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शुक्रवार, 22 जून 2012

AGNIKARMA

AGNIKARMA



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.


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