Trividhakukshiya Vimana

Vimana Sthana Chapter 2. Three parts of abdomen and principles of diet

Abstract

This chapter describes the principles of food and dietary intake for healthy living with special emphasis on the quantum of food ingested. It is advised that one must eat in accordance with the capacity of one’s stomach and the quantity of food is determined by the strength of one’s jatharagni (digestive ability). Ayurveda regards ama, or undigested food, as a source of vitiation of doshas (and consequently, a source of various afflictions). Proper quantity of food when consumed will, therefore, be digested in time without disturbing one’s health. Diet taken with proper consideration of agni positively promotes one’s strength, complexion, health and life, while improper quantity (amatra) of food - heena (less) or adhika (excess) - leads to various disorders.

Keywords: Kukshi, capacity of stomach, digestion, quantity of food,diet, poor digestion, ama, visuchika, alasaka.

Trividhakukshiya Vimana

Section/Chapter	Vimana Sthana Chapter 2
Preceding Chapter	Rasa Vimana
Succeeding Chapter	Janapadodhvansaniya Vimana
Other Sections	Sutra Sthana, Nidana Sthana, Sharira Sthana, Indriya Sthana, Chikitsa Sthana, Kalpa Sthana, Siddhi Sthana

Introduction

Diet plays a vital role in maintenance of good health and in the prevention and cure of the disease. It is also important to be aware that healthy and wholesome diet, plays crucial role in the growth and development of the body, varies from person to person. Food that someone is accustomed to or is suitable for (satmya) may be unwholesome (asatmya) to another. Thus one should observe the dietetic rules to plan one’s dietary regimen to ensure proper digestion and assimilation of food, resulting in better health.

Food taken in excessive quantities aggravates all doshas and produces symptoms characteristic of each of the vitiated dosha separately. In addition to the quantity of food, untimely intake and the quality of food, i.e., intake of heavy, unctuous, cold, unclean and mutually contradictory food are responsible for the formation and vitiation of ama. Wholesome food, even if taken in proper quantity does not get properly digested if the individual is afflicted with anxiety, fear, grief, envy, anger, greed etc. and other such negative emotional states. These causative factors lead to formation of ama.

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.

Sanskrit Text, Transliteration and English Translation

अथातस्त्रिविधकुक्षीयं विमानं व्याख्यास्यामः||१||

इति ह स्माह भगवानात्रेयः||२||

athātastrividhakukṣīyaṁ vimānaṁ vyākhyāsyāmaḥ||1||

iti ha smāha bhagavānātrēyaḥ||2||

AthAtastrividhakukShIya vimAnaM vyAkhyAsyAmaH||1||

itihasmAha bhagavAnAtreyaH||2||

We shall now describe the chapter on the “Trichotomic Division of the Capacity of the Stomach”. Thus said Lord Atreya. [1-2]

Three divisions of stomach

त्रिविधं कुक्षौ स्थापयेदवकाशांशमाहारस्याहारमुपयुञ्जानः; तद्यथा- एकमवकाशांशं मूर्तानामाहारविकाराणाम्, एकं द्रवाणाम्, एकं पुनर्वातपित्तश्लेष्मणाम्; एतावतीं ह्याहारमात्रामुपयुञ्जानो नामात्राहारजं किञ्चिदशुभं प्राप्नोति||३||

trividhaṁ kukṣau sthāpayēdavakāśāṁśamāhārasyāhāramupayuñjānaḥ; tadyathā- ēkamavakāśāṁśaṁmūrtānāmāhāravikārāṇām, ēkaṁ dravāṇām, ēkaṁ punarvātapittaślēṣmaṇām; ētāvatīṁhyāhāramātrāmupayuñjānō nāmātrāhārajaṁ kiñcidaśubhaṁ prāpnōti||3||

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

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]

न च केवलं मात्रावत्त्वादेवाहारस्य कृत्स्नमाहारफलसौष्ठवमवाप्तुं शक्यं, प्रकृत्यादीनामष्टानामाहारविधिविशेषायतनानां प्रविभक्तफलत्वात्||४||

na ca kēvalaṁ mātrāvattvādēvāhārasya kr̥tsnamāhāraphalasauṣṭhavamavāptuṁ śakyaṁ,prakr̥tyādīnāmaṣṭānāmāhāravidhiviśēṣāyatanānāṁ pravibhaktaphalatvāt||4||

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

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]

तत्रायं तावदाहारराशिमधिकृत्य मात्रामात्राफलविनिश्चयार्थः प्रकृतः| एतावानेव ह्याहारराशिविधिविकल्पो यावन्मात्रावत्त्वममात्रावत्त्वं च||५||

tatrāyaṁ tāvadāhārarāśimadhikr̥tya mātrāmātrāphalaviniścayārthaḥ prakr̥taḥ| ētāvānēva hyāhārarāśividhivikalpō yāvanmātrāvattvamamātrāvattvaṁ ca||5||

tatrAyaM tAvadAhArarAshimadhikRutya mAtrAmAtrAphalavinishcayArthaH prakRutaH| etAvAneva hyAhArarAshividhivikalpo yAvanmAtrAvattvamamAtrAvattvaM ca||5||

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]

Signs after consuming proper amount of food

तत्र मात्रावत्त्वं पूर्वमुद्दिष्टं कुक्ष्यंशविभागेन, तद्भूयो विस्तरेणानुव्याख्यास्यामः| तद्यथा- कुक्षेरप्रणीडनमाहारेण, हृदयस्यानवरोधः, पार्श्वयोरविपाटनम्, अनतिगौरवमुदरस्य, प्रीणनमिन्द्रियाणां, क्षुत्पिपासोपरमः स्थानासनशयनगमनोच्छ्वासप्रश्वास -हास्यसङ्कथासु सुखानुवृत्तिः, सायं प्रातश्च सुखेन परिणमनं, बलवर्णोपचयकरत्वं च; इति मात्रावतो लक्षणमाहारस्य भवति||६||

tatra mātrāvattvaṁ pūrvamuddiṣṭaṁ kukṣyaṁśavibhāgēna, tadbhūyō vistarēṇānuvyākhyāsyāmaḥ| tadyathā- kukṣērapraṇīḍanamāhārēṇa, hr̥dayasyānavarōdhaḥ, pārśvayōravipāṭanam,anatigauravamudarasya, prīṇanamindriyāṇāṁ, kṣutpipāsōparamaḥ,sthānāsanaśayanagamanōcchvāsapraśvāsahāsyasaṅkathāsu sukhānuvr̥ttiḥ, sāyaṁ prātaśca sukhēnapariṇamanaṁ [1] , balavarṇōpacayakaratvaṁ ca; iti mātrāvatō lakṣaṇamāhārasya bhavati||6||

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||

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]

Signs after consuming improper amount of food

अमात्रावत्त्वं पुनर्द्विविधमाचक्षते- हीनम्, अधिकं च| तत्र हीनमात्रमाहारराशिं बलवर्णोपचयक्षयकरमतृप्तिकरमुदावर्तकरमनायुष्यवृष्यमनौजस्यं शरीरमनोबुद्धीन्द्रियोपघातकरं सारविधमनमलक्ष्म्यावहमशीतेश्च वातविकाराणामायतनमाचक्षते, अतिमात्रं पुनः सर्वदोषप्रकोपणमिच्छन्ति कुशलाः| यो हि मूर्तानामाहारजातानां सौहित्यं गत्वा द्रवैस्तृप्तिमापद्यते भूयस्तस्यामाशयगता वातपित्तश्लेष्माणोऽभ्यवहारेणातिमात्रेणातिप्रपीड्यमानाः सर्वे युगपत् प्रकोपमापद्यन्ते, ते प्रकुपितास्तमेवाहारराशिमपरिणतमाविश्य कुक्ष्येकदेशमन्नाश्रिता विष्टम्भयन्तः सहसा वाऽप्युत्तराधराभ्यां मार्गाभ्यां प्रच्यावयन्तः पृथक् पृथगिमान् विकारानभिनिर्वर्तयन्त्यतिमात्रभोक्तुः| तत्र वातः शूलानाहाङ्गमर्दमुखशोषमूर्च्छाभ्रमाग्निवैषम्यपार्श्वपृष्ठकटिग्रहसिराकुञ्चनस्तम्भना-नि करोति, पित्तं पुनर्ज्वरातीसारान्तर्दाहतृष्णामदभ्रमप्रलपनानि, श्लेष्मा तु छर्द्यरोचकाविपाकशीतज्वरालस्यगात्रगौरवाणि||७||

amātrāvattvaṁ punardvividhamācakṣatē- hīnam, adhikaṁ ca| tatra hīnamātramāhārarāśiṁbalavarṇōpacayakṣayakaramatr̥ptikaramudāvartakaramanāyuṣyavr̥ṣyamanaujasyaṁśarīramanōbuddhīndriyōpaghātakaraṁ sāravidhamanamalakṣmyāvahamaśītēścavātavikārāṇāmāyatanamācakṣatē, atimātraṁ punaḥ sarvadōṣaprakōpaṇamicchanti kuśalāḥ| yō hi mūrtānāmāhārajātānāṁ sauhityaṁ gatvā dravaistr̥ptimāpadyatē bhūyastasyāmāśayagatāvātapittaślēṣmāṇō'bhyavahārēṇātimātrēṇātiprapīḍyamānāḥ sarvē yugapat prakōpamāpadyantē, tēprakupitāstamēvāhārarāśimapariṇatamāviśya kukṣyēkadēśamannāśritā [1] viṣṭambhayantaḥ sahasāvā'pyuttarādharābhyāṁ mārgābhyāṁ pracyāvayantaḥ pr̥thak pr̥thagimānvikārānabhinirvartayantyatimātrabhōktuḥ| tatra vātaḥ śūlānāhāṅgamardamukhaśōṣamūrcchābhramāgnivaiṣamya-pārśvapr̥ṣṭhakaṭigrahasirākuñcanastambhanāni karōti, pittaṁpunarjvarātīsārāntardāhatr̥ṣṇāmadabhramapralapanāni, ślēṣmā tuchardyarōcakāvipākaśītajvarālasyagātragauravāṇi||7||

punardvividhamAcakShate-hInam,adhikaM ca| tatra hInamAtramAhArarAshiM balavarNopacayakShayakaramatRuptikaramudAvartakaramanAyuShyavRuShyamanaujasyaMsharIramanobuddhIndriyopaghAtakaraM sAravidhamanamalakShmyAvahamashIteshca vAtavikArANAmAyatanamAcakShate, atimAtraM punaH sarvadoShaprakopaNamicchanti kushalAH| yo hi mUrtAnAmAhArajAtAnAM sauhityaM gatvA dravaistRuptimApadyate bhUyastasyAmAshayagatA vAtapittashleShmANo~abhyavahAreNAtimAtre- NAtiprapIDyamAnAH sarveyugapatprakopamApadyante,te prakupitAstamevAhArarAshimapariNatamAvishya kukShyekadeshamannAshritA viShTambhayantaH sahasA vA~apyuttarAdharAbhyAM mArgAbhyAM pracyAvayantaH pRuthak pRuthagimAn vikArAnabhinirvartayantyatimAtrabhoktuH| tatra vAtaH shUlAnAhA~ggamardamukhashoShamUrcchAbhramAgnivaiShamya- pArshvapRuShThakaTigrahasirAku~jcanastambhanAni karoti, pittaM punarjvarAtIsArAntardAhatRuShNAmadabhramapralapanAni, shleShmA tu chardyarocakAvipAkashItajvarAlasyagAtragauravANi||7||

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.

One who eats solid foods in excess and also drinks beverages beyond satiation will have all the three doshas- vata, pitta and kapha - in his stomach vitiated simultaneously due to their getting compressed by all the excess food. Thus, vitiated doshas in the undigested food mass get localized into a part of the stomach, which then either obstruct the movements in the abdomen or suddenly get eliminated through upper and lower channels of the alimentary tract. They produce distinct features in the person as follows:

• Vata causes colic pain, distension of the abdomen, body ache, dryness of the mouth, fainting, giddiness, variability in digestive power, rigidity in flanks, back and waist and contraction (spasm) and hardening of vessels.
• 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]

Other causative factors for ama formation

न च खलु केवलमतिमात्रमेवाहारराशिमामप्रदोषकरमिच्छन्ति अपि तु खलु गुरुरूक्षशीतशुष्कद्विष्टविष्टम्भिविदाह्यशुचिविरुद्धानामकाले चान्नपानानामुपसेवनं,कामक्रोधलोभमोहेर्ष्याह्रीशोकमानोद्वेगभयोपतप्तमनसा वा यदन्नपानमुपयुज्यते, तदप्याममेव प्रदूषयति||८||

na ca khalu kēvalamatimātramēvāhārarāśimāmapradōṣakaramicchanti [1] , api tu khalugururūkṣaśītaśuṣkadviṣṭaviṣṭambhividāhyaśuciviruddhānāmakālē cānnapānānāmupasēvanaṁ,kāmakrōdhalōbhamōhērṣyāhrīśōkamānōdvēgabhayōpataptamanasā vā yadannapānamupayujyatē,tadapyāmamēva pradūṣayati||8||

naca khalu kevalamatimAtramevAhArarAshimAmapradoShakaramicchant, api tu khalugururUkShashItashuShkadviShTaviShTambhividAhyashuci -viruddhAnAmakAlecAnnapAnAnAmupasevanaM,kAmakrodhalobha -moherShyAhrIshokamAnodvegabhayopataptamanasA vA yadannapAnamupayujyate, tadapyAmameva pradUShayati||8||

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]

भवति चात्र- मात्रयाऽप्यभ्यवहृतं पथ्यं चान्नं न जीर्यति| चिन्ताशोकभयक्रोधदुःखशय्याप्रजागरैः||९||

bhavati cātra- mātrayā'pyabhyavahr̥taṁ pathyaṁ cānnaṁ na jīryati| cintāśōkabhayakrōdhaduḥkhaśayyāprajāgaraiḥ||9||

Bhavati cAtra- mAtrayA~apyabhyavahRutaM pathyaM cAnnaM na jIryati| cintAshokabhayakrodhaduHkhashayyAprajAgaraiH||9||

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]

Two types of ama disorders

तं द्विविधमामप्रदोषमाचक्षते भिषजः- विसूचिकाम्, अलसकं च||१०||

tam dvividhamAmapradoShamAcakShate bhiShajaH-visUcikAm,AlasakaM ca||10||

taṁ dvividhamāmapradōṣamācakṣatē bhiṣajaḥ- visūcikām, alasakaṁ ca||10||

Physicians describe two types of diseases caused by ama dosha –visuchika (cholera) and alasaka (sluggish bowels). [10]

Visuchika(cholera)

तत्र विसूचिकामूर्ध्वं चाधश्च प्रवृत्तामदोषां यथोक्तरूपां विद्यात्||११||

tatra visūcikāmūrdhvaṁ cādhaśca pravr̥ttāmadōṣāṁ yathōktarūpāṁ vidyāt||11||

tatravisUcikAmUrdhvaM cAdhashca pravRuttAmadoShAM yathoktarUpAM vidyAt||11||

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]

Alasaka(sluggish bowel)

अलसकमुपदेक्ष्यामः- दुर्बलस्याल्पाग्नेर्बहुश्लेष्मणो वातमूत्रपुरीषवेगविधारिणः स्थिरगुरुबहुरूक्षशीतशुष्कान्नसेविनस्तदन्नपानमनिलप्रपीडितं श्लेष्मणा च विबद्धमार्गमतिमात्रप्रलीनमलसत्वान्न बहिर्मुखीभवति, ततश्छर्द्यतीसारवर्ज्यान्यामप्रदोषलिङ्गान्यभिदर्शयत्यतिमात्राणि अतिमात्रप्रदुष्टाश्च दोषाः प्रदुष्टामबद्धमार्गास्तिर्यग्गच्छन्तः कदाचिदेव केवलमस्य शरीरं दण्डवत् स्तम्भयन्ति, ततस्तं दण्डालसकमसाध्यं ब्रुवते| विरुद्धाध्यशनाजीर्णाशनशीलिनः पुनरामदोषमामविषमित्याचक्षते भिषजः, विषसदृशलिङ्गत्वात्; तत् परमसाध्यम्, आशुकारित्वाद्विरुद्धोपक्रमत्वाच्चेति||१२||

alasakamupadēkṣyāmaḥ- durbalasyālpāgnērbahuślēṣmaṇō vātamūtrapurīṣavēgavidhāriṇaḥsthiragurubahurūkṣaśītaśuṣkānnasēvinastadannapānamanilaprapīḍitaṁ ślēṣmaṇā cavibaddhamārgamatimātrapralīnamalasatvānna bahirmukhībhavati,tataśchardyatīsāravarjyānyāmapradōṣaliṅgānyabhidarśayatyatimātrāṇi| atimātrapraduṣṭāśca dōṣāḥ praduṣṭāmabaddhamārgāstiryaggacchantaḥ kadācidēva kēvalamasya śarīraṁdaṇḍavat stambhayanti, tatastaṁ [1] daṇḍālasakamasādhyaṁ bruvatē| viruddhādhyaśanājīrṇāśanaśīlinaḥ punarāmadōṣamāmaviṣamityācakṣatē [2] bhiṣajaḥ, viṣasadr̥śaliṅgatvāt;tat paramasādhyam, āśukāritvādviruddhōpakramatvāccēti||12||

AlasakamupadeksyamaH- durbalasyAlpAgnerbahushleShmaNo vAtamUtrapurIShavegavidhAriNaH sthiragurubahurUkShashItashuShkAnnasevinastadannapAnamanilaprapIDitaM shleShmaNA ca vibaddhamArgamatimAtrapralInamalasatvAnna bahirmukhIbhavati,tatashchardyatIsAravarjyAnyAmapradoShali~ggAnyabhidarshayatyatimAtrANi| atimAtrapraduShTAshca doShAH praduShTAmabaddhamArgAstiryaggacchantaH kadAcideva kevalamasya sharIraM daNDavat stambhayanti, tatastaM daNDAlasakamasAdhyaM bruvate| viruddhAdhyashanAjIrNAshanashIlinaH punarAmadoShamAmaviShamityAcakShate bhiShajaH, viShasadRushali~ggatvAt; tat paramasAdhyam, AshukAritvAdviruddhopakramatvAcceti||12||

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. 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]

Management of ama disorders

तत्र साध्यमामं प्रदुष्टमलसीभूतमुल्लेखयेदादौ पाययित्वा सलवणमुष्णं वारि, विसूचिकायां स्वेदनवर्तिप्रणिधानाभ्यामुपाचरेदुपवासयेच्चैनम्| ततः लङ्घनमेवाग्रे विरिक्तवच्चानुपूर्वी| आमप्रदोषेषु त्वन्नकाले जीर्णाहारं पुनर्दोषावलिप्तामाशयं स्तिमितगुरुकोष्ठमनन्नाभिलाषिणमभिसमीक्ष्य आमप्रदोषदुर्बलो च, नत्वेवाजीर्णाशनम्; पाययेद्दोषशेषपाचनार्थमौषधमग्निसन्धुक्षणार्थं ह्यग्निर्नयुगपद्दोषमौषधमाहारजातं च पक्तुम्| शक्तः अपि पुनर्विकाराणामपतर्पणेनैवोपरमो सहसैवातुरमबलमतिपातयेत्| आमप्रदोषजानां चामप्रदोषाहारौषधविभ्रमोऽतिबलत्वादुपरतकायाग्निं भवति, सति त्वनुबन्धे कृतापतर्पणानां व्याधीनां निग्रहे निमित्तविपरीतमपास्यौषधमातङ्कविपरीतमेवावचारयेद्यथास्वम्|सर्वविकाराणामपि च निग्रहे वा| कुशलाः, तदर्थकारि हेतुव्याधिविपरीतमौषधमिच्छन्ति विमुक्तामप्रदोषस्य पुनः परिपक्वदोषस्य दीप्ते चाग्नावभ्यङ्गास्थापनानुवासनं विधिवत् स्नेहपानं च युक्त्या प्रयोज्यं प्रसमीक्ष्य दोषभेषजदेशकालबलशरीराहार सात्म्यसत्त्वप्रकृतिवयसामवस्थान्तराण विकारांश्च सम्यगिति||१३||

tatra sādhyamāmaṁ praduṣṭamalasībhūtamullēkhayēdādau pāyayitvā salavaṇamuṣṇaṁ vāri, tataḥsvēdanavartipraṇidhānābhyāmupācarēdupavāsayēccainam| visūcikāyāṁ tu laṅghanamēvāgrē viriktavaccānupūrvī| āmapradōṣēṣu tvannakālē jīrṇāhāraṁ punardōṣāvaliptāmāśayaṁstimitagurukōṣṭhamanannābhilāṣiṇamabhisamīkṣyapāyayēddōṣaśēṣapācanārthamauṣadhamagnisandhukṣaṇārthaṁ ca, natvēvājīrṇāśanam;āmapradōṣadurbalō hyagnirna yugapaddōṣamauṣadhamāhārajātaṁ ca śaktaḥ paktum| api cāmapradōṣāhārauṣadhavibhramō'tibalatvāduparatakāyāgniṁ [1] sahasaivāturamabalamatipātayēt| āmapradōṣajānāṁ punarvikārāṇāmapatarpaṇēnaivōparamō bhavati, sati tvanubandhē kr̥tāpatarpaṇānāṁvyādhīnāṁ nigrahē nimittaviparītamapāsyauṣadhamātaṅkaviparītamēvāvacārayēdyathāsvam| sarvavikārāṇāmapi ca nigrahē hētuvyādhiviparītamauṣadhamicchanti kuśalāḥ, tadarthakāri vā| vimuktāmapradōṣasya [2] punaḥ paripakvadōṣasya dīptē cāgnāvabhyaṅgāsthāpanānuvāsanaṁ vidhivatsnēhapānaṁ ca yuktyā prayōjyaṁ prasamīkṣyadōṣabhēṣajadēśakālabalaśarīrāhārasātmyasattvaprakr̥tivayasāmavasthāntarāṇi vikārāṁścasamyagiti||13||

sAdhyamAmaM praduShTamalasIbhUtamullekhayedAdau pAyayitvA salavaNamuShNaM vAri, tataH svedanavartipraNidhAnAbhyAmupAcaredupavAsayeccainam| visUcikAyAM tu la~gghanamevAgre viriktavaccAnupUrvI| AmapradoSheShu tvannakAle jIrNAhAraM punardoShAvaliptAmAshayaM stimitagurukoShThamanannAbhilAShiNamabhisamIkShya pAyayeddoShasheShapAcanArthamauShadhamagnisandhukShaNArthaM ca, natvevAjIrNAshanam; AmapradoShadurbalo hyagnirna yugapaddoShamauShadhamAhArajAtaM ca shaktaH paktum|api cAmapradoShAhArauShadhavibhramo~atibalatvAduparatakAyAgniM sahasaivAturamabalamatipAtayet| AmapradoShajAnAM punarvikArANAmapatarpaNenaivoparamo bhavati, sati tvanubandhekRutApatarpaNAnAM vyAdhInAM nigrahenimittaviparItamapAsyauShadhamAta~gkaviparItamevAvacArayedyathAsvam| sarvavikArANAmapi ca nigrahehetuvyAdhiviparItamauShadhamicchanti kushalAH, tadarthakAri vA| vimuktAmapradoShasya punaH paripakvadoShasya dIpte cAgnAvabhya~ggAsthApanAnuvAsanaM vidhivat snehapAnaM ca yuktyA prayojyaM prasamIkShya doShabheShajadeshakAlabalasharIrAhArasAtmyasattvaprakRutivayasAmavasthAntarANi vikArAMshca samyagiti||13||

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.

In case of visuchika, treatment should start with langhana measures (therapy that reduces heaviness in the body) and purgation therapies followed by specific dietary regimens.

If in the state of vitiation of ama, the patient has finally digested the previously eaten meal, but while ingesting the present meal, if the doshas still adhere inside the stomach and the feeling in the abdomen is cold/ inactive, heavy and aversion to food, then the patient should be advised medicines for digestion of the remaining doshas (pachana drugs) and also for stimulation of digestive fire (deepana drugs).The patient should not be given food during indigestion since the agni (digestive power) which is already weak by excessive vitiation of ama is incapable of simultaneously digesting the dosha, the drug and the diet. In a patient who is already weak and has low digestive ability, the cumulative effect of excessively morbid ama (ama pradosha), food and drug will further deplete the strength of the patient and could even lead to death.

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.

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]

भवति चात्र- आहारविध्यायतनानि चाष्टौ सम्यक् परीक्ष्यात्महितं विदध्यात्| अन्यश्च यः कश्चिदिहास्ति मार्गो हितोपयोगेषु भजेत तं च||१४||

bhavati cātra- āhāravidhyāyatanāni cāṣṭau samyak parīkṣyātmahitaṁ vidadhyāt| anyaśca yaḥ kaścidihāsti mārgō hitōpayōgēṣu bhajēta taṁ ca||14||

Bhavati cAtra- AhAravidhyAyatanAni cAShTau samyak parIkShyAtmahitaM vidadhyAt| anyashca yaH kashcidihAsti mArgo hitopayogeShu bhajeta taM ca||14||

Thus it is said-

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]

Description of Amashaya(stomach)

अशितं खादितं पीतं लीढं च क्व विपच्यते| एतत्त्वां धीर! पृच्छामस्तन्न आचक्ष्व बुद्धिमन्||१५||

aśitaṁ khāditaṁ pītaṁ līḍhaṁ ca kva vipacyatē| ētattvāṁ dhīra! pr̥cchāmastanna ācakṣva buddhiman||15||

ashitaM khAditaM pItaM lIDhaM ca kva vipacyate| etattvAM dhIra! pRucchAmastanna AcakShva buddhiman||15||

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]

इत्यग्निवेशप्रमुखैः शिष्यैः पृष्टः पुनर्वसुः| आचचक्षे ततस्तेभ्यो यत्राहारो विपच्यते||१६||

ityagnivēśapramukhaiḥ śiṣyaiḥ pr̥ṣṭaḥ punarvasuḥ| ācacakṣē tatastēbhyō yatrāhārō vipacyatē||16||

ityagniveshapramukhaiH shiShyaiH pRuShTaH punarvasuH| AcacakShe tatastebhyo yatrAhAro vipacyate||16||

Thus having been questioned by the disciples led by Agnivesha, Lord Atreya described them the organ where food is digested [16]

नाभिस्तनान्तरं जन्तोरामाशय इति स्मृतः| अशितं खादितं पीतं लीढं चात्र विपच्यते||१७||

nābhistanāntaraṁ jantōrāmāśaya iti smr̥taḥ| aśitaṁ khāditaṁ pītaṁ līḍhaṁ cātra vipacyatē||17||

nAbhistanAntaraM jantorAmAshaya iti smRutaH| ashitaM khAditaM pItaM lIDhaM cAtravipacyate||17||

It is the part of the human body- the amashaya - situated between umbilicus and the breast line wherein all that is eaten, masticated, drunk and licked up is digested .[17]

आमाशयगतः पाकमाहारः प्राप्य केवलम्| पक्वः सर्वाशयं पश्चाद्धमनीभिः प्रपद्यते||१८||

āmāśayagataḥ pākamāhāraḥ prāpya kēvalam| pakvaḥ sarvāśayaṁ paścāddhamanībhiḥ prapadyatē||18||

AmAshayagataH pAkamAhAraH prApya kevalam| pakvaH sarvAshayaM pashcAddhamanIbhiH prapadyate||18||

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]

Summary

तत्र श्लोकः- तस्य मात्रावतो लिङ्गं फलं चोक्तं यथायथम्| अमात्रस्य तथा लिङ्गं फलं चोक्तं विभागशः||१९||

tatra ślōkaḥ- tasya mātrāvatō liṅgaṁ phalaṁ cōktaṁ yathāyatham| amātrasya tathā liṅgaṁ phalaṁ cōktaṁ vibhāgaśaḥ||19||

tatra shlokaH- tasya mAtrAvatoli~ggaMphalaM coktaM yathAyatham| amAtrasya tathA li~ggaM phalaM coktaM vibhAgashaH||19||

Now, to sum up the above verses:

The symptoms and final outcome of the diet taken in proper and improper quantities have been described here. [19]

इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृते विमानस्थाने त्रिविधकुक्षीयविमानं नाम द्वितीयोऽध्यायः||२||

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

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||

Tattva Vimarsha / Fundamental Principles

• 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.

• Quantity of food taken should depend on the capacity of the stomach. One third of stomach should have solids, second third should have liquids and last third should be empty to facilitate biochemical and biomechanical action of stomach.

• If food taken in the morning is digested by evening and food taken in the evening is digested by morning, it indicates that the correct amount of food has been consumed. Excess or inadequate food causes malnourishment while optimum quantity of food causes nourishment. Food ingested in proper quantity produces effects on all biological systems including sense organs, strength and complexion. Assessment of proper digestion and metabolism can be done as per given signs.

• Positive mental status is important while ingesting food. The negative mental status while taking food can lead to improper digestion even if the food is in proper quantity.

• The food that is heavy to digest, dry, cold, dehydrated, disliked by consumer, causing constipation and burning, unclean and incompatible causes amapradoshak vikara, such as visuchika, alasaka, and dandalasaka (indigestion, food poisoning, paralytic ileus).

• In case of alasaka, the vitiated food material causing ama disorders shall be expelled out through emesis, sudation and suppositories. The person shall follow fasting. Digestive and stimulant medicines shall be given to assure proper digestion.