TAU-DAM
 Tau-dam is a traditional Himalayan therapy which is practiced by the
rural Himalayan people for many problems like liver troubles, stomach
troubles,back ache etc.
 Generally practiced by the older people of village and is compulsory
for 6 month to 1-year old children.
 Tau is a 45-60 cm long iron rod, which is sharply curved at one end
and has one or two holes depending upon the diseases. tau device is
placed on burning fire till it gets red-hot and touched on the affected
skin for a few seconds. Then the affected area is massaged with the
mustard or olive oil.
 On the other side, in DAM technique, fresh seeds of Terminalia
chebula are burned on fire and touched on affected part of the body for
few seconds. After that the affected area is massaged with the mustard
or olive oil.
Tewari, V. P. 2002. Uttaranchal ki paramparik chikitsa paddhati: tau-dam (in Hindi). In press
9

CLASSIFICATION- BASED ON PART
INVOLVED.
-, ;
s: II( , . /)
Some say cauterization as of 2 types-
1. - Skin burning
2. -Muscle burning,
Commentator adds dagdhas of
-vessels,
-ligaments,
-joints and
-bones.
10

ACCORDING TO DRAVYAS USED
Type Dravyas used Sites for
agnikarma
1 Snigda agni
karma
madhu, grita, taila sira, snayu, sandhi
and asthi.
2 Ruksha agni
karma
pippali, shara, shalaka,
godanta
twak and mamsa
dhatu.
11

ACCORDING TO SITE;
Types Diseases
Sthanika(local);- kadara, arshas.
Sthananthariya( distal to site of
disease);-
pleehodara, gridrasi, apachi etc.
,|
( . . /) – in Arsha chikitsa
….., , || (. . )
Agnikarma should be performed at wrist joint, umbilicus, and left
thumb to cauterize the veins in case of vata and kaphanubandhi
Pleehodara.
In Yakrithodara- agnikarma done at .
12

ACCORDING TO AKRITI;
1 Valaya Circular Shape
2 Bindu Dot Like Shape(pointed)
3 Vilekha 1. Tiryak (oblique)
2. Riju(straight)
3. Vakra(Zigzag)
4 Pratisarana Rubbing at indicated site
by heated shalaka and
there is no specific shape.
5 Ardhachandrakara Semicircular fashion.
6 Swasthika
7 Ashtapada
13

UPAKARANA OF PLANT ORIGIN;
14

UPAKARANA OF ANIMAL ORIGIN;
15

METALLIC AND OTHER UPAKARANAS;
16

SAMYAK DAGDHA LAKSHANAS
Dravyas Lakshanas
1. Twak
dagdha
Pippali, aja shakrith,
godanta, shalakas,
, , .
2. Mamsa
dagdha
Panchaloha shalakas.
Swarna shalaka,
jambavoshtatara loha.
, , , .
3. Sira snayu
dagdha
Kshoudra, guda, sneha. , .
4. Sandhi
asthi dagdha
Kshoudra, guda, sneha. , , , .
17

 , Vitiated Vayu has affected to skin ,
muscles, vessels, ligaments, .
 ,










 ,
 ( , . /)


Anal tags
Moles
Sciatica
Mechanical back pain
Peri-arthritis shoulder joint
Frozen shoulder
Osteoarthritis knee joint in
early stage
Cervical pain
Tennis elbow
Plantar fasciitis
Corn
warts
Indications Current Practice of
Agnikarma
18

CONTRA-INDICATIONS
 ;
|| (su.su. 12/5)
 -
||
(su.su. 12/14)
 Pittaja and raktaja disorders,
 patients with concealed bleeding,
 intestinal perforation,
 retain foreign body,
 weak,
 children ,
 old age person,
 patients with multiple wounds and
 who are not fit for swedana karma .
19

SAMYAK DAGDHA LAKSHANAS
 (. . /)
which is not deep, has color of thala phala, Even( without
elevation or depression)
thala phala
20

CURRENT PRACTICE OF AGNIKARMA
probes
21

Peri-arthritis
shoulder
joint
24

Plantar fascitis
/ painful heal
27

INDICATION OF AGNIKARMA IN
ARSHAS
,|
( . . /) – in Arsha chikitsa
Agnikarma is indicated in rough, fixed, thick and broad
and hard type of arshas,
These features of arshas can be correlated to Sentinal tag of
Chronic fissure in ano and external haemorrhoids.
33

SYMPTOMS OF VATAJAARSHAS –
Nature of arshas or pile mass:
1. Shushka – dry
2. Chimachimanvita – tingling sensation
3. Mlaana – pale
4. Shyava – blackish blue
5. Aruna – yellowish red
6. Stabdha – hard
7. Parusha / khara – rough on touch
8. Vakra – haphazard, crooked
9. Mithovi sadrusha – split and broken
10. Vishputita – cracks
11. Resembling the fruits of bimbi (ivy gourd), karkandu (jujube), kharjura
(dates), karpasa phala (fruit of cotton, cotton seeds), siddartha (mustard)
etc
34

CORRELATION
 Haemorrhoids are blood -filled swellings caused by dilated varicose
veins.
 The External haemorrhoids are covered by skin, they are innervated
by the inferior rectal nerve. So they are sensitive to pain,
temperature, touch And pressure.
 External Piles: It is swelling at anal edge which is covered by skin.
 Sentinel Tag :It is localised thickening of the mucous membrane at
the distal end of anal fissure. Tag is situated at 6 &12o clock‟
position generally.
36

PURVAKARMA
 Before going for agni karma proper assessment should be made
 Instruments required for agnikarma like shalaka, pichu, grita,
madhu, source of agni should be kept ready.
 Patient should be empty stomach in cases like obstructed labour,
urolithiasis, fistula, in different abdominal diseases, piles and
diseases of oral cavity.
 Inj.TT 0.5cc IM stat.
 Inj. Xylocaine test dose s/c given.
 Pt’s consent
 Part preparation.
37

PRADHANA KARMA
 Aseptic measures.
 Under spinal anesthesia ,
 Position- Lithotomy position.
 Painting and draping.
 Lord’s anal dilatation done.
 Sentinel tag or ext. haemorroids held with the pile holding forcep and
excise the mass with cautery.
 The dagda site should be kept cold immediately with pulp of gritakumari .
38

PASCHATH KARMA

(. . / )
 madhu and grita to be applied.- inflammation↓ and post operative
pain↓.
 NBM for 6 hours
 Foot end elevation for 6 hours.
 Diet Starts with liquids and semi solid diet for 24 hours.
 Sitz bath twice daily.
 Jathyadi taila – taila poorana P/R done twice daily.
40

COMPLICATIONS OF AGNIKARMA IN
ARSHAS
By faulty application of agnikarma, kshara karma and
shasthra karma- cha. Chi. 14/33- 37
 Loss of sexual potency
 Swelling in anorectal region
 Retention of urges
 Severe colic pain
 Profuse haemorrhage
 Relapse of healed wounds
 Wetting and prolapse of anus
 Immediate death.
41

PROBABLE MODE OF ACTION; ACCORDING TO
YURVEDA
PROPERTIES OF AGNI;-
• Sukshma- kapha↓
• Laghu- kapha↓
• Theekshna –vata↓, kapha. ↓
• Ushna - vata↓, kapha↓
42

PROBABLE MODE OF ACTION; ACCORDING TO
AYURVEDA
• Action of agnikarma may be accessed by the properties of agni.
• It removes srotavarodha, avarana and increase in rasarakta samvahana to
the affected site.
• It works deep in tissue because of its power of penetration to deep tissue by
virtue of laghu, sukshma and theekshna guna
• In other theory ushnagunagni improves dathwagni that pacifies the ama
dosha and reduces pain- vata shamana.
• Dahana karma is having the property of sirasankochana by that quality even
it helps for raktha sthambana( haemostasis).
• Skin is one of the place of vayu, agnikarma is perform to release the
sangha(obstruction) of vayu.
• Pain is caused anywhere in the body is due to vata, agnikarma being ushna
chikitsa pacifies vata, and thus pain is relieved immediately after
agnikarma.
43

CAUTERIZATION- MODERN CONCEPT
 The medical practice or technique of cauterization is the burning of a part of a
body to remove or close off a part of it, which destroys some tissue in an
attempt to stop bleeding and remove an undesired growth, or minimize other
potential harm, such as infections.
 The main forms of cauterization used are
1. electrocautery and
2. chemicalcautery.
 useful in stopping severe blood loss
 To close amputations
 Useful in preventing infections, including complications from septicemia.
44

ELECTROCAUTERY
 Process of destroying tissue
 Heat conduction
 Metal probe- heat by electric current.
Electrocautery applies high frequency alternating current
by unipolar or bipolar method.
Uses
To stop bleeding from small vessels
To cut small tissues
45

Monopolar cauterization;
Contacts the tissue with a single small electrode.
Used to cut tissue and coagulate bleeding.
Most commonly used because of its versatility and effectiveness.
Bipolar cauterization;
Passes the current between 2 tips of a forceps like a tool.
Uses lower voltages so less energy is required.
Because it has limited ability to cut and coagulate large bleeding areas, it is
more ideally used to grab tissues on both sides by the forceps electrode.
Gives better control over the targeted area.
Helps prevent damage to other sensitive tissues.
46

(LIGHT AMPLIFICATION
BY STIMULATED EMISSION
OF RADIATION)
 Laser therapies are medical treatments that use focused light.
1. shrink or destroy tumours, polyps, or precancerous growths
2. relieve symptoms of cancer
3. remove kidney stones
4. remove part of the prostate
5. repair a detached retina
6. treat hair loss resulting from alopecia or aging
7. treat pain
By cauterising effect :
1. Nerve endings to reduce pain after surgery
2. Blood vessels to help prevent blood loss
3. Lymph vessels to reduce swelling and limit the spread of tumour
4. Remove warts, moles, birthmarks, and sun spots.
47

RADIOTHERAPY
• Uses ionizing radiation.
• Generally to control or to kill malignant cells.
• Ionizing radiation works by damaging the DNA of cancerous
tissue leading to cellular death.
48

SINGE
o Slight scorching, burn or treatment with flame.
o Treatment of removal of hair or other fibres.
49

MODE OF ACTION
1. Effect on pain: Heat may stimulate lateral spinothalamic tract
which leads to stimulation of descending pain inhibitory fibres
which release of endogenous opoid peptide which bind with opoid
receptors at substantia gelatinosa rolanda which inhibit of release
of P- substance and blockage of transmission pain sensation occur.
2. Gate control therapy : Pain sensations are transferred by two
types of fibers. “A” fibres (stimulated by heat, cold and touch) and
“C” fibers (stimulated by pain). Here the gate mechanism is
blocked by stimuli from A fibers, Activation of other types of
nerve fibers can modify or block the sensation of pain. so the pain
will not be felt.
3. Increased Metabolism : This is in accordance with Van’t Hoff’s
statement that any chemical change capable of being accelerated
by heat is accelerated by a rise in temperature. Consequently
heating of tissues accelerates the chemical changes, i.e.
metabolism. As a result of the increased metabolism there is an
increased demand for oxygen and nutrients, and an increased
output of waste products, including metabolites.
50

4 Effect of heating on nerves : Heat appears to produce definite
sedative effects. The effect of heat on conduction has still to be
thoroughly investigated but a physiological explanation has been
offered by Sidney Licht (1965), there is evidence that any sensory
excitation reaching the brain simultaneously with a pain
excitation results in the pain impulse being more or less
attenuated. 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.
5 Effect on muscular system: Rise in temperature induces muscle
relaxation and increases the efficiency of muscle action, as the
increased blood supply ensures the optimum conditions for
muscle contraction.
6 Effect on sweat glands: There is reflex stimulation of the sweat
glands in the area exposed to the heat, resulting from the effect of
the heat on the sensory nerve endings. As the heated blood
circulates throughout the body it affects the centres concerned
with regulation of temperature, and there is increased activity of
the sweat glands throughout the body. When generalized sweating
occurs there is increased elimination of waste products. 51

SCARRING AFTER AGNIKARMA
THERAPY:
 Burns result from a temperature elevation in tissue over a
threshold value for a period of time. Both the temperature and
the exposure duration greatly affect the extent of the burn.
 So in Agnikarma therapy heat is provided to body tissues by
direct contact with red hot shalaka for a fraction of second at
particular point/ site at one time. This amount of heat
transferred is sufficient to induce the reflex changes in body in
response to heat. Lesser time duration of contact prevents
deep skin burns at the site of Agnikarma. So the scar produced
is very superficial and heal spontaneously(within 3-4 days)
without any complications.
52

COMMON PROBLEMS WITH
AGNIKARMA
 Patient’s consent.
 Fear of Scar formation.
 Needs skill to perform
 Burn injury
53

DISCUSSION
1. Which is the best metal used for agnikarma??
2. What are the benefits of agnikarma ??
3. Why agnikarma contraindicated in sharadh and
greeshma ritu??
4. Whether all can practice agnikarma??
54

PRECAUTIONS

(. . . ;)
Agni, shastra, kshara are dreadful when they are in
unskillful hands. Hence should be used with great care and
skill.
55

CONCLUSION
 Agnikarma therapy is result oriented to Vataja and
Kaphaja disorders,
 It is a good measure for haemostasis.
 It works on the law of pain management.
 The technique and equipments have become advanced
but the basic principles are still the same.
56

TEXTUAL REFERENCES OF
AGNIKARMA
1. Sushruta Sutra Sthana 5/6 Sushruta Samhita, Nibandha Sangraha, Yadavji Trikamji
Reprint edition 2010 Varanasi, Chaukhamba surbharti Prakashana p 19
2. Sushruta Sutra Sthana Sushruta Samhita, Nibandha Sangraha, Yadavji Trikamji
Reprint edition 2010 Varanasi, Chaukhamba surbharti Prakashana p 34.
3. Sushruta Sutra Sthana 8/15 Sushruta Samhita, Nibandha Sangraha, Yadavji
Trikamji Reprint edition 2010 Varanasi, Chaukhamba surbharti Prakashana p 41.
4. Sushruta Sutra Sthana 12/9-10 Sushruta Samhita, Nibandha Sangraha, Yadavji
Trikamji Reprint edition 2010 Varanasi, Chaukhamba surbharti Prakashana p 52
5. Sushruta Chikitsa Sthana 1/8 Sushruta Samhita, Nibandha Sangraha, Yadavji
Trikamji Reprint edition 2010 Varanasi, Chaukhamba surbharti Prakashana p 397.
6. Sushruta Uttara Tantra 14/5 Sushruta Samhita, Nibandha Sangraha, Yadavji Trikamji
Reprint edition 2010 Varanasi, Chaukhamba surbharti Prakashana p 621
7. Charaka Sutra Sthana 24/46 Charaka Samhita, Ayurveda Deepika, Yadavji
Trikamji, Reprint Edition 2009, Varanasi, Chaukhamba Orientalia p 126
8. Charaka Sutra Sthana 28/26 Charaka Samhita, Ayurveda Deepika, Yadavji
Trikamji, Reprint Edition 2009, Varanasi, Chaukhamba Orientalia p 180
9. Shashtri Ambika dutta. 17th ed. 10. Vol. 12. Varanasi: Chaukhambha Sanskrita
Sansthana; 2003. Sushruta, Sushruta Samhita, Ayurveda Tatvasandipika Hindi
commentary, by Kaviraj; p. 39. Su.su.
57

ARTICLE REFERENCES
 MECHANISM OF ACTION OF AGNIKARMA 1Dr. Mohasin
Kadegaon, 2 Dr. Mohammad Yunus 1Lecturer, Dept of Shalyatantra,
2Lecturer, Dept of Roganidana, Shri JGCHS Ayurveda Medical
College Ghatprabha-Karnataka
 A comparative clinical study of Agnikarma and Siravedha in the
management of Gridhrasi w.s.r. Sciatica By Dr Vaneet Kumar
Department of shalya tantra institute for postgraduate teaching and
research in ayurveda gujarat ayurved university jamnagar – 361 008
March – 2013
 A comparitive study of agnikarma with lauha, tamra and
panchadhatu shalakas in Gridhrasi (Sciatica) Babita Bakhashi, S. K.
Gupta, Manjusha jagopala,1
and C. Bhuyan
58

ASAMYAKDAGDA
Plushtadagda;
• Discoloration of skin
• Contraction of parts
• Inflammation
• Burning sensation.
Management;
Warming up of affected part by gradual heating and apply
medicine having heating effect.
61

Durdagda;
• Sphota(blebs formation)
• Tiwra daha(severe burning)
• Lalima(redness)
Management;
Both cooling and heating treatments has been done anointing of
ghrita & liquids sprinklings should be done in cold state only.
62

Atidagda;
• Mamsa avalambana(hanging burnt tissue)
• Gatra vishlesha( parts become loose & useless)
• Distruction of sira, snayu & sandhi.
• Jwara
• Daha
• Pipasa
• Murcha
Management;
Excise withered tissue, cooling treatment should be carried out.
Fine strained powder of rice mix with pieces of tinduka or mixed
with grita should be anointed.
Wound covered by leaves of guduchi.
For snigda dagda - ruksha treatment should be given 63

ASAMYAKDAGDA
Plushtadagda;
• Discoloration of skin
• Contraction of parts
• Inflammation
• Burning sensation.
Management;
Warming up of affected part by gradual heating and apply
medicine having heating effect.
64

DIAGNOSIS:
 *Thorough case recording and examination of the patient
 *X-ray, MRI, CT scan, MR Neurography
 *Chest X-ray to rule out the thoracic causes
 *Abdomino-Pelvic USG to rule out any abdominal or
pelvic causes
 *Urine routine to rule out the renal causes
 *ESR to rule out infections
65

TYPES OF DAGDA VRANA
 Snigda dagda(scald)- burn with hot liquids like water, oil,
milk, ghee, etc
 Ruksha dagda(burn)- burn with hot dry objects like metals
objects.
Based on dagda vrana
 Samyak dagda- i. e. when proper agni karma has been
performed.
 Asamyak dagda- improper agnikarma
 Plushtadagda
 Durdagda
 Atidagda.
68

INDICATIONS
 1. Shiroroga 2. Vataja Shiroroga 3. Kaphaja Shiroroga 4.
Ardhavabhedaka 5. Bhrulata Vedana 6. Vartma Roga 7. Pakshmakopa
8. Shlista Vartma 9. Visa Vartma 10. Alaji 11. Arbuda 12. Puyalasa 13.
Abhisyanda 15. Lagana 16. Medoj Ostharoga 17. Danta Nadi 18.
Krimidanta 19. Adhidanta 20. Shitadanta Dantavriddhi 22. Jalarbuda
23. Arsha 24. Nasa Arsha 25. Karn arsha 26. Lingarsha 27. Yoni-arsha
28. Bhagandara 29. Chippa 30. Kunakha 31. Kadara 32. Valmika 33.
Jatumani - 34. Mashaka 35. Tilakalaka 36. Charmakila 37. Prasupti 38.
VishaChikitsa 39. Sarpadansha 40. Alarkvisha 41. Lutavisha 42.
Mushakavisha 43. Gridhrasi 44. Vatajashula 45. Vishwachi 46.
Galaganda 47. Gandamala √ 48. Apachi -49. Granthi 50. Antravriddhi .
51. Nadivrana 53. Upadansha - 54. Gulma 55. Visuchika
 56. Alsaka 57. Vilambika 58. Sanyasa 59. Unmada 60. Yakruta &
Pleehodara 61. Shonita Atipravritti 62. Sira Sandhi Chheda - 63.
Visarpa 64. Shotha
70

ASWEDYA
(Su. Su. 12/13; Ch. Su. 14/15-18)
 1. Pandu 14. Atisara
 2. Kshaya 15. Guda Bhramsha
 3. Udara Roga 16. Nashta Sangya
 4. Chhardi 17. Shochita
 5. madhatya 18. Oja Kshaya
 6. Vidagdha 19. Rakta Pitta
 7. Sthula 20. Ajirna
 8. Kruddha 21. Trishna
 9. Adhya Rogi 22. Garbhini
 10. Prameha 23. Ruksha
 11. Daurbalya 24. Shranta
 12. Visha 25. Kshudha
 13. Timira 26. Kshata
71

P SUBSTANCE
 Substance P (SP) is an undecapeptide (a peptide composed of a
chain of 11 amino acid residues) member of the tachykinin
neuropeptide family. It is a neuropeptide, acting as
a neurotransmitter and as a neuromodulator.
 Substance P is released from the terminals of specific sensory
nerves. It is found in the brain and spinal cord and is associated with
inflammatory processes and pain.
72

SUBSTANTIA GELATINOSA
 The apex of the posterior grey column, one of the three grey columns of
the spinal cord, is capped by a V-shaped or crescentic mass of translucent,
gelatinous neuroglia, termed the substantia gelatinosa of
Rolando (or SGR) (or gelatinous substance of posterior horn of spinal
cord), which contains both neuroglia cells, and small nerve cells. The
gelatinous appearance is due to a very low concentration of myelinated
fibers
 The substantia gelatinosa is one point (the nucleus proprius being the other)
where first order neurons of the spinothalamic tract synapse.
 Many μ and κ-opioid receptors, presynaptic and postsynaptic, are found on
these nerve cells; they can be targeted to manage pain of distal origin.
 C fibers terminate at this layer. Thus the cell bodies located here are part of
the neural pathway conveying slowly conducting, poorly
localized pain sensation. However, some A delta fibers (carrying fast,
localized pain sensation) also terminate in the substantia gelatinosa, mostly
via axons passing through this area to the nucleus proprius. Thus, there is
cross talk between the two pain pathways.
73

LOCAL EFFECTS OF BURN:
Central zone of coagulation:-When a temperature of about 600 C acts
on a tissue for about 60 seconds, the part is coagulated and
necrosed. Its depth is variable according to degree of burns.
Intermediate zone of stasis:-This zone is responsible for constitutional
disturbances. The capillary blood vessels dilate; water, electrolytes
and proteins are lost for about 48 hours due to increased capillary
permeability. The loss is both external to the surface and internal in
the tissue spaces, leading to tissue oedema. This zone becomes non
viable after about 36 hours and merges with central zone. (That’s
why the scar is larger than size of Agnikarma point)
Peripheral zone of hyperemia-This zone is reversible. The area is
congested and blanches on pressure, pointing to viability with active
circulation. So we see practically that scar of Agnikarma after one
week is slightly larger than scar produced immediately after
Agnikarma.
74

FOR TREATMENT OF GRIDHRASI,
DIFFERENT SITE FOR AGNIKARMA
 Agnikarma: Various Acharya mentioned Agnikarma
in the management of Gridhrasi.
According to Sushruta and Vagbhattata, in the
management of sira,snayu, asthi and sandhigata vyadhi,
Agnikarma is indicated and Gridhrasi is one of the
diseases of these samprapti.
 •Charakaa : Antara kandara gulpha
•Charkradatta: Pada kanisthika anguli (little toe of the
affected leg.
 Mostly in practice where pain is more prominent
primarily Agnikarma chikitsa can be done.
75

PRADHANA KARMA IN GRIDRASI
 Site for Agnikarma procedure: In Gridhrasi, Agnikarma has been done
at the site of Antara-Kandara-Gulpha-Sthana according to Acharya
Charaka (Tendo-calcaneous ligament) Pradesha with the root of sciatic
nerve (LumboSacral Spine).
 Cleaning and Drapping: The patient is advised to lie down on the couch
in prone position. Then the affected area is isolated and painted
(Prakshalana) with Triphala Kashaya or with Savlon. Here, spirit should
not be used because it is heat sensitive agent. The local part of the
patient is drapped.
 To make Samyaka Dagdha Vrana: After assessing symptoms of the
disease, the vital spots and the strength of the patient and disease,
Samyaka Dagdha Vrana is produced by red hot Shalaka (Panchadhatu)
in the affected site. The number of the Samyaka Dagdha Vrana can be 5
– 30 according to the extent of the diseased area.
 Application of cooling agents: After making Samyak Dagdha Vrana
immediately cooling agent is applied to relieve burning pain. Small
pieces of kumari patra can be used after crushing with swab holding
forceps. 76

ASSOCIATED SYMPTOMS OF VATAJA
ARSHAS
Shira shula – headache
Parshwa shula – pain in flanks
Amsa shula – pain in scapular region
Kati shula – low back pain
Uru shula – thigh pain
Vankshana shula – pain in groin
Kshavathu – sneeze
Udgaara – belchings,
Hrid graham – tightness in the chest
Arochaka – anorexia
Kasa – cough
Shwasa – shortness of breath
Agni vaishamya – metabolic errors
Karna nada – tinnitus
Bhrama – giddiness
Grathita, stokam, sashabdam pravahikam – loose stools or dysentery with pellet like stools, coming
in less quantity along with sound, blood, froath, mucus and with delayed evacuation
Gulma – abdominal tumour
Pleeha – spleen enlargement etc
77

ASSOCIATED SYMPTOMS:
 Vankshna anaha – heaviness in groin (hernia)
 Payu avakarshana – pulling pain in anus
 Vasti avakarshana – pulling pain in urinary bladder
 Nabhi avakarshana – pulling pain in navel region
 Kasa – cough
 Shwasa – dyspnoea
 Hrullasa – excessive salivation, nausea
 Praseka – excessive watering in the mouth
 Aruchi – tastelessness
 Peenasa – cold, running or stuffy nose
 Meha – urinary disorders
 Shiro jadya – heaviness of head
 Shishira jwara – fever with cold and chills
 Klaibya – impotence
 Agnimandya – sluggish digestion
 Chardi – vomiting
 Vasaabha sa kapha pureesha – stools appearing like muscle fat and mixed with phlegm
 Pravahika – dysentery
 Na sravanti – no discharges
 Na bhidyanti – will not open up easily
 Pandu snigdha twak adi – pallor of skin, nails, eye etc
78

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