The patient has to remain in the laying posture on his back. The treatment may be carried on daily for a period of 7 to 14 days, according to the nature of the disease and the physical condition of the patient. Generally treatment is done in the morning hours preferably between 7 to 10 p.m.
Duration of Dhara for every day is decided in 2 ways-
1. Steady Method
In this method duration of Dhara is fixed throughout the sitting. It is given for healthy person.
2. Aavartan Method
In this method per day duration of Dhara is increased by 5 min. First day Dhara is given for 15 min. Increase the duration of Dhara by 5 min on next day. Thus minimum 15 min, maximum 45 min Dhara is given for 7 days. It is given for chronic disease.
The total duration of course may be 7 days, 15 days, 21 days (Depending on the chronicity of the disease.)
3. Period for changing the liquid[7]
When milk is used for Shirodhara it should be changed every day. When Dhanyamla is used, it can be used up to 3 days. Oil also should be changed at 3 days. In the first 3 days; half of the oil is used then for next 3 days later half of its used and on the 7th day all the first and second half are mixed together, then it should be discarded on 7th day.
4. Temperature of the Dravya
It should be Sukhoshna (Luke warm)
Pashchata Karma[8]
After completing Shiro Dhara the oil from the head should be removed by a piece of cloth. For drinking purpose warm water boiled with Dhanyajiraka, ginger and cumine seeds may be used. For washing purposes only warm water should be used.
Rest: For 40-50 min after completing the Shiro Dhara. Apply Rasanadi Churna over anterior fontanelle to decrease excess secretions from nose, eyes.
Complication: If Takra is cold it causes cough, cold, shivering, If Tail is cold it causes fainting, headache, Rhinitis, Coldness of foot.
Precautions:
Avoid Shiro Dhara just after an overhead bath. Also avoid Divaswap, Jagarana, Use a scarf to close head and ear. Food must be light, Ushna, Anabhishandi. Use of lukewarm water for Aahar-Vihara.
Pariharyani[9]
The patient should abstain from sexual intercourse as well as from any thought or deed that may excite sexual desire, avoid physical exertions, mental excitement such as anger, grief etc. and exposure to cold, sun, dew, wind, smoke or dust should also be avoided. Riding on elephants or horses, walking, speaking too long or too loud and such other acting that may give any strain to the system must be avoided. Sleeping during daytime and standing continuously for long period must also be avoided. It is also advisable to use a pillow which is neither very high nor very low, during sleep at night.
Pariharakala[10]
Patient should follow Pathya upto the time which is taken for the completion of ShiroDhara.
Dhara Dosha[11]
If Dhara is done from more height, very fast or very slowly then it may produce Sarvanga Daha, Sandhi Shool, Jwara, Kotha etc. For the treatment of Dhara Dosha, following measures may be adopted.
1. Gandusha
2. Nasya
3. Kashaya Pana with Sunthi
4. Light diet at evening, Yusha with black pepper.
5. On the third day Basti should be given in which Saindhava is mixed.
Discussion
The therapeutic effect of Shiro Dhara - This effect will be due to diffusion of medicine through the fine pores present over forehead in similar way as seen by the procedure like Abhyanga, Snana, Udvartana, Parisheka etc.
Effect due to temperature of medicine - The continuous flow of warm liquid on the forehead will cause mild vasodilatation, improving the circulation which help in regular blood supply of the brain.
Effect on Marma - During Shiro Dhara warmed liquid falls on Sthapani Marma, slight stimulation to this Marma prod. beneficial effect on Manovaha Strotas.
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