ŚODHANĀṄGA SNEHA VIDHI AND METHODS OF DOSE FIXATION

शोधनस्नेहपानम् – Oleation before purification

प्रकुपित दोष शोधनार्थं उपयुज्यमान स्नेहः

अरुष्कस्फोट पिडकाकण्डूपामाभिरर्दिताः।

कुष्ठिनश्च प्रमीठाश्च वातशोणितिकाश्चयो॥

नातिबह्वाशिनश्चैव मृदुकोष्ठस्तथैव च।

पिबेयुर्मध्यमां मात्रां मध्यमाश्चापि ये बले॥

मात्रेषा मन्द विभ्रंशा न चातिबलहारिणी।

शुद्धयेन च स्नेहयतिशोधनार्थ च युज्यते॥              – च.सू.13/35-37

महदेहनलबल क्षुत्तृट्क्लेशसहिष्णुभिः।

गुल्मोदावर्तविसर्पदंशाभिपीडितैः।

उन्मत्तैः कृच्छ्रमूत्रैश्च महती शीघ्रमेव सा।

सर्वमार्गानुसारेण जयेत् व्याधीन् सुयोजिता।        – अ.स.सू.25/24-26

या मात्रा परिजीर्येत्तु तथा परिणतेऽहनि।

ग्लानीमू्र्च्छा मदान् हित्वा सा मात्रा पूजिता भवेत्।  – सु.चि.32/28

प्रमेहकुष्ठानिलशोणितारुचिविवर्च्चिकास्फोटविषेषुकण्डौ। मृदौ तथाऽग्नौ प्रवदन्ति मध्यां बले च मध्या अशने चयेस्युः॥      – का.स.सू२२

मध्यमा स्नेहनी क्षेया बृंहणी भ्रमहारिणी॥ – भा.प्र. पू.थ्व.(स्नेहाध्यायं)

शोधनाङ्गस्नेह should be administered for those suffering from eruptions all over the body, boils of various kinds, pimples, itching, papules, various skin disorders, urinary diseases, gout, those who cannot take good quantity food, those who are soft bowels and those who have moderate strength (Physically and mentally). The oleation therapy in this form does not create many complications or affect the strength of the patient.

Shodhanaaṅga snehapāna is best for various psychological disorders like bipolar, psychosis, depression. It is also very good for chronic diseases, various skin diseases and non-healing ulcers.

Knowing or understanding the strength of Agni Is very important before administering snehapāna. Because maṇḍagni or atyagni is contraindicated in snehapāna   .Moreover, assessing agni of the patient is mandatory to fix proper dose of sneha so that it doesn’t create any complications to him.

Acharya Charaka portrays, assessment of Agni depends upon three components viz. अभ्यवहनशक्ति (capacity to eat), आहारजरणशक्ति (capacity to digest) and Ruchi (appetite).

In order to assess Agni, आहारजरणशक्ति and अभ्यवहनशक्ति must be assessed before commencing snehapāna         .

By understanding Sneha जीर्यमान and जीर्णलक्षणा, the person’s अग्निबला can be assessed. By assessing the agni Bala the physician can know what kind of अग्निबल that person possesses i.e. अवर, मध्यम or प्रवर. Depending on this, the exact amount of sneha dravya can be administered from the next day.

According to Vāgbhaṭa, snehapāna Matra can be classified into हृस्वमात्रा, मध्यममात्रा, उत्तममात्रा and the digestion of given Sneha occurs in two, four and eight Yama’s respectively. This classification of snehapāna is based on the assessment of अग्निबला of the patient.

अग्निबल and जरणशक्ति are inversely proportional i.e. when अग्निबल increases, the जरणशक्ति decreases, in both cases where the same dose is administered or when the dose is increased.

During पाचनदीपनकर्माs, उष्ण, कटुतिक्तकषायरसप्रधान and उष्णवीर्यद्रव्याs are employed to correct the presence of āma and to increase the agni Bala which are important prerequisites for shodhanaṅga snehapāna  .

  If the patient is having बहुश्लेष्म or he is स्थूल or if he suffers from विषमाग्नि, before administering snehapāna to him, use of रूक्षद्रव्याs which has laghu, khara tīkṣṇa and uṣṇa guṇa’s and possess कषाय, कटु, तिक्त Rasa is advised (e.g-Hinguvachadi choornam) in order to get proper samyak snigdha lakṣaṇas. (These drugs remove क्लेद and बहुकफा which is common in stoola, vishamaagni etc).

In extreme वात condition administering वस्ति Karma along with फलवर्ति must be administered to correct Agni (usually agni derangement is seen in excessive वात conditions) prior to the administration of snehapāna . 

Dose fixation of shodanaaṅga snehapāna      in day today practice

Agnibala (digestive power) of the patient must be assessed on the previous day of snehapāna       with the help of Hrasiyasi Matra.

Administering snehapāna for Mridu koṣṭham (soft bowel):

1^st day-snehana dravya must be digested in one hour.

2^nd day-sneha dravya which must be digested in 3 hours.

3^rd day-sneha dravya that should be digested in 6 hrs.

Administering snehapāna on madyāmakoṣṭham (moderate bowel)

1^st day-snehana that is digested in 3hrs.

2^nd day- the administered sneha dravya must be digested in 6 hrs.

3^rd day- the administered sneha dravya must be digested in 8 hrs.

4^th day- the administered sneha dravya must be digested in 10hrs.

5^th day- the administered sneha dravya must be digested in 12hrs.

Administering snehapāna on krūra koṣṭham (Hard bowel)

1^st day-snehana dravya must be digested in 3 hours.

2^nd day-sneha dravya which must be digested in 6 hours.

3^rd day-sneha dravya that should be digested in 8 hrs.

4^th day-snehana that is digested in 10 hrs.

5th day- the administered sneha dravya must be digested in 12 hrs.

6th day- the administered sneha dravya must be digested in 18 hrs.

7th day- the administered sneha dravya must be digested in 24 hrs.

Example:

One more method:

Practically the dose can be calculated in the following manner. If a given 30 ml dose is digested in 3 hours, then 240 ml will be digested in 24 hours and this should be the seventh day dose. So, every day 34.28 ml of sneha dravya must be added to the previous day dose so as to achieve 240ml on the 7^Th day.

One more practice of increasing order of snehapāna dosage:

First day             : 50ml.

Second Day         : 100ml

Third day            : 150ml

Fourth Day                      : 200ml

Up to 7th day      : 350ml.

DIET AND PATHYA DURING SNEHAPĀNA      

आहारोपचार – Diet for snehapāna      :

स्नेहपानसमये भोजनं

द्रवोष्णमनभिष्यन्दिभोज्यमन्नंप्रमाणत:।

नातिस्निग्धमसंकीर्णंश्वस्नेहंपातुमिच्छ॥    – क.स.सू.२२/३६

द्रवमितिलघुष्णमन्नंसात्म्यंबलग्निरुग्युक्तम्।

श्व: स्नेहपानमिच्छन्भुजीतशपीतगुप्तश्च॥   – अ.स.सू२५/३६

भोज्योऽन्नंमात्रयापास्यन्श्व: पिबन्पीतवानपि।

द्रवोष्णमभिष्यन्दिनातिस्निग्धमसङ्गरम्। – च.सू.१३/६०

द्रोष्णमन्भिस्यन्दीबोज्यमन्नंप्रमाणतः|

नातिसन्कीर्णंसुस्नेहंपातुमिच्छाता||          -Vs-Snehadikaara

One who wishes to take oily substances should take food that is liquid, hot, easy to digest, in proper quantity and which does not contain too many food articles.

A warm and light diet is prescribed during dīpana, pācana and the entire course of snehapāna. The person who wishes to take snehapāna          should take a small quantity of food which is liquid, warm, that does not obstruct channels, without too much fat and which is not a mixture of incompatible substances and in accordance with his Bala and Saatmya. Before administering snehapāna, the patient must be given mild medicines to stimulate the digestive activity and to make the alimentary canal light (like digestives and laxatives).

स्नेहपान-पथ्यम्

घृतं मनोहारिरसायनं नृणामितिप्रयत्नादिहतत्पिवंतिये

सदैव तेषां हि उष्णोदकं हितमहित यवागुरहिमाल्य अल्पतण्डुलं ||   – Kalyanakaarakam-22/20

The patient, when sneha is digested, should be given a bath with hot water and then served with warm gruel, as desired, having well-cooked little rice or fragrant soup or meat juice devoid of fat or processed and having very little ghee or vilepī. He should abstain from taking any food before the appearance of hunger. rūkṣa and abhiṣyandi aāhāras must be avoided.

Yūṣa can be prepared with kulattha, aadakam and mudga lentils. (lentil soup). vilepī prepared with ṣāṣṭika rice can also be given depending on the doṣa and bala of the patient.

Yūṣa rasa is given in kapha diseases and after intake of taila. Meat soup is for vāta diseases and for ghee in take- aruna dutta

स्नेहोत्तरोपचार – Post oleation management:

स्नेहे व्यायामसंशीतवेगाधात प्रजागरन्।

विवास्वत्नमभिष्यन्दि रूक्षान्नं च विवर्जयेत्॥ – व.से.स्नेहाधिकरण

उष्णोदकोपचारीस्यात् ब्रह्मचारी क्षपाशय:।

व्यायामवेगसंरोधशिकवर्षहिमातपान्।

प्रवातयानाध्वभाष्यात्यासन संस्थिती:॥

नीचात्युच्चोपधानाहस्वप्न धूमरजांसि॥

यान्यहनि पिबेत्तानि तावन्त्यन्यान्यापि।   – अ.स.सू२५/३७-३९

सर्वकर्मस्वयं प्रायोव्याधिक्शीणेषु चक्रम:॥

उपचारस्तु शमने कार्य: स्नेह विरिक्तवत्॥

उष्णोदकोपचारीस्यात् ब्रह्मचारी क्षपाशय:।

श्कृन्मूत्रानिलूद्गारानुदीणैश्च न धारयेन्॥

व्यायाममुच्चैर्वचनं क्रोधशोकौ हिमातपौ॥

वर्जयेत् प्रवातं च सेवेत शयनासनम्॥

स्नेह मिथ्योपचाराद्धि जायन्ते दारुणा गदा:॥  – च.सू.१३/६२-६४

परिषिच्यद्धिरुष्णाभिर्जीर्णस्नेहं ततो नरम्।

The patient who wishes to undergo or who is undergoing snehapāna should use only hot water for drinking, bathing, washing, etc. He should always use the warm comforts. He should avoid sex, day sleep, keeping awake at nights, exertion, suppression of the natural urges, sorrow, rain, mist, sunlight, western breeze, riding on animals and various vehicles, walking very long, talking too much, sitting in a place for a long time, use of too low or high pillow, smoke, dust and other activities which is not good for his mind and body.

If the oleation is administered for the purpose of śamana, the regimes of purgation (post purgative regimen) should be followed.

Note-

सर्वं रोग प्रशमनाय कार्यं If we observe the don’ts during the entire course of snehana cikitsā, most of them increase the vāta doṣa and some of them vitiate the pitta and kapha. The main idea of cikitsā is to bring back the vitiated doṣas into normalcy and the patient who doesn’t follow the rules and regulations will be a victim of doṣa imbalance which will further lead to the worsening of the disease condition.

OBSERVATION OF SNEHA JĪRYAMĀNA, JĪRṆA AND AJĪRṆA LAKṢAṆA

Snehana which is administered internally undergoes various digestive phases. The symptoms of different digestive phases are called as sneha jeeriyanamana lakṣaṇas. These lakṣaṇas will be subsided after the course of snehapāna and does not require any sort of therapeutic intervention.

स्नेहजीर्यमानलक्षण – Signs and symptoms of Digesting fat

तृण्मुच्र्छामुखशोषैः शब्दद्वेशाङ्गमर्दजृम्भाभि:|

तन्द्रीवाग्देहसादैःस्नेहंजीर्यति इत्याह||   – Ka.Sa.Su.22/41-46

शिरोरुजभ्रमनिष्ठिवमूर्च्छा सादारतिक्लमै:||

जानीयाद् भेषजं जीर्यति|| जीर्णंतच्छान्ति लाघवात्।  – As.Su.25/33

स्युःपच्यमानेतृट्दाहभ्रमसादमरतिकलमाः  – Su.Chi.31/33

स्युःपच्यमानेतृट्दाहभ्रमोमूर्चारुचितमः|    – Vs. Snehadikaara

शिरोरुज – Headache. भ्रम -Dizziness. निष्ठीवम् -Nausea. मूर्च्छा –Dizziness. सादम् -Weakness. अरति –Restlessness due to pain. क्लमम् -Tiredness. तृष्णा -Thirst. दाह -Burning sensation in the stomach (sour belching). शब्दद्वेष -Aversion towards sound. जृम्भा -Excessive yawning. अरुचि -Loss of taste. तम- seeing Darkness in front of eyes. मुखशोष -Dryness in the mouth.

Possible reasons for jeeriyanamana lakṣaṇas:

• Nausea –The high fat intake irritates the stomach and the stomach irritation stimulates the vomiting center of the brain, which causes nausea. The abnormal smell of sneha dravya also causes nausea.
• If we put insight in अवस्थापाक, the production of kapha takes place in the first phase of अवस्थापाक. which might be the reason why the person feels Lalasrāva after taking snehapāna
• Headache– stomach irritation by snehapāna can cause a headache. rasa kṣaya can also cause headaches. Dehydration which is usually observed during snehapāna   is the main reason for शिरोरुज.
• दाह-Burning sensation in the stomach (sour belching) occurs due to gastric irritation and excessive gastric secretions.
• सादम् & क्लमम् -Excessive quantity of Fat in stomach causes more blood flow to the stomach area to digest the fat and the brain may not be able to get enough oxygen supply this phenomenon causes fatigue . Lack of food and Nutrition during snehapāna could also be the reason why a person feels weak, tired and fatigued.
• शब्धद्वेष- Aversion towards sound occurs due to Rasa dhatu kṣaya
• तृष्णा & मुखशोष & मूर्च्छा & तम- When we eat a normal diet, the carbs are converted into glycogen, which the body uses for energy. Every gram of glycogen stores approximately 3 grams of water and during snehapāna, the body is in a fat-burning mode and very little amount of carbs are available to the body. This leads to loss of water making the person feel thirsty and dry. When we are on a normal diet, insulin level spikes after having food and the spiked insulin triggers the kidneys to hold water and sodium. During snehapāna  due to restricted diet insulin levels drop, and kidneys release this stored sodium and water. The water that exits from the body, leads to dehydration symptoms like Dizziness, Dry mouth and thirsty feeling.
• Dizziness & Fainting occur when there is a lack of food and Nutrition. During snehapāna the blood supply is more to the stomach and less to the brain and the instant energy from the carbs are not available to the brain. This could be also the reason why the person feels dizzy and fainting.

स्नेह जीर्यमान उपद्रव चिकित्सा

स्युःपच्यमानेतृट्दाहभ्रमोमूर्चारुचितमः

परिषिन्च्यो अपि अनुष्णादिभिः जीर्णस्नेहोयथोनर:

यवागूंप्राशयेदुष्णंकृतांषशटिकतण्डुलैः

अल्पस्नेहाम्विलेपिस्चजीर्णस्नेहंसुखोदनं||   V.S.

At the time of digestion of fats there is thirst, burning sensation, Dizziness, fainting, anorexia and feeling of darkness before eyes.at the time body should be washed with warm water and when the oil is digested warm gruel made from ṣāṣṭika rice should be given to eat or warm vilepī    or rice with ghee.

स्नेहजीर्णलक्षणा  – Signs and symptoms of digested fat

शिरोरुजभ्रमनिष्ठिवमूर्च्छा सादारतिक्लमै:।

जानीयाद् भेषजं जीर्यतिजीर्णंतच्छान्ति लाघवात्||

अनुलोमनिलस्वास्थ्य क्षुत्तृष्णा उद्गार शुद्धिभि|   As.su.25/33

उद्गारस्यविशुद्धि: काक्षा स्थिरता लघुत्वमविषाद:।

बलवागिन्द्रियसपज्जीर्णे स्नेहे बल सुखे च॥   Ka.sa.su.22/41

यदाशरीरलगुचान्नकन्ग्क्षीनंमनोवाचामूत्रपुरीशमरुतः

प्रवृति उद्गार शुद्धि इन्द्रियप्रसन्नताहुज्वलजीर्णलक्षणं||   kalyanakarakam-22/५

प्रशमन- Feeling relieved From Headache, Dizziness, Nausea, Tiredness And Restlessness लघुता- Feeling of lightness.अनुलोम- Downward movement of vāta. क्षुद्प्रवृत्ति -Appetite उद्गारशुद्धि -Clear belching. बल-Feeling strong.मूत्रपुरीशमरुतः -Normal evacuation of urine, feces and flatus.इन्द्रियप्रसन्नता-Proper functioning of sense organs.

Symptoms of proper digestion:

A well‐functioning digestive system is a critical determinant of good health; it directly relates to our ability to break food down and absorb important nutrients to supply energy, build tissues and support hundreds of metabolic reactions in the body.

Regular bowel movement

Proper Stool color.

Normal amounts of flatus

Lack of digestive symptoms – Symptoms such as abdominal discomfort, regular bloating, nausea, diarrhea or constipation may indicate digestive problems. Absence of these symptoms indicates proper digestion.

Good overall health – When food is properly digested and nutrients are absorbed, the benefits may show with clear skin, strong hair and nails and good energy levels.

घृतजीर्णोत्र आहारम् – Diet after snehapāna  

भोज्योऽन्नंमात्रयापास्यन्श्व: पिबन्पीतवानपि।

द्रवोष्णमनभिष्यन्दिनातिस्निग्धमसङ्गरम्॥ – अ.स.सू२५/३६

परिषित्याद्भिरुष्णाभिर्जीर्णस्नेहंततोनरम्।

यवागुंपाययेत्योष्णंकामंक्लिन्नतण्डुलाम्॥

ततश्चकुस्तुब्रुनिम्वसाधितपिबेत्यवागुमथवानुदोषतः |

कुलथमुद्गाडकयुषसत्खलै: लघूष्णमन्नवितरेध्यथोचितं || – Kalyaanakarakam-22/6

यवागूंप्राशयेदुष्णंकृतांषशटिकतण्डुलैः

अल्पस्नेहाम्विलेपिस्चजीर्णस्नेहंसुखोदनं||

विवास्वत्नमभिष्यन्दि रूक्षान्नं चविवर्जयेत्॥   – व.से. स्नेहाधिकरण

स्नेहं पीत्वा नर: स्नेहं प्रति भुज्जान एव च।च.सू.१३/६२-६४

स्निग्धद्रवोष्णधन्वॊत्थरसभुक्स्नेहमाचरेत् |   – Ch. da-68/25

यवागुं पाययेच्चोष्णं कामं क्लिन्नाल्पतण्डुलाम्।

देयौ यूषरसौवाऽपि सुगन्धी स्नेहवर्जितौ॥

कृतो वाऽप्यल्प सर्पितकौ विलेपी वा विधीयते |  – सु.चि 31/३४-३५

Once fat is fully digested, the person will be free of nausea, headache, frequent belching etc. He will develop proper hunger and will feel lighter. He will not have either constipation or diarrhoea and will have a good sleep.

After the digestion of fat, the patient is allowed to consume a light diet only after the development of hunger. Examples: kicchari, yavāgū, maṇḍa, plain rasam with rice, proper quantity light gruel is allowed. For the first few days the patient may need dinner. So, for dinner mung bean kitchari or brown rice gruel is always best.

The patient must be advised to adhere to the restrictions which are narrated before once he is comfortable and hunger less.

Termination of the course of snehapāna       

The snehapāna is continued with an increasing dose in shodanaaṅga snehapāna and a fixed dose in śamana snehapāna till the patient attains the samyak snigdha lakṣaṇas. Every day the physician must observe the samyak snigdha lakṣaṇa like वातानुलोमनं, गात्रा मार्धवं & त्वक् स्निग्धता, असम्हत वर्चस्, स्निग्ध वर्चस्, गात्रा लाघवं and aversion towards fat substances.

The snehapāna procedure must be stopped immediately once the symptoms of proper oleation are observed.

Note: Unlike in Shodhanaṅga sneha, in śamana sneha the patient may not get proper oleation symptoms even in seven days since the dose is less. śamana sneha is continued till the remission of the disease.

SAMYAK ATISNIGDHA AND ASNIGDHA LAKṢAṆA OF SNEHANA

सम्यग्स्निग्धलक्षणम् – Signs of proper oleation:

वातानुलोम्यं दिप्तोऽग्निर्वच: स्निग्धमसंहतम्।

मार्दवं स्निग्धता चाङ्गे स्निग्धानामुपजायते॥      – Ch.Sa.Su13/58

वातानुलोम्यं दिप्तोऽग्निर्वच: स्निग्धमसंहतम्।

स्नेहोद्वेग:क्लम: सम्यक् स्निग्धे रूक्षेविपर्यय:॥    – Ah.Su-16/30, VA.SE

सुस्निग्धा त्वक्विट्शैथिल्यं दिप्तोऽग्नि मृदुगात्रता।

ग्लानिर्लाघवमङ्गानामधस्तात् स्नेह दर्शनं।

सम्यवस्निग्धस्य लिङ्गानी स्नेहोद्वेगस्तर्थैवर्च॥    – Su.Sa.Chi-31/53

धृतिमृदुपुरीषत्वं मेधापुष्ट्यग्नितेजसां वृद्धि:।

कालेसरीरवृत्वि: स्निग्धस्य वदन्ति लिङ्गानि॥     – Ka.Sa.Su-22/34

वातानुलोम्यं दिप्तोऽग्निर्वच: स्निग्धमसंहतम्।

मृवुस्निग्धाङ्गताग्लानि: स्नेहो द्वेगोऽथ्लाघतम्।

विमलेन्द्रियाता सम्यक् स्निग्धे-रूक्षेविपर्ययl:|  – BP.U-snehapāna      vidhi-29^thsl

अवश्यसम्स्नेःमलप्रवर्तनं घृतेतिविद्वेषअङ्गसादनं

भवेश्चसुस्निग्धविशेषलक्षणं – Kalyanakarakam – uttratantra 22^ndch

वातानुलोम्यंदीप्ताग्निर्वर्चः स्निग्धमसंहतं |

स्नेहोद्वेगःक्लमःसम्यक्स्निग्धे रुक्षेविपर्यय||       – Ch.Da.68/26

Downward movement of the flatus, improved digestive fire, unctuous and soft stools, smoothness of the body parts, feeling of exhaustion, aversion to fatty materials, lightness of body, clarity of sense organs, increase in medhā, Tejas and dhṛti are the signs and symptoms of proper oleation.

Table showing samyak snigdha lakṣaṇas according to various Acharya’s.

Clinical evaluation of सम्यक्स्निग्धलक्षणाs

For shodanaaṅga snehapāna- Oily stools and appearance of ghee in the closet before deification and loose oily stools.

For śamana snehana-Aversion towards fatty substances.

Possible reasoning of samyak snigdha lakashanas;

वातानुलोमनं

De arranged vāta doṣa causes abnormal stool consistency giving rise to flatus obstruction. snehapāna           makes vāta flow on a normal path. Usually, carbohydrates cause bloating and farting. High fat always helps to have a normal evacuation of flatus. Having proper vāta anulomana is considered to be a proper digestion symptom. Temporary fat intolerance can also cause more gas production and elimination.

अग्निदीप्ती

Impaired vāta in various chronic diseases cause derangement in pitta and Kapha which causes maṇḍagni. By sneha administration, the deranged vāta is taken care of and by that pitta,kapha and agni become normal. In the initial days, the leptin hormone would have gone up making the person feel full. After some days the body will be in a position to handle the high fat with the help of ghrelin hormone hence the improved appetite. More bile and gastric juice secretion may occur after the course of snehapāna helping in excellent appetite.

अधस्तात्स्नेहदर्शनं & पुरीषस्निग्धता

Impaired digestion or absorption of fat can result in fatty stools. Possible causes for impaired digestion include exocrine pancreatic insufficiency, lack of lipases, loss of bile salts etc which reduces micelle formation.

Bile acid malabsorption: The gallbladder produces bile to help in the breakdown and digestion of fats. If these acids are not properly reabsorbed, they may irritate the intestines. This may lead to loose stools with fat.

Too much fat in the faeces is called steatorrhea. In steatorrhea, the stools are bulkier, pale, and foul-smelling (all can be observed during snehapāna         ). They tend to float because of higher gas content. The stools also tend to be covered in a greasy film. Drops of oil may be seen in the water inside the toilet bowl.

गात्रमार्धवं एवं गात्रस्निग्धता

Snigdha, mṛdu and sneha quantity of sneha dravya enhances the same qualities in the body and that’s why gātramardava and gātrasnigdatha is noticed. Our cell membranes are mostly made of fat, particularly saturated fat. In fact, at least 50% of the membrane is made up of saturated fatty acids. Intake of a low fat diet causes weakness in the cell membranes and the cells cannot stay plump and hydrated. Excessive fat hydration could be a reason for oily and soft skin.

Functional dyspepsia (FD) is a common disorder characterized by persistent, or recurrent upper gastrointestinal symptoms. These symptoms include epigastric pain, postprandial fullness, inability to finish a normal-sized meal, early satiation, anorexia, belching, nausea and vomiting, upper abdominal bloating, and even heartburn and regurgitation.

 The pathophysiology and etiology of FD have been under assessment and are poorly identified. Mechanisms that have been proposed include delayed gastric emptying, visceral hypersensitivity to distension, impaired gastric accommodation to a meal, abnormal duodenojejunal motility, hypersensitivity to lipids or acid in the duodenum, or central nervous system dysfunction.

The presence of a volatile Fatty acid- Butyric acid contributes to the feeling of rancid smell and taste in the air that comes out through the mouth.

क्लमं & ग्लानि

Fat overload can cause the gut to produce neurohormones that make the brain react slowly and this makes the person feel sluggish and fatigued after the consumption of a high fat diet. Circadian rhythm and different hormones also work together to create these effects. The body and the brain are forced to adjust to a sudden carbohydrate deficiency during and after snehapāna           which causes increased cortisol levels and decreased thyroid hormone levels, which leads to fatigue.

अङ्गलाघवं

sūkṣmaguṇa of Sneha dravya causes aṅga     lāghava. Weight loss is observed during snehapāna       which makes the person feel light.

विमलेन्द्रियता

Production of ketone bodies during snehapāna          helps to have good memory and better cognitive functions by slowing down the neuro degeneration.

काले शरीरवृद्धि

Recent work has highlighted a critical role of the immune system, in linking diet with long term health and behavioural outcomes. Medium to long-term ‘dieting’ (calorie restriction which happens in snehapāna         ) in adult life can improve health and lifespan, by altering the hypothalamic inflammatory milieu.

 Both ageing and high-fat diets appear to cause significant changes to the microbiome of the gut. It could be said that a good high-fat intake decelerates microbiome ageing as well as prevents systemic inflammation, which is a known cause for aging. Nourishment provided by snehapāna and elimination of toxins from the body leads to कालेशरीरवृद्धिः

मेधा & द्रुति

Polyunsaturated fats preserve memory. In particular, foods that are high in healthy unsaturated fats have been linked to lower rates of both Alzheimer’s disease and mild cognitive impairment (MCI)—the stage of memory loss that often precedes dementia.

The gene called apolipoprotein E, or APOE is associated with the amount of cholesterol in your blood, and people with a variation in this gene, called APOE e4 are at greater risk for Alzheimer’s disease which eventually leads to memory loss. snehapāna could probably help to form a good cholesterol level and its proper maintenance in the blood which is very essential for having a good memory.

अतिस्निग्धलक्षणा – signs and symptoms of excessive oleation.

पाण्डुता गौरवं जाड्यं पुरीषस्याविपक्तता।

तन्द्रारुचिरुत्क्लेश: स्यादतिस्निग्ध लक्षणम्॥    – Cha.Su.13/59

भक्तद्वेषंमुखस्रावॊगुददाह: प्रवाहिका।

पुरीषाति प्रवृत्तिश्च भृशस्निग्धस्य लक्षणम्॥       – Su.Ch.31/54

प्रवाहिका-अतिसारभेदः                                         – Dalhana

पाण्ड्वामयाङ्गसदनघ्राणवक्रगुदस्राव:।

गुददाहारुचिश्वासछर्दिमूर्च्छा तृष्णाप्रवाहिका:।

शुक्तोद्गारभ्रमकासं…..।                                       – As.su.25/45

अतिस्निग्धेतुपाण्डुत्वंघ्राणवक्त्रगुदस्राव: ||         – Ah. Su-16/31

गौरवजाड्योत्क्लेशध्मानानि पुरीषमविपक्वम्।

अरुचिरपि पाण्शुतन्द्रे वदन्ति अति स्निग्ध लिङ्गावि॥ – Ka.Su.22/25

पाण्डुता सदनं तन्द्रा पुरीषस्य विपक्वता।

उत्क्लेशो जाड्यमरुचि: स्यादतिस्निग्धलक्षणम्॥     – Vaṅga       sena.sneha adikaara

गुदेविदाहो अतिमलप्रवृत्तिरप्यरोचकवक्रेणकफोद्गमः

प्रवाहिका अङ्गविदाहःमोहनं भवेत् अतिस्निग्धनरस्यलक्षणं – Kalyanakarakam-uttratntra 22/18

तिस्निग्धेतुपाण्डुत्वं घ्राणवक्त्रगुदस्रावः ||          – Ch.Da.68/26

If snehapāna    is administered in higher quantity without considering the koṣṭha,  then the person may suffer from ati snigdha lakṣaṇas like yellowish, whitish, Yellowish pale skin or stools, Fatigue Heaviness, Stiffness, Loss of taste, Exhaustion, Nausea, Anorexia with loss of appetite, Secretion from nose, mouth and  anus, Breathing difficulty, Vomiting, Fainting, Morbidthirst, Acid reflux, Dizziness, Hallucinations, cough, Bloating with colic pain, Frequent stools (Diarrhea).

Possible reasoning of अतिस्निग्धलक्षणा:

पुरीषमविपक्वम् पुरीषातिप्रवृत्ति & प्रवाहिका

Bile from the liver creates a typical brown hue of a healthy bowel movement. When the stool is very pale, it often means that enough bile is not reaching the stool or bile is not able to act on the stools which have high-fat content due to snehapāna        . Pancreatic secretions are also responsible for the normal colour of the stools. Excessive fat intake could hamper the action of the pancreatic secretion which may lead to pale stools.

The body cannot absorb excessive fat which is ingested during snehapāna  . Severe malabsorption may cause stools to become bulkier and pale throughout due to higher fat content. The liver produces bile and digestive enzymes to emulsify fat and digest it, but when the body is shocked with more fat than our body is used to, it will be overwhelming for the bile and digestive enzymes to digest that fat. So, excessive fat is evacuated with stools.

Digestive enzymes are small, specialized proteins of the digestive system produced to break down food and drinks we consume into usable macro-and micronutrients.

The body is not used to the high quantity of fat and isn’t able to absorb it all. The sudden high intake of fat overwhelms the digestive system. When unabsorbed fat gets into the small intestines and colon, more water will be pulled in to help its passage, resulting in watery diarrhoea.

Too much fat causes diarrhoea due to malabsorption of fat by the intestines. The digestive enzymes (especially lipase) are not able to digest excessive fat which stimulates the walls of the intestines to move rapidly which causes diarrhoea. The food is also not digested properly due to abnormal enzymatic activity so it is also eliminated along with the stools. That’s why we see purīṣapakwata in ati snigdha lakṣaṇa.

पाण्डुत्वं – yellowish, whitish, Yellowish paleness of the skin – Ref-spoken Sanskrit.org

Nutritional deficiencies can lead to a low red blood cell count which leads to low levels of haemoglobin in these cells causing Anaemia. During snehapāna the diet is very basic without any nutrition or vitamins. This could also be a reason for पाण्डुत्वं (whitish pale skin).

Bilirubin is formed when hemoglobin (the part of red blood cells that carries oxygen) is broken down as a normal process of recycling old or damaged red blood cells. Bilirubin is carried in the bloodstream to the liver, where it binds with bile (the digestive juice produced by the liver). Bilirubin is then moved through the bile ducts into the digestive tract so that it can be eliminated from the body. Most bilirubin is eliminated in stool, but a small amount is eliminated in urine. If bilirubin cannot be moved through the liver and bile ducts quickly enough due to various reasons including high fat intake, it builds up in the blood and is deposited in the skin. The result is jaundice. This could be also a reason for yellowish white skin which is mentioned as ati snigdha lakṣaṇas.

Normally, the bile contains enough chemicals to dissolve the cholesterol excreted by the liver. But if the liver excretes more cholesterol than bile can dissolve, the excess cholesterol may form into crystals and eventually into stones. Excessive fat intake could increase more cholesterol formation and the formed cholesterol may obstruct the bile pathway which leads to jaundice.

HFD (High-fat diet intake) increases the RBC membrane cholesterol content and phosphatidylserine externalization (a marker of RBC damage or senescence), fostering RBC-macrophage inflammatory interactions and promoting the uptake of RBC by macrophages in vitro and by the spleen in vivo. Finally, RBCs from HFD-fed mice augmented macrophage adhesion to the endothelium when incubated with isolated aortic segments, indicating endothelial activation. We propose that RBC dysfunction, analogous to endothelial dysfunction, occurs early during high fat intake and may serve as a mediator of atherosclerosis. So we can safely say excessive administration of fat could lead to RBC destruction in the spleen hence the paleness of the skin. Courtesy.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4772773/

अरुचि

The average human taste bud (nerve endings, essentially) consists of roughly 50 to 100 cells, each with an average life span of about 10 days. Collectively, an entire taste bud can roughly take a month to turn over and replenish. A high-fat diet disrupts this process of renewal. As researchers discovered with mice, fat triggers higher levels of a pro-inflammatory cell called TNF-alpha. The ensuing inflammatory response disrupts the “balancing mechanisms of taste bud maintenance and renewal.

https://www.aarp.org/health/healthy-living/info-2018/taste-buds-fat-diet-fd.html

स्नेहद्वेषं, वक्त्रेणकफोद्गमः & उत्क्लेशम्

 Over saturation of fat in the body leads to production of ketones which are responsible for causing sickness, nausea and to develop an acid taste in the mouth. This is also a result of temporary imbalances in energy sources, insulin, and minerals in the body.

Nauseousness and bloating can occur from consuming too much fat too quickly. There is not enough bile to break down the fat, so the fat is overwhelming to gallbladder, thus causing fat aversion.

Food aversion is the alteration of eating behaviour for psychological reasons. It may be manifested as psychological food intolerance, where there is an adverse physical reaction associated with the ingestion of a particular food, or food avoidance.

Hyperventilation syndrome is a maladaptive anxiety reaction that primarily occurs in apprehensive patients who attempt to hide their anxiety.

In some individuals food aversion can manifest itself as the individuals may hyperventilate to the extent that they suffer severe symptoms and may even lose consciousness. srāva can be understood as nausea and vomiting and gūḍhasrāva can be understood as diarrhoea.

घ्राणक्त्रगुदस्राव

The word srāva means oozing or discharge. घ्राणवक्र srāva can be understood as nausea and vomiting and gūḍhasrāva can be understood as diarrhoea. The reason for these symptoms has been mentioned previously.

शुक्तोद्गार

Excessive fat stays in the stomach for longer duration. This leads to secretion of more stomach acid. Excessive acid affects the Lower esophageal sphincter (LES). This is the reason for the contents of the stomach to splash back up to the throat.

गौरवं, जाड्यं, सदनं, मूर्च्छा, भ्रम and तृष्णा

Insulin production tends to be very low on high fat intake, leading to hypothyroid and symptoms like sluggishness. When your body is in a state of ketosis, it makes you feel extremely tired and fatigued. This is because the body works hard in order to use an alternative source of energy apart from glucose.

 Too much fat leads to ketosis which further leads to excessive build-up of ketones in the body. Excessive ketones can be harmful to health and are passed through the body via urine. Excessive amounts of sodium in the body is also passed through urine when your body is in ketosis. Excessive urination can cause dehydration in the body. Symptoms of dehydration include dizziness, exhaustion, dry mouth, extreme thirst, dark colored urine, dry skin, mild confusion and headaches.

श्वास &कासं

Excessive fat intake for longer duration may lead to electrolyte imbalance and prolonged electrolyte imbalance could lead to mild hypovolemic shock.

Swasa and  kaṣā  are symptoms of hypovolemic shock. So, we can safely say  kaṣā , swasa, Brhmam and mūrchā are very severe complications of excessive fat intake (अतिस्निग्धलक्षणा’s).

Slimile

गृह्णात्यम्बु यथा वस्त्रं प्रस्रवत्यधिक: यथा।

यथाग्नि जीर्यति स्नेहस्तथास्रवति चाधिक:॥

यथा वाऽक्लेध मृत्पिण्डमासिक्त त्वरया जलम्॥

स्रवति स्रंसते स्नेहस्तथा त्वरितसेवित:।               – Cha. Si -1.

A cloth absorbs only the water required and oozes out the excessive quantity. Likewise, the excessive Sneha administered oozes out of the body.

The oleation which is administered properly according to the digestive power will exhibit proper oleation in the person. If it is given excessively then it will cause troubles.

अतिस्निग्धचिकित्सा

स नागरं च उष्णजलं पिबेत्सोसमुध्गयूष ओदनं आशु दापयेत्

सहाजमेदाग्निकसैन्धवन्वितामलंयवगुमथवाप्रयोजयेत्  – कल्याणकारकं-२२

अस्निग्धलक्षणा’s – Signs and symptoms of inadequate oleation. If snehapāna is not done or administered inadequately then these lakṣaṇas can be observed in the patient. Further by observing these lakṣaṇas the physician should rectify the dose according to the koṣṭha and agni of the patient and carry out snehapāna properly which is very important in achieving proper result.

पुरीषं ग्रथितं रूक्षं वायुरप्रगुणोमृदु:।

पक्ता खरत्वं रौक्ष्यं च गात्रस्यास्निग्ध लक्षणं॥    – Ch.Sa-13/57, Vaṅga  sena

वायोरप्रगुणत्वं रौक्ष्यं खरताऽधृतिर्ज्वलनहानि:।

शुष्काग्रथितं पुरीषं लक्ष्णमस्निग्धगात्रस्य।         – Ka.Sa.Su-22/33

पुरीषं ग्रथितं रूक्षं कृच्छादन्तं विपच्यते ।

उरो विदहते वायुकोष्ठादुपरि धावति ।

दुर्वर्णो दुर्बलश्चैव रूक्षो भवति मानव: ॥   – Su.Sa.Ch.31/51-52

 ……………… रूक्षेविपर्यय:            – BP. U-snehapāna      vidhi-29^thsl

Hard, dry stools, derangement of vāta, weak digestive power, roughness and dryness of the skin- these are the signs of under oleation.

Suśruta adds urovidhaaham, durvarṇa and durbala.

Possible reasons for Asnigdhalakṣaṇaa’s

During snehapāna       diet restriction is in place and the food contains less nutrition, minerals and vitamins. The proper amount of fat administration takes care of these nutritional deficiencies. However, if inadequate fat is administered along with food restriction then it could lead to severe dehydration symptoms like dryness, constipation and skin discolouration.

Fats produce the skin’s natural oil barrier, critical in keeping skin hydrated, plump, and young. Not getting enough fatty acids in the diet, the skin may become dry, inflamed, and prone to whiteheads and blackheads.

The least dose causes agnimāndya which leads to indigestion. Which in turn causes urovidāha. In an excessive rūkṣa person if the least dose is administered then it may lead to durbala, durvarṇa etc.

Drastic changes in a person’s diet can adversely affect their digestive system and even cause symptoms such as nausea or constipation. Moreover, the intake of a less fibre diet during snehapāna can cause constipation.

Clinical Assessment of Snigdha, Ati snigdha and Asnigdha lakṣaṇaa’s

1.Agni Related lakṣaṇas

अग्निदीप्ति, अग्निमान्द्यं, अविपाकं, उरोदाहं, अरुचि, भक्तद्वेषं, शुक्तोद्गार, स्नेहोद्वेगं

2.Vaayu Related lakṣaṇas

वातानुलोमनं, उद्गारं, आध्मानं, प्रतिलोमगति of वायु

3. Stool Related Symptoms

अधास्तात्स्नेहदर्शनं, पुरीषस्निग्धता, असंहतवर्चस्, अपक्वपुरीषदर्शनं, शुष्करूक्षाघाडवर्चस्, पुरीष अतिप्रवृत्तिप्रवाहिका

4.Skin Related Symptoms

गात्रमार्दवं, स्निग्धत्वक्, रूक्षणत्वचा, पाण्डुता, दुर्वर्णो, खरत्वं

lakṣaṇas Related to Mental and Physical status of the patient:

सदनं, तन्द्र, गुरुता, भ्रमं, दाहं, ग्लानि, जाड्यं, उरोविदाहम्घ्राणवक्रगुदस्रव: श्वास, छर्दि, मूर्च्छा, तृष्णा,  दुर्बलअङ्गलाघवं, विमलेन्द्रियता, कालेशरीरवृद्धिः

Assessment of samyak snigdha lakṣaṇas practically

1. a) वातानुलोमनं
2. Belching and burping with the smell of sneha dravya frequently along with the heaviness of the abdomen. No evacuation or evacuations of hard faeces.
3. Belching and burping with the smell of sneha dravya occasionally and no heaviness of the abdomen. Evacuation of faeces once with flatus, however heaviness of the abdomen is present. (Patient not satisfied with evacuation).
4. No belching and burping. No smell of sneha dravya. Proper evacuation of vāta, mūtra and purISa Patient is completely satisfied with the evacuation.
5. b) गात्रा मार्दवं & त्वक् स्निग्धता
6. Dry/normal skin/No change in skin texture
7. Soft skin but without oiliness.
8. Soft, oily and shiny skin.
9. c) असम्हत वर्चस्
10. Normal Banana stools, may be once in a day.
11. Semi solid stools, maybe twice a day.
12. Loose stools, more than two times a day.
13. d) स्निग्ध वर्चस्
14. Loose stools with no fat.
15. Loose stools with fat but no fat in closet water.
16. Watery stools with good amount of fat and sneha dravya floating

  on closet water.

1. e) गात्रलाघवं
2. Feeling heavy after taking fat and feeling discomfort.
3. Feeling heavy after taking fat but comfortable.
4. Feeling light and comfortable.
5. f) स्नेहोद्वेगम् -Aversion towards fat substances
6. No aversion.
7. Minimum aversion but sight of fat causing nausea.
8. Can’t withstand even the sight of fat.

Score pattern to assess samyak snigdha lakṣaṇaa’s

10-13 = अवर सम्यक् स्निग्ध लक्षणा

14-17 = मध्यम सम्यक् स्निग्ध लक्षणा

17-21 = प्रवर सम्यक् स्निग्ध लक्षणा