Disease Review

REVIEW OF AYURVEDIC LITERATUREAMAVATA

It is known to us by a diligent literary search that Madhavakara, the author of

'Madhavanidana' is the first who described Amavata as a separate disease. He has described

it explicitly in an elaborate manner.

HISTORY :

Going to the history of Amavata, no reference is available in the Vedic literature. In

Regveda the concept of Vrata(fasting) have been mentioned. Fasting is considered for

elimination of Aam as a product of malnourished state, which has been named as Amadi1-2.

The term Aam and its various synonyms Amashya3 , Amayam4 are used for prohibited food.

In Athervaveda there is description of Vishuchika which results due to dietary

incompatibility(Pragyapradha) and they have advocated certain remedies including many

drugs e.g.Soma, Rudra, Dhatum5 etc. Further in Athrvaveda treatment of joints disorder has

been mentioned. They have established the relation between the pain in joints and bone witn

Hridya6(Heart).

There is also description of joints such as Sakhti(hip joints){Sharma

R.C.,Pg.59},Janu7 (Knee), Gulpha(Ankle joint) and Shroni8 (Ileosacral joint).

In Brihattrayi only a brief description as a passing reference is available.

In Charaka Samhita references are available in Svayathu Cikitsa under the indications

of Kamsa Haritaki (Ch. Chi. 12/52)9 and in Panduroga under Vishaladi phanta (Ch. Chi.

16/62) 10. Further while explaining Avarana also explains Avarana of Vata by Ama (Ch. Chi.

28/195)11.Whereas an elaborate description of etiopathology, clinical manifestations and

treatment regarding Ama and Amapradoshaja Vikara are found (Ch. Vi. 2/12)12. No reference

is found in Susruta samhita. In Ashtanga hridaya, Vagbhata has used the term Amavata

while describing the therapeutic uses of Vatsakadiyoga (A. H. Chi. 21/47) and Vyoshadiyoga

(A. H. Chi. 21/50)13.

Amavata is not being mentioned in Kashyapa Samhita.

In Bhela Samhita, the tenth chapter of Sutrasthana gives a detailed description of

Amapradosa which is the precursor of the disease Amavata.

One complete chapter has been devoted to Amavata in Haritha Samhita where a clear

description about the disease along with its etiology, clinical manifestation, prognosis,

treatment with dietary regime is found. The types of Amavata as Sarvangi, Pakvi, Gulmi,

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Disease Review

Snehi, Vistambhi are also explained by the author (H. S. Chi. 21). The Nidana and Lakshana

of the disease Amavata is also described by Agnivesha in Anjana Nidana (A. Ni. 116/119).

Acharya Vagbhatt has mentioned a broad description of Aam which is produced by

malfunctioning -vitiation of Agni(A.H.Sut.13/25).There is description of Aamvisa

(A.S.Sut.11/19) and Aam Dosh (A.S.Sut.11/21) and further mentioned the treatment of

Aam(A.S.Sut.11/22) in Ashtanga Sangraha.

Vagbhatt has also described this term Aamvat in Ashtanga Hridya and Ashtanga

Sangraha too. It is mentioned in Shoth Chikitsa (A.H.Chi.17/14-16)14, Pandu roga

Chikitsa(A.H.Chi16/10-12)15and in Ashtanga Sangrah Pandu roga Chikitsa(A.S.Chi.18/6)16,

Swayathu Chikitsa (A.S.Chi.19/7)17 but the detailed description of the disease Aamvat is not

available in Ashtanga Hridya and Ashtanga Sangraha also.

Chakradatta was the first person to narrate the principal line of treatment and

effective remedies for Amavata. In later texts like Cikitsa Sara Sangraha (Vangasena)

Yogaratnakara, Bhavaprakasha and Bhaishajya Ratnavali we can find the description of the

disease with its line of treatment and some new formulations as decoctions, pills, powders,

etc.

In modern era, the term 'Rasavata' was given to Amavata by Acarya Gananathasena

(1943). The other clinicians like Prof. V. N. Upadhyaya have equated Amavata with

Rheumatoid Arthritis .

PREVIOUS RESEARCH WORKS DONE AT VARIOUS INSTITUTES OF AYURVDA RELATED WITH THIS THESIS TOPIC.

1. I.P.G.T. & R.A. GUJARAT AYURVEDA UNIVERSITY-JAMNAGARSr. No Year Scholar Topic

1.1962 V.P Sharma Amavata

2. 1969 G.M. Majithia Amavata

3.1986 V.D. shukla

Amavata adhyana evam Ayurvediya vishita chikitsa

ph.d Thesis (K.C.)

4. 1988 Darshana ShahJamangar mein Amavata Vyadhi ka nidana

chikitsatmaka sarvekshana (k.c.)

5. 1990 Jayadevan varierRole of Rasayan and Dhayamla pinda sweda in the

management of Amavata.(K.C.)

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Disease Review

6. 1993 T. popatThe role of virechan and Bhallatak yoga in the

management of Amvata(K.C.)

7. 1994 Sandhya vaghThe role of Rasayan, Bhallatak kshira and

Asvagandha in the management of Amavata (K.C.)

8. 1997 Vijay chaudharyAclinical study on the Role of Rasayan and virechan

in the management of Amavata (K.C.)

9. 2000 Gayatree GandhiA clinical study on the role of Bhallatakadi vati and

rasayan in the management of Amavata(K.C.)

10. 2001 Gaurav Sharma

A critical and comparative study of Ama and free

radical theory with special reference to Amavata.

(K.C.)

11. 2002 Prachi dalviRole of virechana ans Amlakaydi Rasayan in th4e

management of RA.(K.C.)

2. GOVT AKHANDANAND AYURVEDIC COLLEGE AHMEDABAD.Sr. No Year Scholar Topic

1. 1989 K.T. ChanchalaniA clinical study of vaitarana vasti and Rasayan yoga

in Amavata (K.C.)

2. 1993 Vandana DwivediAmavata Para Bhallataka Rasayan ek Adhyayan

(K.C.)

3. BANARAS HINDU UNIVERSITY – VARANASISr. No Year Scholar Topic

1. 1975 B.P. Mishara

An experimental and clinical study on Rheumatoid

Arthritis(Amavata) with special reference to its

diagnosis and treatment (K.C.)

2. 1980 L.c. Jaiswal

Clinical and experimental evaluation of different

parts of semicarpus anacardium (Bhallatak) in the

mangment of RA(Amavata) (K.C.)

3. 1980 A.K.Sharna

Clinical and biological studies on the role of Amrita

Bhallatak as a Niamittika Rasayan in Rheumotoid

Anthritis (Amavata) (K.C.)

4. 1990 Adarsh kumar Evaluation of Rosona compound in the treatment of

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Disease Review

Amavata and sandhivata(R.A & O.A.) (K.C.)

5. 1995 K.P. Reddy

A clinical and immunological study on the role of

langhana in the managemesnt of Amavata (R.A.)

and its treatment withBhallatak Rasayan (K.C.)

6. 1995 A.Chaturvedi

Effect of some indigenous druges on auto immune

disease w.s.r. to Amavata (R.A.)

4. NATIONAL INSTITUTE OF AYURVEDA – JAIPURSr. No Year Scholar Topic

1. 2002 Sunil BorkarClinical evaluation of Narsingh churna in the

management of Amavata (R.A.) (K.C)

2. 1986 J.sharmaAmavata ka nidanatmaka Adhyayan

(upashayanupashaya) (R.V.V.)

3. 2003 Meena Murarilal

Amavata ka nidana smaprapti evam upashayatmak

(Khand sunthyavaleha va Bhallatakadi chuorna

prayoga) Adhyayana (R.V.V)

5. GOVERNMENT AYURVEDIC COLLEGE, TRIVENDRUMSr. No Year Scholar Topic

1. 1986 K.M. Joshi Study on Amavata and its Management (K.C.)

2. 1987 C.R.GeethaStudy on the Role of Bhallatak (semicarpus

anacardium) in the treatment of RA (K.C.)

3. 1993 V.S. AmammaAnti Rheumatic effect of Bhallatak taila (semicarpus

anacardium oil) (K.C.)

6. R.K. TOSHARI BHAT AYURVEDIC COLLEGE, AKOLASr. No Year Scholar Topic

1. 1995 V.N.AdeStudies on Amavata and its management with

Bhallatak ksheera (K.C.)

2. 2003 Trupti LadhhaClinical trials of vaitarana Basti and pippali Rasayan

in Amavata (K.C.)

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Disease Review

7. GOPABANDHU AYURVEDA MAHAVIDYALAY, PURISr.No Yr. Scholar Topic

1. 1983 P.NandaRole of Panchakarma with Amrita Bhallatak upon

R.A. (K.C)

7. STATE AYURVEDIC COLLEGE , LUCKNOW (U.P.)Sr. No Year Scholar Topic

1.1978-

79B.D.Tewari

Effect of Sameerpannag Rasa on Aamvat with

special reference to R.A. (K.C)

2. 1990Avinash Chandra

Srivastava

Vyadhiyon kay sandarbha main Doshaj Prakrtiyon

ka mahatva “Aamvata” kay vishesha sandarbha

main(K.C)

3. 1990Suaman

Srivastava

Aamvat roga par Rasnadi guggul kay prabhav ka

deha prakrati anusar eka chikitsatmaka adhyana

(K.C)

4. 1992Padam singh

shisodia

To study the effect of an indigeous herbal

compound Aamvatari guggul on Aamvata(K.C)

5. 1994Rajesh Kumar

Mishra

Role of herbal compound in cases of Aamvata

special reference to R.A. (K.C)

6. 1999 P.C.ChaudharyClinical Study on the efficacy of Vaishvanar

churna in cases of Amavata (K.C)

7. 2001 Sucheta NaithaniRole of Punanavadi Churna in Aamvata with &

without Ruksha Sweda(K.C)

8. 2002 Purnima Devi A Clinical study on Aamvat(K.C)

9. 2003 M.P.PandayEvaluation of correlation between Vata Prakrati &

Aamvata(K.C)

10. 2003Satya Manav

Dayal

A Clinical study of an Ayurvedic regimen in cases

of Aamvat(K.C)

11. 2006 Ashok KumarRole of Aamvatari Rasa Nirgundi Kwatha with on

without Ruksha sweda in cases of Aamvata(K.C)

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Disease Review

THE DISEASE AMAVATA :Etymology:

The two words Ama and Vata form the word Amavata, which denotes the

involvement of these two factors in the manifestation of Amavata.

Nomenclature of the disease is very important for easy identification and

understanding, of a particular disease. It is done on the basis of vitiated doshas, manifested

symptoms, involved dushya, hetu and the basic pathological factor etc.(ex. Vata-rakta,

Raktapitta etc.)

So far as Amavata is concerned as the term itself denotes, it is formed by the union of

2 word Ama & vata which are the two predominant pathological factor acting in the disease

process. Acharya Madhava adds other dosha also.

Derivation of Amavata –

In different literature, following etymological derivations are found.

- “Amena sahito vatah amavatah”.

The vitiated vata dosha associated with Ama is termed as Amavata.

- “Aman cha vatam amavatam”

Association of Ama and vata collectively forms the term Amavata.

- Amo apakahetuh vata, ‘swanama khyata roga vishesha- (Shabda Kalpadrum)

The derivation gives us an insight into the pathogenesis of amavata. Indigestion

causes production of Ama which along with vata makes Amavata which is well

known by its name itself.

- “Rasen dushito vatah rasavatah” (Sidhant Nidan) .

- According to kaviraj Gananathasen, the derviation of the disease is-

vitation of vata apakwa anna rasa, termed as Rasavata.

- “Ajirnanaraso hyamah tena dushito vatah amavatah.” (Sidhant Nidan)

The improperly formed annarasa is Ama and it cause vitiation of vata which is known

as Amavata.

Definition :

Acharya Madhav was the first scholar to give the appropriate defination of Amavata.

Vitiated vata and Ama simultaneously enters in the kostha trika and sandhi pradesha leading

to gatra stabdhata and trika samdivendana.. This condition is known as Amavata.

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Disease Review

The term ‘yugapat’ means simultaneous vitiation of vata and kapha dosha, as main

pathogenic factor of the disease (B.P.Aamvat Rogadhikar/7-Pg.22)17a.

- According to ‘Atanka darpana’ commentary- Both vata & Ama are responsible

( simultaneouslly) for the patogenesis of the disease.

- Ama can taken as ‘vitiated kapha’ as per Chakrapani in Ch.Chi – 22/5.

- Lakshna and Chikitsa of Ama or vitiated kapha are alike, this can be interchanged.

Trika sandhi –

Variety of description is found regarding the word ‘trika’.

- According to Madhav.Nidan –it includes – kati, manya, amsa samdhi

- According to Dlalhana – (Su.Sha. 5/16) the word trika means –

1. sroni kanda bhaga (sacral region or sacrum)

2. Bahu greeva samghata sthala ( scapular joint, acronio – clavicular joint)

- According to ‘Aruna datta(A.H.Su-12/15) Trika means pristha dhara

- According to Hemadree it is pristhavamsadhara (ileosacral & lumboscral)

Finally the it can be concluded that the word ‘trika’ means sacral joint, Scapular

joint, Intervertebra joint, Ileo sacral joint, Cervical joint,

- All Shakhagata sandhi

It seem that trika means-

The sites where 3 bone unite or Sites of 3 joints all together or the sites seems triangular

shape

Nidana of Amavata :

The term 'Nidana' is related with both etiology as well as diagnosis of a disease. The

factors which are responsible for the weakening of Agni and aggravation of Vata are well

considered as the causes for the production of Amavata. The causation factors of Amavata

described by the classics is shown in the table below :

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Disease Review

Table No.1 –Showing varied aetiological factors responsible for the

production of Aamvata mentioned in Ayurvedic Litreture17B

No. Nidana H.S. M.Ni. B.P. Y.R.

1. Guru Ahara + - - -

2. Kandasaka Sevana + - - -

3. Viruddhahara - + + +

4. Viruddha Chesta - + + +

5. Mandagni + + + +

6. Avyayama - + + +

7. Snigdham Bhuktavatah Vyayamain

Kurvatah

- + + +

8. Vyavaya + - - -

Viruddhahara : Eighteen types of Viruddhahara have been described in Ch. Su. 26/86-87.

Indulgence in any of these Viruddhahara leads to formation of Ama or the Dosas and thus

initiates the pathology.

Viruddha Chesta :

Viruddha Chesta include wide variety of causative factors like sedentary habit,

exertion immediately after the intake of unctuous food (M. Ni. 25/1)17B, day sleep, awakening

at night, upholding the natural urges, excessive exercise, sexual intercourse after meals etc.

(Su.Sut. 46/507-508) which lead to the vitiation of Dosas and thus initiates the pathology.

Mandagni :

Mandagni is most important among the causative factors of Ama. This Ama is

supposed to act as antigen or foreign body inside the body and thus cause various diseases

(A. H. Ni. 12/1).

Snigdham Annam Bhuktavatah Vyayamam Kurvatah :

Physical exercise after taking unctuous food which is likely to disturb the Jatharagni

and will lead to the production of Ama.

CONCEPT OF AGNI:

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Disease Review

Nirukti-

The word ‘agni’ is a samskrit word which derived from – ‘Ang dhatu’/Gati parak

“Ag” dhatu which means – ‘widely spreading’

- ‘Angati vyapnoti iti agnih’ Agni is wide spread in all the substances. In vedic iterature

it has specific importance.

- According to yaska –

“Agni kasmat Agrani bhavati’” In each and every proceduce worship of Agni is

indicated first. It is applicable to both the spiritual and treatment aspect. So it is called

‘Agrani’.

- In Rigveda divinity of “Agni’ is praised and said to exists as’Antaryami” in water,

davagni’ in forest trees, ‘jatharogni’ in moving organism.

- The presence of ‘agni’ in human system responsible for digestion and mestabolism is

also mentioned in upnishad and Bhagvat geeta.(15/14)

- According to Shabdakalpdrum Agni is of three types

eg.1.Bhaumya2.Divya3.Audarya18.

- The creation and destruction of the universe, metabolism and catabolism in organism

all are regulated through Agni.

Important Synonym :

Oldest Veda Rigveda contain Agni as 1st Rich.19

(i) Vaiswanara –

‘Viswan naran nayati, viswe enam nara nayanti va’ (Nirukta, Daivata 7/6)

“Viswesam naranam kukshisthotwat” (Taranatha Bhattacharya)

It means Agni exists in all human being, resides in the kostha of all organisms.

(ii) Sarvapaka-

It digests all the macro and micro-particles

(iii) Tanoonpata – (Tanoon apata)

As long as it exists in the body. Positive health is maintained and one can not

dead.

Agni in Ayurveda:

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Disease Review

Concept of Agni is the soul of Indian medicine and considered the whole chikitsa is

nothing but correction of “Antaragni”.

The term “kaya” comprehends the entire process of metabolism. The term

“kayachikitsa” will therefore refer to the treatment of disease, originated from impaired

metabolism that is to say – the concept of kaya chikitsa rests on the concept of ‘antaragni’.

Agni in Ayurveda concerned with Kayagni / pachakagni / kosthagni / Audaryagni only.

Agni in common language means fire. The living organism maintains its integrity and

performs its vital avctivities by converting the pakadi karma or bio-physical and bio-

chemical process through Agni.

- Agni is usually employed to cook our food and render it fit for digestion. In our

chemical laboratories we employ, the agency of heat to decompose, diaintigrate, sparate,

fit for digestion, which is possible only by ‘kayagni’.

- Being the biological fire that governs metabolism. Agni acompasses all the changes

include thedigestion and absorption of food, cellular transformation, assimilation of

sensory perception, mental and emotional experiences.

Agni is therefore cover whole sequence of chemical interaction and changes in

the body and mind as Digestive abilities are related to the strength of Agni.

Agni & Ushma:

Ushna is different from agni and pitta, ushma is producesd from agni dravya,

spreading in nature, resides in the body and can converted into energy. “Agni mulam

balam pansam”.

The up and down of body temperature (ushma) denote Agni vikruti (A.S.Su-4)

Agni Types :

Agni is wide spread and is splitted to various type in various substance. In

“Darshana” it is descsribed as 4 types. Mainly-

The main 4 different types –

1. Divyagni –Resides in graha, Nakshatra (‘x’-ray, u.v.-ray can compared)

2. Bhaumagni-common fire resides in earth

3. Akaraja Agni – Resides in Bhu-garbha and in various metals like gold etc.

4. Audaryagni – Resides in udara/jathara which is the subject of Ayurveda.

Types of Agni :

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Disease Review

According to Ayurveda, there are 13 types of agni in the body and mind according to

the conversion and the transformation made. The most important of them is jatharagni – .

1. Jatharagni -1

2. Bhatagni -5

3. Dhatwagni – 7

4. Asamakya Agni

JATHRAGNI :

In Ayurveda which deals with the knowledge of science of Ayu or life, Agni is

understood as antaragni does not indicate only Agni, but any agni in the body which has the

function of dahana, paka etc.

Charak has clearly stated that the Agni or pitta that digests the ingested food is

superior to other Agni and also controls them(Ch.Chi15/39)20.

Vagbhatta relates the pachakgni with Dhatwagni carrying a direct suggestion that the

pachakagni contributes its Amsa to the dhatu. (A.H.Su.11/34)

Site of Jatharagni.

- In between pakwashaya and Amashay, ½ Amgula left to Nabhi.

- According to Dhanwantari – it is pitta dhara kala, Relates to the organ. (Grahani)

Function

It is already stated that the Agni which does the function of paka, dahana etc. implicit

in the pitta in the body.

Pitta located in between pakwashaya & Amashaya is panchabhautik, tiktadrava in

nature which performs the action similar to Agni due to its ‘Tejo’ component.

- It digests the food and separates the sara & kitta. (nutrient fraction and residue) in

addition while being located in its own place it contribute or gives bala to the functions of

other pitta elsewhere in the body.

The kayagni is mainly concerned with chemical process involved in gastro-intestinal

digestion.

It has 2 aspects –

(1) General – Directly concerned with the digestion.

(2) Special – Hormonal mechanisms located in the duodenal mucosa responsible for

exciting the secretion of digestive juice, pancreatic juice etc.

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Disease Review

Amount of Jathragni :

In Bhela samitha the amount of jatharagni is also described.

In sthula kaya – yava matra pramana

In hraswa kaya – truti matra pramana

In krimi, keeta, patanga- vayu matra pramana.

Functional Stage of Jatharagni :

Different functional states of jatharagni are produced due to vitiation of doshas. there

are-

(i) mandagni – in fluence of kapha

(ii) teekshagni – in fluence, predominantly pitta

(iii) vishamagni – influence, predominantly of vata

(iv) samagni – influence of normally equilibrated doshas.

Mandagni - Due to dominace of kapha, the action of jatharagni is inhibited which

ultimately produce Ama, which is the main cause of almost all the disease.

In mandagni state, it takes a very long period for the digestion of food though

taken in a proper quantity. (A.H.Sh.-3/73,76). It produce Adhmana, Antra kujana, atopa,

gaurav etc.

Teekshnagni - This state is predominant by pitta, leads to symptoms like, Talu sosha,

Daha etc. This person easily digests even very heavy meal in a very short time period,

irrespective of its pathyapathya, environment. It causes voracious hunger (Bhasmaka)

Acoording to Bhela, repeated hungereness is repeated there,but there is no body

nourishment as per repeated food intake.

Vishamagni - There is irregular action of agni due to the influence of vata. In this state of

jatharagni. Sometime the ingested diet is digested and sometime not. Sometime there is not

any harmful condition even after intake of apathya, and sometime there is indigestion and

abdominal pain taking least apathya.

The above condition also termed as ‘Grahani’ dosha according to Bhela.

Samagni - The state of jatharagni which ensures the complete digestion of proper quantity

food at a propser interval is called samagni.

In this state tridoshas are in equidibrium state of functioning. It is an ideal state

because it does not produce any disease.

These 4 states of jatharagni is divided on the basis of its bala (Ch. Chi.6)

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Disease Review

The seat of pachakagni relates to the organ ‘Grahani’ responsible for holding the food

in the Amashaya for the duration of its digestion.

The references from Ayurvedic classics when examined in the light of later

developments in the medical science-shows.

- A local or regional influence exercised by some chemical factor, or complex of such

factors, which may be mainly responsible for making available to the intestine,

powerful digestive juces necessary for ensuring proper digestion of food.

- The several internal secretion elaborated by the duodenal mucosal glands, such as the

secretin, pancreoxymin, cholecystokinin, urogastrone and enterogasterone represent a

few important chemical agencies, some of which excite the secretion of the pancreatic

juice and the discharge of bile from the gall bladder. There may be many more of

such factors.

BHUTAGNI:

The physical matter in the universe is formed by the combination of the 5 bhutas.

Therefore the human body also is the product of the combination of the five Bhutas, and

substance present in the body also is panchabhautik. What ever thing is available and is

used in therapy is created from pancha Bhutas. (A.S.Su)

Prameyas are generally divided into 2-

(i) Dravya para- Rasa, Guna, Veerya etc.

(ii) Shareera para – Dosha, Dhatu & Mala

Bhautik samanya is common for both of them. (Dravya & Sharir).

The food consists of 5 mahabhuta is digested in turn by the 5 Bhutagni and each of

its principles process to its own analogus in the human body (Su.Sut)

The digestion of food by Jatharagni leads to the break down of food into 5

distinct – physio-chemical group- parthiva, Apya,Agneya, vayaviya & nabhasa. Thus the

food substances are fit for being assimilated into and built up as part of the corresponding

Bhuta. This ‘Bhutagni vyapara’ also found in Dhatu. (Ch.Chi.15/13)

These 5 types are –

(i) parthivagni

(ii) Apyagni

(iii) Tejasagni

(iv) vayvagni

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Disease Review

(v) Nabhasagni

The final product of ‘Jatharagni paka” suitable processed by ‘Bhutagni paka” and are

fit to be acted upon by the specific Agni present in each Dhatu. In the course of Bhutagni

paka, the agni present in the molecule of each group (parthivagni in parthiva group,

Apyagni in Apya group etc.) is state to digest the entire molecule loading to a complete

change in its qualities.(vilakshana guna-chakrapani ).

The Bhutagni paka is suggestive of a kind of autodigestion compare to anaerobic

reaction. In modern physiology and Bio-chemistry the main purpose of digestion of food in

the elementary canal is to break down the ingested carbohydrate, protein and fats which are

entirely foreign to the body (vijatiya) fit for being converted into and utilised by the body

(sajatiya)

It takes place in liver as the liver concerned with carbohydrate, lipid and protein

metabodism and it gives additional support to post digestive functions and metabolic

events.

According to Ayurveda the guna present in Ahara dravya are activated by Jatharagni

paka and actualized by Bhutagni paka in the final stage of digestive process in ‘Adho-

amashaya’ before they are utilized by ‘Dhatupaka’.

The process of Bhutagni paka is not limited to Liver or Adhoamashaya but it extends

upto dhatu level also, as per chakrapani. The role of Bhutagni comes at the time absorption

of sara bhaga, the main site is yakrit and pitta dhara kala’. Again it comes to action when

the portion of rasa reaches to each dhatu level separately.

DHATWAGNI

The term Dhatvagni refers to Agni situated in Dhatu. It is 7 in No.

(i) Rasa Dhatwagni

(ii) Rakta Dhatvagni

(iii) Mamsagni

(iv) Medagni

(v) Asthyagni

(vi) Mjjagni

(vii) Sukragni

The nutrients that supports the body are subjected to paka again being acted upon by 7

Dhatwagni, leading to the formation of sara and kitta. (Cha.Chi 15/5)

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Disease Review

The nutrient which naurishes sthe dhatu undergoes paka by the ushma (Agni) of the

Agni and then they are made available to the dhatu through their respective srotamsi..

(Ch.Chi 8/39).

According to Arunadatta - at the time of assimilation of annarasa by Dhatu, the

amsa of Bhutagni converts into Dhatwagni.

The presence of a portion of kayagni in Dhatu determines their vriddhi & Kshaya.

(A.H.Su).

Dhatwagni paka has a parallel in the intermediary metabodism described by moren

physiology and bio-chemistry. Changes which may takes place between the moment of

entry of nutrients to the organism and the moment of discharge of ultimate chemical

product to the environment.

The description of Dhatwagni would appear to be a broad based generalistion of total

bio-chemical reaction and each species of Dhatvagni Should therefore include many group

of reaction of specific enzymes.

The nutrient substance as processed by Bhutagni are taken-up for further metabolic

reaction by 7 Dhatwagni. The end product of Bhutagnipaka is known as “poshaka dravya”.

Dhatwagni paka is stated metabolise the product of Bhutagni paka with the specific Agni

corresponding to each Dhatu.

It is 2 type-

(i) Prasada paka – The end product of prasada paka are utilized for nourishment of

sthayee Dhatu and upadhatu.

(ii) Kitta paka – formation of excreted material i.e mala, sweda, pitta etc.

IMPORTANCE OF AGNI IN HUMAN BODY-

1. To maintain the health it is important to keep the balanced state of Dosha, Dhatu and

Agni.

The balanced state of dosha depends on Agni. Dosha sama and prokopa is

dependent upon Agni. So samagni state should be maintained by nidana parivarjana.

(the cause which vitate Agni) (Cha.Chi – 5/136)

2. The digestion, absorption, sarakitta bibhajana, dhatu poshana etc. all are carried out

by Agni, vata & srotas. Among these Agni is most important . (Su.Sut. 35/27)

In addition while being located in its own place it contributes to and augments the

functions of other pitta elsewhere in the bnody.

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Disease Review

3. Chikitsa is nothing but the Chikitsa of Antargni

4. It is the Agni in the body, that, the diets are helpful or responsible for the

Production of oja, bala, varna etc, because- from Apakwa. ‘Ahara rasa’ Rasadi

dhatu can not formed. (A.H.Sut.3/54)

5. Jatharagni is the main source of other Agni like Dhatwagni and Bhutagni. If Agni will

destroy, the purusha will dead. Vitiation of Agni leads to disease and samagni state

leads to health condition. The root cause of bala, varna, utsaha, prabha. etc is due to

Agni. (Ch.Chi-15/3)

6. Dhatwagnimandya is aresult of Jatharagni mandya, by which Ama is produced in the

mahasrotas and dhatwashaya. Inspite of Annarasa pusti and Dhatu dusti, mala dusti

occurs. Tridosha are also include in this mala.

Vata dusti occurs by Jatharagnimandya

Pitta dusti occurs by Raktagnimandya

Kapha dusti occurs by Rasagnimandya

Doshaprakopa occurs by durvala Agni and is responsible for all diseases.

Dhaurvalya Jatharagni is not able to digest and separate even the wholesome diet

properly as a result of which the shareera dhatu, Updhatu, dosha, mala etc. don’t get

‘poshaka tatwa’ thus becomes weak.

1. Agni is also part of the immune system since its heat destroys harmful organism and

toxins. The activities of Agni varies throughout the day and maintaining the strength

and natural ebb and flow of our digestive fire is needed for good digestion, good

immune function and resistance to disease. It is needed to form oja.

CONCEPT OF AMA:Derivation of The Word Ama – (Nirukti)

The word ‘Ama’ is derived form the root.

- Am Roga dhatu + Aa + Dhang Pratyaya (A.K). Here the presiding vowel is elongated

and the word ‘AMA” is formed.

- According to Hemachandra - Gatyartha Am dhatu + Nich pratyaya = Ama (A.K)

Ama by Utapatti :

“Amyatae Gamyate pakadartham iti Amah” (A.K )

The substance which is not digested properly and needs further digestion is called Ama.

- “Amayate pidyate srotasamauha aneneti Amah” (A.K.)

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Disease Review

Substance which is detrimental to srotas is termend as Ama.

It produce pain or create pressure on Srotamukha and accumulate in Srotamukha.

- “A isat amyate pachyate iti Amah” (S.K.D.) “paka rahita kancha is bhasa”

Incompletely digested or unprocessed matter is Ama.

In Ayurveda the term “Ama” means – substance which is supposed to under go

digestion ( Amyate……iti amah)

- The term “Ama” is a synonym of vyadhi found in Charka Nidana sthana.

“Tatra vyadhiramayo gada ……ityanathantaram” (Ch.Ni – 1)

- “Prayena Ama samuthena Amaya ityuchyate” (Chakrapani)

- According to Aruna datta – “kilama samutthah sarve vyadhayah”

The most part of the disease are ingendered by Ama.

- AA – As a prefix to verb & noun. It means near, near to.

- MA – poison

Ama denotes a substance, or a group of substance which is near to poison or act like poison.

Defenition of Ama :

The term ‘Ama ordinarily means, unripe, uncooked, immature undigested substance. It is

produced from the impaired function of the kayangni. It is a toxic substance of gastroenteric

origin.

Different definitions of Ama have been quoted in the Ayurvedic texts. Some of which

are as follows.

Due to hypofunctioning of Ushma (Agni) the first Dhatu _ ‘Rasa” or chyle is not properly

digested, instead the Anna rasa undergoes fermentation or putrefaction (Dusta) being

retained in the Amashaya. This Rasa is called as Ama. (A.H. Su.13/25) 21

Aamvisa or toxic product it act immediately and the disease produced by this Aamdosha is

incurable.(Ch.Vi.2/12)22.

Ushmane :

Aruna datta – “Agneh Alpabalatwena daurvalyena”

Hemadree – Rasagni “Ushmano Rasagneh dhatum na dosham malam Va”

Dalhana - Dhatwagni, Dhatwagnibhih apakat Ama ityuchyate ( Su.Sut. 15/38)23.

Adhya dhatu :

Aruna datta – Adya prathamam dhatu rasam rasaravyam apachitam amam prachakshate.

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Disease Review

Hemadree – Rasa which is not capable of executing its function and also not capable of

transforming into Rakta.

Chandra nadana & sridas Pandit – Ahara rasa (usually it will not beyond Rasa dhatu)

Dusta Amashaya :

1. Hemadree – “Amasayo yatra Ama Anna tisthati” The name of this ‘Ashaya ‘ itself

suggests that the digestion of food is not completed here.

1. According to Bhava prakasha & Vijaya rakshit - The food residue which is not

digested due to hypofunctioning of Agni is known as Ama and it is the root cause of all the

disease. A residue of ahara rasa is still left behind undigested towards the end of digestion.

2. Ahara rasa which is not digested due to hypofunctioning of Agni is Ama and root

cause, provocation of all the disease . (M.Ni)24.

3. According to Vijay Rakshit in M.N. Amavata chapter – the term “Anna rasa iti

Ama”. If Annarasa is not properly digested and formed then the outcome of such a

digestion is known as Ama .

4. The first phase of dosha dusti is Ama. (Vijay Rakshit). It means the 1st stage of the

disease is Ama stage(M.Ni) 24.

5. The food which is not properly digested is Ama. Yet others describes – the

accumulation of Mala in the body as Ama . The Mala here denotes the by – products of

metabolism, not properly eliminated or utilized in the body.

6. According to Harita – due to ajirna. the stored rasa dhatu (retained) infected and

termed as Ama.

7. Vagbhata describes that when the food digested properly, it is good for the body like

‘Amrita’ and keeps a man healthy while if it is not digested properly and remains as

Apakwa, it is harmful for the body as the ‘visha’.

8. Acharya Charka has also described the poisonous stage of Ama while describing the

samprapti process of ‘Grahani roga’ when the taken food is not being digested properly and

remains in the stomach, then it is bound to get fermented and latter on it becomes as

harmful as visha for the living body.

9. Ama visha – The impaired vatadi dosha being mixed up with one another leads to

the formation of Ama dosha very much like the yeilding of visha ( toxic substance) by

the spoilt kodrava.

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Disease Review

The obvious implication of these sloka appears to be that, in the absence or due to

inhibition of kayagni, the food ingested is not properly digested and the product which arise

out of such and impaired digestion, i.e. the chyme or chyle being retained in the Amashaya,

undergoes such changes as yield toxic substance. This state is spoken of as Ama.

Describing Amavisha as a serious toxic condition comparable only to acute stage of

poisoning. Vagbhata observes – in a person who consumes mutually incompatible articles

articles of dietary or ingest heavy food, arises Ama dosha, a condition which exhibits a

symtomatology comparable to that of visha and hence is harmful.

Amavisha which is intensely toxic, may endenger life, as the line of treatment of Ama

dosha and visha are the opposite kind, the former, has to be treated as one of fatal

prognosis. (A.H.Su. 8/13,14).

Again vagbhata describes ‘kaphajirna’ due to the excitation of kapha as Amadosha’.

So in short it can be said : The deficient function of Agni produces Ama which comprises

a group of toxic substances and not capable of nourishing the body, but vitiated the doshas

and cause diseases.

Many other meanings related to Ama are available in various Ayurvedic texts as

Ama - Incompletely developed Garbha ( Cha. Sh. 8/27)

Ama - Unprocessed sneha (Ch.Si -4/48)

Amavastha - First stage of vrana shotha (M.N.-41)

Sama, Nirama purisha (Ch.Chi -15)

Amavastha as roga vishesa (M.N. 25)

Properties Of Ama.

The indigested Anna rasa possessing foul- odour & exessive pastiness deprives the body of

its nutrition and in consequence causes ‘sadana’ (M.N -25)

1. Avipakwam – the term refers to the avipaka or indigestion due to hypofunctioning of

Jatharagni, Bhutagni & Dhatwagni. The individual poshakamsa of Rasa dhatu nourishes its

particular Dhatu. Disorder rises in poshakamsa leads to metabolic disturbance that mean

“Apakva Amarupa dhatuvriddhi” occurs. So Apakva guna is always found to be in the Ama

due to huypofunctioning of Agni, Ama wherever it may be it must be understood as

Apakava substance.

2. Asamyuktam – the term refers to the incompactness. Since it is undigested, it

remains in an inassimilable state, to the body substances.

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Disease Review

3. Durgandham, Bahupicchilam - Any apakva substance after sometime get putrified

and some foul smell is being produced in it with a characteristic extreme pastiness. The

action of coating or plastering of srotas is possible by ‘picchila guna’ of Ama.

Retarded or sluggish gastro intestinal motility and other thing leads to the fermentation,

shuktata or shuktapaka. The production of foul odour and extreme pastiness to the

putrefaction of the protein components.

4 Sadanam – “Swakarya akshamatwan iti” (Himadree)

“Amganam kriyasu asamarthya iti” (Arun datta).

Disability to do any function by bodily part is sadana. The Ama dosha, Dhatu & Mala

are being formed by the Ama produces obstruction in the natural function of the body and

then Amgasada is found.

5. Tantumatwa – Ama being an intermediary substance with viscos and spindle

property not completely expelled out from the body.

6 Snigdhata – Ama is a substance of kapha group and due to this property it adhers to

the bodily element.

7. Guruta – Every dravya depends on Agni to become laguhu. So apakwa dravya

remains guru than pakwa dravya as in case of Ama. Guruta in Ama is due to dominancy of

Jala and prithwi Mahabhuta.

8. Aneka varna yukta – Commentator Gangadhar defines combination of various

Amsas of pancha mahabhuta are the cause of different colours such as lohita, shukla,

krishna, etc. The improper digested Panchabhautika Ahradravya produces Ama of various

colour.

9. Asukari – “Asurasukaro dehe dhavatyambhasi tailavat” (B.P.)

It is the property of Amavisa which quickly spreads in the body.

10. Shulanubandha – “vatat rute nasti Ruja” (Su.Sut. 17/8). There is no pain without the

intervention of the deranged vayu. Due to srotarodha by Ama, the proper function of vata

get hampered and causes shula.

10. Visha rupata – Amadosha displays a symptomatalogy comparable to visha. Visha is

capable of producing many diseases, likewise Ama also produces serious diseases.

1. Sarvaroga hetutwa – “Ama hi sarva roganam hetu”. (Ayurveda sutra)

Ama being mixed with Dosha, Dhatu & Mala, produces all types of disease. So in

Ayurvedic texts the word ‘Amaya’ is used for disease or vyadhi.

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Disease Review

Pathogenesis of Ama & Definition of Sama :

As regarding Sama, Vagbhata describes it as a condition in which the tridosha & sapta

dhatus as well as Malas become permeated with the Ama produced in Amashaya. Diseases

which arise in consequence are also spoken of as Sama types of diseases. (A.H.Su. 8/11).

Doshas and Dushyas which get mixed with Ama is termed as same. It is being able to

vitiate Doshas, Dushyas, Malas and reponsible for disease production. Ama spread over

along with vitiated dosha by there marga and produces many disease. Sama dosha spreads

to all roga marga. It can goes to shakha from koshtha and vice-versa there by producing all

type of disease.

Ama circulate along with Rasa dhatu and accumulate in place where it get obstructed

and becomes the site of origin of the disease.

- Sama dosha or Dushya are passing through the one srotas to another srotas and it

gives rise to a disease at the place where it get obstructed.

- Ama also becomes a nidanarthakara factor to produce ‘khavaigunya’ in any of the

srotas and makes the seat for “Sthana samashraya” of provoked dosha and they get

conjugated at this place i.e. Doshadusya samurcchana takes place.

- All the disease which are described under the heading of “prodoshaja vikara” is Ama

prodoshaja vikara.

Disease Production By Ama :

Agni dusti (kayagni, Bhutagni, Dhatwagni)¯

Ama (Mixed with Dosha, Dushya and Mala)¯

(Circulate in all srotas and kha-vaigunya at particular site)¯ (samavastha)vyadhi (sakhagata, kosthagata, marmasthi sandhi gata)

According to some author :

The impaired vatadi dosha being mixed up with one another lead to the formation of Ama

very much like the yielding of visha by the sploit kodrava. It means due to inhibition or

absence of kayagni the food ingested is not properly digested and the product with arise out

of such an impaired digestion being retained in the Amashaya undergoes such changes as

yield toxic substances. (A.H.Sut.13/26)

Symptoms of Ama :

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Disease Review

To have a clear understanding of the mode of pathological state of Ama in the body, the

characteristic of doshas in Samavastha & Niramavastha should well known. Samadosha

and their symptoms are stated by samavastha. Symptoms of Ama are tabulated according to

different authors are :-

Table No.2- Showing Symptoms of Ama according to different Ayurvedic Acharyas:

Symptoms A.H. Su/13 A.H.Su 13/23-29 Y.Satak

Srotarodha + - -

Balabhramsa + - -

Gaurava + + -

Anila mudhata + - -

Alasya + - +

Apakti + - -

Nisthiva + - -

Mala samga + - -

Aruchi + + +

Klama + - -

Praseka - + +

Vistambha - + -

Arti - + -

Bidaha - + -

Tandra - - +

Hridayavisuddhi - - +

Garu udara - - +

Suptata - - +

Table No.3- Showing Charactaristics of Sama, Nirama dosha Dosha Samavastha Nirmavastha

Vata

Agnisada, vivandha, sthambha, Antra

kujana, vedana, sopha, toda, Amga pida,

snehadai vriddhi, meghodaye vriddhi, nisi

vriddhi (A.H)

- Sarti, Adhmana, Asamchara (A.S)

Vishada, ruksha, nirvivandha, alpa

vedana, shamana in snidgdha

upachara (A.H)

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Disease Review

Pitta

Durgandha, Harita syava varna, Ghana,

guru, amla, kantha hrit daha krit, (A.H)

- Durgandha, Asita, Bahala (A.S)

Atamra Varna, peeta varna,

Atyushna,vivandhi, katurasa,

asthira, vigandhi, pakwa, balakari,

ruchi (A.H)

Kapha

Avila, Tantula, Tstyana, Durgandi, stick

to kantha, kshut udgar bigha takrit (A.H)

pralepi, picchila

Phenila, pindita, pandu,

Agandhita, vaktra sodhaka Nisara,

chhedi (A.H) visada, dhavala,

Madhura rasa (A.S)

The Ama and sama states are the index of the inability of the organism to achieve a new

steady state equilibrium. Hence in planning the line of treatment and therapies, it is essential

to ascertain and determine the samata or niramata as on this will depend a decision, if

sodhana or shamana methods of treatment are to be adopted in any given condition.

Nidan of Ama :

The main factor concerned in the production of Ama is Mandagni. It is in this state that the

food ingested produce Ama.

The nidana concerning Ama formation may be divided into 4 parts :

1. Aharaja ( Dietic indiscretion)

(i) According to guna

(ii) According to kala, Matra

(iii) Asamyak yoga of Ahara parinamakarabhavas

2. Viharaja ( unwholesome habits)

3. Mannasika (psychological factors)

4. Others.

Aharaja (Ch.Chi 15-43)

- Abhojana - Dagdha & Ama ahara sevana

- Adhyasana - Asuchi, Asatmya sevana

- Viruddha bhojan - Sushka, Ruksha Ahara

- Ati seeta bhojan - Atyambhupluta ahara (for long duration)

- Bistambhi Ahara sevana

According to guna – guru, seeta, bistambhi, suska, vidahi, ruksha, picchiha guna causes

Ama formation.

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Disease Review

According to kala, matra – A person should eat when the previous meal is digested,

because if one eats during indigestion, the eaten food mix, with the product of earlier meal

and vitiates all the food quickly. Therefore Ajirna Bhojana, adhayshana, Vishamashana etc.

produces Ama vikara.

Again one should take food in proper quantity, because it depends on Agnivala. (Ch.Sut.

5/8) – “Aharamatra punargnibalapekshini”

Asamyak yoga of Ahara parinamakara bhava :

Ahara Parinamakara bhavas take active role on the food digestion process. Like – ushna

digests, vayu, absorbs, kleda produces looseness, sneha generate softness, kala brings it to

complete transformation and Samayoga means the use and need of the Asta aharavidhi, rutu

desa etc. Samyoga is interpreted as balanced use of 8 factors regarding diet. (Ch.Sh. 6/14, 15)

Imbalanced state of Ahara parinama karabhava causes Agni vikruti which is the main

causeof Amotpatti.

Vihara :

(i) RatriJagrana - It creates provocation of vata and kapha which produce Agni dusti and

ultemately Amotpatti

(ii) vega dharana

(iii) diva swapna

(iv) uncomfort bed (Dukha sayya)

Manasika : (Ch.Vi. 2/9) , ( Bhel.S. 10/1.2) (A.H. Su 8/33)

- Chinta , Shoka, bhaya, Krodha, Uptapa mana (Ch.Vi)

- Irsya, Lobha, Udvega, Hri, Kama (Bhel. S.)

Others – (Ch.Chi.15/43)

(i) Mal effect of virechana, vamana & snehana.

(ii) wasting of the tissue which follows in the wake of disease ( vyadhi karshana )

(iii) Allergic states engendered by faults or change in place, climate, season. (deshakalarttu

vaishamya)

Dietic indiscretion and emotional stresses may, between them, impair the effective

functioning of the neuro – humoral mechanisms responsible for ensuring proper secretion of

the digestive juices, the disturbance of the PH in the gastro – intestinal environment and more

often sluggish and sometime hypermotility of the stomach and intestine, leads to formation of

Ama.

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Disease Review

Following conditions are necessary for the causation of Ama, sama and Amavisha.

- Dosha vaishamya – corresponding to the neuro humoral, metabolic and cytoplasmic

events leading to –

- Mandgni or hypo functioning of – The mechanism responsible for the secretion of

the digestive juice resulting in-

- The lack of required quality and quantity of the digestive juice.

- Hyper or hypomotility of the stomach and intestine -

In Hypomotility - Retard movement of food in the GIT resulting in the fermentation

and putrefaction obviously due to the activity of some the sahaja krimi. ( intestinal flora)

In Hypermotility – the harried or accelerated emptying of the partly or incompletely

digested food.

In either case leading to mal ( impaired nutritional or metabolic state resulting in mal

– nutritional syndrome low-toxic states & lowered resistance constituting the condition

known as sama.

Classification of Formation of Ama :

From previous discussion it is clear that mandagni at different level is the main causative

factor responsible in the production of Ama. On the basis of above definition, Ama can be

classified as follows,

1. Ama produced by Agimanadya.

(i) Ama produced by jatharagnimandya

(ii) Ama produced by Bhutagnimandya

(iii) Mala samchaya rupa Ama.

2. Ama produced independent of Agni –

(i) Ama produced as the first stage of doshik vitiation

(ii) Ama produced by ingestion of poison or other external factors.

(i) Ama produced by Jatharagnimandya –

Normally Jathargagni digests the food in the Amashaya and pachyamanashaya, and

leads to separation of sarabhaga from kitta bhaga. Due to hypofunction of Jatharagni , more

Mala is formed in compare to sara. The Ama thus formed is the main cause of Acute disorder

of the alimentary system like Jwara, Atisara, pravahika.

The Ama formed by Jatharagnimandya is as follows.

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Disease Review

(a) Apakwa Annarupa Ama

(b) Apakwa Ahara rasa

(a) Apakwa Anna rupa Ama – The deranged Agni becomes unable to digest even the light

food and thus the undigested Anna retained in the Amashaya undergoes process of

formentation and putrefaction assuming the form of visha. (Ch.Chi 15/45)

The disease produces

- If the Amadosha comes out through upper passage it is called ‘cchardi’.

- If it comes through lower passage it is called ‘Atisara.”

- If it comes out by both passage in the acute form it is called ‘visuchika’.

- When Apakwa Anna neither expel out by mouth or by Guda it produced a condition

called ‘Alasaka’

- Grahani is the seat of Agni. But due to hypofunction of Agni when it releases the

ingested material either in ripe or unripe condition, it is known as the disorder of

‘Grahani.’

(b) Apakwa Ahara rasa Ama – second type of Ama is Apakwa ahara rasa which is

manifested as “Rasashesajirna”, the condition, in which the Apakwa food stuff is restored

in the Amashaya to be converted into pakwahara rasa.

In modern science we can compare this’Jatharagnimandya’ with the

hypofunctioning of the neuro-humoral mechanisms responsible for the secretion of

digestive juice and regulation of general metabolism.

(ii) Ama produced by Bhutagnimandya –

Since pachakagni is the basic factor, and Dhatwagni, Bhutagni are dependingon

pachakagni, the pachakagni may produce Dhatwagnimandya or Bhutagnimandya.

Tow types of Ama can be considered at the level of Bhutagni.

(a) At first level this results, either if that particular food particle is improperly processed, i.e.

deficient in its own Bhutagni – for ex – improperly cooked food like Mandaka, Kurchika

will leads to Ama production being deficient in their own Agni.

(b) If further not digested well by sharirantargata Bhutagni will lead to formation of Ama of

that Mahabhautikamsa at the Bhutagni level.

Now if this undigested Mahabhautikamsa of Ahara reach to Dhatwagni consequently

results Dhatwagnimandya.

(iii) Ama produced by Dhatwagnimandya –

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Disease Review

Here, at the level of Dhatwagni two types of Ama can be considered, depending upon

their process of formation –

(a) Dhataugata Ama

(b) Dhawgnimandya janita Ama

(a) Dhatugata Ama – If improperly digested Bhautikamsa produced at the level of

Bhutagni mandya, enter into respective Dhatus which are comprised of those

Mahabhuta are called as Dhatugat Ama.

For ex- improperly digested Bhautikmsa enters into respective dhatus it produced

‘Dhatu pradoshaja vikara’.

It is also called ‘sama dhatu’ because when this Ama will vitate the dosha and Dhatu,

they are termed as ‘sama dosha’ and ‘sama Dhatu’ respectively. (A.H.Su 8/11)

In Dhatugata Ama, Dhatu may not be increased in their quantity as the Ama visha

which combined with particular Dhatu will hamper the normal function of that

Dhatwagni.

Very often it may also be found that the Dhatugata Ama may converted into the

Dhatwagnimandyajanya Ama. (Ch.Chi 15/49)

(b) Dhatwagnimandya janita Ama –

If jatharagni and bhutagni are not capable of digesting the anna Ahara rasa respectively,

the Dhatwagni also may not become efficient to digest that Apakwa Ahara rasa or

Apakwa Bhautikamsa which have reached at their Dhatwagni level and ultimately the

result is production of Ama.

Dalhana and Chakrapani in their commentaries of Sushruta have stated that the

formation of Ama need not necessarily be due to Jatharagni mandya only and it may be

also occur due to the impairment of Dhatwagni paka also.

According to charkrapani and Vachaspati in A.D., the term Dhatu used in this context

is for Asthayi Dhatu and Agni is for Dhatwagni.

Impaired functioning of Dhatwagni causes incompletely or intermediatory formed of

Dhatu thus it can increased in quantity (Apakwa Amarupa dhatu) which is termed as

Dhatwagnimandya janita Ama – ex – cholesterol.

Dhatugata Ama requires to improve that power of Jatharagni through Deepana, pachana

process, while Dhatwagnimandya janita Ama requires to improve the power of

Dhatwagni through only pachana therapy.

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Disease Review

(iv) Mala sanchaya rupa Ama –

Mala by definition encompasses a variety of substances produced in both normal and

abnormal functioning of the body. Those which are Abadhakara and upaghatakara for the

body are called as Malas.

Chakrapani has mentioned that samadhatu are also named as Mala. Sharira dhatu

which traverse in wrong channels and the Apakwa dhatu which may cause disease

condition are taken as Mala. (Chakrapani)

As a result of Jatharagnipaka and Dhatwagnipaka various Malas are produced like

Mala, Mutra, Nakha, Kesha etc. and these Malas require to be eliminated form the body

otherwise accumulation occurs which can produce various functional and organic disease

by the derangement in different systems of the body. For ex-mala sanchaya rupa Ama is

seen in purva rupa of prameha such as – kesha nakhati vriddhi……etc. (Ch.Chi 6/13)

Rasadhatwagnimandya brings about over production of kapha which creates

srotarodha and produces kasa etc.

So in short apart form the definition of Mala, the originator and fundamental

substance of the body like Dosha, Dhatu, Mala are also considered as Malas when they

are vitiated by any causative factor. ( Ch.Sh.6/17)

The term ‘Mala Samchaya’ used to designate Ama & sama. It has two meaning –

Metabolic waste product and Malas not properly eliminated or utilized in the body

economy. This state of formation of Ama also caused by Agnimandya.

So the first category of Ama formation produced by a long term process which

includes Samchaya, Prakopa, Prasara of Doshas in the body due to intake of different

Dosha prakopaka nidana.

2. Ama Produced Irrespective of Agni :

Second category of Ama is independent of Agni though here the rode of Agni is not

totally absent but its working is insidious. These are –

(i) Ama, the first stage of Doshik vitiation –

The processs of Dosha sanchaya reflects the first stage of samprapti. This term refers to

the primary stage of Dosha dusti. It is called Ama, because this stage is not able to

manifest the vyadhi. In the next stage, vitiated Dosha gain strength & intensity for the

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Disease Review

manifest the vyadhi. In the next stage, vitiated Dosha gain strength & intensity for the

manifestation of the disease. So the first stage of Dosha vitiation is called as Ama.

(ii) Ama produced by ingestion of poison or other external factors - Toxic feature of

Ama is due to specific etiology. Here the production of visha is by the process of vikruti

vishama samabeta process, analogus to the formation of incompatible substance by the

equal mixture of Madhu & Ghrita. (Chakrapani)

Ama visha quickly spreads all over the body and produces severe type of the disease.

Various types of dietic errors & indiscretions leads to the impairment of digestion,

when complicated by bacterial activity cause profound toxic states. Endotoxins produced

by some parasitic bacterias can be termed as Ama.

Food poisoning produces a symptomatology closely resembling that of Amavisha. The

conditions are infective gastro – enteritis, toxic gastro enteritis etc.

Since Agni is present in each and every cells of the body, similarly may also formed

by derangement of Agni at any cellular level and it will be of several type.

STAGES OF AMAVASTHA :

Stage of Amavastha can be devided into 3 –

(i) vikrita samavastha

(ii) vikruta Amavastha

(iii) vikruta Niramavastha

Vikruta samavastha – Ama produced in the body get adheres to Dosha, Dushya, Mala

which hampers their normal function. Though there is no structure wise deformity in

Dosha, Dusya, Mala but due to Ama, they are unable to perform their normal functions.

Vikruta Amavastha –

In this condition, Dosha, Dushya, Mala improperly formed due to improper function of

Agni. Here the structural defect is seen. Sthayi Dosha, Dushya, Mala are continuously

formed to replace the deficit produced due to swabhaboparama principle. In this stage, the

Dosha Dhatu & Mala produced are structurally abnormal and are therefore they are

termed as Ama dosha, Ama dushya etc.

Vikruta Niramavastha –

After treatment of samavastha by Ama pachana this stage produce. In this stage though

the diseased condition is not cured completely and Dosha, Dhatu, Mala remains in a

vitiated state, but the Ama adhered to them gets cured by niramikarana, after this

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Disease Review

Doshavasechana and other treatments are required for Dosha, Dhatu & Mala to make the

patient completely cured.

MODERN CONCEPT OF AMA & ITS CORRELATION WITH FREE

RADICAL THEORY :

The term “Ama” is not a single entity but is a generalised form which can be applied to

many malformed substance in the body.

- Uric acid which is produced from the impaired digestion of protein can termed as

Ama.

- Form the bacterial action (in putrefaction) the production of indol, sketol. Hydrogen

sulphide methen etc can termed as Ama.

- Lactic acid, ketone, ketonebodies produced form impaired digestion of carbohydrate

& fat can termed as Ama.

- Impaired glycogenesis also produce substance which can compared with Ama.

- Discolouration of stool is due to incomplete process of bile in intestine which can

called Ama.

CORRELATION WITH FREE RADICAL :

Free radical is an atom/molecule that contain one or more unpaired electron which

requires neutralisation by free radical scavengers. Thus it exists in incomplete metabolic state

which is also the state of Ama described as Avipakwam.

-Asmyuktam state of Ama correlated with inassimilable state of free radical which exist in

free state.

Durgandha or putrafaction occurs due to damaged cells caused by F.R

- Ama as picchila form stick to the srotas or body tissue, like F.R. quickly attack the

healthy molecule of the body to seek stability in their structure.

- Impairment of Agni at cellular level causes the generation of Ama as well as F.r.

where body’s primary defence is disturbed.

- Certain toxic substance like heavy metals also produce F.R. similarly Ama also

produced from visha dravya.

- Like Ama, depending upon the site and method of production , many different forms

of F.R. are produced.

IMPORTANCE OF AMA :

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Disease Review

1. According to Maharshi Charka. First sama, nirama condition should be examine and

than treatment should done.

2. Symptoms can be observed in sama vyadhi which also proves the importance of Ama

in sama, nirma condition of the disease.

3. Different treatment principles are advised to sama & nirama condition –

In samavastha – Apatarpana is main treatment where as in niramavastha – samtarpana

is advised.

- samavastha is first treated with Langhan and Pachan.

Sodhan should not done at once due to spreading of Dosha all over the body (in

cellular level, Leena dosha). By pachanakarma first it is made to pakwa and latter

shodhan can applied. In niramavastha Langhana should not be advised, here shodhan

can apply.

4. The knowledge of sama & nirama is necessary to avoid all kind of vyapad while

treating the patient.

5. After all it is said that – The medicine used in a Nirma deha works like Amrita.

CONCEPT OF VATA : Derivation of The Word Vata (NIRUKTI )-

- The term ‘vata’ is derived form the root. ‘va’ which means-‘gatigandhanayoh’ I.e. to

move (Su.Sut.21/5).

- ‘Gati gandhopadanarthasya ‘va’ dhatoh ‘Asrigdaradibhya Ityadisutrotpanne Tan

pratyaya vata iti rupam’ (Dalhana on Su.Sut.21/5)

To the verb root ‘va’ addition of ‘tan’ pratyaya and expelling ‘n’ pratyaya leads to the

term ‘vata’.

Va dhatu + Tan pratyaya = vata (‘n’ expelltion)

- The term ‘Gati’ has 4 maning.

(i) Gamana (to move)

(ii) Gnana (to make known)

(iii) Prapti (to gain)

(iv) Moksha

Usually ‘Gati’ indicates to the ‘motor function’

- The term ‘Gandhana’ has also 4 meaning.

(i) Soochana – (Himsarthaka-To inform against information, intimation)

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Disease Review

(ii) Prakashana – (To enlighten)

(iii) Utsaha – (To enthus)

(iv) Prerana – (To stimulate)

The information is also known as knowledge and it is gained by reception through the

5 sense organs i.e. sensory functions.

- In Siddhanta kaumaudee-

To the same verb root ‘va’ – addition of ‘kta’ pratyata or ‘knt pratyaya’

derived the term vata.

The movement in the body is due to contraction & relaxation of the mascles

i.e. motor function

DEFINITION OF VATA –

- “Vata gatim karoti pravahati iti vayuh”

- “Vati gandhayati suchayati iti vayah” (S.S.M.)

Synonymes :

In the text Amarakosha, 20 type and in Abhidhara chudamani, 26 type of paryaya of

vayu has described some important paryaya with its nirukti are given below –

Vayu – vati iti vayuah

Pavana – punati iti pavana

Sameera – smayak etc

Anila – aniti jivati, Jivayati va sa anidah.

Maruta – mriyante anena briddhena vina va iti marutah.Sparshanan – sprishyati iti sparshanah.

WHAT IS VATA-- Vata is that primal constifuent of the living body whose structure is ‘Akasha’ and

‘vayu’ and whose function is Rajasika. It being concerned with the production of

those somatic and psychic processes which are predominatly rajasik or dyanamic in

nature. Hence the presence of vata is to be inferred in such mental phenomena as the

exhibition of enthusiasm, concentration etc. It upholds all the supporting constituents

and their due circulation throughout the body.

- Vata is the prime mover and motivator in the human body responsible for the intiation

of every kind of activity.

SWARUPA OF VATA-

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Disease Review

In Charka Sutra 12/20 the atmaroopa of vata are – .

1. Raukshya 2.Saitya 3.Laghava 4.Vaishadya 5.Gati

6. Amoortawa 7.Anavasthitatwa

In Ch-Sut.12/3. the Atma roopa of vata-

1. Asamghatam 2. Anavasthitatwam

In Cha Sut. 12/3-

1. Anasadhyam (inaccessible)

In sushruta it is described as

1. Swayambhu

Sharir vayu is a bio-physical force, event or phenomena. The manifestation of

this force appears to be intimately correlated with some material substances in the

body which possess sensible qualities.

Asanghata –

‘Asamghatamiti Avayava samghata rahitam’ (Chakrapani)

The term ‘Asamghata’ means-

Devoid of a definite structure. The absence of a corporeal form like pitta and kapha.

Amoortatwa – i.e invisibility – (Adrishya)-Chakrani on Ch.Sut.20.

This is due to predominace of Akasha and vayu Mathabhoota. According to

shusruta – it is “Avyakta”

“Avyakto adrishya murttih” (Dalhana-Su.Ni.1)

Anavasthitatwa – (unstability)

“Anavasthitamiti chalaswabhavam” (Chakrapani on Ch.Sut. 12/3)

chala – Directional in character. Vata moves from Buddhi & mana towards

karmendriya where as in sensory libres the movement is towards ths mana and

Buddhi.

- Vata is instantaneous in action and radiates through the body in repeatative currents.

(asurcari,mihuschari-sushruta)

Swayambhu-

According to sushruta shareera vayu which courses through the body is self

originated, self propagated, subtle and all pervasive.

Vata may be self originated in Buddhi which initiate the action in the body,

(cha-sha-2) after conclusive judgement (Nischayatraka jnana) about the information

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Disease Review

transmitted by mana regarding the Arther as received from Jnanendriyas. Mana may

also trigger Buddhi for action without sensory connection and this independent

triggering is understood as “swayambhu”

VATA GUNA-

The characteristics of vata described in various texts are –

Cha.su 12/4 – (i) Ruksha (ii) Laghu (iii) Seeta (iv)Daruna (chala) (v) Khara (vi)

Vishada

Cha.su-1- (i) Rusha (ii) Laghu (iii) Seeta (iv) Khara (v) Vishada (vi) Sukshma

Cha.vi -8/98 - (i) Ruksha (ii) Laghu (iii) Seeta (iv) Chala (v) Vishada (vi)

Parusha (vii) Seeghra (viii) Bahu

A.H.Sh -4/10- (i) Ruksha (ii) Laghu (iii) seeta (iv) chala (v) khara (vi)

Sukshma

Su.Ni-1/7 – (i) Ruksha (ii) Laghu (iii) sheeta (iv) khara (v) Asukari (vi)

Muhuschari

Others special characteristics.

(Vii) Avyakta vyakta karma (viii) Rajobahula

Table No.4- Showing Vata Guna According to Ayurvedic Acharyas

Guna Ch.Su.12/4 Ch.Vi.8/98 Ch.Sut.1 Su.Ni.1/7 A.H.Sh4/10

Ruksha + + + + +

Laghu + + + + +

Sheeta + + + + +

Daruna + +(chala) - - +(chala)

Khara + - + + +

Vishada + + + - -

Parusha - + - - -

Sheeghra - + - - -

Bahu - + - - -

Sukshma - - + - +

Asukari - - - + -

Muhusehari - - - + -

Total 6 8 6 6 6

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Disease Review

Avyakto vyakta karma-

‘Although invisible in itself, yet its works are patent or manifest.

- ‘Avyakto Adrishya moortti vyakta karma prakata kriyah’ (Dalhana on Su.Ni1/7).

It is invisible but can perceived by Anumana pramana.

Asukari – It is instantaneous in action

Muhuschari-

‘Muhurmuhu prakritibhutopi charati iti, muhaschari’ (Dalhana on Su. Ni 1/7)

- It radient through the organism in constant current.

Repeatative discharges or rythimicity occur normally in many of the neurons

of the CNS. For the maintainance of Physiological functions, Vata should have

movement without obstruction. An obstruction to its movement will lead to

pathological condition (Margasyavarane cha)

Rajo vahula – It abounds in the fundamental quality of Rajas.

Yogavahi – (Ch.Chi.3/38) – Yogavahi param vayu sanyogat ubhayanthkrit. Vata

when comes in contact with pitta or kapha, it takes numerous in number.

VATA STHANA –

Samanya sthana – Adhorabhi (A.S.)

Vishesha sthana – Pakwashaya

Others – Kati, sakthi, srotas, asthi, twak, pala, vasti, purishadnana.

Table No.5- Showing Vata Sthana According to Ayurvedic AcharyasVata sthana Ch.Sut.20/8 Su.Sut. Su.Ni. A.H.Su.121 A.S.Su.20/3

Basti + - - - -

Parishadhana + - - - -

Kati + - - + +

Sakthi + - - + +

Pada + - - - +

Asthi + - - + +

Pakwashaya + - + + +

Sroni - + - - -

Guda - + - - -

Srotra - - - + +

Twak - - - + +

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Disease Review

According to Atharva veda – Location of vata – upper portion of Mastiska

VATA KARMA – (PRAKRUTA)

1. Vata is responsible for al activities of the body and in fact it constitute the very life of

living being.(Ch.Su.)

2. In Ch.Sut, A.H. Sut. 11/1-2-

Utsaha – Governs enthusiasm (mental state)

“Karyesu udlyoga manasah” (chakrapani)

Utswasa – Govern Respiration

Chesta – Motor activites of the body.

Vega – Regaulation of natural urges.

Spino-cerabral reflex which can be volitionally inhibited or provoked.

Dhatunam Samyak gati – The regulation of the proper circulation and functions of 7

dhatus.

Akshanam patav – proper function of sensory organs. (A.H)

Sama Moksha – proper expulsion of the waste product form the body.

3. In Su.Ni 1/10-

- Dosha dhatwagni samata

- Vishaya samprapti – (Savda, Sparsa etc.)

- Kriyanam anulomana – normal function like respiration, circulation etc.

4. The movement in the body is due to contraction and relaxation. Of the muscles i.e.

motor functions.

5. In Ch.Su.12 -

(a) Vayuh Tantrayantradhara – (Intigration) upholder of structure and function of the

body

(b) Pravartakasehaetanamuccha vachanam – impleller of upward and downword

movement.

(c) Niyanta praneta cha manasah- controller and conducter of mind.

(d) Sarvendriyanam uddyojakah- Onspirator of all Indriyas (motor & sensory)

uddyojakah-prerakah (chakrapani)

(e) Sarvendriyarthanam Abhibodha – saevendriyarthagrahakatwena (charkapani)

conveyer of all sense stimuli.

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Disease Review

(f) Sarva sharira dhatu by vyuhakara - creator of body elements (synthesis of dhatu)

(g) Sandhanakarh sharrerasya- maintain the cohesive unity of the body.

(h) Pravarttako vachah- it brings about speech.

(i) Prakriti shpasrsa shavdayoh-Basis of sound & touch

(j) Srotrashparsanayormoolam – Root matters of the organs of hearing & touch.

(k) Harshotsayoh yoni – origin of all excitement, joy & enthusiasm

(l) Sameerano Agnih – stimultor of Agni

(m) Dosha samsoshanam- cause of the doshas getting dried up (sareera keeda)

(n) Kshepta vahirmalanam - It is the cause of waste product being thrown out of the

body.

(o) Sthulanu srotasam bhetta – it is the creator of all vessels of the body both sthula

(macro scopic) and sukshma (microscopic)

(p) Karta Garbhakritinam – it is the cause which makes embryo in the womb to take

particular form. (Division & differentiation of cells)

(q) Ayushonuvrittipratyaya bhuta – it stands as an evidence of the existence of life.

Table No.6- Showing Vata Vriddhi Lakshan According to Ayurvedic AcharyasLakshna Su.Sut 15/8 A.H.Sut. 11/6 A.S.Sut 21/6

Sharirika

Bak parusyam + - -

Karsyam + + +

Karshnayam + + +

Gatra sphurana + +(kampa) -

Ushma kamita + + -

Nidra nasa + + -

Alpa balatwam + - -

Gadha varcha + - -

Anaha - + -

Bala bhramsa - + -

Indriya bhramsa - + -

Sakrit graham - + -

Bhrama - + -

Atopa - - +

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Disease Review

Majja sosa - + +

Asthi sula - - +

Mala samga - - +

Adhmana - - +

Manasika

Pralapa - - -

Dinata - + +

Moha - - +

Bhaya - - +

Shoka - - +

Table No.7- Showing Vata Kshaya Lakshan According to Ayurvedic AcharyasLakshana Su.Su.15/11 A.H.Su. 11/15 A.S.Su. 26/9

Shareerika:-

Alpa chesta + - +

Alpa vak + + +

Apraharsha + + +

Mudha sanjnata + + +

Anga sada - + +

Praseka - Shleshma

Vriddhi Amaya

+

Aruchi - +

Hrillassa - + +

Agni vaisamya - - +

Manasika:-

Sajna moha - + +

VATA PRAKOPA LAKSHNA –

“Virddhi hi dwidha chayakopa bhedena” (A.S.Su.20)

“vilayana rupa vriddhi prakopa” (Su.Su 21)

Dosha vriddhi si 2 type.

(i) chaya (ii) prakopa

Prakopa is the condition in which dosha having increased and accumulated in its own place

being excited by appropriate causes spread over to parts other than its own.

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Disease Review

According to sushruta – Vata prokopa lakshana like kostha, toda samcharana are lakshana

of prakupita vata.

VIKRUTA VATA KARMA –(A.S. Su. 20/20 )–

1. Srams – sandhi bhramsa/Adha patana/sthana chyuti

2. Vyasa – To spread

3. Samga – Avarodha (of matra mala)

4. Sada – sithilate ( of shareera)

5. Bhedana – To tear

6. Toda – Suchee vidhavat pain

7. Harsha – Romancha

8. Vartta – Mala varttana (Round shape)

9. Angamarda

10. Kampa

11. Vyatha – Compressing pain(of anga)

12. Vesta

13. Bhanga

14. Shula

15. Sosha

16. Swapa

17. Parushya

18. Sausurya

19. Samkocha

20. Spandana – (chala)

21. Syava Aruna varna ( of Twacha)

Including above these symptoms some others symptoms has been described in

(Ch.Sut.20/2).

1. Bharamsa – distal displacement

2. Chala – shareera spandana

3. Chesta – (shareera/mana chanchala)

4. Stambha

5. Kanjana

6. Kharata

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Disease Review

7. Visadata

8. Asya vairasata etc.

VATA PRAKOPA KARANA –(Chikitsa Kalika) –

1. Vyayama 7. Apatarpana

2. Prapatana 8. Bhanga

3. Kshaya 9. Vijagara

4. Vega dharana 10. Ati trasa

5. Ati seeta 11. Ruksha, katu, kasaya, tikte, sevana

6. Varsha kala 12. Anna paripaka avastha (Antima)

7. Aparahna kala

In A.H.Ni Vagbhatt says :Ahara – tikta, ushana, kashaya, alpa, ruksha pramitasana

Vihara – vega dharana – vyayama

Vega udeerana – maithuna

Ati accha bhashana

Manasika – Bhaya, Soka, Chinta

Samaya - Grishma Anta ( varsha)

- Dina Anta

- Ratri Anta

- Bhojana Anta

Otheras – kriya atiyoga (vamana, virechanadi & other chesta) in short vata prakopa

occars due to 2 main cause.

(i) Dhatu kshaya – Due to ruksha aharadi

(ii) Avarana – (sanga) – obstruction in the pathway of vata

SPECIAL FUNCTION OF SPECIAL GUNA OF VATA :-

Ruksha – Rukshata, Krishata, Swarabheda, Nidra alpata, jarjara

Seeta – Seetata, kampa, stambha

Laghu – Gati, chesta, Alpa chesta, Aniyata chesta

Chala – sandhi, asthi, bhru, hanu, jihwa, chanchalata

Vishada – sandhi, atopa, amga sphutana

Sara, daranu, amurta, sukshma – yogavahi.

Parusha – kesa, roma,. Nakha, danta parusata

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Disease Review

CLASSIFICATION OF VATA

The 5 classes of vayu located in their specific regions contdribute towards the

integration and maintainance of the body.

These 5 types of vata are –

(i) Prana (ii) Udana (iii) Samana (iv) Vyana (v) Apana.

These classification is based on their, name. specific site, specific function and role in

different disease.

According to Acharya susruta, the 5 special karma of 5 types of vata are –

Praspandana, Udvahana, Purana, Viveka, Dharana

Table No.8- Showing Sthana ,Varna of Individuals Vata According to Ayurvedic Acharyas

VataMukhya

AdhisthanaPravartana Desa Level In C.N.S. Varna

Prana

Moordha –

(Cha,A.S)

Nabhi – (su)

Hridaya –

(Sarang.)

Kantha (A.H) ura,

karna, jihwa,

Asya, nasika

(cha),

Mukha (Su)

Reticular for

mation for the

brain stem to

medulla oblaganta.

Drutatara

(morten silver)

VyanaVra (A.S,

Sarang.)

Nasa (A.H. nabhi,

ura, kantha (Cha)

Urdhwa jatru

(Su.) kantha,

nasika (A.S)

Reticular forma

tion from lower

part of pons to the

spinal cord up to

c3 c4 c5 t2 t6

motor nuclci of

seranial never

7,9,10,11,12

Kasheerabh

(milky)

Samana Antaragni

sameepa (cha,

A.S)

- Nabhi –

(sarangdhar)

Kostha (A.H.)

Amapakwashya

(S.U.) swedavaha,

Ambuvaha,

dosavaha,

Mesentric &

subcutaneous

plexus of GIT

Indra gopa

(orange, red)

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Disease Review

srotas(Cha.)

Vyana

Hirdaya (A.S)

sarvadeha

(Saranga dhara)

Sarva shareera

(cha, su, A.h.)

Anterior & Lateral

horn cell of spinal

cord(T,-L2 or L3)

Sphatika

(crystal)

Apana

Apana Pradesh

(A-S)

pakwadhana (Su.)

Guda(sarang

adhana)

Sroniguda,

Mutrashaya

(A.H.) Vrishana,

vasti, medhra,

Nabhi, guda(cha)

Uru,

Bankshana(A.S)

Lower lumber &

sacral Segment

Raktabha

(reddish)

Table No.9- Showing Karma, Pravartan, Disa of Individuals VataVata Karma Action Pravartan Disa

Prana

Sthivana,kshavathu,udgara,swasa kriya, Ahar intake(cha), prana

avalambana, anna pravesha (su), Buddhi, Hridaya, Indriya

chitta dhruk(A.H), mena, dhamani dharana(A.S.)

Sensation form all sense organs are

regulated

Multi directional(sarva)

Udana

Vak pravritti, prayatna, Gives vala,varna toshreera(cha),

Bhasana, preenana, Dhidhrutismritimana vibidhana

(A.S.)

Voluntary phase of swasa kriya,

asychological function.

Upoward(urdhwa)

Samana

Gives strength to jatharagni (Chq),Anna pachana, sara kitta

bheda (su),Anna grahana, pachana(A.H) Antaragni

jandhukshana, pakwamasaya dosha,mala,sukera,artlava,Amb

u vahabnq,jrota vichari, Apakwa anna dharana, pchana, vivchana,kitta adho naaayana

(A.S)

Secretion of GIT, neural control & function of para

sympathetic division

Hori lontal

Vyana Tati prasarana, Akshepa,Nimesa (chq), rosa

samvahana,seda,rakta nirmana & elimination,rakta

samchalana(su) Rasa vikshepana(A.H),Jrimbhana,An

Action on heart & blood vessel, motore

function of voluntary muscle

Multi directionakl (sarvo)

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Disease Review

na swadana, srofa sodhana, Jonau sukra pratipadana, Dhatu

tarpana(A.S)

ApanaSukra,mukra,purisha,arttav,garb

ha biarjana at their time(cha,su,A.H,A.S)

Function of Annacaha &

purisavaha srotas

Adhe(Down ward)

VATA/C.N.S ACTION –

From the above study it is seen that vata is closely resembles with the totoal CNS

action that of the nerve impulses. The energy for the transmission of the impulse is stated to

be derived from the nerve fibre over which it passes. The self propagating nature of the

nerve impulses is due to circular current flow and successive electric depolarization to the

firing level of the membranes ahead of action potential. So vata is not a physical matter but

a form of energy capable of conducting some physiological function in the body.

Muhuschari – Repitative discharges or rythmicity occur normally in many of the neurons

of the CNS.

Chalatwa – conduction of nerve impulses in one direction from the neurons through axon

to its termination. It moves form buddhi and mana towards karmendriya where as in

sensory fibres the movement, is reverse.

IMPORTANCES OF VATA –

1. So long as vata lasts in the body as long does life exists. (Bhe.Sa)

2. Ayushonubrutti – (Ch.Sut.12)

It is indivcative of the confinuity of life.

3. Vata is powerful and important because of its control over the function of body

(Bibhutwat)

- Asukaritwat – it is capable to quickly traversing through all the minute channels of

the body. It is capable to spread throughout body.

Anya kopanat – it is capable to vitiate other factors.

Swatantryat – It remains in a free state. It keeps all other doshas in motion, but itself

don’t alter by any other doshas.(independent)

Bahurogatwat – It causes large number of disease, compairatively to other two

doshes. (A.H.Sh.)

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Disease Review

4. Vata is that force which keeps the kapha,pitta, dhatu & mala (all of which are

incapable of independent volition) in motion very much like the wind which is the

force that propels clouds from place to lace in the sky. (Sharangdhara.Pu .Kha.5/25) .

5. Vata excels in vala, parushata,sheeghra and in causing emergency situations.

(Ch.Su.12)

6. A person whose vata dosha is not hampered, which is at its own loci and its natural

form,that person leads a healthy life of 100 years. (Ch.Chi 28/34).

7. According to Acharya Charak vayu is the total life span and strength of our body. It is

the holder of our soul, total aniverse is vayu, also the God. It can do everything im our

life. (Ch.Chi 28/3).

8. The disease of sakha,kosha,marma, sandhi (any rogamarga) or the disase involved in

any rogamarga like urdhwa, adha, tiryag,or it is situated in sarvanga or Ekanga, the

cause is only vayu. (Ch.Si. 1/38)

9. Vata is responsible for the equilibrium state of other doshas, dhatu, malas, & agni.

(Ch.Su.18/49)

10. The capacity of vayu is unimaginable. It is the king of all doshas & all roga .

(Su.Ni .1/8)

11. In Hatha-yoga pradipika – it has been described mana is the controller of all indriyas.

& vayu is the controller of mana.30

12. According to susruta it one among the 12 pranas.

13. In all shulas – vata is generally involved with its priority.

VATA IN AMAVATA-

- When the normal physiological process in which vata is produced is impaired & results in

the malformation of vata. Then it is termed as Amavata.

- Vata can be of 2 types due to Ama – when Ama producd in body get associated which

vata then it is termed as samavata.

- When Ama adheres to vata, the clinical symptom produced are well discribed in texts like

Agnimandya, vivandha etc.

- Vata dosha pleys an important role in the manifestation of the disease Amavata. Srotas

dusti also occurs due to vata.

- Ama is thrown out by vitiated vata, to sleshma sthana as vayu keeps the Ama in a mobile

state

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Disease Review

- Chesta like Akunchana,prasarana is restricted in Amavata due to pain. It reveal the

predomi nance of vata dosha.

- There are several phase of Doshik vitiation like vriddhi, kshaya, prkopa of vata in

different stages of Amavata.

- According to the site and function of different types of vata, the symptoms are very much

produced in Amavata,these are as follows-

Prana vayu – sira sula, moorcha,praseka etc.

Udana – cchardi

Vyana – Sandhi graham,sandhi sula,sadana,Anga gaurava.

Samana – Agni Mandya,Ama formation,Atopa

Apana – Vivandha,Bahu Mutrata,Antrakujana.

Niscalasya :

Sedentary habit is responsible for the initiation of Kapha Dosa which further impairs

the normal function of Agni and will lead to Ajirna and consequently helps in the production

of Ama.

(d) Samprapti :

Formation of Ama and Vata Prakopa are the main events in the manifestation of

Amavata.

Formation of Ama :

Because of the disturbance in the normalcy of Agni (Jatharagni), either Vishamagni or

Mandagni will be resulted according to Doshic predominance (aggravated due to their

specific etiology) i.e. Visamagni by Vata, Mandagni by Kapha Dosa (Su Sut. 35/9). This

disturbance in Agni will alter the normal process of digestion which results in formation of

improperly digested food material which is otherwise called as Ama (A. H. Su. 13/25, Ch.

Chi. 15/93). This is the stage where Ama is formed by Annarasa by the involvement of

Jatharagni only. If this state is continued or indulgence of etiological factors are still

continued, the disturbed Jatharagni will lead to weakening of all the other Agnies viz.

Dhatvagnies, Bhutagnies, as it is the supportive Agni for all the other Agnies (Ch. Chi. 15/39-

40). So, according to the duration and other etiological factors, Ama will be formed at

different levels of Doshas and Dhatus. At this level the specific Dosas or dhatus involved

with Ama will be called with the prefix Sama, for example Samavata, Samapitta, Samakapha,

Samarasa and so on (A. H. Su. 13/27)24a-b.

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Disease Review

Symptoms of Ama :

Acarya Vagbhata gave the general symptoms of Ama as - Srotorodha (obstruction in

the channels), Balabhramsa (general weakness), Gaurava (heavy feeling of the body), Anila

Mudhata (impaired activity of Vata Dosa), Alasya (lazyness), Apakti (indigestion), Nisthiva

(excessive salivation), Malasanga (constipation), Aruci (distaste) and Klama (lethargy) (A. H.

Su. 13/27).

Symptoms of Samavata :

In the context of Amavata the symptoms of Samavata have great importance. They

are Vibandha (constipation), Agnisada (diminished appetite), Sthambha (stiffness),

Antrakujana (kooing in intestine), gradual or sudden manifestation of Vedana (pain), Sotha

(oedema), Toda (pricking sensation) and restricted movements of body parts. These

symptoms are aggravated by oleation, during morning hours, at night and during the cloudy

climate (A. H.Su. 13/Praksipta).24c-d

Role of Vata :

Though Ama plays a major role in the manifestation of Amavata, unless and until it

gets lodged (Sthana Sansraya) in joints it cannot produce the disease. Here, the Vyanavayu

one among the five varieties of Vata plays an important role by transporting the Ama to the

abodes of Kapha (Sleshmasthana) - joints (Sandhis) through general circulation. In addition

Samanavayu which is also responsible for digestion and assimilation will also play a role in

the formation of Ama if it is disturbed.

Manifestation of the disease Amavata :

Vata aggravated due to its specific etiological factors transports the Ama (formed as

described earlier) to the abodes of Kapha - Amasaya and Sandhis. The Ama thus reached will

get more Apakvavastha (morbidity) due to high content of Kapha at its abodes and will be

recritiated by Vata, Pitta and Kapha Dosas. The Ama thus formed will have different colours

and it causes obstruction in Rasavaha and Annavaha Srotas due to its Atipiccilata (excess

sliminess). The involvement of Rasavaha, Annavaha Srotas will in turn lead to Daurbalya,

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Disease Review

Hrdgaurava and further weakening of Agni. Ultimately the Ama formed in abundance along

with Kapha with the help of Vata reaches the Sandhis and gets manifested as Amavata (M.

Ni. 25/2-5)25-25a.

SAMPRAPTI OF AMAVATA (Schematic representation)

Nidana Sevana

Jatharagnimandya Vataprakopa

Amotpatti

Aggravated Vata propels Ama throughout the body,

especially to Sleshmasthanas through Rasayanis

Repeated vitiation of Amarasa by all the three Dosas

Srotobhisyanda

Amavata Vyadhi

Samprapti Ghatakas :

A vast number of factors invariably take part in the manifestation of a disease and are

collectively known as Samprapti Ghatakas. The Samprapti ghatakas of Amavata are :

i) Udbhavasthana Amasaya and Pakvasaya

ii) Sancarasthana Throughout the body - Rasavahini

iii) Adhisthana Sleshmasthana, Sandhi

iv) Rogamarga Madhyama

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Disease Review

v) Agni Jatharagni,Dhatvagni

vi) Ama Jatharagni mandyajanya

vii) Dosa Tridosa; Vyana and Samanavayu,

Pacaka Pitta, Kledaka and Sleshaka Kapha

viii) Dusya Rasa, Majja, Asthi, Sandhi, Snayu,

Purisha, Mutra

ix) Srotas Rasavaha, Majjavaha, Asthivaha,

Purishavaha, Mutravaha, Annavaha

x) Srotodusti Sanga

xi) Vyadhisvabhava Asukari, Kastatama, Punah Punah

Akramanasila

Sankhya Samprapti :

On the basis of involvement of Dosas Amavata is divided into 7 types viz.

1. Vataja, 2. Pittaja, 3. Kaphaja, 4. Vatapittaja, 5. Vatakaphaja, 6. Pittakaphaja, 7.

Sannipataja (M. Ni. 25/11).

Again it is classified according to the severity into two types :

1. Samanya Amavata and

2. Pravriddha Amavata (M. Ni. 25/6)26

Here, Samanya Amavata is the first stage of Amavata with more or less general

symptoms or less severe. The more advanced stage of this is Pravriddha Amavata. Where as

Harita classified Amavata as :

1. Sarvangi and

2. Pakva

On the basis of clinical manifestations it is of five types viz.

1. Vistambhi Amavata, 2. Gulmi Amavata, 3. Snehi Amavata, 4. Sarvangi Amavata,

5. Pakva Amavata (H. S. 21).

Depending on the chronicity, the disease is classified into :

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Disease Review

1. Navinamavata and

2. Jirnamavata.

A clear parameter regarding classification of Amavata as Navina and Jirana has not

been laid down but generally after one year Amavata may be considered as Jirna.

Purvarupa :

As Ama and Vata are the major factors in the pathology of Amavata, the symptoms

related to Ama and Vata can be seen as prodromal symptoms of Amavata.

The symptoms such as Aruci, utrahahani, Alasya, Apaka, Angasunyata and jvara are

also considered as a purvarupa of Amavata. In addition :

1. Daurbalya

2. Hrd Gaurava and

3. Gatrastabdhata

are also mentioned as purvarupa of Amavata (M. Ni.25/6)26

Rupa :

The onset of Amavata is insidious and involves many Samprapti ghatakas in the

disease manifestation and hence variety of symptoms will be produced at different levels by

different Samprapti ghatakas. As Ama formation is the first and foremost stage in the process

of Samprapti the symptoms such as Aruci, Angamarda, Alasya, Apaka, Angasunyata, jvara,

mamsaksaya, stabdhata and trsna are seen at earlier stage (M. Ni.25/6, B.S., Y.R.).

When the Ama along with Dosas gets sthanasamsraya at Sandhi it produces the

symptoms such as sotha, ruk, graham, Gaurava and Arthi (A. Ni. 116-117).

The signs and symptoms according to dosanubandha -

i) Vatanubandha Trikasandhisula

ii) Pittanubandha Sandhigraha and daha

iii) Kaphanubandha Stainmitya, guruta and kandu

(M. NI. 25/11 and A. Ni. 118)27.

Rupa of Pravrddha Amavata :

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Disease Review

With the progression of disease process the symptoms become severe and involve

more number of joints. In addition complications may also develop. The signs and symptoms

are praseka, Aruci, Asyavairasya, trt, chardi, Agnidaurbalya, kuksirula, vibandha, ruksika-

thinya, Anaha, Antrakujana, sarujanisotha, siroruk, hrdgraha, bhrama, murcha, bahumutrata,

gaurava, Alasya, daha, nidraniparyaya, grahani dosa, Amatisava, Angavaikalya, jadya,

Vataroga, sandhisabda and Anyain upadravani. (M. NI. 25/7-10)28

Upadrava :

Upadravas are those rogas either Sthula or Anu which develops after the

manifestation of Pradhana roga with some dosic involvement. The deformities like

Angavaikalya (Harita), Khanja, Sankoca (Vijayaraksita and M. Ni. 25/10) explained

Vatavyadhis if seen in Amavata patients and / or the symptoms seen at the advanced stage of

Amavata (Vacaspati) are said to be upadravas of Amavata. Whereas Vijayavarsita in M. Ni.

25/10 differentiated the symptoms of advanced stage with that of upadravas.

Table No.10- Showing Sign & Symptoms according to different Ayurvedic Acharyas Symptoms M.Ni. A.Ni. B.S. Y.R. H.S.Daurbalya + - + + -

Hrdgaurava + - + + -

Gatvastabdhata + - + + -

Angamarda + - + + -

Aruci + - + + -

Trisna + + + + -

Alasya + - + + -

Gaurava + + + + -

Jvara + + + + +

Apaka + + + + -

Angasunyata + - + + -

Sandhiruja + + + + +

Sandhisotha + + + + +

Sirassula + - + + +

Trikasula + - + + +

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Disease Review

Agnisada + + + + -

Praseka + - + + +

Utsahahani + - + + -

Asyavairasya + - + + -

Bahumutrata + + + + -

Kuksikathinya + - + + -

Kuksisula + - + + -

Nidranipargaya + - + + -

Chhardi + + + + -

Bhrama + - + + -

Murchha + - + + -

Hrdgvaha + - + + -

Vibandha + + + + -

Jadyata + + + - -

Antrakujana + + + + -

Anaha + + + + -

Staimitya + - + + -

Kandu + - + + -

Sandhiraga + - + + -

Daha + + + + -

Amatisara - - - - +

Angavaikalya - - - - +

Grahanidosha - - - - -

Sandhyasadhyata (Prognosis) :

The Amavata with Anubandha of solitary dosha, short course of the disease, presence

of the symptoms in the wilder form, affliction of fewer joints and absence of upadrava is said

to be sadhya. Involvement of two Doshas suggest krcchrasadhya, tridoshic Anubandha,

affliction of almost all the joints, chronic course of the disease and presence of upadrava

points towards the yapyata of the disease( M.Ni.25/12)

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Disease Review

Sapeksha Nidana (Differential Diagnosis) :

The diseases such as Vatarakta, Sadhigatavata, Krostukasirsa, Sandhikasannipataja

jvara, Phirangaja sandhisotha which look similar to Amavata are to be differentiated from it.

Upashayanupashaya :

The factors which provocate Ama and Vata such as Snigdha sveda, santarpana,

sitakala, ruksa sevana, pratalikala etc. are considered as Anupasaya (unfavourable) for

Amavata. On contrary, ruksasveda, langhana, ushnakala, ushnopachara, pathyahara and the

factors which bring vitiated Vata and diminished Agni back to the normal state are

considered as upasaya.

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