Original Article Journal of Indian

System of Medicine

Concepts and Prospects of Snehapana in

Children
Reena Kulkarni

Abstract: Joinsysmed ID: JID15030OA

Submitted Date: 17-07-2015
Snehapana is internal administration of Sneha (medicated or non-
Approved Date: 29-12-2015
medicated lipid substances) with a definite therapeutic aim. Apart from
Corresponding Author:
nutritive value, Sneha gains importance even in therapeutic application Reena Kulkarni, Asso. Professor
especially in Ayurveda. Present work highlights the findings of an SDM College of Ayurveda, BM
observational study in sixty children who underwent Snehapana. Arohana Road, Thannirhalla, Hassan-573201
Snehapana in children needs to be addressed on background of acceptance, Karnataka, India
Email:
smell, quantity, taste etc along with the diet schedule to be followed.
drreenakulkarni@gmail.com
Vicharanasneha (administration of Sneha either with food orally or other
Co-author (s): NIL
routes) can be adapted in administration of Shamana (Palliative), Brihmana Conflict of Interest: NIL
(Nourishing) and Shodhananga Sneha (just prior to cleansing). Aversion to Source of Support: NA
Sneha is major challenge to manage during administration in children. Ethical Clearance: NA
There is need to explore alternative route to improve the acceptance in Registered to: NA
children. Shodhana (detoxification therapy) following Snehapana reported Acknowledgment: NIL
to give excellent results in management of chronic allergy, respiratory and How to cite the article:
Reena Kulkarni, Concepts and
skin disorders.
Prospects of Snehapana in
Key words: Snehapana, Children, Vicharana, Shodhananga, Arohana Children, Joinsysmed 2015 vol
Introduction: 3(4), pp 175-179.
Snehapana means internal administration of medicated lipid
substances. It is aimed at bringing about Snigdhata (unctuosness),
Vishyandata (liquefaction), Mardavata (softness) and Kledana (feeling of
wet) [1]. The lipid substances thus used can be a drug processed in ghee, oil,
meat fat or marrow [2]. The type of lipid selected shall be based on the
requirement of the body or the disease condition. Children are considered as
embodiment of Sneha due to their diet predominant of Ksheera (milk) and
Ghrita (clarified butter). Hence as a rule Snehapana is not essential for them
unless there is lack of Snehana (unctuousness) in body or in case of severity
of diseases which need a thorough Shodhana (detox therapy) [3]. Common
illnesses in children approaching Kaumarabhritya outpatient department in
any Ayurveda hospital are recurrent respiratory infections, allergies,
diarrheal diseases, malnutrition, skin diseases and etc. Recently there is also
a raising trend of neuropsychiatric and behavioral problems seeking for
health needs. As per professional experience many of these conditions are
well managed through Ayurveda practice using Panchakarma (the five
detox principles of Ayurveda). Snehapana is one among the prerequisites
for Panchakarma. Few data is available on therapeutic use of Sneha in
adults. There is a need to generate data on therapeutic utility of the same in
children and its associated factors. Thus this article brings out the current
practices of Snehapana in therapeutics for children and its future
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 Reena Kulkarni, Concepts and Prospects of Snehapana in Children, Joinsysmed 2015 vol 3(4), pp 175-179

perspectives with possible critical appraisal. preferred for Snehapana and if at all there is a need,
Materials and methods: it should be in the form of Shamana or Brhmana
A literature review was conducted from Ayurveda type. Food processing for a kid of weaning age
Samhita, published articles and available research must be with addition of ghee or oil to bridge the
works. Present data also includes facts and calorie and nutrient gap [8]. Best therapeutic
observations based on Snehapana professional application of Shamana and Brhmana is seen in the
practices followed in the department of management of nutritional disorders where in
Kaumarabhritya (Ayurveda Pediatrics). Pippalyadi Ghrita, Kalyanaka Ghrita, Shatpala
Mode of Snehapana: Ghrita are administered [9]. Even current trends in
Snehapana aids in attainment of Snigdhata in the management of malnutrition encourages
the body. It is achieved by means of Shamana adding the food with medium chain fatty acids to
(Palliative), Brhmana (Nourishing) and Shodhananga enhance the nutritive property [10]. Older children
(just prior to cleansing). Snehpana referred to as the who are independent, developed good physical
three therapeutic applications of Sneha. Shamana strength and can follow the regimen as instructed
Snehapana is given on empty stomach, when hungry can be the subjects for Shodhananga Snehapana.
and in a quantity that is digested in Madhyamamatra Shodhananga Snehapana in children:
(that requiring 12 hours for digestion) [4]. Snehapana Therapeutic Snehapana administered
when administered with accustomed tasty food, in prior to purification is called as Shodhananga
small quantity (the quantity requiring 3hours for Snehapana. The suitability, dose, selection of
digestion) is called as Brhmana [5]. Shodhananga Sneha as either medicated ghee or oil and the mode
Snehapana is one among the Purvakarma of Snehapana namely Sadyasneha (Instant
(preparatory procedures) before the administration of oleation) or Arohanasneha (systematic increment
Shodhana (detox therapy). In this Sneha is given on in the dose) are based on proper assessment of Agni
empty stomach, when previous night's meal is (digestive capacity), Koshta (nature of bowel),
completely digested but child did not feel hunger and Prakriti (constitution), Bala (strength) of child as
in a dose that digests in 12 hours [6]. Based on the well as diseases and the psyche of the subject.
nature of Sneha selected it could be Accha Snehapana Preferred time of administration is early morning
(drinking of medicated Sneha alone) and Vicharana when previous meal is completely digested and
Snehapana (administration of Sneha either with food wastes are evacuated. This type of Snehana is well
orally or other routes). Vicharana Snehapana also practiced in children above ten years [11], unless it
includes external application, rectal route, nasal route, is very essential in children of lesser age [12]. Strict
through ear and bladder or vaginal route [7]. The regimen makes the type intolerable for children. As
selection of these modalities is purely based on the a rule, it is essential to improve the digestive
requirement and strength of the child undergoing capacity of child and removal of Ama (morbid
treatment. metabolic waste) through administration of
Mode of Snehapana selected could be based Pachanaoushadha (carminative medicine).This
on age of the child. Children below 2 year usually not also brings about lightness. The best suited way is

Table.1.Commonly used Pachanaoushadha in pediatric practice

Sr.no Pachanaoushadha Dose
1 Trikatuchurna 2.5g thrice daily half hour before food or mixed with first few
morsel of food for minimum 3 days
2 Vaisvanarachurna 2.5g thrice daily half hour befor e food for minimum 3 days
3 Panchakolaphanta or 30ml thrice daily half hour before food or food processed with
Shunthijala Panchakola for minimum 3 days
4 Chitrakadivati ½ - 1 tab thrice daily ha lf hour before food for minimum 3 da ys
5 Tab Hingvastaka ½ - 1 thrice daily half hour before food or mixed with first few
morsel of food for minimum 3 days
6 Supachya drops 2.5 to 5 ml thrice daily half hour before food for 3-5 days

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Table2: Average quantity of Sneha in to process food with carminative drugs and
Shodhananga Snehapana in 60 children administer. Older children accept medicines well
Day Average Quantity of with suitable adjuvant. Commonly preferred
Sneha(ml) Pachanaoushadha in pediatric practice are listed
1 27 in table.1.
2 55
Quantity of Sneha:
3 85
110 Shodhananga Sneha when intended
4
5 146 started with a Hrsiyasimatra (test dose of
6 165 approximately 20-30ml) after achieving proper
Amapachana. The time taken for the complete
digestion of the same is used as basis to calculate
Table 3: Schedule of Snehabasti as an
alternative to Snehapana in children the dose for the next day schedule. There is no
Day Quantity of Basti (ml) definite consensus on the dose schedule in
1 30 Shodhananga Snehapana though the available
2 50 reference hints to calculate the dose based on Agni
3 70 (the digestive capacity) of the individual[13]. Due
4 90 consideration of Koshta (bowel nature) of the
5 110 individual would yield better results. Madhyama
6 130 Matra Sneha is indicated in children. When the
7 150 strict regimen is difficult to comprehend and
Tab le 4 : Difficulties with Snehap ana in Ka uma rb hritya pra ctice
Difficulties faced
By Ayurvedic pediatricia n Wh ile ad min ist ering Sn eh an a B y chil d
Ass ess emen t of Ag n i and Ap pearance (co lor and Nau sea, v om it ing
Ko sh ta co ns is tency o f S neha ) R elu ctance for inpat ient
Co nv incin g p aren ts and Qu antity : in creas ing ad miss ion
chil dren d os age i ncreas es cha nce o f Po or co mp liance wit h
Wh en chil d has co mp let e refu sal to conti nu e d iet ary an d behav ioral
av ersio n to S neha S neh ap an a restriction s
Non coop erative child S mell : od or of S neha (e.g .
b itter smell an d tas te of
In du ka nta Ghr ita)
P alata bility: ma jority
m edicated Gh rita pres ents
u np leas ant taste th at
ch ildren refu se to drink .
(Eg: bitt er taste of
M ah atikta ka and
K alya na ka Ghr ita)
Table 5: Clinical conditions underwent Snehapana
Disease category NO. of
cases
Swasa (Asthma) 13
Twakvikara (Skin diseases) 21
Vatavyadhi 09
(Neuropsychiatric conditions)
Dustaprathisyaya (allergic rhinitis) 08
Pandu(Anemia) 03
Karsya (Nutritional anemia ) 03
Badhirya (Sensory neural deafness) 2
Refractive errors 1
Total 60
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children debilitated of long standing diseases one can Panchakarmachikitsa at SDM College of
adapt Hrsvasnehamatra.[14]In this pattern, 95% Ayurveda and hospital, Thanniruhalla, BM Road,
th
children attained Samyaksnigdhata on 5 or 6 day.
th
Hassan revealed difficulties with regards to smell,
Table 2 summarizes average quantity of Sneha taste and procedural compliance with
administered in 60 children who underwent Shodhananga Snehapana (Graph 1). Table 5 lists
Shodhananga Snehapana. out children with specific categories of diagnosis
When Snehapana is intended before who underwent Shodhananga Snehapana from
Shodhana but Arohanasneha is not adoptable, the January 2015 to April 2015. Amongst the Ghrita
other choice of therapy would be Pravicharanasneha. used for Snehapana, maximum was Indukanta
In this different diet are cooked with addition of Sneha Ghrita (38.33%) followed by Mahatiktaka Ghrita
and administered. Some of the external therapies that (26.66%), Brahmi Ghrita (11.33%), Dadimadi
are used to restore the Snigdhata instead of Snehapana Ghrita (8.33%), Amritaprasha Ghrita (6.66%),
are also enlisted as Vicharanasneha. In this the Vidaryadi Ghrita (3.33%), Kalyanaka Ghrita
quantity of Sneha used is less hence role of digestive (3.33%) and others (3.3%). Children who took
power is less; more over the external therapy do not Amritaprasha Ghrita, Dadimadi and Vidaryadi
come directly in contact with Agni. But this type of Ghrita showed better compliance with Snehapana.
Sneha is considered less potent owing to less quantity Discussion:
hence, can be easily adapted in children due to less Children regarded as epithet of Sneha due
complications and less restrictions. [15] to their diet rich of milk and ghee. Hence,
In practice, Pravicharana Snehapana is given Snehapana is not advisable unless the condition
along with food or in a small, fixed dose on empty demands. Recently, the change in lifestyle, diet and
stomach for 7 days or till the features of proper oleation regimen many systemic, allergic, skin,
appears.[16]The best therapeutic application of this is neuropsychiatric and lifestyle diseases have their
seen in Phakkachikitsa (management of Nutritional stride in pediatrics which need Shodhana. Thus
disorders). It can also be practiced as Sadyosneha Snehapana becomes an essential prerequisite. A
where in maximum quantity of Sneha is given in a day thorough Pachana is essential before start of
or two or three to obtain Samyaksnigdha Lakshana Snehapana. Food processed with carminative
(proper features of oleation). [17,18] drugs ispreferred for young children and in older
There is a practice of giving Snehabasti children drugs can be given with suitable adjuvant.
(Rectal administration of Sneha) in children as an Sneha can be the choice of therapy in Shamana and
alternative to Shodhanangasneha. This practice is Brhmana Chikitsa. In this Sneha is given over a
found to be equally effective[ 19,20, ]. Table 3 period of time in small doses either alone or
summarizes the schedule of Snehabasti as an processed with food till the desired features of
alternative to Snehapana in children as per oleation are seen. Shodhananga Sneha is best in
professional experience. chronic illnesses before Panchakarma, which
Following appearance of proper features of needs proper understanding of Agni, Koshta,
Snehana, the child undergoes Abhyanga (therapeutic
massage) and Sveda (therapeutic sudation) before
subjecting for Vamana (emesis) or Virechana
(purgation).
Data pooled from opinion of different
Kaumarabhritya practitioners on feasibilities of
Shodhananga Snehapana in children yielded
following facts summarized in three different headings
(table 4).
A retrospective analysis of hospital records of
60 children admitted in Kaumarabhritya (Ayurveda
paediatrics) ward who underwent Snehapana before Graph 1: Difficulties associated with Snehapana
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strength and stage of disease. Children accept Sneha References:

better if it is sweet and devoid of smell. [1] Agnivesha, Charaka, Dridhabala, Chakrapanidatta,
CharakaSamhita, Sutra Sthana, Langhanabrhmhaniya
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[16] Ibid[2]13/58.. p.85.
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escalating dose is an alternative for Snehapana before
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Vamana and Virechana: Trends from a pilot study. J
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