Ama (आमः)
Ama (आमः) is an extremely important and exclusive concept in Ayurveda discussed under physiology and pathology sections. The term literally means 'unripen' or 'uncooked'. The food that passes through the process of digestion but doesn't get transformed into the rasa dhatu (रस धातुः) properly and remains in the body in such undigested form which can not be utilized by body tissues is called as Ama. It is considered as an important factor in development of variety of diseases related to any and every system of the body. Thus the concept is discussed in depth in Ayurveda.
परिचयः॥ Introduction
Ama translates to undigested or unripe or raw. This again is one of the fundamental and unique concepts in Ayurveda. “Amaya” (आमयः) is the Sanskrit synonymous term for roga (रोगः) or disease, meaning which originates from ama is a disease. Deranged agni (अग्निः) or the digestive fire is one among the prime causes of ama formation in the body along with unhealthy food habits. This concept being significant to vaidyas to understand and treat a disease. Amavata the most commonly found joint disorder described in ayurvedic pathology has the involvement of ama as a causative factor.
व्युत्पत्तिः ॥ Etymology
The term Ama has been decoded in the following way.
आम्यते ईषत्पच्यते | (Shabd. 1/180)[1]
Meaning: That which is slightly digested or digested to some extent is known as Ama.
That which is apakva (अपक्वम् not digested), asidhi (असिद्ध incomplete) is ama.
परिभाषा॥ Definition
Ayurveda acharyas have defined and explained the term Ama as follows.
ऊष्मणोऽल्पबलत्वेन धातुमद्यमपाचितम्| दुष्टमामाशयगतं रसमामं प्रचक्षते| (Asht. Hrud. 13.5)[2]
Meaning: Ama is that form of rasa dhatu which remains undigested (unmetabolized) due the poor strength of the digestive fire or agni. When the ushma (उष्मा) or the agni (अग्निः) or the digestive fire reduces, the dhatus (धातवः) in the body cannot form appropriately and moves towards amashaya (आमाशयः), there they get contaminated by doshas (दोषाः), further after the digestion what remains is termed as ama.
अन्ये दोषेभ्य एवाति दुष्टेभ्योऽन्योन्यमूर्छनात्|कोद्रवेभ्यो विषस्येव वदन्त्यामस्य सम्भवम्|| (Asht Hrud 13.26) [3]
Also according to some acharyas, Vata, Pitta, and Kapha when get contaminated due to certain reasons lead to the formation of ama.
आमलक्षणानि॥ Features of ama
Ama formed in the body is of particular properties, owing to which is shows ability to start illnesses. The features or properties of ama are described as below,
“अविपक्वमसंयुक्तं दुर्गन्धं बहु पिच्छिलम्| सदनं सर्वगात्राणामाम इत्यभिधीयते|| (Madhu Commentary on Madh. Nid. 25.2) [4]
Meaning: That element in body which is, undigested, which has a foul smell, very sticky, generates weakness in the whole body is known as ama.
Any untransformed and filthy component can not create any new process or element and can not generate energy too. Thus such peculiar features of ama are responsible for its disease causing nature.
आमहेतवः॥ What causes Aama?
Ama is generated from the food that a person consumes. However, the process through which it goes, the type of the food consumed, the method in which it is consumed and the internal body conditions which lead to its formation are considered as its causes. They are mentioned below,
न च खलु केवलमतिमात्रमेवाहारराशिमामप्रदोषकरमिच्छन्ति अपि
तु खलु गुरुरूक्षशीतशुष्कद्विष्टविष्टम्भिविदाह्यशुचिविरुद्धानामकाले
चान्नपानानामुपसेवनं,कामक्रोधलोभमोहेर्ष्याह्रीशोकमानोद्वेगभयोपतप्तमनसा वा यदन्नपानमुपयुज्यते,
तदप्याममेव प्रदूषयति|| (Cha. Samh. 2.8-9) [5]
There are certain basic food habits or mental factors which are easily overlooked which are a few prime factors for causing aama in the body. As explained by Acharya Charaka,
- Excessive intake of food - The quantity of food
- Guru guna (गुणः) ahara (आहारः) means food items that are heavy to digest - Quality of food
- Ruksha and sheeta guna ahara meaning those food substances which are dry in property and cold in potency.
- Food that is disliked by the eater, is constipating in nature, leads to a burning sensation after intaking, and is unhygienic causes aama in the body.
- Food items that are viruddha (विरुद्ध आहारः) or incompatible according to Ayurveda shastra (eg. Milk and fish)
- Untimely food consumption as well can lead to aama formation.
- Aama can be formed due to mental factors as well. if food is consumed when the mind is distressed with anger, excess passion, greed, obsession, jealousy, grief, etc.
मानसहेतवः॥ Mental factors
Various psychological factors are also responsible for formation of Ama. These factors are so potent that despite absence of any other causative factor for Ama from diet or other environmental factors. These psychological factors are listed by Acharya Charaka as follows,
मात्रयाऽप्यभ्यवहृतं पथ्यं चान्नं न जीर्यति| चिन्ताशोकभयक्रोधदुःखशय्याप्रजागरैः||९|| (Cha. Samh. 2.9) [5]
Chinta means stress, shoka (शोकः grief), anger (क्रोधः), sadness (दुःख), excess sleep and staying awake late night are the psychological factors that affect physiology of the digestive process leading
आमजन्यविकाराः॥ Diseases caused by ama
Ama is responsible for development of multiple diseases. Although all the diseases are said to be due to poor agni and resultant ama, there are other specific factors that are responsible for development of certain diseases. However, there are some medical conditions which are solely due tp the ama and those are chiefly listed below.
आमसंज्ञां स लभते बहुव्याधिसमा-श्रयः (Vachaspatyam762)
The concept of aama or aama as the entity is the cause of several diseases. Aamavata, alasaka, visuchika, aamatisara to mention a few.
Acharya Charaka explained specifically alasaka and visuchika as prime diseases caused by aama.
Alasaka
The non-expulsion of undigested food or aama from the body is alasaka. There is obstruction cause because of kapha dosha along with the involvement of weak agni. (cha.vim2.12)
Visuchika
The expulsion of undigested food or aama dosha through upper and lower passages meaning, vomiting and diarrhoea is visuchika. (cha.vim.2.11)
Aamavata
Excessive unctuous food when taken right after the exercise, in the presence of weak agni, this food doesn’t get digested appropriately and aama is formed. This aama gets circulated with the help of vata dosha in the whole body and finally accumulates in the sandhi sthana (joints) causing pain, fever, heaviness of the body, and other symptoms. This is very commonly co-related with Rheumatoid arthritis. (madh.nida.25.1-6)
Aamaatisara
When excessive heavy, unctuous, dry food, incompatible food is taken on a chronic basis and untimely, the food does not get digested appropriately and aama is formed, this leads to amatisara. Aamatisara is mildly co-related with dysentery. Where there is a pain in the abdomen, increased motion frequency along with other symptoms. (madh.nida.3.1-11)
आमचिकित्सा ॥ Management of Ama disorders
(cha.vim2.13)
In visuchika, langhana(therapeutic fasting) is advised followed by a strict dietary regimen. Application of suppositories and Further,if still not managed Virechana or Purgation is done.
In certain cases of ama disorders, ahara (food) is not recommended at all, because the derangement of agni(digestive fire) is incapable of digestion. And food intake can derail the agni(digestive fire) further leading to the severity of the disorder.
Also, Aptarpana means fasting or undernutrition is adopted as well.
Nidana privarjan chikitsa method is adopted as well, which means the exclusion of the factors which caused the disease in the first place.
When the aama is skilfully digested basti chikitsa is administered systemically.
Administration of Pachana and Deepana dravya.
पाचनम्॥ Pachana
Pachana means digestion. It is karma or the action of a certain drug on the body. The dravya or drug that acts by digesting the undigested food or aama in the body is the pachana dravyas. These dravya digest what is undigested without stimulation of the agni (digestive fire). one such example of Pachana dravya is Haritaki(Terminalia chebula). (sha.purv.4.1)
दीपनम्॥ Deepana
Deepana means stimulating, here it means stimulation of digestive fire meaning agni. Thus, the karma of the dravya which initiates the kindling of agni(digestive fire) is termed deepana dravyas. One such example of deepana dravya is shatapushpa(Anethum sowa). Hot water, and cow’s milk are examples of depana karma dravya which are used routinely (Sush.Sutra 45.39 and 51) . Snana (bathing) is also one example of deepana karma(Asht.hrid sutr 2.16).
Pachan, snehan (anointing) and swedana(therapeutic steam) methods of dosha expulsion should be adopted according to the rutu(season) and bala(strength) of the patient, pathway of expulsion(vamana or emesis, virechana or purgation). (Asht,hrid.sut.13.29)
सामदोषा॥ Saamadosha (ash.hrid.sut.13.27)
When doshas(vata, pitta, kapha) and dhatus, like rasa, rakta etc are contaminated because of aama formation then these doshas are termed as sa-aama doshas. And when a certain individual is affected with any disease when doshas are in sa-ama condition the diseases are also in sa-ama stage. This is important from a Vaidya’s or physician's point of view while planning the treatment.
Sama pitta dosha
Asht.sutr.13
सामदोषलक्षणानि॥ Sa-ama dosha lakshana| Symptoms of sa-ama dosha in body (ash.hrid.sut.13.23-24)
1. Obstruction of strotas(channels/passage)
2. Laziness
3. Heaviness in the body
4. Loss of strength
5. Exhaustion
6. Constipation
7. Indigestion
सामदोषचिकित्सा॥ Management of saama dosha
When sa-ama doshas arespread across the body, when they are unified with dhatus(tissues), shodhana chikitsa method or expulsion of doshas from the body should not be adopted. Shamana chikitsa(pacification of doshas through oral medication) must be adopted initially. (ash.hrid.sut.13.28)
On the contrary, when the doshas are highly vitiated, they get expelled out in the form of vomit or diarrhoea, and these doshas should not be stopped. If done so are capable of producing diseases. (ash.hrid.sut.13.31).