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=== Introduction ===

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== Introduction ==

The chapter [[Snehadhyaya]] is the first chapter of ''Kalpana Chatushka'' (tetrad describing planning of purification therapies). It follows the [[Vatakalakaliya Adhyaya]], the last chapter of ''Nirdesha Chatushka'' (tetrad describing guidelines for clinical practice). This sequencial order of the tetrads suggests the logical progression in the clinical training of [[Ayurveda]] learners – from a foundational course in therapeutics to more specialized procedures (including purification therapies). ''Snehana'' (oleation) is the first step before purification therapies, like ''vamana'' [therapeutic emesis] and ''virechana'' [therapeutic purgation], and also the best medicine suggested for vitiated vata - the key pathological factor responsible for many diseases.

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==== History and broad outline of chapter ====

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=== History and broad outline of chapter ===

The earliest reference to ''snehana'' is found in the ancient text ''Markandeya Purana'' where ''ghrita'' (clarified butter), ''taila'' (oil), ''vasa'' (muscle fat) and ''majja'' (bone marrow) were quoted as ''sneha'' drugs (Mar. 165, 166, 244-245). However, a detailed description of ''snehana- swedana'' (sudation) with complications and their treatments is only found in [[Charak Samhita]] and related [[Ayurveda]] texts. The [[Snehadhyaya]] provides comprehensive information about ''sneha'' (lipids) and ''snehana'' (its therapeutic administration/oleation).

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===Sanskrit text, Transliteration and English Translation===

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==Sanskrit text, Transliteration and English Translation==

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Noticing Punarvasu sitting among learned sages, Agnivesha shared his doubts for the wellbeing of world by asking the following questions [3]

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==== Questions asked by Agnivesha ====

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=== Questions asked by Agnivesha ===

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Through these questions, I want to know all details of ''snehana'' (oleation therapy), revered Sir. [4-8]

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==== Sources of lipids ====

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=== Sources of lipids ===

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==== Oils ====

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=== Oils ===

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Among all varieties of oils, sesame oil is considered the best and is ideal for giving strength and unctuousness. Castor oil is the best for ''virechana'' (purgation). It is pungent, ''ushna virya'' (hot potency), alleviates vitiated ''vata'' and ''kapha'', ''guru'' (dense, viscous or heavy) in nature and when used with astringent, sweet, bitter drugs it also helps mitigate aggrevated ''pitta''. [12]

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==== Four major lipids ====

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=== Four major lipids ===

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''Ghrita'' (clarified butter), oil (of sesame), ''vasa'' (muscle fat) and ''majja'' (bone marrow) are considered the best ''sneha''. Among these, ''ghrita'' is superior as it possesses the qualities of ''samskara'' i.e. blending with other substances having different properties without losing its own properties. [13]

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==== Benefits of lipids ====

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=== Benefits of lipids ===

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*''Majja'' (bone marrow) improves strength, semen, ''rasa'', ''kapha, meda'' and ''majja''. It especially strengthens bones and useful for oleation. [17]

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==== Time of administration ====

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=== Time of administration ===

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''Sneha'' consumed at night during cold season or by person who has great aggravation of ''kapha'', can causes diseases such as flatulence, loss of taste, pain in abdomen, or anemia. [20-21]

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==== Vehicle for lipids ====

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=== Vehicle for lipids ===

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After consuming ''ghrita'', hot water should be drunk as ''anupana'' (after drink), and after oil ''yusha'' (pulses soup), and after consuming ''vasa'' and ''majja,'' consumption of ''manda'' (scum of gruel) is advised.[22]

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==== Various recipes of lipids ====

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=== Various recipes of lipids ===

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==== Preferred form of lipid ====

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=== Preferred form of lipid ===

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''Sneha'' though is only one, depending upon permutations and combinations based on six tastes, could be of sixty three types. Thus, ''vicharana'' could be of sixty four kinds. These should be administered according to the habits, season, diseases and the constitution of the person. [27-28]

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==== Doses of lipids and their indications ====

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=== Doses of lipids and their indications ===

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Further I will explain to you their usage depending upon individual patient. [29-30]

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==== Persons suitable for maximum dose and its benefits ====

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=== Persons suitable for maximum dose and its benefits ===

Those persons who consumes large quantity of ''sneha'' daily, those who can tolerate hunger and thirst, whose digestive and bodily strength is strong, who suffers from ''gulma'' (inflammation in digestive tract), snakebite cases, patients of ''visarpa'' (erysipelas), ''unmada'' (insanity), ''mutrakrichchra'' (dysuria) and constipation are advised to consume maximum doses of ''sneha''.

Maximum dose when used correctly quickly cures diseases. It removes excess of vitiated ''dosha'' out of the body, reaches all body channels, improves strength and rejuvenates the body, sense organs, and the mind. [31-34]

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==== Persons suitable for moderate dose and its benefits ====

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=== Persons suitable for moderate dose and its benefits ===

Patients of ''arushka'' (eruptions on scalp), ''sphota'' (vesicles), ''pidaka'' (big eruptions), itching, ''pama'' (scabies), ''kushtha'' (skin disorders), ''prameha'' (diabetics), ''vatashonita'' (gout), those who never consume large quantities of food, those with ''mridukoshtha'' (soft bowel habit) ,and those having moderate strength are advised to consume moderate doses of ''sneha''.

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A moderate dose never causes any serious complication. It never reduces strength, provides oleation with ease, and can be used for ''shodhana'' (body purification). [35-37]

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==== Persons suitable for lowest dose and its benefits ====

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=== Persons suitable for lowest dose and its benefits ===

Those who are old, young (children), those with tender physique, living luxurious life, those who cannot tolerate hunger or have difficulty with empty stomach, those suffering from poor digestion, patients suffering from fever, diarrhea and cough, those having poor body strength are advised to consume the smallest dose of ''sneha''.

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==== Persons suitable for consumption of ''ghee'' ====

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=== Persons suitable for consumption of ''ghee'' ===

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Persons having ''vata-pitta prakriti'', those suffering from ''vata- pitta'' disorders, those desiring good eyesight, those who are wounded, emaciated, old and infirm, those who are children and women, those willing to live long, those willing to have good strength, complexion, voice, nourishment, healthy progeny, luxurious lifestyle, good vitality, memory, intelligence, digestive strength, strength of sense organs, and those suffering from burning sensation, injury by weapon, poison and fire should drink ''ghrita''. [41-43]

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==== Persons suitable for consuming oil ====

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=== Persons suitable for consuming oil ===

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==== Persons suitable for consumption of muscle fat ====

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=== Persons suitable for consumption of muscle fat ===

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==== Persons suitable for consumption of bone marrow ====

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=== Persons suitable for consumption of bone marrow ===

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Those having strong digestive power, are capable of tolerating excessive physical exertion, who eat large quantities of food often, who consume ''sneha'' often, those suffering from ''vata'' disorders, and those suffering from hard bowel movement are advised to consume bone marrow. [50-51]

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==== Duration of oleation ====

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=== Duration of oleation ===

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The recommended maximum duration for ''snehapana'' is either seven nights or three nights. [51]

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==== Persons suitable for ''snehana'' (oleation) ====

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=== Persons suitable for ''snehana'' (oleation) ===

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Those who are scheduled for sudation or purification therapies, those having dryness in body, those suffering for vata disorders, those doing exercise regularly, those drinking alcohol often, those indulged in sexual activities often and those suffering from mental stress are advised to undergo oleation therapy. [52]

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==== Contraindications of oleation ====

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=== Contraindications of oleation ===

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==== Signs of inadequate, proper and excess oleation ====

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=== Signs of inadequate, proper and excess oleation ===

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===== Table 1: Signs of Inadequate, proper and excess oleation are as follows: =====

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==== Table 1: Signs of Inadequate, proper and excess oleation are as follows: ====

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==== Regimen before sneha consumption ====

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=== Regimen before sneha consumption ===

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If ''sneha'' is for the purpose of ''samshamana'' (pacification of ''dosha'' internally), it should be taken at the time of meals and if meant for ''shuddhi'' (purification) it should be given when food consumed in the previous night has been digested. [60-61]

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==== Regimen during ''sneha'' consumption ====

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=== Regimen during ''sneha'' consumption ===

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==== Do’s and don’ts after ''sneha'' consumption ====

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=== Do’s and don’ts after ''sneha'' consumption ===

#Use warm water for all purposes

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One who after consuming ''sneha'' takes oily food and does not follow the aforementioned guidelines gets affected by severe diseases. [62-64]

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==== Features according to bowel habits ====

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=== Features according to bowel habits ===

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==== Complications of improper ''sneha'' consumption and its treatment ====

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=== Complications of improper ''sneha'' consumption and its treatment ===

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''Sneha'' given at improper time, to those it does not suit, without considering proper dose, not following guidelines, and for extended duration causes complications. [79]

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==== Prescription for therapeutic purgation and emesis after oleation ====

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=== Prescription for therapeutic purgation and emesis after oleation ===

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Therapeutic purgatives should be given three days after ''sneha'' consumption and during these three days warm and creamy (unctuous) ''mamsa'' ''rasa'' (mutton soup) and rice should be consumed. Therapeutic emesis should be administered a day after stopping ''sneha'' , and guidelines for purgation should be followed.[80-81]

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==== Alternative recipes for persons averse to lipids ====

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=== Alternative recipes for persons averse to lipids ===

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''Sneha'' added with salt produces oleation quickly since salt is ''abhishyandi'' (produces more moisture in the tissues), not dry, subtle (enters minute pores), hot in potency and ''vyavayi'' (spreads to all parts quickly and then undergoes digestion). [98]

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==== Sequence for oleation and sudation ====

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=== Sequence for oleation and sudation ===

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Oleation should be used first, then sudation. Only after oleation and sudation should the person undergo purification and other therapies. [99]

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==== Summary ====

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=== Summary ===

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Thus ends the thirteenth chapter by name [[Snehadhyaya]] in the [[Sutra Sthana]] of Agniveshatantra redacted by Charak.[13]

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==~~= ''~~Tattva Vimarsha~~'' /~~ Fundamental Principles ===

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== Tattva Vimarsha (Fundamental Principles) ==

*There are two sources of lipids recommended for oleation: vegetable and animal origin. ''Ghrita'' (Clarified butter), oil (of sesame), ''vasa'' (muscle fat) and ''majja'' (bone marrow) are the best forms of lipids. [9-13]

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==~~= ''~~Vidhi Vimarsha~~'' /~~ Applied Inferences ===

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== Vidhi Vimarsha(Applied Inferences) ==

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==== Sources of ''Sneha'' ====

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=== Sources of ''Sneha'' ===

''Sneha'' i.e. fats that are available today can be categorized in ''sthavara'' (vegetable origin) and ''jangama'' (animal origin) as a part of therapeutics or dietetics. E.g.

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Cod liver oil, shark liver oil, all ''ghee'', milk, milk products, curd, all types of meats, etc. are sources of animal fats.[verse 9-11]

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==== Reasons for superiority of sesame oil ====

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=== Reasons for superiority of sesame oil ===

Sesame oil is considered the best among all oils because it provides strength and unctuousness in body. It is ''ushna'' (hot) in nature, possesses ''kapha-vatahara'' (pacifying ''kapha'' and ''vata dosha'') properties, and is beneficial for voice and complexion. It also cures fractures and dislocations, purifies ''dhatu'' (body tissues) and ''vrana'' (wound) (Ka. Su. 22/7). Ongoing research also indicates that the rich presence of antioxidants and polyunsaturated fats in sesame oil could help control blood pressure.<ref> "Sesame and rice bran oil lowers blood pressure, improves cholesterol", American Heart Association Meeting Report - Abstract 186, Retrived from http://newsroom.heart.org/news/sesame-and-rice-bran-oil-lowers-238424 [cited on 19 dec 2013] </ref>

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==== Properties of Castor oil ====

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=== Properties of Castor oil ===

The United States Food and Drug Administration (FDA) has categorized castor oil as "generally recognized as safe and effective" (GRASE) for over-the-counter use as a laxative with its major site of action in the small intestine (where it is digested into Ricinoleic acid).<ref> "Ingredient List A-C" . FDA. Archived from the original on 2006-12-17. Cited on 19 dec 2013 </ref>

At low doses, castor oil is readily absorbed. As the oral dose increases, percent absorption decreases and laxation occurs.<ref> Watson, W. C. et al. (1963) Journal of Pharmacy and Pharmacology;15: 183 </ref> Castor oil is widely used in treatment of musculo-skeletal and spine disorders. It is considered useful in ''ama'' dominant conditions like rheumatoid arthritis where less absorption of ''sneha'', ''vata'' alleviation and body purification are expected simultaneously. Castor oil in large doses is administered for therapeutic purgation. [verse 12]

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==== Best ''Sneha'' and their Therapeutic Applicabilities ====

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=== Best ''Sneha'' and their Therapeutic Applicabilities ===

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===== ''Ghrita'' (clarified butter / ''ghee'') =====

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==== ''Ghrita'' (clarified butter / ''ghee'') ====

''Ghee'' is the best oleate due to prominence in its unctuousness. This property of fats is indicated by saponification value which is highest in ''ghee'' ( 225-235 )<ref> Dhurvey Y.R.*, Kawtikwar P.S., Sakarkar D.M., Evaluation of Physicochemical Properties of Cow Ghee before and after Hydrogenation, International Journal of ChemTech Research,2012, Vol.4, No.1, pp 185-189 </ref> as compared to sesame oil (188-193)<ref> Retrived from http://en.wikipedia.org/wiki/Sesame_oil, cited on 20 dec 2013 </ref>,and animal fat (190-205)<ref> Retrived from http://en.wikipedia.org/wiki/Animal_fat, cited on 20 dec 2013 </ref> etc. ''Samskara'' (processing) leads to transformation of inherent attributes of a substance. But this change is due to changes in the basic composition of a drug. ''Ghee'' has a unique quality to adopt properties of herbs processed with it without losing its own. If ''ghee'' is processed with drugs with nourishment properties, then it is indicated in degenerative diseases. If it is processed with drugs having hot and strong properties, then it is indicated in obstructive diseases. Therefore, it is considered as the best media for processing. One or the other medicated ''ghee'' preparation is indicated in almost all diseases. It pacifies ''vata'' due to ''snigdha guna'' (unctuous properties) and ''pitta'' due to ''madhura'' (sweet) and ''sheeta'' (cold) properties (Cha. Ni. 1/39). It increases ''shukra'' and ''ojas'' due to similar properties.

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===== ''Vasa'' (muscle fat) =====

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==== ''Vasa'' (muscle fat) ====

''Vasa'' i.e. intramuscular fat is a normal content of human body and its function is to lubricate the muscles while also serving the role of a fat store to be used up by the body when subjected to energy-intensive activities, such as physical workouts where it may contribute up to 20% of total energy turnover.<ref> Roepstorff C, Vistisen B, Kiens B (2005). "Intramuscular triacylglycerol in energy metabolism during exercise in humans". Exercise and Sport Science Reviews 33 (4): 182–8. </ref> This is a possible reason for it to be recommended for individuals engaged in intensive physical acitivities, as well as for oleation therapies.

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===== ''Majja'' (bone marrow) =====

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==== ''Majja'' (bone marrow) ====

Bone marrow contains about 96 percent fat. It contributes to 50 to 175 g of protein required by body each day. It has all the amino acids needed for good health. Each serving of marrow provides 3% of the calcium required each day. Calcium is commonly understood to strengthen bones and decrease risk of developing brittle, easily-broken bones as one gets older.<ref> Retrieved from http://www.livestrong.com/article/445905-what-are-the-health-benefits-of-eating-bone-marrow/ cited on 2-01-2014 </ref> All these factors explain why bone marrow is beneficial, especially for one’s bone health. In Ayurvedic clinical practice, soup of bone marrow is prescribed for osteoporosis and degenerative disorders of the vertebrae.[verse 13-17]

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==== Proper season and time for ''sneha'' consumption ====

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=== Proper season and time for ''sneha'' consumption ===

The proper season for consumption of a ''sneha'' depends upon the physiological dominance of ''dosha'' in the body during that particular season, as well as the inherent properties of the ''sneha''. On the basis of its inherent properties, ''ghee'' is indicated in ''sharada'' (autumn) season, when ''pitta dosha'' is increased. Muscle fat and bone marrow do not possess much hot or cold potency, and hence are advised in ''sadharana kala'' (i.e. seasons that are not very hot or cold), except in ''Chaitra'' month (mid-March to mid-April) when it may vitiate ''kapha dosha''. Oils are the best medicines for ''vata'', hence they are recommended for consumption in the ''pravritta'' (early rainy) season. These rules are to be followed universally according to seasonal and temperature variations. If this is not followed, then complications in oleation therapy could be observed.[verse 18-21]

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==== ''Anupana'' (after consumption) ====

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=== ''Anupana'' (after consumption) ===

Most of the ''sneha'' gets stuck in upper gastrointestinal tract due to stickiness. The vehicles or after-drinks assure proper transport of the ''sneha'' (oleate or lipid or fat) to its intended site of digestion and absorption, and help in proper metabolism to increase bio-availability. However, those after-drinks should not affect the actions of the ''sneha''. Warm water liquefies ''ghrita'' and facilitates its transport and absorption. Similar facilitation is seen in the use of lentil soup and scum of gruel after consuming oil and ''vasa-majja'' respectively. However, warm water is usually accepted as an after-drink in all cases of ''sneha'' consumption (with an exception of ''bhallatak'' and ''tuvaraka'' oil.)[verse 22]

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==== ''Pravicharana'' (medium of administration) ====

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=== ''Pravicharana'' (medium of administration) ===

''Pravicharana'' implies the medium of administration of ''sneha'' advisable for those who need to undergo oleation therapy but are unfit to consume ''sneha'' as such. In such cases, optional modes of administration of oleation are suggested based on palatability of the oleate and the tolerance (and the digestive power) of the person. Ideally, food and external applications are considered as ''Pravicharana''. Cooked rice, gruel, meat juices etc. mixed with fats are administered and external massage, unctuous enema, oil through nose and ears etc. are considered optional modes of administration of oleation therapy.[verse 23-25]

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==== ''Acchapana'' (drinking fat alone) as a preferred mode for oleation ====

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=== ''Acchapana'' (drinking fat alone) as a preferred mode for oleation ===

There are number of factors that affect the absorption of any drug<ref> Retrieved from http://www.codental.uobaghdad.edu.iq/uploads/lectures/Pharma%20lectures/2%20Pharmacokinetics%20finishing%20with%20bioavailibility.pdf cited on 2-01-2014 </ref> ,

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#Drug/food interaction

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==== Dose of ''sneha'' ====

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=== Dose of ''sneha'' ===

The recommended dose of ''sneha'' would be different for every individual, depending upon the individual’s ''agni'' (digestive capacity), ''koshtha'' (bowel habit) etc. However, for ease in therapeutic applicability, specific doses in ''pala, karsha'' etc. are advised by Arunadatta in his commentary on Ashtangahridaya ([[Sutra Sthana]] Chapter 16/17). Two ''pala'' (96 ml) as minimum, four ''pala'' (192ml) as medium, and six ''pala'' (288ml) as maximum dose have been suggested. Sharangadhara (Madhyama Khanda 1/7) and Bhavamishra (Bhavaprakash I-79 iv. 6) suggest the quantities of one ''pala'' (48ml), three ''karsha'' (36ml) and two ''karsha'' (24ml) as the best, medium and least doses respectively.[verse 29-30]

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==== Deciding suitable dose ====

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=== Deciding suitable dose ===

[[Ayurveda]] ''acharyas'' have advised three dosage forms - high, medium and low doses. The following points need to be considered to determine the applicable dose for an individual:

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==== Indications of oleation ====

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=== Indications of oleation ===

Oleation and sudation are essential pre-purification therapies to channelize dosha from all body parts to the gut.

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===== ''Sneha'' in regular exercise =====

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==== ''Sneha'' in regular exercise ====

Those doing regular exercise require high calorific diet to maintain body weight and healthy fat deposits in the body. Hence ''sneha'' consumption is necessary for them. Fats also serve as energy stores for the body, containing about 37 kilojoules of energy per gram (8.8 Cal/g)<ref> United Kingdom The Food Labelling Regulations 1996 – Schedule 7: Nutrition labelling </ref> (the highest in comparison to those of proteins and carbohydrates which provides 4 Cal/g of energy).<ref> Retrived from http://www.fao.org/docrep/006/y5022e/y5022e04 cited on 2-01-2014 </ref> <ref> Retrived from http://en.wikipedia.org/wiki/Protein_(nutrient) cited on 2-01-2014 </ref> In case of starvation, fats are broken down in the body to release glycerol and free fatty acids.<ref> Retrived from http://en.wikipedia.org/wiki/Fat cited on 2-01-2014 </ref> Glycerol is further converted to glucose by the liver and thus used as a source of energy.

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===== ''Sneha'' in chronic alcoholics =====

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==== ''Sneha'' in chronic alcoholics ====

Alcoholics gain weight because of excess energy intake with food and inhibition of fat oxidation from alcohol.<ref> Suter PM, Schutz Y, Jequier E. The effect of ethanol on fat storage in healthy subjects. N Engl J Med. 1992 April 9;326(15):983–7 </ref> But chronic alcoholics (''Madyanitya'') show a lower body weight due to fat mass reduction.<ref> Addolorato G, Capristo E, Greco AV, et al. Energy expenditure, substrate oxidation, and body composition in subjects with chronic alcoholism: new findings from metabolic assessment. Alcoholism: Clinical and Experimental Research. 1997 September; 21(6):962–7. </ref> This alteration could be due to induction of the non-alcohol dehydrogenase pathway, likely the microsomal ethanol oxidizing system.<ref> Addolorato G, Capristo E, Marini M, et al. Body composition changes induced by chronic ethanol abuse: evaluation by dual energy X-ray absorptiometry. American Journal of Gastroenterology. 2000 September;95(9):2323–7. </ref> Moreover, ethanol might have direct effects on human adipocytes.<ref> Suthat Liangpunsakul, David W. Crabb,Rong Qi, Relationship between alcohol intake, body fat and physical activity- a population based study, Annals of Epidemiol. 2010 September; 20(9): 670–675. </ref> Therefore, ''sneha'' is indicated in chronic alcoholics.

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===== ''Sneha'' in excessive sex =====

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==== ''Sneha'' in excessive sex ====

Those who are involved in excessive sexual activity lose their ''oja'' (vitality) leading to ''dhatukshaya'' (depletion of ''dhatu''), ''vata'' aggravation and loss of unctuousness as mentioned in the pathology of ''rajayakshma''. (Cha. Chi. 8/ 24-25). Hence oleation is required in such debiliated persons.

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===== Contraindications of ''Sneha'' =====

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==== Contraindications of ''Sneha'' ====

''Sneha'' is mainly contraindicated in conditions where there are excessive body secretions especially from mouth and rectum, ''ama'' formation, poor digestion, excess aggravation of ''dosha'', and in cases where other therapies such as ''nasya'' and ''basti'' are being administered. Oleation therapy worsens the condition in these cases. [verse 52-56]

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==== Signs of inadequate, proper and excess ''Sneha'' ====

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=== Signs of inadequate, proper and excess ''Sneha'' ===

Inadequate oleation does not pacify ''vata'' and disturbs ''agni'' leading to poor digestion. Proper oleation due to proper ''sneha'' improves digestion. The skin acts as a water resisting barrier to prevent flow of essential nutrients out of the body. The nutrients and oils that help hydrate the skin are covered by the outer layer of skin, the epidermis.<ref> McCracken, Thomas (2000). New Atlas of Human Anatomy. China: Metro Books. pp. 1–240. ISBN 1-58663-097-0 </ref> Softness or tenderness of skin is a result of proper oleation since ''snehana'' adds to the functional improvement of fat deposits of the body. Excess oleation causes improperly formed faeces, which may be due to increase in colorectal transit time as a result of excess unctousness in gastrointestinal lumen. Stools are formed in the colon in the last phase of digestion. Through peristalsis, the muscles of the colon and the abdomen advance the liquid feces through the colon and compress the fecal matter into stool. During this process the colon extracts water from liquid feces as it passes down. The water is absorbed by the lumen, leaving the larger waste particles to be further tumbled along and formed into stools.<ref> Retrived from http://web.pdx.edu/~sujata/FruitEze/education/colon/stool.html cited on 2-01-2014 </ref> Due to excess oleation, blockage of microchnnels and villi occurs and absorptive function may become hampered leading to improperly formed stool. All other symptoms of excess oleation are due to increase in ''kleda'' (moisture) in body leading to heaviness, loss of digestive strength etc.[verse 57-59]

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==== Do’s and Don’ts after ''Sneha'' Consumption ====

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=== Do’s and Don’ts after ''Sneha'' Consumption ===

Guidelines to be followed after ''sneha'' consumption are intended:

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==== Bowel habits and duration of oleation therapy ====

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=== Bowel habits and duration of oleation therapy ===

''Koshtha'' i.e. bowel habits are the outcome of ''dosha'' dominance in bowel. ''Vata, pitta'' and ''kapha'' dominance causes ''krura'' (hard), ''mridu'' (soft) and ''madhyam'' (moderate) ''koshtha'' (bowel habit) respectively. ''Vata'' due to its ''ruksha'' (dry) (As. Hri. Su. 1/ 11 ) properties causes fast absorption of ''sneha'' and also requires large doses and longer duration for complete oleation. ''Pitta'' has natural unctuousness associated with it due to its ''ushna'' (hot), ''sara'' (easy for dispertion), and ''drava'' (liquid) (AH. Su. 1/ 11) properties. These properties aid in the flow of ''sneha'' across all body parts and hence, an early push of ''dosha'' towards the bowel requires least dose and minimum duration. ''Kapha'' has similar properties as ''sneha''. However, the bowel habit in a ''kapha'' person is moderate due to its ''sthira'' (stable) and sticky properties. (AH. Su. 1/ 12). Modern science also explains bowel habits, its effects and considers intestinal transit time responsible for it. 40-45 hours is the normal bowel or in Ayurvedic terminology ''madhyama koshtha'' person’s intestinal transit time.<ref> Retrived from http://healthyliving.msn.com/health-wellness/what-your-bowel-movements-are-telling-you-about-your-health-1 cited on 3-01-2014 </ref> If it stays in the gut for longer than that, fluid is re-absorbed into the body and the stool becomes harder and dryer. Body secretes about eight liters of fluid during the course of a day<ref> F. John Gennari, and Wolfgang J. Weise, Acid-Base Disturbances in Gastrointestinal Disease, Clinical Journal of the American Society of Nephrology, November 2008, (3)6: 1861-1868 </ref> —from the stomach, salivary glands and pancreas—to decompose food and push it through the digestive system. But if food passes through too quickly, there isn’t enough time for all of that liquid to get absorbed, and the stool emerges in a semi-solid or liquid state. Thus, it is the physiological differences based on intestinal transit time that decide the duration of oleation therapy. The nature of a food item or a drug ingested affects bowel movement and explains the differences mentioned above.[verses 65-69]

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==== Complications of oleation therapy ====

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=== Complications of oleation therapy ===

Excessive thirst is a result of impaired digestion and absorption of lipids. Alpha-linolenic acid (an omega-3 fatty acid) and linoleic acid (an omega-6 fatty acid) are essential fatty acids supplied by almost all polyunsaturated fats.<ref> Reiffel JA, McDonald A (August 2006). "Antiarrhythmic effects of omega-3 fatty acids". The American Journal of Cardiology 98 (4A): 50i–60i. </ref> But any defect in their absorption may cause deficiency leading to excessive thirst and dry skin, brittle hair &nails, sleep and attention problems.<ref> Colquhoun I, Bunday S., A lack of essential fatty acids as a possible cause of hyperactivity in children., MedicalHypotheses. 1981 May; 7(5):673-9. </ref>

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==== ''Shodhana'' (purification) after oleation ====

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=== ''Shodhana'' (purification) after oleation ===

''Vamana'' (therapeutic emesis) is done in ''utklishta kapha'' (therapeutically aggravated ''kapha'' by oleation) condition. ''Virechana'' (therapeutic purgation) is done when ''kapha'' is reduced in body. (Cha. Si. 1/ 8-9)., Hence, the rest period for performing ''virechana'' after oleation is more (three days) than that of ''vamana''.[verse 80-81]

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==== ''Vicharana'' (alternative methods of fat administration) ====

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=== ''Vicharana'' (alternative methods of fat administration) ===

''Sneha'' consumption alone is generally associated with considerable degree of nausea. Also, persons living luxurious lifestyles hate therapeutic fat consumption. Those habitual to fatty diets need larger doses of fats which in turn results in nausea. Soft bowel persons are naturally have rapid intestinal transit rate. Due to this, less fat absorption occurs and excreted without digestion. Those who cannot tolerate exertion also suffer from nausea due to ''sneha'' administration. Those having alcohol addiction can not suddenly discontinue their habit and thus they need fats to be given in some form of alcoholic preparation.

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==== Benefits of ''pravicharana'' in palatability and taste perception ====

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=== Benefits of ''pravicharana'' in palatability and taste perception ===

*''Pravicharana'' can change the physical nature of sneha by addition of different substances.

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In patients suffering from skin diseases, edema, diabetes, meat of domesticated animals and animals from marshy lands , or of aquatic animals is contraindicated. Moreover, jaggery, curd, milk and sesame are also not suitable for ''vicharana''. All these articles increase moisture content in body causing aggravation of symptoms.

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==== Mode of action of ''sneha'' ====

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=== Mode of action of ''sneha'' ===

''Sneha'' acts as a solvent and it increases ''apyamsha'' (liquid content) of the body which ultimately leads to ''utklesha'' (aggravation of ''dosha'' for removal).[verse 96-97]

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===== I. Action as a solvent =====

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==== I. Action as a solvent ====

Fats acts as good solvent for many metabolic wastes and it enters the cells easily because cell membrane is made up of phospholipids.<ref> Retrived from http://en.wikipedia.org/wiki/Cell_membrane cited on 3-01-2014 </ref> Compared to other non-unctous substances, fat materials stays in the body for a stipulated period without causing any harm and also possesses better permeability. The large quantity of fats administered before purification therapies do not undergo digestion and metabolism cycle because the sneha is intended to increase and channelize ''dosha'' towards ''koshtha''.

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===== II. Increase in the ''apyamsha'' (liquid content) of the body =====

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==== II. Increase in the ''apyamsha'' (liquid content) of the body ====

This particular phenomenon should be understood regarding ''vriddhi'' i.e. increase in the ''apyamsha'' i.e. liquid content of the body. This leads to ''utklesha'' and can be called as transient increase in ''rasa'' (body fluids) and ''kleda'' (moisture). ''Sneha'' has the predominance of ''apa mahabhuta'', which is corroborated by the specific qualities. (Cha.Su.22/15, AH.Su.1/11) and it is hydrophilic in nature. After proper ''snehana'', all the cells of body become completely saturated with fats. Then the fat material comes out of the cell to extra-cellular fluid by osmosis. So, due to the aqueous properties of ''sneha'' and liquefied waste brought from the tissues, the levels of fatty acids etc. increase in the blood resulting in the high plasma volume. To keep up the equilibrium of the normal plasma, the extra amount of liquid from it, reaches the ''koshtha'' for excretion. This is called as ''anu pravana bhava''. Later on when emetics or purgatives are administered, this increased amount of the body fluids are evacuated by which the vitiated ''doshas'' and in-excreted ''malas'' also expelled out resulting in the radical cure of the disease. By the combined effect of oleation and sudation, excessive increase of ''dosha'' liquification of ''dosha'', digestion of ''dosha'', opening of micro-channels and control of ''vata'' occurs so that, the ''doshas'' come to the ''kostha'' by Anupravana Bhava, then they are expelled out through nearest route by proper ''shodhana karma'' (Ch.Su. 28/33).

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==== ''Sadya snehana'' (instant oleation) and salt with fats for early oleation ====

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=== ''Sadya snehana'' (instant oleation) and salt with fats for early oleation ===

Instant oleation is required in some conditions requiring immediate purification therapy. In exacerbation of ''asthma sadya snehana'' is done and ''vamana'' is performed to remove ''avarana'' (obstruction) by ''kapha''. Salt is having hygroscopic nature,<ref> Retrived from http://en.wikipedia.org/wiki/Hygroscopyhttp://en.wikipedia.org/wiki/Hygroscopy cited on 3-01-2014 </ref> thus when consumed with fats it increases moisture content in the body, that eventually results in early oleation.[verse 89-98]

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==== Common method followed for oleation purpose before purification therapies ====

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=== Common method followed for oleation purpose before purification therapies ===

Practically approximately 30 ml of ''sneha'' is administered on first day and based upon duration required for its digestion the dose of ''sneha'' to be administed is decided, which is the dose of ''sneha'' consumption on last day. For e.g. if a hard bowel person gets appetite after 2 hours of 30 ml sneha drinking and requires medium dose oleation (sneha dose which is digested in 12 hours) then the dose on last day will be approximately 180 ml, which is achieved by gradually increasing doses of ''sneha'' in seven days.

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=== Research works done ===

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== Research works done ==

There are several research work carried out in field of oleation therapies which are as follows:

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*Combination of fats is an area least evaluated and has scope for improvement in fat properties.

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~~=== Glossary ===~~

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~~<div style="text-align:justify;">~~

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*Snēha (sneha; स्नेह): Oiliness, unctousness, lubricity, Moisture, Oil

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*Vicāraṇāḥ (vicAraNAH;विचारणाः): A special mode of administration of the unctuous substance either given orally in association with food or administered in any route other than oral.

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*Ānupāna (AnupAna; अनुपान): Vehicle or medium of transporting food/drug within the body, primarily liquids. A fluid vehicle prescribed to be used while taking medicine or a drink prescribed to be had soon after a medicine is taken. The purpose is to facilitate absorption or assimilation of the drug in the system, to increase the efficacy of the drug and to check the undesirable effects of the drug.

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*Kōṣṭha (koShTha; कोष्ठ): bowel habit

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*Acchasnēha (acchsneha; अच्छस्नेह): A therapy that emphasizes upon therapeutic oral administration of unctuous substances - either medicated or non-medicated - but without mixing them with any other food or drug.

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*Saṁśōdhana (saMshodhana; संशोधन): A major purification, bio-cleansing, or detoxication therapy. One of the two important divisions of the treatment in internal medicine, it signifies holistic cleansing of the physical system by ejecting out of the body waste products and byproducts of the metabolism and maintaining the equilibrium of humors.

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*Virēcana (virecana; विरेचन): Therapeutic catharsis. Virecana literally means catharsis, and implies the administration of purgative drugs which are pleasant to ingest , and effective in eliminating or ejecting the vitiated dosha, especially pitta, from the lower regions of the body.

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*Saṁskāra (saMskAra, संस्कार): processing (a drug, a formulation, or a food item) with some other substance.

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*Rasa (rasa, रस) : The first dhātu among seven dhātus , rasa is dominated by Jala (water). This is pumped out of the Hṛdaya (heart) and continuously circulates all over the body to nourish other tissues. It is of 9 Anjalis in quantity. Vyāna and Samāna Vāyu help in its circulation. The major function of the Rasa Dhātu is Prīṇana (nourishing).

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*Śukra (shukra; शुक्र): The seventh dhātu, whose function is reproduction. Generally equated with Semen. Shukra is present in two forms: one, that is pervading the entire body, and second, that which is fertilizing the ovum. It is also predominantly made up of Jala Mahābhūta (water)

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*Oja (oja; ओज): immunity or the general strength of body or the bodily essence

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*Mēda (meda; मेद): The fourth dhātu among the seven dhātus of the body, whose function is to provide Snehana. It is primarily made up of Jala (water) and Prthvi (earth) Mahabhutas (elements). Designative of adipose tissue and other lipids in the body.

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*Majjā (majja; मज्जा): Sixth of the seven basic dhātus, whose function is to fill the osseous cavities. It is predominantly formed of Jala (water) Mahābhūta.

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*Prakriti (prakRuti; प्रकृति): 1. The nature of an individual or a substance. 2. The physical and psychological features specific to an individual that are produced to the dominant Doṣa prevailing at the time of conception. Prakriti may be classified as Deha Prakriti (physical) and Manasa Prakriti (psychological). Deha Prakriti may be formed or shaped due to the dominance of a single dosha, two doshas or a combination of all the three doshas.

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*Āma (Ama; आम): 1. Raw, uncooked, unbaked, immature, unripe 2. May be associated with food or other physiological entities to mean incomplete transformation or metabolism causing a harmful effect on health.

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*Saṁśamana (saMshamana; संशमन): Pacifying, allaying, or tranquilizing therapy. This is one of the two important divisions of Internal medicine, besides samshodhana. It signifies curative or corrective treatment through drugs, food, and conduct by pacifying, and thereby normalizing, the humors that have become errant.

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*Vyavāyī (vyavAyi; व्यवायि): Quality due to which a substance permeates all over the body before getting digested; caused due to activated Vayu and akash; e.g. Bhanga (Cannabis sativa)

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*Abhiṣyandi (abhiShyandi; अभिष्यन्दि): substances which cause obstruction to srotas and are slimy & heavy in nature; e.g. Curd

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~~</div>~~

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====References====

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== References ==

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