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Introduction: Anna Lepana is a process similar to Shastika Shali Pinda Sveda. In this treatment, a special kind of pudding (Payasa) is prepared with Shastika Shali and smeared over the whole body or any particular part. Though this treatment resembles Pinda Sveda in many aspects, it differs in certain aspects as it is superior to Pinda Sveda. In Kerala it is known in the name of Teccirippu or Kali.

Benefits: It cures Vata diseases like pain and stiffness in the body, general debility and emaciation. It is effective in high blood pressure. Anna Lepana is beneficial in some of skin diseases.

Materials required:

Indications: It is indicated in Dystrophic/Atrophic muscular disease, muscle wasting due to trauma and injury, motor neuron disease and psoriasis. It is also indicated in premature senility, general debility, and emaciation, degenerative disorders of the nervous system, Ojas Kshaya conditions and those who need nourishment. In Vata Vyadhi, the application of prepared Shastika Anna Lepa is advised, which should be wiped off after half a Yama following which the oil prepared from Bala and milk has to be applied.

Preparation of Kashaya and Rice: Take 3 Pala (144gm) of crushed Balamoola in an earthen pot. Add 3 Prasta (2.3liters) of water to it. Put it in mild fire and reduce to get one fourth which is 576ml of Kashaya. This decoction is filtered and an equal quantity of milk is added to it. In this mixture 1 Kudava (192gm) of Shastika rice is cooked. This is boiled till it attains a semisolid consistency.

Preparation of patient: After passing natural urges, patient should sit on the Droni with extend legs, with minimum cloths. Apply little oil on the vertex and body and do massage to the ears, legs and finally to all over the body for a few minutes.

Procedure: Ask the patient to sit in Droni. Take the prepared paste. Heat it moderately. Two attendants should stand on each side of the patient and apply it all over the body and massage gently with their hands. Keep there for a while. When paste gets cold, wipe out and heat it again. Again apply the paste all over the body. The pudding has to be applied below the neck, little by little and rubbed, beginning from the shoulders and going down to the feet. Here, as the Shastika is powdered and the contact time is more it is much superior to Shastika Shali Pinda Sveda. As absorption is more it is more Bramhana.

After Care: Pudding of the body may be removed by scraping with coconut leaves and oil should be rubbed with clean towel. Patient must take rest after this for an hour. After taking rest patient may take bath using warm water.

Duration: It is done daily for 7 – 14 days taking about 30 – 60 minutes each day.

Diet and Advice: After the procedure patient is advised to take light food. He should avoid immediate exposure to cold breeze, open air and contact with cold water.

Precautions: Care must be taken to remove the paste soon after it gets cooled. As a result of this process Ushma Avarodha (of skin) occurs and has a chance to burn the skin. So the paste while applying should not be heated much.

Introduction: It is a process by which the whole body or any specific part is made to perspire by external application of certain medicinal puddings in the form of boluses tied up in a bag. It provides Snehana, Svedana and Brumhana effect simultaneously.

Benefits: Shastika Shali Pinda Sveda is very good treatment modality in many chronic Vata diseases. It can also practice in the diseases of Rakta Prakopa and diseases which are affecting the strength or immunity of the body. In addition to these, Shastika Shali Pinda Sveda cures all types of diseases of the nervous system, chronic rheumatism, pain in the joints, emaciation of the limbs and diseases born of vitiated blood. This Karma makes the body strong and sturdy with well-developed musculature. It pacifies various kinds of pain, improves the digestive capacity, resolves drowsiness, cures lethargy and promotes sleep. It maintains the metabolism in a healthy condition from every point of view. This treatment is found to be efficacious in subjects suffering from blood pressure and in certain kinds of skin diseases resulting from impurity of the blood. This may also be resorted to once a year, by healthy persons to keep up perfect health during old age and to prevent premature aging.

Materials required: If this procedure is to be done for children’s then take half the quantity of below mentioned.

According to Ayurvedic classics, there are two varieties of Shastika Shali, viz., Goura and Krishnagoura out of which Goura is the best.

Morphology & Duration of growth of Shastika rice – Navara (Malayalam name) is in the group of very early maturing type of rice (Some farmers claim that they have harvested it within 57days). If it is grown in proper field (commonly rain fed upper and low land) and there is no fault in cultural practices, it matures in the sixtieth day. However, in no case its duration will exceed 90 days. There are two clearly distinguished ecotypes existing in this cultivar – one with golden-yellow glumes and the other with black glumes. Within each ecotype, there are two different forms – one with awn and another without awn. Thus, in this variety there exists four a morphologically distinguishable strain, but adapted to same kind of agro-ecological conditions. Plant generally grows up to 1 meter tall. Grains are narrowly ellipsoid, small, slender and light in weight with red kernel.

Chemical constitution of Shastika rice – There are few reports to show that this variety of rice possesses some characteristic amino acids. Few scholars have attempted to understand the amino acid composition in the two known strains. It shows that total free amino acid composition in them is more when compared to other high yielding varieties. They reported that the amino acid content varies under different agro-ecological conditions. According to them, the Methionine might be the responsible active compound for the medicinal quality. Methionine is the only common amino acid with either linkage and is an important donor of active methyl groups.

Although variety like Navara is being used in the traditional medicine for a very long time, the bio-chemical or physico-chemical components governing its unique medicinal property is neither established nor scientifically validated. The chemical composition of rice is shown below.

Indications: It is effective in Rheumatic ailments, Rheumatoid arthritis, and stiffness of joints, spasticity, spinal cord degeneration, reduced mobility, low backache, cerebral palsy and sciatica. The recent studies showed that it is indicated in paralysis especially of lower motor neuron such as post polio paralysis and paraplegia, congenital spastic paralysis, hemiplegia and pseudo hypertrophic muscular dystrophy.

Contraindications: It is contraindicated in the persons, who are suffering from ischemic heart disease, fractures and dislocations, osteoporosis and pregnancy condition.

Preparation of medicine:

Preparation of Kashaya – Take 200gms of crushed Balamoola in an earthen pot. Add 3 liters of water to it. Put it in mild fire and reduce to get 1.5liter Kashaya.

Preparation of Shastika Shali or Navara rice – Take 200gms Shastika rice in a vessel. Add 750ml Balamoola Kashaya and 750ml of milk to it. Keep the vessel in mild fire until the rice gets cooked well to a semi solid consistency.

Preparation of Pottali –Take a cloth of one-meter square and divide it into four equal pieces. Place four small square pieces of cloth (each four inch) at the center of each cloth. Put equal portion of prepared drug into the four pieces. Hold the cloth by the four corners and make the drug into a bolus. Hold tightly at the junction. Leave the larger end of the cloth and fold the other three corners by inserting into the center. By using the large flap of cloth surround the folded ones neatly and tightly so that it is sufficient to hold with hand. Tie the twine at the junction of handle and bolus. Wind this tightly with the free end of twine and fasten the knot. 8 such packs are prepared. Divide the cooked rice into 8 equal parts.

Procedure: Ask the patient to sit in the Droni in leg stretched position. Apply oil on head and body. Do gentle body massage for few minutes. Take remaining 750ml Kashaya in a wide mouthed vessel. Dip the Pottali in the mixture and heat the vessel in mild fire. Take heated Pottali from the vessel. Check the temperature and apply it over the body. Press the Pottali over the extremities for a fraction of second. Start massaging in Anuloma direction over muscle creases. Apply the Pottali in circular manner in joints and abdomen. Continue the process in seven postures. Strict care is to be taken to ensure uniformity of temperature and pressure on all part of the body. Therapist should be very cautious during the procedure as increased temperature may cause severe injury or burns. While four Pottali are in use, the other four are kept in the mixture of Kashaya over the fire; when the four in use are cooling down they are returned to the mixture for the four that were there till then and the massage is maintained continuously without any considerable break. Massage in each posture is maintained for about 15 minutes, the whole process is taking about an hour and three quarters. The time for the treatment may be increased or reduced according to the condition and health of the patient. When massaging is finished, all the bolus bags are opened out and the pudding remnants remaining there are taken and applied to the body of the patient and rubbed by the hands. Soon after completing the procedure wipe out the remaining rice from the body using coconut leaves. Heat the medicated oil and apply it over the body. Cover the patient with a thick blanket so that temperature loss can be prevented.

After Care: Advice the patient to take rest for one hour. After taking rest patient may take bath using warm water.

Duration: It is done daily for 7 – 21 days taking about 45 minutes each day. 14 days course is ideal in normal individuals for promotion of health.

Diet and Advice: After the procedure patient is advised to take light food. He should avoid immediate exposure to cold breeze, open air and contact with cold water.

This is a variety of Moordhnitaila, where in cotton/gauze soaked with oil is kept on the head(Anterior Fontanelle) by tying for a prescribed time. It is indicated in most of the shirorogas, especially of vataja type, hair loss, graying of hair and psychological diseases.

Indications:- Hairfall, Itching, Cracking of the Skin, Burning Sensation, Netra Stambha(Stiffness of Eyes), Disease of Head, Paralysis, Facial Palsy, Cerebellar Dysfunction, Disease of Eyes, Insomnia, Darunaka.

Materials required:

1. Suitable sneha-50-100 ml.(just above body temperature.)
2. Cotton- Q.S.
3. Hot waterbath- Q.S.
4. Gauze (60cm)- 1
5. Vessel (200ml)- 1
6. Rasnadi choorna- 5g
7. Soft towel- 1
8. Attendant-1
9. Armed chair-1

Pre operative procedure:

Remove hair completely from the head for better therapeutic efficacy. It may also be done without removing the hair. Do Abhyanga over Head, Neck and Shoulders.

Procedure:

Patient should sit comfortably. Massage the head with lukewarm oil (around 40^oC). Place the cotton over the scalp uniformly with a thickness of 2 cm. Gauze piece is tied around the head above the eyebrows, to hold the cotton in place and to prevent oozing of oil into the face. Pour the lukewarm oil (around 40^oC) over the Bregma region so that sufficient quantity reaches the scalp.

Post operative procedure:

After the prescribed time, gauze and cotton should be removed. Wipe the head and Rasnadi choorna should be applied. Bathing can be done after 1hour.

Duration: 30minutes -1hour, for required number of days.

Complication and management:

Peenasa– Stop the procedure and treat accordingly.

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Introduction:

Shirovasti is a procedure in which the medicated oil is allowed to stay over the head for the prescribed time. It is one among the moordhataila. It is beneficial to do Shirovasti after proper purificatory procedures. But in cases where shodana is not necessary it can be done directly.

Indications:- Numbness of Head, Facial Paralysis(Ardita), Insomnia, Anidra(Lack of Sleep), Kampavata(Shivering), Headache(Shirashoola).

Materials required:

1. Rexin/leather (75 cm X 20 cm)- 1
2. Black gram flour – 200 g
3. Taila – 1.5 litres
4. Cotton ribbon (120 cm X 10 cm)- 2 strips, moderately tough, clean and dry
5. Spoon -1
6. Vessel (2 litre) -1
7. Large vessel- 1
8. Rasnadi choorna- 5 g
9. Oil for abhyanga- 100 ml
10. Soft towel- 2
11. Hot waterbath-1
12. Armed chair of knee-height- 1
13. Attendent-2

Pre operative procedure:

Shave the head completely. Do generalised abhyanga. Keep cotton cloth in both ears to prevent the entry of oil in to the ear. Bowel and bladder should be emptied .

Procedure:

The patient should be properly seated in an armed chair. The strip of cloth smeared with the paste of black gram flour is to be wound round the head 2 cm above the eye brows. It should be tight enough to prevent leaking of the oil, but not causing any discomfort. The rexin or leather should be fixed over the strap and the junctions are sealed with black gram paste. Another layer of cloth strap smeared with the black gram paste is wraped over this, sealing the junction of rexin and skin layer. The medicated oil is warmed to just above body temperature and poured into the vastiputaka with a strip of cloth touching the scalp and oil being poured from the other end or a long piece of coconut leaflet held obliquely inside the vastiputaka 2 –3cm above the scalp. . The oil is filled up to a height of 2-3cm above the hair root. To maintain the temperature, some amount of oil should be replaced with warm oil at regular intervals. The procedure should continue till secretions through nose, throat and eyes are observed. In case of non attainment of these lakshanas the time should be fixed as 30 minutes for Kapha, 40 minutes for Pitta and 50 minutes for Vata.The patient should sit comfortably with eyes closed. Oil in kharapaka is preferred. Temperature of the oil should be just above body temperature. During procedure gentle massage to neck and shoulders should be done frequently.Movements of neck should be prevented.

Postoperative procedure:

At the end of the procedure, a passage is made above the ear, to remove the oil. Oil over the head must be wiped out with a dry cloth, and abhyanga is done over head, shoulder, palms and soles. Rasnadi choorna is rubbed over the head. Take rest for one hour and then, patient should take bath with lukewarm water..

Time: 3-6 pm, for 7 days

The Process should be continued till the period of Samyak Lakshana such as Vaktasrava(Watering in mouth), Nasikotklesha(Moisture in Nose), Karna Srava.

The time can be fixed according to the disease also like:-

10,000 Matrakala in Vata predominant disease

8000 Matrakala in Pitta predominant disease

6000 Matrakala in Kapha predominant disease

1000 Matrakala in Swastha

Precautions:

1. Ensure that there is no hole in the junction of the cap before pouring to check leakage of oil.
2. Ensure the uniformity of the taila temperature.
3. Should not heat oil over direct fire, heat through boiling water.
4. Patient should not sleep, sneeze, and laugh during the treatment.
5. Avoid cold food items, cold breeze exposure.
6. Avoid very hot and cold conditions.

7.Avoid head bath if the disease is contra indicated for the same such as Ardita.

Complications and management:

1. Sneezing and rhinitis– Talam with Rasnadi choorna and Jambeera swarasa, dhoomapana with Haridra dhooma varti
2. Neck pain– Local massage
3. Heaviness of head– Stop the procedure and treat accordingly
4. Fainting,Headache&Shiverng.Treat accordingly.

Sirodhara is the process in which medicated oil, milk, butter milk or Kwatha is poured in a continuous stream of drip on the head, especially on the forehead. Depending on the drug components, Dhara is known by different names like Takradhara, Kshira Dhara, Taila dhara, Kwatha Dhara, Jala Dhara

Synonyms:- Dhara, Seka, Parisheka, Avasheka, Secana, Prasecana

Introduction: Pouring of a liquid over the forehead or scalp is known as Shirodhara. It can be done by different medicaments like Taila, Takra, Kshira, Kwatha, etc. When it is done with medicated Ghee or Taila, it is called Taila Dhara which is commonly called as Shirodhara. It is one among the four types of Murdha Taila procedures. Murdha Taila means application of medicated oils over the head in different forms. Dhara means a continuous flow of liquid from the hole of the pot.

Benefits: Shirodhara by using medicated oil or ghee will enhance the firmness of mind and speech, strength of the body, inclination to food, makes the skin healthy, enhances the sharpness of eyes, virility, semen and blood and promotes longevity. It reduces the excess body temperature and induces good sleep.

Materials required: Droni, Dhara pot, wick, rope, cloth, Hotwaterbath, vessels, medicated oil, blanket or bed sheet and Amalaki powder for Taladarana.

Selection of Drugs for Shirodhara: Drugs used for Shirodhara should be selected on the basis of the nature of the disease, vitiated Dosha as well as the constitution of the biological strength of the patient. Drugs specifically indicated in certain disease are-

• Vataja Roga – Bala Taila, Dashmool Kwath, and Ghrita etc
• Pittaja Roga – Chandana, Usher Kwatha etc
• Kaphaja Roga – Naagara, Mustaka and Madhuyasti Kwatha

According to Dhara Kalpa, Sneha is selected as per the condition of Dosha which is mentioned below.

• Vata Dosha – Tila Taila
• Pitta Dosha – Ghrita
• Kapha Dosha – Tila Taila
• Rakta Dosha – Ghrita
• Vata + Pitta + Rakta – Ghrita + Taila in equal portion;
• Vata + Kapha + Rakta – ½ part Ghrita + 1 part Tila Taila

The quantity required is about 2 to 3 liters.

Indications: This Shirodhara is indicated in the diseases like Ardhavabhedaka, Suryavarta, Ardita, Pakshaghata, Hanugraha, Akshi Shoola, Nidra Nasha, Shiro Gata Vata and Shira Kampa. Nowadays, it is indicated in almost all stress and psychosomatic disorders such as IBS, Asthma, neurological disorders viz. headache, epilepsy, and psychiatric disorders like psychosis, neurosis, insomnia and also in psoriasis, eczema, anxiety neurosis, other psychological illness, sleeplessness, hypertension, headache, migraine, paralysis, premature graying of hair and premature baldness, stress related conditions.

Contraindications: In Kaphaja diseases if Shirodhara is practiced then it further increases Kapha, which makes the disease difficult to cure.

Preparation of patient: Shirodhara is done in the morning or evening on empty stomach after proper massage. Shave the head or in case of women tie the hair tightly so that oil reaches all parts of scalp. The patient should pass stool and urine. Then patients pulse, temperature and blood pressure should be recorded. The patient is asked to lie down on the massage table in supine position. Apply little oil over head and body. Do Abhyanga for 5-10 minutes. Tie a band of cloth over forehead above the ears and eyebrows. The band should be round in front and flat at back. Tie the knot at one side of head. A cushion pad is kept beneath the neck of the patient so that the head of the patient gets tilted slightly backwards. The eyes are covered with cotton pad and may be lightly bandaged so that liquid doses not enter the eyes of the patient.

Materials required:

1. Shirodhara device-1
2. Varti- 1
3. Suitable oil-1.5litres
4. Gauze- 1
5. Cotton earplugs-2
6. Soft pillow covered with rexin-1
7. Hotwaterbath-1
8. Vessels -3
9. Nadisweda device-1
10. Oil for Talam-10ml
11. Rasnadi choorna- 5g
12. Soft towels-2
13. Dhara patra-1
14. Attendents-2

Specification of Dhara patra and varti:

Dhara patra should be 5-6 inches depth with wide open mouth, round at the bottom with a capacity of approximately 2 litres. There should be a hole to the size of little finger at its centre of the bottom. There should be three holes with equal distance to the ridges of the patra, to tie up three strings for the purpose of hanging over the stand.

Dhara varthi is a wick or a string of loose cotton threads with a free end of about 4 inches coming out through the hole of dhara vessel. The threads of the wick should be packed only just firmly as not to slip of the hole, but loose enough to permit a continuous and uniform flow of the liquid that is poured in to the dhara vessel.

Pre operative procedure:

Abhyanga should be done over the face, neck, shoulder and chest.(Whole body abhyanga can also be done) Gauze is tied around the head above the eyebrows of the patient. After closing the eyes cotton is kept over the eye lids and it should be tied with proper bandage. Ear plug should be applied.

Procedure:

Patient should lie in supine position on the droni with a pillow under the neck and the shirodhara device should be placed near his head .Eyes should be covered to protect from oil with cotton and gauze. Its height should be fixed such that oil should fall from a height of 4-5 inches in a continuous stream of little finger thickness. Serrated coconut shell should be placed inside the apparatus to maintain uniform dhara. Oil should be heated just above body temperature(38- 40^oC) and poured into the dharapatra . A continuous stream of oil should be allowed to fall on the entire forehead, while oscillating the dharapatra to coverb the entire head…Uniform oscillation is required for uniform dhara .Simultaneous massage with other hand should also be done.

The oil should be recollected from the droni, reheated and poured back into the dharapatra.

For this procedure a specific table having seven feet length, two and half feet breadth and two and half feet height is required .It must have a slope and a hole toward head side for the collection of the liquid and provision to keep the head of the patient comfortably. For filling the liquid a Dhara Patra is taken which is a round vessel prepared from brass, steel, clay etc The mouth of the vessel should be wide and sides are tapering gradually to a ventral point in the bottom. At this point a hole may be made approximately of little finger size. The depth of vessel may be 5 to 6 inches. The capacity of the vessel may be 2 Prastha (1.5 – 2 liters). Inside the vessel a small wooden bowl having a central hole should be put inversely so as to both holes of the vessel come in the medial line. In this small vessel a wick should be entered passing through the both holes and hanging down from the big vessel so as to maintain a continuous flow of liquid. The length of the wick outside the vessel should be 4 inches. The upper end of the wick should have knot to prevent slipping from the vessel. The Dhara Patra should be hanged just above the forehead of the patient. The end of the wick should be 4 fingers (3 inches) above the forehead of the patient. The vessel is kept refilled with the recollected liquid. On the upper edge of the vessel, 3 holes should be made to hang it in a horizontal plane to

avoid spillage.

Take the selected medicated oils like Himasagara Taila, Ksheerabala Taila or Brihat Masha Taila etc. in a vessel. Oil should be heated just above body temperature (38- 40^oC) and collected in Dhara Patra. Start pouring the oil continuously and slowly from 4-inch height over the forehead. A mild oscillation should be given to maintain the flow all over the forehead. The oil should be recollected from the Droni, reheated and poured back into the Dhara Patra and continue the procedure.

After Care:

Gauze and earplugs should be removed and head must be wiped off with the towel. Rasnadi choorna should be applied over the head. Hot water bath can be done if prescribed, after 1 hour. Give some rest to the patient .At last advice him to take hot water bath. The water boiled with coriander seeds and ginger is prescribed to drink.

Duration: It should be done for 53 minutes and for 7-14 consecutive days. The patient having dryness and Pittayukta Vata, the period is 2½ Prahara or 2 Prahara and in Snigdha Kaphayukta Vata it is one Prahara, or it should be upto perspiration initiate. 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 am.

Diet and Advise: Advice the patient to take rice gruel and light diet. In the days prior, during and after the procedure, one has to consume that quantity of food which gets digested properly. The hot rice should be given with the soup of greengram or hot Vilepi. The food should not be Abhishyandi i.e. it should not increase Kapha. He should drink water, which is prepared with Vata pacifying drugs. He should take Pathya up to 7 days. For drinking purpose warm water boiled with Dhanyajiraka, ginger and cumin seeds may be used. For washing and ablating purposes only warm water should be used. Avoid hard work and activities. Exposing to cold weather and taking cold items during the procedure is strictly prohibited. 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. During the course of the treatment, the patient should be cheerful and happy and should avoid wearisome exertions, distasteful diet or excessive indulgence in tasty foods. He should wear clean and dry cloths and may have anointed with sandal wood paste.

Precautions: During the process if headache, giddiness and burning sensation of the body are observed then we have to reduce the height of Dhara. If Dhara is done from more height, very early or very slowly then it may produce burning in body, pain in all joints, bleeding tendency, fever etc. For the treatment of this 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.

Practical tips: It is the most important point that Shirodhara should be performed in a very peaceful and pleasant atmosphere to get the maximum benefit of therapy.

The same temperature, force and continuous flow should be maintained throughout the procedure. Moderate height, thickness and speed should be maintained. Patient should not sleep during the process.

In Kevala Vata conditions, oil should be bearably hot, in Pitta conditions, slightly warm and in Kapha conditions oil should be heated till the substance just melts and in the diseases above the clavicle it should be cold.

Period for changing the liquid: When milk is used for Parisechana 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 used, 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.

Mode of action: Shirodhara as it comes under Bahya Snehana, which produces viscosity, softness, solubility and Kleda in the body. Continuous pouring of oil on fore-head for a specific period has tranquilizing effect and induces sleep. As per modern science, local application as ointment may pass through the stratum corneum into blood vessel and producing desirable effects by reaching the target organ. The continuous pouring of oil in relaxed and comfortable position has an additional effect which can be comparing to cradling of mother to a child. This function acts as sedative and soothing effect for the brain and produces sleep. Oil poured on fore-head may be absorbed; producing Tranquilizing effect by reaching the Brain cortex.

The chemical constituent of medicated oil may act as a Neuro transmitter as deficiency of certain Neurotransmitter can be checked hypothetically if oil percolates in to Brain cortex while treating the patient of Angina by Nitroglycerine.

As Tila Taila is Vatahara and Snigdhata, properties help Tarpaka Kapha in proper facilitation and sound connection of Indriyas and their Vishayas which was deranged earlier by aggravated Vata. Active ingredients of oil penetrate into the circulation via for- head and produces Vatahara effect. However oil produces lubrication and nutrition. Shirodhara acts as Medhya if oil which is used is processed with Medhya drugs.

According to Dhara Kalpa, the time required for the medicinal potency of the oil which is used for Shirodhara to traverse through the body elements is mentioned. The unctuous substances after laying over the hair follicles for a period of 300 Matra Kala, enter the skin by 400 Matra Kala; in the similar manner the unctuousness reaches Rakta, Mamsa, Meda, Asthi and Majja in each successive 100 Matra Kala i.e. it reaches Majja by 900 Matra Kala. It is mentioned in the classics that potency of the drug reaches Shukra by 1600 Matra Kala. The medicinal potency, during the course of successive transference, reduces the disease of Vata, Pitta and Kapha located in the respective body elements.

Effect on Marma:

• Sthapani Marma: Just below this area inside the skull lies the venous reservoir of the brain the superior Sagittal and Cavernous Venous Sinuses.
• Shankha Marma: It corresponds to temporal bone of the skull underneath which lies the temporal lobe of cortex arterial branches and at the base is also some of the important structures of the brain.
• Utkshepa Marma: Intracranial cavity and venous sinuses the wall of which are made of coverings of the brain lie in this region
• Adhipati Marma: This location is well known as the anterior fontanelle on the vertical groove of the frontal bone. Underneath this point, there is sagital sinus of the brain and also the sulcus between two hemispheres of the cortex.

Shirodhara stimulates these Marma’s and improves circulation, as oil used for Shirodhara is always warm which causes vasodilatation of all the channels and thereby improving their circulation which in turn improves the blood circulation of brain. This improves the higher intellectual functions also. So an improvement in psychic symptoms is achieved. Improvement in circulation to hypothalamus also improves the function of Autonomic Nervous System as its stimulation during stress causes many physiological disturbances.

Effect on Chakras: Shirodhara stimulates Agnya Chakra thereby improving the functions of mind which is vitiated in Stress as it is the place of subtle mind. Structures like Pituitary gland, pineal body, subcortic structures of mid brain are related with mental functions like anger, grief, pain, fear, memory and other higher intellectual functions .Shirodhara acts at this level correcting their functions.

Effect on Central Nervous System: The Shirodhara procedure and various drugs used for it, can affect the Central Nervous System in the following ways:

· They may act directly on neurons and modify the neuronal functions.

• They may act reflexly by sending afferent impulses to the central nervous system via the chemoreceptors, baroreceptors and peripheral nerves and there by eliciting psychic, somatic or visceral responses.
• They may affect the nutrition and oxygen supply of the CNS by altering its blood supply or affecting its metabolism.

To reach the central nervous system, a drug must have a high degree of lipid solubility (high oil / water partition coefficient) or a specialized transport mechanism. Ionized drugs as a rule cannot penetrate into the central nervous system. For this reason the existence of a blood brain barrier has been postulated. Drugs may either stimulate or depress the central nervous system.

Basis of drug action:

1. a) Drugs may modify the synthesis, storage, release or metabolism of the inhibitory or excitatory Neuro-chemical transmitters. Thus, monoamine oxidase inbitors act as antidepressants by inhibiting the destruction of noradrenaline by the enzyme, Mono Amine Oxidaze (MAO) the transmitter dependent actions of drugs can be classified into pre-synaptic and post – synaptic.
2. b) Drugs may modify the energy supply of the central nervous system. This may be achieved by local inhibition of the Synthesis of high energy phosphate bonds (barbiturates), by inhibition of action of certain enzymes involved in cellular respiration and energy processors or by increasing or decreasing the availability of the substrate for energy production.
3. c) Drugs may act by modifying ionic fluxes across the cell membrane.
4. d) Drugs may specifically acts as antagonists of other drugs at receptor levels. It is extremely difficult to define what constitutes psyche or ‘mind’ which is supposed to carry out three functions.

• Reception of environmental stimuli (cognition)
• Analyzing the information received and formation of a reaction pattern (affect)
• The actual behavioral response (conation)

The exact site and mode of action of various psycho-therapeutic agents therefore remain unidentified. By affecting three of the major integrating systems of the brain firstly, they may reduce the incoming sensory stimuli by acting on brain stem reticular formation. The drugs also modify the function of limbic system. Lastly they are known to cause blockage of post synaptic Monoaminergic (noradrenalin, dopamine and 5-hydroxy tryptamine) transmission in the brain, thus leading to a decrease in the central sympathetic activity.

Effect on Autonomic Nervous System: Shirodhara may also have Alpha Adrenergic blocking effect and can thus block certain actions of adrenaline and nor adrenaline. Shirodhara may also act on the adrenergic neuron probably produce their effects by modifying the synthesis storage and uptake mechanisms of noradrenaline.

Effect on Endocrine system: The effect of Shirodhara on hormone secretion can also be postulated considering the effect on hypothalamus as hypothalamus is the main controller of endocrine secretions. The hypothalamic Neurons which secrete the regulatory hormones are themselves under the control of specialized Monoaminergic, neurotransmitter neurons which arise in the mid brain where these latter releases Dopamine, Noradrenaline and Serotonin. In turn, these mid brain nuclei are under the control of visceral brain and are responsive to stress and emotional disturbances.

Regulation of emotional and behavioral patterns: Together with the limbic system with the hypothalamus regulates the feeling of rage, aggression, pain and pleasure and behavioral patterns of sexual arousal ultimately it can be postulated that Shirodhara may be having some effect on hypothalamus resulting in decrease of most of the psychic and somatic disorders.