What is Snehana?

Snehana is the process of lubricating and nourishing the body using unctuous substances such as ghee and oils. This loosens morbid matter, enhances the resilience of tissues, and prepares the body for purification therapies.

In Ayurveda, Snehana is of two types:

• Internal Snehana (Sneha-pana)
• External Snehana (Abhyanga)

Internal Snehana (Sneha-pana)

Among all internal oleation methods, Shodhana Sneha-pana is specifically used to prepare the body for purification (Shodhana).

This therapy lubricates the channels of the body, allowing doshas to be loosened and expelled. It also enhances tissue strength so the body can tolerate Panchakarma cleansing more effectively.

The selected ghee or oil is consumed early in the morning on an empty stomach, after the previous day's food has been properly digested.

The dose is tailored to the patient's digestive capacity and disease condition. It is gradually increased daily (e.g., 30 ml ? 60 ml ? 90 ml) and is continued for 3-7 days until the body is sufficiently lubricated.

Completion is determined by clinical signs assessed by a physician.

Because dose adjustment is critical, Internal Snehana must always be performed under the supervision of a trained Ayurvedic physician.

External Snehana (Abhyanga)

In Abhyanga, oils, ghee, or medicated fats are applied externally to the body. The oil penetrates through the skin pores, nourishes tissues, and pacifies Vata Dosha.

Oil selection based on climate:

• Sesame oil - Hot in nature, ideal for cold climates.
• Coconut oil - Cooling, ideal for warm climates.

Daily Abhyanga is recommended for all healthy individuals. Special emphasis is given to head massage, foot massage, and even instilling a few drops of warm oil into the ears.

After Abhyanga, Swedana (sudation) or a warm water bath is advised. Harsh soaps should be avoided; instead, herbal ubtan (scrub powder) may be used.

Benefits of Abhyanga

• Reduces fatigue and stress
• Pacifies Vata dosha
• Promotes sound sleep
• Improves skin tone, softness, and strength
• Enhances physical endurance
• Improves eyesight
• Slows aging and promotes longevity

What is Swedana?

Swedana refers to inducing perspiration using controlled heat. Sweating dilates body channels, dislodges Doshas, and facilitates their movement toward the gastrointestinal tract for elimination.

It is one of the most important preparatory procedures in Panchakarma, usually performed after oleation therapies.

Methods of Swedana

Swedana can be done through various methods, depending on the condition and the part of the body involved:

• Steam chambers: Full-body steam with herbal decoctions.
• Herbal boluses (Pinda Sweda): Warm herbal bundles applied over the body.
• Localized fomentation (Nadi Sweda): Directed steam to specific joints or areas.
• Full-body steam (Bashpa Sweda): Enclosing the body in a steam chamber while the head remains outside.
• Dry fomentation: Used when oil application is contraindicated.

Duration & Combination with Other Therapies

The duration of Swedana is usually about 10-15 minutes, or until proper sweating is achieved without excessive discomfort.

Swedana is typically combined with Snehana (internal or external oleation) for best results, as the oil loosens the Doshas and the heat mobilizes them toward the gut.

Benefits of Swedana

Benefits of therapeutic sweating include:

• Pacifies Vata and relieves stiffness.
• Improves appetite and digestive fire.
• Makes the skin soft, smooth, and supple.
• Reduces heaviness, lethargy, and excess fat.
• Improves joint mobility and flexibility.
• Relieves bloating by facilitating expulsion of gas.

Precautions & Overuse

While Swedana is highly beneficial when done correctly, excessive or improper sudation can cause:

• Weakness and fatigue
• Dizziness or faintness
• Skin rashes or burning sensation
• Excessive dryness

What is Vamana?

The word Vamana means "therapeutic vomiting." In Ayurveda, it refers to a scientifically guided procedure where vomiting is deliberately induced using specific herbal formulations to eliminate aggravated Kapha Dosha and, to some extent, Pitta.

Unlike random vomiting caused by irritation or salt water, Ayurvedic Vamana is a structured, physician-guided detoxification therapy with clear stages, indications, and expected outcomes.

Indications

Vamana is highly beneficial in Kapha-dominant and Kapha-Pitta mixed disorders:

• Allergic rhinitis and chronic nasal congestion
• Asthma and chronic cough
• Skin diseases like eczema and psoriasis
• Indigestion and recurrent fevers
• Nodular swellings and lymphatic congestion
• Chronic allergies and respiratory sensitivity

Preparatory Phase

Since Vamana is an intensive purification therapy, the body must be prepared properly. This preparation mobilizes the Doshas and brings them into the stomach for removal.

• Snehana (Oleation): internal or external oiling for 3-7 days.
• Swedana (Sudation): steam therapy to liquefy and mobilize Doshas.
• The evening before Vamana, a Kapha-promoting meal like curd rice or Udad dal Khichadi is given to loosen and gather the Doshas.

The Procedure

On the day of Vamana, the sequence is structured and monitored carefully:

• The patient receives Snehana and Swedana again in the morning.
• They are then given specially prepared Vamana decoctions in large quantities - usually 5-8 liters of liquids.

Common liquids used:

• Sugarcane juice
• Medicated milk
• Herbal decoctions
• Warm medicated water

After consuming a few glasses, medicinal vomiting begins. The expulsion generally follows this classical sequence:

• Kapha comes out first
• Pitta follows

The full process usually takes 70-90 minutes, during which the physician observes the quantity and quality of expelled Doshas to evaluate success.

Signs of Successful Vamana:

• Lightness in chest, abdomen, and limbs
• Improved clarity of senses
• Relief of congestion
• Mild, pleasant fatigue

After Vamana, Dhumapana (medicated herbal smoking) is administered to clear any remaining Kapha in the respiratory tract, followed by Gandusha (herbal gargles).

Post-Therapy Care

Proper aftercare ensures digestion and strength return gradually:

• Resting is advised - but no daytime sleep.
• A structured post-Vamana diet (Samsarjana Krama) is followed for 4-5 days.
• Foods begin with thin gruels and gradually progress to thicker, nourishing preparations.

As Vamana requires taking large amounts of therapeutic liquids and following strict guidance, patient cooperation and discipline are essential for success.

What is Virechana?

Virechana is the therapeutic induction of controlled purgation to expel aggravated Doshas - primarily Pitta, and secondarily Kapha - through the downward route of the gastrointestinal tract.

Unlike ordinary laxatives, Virechana has a deeper purpose: to eliminate not only waste products but also the root cause of disease lodged in tissues.

Indications

Virechana is indicated in a wide range of Pitta-dominant and systemic disorders, such as:

• Pitta disorders like jaundice, skin diseases, and blood disorders
• Hemorrhoids and piles
• Digestive and metabolic disorders
• Asthma and chronic fevers
• Genital and urinary disorders
• Chronic toxicity and accumulation of metabolic wastes

Contraindications

Virechana should not be performed in:

• Pregnancy
• Childhood and very advanced age
• Certain heart diseases and severe debility

Preparatory Phase

Similar to Vamana, the body is prepared with 5-7 days of Snehana and Swedana. Once the Doshas are sufficiently loosened and collected in the GI tract, Virechana can be administered.

The Procedure

• The day before Virechana: Internal oleation (oral ghee/oil) is stopped.
• On the morning of Virechana:
  A light breakfast (commonly Moong dal preparation) is given soon after sunrise.
• After partial digestion of this meal (about 2-2.5 hours later), the patient receives Abhyanga and Swedana.
• Then, the purgative medicine (chosen according to constitution, strength, age, and disease) is administered.
• The patient drinks only warm water and remains indoors, close to toilet facilities.

Elimination usually begins within 2-3 hours, producing about 5-20 bowel evacuations, depending on the dose and individual factors.

Signs of proper Virechana:

• Expulsion of fecal matter first, followed by Pitta and Kapha
• Feeling of lightness, enthusiasm, clarity, and freshness
• Mild fatigue without collapse or extreme weakness

Post-Therapy Care

• Food and sleep are avoided until the elimination phase is fully complete.
• Only warm water should be used for drinking and external purposes.
• A special post-procedure diet, Samsarjana Krama, is followed for 3-5 days to rekindle digestive fire (Agni).
• The diet progresses gradually from thin rice gruels to normal food, based on hunger and strength.

What is Nasya?

In Ayurveda, the nose is considered the gateway to the head and brain. Nasya is a therapeutic procedure in which medicinal substances are administered through the nostrils to eliminate Doshas accumulated in the head, neck, and face.

Depending on the medicine used, Nasya can be either nourishing (strengthening, tonifying) or purifying (cleansing and detoxifying).

Procedure

The Nasya procedure is carried out in a systematic and gentle way:

• The face, head, and neck are first massaged with oil (Abhyanga).
• Local Swedana (fomentation) is given to open the channels.
• The medicine (oil, ghee, herbal decoction, powder, or medicated smoke) is warmed to a lukewarm temperature.
• With the patient lying down, head slightly tilted back, the medicine is instilled drop by drop into each nostril.
• Gentle massage is given on the nose, cheeks, and forehead to encourage absorption.
• The patient then spits out the discharge instead of swallowing, as it contains morbid Doshas and toxins.

Indications

Nasya is beneficial in a wide range of conditions involving the head, neck, and senses, particularly where Vata and Kapha are aggravated.

• Headache and migraine
• Neck stiffness and cervical spondylosis
• Hoarseness of voice and throat discomfort
• Eye and ear disorders related to congestion or dryness
• Tonsillitis, sinusitis, chronic rhinitis, nasal blockage
• Facial paralysis and TMJ (jaw joint) disorders

Contraindications

Nasya should not be performed in the following situations:

• Immediately after meals or alcohol consumption
• During indigestion or fever
• In states of extreme fatigue or exhaustion
• During pregnancy or immediately postpartum
• Immediately after coitus or intense exercise
• Right after other Panchakarma procedures like Vamana or Virechana

Types of Nasya

• Classical Nasya:
  An intensive, therapeutic form of Nasya performed under a physician's supervision, using specific medicated oils or decoctions tailored to the disease.
• Pratimarsha Nasya:
  A mild, daily preventive practice in which about 2 drops of oil or ghee are instilled into each nostril. It is considered safe for all ages and all seasons when done correctly.

Benefits of Nasya

Regular and properly administered Nasya can offer a broad spectrum of benefits for both prevention and treatment:

• Strengthens the head, neck, and sensory organs
• Enhances cognitive function, clarity, and memory
• Improves immunity against respiratory and allergic conditions
• Relieves stress, mental tension, and emotional heaviness
• Improves voice, vision, and overall facial vitality and glow

What is Basti Therapy?

Long before the advent of intravenous fluids, the physicians of Ayurveda administered numerous herbal preparations directly into the anal canal to reach the deep tissues of the body and manage various acute and chronic disorders. This form of treatment is known as Basti in Ayurveda.

Though commonly translated as "Enema Therapy," Basti Therapy far exceeds the Western understanding of enemas. It utilizes a wide range of medicinal substances to treat very specific disorders.

The word Basti literally means "bladder." In ancient times, prior to the invention of catheters and syringes, physicians used cleaned and fashioned urinary bladders of animals to administer herbal preparations. Today, enema bags, pots with catheters, and syringes are used.

The concept of Basti also extends to the administration of herbal preparations through the vagina and urethra, which is specifically called Uttar Basti.

Basti & the Doshas

Basti Therapy is most commonly used for disorders of Vata Dosha. Through Basti, herbal preparations are absorbed through the large intestine and spread throughout the body into the deepest tissues, pulling aggravated Doshas back into the colon.

Since the large intestine is the main seat of Vata, Basti is especially effective for Vata disorders. However, it can also be employed in Pitta and Kapha disorders by modifying the herbal preparations.

For Kapha Dosha, for example, Bastis are administered with Kapha-reducing (scraping) substances and appropriately chosen Snehas.

Types of Basti Therapy

Basti Therapy is divided into two main categories:

• Niruha Basti (Decoction Enemas)
• Anuvasana Basti (Oil Enemas)

Niruha Basti (Decoction Enema)

In Niruha Basti, a strong herbal decoction is first prepared. To this, ingredients such as:

• Honey
• Saindhava (rock salt) and other suitable salts
• Herbal powders
• Different oils or animal fats
• Occasionally small amounts of black salt or specific herbs

are added according to the classical formula. Niruha Basti expels aggravated Vata and accumulated wastes from the body.

Anuvasana Basti (Oil Enema)

Anuvasana Basti primarily contains oil or ghee. While Niruha Basti emphasizes expulsion, Anuvasana Basti pacifies and nourishes Vata within the system, lubricating tissues and preventing excessive dryness.

Preparatory Measures

Before administering Basti Therapy, the body is prepared through:

• Snehana (oleation)
• Swedana (sudation)

These procedures strengthen tissues, widen internal channels, and encourage Doshas to move into the gastrointestinal tract. Often, external Snehana and Swedana are applied locally to the back, abdomen, and thighs depending on the disorder.

After Abhyanga and Swedana, the patient lies prone with the left leg extended and the right knee bent. A small amount of oil is applied to the anus, and then a well-lubricated catheter is gently inserted in the direction of the vertebral column. The Basti fluid is administered gradually with uniform pressure. Afterwards, the patient lies supine with hips elevated on a pillow until the urge to evacuate arises.

Administration Guidelines

• Niruha Basti is administered on an empty stomach, immediately after Abhyanga and Swedana. It is usually expelled quickly due to the potency of the preparation and is rarely retained beyond 45 minutes. The patient may eat immediately afterward, and should drink only hot water.
• Anuvasana Basti is given after a light meal. It is retained for a longer duration - often 3-4 hours, and sometimes overnight. The patient should not eat again until expulsion occurs and genuine hunger is felt.

For therapeutic purposes, Niruha and Anuvasana Bastis are often alternated in a planned sequence, sometimes for extended periods up to a month.

Indications

Niruha Basti is useful in:

• Abdominal disorders and distension
• Gout and various joint pains
• Splenic disorders and recurrent fevers
• Respiratory complaints
• Male and gynecological disorders
• Infertility and obstructed stools or urine
• Scrotal enlargement and urinary stones
• Amenorrhea and neurological disorders (tremors, paralysis, sensory dysfunctions)

Anuvasana Basti is indicated in conditions such as:

• Wasting, debility, and dryness
• Fatigue and convalescence
• Fractures and musculoskeletal weakness
• Anxiety and excessive thinking
• Support during pregnancy - especially in the ninth month, to facilitate easy and comfortable labor (under expert guidance).

Uttar Basti

As mentioned earlier, Uttar Basti refers to therapeutic enemas administered through the vaginal or urethral passages. Special medicated oils and Snehas are chosen depending on the specific disorder.

It is indicated in:

• Urinary problems such as dysuria, burning, delayed or obstructed urination
• Urinary stones
• Seminal disorders (e.g., poor motility, oligospermia)
• Reproductive and menstrual disorders
• Infertility and uterine health issues

Preparatory cleansing with Snehana and Swedana enhances the efficacy of Uttar Basti. Vaginal douching with specific herbal decoctions, known as Yoni Dhavana, is also performed prior to therapy.

The procedure is usually carried out immediately after menstruation, by inserting a catheter through the cervical passage. Following Uttar Basti, medicated tampons called Picchus are placed inside.

What is Raktamokshana?

Raktamokshana literally means "release of blood." It is the process of removing vitiated (impure) blood from the body and has parallels in many ancient as well as modern medical traditions.

In Ayurveda, Raktamokshana is performed either surgically (venesection) or para-surgically (using leeches, cupping, scratching, or suction). It is considered a Shodhana (purification) therapy, indicated when the blood itself is vitiated and carries Doshas throughout the body.

Where Vamana is best for Kapha, Virechana for Pitta, and Basti for Vata - Raktamokshana is prescribed when the blood itself is corrupted.

Causes of Vitiated Blood

Blood becomes impure due to long-term exposure to certain foods, habits, and emotional states. Common causes include:

• Regular intake of very hot, spicy, and oily foods
• Excessive use of salt and fermented foods
• Frequent consumption of alcohol
• Daytime sleeping and a sedentary lifestyle
• Overexertion in hot climates or direct sun
• Negative emotions such as anger, sadness, and fear

As the body attempts to eliminate this vitiation, toxins tend to rise toward the surface. During Raktamokshana, this impure blood is removed first, stimulating the production of fresh, healthy blood.

Typical quantities removed are:

• Venesection: Approximately 100-120 ml of blood
• Leech therapy or suction: About 10-20 ml of blood

Seasonal Considerations

Autumn is considered the ideal season for Raktamokshana, as the weather is relatively balanced and clear.

If needed, the procedure may also be performed in:

• Cooler seasons: Preferably around midday
• Summer: Preferably in the early morning hours

Indications & Benefits

Raktamokshana is beneficial in a wide range of conditions where blood and Pitta are prominently involved. It can bring almost instantaneous relief in some cases.

• Skin diseases and chronic rashes
• Splenomegaly and certain liver disorders
• Jaundice and piles
• Acne and other inflammatory skin eruptions
• Ocular (eye) disorders with congestion or redness
• Hypertension (raised blood pressure)
• Abscesses and inflammatory swellings
• Headaches and migraine with vascular involvement
• Epistaxis (nosebleeds)
• Blood in urine or stool
• Certain joint disorders with heat and swelling

However, it is contraindicated in:

• Pregnancy
• Severe chronic fatigue and debility
• Generalized body swelling (anasarca) and extreme weakness

Methods of Raktamokshana

Different methods are selected based on the nature of the disease, the Dosha involved, and whether the pathology is local or systemic.

• Venesection (Siravyadha):
  Used when there is systemic blood vitiation, spreading Doshas throughout the body.
• Scratching (Pracchana):
  Series of fine superficial scratches, useful in local Kapha and blood disorders near the skin.
• Cupping (Alabu / suction):
  Applied for Vata disorders and deeper impurities, often over muscles and joints.
• Leech therapy (Jalauka):
  Ideal for Pitta and localized, inflamed conditions where a gentler approach is needed.

Leech Therapy - Gentle & Effective

Leech therapy is especially gentle and almost painless, making it suitable even for children and the elderly.

Leeches secrete a natural substance called Hirudin, which prevents clotting and allows effective, controlled blood withdrawal from the affected site.

In Ayurveda, leeches are preserved and reused after a proper purification process using turmeric, oil, and rock salt. This ensures both safety and effectiveness.

Aftercare & Diet

After Raktamokshana, the body is in a sensitive, cleansing phase. Proper aftercare is essential to support recovery and the formation of fresh, healthy blood.

• Consume light, soupy, and easily digestible foods
• Avoid excessively hot, cold, heavy, or stale foods
• Refrain from alcohol and very spicy meals
• Avoid daytime sleep, emotional outbursts, and anger
• Protect yourself from excessive heat and direct sun exposure

Conclusion

Raktamokshana, though apparently simple, is a profoundly effective therapy when used judiciously. By directly removing vitiated blood, it acts at a deep level to purify the body and restore balance.

Just as Basti is considered half the treatment for many Vata disorders, Ayurvedic tradition regards Raktamokshana as half the treatment in many blood-borne and Pitta-dominant diseases. When performed under the guidance of a skilled Vaidya, it can offer remarkable relief and long-term healing.