Digestion Of Ama Associated With Doshas In Fever – Pachana In Jwara

By Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S

Pachana means digestion or to cook. In the context of Ayurveda treatment principles Pachana is a highly praised and most needed intervention in most of the diseases. Pachana is a shorter version of ‘ama pachana’ which means ‘methods to digest ama’.

Pachana is used for –

• Digestion of ama
• Separating ama from its association with doshas, tissues and excreta
• To prepare the doshas to get expelled out of the body (since doshas associated with ama should not and cannot be expelled from the body, as a rule)

Pachana is also an effective measure in the treatment principles of fevers.
Read – Use Of Water In Fever, Rules, Method, Ayurveda Perspective

Pachana in Fevers

Fever, according to Ayurveda has its origin from stomach. It manifests when the aggravated doshas weaken the digestive fire and displace it from stomach. Consequently there is indigestion and formation of ama.

Ama, over a period of time is put into circulation and gets associated with doshas. It also associates with tissues and cause blocks in tissues and related channels. When it is associated with excreta, they are not expelled out of the body and adhere within the body.

Langhana – lightening therapies, fasting to be precise is the first line of treatment in fevers. This is with an intention to give rest to the stomach, kindle the weak fire and produce lightness in the body.
Read – Langhana Therapy – A Unique Ayurvedic Treatment Principle

Rules for administration of pachana

Master Charaka has mentioned Pachana after Langhana in treatment of fever. Therefore it should be administered after fasting or after the signs of proper fasting have been observed. Both these measures are highly effective and should essentially be administered in taruna jwara i.e. acute fevers, first 6-7 days of fever.
Read related: Langhana in Jwara

Methods of Pachana

Below mentioned are the methods of Pachana which should be implied in treating acute fevers.

• Fasting – Langhana
• Sudation – Swedanam
• 8^th day – Kala
• Gruels of different consistencies, includes manda, peya and vilepi – Yavagva
• Bitter tasting herbs -Tiktako Rasah

Note – Some have opined to consider yavagu and tiktaka rasa together. When done so, Yavagvah Tiktako Rasah – means gruels prepared with bitter tasting herbs.

Though they are different types, they complement each other. They can be used either individually or in combinations as and when needed. The physician should take the call of making the choice / choices of pachana measures depending on the status of the involved doshas and their association with ama.

All the above mentioned measures are said to be Pachana i.e. they perform the action of pachana.

Pachana of what?

Pachana of avipakva doshas i.e. doshas associated with ama. When doshas are associated with ama, they are called as avipakva or unripe doshas. Pachana aims at ripening these doshas by destroying the ama associated with the doshas causing fever. Once the ama has been removed effectively the doshas become free of ama and will be called as pakva doshas i.e. ripened doshas. Aggravated doshas can only be expelled out of the body by suitable purifying therapies, mainly emesis and purgation, only after the ama has been properly dealt with.
Read – Vamana Virechana – Emesis and Purgation – Ashtanga Hridayam Sutrasthana 18

In which condition of fever should pachana be given?
Pachana is useful and should be implemented in treatment of Acute fever – Taruna Jwara.

Langhana

Langhana – fasting, has been mentioned as the first line of treatment of jwara. But why is langhana mentioned again in the pachana measures?

Langhana too performs the role of dosha pachana. Agni deepana i.e. kindling digestive fire strength is one of the benefits of langhana. Thus langhana has multidimensional role, it kindles the digestive fire and also causes digestion of ama.

If fasting itself can cause digestion of ama, then why other measures have been mentioned?

If the patient doesn’t tolerate fasting or in conditions wherein fasting is contraindicated or if it fails yielding desired results, the other forms of pachana can be administered. Fasting can also be combined with sudation or gruels to hasten up the process of inducing lightness in the body as well as digesting ama simultaneously.
Read – Qualities And Symptoms Of Ama – Ama Guna Lakshana

Swedana

Sudation is one of the best measures to destroy ama. It is preferred in all conditions associated with ama and all diseases in which ama needs to be destroyed, detached and separated.

Sudation is a process of inducing sweating. It includes heat processes. Apart from this sudation also removes obstruction caused in the cells and channels of the body by ama and also destroys heaviness and coldness. Even by quality sudation is antagonistic to properties of ama. The heat, intensity and dry quality associated with sudation process will enable in destruction and digestion of ama.

‘Obstruction to the process of sweating and absence of sweating’ is one of the chief symptoms of fever as per Ayurveda. Sudation will help in opening up the channels of the body, including those of sweat and enable sweating.
Read – Sweating Treatment – Swedana Types And Methods – Charaka Samhita 14

Kala

Kala means time. As we know that time heals many things if left alone. In the context of pachana measures, kala means 8^th day. This means that even without administering any measures for dosha pachana, the ama is destroyed on the 8^th day. Here we have a clue for wait and watch without doing much. This can be done in only patients who can tolerate disease, physically and mentally strong to wait for recovery to set in naturally. In this period he can follow fasting and intake gruels and wait for the signs of destruction of ama to appear on 8^th day.

Alternatively from a therapeutic angle, the physician should target 8^th day as the limit for inducing dosha pachana in the patient. He should do all kinds of permutations and combinations of pachana therapies and see that the ama has been destroyed completely within 7 days from the onset of fever.
Read – Ayurveda Home Remedy For Fever

Yavagvaha

Yavagu means gruels. Here in this context the plural of yavagu has been mentioned. Thus, this term includes different kinds of gruels peya, manda and vilepi. All three forms may be used as and when required or depending on the status of doshas and associated ama. The difference in each gruel is the relative quantitative difference between the solid and liquid (water) taken in the preparation and the final consistency of the preparation.

Yavagu not only digests ama, but is also therapeutic. Being prepared with medicinal herbs it is antipyretic, cleanses the channels, is a dietetic supplement and is supportive to the life of the patient of fever and provides energy while he or she is fasting. Therefore gruels can form effective pachana combination with fasting or sudation (in those who cannot tolerate fasting or in whom fasting has been contraindicated).
Read – Yavagu – Preparation, Benefits, Uses In Fever

Tikta Rasa

Tikta Rasa means bitter tasting herbs. Here, in acute fevers direct administration of bitter tasting herbs in the form of medicine is contraindicated because bheshaja (medicine) should not be given in this condition.

It is said that when medicine is administered in presence of ama associated with doshas, especially in acute fevers, the fever will further aggravate.

Therefore the bitter herbs should be given being processed with gruels, drinks, water etc.
Read – Bitter Taste – Qualities, Health Benefits, Side Effects

Limitations of administering langhana etc measures as pachana in taruna jwara

So we will consider two conditions –

Taruna Jwara – fever for first 7 days is called as taruna jwara. In these 7 days to get rid of ama associated with doshas langhana etc measures are administered as discussed above.

Ataruna Jwara – fever after 7 days is called ataruna jwara. In this period if ama is still associated with doshas, ama pachana should be done by administering kashaya – medicated decoctions and not langhana etc measures.

Click to Consult Dr Raghuram Y.S. MD (Ayu)

Medicines for Ama Pachana from Sahasrayoga Textbook

Pachana kashayam
Amritadi Kashayam (Pachanamrita Kashayam)