E-ISSN:2456-3110

Review Article

Amlapitta

Journal of Ayurveda and Integrated Medical Sciences

2023 Volume 8 Number 4 April
Publisherwww.maharshicharaka.in

A critical appraisal on the role of Agni in Amlapitta

G. Nair A.1*, Bhat R.2
DOI: http://dx.doi.org/10.21760/jaims.8.4.18

1* Arun G. Nair, Post Graduate Scholar, Department of PG studies in Kayachikitsa, Dhanvantari Ayurveda Medical College and PG Research Centre, Siddapur, Karnataka, India.

2 Roopa Bhat, Professor & HOD, Department of PG studies in Kayachikitsa, Dhanvantari Ayurveda Medical College and PG Research Centre, Siddapur, Karnataka, India.

Background: Ayurveda is a peculiar domain of medical science which has its remedies for different ailments; either in the form of dietary modifications, lifestyle alterations or treatment modalities. In modern era, due to over inclination towards materialistic life, people often tend to compromise on their lifestyle, which indeed leads to depletion in health causing several ailments. Such compromises in life style and food habits will lead to the manifestation of diseases mainly of Annavaha Srotas. Such a commonly encountered disease is Amlapitta. Along with Tridosha, another entity i.e., Agni also plays an important role in the manifestation of the same. Hence, it is worth a discussion to explore the role of Agni in the development of Amlapitta. Materials and Methods: Extensive literary research was conducted inclusive of electronic databases such as Pubmed, Pubmed central, index medicus And index in Services like Elsevier, Scopus, Embase etc along with classical textbooks of Ayurveda. Discussion: Amlapitta is such a frequently encountered pathological manifestation of Annavaha Srotas which is explained in Ayurveda classics; wherein the Shuktata of Pitta Dosha gets elevated. Agni is an important factor which is responsible for proper occurrence of metabolism, which is utmost important for a disease free life. Conclusion: An effort is made in this paper to emphasize the role of Agni in Amlapitta, which can decide the fate of treatment planned and the rationality behind it.

Keywords: Ayurveda, Amlapitta, Agni, Annavaha Srotas, Agnimandya

Corresponding Author How to Cite this Article To Browse
Arun G. Nair, Post Graduate Scholar, Department of PG studies in Kayachikitsa, Dhanvantari Ayurveda Medical College and PG Research Centre, Siddapur, Karnataka, India.
Email: 		Arun G. Nair, Roopa Bhat, A critical appraisal on the role of Agni in Amlapitta. J Ayu Int Med Sci. 2023;8(4):106-110.
Available From
https://jaims.in/jaims/article/view/2407

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2023-02-20 2023-02-22 2023-03-01 2023-03-08 2023-03-15
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
Nil Nil Yes 16%

© 2023by Arun G. Nair, Roopa Bhatand Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

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Introduction

Amlapitta is a frequently encountered pathological manifestation of Annavaha Srotas which is explained in Ayurveda classics; wherein the Shuktata of Pitta Dosha gets elevated.[1] Amlapitta is a pathology which has a bare minimum explanation in Bruhatrayee’s. Even though much references are not there in Bruhatrayee’s, scattered references about Amlapitta are seen in Charaka Samhita. Acharya Charaka has

described Ahara Vidhi Vidhana which conveys the methods of consumption of food. According to him, man under psychological problem, can’t digest the food properly even if it is delicious, adequate and with appropriate food value.[2] Thus, this undigested food disturbs the physiology of Annavaha Srotas. As per Ayurveda, when a person with a pre-existing tendency for excessive Pitta secretion habitually takes incompatible, sour, heart burn producing Pitta vitiating food and drinks, leads to a pathological condition called Amlapitta.[3] In Amlapitta, due to Nidana Sevana, Agnimandya manifests in the body because of which ingested food becomes Vidagdha and finally the prodromes like Amlodgara, Urovidaha, Aruchi are manifested clinically.[4] The Manifestation of Amlapitta and its course of development depends on another entity other than the Nidana’s i.e., Agni. Agni can be considered as an internal force which helps in the proper metabolism of the body. The changes or a disturbance in the functioning of Agni is an important factor in the pathogenesis of Amlapitta. Acharya Vagbhata emphasizes this when in Udara Chikitsa he says Mandagni is the root cause for the manifestation of almost all the diseases.[5] Acharya Charaka explains the importance of Agni in a quite serious way itself when he says Agni in the state of its normalcy provides Ayu, Varna, Bala, Swasthya, Utsaha etc and when Agni function stops death is inevitable.[6] Charaka, in Gulma Chikitsa also explains the importance of Agni when he says that the Shamana and Prakopa of Dosha’s depend on Agni and hence Agni should be protected always especially through Nidana Parivarjana.[7] Hence, Agni is such an important entity in the maintainance of health as well as the manifestation and progression of any of the diseases and here is an attempt made in this article to understand the importance of Agni in Amlapitta disease.


Amlapitta Nidana - An Overview[8-10]

Aharaja

Abhojana
Abhojana
Atibhojana
Ajeerna
Amapurana
Vishamashana
Adhyasana
Gurubhojana
Gorasa Atisevana
Phanita-Atisevana
Pishta-Atisevana
Ikshuvikara Atisevana
Ushna Atisevana
Katurasa Atisevana
Amla Rasa Atisevana
Drava Atisevana
Kulattha Atisevana
Madya Atisevana
Ruksha Atisevana
Bhrustadhanya
Atisevana

Viharaja

Vegadharana
Bhukte Bhukte Snana
Bhukte Bhukte Avagaha
Bhukte Bhukte
Divaswapna

Manasika

Chinta
Shoka
Bhaya
Krodha

Purvarupa: Acharya Charaka considered Amlapitta as symptoms of diseases during description of Grahani. He mentioned Purvarupa’s like Trishna, Alasya, Balanasha, Annavidha, Gauravata etc., these symptoms also can be considered as Purvarupa for Amlapitta.[13]

Upashaya Anupashaya: Specific mentioning about Upasaya and Anupasaya is given only by Kashyapa while describing Doshaja types of Amlapitta.[15]

1. Vataja Amlapitta - Snigdha Upasaya

2. Pittaja Amlapitta - Swadu and Sita Upasaya

3. Kaphaja Amlapitta - Ruksha and Ushna Upasaya



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Samprapti[11,12]

Kashyapa’s View

Tridoshaja Nidana

↓

Vidagdha Pitta

↓

Agnimandhya

↓

Vidagdha Ahara

↓

Shukthata of Ahara

↓

Amlata Udriktata

↓

Amlapitta

Madhava’s View

Pitta Prakopaka Nidana

↓

Drava Guna Vridhi of Pitta

↓

Agnimandhya

↓

Vidagdha Ahara

↓

Vidagdha Ahara

↓

Amlata Udriktata

↓

Amlapitta

Agni: Agni is the cause of all diseases means majority of the diseases are outcome of malfunctioning of the Agni[16] which rightly has been called as centre to health. Agni plays not only a vital role in the absorption of macro as well as micronutrients, but it is also responsible for the destruction of pathogens in the body system.[17]

Types of Agni: Ayurveda has classified Agni physiologically into 13 types in the body[18]

1. Dhatvagni - 7

2. Bhutagni - 5

3. Jatharagni - 1

Clinically, Agni are of four types[19]

1. Teekshna Agni

2. Vishama Agni

3. Manda Agni

4. Sama Agni

Rupa of Amlapitta[14]

Lakshana’s KS MN BP YR GN RRS SHS HS
Adhmana + - - - - - - -
Amlodgara + + + + + + + +
Amlotklesha + - - - - - - -
Angasada +  - - - - - - -
Antrakoojana + - - - - - - -
Aruchi - + + + + + - -
Atisara - + + + + - - -
Avipaka - + + + + - + -
Vanti - + + + + - - -
Gourava - - + + + - + -
Gurukoshtata + - - - - - - -
Hikka - - - - - - - +
Hritdaha + + + + + + + +
Hritshoola - + - - - - + -
Kantavidaha + + + + + - + +
Klama - + + + + - - -
Romaharsha + - - - - + - -
Shiroruk + - - - - - - +
Tiktodgara - + + + + + + -
Udgara + - - - - - - +
Urovidaha + - - - - - - -
Utklesha - + + + + - - -

Discussion

Role of different Agni types in Amlapitta Samprapti

Even though Agni is a physiologically important entity, it has its own implications in pathological manifestation of almost all the diseases. Basically, Agni has four important states of clinical significance. They are: Teekshna, Vishama, Manda and Sama Agni.


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In case of Amlapitta, due to Agnimandya, whichever food taken will not be digested properly and Vidagdhata will develop in the person. This Vidagdhata will lead to the development of Shuktibhava which inturn leads to the development of Amlata in Amashaya. During this stage, Samanya Lakshana’s of Ajirna like Glani, Gourava, Vishtambha, Jrimbha, Anga marda etc are manifested which is considered as the Purvarupa of Amlapitta.[20] Since Agnimandya is the root cause for Amlapitta, the food which is taken even in small quantities will not get digested, which leads to Ajeerna and it is the basic stage in the manifestation of Amlapitta. Hence, our Acharya’s consider Ajeerna Lakshana’s as the Purvarupa of Amlapitta. According to Kashyapa Samhita, the Nidana’s if consumed causes vitiation of Tridosha’s.[21] Any of these Dosha’s decreases the Jatharagni, i.e., causes Jatharagnimandya. During this state, whatsoever food consumed, becomes Vidagdha. Then it becomes Sukta and it lies in the stomach as it is. During this time, even minute quantity of food taken will turn obviously into Vidagdha Avastha. At this stage Vidagdhajirna manifests which is the Purvarupa of Amlapitta as explained earlier. Further vitiated Pitta gets mixed with Sukta and causes Pitta Amavisa Sammurchhana. The Amlapitta with its cardinal symptoms is then manifested in the patient. If not treated properly in this stage, the disease leads to Bhedavasta where the typical characteristic types like Urdhwaga, Adhoga etc. are differentiated. Further complications like Sheetapitta, Udara, Annadrava and Parinama Shula etc. may occur in the advanced course of the disease.[22]

Role of Agni in Nidana, Purvaroopa and Rupa of Amlapitta

Now coming to Nidana Panchaka’s of Amlapitta, if the Nidana’s are analysed thoroughly, we can understand that the Nidana’s such as Abhojana, Atibhojana, Ajeerna etc. has direct relationship with different states of Agni which results in its manifestation. Similarly, when comes to the Purvaroopa of Amlapitta, such as Trishna, Alasya etc. which are also the symptoms of Ajeerna signifying again the pivotal role of Agni in this process of disease manifestation. The majority symptoms manifested in Amlapitta are nothing but the effect of clinical variants of Agni shedding its efficacy.

In such a way if we critically analyse the Rupa’s of Amlapitta, the inseparable relation of Agni with the corresponding symptoms can be observed such as in case of Avipaka, Gourava etc. which is significant in the pathogenesis of Amlapitta.

Role of Agni in peculiar Amlapitta Samprapti’s

The pathological picture of Amlapitta explained by Madhava Nidana varies slightly from other Acharya’s as he explains the Drava Guna Vridhi of Pitta Dosha as the precursor of the development of Agnimandhya and later on the manifestation of Amlapitta.[23] Gananath Sen in Sidhanta Nidana has mentioned slightly different angle of Samprapti where when food is dominant with Amlarasa, then in Amashaya also Amlarasa is produced and when it is taken in more quantity it irritates the Amashaya, which also leads to Agnimandhya and later to the manifestation of Amlapitta Roga.[24]

Role of Agni in Amlapitta Chikitsa

If we come to the aspect of Amlapitta Chikitsa, the Chikitsa Sutra includes Vamana, Mridu Virechana, Anuvasana Basti etc.[25] Here, Vamana has been told for removing the vitiated Kapha dosha whereas Virechana guides in removing excess Vidagdha Pitta and Anuvasana Basti helps in the correction of Vata Dosha as well as improves the status of Agni. This explains the rationality behind the importance of correcting the Agni. Hence, Agni has been given prime importance in almost all the aspects of Amlapitta starting from Nidana to Chikitsa.

Conclusion

To conclude, the successful treatments of Amlapitta depends on the way and extend of correction of Agni along with the treatment of presenting symptoms. The correction of Agni should be done first by Nidana Parivarjana i.e., by avoiding the use of Agnimandhyakaraka Ahara and Vihara’s. The proper correction of Agni leads to the breakage of the above mentioned vicious cycle of Samprapti and after the initial concentration on bringing back the Agni into normalcy, we can easily manage all the other symptoms without any difficulty using various formulations mentioned in our classics. Hence, not only in the management of Amlapitta but in almost all the diseases Agni plays a pivotal role both in the manifestation as well as the proper correction of the diseases.



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References

1. Vijayaraksita & Srikanthdatta & extract from Atankadarpan by Vasapti Vaidya Edited by Vaidya Jadavji Tricumji Acharya, Madhavnidan by Madhavkara with the commentary Madhukosh 5thedition Nirnayasagar Press Bombay 1955, Amlapittanidanam 51/1

2. Agnivesha, Charaka Samhita, Part 2nd, Chikitsasthana, Hindi commentary by Brahmanand Tripathy, Chaukhamba Sanskrit Sansthan, Varanasi, 2001, 15/34.

3. Tripathy Brahmanand, Madhavanidana of Madhavakara with Madhukosha vyakhya by vijayarakshita and Shrikanthadatta, Varanasi: Chaukhamba Surabharati Prakashana;2003,51/1, p.228

4. Sri Satyapala, Kashyapa Samhita, Khilasthana, with vidyotini hindi commentary, Varanasi: Choukambha Sanskrit Sansthan;2010, 16/7-9,p.336

5. Vagbhata, Astanga Hrudaya, Nidanasthana, collated by Anna Moreshwar Kunte, ninth edition, Chaukhamba Orientalia, Varanasi, 2005, 12/1.

6. Agnivesha, Charaka Samhita, Part 2nd, Chikitsasthana, Hindi commentary by Brahmanand Tripathy, Chaukhamba Sanskrit Sansthan, Varanasi, 2001, 15/3.

7. Agnivesha, Charaka Samhita, Part 2nd, Chikitsasthana, Hindi commentary by Brahmanand Tripathy, Chaukhamba Sanskrit Sansthan, Varanasi, 2001, 5/136.

8. Vruddha Jivaka, Kashyapa Samhita, with Sanskrit introduction by Pandit Hemraj Sharma, Chaukhamba Sanskrit Sansthan, Varanasi, 2006, 16/3-5.

9. Vruddha Jivaka, Kashyapa Samhita, with Sanskrit introduction by Pandit Hemraj Sharma, Chaukhamba Sanskrit Sansthan, Varanasi, 2006, 16/6.

10. Agnivesha, Charaka Samhita, Vimanasthana, Hindi commentary by Brahmanand Tripathy, Chaukhamba Sanskrit Sansthan, Varanasi, 2001, 2/9

11. P.V. Tewari, Kasyapasamhita/ Vrddhajivakiya Tantra, 2nd Edition Chaukhambha Visvabharati 2002 16/7

12. Vijayaraksita & Srikanthdatta & extract from Atankadarpan by Vasapti Vaidya Edited by Vaidya Jadavji Tricumji Acharya, Madhavnidan by Madhavkara with the commentary Madhukosh 5th edition Nirnayasagar Press Bombay 1955, Amlapittanidanm 51/2

13. Agnivesha, Charaka Samhita, Part 2nd, Chikitsasthana, Hindi commentary by Brahmanand Tripathy, Chaukhamba Sanskrit Sansthan, Varanasi, 2001, 15/55.

14. Madhavakara, Madhava Nidana, Part 2nd, with Madhukosha Sanskrit commentary by Sri Sudarshan Sastri, 13th edition, Chaukhamba Sanskrit Sansthan, Varanasi, 2001, 51/1-2.

15. P.V. Tewari, Kasyapasamhita/ Vrddhajivakiya Tantra, 2nd Edition Chaukhambha Visvabharati 2002 16/16-17

16. https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=2ahUKEwiNgZ2Au4bAhXL7zgGHYMNARQQFnoECCEQAQ&url=https%3A%2F%2Fwww.ayurline.in%2Findex.php%2Fayurline%2Farticle%2Fview%2F564&usg=AOvVaw1Ma3BElsNXm6fQUpXk6Goj

17. https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=2ahUKEwiNgZ2Au4bAhXL7zgGHYMNARQQFnoECCEQAQ&url=https%3A%2F%2Fwww.ayurline.in%2Findex.php%2Fayurline%2Farticle%2Fview%2F564&usg=AOvVaw1Ma3BElsNXm6fQUpXk6Goj

18. Sharma RK, Das VB: Editor, Caraka Samhita of Agnivesa, Chikitisa Sthan; Grahani Dosa Adhyaya: Chapter 15, Verse 5,13,15. Varanasi:Chaukhamba Krishnadas Academy Ed., 2009; 1(IV): 3-10

19. Sharma RK, Das VB: Editor, Caraka Samhita of Agnivesa, Vol. IV Chikitisa Sthan; Grahani Dosa Adhyaya: Chapter 15, Verse 50-51. Varanasi:ChaukhambaKrishnadas Academy, Ed., 2009; 1:27.

20. Sharma RK, Das VB: Editor, Caraka Samhita of Agnivesa, Vol. IV Chikitisa Sthan; Grahani Dosa Adhyaya: Chapter 15, Verse 45-49. Varanasi:ChaukhambaKrishnadas Academy, Ed., 2009; 1:27.



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21. Vruddha Jivaka, Kashyapa Samhita, with Sanskrit introduction by Pandit Hemraj Sharma, Chaukhamba Sanskrit Sansthan, Varanasi, 2006, 16/7-10.

22. Vruddha Jivaka, Kashyapa Samhita, with Sanskrit introduction by Pandit Hemraj Sharma, Chaukhamba Sanskrit Sansthan, Varanasi, 2006, 16/49.

23. Madhavakara, Madhava Nidana, Part 2nd, with Madhukosha Sanskrit commentary by Sri Sudarshan Sastri, 13th edition, Chaukhamba Sanskrit Sansthan,Varanasi, 2001, 51/1-2.

24. Agnivesha, Charaka Samhita, Part 2nd, Chikitsasthana, Hindi commentary by Brahmanand Tripathy,Chaukhamba Sanskrit Sansthan, Varanasi, 2001, 15/42-45

25. Tripathi. Indradev Yogratnakar. Amlapiita Chikitsa 16 Chaukhamba Krushnadas Academy, Varanasi, 2009


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