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DESCRIPTIONSnehana is one of the Purvakarma of Panchakarma
` ABHYANTARA SNEHAPANA Dr. Ketan Mahajan M.D. Panchakarma Assistant Professor Department of Panchakarma Patanjali Bhartiya Ayurvigyan Evam Anusandhan Sansthan Haridwar, U.K. Email: firstname.lastname@example.org 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.
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