Tridoshaja, Raktaja Shiroroga – Causes, Symptoms, Treatment

By Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S
Sannipataja / Tridoshaja Shiroroga is caused by simultaneous vitiation of all the three doshas.
Read – Headache Caused By Vata Dosha – Causes, Symptoms, Treatment

Headache due to Tridosha

Meaning and definition of Tridoshaja Shiroroga
When a person has headache in which signs and symptoms of vitiation of all three doshas are found in mixed proportions, the person is said to be suffering from tridoshaja or sannipataja shirashula / shirorog i.e. headache caused due to simultaneous vitiation of all three doshas.

Other names –


Causes and Pathogenesis of Tridoshaja Shiroshool
The commom causes and pathogenesis explained in all Shirorogas is also applicable to Tridoshaja / Sannipataja Shiroroga.

Though specific causes for tridoshaja headache have not been enumerated in the Ayurvedic texts, we can tell that it has been caused by causes which are responsible for disturbing and vitiating all the three doshas at a time.

Pathogenesis –
The three doshas vitiated simultaneously due to the consumption of and exposure to the etiological factors capable enough for simultaneous vitiation of all three doshas will get lodged in the head and cause disorders of the head and tridoshaja headache.
Read – Tension Headache Ayurvedic Treatment, Remedies, Tips, Herbs

Symptoms of Tridoshaja Headache
Sannipataja / Tridoshaja headache will have signs and symptoms of all the three doshas in mixed proportions. Though the tridoshaja conditions manifest with complexity of signs and symptoms, master Charaka has given hints of involvement of all three doshas by separately mentioning the symptoms contributed by each dosha. This is for convenience of understanding. One should not think that only these symptoms would be present. The symptoms and signs will follow the complexity, permutations and combination of the doshas and the nature of admixture. It is true for any tridoshaja condition, including tridoshaja headache.

According to master Charaka –

Probable modern correlation
Since all three doshas are involved in the causation of tridoshaja headache, we can consider and correlate this condition to ‘headache caused due to constitutional causes/ diseases’.

According to correlations made by many scholars –

  • Tridoshaja headaches may have their origin in the disorders of heart and kidney and as an effect of these conditions
  • Toxemia caused due to various pathological conditions in the body
  • Circulating toxins
  • Acidosis
  • Alkalosis
  • Acute and chronic / long standing fevers – typhoid, irregular fevers etc
  • High blood pressure (read aboutHypertention in Ayurveda)
  • Intoxication / chronic alcoholism
  • Meningitis
  • Sinusitis etc
    Read – Trigeminal Neuralgia: Ayurvedic Treatment, Medicines

Ayurvedic treatment for Tridoshja / Sannipataja Headaches
All tridosha alleviating remedies, comforts, therapies, food and lifestyle changes will help in treating the tridoshaja headaches, though these conditions are difficult to manage.

Treatment principles of Tridoshaj headache

Sannipata hita kriyah – tridosha mitigating measures
All measures, medicines, treatment strategies and dietetic corrections which help in mitigating and balancing tridoshas should be adopted while treating tridoshaja headaches.
Read – Shoola Prashamana Gana – Review, Benefits, Disadvantages

Other principles of treating sannipataja headache as explained in Yogaratnakara treatise

  • Use of ghee and Oil
  • Medicated enemas
  • Medicated smoking
  • Nasya – errhines (read here)
  • Shirovirechana – head purgatives
  • Application of medicinal pastes over the head
  • Sudation
  • Purana sarpishah paanam visheshena – very importantly the person suffering from tridoshaja headache should be encouraged to drink old ghee.
    Read – 60 Benefits Of Ghee, Side Effects, Contra Indications

Nasya – nasal medication

Madanaphaladi Nasya
The powder of the below mentioned ingredients should be stored in air tight containers and should be used as and when required to treat tridoshaja headache.

  • Fruit of Randia dumetorum
  • Sesame seeds
  • Seeds of drumstick
  • Jatamansi – Nardostachys jatamansi
  • Roots of kusha grass
  • Tejapatra – Cinnamomum tamala
  • Root of Baliospermum montanum
  • Tuttha – purified copper sulfate
    Read – Drumstick (Moringa): Multiple Uses, Home Remedies

Shunti ksheera nasya
Ginger should be boiled in the milk. This milk processed with ginger should be used for nasal drops to cure headache caused by tridoshas.

Karanjadi churna nasya
Powder of the below mentioned herbs should be used as snuff to mitigate tridoshaja headache.

Tryushanadi kashaya nasya
Decoction prepared from the below mentioned herbs should be used for administering nasal drops so as to relieve the patient from tridoshaja headache.

Ghrita prayoga – use of ghee
Triphala ghrita – the ghee processed and prepared with the powder of fruits of Terminalia chebula, Terminalia bellirica and Emblica officinalis should be used for drinking.

Taila prayoga – use of oil

  • Jeevakadi taila and Brihat Jeevakadi taila should be used for massage, errhines and for administering enema.
  • Shatahvadi taila shall be used for nasal medication / nasal drops / errhine.

Lepa – anointment of medicinal pastes

Chandanadi lepa

The below mentioned ingredients should be made into paste by grinding them with rose water and applied on the head.

  • Sandalwood
  • Camphor
  • Kesara (read)
  • Old rice

Priyangvadi lepa

Paste of the below mentioned ingredients should be applied on the head of the person suffering from tridoshaja headache.

Kushtadi Lepa

The paste of the below mentioned herbs should be applied warm on the head of the patient suffering from sannipataja headache.

  • Kushta – Saussurea lappa
  • Ginger
  • Licorice (read here)
  • Shatapushpa – Anethum sowa
  • Nila kamala – blue variety of lotus
  • Long pepper

Raktaja Shiroroga – Due To Vitiated Blood

Raktaja Shiroroga is caused by vitiation of blood.
Read – Trimarmeeya Chikitsa – Charaka Chikitsa 26th Chapter

It is also called as Raktaja Shirashula / Raktaja Shirobhitapa. Raktaja head disorders / headache is said to be almost similar to Pittaja headache.

Meaning and definition of Raktaja Shiroroga
When a person has headache caused due to the vitiation of blood and presents with signs and symptoms similar to pittaja headache i.e. in which the head is hot just like burning charcoal, severe burning sensation in the eyes and nose as if they are filled up with hot smoke and the pain reduces at night time and by cold measures and comforts, along with an additional symptom i.e. tenderness in the head wherein the person feels pain on touching the head, the person is said to be suffering from headache caused by aggravation of blood.
Read – Headache Caused By Vata Dosha – Causes, Symptoms, Treatment

This type of headache has been described briefly, rather mentioned to be precise, just because of its resemblance with pittaja headache and pittaja headache has been elaborated in detail earlier in the context.

Causes and Pathogenesis of Raktaja Shiroroga
The general causes and pathogenesis explained in the context of all Shirorogas is applicable to Raktaja Shiroroga.

Specific causes of raktaja headache
Same causes which causes pittaja headache are also responsible for manifestation of raktaja headache.

Let us glance at those causes in brief –

The blood aggravated due to the consumption and exposure to the above said etiological factors will get lodged in the head and cause disorders of head and headache of blood origin.

Symptoms of Raktaja Headache

Signs and symptoms of raktaja headache will have its symptoms and signs similar to those of pittaja headache.
Read – Tension Headache Ayurvedic Treatment, Remedies, Tips, Herbs

Specific symptom of raktaja headache –

  • Sparshasahatvam shiraso – tenderness in the head, the person doesn’t allow you to touch his head and even if touched he cannot tolerate the pain and would wince in pain. Such is the severity of pain in raktaja headache.

Symptoms of pittaja headache which will be found in raktaja headache –

Probable modern correlation
Raktaja headache cannot be exactly compared to any condition explained in the modern texts. But seeing ‘tenderness of head’, the specific and special symptom of raktaja headache which differentiates it from pittaja headache, it can be compared to two conditions –

The symptoms of raktaja headache can also be found in some systemic diseases. Therefore some scholars have compared raktaja headache with ‘constitutional headache’.

Those conditions include –

Ayurvedic treatment for Raktaja Headaches
Since raktaja headache resembles the clinical picture of pittaja headache, the treatment strategies too will be similar to the treatment of pittaja headache. In Raktaja headache, all pitta alleviating remedies, comforts, therapies, and food and lifestyle changes should be used.

Specific remedies for raktaja headache will be administration of

Principles of treating Raktaja Headaches

Pittavat sarvam bhojana alepa sevanam – Pitta alleviating remedies
In the treatment of raktaja headache, all measures which are prescribed for alleviating pittaja headache should be administered. They include pitta mitigating foods, lifestyle changes, treatments, anointments etc.
Read – Ayurvedic Pitta Diet – Food Suitable For Pitta Body Type

Sheeta ushnayoh cha vinyaso – cold and hot remedies
In raktaja headache, the physician should arrange alternative cold and hot remedies.

Raktamokshana – bloodletting
Bloodletting relieves blood congestion, removes contaminants of blood and cures raktaja headache. It is the chief and most praised treatment in all diseases caused by contaminated blood, including raktaja headache.
Read – Siravyadha Method Of Bloodletting: Procedure, Precautions, Benefits

Specific Lepas – anointments in raktaja headache
Amalakyadi Lepa – paste prepared using Emblica officinalis, lotus flowers, raisins, Anogeissus latifolia, valerian and vetiver should be ground in rose water and applied over the head. Owing to its coolant properties, this application will relieve the headache caused due to vitiation of blood tissue. 
Read – Amla Benefits, Dose, How To Use, Side Effects, Home Remedies

Baladi Lepa – Paste of the below mentioned should be applied on the head

  • Roots of Sida cordifolia
  • Sandalwood,
  • Ushira – Vetiver
  • Licorice (read more)
  • Blue variety of lotus
  • Durva – Cynodon dactylon / Bermuda grass
  • Nakha – Capparis sepiaria

Shatadhauta Ghrita – ghee washed and processed for 100 times is said to have immense coolant, pitta and rakta alleviating properties and shall be applied on the head of the person suffering from pittaja headache.

Specific Nasya (errhines) in Raktaja headache
Shadbindu taila – oil should be used for providing errhine, its drops need to be instilled into the nostrils of the person suffering from raktaja headache.
Read – Shadbindu Tail – Benefits, How To Use, Ingredients, Side Effects

Sharkaradi nasya – sugar, raisins and liquorice are grinded in water, their juice extracted and used as nasal drops.

Yashtyahvadi nasya – ghee processed with coolant herbs like liquorice, sandalwood, vetiver etc should be used as nasal drops.
Read – Sandalwood Benefits, How To Use, Side Effects, Research

Other treatments on the lines of treating Pittaja headache

  • Snehana – administration of medicated fats for drinking
  • Head massage with coolant oils like Himsagara taila
  • Purgation therapy, which is ideal treatment to deal with morbid pitta and blood conditions and disorders
  • Nasal medications
  • Shiro vasti – pooling of medicated ghee or milk on the head
  • Applying pastes prepared from coolant herbs and herbs having anti-pitta and anti-rakta properties on the head
    Example – Amalakyadi lepa, Shatavaryadi lepa, Naladadi lepa, Mrunaladi lepa, Chandanadi lepa, application of shatadhauta ghrita on the head etc as explained in the treatment of pittaja headache
  • Parisheka – sprinkling of medicaments like Chandanadi kashaya etc over the head
  • Drinking of milk
  • Use of Jeevaniya ghrita ghee for drinking, eating with food, errhine, enema and for application over the head

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