HAVE

Knowledge

Clinical importance of
Pittadhara Kala
Guest lecture at AMC, Davangere

Dr. K. Shiva Rama Prasad

M.D.(KC), M.A, Ph.D (Jyo)
doctorksrprasad@gmail.com 1
 Need to know
Kala are very much neglected in the clinical
medicine
Kala possess major importance in the body
Many diseases of present day are specifically
Kala concern, such as –
Grahani (Pittadharakala)
Durmedas (Medodhara Kala)
Infertility (Sukra dhara kala)
Musculo skeletal problems (Mamsadhara kala)
I.B.S ( Pureeshadhara kala) etc.
doctorksrprasad@gmail.com 2
Many a times we never think of
understanding the structural disturbances
in the body and rectification of the
structural integrity disturbed by the dosha
in the body
Apart from the rectification and
pacification of the dosha out of srotodusti
lakshana – Atipravrutti & Apravrutti
(Sanga) – Sira granthi & Vimargagamana
are essential to examine in detail
Rectify the structural and functional
disturbances of Kala With special
reference to Kayachikitsa
doctorksrprasad@gmail.com 3
 Pittadhara Kala
Pitta & Agni
Ama
Ama Pradoshaja
Pittadhara kala Janya Vyadhi

Pittadhara Kala Chikitsa

doctorksrprasad@gmail.com 4
 Saptakala Vijnana
Kala are seven in number
Kala lies in between the Dhatu and
Ashaya
Kala are like pith of the steam in the
Tissues

MüsÉÉ: ZÉsuÉÌmÉ xÉmiÉxÉqpÉuÉÎliÉ kÉÉiuÉÉvÉrÉÉliÉU qÉrÉÉïSÉ:

rÉjÉÉ ÌWû xÉÉU: MüɹåwÉÑÎccɱqÉÉlÉåwÉÑ SìÓvriÉå - xÉÑ.vÉÉ 4/5

doctorksrprasad@gmail.com 5
 Kala Nomenclature
¾ The fluid between the Dhatu
and Ashaya subjected to the
heat developed from Ushma
gives rise the Kala
¾ The Kala is covered by the
layer of phlegm

kÉÉiuÉÉvÉrÉÉliÉUYsÉåS: ÌuÉmÉYuÉ: xuÉÇ xuÉqÉÔwqÉhÉÉ vsÉåwqÉ

xlÉÉruÉmÉUÉcNû³É: MüsÉÉZrÉ: MüɹxÉÉUuÉiÉç, iÉÉxxÉmiÉ –
A.¾Òû.vÉÉ 3/9 doctorksrprasad@gmail.com 6
 Kala Division

1) Mamsadhara kala
2) Raktadhara kala
3) Medodhara kala
4) Shleshmadhara kala
5) Pureeshadhara kala
6) Pittadhara kala
7) Shukradhara kala

doctorksrprasad@gmail.com 7
 Difference of opine
Kala is defined as a layer between – Rasa-
Rakta – Mamsa – Medo- Asti – Majja –
Shukra, 7 dhatu and Vata – Pitta – Shleshma
– Ama – Mala – Mootra – Raktashaya of 7
Ashayas
2nd opine is – dhatu means Mamsa – Rakta –
Medas – Shleshma and Sukra along with the
Ashaya as Pittashaya, Pakwashaya.
Both of the above are considered & needs
further discussion to specify any one of them
doctorksrprasad@gmail.com 8
 Pittadhara Kala
Pittadhara Kala is 6th in order
Receives when the food is propelled from
Amashaya Holds in the Pakwashaya -
The four verities of food ingested – viz.
Asita, Khadiata, Peeta and Leeda

wɹÏÌmɨÉkÉUÉ lÉÉqÉ, rÉÉ cÉiÉÑÌuÉïkÉqɳÉmÉÉlÉqÉÑmÉrÉÑ£ü

qÉÉqÉÉvÉrÉÉimÉëcrÉÑiÉÇ mÉYuÉÉvÉrÉÉåmÉÎxjÉiÉÇ kÉÉUrÉÌiÉ -
xÉÑ.vÉÉ 4/17
doctorksrprasad@gmail.com 9
 Structural Aspect of
Pittadhara Kala
In between Pakwashaya and Amashaya
Holds the food at Pakwashaya
These statements refer to the activity
concern and states that the Pittadhara kala is
as such below to that of the Ashaya which
holds the undigested food and in the Ashaya
which propels the digested food for
absorption With the function of assimilation

mÉYuÉÉqÉÉvÉrÉqÉkrÉxjÉÉaÉëWûhÉÏ mÉËUMüÐÌiÉïiÉÉ –
AÉqÉÉvÉrÉÉimÉëcrÉÑiÉÇ mÉYuÉÉvÉrÉÉåmÉÎxjÉiÉÇ kÉÉUrÉÌiÉ -
xÉÑ.vÉÉ 4/17 doctorksrprasad@gmail.com 10
As the Sigmoid colon
and Rectum are
termed with “Pureesha
Vaha srotas” and lined
by “Pureeshadhara
Kala” – these parts of
GIT are ruled out of
the discussion of
pittadharakala

doctorksrprasad@gmail.com 11
From mouth till to and in the
Amashaya – 4 food varieties
are passed in undigested form
– thus comfortably can be
termed as Amashaya

doctorksrprasad@gmail.com 12
Consideration of Amashaya
Amashaya is with undigested food
Contemporary science explains as –
carbohydrate digestion starts at mouth and
protein at stomach and fats at duodenum
As the fat digestion is continued till to that of
Jejunum – it has to be considered even the
duodenum is also as a part of Amashaya
Even at the Jejunum, absorption doesn’t takes
place thus till to that of Ileum jejunum junction –
Amashaya extends

doctorksrprasad@gmail.com 13
The part between
Jejunum and Sigmiod
colon is the Ileum –
Pakwa-Amashaya
madhya is the part
anatomically to consider
as Grahani or

Pittadhara Kala

doctorksrprasad@gmail.com 14
 Functional Aspect of
Pittadharakala
It digests the 4 verities of food
Digestion in terms of – Pachana –
Vivechana – Mumchana
All the functions of Pitta are attributed to
Pittadharakala based on the concept of
Adhara-Adheya bhava. The integrity of
the Pittadhara kala (Grahani) depends
upon the proper function of Agni so it can
be termed as even “Agnidhra Kala”

aÉëWûhrÉÉoÉsÉqÉÎalÉÌWïû ---- iÉxqÉÉSalÉå mÉëSÕÌwÉiÉå aÉëWûhÉÏ

xÉÇmÉëSÕwrÉiÉÏÌiÉ- xÉÑ.E¨ÉU- QûsWûhÉ 40/170
doctorksrprasad@gmail.com 15
 Enumeration & Examination
of Functions
Functions of Pittadharakala are enumerated by -
Grahana - collection (Grahana
Pittadharakala - Amashayastha)
Pachana - digestion (Pachana
Pittadharakala - Pachyamanashayastha)
Vivechana & Mumunchana – Separation
& Absorption (Vivechana Pittadharakala
- Pakwashayastha)

doctorksrprasad@gmail.com 16
Grahana - collection
The collection anomalies (Functional or
Organic) are subjected to the movements
of the stomach to make the food as
amalgam and
To initiate the normal peristaltic
movements in the intestines
Main diseases pertained are of Grahani
roga – Kosta stabdhata - sroto sanga
(carcinoma, etc) - etc,. Even Dosha wise
diseases can be enumerated
doctorksrprasad@gmail.com 17
Pachana - digestion
The digestion disturbances are well
narrated in Ayurveda and many Agni inter
linked diseases are explained
To initiate the normal Agni, examination of
Agni is necessary
Main diseases pertained to Agni are -
Agnimandya, Ajeerna, Parinama
shoola, Annadrava shoola, etc,.

doctorksrprasad@gmail.com 18
Summary of
chemical
events in
digestion

doctorksrprasad@gmail.com 19
Vivechana & Mumunchana
– Separation & Absorption
Water, electrolytes, and vitamins can be
absorbed without preliminary processing, but
special transport mechanisms are commonly
involved.
The intestinal epithelium then absorbs the
monosaccharides by facilitated diffusion and
cotransport mechanisms.
cells lining the small intestine will continue to
absorb glucose when glucose concentrations
inside the cells are much higher than they are in
the intestinal contents.
doctorksrprasad@gmail.com 20
triglycerides, in company with absorbed
steroids and phospholipids, are then coated
with proteins, creating complexes known as
chylomicrons
amino acids, as well as those produced by
the pancreatic enzymes, are absorbed
through both facilitated diffusion and
cotransport mechanisms
The anions chloride, iodide, bicarbonate, and
nitrate may be absorbed through diffusion or
carrier-mediated transport. Phosphate and
sulfate ions enter epithelial cells only
through active transport.
doctorksrprasad@gmail.com 21
Here I wish to make a comment
Ayurveda and Contemporary medicines are
appropriative and doesn’t fit one to another as
like Relative theory and Quantum theory
Ayurveda is like a Relative theory of Einsteen,
which speaks about the “G” – Gravity
On the other hand – contemporary medical
sciences speak of Quantum theory of –
Electromagnetism, Strong force and Weak force
A major exercise is necessary to understand and
bind the two poles of Health sciences

doctorksrprasad@gmail.com 22
Secretion and
water
absorption in
the Digestive
tract - suggests
the placement
of the
Pittadhara Pittadhara Kala
Kala
physiologically
after the
Pureeshadhara
Duodenum
Kala
and before to
the Ileoceacal
Valve
doctorksrprasad@gmail.com 23
 Pittadhara Kala
Pitta & Agni
Ama
Ama Pradoshaja
Pittadhara kala Janya Vyadhi

Pittadhara Kala Chikitsa

doctorksrprasad@gmail.com 24
 Examination of Pitta & Agni
There is no other Agni available in the
body other than that of Pitta 1
Agni is examined by the “Jarana shakti”
Jarana Shakti is the capacity of digestion
in terms of food taken under the
stipulations and norms
For this only questionnaire are sufficient
Few of the concern terms are -
1 lÉZÉsÉÑ ÌmɨÉurÉÌiÉUåMüÉSlrÉÉåÅÎalÉÂmÉsÉprÉiÉå - xÉÑ.xÉÔ.21/8
doctorksrprasad@gmail.com 25
 Food in connection with
digestion
™ Aahaarasakti (Pachana Pittadhara kala)
means the capacity to the intake of food and
digestion
™ How much a person can consume food without
any discomfort is considered as
Abhyavaharana sakti (Grahana Pittadhara
kala)
The proper digestion of food in time with out any
discomfort is considered as the capacity of his
digestion is Jarana sakti (Vivechana
Pittadhara kala)
doctorksrprasad@gmail.com 26
AVIPAAKAH (Indigestion) is
resultant of improper Agni

Ajarakam
Ajeernam
Apaakah
Apaktisaktih
Paktinaasah are the synonyms of
Avipaka.

doctorksrprasad@gmail.com 27
Impaired Pittadhara Kala means
impaired Agni and development
of Ama

Ama Produces at GIT and also in Dhatus

at Biochemical expression Ama can be

„ Improperly metabolized intermediate byproducts

„ Increased antigenicity
„ Free radicals

doctorksrprasad@gmail.com 28
 Pittadhara Kala
Pitta & Agni
Ama
Ama Pradoshaja
Pittadhara kala Janya Vyadhi

Pittadhara Kala Chikitsa

doctorksrprasad@gmail.com 29
 Ama Definition
By definition Ama is -
Apakwa Ahara - undigested food
Shukta Ahara - fermented food
Visharoopa Ahara - toxic like food
Mala sanchaya - eliminative accumulation
Ahara rasa shesha - left of rasa in
Amashaya
first stage of Dosha Dusti
AmÉcrÉqÉÉlÉÇ vÉÑ£üiuÉÇ rÉÉirɳÉÇ ÌuÉwÉÃmÉiÉÉqÉç - cÉ.ÍcÉ.15/42
doctorksrprasad@gmail.com 30
Enumeration and Examination of Ama
It is difficult to enumerate quantitatively Ama in
clinical aspect
But it is not an Impossible task
The normal terms come across are - Ushma -
Adyadhatu and Amashaya
Here the Ushma - Heat is the concern
Ushma maintenance is done by Pitta of
Amashaya (Pachakapitta) and Pitta of Twak
(Bhrajakapitta)
So, to examine Ama clinically is possible by
examining the contextual Ama Lakshana and
Twak doctorksrprasad@gmail.com 31
Ama Lakshana (A.H.Su.13/24)
Srotorodha - obstruction to channels
Balabhramsha - loss of strength
Gourava - heaviness
Anila moodhata - loss of impulses
Aalasya - laziness
Apakti - loss of digestion
Nisteeva -spitting
Malasanga - accumulation of waste
Aruchi - tastelessness
Klama - fatigue -
out of these except Srotorodha, Anila Moodhata and
Malasanga rest are self explainable
doctorksrprasad@gmail.com
doctorksrprasad@gmail.com 32
32
 Srotorodha examination

Out of the 13 srotas explained each and

every srotas are individually examined
along with specificity of Rasa and Rakta
as they are related to pittadharakala
directly.
Any Atipravrutti - Apravrutti with reference to
functions and
Sira Granthi and Vimarga Gamana with the
structure is considered

doctorksrprasad@gmail.com 33
 Malasanga examination
Mala are Pureesha - Mootra - Sweda
at present context Pittadhara Kala separates the Mala
and Sara in general is impaired to accumulate the Mala
and obstructs or
another understanding is the mala which is formed is not
separated by the Pittadhara Kala
The Mala are - biological end products which interfere
the digestion and metabolism -
eg. Enteroendocrine cells (Glands in the pylorus)
produce at least seven different hormones, most notably
the hormone gastrin (G cells) in the gastric pits of the
pyloric antrum. The pyloric glands also contain D cells,
which release somatostatin a hormone that inhibits
gastrin release. doctorksrprasad@gmail.com 34
 Anila Moodhata examination
The neural output proceeds via the
parasympathetic division of the ANS and reaches
the stomach by means of the vagus nerves
As par Ayurveda - the Vata (Samana) in the Kosta
is responsible for the Anna Grahana, Pachana,
Vivechana
thus the Kostashrita Vata is much clinically
evaluated
When Vagatomy or any surgical procedures under
taken impulsive nerve reflexes lessens the
enzymatic secretion in the Stomach or vice versa
doctorksrprasad@gmail.com 35
Skin in the examination of Ama
The importance of the Twacha should not
be forgotten as the “Ushma” is regulated
by the it self
Skin respires even
the examination of Twacha includes with
the - temperature variances, Temperature
disturbances over the enzyme secretions
and digestion

doctorksrprasad@gmail.com 36
Twak Gourawa, Twak Rodhata, Prabha-
Chaya nasha, twakgata vata (Vyana)
karma hani, Non absorbability of skin, skin
fatigue, Depositions of eliminative
materials (Malasanga) – sweda abhavata
– are common conditions of Ama in Twak
At the time of Abhyanga - the Drug
designated is absorbed and assimilated
well by the Skin is witnessed as an
example through Bhrajaka Pitta (Agni)

doctorksrprasad@gmail.com 37
Clinical Identification of Ama
Where ever Ama is seated there -
Sthambha - immobility
Gourava - Heaviness
Staneeya Deha Vishesha Vikara
Dosha vishesha Saama Lakshana
Dhatu vishesha Saama Lakshana -
are seen

doctorksrprasad@gmail.com 38
 Pittadhara Kala
Pitta & Agni
Ama
Ama Pradoshaja Pittadhara
kala Janya Vyadhi

Pittadhara Kala Chikitsa

doctorksrprasad@gmail.com 39
 Ama Pradoshaja Vyadhi
If spreads upward - Vishuchika
If spreads down ward - Alasaka
with the Ajeerna it is called as Amavisha
Amadosha, Amavatagrahani (Sangraha
grahani), Amavata, etc are considered as
Amaja Vyadhi
Apart from all the basic definition of
“Amaya” includes all diseases in Ama
with special reference to the Pittadhara
Kala Janya vydhi
doctorksrprasad@gmail.com 40
 Vardhakya & Pittadhara Kala
AGING AND THE DIGESTIVE SYSTEM

The rate of epithelial stem cell division

declines
The digestive epithelium becomes more
susceptible to damage by abrasion, acids, or
enzymes. Amlapitta, Parinama Shoola etc, Acid
Peptic disorders, therefore become more likely.
In the mouth, esophagus, and anus, the stratified
epithelium (Pittadhara Kala) becomes thinner
and more fragile.

doctorksrprasad@gmail.com 41
 Smooth muscle tone decreases
General motility decreases (Anila
Moodhata), and peristaltic contractions
are weaker.
These changes slow the rate of fecal
movement and promote constipation
(Malasanga)
Sagging and inflammation of the haustra
in the colon can produce symptoms of
diverticulosis (Vimargagamana)
doctorksrprasad@gmail.com 42
 Straining to eliminate compacted fecal
materials can stress the less-resilient walls
of blood vessels, producing hemorrhoids
(Arshas)
Problems are not restricted to the lower
digestive tract. For example, weakening of
muscular sphincters can lead to esophageal
reflux and frequent bouts of "heartburn."
(Apakti-Amlodgara)

doctorksrprasad@gmail.com 43
The effects of cumulative damage become
apparent
A familiar example is the gradual loss of teeth
due to dental caries or gingivitis.
Cumulative damage can involve internal organs
as well.
Toxins (visha) such as alcohol and other
injurious chemicals that are absorbed by the
digestive tract are transported to the liver for
processing (Bhutagnipaka). The cells of the liver
are not immune to these toxic compounds, and
chronic exposure can lead to cirrhosis or other
types of liver disease.
doctorksrprasad@gmail.com 44
Cancer rates increase. Not surprisingly, cancers
are most common in organs in which stem cells
divide to maintain epithelial cell populations. Rates
of colon cancer and stomach cancer rise in the
elderly; oral and pharyngeal cancers are particularly
common among elderly individuals who smoke.
Changes in other systems have direct or indirect
effects on the digestive system. For example, the
reduction in bone mass and calcium content in
the skeleton is associated with erosion of the tooth
sockets and eventual tooth loss.
™The decline in olfactory and gustatory sensitivity
with age can lead to dietary changes that affect the
entire body.
doctorksrprasad@gmail.com 45
 Ama (Mandagni) Nadi

Ajeerna, Ama Dosha, invasion of Fever,

Appetite, Vitiated Vata, Pitta and Kapha
are known by the Hasta Nadi - Basava
Rajeeyam

AeÉÏhÉïqÉÉqÉ SÉåwÉÇcÉ euÉUxrÉaÉqÉlÉÇ ¤ÉÑjÉÉÇ, uÉÉiÉÌmɨÉMüTüÉlÉç

SÒ¹ÉlÉç WûxiÉlÉÉQûÏ ÌlÉSvÉïrÉåiÉç - oÉxÉuÉUÉeÉÏrÉqÉç

doctorksrprasad@gmail.com 46
 Agnimandya and
Grahani roga Nadi
At Mandagni Nadi is always slow
like a Swan – but
in Agnimandya and Grahani roga
(Pittadhara Kala vikruti) Nadi at feet
is like swan- slow, rhythmic
(Mandagni Nadi) and at hand like a
frog - jumping
qÉÇSÉalÉÉæ ¤ÉÏhÉiÉÉÇ rÉÉÌiÉ lÉÉQûÏ WûÇxÉÉ¢ÑüÌiÉxiÉjÉÉ
mÉÉSåcÉ WûÇxÉaÉqÉlÉÉ MüUå qÉÇQÕûMüxÉÇmsÉuÉÉ
iÉxrÉÉalÉåUÇSiÉÉ SåWåûiuÉkÉuÉÉ aÉëWûhÉÏ aÉS:- lÉÉQûÏlɤɧÉqÉÉsÉ
doctorksrprasad@gmail.com 47
 Pittadhara Kala
Pitta & Agni
Ama
Ama Pradoshaja
Pittadhara kala Janya Vyadhi

Pittadhara Kala Chikitsa

doctorksrprasad@gmail.com 48
Normal patterns of Management
Nidana Parivarjana
Pachana
Deepana
snehana
swedana
Shodhana
Are they sufficient to combat
Pittadhara Kala Disease, which is
deep rooted, wide spread and
embedded with Ama?

doctorksrprasad@gmail.com 49
 ÌmɨÉkÉUÉMüsÉÉ LuÉqÉç qÉeeÉÉkÉUÉMüsÉÉ
Pitta vs Vata
The contextual thoughts of the
interference of Vata and Majjadhara kala
makes panic to one – who wish to treat
Ama in Vata Vyadhi (Pakshaghata)
As already it is discussed about Ca+
absorption from the Ileum (Pittadhara
Kala) is the right answer – that the Ca+
interference with the synape at Neuro-
muscular junctions makes to either vitiate
or pacify the vata (Expressional)
doctorksrprasad@gmail.com 50
Anulomana (Minor purgation) is the
treatment for the Vata and Virechana
(Major purgation) for that of Pitta and
based upon Ashrayasrayee bhava
even to that of the Pittadhara Kala
Thus it is evident that the Ama of
Pittadhara kala can be nullified
appropriately used “Virechana –
elimination” along with Deepana and
Pachana

doctorksrprasad@gmail.com 51
The present discussion opens new
thoughts as such –
No specific patterns of treatment is used to
eliminate the “Pittadhara kala” associated
diseases of either exclusively structural or
of functional
Apart from above problem – Uthana and
Leena Ama dosha is also seated
Amashaya/Pakwashaya (Pittadhara Kala)
and Dhatus respectively

doctorksrprasad@gmail.com 52
As the problems of Grahana –
Pachana – Vivechana –
Mumunchana are individual; at a
streach management is not
adoptable

What to do then?
doctorksrprasad@gmail.com 53
 Deepaneya
– Churna
– Arista
– Ghruta – according to the
situation has to be administered

SÏmÉlÉÏrÉÉÌlÉ xÉuÉÉïÍhÉ cÉÔhÉÉïËU¹bÉëÑiÉÉÌlÉ cÉ

ÌuÉpÉerÉ rÉjÉÉuÉxjÉÇ rÉÉåeÉrÉåSèaÉëWûhÉÏaÉSå – oÉxÉuÉ UÉeÉÏrÉqÉç
mÉëÌu

doctorksrprasad@gmail.com 54
Agnikarma – will it be a good
treatment?
It is told as when a disease of the
Pittadhara Kala is not possible to be
treated with normal protocols – adopt
“Agnikarma”
Agnikarma has to be performed at
“Veenasti moola - Trika” or 2 inches below
to the Umbilicus

doctorksrprasad@gmail.com 55
 Forgotten but best even
not available for the divine -
The Buttermilk – Takram is the best
for any of the Pittadhara kala janya
Vikara
This is not Lassi – A shaken Curd
Butter milk is to be prepared with
always with 1 part of curd to 4 parts of
water churned well and filtered with a
cloth and with Hingu, Jeera,
Saindhava, Sarshapa (Bhava
Prakasha) doctorksrprasad@gmail.com 56
Kayasya Antaragni chikitsa is Kayachikitsa
Agni and Pitta are similar according to
Susruta
No other Agni is available in the body
other than that of Pitta
Pittadhara Kala associates with Pitta
Pitta management is adoptable for
Pittadhara kala Diseases even
Proper care of Pittadhara Kala can prevent
the Dosha Vitiation and Disease
manifestation
doctorksrprasad@gmail.com 57
Amashayastha Grahana Pittadharakala
– in comparison with the intrinsic factor
is having the Rakta kala maryada
(Blood)
Pachyamanashayastha Pachana
Pittadharakala has the relation with the
Rasa Kala Maryada
Pakwashayastha Vivechana
Pittadharakala establishes the
relationship with Majja kala maryada by
absorbing Ca+
The kala maryada is used to establish
the disease entity to treat appropriately
doctorksrprasad@gmail.com 58
After hearing all one has to decide what
management protocol is to be adopted
for an individual disease entity of
Pittadhara Kala at the interference of
Dosha and Ama in the continuity of
Amashaya – Annavaha srotas and
beginning of the Pakwashaya -
Pureesha Vaha srotas –
Pureeshadhara Kala – appropriately
according to the situation and the
symptomatology
doctorksrprasad@gmail.com 59
HAVE
Knowledge
mÉëÑccÉMåülÉ ÍvÉwrÉÉæ xÉÇvÉrÉÌlÉuÉëѨÉåÅÌmÉ aÉÑÂ:
aÉÑÂ ÌuÉlÉ lÉ ÍvÉwrÉÉ: ÍvÉwrÉÌuÉlÉÉ lÉ aÉÑÂ

™Haral’s Academy of Vedic

Education, Hyderabad
doctorksrprasad@gmail.com 60
 It is from

HAVE
Knowledge
doctorksrprasad@sify.com

doctorksrprasad@gmail.com 61