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.
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.
Etymolgy
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.
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 or the agni or the digestive fire reduces, the dhatus in the body cannot form appropriately and moves towards amashaya, there they get contaminated by doshas, further after the digestion what remains is termed as aama.
अन्ये दोषेभ्य एवाति दुष्टेभ्योऽन्योन्यमूर्छनात्|कोद्रवेभ्यो विषस्येव वदन्त्यामस्य सम्भवम्||(asht.hrid sut.13.26)
Also according to some acharyas, Vata, Pitta, and Kapha when get contaminated due to certain reasons lead to the formation of aama.
Features of aama - Ama lakshanas
“अविपक्वमसंयुक्तं दुर्गन्धं बहु पिच्छिलम्| सदनं सर्वगात्राणामाम इत्यभिधीयते|| (madh.nid.25.2,madhukosha teeka)
That which is, undigested, which has a foul smell, very sticky, deteriorates the whole body are certain features of aama.
What causes Aama?
न च खलु केवलमतिमात्रमेवाहारराशिमामप्रदोषकरमिच्छन्ति अपि
तु खलु गुरुरूक्षशीतशुष्कद्विष्टविष्टम्भिविदाह्यशुचिविरुद्धानामकाले
चान्नपानानामुपसेवनं,कामक्रोधलोभमोहेर्ष्याह्रीशोकमानोद्वेगभयोपतप्तमनसा वा यदन्नपानमुपयुज्यते,
तदप्याममेव प्रदूषयति||(cha.vim2.8)
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,
1. Excessive intake of food
2. Guru ahara means food items that are heavy to digest
3. Ruksha and sheeta ahara meaning those food substances which are dry in property and cold in potency.
4. 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.
5. Food items that are viruddha or incompatible according to Ayurveda shastra (eg. Milk and fish)
6. Untimely food consumption as well can lead to aama formation.
7. 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.
Mental factors - maanas hetu
भवति चात्र-
मात्रयाऽप्यभ्यवहृतं पथ्यं चान्नं न जीर्यति|
चिन्ताशोकभयक्रोधदुःखशय्याप्रजागरैः||९|| (cha.vm.2.9)
Chinta means stress, shoka or grief, anger, sadness, and sleeplessness are the psychological factors that affect the physiology of the digestive process
Diseases caused by aama
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)
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.
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)
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)
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
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
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).