PURVAKARMA IN PANCHAKARMA: SNEHANA, SWEDANA AND PREPARATORY PROCEDURES – RATIONALE, SAFETY AND RESEARCH GAPS
Background: Purvakarma, the preparatory phase of Panchakarma, comprises Deepana-Pachana, Snehana (oleation) and Swedana (sudation). It is regarded as essential for the safe and effective conduct of Shodhana therapies. Objective: To describe the classical rationale of Purvakarma and review contemporary evidence on its practice, safety and outcomes. Methods: Narrative review based on a PubMed search and classical texts. Findings: In 29 healthy volunteers, escalating oral ghee given until proper oleation was associated with weight loss and reduced abdominal circumference, with no significant change in total cholesterol, HDL or LDL and a fall in triglycerides and VLDL. A pilot study in ten patients suggested escalating Anuvasana Basti as an alternative to oral Snehapana in patients with poor compliance. A seasonal Vamana study provided reference data on the dose and duration of Snehapana. Studies specifically evaluating Swedana were not identified in the sources retrieved. Conclusion: Evidence on oleation is accumulating, with encouraging safety data, whereas evidence on sudation is lacking. Standardised reporting of Purvakarma parameters and consensus guidelines are needed.