‘Snehana’ in Disease Induced Debility

Article by Dr Raghuram Y.S. MD (Ay) & Dr Manasa S, B.A.M.S

Debility is one of the most important complications of any long-standing disease. The disease goes away with treatment. The symptoms also get reduced. The patient is happy that things are back to normal. On the other hand, the physician too is satisfied with what outcomes he did get in handling that given disease or disease. But most times, what is left out in the backdrop is the footprints of the disease. These may be subtle and go out of notice from the point of view of a physician. On the other hand, the patient will take the relief for granted if all troublesome symptoms of the disease have settled down and he or she is capable enough to hit back to work and daily chores.

Table of Contents

Snehana In acute conditions

Physically or mentally weak persons would complain of tiredness and debility even after having recovered from the diseases. It takes a long time for these people either to recover or to believe that they have recovered completely. Debility may also be a mindset or an excuse for people who procrastinate or push things too much ahead and want to spend more hours or days in rest. From a physician’s perspective, this is an easy affair to deal with, because the person ‘complains’.

Stronger individuals by body and mind are the other category of people. Even 60% betterment in symptoms of the disease is enough for them to ‘get going’. These people, many times, would not complete the treatment schedule completely. They will not adhere to the dietetic and activity restrictions. They hate resting and want to jump back into the business of life. In such conditions, the body will not get sufficient time to reboot and rejuvenate. The ongoing pathological reversion will not get support it needs to reshine. On the other hand, the residual morbidity will take opportunity from the person hitting back to normal life in a hurry, when he or she tries to quickly jump back into regular foods and activities and push themselves too hard.

In both cases, the pathogenesis can re-trigger and many complications can occur, some noticeable and many not, some spelt and many ignored. The first kind of person complains, the second one ignores.

Debility: A point of concern

Debility is one such point of concern which will be ongoing in the backdrop for many days to months. People get alerted when it bothers a lot and meddles with daily activity, not until then. Strong people try to manage the debility by eating more food and occasionally more rest, prompted by near and dear ones or maybe by Google. But debility may be more than what it appears to be. It may be a silent indicator of something sinister coming in the way. It may be an indicator of certain tissues, organs or organ systems slowly compromising. This is a sign of a latent ongoing disease process, slowly but steadily, waiting for an opportunity to hit back.

Chronic Debility in chronic and recurring diseases

Debility of long-standing nature is dangerous and should be addressed as soon as possible.

Below mentioned are the points of concern –

– If the disease is chronic

– Disease having recurring nature – a frequent visitor

– Diseases in which the treatment is ongoing

– Debility not getting addressed by intake of good foods or disease specific medicines

– Patient not taking the treatment properly – bad follow-ups

– Patient trying to manage the debility with home remedies or over the counter medicines

– Diseases having severe loss of tissues

– Diseases in which the immunity has been compromised

– Diseases which have not received proper or complete treatment

– Diseases wherein the samprapti has not been broken completely – i.e. has latent ongoing pathogenesis

– Patient taking debility casually and not bringing it to the notice of the physician – ‘This is not important, I will take care of myself’ type of persons

– Diseases involving the Marmas

– Diseases whose Samprapti is strong enough to break through completely, especially so in weak persons having strong pathogenesis

– Doshas and malas not flushed out of the system

Snehana for combating ‘disease induced debility’

There are many Ayurveda interventions for combating debility. The cause, pathogenesis, dosha or disease in the backdrop of debility needs a cautious scrutiny before starting the treatment for the same.

In this article, we will not discuss the treatment options for combating debility. We will only focus on the topic of discussion and touch upon the importance of snehana in combating debility caused due to chronic diseases (or acute diseases), especially that caused due to dhatu kshaya – depletion of tissues.

This explanation is in accordance with a reference from Ashtanga Hridaya.

Master Vagbhata emphasizes usage of Sneha – medicated fats, for combating the debility or tissue loss occurring due to the impact of chronic diseases.

Reference – Ashtanga Hridaya Sutra Sthana – Chapter 16, verse 45

Understanding the reference and context

क्षीणानां त्वामयैरग्निदेहसन्धुक्षणक्षमान्॥४५॥

Here, Acharya Vagbhata mentions the indication as ‘amaya ksheenanam’.

The word ‘ksheena’ means –

– Debility

– Depletion of tissues

– Debility caused by depletion of tissues

To put it short, Amaya ksheenanam – can be understood as

a. ‘those debilitated by diseases’ – here, the treatment principle of administering snehana is for acute or chronic diseases or

b. ‘those suffering from debility caused by dhatu kshaya occurring in chronic diseases’ – here, the treatment principle of administering snehana is limited for chronic diseases only

Goals of administering sneha in this context

Administration of Sneha, for Amaya ksheena individuals is done mainly with two purposes –

– To increase the strength of the digestive fire i.e. to enhance the digestion / metabolism capacity of the gut and consequently in the tissues

– To increase the strength of the body of the patient

Types of Sneha to be administered to combat debility caused due to chronic diseases

The above mentioned two main goals or purposes of administering the Sneha in these debility conditions itself will give us two types of Sneha which need to be used herein –

1. Agni Sandhukshana Kshaman – the medicated fats which have the capacity to enhance the agni and in turn the digestion capacity of the individual. This principle coincides with the principle – ‘all diseases, mainly those of abdominal origin, are caused due to sluggishness of digestive fire’. Enhancing agni – is the chief principle in combating many systemic disorders and there is nothing as good as Sneha to do that, ‘the fuel for fire’ principle.

2. Deha Sandhukshana Kshaman – the medicated fats which have the capacity to enhance the strength of the patient. Every cell has a layer of fat around it. The main quality of fats is to provide oleation to all tissues and organs. Snehana is counted among the therapies which provide strength and endurance.

How does Sneha work here? – The principle of use of Sneha

Sneha, when administered in chronic debility caused due to the diseases or depletion of tissues keeping into consideration both the above said purposes, will help the body to recover from the debility, mainly owing to the properties of Sneha – which are supportive for building up the body tissues and enhancing the metabolism.

Firstly, the Sneha would kindle the weak agni. This will enhance the capacity of the digestive fire to digest the food properly. In turn, the properly digested food will get absorbed and distributed to the tissues. By feedback mechanism, the agni which has been kindled by Sneha, will also enrich and kindle the dhatu agni. The kindled dhatu agni – tissue fires, will make use of the nutrition provided to them and build up the relative dhatus in a healthy way. This will establish dhatu samya – equilibrium of tissues. Now, the body would gain strength, endurance and immunity.

When the agni of the person is good, but the person still has debility, Sneha which can predominantly enrich the strength of the person should be administered.

The biggest plus point is that, most of the times, Sneha given for either purpose will be bi-phasic and multidimensional. This is due to the formulations that are brilliantly designed by our Acharyas.

What type of Sneha should be given here?

Though the details about which type of Sneha should be given to enhance strength and digestive capacity in people suffering from post-disease debility has not been given, it can be inferred that Brimhana type of Sneha can be preferred here. The intended Sneha can be given mixed with food.

Nitya Sneha – This description by Acharya also looks like ‘daily consumption of metered doses of sneha’ rather than a ‘snehapana’ type of formatting. Snehana can be given on a daily basis, in small quantities.

Vicharana Sneha – Sneha can be given with nutritious foods which will add to the multidimensional action of the Sneha.

In what dose Sneha should be given?

Usually, a dose which is equal to or less than hrisiyasi matra should be given, following the other principles and rules of snehapana. 10-15 grams / ml is ideal. The dose needs to be customised in accordance to prakriti, vikriti, age, tolerance / compatibility etc of the patient, though it is not mandatory, since it is not snehapana.

When to stop Sneha?

The Sneha can be stopped once the person recovers from debility, completely. Opinion of the physician does matter.

There is no harm in continuing to use Sneha in small quantities daily, for a long time, especially if it is Ghrita – ghee, because it is a Nitya Rasayana – Rasayana which can be taken daily, throughout the life.

Which Sneha form should be taken?

All Sneha forms can be taken according to prescription or suitability, as recommended by the physician – Ghee, bone marrow, muscle-fat and oil, singly or in permutations and combinations.

Can plain – Achcha Sneha be used?

Absolutely yes!