AGNIKARMA

AGNIKARMA	Posted By : DR. MANOJ L.SONAJE nashik Dated : Wednesday, March 24, 2010
DEFINITION: Treatment performed by the use of different sources of heat. Therapeutic thermal cauterization can be compared to Agnikarma of Ayurveda, where as accidental burn i.e. termed as Etaratha Dagdha or Pramad Dagdha. INTRODUCTION: Treatment done with the help of Agnikarma (cauterization) has been claimed superior to the Aushadhi (medicinal), Ksharkarma (caustic) & Shastrakarma (surgical treatment), because there are least chances of recurrence. It has been clearly stated in the literature that the disease which are not cured by aushadhi, shastra & kshar they may be cured by the application of Agnikarma. It is safe & effective measures because it provides distruction of Jivanu (microorganism) locally as well as check the bleeding sirasankocha ((vasoconstriction). It is well documented by so many eminent scholars of ayurveda in their research work at M.D. as well as Ph.D. level works at different institutions of India; that Agnikarma is found more effective particularly in cases related to musculoskeletal & neuromuscular disorder like osteoarthritis, sciatica, spondylosis, skin disorders, piles, fistula, tumor, etc INDICATIONS OF AGNIKARMA: • Vitiated vayu has affected to skin, muscle, vessels, ligaments, joints & bones • Severe pain in ulcer with excessive granulation • Indurate tissue • Anesthetic patches, Pigmented moles • Lymph nodes, Lymphadenitis, Elephantitis • Arsha (Piles), Bhangadar (Fistula in ano) • Granthi (Warts), Arbuda (Tumors) • Antraja vridhi (Inguino-scortal hernia) • Traces & sinuses CONTRA INDICATIONS OF AGNIKARMA: • Paittika constitution • Internal bleeding • Ruptured viscera • Unextracted foreign body • Weak • Very young & very old • Timed • Multiple lesions • In those fomentation treatment is contraindicated TYPES OF DAGDHA VRANA: As after Agnikarma Dagdha has been produced so Sushruta described the following type of Dagdha to know the proper Agnikarma. Snigdha Dagdha (scald)- Burn with hot liquids like water, oil, milk, Ghrita, etc Ruksha Dagdha (burn)- Burn with hot dry objects like metal objects. Samyaka Dagdha- i.e.When proper Agnikarma has been performed. Asamyaka Dagdha- i.e.Improper Agnikarma which divided into three sub group i.e. Plushthadagdha, Durdagdha, Atidagdha (A) SAMYAKADAGDHA Symptoms: Twaka Dagdha- • Shabdapradurbhao (Production of audible sound) • Durgandha (Foul smell) • Twakasankocha (Contraction of skin) Mansa Dagdha- • Kapotvarnata (Color like a bird parrot) • Alpa swayathu (Less edema) • Alpa vedana (Less pain) • Shuska sankuchit vranata (Dry contracted wound) Sira-Snayu Dagdha- • Krishna vranata (Black coloration) • Unnata vranata (Raised wound) • Shrava sannirodha (Stoppage of discharge) Sandhi-Asthi Dagdha- • Rukshata (Dryness) • Arunata (Dark red coloration) • Karkashata (Roughness) • Sthirata (Stability) Management: Demulcent ointment made of tugakshiri, plaksha, chandan, gairik, amruta & Ghruta should be applied. Paste of minced flesh of domestic, swampy & aquatic animals should be applied. If severe burning management should be done as for Paittika (abscess). (B) ASAMYAKADAGDHA a) PLUSHTHADAGDHA Symptoms: • Twakavaivarnya (Discoloration of part) • Twakasankocha (Contraction of part) • Shotha (Inflammation) • Daha (Burning pain) Management: Warm up the affected part by gradual heating & apply medicine having heating effect, because when body gets heated blood become fomented & water being cool by nature, readily makes the blood thick. So application of heat is helpful & never that of the cool. Vagbhata (Astang Hradya) describe as a tuccha dagdha b) DURDAGDHA Symptoms: • Sphota (Blebs formation) • Tiwra Daha (Severe burning) • Lalima (Redness) Management: In this both cooling & heating treatments has been done anointing of ghrita & (liquid) sprinklings should be done in cold state only. c) ATIDAGDHA Symptoms: • Mansa Avalamban (Hanging burnt tissue) • Gatra Vishlesha (Parts become loose & useless) • Distruction of sira, snayu & sandhi. • Jwara (Fever) • Daha (Burning) • Pipasa (Thirst) • Murcha (Unconciousness) Management: Excise withered tissue; cooling treatment should be carried out. Fine strained powder of rice mix with pieces of Tinduka (contains lot of tannic acid) or mixed with ghruta should be anointed. Wound covered by leaves of guduchi. Patient should be treated as for paittika cellulites. For scalds (snigdha dagdha) ruksha (dry) treatment should be carried out. Beewax, Madhuka (Bassia latifolia Roxb), Rodhara (Symplocos racemosa Roxb), Sarjaras, Manjishtha, Chandan, Murva should be powdered & then cooked with ghruta. This recipe is good for all types of dagdha (burn) PURVAKARMA: The Shalyakarma Mandir (O.T.) was made ready & furnished with Agnikarma Shalaka, Trifala Kashaya, Yashthimadhu Powder, Ghrutakumari Swaras, Prot, Pichu etc. The stove was kept outside the theater & Shalaka was made red hot. The patient was kept asked to lie down on table. The part of patient was washed first by Trifala Kashaya Preparation of patient: Diet should be given slimy. As it is minor procedure so soft, light & nourishing diet can be given before procedure. Surgeon should thorough examination of - shape of lesion, vital parts of body, strength of patient, disease & Season. Agnikarma can be performed in all seasons except Autumn & Summer. Agnikarma has been performed on Twaka (Skin) Mansa (Muscle), Sira (Vessels), Snayu (Ligament), Asthi (Bone), Sandhi (Joint) Materials used for Agnikarma: Twakagat (Skin) Agnikarma- Pipali (Piper longum Linn), faces of goat, cow’s teeth, arrow & Shalaka (rod) should be used. Mansagat (Muscular) Agnikarma - Jambavaustha (rod like instrument made up of black stone looking nut of Jambu fruit) Sira (Vessels),Snayu (ligament), Sandhi (Joints) & Asthigat (bones) Agnikarma- Honey, treacle & fats Different Agnikarma Shalaka: PRADHANKARMA- On the diseased skin of the patient the Samyakdagdha varna were produced by red hot Shalaka. The number of Samyakdagdha was from 5 to 30 according to extend of the diseased area. The dagdha varna were covered with Yashthimadhu powder (Glycyrrhiza Glabra) or with Ghrutakumari Swaras (Aloe Vera) Specific sites: • Head- frontal & temporal area • Glaucoma- eyebrows • Eyelids- root of eyelashes • Twaka, Mansa , Sira, Snayu, Asthi, Sandhi -at the place of vedana • As per diseases (as Vrana, Arsha etc) the most painful site for agnikarma Pattern of Agnikarma: Acharya Sushruta 4 types & additional 3 by Ashtanga Sangrahakar 1. Valaya (Circular) 2. Bindu (Dotted) 3. Vilekha (Linear) 4. Pratisaran (Flat) 5. Ardhachandra (Semicircula) 6. Swastika (Cruciform) 7. Asthapada (multitail) Surgeon can design according to site size & shape of lesion. PACCHATKARMA: • The samyak dagdha vrana were covered with prota of honey & ghruta. • Then proper pattabandhan should be done. • On next day avachurnan (sprinkling) of yashthimadhu powder was done. • On third day onward the varna were observed for any complication. • Agnikarma chikitsa can be repeated after seven days if required.

Concept of Shukra Dhatu in females

There are three important events that occur in every living organism, these are Utpatti, Sthiti and Laya i.e. birth, growth and death. Body as a whole is born and dies only once, but at Paramanu level this cycle of creation and destruction is going on continuously. Shukra Dhatu, the seventh and last among the seven Dhatu not only performs function of Dehadharan, as the definition of Dhatu suggests, but is also necessary for the propagation of species i.e for reproduction. Moolsthan of Shukravaha Srotas Regarding Shukravaha Srotas there are different opinions. According to Charakacharya, Vrishanau and Shepha are the Moolasthana of Shukravaha Srotas. Sushrutacharya describes Moolasthana of Shukravaha Srotas as Stanau and Vrishanau. These are more developed in females at puberty. While in males it is rudimentary. There are some reasons to consider breasts as Moolasthana of Shukravaha Srotas, these are as follows- 1) Stanya and Shukra both are present all over the body. 2) Shukra is responsible for reproduction and Stanya is responsible for the nourishment of the new born. 3) Acharya Kashyap has told to give Vajikar Dravya Siddha Kshira to Dhatri. This also shows relation between Shukra and Stanya. 4) Shukra Pravartan and Stanya Pravartan Hetu are mostly at the psychological level. 5) Considering Dalhanacharya’s opinion, that Artava is Stree shukra, and then the relation between Stanau and Shukra becomes clear. According to the classical texts, during pregnancy or Garbhakala, Artava is blocked and therefore it rises upwards and splits into 2 parts- One forms the Apara or placenta and the other nourishes the breasts. Shukra is a Dhatu and as said by Acharyas, there are seven Dhatus in the body both in male or female. There are different opinions related with existence and nature of Shukra Dhatu in females, these are as follows-  As Shukra is a Dhatu, necessary for sustenance of life, females also have Shukra Dahtu in their body.  In females, Artav performs the function of Gabhotpadan alike Shukra in males.  The secretions at the time of coitus (Madanavari) are said to be Shukra but unlike Shukra in males it doesn’t cause conception.  Chakrapani quoting opinion of others, writes that few erudite accept development of moustache as Mala of Shukra which is not accepted by Charaka, had this been the process, even women would have had the moustache due to presence of Shukra. Moreover Shukra of females does not take part in fertilization.  Artav is an essential factor for conception in females, gives strength to Shukra and is responsible for strength and complexion. This means that Artav and Shukra are different. Considering these points, Bhavamishra has presented the idea of eight Dhatus in females i.e. Artava as seventh and Shukra as eighth, but the exact description regarding location, characteristics etc. is lacking.  Sushrut commentator Dalhanacharya has considered Artav in females as Shukra, as it is meant for conception. If not considered so then females will have 6 Dhatu which is not correct. So he has considered Artav as Shukra in females. It is worth noting that during Shukrapradurbhav, some changes in mind and body also start to appear like hair growth on pubic and axillary region, shyness etc.  Charak commentator Gangadhar has explained that, even females have seven Dhatus as in males. Rasa produced from Ahar serially goes through Dhatuparinaman process, producing Shukra. Most of the part of this Shukra, transforms into Artava in females by Agni Sanskar of Shukragni and very small amount remains as Shukra Dhatu. This is how Artav is formed every month after previously formed Artav gets discarded. Consideration of Artav according to Modern View: Oogenesis- In the human embryo, the thousand of oogonia divide rapidly from the second to the seventh month of gestation to form roughly 7 million germ cells. After that oogonia enter the first meiotic division forming primary oocytes, and are maintained until puberty. With the onset of adolescence, primary oocyte divides, forming the first polar body, and the secondary oocyte. During the second division of meiosis, a similar unequal cytokinesis takes place forming the mature egg (ovum), and a second polar body. Functions of ovarian hormones- estradiol and progesterone  There are two types of ovarian sex hormones the estrogens and the progestins. By far the most important estrogen is estradiol and the progestin is progesterone. The estrogens mainly promote proliferation and growth of specific cells in the body that are responsible for development of most secondary characteristics of female while the progestins are concerned entirely with final preparation of uterus for pregnancy and the breasts for lactation. Synthesis  As both, estrogens and progesterone are steroids, they are synthesized in the ovaries mainly from cholesterol and slightly from acetyl co-a. During synthesis, progesterone and male sex hormone testosterone are mainly synthesized first; then, during follicular phase of ovarian cycle, almost all the testosterone and much of the progesterone are converted into estrogens by granulose cells. Also, about 1/5th as much testosterone is secreted into the plasma of the female by ovaries as is secreted into the plasma of the males by testes. Functions of estrogens  The principal function of estrogen is to cause cellular proliferation and growth of the sex organs and other tissues. Effect on uterus and sex organs  At pubertal age, estrogen is secreted 20times more than childhood. It results in increase in size of ovaries, fallopian tubes, uterus and vagina. It causes change of vaginal epithelium from a cuboidal to stratified type and increases resistance against infection. It also causes marked proliferation of endometrium and endometrial glands. Effect on breasts  Primordial breasts of male and female are exactly alike. Under the influence of appropriate hormones, the masculine breasts also develop sufficiently to produce milk as in females. Estrogen causes, development of stromal tissues of breasts, growth of an extensive ductile system, and deposition of fat in the breasts. Along with progesterone and prolactin it causes the determinative growth and function of these structures. Effect on skeleton  It causes increased osteoblastic activity in bones. Therefore there is rapid growth in height in pubertal age and is much stronger than testosterone in males. After menopause there is almost no estrogen, which leads to osteoporosis in menopausal females. Effect on protein deposition  It causes increase in total body proteins. The same effect produced by testosterone but in more general and many times powerful. Effect on metabolism  It slightly increases whole body metabolic rate but only 1/3 that of male sex hormones. It also causes deposition of fats in the buttocks, thighs and breasts that is characteristic of feminine figure. Functions of progesterone  Effect on uterus  It causes secretary changes in the uterine endometrium during secretory phase of menstrual cycle, for preparation of uterus for implantation of fertilized ovum.  Effect on breasts  It promotes development of lobules and alveoli of the breasts, causing proliferation and enlargement of them. It causes breasts to swell and is due to secretary development in lobules and also due to increased fluid in the subcutaneous tissue. From above references it can be stated that, Shukra Dhatu is present in male and female both, but its expression is different. Author:*Dr. Shweta V. More **Prof. Dr. K.D. Sathe **Guide & Professor Dept. of Sharirkriya, Sumatibhai Shah Ayurved Mahavidyalay, Hadpasar. *PG (Sch.)

Conceptual Review of Ojovardhan: In Preventive Cardiology

According to “Cardio- Vascular Disease Trends in India” presented by ‘Escort Heart Institute and Research Centre, New Delhi, India – 1) Cases of CVD (cardio-vascular diseases) may increases from about 2.9 crore in 2000 to as many as 6.4 crore in 2015 , And deaths from CVD will also be doubled 2) The prevalence rate of CVD among younger adults is also likely to increase. This study shows that the rate of CVD i.e. Hrudrog is increasing rapidly, Also in young generation. World Health Organisation says that use of tobacco, unhealthy diet, and physical inactivity increases risk of heart attack and stroke. Also extreme exertion and emotion can spark repeated heart attacks. And prevalence rate of CVD in ruralpopulation will remain lower than that of urban population. From the above refferences, we can conclude that the changes in life style and habits of urban population such as daily exertion , stress ,tension, eating fast food, tobacco chewing and smoking , alcohol consumption may be responsible for increase in the rate of heart diseases. In Ayurveda, Hruday (heart) is site of Oja. At the time of organogenesis, this oja comes in to heart and maintain Pran in Sharira. And it provides Bala and Sthairya to heart. The causes and symptoms of Ojokshaya and that of Hrudroga described in Samhitas are almost similar. Ojokshay causes and symptoms:- Hrudroga Hetu:- Hrudroga Causes Ojokshaya Causes and symptoms (Su.Su.15/30) Ativyayama Atishrama Bibheti Bhaya Chinta,Traasa Vyathetendriya Karshana Ruksho,Bhavetksham Abhighaat Abhighaat As causes and symptoms of Ojokshaya are similar to causes of Hrudroga , the Persons having Ojokshaya are more prone to suffering from Hrudroga. The change in life style and habits are likely to be same as that of causes of Ojokshay which include:- Atishram- Daily exertion, Chinta - stress, tension, Krodh – angar In Charak Chikitststhan 24, it is described that the Gunas of Madya (alcohol) are opposite to all Gunas of Oja.Thus consumption of alcohol leads to Ojokshay and can form pathogenesis in heart. Guna of tobacco are also opposite to that of Oja such as Vyvayi , Vikasi , Ruksha , Vishad , Ushna these Guna of tobacco are opposite to Sthir, Shlakshna , Snigdha, Pichchhila, and Sheeta of Oja. So chewing or smoking of tobacco can cause Ojokshay and may lead to Hrudroga . According to Samanya Vishesh Siddhanta , above factors can cause Ojokshaya . Due to Ojokshaya in the body, the Bala and Sthir Guna in heart decreases and thus increases the risk of Hrudroga. So , for prevention from Hrudrog , the Bala and Sthir Guna should be increased in heart. And to enhance the Bala and Sthir Guna of heart, the Ojokshaya should be prevented or corrected and for that Ojovardhan dravyas should beused in daily routine . Kshir (Cow’s milk), Jivaniya Gana (Jivanti,Jivak,Madhuk etc), Ghrit (ghee), Mansras are indicated in Ojokshaya. In Sushuta, the treatment which is in favour of Oja such as Rasayana-Vajikarana is indicated. It enhance the quality of Oja as Gunas of these dravyas are similar to that of Oja. So according to Samanya-Vishesh Siddhant they increase Oja which responsible for Bala and Sthir Guna in heart. Thus the concept of Ojovardhan in prevention of cardiac diseases can be clinically witnessed. (References: - Cha.Su.17/77, Cha.Su.17/74, Cha.Su.30/13, Cha.Chi.26/77, Ash.Hru.Su11/33, Su.Su.15/32,33, Cha.Chi.24/37-40) Author :*Vd. Nitin P.Sarode. Dept of Kriya Sharir, S.S.A .Mahavidyalaya. ** Vd.V.R.Veer. Guide & Reader, Kriya sharir Dept.