Ayurveda sees us as an upside down tree. Our head, called the śiras in Sanskrit, is equated with the root of this upside down tree. Like the roots of a tree holding it firm to the ground and absorbing the nutrients, it is from our head that we collect most of our nourishment- both for the body and for the brain.

Ayurveda has always tried to understand the physiology of the body in relation to the existing cosmos, analyzing it to its most subtle and simple derivations. The head is the abode of important functional elements. The life-breath (prāṇa vāyu), the processing of sensory inputs such as conversion of light energy to electrical impulses for the brain to interpret what we see (ālocaka pitta) and the structural integrity of the senses (tarpaka kapha)..all of this and many more is happening in our head. The head is also the abode of the sensory faculties (jñāna indriyas). It is also counted as one among the three primary vital points (marma). So naturally, the supreme status the head enjoys in Ayurveda is unparalleled. There are dedicated treatment procedures exclusively for the head. Among the five major procedures (pañcakarma) the nasya or nasal instillation is focused on the head.

Apart from cleansing procedures, there are certain therapies that are administered locally on the head but the benefits are reflected throughout the body. One such procedure is the renowned śirodhāra. Even though there is a very high chance that many of us may have come across a picture of it or even have experienced it ourselves, we may still not be knowing what śirodhāra is and how exactly it works. So let us try and figure it out..

What is Śirodhāra?

The Sanskrit word ‘śiro-dhāra’ may be crudely translated to ‘head-irrigation’. The key element is the continuous pouring of a medicated liquid over the forehead and then allowing it to flow over the scalp. The special equipment used for this procedure is called a “dhāra yantra”.

Who are generally prescribed śirodhāra?

 In clinical practice, śirodhāra may be advised for the following conditions:

• Psychological or mental issues such as stress, depression and anxiety
• Hypertension
• Diabetes and its associated illnesses
• Various  skin diseases
• Different types of headaches
• Insomnia
• And as a procedure to maintain good health 

What all are needed for śirodhāra?

The procedure requires some special equipment for best results. They are..

Dhāra Table

This is a treatment table custom made for Ayurveda procedures. It has a shallow rounded depression at its head end where the head is rested. Also this head portion of the table possesses a small hole at the center of the shallow depression which may be fitted with a tube in its under surface for draining out the liquids poured. A vessel may be placed under the table to collect this liquid.

Dhāra yantra

Traditionally, a dhāra yantra consists of the following-

• a wide mouthed vessel with a rounded base (dhāra pātra) which is usually made of metals (like brass) or clay. This vessel is about two litres in capacity. It has a hole of about 0.5 CM diameter in its exact center.
• a stand with a horizontal arm on top from which the vessel is suspended via metal chains or ropes in such a way that the vessel is hung over the head of the dhāra table and can be swung to either side along the breadth of the table.
• a spherical disc to control the flow of the liquid (often a cut half of coconut shell with its edge serrated)
• a wick prepared from cotton, wool or gauze which is inserted via the nozzle for the liquid to flow in a steady stream
• a small stick of the size of a little finger to hold the wick in position

Modern day treatment centers use several types of dhāra yantras, some even automated and mechanized. But they are often modified versions of the components mentioned above. 

What is the sequence of the śirodhāra procedure?

• The person readied for the procedure is first given an oleation therapy such as abhayṅgaṃ (oil massage)
• They are made to lie down on the dhāra table.
• A cotton ribbon is tied along the lower border of the forehead, slightly above the eyebrows to prevent the liquid poured from flowing into the eyes and face. Additionally, the eyes may be covered with cotton pads.
• The dhāra yantra is placed at the head end of the table, with the dhāra pātra or the main vessel hanging above the head of the person, with its wick pointing towards the center of the forehead. A distance of about 3 inches is maintained between the free end of the wick and the forehead.
• The temperature of the liquid to be used is optimized based on the condition and is poured into the dhāra pātra. All throughout the procedure this set temperature is maintained. Usually in vāta and kapha conditions, the liquid used is kept warm by mild heating. Cold infusions or other liquid medicines are preferred if there is high pitta.
• The hole of the vessel is kept closed (with the index finger of the therapist) when the liquid is poured into it and is gently opened to start the liquid flow.
• Special attention is given to allow the liquid to flow down via the thread in a single uninterrupted stream onto the center of the forehead.
• Now, the vessel is oscillated rhythmically and steadily from one temple (the side of the forehead) to the other.
• The spread of the liquid along the entire scalp is ensured.
• The fluid that falls on the forehead flows first into the head support of the dhāra table and then gets collected in a container placed under it. This fluid is then taken and once again filtered and poured into the vessel after optimizing its temperature, to keep the liquid levels in the vessel steady. This way, one can achieve a continuous flow of the fluid for the desired period.
• After the procedure, the person is asked to take rest for about 15- 20  minutes and then to take a head bath with warm water. Use of soap is discouraged; alternatively green gram powder may be used. The use of medicated waters like that of amla decoction or decoction made with dried fruits of chebulic myrobalan (harītakī) for head bath is also practiced. 

What is the typical duration of a śirodhāra procedure?

On a general note, the procedure may take about 30 to 90 minutes. However the specific duration is determined by evaluating the person and the condition. Depending upon the nature of the illness and the physical condition of the person, śirodhāra may be performed daily for up to 7 or 14 days or even 21 days which is decided by the physician by closely observing the person’s response on a daily basis. 

What are the liquids used for śirodhāra?

Various medicated oils, medicated butter milk, processed milk etc. are used for śirodhāra. The medicated liquid is carefully selected by the Ayurveda physician by taking into account, the health status, specific requirement of the illness, nature of the person and even the season.

What is the best time to do śirodhara?

The time of the procedure is also decided according to condition. In vāta disorders usually when oils are preferred, evening from 3 PM to 5 PM is considered ideal. In kapha disorders, morning time is preferred. The timings are even dependent on the climatic condition and the type of liquid used as well.  

To Conclude..

Śirodhāra as a therapeutic procedure  has multiple roles to play, both in the preventive  and curative aspects of health issues. It can become a part of regimen that can help to maintain physical, mental and psychological health. Let us popularize its utility to reach many more of the needed.