Shirodara

[Guest guest]

Hi

 

I recently had panchakarma treatment while in India and the doctor

did say that Shirodara was part of the treatment. However when the

panchakarma was over he changed his approach and said that Shirodara

was separate and had to be paid for (at what appeared quite a high

price per treatment). He said I needed 4 or 5 treatments. My family

seemed to think that he was just trying to make money and

overcharging. I wonder if anyone knows a) if Shirodara is part of

the panchakarma treatment and b) what the correct average price of

shirodara treatment is in India.

 

I would be very grateful for any ideas.

[Guest guest]

Unfortuantely the problem you mention is very common. I have made

many complaints about the cheating practices of many so called

reputable ayurveda centers in India. In defense of those people it is

partially a cultural differance that keeps them from seeing their

mistake.

 

Many Indian business men (Panchakarma treatments is little more than

a business in most Indian Ayurvedic centers) see nothing wrong with

having a multi leveled pricing scheme. They think if you are a rich

foreigner then naturally you should pay more (sometimes many times

more). This is not really a racial issue as foriegn Indians like me

are also charged more.

 

Setting up treatment programs to exploit foreigners is common in

India and according to me is spoiling the name of Ayurveda. As many

foreign people feel exploited when they go to one of those places - I

rarely recommend for people to go to India for these treatments

because they are often run on money considerations rather than

scientific principles.

 

As far as your general question about Shirodara. Shirodara is not a

regular treatment in Panchakarma but many Vaidyas use it with most

patients as it is helpful for many modern stress disorders. Prakruti

and the nature of the disease is most important in determining

whether any particular treatment (and its type - such as oil or

buttermilk, etc.).

 

Unfortuantely the practice of Ayurveda in India today is at very low

ebb. Using the south as an example as it is the area I know most

about. In Kerala they do not traditionaly use the same concepts for

purification that are used in the north - this confuses many people.

This is especially true when it appears that Malayalee vaidyas seem

not to follow traditional understandings concerning many therapies.

this is not actually an error it is the result of differant

techniques of treatment being independantly developed over the years.

Since many foreigners have heard of Panchakarma as practiced in the

north - many southern vaidyas have adopted these northern techniques

as a marketing tool. this has caused many problems and is

consequently making many doubts for foreigners looking for health

treatments.

 

I have taken many treatments in many of the best centers in Kerala

and did not get the benefit I expected from half of the treatments.

Also in at least 50% of the cases I ended up with serious side-

effects that took a long time to recover from. A properly

adminestered Ayurvedic cleansing program should leave one feeling

fresh and clear.

 

It is a gamble. There are a few gifted Vaidyas who understand how to

combine many old and modern techniques for maximum benefit - but most

do not clearly understand the science involved in that process and

consequently make big mistakes. One big error I notice in Kerala is

the overuse of hot treatments in modern people many of whom are

suffering from serious Pitta diseases and will surely get problems

from hot treatments on body and head. The problem involved when a

patient presents with mixed symptom picture such as mixed

Vata-Pitta disease or mixed Vata-Kapha - both common in modern

people - often are not clearly understood by many young inexperienced

Vaidys - consequently they do not manage the cases well.

 

One fellow with serious Vata-Pitta disease having hypometabolism and

high blood pressure combined - was treate4d with hot oils extinsevly -

he ended up in an alleopathic hospital after leaving the Ayurvedic

hospital (a very famous place) with a dangerous hypertensive crisis -

the combination of those Ayurvedic treatments and the alleopathic

medicines he took ended him up in worse shape than before the

treatments.

 

The issues are very complicated and are not actually easily solved

because of the fact that many centers use their own approach and the

Ayurvedic science involved is something invented by the head

physicians and may have no actual validity according to traditional

methods.

 

Bottom line is if you are a foreigner then you will undoubtably pay

more in most places for the same treatments the Indian patients get

for less. Many programs are designed as 'Ayurvedic Packages'these are

often designed with many compromises based on economics and time

consederations. These problems can not actually be solved but

hopefully more Ayurvedic 'SCIENCE' will be applied to these programs.

Also Indian business men need to understand that many foreigners that

go to India for treatments do not have more money and actually are

taking a big chance to spend so much money taking off from job and

going to India for costly treatments that do not benefit very much.

 

The excesses of the Ayurvedic 'Holiday' could be solved with strict

adherance to Ayurvedic science - but many vaidyas are not qualified

to translate complicated short term treatments into meaningful

therapies.

 

Hopefully these things will be solved sooner are later. I have heard

that many programs of some big players in Ayurveda in India that were

developed to catch foreign dollars have failed. I know of one place

that was set up at great expense to cater to foriegners that is a

financial flop. The director of that institution asked me why the

foreigners did not come. My answer was 'It is too costly - and they

get little benefit - so why would they come'.

 

The standards at these places in no way reflect the cost - they are

way overpriced. Some places that charge seperately for room rate -

charge equal to a four or five star hotel for the simple rooms.

Foreigners will naturally feel cheated.

 

I pray that serious Ayurvedic practioners will reevaluate the isuues

and come to a new conclusion that will lift the name of Ayurveda in

the minds of foreigners not bring it down.

[Guest guest]

Dear Lorraine,

You have touched upon a vey sensitive subject in ayurveda.

You have asked 2 specific questions :-

a) Is Shirodara is part of the panchakarma treatment.

b) What the correct average price of shirodara treatment is in India?

 

a) There are many misconceptions about what panchakarma is. The

subject is so vast that many books have been written on it.

However to summarize in a nutshell, ayurvedic treatment is classified

into 2 broad types namely "shaman" and "shodhan".

Ayurveda beleives all diseases are caused by am imbalance of doshas

i.e. either they are increased or decreased.

In practise however we have to deal with increased doshas mostly

(whether decreased doshas are really capable of creating disease is a

major debate in ayurvedic academic circles).

Shaman means supression of these imbalanced doshas by giving oral

medications.

Till over a decade ago ayurvedic treatment consisited mostly of this

type only.

However when the doshas are imbalanced (read increased) in large

quantities shaman treatment proves ineffective or takes a very long

time.

The need then is to physically remove these increased doshas. The

method adopted for that is called as shodhan.

There are many procedures by which shodhan is effected. The five

major processes are what are collectively termed as panchakarma.

"Panch" means five, "karma" means "procedure" - plain and simple.

These five are emesis, purgation, medictaed enema, blood-letting and

nasal medication.

However over the years (rather centuries) some other procedures were

also found to be effective (the most popular among them was

shirodhara). Though they could be technically called as shodhan

treatment since panchakarma had a special appeal to it (because the

effects of panchakarma were visible immediately, as opposed to oral

medication) they began to be included under panchakarma.

Though this violates the meaning of "pancha", since the basic aim of

the procedures (the new ones) was the same as the first five many

people included them under panchakarma.

The problem arises because many people think that all 5 procedures in

panchakarma should be done at the same time. This is not true. Only

in certain conditions, like administration of Kuti-Praveshik Rasayan

should all 5 procedures be done simultaneously. Otherwise any one or

two of the procedures are to be done depending on the disease. Why

some Panchakarma centers insist on doing all 5 or rather they add

their own procedures in between (for example oil massage and steam,

which are like pre-operational procedure are passed of as

panchakarma) is very obvious.

The second misconception which has been spread about panchakarma is

that "you feel nice", "you feel light" etc. Panchakarma is a

treatment procedure. The feeling of well-being after panchakarma

should not be confused or expected of the feeling you get after a

good hot water bath.

If the feeling of lightness is due to your wallet getting lightened,

that also should not be considered a side-effect of panchakarma.

I can go on and on but in short the answer to your first question is

shirodhara though not strictly a panchakarma procedure can be

included in your shodhan treatment if required. What was wrong in

your case was to first say that shirodhara is a part of panchakarma

and then to charge separately for it. This is like charging for water

separately after you have had a five course meal. Whether water is

included in a five course meal would be a tough question to answer.

 

b) Because of its nature, panchakarma treatment is expensive. This is

one of the major reason why both the practise and use of panchakarma

treatment was not so prominent till a decade ago. How much a certain

procedure will cost (the basic cost incurred by the doctor to

administer panchakarma) depends on location of the center, cost of

raw material, cost of labour, experience of the doctor etc. Just as

many surgical procedures are cheaper in India than in the US or UK,

so also a panchakarma procedure done in cities like Mumbai, Delhi,

Chennai will be 10 times more costly than if done in a small town.

The reason here is not only that there are some people in it only for

the money, but sometimes doing panchakarma as is mentioned in the

texts is unglamorous and not too rewarding. So instead of sesame oil,

some medicated or scented oil is used. This increases the cost and is

abviously passed on to the patient (I refrain from using the word

consumer). All said and done a single sitting of shirodhara should

cost you anywhere between Rs.350/- to Rs.1500/- if done at a regualr

center and Rs.1000/- to Rs.5000/- if done at resorts, five star

hotels etc. (whether they should be done at resorts and five star

hotels is another debatable issue)

 

Cybervaidya