VIDDHAKARMA POINTS 1
In practice, one question always comes in our mind is, is there any treatment in Ayurveda to stop the pain immediately. No one has shown to us and we have never seen such treatment. But in my professional career of so many years I can assure you that Ayurveda has such treatment to stop the pain immediately. This treatment of pain relief is described by Sushruta in chapter of Viddha chikitsa. Of course he has described that wherever raktamokshan is not possible (Blood letting) you can go for Viddha chikitsa (To bore a hole to drain). SO this Viddha chikitsa is also used in various diseases other than pain treatment, For Example: to drain the accumulated fluid in Jatodak awastha (Ascites), to let out entrapped vaayu in circulation of blood vessels, to let out pus in vidradhi (abscess). When Viddha chikitsa is used for pain relief, then different measurements are described according to site of pain. If blood vessel is clearly visible at the site described then raktamokshan should be done first, as described by Ayurveda. But site like ear nose where blood vessels are not clearly visible, we have to do Viddha chikitsa. Viddha word has meaning ‘deep wound’. When we have to let accumulation from the site, then this wound should be hollow. The needle we use for siravyadha is also hollow instrument. When we do raktamokshan for pain relief by siravyadh we use blood pressure instrument to assist us. Text describes that such site should be tied or such site should be kept hanging. But instead of this, cuff of BP instrument acts as a good tourniquet to give pressure on the vein and make it clearly visible. It helps to monitor blood pressure also because if blood pressure falls bellow 90 mmHg systolic then there are chances of gangrene, especially when we perform siravyadh at the site with very small finger like capillaries. Medico legally it is very important to monitor gangrene like side-effects during siravyadh.
After draining, do not stop the oozing blood immediately. Let it come out side naturally. And wait for it to stop naturally. During this process we can monitor the positive blood pressure. After blood stops completely we remove the needle. Hence taking all these aspects into consideration, it is very useful to use BP instrument for siravyadh in present era. It is useful in aspect of patient as well as the doctor.
In siravyadh and Agni karma treatment Viddha chikitsa is performed first and then followed by Agnikarma. Even in texts same pattern is described. Reason behind this is; Agni karma is indicated in severe pain but in diseases like sciatica, frozen shoulder, pain is present in large area, in such area it is difficult to perform Agni karma and patient refuses to perform it at many sites.
In such cases, all points where Viddha chikitsa is indicated we can perform Agnikarma & it has been proved to be fruitful. In Ayurveda, treatments advised to relieve pain include Snehan, Swedan, mardan, bandhan, Viddha and then Agnikarma. So inference can be drawn that if pain is not relieved by Viddha chikitsa then perform Agnikarma for pain relief. And it is seen in practice that when pain is not relieved by Viddha in that case Agnikarma is seen to be useful. When we perform Viddha chikitsa raktamokshan is the first choice. Principle behind this is after Viddha impure blood come out first which is cause of disease. For Viddha chikitsa, Ayurveda has described different types of needles, length of such needle is described as ‘Yavamatra’ or ‘Vrihimatra’ commonly, it appears to be 11 to 13 mm. In ancient time ‘Aara’ instrument was used for this purpose. But now it is difficult to use such instruments. Practically it is difficult for patient to sustain, hence we use needle for this purpose. Insulin needle has exact measurement of 11mm in length and 0.45 mm in breadth. So we can achieve exact Viddha up to Yava, Vrihi, Ardha Vrihi proportion. (It comes approx. 4-6 mm as 1 Yava or Vrihi. and 2-4 mm as ½ Yava or Vrihi) insulin needle is used for Viddha. We can use it to relieve pain up to mamsa dhatu. This needle produces very little amount of blood letting, so patient doesn’t get frightened. After practice, we can use this needle to make Viddha at the base of tongue at palate. For newcomers it is little difficult to use such needle to perform Viddha at such places. Hence such newcomer Doctors should use insulin needle to perform such Viddha. There are indications for how deep we should prick the needle. For Example: When pain or tingling present only in skin, then Viddha should be performed up to the skin level.
When disease in mamsa dhatu, we perform Viddha little deep so as to reach up to mansa dhatu. This is generally up to ¼ vrihi and when we have to perform it up to bone, vessels, tendon, then full 1 vrihi Viddha should be performed which is deeper. In obese patient, insulin needle is not so much useful. Needle no 24 is used in such cases. This needle should be used carefully. When insulin needle is small, it is very safe for the patients.
Ayurveda has described various points for Viddha. But even if we make Viddha nearby these points it is also very useful. Viddha chikitsa should not be performed on small children, pregnant women, old persons. Though these people are contraindicated for Viddha as per texts, we can perform Viddha by using instruments which we use now. As these instruments are very safe and do not create any side effects in these people. Only problem occurs in small children is that they do not sit in required proper position of Viddha. Hence it becomes difficult to perform Viddha in them. But we can perform Viddha in pregnant women and old people very neatly. As stated earlier, because of safe instruments we can perform Viddha in these people without any complications. This is my routine experience. Viddha or raktamokshan is contraindicated in following environmental conditions; namely cloudy weather, during rain and at night. Though these contraindications are described in texts, we can perform Viddha even in these conditions with the help of some artificial assistance. These natural conditions don’t create any hazard for us. But it is observed that Viddha performed in such natural conditions doesn’t get well performed. In cold conditions, Viddha is not fully achieved. In spite of all this we can perform Viddha in such conditions without any complications. When patient is in acute condition, we should not consider these contraindications. Viddha or Agni karma should be performed immediately. For example: colicky pain, appendicitis pain, severe headache. In emergency conditions Viddha can be done immediately without any poorva karma. For example: pain in abdomen, colicky pain, pain in appendicitis. If we don’t perform Viddha or Agni karma in such conditions, there are chances of severe complications. Hence Viddha or Agni karma Is immediately performed. In chronic diseases, Viddha or Agni karma has to be performed many times. For example: chronic pain in sciatica, lumbago, cervical spondylosis, etc. When pain in such diseases is long standing, then Viddha or Agni karma should be done many times. In such cases it should be performed at evening, on next day morning and again in the evening. When Viddha or Agni karma is repeated in such way, patient definitely gets relief. As per text, Viddha should be followed by Agni karma in some conditions. but This rule is not for every situation. specially in headache, nasal disorders Viddha should be followed by Agni karma as per text. Again this description is not mentioned in text for every situation but points of Viddha and Agni karma are same. Generally, blunt probe of gold (Suvarna Shalaka) is used for Agni karma.