ŚODHANARTHA SNEHA: ACCHAPĀNA AND VICĀRAṆA

• Accha sneham

अच्छपॆयस्तुयःस्नॆहोनतमाहुर्विचारणाम्।

स्नॆहस्यसभिषादृष्टःकल्पःप्रथमकल्पिकः॥          – च. सू. १३/२६

अच्छश्चपॆयश्चअच्छपॆयः।

औदनाद्यसम्बन्धीसतिपॆयः॥ चक्रपाणी on च. सू. ३/२६

Intake of simple (unmixed) unctuous substance is Acchapāna. It is said to be administered without mixing with food or any other substance. It is considered to be the best form of sneha administration, because it is highly effective in achieving samyak snehana lakṣaṇas very quickly.

In a nutshell.

• It is administered internally.
• Used for śodhana and śamana.
• Pathya must be followed.
• Large dose is given.
• It is given for śodhana or śamana of Doṣa’s.

Intake of accha sneha according to doṣa:

केवलं पैत्तिक सर्पिवातिके लवणान्वितम्। देयं बहुकफे चापि व्योष क्षारसमायुतम्॥

(su.ci 31/19)

In kevala pitta condition pure ghee, in kevala vāta condition ghee with salt and in excessive kapha vitiation ghee is mixed with vyoṣa etc is given as snehapāna.

Contra indications of अच्छपान:

स्नेहद्विषिक्षामोमृदुकोष्ठ: स्नेहमद्यनित्यश्च।

अध्वभारप्रजागरस्त्रिश्रान्तनाच्छपिबेयुस्ते॥ – Ka.Su – 22/25

अच्छपान should not be given to those who hate to take snehapāna, who are too tired, those who take sneha dravyas every day, liquor every day, those who do strenuous work and who always indulge in women.

अच्छपानकाल – duration of pure fat drinking:

According to Charaka,

स्नेहस्यप्रकर्षोतुसत्तरात्रत्रिरात्रकौ॥

The maximum and minimum period of pure fat administration is 7 and 3 days.

मृदुकोष्ठस्त्रिरात्रेणस्निह्चत्च्छोपसेवया।

स्निह्यतिक्रूरकोष्ठस्तुसत्तरात्रेणमानव:॥ – Ch.Su. 13/51

त्रयहमच्छमृदौकोष्ठेकूरेसत्तदिनंपिबेत्॥

सम्यक्स्निग्धोऽथवायावदत: सात्म्यीभवेतपरम्॥  – A.H.Su.16/29, 30

पिबेत्त्रयहंचतुरहंपञ्चाहंषडहंतथा।

सप्तरात्रात्परंस्नेहसत्मीभवतिसेवित॥-च.पा

अच्छपान should be administered 3 days in mṛdu koṣṭha person and 7 days for the krūra koṣṭha person or till the symptoms of proper oleation appear. The acchasneha should not be administered more than 7 days because it will be accustomed to the administered person and It will not yield any desired effect or It may cause side effects.

Acchapānamātrā:

The mātrā is decided upon considering the doṣa, agni, vaya, bala, etc of the patient. Excessive or less dose doesn’t yield any results rather it leads to complications. Snehapānamātrā -Dose of oily substances depends on doṣa and digestion. In Brhat trayees, there are two views regarding the mātrā of sneha. Charaka and Vaghbata have explained three mātrās whereas, Ācārya Sushruta has explained 5 mātrās as per time required for digestion.

अहोरात्रमहः कृत्स्नमर्धाहं च प्रतीक्षते

प्रधाना मध्यमा ह्रस्वा स्नेहमाना जरां प्रति।।

इति तिस्रः समुद्दिष्टा मात्रा स्नेहस्य मानतः  – Ch. Su, 13/29

1) Hraswa Mātrā – the dose of sneha that is digested within 6 hours

2) Madhyama Mātrā – the dose of sneha that is digested within 12 hours

3) Uttama Mātrā-the dose of sneha that is digested within 24 hours

Table showing difference between śodhana accha sneha and śamana accha sneha.

अनुपान for accha sneham:

जलमुष्णं घृते पेयं यूषस्तैलेऽनु शस्यते।

च सा मज्जास्तु मण्डः स्यात् सर्वेयूष्णमथाम्बु वा॥–

Uṣṇajalam is a universal anupāna for any snehadravyas. It helps for the disintegration of the fat. Helps in the better absorption of the given Sneha. Uṣṇajalam should not be advised for snehas of bhallātaka and tuvaraka because both are uṣṇa and tīkṣṇa in nature. Yūṣa is a very good anupāna for vāta. yūṣa contains more protein and alkaline in nature and it counteracts the vidāhi nature of the taila.

 Vasā and majjā are gurutama in nature so lagu anupāna must be given. Maṇḍa is a simple starch and digested easily.

 The quantity of anupāna varies according to the quantity of sneha substance, the efficiency of the drugs used or the pharmaceutical process involved. Anupāna makes the fat to digest fast – chakrapani.

Vicharana sneha:

Methods of administration of fat substances that require regular practice to achieve the snehana effect are known as vicāraṇa sneha.

Vicāraṇa also means thoughtful.

Snehana-fats

Hence it can be said as a thoughtful application of fats.

विचारणेति विशब्दे ईषदर्थे ॥

प्रविचरियते अवचार्यते अनुकल्पेन उपयुज्यते आनयेति प्रविचारणः- चक्रपाणि

किं कारणमेता: प्रतिविचारणा उच्यन्त इति युक्तिद्वयमाह स्नेहस्याल्पत्वादल्पोपयोगित्वात्तथाभिभूतत्वादन्नेन

भक्ष्यादिनां बहुनां तथा रसभेदेनापि तथा विविधेन सहोपयुक्तस्य

स्नेहस्याभिभव: क्रियते। तास्तास्तस्य विचारणा उच्यन्ते॥ चन्द्रनन्दन:

ख चर इति धातु । प्रतियत्ने वर्तते । प्रतियत्न संस्कार:। इषत्संस्कार हेतव प्रतियोगविशेषा विचारणा शब्द वाच्या इति यावत् । अच्छपाने शोधनशमन बृंहणानां विचारणा संञा नेति सूचयितुं संज्ञाव्याग्रहणं कृतम् ।

Literally vicāraṇa means little quantity (Hemādri), processed (parameśvara)

Definition:

युक्त्यावचारयेत् स्नेह भक्ष्याद्यन्नेन बस्तिभि:।

नस्याभ्यञ्जनगण्डूषमूध्कर्णाक्षितर्पणै:

रस भेदैकत्वाभ्या चतुष्षष्टिर्विचारणा।

स्नेहस्यान्याभिभूतत्वादल्पत्वाच्चक्रमात्स्मृता:॥

Sneha when classified, applied and used as a substitute or alternative for primary one (Prathamakalpika) it is called as Pravicāraṇa. Gaṅgadhara noted that, when Sneha is pre-eminently and particularly used in the form of Bhaksha, Pāna, Leha, Abhyañjana etc. it is called as Pravicāraṇa.

 Consumption of the sneha in conjunction with different food preparations is referred to by the name vicāraṇa sneha. Further, the procedures like abhyaṅga, Karṇa Pūraṇa etc where the sneha administered does not undergo the process of digestion in the gastrointestinal tract are also included under vicāraṇa  sneha.

 According to Hemādhri when the sneha dravya is mixed with māṃsa rasa, madhya or when it is mixed according to the taste, Palatability and sātmya of the individual that snehana is called as vicāraṇa .

मूर्धाक्षितर्पणार्ते हि पान इव प्रभूतस्यावचारयितुमशक्यत्वात् विचारण स्मृत: । हेमाद्रि

Though mūrdhatarpaṇa or akṣi tarpaṇa śuddha sneha is used, it cannot be called as accha sneha because these are not as powerful as that of acchapāna  in alleviating the unbalanced doṣa.

अल्प उपयोगित्वात् अल्पमात्रत्वात् अल्पवीर्य:- हेमाद्रि

Difference between accha sneha and vicāraṇa sneha:

Classification:

1. Bāhya vicāraṇa
2. Ābhyantara vicāraṇa

Fat substances used in the vicāraṇa  snehapāna are usually mixed with food or processed along with different food preparations. Madhura (sweet), amla (sour), lavaṇa (salt), tikta (bitter), kaṭu (pungent), and kaṣāya (astrīngent) are the six tastes, any or all of these tastes may be present in the food and the same is imbibed in to the fat substances during the food preparations.Thus, there can be 63 variety of combination of sneha according to the permutation and combination of six tastes. Adding the sneha to this list, that is given alone and not in combination with any other foods is the 64^th one.

All 64 varieties of sneha are used for the therapeutic purpose and it is administered In according to the habit of the Patient, season in which the snehapāna is carried out, morbidity of doṣa or different disease process.

रसश्चोपहित: स्नेह: समासव्यासयोगिभि:।

षडभिस्त्रिषष्ठिधा संख्या प्राप्नोत्येकश्चकेक्ल:।

एवे मेताश्चतु: षष्टि स्नेहानां प्रविचारणा।

ओकर्तुव्याधिपुरुषान् प्रयोज्या जानता भवेत्।

दोषाणामल्पभ्यस्त्वं ससंर्ग समवेक्ष्य च।

युञ्जयात्रिषष्टिधाभिन्नै: समासव्यासतो रसै:।

According to action the Pravicāraṇa can be narrated as

Dvādaśa aśana pravicāra This unique concept is given in suśruta saṃhita.

The twelve different forms of diets are,

• Śīta āhāra (cold food)
• Uṣṇa āhāra (hot food)
• Snigdha āhāra (food with fat)
• Rūkṣa āhāra (food without fat)
• Drava āhāra (liquid food)
• Śuṣka āhāra (food without moisture)
• Ekakālikam āhāra (single time food)
• Dwikālika āhāra (two time food)
• Auṣadhayukta āhāra (food with medicine)
• Mātrāhīna āhāra (less quantity of food)
• Doṣapraśamana āhāra (food pacifying the vitiated doṣa)
• Vrittyartha āhāra (food to maintain health)

As the dose of sneha used in the vicāraṇa sneha is less, the therapeutic efficacy of the procedure in terms of snehana effect is also less in comparison to the achchhapeya. Even then, this form of snehana is specially indicated in patients who are unable to take the sneha alone due to snehadwesham. Samyak snigdha lakṣaṇa is easily achieved by administering small doses of fatty substances (in vicāraṇa form) in patients having mṛdu koṣṭha. Even if the person is addicted to alcohol, snehana is best carried out by the method of vicāraṇa. More than anything, regular intake of small amounts of fat substances along with the food in therapy.

Indications of vicāraṇa sneha:

स्नेहद्विष: स्नेहनित्यामृदुकोष्टाश्चयेनरा:|

क्लेशासहामद्यनित्यास्तेषामिष्ठाविचारणा ॥

सुकुमारंकृशंवृद्धंशिशुंस्नेहद्विवतथा।

तृष्णार्तमुष्णकाले च सहसक्तेनपाययेत् ॥

In delicate person, emaciated, old, children and those who doesn’t like sneha, who are suffering from excessive thirst, who have aversion for unctuous substances, soft bowels, those who always indulge in alcoholic drinks, those who cannot tolerate physical strains and in uṣṇakāla the snehana should be administered with food internally.

Snehadviṣa: Generally, people show dislike towards ghee and oil due to its taste, aroma and texture. So, they refuse to take accha snehapāna due to its unpalatability. Thus, the persons having dislike towards sneha (snehadviṣa) are mainly indicated for sneha pravicāraṇa.

Snehanitya: The individuals who regularly take fatty diets are indicated for Pravicāraṇa. When one is habituated to Sneha then the administration of sneha cannot provide proper doṣa utkleśana which is the main intention in śodhanāṅga snehapāna. In this condition if sneha pravicāraṇa is used it may provide better doṣa utkleśana thus helps to achieve proper śodhana.

Vṛddhaḥ and bāla: During childhood the dhātu are immature and in the process of development in nature and in old age there will be a dhātukṣayam So, in both the conditions where the physical and mental strength is weak. to take a large amount of sneha dravya as acchapāna is impossible. Hence They are suitable for śamana pravicāraṇa sneha.

Mṛdu koṣṭha is pitta pradhāna. Ārohaṇa acha snehapāna will stimulate excessive secretion of Pitta which may lead to Drava Mala. In such conditions use of pitta śāmaka pravicāraṇa is advisable.

Sukumāra, kleśa-asaha, kṛśa etc possess hīna sattva. These people will never tolerate acchapāna  due its complexity. Pravicāraṇa is less complex in nature, so it is indicated in these individuals.

In uṣṇakala or in greeshma ritu if acchapeya is given in large quantities may give rise to complications. Use of śīta sneha pravicāraṇa may be helpful in such conditions.

Adhva, prajāgara, strī-nitya, madya nitya and in tṛṣṇārta vāta is in prakopa avasthā which results in dhātu kṣaya. As, proper gati of vāta is required for appropriate oleation, in the above said conditions improper vāta gati is observed and administering accha snehapāna may lead to sneha vyāpats. So sneha pravicāraṇa is the only option.

Contra indications of sneha pravicāraṇa

1. Prameha 2. Kuṣṭa 3. Śopha 4. Kaphaja Vyādhi

All these conditions are kapha pradhāna in nature and santarpaṇajanya vyādhis, in these diseases doṣotkleśa is already present in the body and moreover sneha may add in to their pathogenesis, hence it is contra-indicated, but contraindication is only for guru pravicāraṇa e.g., guru māṃsa, guḍa, dadhi, tila, dugdha etc. One can use laghu, dīpanīya, rūkṣa pravicāraṇa e. g. madya, khaḍa, kāmbalika etc.

Criteria’s For Classifying Virecana Sneha:

Acaryā vāgbhaṭa has specified that pravicāraṇa must be used with the help of yukti pramana.

The intellect, which perceives things as the outcome of a combination of multiple factors, is known as yukti. The source of knowledge known as yukti helps in determining an effect in relation to the various factors involved.

In the same context acaryā yogendra nath sen stated that specific preparations are to be administered according to the requirements of individual patients with due regards to their habits, season, nature, age, strength etc.

24 sneha pravichāraṇās:

ओदनश्च विलेपि च रसो मंसं पयो दधि ।

यवगु सूपशार्को च यूष: काम्बलिक: खड: ॥

सक्तवस्तिलपिष्टं चमद्यं लोहास्तथैव च।

भक्ष्यमभ्यञ्जनं बस्तिस्तथा चोत्तरबस्तय: ॥

गण्डूष: कर्ण्तैलं च नस्त कर्णाक्षितर्पण: ॥

चतुर्विशतिरित्येता स्नेहस्य प्रविचारणा:।   – Cha.Su. 13

Odana

One part of rice is properly boiled with five parts of water and then the excess of water is strained off to get the odana. This boiled rice is added with an extra amount of ghee while seasoning and then served in the meals for the purpose of vicāraṇa sneha.

Vilepī

Vilepī is a food preparation obtained by adding one part of cereal, usually rice, with four parts of water, and boiling the mixture to make it thick. This vilepī is mixed with a certain amount of ghee or edible oil before serving in the meals.

Rasa

Rasa means meat soup. Thick, average or thin soup may be prepared for oral consumption. Thick meat soup is prepared by boiling 320 grams of meat in 620 ml of water. Boiling 240 grams of meat in 620 ml of water gives average thick meat soup. Thin soup is obtained by boiling 160 grams of meat in 620 ml of water. Comparatively the thick meat soup is heavier for digestion, and the thin soup is light for digestion. According to one’s ability of digestion one should select thick, average or thin meat soup for the purpose of vicāraṇa sneha.

Māṃsa  

Different dishes of the meat are added with extra amounts of edible fat and then served in the meals as vicāraṇa sneha.

Dugdha 

Milk may be added with a certain amount of ghee before consumption to get the effect of vicāraṇa sneha.

Dadhi

For the purpose of vicāraṇa sneha, curds’ consisting of a good percentage of sneha are mixed with a specific amount of ghee before oral intake.

Yavāgū 

The mixture of one part of cereal in six parts of water is boiled properly till the liquid portion is scarcely left to get the yavāgū. Before serving in the meals, this yavāgū is mixed with a certain amount of ghee or oil depending upon the plan of vicāraṇa sneha.

Sūpa

The soup is prepared by one part of a pulse mixed with either 14 parts or 18 parts of water and then the mixture is boiled to reduce it to ¼ Th. Thus prepared soup is added with ghee or oil and then given for oral consumption as vicāraṇa sneha.

Śākhā 

A food preparation where different vegetables are boiled and treated with seasoning is known as śākhā. In vicāraṇa sneha this śākhā is mixed with an adequate amount of ghee or edible oil before oral consumption.

Yūṣa   

The liquid food prepared by one part of pulse added with 14 or 18 parts of water, and then boiled to reduce the mixture to half is known by the name yūṣa. This yūṣa is mixed with a certain amount of ghee or oil and then given orally as vicāraṇa sneha.

Kāmbalika 

During the preparation of yūṣa with one part of pulse mixed with 14 or 18 parts of water, this combination is further added with curds, sour tasting herbs, salt, edible fat, tila (Sesamum indicum) and māṣa (Phaseolus roxburghii). This mixture is boiled properly to get the kāmbalika. To use this in vicāraṇa sneha, Kāmbalika is added with an extra amount of edible fat.

Khaḍa

The combination of one part of pulse and 14 or 18 parts of water is added with specific amount of buttermilk, kāpittha (Feronia elephantum), cāṅgerī (Oxalis corniculata), marīca (Piper nigrum), ajāji (Cuminum cyminum) and citraka (Plumbago zeylanica). This mixture is properly boiled to get the khaḍa yūṣa. Before serving in the meals this khaḍa yūṣa is mixed with an adequate amount of ghee or edible oil for the vicāraṇa sneha.

Saktu

The flour of cereals and pulses is moistened with an adequate amount of edible fat and then given orally in the form of vicāraṇa sneha.

Tilapiṣṭa   

The cakes of tila (Sesamum indicum) are moistened with a certain amount of ghee or oil and then eaten. This will be a form of vicāraṇa sneha.

Madya

Different alcoholic beverages are mixed with desired amount of ghee or oil and then taken internally to get the effect of vicāraṇa sneha.

Leha

Soft and thick confectionery, a kind of sweet dish prepared out of sugar and pulses like black gram is called leha. For the purpose of vicāraṇa sneha, this leha is mixed with ghee or edible oil and then consumed.

Bhakṣyaanna

Different sweet dishes are known by the name bhakṣyaanna. The sweet dishes are added with edible fat before consumption to get the effect of vicāraṇa sneha.

• Abhyaṅga
• Application of the oil followed by massage by specific maneuvers.
• Gaṇḍūṣa
• Holding and gargling the liquid medicines mixed with fat substances.
• Karṇa Pūraṇa
• Dropping oil into the ears.
• Nāsā tarpaṇa
• Dropping oil into the nostrils.
• Akṣi Tarpaṇa
• Administration of sneha into the eyes.
• Basti
• Administration of sneha in the form of enema.
• Uttara basti

Administration of sneha through the urethral route.

Among the above said 24 types of vicāraṇa sneha, initial 18 are the different food preparations added with fat substances and are administered through the oral route.

Basti and uttarabasti are administered through the rectal and urethral route respectively.

Karṇa Pūraṇa, abhyaṅga are the different forms of external administration of the snehana therapy.

Further the preparations like māṃsa rasa, māṃsa etc are the non-vegetarian preparations, and hence the client having the habit of non-vegetarian foods may prefer these for the snehana. And the preparations like odana are the vegetarian preparations, and clients having vegetarian food habits may select these items for the purpose of vicāraṇa sneha.

Table showing various sneha pravicāraṇas and their properties

सद्यो स्नेहनं – Instant Oleation

Classical snehapāna like śodhana sneha, śamana sneha, bṛṃhaṇa sneha (up to certain extent) if at all administered, there are so many rules and restrictions must be followed properly and compulsorily in order to avoid complications.in case of children, Elderly or in Emergencies implementation of above snehapāna methods are difficult to practice.in this scenario Sadyaḥ sneha is only option available which is simple and effective method in those conditions where normal sneha administration is contraindicated or difficult to administered .

What is sadyaḥ sneha?

Definition:

The word sadyaḥ means              – Instantaneous

The word sneha means                – any fatty substance

Sadyaḥ snehana is a procedure of administration of sneha to achieve snigdha lakṣaṇa immediately or within a shorter duration. It is based on the principles of pravicāraṇa snehana.

Dalhana, adhamalla and cakrapani commentaries give the description that; sadyaḥ snehana brings snigdha lakṣaṇa quickly on the day of administration.

Cakrapani and adhamalla opine that the snehana therapy, which is said to produce unctuousness instantaneously, may also take three days to bring snigdha lakṣaṇa. Only for praising it is said as sadyaḥ snehana. Sadyaḥ snehana quickly oleates even within 3, 4 days.

Why Sadyaḥ sneha?

सातत्यास्वाद्वभावाद्वापथ्यंद्वेष्यत्वमागतं |

कल्पनाविधिभिस्तैस्तैर्प्रियत्वंगमयेत्वं पुन: |        – च.चि .30/331

If doṣa are in cala avasthā or are already present in koṣṭha then alpa snehana (read sadyaḥ sneha) alone can bring them to līnaavasthā.

The śodhanaṅga snehapāna is administered for the purpose of doṣa utkleśana, when doṣas required a central position (pradhānaavasthā) and are scattered in remote places, i.e., to bring the upasthita doṣas from śākhā to koṣṭha and expel them out of the body through unique procedures like vamana and virecana.

Proper administration of snehana is highly essential for the successful conduction of śodhana cikitsā. If doṣa is in līna śākhāgataavasthā (the doṣa’s which has not attained pradhānaavasthā), then proper snehana karma is required. If doṣas are in cala avasthā, i.e pradhānaavasthā or are already migrated to koṣṭha then alpa snehana alone is sufficient. This is where sadyaḥ sneha comes handy in the form of vicāraṇa.

Accha Sneha is considered as best for oleation therapy. However, in certain situations administration of accha snehapāna in patients is difficult and cumbersome due to pālatability issues, lack of time, difficulties in following pathya apathya etc.

In emergency times or cases in which śodhana karma must be administered in a short time frame then sadyaḥ snehana is the only option.

The intensity of sneha jīrṇa and jīryamāṇā lakṣaṇa are very much in acchapāna whereas sadyaḥ snehana will not produce unpleasant experiences once taken in the vicāraṇa form and have better compliance. Of course, sadyaḥ snehana is only beneficial in calaśākhāshrita and līna koṣṭha and koṣṭhashritavyādhī.

Indication

बालवृद्धादिषुस्नेहपरिहार असहिष्णुषु।

योगानिमाननुद्वेगान्सद्योस्नेहान्प्रयोजयेत्॥    – अ. हृ. सू. 13/39

It is adopted in children, old persons and who are not able to take the snehapāna or cannot follow the स्नेहपानोपचार skin diseases, dropsy and diabetes.

Sadyaḥ sneha vs Classical sneha

• Classically sneha is one which does the functions of snehana, Viṣyandana, Mārdavata and kledana.
• Na atisnigdhaviśodhayeth could be the base of sadyaḥ snehana.
• Ḍalhaṇa says that sadyaḥ- snehana may bring samyak snigdha lakṣaṇa on the day of administration.
• According to Cakrapāṇi and Aadamalla sadyaḥ, snehana therapy can be given for three days in order to bring samyak Snigdha lakṣaṇa.
• Post sadyaḥ snehana has mild rules and regulations in diet and regimen.
• Can be administered With or without svedana procedure.
• Fixed dose in fixed duration of one day or mild increase of dose on second and 3^rd
• Specific clear yoga are mentioned in texts.
• Less chance of complications.

Pros and Cons of Sadyaḥ Snehana

Pros

• Simple procedure
• Sneha for Short duration
• Highest patient compliance
• Can be done With or without svedana
• Easy Receptivity
• Less complications
• Pālatable and tasteful Yoga
• Cost effective
• Smooth sailing of Jīryamāṇā and Jīrṇa lakṣaṇa

Cons

• Chances of Vyādhī punaḥrbhāva
• Dose fixation
• Difficulty in assessing samyak Snigdha Lashanas.

Use of Lavaṇa in sadya sneha

लवणोपहिता: स्नेहा: स्नेहयति चिरान् नरम् |

तत् हि विष्यन्दि अरूक्षं च रूक्षमुष्णं व्यवायी च ||              – अस.सू .२५/६९

Oily substances mixed with salt lubricate the body quickly in view of their properties such as causing secretion from the tissue pores, unctuousness, thinness (capable of entering into minute pores). Hot potency and vyavāya property (rapidly spreading to all the parts of the body first and undergoing digestion later).

स्नेहयन्ति तिला: पूर्वजघ वा सस्नेह फाणिता:।

कृशराश्च बहुस्नेहास्तिलकाम्बलिकास्तथा।

फाणितं श्रृङ्वेरं च तैलं च सुरया सह।

पिवेद्रक्षो भूतैर्मासैर्जीऽक्ष्नीयाच्य भोजनम्॥

तैलं सुराया मण्डेन वसां मज्जाननेव वा।

पिबन्सफाणितंक्षीरं नर: स्निह्यति वातिक:॥

धोरोष्णं स्नेहसंयुक्तं पीत्वा सषर्करं पय:।

नर: स्निह्यति पीत्वा वा सरं दहन सफाणितम्।

क्षीरिसिद्धाबहुस्नेह: स्नेहयेदचिरान्नरम्।

सर्पिस्तैलवसामज्जतण्डुलप्रसृतै श्रृता।

पाञ्चप्रसृलिको पेया येया स्नेहनमिच्छता॥         – च.सू 13/59-60

पिप्पलीलवणं स्नेहाश्चत्वारो दधिमस्तुक:।

पीतमेकध्यमेतद्धिसद्य: स्नेहमुच्यते॥

भृष्ट माम्स रसे स्निग्धा यवागू: सूपकल्पिता।

प्रक्षुद्रा पीयमाना तु सद्य: स्नेहनमुच्यते।

सर्पिष्मति पय: सिद्धा यवाम् स्वल्पतुण्डुला।

सुखोष्णा सेव्यमाना तु सद्य: स्नेहनमुच्यते।

पित्पल्यो लवणं सर्पिस्तिलपिष्टं वराहजा॥

वसा च पीतमैकध्यं सद्य: स्नेहमुच्यते।

शर्कराचूर्णसंसृष्टेदोहनस्थे घृतेतुगम्

दिग्धवाक्षीरं पिबेत् रूक्ष: सद्य: स्नेहनमुच्यते।

थवकोल कुलत्थानाक्वाथो मागधिकान्वित:।

पयो दधि सुराचेति घृतमत्यष्टमं भवेत्।

सिद्धगेतैर्घृतं तं पीतं सद्य: स्नेहमुत्तमं।

राजं राजसमेभ्यो वा देया मेतद्घृतोत्वं।

बलहानेषुवृद्धेषु मृद्वग्नि स्ती हतात्मसु।

अल्पदोषेषु योज्य: स्थुर्ये योगा:॥         – सु.चि 31-35-47

प्रभूत मांसनिष्क्वाथान् जाङ्गलानुपजान् रसान्।

स्नेह भृष्टेषु बातेषु यवारं नातिसंहताम्।

तिलेचूर्णनं च स स्नेह फाणितं कृसरां तथा॥

तिलकाम्बलिक भूरिस्नेहं सर्पिष्मतीमपि।

पेयां सुघोष्णाक्षरेयां पात्रेवा ससिताघृते।

सर्पिर्लवणयुक्तं वा सद्योदुग्धं तथा पय:॥

पेयां च पञ्चप्रसृतां स्नेहैस्तण्डुलपञ्चमै:।

पायसं माषमिश्रं च बहु स्नेहसमायुतम्।

तैलशुण्ठी गुडरसं जीर्णे मांसरसाशिन:॥

स्नेहवैकं सुराच्छन दनो वा सगुड सरम्।

वसां वराहजां सर्पि: पिप्प्लीं लवणं तिलान्।

पिप्पलीं लवणं स्नेहांश्चतुरो दधिमस्तुकं।

दध्ना सिद्धं व्योषगर्भं धात्रीद्राक्षारसे घृतम्

यव कोलकुलत्थोम्बू क्षार क्षीर सुरादधि।

घृतं च सिद्धं तुलायाशं अद्य: स्नेहमुत्तम।

सिद्धाश्च चतुर: स्नेहान् बदरत्रिफलारसै:।

योनिशुक्रामयहरान् अद्य: स्नेहान् प्रयोजयेत्॥  – A.S. Su- 25-60-68

सर्पिष्मति बहुतिला यवागूस्वल्पतण्डुला।

सुखोष्णा सेव्यमाना तु सद्य:स्नेहनकारिणी।

शकीराचूर्ण संयुक्ते दीहनस्थे घृते तु गाम्।

दुग्ध्वा क्षीरं पिबद्रूक्ष: सद्य: स्नेहनमुत्तमं॥    – भा.प्र -Snehadyaayam

ग्राम्यानू पौदकं माम्सं गुडं दधि पयस्तिलाम्।

कुष्ठिशोथि प्रमेही च स्नेहन न प्रयोजयेत्॥

गुशानूपामिष क्षीर तिलमाषा सुरादधि।

कुष्ठशोफ प्रमेहेषु स्नेहार्थं न प्रकल्पयेत्॥   – A.S.Su.25

Procedure – Sadyaḥ Snehapāna Vidhī:

1. Pūrva karma:

Administer Triphalā or Kaṭuki (depends on the koṣṭha of the patient) for DehaRūkṣaṇa (sneha Pūrvarūkṣaṇa) in the dose of 3 to 5 gms with hot water at night for 3-5 days (Dīpānapācana can also be done if presence of āma is noticed) before Snehapāna followed by administration of Hrasīyasīmātrā for one day in order to fix the sadyaḥsnehapāna dose.

2. Pradhāna karma:

Early morning after sunrise on the day of Snehapāna advises the patient to fulfil his natural urges and ask him about his jīrṇaajīrṇa symptoms to assess the agni. When a person is not in Kṣudhīta Avasthā, Sadyaḥ sneha recipes such as tilayavāgū, kṣīrayavāgū, ghee with saindhava, pañca prāsthika peya etc can be given.

1. Hot water must be advised after the administration of snehana as anupāna.
2. The duration of jīryamānā lakṣaṇa as well as the time required for the appearance of jīrṇa lakṣaṇa & samyak snigdha lakṣaṇa can be assessed if necessary.
3. Paścāt karma: instruct the patient to follow pathyapathya mentioned under snehapāna vidhī.
4. Depending on the samyak snigdha lakṣaṇa and doṣa utkleśaavasthā the śodhana procedures like vamana, virecana or sirāvedha can be decided.

Assessment of samyak Snigdha lakṣaṇa (सद्यो स्नेहं)

Why do Samyak Snigdha Lakṣaṇa happen?

1. By virtue of its snigdha, sara properties correct the koṣṭharūkṣatā, aiding in normal gait of vāta. This will help indirectly in mala mūtra visarjana and agni vṛddhī.
2. Vātanulomana is the very first samyak snigdha lakṣaṇa that appears in sequence after the śodhanaṅga snehapāna. Proper anulomana of vāta corrects the functioning of samāna vāta and pācaka pitta, which helps in bringing the agni dīpti.

iii.  Due to snigdha, drava, sara and mṛduguṇa of sneha, purīṣa becomes drava and snigdha and individuals may pass asaṃhata and snigdha varcas.

1. The Sneha imparts its qualities to all the dhātu gradually; once all the dhātu get saturated with sneha, their qualities like snigdhata and mṛdutā manifest in the tvak.
2. Snehapāna removes obstruction to the gati of vāta; vāta anulomana takes place hence individuals may feel laghutā and vimalendriyata. śodhanaṅga snehapānaa itself may act like laṅghana due to diet restriction during the course of snehana.

Some thoughts

• Basically, selection of sneha mātrā is mystery and contingent because of agni and koṣṭha former is different from person to person towards a later along with involvement of Vyādhī, bāla, Vayas and Kāla
• According to Classics Hrasīyasī Mātrā (30-40 ml) of Sneha takes 3 hrs (1 Yāma) to digest. Practically 50ml to 300ml range of Sneha usually gets digested in 6 to 12hrs. which is a madhyāma mātrā dose
• Frequency can be fixed as one day or for 3 days. Depends on the patient’s strength and
• 1 pāla to 6 pāla for Śodhanaartha in Liquid form (diet)for Śodhanaarthasnehapāna.
• 1-2 pāla for śamanaarta Semi solid form. (diet)
• Sadyaḥ sneha must be carried out morning after seeing Nirāmalakṣaṇa.:
• Purpose: For stimulating utkliṣṭakapha or to make the kaphautkleśana during sadyaḥvamana or to make doṣa utkleśana before siravyadha.
• Stimulating the utkliṣṭa pitta (Kapha a vṛddhīkara condition) Or to make pitta utkleśana during Emergency for virecanaartha.
• Sadyaḥ sneha can change the physical nature of sneha by addition of various edible substances. Because of the involvement of supportive carbohydrate and Protein metabolism.
• It may change the internal stomach environment to some extent Ex: It may neutralise the gastric Ph and also may balance the gastric secretions, mucus, acids, enzymes etc.
• Also, sneha can be more palatable, pleasant to mind because of disaccharides and monosaccharides.

Effect achieved through Samyak Snigdha Lakṣaṇa by only:

Udgāraśuddhī, bhojana ruci, viṣyandana, kledana, vāta anulomana, asaṃhata varcasrs but it may or may not produce gātramardhava, gātrasnigdhata, tvak snighdata.

Indications of Sadyaḥ sneha according to different Accharyaa’s

बालव्रिद्दादिषूस्नेहपरिहारसहिष्णूषू॥

योगानिमान्नुवेगान्सद्धःस्नेहान्प्रयोजयेत।

प्राज्यमाम्सरसास्तेषूपेयावास्नेहभर्जिता॥

तिलचुर्णःचसस्नेहफाणीतःक्रिशरातथा।

क्शिरपेयाघृताढ्योष्णादध्नोवासगुडःसरः॥

पेयाचपञ्चप्रस्रृतास्नेहैस्तण्डूलापञ्चमैः।

सप्तैतेस्नेहनाःसद्धःस्नेहाश्चलवणोल्बणाः॥

तद्ध्याभिष्यन्द्यरूक्शम्चसूक्ष्मष्णंव्यवायिच।  – Ah.Su. 16/39-43

General Indications of sadyaḥ sneha

Hridayabodhika explains the term tvarāyam may also denote śīghrasampādana of snehana which is indicative of sadhyasneha prayoga

Contraindications of sadyaḥ sneha

Kuṣṭha, prameha, śotha, nava jvara, udara roga, ūrustambha

Sadyaḥsneha Yoga (In Saṃhitā’s)

Difference between Śodhana accha sneha, Pravicāraṇa sneha and sadyaḥ snehana.

Avapīḍaka sneha

अव (prefixes)-means down.

पीड – Means pressing or squeezing or suppressing.

So literally Avapīḍa snehapāna means pressing down the fat. Here the fat squeezes down the food and after digestion of food, vāta doṣa suppresses down the food. (empty stomach is vāta pradhāna).

Indication:

मूत्रजेषु तु पाने प्राग्भक्तं हितम्||                  – Ah.Su.4/6

अवपीडकसर्पिश्चविशेषानमूत्रजेगदे||               – As. mūtra udāvarta cikitsā

स्वेदावगाहनाभ्यञ्जन नाभे: सर्पिश्च अवपीडकं ||  – च. सू -७/८

बस्तिकर्म तु अधो नाभे: शस्यते चावपडक: ||   – च. सि.

This avapīḍaka snehapāna administration, is narrated in mūtravegavarodha avarodha vikāras. A careful observation of the texts from various ācāryas can give some insight about avapīḍaka snehapāna indications. This form of snehapāna can be administered in all adhogata vāta rogas.(apāna vaiguṇya).The symptoms of mūtra vega dhāraṇa includes adhovāta rodha symptoms and śakṛt rodha symptoms. So, in those symptoms or diseases avapīḍaka sneha can be safely administered. (मूत्रस्यरोधात्पूर्वं च प्रायो रोगाः -ah.su.4/4)

Practically diseases related to thighs, lower back and in kidney diseases also can be practiced.

यत्तुप्रक्षीणदोषस्यरक्तंवतोल्बनस्य वा ||

स्नेहै: तत्सादयेत्युक्तै:पानअभ्यञ्जनवस्तिषु||       – Ch.Chi.8/100

रसै: कोष्णैः च सर्पि: अवपीडकयोजितै:           – Ah.Chi.8/124

वस्तिकर्म तु अधोनाभे: शस्यते अवपीडक:         – च.चि .२८/९८

Avapīḍaka snehapāna is also indicated in raktārśas (bleeding piles) and adho nābhi gata vāta (disorders of pelvic cavity specifically bowel bladder and genito pelvic diseases due to vāta).

It can also be administered in conditions like infertility, BPH, शुक्र and आर्तवरोग, ulcerative colitis, IBS, Chron’s etc.

पित्तानिलामयघ्नं बस्त्युरुकटिदृढीकरं वृष्यम्।

ऊर्जस्करं श्रमघ्नं विद्यात्स्नेहावपीडं तु॥     – क.स.सु२२/४७

According to Kāśyapa, avapīḍaka snehapāna it is best for pitta and ānila. It strengthens the bladder, thighs and hips. It is aphrodisiac, provides enthusiasm and removes tiredness.

Why is ghee preferred as Sneha dravya?

Here fat administration must be in the form of ghee only, not in taila form. Though taila is best for vāta, it is not advisable in avapīḍaka snehapāna because it is baddhavittkam and alpamūtraprāvartakam (obstructs free flow of feces and urine) which is already present in those indicated diseases. However, ghee is not baddha vit and mūtra so grita is the obvious choice.

पवन विजये च तैलं यथा वरं न तथा घृतं अत तैलस्य एव अवपीडक योजना मात्र उचितं न सर्पिषः | अत्रोच्यते तैलस्य वतजितो अपि बद्ध विट्क अल्प मूत्र स्वभावात् अत्र अयोग्यं पानं ||तथा च वक्ष्यति तैलं स्वयोनिवत् |  अ.हृ.सू. ६/२९

इत्यारम्भ यावत् बद्ध विट्कं इति || स्व योनि वत् इत्युक्ते च अल्प मूत्रत्वं | तथा च वक्षति उष्णस्त्वच्यो हिमः स्पर्शे केश्योबल्यस्तिलो गुरु | अल्प मूत्रः इति

तदेवं तैलस्य बद्धविट्कं अल्पमूत्र भवतया तदीयो अवपीडको मूत्ररोदोथेषु रोगेषु औषधत्वेन न युक्तः अपि तु सर्पिष एव युक्तः||

Procedure

जीर्णान्तिकं च उत्तमयमात्रया योजनद्वयं |

अवपीडकंतत्चसंजितं    – Ah.Su.4/6

सर्पिषो अवपीडक: यत्रसर्पि: पीत्वातत्पीडकं अन्नंभुज्यते || -चक्रपाणि on Ch.Chi.28/98

जीर्णातिकं च उत्तमयमात्रया योजनद्वयं |अवपीडकंयेतत्संजितं ||   – अ.ह्र.सू.४/६

भोजनपूर्वं घृतपानं जीर्णान्तिकञ्चघृतं प्रशस्यते। जीर्णान्तिकं यद्ध्यस्तनेऽन्नेजीर्णेयुज्यते॥

उत्तमयामात्रया अहोरात्रजरणलक्षणया इति। प्राग्भक्तस्नेह योजनाजीर्णान्तिकस्नेहयोजना।

उभयमवपीडकमुच्च्यते॥   – Aruna dutta

मूत्ररोधजानां विशेषमाह मूत्रजेषु इति ||

अवपीडको द्विविध:- ह्रस्वया मात्रया प्राक्भक्त प्रयोगः उत्तमया अनन्न प्रयोगस्च | उक्तं हि संग्रहे मूत्रजेषु तु पाने च प्राक् भक्तं शास्यते घृतं | जीर्णातिकं च उत्तमया मात्रया योजनात्द्वयं अव पीडक ए तत् संजितं इति –हेमाद्रि

ह्रर्स्वयामात्रयाप्राक्भक्त प्रयोग: उत्तमयाअनन्नप्रयोगश च – Hemādri

Avapīḍaka snehapāna is either used for doṣa utkleśana or śodhana pūrvaka snehapāna. Its action is either doṣa śamana or bṛṃhaṇa

The word yojanā dwayam is interpreted in 2 ways.

It can be administered in two ways Initially ghee (medicated) is administered in a low dose (hruswa mātrā) followed by (after some time, when the patient is relaxed after exhausting ghee drinking) light food (manda or yūṣa). Once the patient develops proper hunger (udhgaara śuddhī, ruci and lagutha) once again the ghee must be given in uttamaa mātrā dose.

In the second method instead of administering hirswa mātrā in the beginning (before food), uttamaa mātrā is given followed by food and once the food is digested once again uttamaa mātrā ghee is given.

Note: As per aruna Dutta in mūtra rodha avarodha vikāras, adho Naabhi vikāras etc uttamaa mātrā or hirswa mātrā ghee is given first, followed by food and then uttma mātrā ghee is used.

 In raktaja arśas, (Bleeding piles), when the bleeding is not stopping even after proper treatments then avapīḍana snehana must be administered as a last option. First, hirswa mātrā ghee mixed with kouṣṇamāṃsa is administered and after its digestion once again Luke warm ghee is given. (Here Avapīḍa sneha acts as bṛṃhaṇa. In Raktārśas due to heavy bleeding rakta kṣaya, ojokṣaya and vāta vārdhaka is enormous hence Brumana avapīḍaka is advised.)

When to administer?

पिबेत् संशमनस्नेहं अन्नकाले प्रकाक्षितः।   – च. सू .१३/६०

शमनः क्षुद्वतोऽनन्नो….

Ghee should be administered when the person is hungry, in the morning either in the form of uttamaa mātrā or hirswa mātrā.

Dose– The dose must be decided according to the agni and koṣṭha of the person. Or in quantity wise one phala-50ml.

उत्तमस्य फलं मात्रा। शा.स.उ.117

जघन्यस्य पलार्ध अथवा द्विकर्षिका। -Sha.Su. Ch-17-around 25ml (with reference to bleeding piles)

Diet during avapīḍana snehapāna:

अत्र च उत्तमया मात्रया स्नेहपानानन्तरं पथ्यं कार्यं। -अरुणदत्त

पेया यूषो रसो वा स्यादकृतः कृतोवा।

अल्पाल्य सर्पिष्को विलेपि वा विधीयते॥          – सु.चि. 32/ 31/34.

Practically 50ml can be given as prāgbhakta (prior to food) and again100-250 ml can be given after the digestion of the food.

How many days to be administered?

If uttamaa mātrā is used, then for a maximum of 7 days it can be administered or until samyak Snigdha lakṣaṇa. If hriswa mātrā is given then it can be continued until Roga śamana.

SomeThoughts

Prāgbhakta is indicated in the apāna vāta vaiguṇya.

All the diseases controlled or cured by avapīḍaka snehapāna is due to pratiloma  gati of (upward direction) of apāna vāyu.

To correct this pratiloma  ghṛtapāna vāta is done by administering ghee, that is pīḍana (squeezing) of pratiloma  vāta doṣa. This is the reason behind the name Avapīḍaka.

Avapīḍaka snehapāna which is Snigdha guṇa pradhāna is very much useful in pathology initiated by rūkṣa guṇa of vāta in various mūtravega rodha avarodha Vyādhīs.

Due to the suppression of mūtra, adhovāta and PurīṣaVegas, both apāna and vyāna vāyu get deranged. Avapīḍaka snehapāna corrects pathophysiology of deranged apāna and vyāna vaāyu’s. Hence it is considered as a unique therapeutic method to treat mūtravega rodha, udāvartaja śukra ja etc vikāras.

Ghṛta is preferred in avapīḍana sneha due to its vātanulomana and agni vārdhaka Guṇas.The therapeutic utility of avapīḍaka snehapāna can be further extended for the treatment of similar diseases where apāna vāta vaiguṇya is noted.

The functions of apāna vāta is the initiation of micturition, defecation, ejaculation, menstruation, and childbirth and apāna vāta is vitiated in diseases like mūtra aśmarī (urinary calculi), śukraśmarī, udāvarta (reverse peristalsis, mūtrakrechra (dysuria) and mūtra gatha. so in above diseases avapīḍaka sneha can be safely administered.

Procedure of avapīḍaka snehapāna-Practical point of view

Materials required:

1. Ghṛta according to the patient’s disease condition- Q.S.
2. Measuring jar-1
3. Glass-1
4. Cloth-1
5. Lemon sliced and sprinkled with salt-1
6. Water boiled with Śuṇṭhī and Dhānyaka -Q.S.
7. Cotton- Q.S.

8   Gauze-1

Quantity of sneha

The quantity of medicated ghee is uttamaa mātrā. Hrasīyasī dose must be performed first so as to fix the dose.

Procedure

The patient should be observed for the lakṣaṇa of vega pravṛtti, agnidīpti etc to ensure the nirāma avasthā

 Ask the patient to sit in the knee high chair and his eyes must be closed with cotton and gauze. Now measure the ghee which is in lukewarm state according to the strength of the patient with the help of measuring glass.

1. The administration procedure of Sneha involves two steps. One is done before intake of food and the second after the digestion of food.
2. Initially half portion of ghee is given, followed by a little quantity of hot water.If the person feels nauseous, he can lick sliced lime with salt and smell the lime. The patient should be advised to take light food soon after drinking half the portion of ghee.
3. Once the food is digested, which is evidenced by clean belching, lightness, thirst and hunger the remaining ghee should be given.
4. Patients should drink a little quantity of śuṇṭhī dhānyaka jala now and then for the digestion of sneha dravya. He should be made to stay inside a room which is devoid of excessive breeze/wind and need to himself, awaiting the digestion of sneha.
5. Feeling of  lightness, relief  from  the  symptoms  like  headache, giddiness, exhaustion,  appearance of appetite,  thirst and pure belching indicates the complete digestion of sneha.
6. Once the patient develops proper appetite, he must be advised to take light food.
7. In this manner, the snehapāna can be administered for 3, 5 or 7 days.

Method 1: Here Hraswa mātrā sneha to be administered by early evening and food is administered after a while. The next morning after attaining the Jīrṇāhāra lakṣaṇa, Uttamaa mātrā is calculated. During Sūryodayakāla (sunrise) and before the feeling of hunger Uttamaa mātrā, sneha is administered. The diets and regimens to be followed during and after the Snehana are advised during the period of Snehapāna. Rice gruel can be consumed whenever the patient feels hunger till the procedure ends.

Method 2: The Hraswa mātrā sneha to be administered during sunrise and Sātmya āhāra (compatible food, preferably rice gruel) is given after 30 to 45 minutes. The time of administration is significant as it is the ideal time for Utkleśana (secretary). Uttamaa mātrā to be calculated and administered after attaining the proper digestion of food. The diets and regimens to be followed during this period. Rice gruel can be consumed when the patient feels hunger.

Method 4: Uttamaa mātrā can be administered during sunrise if you know the Agnibāla (digestive strength) of the patient and is advised to sip hot water frequently. When the person is hungry, rice gruel is given as food. This is repeated till he or she attains Samyak Snigdha lakṣaṇa

Paścāt karma

Same that of śodhanaaṅga snehapāna

Auṣadhas Sevana kāla of Avapīḍaka Sneha

 The auṣadhasevanakāla for vitiated apāna vāyu, vāyu get lodged in anal region, diseases of lower part of the body and for the strengthening the lower part is prāgbhakta. 20he auṣadha kāla for avapīḍaka sneha is prāgbhakta and jīrṇantika. In mūtravegadhāraṇaavarodhavikāras vāta doṣa especially apāna vāta get vitiated. Here we can see that Prāgbhaktaauṣadhasevana of Hraswa mātrā sneha will act up on vitiated Apāna vāyu condition and uttamaa mātrā sneha to be given after digestion of previous food.

The following gritaas can be used for avapīḍaka snehana

• In BPH- Vasti āmayantakam ghṛta.
• Spastic colon-Indukāntā ghṛta.
• For Bladder problems/mūtra kṛcchra/ mūtra ghatam – Dhanwantaram, vasti āmayantakam, trikantakaadi, sukūmāra gritham
• Colon diseases-Changeriyaadi ghee, dāḍimadi ghee
• Infertility-Kalyāṇakam, phalasarpīs.
• In udwaarthanam and Arśass- Sukūmāram ghṛta, shatpālam ghee.