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A CONCEPTUAL STUDY ON SHIRODHARA PROCEDURE
Nidhi Gupta 1*, Gopesh Mangal 2
1PG Scholar, Department of Panchakarma, National Institute of Ayurveda, Jaipur, Rajasthan, India
2Assistant Professor & Head, Department of Panchakarma, National Institute of Ayurveda, Jaipur, Rajasthan, India
Received on: 26/02/19 Accepted on: 26/04/19
*Corresponding author
E-mail: dr.nidhigupta20@gmail.com
DOI: 10.7897/2277-4343.100353
ABSTRACT
Pouring of medicated Kwatha (Decoction) or oil on forehead is known as Shirodhara. Shirodhara is also a type of Bahya Snehana (external oleation
therapy) as mentioned in Ayurveda. Shirodhara is mainly indicated in neurological and psychosomatic disorders. Today’s modern life style is full of
stress and thus interfering the individual daily function. In current era the problems like insomnia, headache, facial paralysis, scalp psoriasis, hair fall
etc. are the most common and challenging conditions. But till now effective management for these complaints are still lacking. Hence it is the need of
time to find out the safe and effective treatment modalities for these diseases. Thus an effort is made to rule out the efficacy of Shirodhara in different
psychological disorder. The apparent mode of action of this procedure is not understood. Ayurveda mainly highlighted the outcomes of the procedure
rather than its action. So a review of Samhita, Chikitsa Grantha, Nighantus and Ayurveda text with regard to Shirodhara was conducted. Indication and
Contraindication and therapeutic efficacy of Shirodhara were noted during the study.
Keywords: Shirodhara, Murdha Taila, Panchakarma, Dharapatra
INTRODUCTION
There are various form of Shirodhara such as Tailadhara
Takradhara, Ksheeradhara, Jaladhara and Kvathadhara.
Classically this procedure is not described under the
Panchakarma, but it incorporated under Snehana karma.
Murdhatailam has been described in the Ayurveda which is of
four type’s viz. Shiroabhyanga, Shirosheka, Shiropichu,
Shirobasti. These are superior in their succeeding order [1]. It is
one of Bahya Snehana (external oleation therapy) procedure in
which Snehan is applied in head or it is a procedure wherein
involves gently pouring liquids over of the forehead and has been
indicated for psychosomatic disorders and neurological disorders
etc. These disorders are not only the diseased condition but also
affect the quality of life and cause anxiety, depression and work
ability is decreased. In Ayurveda human body is compared to an
inverted tree where the head is the main part of the body and other
organ are its branches [2]. So the head controls every system,
hence application of medicine in the form of Shirodhara, on the
head can cure many disease of different parts of the body.
Classically Shirodhara is advised for many diseases like
Headache, Daha (burning sensation), Paka (Abscess), Vrana
(Wound), Arunsika (Boils) etc. It also indicated in Ardhavbhedak
(Migraine) [3], Suryavarta (Type of headache) [4]. Application of
oil does not follow any form of massage. By the employment of
this procedure one can achieve all the benefits in dermatological
condition of scalp as well as psychological disorders. It can be
performed in painful conditions or ulcerations of the scalp also.
References regarding Shirodhara were collected from various
textbook, published research papers, previous work done and
compilation was done. Concept of Shirodhara and procedure was
studied in detail.
Definition- Shirodhara term comes from the Sanskrit words,
Shiro-means Head and Dhara-means Flow. Shirodhara is a form
of Ayurveda therapy that involves gently pouring warm liquids
over the forehead. It is the process in which medicated oil, milk,
Kwatha is poured in a continuous stream of drip on the forehead
in a specific manner and height [5].
Procedure- The Shirodhara procedure is divided in to 3 parts [6];
1. Purva Karma
2. Pradhana Karma
3. Paschata Karma
Purva Karma
Materials required- Shirodhara patra, Shirodhara stand,
Shirodhara table, Gauze, cotton earplug, Vessels, Soft towels,
Suitable oil/milk/any liquid.
Preparation of the patient- The patient is thoroughly examined
whether he is fit with for procedure. Patient should be advised to
pass stool and urine. Then pulse, temperature and blood pressure
of the patients should be recorded. Patient is advised to lie down
in supine position and Dhara Patra should be fixed 4 Angula
above the forehead. The eye and ear should be covered with
cotton to prevent the entry of liquid into eyes.
Selection of Sneha- According to Dharakalpa, Sneha is taken
according to the condition of Dosha [7]-
Vata Dosha- Tila Taila
Pitta Dosha- Ghrita
Kapha Dosha- Tila Taila
Rakta Dosha- Ghrita
Vata + Pitta + Rakta- Ghrita and Taila in equal par portion
Vata + Kapha + Rakta- ½ part Ghrita and 1 part Tila Taila
Pradhana Karma
Shirodhara room should be cleaned well, ventilated and very
quiet. Shirodhara is done in the morning time on empty stomach
after massage. Any type of liquid (Taila, Milk, Kvatha, water)
should be kept in Dharapatra. Dhara should be poured
continuously on forehead neither very fast nor very slow. The
liquid of shirodhara should not be too hot or too cold. The stream
of Dhara liquid should not be too thick or thin. When the liquid
Nidhi%Gupta%&%Gopesh%Mangal%/%Int.%J.%Res.%Ayurveda%Pharm.%10%(3),%2019%
11#
starts pouring then the vessel is moved in the pendulum manner
starting from one lateral side to the other lateral side. The liquid
is collected in another vessel kept and is used to refill the
Dharapatra before it becomes empty. Shirodhara process is done
for at least ½ an hour in the morning up to 14/21 days.
Temperature of liquid for Shirodhara should be above to the body
temperature.
Period for changing the liquid-When milk and water is used in
Shirodhara, it should be changed every day. When Dhanyamla is
used, it can be used up to 3 days. The oil also should be changed
every 3rd day, but it can be reused, so in the first 3 days, half of
the oil should be used, for next 3 days the other half of the oil
should be used and on the 7th day all the first and second half both
are mixed together, then it should be discarded.
Paschata Karma
After the Shirodhara process is completed; the head of the patient
should be wiped out and dried. This is followed by a short
duration of rest and massage of the body including head with oil
and then a lukewarm bath. The patient is advised to have a Pathya
Ahara (light diet).
Indications- Stress and psychosomatic disorders such as IBS
(Irritable Bowel Syndrome), Neurological disorders (Headache,
Epilepsy etc.), Psychiatric disorders (Psychosis, Neurosis,
Insomnia etc.), Convulsive disorders and also in Psoriasis,
Eczema, Hypertension etc. Shirodhara is also used in patient Vata
Vyadhi, Facial palsy, Loss of memory.
Contraindication- In Kaphaja Vikara, Shirodhara further
increase Kaphaja, this makes the diseases difficult to cure.
DISCUSSION
Clinically the efficacy of Shirodhara is proved; still it is a difficult
task to understand the mode of action of this procedure.
Shirodhara is effective in following ways.
A/c to Ayurveda- In a living being, the head is the substratum of
all the sense faculties, or Indriyas (sense organs), it is also known
as Uttamanga [8]. Because of this, Shirodhara gives strength to
the Prana and Indriyas, which are mostly vitiated in case of
psychological disorders. Indriyas are in close contact with the
mind, so when Indriyas stay healthy the mind automatically stays
healthy. Shirodhara thus keeps the body and mind healthy.
Imbalance of Prana, Udana and Vyana Vayu, Sadhaka Pitta and
Tarpak Kapha can produce stress and tension. Shirodhara re-
establishes the functional integrity between these subtypes of
Dosha through its mechanical effect [9].
Therapeutic effect of medicament- As per the principle of drug
absorption, absorption of the substances through the skin depends
on a number of factors, the most important of which are
concentration duration of contact, solubility of medication, and
physical condition of the skin and part of the body exposed. In
Shirodhara oil form is used which has good dense concentration
with longer duration of contact. Also the skin over the scalp is
thin as compared to other part of body and absorption is faster and
more from the scalp. (As per the principle of drug absorption
maximum absorption is in the scalp region and comparatively oil
is better absorbing then water [10].)
Dermal absorption [11]- The skin is relatively permeable to fat
soluble substances and relatively impermeable to water soluble
substances. Essential oil molecules are so minute that when they
are applied to the skin; they are able to pass through the stratum
corneum (the outer layer of the epidermis). From here the oil
molecule passes through dermis, into the capillaries and into the
bloodstream. Absorption also occurs through the hair follicles
and sweat ducts. There are many factors that affect absorption of
an oil molecule. Both rate of circulation and the warmth of the
skin increase blood flow to the surface, therefore increasing the
skin’s ability to absorb the oil. Circulation and warmth can be
increased by massage .
Procedural effect of the Shirodhara process- Each substance at
a certain altitude possesses potential energy, and that energy
becomes kinetic energy when it falls down from a certain altitude
under 'Law of Energy Conservation'. This law means that energy
can neither be created nor destroyed; rather, it can only be
transformed or transferred from one form to another [12].
Potential energy depends on the mass and height of the substance.
If height remains constant then potential energy depends on mass
of substance or mass energy, more mass of a substance will be the
energy the substance possesses. When anything pours on the
forehead from a certain height due to the change in the form of
energy it generates momentum, it can cause voltage changes and
stimulate the generation of nerve impulses or accentuate the
conduction of nerve impulses. The magnitude of momentum is
the factor that determines the voltage difference between the
generation and conduction of the nerve impulse if its magnitude
is small; the energy is absorbed by the skull. According to modern
physiology continuous electrical activity in the brain that
generates electromagnetic waves and that is recorded by the
Encephalogram (EEG).
Effect of temperature in Shirodhara procedure- The
continuous flow of warm liquid on the forehead for such a long
period will cause mild vasodilatation. Shirodhara improves the
circulation in these areas and help in regularization the blood
supply of the brain. Vibration along with temperature may
activate the function of thalamus and the basal forebrain which
then brings the amount of serotonin and catecholamine to the
normal stage.
Effect of constant pressure in Shirodhara procedure- Constant
pressure and vibration produced in the Shirodhara procedure,
amplified by the hollow sinus present in the frontal bone. The
vibration is transmitted inward through the fluid media of
cerebrospinal fluid (CSF). Pressure also affects impulse
conduction. If prolonged pressure is applied to a nerve, impulse
conduction is interrupted, and part of the body relaxes in
Shirodhara's procedure. Due to the tricking of medicated liquid
over the forehead, prolonged and continuous pressure causes
tranquility of mind and reduces stress by modulating nerve
stimulation. When nerve ending of autonomic nervous system is
stimulated, they produce chemical substances like Acetylcholine
which exists in the tissues in the inactive form and is activated by
a nerve impulse vibration produced due to continuous pouring of
liquid over the forehead which may stimulate nerve ending and in
turn Acetylcholine cause fall of blood pressure leading to
decreased activity of central nervous system resulting in
tranquility of mind. During the process of patient concentrations
of Dhara Drvya (Medicated oil or any type of liquid), this is
falling on his forehead, which increases the intensity of brain
waves and decreases the brain cortisone and adrenaline level. This
factor is also work as an anti-stress effect of Shirodhara.
On the basis on Marma- Some Marma (Vital spot) are located
in forehead and head region as mentioned in Ayurveda classics.
Mainly Sthapni, Utshepa, Avarta, Shankha and Apanga Marma
are situated in this region [13]. According to Acharya Bhela
Bhrumadhya (Between both eyebrows) is the site of Chitta
(Mana). It is also place of Sthapni Marma [14]. Most of the
Marma of head region are Agni and Vayu Pradhana Mahabhoota
Nidhi%Gupta%&%Gopesh%Mangal%/%Int.%J.%Res.%Ayurveda%Pharm.%10%(3),%2019%
12#
[15]. The site of Sthapni Marma and the site of pituitary and
pineal gland exist at the same level. The function of pituitary
gland is controlled by hormones. It is the master of the gland. It
has the capacity to maintain all the endocrine system of human
body [16]. Mental stress and irritability were the causative factors
were endocrine system gets imbalance of its normal function [17].
Due to the stimulation of Sthapni Marma and indirect stimulation
of pituitary gland brings changes in psycho-somatic level. Hence
Shirodhara therapy helps in reliving the mental stress by
regulating the normal function of this gland.
CONCLUSION
Shirodhara is an important therapeutic measure in Ayurveda
system of medicine, which has got worldwide popularity because
of its simple administration and effectiveness in several disorders
and life style diseases. It is a purifying and rejuvenating therapy
which eliminates toxins and mental exhaustion as well as relives
stress and any ill effects on the central nervous system. On the
basis of above description, it is clear that Shirodhara has both the
therapeutic effect of medicament and procedural effect. These can
be understood from the aspect of Ayurveda, mechanical and
Marma science. Shirodhara can be used for treatment of scalp,
hair and psychological disorders.
REFERENCES
1. Vagabhata, Ashtanga Hridayam, Vidyotini Hindi
commentary Sutrasthana, 22/24 Chaukhamba Prakashana,
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2. Charak smhita, Vidyotini Hindi commentary
vol.1,Sutrasthana, 17/3 Chaukhamba Bharati Akadmi;
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Shashtri, page no.332
3. Ashtanga Hrdayam of Vagabhata, Vidyotini Hindi
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4. Shushrut samhita Chaukhamba Sanskrit Sansthana, Edition:
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commentary Uttarsthana, 24/12 page no-110
5. Principles and Practice of Panchakarma Dr. Vasant C.Ptil,
Chaukhamba Publication; Edition; Reprint 2016, chapter 8,
page no.162
6. Principles and Practice of Panchakarma Dr. Vasant C.Ptil,
Chaukhamba Publication; Edition; Reprint 2016, Chapter 8,
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7. Dharakalpa (Prachina Kerliya Panchakarma Chikitsa
Vighyana) Dr.S. Sharma Comm. Dr. H. L. Sharma, chapter 1
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8. Charak smhita, Vidyotini Hindi commentary vol.1,
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9. Patel D.V., Chandola H.M., Baghel M.S. & Joshi J.R.
(2009), Evaluation of the role of Mansika bhava in the
etiopathogenesis of Madhumeha (NIDDM) and its
management by polyherbal antidiabetic Formulation with and
without Medhya Rasayana-Ph.D. thesis, I.P.G.T.& R.A.,
G.A.U.
10. Available from; http;/www.thedermreview.com/water-
based-moisturizer-vs-oil-based-moisturizer
11. https://healingscents.net/blogs/learn/18685875-how-
essential-oils-enter-the-body
12. http://www.iamj.in/panchkarma_setup/images/upload/shirod
hara.pdf
13. Shushrut samhita, Chaukhamba Sanskrit Sansthana, Edition:
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commentary Sharira sthana,5/28, page no.61
14. Shushrut samhita Dalhana comm. Ayurved Tatva Sandipika,
edited K. S. Shastri. Sharir Sthana 5/28 page 56. Varansi;
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16. Guyton, hall pituitary hormone and their control by
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17. Anthony S. Fauci, Eugene Brauwald Dennis L. Kasper,
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McGraw-Hill companies. P.2710.
Cite this article as:
Nidhi Gupta and Gopesh Mangal. A conceptual study on
shirodhara procedure. Int. J. Res. Ayurveda Pharm.
2019;10(3):10-12 http://dx.doi.org/10.7897/2277-4343.100353
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ResearchGate has not been able to resolve any citations for this publication.
Vidyotini Hindi commentary Sutrasthana, 22/24 Chaukhamba Prakashana
  • Ashtanga Vagabhata
  • Hridayam
Vagabhata, Ashtanga Hridayam, Vidyotini Hindi commentary Sutrasthana, 22/24 Chaukhamba Prakashana, Varanasi, Edition; Reprint, 2009 page no.182 2. Charak smhita, Vidyotini Hindi commentary vol.1,Sutrasthana, 17/3 Chaukhamba Bharati Akadmi;
Vidyotini Hindi commentary Uttarsthana, 24/9 Chaukhamba Prakashana, Varanasi, Edition; Reprint
  • Ashtanga Hrdayam
  • Vagabhata
Ashtanga Hrdayam of Vagabhata, Vidyotini Hindi commentary Uttarsthana, 24/9 Chaukhamba Prakashana, Varanasi, Edition; Reprint, 2009 page no.730
  • Shushrut Samhita Chaukhamba Sanskrit
  • Sansthana
Shushrut samhita Chaukhamba Sanskrit Sansthana, Edition: Reprint, 2014 volume 2, Chaukhamba publication Hindi commentary Uttarsthana, 24/12 page no-110
Evaluation of the role of Mansika bhava in the etiopathogenesis of Madhumeha (NIDDM) and its management by polyherbal antidiabetic Formulation with and without Medhya Rasayana-Ph.D. thesis, I
  • D V Patel
  • H M Chandola
  • M S Baghel
  • J R Joshi
Patel D.V., Chandola H.M., Baghel M.S. & Joshi J.R. (2009), Evaluation of the role of Mansika bhava in the etiopathogenesis of Madhumeha (NIDDM) and its management by polyherbal antidiabetic Formulation with and without Medhya Rasayana-Ph.D. thesis, I.P.G.T.& R.A., G.A.U.
Ayurved Tatva Sandipika
  • Dalhana Shushrut
  • Comm
Shushrut samhita Dalhana comm. Ayurved Tatva Sandipika, edited K. S. Shastri. Sharir Sthana 5/28 page 56. Varansi;
  • Chaukhamba Sanskrit Shushrut Samhita
  • Sansthana
Shushrut samhita, Chaukhamba Sanskrit Sansthana, Edition: Reprint, 2014 volume 1. Chaukhamba publication Hindi commentary Sharira sthana,6/17, page no.70
hall pituitary hormone and their control by hypothalamus. 11 th edition Textbook of Medical physiology. Noida
  • Guyton
Guyton, hall pituitary hormone and their control by hypothalamus. 11 th edition Textbook of Medical physiology. Noida, Elsevier. Reprint 2008.p.919-20
Dan disorders. Harrison's principles of internal medicine
  • Anthony S Fauci
  • Eugene Brauwald Dennis
  • L Kasper
  • Stephen L Hauser
Anthony S. Fauci, Eugene Brauwald Dennis L. Kasper, Stephen L. Hauser, Dan disorders. Harrison's principles of internal medicine. 2 nd volume 17 th edition New Delhi, McGraw-Hill companies. P.2710.
Cite this article as: Nidhi Gupta and Gopesh Mangal. A conceptual study on shirodhara procedure
Cite this article as: Nidhi Gupta and Gopesh Mangal. A conceptual study on shirodhara procedure. Int. J. Res. Ayurveda Pharm. 2019;10(3):10-12 http://dx.doi.org/10.7897/2277-4343.100353