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Clinical Assessment Criteria for Ama Diagnosis | OMICS International
ISSN: 2573-4555
Journal of Traditional Medicine & Clinical Naturopathy
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Clinical Assessment Criteria for Ama Diagnosis

Neera Saini1 and Byadgi PS2*
1Junior Resident, Department of Vikriti Vigyan, Faculty of Ayurveda, IMS, BHU, Varanasi, India
2Assistant Professor, Department of Vikriti Vigyan, Faculty of Ayurveda, IMS, BHU, Varanasi, India
Corresponding Author : Byadgi PS
Assistant Professor, Department of Vikriti Vigyan
Faculty of Ayurveda, Institute of Medical Sciences (IMS)
Banaras Hindu University (BHU), Varanasi -221005, India
Tel: 9450711759
E-mail: [email protected]
Received February 28, 2014; Accepted March 27, 2014; Published March 29, 2014
Citation: Saini N, Byadgi PS (2014) Clinical Assessment Criteria for Ama Diagnosis. J Homeop Ayurv Med 3:148. doi: 10.4172/2167-1206.1000148
Copyright: © 2014 Saini N, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Abstract

The term Ama refers to raw, unripe, unprocessed or improperly digested condition of food substances probably.
Acharyas has said that mandagni (low digestive power) is the root cause of all diseases & Ama is also produced by mandagni, which produces almost diseases. Ama is described by all Acharyas but the greatest clinical detail about this entity (Ama) has been described for the first time by Acharya Vagbhatta. Identification of presence of Ama in body is very crucial need in today’s era for healthy living and to manage and prevent the diseases. There are some basic characters are described by Acharyas in various samhitas which may be helpful for the diagnosis of Ama condition. Ama may produce due to exogenous and endogenous sources, substances which are unwholesome to the body and can be termed as an antigen which is very much capable for inducing immunological reactions in Amavata (Arthropathies).

Keywords
Ama; Mandagni; Antigen; Srotorodha
Introduction
Human body has three basic physical components dosha, dhatu and mala, which are responsible for the stability of the body in their natural state while disequilibrium state causes diseases. Ama is also an entity which causes vitiation in dosha, dhatu and mala. Ama is a pathological entity and causes abnormality in srotas, dhatu etc resulting into development of various diseases. Ama is responsible for the initiation of many diseases in body hence during the description of synonyms of vyadhi, Amaya [1] (disease produced due to Ama) synonym is also given. Ama has a great significant place in some diseases as Amavata, Obesity, Visuchika, Atisara, Pandu etc. Elimination of Ama is one of the most important steps during the management of these diseases. Ama is always unwanted substance to body and immunologically powerful in activating strong immune response resulting into genesis of certain set of diseases because it acts as a foreign body to human body [2]. Ama is a condition that occurs when the immune system mistakenly attacks its own constituent parts as self and destroys its own cells and tissues. The Ama and antibodies then interact with each other to form an immune complex’s and dAmages the joints and other body parts leading to acute pain and swelling. According to new researches also, it has been stated one of the most attractive explanations for the autoimmune phenomenon has centered on the exposure to various environmental factors such as infections that are capable of initiating disease in genetically predisposed individuals. Synovial fluid of patients with RA shows the presence of bacterial DNA and their products arising from naturally occurring commensals in the gut and other mucosal surfaces. One explanation for the presence of gut commensals in the joints of RA patients could be a leaky gut or loss of intestinal integrity that facilitates the migration of gut commensals or their products to the peripheral organs. The bacterial products released in the joints may result in local and systemic immune stimulation [3]. This explanation probably proves the theory in context of Amavata i.e. Ama reaches to sleshmika sthana and act as an antigen. Always a process or a chain reaction starts and ends up to attaining certain form either in synthetic process (Anabolic) or in decaying process (Catabolic), which is capable of carrying a function. If this process of transformation gets deranged due to trividha hetus (pragyapradha, asatmyendriyartha sanyoga and parinama) leads to formation of Ama. It forms in the process of paka or transformation or Gunantaradhana but not attained complete paka or finality”. When the process of paka is not completed, the ultimate function of the srotas or tissues hampers resulting in a disease. Ama resulting from incomplete digestion of food accumulates slowly in genetically weak individuals and causes manifestation of diseases in favorable condition. Incomplete or partial digestion of food, due to decrease in digestive power leads to Ama formation [4]. Some says that apakva anna rasa is Ama, while some other quote that accumulation of mala is Ama. According to some, the first stage of vitiation of dosha is Ama [5]. When the amount of food taken is beyond one’s digestive power, leads to formation of Ama. Thus, a person with good digestive power never suffers from Ama condition. Ama is also formed when doshas affect each other [6]. Certain essential factors responsible for the production of Ama i.e., substances which provokes and vitiates dosha, dhatu, mala, srotas, agni and manas.
All these produce Ama at two levels-
1. At jatharagni level (Amashaya) it is produced as apakva anna rasa. The molecules of apakva anna rasa are got absorbed inside the body and produce various gastrointestinal problems such as visuchika, pravahika, atisara, etc.
2. At dhatvagni level, sama dhatu develops and it is absorbed and spread to other tissues and causes various type of diseases as medoroga (obesity), madhumeha (diabetes mellitus), sopha (inflammation), Amavata, pakshaghata, ardita vata etc.
Method
Clinical assessment criteria of Ama
Acharya Vagbhatta has described in detail about the general characteristic feature of Ama and Charaka also has described some clinical characters i.e. improper digestion of food, excessive salivations, constipation, pain, burning sensation, anorexia and heaviness. Sama mala and Nirama mala characteristic features are also described in Charaka samhita. Ama may produce generalized symptoms and systemic clinical features [7,8].
Generalized symptoms
a) Balabhransha (Decrease strength or immunity)
b) Gauravam (Heaviness in body and head)
c) Alasya (Lethargy)
d) Arti (Restlessness)
e) KlAma (Exhaustion)
Systemic clinical features
a) Apakti (Indigestion)
b) Vistambha (Constipation)
c) Vidaha (Burning sensation)
d) Aruchi (Lack of desire towards food)
e) Nisthiva (Excessive salivation).
f) Srotorodha (Obstruction in Srotas)
g) Anila mudhata (Disturbances in normal movements of Vata)
h) Malasanga (Obstruction of urine and stool and other waste product)
Detail description of clinical features of Ama
Srotorodha: It means obstruction in the channels. Srotorodha may involve whole body or a particular srotas. Srotorodha can be understood as blockage in the existing route of dosha, dhatus and malas etc. As Ama is sticky in nature due to which it has tendency to stick in the srotas and produces symptoms accordingly. As in disease Amavata blockage of vata due to Ama causes stiffness in joints. Vikrita kapha (Ama) also causes the formation of ashmari (stones) [9] which causes obstruction of urine if stone produces at any level of urinary system. Due to stickiness nature it sticks in blood vessels and causes atherosclerosis due to which blood circulation inhibits and causes ischemia. Due to Amalakshana there will be no free flow or conduction or transport of particles in membranes and tissues resulting in inhibition of secretion of fluids, including enzymes also. Due to viscosity nature of Ama, the cell membrane permeability and transportation of nutrients and essential mineral exchanges becomes hampered.
Balabhransha: lack of energy or diminution of bala or ojas. Ojas is called bala [10]. Bala means vyayAmashakti (capacity to do exercise). Now, it can be understood in two ways as first being is unable to do anything due to less power and another is the loss of vyadhik shamatva (decreased immunity against diseases). Due to obstruction in channels nutrition of dhatus decreases as a result proper dhatus do not form, due to this there is decrease in strength. On the other way as ojas is the essence of all dhatus and is the cause of strength of body [11], does not form due to lack of nutrition of dhatus. As a result body immunity also decreases.
Gauravam: It means heaviness in body or any part of body and patient may feel as whole body is covered with wet skin. It may due to excess storage of Ama and flow of Ama rasadhatu and Ama raktadhatu through srotas in those parts. Feeling of heaviness in the body is the result of guru guna present in Ama. When Ama rasa remains in circulation, causes less oxidation, less physical activity, less cerebral blood flow, which slows down the function of the organs, leading to feeling of heaviness in the body. It may be due to less BMR prevalent during Ama condition due to mandagni.
Anila mudhata: Loss of normal movements of vata inside the channels or it can interpreted as jadatva of vata dosha i.e., sluggishness of its functions. In Amavastha, samana vayu inhibition results in decreased peristaltic movements due to which adhmana, alasaka, kostha stabdhata, etc. symptoms appear. Due to obstruction in normal movements of vata, it comes out through mouth as eructation. In the joints also when vata gets obstructed by Ama causes stiffness in the joints.
Alasya and klAma: It means lack of desire to do anything or lack of enthusiasm to do work in spite of having energy. On the other hand klama may be understood as when there is no physical work but having excessive tiredness in body, having dyspnea and no interested in whatever happening in surroundings. Ama has the tendency to vitiate kapha quickly due to their similar nature; hence patient develops laziness due to abnormal kapha. When the cerebral blood comes down due to increased viscosity of blood [12] due to presence of Ama and may result in alasya and klAma.
Apakti: It means indigestion. It may be due to lack of secretion of digestive enzymes, sluggish peristaltic movement and diminished functions of bio-digestive fire.
Nisthiva: Spitting of dusta kapha is known as nistheevana. When Ama rasa dhatu circulates it produces more mala roopa kapha due to rasagnimandyata (Rasa dhatu mala is dusta kapha). This increased mala roopa kapha accumulates in kapha sthanas due to its tulyata. Thus the secretions in the uras (Kapha sthana -lungs) get increased, causing reflex of spitting, resulting kapha nistheevana.
malasanga: It means Apravrittishca i.e., there is obstruction in the passage of waste substances. Abnormal accumulation of waste in the body is a sign of Ama in that part. Examples are nasolacrimal duct obstruction, blocked tear ducts, wax blockage, ear congestion, eustachian tube blockage; nasal obstruction etc. purisha does not move properly because of stickiness in the membranes due to tantumaya, abshiyandi gunas of Ama [13].
Aruchi: It is the condition in which there is no interest towards food either tasty or not. It may due to less secretion of digestive enzymes due to obstruction in channels and glands.
Conclusion
Ama is a condition that occurs when the immune system mistakenly attacks its own constituent parts as self and destroys its own cells and tissues. The Ama and antibodies then interact with each other to form an immune complex’s and dAmages the joints and other body parts leading to acute pain and swelling. Ama is the basic causative factor for the development of many diseases. Ama, because of its sticky and having stagnant property, produces obstruction (srotoavarodha) at the level of large and smallest channels of body i.e. srotasas of any system. This initiates and triggers the process of doshadushya sammurchana i.e., interaction of doshas with dushyas which initiates the pathogenesis of any disease. Understanding of Ama is important to prevent and to manage the diseases successfully. Present article through light on concept of Ama from modern perspective. It is a review article hence grading of the criteria was not mentioned.
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