Agni-Karma

Sushruta samhita is the most authentic text concerned to surgical and para-surgical procedures which were in practice thousands of years ago when techniques were not as much advanced as today and ayurveda was enjoying its golden period. Today technology is so advanced that if we have a glance at ayurvedic literature it seems to be an obsolete science. But if you study it thoroughly and also see what is going on in today’ medical world it is clearly evident that it is the technology which has made the difference, principles are similar, whether it is larva therapy for wound debridement or leech therapy being used in the reconstruction surgery. One of such important para-surgical procedure mentioned in the ayurvedic literature is Agni-karma indicated for the management of various painful disorders which is being explored and various treatment modalities which are in use like infra red heating are based on the same principle. But a lot more work is required.

Acharya Sushruta has written a complete chapter (AgniKarma Vidhimadhyaya-Sutrasthana chapter 12) about various aspects related to Agnikarma, which itself shows its importance in those days as a parasurgical procedure and no treatment modality can gain such an importance if it does not gives the results. The word Agni Karma comprises of two words-Agni and Karma, collectively gives the meaning-When samyaka dagdha vrana is produced by agni with the help of various dravyas.

In classics, different types of dahanopakarna have been described.Each of them is having its own pecularity.Acharya Sushruta have classified them according to the site of agni karmaviz.
(1) Twaka- Pippali, Ajasakrida, Godanta, Shara, Shalaka.
(2) Mamsa- Jambavostha shalaka and other lohas.
(3) Sira,Snayu,Sandhi, Asthi- Madhu, Gudda and Sneha.

Besides above description, different woods used for heating purpose has been described in texts viz. Khadir, Badar etc. The selection of dahanopkarana and amount of agni depends upon the condition and site of disease. It has been said that agni should be nirdhoom and sufficiently hot for heating of dahanopakarna.



Types of Agni-Karma-
According to akriti,Acharya Sushruta have mentioned four types and named them dahanvishesha-
(1) Valaya (2) Bindu
(3) Vilekha (4) Pratisarana
Acharya Vagbhatta has added three more types-
(1) Ardhachandra
(2) Ashtapada
(3) Swastika
Here akriti should be taken both as a shape of dahanopakarana and final shape produced after agni-karma.

Types according to dhatus-
(1) Twaka dagdha
(2) Mamsa dagdha
(3) Sira and Snayu dagdha
(4) Asthi and Sandhi dagdha
This does not means that we have burnt skin, mamsa,sira, snayu, asthi aur sandhi. It simply means that we have to transmit heat or give thermal stimulus to different dhatus, that is why different types of dahanopakarana were used, because they maintain different temperature when heated,and thus are capable of transmitting heat to various tissues according to the depth.
Symptoms and methodology has been described in detail.

Agnikarma is said to be superior over all parasurgical procedures because the disease which are incurable by medicines, surgery and other parasurgical procedures can be cured by agnikarma. The qualities which make agnikarma superior are as follows:
(1) Apunarbhavat
(2) Sterlization property
(3) Haemostatic
(4) Curative property
(5) Effects on doshas
Mode of action of agnikarma:
Any chemical change capable of being accelerated by heat, is accelerated by a rise of temperature. Consequently heating of tissue accelerates the chemical change i.e. metabolism. As a result of increased metabolism, there is an increased demand for oxygen and food stuff and increased output of waste products, which includes metabolites, which act on the walls of the capillaries and arterioles causing vaso-dilatation. In addition, the heat has a direct effect on the blood-vessels causing vaso-dilatation, particularly in the superficial tissues where the heating is maximum.

Stimulation of nerve endings can also cause reflex dilatation of the arterioles. As a result of the vasodilatation there is an increased blood flow through the area, so that the necessary oxygen and the nutrient materials are supplied and waste products are removed which promotes healing. Heat appears to produce definite sedative effects on the nerves. The effect of heat on nerve conduction is still to be thoroughly investigated. There is evidence that any sensory excitation reaching the brain simultaneously with pain excitation, results in pain impulse being more or less attenuated.