अग्निकर्मविध्यध्यायः
अथातोऽग्निकर्मविधिमध्यायं व्याख्यास्यामः ||१||
यथोवाच भगवान् धन्वन्तरिः ||२||
"Now, we shall expound the chapter on the procedure of using fire (cauterzation). "
"Thus said the venerable Dhanvantari."
This introduction sets the stage for discussing the methods and techniques for using fire in medical procedures, following the teachings of the revered Dhanvantari.
क्षारादग्निर्गरीयान् क्रियासु व्याख्यातः, तद्दग्धानां रोगाणामपुनर्भावाद्भेषजशस्त्रक्षारैरसाध्यानां तत्साध्यत्वाच्च ||३||
"Fire is considered superior to alkali in procedures, as diseases treated with cauterization do not recur and diseases that are untreatable with medicine, surgery, or alkali can be treated with it."
This shloka emphasizes the importance and superiority of cauterization in medical procedures. It highlights that fire treatment not only prevents the recurrence of diseases but also treats conditions that are resistant to other forms of treatment such as medicine, surgery, and alkali.
अथेमानि दहनोपकरणानि भवन्ति- तद्यथा- पिप्पल्यजाशकृद्गोदन्तशरशलाकाजाम्बवौष्ठेतरलौहाः क्षौद्रगुडस्नेहाश्च |
तत्र, पिप्पल्यजाशकृद्गोदन्तशरशलाकास्त्वग्गतानां, जाम्बवौष्ठेतरलौहा मांसगतानां, क्षौद्रगुडस्नेहाः सिरास्नायुसन्ध्यस्थिगतानाम् ||४||
"The following are the instruments used for cauterization: Pippali (long pepper), cow dung, teeth of animals, arrowheads, metal rods, Jambava (plowshares), and other iron instruments. Honey, jaggery, and oils are also used. Pippali, cow dung, teeth, and arrowheads are used for cauterizing surface conditions; Jambava, plowshares, and other iron instruments are used for deeper conditions; honey, jaggery, and oils are used for conditions involving veins, ligaments, joints, and bones."
This shloka describes various instruments and substances used for cauterization, emphasizing their specific applications based on the location and nature of the condition being treated.
तत्राग्निकर्म सर्वर्तुषु कुर्यादन्यत्र शरद्ग्रीष्माभ्यां; तत्राप्यात्ययिकेऽग्निकर्मसाध्ये व्याधौ तत्प्रत्यनीकं विधिं कृत्वा ||५||
"Cauterization can be performed in all seasons except autumn and summer; if it is necessary to perform cauterization during these times due to an emergency, appropriate precautions should be taken."
This shloka advises that cauterization is generally suitable for all seasons, with the exception of autumn and summer. However, if an emergency requires cauterization during these periods, it emphasizes the need to take appropriate countermeasures to ensure safety and efficacy.
सर्वव्याधिष्वृतुषु च पिच्छिलमन्नं भुक्तवतः; मूढगर्भाश्मरीभगन्दरोदरार्शोमुखरोगेष्वभुक्तवतः कर्म कुर्वीत ||६||
"In all diseases and seasons, cauterization can be done after consuming sticky foods; however, for conditions such as impacted fetus, urinary stones, fistula-in-ano, ascites, hemorrhoids, and mouth diseases, it should be done on an empty stomach."
This shloka provides guidelines on dietary considerations before performing cauterization, emphasizing that sticky foods can be consumed in general, but for certain conditions, the procedure should be performed on an empty stomach to ensure safety and efficacy.
तत्र द्विविधमग्निकर्माहुरेके- त्वग्दग्धं, मांसदग्धं च; इह तु सिरास्नायुसन्ध्यस्थिष्वपि न प्रतिषिद्धोऽग्निः ||७||
"Some say there are two types of cauterization: superficial and deep; however, here it is stated that fire can also be used on veins, ligaments, joints, and bones."
This shloka explains that cauterization can be categorized into two types: superficial, which affects the skin, and deep, which affects the muscles. It also mentions that fire can be used safely on veins, ligaments, joints, and bones, contrary to some opinions.
तत्र, शब्दप्रादुर्भावो दुर्गन्धता त्वक्सङ्कोचश्च त्वग्दग्धे, कपोतवर्णताऽल्पश्वयथुवेदना शुष्कसङ्कुचितव्रणता च मांसदग्धे; कृष्णोन्नतव्रणता स्रावसन्निरोधश्च सिरास्नायुदग्धे, रूक्षारुणता कर्कशस्थिरव्रणता च सन्ध्यस्थिदग्धे ||८||
"In superficial burns, there is a popping sound, foul odor, and skin contraction. In muscle burns, there is a pigeon-grey color, slight swelling, pain, dry and contracted wound. In burns involving veins and ligaments, there is a black, raised wound with a continuous discharge. In burns involving joints and bones, there is dryness, redness, roughness, and a firm wound."
This shloka describes the different characteristics and symptoms of burns at various depths, including superficial burns, muscle burns, and burns involving veins, ligaments, joints, and bones.
तत्र शिरोरोगाधिमन्थयोर्भ्रूललाटशङ्खप्रदेशेषु दहेत्, वर्त्मरोगेष्वार्द्रालक्तकप्रतिच्छन्नां दृष्टिं कृत्वा वर्त्मरोमकूपान् ||९||
"For head diseases and eye pain, cauterize the areas of the eyebrows, forehead, and temples. For eyelid diseases, cover the eye with moist red lac and cauterize the hair follicles of the eyelids."
This shloka provides specific guidelines for using cauterization to treat head diseases and eye pain by targeting specific areas such as the eyebrows, forehead, and temples, and for treating eyelid diseases by cauterizing the hair follicles of the eyelids after covering the eye with moist red lac.
त्वङ्मांससिरास्नायुसन्ध्यस्थिस्थितेऽत्युग्ररुजि वायावुच्छ्रितकठिनसुप्तमांसे व्रणे ग्रन्थ्यर्शोऽर्बुदभगन्दरापचीश्लीपदचर्मकीलतिलकालकान्त्रवृद्धिसन्धिसिराच्छेदनादिषु नाडीशोणितातिप्रवृत्तिषु चाग्निकर्म कुर्यात् ||१०||
"Cauterization should be performed on wounds and conditions involving the skin, muscles, veins, ligaments, joints, and bones that have severe pain, are hard, elevated, and numb due to vitiated Vata. It should also be used for wounds, nodules, hemorrhoids, tumors, fistula-in-ano, abscesses, elephantiasis, warts, freckles, black moles, prolapsed or displaced joints, ligaments, or veins, and for excessive discharge from fistulae or wounds."
This shloka provides detailed guidelines for using cauterization in various conditions, emphasizing its application for severe pain, hard and elevated tissues, and specific diseases involving wounds, nodules, tumors, and excessive discharges.
तत्र वलय-बिन्दु-विलेखा-प्रतिसारणानीति दहनविशेषाः ||११||
"Among them, the different types of cauterization are circular (valaya), dot-like (bindu), line-like (vilekha), and rubbing (pratisarana)."
This shloka describes the different techniques of cauterization, categorizing them into four types based on their shapes and methods: circular, dot-like, line-like, and rubbing.
भवति चात्र-
रोगस्य संस्थानमवेक्ष्य सम्यङ्नरस्य मर्माणि बलाबलं च |
व्याधिं तथर्तुं च समीक्ष्य सम्यक् ततोऽव्यवस्येद्भिषगग्निकर्म ||१२||
"Here, considering the location of the disease, the vital points of the person, their strength and weakness, and the season, a physician should skillfully decide on the use of cauterization."
This shloka emphasizes the importance of a thorough assessment of the disease, the patient's vital points, their overall strength and weakness, and the season before deciding on the appropriate use of cauterization.
तत्र सम्यग्दग्धे मधुसर्पिर्भ्यामभ्यङ्गः ||१३||
"When properly cauterized, massage with honey and ghee."
This shloka recommends massaging with honey and ghee as a treatment for wounds that have been properly cauterized, promoting healing and soothing the affected area.
अथेमानग्निना परिहरेत्- पित्तप्रकृतिमन्तःशोणितं भिन्नकोष्ठमनुद्धृतशल्यं दुर्बलं बालं वृद्धं भीरुमनेकव्रणपीडितमस्वेद्यांश्चेति ||१४||
"These individuals should be avoided for cauterization: those with a pitta constitution, internal bleeding, ruptured abdomen, unremoved foreign bodies, weakness, children, the elderly, the fearful, those with multiple wounds, and those who do not sweat."
This shloka lists the contraindications for cauterization, emphasizing that individuals with certain conditions should not undergo this procedure to avoid complications and adverse effects.
अत ऊर्ध्वमितरथादग्धलक्षणं वक्ष्यामः |
तत्र, स्निग्धं रूक्षं वाऽऽ(चा)श्रित्य द्रव्यमग्निर्दहति; अग्निसन्तप्तो हि स्नेहः सूक्ष्मसिरानुसारित्वात्त्वगादीननुप्रविश्याशु दहति; तस्मात् स्नेहदग्धेऽधिका रुजो भवन्ति
||१५||
"Now we shall describe the signs of burns caused by other means. The fire burns substances by adhering to oily or dry properties; when heated by fire, oil penetrates the fine vessels of the skin and tissues and burns quickly; therefore, burns caused by oil are more painful."
This shloka explains the mechanism of burns caused by different substances, highlighting that oil, when heated, penetrates the skin and tissues quickly, resulting in more painful burns.
तत्र प्लुष्टं दुर्दग्धं सम्यग्दग्धमतिदग्धं चेति चतुर्विधमग्निदग्धम् |
तत्र यद्विवर्णं प्लुष्यतेऽतिमात्रं तत् प्लुष्टं; यत्रोत्तिष्ठन्ति स्फोटास्तीव्राश्चोषदाहरागपाकवेदनाश्चिराच्चोपशाम्यन्ति तद्दुर्दग्धं; सम्यग्दग्धमनवगाढं तालवर्णं सुसंस्थितं पूर्वलक्षणयुक्तं च; अतिदग्धे मांसावलम्बनं गात्रविश्लेषः सिरास्नायुसन्ध्यस्थिव्यापादनमतिमात्रं ज्वरदाहपिपासामूर्च्छाश्चोपद्रवा भवन्ति, व्रणश्चास्य चिरेण रोहति, रूढश्च विवर्णो भवति |
तदेतच्चतुर्विधमग्निदग्धलक्षणमात्मकर्मप्रसाधकं भवति ||१६||
"There are four types of burns: superficial (plusta), deep (durdagdha), well-cauterized (samyakdagdha), and excessively cauterized (atidagdha).
Superficial burns are discolored and overcauterized;
Deep burns have blisters, intense heat, redness, and pain that subside slowly;
Well-cauterized burns are not deep, have a red color, and are stable with earlier signs;
Excessively cauterized burns result in tissue hanging, body separation, damage to veins, ligaments, joints, and bones, along with high fever, burning sensation, thirst, and fainting as complications. Such wounds take a long time to heal and leave discolored scars.
These four types of burn symptoms are indicative of the effectiveness of cauterization."
This shloka categorizes burns into four types based on their severity and symptoms, providing detailed descriptions of each type. It highlights the importance of correctly identifying the type of burn to ensure appropriate treatment and care.
भवन्ति चात्र-
अग्निना कोपितं रक्तं भृशं जन्तोः प्रकुप्यति |
ततस्तेनैव वेगेन पित्तमस्याभ्युदीर्यते ||१७||
तुल्यवीर्ये उभे ह्येते रसतो द्रव्यतस्तथा |
तेनास्य वेदनास्तीव्राः प्रकृत्या च विदह्यते ||१८||
स्फोटाः शीघ्रं प्रजायन्ते ज्वरस्तृष्णा च बाधते |१९|
"Here, blood irritated by fire greatly aggravates the body. Consequently, pitta increases rapidly. Both are similar in potency and nature. Thus, the pain becomes intense and there is burning sensation naturally. Blisters form quickly, and fever and thirst also trouble the individual."
These shlokas explain the effects of fire on the body, emphasizing how it irritates blood and aggravates pitta, leading to intense pain, burning sensations, quick formation of blisters, fever, and thirst.
दग्धस्योपशमार्थाय चिकित्सा सम्प्रवक्ष्यते ||१९||
प्लुष्टस्याग्निप्रतपनं कार्यमुष्णं तथौषधम् |
शरीरे स्विन्नभूयिष्ठे स्विन्नं भवति शोणितम् ||२०||
प्रकृत्या ह्युदकं शीतं स्कन्दयत्यतिशोणितम् |
तस्मात् सुखयति ह्युष्णं ननु शीतं कथञ्चन ||२१||
"Now, the treatment for burns will be described. For superficial burns, heat and warm medicines should be applied. When the body is well-heated, the blood also becomes heated. Cold water, by nature, causes coagulation of the blood. Therefore, warmth provides comfort, while cold should be avoided in any case."
These shlokas describe the treatment for burns, emphasizing the importance of using heat and warm medicines for superficial burns. It explains that heating the body helps in treating burns and preventing blood coagulation, while cold treatments are to be avoided.
शीतामुष्णां च दुर्दग्धे क्रियां कुर्याद्भिषक् पुनः |
घृतालेपनसेकांस्तु शीतानेवास्य कारयेत् ||२२||
"For deep burns, a physician should alternate between cold and warm treatments. Cold applications of ghee, ointments, and irrigations should be used for such burns."
This shloka describes the treatment for deep burns, recommending a combination of cold and warm treatments. It emphasizes the use of cold applications of ghee, ointments, and irrigations to provide relief and promote healing.
सम्यग्दग्धे तुगाक्षीरीप्लक्षचन्दनगैरिकैः |
सामृतैः सर्पिषा स्निग्धैरालेपं कारयेद्भिषक् ||२३||
ग्राम्यानूपौदकैश्चैनं पिष्टैर्मांसैः प्रलेपयेत् |
पित्तविद्रधिवच्चैनं सन्ततोष्माणमाचरेत् ||२४||
"For well-cauterized burns, a physician should apply ointments made from Tugaksheeri (bamboo manna), Plaksha (fig), Sandalwood, and Red ochre, mixed with ghee. The burns should also be covered with a paste made from the meat of domestic, aquatic, and marshy animals. The treatment should be carried out with continuous warmth, similar to treating pitta-induced abscesses."
These shlokas describe the treatment for well-cauterized burns, recommending the application of ointments made from specific herbs and substances mixed with ghee. It also advises covering the burns with a paste made from the meat of various animals and maintaining continuous warmth during the treatment.
अतिदग्धे विशीर्णानि मांसान्युद्धृत्य शीतलाम् |
क्रियां कुर्याद्भिषक् पश्चाच्छालितण्डुलकण्डनैः ||२५||
तिन्दुकीत्वक्कपालैर्वा घृतमिश्रैः प्रलेपयेत् |
व्रणं गुडूचीपत्रैर्वा छादयेदथवौदकैः ||२६||
क्रियां च निखिलां कुर्याद्भिषक् पित्तविसर्पवत् |२७|
"For excessively cauterized burns, the physician should remove the damaged flesh and apply a cool treatment using ground rice. Alternatively, a paste made from the bark of Tinduka mixed with ghee can be applied. The wound can also be covered with Guduchi leaves or cold compresses. The entire treatment should be similar to that for pitta-induced spreading inflammation (Visarpa)."
These shlokas provide guidelines for treating excessively cauterized burns, emphasizing the removal of damaged tissue and the application of cooling treatments using ground rice, Tinduka bark paste, Guduchi leaves, or cold compresses. The overall treatment approach should be similar to that for pitta-induced spreading inflammation.
मधूच्छिष्टं समधुकं रोध्रं सर्जरसं तथा ||२७||
मञ्जिष्ठां चन्दनं मूर्वां पिष्ट्वा सर्पिर्विपाचयेत् |
सर्वेषामग्निदग्धानामेतद्रोपणमुत्तमम् ||२८||
"Mixing beeswax with licorice, lodhra, sarjarasa, manjishta, sandalwood, and murva, and cooking it with ghee makes an excellent healing ointment for all types of burns."
These shlokas describe the preparation of a healing ointment for burns, emphasizing the use of beeswax mixed with specific herbs and cooked with ghee to create an effective treatment.
स्नेहदग्धे क्रियां रूक्षां विशेषेणावचारयेत् |२९|
"For burns caused by oil, a dry treatment should be applied with special care."
This shloka advises using dry treatments specifically for burns caused by oil, highlighting the need for special care in such cases.
अत ऊर्ध्वं प्रवक्ष्यामि धूमोपहतलक्षणम् ||२९||
श्वसिति क्षौति चात्यर्थमप्याधमति कासते |
चक्षुषोः परिदाहश्च रागश्चैवोपजायते ||३०||
सधूमकं निश्वसिति घ्रेयमन्यन्न वेत्ति च |
तथैव च रसान् सर्वान् श्रुतिश्चास्योपहन्यते ||३१||
तृष्णादाहज्वरयुतः सीदत्यथ च मूर्च्छति |
धूमोपहत इत्येषः शृणु तस्य चिकित्सितम् ||३२||
सर्पिरिक्षुरसं द्राक्षां पयो वा शर्कराम्बु वा |
मधुराम्लौ रसौ वाऽपि वमनाय प्रदापयेत् ||३३||
वमतः कोष्ठशुद्धिः स्याद्धूमगन्धश्च नश्यति |
विधिनाऽनेन शाम्यन्ति सदनक्षवथुज्वराः ||३४||
दाहमूर्च्छातृडाध्मानश्वासकासाश्च दारुणाः |
मधुरैर्लवणाम्लैश्च कटुकैः कवलग्रहैः ||३५||
सम्यग्गृह्णातीन्द्रियार्थान् मनश्चास्य प्रसीदति |
शिरोविरेचनं चास्मै दद्याद्योगेन शास्त्रवित् ||३६||
दृष्टिर्विशुध्यते चास्य शिरोग्रीवं च देहिनः |
अविदाहि लघु स्निग्धमाहारं चास्य कल्पयेत् ||३७||
"Now, I shall describe the symptoms of smoke inhalation. The person breathes heavily, coughs intensely, sneezes, and feels a burning sensation in the eyes, accompanied by redness. They inhale smoke, and their sense of smell is impaired. They lose their sense of taste and hearing. They suffer from thirst, burning sensation, fever, fatigue, and fainting. These are the symptoms of smoke inhalation. Listen to the treatment for it.
Administer ghee, sugarcane juice, grapes, milk, or sugar water. Sweet and sour liquids can also be given to induce vomiting. Vomiting clears the stomach and eliminates the smell of smoke. This procedure alleviates conditions like intense sneezing and fever, burning, fainting, thirst, bloating, breathlessness, and severe coughing. Using sweet, salty, sour, and pungent mouthwashes, the patient regains their sensory perceptions, and their mind calms down. Head cleansing treatments should be given according to the proper method. Their vision clears, and their head and neck feel refreshed. Provide a light, non-irritating, and nourishing diet."
These shlokas describe the symptoms and treatment of smoke inhalation, emphasizing the use of ghee, sugarcane juice, grapes, milk, sugar water, and inducing vomiting to clear the stomach and alleviate symptoms. The treatment also includes head cleansing and providing a nourishing diet.
उष्णवातातपैर्दग्धे शीतः कार्यो विधिः सदा |
शीतवर्षानिलैर्दग्धे स्निग्धमुष्णं च शस्यते ||३८||
तथाऽतितेजसा दग्धे सिद्धर्नास्ति कथञ्चन |
इन्द्रवज्राग्निदग्धेऽपि जीवति प्रतिकारयेत् |
स्नेहाभ्यङ्गपरीषेकैः प्रदेहैश्च तथा भिषक् ||३९||
"For burns caused by heat, wind, or sunlight, a cooling treatment is always recommended. For burns caused by cold, rain, or wind, a warm and oily treatment is beneficial. When burns are caused by extreme heat, there is generally no effective treatment. However, even for burns caused by Indra's thunderbolt or fire, one may survive with proper treatment, which includes the use of oil massages, warm baths, and poultices."
These shlokas provide guidelines for treating burns based on their causes. They recommend cooling treatments for burns caused by heat and warm, oily treatments for burns caused by cold. They also emphasize the importance of proper treatment for survival even in cases of severe burns caused by extreme heat or other intense sources.
इति सुश्रुतसंहितायां सूत्रस्थानेऽग्निकर्मविधिर्नाम द्वादशोऽध्यायः ||१२||
"Thus ends the twelfth chapter named 'Agnikarmavidhi' in the Sutra Sthana section of the Sushruta Samhita."
This verse signifies the conclusion of the twelfth chapter called 'Agnikarmavidhi' in the Sutra Sthana section of the Sushruta Samhita, which discusses the procedures and techniques for using fire (cauterization) in medical treatments.