Keynote Address - By Dr. K. Shiva Rama Prasad, Assessment and Utility of Sneha Karma in Disease Management - CME On 19th June 2012, Organized by Department of Panchakarma, At: Seminar Hall, MGAC, DMIMS, Selod (H), Wardha, Maharastra

1. Assessment and Utility of
Sneha Karma in
Disease Management
Dr. K. Shiva Rama Prasad,
Vice Dean, Ayurveda
Prof. & Head of Dept. of Panchakrma,
MGACH&RC, Wardha
19th June 2012
At: Seminar Hall, MGAC Campus,
Organized by Department of Panchakarma
Mahatma Gandhi Ayurved College, DMIMS,
Selod (H), Wardha, Maharastra
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/

2. Assessment and Utility of Sneha Karma in Disease Management
“Develop something what
people want and
NOT What you can do.”
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/

3. Assessment and Utility of Sneha Karma in Disease Management
Introduction
• Sneha – indicates / includes
– Oiliness, Unctuousness, Viscidity,
Lubricity, etc.
– “Sneha” is the essence of Human
– “Life” it self is dependent on
“Sneha”
– The entire strength of an individual
is dependent on “Sneha”
xlÉåWûxÉÉUÉåÅrÉÇ mÉÑÂwÉ: mÉëÉhÉÉ: xlÉåWûpÉÔÌrɸÉ: xlÉåWûxÉÉkrÉÉ¶É pÉuÉÎliÉ – xÉÑxÉëÑiÉ ÍcÉÌMüixÉ 31/3
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/

4. Assessment and Utility of Sneha Karma in Disease Management
Sneha in Normal
• Sneha makes the Vishyanda i.e.
vilayana – which means the
dissolution, liquefaction, destruction,
death, etc.
– The all above are referral to the Dosha
and the Dhatu
• The Death is inevitable with the lack of
sneha in the body
– a cellular death or
– organ function cessation
• Excess Unctuousness cause thinning of the
cell membrane & intiate the cytokins
• Apart from it induces the softness
xlÉåWûlÉÇ xlÉåWû ÌuÉwrÉlS qÉÉSïuÉqÉç YsÉåSMüÉUMüqÉç – and generate Kleda (Glucose?? –
cÉUMü xÉ賈 22/10 – ÌuÉwrÉÇSå - ÌuÉsÉrÉlÉqÉç as in lipid metabolism)
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/

5. Assessment and Utility of Sneha Karma in Disease Management
Sneha in Normal
• Sneha makes the person with –
– Increased appetite
– Clean Kosta (GIT)
– Increased tissue metabolism
– Control on senses
– Strength
– Colour / complexion
– Delayed ageing
SÏmiÉÉÎalÉ zzÉÑ®MüÉå¸¶É mÉѹkÉiÉÑÎeÉïiÉåÎlSìrÉ: ÌlÉeÉïUÉå oÉsÉuÉhÉÉïžxlÉåWûxxÉåuÉÏ pÉuÉå³ÉU: - zÉÉ. xÉÇ E. 1/ 32
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/

6. Assessment and Utility of Sneha Karma in Disease Management
What are lipids
• Sneha vis-à-vis Lipids are a broad
group of naturally-occurring
molecules which includes -
– fats, waxes, sterols, fat-soluble
vitamins (such as vitamins A, D, E
and K), monoglycerides,
diglycerides, phospholipids, and
others.
• The main biological functions of
lipids include energy storage, as
structural components of cell
membranes, and as –
• important signaling molecules.
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/

7. Assessment and Utility of Sneha Karma in Disease Management
• Ayurveda states that – disease causative
factors are – 5 Samprapti Ghataka – viz.
The route of – Dosha (Vata, Pitta, Kapha)
– Dhatu (Rasa, Rakta, Mamsa, Meda, Asthi,
Disease Majja, Sukra)
– Agni (Teekshna, Manda, Vishama)
– Ama (Leena, Aleena)
– Srotas – (13 srotas along with sanjna, Chesta,
Sthanya, & Artava)
• The manifested Disease is predominantly
in Shakha (peripheral [tissue] – not in the
Kosta i.e. Central lumen / GIT)
• As the Disease manifestation starts from
Kosta (GIT) and spreads to the (Shakha
(Tissues), the pathogen particles are
brought back to kosta for elimination of
disease.
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/

8. Assessment and Utility of Sneha Karma in Disease Management
Bringing the Dosha to Kosta
• The methods of Shakha
precipitated Dosha to bring back to
Kosta are –
– Vruddhi (increasing dosha)
– Vishyanda (dissolution) – is done
by “Sneha”
– Paka (ripening the Dosha)
– Srotomukha Vishodhana (opening the
srotas outlets)
– Vata Nigrahana (blocking the neural
reflexes)
uÉëÑSèkrÉÍpÉwrÉlSlÉiÉç mÉÉMüÉiÉç xÉëÉåiÉÉåqÉÑZÉÌuÉzÉÉåkÉlÉÉiÉç zÉÉZÉÉÇ irÉYiuÉÉ qÉsÉÉ: MüÉå¸Ç rÉÉÎliÉ uÉÉrÉÉå¶É ÌlÉaÉëWûÉiÉç - cÉUMü
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/

9. Assessment and Utility of Sneha Karma in Disease Management
Sneha Vishyanda
• The infectious theory is denied in Ayurveda
• The pathogenic origin of Ayurveda is Tridosha
• The levels of Dosha accumulation & segregation cause the
stages of disease & pathogenesis
• Reversal of the pathogenesis is based upon the “dissolution of
Segregated Dosha” which is brought back to Central Lumen –
Kosta and eliminated – or
– Suppressive management of Dosha and Disease
• So, the Moorchita Sneha (Taila / Ghrita) – medicated fragmented
lipid bonds join the segregated pathogenic Dosha in Tissues and
dissolute / liquefy Dosha
• Lipid fragments leaves the drug active principle in Shakha
(where the pathogenesis is) and lodge dissolute Dosha to bring
back to Kosta through mucosal secretion
• From Koshta, the sneha lodged Dosha is eliminated.
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/

10. Assessment and Utility of Sneha Karma in Disease Management
Sneha timing
• The consumption of sneha as
– shodhana is in the morning, when the
previous day meal is digested
– for shamana it is consumed in the night
• Day snehana in cold season / Vata
sleshma predominance &
• Night snehana in hot season /
Vatapitta predominance
Charaka sutra 13/61, Susruta chikitsa 31 /23-24, Sharngdhara Uttara 1/15
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/

11. Assessment and Utility of Sneha Karma in Disease Management
Sneha Typology
• The lipids vivid in use are – Taila, Ghrita, Vasa and Majja (these sneha are used
either one or in combination & permutations, according to the severity and Dosha
predominance)
• Abhyantara (Internal)
– Pana (oral administration – Shodhananga – to eliminate the Dosha)
– Bhojana (oral – Shamananga – to pacify the Dosha)
• Bahya (External)
– Anuvasana (per-rectal), Uttara (per-urethral), Nasya (per-
nasal), Karna Poorana (per-ear canal), Gandusha (per-oral
gargling), Akshi Tarpana (per-ophthalmic)
– Moordhnitaila Chikitsa (Shirovasti [Residual oil], Pichu [oil
patch], dhara [oil pouring], mastishkya [oil cover], lepa [oily
paste])
– Gatrabhyanga (body massage), Padabhyanaga (pedal
massage), Mardana (centrifugal massage), Udwartana
(centripetal massage), Padaghata (Foot Massage), Samhanana
(smooth massage),
– Parisheka (pouring), Avagaha (submerging),
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/

12. Assessment and Utility of Sneha Karma in Disease Management
Dalhana Clarification
• Ayurveda suggest the • Sneha reaches –
Snana (bath) before • Romakoopa (hair follicle) in
external oil application 300 matra (95sec)
– Abhyanaga (Massage) • Twak (Skin) in 400 matra (133
– It facilitates the rapid sec)
absorption of the Sneha • Rakta (Blood) in 500 matra
used and reaches the (160 sec)
target faster • Mamsa (muscle) in 600 matra
• In the context of (190sec)
Abhyanaga, Dalhana • Medas (Fat) in 700 sec (228
sec)
(Su.Chi. 24/30) has
• Asthi (bone) in 800 matra (245
clarified about the sec)
dynamics of Sneha • Majja (Marrow) in 900 matra
absorption from the (285sec)
skin -
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/

13. Assessment and Utility of Sneha Karma in Disease Management
Sadyah-Sneha
• Sadyah-Sneha means instant unctuousness
• Sandhava Lavana added sneha (Ghee /Oil) is a
faster unctuous agent as it has the qualities of –
– Abhshyandi – quality of liquefaction
– Arooksha – non dry
– Sookshma – minute
– Ushna – hot
– Vyavayi – spreads in the body well before to digest
• These qualities enhance the unctuousness in the
body instantly
sÉuÉhÉÉåmÉÌWûiÉÉ: xlÉåWûÉ: xlÉåWûrÉlirÉÍcÉUɳÉUqÉç - cÉxÉëMü xÉ賈 13/98
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/

14. Assessment and Utility of Sneha Karma in Disease Management
Best Sneha for Practice
• Out of the 4 sneha we
practice the best two are
–
– Morchita tilataila
(Sha. Sam. Madyama 6/13-14)
– Kolakulutha Ghrita
(cha. Su. 13/94)
• Apart from the sadya
sneha of –
– Dharoshna Sneha
(Sha. Sam. Uttara 1/20)
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/

15. Assessment and Utility of Sneha Karma in Disease Management
Disease management with Sneha
• Even though the Shodhananga Sneha
pana is practiced in Vata vyadhi & twak
(Skin) diseases – many other areas are
also indicated – viz.
– Jwara, Gulma, Rajayakshma, Apasmara,
Unmada, Shotha, Udara, Kasa swasa,
Grahani, Pandu, Shiroroga, Yonivyapat,
Vandhya, etc.
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/

16. Assessment and Utility of Sneha Karma in Disease Management
Utility of Sneha
• Sneha is used as Vicharana or directly as Sneha pana
either to pacify (Shamana) the disease or to expel
(Shodhana)
• The regulated use of the sneha will make the person to
expel the deposited sneha (fats) and restructure the
“fatty contents” in the body
• The excess usage of Sneha cause the “Santarpanotha
Vikara” (Over Nutritive Disorders) such as Medomaya
Yakrut, Ama, Kusta, pandu, Jwara, Sthoulya, Vandhya,
Klaibya, etc.
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/

17. Assessment and Utility of Sneha Karma in Disease Management
Assessment of sneha
• Assessment of the Samyak Snehana is done by the Symptoms
• Here we observe the 3 sets as – Jeeryamana, Jeerna & Samyak
lakshana (symptoms)
• Why not a parametric evaluation is introduced to check the same?
•Jeeryamana •Jeerna •samyak
lakshana lakshana lakshana
AHSu 16/30,
SuChi 31/ 43
AH Su 25/, Su chi 31/ 33 ChaSu13/38
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/

18. Assessment and Utility of Sneha Karma in Disease Management
ASAMYAK SNIGDHA LAKSHANAS
• Asnigdha Lakshanas – Ruksha Purisha/
Grathita Purisha/ Apravaguna Vata/ Mrdu Pakta/
Kharatva/ Raukshyata.
• Ati Snigdha Lakshana – Panduta/ Gaurava/
Jadya/ Tandra/ Aruchi/ Utklesha/ Purishasya
Avipakvata.
• SNEHAPANA VYAPAT - Tandra/ Utklesha/
Anaha/ Jvara/ Stambha/ Visanmyatha/ Kushta/
Pandu/ Kandu/ Shopha/ Arsha/ Aruchi/ Trishna/
GrahaniDosha/ Staimitya/ Vakyanigraha/ Shula/
Ama Pradosha.
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/

19. Assessment and Utility of Sneha Karma in Disease Management
Objective parameter for Sneha Assessment
• As the observation offer an area of setting
the objective assessment apart from “Lipid
Profile”
• The sneha (Fat) quantity in the fecal
matter is the best method as –
– The samyak sneha symptom is oiliness in
fecal matter - and
– the excess is also seen in the same
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/

20. Assessment and Utility of Sneha Karma in Disease Management
THE STUDY OF AROHANA SNEHAPANA AND ITS
EFFECT ON SAMEDARAKTA WITH SPECIAL REFERENCE TO
HYPERLIPIDAEMIA AND NORMALLIPID VALUES
• Large quantities of Sneha is using for Snehapana, the
people in this era are afraid of this therapy, because it
may increase fat specially Cholesterol and Triglycerides
which was the important causative factor for
Atherosclerosis, Heart attack etc.,
• Shodhananga Snehapana with Murchita Tila Taila was
given in Arohana Krama in two groups.
• In one group, the 15 patients with primary
Hyperlipidaemia (especially raised values of either
Cholesterol or Triglycerides) and who are fit for Snehana
and Shodhana karma excluding secondary
Hyperlipidaemia were selected
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/

21. Assessment and Utility of Sneha Karma in Disease Management
STUDY OF AROHANA SNEHAPANA . . . continued
• In both the groups after Ama Pachana,
Snehapana was done in Arohana krama after
30ml of Hrasiyasi matra – the result is under -
Varsha S. Kulkarni, THE STUDY OF AROHANA SNEHAPANA AND ITS EFFECT ON SAMEDARAKTA WITH
SPECIAL REFERENCE TO HYPERLIPIDAEMIA AND NORMAL LIPID VALUES, 2005, RGUHS, Bangalore
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/

22. Assessment and Utility of Sneha Karma in Disease Management
The effect of ghee (clarified butter) on serum lipid levels
and microsomal lipid peroxidation
• In the present study, investigated the effect of 10% dietary ghee on
microsomal lipid peroxidation, as well as serum lipid levels in Fischer
inbred rats to assess the effect of ghee on free radical mediated
processes that are implicated in many chronic diseases including
cardiovascular disease.
• Results showed that 10% dietary ghee fed for 4 weeks did not have
any significant effect on levels of serum total cholesterol, but did
increase triglyceride levels in Fischer inbred rats.
• Ghee at a level of 10% in the diet did not increase liver microsomal
lipid peroxidation or liver microsomal lipid peroxide levels.
• Animal studies have demonstrated many beneficial effects of ghee,
including dose-dependent decreases in serum total cholesterol, low
density lipoprotein (LDL), very low density lipoprotein (VLDL), and
triglycerides; decreased liver total cholesterol, triglycerides, and
cholesterol esters; and a lower level of nonenzymatic-induced lipid
peroxidation in liver homogenate.
Hari Sharma, et.al. Ayu. 2010 Apr-Jun; 31(2): 134–140.
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/

23. Assessment and Utility of Sneha Karma in Disease Management
Influence of vitamin D supplementation on plasma lipid profiles:
A meta-analysis ofrandomized controlled trials
• Observational studies have shown that low serum levels of vitamin D have
been associated with an atherogenic lipid profile. However, the intervention
studies gave divergent results.
• The mean change in total cholesterol (TC), low-density lipoprotein cholesterol
(LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglycerides (TG)
from baseline was treated as a continuous variable.
• In all, 12 clinical trials consisting of 1346 participants were included in the
analysis.
• The pooled estimate of effect for vitamin D supplementation on LDL-C was
3.23 mg/dl (95% confidence interval, 0.55 to 5.90 mg/dl).
• No statistically significant effects for vitamin D supplementation were observed
for TC, HDL-C and TG (differences in means were 1.52 mg/dl (-1.42 to 4.46
mg/dl), -0.14 mg/dl (-0.99 to 0.71 mg/dl) and -1.92 mg/dl (-7.72 to 3.88 mg/dl)
respectively).
• The lipid modulating effects of vitamin D supplementation should be further
investigated though large-scale, randomized trials with adequate doses which
can effectively elevated the active form of vitamin D in plasma and with proper
population which has hyper-lipemia as an inclusion criterion.
Wang et al. Lipids in Health and Disease 2012, 11:42, 11:42, http://www.lipidworld.com/content/11/1/42
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/

24. Assessment and Utility of Sneha Karma in Disease Management
Influence of diet with different lipid composition on
neutrophil chemiluminescence and disease activity in
patients with rheumatoid arthritis
• Twelve patients were randomly assigned either to a diet high in
polyunsaturated fatty acids supplemented with eicosapentaenoic
and docosahexaenoic acids or to a diet high in saturated fatty acids.
• A correlation with clinical and laboratory parameters is also reported.
No statistical difference was observed in neutrophil
chemiluminescence and in clinical parameters in the group of
patients treated with a diet high in saturated fatty acids.
• Fish oil ingestion resulted in subjective alleviation of active
rheumatoid arthritis and reduction of neutrophil chemiluminescence.
This study corroborates the hypothesis of an anti-inflammatory role
for polyunsaturated fatty acids in patients with chronic inflammatory
diseases.
M MAGARO et. al. Annals of the Rheumatic Diseases, 1988; 47, 793-796
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/

25. Assessment and Utility of Sneha Karma in Disease Management
Hypocholesterolemic effect of anhydrous milk
fat ghee is mediated by increasing the
secretion of biliary lipids
• To evaluate the mechanism of the hypocholesterolemic effect of ghee,
male Wistar rats were fed a diet containing 2.5 or 5.0 wt% ghee for a
period of 8 weeks. The diets were made isocaloric with groundnut oil.
• Both native and ghee heated at 120 degrees C containing oxidized
lipids were included in the diet. The ghee in the diet did not affect the
3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) reductase activity
in the liver microsomes, but it significantly increased biliary excretion
of cholesterol, bile acids, uronic acid, and phospholipids.
• The rats fed ghee had lower levels of cholesterol esters in the serum
as well as in the intestinal mucosa. Both native and oxidized ghee
influenced cholesterol metabolism.
• These results indicate that supplementation of diets with ghee lipids
would increase the excretion of bile constituents and lower serum
cholesterol levels.
Kumar MV, Sambaiah K, Lokesh BR. J Nutr Biochem. 2000 Feb;11(2):69-75.
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/

26. Assessment and Utility of Sneha Karma in Disease Management
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/

27. Assessment and Utility of Sneha Karma in Disease Management
• The Sneha bound medicines are
long acting with smaller chains of
Lipid molecules
• The Ayurvedic Medicinal Fats are
homogeneous and target oriented
• The sneha in Ayurveda (under
normal dose) does not increase the
fats in body rather regulate them
• Assessment parametric in
Ayurveda is based upon the
“Symptoms” is necessary to be
shifted for Objective Type
Conclusion • Even though the Fatty Medicine
usage in Ayurveda is more – a
standard research to establish the
facts is necessary.
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/