Usually the vitiated Doṣa are located in such parts of the body where the disease is produced. These vitiated Doṣa are to be brought into the Koṣṭha or alimentary canal wherefrom they are eliminated by the specific measure of Pañcakarma. For bringing these Doṣa in the alimentary canal, Snehana (oleation therapy) and Svedana (sweating therapy) are performed. By doing so, the Doṣa are channeled to the Koṣṭha. This is called preparation of the patient. Snehana and Svedana play a major role not only as a Pūrvakarma (preparatory measure) but also as a line of main treatment in some of the diseases e.gVātavyādhi.
Snehana (Oleation Therapy)
There are two sources of getting fat viz. animal and vegetable. The animal fats are of three kinds viz. Ghṛta (ghee), Vasā (fat) and Majjā (bone marrow), and vegetable fat is oil. Thus fats are four i.e. Ghṛta, Taila, Vasā and Majjā.
There are mainly four methods of administration of fats viz. through diet, drinking, massage and Basti. It can be taken internally by way of mixing with diet articles or may be drunk straight way. Apart from the above, fat can also be administered by gargles (Ganḍūṣa), ear-filling (Karṇapūrana) and through nose (Nasya).
Indication of Snehana
Snehana is mainly indicated for those who are to undergo Svedana or Śodhana, Rūkṣa persons, those suffering from Vātavyādhi, those who do excessive exercise and sexual intercourse, and addicted to wine.
Contraindications of Snehana
Snehana is contraindicated for the persons having increased Kapha, those whom Rūkṣaṇa is prescribed, very weak and very fatty persons, persons suffering from profuse mucus discharge from mouth or anus and having low digestive power, and suffering from thirst, fainting and Tāluśoṣa. It is also contraindicated to those having aversion for food, tendency to vomiting, and suffering from diseases of stomach specially Āmadoṣa, chronic poisoning etc.
Administration of Sneha (Fat)
There are three Mātrā (doses) of Sneha viz. Pradhāna (maximum), Madhya (moderate) and Hrasva (minimum), which are based on the digestion of the ingested Sneha by the patient within twenty four hours, twelve hours and six hours respectively.
The Sneha should be administered minimum for 3 days and maximum for 7 days depending upon the Koṣṭha of the patient. The Snehana given beyond 7 days may lead to habituation and act as the part of the diet.
On the preceding night of giving the Snehana, the patient should be given liquid and warm diet which does not obstruct body channels. SaṁśamanaSnehana should be taken at the usual time of meals and for Śodhana (purification) it should be taken after the complete digestion of meal taken previous night.
Criteria for proper Snehana
The effect of Snehana therapy is assessed in terms of Ayoga (hypo), Samyak Yoga (proper) and Atiyoga (hyper) of Snehana.
If the patient after Snehana therapy passes dry stool, has abnormal movement of ApānaVāyu, weak digestion, and roughness and dryness of the body, this means the proper Snehana of the patient has not been done (Ayoga). In this case a further course of Snehana may be given depending upon the condition of the patient.
Normal Vāta, increased digestive power, soft stool, and softness and smoothness of the body are the signs and symptoms of proper (Samyak) Snehana. Thereafter the patient may be put on the next measure of Pūrva Karma or Pañcakarma as the case may be.
Pallor, heaviness, dullness, loose stools, torpor, anorexia and nausea are the signs and symptoms of excessive administration of Snehana (Atiyoga). In case of Atiyoga the administration of Snehana should be stopped immediately and the patient should be treated accordingly.
After taking the Snehana therapy, the patient should use only warm water, refrain from suppressing natural urges of faeces, urine, flatus and eructation; avoid physical exercise, anger, grief, loud speaking, severe cold and sunshine.
Complications of Snehana
Snehana should be given only to those patients where it is indicated and in proper doses otherwise it may cause torpor, nausea, constipation, fever, stiffness, unconsciousness, skin diseases, pallor, oedema, piles, anorexia, thirst, Grahāṇīdoṣa, suppression of speech, colic and Āmadoṣa.
Above mentioned complications of Snehana therapy should be treated with Vamana, Svedana and Virecana. In addition to these Takrārṣṭa, dry diet and drink and Triphalā should be administered.
Svedana (Sweating Therapy)
The Svedana is given generally after performing the Snehana. Suśruta has described four types of Sveda viz. TāpaSveda, ŪṣmaSveda, UpanāhaSveda and Drava Sveda.
TāpaSvedais dry in nature and it is performed with warm hand or application of hot metal or with tiles or sand. The affected part or whole body should be fomented by wraping cloth on the above mentioned articles.
ŪṣmaSveda is done with tiles or such other things, which are made very hot and immersed in hot liquids, generally water, and then the affected part is fomented. When the fomentation is to be done to the whole body, the steaming Kvātha (decoction) is to be put down below the cot placed in a draught free room. The patient should have one bed sheet below and another to cover him.
UpanāhaSveda(poultice) is to be put in the form of warm Lepa on the affected part and then it is to be bandaged. Drava Sveda is a type of tub bath in which a hot decoction of the drug is placed in a tub and the whole body or the affected part is immersed in the tub. Tāpa and ŪṣmaSveda are useful in Kapha disorders, Upanāha-Sveda in Vāta disorders and Drava-Sveda in Pitta disorders.
Caraka has described two ways of giving Svedana i.e. with Agni (fire) and without Agni. Those to be conducted with the help of fire are 13 types which may be included in one or the other of the four types described above. In NiragniSveda, the sweating is produced by the acts like exercise, use of closed and insulated room in summer, to cover the body with thick blankets, prolonged sunbath.
Indications of Svedana
Cold (Pratiśyāya), cough (Kāsa), hiccough (Hikkā), breathlessness (Śvāsa), pain in ear and neck, head etc., hoarseness of voice, pharyngitis, facial paralysis and other types of paralysis, lumbago, flatulence, pain in the abdomen, retention and suppression of urine, sciatica, pain anywhere in body, inflammation (Śotha), stiffness, heaviness and numbness of body, rigors, and shivering are the diseases where Svedana is indicated.
Contraindications of Svedana
The Svedana therapy should not be undertaken in the conditions like pregnancy, bleeding tendency (Raktapitta), diarrhea (Atisāra), Dryness (Rūkṣaṇam), diabetes (Madhumeha), hernia, diseases due to poisons or alcohol, fatigue, thirst, hunger (Kṣudhārta), anger (Kruddha) or worry, Udararoga, Timira, Kāmalā (jaundice) and other Pitta disorders. It should also not be giving to the very fat persons, injured and thin persons.
Criteria for proper Svedana
Appearance of sweat, feeling of lightness in the body and disappearance of the feeling of cold and pain are the symptoms of proper Svedana.
Thus Sneha subsides the provocation of Vāta, softens the body and loosens the Mala (waste matter); while Sveda by liquefying, brings the waste matter to the alimentary canal, from where it becomes easier to excrete by the measure of Pañcakarma.