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Snehana is one of the Purvakarma of Panchakarma
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- ABHYANTARA SNEHAPANA Dr. Ketan Mahajan M.D. Panchakarma
Assistant Professor Department of Panchakarma Patanjali Bhartiya
Ayurvigyan Evam Anusandhan Sansthan Haridwar, U.K. Email:
ketanmahajan82@gmail.com
- Order of Treatment Deepana Pachana Poorvakarma Snehana Svedana
Pradhankarma Shodhana Paschatkarma Ahara Aushadh Vihar
- Classification Bahya Abhyantara
- The process which produces: Sneha Vishyandana Mriduta
Kledana
- Sneha therapy can be administered only when:- There is good
Agnideepti There is Srotoshodhana For this purpose Deepana,
Pachana, Rooksha aushadhis are given before Snehana.
- Deepana- Pachana Chikitsa Enhances the Agni Clears the Srotas
Better absorption & efficacy Reduces the risk of
complications
- How to apply Deepana Pachana in practice CHOORNA Panchakola
Ajmodadi Vaishwanara etc.. KASHAYA Dashmoola Chirbilwadi Shunthi
etc.. VATI Chitrakadi Agnitundi etc..
- Agnitundi Vati Trikatu Churna Jeerak Churna Panchakola Phanta
Vata Pitta Shoola Pradhan Roga Kapha
- Note: If necessary mild Anulomana Dravyas can be advised during
Deepana Pachana like Abhayarishta, Avipattikara Churna etc.. If
Rukshana is necessary Takrarishta, Udvartana can be adviced.
- Multifaceted Therapy As Poorvakarma External & Internal Use
Localized & Systemic Action Different modes of Administration
Nourishes Body & Mind
- Where can we give Sneha ??
- Indications Svedya Samshodya Ruksha Vata Vikara Vyayamanitya
Madhyanitya Streenitya Chintaka Vriddha Bala Abala Krisha
Ksheenasra Ksheenaretas Syanda Timira Daruna Pratibodhinah
- Practically what we come across.. Degenerative disorders of
joints Skin disorders Psychiatric illnesses Neurological diseases
Immune pathologies Myopathies Gynecological disorders
- Contraindications Rukshanarha Utsanna Kapha Utsanna Medas
Abhishyanna- Anaha Abhishyanna Guda Mandagni Trishna Murcha
Garbhini Talushosha Annadvesha Chardi Gar-ardita Ama-ardita Durbala
Snehaglanayah Madatura Ajirna Taruna jwara Basti karma Aruchi
Vamita Virikta Akala prasruta Udararogi Urustambha Atisara
- Practically what we come across.. Patients with Mandagni
Diseases of Kapha Anubandha Diseases of Meda Anubandha
- Variety Pitta Vata Vata Kapha Vata Vata
- Ghee- Points to remember Samskara Anuvartanam Madhura
Avidahitvat Janmadyeva Cha Sheelanat Administered in Sharad Ritu
Those who desire for longevity, Bala, Varna, Svara, Pushti, Smriti,
Medha, Dhee, Agni etc..
- Taila- Points to remember Madhura Rasa Ushna Guna Administered
in Pravrut & Sheeta Kala Pravriddha Shleshma & Medas In
Krimi Kostha In Krura Kostha Those who desire for Bala, Laghuta
etc..
- Vasa- Points to remember Having best Agni Bala Ruksha Emaciated
from weight lifting, coitus & excessive walking Sandhi, Asthi,
Marma, Koshha Ruja Vata Avarana Vasa Satmya
- Majja- Points to remember Diptagni Klesha Saha Krura Koshha
Sneha Sevi Those who desire of Bala-Shukra-Majja-Asthi
Vardhana
- Yamaka & Maha Sneha To use in different degrees of Vata
vitiation Eg. Jeevantyadi Yamak in Vipadika, Mahasneha in
Asthimajjagata Vata
- Karmukta Bheda of Sneha Criteria Shodhana Shamana Brimhana
Purpose Doshutklesha Vyadhi Shamana Brimhana Form Accha, Vicharana
Accha Vicharana Dose Uttama Madhayam Alpa Time & Method of
administration Morning Akshudhita Morning Kshudhita Any time with
food Duration Maximum 7 days Till Vyadhi Shamana Till samyak
Brimhana
- Types of Abhyantara Snehapana in Practice Accha Sneha
Pravicharana Sneha Sadhya Sneha
- Accha Sneha
- Intake of large quantity of Sneha, without mixing with any
other materials. Taking large quantity of Sneha after the digestion
of previous night meal. If Accha Sneha is taken during Kshudha Kala
it does not serve the purpose of Shodhana because of
Deeptagni.
- Indications Contraindications Sneha Satmaya Sneha Dveshi Klesha
Saha Kshama Nati Sheeta/Ushna Kala Mridu Kostha Sneha-Madhya
Nitya
- Duration of administration Krura Koshta - 7 days Madhyama
Koshta - 4 to 5 days Mrudu Koshta - 3 days Or Upto Samyak Snigdha
Lakshana, whichever is earlier. If administered for long time it
will lead to Satmyata.
- Materials required Sneha- Q.S. Measuring jar-1 Glass-1 Cloth-1
Lemon-1 Water boiled with Shunti - Q.S. Cotton- Q.S. Gauze-1
Tumbler-1
- Pre operative procedure Proper Patient examination Assessment
of digestion and bowel Test dose
- Important Factors for Abhyantara Snehapana KOSTHA AGNI
- Assessment of Kostha Frequency of stool Consistency of stool
Time for defecation Level of satisfaction Effect of food items
& medicines Any GIT pathology
- Assessment of Agni Understand the level and degree of Appetite
Details of Food habit Any history of Ajeerna Quantity and Quality
of food Timing and interval of Food
- Investigations required prior to Accha Snehapana Blood - RE,
LFT, Sugar levels , Lipid profiles. Urine - RE Stool - RE
- Procedure Dosage of the sneha must be decided according to
Vayas, Prakriti, Vikriti, Dosha and Agnibala. It must be in between
30-50 ml The dose for the next day should be fixed after assessing
the time taken for digestion.
- Within half an hour of sunrise, patient should be seated in a
comfortable position and Sneha should be given in empty stomach.
After giving the Sneha warm water should be given as Anupana
- Specific Anupana Ushnodaka for most of the sneha except those
processed with Tuvarak & Bhallatak Yusha- for Taila Manda- Vasa
& Majja
- Then the patient should wash the face and mouth with hot water
to remove the taste of Sneha. When thirst occurs, hot water can be
given.
- Jiryamana Lakshana Jirna Lakshana Shiroruja Shirorujadi
Jiryamana Lakshana Prashamana Bhrama Vatanulomana Nishthiva
Svastyata Murcha Kshut Sada Trishna Arati Udgarashuddhi Klama
Laghuta
- Samyak Snigdha Lakshana 1. Agnideepti (increase in appetite) 2.
Sneha- Dvesha (intolerance to fat) 3. Asamhata Varcha (loose
stools) 4. Anga Laghava (lightness in the body) 5. Gatra Mardawa
(soft feeling of body parts) 6. Snigdha Gatrata (smoothness in the
body)
- 7. Snigdha Pureesha (oily stools) 8. Snigdha Twcha (oily skin)
9. Vatanulomana (passage of flatus) 10. Adastad Sneha Darsanam
(passing of fat in stools) 11. Klama (tiredness without doing
physical work) 12. Shaithilya (lethargy)
- Key Points Vatanulomana Normal GIT movements Agnideepti Normal
Appetite Varcha Snigdhata and Asamhata Oily stool Snehodwega
Aversion to Sneha Klama - Lassitude
- Asnigdha Lakshana 1. Grathita Purisha (passing of hard stools)
2. Ruksha Purisha (passing of dry stools) 3. Agnimandya (weak
digestive power) 4. Vayu Pratilomata (unregulated vata) 5. Gatra
Kharata (roughness of body) 6. Gatra Rukshata (dryness of body) 7.
Urovidaha (burning sensation in chest) 8. Dourbalya (weakness) 9.
Kricchra Annapachana (late digestion) 10.Susnigdha Viparyaya
(features opposite to those of Samyak Sneha)
- Atisnigdha Lakshana 1. Panduta (pallor) 2. Sharira Gaurava
(heaviness of body) 3. Jadyata (sluggishness) 4. Apakva Purisha
(undigested foods in stools) 5. Tandra (drowsiness) 6. Aruchi (lack
of taste in the mouth) 7. Utklesha (nausea)
- 8. Bhaktadvesha (aversion to take food) 9. Mukhasrava
(Excessive salivation) 10. Ghranasrava (discharge from the nose)
11. Gudasrava (secretions in the anus) 12. Gudadaha (burning
sensation in the anal region) 13. Pravahika (dysentery) 14. Purisha
- Atipravritti (excessive passing of stools)
- Complications practically observed.. Complication Management
Headache Ushnanupana, Rasnadi Lepa, Shunthidhanyak Pana Gas Trouble
Hinguvachadi Gutika, Pippalyasava Hiccup Hinguvachadi gutika,
Shunthidhanyak Pana, Dhanvantaram Gutika Burning Sensation
Drakshadi Kashaya, Avipatti Churna, Nishunthi Shadang Paniya
- Complication Management Fatigue Purnachandrodaya Gutika,
Balaristha, Draksharistha, Mild Shodhana Diarrhoea Bilvadi Gutika,
Mustarishta Vomiting Bilvadi Kashaya, Bilvadi Lehya, Dadima Rasa
Indigestion Hinguvachadi Gutika, Abhyarishta, Jirakarishta
- Post Operative Procedure Patient should take rest during the
Snehapana period but he/she should not sleep during the day time.
Lemon can be given to smell to avoid nausea. Warm Vilepi should be
given when the Sneha is completely digested and good appetite
occurs.
- Pathya - Diet and Regimen Usage of hot water for all purposes
Abstinence Non-suppression of urges Non-exposure to cold, dust
& sun Stable mentality
- Pravicharana Sneha
- When Sneha is particularly used in the form of Bhaksha, Pana,
Leha, Abhyanjana etc. it is called asPravicharana. While describing
the Brimhana Snehapana Hemadri says that Rasa, Madya etc. when
mixed according to taste, palatability and Satmya of the individual
in the Sneha is called as Vicharana.
- As per the mode of application these preparations can be
divided in to two groups as a) Internal Pravicharana. b) External
Pravicharana. The preparations like Odana, Vilepi, Mamsarasa, Paya
(milk), Dadhi, Yavagu, Supa, Shaka, Yush, Kambalika, Khada, Saktu,
Tila pishta, Madya, Lehya etc. comes under internal use category.
Whereas, Abhyanga, Basti, Uttarbasti, Gandusha, Karnatail, Nasya,
Akshitarpana, Karnatarpana are the external types of
Pravicharana.
- Karma Bheda of Pravicharana Sneha Criteria Vamana Virechana
Basti Nasya Rakta Mokshana Purpose Kaphotklesha Kapha- Avriddhikara
Angamardava, Vatanulomana Dosha Vilayana Doshotkleshana Type Int
& Ext Int & Ext Ext Ext Int Example Dugdha, Dadhi, Mamsa,
Tilapishta Yusha, Supa, Kambalika, Khada, Madya Abhyanga, Anuvasana
Basti Abhyanga, Gandusha Yavagu, Madya
- Commonly prepared Pravicharana Odana: 1 part rice + 5 parts
water Vilepi: 1 part cereal + 4 parts water Rasa: 1 part meat +
2/3/4 parts water
- Yavagu: 1 part cereal + 6 parts water Supa: 1 part pulses + 18
parts water reduced to 1/4th Yusha: 1 part pulses + 18 parts water
reduced to 1/2 Saktu: Flour of cereals & pulses mixed with
Ghee
- Sadhyo Sneha
- To achieve Samyak Snigdha Lakshana immediately Lakshanas are
attained within 1-3 days Based mainly on the principal of
Pravicharana Sneha
- Indications Bala Vriddha Sneha Parihara Asahishnu Balahina
Mridu Agni Alpa Dosha
- Contra-Indications In Kustha, Prameha & Shotha it should
not be given with Gramya, Anupa, Audaka Mamsa, Kshira, Guda, Dadhi
and Tila.
- Commonly used Sadhyo Sneha Yogas Pippali, Saindhava, Tila
Pishta, Ghee Ghee, powdered sugar, milk Ruksha Person Yavagu ( rice
& milk) with Ghee Dugdha with Ghee & Lavana
- Pancha Prasruta Sneha Chatur Sneha ( 1 Prastha each) mixed with
1 Prastha rice Lavanayukta Sneha Instant Snehana due to
Abhishyandi, Sukshma, Ushna , Vyavayi Guna
- How Snehana acts..
- Sneho Anilam Hanti Vata Shamak property of Sneha Sneha have
opposite Gunas of Vata Vatanulomana 1st Samyak Snigdha Lakshana
Helps in proper Gati of Vata
- Mrudukaroti Deham Snigdha & Mridu Guna of Sneha Sneha
Mardavkrut Can be assessed by Gatra Mardava
- Malanam Vihanti Sangam Malasanga is caused due to Rukshata
Snigdha property of Sneha overcomes the Rukshata Sanga is
corrected
- Commonly used drugs for Snehapana
- Skin Disorders Tiktaka Ghrita- Pitta Gulgulutiktakam Ghrita-
Psoriatic Arthropathy Patoladi Ghrita- Infectious Skin
Diseases
- Neurological Disorders Gulgulutiktakam Ghritha- Asthi Majja
Gata Vikara Vidaryadi Ghritha- Vata Pitta Shamana & Brumhana
Ksheerabala Taila- Pittanubandha Vataroga, Brumhana Sahacharadi
Taila- Used in Cerebellar Ataxia, wasting disorder, tremors,
rigidity, spasticity Narayana Taila- Vata Pitta Shamana &
Brumhana
- GIT Disorders Dadimadi Ghrita- Vatanulonana, ulcers, folic acid
& B12 deficiency Sukumara Ghrita- Chronic constipation, Arsha,
Kostha Shodhana Indukanta Ghrita- Agni Deepana, Sroto Shodhana,
acid peptic disorders
- Genito-Urinary Disorders Sukumara Ghrita- Vatanulomana &
Kostha Shodhana Vastyamayantaka Ghrita Cystitis & Prostatitis,
neurological bladder, Vatanubandha Mutraroga Phala Ghrita-
Vandhyatva
- Psychiatric Disorders Panchagavya Ghrita- Vatapradhana
Manovikara Kalyanaka Ghrita- Tridoshahara, Apasmara, Vaksanga
Brahmi Ghrita- Medhya
- Locomotor disorders Madhuyashtyadi Taila- Vata Pitta Shamana,
Vatarakta Dhanwantaram Taila- Vatarakta Guggulutiktakam Ghrita-
Asthi Majja Gata Vata Ganda Taila- Osteoporosis, Recovery stage of
pathological fractures, ligament injury
- Immunopathology Indukanta ghrita- Agni Deepana, Sroto Shodhana,
Jwara Hara Shatpala Ghrita- Vatahara, Agnideepana, bronchial
ailments
- Practical considerations during Snehapana
- In Paittika disorders, Kevala Ghrita should be given. In Vatika
cases mixed with Lavana In Bahu Kapha Ghrita should be combined
with Trikatu and Yavakshara In Mandagni to enhance Agni Ghrita
should to be administered along with Kshara and Lavana
- In Kushta, Shopha, and Prameha one should not use Gramya-
Anupa- Audaka Mamsa, Guda, Dadhi, Kshira, and Tila for
Sadyo-Snehana. Snehas processed with Pippali, Haritaki and
Triphala. Agni & Kostha should be considered before Snehapana.
Onset of Samyak Snigdha occur in sequential manner which is helpful
in predicting duration of snehapana.
- Selection of Sneha is very important for desired therapeutic
effect. Rukshana should be done in Mamsala, Medura, Bahu Kapha,
Vishamagni & Sneha Satmya before Snehapana.