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Trividhakukshiya Vimana (view source)

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<big>'''Abstract'''</big>

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<div style="text-align:justify;">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. </div>

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<div style="text-align:justify;">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 digestion capacity ([[agni]]). [[Ayurveda]] regards [[ama]], or undigested food, as the cause of vitiation of [[dosha]] and consequently various disorders. Proper quantity of food is 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 - less (heena) or excess (adhika) - leads to various disorders. The chapter mentions various aspects of satiety and its physioloigcal mechanisms. </div>

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

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'''Keywords:''' ''Kukshi'', capacity of stomach, digestion, quantity of food, diet, poor digestion, [[ama]], [[visuchika]], [[alasaka]], satiety, indigestion.

== Introduction ==

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Food taken in excessive quantities aggravates all [[dosha]] 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]].

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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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[[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.

</div>

==Sanskrit Text, Transliteration and English Translation==

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</div></div>

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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 quantity of diet. [3] </div>

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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 quantity of diet. [3]

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</div>

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=== Importance of eight factors in beneficial effect of food ===

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</div></div>

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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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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]

</div>

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=== Focus on qunatum of food ===

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</div>

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=== ~~Signs~~ after consuming proper quantity of food ===

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=== Features after consuming proper quantity of food ===

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</div></div>

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Whether the quantity 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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Whether the quantity 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.

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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]

</div>

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=== ~~Signs~~ after consuming improper quantity of food ===

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=== Features after consuming improper quantity of food ===

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</div></div>

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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, quality of 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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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, quality of body tissues ([[saara]]), 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 beyond satiation will have all the three [[dosha]]- [[vata]], [[pitta]] and [[kapha]] - in his stomach vitiated simultaneously due to their getting compressed by all the excess food. Thus, vitiated [[dosha]] 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:

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</div>

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

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=== Other causative factors for [[ama]] formation ===

न च खलु केवलमतिमात्रमेवाहारराशिमामप्रदोषकरमिच्छन्ति अपि

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तु खलु गुरुरूक्षशीतशुष्कद्विष्टविष्टम्भिविदाह्यशुचिविरुद्धानामकाले

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चान्नपानानामुपसेवनं,कामक्रोधलोभमोहेर्ष्याह्रीशोकमानोद्वेगभयोपतप्तमनसा वा यदन्नपानमुपयुज्यते, तदप्याममेव प्रदूषयति||८||

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चान्नपानानामुपसेवनं,कामक्रोधलोभमोहेर्ष्याह्रीशोकमानोद्वेगभयोपतप्तमनसा वा यदन्नपानमुपयुज्यते,

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तदप्याममेव प्रदूषयति||८||

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</div></div>

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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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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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</div>

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=== Influence of mental status on digestion ===

भवति चात्र-

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मात्रयाऽप्यभ्यवहृतं पथ्यं चान्नं न जीर्यति|

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मात्रयाऽप्यभ्यवहृतं पथ्यं चान्नं न जीर्यति|

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चिन्ताशोकभयक्रोधदुःखशय्याप्रजागरैः||९||

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Thus it can be said that any wholesome food, even if taken in the right quantity, 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]

</div>

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

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===Two types of [[ama]] disorders ===

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</div></div>

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

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

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==== ''Visuchika''(cholera) ====

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==== [[Visuchika]](cholera) ====

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</div></div>

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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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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]

</div>

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

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==== [[Alasaka]](sluggish bowel) ====

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अलसकमुपदेक्ष्यामः- दुर्बलस्याल्पाग्नेर्बहुश्लेष्मणो वातमूत्रपुरीषवेगविधारिणः स्थिरगुरुबहुरूक्षशीतशुष्कान्नसेविनस्तदन्नपानमनिलप्रपीडितं श्लेष्मणा

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अलसकमुपदेक्ष्यामः-

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

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दुर्बलस्याल्पाग्नेर्बहुश्लेष्मणो वातमूत्रपुरीषवेगविधारिणः स्थिरगुरुबहुरूक्षशीतशुष्कान्नसेविनस्तदन्नपानमनिलप्रपीडितं श्लेष्मणा

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च विबद्धमार्गमतिमात्रप्रलीनमलसत्वान्न बहिर्मुखीभवति,

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ततश्छर्द्यतीसारवर्ज्यान्यामप्रदोषलिङ्गान्यभिदर्शयत्यतिमात्राणि अतिमात्रप्रदुष्टाश्च दोषाः प्रदुष्टामबद्धमार्गास्तिर्यग्गच्छन्तः कदाचिदेव केवलमस्य शरीरं दण्डवत् स्तम्भयन्ति,

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ततस्तं दण्डालसकमसाध्यं ब्रुवते|

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विरुद्धाध्यशनाजीर्णाशनशीलिनः पुनरामदोषमामविषमित्याचक्षते भिषजः,

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विषसदृशलिङ्गत्वात्; तत् परमसाध्यम्, आशुकारित्वाद्विरुद्धोपक्रमत्वाच्चेति||१२||

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</div></div>

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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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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] </div>

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The extremely vitiated [[dosha]] 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>

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

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=== Management of [[ama]] disorders ===

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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|

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तत्र साध्यमामं प्रदुष्टमलसीभूतमुल्लेखयेदादौ पाययित्वा सलवणमुष्णं वारि, विसूचिकायां स्वेदनवर्तिप्रणिधानाभ्यामुपाचरेदुपवासयेच्चैनम्| ततः लङ्घनमेवाग्रे विरिक्तवच्चानुपूर्वी|

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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||

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आमप्रदोषेषु त्वन्नकाले जीर्णाहारं पुनर्दोषावलिप्तामाशयं स्तिमितगुरुकोष्ठमनन्नाभिलाषिणमभिसमीक्ष्य आमप्रदोषदुर्बलो च, नत्वेवाजीर्णाशनम्;

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पाययेद्दोषशेषपाचनार्थमौषधमग्निसन्धुक्षणार्थं ह्यग्निर्नयुगपद्दोषमौषधमाहारजातं च पक्तुम्|

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शक्तः अपि पुनर्विकाराणामपतर्पणेनैवोपरमो सहसैवातुरमबलमतिपातयेत्|

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आमप्रदोषजानां चामप्रदोषाहारौषधविभ्रमोऽतिबलत्वादुपरतकायाग्निं भवति, सति त्वनुबन्धे कृतापतर्पणानां व्याधीनां निग्रहे निमित्तविपरीतमपास्यौषधमातङ्कविपरीतमेवावचारयेद्यथास्वम्|सर्वविकाराणामपि च निग्रहे वा|

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कुशलाः, तदर्थकारि हेतुव्याधिविपरीतमौषधमिच्छन्ति विमुक्तामप्रदोषस्य पुनः परिपक्वदोषस्य दीप्ते चाग्नावभ्यङ्गास्थापनानुवासनं विधिवत् स्नेहपानं च युक्त्या प्रयोज्यं प्रसमीक्ष्य दोषभेषजदेशकालबलशरीराहार सात्म्यसत्त्वप्रकृतिवयसामवस्थान्तराण विकारांश्च सम्यगिति||१३||

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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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In case of ~~''visuchika''~~, treatment should start with [[langhana]] measures (therapy that reduces heaviness in the body) and specific dietary regimen as followed after therapeutic purgation.

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In case of [[Visuchika]], treatment should start with [[langhana]] measures (therapy that reduces heaviness in the body) and specific dietary regimen as followed after therapeutic purgation.

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 [[dosha]] 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 [[dosha]] ([[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.

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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 [[dosha]] 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 [[dosha]], drugs, place, time, strength, body, diet, [[satmya]], psyche, constitution, age etc. and also the diseases .[13] </div>

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When the patient is relieved from excessive morbidity of [[ama]], the [[dosha]] 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 [[dosha]], drugs, place, time, strength, body, diet, [[satmya]], psyche, constitution, age etc. and also the diseases .[13]

+

</div>

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===Importance of [[dietary guidelines]] in preservatio of health ===

भवति चात्र-

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आहारविध्यायतनानि चाष्टौ सम्यक् परीक्ष्यात्महितं विदध्यात्|

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अन्यश्च यः कश्चिदिहास्ति मार्गो हितोपयोगेषु भजेत तं च||१४||

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अशितं खादितं पीतं लीढं च क्व विपच्यते|

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एतत्त्वां धीर! पृच्छामस्तन्न आचक्ष्व बुद्धिमन्||१५||

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इत्यग्निवेशप्रमुखैः शिष्यैः पृष्टः पुनर्वसुः|

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आचचक्षे ततस्तेभ्यो यत्राहारो विपच्यते||१६||

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

</div>

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=== Description of [[Amashaya]](stomach) ===

==== Surface anatomy of [[amashaya]] ====

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नाभिस्तनान्तरं जन्तोरामाशय इति स्मृतः|

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अशितं खादितं पीतं लीढं चात्र विपच्यते||१७||

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</div></div>

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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]

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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]

</div>

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==== Functions of [[amashaya]] ====

आमाशयगतः पाकमाहारः प्राप्य केवलम्|

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पक्वः सर्वाशयं पश्चाद्धमनीभिः प्रपद्यते||१८||

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तत्र श्लोकः-

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तस्य मात्रावतो लिङ्गं फलं चोक्तं यथायथम्|

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अमात्रस्य तथा लिङ्गं फलं चोक्तं विभागशः||१९||

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

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

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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||

</div>

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== Tattva Vimarsha (Fundamental Principles) ==

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* 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.

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* 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).

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* The food that is heavy to digest, dry, cold, dehydrated, disliked by consumer, causing constipation and burning, unclean and incompatible causes disorders of [[ama]] 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.

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==== Role of satiety and three parts of ingestion capacity ====

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Satiety is one of the subjective parameters to assess the ingestion capacity of a person. The maximum ingestion capacity of a person should be divided into three parts. One-third part of food intake should be consumed in solid form and one third part as liquid diet, remaining one third part of total capacity should be kept empty for movement of [[vata]], [[pitta]] and [[kapha]]. This is the indicator of satiety. This means once the two third part of stomach will be filled, a person will have the feeling of satisfaction [Cha.Sa.[[Sutra Sthana]]25/40]. At this point the person should stop eating. If this limit is crossed, the excess food stuff will occupy the third part of stomach which interrupts the process of digestion, causing extra burden on [[agni]] (digestive power) and may result indigestion. The divisions of stomach (amashaya) are not in equal proportion, but it is in accordance with user’s suitability and the adaptive pattern of food consumption [Chakrapani on Cha.Sa.[[Vimana Sthana]]2/3]. Power of ingestion (abhyavaharana shakti) is different for every individual and it depends upon the strength of digestive capacity (jatharagni). The proper quantity of food (~~aahara~~ matra) to be consumed is subjected to power of ingestion and consistency of food articles i.e. solid and liquid.

+

Satiety is one of the subjective parameters to assess the ingestion capacity of a person. The maximum ingestion capacity of a person should be divided into three parts. One-third part of food intake should be consumed in solid form and one third part as liquid diet, remaining one third part of total capacity should be kept empty for movement of [[vata]], [[pitta]] and [[kapha]]. This is the indicator of satiety. This means once the two third part of stomach will be filled, a person will have the feeling of satisfaction [Cha.Sa.[[Sutra Sthana]]25/40]. At this point the person should stop eating. If this limit is crossed, the excess food stuff will occupy the third part of stomach which interrupts the process of digestion, causing extra burden on [[agni]] (digestive power) and may result indigestion. The divisions of stomach (amashaya) are not in equal proportion, but it is in accordance with user’s suitability and the adaptive pattern of food consumption [Chakrapani on Cha.Sa.[[Vimana Sthana]]2/3]. Power of ingestion (abhyavaharana shakti) is different for every individual and it depends upon the strength of digestive capacity (jatharagni). The proper quantity of food (ahara matra) to be consumed is subjected to power of ingestion and consistency of food articles i.e. solid and liquid.

Some Ayurveda scholars have divided ingestion capacity of amashaya in four parts and advised to take two parts with solid food, one part with liquids and rest one fourth part to be left empty for [[dosha]] (as a normal physiology of digestion). [A.Hr.[[Sutra Sthana]]8/46-47]<ref name="A. Hridaya">Vagbhata. Ashtanga Hridayam. Edited by Harishastri Paradkar Vaidya. 1st ed. Varanasi: Krishnadas Academy;2000.</ref> Arundatta, commentator of Vagbhata has considered this capacity of amashaya as the measurement of satiety.

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==== Understanding of [[Amashaya]] ====

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Amashaya is described in physiological consideration as a site of digestion of food. Surface anatomy describes amashaya as the organ situated between the umbilicus and the breast. All that is eaten, masticated, drunk and licked up is digested here. Once the digestion is completed, the digested essence of food reaches all the body organs by means of vessels. Amashaya is also considered as seat of [[pitta dosha]] and [[kapha dosha]]. [Cha. Sa.[[Sutra Sthana]] 20/8] There observes predominance of [[kapha]] and [[vata dosha]] in manifestation of respiratory disorders like [[hikka]] (hiccups) and [[shwasa]] (dysnoea). These disorders originate at the site of [[pitta]]. [Cha.Sa.[[Chikitsa Sthana]]17/8] In this context, Chakrapani mentioned the two segments of amashaya as upper segment (urdhva amashaya) and the lower segment (adho amashaya). Seat of [[pitta]] refers lower segment (adho amashaya) which clearly differentiates from the upper segment of [[kapha dosha]]. Anatomically Stomach can be considered as upper segment of amashaya. Small intestine along with liver and pancreas can be considered as the lower segment of amashaya. Amashaya rooted disorders are specifically grouped as the disorders having a predominance of [[kapha]] and [[pitta dosha]].[Cha.Sa.[[Vimana Sthana]] 6/3]

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Amashaya is described in physiological consideration as a site of digestion of food. Surface anatomy describes amashaya as the organ situated between the umbilicus and the breast. All that is eaten, masticated, drunk and licked up is digested here. Once the digestion is completed, the digested essence of food reaches all the body organs by means of vessels. Amashaya is also considered as seat of [[pitta dosha]] and [[kapha dosha]]. [Cha. Sa.[[Sutra Sthana]] 20/8] There observes predominance of [[kapha]] and [[vata dosha]] in manifestation of respiratory disorders like [[hikka]] (hiccups) and [[shwasa]] (dysnoea). These disorders originate at the site of [[pitta]]. [Cha.Sa.[[Chikitsa Sthana]]17/8] In this context, Chakrapani mentioned the two segments of amashaya as upper segment (urdhva amashaya) and the lower segment (adho amashaya). Seat of [[pitta]] refers lower segment (adho amashaya) which clearly differentiates from the upper segment of [[kapha dosha]]. Anatomically Stomach can be considered as upper segment of amashaya. Small intestine along with liver and pancreas can be considered as the lower segment of [[amashaya]]. Amashaya rooted disorders are specifically grouped as the disorders having a predominance of [[kapha]] and [[pitta dosha]].[Cha.Sa.[[Vimana Sthana]] 6/3]

=== Classification of food ===

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Depending on the consistency, the food articles are classified into four categories: drinkable, likable, eatable, and chewable. These four types are further abbreviated under two classes as liquid foods and solid foods respectively. Thus both type of food shall be consumed till half of it satiety or till feeling of satiety. This quantity will definitely be digested in due time, without disturbing [[dosha]] physiology ([[prakriti]]), thus indicates proper ~~qunatity~~ (aahara matra). Subjective parameters shall be observed carefully to decide the proper quantity of food. [Cha. Sa.[[Vimana Sthana]] 2/6] Food consumed in the appropriate quantity enhances strength, complexion, and nourishment of tissues.

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Depending on the consistency, the food articles are classified into four categories: drinkable, likable, eatable, and chewable. These four types are further abbreviated under two classes as liquid foods and solid foods respectively. Thus both type of food shall be consumed till half of it satiety or till feeling of satiety. This quantity will definitely be digested in due time, without disturbing [[dosha]] physiology ([[prakriti]]), thus indicates proper quantity (aahara matra). Subjective parameters shall be observed carefully to decide the proper quantity of food. [Cha. Sa.[[Vimana Sthana]] 2/6] Food consumed in the appropriate quantity enhances strength, complexion, and nourishment of tissues.

There are other six types of food patterns described depending upon the consistency of food viz.

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# Drinkable(peya) e.g. water, milk etc.

# Lickables (lehya) e.g. rasala (curd mixed with sugar and spices) and kadhi (a traditional Indian dish consisting mainly of yogurt and gram floor)

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# Bhojya (soft eatables) e.g. ~~Dal~~ Rice

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# Bhojya (soft eatables) e.g. dal Rice

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# Bhakshya (hard eatables) e.g. ~~Laddu~~, ~~Modak~~ (kind of sweet meal),

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# Bhakshya (hard eatables) e.g. laddu, modak (kind of sweet meal),

# Charvya (chewables) e.g. poha, roasted horse gram.

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==== Disorders of [[ama]] ====

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Two types of diseases caused by [[ama]] namely cholera-like symptoms ([[visuchika]]) and sluggish bowels ([[alasaka]]). A frail person having weak digestive power and aggravated [[kapha]] condition, even exerting pressure does not push the undigested food out of the passage since it is obstructed by [[kapha]]. This condition is called "alasaka". Taking food either in excess quantity or very little quantity is a type of "vishamashana" (a type of unhealthy dietary pattern). This leads to various [[ama]] disorders [Cha.Sa.[[Chikitsa Sthana]] 15/236].

+

Two types of diseases caused by [[ama]] namely cholera-like symptoms ([[visuchika]]) and sluggish bowels ([[alasaka]]). A frail person having weak digestive power and aggravated [[kapha]] condition, even exerting pressure does not push the undigested food out of the passage since it is obstructed by [[kapha]]. This condition is called [[alasaka]]. Taking food either in excess quantity or very little quantity is a type of "vishamashana" (a type of unhealthy dietary pattern). This leads to various [[ama]] disorders [Cha.Sa.[[Chikitsa Sthana]] 15/236].

==== Assessment of [[ama]] ====

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==== Secondary treatment (in niraama state) ====

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When patient is relieved from excessive morbidity of [[ama]]; the [[dosha]] are free from [[ama]] state (pakava avastha) and once digestive fire is kindled; oil ~~embrocation~~ ([[abhyanga]]), internal unction ([[snehapana]]), corrective and unctuous enema ([[asthapana]] and [[anuvasana]] types of [[basti]]) should be administered.

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When patient is relieved from excessive morbidity of [[ama]]; the [[dosha]] are free from [[ama]] state (pakava avastha) and once digestive fire is kindled; external oil unction ([[abhyanga]]), internal unction ([[snehapana]]), corrective and unctuous enema ([[asthapana]] and [[anuvasana]] types of [[basti]]) should be administered.

==== Emesis treatment ====

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The dietary guidelines ([[ahara vidhi]]) shall be strictly followed to prevent formation of [[ama]]. Taking food twice only in day is important measure to prevent formation of [[ama]]. [[Ayurveda]] prohibits the ingestion of food during night time. Hence, during day two meal times are suggested for health preservation. The ideal times are when the person feels hungry in the morning and evening before sunset. [Indu on A.S.Sutra Sthana 11/54] Bhavamishra advises to take food after three hours of sunrise for proper digestion suggest avoiding food past afternoon. The second meal can be taken before sunset. [B.P.Pradhama Khanda 4/115-116] It is advisable to consume that quantity of food which will be digested within twelve hours, without disturbing daily physical activities. Many efforts have been taken in biomedical science to unlock the complex mechanism underling this appetite science.

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Depending on the predominance of afflicted [[dosha]], four types of digestive patterns (~~jatharagni~~) are described:

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Depending on the predominance of afflicted [[dosha]], four types of digestive patterns ([[agni]]) are described:

#Samagni (Normal state of digestion and metabolism)

#Vishamagni (irregular state of digestion and metabolism)

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The first type of normal digestion (samagni) needs 12 hours (4 yama) for complete digestion of food, and 6 hours (2 yama) for proper digestion of medicine. [A.S. Sutra Sthana 11/53]

</div>

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=== Contemporary views and research updates ===

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Variety in food and pleasantness of food to sensory organs increase the intake of food. De Graaf C et al concluded that pleasantness of food affect satiation but do not have significant effect on satiety. <ref>De Graaf C, De Jong LS, Lambers AC. Palatability affects satiation but not satiety. Physiol Behav. 1999;66(4):681-688. doi:10.1016/s0031-9384(98)00335-7 </ref> <ref>Raynor HA, Epstein LH. Dietary variety, energy regulation, and obesity. Psychol Bull. 2001;127(3):325-341. doi:10.1037/0033-2909.127.3.325 </ref>

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The sensory-specific satiety phenomenon has been explained by Rolls et al with reference to sight and test of food.<ref>Rolls ET, Rolls BJ, Rowe EA. Sensory-specific and motivation-specific satiety for the sight and taste of food and water in man. Physiol Behav. 1983;30(2):185-192. doi:10.1016/0031-9384(83)90003-3</ref> <ref>Rolls BJ, Van Duijvenvoorde PM, Rolls ET. Pleasantness changes and food intake in a varied four-course meal. Appetite. 1984;5(4):337-348. doi:10.1016/s0195-6663(84)80006-9</ref>. Study of Spetter M S et al shows that oral food ingestion evokes greater neural activation of brain signaling pathways specifically in the midbrain, amygdala, hypothalamus, and hippocampus area neural activity related to sensory-specific satiety.<ref>Spetter M S, de Graaf C, Mars M, Viergever MA, Smeets PAM . The sum of its parts—effects of gastric distention, nutrient content and sensory stimulation on brain activation. PLoS ONE. 2014; 9(3): e90872: doi:10.1371/journal.pone.0090872 https://journals.plos.org/plosone/~~article?id~~=10.1371/journal.pone.0090872</ref>

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The sensory-specific satiety phenomenon has been explained by Rolls et al with reference to sight and test of food.<ref>Rolls ET, Rolls BJ, Rowe EA. Sensory-specific and motivation-specific satiety for the sight and taste of food and water in man. Physiol Behav. 1983;30(2):185-192. doi:10.1016/0031-9384(83)90003-3</ref> <ref>Rolls BJ, Van Duijvenvoorde PM, Rolls ET. Pleasantness changes and food intake in a varied four-course meal. Appetite. 1984;5(4):337-348. doi:10.1016/s0195-6663(84)80006-9</ref>. Study of Spetter M S et al shows that oral food ingestion evokes greater neural activation of brain signaling pathways specifically in the midbrain, amygdala, hypothalamus, and hippocampus area neural activity related to sensory-specific satiety.<ref>Spetter M S, de Graaf C, Mars M, Viergever MA, Smeets PAM . The sum of its parts—effects of gastric distention, nutrient content and sensory stimulation on brain activation. PLoS ONE. 2014; 9(3): e90872:doi:10.1371/journal.pone.0090872 https://journals.plos.org/plosone/articleid=10.1371/journal.pone.0090872</ref>

===== 2. Gastric mechanism of satiation =====

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'''a)Gastric distention''': Stomach functions as key component in digestion. It acts as a reservoir of food. The reservoir capacity of the stomach allows it to increase its volume significantly. Its capacity limits the amount of food to be ingested. Stomach distention significantly controls the food intake and satiety.<ref>Geliebter A, Hashim SA. Gastric capacity in normal, obese, and bulimic women [published correction appears in Physiol Behav 2002 Mar;75(3):433]. Physiol Behav. 2001;74(4-5):743-746. doi:10.1016/s0031-9384(01)00619-9</ref>,<ref>Geliebter A. Gastric distension and gastric capacity in relation to food intake in humans. Physiol Behav. 1988;44(4-5):665-668. doi:10.1016/0031-9384(88)90333-2</ref> Geliebter A and team while assessing the changes in gastric capacity of obese patients determined the gastric capacity by oral insertion of a latex gastric balloon method.<ref>Geliebter A, Schachter S, Lohmann-Walter C, Feldman H, Hashim SA. Reduced stomach capacity in obese subjects after dieting. Am J Clin Nutr. 1996;63(2):170-173. doi:10.1093/ajcn/63.2.170 </ref>In other works also this is used as a tool to assess the gastric capacity.<ref>Tate CM, Geliebter A. Intragastric Balloon Treatment for Obesity: Review of Recent Studies. Adv Ther 34, 1859–1875 (2017). https://doi.org/10.1007/s12325-017-0562-3</ref>

+

'''a)Gastric distention''': Stomach functions as key component in digestion. It acts as a reservoir of food. The reservoir capacity of the stomach allows it to increase its volume significantly. Its capacity limits the amount of food to be ingested. Stomach distention significantly controls the food intake and satiety.<ref>Geliebter A, Hashim SA. Gastric capacity in normal, obese, and bulimic women [published correction appears in Physiol Behav 2002 Mar;75(3):433]. Physiol Behav. 2001;74(4-5):743-746.doi:10.1016/s0031-9384(01)00619-9</ref>,<ref>Geliebter A. Gastric distension and gastric capacity in relation to food intake in humans. Physiol Behav. 1988;44(4-5):665-668. doi:10.1016/0031-9384(88)90333-2</ref> Geliebter A and team while assessing the changes in gastric capacity of obese patients determined the gastric capacity by oral insertion of a latex gastric balloon method.<ref>Geliebter A, Schachter S, Lohmann-Walter C, Feldman H, Hashim SA. Reduced stomach capacity in obese subjects after dieting. Am J Clin Nutr. 1996;63(2):170-173. doi:10.1093/ajcn/63.2.170 </ref>In other works also this is used as a tool to assess the gastric capacity.<ref>Tate CM, Geliebter A. Intragastric Balloon Treatment for Obesity: Review of Recent Studies. Adv Ther 34, 1859–1875 (2017). https://doi.org/10.1007/s12325-017-0562-3</ref>

'''b)Gastric and Intestinal Signals''': In response to the food many gut peptides are secreted from enteroendocrine cells, which play essential role in regulating food. Steinert RE et al reveals that along with gastric distention, Gastric and intestinal signals (increased GLP-1 and PYY secretions and reduction in plasma ghrelin secretions) synergies to support satiation.<ref>Steinert RE, Meyer-Gerspach AC, Beglinger C. The role of the stomach in the control of appetite and the secretion of satiation peptides. Am J Physiol Endocrinol Metab. 2012 Mar 15;302(6):E666-73. doi: 10.1152/ajpendo.00457.2011. Epub 2012 Jan 3. PMID: 22215654.

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Food is considered the basic necessity for sustenance of life and attain physical stoutness [Cha.Sa.[[Sutra Sthana]] 25/40(1)]. Energy hemostasis depends on food we consume. Hypothalamus and brainstem are mainly involved to maintain the energy levels. The arcuate nucleus (ARC) of hypothalamus plays important role to control intake of food. ARC has orexigenic neurons (appetite stimulating) and anorexigenic neurons (appetite inhibiting). During digestion, food nutrients stimulate G-protein coupled receptor present on enteroendocrine cell, which stimulates release of gut hormone. Gut hormones influences the vagus nerve, hypothalamus and brainstem. Stimulating and inhibitory neurons present in hypothalamus interact with peripheral signals which results in alteration of eating drive. Vagal afferents stimulated by the gut hormone and sensitive to the stomach's mechanical stretch further connect with the nucleus of the brainstem. Brainstem passes neural signals to hypothalamus. Numerous hormonal and neural signals influence ARC nucleus, which projects to a number of regions including hypothalamic paraventricular nucleus where some essential energy regulating pathways arise.

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Gastrointestinal track releases various peptide hormones. Stomach has its hormonal and neural control mechanism. Presence of food nutrients along with distention of stomach release gut hormones such as PPY, GLP-1, and oxyntomodulin (OXM).Theses are mainly responsible for phenomenon of satiation. These peptide, decreases hypothalamic orexigenic signaling and increases anorexigenic signaling. Negative feedback mechanism results due to these peptides also contribute to increase satiety between meals. Effect of these gut hormones in union with CNS effect results in satiation and satiety. The enteroendocrine cells released hormones interact at different brain levels through circulation and or through primary afferent neurons. Along with induction of satiation and meal termination, gut hormones also produce a positive feeling of reward and satisfaction.Nutrient sensors and their signaling to brain are vital to give feeling of satisfaction.<ref>Sam AH, Troke RC, Tan TM, Bewick GA. The role of the gut/brain axis in modulating food intake. Neuropharmacology. 2012 Jul;63(1):46-56. doi: 10.1016/j.neuropharm.2011.10.008. Epub 2011 Oct 21. PMID: 22037149</ref> <ref>Murphy KG, Bloom SR. Gut hormones and the regulation of energy homeostasis. Nature. 2006 Dec 14;444(7121):854-9. doi: 10.1038/nature05484. PMID: 17167473.</ref> <ref>Berthoud HR. Vagal and hormonal gut-brain communication: from satiation to satisfaction. Neurogastroenterol Motil. 2008;20 Suppl 1(0 1):64-72. doi:10.1111/j.1365-2982.2008.01104.</ref>

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Gastrointestinal track releases various peptide hormones. Stomach has its hormonal and neural control mechanism. Presence of food nutrients along with distention of stomach release gut hormones such as PPY, GLP-1, and oxyntomodulin (OXM).Theses are mainly responsible for phenomenon of satiation. These peptide, decreases hypothalamic orexigenic signaling and increases anorexigenic signaling. Negative feedback mechanism results due to these peptides also contribute to increase satiety between meals. Effect of these gut hormones in union with CNS effect results in satiation and satiety. The enteroendocrine cells released hormones interact at different brain levels through circulation and or through primary afferent neurons. Along with induction of satiation and meal termination, gut hormones also produce a positive feeling of reward and satisfaction. Nutrient sensors and their signaling to brain are vital to give feeling of satisfaction.<ref>Sam AH, Troke RC, Tan TM, Bewick GA. The role of the gut/brain axis in modulating food intake. Neuropharmacology. 2012 Jul;63(1):46-56. doi: 10.1016/j.neuropharm.2011.10.008. Epub 2011 Oct 21. PMID: 22037149</ref> <ref>Murphy KG, Bloom SR. Gut hormones and the regulation of energy homeostasis. Nature. 2006 Dec 14;444(7121):854-9. doi: 10.1038/nature05484. PMID: 17167473.</ref> <ref>Berthoud HR. Vagal and hormonal gut-brain communication: from satiation to satisfaction. Neurogastroenterol Motil. 2008;20 Suppl 1(0 1):64-72. doi:10.1111/j.1365-2982.2008.01104.</ref>

D Chapelot has described subjective and objective tools for measuring meal size, microstructure of the meal, meal request and inter-meal intervals. A multidimensional approach for assessing satiety is proposed with intensity, duration and intake as main variables.<ref>Chapelot D. Quantifying satiation and satiety. In: Blundell JE, Bellisle F, ed. Satiation, Satiety and the Control of Food Intake:Woodhead Publishing Series in Food Science, Technology and Nutrition; 2013:Pages12-39. https://www.sciencedirect.com/science/book/9780857095435</ref> Commings DE et.al have reviewed the interaction of gastric, intestinal, and pancreatic signals in food regulation. They have also discussed the important role of short acting GI factors and long-acting adiposity hormones in food intake regulation. Gerry Smith survey indicates that gastric signals are volumetric in nature and intestinal signals are nutritive in nature.<ref>Powley TL, Phillips RJ. Gastric satiation is volumetric, intestinal satiation is nutritive. Physiol Behav. 2004 Aug;82(1):69-74. doi: 10.1016/j.physbeh.2004.04.037. PMID: 15234593.</ref>

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'''The satiety quotient (SQ):''' GREEN SM et al developed a satiety quotient (SQ) to assess an eating episode's satiating effect. This is considered as a remarkable contribution in the field in quantifying satiating effects of foods. This quotient relates food intake with the rate of return of motivation to eat post ingestion, which is predictive of energy intake. Thus, for a person, the satiety quotient will vary based on weight, macronutrient composition, and energy density of food.<ref>Green SM, Delargy HJ, Joanes D, Blundell JE. A satiety quotient: a formulation to assess the satiating effect of food. Appetite. 1997 Dec;29(3):291-304. doi: 10.1006/appe.1997.0096. PMID: 9468762. https://doi.org/https://doi.org/10.1006/appe.1997.0096</ref>

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'''Low satiety phenotype:''' ‘Low satiety phenotype’ is associated with specific behavioral and metabolic profiles that could explain their susceptibility to overeating. These individuals do not recognize their appetite sensation before and after meal. This is considered as an important step in individualized obesity treatment.<ref>DrapeauV, Gallant A.The low satiety phenotype. In: Blundell JE, Bellisle F, ed. Satiation, Satiety and the Control of Food Intake: Woodhead Publishing Series in Food Science, Technology and Nutrition; 2013:Pages 273–297. https://doi.org/10.1533/9780857098719.5.273</ref>

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'''Low satiety phenotype:''' ‘Low satiety phenotype’ is associated with specific behavioral and metabolic profiles that could explain their susceptibility to overeating. These individuals do not recognize their appetite sensation before and after meal. This is considered as an important step in individualized obesity treatment.<ref>DrapeauV, Gallant A. The low satiety phenotype. In: Blundell JE, Bellisle F, ed. Satiation, Satiety and the Control of Food Intake: Woodhead Publishing Series in Food Science, Technology and Nutrition; 2013:Pages 273–297. https://doi.org/10.1533/9780857098719.5.273</ref>

=====Research tools to assess digestive processes (Jatharagni) =====

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Wholesome diet is considered as the prime factor for nourishment and growth of a human being. Nourishing benefits of diet is subjected to the status of [[agni]].Thus [[agni]] is an important facilitator between health and food. Assessment of the status of ~~jatharagni~~ is an essential component in maintenance of health as well as while treating diseased conditions. Singh A, Patwardhan K. et. al. have developed and validated a self-assessment tool to estimate ~~Agnibala~~. The study also evaluates the practical utility of developed tool by recording serum lipid parameters. Lipid parameters vary significantly according to the status of [agni]]. <ref>Singh A, Singh G, Patwardhan K, Gehlot S. Development, Validation and Verification of a Self-Assessment Tool to Estimate Agnibala (Digestive Strength). J Evid Based Complementary Altern Med. 2017 Jan;22(1):134-140. doi: 10.1177/2156587216656117. Epub 2016 Jul 4.</ref>Eswaran H T et al have prepared an agni assessment scale with total 64 questions to evaluate the four types of nature of digestive fire (jatharagni). The study has validated the scale for internal consistency. Validation is essential for accuracy and reproducibility.<ref>Eswaran HT, Kavita MB, Tripaty TB, and Shivakumar. Formation and validation of questionnaire to assess Jāṭharāgni. Anc Sci Life.2015 Apr-Jun; 34(4): 203–209.</ref> Patil VC, Baghel MS et. al. have developed formulae for assessment of the digestive function ([[agni]]) in during administration of [[snehana]] (internal oleation). <ref>Patil VC, Baghel MS, Thakar AB. Assessment of [[agni]] (digestive process) and [[koshtha]] (bowel movement with special reference to abhyantara [[snehana]] (internal oleation). Ancient Sci. Life. 2008; 28:26-28</ref> [[Agni]] performs various functions of digestion, metabolism and assimilation. Gastric secretions is a digestive fluid, formed in the stomach and contain numerous compounds including hydrochloric acid (HCL), pepsin, lipase, mucin. Kulatunga et al assessed the status of agni in the patients of pandu ~~roga~~ and find out its relationship with the acidity of gastric secretions by use of fractional test meal examination. Their study concluded that HCL reduction in patients of anemia seriously affects the protein and iron absorption; thus ~~Hypochlohydria~~ (found in 72.8% of the patients) indicates hypofunction of [[agni]].<ref>Kulatunga R D H, Rai N P, Ali Z. Status of Agni in Pandu Roga (anemia) and its association with the acidity of gastric secretions-A Clinical Study. IAMJ: Volume 7, Issue 1, January – 2019.</ref>

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Wholesome diet is considered as the prime factor for nourishment and growth of a human being. Nourishing benefits of diet is subjected to the status of [[agni]].Thus [[agni]] is an important facilitator between health and food. Assessment of the status of [[agni]] is an essential component in maintenance of health as well as while treating diseased conditions. Singh A, Patwardhan K. et. al. have developed and validated a self-assessment tool to estimate strenght of [[agni]]. The study also evaluates the practical utility of developed tool by recording serum lipid parameters. Lipid parameters vary significantly according to the status of [agni]]. <ref>Singh A, Singh G, Patwardhan K, Gehlot S. Development, Validation and Verification of a Self-Assessment Tool to Estimate Agnibala (Digestive Strength). J Evid Based Complementary Altern Med. 2017 Jan;22(1):134-140. doi: 10.1177/2156587216656117. Epub 2016 Jul 4.</ref>Eswaran H T et al have prepared an agni assessment scale with total 64 questions to evaluate the four types of nature of digestive fire (jatharagni). The study has validated the scale for internal consistency. Validation is essential for accuracy and reproducibility.<ref>Eswaran HT, Kavita MB, Tripaty TB, and Shivakumar. Formation and validation of questionnaire to assess Jāṭharāgni. Anc Sci Life.2015 Apr-Jun; 34(4): 203–209.</ref> Patil VC, Baghel MS et. al. have developed formulae for assessment of the digestive function ([[agni]]) in during administration of [[snehana]] (internal oleation). <ref>Patil VC, Baghel MS, Thakar AB. Assessment of [[agni]] (digestive process) and [[koshtha]] (bowel movement with special reference to abhyantara [[snehana]] (internal oleation). Ancient Sci. Life. 2008; 28:26-28</ref>

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[[Agni]] performs various functions of digestion, metabolism and assimilation. Gastric secretions is a digestive fluid, formed in the stomach and contain numerous compounds including hydrochloric acid (HCL), pepsin, lipase, mucin. Kulatunga et al assessed the status of [[agni]] in the patients of [[pandu]] (anemia and blood deficiency disorders) and find out its relationship with the acidity of gastric secretions by use of fractional test meal examination. Their study concluded that HCL reduction in patients of anemia seriously affects the protein and iron absorption; thus Hypochlorhydria (found in 72.8% of the patients) indicates hypofunction of [[agni]].<ref>Kulatunga R D H, Rai N P, Ali Z. Status of Agni in Pandu Roga (anemia) and its association with the acidity of gastric secretions-A Clinical Study. IAMJ: Volume 7, Issue 1, January – 2019.</ref>

==== Understanding links between mental health and gastrointestinal tract mediated through gut microbiota ====

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==== Contemporary views and research updates on [[ama]] ====

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[[Ama]] is an important principle to understand the etiopathogenesis of all disorders and to decide the treatment modalities. [[Agni]] is the digestive and metabolic ~~fire which is~~ responsible for any transformation in body. Transformation of food material predominantly takes place at the level of gastrointestinal tract ([[grahani]]-seat of ~~jathragni~~) and at the level of tissues (dhatvagni-abodes of [[dhatu]]). Dysfunction of [[agni]] results into undigested or partly digested intermediator product called as [[ama]]. [[Ama]] act as toxic element and form the basis for many pathological conditions. It can be considered raw, uncooked, unripe, immature, undigested or incompletely oxidized / metabolized or similar to a poisonous substance that disrupts body physiology. Accumulation of metabolic waste ([[mala]]) may takes place at various levels in body physiology. The amalgamation of aggravated [[dosha]] with metabolic waste results in [[ama]] formation, which is considered the initial stage of disease formation. Origin of [[ama]] is mainly considered from gastrointestinal tract (amashaya). [[Agni]] functions at different levels; hence, [[ama]] can be formed at different levels at different body sites. Forms of [[agni]] - jatharagni, bhutagni and dhatvagni functions at different level hence any impairment at the corresponding level leads to [[ama]] formation.

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[[Ama]] is an important principle to understand the etiopathogenesis of all disorders and to decide the treatment modalities. [[Agni]] is the digestive and metabolic factor responsible for any transformation in body. Transformation of food material predominantly takes place at the level of gastrointestinal tract ([[grahani]]-seat of jatharagni) and at the level of tissues (dhatvagni-abodes of [[dhatu]]). Dysfunction of [[agni]] results into undigested or partly digested intermediator product called as [[ama]]. [[Ama]] act as toxic element and form the basis for many pathological conditions. It can be considered raw, uncooked, unripe, immature, undigested or incompletely oxidized / metabolized or similar to a poisonous substance that disrupts body physiology. Accumulation of metabolic waste ([[mala]]) may takes place at various levels in body physiology. The amalgamation of aggravated [[dosha]] with metabolic waste results in [[ama]] formation, which is considered the initial stage of disease formation. Origin of [[ama]] is mainly considered from gastrointestinal tract ([[amashaya]]). [[Agni]] functions at different levels; hence, [[ama]] can be formed at different levels at different body sites. Forms of [[agni]] - jatharagni, bhutagni and dhatvagni functions at different level hence any impairment at the corresponding level leads to [[ama]] formation.

Digestion process starts from mouth where mechanical and chemical digestion of food takes place. Thinking, smelling and seeing food secrets saliva, helps in digestion. Component of saliva like water, mucus, electrolytes and enzymes has a unique function. Starch breakdown starts here due to the enzyme in saliva called salivary amylase. Mucus lubricates the food and helps in the formation of bolus in mouth. Small food particles are dissolved by saliva and it makes dry food moist enough to swallow comfortably. If person is not following dietary codes, eating hurriedly without proper mastication, disturbed mental health while taking food will affect this cephalic phase of digestion. It will lead to [[ama]] formation due to improper digestion process in mouth. Mastication of food is subjected to condition of teeth. Studies have attempted to find a correlation between tooth loss and nutrition. Deteriorated dental health affects mechanical digestion process and leads to nutritional deficiency.<ref>Najeeb S, Zafar MS, Khurshid Z, Zohaib S, Almas K. The role of nutrition in periodontal health: An Update. Nutrients. 2016 Aug 30;8(9):530. doi: 10.3390/nu8090530. PMID: 27589794; PMCID: PMC5037517. </ref> Another study observed that modifying the mastication rate alters the glycemic index of rice. Its glycemic index classification shows impact of digestion process on the final outcome of food.<ref>Ranawana, V., Leow, M. K.-S., & Henry, C. J. K. (2014). Mastication effects on the glycemic index: impact on variability and practical implications. European Journal of Clinical Nutrition, 68(1), 137–139. https://doi.org/10.1038/ejcn.2013.231</ref>

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[[Ama]] formation occurs due to the accumulation of toxic or intermediate product of metabolism in the body termed as mala. These intermediate products are formed due to defect in the metabolism of protein, carbohydrate or lipid. Excessive uric acid is formed due to improper metabolism of protein which is hazardous to body tissue and joint structure. Lactic acid, acetone and ketone bodies are formed due to improper metabolism of carbohydrate and fats. Lack of insulin activity defunct carbohydrate metabolism and leads to formation of intermediate products in the body. This intermediate products act as [[ama]] and leads to many disease conditions.

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'''Metabolic waste functions as [[ama]]''': Tissue nutrients after action of metabolism (dhatvagni) nourishes body tissues and part is formed as excretory product ([[mala]]). Accumulation of this metabolic waste beyond certain limits disrupts the dosha hemostasis, leads to formation of ama. Depending on the type of metabolic waste and predominance of doshas exhibits many diseases.

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'''Metabolic waste functions as [[ama]]''': Tissue nutrients after action of metabolism (dhatvagni) nourishes body tissues and part is formed as excretory product ([[mala]]). Accumulation of this metabolic waste beyond certain limits disrupts the [[dosha]] hemostasis, leads to formation of [[ama]]. Depending on the type of metabolic waste and predominance of doshas exhibits many diseases.

</div>

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=== Research theses done (M.D./Ph.D. works) ===

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=== Research theses done (M.D./Ph.D.(Ayurveda) reserach works) ===

#Badeka B.P.(1964 ) : Aam vivechan. Institute for Post Graduate Teaching & Research in Ayurveda, Gujarat Ayurved University, Jamnagar.

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