Tests and procedure
Agni Karma
Definition:
The word Agni Karma comprises of two words - Agni and Karma, i.e. fire and procedure and collectively gives the meaning, a procedure done by Agni. A study of different texts regarding the derivation of Agni revels that, the word Agni derived by the root “Agi Gatou”.
In short the word Agni denotes its upward going nature and universal presence. The word Karma derived by the “Doing” “Kriya Karne”. In texts there are different types of Karma have been explained viz. Spandanda, Gamana etc. but in present context it denotes only about procedure. In context of present study, the meaning of Agni Karma can be taken as a specific procedure done by the help of Agni for treating a disease.
Historical Review:
There are so many references regarding the Agni Karma for different purpose are available in text, beginning right from Vedic period.
Since Vedic period, Agni Karma is in practice to treat the human ailments.
• In Rig-Veda, Agni Karma has been indicated in the context of Obstetric disease.
• In YajurVeda, Agni is accepted as a treatment of Sheeta.
• In Sama Veda, the importance of Agni is proved by the presence of a chapter known as “Agney Kanda”.
• In Atharva Veda, Agni is accepted as God and Beshaja in context of Krimi.
Charaka Samhita:
Acharya Charaka has considered Agni Karma, under one of the three fold treatment i.e. Shastra Pranidhana. Charaka Samhita is mainly text of Medicinal treatment but the use of Agni Karma has been indicated at different places. In the chapter of “DwiVraniya Chikitsa” Agni Karma is indicated under 36 Upakramas of Vrana.
Sushrutha Samhita:
During the period of Sushrutha, Agni Karma has gained importance as a treatment for so many diseases. It was the Sushrutha, who have earmarked the Agni as supreme in all the Para-surgical procedures. A separate chapter in Sutra Sthana with details about every aspect of Agni Karma denotes its importance in the treatment, during those periods.
Sushrutha has referred Agni in Agropaharaniya, as Upayantra, Anushastra and one of sixty measures for Vrana.
Ashtanga Sangraha
40th chapter of Sutra Sthana of Ashtanga Sangraha deals specifically with Agni Karma. On other hand Agni Karma indicated for different disease.
Ashtanga Hridaya
A detailed description of Agni Karma is described in 30th chapter of Sutra Sthana of Ashtanga Hridaya. Besides, for different diseases Agni Karma is also indicated as a line of treatment.
Haritha Samhita
Acharya Haritha has identified Agni Karma as one of the eight important types of treatment. Beside this, he has also indicated Agni Karma in various diseases as follows.
Beside of above in Yoga Ratnakara, Sharangadhara Samhita, Bhavaprakasha, Gada Nigraha and Vangasena a lot of indications of Agni Karma are present.
Classification of Agni Karma
During describing the Agni Karma there is no description available regarding its classification, but it can be classified on various basis as below: viz.
1 According to Dravyas used.
2 According to the Site.
3 According to the Disease.
4 According to Akriti.
5 According to Dhatus to be cauterized.
1. Acc. to Dravyas used: Agni Karma can be classified into two groups
a) Snigdha Agni Karma: Performed by the means of Madhu, Ghrita, and Taila etc. According to Sushrutha they should be used for Sira, Snayu etc. type of deep structures.
b) Rooksha Agni Karma: Done by Pippali, Shalaka, and Ajasakrit etc. According to Sushrutha they should be used for Twakdagdha.
2. Acc.to the Site: On the basis of site Agni Karma can be grouped under two types –
a) Sthanika (Local): As in Vicharchika, Arsha etc.
b) Sthanantariya (Distal to the site of disease) as in Visuchikta, Apachi etc.
3 Acc. to the Disease: There are so many types of Agni Karma eg.
a) In the disease like Arsha, Kandara etc. it should be done after surgical excision.
b) In Sinus, fistula in ano etc. it should be done after incision.
c) In Krimidanta it should be done after filing the cavity by Jaggery, Madhuchhista etc.
4 According to Akriti:
Acharya Sushrutha has mentioned four types of Agni Karma acc.to Akriti
• Valaya
• Vilekha
• Bindu
• Pratisarana
Acharya Vagbhata has added more three types. (A.S. Su. – 40/4)
• Ardha chandra
• Swastika
• Ashtapada
Here Akriti should be taken as shape of Dahnopakarana and final shape produced after actual Agni Karma both.
Acharya Dalhana has given explanation regarding the shapes of Agni Karma in his commentary.
Valaya Circular shape.
Bindu Dot like shape. According to Dalhana Shalaka should be of pointed tip.
Vilekha Making of different shapes by heated Shalaka
PratiSarana Rubbing at indicated site by heated Shalaka and there is no specific shape.
Ardhchandra Crescent shape.
Swastika It is specific shape of Swastika Yantra.
Ashtapada It is specific shape containing eight limbs in different directions.
5 Acc. to Dhatus:
According to Acharya Sushrutha and Vagbhata the Agni Karma should be done as per involvement of the Dhatus such as Twak dagdha, Sira and Snayu dagdha, Mamsa dagdha, Asthi Sandhi dagdha
But Sushrutha have classified it in two groups only – (a) Twaka dagdha (b) Mamsa dagdha
While Acharya Kashyapa and Bhadra Shounaka have contraindicated Agni Karma in other dhatu besides Twak and Mamsa even in case of Snake bite.
Sign and Symptoms produced after Agni Karma as per Dhatus
A. Twak Dagdha: When the Twak is cauterized, burning is attended with a crackling sound, bad odour, and contraction of the skin.
B. Mamsa Dagdha: When Mamsa is cauterized, there occurs a pigeon like discoloration of the part, inflammation, mild pain, lesion get dried up and shriveled.
C. Sira Snayu Dagdha: When the Snayu and Siras are cauterized, there occurs black discoloration, swelling of the lesion and a cessation of discharge (including that of blood).
D. Sandhi and Asthi Dagdha: When Asthi and the Sandhis are cauterized there occurs dryness, redness, hardness and fixity of the lesion.
Indications of Agni Karma:
A number of diseases and conditions have been explained in text where Agni Karma as therapeutic measure has been indicated as below:
Name of Disease Ch. Su. A.S. A.H. B.P. Y.R. G.N. Sha
1 Shiroroga - + - + - - - -
2 Vataja Shiroroga - - + - - - - -
3 Kaphaja Shiroroga - - + - - - - -
4 Ardhav bhedaka + - - - - - - -
5 Bharu-lalata Vedana - - + - - - - -
6 Vartma Roga - + - - - - - -
7 Pakshama Kopa - + + - - + + -
8 ShlistaVartma - - + + - - - -
9 Bisa Vartma - - + - - - - -
10 Alaji - - + + - - - -
11 Arbuda - - - + - - - -
12 Puyalasa - - - + - - - -
13 Abhisyanda - - + - - - - -
14 Adhimantha - + + - - - - -
15 Lagana - + + + - - - -
16 Medaja Ostha Roga - + + + - - - -
17 Danta Nadi - + + + + + + -
18 Krimi Danta - + + + - - - -
19 Adhidanta - - + + - + + -
20 Sheeta Danta - - + + - - - -
21 Danta Vidhradhi - - + + - - - -
22 Jalarbuda - - + + - - - -
23 Arsha (Vataja-Kaphaja) - + + + - - - -
24 Nasa arsha - - + + - - - -
25 Karnarsha - - + + - - - -
26 Lingarsha - - - + - - - -
27 Yonya arsha - - - + - - - -
28 Bhagandar + + + + + - + -
29 Chippa - + - - - - - -
30 Kunakha - + - - - - - -
31 Kadara - + + + + + + -
32 Balmika - + + + + + - -
33 Jatumani - + + + + + + -
34 Mashaka - + + + + + + -
35 Tilakalaka - + + + + + + -
36 Charmakila - + + + + + + -
37 Prasupti - + - + - - - -
38 Visha Chikitsa + - - - - - - -
39 Sarpna Damsa + + + + - - - -
40 Alarka Visha - + - + - - - -
41 Luta Visha - - + + - - - -
42 Mushaka Visha - - + + - - - -
43 Gridhrasi + - - - - - - -
44 Vataja shoola in Twaka - + - - - - - -
45 Vishwachi - - + + - - - -
46 Galaganda - + + + - - - -
47 Ganda mala + - + + - - - -
48 Apachi - + + + + - + -
49 Granthi + + + + - + - -
50 Arbuda + + + + - - - -
51 Antra Vridhi - + + + - + - -
52 Shlipada - + + + - - - -
53 Nadivrana - + + - - - - -
54 Upadamsa - + - - - - - -
55 Gulma + - + + - - - -
56 Vishuchika - + + + - - - -
57 Alasaka - + - - - - - -
58 Vilambika - + - - - - - -
59 Sanyasa + - - - - - - -
60 Unmada - - - + - - - -
61 Yakrita Plihodara - - + + + - - +
62 Sonita Ati Pravriti + + + - - - - -
63 Sira Sandhichheda - + + - - - - -
64 Visarpa + - - - - - - -
65 Sotha + - - - - - - -
Suitable Season for Agni Karma:
Agni Karma can be done during all the seasons except Greeshma and Sharada. Even in these Seasons, during emergency States amenable only to cautery, it may be used after taking appropriate counter measures against them.( S. Su. 12/4 ). It is because of, in Sharada there is Prakopa of Pitta and Agni Karma also aggravates Pitta and it may be lead Pitta Prakopa, that’s why here Agni Karma is contra indicated. While Greeshma season is also a hot season and in this season Agni Karma is contra indicated.
Pre Agni Karma Diet:
In all diseases and during all seasons, the Agni Karma can be done after feeding the patient with pichhila diet, and on an empty stomach in case of Mal presentation of foetus, Calculus diseases, Fistula in Ano, abdominal diseases, Piles and diseases of Oral Cavity.
Pre Agni Karma Assessment:
Before going to any surgical or Para surgical procedure, complete assessment should be carried out regarding all the factors. So here too before going to Agni Karma a thorough examination of patient, shape of the lesion, related vital part of the body, the disease and the season etc. should be done.
Post Agni Karma Management:
After completion of Agni Karma the part where Agni Karma has done should be anointed with Madhu and Ghrita for Ropana of Dagdha Varna.
Contra indications for Agni Karma: In following conditions Agni Karma should not be done. Pitta Prakriti, Bhinna Kostha,Durbalya, Vriddha, Antah Shonita, Anuddhrata Shalya, Bala, Bhiru, A person afflicted with a large number of Vranas, A person who is forbidden for Swedana
Swedana is contra indicated for person and suffering from - Pandu Atisara, Kshaya Guda Bhramsa,Udara Roga Nasta Sangya, Chhardi Shochita, Who has taken Alcohol Oja Kshaya, Vidagdha Rakta Pitta, Sthula Ajirna, Kruddha Trishna, Adhya Rogi Garbhini, Prameha Ruksha, Daurbalya Shranta, Visha Kshudha. According to Charaka Agni Karma should not be done in the Vrana of Snayu, Marma, Netra, Kushta and Vrana with Visha and Shalya.
Superiority of Agni Karma:
Agni Karma is superior to Ksharakarma, as a disease burnt with Agni will never reoccur. Disease which cannot be cured with medicines, Kshara and Shastra, can be cured with Agni.
The Surgical excision should be done with the sharp instrument which is heated by Agni with benefit of asepsis; otherwise there will be sepsis by unheated instrument. There will be vaso constriction due to heat and it will check the Haemorrhage. By these virtues Agni Karma is superior to every other procedure.