Shirodhara

Shira means head and dhara means to stream or to pour. Thus, shirodhara (also known as shiraseka or shiraparisheka)literally means therapeutic streaming overhead.It is the procedure of pouring a suitable liquid on the forehead in a synchronized and rhythmic manner for a stipulated period. The reference from samhita for shirodhara is available under murdhni taila (oil applications to head). Various decoctions, milk, butter milk, sugarcane juice, ghee, oil etc. are used for shirodhara either in medicated or unprocessed forms. Conceptually shirodhara is indicated for eruptions on head having multiple openings/furunculosis, pricking type of pain in head (shirasthoda), burning sensation (daha), suppuration (paka) and wounds (vranas). [A. Hri.Sutra Sthana 22/24]. In all these conditions there is association of pitha dosha. So, it can be assumed that the procedure of shirodhara is mainly pacifying the pitta dosha. The medicines are chosen based on associated doshas. For example the group of four unctuous substances or sesame oil alone in vata, ghee and milk in pitha and decoction, sesame oil ,and butter milk in kapha.Shirodhara is said to have greater effect than head massage (shirobhyanga) and lesser effect than therapeutic procedure of placing tampon with oil over head region (shiropichu).[A.Hri Sutra Sthana 22/23] This is based on the pacification of vata dosha (vata shamana) property of the procedure as the session deals with the various oil applications of head where shirobasti is considered the supreme.This article deals with conceptual understanding and practical application of shirodhara.

Contributors

Section/Chapter/topic	Concepts/Panchakarma/Shirodhara
Authors	Adarsh P. M. 1, Deole Y.S. 2
Reviewer & Editor	Basisht G.3
Affiliations	1 Charak Samhita Research, Training and Development Centre, I.T.R.A., Jamnagar, India 2 Department of Kayachikitsa, G. J. Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India 3 Rheumatologist, Orlando, Florida, U.S.A.
Correspondence emails	dryogeshdeole@gmail.com, carakasamhita@gmail.com
Publisher	Charak Samhita Research, Training and Development Centre, I.T.R.A., Jamnagar, India
Date of publication:	August 25, 2023
DOI	10.47468/CSNE.2023.e01.s09.144

Etymology and derivation

The word shirodhara comprises two words viz shiras and dhara. ‘Shiras’ means head and ‘dhara’ means pouring liquids on the body (seka). The word dhara comes from the Sanskrit root ‘dhr’ (dhr +nich+ang) which means falling of liquid. [ ] Thus, shirodhara is pouring liquid on the head.

Synonyms

Shiraseka, Parisheka [A. Hr. Sutra Sthana 22/23-26], Murdhaseka, Anusechana [Su. Sa. Sarira Sthana 10/21], Parishechana [Cha.Sa. Chikitsa Sthana 6/105], Avaseka [Cha.Sa.Chikitsa Sthana 5/181].

Classification

Shirodhara can be classified according to the type of medicated liquid used.

1. Taila dhara (therapeutic streaming of oil)
2. Sarpi dhara (therapeutic streaming of ghee)
3. Takra dhara (therapeutic streaming of medicated/plain butter milk)
4. Kshiradhara (therapeutic streaming of plain / medicated milk)
5. Kwatha dhara (therapeutic streaming of decoction)
6. Jala dhara (therapeutic streaming of water)

Taila dhara (therapeutic streaming of oil)

Here medicated taila (oil) is used for shirodhara which is either vatashamana (pacifying vatadosha) or vatakapha shamana (pacifying both vata and kapha dosha) in nature. Taila(oil) is the best medicine for vata. [Cha.Sa. Siddhi Sthana 1/29]. Udumbaradi siddha taila is mentioned for therapeutic streaming in the management of bleeding disorders (raktapitta) [Cha.Sa.Chikitsa Sthana 6/105]

Sarpi dhara (therapeutic streaming of ghee)

Medicated or non-medicated ghee can be used for shirodhara in vata, pitta and rakta vitiated conditions. Sarpi is mentioned for therapeutic streaming in pain produced by vitiation of vata. [Cha.Sa.Chikitsa Sthana 5/181].

Takra dhara (therapeutic streaming of butter milk)

Here medicated takra (butter milk) is used for shirodhara. It is indicated in diseases having kapha pitta vitiation. The drugs which are cold in touch/potency are indicated for shirodhara in headache due to vitiated pitta (paittika shirobhitapa)). [A. Hr. Uttara Sthana 24/11]

Ksheera dhara (therapeutic streaming of milk)

As the name suggests, medicated or non-medicated milk is advised for shirodhara in pitta associated diseases of vata. The milk processed with dashamula is indicated for therapeutic streaming overhead in headache due to vitiated vata dosha (vatika shirobhitapa). [A. Hri. Uttara Sthana 24/3]

Kwathadhara (therapeutic streaming of decoction)

Here, the liquid used is decoction (kwatha) which pacifies both vata and kapha (vata kapha shamana). In vatarakta associated with burning sensation, boiled and cooled decoction of jivaniya group of drugs is advised for therapeutic streaming. [Cha.Sa. Chikitsa Sthana 29/126]

Jaladhara (therapeutic streaming of water)

Even the use of mere cold water can give benefits of the shirodhara procedure in the case of paithika rogas (diseases having origin from pitta dosha). Therapeutic streaming of cold water (shita jala) is indicated for bleeding hemorrhoids. [Cha. Sa. Chikitsa Sthana 14/218]

Types of shirodhara based on reusage. =

Types	Reusage
Uthama	fresh sneha each day
Madhyama	same sneha for 3 days
Adhama	beyond 3 days or mixed with already used sneha

Indications of shirodhara in general

§  Headache (tension headache and migraine)

§  Wounds especially affecting the upper part of the body above the clavicle (urdhva jatru).

§  Suppurations in the scalp

§  Ulcerations of the scalp

§  Burning sensation [A. Hri. Sutra Sthana 22/25]

§  The diseases affecting the upper parts of the body (neurological diseases).

§  stress, psychic and psychosomatic diseases like psychosis, neurosis, epilepsy, irritable bowel syndrome.

§  Insomnia

§  Generalized anxiety disorders.

§  Addition disorders like alcoholism

§  Excess sweating, hypertension.

§  Syncope

§  Exhaustion without exertion.

§  Loss of consciousness

§  Enlargement of glands

§  Diabetes

§  Autoimmune skin diseases like psoriasis, dandruff, and chronic eczema.

Contra indications of shirodhara^[1]

§  Shirodhara is not indicated in diseases arising out of dominance of kapha dosha.

§  It is not advised during extreme hot and cold seasons.

§  It is not advised at the time of mild increase of doshas.

§  Contraindicated at noon and midnight.

§  It is also prohibited on poor sunny days.

Shirodhara procedure

Purva karma (pre therapeutic procedure)

Collection of materials

Materials required	Quantity
Dhara patra (pot)	1
Dhara stand	1
Dhara droni (table)	1
Suitable liquids like oil, butter milk or milk	1.5 liter
Gauze	1
Cotton ear plugs	2
Soft pillow covered with rexin	1
Hot water for bath	Q. S
Vessels	3
Rasnadi churna for tala	5g
Towels	2
Attendants	2

Dhara dravya according to diseases

Diseases	Dharadravya
Klama, daha	Coconut water
Pittaja vikara	Cold water/milk
Vata pittottara	Ghee
Vathadhika, arumshika	Sesame oil

Dhara Dravya according to dosha

Dosha	Indicated dhara dravya
Kevala vata	Chatusneha (oil, ghee, muscle fat, bone marrow)
Pitta or rakta pradhana vyadhi or raktapitta associated with vata or kapha	oil and ghee in equal proportion
Kapha associated with vata	Oil (2 parts) +ghee (1 part)
Pitta	Different types of milk

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[i] Dr Vasant C Patil, Principles and Practice of Panchakarma.1^st ed. Ilkal,Bagalkot.Atreya Ayurveda publications.2010.p.161

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