Principles of Agnikarma and its Advances for Shonitsthapana (Hemostasis)

Abstract

Agnikarma has been one of the peculiar parasurgical procedures described in Sushrut Samhita. The most
important indication of Agnikarma is when there is bleeding from vessel or diseases in which bleeding is
expected. Technology and instruments used for hemostasis now a days differ from ancient ones. However
fundamental principle of heating the tissues remains same which is widely used in present era. Earlier rods
(shalaka) made from different metals were used for burning out bleeding veins. Red hot shalaka was applied
on tissues and bleeders so that contraction of vessels occurs. So hemostasis was achieved by cauterization of
tissues at high temperature. With advancement of technology in bio-medical engineering various machines
like Electrocautery, Infrared coagulation, Electrosurgical unit (high frequency and low frequency) and
LASERs were invented for similar purpose.
In Electrocautery electrical current is used to heat a metal wire to burn or coagulate the specific area
of tissue. In Electrosurgical unit alternating current is passed through tissue and heat is created by the
resistance of tissue to current. Electrodes are used to cut, coagulate or even fuse the tissue. IRC involves
the use of infrared light as a heat source to coagulate vessels supplying blood. Lasers are used to ablate the
veins in which amplified light energy is used to generate heat. Tissue dehydration, protein coagulation and
vaporization are the processes involved in achieving hemostasis.
Working principles and energy sources used in these devices vary from each other; however the hemostasis
is achieved by common fundamental principle i.e. generating heat which is similar to Agnikarma.