Agnikarma means an action performed with fire, or an action connected with fire. Vidhi means its prescribed method. Others read the title as Agnikarmiya, meaning a chapter composed on agnikarma.
Key terms
agnikarma
Action performed with fire or connected with fire.
In therapeutic actions, fire is described as superior to kshara, because diseases treated by its burning do not recur and because it can treat diseases not amenable to medicines, sharp instruments or kshara.
The superiority concerns therapeutic actions, not every property. Kshara remains foremost in properties such as acting against three doshas and performing cutting, opening and scraping. Both are superior in their own sphere, just as Karna excels Arjuna in striking firmly, while Arjuna excels Karna in shooting far. Nonrecurrence applies to curable conditions properly cauterised; otherwise even a cauterised condition can recur. Others explain that after lesions such as arbuda have been completely eradicated by fire, improper diet and related causes may provoke doshas anew, producing another lesion at the same site resembling the former one. Some read 'sveda, instruments and kshara' instead of 'medicines, instruments and kshara.' On that reading, bhagandara and arshas first receive sveda and then instrumentation. Alternatively, sveda represents medicinal treatment generally: instruments follow when medicines cannot accomplish the task, kshara addresses disease left after instruments, and fire addresses deeply rooted disease beyond kshara.
The text names these cauterisation implements and substances: pippali, goat dung, a cow's tooth, a reed implement, jambavaushtha and other metal implements, honey, jaggery and fats. Pippali, goat dung, a cow's tooth and a reed implement are assigned to skin conditions; jambavaushtha and other metal implements to flesh conditions; honey, jaggery and fats to conditions associated with vessels, sinews, joints and bones.
Ajashakrit means goat dung. Jambavaushtha is a black-stone implement with a tip resembling a jambu fruit. Other metals include copper and silver and their fashioned implements. The conjunction also includes sarjarasa, beeswax and related substances. Skin conditions mean vata-kapha disorders such as numbness; the same dosha qualification applies to flesh and deeper structures. An objection cites Kashyapa's prohibition against excising or burning a bite at vessels, sinews, joints, bones and vital points. The commentator explains that the present burning of vessels and similar structures is an emergency response to excessive bleeding after their division, rather than an attempt to destroy disease directly within them. Burning the flesh is said to address disease in deeper structures. Bhadrashaunaka is quoted as saying that vayu in skin and flesh subsides through burning the skin, whereas disorders arising in vessels, sinews, bones and joints subside when the flesh is burnt.
Key terms
jAmbavauShTaM
A black-stone implement with a jambu-fruit-like tip.
The text permits agnikarma in all seasons except autumn and summer. Even in those seasons, for an urgent disease amenable to agnikarma, it allows the procedure after measures opposing the seasonal conditions have been arranged.
The general permission is limited by the exception for autumn and summer. Atyayika means rapidly life-threatening. Measures opposing these fire-like seasons include cooling coverings, food, applications and similar arrangements. The instruction to perform agnikarma carries forward. Some readings omit vidhi.
सर्वव्याधिष्वृतुषु च पिच्छिलमन्नं भुक्तवतः; मूढगर्भाश्मरीभगन्दरोदरार्शोमुखरोगेष्वभुक्तवतः कर्म कुर्वीत ||६||
Meaning of the śloka
For the diseases and seasons concerned, the text generally places agnikarma after a meal of picchila food. In mudhagarbha, ashmari, bhagandara, udara, arshas and oral diseases, however, the procedure is described for a person who has not eaten.
Picchila food possesses picchila potency; cold, soft and picchila qualities are said to counter pitta. Food is excluded in the listed conditions because upward or downward urges could interrupt the procedure, and in some cases because space in the abdomen is lacking. Some omit the passage beginning with mudhagarbha and ashmari.
Some authorities describe two kinds of agnikarma: burning the skin and burning the flesh. In this teaching, however, fire is not prohibited even in relation to vessels, sinews, joints and bones.
The first statement presents the view of some authorities; the second gives this treatise's position. The intended application to vessels and similar structures has already been explained. Others restrict this permission to urgent, life-threatening disease, excluding other circumstances.
The text includes agnikarma for intensely painful vayu in skin, flesh, vessels, sinews, joints or bones; a wound with raised, hard and insensible flesh; granthi, arshas, arbuda, bhagandara, apachi, shlipada, charmakila, tilakalaka and antravriddhi; conditions involving division of joints or vessels and similar injuries; nadi lesions; and excessive bleeding.
The remaining applications are explained according to the condition present. Intensely painful vayu means vayu with severe pain. Raised flesh means elevated flesh, and supta means lacking sensation. Nadi is a particular wound type.
भवति चात्र- रोगस्य संस्थानमवेक्ष्य सम्यङ्नरस्य मर्माणि बलाबलं च |
व्याधिं तथर्तुं च समीक्ष्य सम्यक् ततोऽव्यवस्येद्भिषगग्निकर्म ||१२||
Meaning of the śloka
A verse states: after carefully considering the disease's form, the person's vital points and strength or weakness, and examining the disease and season properly, the physician should decide on agnikarma.
The elongated or other shape of a disease such as granthi guides the choice of a ring or other pattern. Vital points must be avoided. Strength and weakness concern the patient: strength permits undertaking the procedure, weakness calls for avoidance. Vata-kapha disease permits it, while conditions such as rakta-pitta call for avoidance. Seasons such as hemanta permit it; autumn and summer generally do not. Repeated expressions for careful examination stress attention both to circumstances for undertaking and for avoiding the procedure. Adhyavasyet is explained as performing the action. Some replace the first 'having examined properly' with 'then having understood'; viditva means having known.
Key terms
marmANi
Vital points to consider and avoid.
balAbalaM
Patient strength and weakness.
Adhikarana ௧௨ (௧௩) · Śloka ௧௩
தத்ர ஸம்யக்தக்தே மதுஸர்பிர்ப்யாமப்யங்கஃ ||௧௩||
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तत्र सम्यग्दग्धे मधुसर्पिर्भ्यामभ्यङ्गः ||१३||
Meaning of the śloka
For a properly cauterised site, the text specifies an application of honey and ghee.
The text excludes the following people from agnikarma: someone of pitta constitution, someone with internal bleeding or a breached body cavity, someone with a foreign body still unremoved, a weak person, a child, an elderly person, a fearful person, someone afflicted by many wounds, and those considered unsuitable for svedana.
The commentary explains that, in the circumstances of internal bleeding and a breached cavity, obstructing the blood can give rise to burning, suppuration and related problems. Some readers substitute 'afflicted by many diseases' for 'afflicted by many wounds'. Those unsuitable for svedana include the groups listed elsewhere beginning with persons with pandu, prameha, raktapitta or distressing thirst.
Key terms
anuddhRutashalyaM (anuddhṛtaśalyam)
Someone with a foreign body that has not been removed.
The text next describes the signs of burns occurring in other ways. Fire burns through either an unctuous or a dry material. It explains that fat heated by fire quickly burns the skin and other structures because it enters them by following the fine siras. Burns involving hot fat are therefore said to produce greater pain.
'Burnt in another way' distinguishes accidental burning, occurring without a physician, from the previously described patterns such as circular cauterisation. Unctuous material includes ghee; dry material includes wood, stone and clods of earth.
Key terms
sUkShmasirAnusAritvAt (sūkṣmasirānusāritvāt)
Because of following the fine siras, the source's explanation for the penetration of heated fat.
snehadagdhe
In a burn caused by hot fatty or unctuous material.
Burning by fire is divided into four kinds: plushta, durdagdha, samyagdagdha and atidagdha. Plushta changes the colour and produces intense burning. In durdagdha, blisters arise, with severe sensations of heat, burning, redness, suppuration and pain that take a long time to subside. Samyagdagdha is not excessively deep, has the colour of a tala fruit, has a well-formed appearance, and possesses the signs described earlier. In atidagdha, flesh hangs loose, parts of the body separate, and siras, snayus, joints and bones are damaged. Severe fever, burning, thirst and fainting occur as complications. Its wound takes a long time to heal and remains discoloured after healing. Knowing these four sets of signs supports the physician's work.
The four kinds can result from a physician's fault or from an accident. Although plushta and durdagdha both fall under insufficient burning, they are distinguished because their signs and treatment differ. Repeating that there are four kinds prevents their being collapsed into a threefold classification. In plushta, the colour differs from the normal colour and burning is intense, but blisters do not arise. An alternative reading describes a markedly pale area that appears as though made to sweat by the fire's heat. In durdagdha, chosha denotes a drawing or sucking kind of pain; daha feels as though the part were being reduced to ash; raga means redness; and vedana includes the other sensations of heat and pain.
For samyagdagdha, 'not deep' means free of the signs of excessive burning. The colour is that of a ripe tala fruit, as made explicit in two alternative readings. A well-formed appearance lacks defects such as excessive elevation or depression. The earlier signs are those given for cauterisation of skin, flesh, siras, snayus, joints and bones. In atidagdha, separation means disintegration and damage means injury to those structures. 'Excessive' qualifies each complication, including fever and the others, and the connecting word also brings in bleeding and similar events.
The statement that all four kinds support the physician's work raises an objection: surely only proper cauterisation assists the physician? The answer distinguishes what is to be attained from what is to be avoided. The signs of samyagdagdha guide the intended result, while recognising the other three guides avoidance. A variant says these signs support the previously described procedures. Its interpreters take this either as clarifying the signs of the earlier skin- and flesh-based cauterisation, or as assisting the procedures prescribed for head disorders, adhimantha and other conditions by distinguishing desirable from undesirable results. Another variant adds a connecting 'and'. Its interpreters understand the statement as referring to treatment by the measures already taught, beginning with honey and ghee for a properly cauterised site, while the added word also includes the measures to be taught subsequently, such as warming in plushta.
Key terms
pluShTaM (pluṣṭam)
A burn category with altered colour and intense burning but, in the commentary, no blisters.
durdagdhaM (durdagdham)
A burn category characterised here by blisters and persistent severe symptoms.
samyagdagdham
Proper cauterisation, distinguished by the specified colour, depth and appearance.
atidagdham
Excessive burning, involving tissue damage and severe complications.
Verses on this subject state that fire intensely aggravates a person's rakta, and through that same force pitta is stirred up. The two are described as alike in potency, taste and material nature. Severe pain and burning follow; blisters develop quickly, and fever and thirst cause distress.
The commentary explains the affected dushya and dosha in order to introduce treatment of burns. Pitta is stirred up by both the fire and the affected blood. In the first interpretation, 'the two' means fire and pitta: both have hot potency, both are described as pungent in taste, and their material supports are said to be similar. Dravya here means the support of taste and other qualities. Aggravation of pitta by fire produces burning and related pain, while burning also follows from its inherent nature. The affected rakta and pitta together are said to produce blisters, fever and other symptoms quickly.
Other interpreters understand 'the two' as rakta and pitta. They explain hot potency, despite the sweetness attributed here to them, through the ability to cause burning, comparing this with mechanically pressed sugarcane juice. In this interpretation dravya concerns both cause and support: tejas is described as the cause and the support of both rakta and pitta. The two interpretations are distinct and are not resolved into one identification.
Key terms
tulyavIrye (tulyavīrye)
Having the same potency, explained here as hot potency.
dUShya (dūṣya)
The affected constituent, here rakta in the account introducing burn treatment.
tejo (tejaḥ)
Tejas, identified in one interpretation as the cause and support of rakta and pitta.
The text now describes treatment intended to ease burns. For plushta it prescribes warming by fire and warm medicinal measures. It states that, when the body is thoroughly warmed, the blood is also warmed. Water is naturally cold and is said to make the blood congeal strongly. On this reasoning the passage says warmth brings relief in plushta, whereas cold does not.
Warming by fire is explained as svedana. Warm medicinal measures include applications, food and drink. The commentary asks why treatment here addresses the body rather than directly calming the rakta and pitta aggravated by fire. It answers that even a small amount of blood remaining unwarmed can cause distress under the cooling measures ordinarily used to calm rakta and pitta. Cold is said to make the blood congeal; the thickened blood then obstructs vayu, and heat cannot escape. The commentary attributes the pain, swelling, redness and related symptoms of plushta to this obstruction. Warm measures are instead said to liquefy the blood, permit heat to leave and allow vata to move in its proper direction, thereby producing relief. This is the source's explanation of its prescribed measures.
Key terms
agnipratapanaM (agnipratapanam)
Warming by fire, glossed in the commentary as svedana.
skandayati
Causes to congeal, describing the effect attributed here to cold on blood.
The text describes cooking ghee with ground beeswax, madhuka, rodhra, sarjarasa, manjishtha, chandana and murva. It calls this an excellent preparation for healing burns caused by fire.
The commentary presents this as a general wound-healing ghee for fire burns. It notes that some recensions include the preparation, whereas the nibandha authors do not. The commentator says that he has also recorded it because of its usefulness.
Key terms
madhUcchiShTaM (madhūcchiṣṭam)
Beeswax, an ingredient in the stated ghee preparation.
ropaNam (ropaṇam)
Healing of the burn wound, as claimed for the preparation.
उष्णवातातपैर्दग्धे शीतः कार्यो विधिः सदा |
शीतवर्षानिलैर्दग्धे स्निग्धमुष्णं च शस्यते ||३८||
तथाऽतितेजसा दग्धे सिद्धर्नास्ति कथञ्चन |
इन्द्रवज्राग्निदग्धेऽपि जीवति प्रतिकारयेत् |
स्नेहाभ्यङ्गपरीषेकैः प्रदेहैश्च तथा भिषक् ||३९||
Meaning of the śloka
For injury resembling a burn from hot wind or sunlight, the text specifies cooling treatment. For injury from cold or rain-bearing wind, it commends unctuous and warming measures. It states that burning by extremely intense fire has no successful treatment. It also says that a person burned by the fire of Indra's thunderbolt should still be treated if alive, with unctuous applications, oil massage, pouring treatments and pastes.
The commentary extends the discussion of burns to similar injuries. Hot wind means summer or autumn wind; the effects of hot wind and sunlight resemble burning. The plural wording includes other unnamed sources of heat. Some read 'in a wound' rather than 'always,' explaining wound here as its bodily site, such as the skin. Cold refers to snow or frost, whose injury also resembles burning; rain-wind means wind accompanied by rain. The plural includes other unmentioned cold exposures. Some read 'injured' instead of 'burned.' Extremely intense fire is explained as thunderbolt fire. The statement that such severe burning is untreatable is understood to imply that a slight burn may nevertheless respond, using the previously described cooling or warming measures as appropriate. Some recensions then include the lines about treating a living person burned by Indra's thunderbolt with unctuous applications, massage, pouring and pastes; the nibandha authors do not include them.
Key terms
atitejasA (atitejasā)
By extremely intense fiery force, explained here as thunderbolt fire.
parIShekaiH (parīṣekaiḥ)
With pouring treatments in the historical treatment description.