Agnikarma is a medical procedure done using controlled heat and fire. It is done in various Disease like Corn, Warts, Piles, Fistula in Ano, To Arrest bleeds etc.

1. Presenter : Dr. Ayesha Tasneem M.Z
1st year Shalya Pg
Under the Guidance of- Dr. Shailaja S V
HOD of shalya tantra
Sri Kalabyraveshwara swamy Ayurvedic Medical college and Hospital, vijaynagar Bangalore- 1

2.  Introduction
 Derivation & Definition
 Importance of Agnikarma
 Dahanopakarana
 Classification of Agnikarma
 Indication & Contraindication
 Trividhakarma
 Samyak Daghdha Laxana
 Mode of Action
 Agnikarma in various shalya tantra vyadhi
 Modern corelation to Cauterization
 Challenges of Agnikarma
 Discussion
 Conclusion 2

3. Shalyatantra is one of the Important branch of Ayurveda based on
six major methods of management such as Bhesajkarma,
Ksharakarma, Agnikarma, Sastrakarma, Yantrakarma,
Raktamoksana. Agnikarma is superior among them and boon for
local vata & kaphaja vyadhi.
Agni karma is one among the Para surgical procedure,
Anushastra and Upayantra.
In modern words, “Agni Karma” therapy can be closely associated
with “Intentional Heat Burn Therapy / Therapeutic burns /
Cauterization”
3

4. अगि ितौ । (अमरकोश)
The word ‘Agni’ is derived from dhatu ‘Ang’ which means ‘Gati’ that
explains about Movement/Transformation / spreading
Agni is foremost, among that which controls our body and
responsible for the janma (life) (Shabdakalpadruma)
Karma – Action
The word “Agni Karma” comprises of two terms ‘Agni’ and ‘Karma’,
which represents fire and procedure respectively.
अग्नििा कृ त्वा यत ् कर्म, अनिनेः सम्बग्धि वा यत ् कर्म, तदग्निकर्म|
(Dalhana on Su.Su.12/2)
The treatment protocol done using fire or which is related to fire is
called Agnikarma.
4

5. क्षारादग्नििमरीयाि् क्रियासु व्याख्यातेः तत् दनिािाां रोिाणाां अपुिर्ामवात्
र्नषज शस्त्र क्षारेःअसाध्यािाां तत् साध्यत्वात् च​ ॥ (सु.सू.12/3)
The Agnikarma is Considered to be better than Kshara
Karma.
The disease treated with proper Agnikarma has no chance of
recurrence.
It cures the disease which are not Managed with Bheshaja
karma, Shastra Karma and kshara karma.
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’’. 5

6. Dahanopakarana are the Instruments / Materials used to
produce therapeutic burns ( Samyak Dagdha) during
Agnikarma Chikitsa.
Various dahanopakarana of various origins like plant origin,
animal origin & metal origin are mentioned which are
selected according to the disease, site etc.
Acharyas mentioned different materials to perform
Agnikarma in different structures for the temperature
regulatory purpose.
6

7. Sl.No Dahnopakaran Su Ch A.S A.H
1 Pippali + - + -
2 Aja Shakrut + - + -
3 Godanta + - + +
4 Shara + + + +
5 Shalaka + - + -
6 Jambavastha + - + +
7 Other Dhatu ( metal) + - + -
8 Kshaudra + + + +
9 Madhuchista + + + -
10 Guda (Jaggery) + - + +
11 Sneha + - + +
12 Loha + - + -
13 Ghrita - + + -
Sl.No Dahnopakaran Su Ch A.S A.H
14 Taila - + + -
15 Vasa - + + -
16 Majja - + - -
17 Yashtimadhu - - + -
18 Suchi(needle) - - + -
19 Hema (gold) - + + -
20 Tamra - - + -
21 Rajata - - + -
22 Kamsya - - + -
23 varti - - - +
24 Suryakanta - - + -
25 Ardhendu vaktra
shalaka
+ - + +
26 Kalasthidal tulya
shalaka
+ - + -
7

8. Dahanopakarana & their corresponding temperatures
when red hot
8
•Gold
62℃
•Silver
350℃
•Copper
212℃
•Iron
228℃
•Panchalouha Shalaka
235℃
•Snigdha Dravyas
140 – 160 ℃
•Pippali
57℃
•Aja Sakrit
45 – 55 ℃

9. 9

10. 10

11. 11

12. पपप्प​ल्याजाशकृ द्िोदधतशरशलाका त्वक् ितािाां
i.e. for vata kaphaja Twak vikaras. (su.su. 12/4)
12

13. जाम्बवौष्ठनतरलौहा:र्ाांसितािाां
i.e. for vata kaphaja Mamsa vikaras. (su.su. 12/4)
13

14. क्षौद्रिुडस्त्िनहाेः ससरास्त्िायुसधध्यग्स्त्िितािार् ्(su.su. 12/4)
i.e. For vata kaphaja disorders of Sira,Snayu,Sandhi & Asthi.
14

15. Components of Panchalauha Shalaka
 Tamra (copper) → 40%
 Loha (iron) → 30%
 Yashada (zinc) → 10%
 Rajata (silver) → 10%
 Swarna (Gold) → 10%
15

16. 16
1)Type of Akriti ( Shape)
1)Sthana /Part to be Cauterized
1)Based on Dravya used
Based on the disease Site
Nature of the Disease

17. The first 4 shapes are described by Acharya Sushruta,
whereas the last 3 shapes are described by Acharya Vagbhat- Ashtang
Sangrah.
17

18. तर द्पवपविर्ग्निकर्ामहुरनक
न -त्वनदिां,र्ाांसदनिञ्च ||
इह तु ससरास्त्िायुसधध्यग्स्त्िष्वपप ि प्रततपषद्िोऽग्निेः| ( Su.Su.12/7)
cauterization mainly as of 2 types-
1. – Twak Dagdha (Skin burning)
2. –Mamsa Dagdha (Muscle burning),
Agnikarma in the below mentioned dhatu is also not prohibited.
3.Sira
4. Snayu
5. Sandhi
6. Asthi
18

19. 19
Snigdha Agni
Karma
Madhu, Ghrita ,
Taila
Sira ,Snayu, Sandhi
& Asthi
Ruksha Agni Karma
Pippali, Shara ,
Shalaka,Godanta
Twak And mamsa
Dhatu.

20. .
20
•Kadara
•Arshas
Sthanika(local)
•Pleehodara
•Antra Vruddhi
Sthanantariya
(Distal to the
site of disease)

21. 21
a)In Disease
like
• kadara
• Arshas etc
Agnikarma Done
After Chedana
Karma (Surgical
Excision)
a)In Disease
like
• Fistula
• Sinus
Agnikarma Done
after Bhedana
Karma (Surgical
Incision)
a)In
krimidanta –
done after
filling the
cavity with
Guda,
madhuchista
etc.

22. त्वक् र्ाांस ससरा स्त्िायु सग्धि अग्स्त्िग्स्त्ितन अतत उग्ररुग्ज वायावुग्रित
कठठिसुप्तर्ाांस व्रणन ग्रग्धि अशोऽबुमद र्िधदर अपची श्लीपद चर्मकील
ततलकालका आधरवृद्गिसग्धिससरारछनदिाठदषु िाडीशोणणत अततप्रवृपिषु
चाग्निकर्म क
ु यामत ्(su.su. 12/10)
The pain aggravated by vata in tvacha , mamsa, sira, snayu, sandhi
and asthi.
Chronic wound having some hard elevated tissue.
Cystic lesion, hemorrhoids, tumour, fistula, sinus lymphadenopathy,
filarial, skin tag, hernia, joints disorders,
To stop bleeding from cut vessels.
22

23. तराग्निकर्म सवम ॠतुषु क
ु यामत ् अधयर शरद् ग्रीष्र्ाभयाां…. ( Su.Su. 12/5)
Agnikarma can be done in all the seasons of the year except in Sharad
(Autumn) & Grishma (Summer)
अिनर्ािग्नििा पररहरनत ् - पपिप्रकृ ततर्धतेः शोणणतां सर्धिकोष्ठर्िुद्िृतशल्यां
दुबमलां बालां वृद्िां र्ीरुां अिनकव्रणपीडडतां अस्त्वनद्याांश्चनतत ( Su.Su.12/14)
All types of pittaja and raktaja disorders, patients with concealed
bleeding,
Intestinal Perforation, retain foreign body, weak person, children , old age
person,
and patients with multiple wounds and who are not fit for swedana karma .
 Acc. To Ch.Chi.25/105 agnikarma should not be done In vrana of snayu,
marma, Netra, kushta and vrana with visha and shalya.
 Acc to A.H.Su. 30/44 Agnikarma should not be employed in persons who are
contraindicated for Kshara karma. 23

24. 24

25. रोिस्त्य सांस्त्िािां अवनक्ष्य सम्यक् िरस्त्य र्र्ामणण बलाबलां च ।
व्यागिां तिॠतुां च सर्ीक्ष्य सम्यक् ततो व्यवस्त्यनत ् सर्षक् अग्निकर्म॥
(Su.Su.12/12)
Pre Agnikarma Assessment: A physician, after having carefully analyzed the seat
of the disease and examining the individual for the strength, locations of the
Marma, disease and season should resort to Agnikarma.
सवमव्यागिषु ॠतुषु च पपग्रछलर्धिां र्ुक्तवतेः कर्म क
ु वीत; अश्र्री र्िधदर
अशो र्ुखरोिनष्वर्ुक्तवतेः (Su.Su.12/6)
Pre AgniKarma Diet: In all diseases and in all seasons, the patient should be fed
on a diet which is Picchila before Agnikarma;
While the patient should be on empty stomach before the therapy, in case
of Mudhagarbha (malpresentation of fetus), Aśmari (renal stones), Bhagandara
(fistula-in-ano), Udara (ascitis), Arsa (haemorrhoids) and Mukha Roga (diseases
of oral cavity).
25

26.  AS.Su.40/5
Before doing the procedure of Agnikarma,
swasthikvachan should be done; the patient kept in
suitable position by keeping head in the East
direction and held by expert assistants to avoid
movement.
 After this the surgeon should make the different
shapes of Agnikarma viz.:- Valaya, Ardhchandra,
Swastika, etc. as per need by heated Shalaka in a
smoke free fire of Khadira or Badara.
 During this period if patients feel discomfort then
keep them satisfied by courageous, consolations
talks, give cold water for drink and sprinkle cold
water. But procedure of Agnikarma should be done
till production of complete cauterization/Samyak
Dagdha. 26

27. सम्यनदनिर्िविाढां पूवमलक्षणयुक्तां च तालवणं
सुसांग्स्त्ितां| (su.su.12/16)
Ana awagadha vranata ( wound which is
not deep )
Talaphala varnata ( Fruit of tala tree –
Asian palm fruit)
Susamsita vrana ( without elevation or
depression )
This is not considered as injury when
performed for the therapeutic purpose. If the
above sign and symptoms occurs that indicate
the perfect Agnikarma/ Samyak Agnikarma.
27

28. According the Acharya Sushruta (Su.Su.12/8)
तर, शब्दप्रादुर्ामवो दुिमधिता त्वक्सङ्कोचश्च त्वनदनिन ।
Shabdapradurbhava ( production of sound)
Durghandata (Bad odour)
Twak Sankocha (Contraction of the skin)
कपोतवणमताऽल्पश्वयिुवनदिा शुष्कसङ्कगचत व्रणता च र्ाांसदनिन ।
 kapotavarnata (Colour like that of pigeon i.e ashy, dark
grey )
Alpa swayathu (mild swelling)
Sushka sankuchit vranata (dry, contracted wound)
28

29. कृ ष्णोधितव्रणता स्त्रावसग्धिरोिश्च ससरा स्त्िायुदनिन
Krishna vranata (black coloration )
Unnata vranata (elevation)
Srava sannirodha (stoppage of discharge)
रूक्षारुणता कक
म श ग्स्त्िरव्रणता च सधध्यग्स्त्िदनिन
Ruksha (Dryness)
Arunata (Red colour)
Karkasha (Roughness)
Sthira vranata(Firmness of ulcer)
29

30.  तर सम्यनदनिन र्िुसपपमभयार्भयङ्िेः | (su.su. 12/13)
The Madhu (honey) and Ghrita (Ghee) should be applied
after the agnikarma procedure.
 सम्यनदनिन तुिाक्षीरीप्लक्षचधदििररकेः ।।
सार्ृतेः सपपमषा ग्स्त्िनिरालनपां कारयनद्सर्षक् ।
ग्राम्यािूपौदकश्चिां पपष्टर्ामसेः प्रलनपयनत् ।
पपिपवद्रगिवत्चिां सधतत उष्र्ाणर्ाचरनत्( Su.Su 12/23,24)
Paste of Tugakshiri, Plaksha, Chandan, Amrita & Gairika with Gritha can be used as
ointment for local application.
Paste of flesh of some animals like horse, pig etc may also be used as lepa /ointment for
local application. (for local as well as internal medication).
If person doesn't get relief from above medicine that surgeon should follow the line of
treatment like Pitta Vidradhi.
 Madhuchisth ghrita prepared by processing of wax ,in ghrit with Yashtimadhu,
lodhra, raal , sarjras, manjistha, rakta Chandana and murva. (Su.Su.12/27-28)
30

31. इतरिा दनिसर्तत प्रकारा अधतरनण वद्यादृतन (Dalhana su.su. 12/15 )
The word Etartha Dagdha indicates the other kinds of burns
other then samyak dagdha Caused by the mistake of Vaidya.
 It is of two types
Snighda and Ruksha.
अग्निसधतप्तो ठह स्त्िनहेः सूक्ष्र्ससरािुसाररत्वात्त्विादीििुप्रपवश्याशु दहतत;
तस्त्र्ात ् स्त्िनहदनिनऽगिका रुजो र्वग्धत |(Su.Su.12/15)
Acharya stated that Snigdha Dagdha is more painful than
Ruksha because of its ability of penetrating into the minutest
vessels. 31

32. The diseases in which Agnikarma is indicated are due to vitiation
of vata and kapha, so Agnikarma is considered as better therapy to
pacify these doshas. Due to Ushna, Sukshma, thekshna and
Ashukari guna of Agni, it pacifies vitiated vata and kapha dosha.
As per Acharya Sushruta basically Agnikarma is used in two
manner i.e. one for रोि उधर्ूलि (diseases cure) and other for
Vedana Shamana (Pain Management).
 The diseases cure Agnikarma is used in assistance with surgery
and for pain Management, Agnikarma is used independently.
It also destroys the Vitiated tissue on wound surface by its
mechanical burn causing thermal injury. In this way it promotes
the healing in chronic non healing wounds.
32

33. Agnikarma
Ushna, Teekshna,
Sukshma Guna
Qualities Against Vata
& Kapha Dosha
Pacifies vata &
Reduces Kapha
Vedana Shamana
Reduces Pain 33
Agnikarma
Ushna guna
Improves
Dhatvagni
Manda
Dhatvagni gets
Pacified
Ama Pachana &
Vata Shamana

34. 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
Dahana karma is having the property of
sirasankochana by that quality even it helps for
raktha sthambana( haemostasis).
34

35. 35

36. छिन्नां छ्िःशेषतिः शनखनां दग्ध्वन
तैले् बुद्धिमन् ् |
ब््ीयनत् कोशबनिे् प्रनप्तां कनयं
च रोपणम्|| (Su. Chi. 2/37)
Wound that developed after
limb excision during trauma
should be treated with
Agnikarma using heated taila
and then bandaged In the
manner of kosha Bandha
followed by appropriate
Ropana Karma.
36

37. ग्रग्धििर्र्म प्रर्वाि अपक्वािुद्िृत्य चाग्निां पवदिीत पश्चात ्……(सु.गच.18/24)
A Granthi occurring in any part of the body other than a marma, not
suppurated, should be opened and Cauterized with fire.
According to Sushruta (सु.गच. 18/14)
A Kaphaja Granthi on any part of the Body other than a Marma &
not resolved should be incised even in its non suppurated stage and
removed. The expert surgeon should then cauterize the incidental
wound after the arrest of bleeding and treat like sadyavrana
treatment.
Mainly followed in Kaphaja and medoja Granthi
37

38. AGNIKARMA IN
KAPHAJA ARBUDA
अल्पनवशशष्टे कृ शमभक्षिते च शलखेत ्
ततो अग्निां पवदिीत पश्चनत ् |
(सु.धच.18/37)
When only a small remnant (of
the tumor) remains after the
worms have eaten, the area
should be scraped and
cauterized by Agnikarma;
AGNIKARMA IN
UPADAMSHA
दुष्टव्रणववधिां क
ु यनात् क
ु धितां मेह्ां
त्यजेत ् ।
जम्ब्वोष्ठनिाग्निवणेि पश्चनच्िेषां
दहेद्शभषक् || (Su.Chi.19/49-51)
The putrid portion of the
penis should be excised and
the remaining part should be
completely cauterized with
Jambaoshta Shalaka, made
red hot by Agni.
38

39. Agnikarma is one among the Shashti Upakrama.
स्रवतोऽश्र्र्वाधर्ूरां यन चाधयन रक्तवाठहिेः |
तिेःशनषग्रछधिसधिीांश्च साियनत्अग्निकर्मणा | (Su.Chi.1/89)
When there is bleeding in the basti after removal of
Ashmari then Agnikarma should be done for
RaktaStambhana.
During Surgical Procedure Any Bleeding Spots Should be
Controlled by AgniKArma
If there is Bleeding After An Injury from the cut ends , it
should be Cauterized by using AgniKarma 39

40.  Acording toAcharya Sushruta (Su.chi.20/9-11)
After Draining the Pus by cutting it with knife if
the Disease does not Subside then The affected
part should be cauterized with Agni and an oil
prepared with decoction of the drugs of the
Madhura (Kakolyādi) Gana should be applied for
healing.
The same course of treatment should also be
employed in a case of Kunakha (bad nail)
40

41. According to Su.Chi 19/22
If the intestines have
descended down to inguinal
region (Vamkṣaṇa), it should
be cauterized with a heated
Ardhacandra Salaka
(crescent-mouthed rod) to
prevent its descending down
into the scrotal sac.
41

42. 42
जतुमणण समुत्कृ त्य मषक
ां छतलकनलकम् ॥३२॥
िनरेण प्रदहेद्युक्तत्यन वन्नह्न वन श्ैिः श्ैिः ||( Su.chi.20/32)
The seats of affection should be scraped and gradually and
judicially cauterized by applying Kshara or agnikarma in case of
Jatumani,Mashaka & Tilakaalaka

43. चतुपवमिां यदनतद्गि रुगिरस्त्य तिवारणर्् ।
सधिािां स्त्कधदिां चव पाचिां दहिां तिा ||39||
व्रणां कषायेः सधििन रक्तां स्त्कधदयतन ठहर्र् ् |
तिा सम्पाचयनद्र्स्त्र् दाहेः सङ्कोचयनत ् ससराेः
||40|| (Su.Su/14/39-40)
Is one among the raktasthambhana
upanya i.e, sandhana, skandhana,
pachana and agnikarma.
Agnikarma has the property of
Contraction of Sira ( Vein) i.e.
SiraSankochana.
43

44. …With any of the three of these
preceding measures a physician
should try to check the flow of Rakta,
the process of cauterization should
be resorted which is considered as
the best among the four and should
be used as last resort.
Acharya Sushruta mentioned
Dahana Karma as one among the
Raktasthambanopaya, Currently in
Modern Surgery as well Agnikarma
is Utilized in the form of
Cauterization for Hemostatic
Purpose During Surgery.
44

45. • In Su.Su .12/10. Acharya Sushruta
has given Agnikarma Chikitsa in
the disease Charmakila which can
be correlated with warts in modern
science on the basis of visual
appearance.
• In Ch.Chi. 14/5 , Acharya Charaka
explained Charmakila as
Adhimansa and also advocated
Agnikarma Chikitsa for
Adhimansa
45
Wart in Axilla Application of
probe at base
of wart
Removed
wart Wound after
removal of wart

46. उत्कृ त्य दनध्वा स्त्िनहनि जयनत ्
कदरसांज्ञकर््॥Su.Chi.20/23॥
In Kadara, the lesion should
be excised and cauterised
with heated oil.
46

47.  Samanya Chiktsa of Bhagandara.
…अधतर्ुमखन चवां सम्यनयधरां प्रणणिाय प्रवाहर्ाणस्त्य
र्िधदरर्ुखर्ासाद्यषणीां दत्त्वा शस्त्रां पातयनत्; आसाध्य वाऽग्निां
क्षारां चनतत; एतत् सार्ाधयां सवेषु ।(Su.Chi.8/4)
…after the orifice is obtained, it is cut/incised by a
sharp instrument; If that (incising) is not possible,
then it should be Treated by AgniKarma (heated rod)
or by KsharaKarma ; this treatment is common for all
varieties of fistula.
 सवमतेः स्त्िाव र्ािांस्त्तु दहनद्वद्यस्त्तिाऽग्नििा |(Su.Chi.8/11)
All discharging Nadi (Channels) in the affected region
should be cauterized with fire by the surgeon.
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Agnikarma with gold
shalaka

48. चतुपवमिोऽशमसाां साििोपायेः । तद्यिा-र्नषजां क्षारोऽग्निेः शस्त्रसर्तत|
……कक
म शग्स्त्िरपृिुकठठिाधयग्नििा…. (Su.Chi.6/3)
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.
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49. 49

50. Excising tag with cautery
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51. 51
• In Current Practise of
Agnikarma, The shalaka is
modified with the heat
source being electricity
• The Shalaka has Different
Shape of Probe from
Various Specified use

52. 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.
52

53.  Electrocautery uses electrical current to heat a metal
wire that is then applied to the target tissue in order
to burn or coagulate the specific area of tissue.
 Electrosurgery passes electrical current through
tissue to accomplish a desired result. The electricity
used is a form of alternating current similar to the
that used to generate radio waves.
Uses
To stop bleeding from small vessels
To cut small tissues
Is often used in surgery to remove
unwanted or harmful tissue.
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54. Monopolar Bipolar
54

55.  Using a pencil instrument, the
active electrode is placed in the
entry site
 Uses : cut tissue and coagulate
bleeding.
 The return electrode pad is
attached to the patient.
 Most commonly used because of
its versatility and effectiveness.
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From the
generator
To the
electrode
Through
the target
tissue
To the
patient
return
pad

56. Passes the current between 2
tips of a forceps like a tool.
It prevents the flow of current
through other tissues of the body
and focuses only on the tissue in
contact.
This is useful in microsurgery
and in patients with cardiac
pacemaker
Gives better control over the
targeted area.
Helps prevent damage to other
sensitive tissues. 56

57. As with any procedure, there are potential risks to the patient, as
well as the operating physician.
 Patient’s consent.
 Fear of Scar formation
 Needs skill to perform
 Burns
 Transmission of Infection 57

58.  Agnikarma works by virtue of its guna but in some
places it works by mechanical degeneration of tissue.
Acharya Sushruta indicated Agnikarma in Arbuda,
bhagandar, Nadivrana and dushtavrana. Here
agnikarma works by its power of destroying the
Unhealthy granulation tissue by heat.
In contemporary Science also agnikarma has been
enumerated in different forms such as
monopolar,bipolar electro cautery
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59. Acharya sushruta mentioned Agnikarma as one
among Raktasthambanopaya, now in modern
surgery also Agnikarma is utilized in the form of
cauterization for haemostatic purpose.
Acharyas mentioned different materials to perform
Agnikarma in different structures for the
temperature regulatory purpose
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60.  The Technique and Equipment have become advanced but the basic
principle remains the same.
 Agnikarma therapy is result oriented to Vataja and Kaphaja disorders,
 Agnikarma, due to its usna, suksma, asukari guna pacifies the vata kapha
dosa and removes srotavarodha. Patient is effectively relieved from pain
and other associated symptoms.
 It is a good measure for haemostasias.
 There will be no recurrence of the disease which are managed by
Agnikarma
 According to Acharya Sushruta when bheshaja chikitsa, kshar chikitsa and
shastra chikitsa are unable to cure the disease then Agnikarma can be
used to treat the disease successfully.
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61. THANK YOU
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