Ama Chikitsa: Treatment For Ama And Saama Conditions

By Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S
Ama is improperly processed food juices formed at end of digestion in stomach. This happens due to weak digestive fire. It is immature essence of food and is dangerous for body and health. Presence of ama in body demands separate treatments to be done in order to get rid of this toxic element.

Importance of ama

Why should we address this ama and treat it in a special, delicate way?
Doshas, tissues and excreta would be associated with ama and make way for complicated diseases on long run. Association of ama makes body elements stick to the walls of cells, tissues, organs and channels in a stubborn way.
Read – Ama – Word Derivation, Meaning, Definition, Formation

Ama also creates multiple blocks in body channels depleting tissues of their nutrition and essential elements needed to run the body factory. Thus most of functions of the body would be shut down or slow down. Organs, channels and tissues will be damaged and excreta will get piled up in body while toxins accumulate in all tissues.

Morbid doshas and excreta should be expelled from body to keep it clean and healthy.
They can be easily eliminated by suitable medications and treatments like emesis and purgation.
But when same doshas and excreta are associated with ama, they cannot be eliminated from body easily and directly because doshas and excreta are sticking to the walls of channels and passages.

If we forcibly try to push these doshas from body, they will cause damage to the structures to which they are adhering. Similarly tissues associated with ama should also be treated delicately.
Read –Association Of Ama With Doshas, Tissues And Waste Products

Sanskrit verse

Remedy

So what is the remedy?
Remedy is to separate this association of ama and body elements.
Before expelling doshas or excreta from body, they should be separated from their association with ama.
Even in case of sama doshas located in tissues, the ama should be first digested with help of ama digesting or destroying medicines and measures.
Later doshas devoid of ama should be brought to stomach.
From stomach they can be thrown out by administering emesis or purgation.

Thus, dealing with ama is like removing a cloth which has fallen over thorny bush. Cloth should be delicately removed so that thorns do not tear away the cloth. To do so, cloth should not be pulled in a hurry. It should be slowly separated from thorns and gradually lifted up.
Read – Importance Of Diet (Pathya) For Specific Diseases

Treatment principle

Treatment principles of ama and sama elements of body
Below mentioned principles and methods of treating ama holds good for treating sama doshas, tissues and excreta. Same principles are followed while treating diseases caused due to ama or association of ama.

Generally most diseases are treated through –
– Santarpana i.e. strengthening treatments
– Apatarpana i.e. depleting treatments

Treatment is also of 6 types which are very popular strategies in Ayurveda.
They are called Shad Upakramas i.e. 6 sub-treatments
– Brimhana – bulk promoting treatments
– Snehana – unctuousness producing treatments
– Stambhana – constipating treatments, checking therapies
– Langhana – lightening therapies
– Swedana – sudation therapy
– Rukshana – drying therapies
Read – Sama Mala: Metabolic Wastes With Toxins (Ama) Of Improper Digestion

Among these, first three i.e. brimhana, snehana and stambhana serve purpose of strengthening treatment while  later three therapies i.e. langhana, swedana and rukshana serve the purpose of depleting therapy.

Depleting treatments are said to be best treatment of choice in diseases caused due to ama or sama doshas.
Thus, the key steps in treatment of ama or ama dosha or ama diseases are –
– Langhana
– Swedana and
– Rukshana
Read – Qualities And Symptoms Of Ama – Ama Guna Lakshana

This is possible only if physician is wise enough in discriminating between a diseases associated and not associated with ama.
If without the knowledge of ama and saama if physician administers strengthening treatments in ama and saama diseases, conditions will become worse and create lot of complications because it becomes incompatible and opposite treatment for ama.

Strenthening treatment increase ama and its complications in body while depleting therapies will digest and destroy ama and cure diseases and conditions caused by it.

Planning of depleting treatment in Ama conditions
Though all three inclusions of depleting therapy i.e. langhana, swedana and rukshana are highly effective in treating diseases caused by ama, langhana forms  most important strategy in treating these conditions.
Read – Koshta Shakha Marma-Asthi-Sandhi Gati Of Dosha – Doshas In Organs And Joints

Depleting therapy is once again of three types.
– Langhana – Lightening therapies
– Langhana Pachana – Combination of lightening and ama digesting therapies
– Dosha avasechana – elimination of doshas from body by administering cleansing treatments

Langhana

Only lightening therapies should be administered when small quantities of doshas / ama are aggravated or when aggravated doshas have less strength to produce disease in a large scale.
Langhana increases fire and vata in body.
Just like intensity of heat of sun and breeze evaporates small quantity of water in pond, langhana also destroys small quantity of doshas.
Read – Langhana Therapy – A Unique Ayurvedic Treatment Principle

Langhana Pachana

Combination of lightening and digestive therapy should be administered when moderate quantities of doshas / ama are aggravated or when the vitiated doshas are moderately strong.
Just like when layers of dust and gravel is put in pond having moderate amount of water absorbs all water when combined with heat of sun and breeze, langhana and pachana will destroy moderately aggravated doshas / ama.
Just like Sun and breeze evaporates water, lightening therapy evaporates moderately aggravated doshas and as dust absorbs water, digestive measures absorbs doshas.

Dosha avasechana

When doshas are severely aggravated, doshavasechana i.e. expulsion of morbid doshas and ama should be done by administering cleansing treatments like emesis, purgation etc.
Just like water stagnated in fields cannot be eliminated without breaking barriers and constrictions,  doshas which have severely aggravated cannot be controlled without expelling them by administering panchakarma treatments.
Read – Treatment For Dosha Imbalance, Ama – Ashtanga Sutrasthana 13

Role of swedana

Role of Sudation and Drying therapy in treating ama
Sudation and drying therapy are important strategies of dealing with ama. They are part of depleting treatment.

Ruksha Sweda or dry sudation can be provided in form churna pinda sweda, valuka sweda etc to give instant relief from ama symptoms.
Drava sweda in the form of Nadi sweda or bashpa sweda is administered to mobilize doshas detached from ama towards stomach.
From stomach these nirama doshas are expelled out of body by administering emesis or purgation.

Drying therapy almost does same task as that of dry sweating but can be administered in form of  dryness producing and ama depleting medicines, diet and lifestyle.
It is beneficial in tackling mild to moderate quantity of doshas.

Chronology of treatment

Chronology Of Treating Ama And Sama Diseases As Explained By Vagbhata
Acharya Vagbhata has discussed treatment of ama and diseases caused by ama or doshas associated with ama in a chronological way. It is very important for physician to know about chronology of this intervention, not only to treat these conditions effectively but also to prevent complications arising from erroneous treatment.

Read –Symptoms Of Doshas Associated Ama – Treatment Principle

Chronology of ama treatment according to Acharya Vagbhata
It is very important to remove and expel doshas hidden and stuck within tissues. But doshas associated with ama which are adherent within tissues should not be forcibly removed.
Simily – When we try to extract juice from unripe fruit, fruit is destroyed but it doesn’t yield juice. Similarly when we forcibly try to pull doshas associated with ama from tissues, they will not come out but in fact destroy tissues and organs made up of those tissues.
Read – Ama – Word Derivation, Meaning, Definition, Formation

The following treatments should be administered in chronological way –

Pachana

Ama digesting medicines should be administered initially.
This will help in digesting ama and separating it from its association with body elements i.e. tissues, doshas and excreta.
This is very essential in order to expel morbid doshas from body because doshas associated with ama cannot be removed from body.
Read – Ayurvedic Home Remedy To Improve Digestion

Deepana

Simultaneously, medicines and measures for kindling digestive fire, to improve appetite and digestion should be administered. This is because if fire is not kindled, the weak fire can once again produce ama.

Snehana

Oleation in form of internal consumption of medicated ghee in metered and increasing dose should be given for 3-7 days or until proper symptoms of oleation are seen.
This causes swelling of doshas in tissues and also will increase their quantity temporarily.
This is very essential because by increasing quantity of doshas we will be preparing them to get expelled from tissues.
Snehana also will produce pressure on tissues to expel doshas.
Read – Langhana Therapy – A Unique Ayurvedic Treatment Principle

Swedana

Sudation in form of steaming or sweating treatment is administered for 1-7 days.
It will dissolve swollen morbid doshas in tissues.
Sudation should be given after oleation therapy.
Once the doshas get dissolved in tissues, they will overflow and come into stomach or intestines. From here, doshas can be removed from nearest passages i.e. mouth or anus in case of kapha predominant and pitta predominant doshas respectively by administration of emesis and purgation respectively.
In case of morbid doshas located in neck and head, oleation and sudation will enable movement of doshas towards nose or mouth to get expelled from those passages.
Read – Sweating Treatment – Swedana Types And Methods – Charaka Samhita 14

Mobilization of doshas from tissues towards visceral organs and administration of shodhana After administration of above mentioned treatments, doshas detached from association with ama move towards stomach or intestines, they are expelled out of body by administering shodhana i.e. cleansing treatments after considering place and time and after analyzing strength of patient.

Doshas should be expelled from the nearest routes –
Cleansing should be from nearest route. Doshas from stomach should be expelled through mouth because mouth is nearest opening to stomach.
If the doshas are located in intestines, they should be eliminated from anal passage because anus is nearest to small intestine.
– Doshas and ama in stomach should be expelled by administering emesis, through mouth.
– Doshas and ama in neck and head should be removed by administering nasal instillation, through nose.
– When located in intestines and colon should be expelled by administering purgation, through anus.
– Doshas and ama which are ready to get expelled by themselves should not be stopped forcibly.
In fact they should be facilitated to get expelled. Only healthy diet should be consumed during this period.
Read – Dosha Gati: Normal And Abnormal Movements Of Doshas

Digestive and cleansing therapy in severe accumulation of doshas –
If there is severe accumulation of ama doshas in body, strong ama digesting medicines and measures should be administered.
Apart from that, timely shodhana or cleansing treatments should be administered to constantly remove accumulated ama from body.
Read – Treatment For Dosha Imbalance, Ama – Ashtanga Sutrasthana 13

The knowledge of this chronology of treatment will enable the physician to conquer ama in quick time and save the body from serious complications and consequences.
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Medicines for Ama Pachana from Sahasrayoga Textbook

Pachana kashayam
Amritadi Kashayam (Pachanamrita Kashayam)