Agnikarma in Shalya Tantra: Translational Reappraisal of a Classical Thermal Intervention Through Contemporary Biomedical Mechanisms

Background: Agnikarma, a para-surgical intervention described in Ayurvedic Shalya Tantra, employs controlled therapeutic heat for managing Vata-Kapha dominant disorders.[1,2] Despite extensive classical documentation, its biological basis remains underexplored within modern translational frameworks. Objective: To critically reinterpret Agnikarma through integration of classical Ayurvedic doctrine and contemporary biomedical mechanisms. Methods: A narrative-critical review was conducted using classical Ayurvedic treatises and PubMed-indexed biomedical literature. Mechanistic mapping correlated Agnikarma principles with wound biology, neurophysiology, and inflammatory modulation.[6,15,25] Results: Evidence suggests plausible mechanisms including thermal coagulation[11], TRPV1-mediated nociceptor modulation[13,14], cytokine-mediated inflammatory regulation[15], and fibroblast-driven tissue remodelling.[16–18] Clinical parallels exist in hemorrhoidal therapy[20], dermatologic lesion ablation[21], and chronic wound care.[22] Conclusion: Agnikarma represents a structured thermal modulation technique with translational relevance. Scientific validation through standardized protocols and controlled trials is essential for global integration.