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Trividhakukshiya Vimana (view source)

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''Ama'' is the undigested food material which remains inside body and produces toxic effects. The clinical presentation of ''ama'' has two variations-''visuchika'' (cholera) and ''alasaka''(sluggish bowels) - with primarily gastrointestinal and few systemic features. The line of management of ''ama'' includes emesis, fomentation, use of suppositories, and fasting followed by the use of ''deepana'' and ''pachana'' class of drugs. The patients should be given massage, ''asthapana'' and ''anuvasana'' types of ''basti'' and also oleation therapy after the patient is free from ''ama'', helping restore the patient’s lost strength.

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==Sanskrit Text, Transliteration and English Translation==

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yu~jjAnaH; tadyathA- ekamavakAshAMshaM mUrtAnAmAhAravikArANAm, ekaM dravANAm, ekaM punarvAtapittashleShmaNAm; etAvatIM hyAhAramAtrAmupayu~jjAno nAmAtrAhArajaM ki~jcidashubhaM prApnoti||3||

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The consumer of the food should divide the total capacity of his stomach into three parts – a third of the portion of the space should be allocated to solid food articles, a third to liquid food substances and the remaining third should be left for the (movement of) ''vata'', ''pitta'' and ''kapha''. One who keeps this basic thumb-rule during dietary intake, does not get affected by any adverse effect arising out of improper amount of diet. [3]

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The consumer of the food should divide the total capacity of his stomach into three parts – a third of the portion of the space should be allocated to solid food articles, a third to liquid food substances and the remaining third should be left for the (movement of) ''vata'', ''pitta'' and ''kapha''. One who keeps this basic thumb-rule during dietary intake, does not get affected by any adverse effect arising out of improper amount of diet. [3] </div>

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Na ca kevalaM mAtrAvattvAdevAhArasya kRutsnamAhAraphalasau ShThavamavAptuMshakyaM, prakRutyAdInAmaShTAnAmAhAravidhi- visheShAyatanAnAM pravibhaktaphalatvAt ||4||

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It is not possible to derive all the beneficial effects of any diet only on the basis of the quantity of food consumed because the other seven factors (discussed in the preceding chapter, such as ''prakriti'' (nature of food) etc.) have their own individual role to play.[4]

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etAvAneva hyAhArarAshividhivikalpo yAvanmAtrAvattvamamAtrAvattvaM ca||5||

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However, the focus of this chapter is only to analyze the effect of the quantum of food (''rashi'') ingested, with the objective of determining appropriate and inappropriate quantities. This is the only consideration to decide how much is the proper and improper amount of food. [5]

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=== Signs after consuming proper amount of food ===

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tatra mAtrAvattvaM pUrvamuddiShTaM kukShyaMshavibhAgena, tadbhUyo vistareNAnuvyAkhyAsyAmaH| tadyathA kukSherapraNIDanamAhAreNa, hRudayasyAnavarodhaH, pArshvayoravipATanam, anatigauravamudarasya, prINanamindriyANAM, kShutpipAsoparamaH, sthAnAsanashayanagamanocchvAsaprashvAsa hAsyasa~gkathAsu sukhAnuvRuttiH, sAyaM prAtashca sukhenapariNamanaM balavarNopacayakaratvaM, ca; iti mAtrAvato lakShaNamAhArasya bhavati||6||

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Whether the amount of food to be consumed is appropriate or not is determined on the basis of the capacity of the stomach and its division into three parts, as mentioned earlier. This will again be described here in detail. Any quantity of food to be consumed can be considered appropriate if it does not exert undue pressure on the abdomen, does not cause obstruction in the proper functioning of the heart, does not exert any pressure on the sides of the chest, does not leave a feeling of excessive heaviness in the abdomen, properly nourishes(satisfies) the sense organs, subsides hunger and thirst, after consuming which the person is able to perform activities such as standing, sitting, walking, exhaling, inhaling, laughing, and talking with ease, and is easy to digest when taken in the morning and evening hours. Food consumed in the appropriate quantity enhances strength, complexion, and nourishment of tissues. [6]

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=== Signs after consuming improper amount of food ===

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tu chardyarocakAvipAkashItajvarAlasyagAtragauravANi||7||

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Inappropriate quantity is of two types - deficient or excessive in quantity – as briefly mentioned earlier. The food taken in deficient quantity is said to be the cause of reduction in strength, complexion and nourishment of body tissues, non–satisfaction, altered peristalsis and misplacement of ''vayu'', impairments in life-functions, body tissues (''sara''), sexual stamina (virility) and ''ojas'' (vitality), damage to the body, mind, intellect, and sense organs, inducing inauspiciousness and also making the person home to a variety of disorders of ''vata''.

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*''Pitta'' causes fever, diarrhea, burning sensation inside body, thirst, intoxicated state, giddiness and delirium, and

*''Kapha'' causes vomiting, anorexia, indigestion, fever with cold, laziness and heaviness in the body .[7]

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=== Other causative factors for ama formation ===

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vA yadannapAnamupayujyate, tadapyAmameva pradUShayati||8||

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The quantum of food is not the only cause of formation of ama (undigested and non-metabolized food) in the body but also the use of diet and drinks which are heavy to digest, and with properties like dry, cold, dehydrated, disliked by the consumer, constipation-causing, causing a burning sensation, unclean, incompatible, and/or consumed untimely. Intake of food while the mind being afflicted with passion/desires, anger, greed, infatuation, envy, bashfulness, grief, conceit, excitement and fear are also the cause of formation of ama. [8]

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The quantum of food is not the only cause of formation of ama (undigested and non-metabolized food) in the body but also the use of diet and drinks which are heavy to digest, and with properties like dry, cold, dehydrated, disliked by the consumer, constipation-causing, causing a burning sensation, unclean, incompatible, and/or consumed untimely. Intake of food while the mind being afflicted with passion/desires, anger, greed, infatuation, envy, bashfulness, grief, conceit, excitement and fear are also the cause of formation of ama. [8] </div>

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cintAshokabhayakrodhaduHkhashayyAprajAgaraiH||9||

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Thus it can be said that any wholesome food, even if taken in the right amount, does not get digested if the mental state of the person is riddled with anxiety, grief, fear, anger, or restless and irritable due to lack of sleep.[9]

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===Two types of ''ama'' disorders ===

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yathoktarUpAM vidyAt||11||

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The expulsion of ''ama dosha'' (undigested food) through both upper and lower passages of the gastrointestinal tract with the features already described above is ''visuchika'' (cholera).[11]

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==== ''Alasaka''(sluggish bowel) ====

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punarAmadoShamAmaviShamityAcakShate bhiShajaH, viShasadRushali~ggatvAt; tat paramasAdhyam, AshukAritvAdviruddhopakramatvAcceti||12||

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If a frail person having weak digestive power and excess of ''kapha'' in the body, habitually suppresses the urges of passing flatulence, micturition and bowel movement and at the same time consumes solid, heavy, excessively dry, and cold, dehydrated foods in excessive quantities, his ingested food gets afflicted by ''vayu''. Even exerting pressure does not push the undigested food out of the passage since it is obstructed by ''kapha'', by excreta accumulated already, and also because of sluggishness caused by all these factors. This condition is called ''alasaka''. All the characteristic features of ''ama dosha'', devoid of vomiting and diarrhea, are manifested severely in ''alasaka''.

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The extremely vitiated ''doshas'' move towards oblique passages as the other passages are blocked by aggravated ''ama''. This will sometimes cause the body to become rigid, like a wooden rod/staff. This incurable clinical condition is known as ''dandaalasaka''. The ''ama dosha'' of an individual who regularly consumes incompatible diet, multiple heavy meals (in short intervals) and eats even before the previous meal is digested is called ''ama visha'' (clinical state of indigestion characterized by manifestation of toxic symptoms) because of resemblance of manifested symptoms to that of poisoning. It is considered incurable because of its acute presentation and also because of its contradictory line of management .[12]

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The extremely vitiated ''doshas'' move towards oblique passages as the other passages are blocked by aggravated ''ama''. This will sometimes cause the body to become rigid, like a wooden rod/staff. This incurable clinical condition is known as ''dandaalasaka''. The ''ama dosha'' of an individual who regularly consumes incompatible diet, multiple heavy meals (in short intervals) and eats even before the previous meal is digested is called ''ama visha'' (clinical state of indigestion characterized by manifestation of toxic symptoms) because of resemblance of manifested symptoms to that of poisoning. It is considered incurable because of its acute presentation and also because of its contradictory line of management .[12] </div>

=== Management of ''ama'' disorders ===

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doShabheShajadeshakAlabalasharIrAhArasAtmyasattvaprakRutivayasAmavasthAntarANi vikArAMshca samyagiti||13||

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The curable variety of ''ama dosha'' should be eliminated through emesis, by administering warm saline water and thereafter fomentation and application of suppositories while the patient is kept on fasting.

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The amelioration of diseases caused by ''ama'' is done by ''apatarpana'' i.e. depletion therapy. If the disease further progresses even after depletion therapy, appropriate measures should be adopted to counter the morbid condition. Experts recommend the use of measures antagonistic to both the disease as well as its etiological factors, especially medications that could treat them both.

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When the patient is relieved from excessive morbidity of ''ama'', the ''doshas'' are in completely digested form and once his digestive fire has been rekindled/restored, he should be administered, systematically and skillfully, measures such as oleation, corrective and unctuous enema (''asthapana'' and ''anuvasana'' types of ''basti''), and appropriate internal administration of unctuous substances following the specific procedure after careful assessment of the status of ''doshas'', drugs, place, time, strength, body, diet, ''satmya'', psyche, constitution, age etc. and also the diseases .[13]

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When the patient is relieved from excessive morbidity of ''ama'', the ''doshas'' are in completely digested form and once his digestive fire has been rekindled/restored, he should be administered, systematically and skillfully, measures such as oleation, corrective and unctuous enema (''asthapana'' and ''anuvasana'' types of ''basti''), and appropriate internal administration of unctuous substances following the specific procedure after careful assessment of the status of ''doshas'', drugs, place, time, strength, body, diet, ''satmya'', psyche, constitution, age etc. and also the diseases .[13] </div>

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anyashca yaH kashcidihAsti mArgo hitopayogeShu bhajeta taM ca||14||

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Thus it is said-

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The person should promote his wellbeing himself by properly examining the eight factors of dieting which determine the wholesomeness of the food. In addition, other measures which are conducive to health and wellbeing (that are described elsewhere) should also be adopted (per the recommendations of [[Ayurveda]] practitioners). [14]

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The person should promote his wellbeing himself by properly examining the eight factors of dieting which determine the wholesomeness of the food. In addition, other measures which are conducive to health and wellbeing (that are described elsewhere) should also be adopted (per the recommendations of [[Ayurveda]] practitioners). [14] </div>

=== Description of ''Amashaya''(stomach) ===

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etattvAM dhIra! pRucchAmastanna AcakShva buddhiman||15||

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Where all the food that is eaten, masticated, drunk and licked up are digested, O perseverant? We ask this question to you, so please solve our query, O enlightened one! [15]

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Where all the food that is eaten, masticated, drunk and licked up are digested, O perseverant? We ask this question to you, so please solve our query, O enlightened one! [15] </div>

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pakvaH sarvAshayaM pashcAddhamanIbhiH prapadyate||18||

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All the food articles are fully digested after reaching the ''amashaya''. Once the digestion is complete, the digested essence of food reaches all the organs of the body by means of the vessels. [18]

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All the food articles are fully digested after reaching the ''amashaya''. Once the digestion is complete, the digested essence of food reaches all the organs of the body by means of the vessels. [18] </div>

=== Summary ===

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ityagniveshakRute tantre carakapratisaMskRute vimAnasthAne trividhakukShIyavimAnaM nAma dvitIyo~adhyAyaH||2||

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Thus ends the second chapter on characteristics of three divisions of the capacity of the stomach, of the Vimana Section of Agnivesha’s treatise, redacted by Charak. ||2||

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== Tattva Vimarsha (Fundamental Principles) ==

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* Diet plays an important role in the maintenance of good health and in the prevention and cure of the disease; the proper balanced food is the most important factor in the promotion of positive health.

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