AGNIKARMA IN SHIROROGA/ KAPALAGATA ROGA

STEPS INVOLVED IN PERFORMING AGNIKARMA IN SHIROROGA/ KAPALAGATA ROGA

• Agnikarma is a para-surgical procedure involving the application of therapeutic heat using various instruments.

• In Shiroroga/Kapalagata Roga (diseases of the head and forehead), Agnikarma is indicated primarily for localized pain, swelling, sinus conditions, chronic headaches, and neuralgia.

• It helps pacify Vata-Kapha doshas, promotes circulation, and relieves congestion or blockage in the cranial region.

INDICATIONS OF AGNIKARMA IN SHIROROGA / KAPALAGATA ROGA

• Ardhavabhedaka (Migraine-like condition)

• Suryavarta (Sunrise headache)

• Kanta Shoola (Throat pain radiating to the head)

• Anantavata (Trigeminal neuralgia-like symptoms)

• Kapalagata Shotha (Frontal sinusitis)

• Gridhrasi (when pain radiates upwards towards head in chronic cases)

• Chronic frontal sinus pain or supraorbital neuralgia

सङ्क्षिप्ते दोषभूतानि शिरोरोगाणि सर्वशः।
तान्निवार्यं यथायोग्यं शस्त्रौषधिकषायकैः॥
— Aṣṭāṅgahṛdaya Uttarasthāna 23/7

PRELIMINARY PREPARATION

• Patient Selection: Choose a patient with symptoms of chronic pain, swelling, or congestion in the frontal/head region, unresponsive to conservative therapy.

• Consent: Informed consent is taken before the procedure.

• Examination: Assess doshic involvement (mainly Vata and Kapha).

• Positioning: Patient is made to lie in supine position with head support and area cleaned.

• Marking of Site: Based on clinical findings, marma-sparsha (avoidance of marma points) is ensured before marking the site.

• Sterilization: Modern aseptic techniques are followed. The area is cleaned with antiseptic solution.

• Instruments Ready: Agnikarma shalakas (metal rods – gold, silver, iron), heating source (blow lamp), gauze, cold water, and ghee for dressing are kept ready.

INSTRUMENTS USED FOR AGNIKARMA

• Shalakas: Made of metals like gold (Suvarna), silver (Rajata), copper (Tamra), and iron (Loha)

• Each metal has different thermal conductivity and dosha pacification action

• For head region, milder metals like gold or silver are often preferred to avoid excess heat

राजतं शुक्रलं तिक्तं शीतलं कटुतिक्तकम्।
रक्तपित्तहरं वृष्यं दोषानां हरणं परम्॥
— Suśruta Saṃhitā Sūtrasthāna 12/10

PROCEDURE OF AGNIKARMA

• Heating the Instrument: The chosen shalaka is heated till it attains red-hot condition.

• Testing Temperature: It is briefly tested on a turmeric piece or gauze to confirm the correct temperature.

• Application:

  • The heated shalaka is briefly touched to the marked area on the forehead or temple (based on site of roga).

  • Avoid deep pressure—the contact should be brief and superficial.

  • Depending on the condition, multiple small touches may be done in a grid-like or linear pattern.

• Caution: Avoid sensitive/marma regions like Bhrumadhya (glabella), Sthapani marma, and Shankha.

• Aftercare: The burnt area is dressed with ghee or cooling pastes (like sandalwood paste).

• Pain Management: Mild analgesics may be prescribed in modern context if needed.

POST-PROCEDURE CARE

• Local application of ghee or Jatyadi taila

• Avoid sun exposure, head baths, and Vata-provoking diet for 3–5 days

• Monitor for signs of infection or excessive scarring

• Advise rest and light diet

नित्यमभ्यङ्गनं स्नानं स्वेदनं लघुभोजनम्।
दोषहरं समं चेष्टं कर्मणां पश्चातः शुभम्॥
— Aṣṭāṅgahṛdaya Sūtrasthāna

MODERN MEDICAL CORRELATION

• Agnikarma can be correlated with cauterization or local thermal therapy in modern medicine

• In ENT practice, chronic frontal sinusitis or neuralgia may benefit from radiofrequency ablation or superficial cautery

• It creates local hyperemia improving circulation and reducing pain

• Neural desensitization by thermal stimulation is also a recognized concept in modern pain management

• Sterile technique and precision are crucial to avoid burn complications, infection, or scarring

PRECAUTIONS AND CONTRAINDICATIONS

• Not advised in children, pregnant women, and those with bleeding disorders

• Avoid in Pitta prakriti patients during summer or hot weather

• Avoid in deeply seated infections or where there is active pus formation

• Never touch marma areas like Shankha, Apanga, or Sthapani directly

COMPLICATIONS IF IMPROPERLY DONE

• Hyperpigmentation

• Scar formation

• Infection

• Excessive pain or burning sensation

• Injury to underlying nerves or blood vessels