Changes

== Treatment of ama in other disease conditions ==

== Treatment of ama in other disease conditions ==

<p style='text-align:justify;'>If ama dosha is in [[Grahani Chikitsa|grahani]] (duodenum) and symptoms of ama dosha are present, then emesis is advised by warm water, madanphala (Randia dumetorum) (Emetic nut) or pippali (Piper longum) or sarshapa (Brassica campestris).   

<p style="text-align:justify;">If ama dosha is in [[Grahani Chikitsa|grahani]] (duodenum) and symptoms of ama dosha are present, then emesis is advised by warm water, madanphala (Randia dumetorum) (Emetic nut) or pippali (Piper longum) or sarshapa (Brassica campestris).   

<br/>If ama dosha is in leena avastha (dormant state), [[Deepana|deepana]] medicines are advised first. If amadosha is spread throughout the [[Sharira|body]] then first [[Langhana|langhana]] is to be given followed by [[Pachana|pachana]] medicines. [Ca. Sa. [[Chikitsa Sthana|Chikitsa Sthana]] 15/73-75]  

<br/>If ama dosha is in leena avastha (dormant state), [[Deepana|deepana]] medicines are advised first. If amadosha is spread throughout the [[Sharira|body]] then first [[Langhana|langhana]] is to be given followed by [[Pachana|pachana]] medicines. [Cha. Sa. [[Chikitsa Sthana|Chikitsa Sthana]] 15/73-75]  

<br/>If stomach is free from amadosha, then panchakola churna (powder) and peyadi laghu ahara (light to digest thin gruel) and [[Deepana|deepana]] (drugs which kindles digestive fire) medicines should be given. [Cha. Sa. [[Chikitsa Sthana|Chikitsa sthana]] 15/76]

<br/>If stomach is free from amadosha, then panchakola churna (powder) and peyadi laghu ahara (light to digest thin gruel) and [[Deepana|deepana]] (drugs which kindles digestive fire) medicines should be given. [Cha. Sa. [[Chikitsa Sthana|Chikitsa sthana]] 15/76]

<br/>Following measures to be adopted for [[Shamana|shamana]] chikitsa (palliative therapy) in general during the treatment of Ama:<ref name="ref5">Yog ratnakara with Vidyotini tika by Vaidya Lakshmipati Sastri. Purvakhanda. Editted by Brahmashankar Sastri. Chaukambha Prakshana. Varanasi. Ed: 2017. Pg. no. 19.</ref>

<br/>Following measures to be adopted for [[Shamana|shamana]] chikitsa (palliative therapy) in general during the treatment of Ama:<ref name="ref5">Yog ratnakara with Vidyotini tika by Vaidya Lakshmipati Sastri. Purvakhanda. Editted by Brahmashankar Sastri. Chaukambha Prakshana. Varanasi. Ed: 2017. Pg. no. 19.</ref>

== Current researches ==

== Current researches ==

=== Theses works on ama ===

=== Theses works on ama ===

Following are the some theses work of ama

Following are the some theses work of ama

<ol style='text-align:justify;'><li style="font-weight:bold">A clinical study on the role of ama in relation to Grahini roga and its management by kallingadi ghanavati and tryushnadi ghrita<span style="font-weight:normal"><br/><b>Discussion over role of ama in relation to [[Grahani Chikitsa|Grahani]] [[Vyadhi|disease]]: </b>When the vitiated [[Dosha|dosha]] get confined only to the organ [[Grahani Chikitsa|grahani]] (duodenum), then it should be called ‘Grahani dosha’. But when the vitiated [[Dosha|doshas]] travels throughout the rasadi [[Dhatu|dhatus]] (seven bodily tissues) i.e. throughout the [[Sharira|body]], then it should be called as ‘Grahani roga’ (functional impairment of [[Agni|agni]]). The [[Grahani Chikitsa|grahani]] and [[Agni|agni]] (digestive process) are having co-existing nature/dependent on each other (adhara adheya sambandha). This view is confirmed by corroborative evidence from recent development in pathology. The mucosal damage in the form of villous atrophy and other microvillus changes in different enteropathies affect the enzymes present in the enterocyte brush borders. When the [[Vyadhi|disease]] process progresses, further it affects the pancreatic secretion as it depends upon cholecystokinin and secretin secretion from the enterocyte. The immature epithelial cells are unable to secrete the required amount of cholecystokinin and secretin. In the pathogenesis ([[Samprapti|samprapti]]) of [[Grahani Chikitsa|grahani]] [[Vyadhi|disease]], Acharya Charak elaborated a series of events as below.  

<ol style='text-align:justify;'><li style="font-weight:bold">A clinical study on the role of ama in relation to [[Grahani Chikitsa|Grahani]] roga and its management by kallingadi ghanavati and tryushnadi ghrita<span style="font-weight:normal"><br /><b>Discussion over role of ama in relation to [[Grahani Chikitsa|Grahani]] [[Vyadhi|disease]]: </b>When the vitiated [[dosha]] get confined only to the organ [[Grahani Chikitsa|grahani]] (duodenum), then it should be called ‘Grahani dosha’. But when the vitiated [[Dosha|doshas]] travels throughout the rasadi [[Dhatu|dhatus]] (seven bodily tissues) i.e. throughout the [[Sharira|body]], then it should be called as ‘[[Grahani Chikitsa|Grahani]] roga’ (functional impairment of [[agni]]). The [[Grahani Chikitsa|grahani]] and [[agni]] (digestive process) are having co-existing nature/dependent on each other (adhara adheya sambandha). This view is confirmed by corroborative evidence from recent development in pathology. The mucosal damage in the form of villous atrophy and other microvillus changes in different enteropathies affect the enzymes present in the enterocyte brush borders. When the [[Vyadhi|disease]] process progresses, further it affects the pancreatic secretion as it depends upon cholecystokinin and secretin secretion from the enterocyte. The immature epithelial cells are unable to secrete the required amount of cholecystokinin and secretin. In the pathogenesis ([[samprapti]]) of [[Grahani Chikitsa|grahani]] [[Vyadhi|disease]], Acharya Charak elaborated a series of events as below.  

<br/>Indulgence in causes that vitiate [[Agni|agni]] (digestive f) → [[Agni|agni]] dushti (vitiation og [[Agni|agni]]) → indigestion (apachana) → production of ama (non-metabolized, poorly formed product) → putreification (shukta paka)→ advanced condition of ama manifestating as a poisoning codition (anna visha or ama visha) → [[Grahani Chikitsa|grahani dosha]] (functional impairement of [[Grahani Chikitsa|grahini]]) → [[Grahani Chikitsa|grahani]] dushti (vitiation of [[Grahani Chikitsa|grahani]])→ grahini roga ([[Vyadhi|diseases]] manifestating as functional impairement of [[Agni|agni]]/digestive funtions). Ama is the root cause of almost all [[Vyadhi|diseases]] produced in the [[Sharira|body]] and the treatment of any [[Vyadhi|disease]] can be based on stage of the [[Vyadhi|disease]] associated with ama (saama) & stage of the [[Vyadhi|disease]] not associated with ama (nirama avastha).  

<br />Indulgence in causes that vitiate [[agni]] (digestive factors) → [[agni]] dushti (vitiation of [[agni]]) → indigestion (apachana) → production of ama (non-metabolized, poorly formed product) → putrification (shukta paka)→ advanced condition of ama manifestation as a poisoning condition (anna visha or ama visha) → [[Grahani Chikitsa|grahani dosha]] (functional impairement of [[Grahani Chikitsa|grahini]]) → [[Grahani Chikitsa|grahani]] dushti (vitiation of [[Grahani Chikitsa|grahani]])→ grahini roga ([[Vyadhi|diseases]] manifestating as functional impairment of [[agni]]/digestive functions). Ama is the root cause of almost all [[Vyadhi|diseases]] produced in the [[Sharira|body]] and the treatment of any [[Vyadhi|disease]] can be based on stage of the [[Vyadhi|disease]] associated with ama (saama) & stage of the [[Vyadhi|disease]] not associated with ama (nirama avastha).  

<br/><b>Outcome of clinical study: </b>This clinical trial was carried out in 66 patients of 16-60 year of age group having cardinal sign and symptoms of [[Grahani Chikitsa|grahani]] [[Vyadhi|disease]]. Patients were selected randomly into Group A, Group B and Group C treated by kallingadi ghanavati, tryushnadi ghrita and combination of both (ghanavati & ghrita) respectively for 2 weeks. The overall effect of therapies showed that better results observed in group B in comparison to group A. In comparison of all three groups, group C showed slight better results than those of rest two groups.<ref name="ref8">A clinical study on the role of ama in relation to grahini roga and its management by kallingadi ghanavati and tryushnadi ghrita by Alpesh P. Sorathiya, Dept. of Kayachikitsa, IPGT&RA, Jamnagar, 2009. </ref> </span></li>

<br /><b>Outcome of clinical study: </b>This clinical trial was carried out in 66 patients of 16-60 year of age group having cardinal sign and symptoms of [[Grahani Chikitsa|grahani]] [[Vyadhi|disease]]. Patients were selected randomly into Group A, Group B and Group C treated by kallingadi ghanavati, tryushnadi ghrita and combination of both (ghanavati & ghrita) respectively for 2 weeks. The overall effect of therapies showed that better results observed in group B in comparison to group A. In comparison of all three groups, group C showed slight better results than those of rest two groups.<ref name="ref8">A clinical study on the role of ama in relation to grahini roga and its management by kallingadi ghanavati and tryushnadi ghrita by Alpesh P. Sorathiya, Dept. of Kayachikitsa, IPGT&RA, Jamnagar, 2009. </ref> </span></li>

<li style="font-weight:bold">Association of stress inducing factors (manoabhitapakara bhava) and free radical over [[Prameha Chikitsa|madhumeha]]<span style="font-weight:normal"><br/><b>Discussion over association of stress inducing factors (manoabhitapakara bhava) and free radicals with chronic metabolic [[Vyadhi|diseases]] such as diabetes mellitus type 2 ([[Prameha Chikitsa|madhumeha]]):</b><br/>This research explains about how adherence with stress (manobhitapakara bhava) lead to produce ama or free radical, and in turn produces chronic metabolic [[Vyadhi|diseases]]. The harmony of [[Manas|mind (manas)]] responsible for the perfect harmony of [[Sharira|body]]. Altered external living sources like demographic alteration, change in family system, urbanization, industrialization, westernisation have a potent role to induce the pathogenesis at psychic level as well as [[Sharira|body]] level by the faulty pattern of adaptataion. Repeated attachment with stress (kamadi bhavas) are the potent cause for morbidity and mortality rate of obstinate urinary [[Vyadhi|disease]]/diabetes melitus type 2([[Prameha Chikitsa|madhumeha]]). This is not only for the cause but it also responsible for the complication. Excessive generation of free radical sustained affection of stress (manobhitapakara bhavas) altered the [[Sharira|body]] defence mechanism, which in terms can be understand. Treatment like pacifying vitiated manasika dosha (manasa doshahara), counseling, antistress approach, [[Deepana|dipana (appetizers)]], [[Pachana|pachana]] (digestives), can check the vicious pathogenesis involved in [[Prameha Chikitsa|madhumeha]] (obstinate urinary [[Vyadhi|disease]]/ diabetes mellitus type 2). <br/><b>Outcome of  the study: </b>There is a direct relation of the mean score of manobhitapakara bhavas (stress), lipid peroxide and fasting blood sugar. By changing mode of [[Ayu|life]] style, optimistic attitude, keeping faith in good, decreasing the high blood pressure level stress hormones can be reduced. Which it reflects through the sufficient decrease in signs and symptoms of the [[Vyadhi|disease]].<ref name="ref9">Manoabhitapakara bhava, free radical, madhumeha by Bishnupriya, Dept. of Basic principles, IPGT& RA, Jamnagar,2001.</ref></span></li>

<li style="font-weight:bold">Association of stress inducing factors (manoabhitapakara bhava) and free radical over [[Prameha Chikitsa|madhumeha]]<span style="font-weight:normal"><br/><b>Discussion over association of stress inducing factors (manoabhitapakara bhava) and free radicals with chronic metabolic [[Vyadhi|diseases]] such as diabetes mellitus type 2 ([[Prameha Chikitsa|madhumeha]]):</b><br/>This research explains about how adherence with stress (manobhitapakara bhava) lead to produce ama or free radical, and in turn produces chronic metabolic [[Vyadhi|diseases]]. The harmony of [[Manas|mind (manas)]] responsible for the perfect harmony of [[Sharira|body]]. Altered external living sources like demographic alteration, change in family system, urbanization, industrialization, westernisation have a potent role to induce the pathogenesis at psychic level as well as [[Sharira|body]] level by the faulty pattern of adaptataion. Repeated attachment with stress (kamadi bhavas) are the potent cause for morbidity and mortality rate of obstinate urinary [[Vyadhi|disease]]/diabetes melitus type 2([[Prameha Chikitsa|madhumeha]]). This is not only for the cause but it also responsible for the complication. Excessive generation of free radical sustained affection of stress (manobhitapakara bhavas) altered the [[Sharira|body]] defence mechanism, which in terms can be understand. Treatment like pacifying vitiated manasika dosha (manasa doshahara), counseling, antistress approach, [[Deepana|dipana (appetizers)]], [[Pachana|pachana]] (digestives), can check the vicious pathogenesis involved in [[Prameha Chikitsa|madhumeha]] (obstinate urinary [[Vyadhi|disease]]/ diabetes mellitus type 2). <br/><b>Outcome of  the study: </b>There is a direct relation of the mean score of manobhitapakara bhavas (stress), lipid peroxide and fasting blood sugar. By changing mode of [[Ayu|life]] style, optimistic attitude, keeping faith in good, decreasing the high blood pressure level stress hormones can be reduced. Which it reflects through the sufficient decrease in signs and symptoms of the [[Vyadhi|disease]].<ref name="ref9">Manoabhitapakara bhava, free radical, madhumeha by Bishnupriya, Dept. of Basic principles, IPGT& RA, Jamnagar,2001.</ref></span></li>

<li style="font-weight:bold">A critical and comparative study of Ama and Free radical theory with special reference to [[Amavata|Amavata]]<span style="font-weight:normal"><br/><b>Outcome of study: </b>Free radical is an atom/molecule that contains one or more unpaired electron, which requires neutralisation by free radical scavengers. Thus it exists in an incomplete metabolic state which is also the state of ama described as incompletely digested (avipakvam). Free radicals cause damage to cell membrane and thus the cell is destroyed. This destruction may lead to putrification and foul smell generations which is similar to one of the property of ama described as unpleasant smell (durgandham). Though ama remains in the [[Sharira|body]] as isolated or not mized (asamyuktam), but due to its properties like excessive sliminess (bahupicchilam) etc. it sticks to normal healthy [[Sharira|body]] tissues very quickly, similar is the case with free radicals. To seek stability in their structure they quickly attack the healthy molecules of the [[Sharira|body]] and thus setting a chain reaction. The cells throughout [[Sharira|body]] are continously exposed to these damaging molecules, same has been described for ama as causing sluggishness of whole [[Sharira|body]] (sadanam sarva gatranam). From above one can observe that properties of free radicals are similar to the properties of ama described in classics. Now the process of production of free radicals in [[Sharira|body]] and production of ama would be considered. So it may be concluded that the causative factors ([[Nidana|nidana]]) such as heavy to digest (guru), unctuousness (snigdha) etc. qualities of [[Ahara|diet (ahara)]] of [[Amavata|amavata]] (rheumatism) as mentioned in the classics have a specific role to play in production of ama and also in the generation of free radicals. Also the line of treatment of ama advocated in the classics is effective in reducing the level of ama as well as free radicals. So it can be inferred that a positive correlation exists between ama and free radicals.<ref name="ref10">A critical and comparative study of Ama and Free radical theory with special reference to Amavata by Gaurav sharma, Department of Basic principles, IPGT& RA, Jamnagar, 2001.</ref></span></li>

<li style="font-weight:bold">A critical and comparative study of Ama and Free radical theory with special reference to [[Amavata|Amavata]]<span style="font-weight:normal"><br/><b>Outcome of study: </b>Free radical is an atom/molecule that contains one or more unpaired electron, which requires neutralisation by free radical scavengers. Thus it exists in an incomplete metabolic state which is also the state of ama described as incompletely digested (avipakvam). Free radicals cause damage to cell membrane and thus the cell is destroyed. This destruction may lead to putrification and foul smell generations which is similar to one of the property of ama described as unpleasant smell (durgandham). Though ama remains in the [[Sharira|body]] as isolated or not mized (asamyuktam), but due to its properties like excessive sliminess (bahupicchilam) etc. it sticks to normal healthy [[Sharira|body]] tissues very quickly, similar is the case with free radicals. To seek stability in their structure they quickly attack the healthy molecules of the [[Sharira|body]] and thus setting a chain reaction. The cells throughout [[Sharira|body]] are continously exposed to these damaging molecules, same has been described for ama as causing sluggishness of whole [[Sharira|body]] (sadanam sarva gatranam). From above one can observe that properties of free radicals are similar to the properties of ama described in classics. Now the process of production of free radicals in [[Sharira|body]] and production of ama would be considered. So it may be concluded that the causative factors ([[Nidana|nidana]]) such as heavy to digest (guru), unctuousness (snigdha) etc. qualities of [[Ahara|diet (ahara)]] of [[Amavata|amavata]] (rheumatism) as mentioned in the classics have a specific role to play in production of ama and also in the generation of free radicals. Also the line of treatment of ama advocated in the classics is effective in reducing the level of ama as well as free radicals. So it can be inferred that a positive correlation exists between ama and free radicals.<ref name="ref10">A critical and comparative study of Ama and Free radical theory with special reference to Amavata by Gaurav sharma, Department of Basic principles, IPGT& RA, Jamnagar, 2001.</ref></span></li>