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Ama & Aptarpana chikitsa

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Krupali Pithva Manoj Pande

RK University RK University Ayurvedic College, Rajkot, India
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 शान्तिरामविकाराणाां भिवि िु अपिपपणाि् (APATARPANA IN AMA)

Ayurveda is an ancient literature of life. Ayurveda word itself says “Ayusho vedaha” that
means veda of life is Ayurveda. The main purpose of the Ayurveda is to maintain health of the
healthy and cure the diseases.

In ayurveda acharyas explained various types of medicines. Along with it Apatarpana also
told by Granthakaras. It means avoid of nourishing food and medicine is done, which takes away
heaviness of the body.

Apatarpana mainly used in amavastha of vyadhi. Ama is undigested food product of food
which creates various diseases by creating unbalance between doshas. Ama has guru guna and
difficult to digest, for that langhana, ushna, teekshna deepana, pachana dravyas are used. When
jatharagni decreased and becomes cool, amavastha is created. When ama is present, until it is not
cured there is no use of medicine for curing diseases; rather than the given drug will also convert
into ama and the disease will increase.

According to Ayurvedic point of view, most of diseases are created from Amadosha, Due to
vitiation of Agni, it produces Ama. Ama means undigested food particles. The main cause of most
of Vyadhi is Ama utpatti and Agnidushtti so proper understanding of Ama is important.

✓ AMA:-

Nirukti of Ama (Derivation):-

The term Ama is derived from the root “Am” with the suffix “ninj” which mean, ‘the substance
which undergoes digestion and associated changes is Ama’

The unprocessed or undigested food particle is Ama.

In which substances produces pain or creates pressure on Sratomukha and accumulates on the
Srotomukha is called Ama.
 Paribhasha of Ama:-

1) ऊष्मणो अल्पबलत्वेन धािुमाद्यां अपावििम्

दु ष्टां आमाशयगिां रसमामां प्रिक्षिे | (A.H.Su.13/25)

Due to hypo-functioning of Ushma the first Dhatu Rasa is not properly digested, instead the
Anna rasa undergoes fermentation being retained in the Amashaya. This Rasa is called as Ama.

2) अन्ये दोषेभ्य एवाति दु ष्टेभ्योोः अन्यो अन्य मूर्च्छनाि्।

कोद्रवेभ्योोः तवषस्येव वदन्त्यामस्य सम्भवम् ।। (A.H.Su.13/26)

Ama gets formed from intimate mixing of vitiated doshas with one another just as the poison
is formed from mixing of different kinds of kodrava.

3) The matter which has not undergone Vipaka, leading to Durgandha (bad smelling), which
is large in quantity, which is Picchila (Sticky) and which leads to Gatrasadana called as
Ama.

Swarupa of Ama:-

Ama is unprocessed, undigested, consisting of Guru(heavy), Snigdha (unctuous)

Drava(liquid), sticky, fibrous material which has foul smelling & becomes cause of daurbalya
(weakness) and karshya (debility) to body and many diseases.

Apakwa aahar rasa cannot get absorbed in body as compare to Prakruta aahar rasa. It remains
in gastro intestinal track. It has fermented Swarupa which is harmful for the body.

Ama acts like a poison in body.

 Formation of Ama:-

Due to nidana sevana doshas gets vitiated and casues disturbance in agni (Hypo functioning
of Agni at Jatharagni level). It causes Dhatwagni daurbalya and results in unmetabolism of Rasa
dhatu.

So there is collection of annarasa, which is remained undigested and causes sanchaya and
prakopa of Ama. There is sthanasamsraya of Ama in khavaigunya and it manifests a diseases.

Relation of Dosha with Ama:-

1. Shararik Dosha:-

Ayurveda mentioned three Doshas in body. Aggravated doshas mixed with Ama and produces
sama avastha. Symptoms of Sama and Nirama doshas are mentioned in Samhitas.

2. Manasika doshas:-

Raja & Tama are Mansik dosha.

All physical effect of disease do effect on mind and vice versa. Ama is also affected on our
mind. It effects on quality of consciousness, in such cases increasing Satva guna is part of
treatment.

Classification of formation of Ama:-

1) Ama produced due to hypo functioning of Agni i.e.,

• Ama due to Jatharagni Mandya
• Ama due to Dhatvagni Mandya
• Ama due to Bhutvagni Mandya
2) Ama produced irrespective of the action of Agni:-
• Accumulation of mala.
 • Ama due to interaction & virulently vitiated Dosas
• First phase of Doshika vitiation.

Nidana of Ama:-

In Charaka samhita Ama formulating cause can be grouped under following:-

1. Aharajanya
2. Viharaja
3. Mansika karanjanya
4. Other

1) Aharaja:-
• Guru, Shita, Vishtambhi, Shushka, Vidahi, Ruksha, Pichhilha guna cause formation of Ama.
• One should take food in proper quantity, because it depends on Agnibala.
• A person should eat food only when the previous meal is digested, if one eats during
indigestion then eaten food mix with the product of earlier meal and vitiates all the food.
• Thus Ajeerna bhojana, Adhayshana, Vishmasana etc. produces Ama vikara and Grahani
vikara. In the process of digestion, Aahara parinamkara bhavas plays an important role.
• Like Ushma digested, Vayu absorbed, Kleda produced looseness, Sneha generate softness,
Kala bring it to complete transformation and Samyoga means the use and need of the Ashta-
aharvidhi, Rutu, Desha etc.
• Samayoga is interpreted as balance of factor regarding diet. Imbalanced state of Ahara
Parinamkarbhava cause Agni vikrutti which is the main cause of Amotapatti.

2) Viharaja:-
• Ratri jagarana: It creates provocation of Vata and Kapha which produce Agni dushti and
ultimately Amotpatti.
• Vega dharana
• Diva swapa.
• Dukha shayya
3) Mansika:-
• Chinta, Shoka, Bhaya, Krodha, Uptapa mana
• Irshya, Lobha, Udvega, Hri, Kama

4) Others:-
• Atidushata doshs sammilana
• Improper management of Virechana, Vamana, and Snehana.
• Wasting of the tissue which follows in the awake of disease.
• Imcompability of season: allergic states engendered by faulty or change in phase, climate,
season (Desh-kala-rutu vaishamya)

Samprati of Ama:-

Ama is a condition in which the Tridoshas, Sapta dhatus as well as Malas spread in the body
with Ama. Disease which arises in consequence are also called as Sama types of diseases. which
get mixed with Ama are termed as Sama. It is being able to vitiates Doshas, Dushyas, Malas and
responsible for the disease production. Sama doshas gets spread to all the roga margas. It can go
to Shakaha from Koshta and vice versa by producing all types of disease.

Ama circulate along with Rasa Dhatu and accumulate in the place where it gets obstructed
and become the site of origin of the disease. Sama doshas or Dushyas are passing through one
Srotasa to another Srotasa and it gives rise to a disease at the place where it get obstructed.

Ama also become ‘Nidnaarthakara factor’ to produce ‘Khavaigunya’ in any of the Srotus and
make the seat for ‘Sthana Samashrya’ of provoked Doshya and they get conjugated at this place
i.e., Doshadushya samruchana takes place.

Role of Ama in formation of Vyadhi:-

• आहारस्य रसः शेषो यो न पक्वो अवि लाघिाि्।

स मूलम् सिपरोगाणाम् आमां इत्यवभधीयिे|| (Ma.Ni. 25)

 The remnant of ahara rasa which is not digested due to weak agni becomes the root cause of
all diseases.

Vyadhis due to Ama:-

1) Abhyantara Rogamarga:-
• Amajirna
• Vishtabdhajirna
• Vidagdhajirna
• Visuchika
• Vimlambika
• Alasaka
• Grahani
• Chardi
• Atisara

2) Madhyama Rogamarga:-
• Hrudroga
• Pakshaghata
• Ardita
• Amavata

3) Bahya Rogamarga:-
• Medoroga
• Prameha
• Urustambha
• Shopha
 Ama Vyadhi Lakshana:-

• आलस्य िन्द्रा ह्रदयाविशुन्तधः दोषप्रिृत्ताकुल मूत्रभािेः ।

गुरूदरत्वम् अरूविः सुप्तिावभः आमान्तििां व्यावधां उदाहरन्ति।। (Yogaratnakara)

- Lazziness
- Drowsiness
- Discomfort in chest
- Distress
- Improper urge for stools and urination
- Heaviness in belly
- Anorexia
- Inactivity are the features of ama Vyadhi.

Sama and Nirama avastha:-

• Sama:- Dosha-Dushya samurchhana occurs un the presence of Ama

• Nirama:- Prakruta avastha of srotasa and Prakruta karya of sharira.

▪ Definition of Sama dosha:-

• आमेन िेन सम्पृक्ता दोषा दू ष्याश्च दू वषिाः |

सामा इत्युपवदश्यिे ये ि रोगास्तदु द्भिाः || (A.H.Su. 13/27)

Sama is a condition manifested due to amalgamation of dosha & dushya with ama

Resulting into formation of various kinds of disorders.

▪ Sama dosha Lakshana:-

 • स्रोिोरोध बलभ्रांश गौरि अवनल मूढिाः |
आलस्यापन्तक्तवनष्ठीिमलसङ्गारुविक्लमाः || (A.H.Su. 13)

- Srotorodha (obstruction in the channels)

- Balabramsha (feeling of weakness)
- Gaurava (feeling of heaviness)
- Anila Mudhata (impaired activity of Vata dosha)
- Alasya (laziness)
- Apaki (indigestion)
- Nisthivana (excessive salivation)
- Mala sanga (constipation)
- Aruchi (lack of taste)
- Klama (lethargy)

Modern Concept of Ama:-

Ama can be understood as the intermediary products of metabolism of proteins, fats and the
carbohydrates. Ama can be compared to unstable reactive, free radicals which are the main causes
of numerous diseases and degenerative changes in the body.

Different forms of Ama:- (Ref:- Ma.Ni 25/1-5,Madhukosha)

• Apakwa Anna/ Rasa roopa Ama

• Mala Sanchaya Roopa Ama
• Prathama Doshadushti
• Dosha Murchajanya Ama
• Amavisha

1. Apakva Anna/rasa Roopa Ama:-

a) Apakva Annaroopa Ama:-
• The ingested food when improperly digested due to durbala Jatharagni, gets accumulated
in the Amashaya is termed Ama. This is appropriately the “Apakva Anna Rupa Ama”.

b) Apakva Annarasa Roopa Ama:-

• Improperly digested Anna Rasa does not participate in the dhatvagni paka while remaining
in Amashaya it gains “Amatva”. This is known as the Apakva Annarasa Rupa Ama.
Acharya Sushruta considers the Apakva Annarasa Rupa Ama as the cause of Karshya and
Sthaulya, as the dhatu receive their nutrition from this Ahara Rasa.

2. Mala Sanchaya Roopa Ama:-

• Accumulation of Mala in the body is termed as Ama that includes : -

- Purisha, Mootra and Sweda
- Kha malas
- Aparipakwa dhatus
- Prakupita Vata, Pitta and Kapha,
- Other factors which are harmful to body

3. Prathama Doshadushti:-
• The initial state of Dosha vitiation is also called as Ama. While elaborating the treatment
of Amaja Sotha Chakrapani has explained that the Doshas will be in apakvavastha during
the first phase of vitiation.
• Acc to Sushrutha, Prathama Dosha dushti is ‘Sanchayavastha’ . Where the Dosha gets
accumulated at their own sthana.

4. Dosha Murchana janya Ama:-

• The Ama, formed when the highly vitiated dosha interacts with each other, just as How the
toxic substance is produced from kodrava.

5. Amavisha:-
• The Amadosha formed by unwholesome food habits like Viruddhasana, Adhyasana,
Ajirnasana is known as Amavisa.
• Due to all these reasons the ingested ahara will not get properly digested.
• It retains in the Amashaya , gets vitiated and further transforms into visha .

Symptomatology of Amavisha:-

• Resembles that 3 conditions of food poisoning :-

- Botulism
- Toxic Gastro-enteritis
- Infective Gastro-enteritis

Therapeutic treatment for Ama:-

• Langhana (Keeping on fast)

• Swedana
• Sunbath
• Pranayama
• Yoga
• Panchakarma: its include Vaman, Virechana, nasya.
• Some herbal drugs: fresh ginger, garlic, black peeper, castor oil, aloe vera, coriander,
Guduchi, cumin, Pushkarmool, Tulsi, Guggul
 Importance of Ama:-

The concept of Ama is the most important fundamental principle of Ayurveda in

understanding the physio-pathology of the diseases.

According to Achrya charaka, for treatment first Sama-Nirama condition should be examined.
Symptoms can be observed in Sama-vhyadhi which also proved the importance of Ama in Sama
and Nirama condition of the disease. Choice of drug also depend on Sama & Niramavastha of
disease. Sutshekharrasa used in Samaavashta of Amlapitta while Kamdudharas used in
Niramavastha of drug.

Distinction between Sama (with Ama) and Nirama (without Ama) disease is of prime
importance to define treatment strategies. Ama pathogenesis portrayed in light of Nidana panchaka
(five disease illuminating factors) and Shatkriya kala (six stages of disease progression) along with
clinical manifestation of Sama condition are worth appreciation from clinicians.

Different treatment principle are advised for Sama and Nirama condition:-

- In Samaavastha Apatrapana is main treatment where as in Niramawastha Samtarpana is

advised.
- The knowledge of Sama and Nirama is necessary to avoid all kind of Vyapada while
treating the patient.

✓ APATARPANA:-

Apatarpana means depleting treatment. It is also correlated to Langhana (starvation, thinning

therapies, and lightening therapies). This treatment is preferred in those who are suffering from
diseases having their origin in over nutrition or saturation. In ashtanga hridaya Acharya vagbhatta
consider it as a best treatment for Ama condition.
 Types of Apatarpana:-

• It is of 3 types viz.
a) Langhana (fasting)
b) Langhana-Pachana (fasting and digestive drugs)
c) Doshavasechana (elimination)

1. Langhana:-
• It means fasting.
• Langhana is indicating when the doshas are mild, just as a little amount of water in a tank
absorbed by the wind and sun, the mild vitiated doshas also comes to normal with the help
to fasting.
• It increases the power of digestion as well as Samana vata in the body.

2. Langhana-Pachana:-
• Both fasting and digestive drugs are indicated when the doshas gets aggravated moderately.
• To dry up the tank which contains medium quantity of water, some dust and sand also
required along with the above factors like wind and sun.
• Similarly both fasting and digestive drugs are essential to manage moderately vitiated
doshas.

3. Doshavasechana:-
• When doshas are high, expulsion or elimination is the only way.
• Just as, the crops in the field don’t grow well unless the excessive water drain out.

Introduction of Langhana:-

Langhana is the therapy which creates laghavata (lightness) in our body. It is a type of
apatarpana.
 Nirukti of Langhana:-

• लवघ गिौ लवघ शोषणः । (Amarakoṣa 1/1/64)

- “ Langhana‟ word derived from ‘langha’ dhaatu and ‘lyuṭ’ pratyaya.

- Langha dhaatu indicates gati or shoshana

Paribhasha of Langhana:-

• यन्तिविि् लाघिकरम् दे हे ित्लङ्घनांस्मृिम्।

• लङ्घनां लाघिाय िि्।
- In gross meaning, it indicates the whole procedure of producing lightness in the body.

Synonyms of Langhana:-
• Anashana
• Apatarpaṇa
• Laghubhojana
• Upavaasa are the synonyms of langhana.
• Langhana as upavasa found in Samhitas.

Types of Apatarpana (Langhana):-

a) Acharya Charaka:-
• Apatarpaṇa (3 types) = langhana, Langhana- pachana, Doṣavasechana
• Langhana (10 types) = 4 Shodhana, Pipaasa, Maruta, Atapa, Pachana, Upavasa,Vyayama
b) Acharya Vagbhatta:-
• Langhana (2 types):- Shodhana, Shamana
• Langhana (12 types):-
- Shamana = Pachana, Deepana, Kshuta, Truta, Vyayama, Atapa, Maruta
- Shodhana = Niruha, Vamana, Kayavireka, Shirovireka, Asravisruti

The whole langhana karma can be implimented as Shodhanaroopi and Shamanaroopi langhana.

• There are ten types of langhana:-

1. Vamana (vomiting)
2. Virechana (use of laxatives)
3. Niruha (kind of enema)
4. Nasya
5. Pipasa (Thirst)
6. Maruta (Air)
7. Atapa (Sunrays)
8. Pachana (use of digestive drugs)
9. Upavasa (fasting)
10. Vyayama (Exercise)

Among the first 4 types of langhana shodhana chikitsa is given to the patients who are having
strong physic, powerful, vitiating Kapha, Pitta, Rakta, mala along with Vayu.

Patients having medium body strength and suffering from vomiting due to vitiated kapha and
Pitta, Atisara (dysentery), Hrudroga (Heart disease), Visuchika, Alasaka, Jwara (fever), Vibandha
(obstruction), Gaurava (heaviness), udgaara (belching), Hrullasa (nausea), arochaka diseases use
pachana dravyas for langhana.

Patients having low body strength and suffering from above mentioned diseases but of low
severity then thirst and fasting is used for langhana.
Qualities of Apatarpana (Langhana) dravyas:-

• Laghu (light)
• Ushna (hot)
• Teekshna
• Vishada
• Ruksha (dry)
• Sukshma (minute)
• Khara
• Sara
• Kathina (hard)
- These qualities of Apatarpana (langhana) dravyas are opposite to that of ama. So it is
mainly prefered for Amavastha.

Dominancy of mahabhuta in langhana dravya:-

• Langhana dravyas possesses Akasha, Vaayu and Agni mahabhuta dominancy.

Indications of Apatarpana (Langhana):-

• Amavastha
• Skin diseases
• Atisnigdha (unctuous), abhishyandi, brumhana
• In shishira rutu, shishira guna yukta hemanta rutu.

Contraindications of langhana therapy:-

• Vaidya Shodhala states avasthavishesha langhana nishidha:- Vaatarogi, Kshudha,
Trushanapeedit, Mukha shosha, Bhram, Bala, Vriddha, Garbhini, Durbala, one who is tired
due to margparikramana, krodha, shoka, kaam and kshayajajwara.
• Its very essential to follow the indications and contraindications during treatment. Since dosha
samyata is our main objective if don’t follow this then instead of establishing the balance it
would vitiate the doshas.

Samyaka yoga of langhana (proper langhana):-

• Easy excretion of flatulence, urine, feces without any interference

• Lightness of body and chest part
• Clear belching
• Cleanliness in throat and mouth region
• Vanishing of giddiness and tiredness
• Sweating
• Ruchi (desire for intake of food)
• Increase in thirst and appetite

✓ APATARPANA CHIKITSA IN AMAVASTHA:-

Now a days, All the working sectors need skillful and dedicated workforce willing to put extra
efforts to achieve business objectives. Most of these professionals are habituated to shortcuts in
their normal daily routine.

Eating habits are disturbed in these peoples which creates indigestion and ultimately leads to
ama. Another crowd of people are who have ample free time to spend and think mainly about over
eating, attracted towards different kind of heavy food which creates indigestion (ama) in them.
Agnimaandya acts as primordial factor in every disease which leads to formation of Ama at initial
stage of vyadhi where langhana is done as treatment. So it is a very important type of treatment in
Ayurveda.

Apatarpana as a treatment for Amavastha is properly described in Ayurveda literature:-

a) According to Vagbhatta:-

• शान्तिरामविकाराणाां भिवि िु अपिपपणाि् |

वत्रविधां वत्रविधे दोषे ित्समीक्ष्य प्रयोजयेि् || (A.H.Su. 8/20)
- Diseases produced by ama (undigested food) such as, Alasya, Agnimandhya etc become
relieved by apatarpana (non-nourishment).
- Three kinds of apatarpana should be adopted appropriately in case of tridoshas after carefull
consideration of all aspects like desha, kala etc.

• ित्राल्पे लङ्घनां पथ्यां, मध्ये लङ्घन पािनम् |

प्रभूिे शोधनां, िन्तध मूलादु न्मूलयेन्मलान् || (A.H.Su. 8/21)
- Langhana is indicated when doshas are in a mild state.
- Langhana-Pachana is indicated when the doshas gets aggravated moderately.
- When doshas vitiates excessively expulsion is the only way to root out them from their origin.

b) According to Charaka:-

• आमप्रदोषजानाां िामप्रदोषाहारौषधविभ्रमोऽविबलत्वादु परिकायाविां भिवि, सवि त्वनुबन्धे

कृिापिपपणानाांव्याधीनाां वनग्रहे वनवमत्त विपरीिमपास्यौषधमािङ्कविपरीिमेिाििारयेद्यथास्वम्
|सिपविकाराणामवप ि वनग्रहे िा| (Cha.Vi. 2/13)
- 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.

c) According to Sushruta:-

• ित्रामे लङ्घनां कायपम्। (Su.su. 46/505)

- In Ama condition, Langhana should be given.

• The qualities of apatarpana dravyas are exactly opposite to the qualities of Ama. So for
Amavastha Apatarpana will be beneficial.

Langhana and other medications are useful in amavastha of many vyadhis:-

1) Amavata:-

• Langhana:- Katu and tikta dravyas, Sunthi, Ardraka, Shunthi, Maricha, Hingu, Lashuna,
Jeeraka, Sahajana, Yava, Kulattha, Erdanda taila etc. along with laghu supachya ahara.
• Langhana-Pachana:-
- Panchakola churna, Ajamodadi churna or Trikatu churna with ushnodaka as anupana
- Shunthi and jeeraka kwatha 20ml
• Doshavasechana:-
- Virechana:- Snigdha virechana with Haritaki churna, Eranda taila, Kansa haritaki,
Simhanada guggulu, Abhyadi modaka, Trivrutadi(Trivruta, saindhava, sunthi) churna
- Basti:- Anuvasana with Saindhavadi taila or Narayana taila. Niruha basti such as,
Erandamuladi niruha basti, Dashamuladi niruha basti, kshara basti, vetarana basti.
2) Prameha:-

• Langhana:-
- Ghola and Kashaya of Sattu, Yava churna, yava leha etc.
- Haridra churna with madhu and amalaka swarasa
- Daruharidra, Devdaru, Amalaki, Bibhitaki and nagarmotha kwatha in pratahsayam.
• Langhana-Pachana:-
- Mudga yusa with tikta shaka and purana shali odana
- Danti, Hingu, Atasi, Sarshapa taila yukta shali
• Doshavasechana:-
- Vamana:- In Kaphaja Prameha with Tuvaraka taila, Priyangu etc. gana siddha ghrita or
taila
- Virechana:- In Pittaja Prameha with tikshna dravyas(if rogi is balwana), after virechana
Asthapana basti with Surasadi gana Kashaya, Sunthi, devdaru, musta churna, madhu and
saindhava.
- Basti:- Panchatikta panchprasuta niruha basti, Mustadi yapana basti, Madhutailika basti

3) Grahani:-

• Langhana:- Laghu supachya ahara, manda, peya, vilepi

• Langhana-Pachana:- For Samasta sharira vyapta apakwa ama
- Panchakola (Pippali, Pippalimula, chavya, chitraka and sunthi) aushadha kwatha yukta
peya and laghu anna
- Panchamula (Bilwa, Agnimantha, shyonaka, Patala and Gambhari), Haritaki, Trikatu
(Pippali, Maricha and Sunthi), Pippalimula, Rasna, Saidhava, Yavakshara, Sarji kshara,
vidanga churna mixed with sukhoshna jala and taken for Pachana and langhana.
- For Ama pachana:- Haritaki churna, Sunthi churna with ushna jala; Sunthi, Ativisha
and Musta kwatha/churna
• Doshavsechana:-
 - Vamana:- In amadoshayukta grahani vamana should be done With sukhoshna jala or
Madanaphala kwatha mixed with Pippali and Sarshapa churna
- Virechana:- In leena and pakwashayastha ama Agnideepana dravya yukta virechana
aushadha prayoga

4) Amatisara:-

• Langhana:- In alpa dosha avastha

- Pathya ahara with Takra, Kanji, Yavagu, Tarpana, Madira or Madhu
- Peya, Manda, Vilepi etc. laghu bhojana
- Shadangapaniya
• Langhana-Pachana:-For madhyama dosha avastha
- In Kapha anubandha:- Vacha and ativisha
- In Pitta anubandha:- Musta and Parpata
- In Kapha anubandha:- Sunthi and Ardraka
- Use of Hriberadi or Pippalyadi Pramathya
- Dravyas such as:- Shaliparni, Prishniparni, Bruhati, Kantakari, Bala, Bilwa, Patha,
Svadamstra, Nagara, Dhanyaka, Shati, Palasha, Vacha, Jeeraka, Pippali, Chitraka etc.
• Doshavsechana:-
- Pichha Basti:- In Kaphaja atisara and vata-pitta vibandha Pichhabasti with Pippali,
Bilv, Kushtha, Shatahva, Vacha churna with saindhava should be used.

5) Chhardi:-

• Langhana:- In alpa bala rogi and dosha for Amashayottha roga

- Desired madhuradi rasayukta madhura ahara
- Contraindicated in Vataja chhardi
• Langhana-Pachana:-
- Eladi vati, Lavangadi vati
- Parpataka kwatha, Dhanyadi panaka, Jatyadi leha
 • Doshavsechana:-
- Vamana:- Pippali, Sarshapa, Nimba kwatha with madanaphala churna and Saidhava
lavana or with valliphala beeja
- Virechana:- Haritaki churna with madhu or anya ruchikara virechaka with
Madhya/milk.

Benefits of Apatarpana:-

• Calm down the vitiated Doshas

• Increase the jatharagni
• Subsides Jwara
• Lightness in body and increase appetite.
• Langhana should be done upto the strength of body is maintained.
• Excretion of residing ama in the body without curing or digesting it destroys the body.
• Hence it is very important to treat ama with the help of langhana and pachana dravyas before
excretion. Some conditions in Jwara is contraindicated for langhana as kshayaja, vataja,
• Bhayaja, krodhaja, shokaja, shramajanya Jwara.
• In Raktapitta blood get vitiated with Pitta due to amadosha and comes out from natural
openings of the body, firstly should treated with langhana for ama pachana.
• In this disease according to factors, way of coming out of blood, relations of Doshas, should
decide langhana or brumhana (nourishment) to the patient.
• In sheet (cool), guru (heavy), snigdha (unctuous) quality of Kaphaja Gulma where vamana is
contraindicated and agnimaandya, langhana is told as treatment.
• In amatisara (dysentery)with diarrhoea should not be stopped, rather than it must be flushed of
with ama and treat it with deepana pachana dravyas.
• When the dosha located in Grahani is afflicted by food, which is not fully digested, then the
signs of ama . Such a patient should be administered emetic therapy with the help of Luke
warm water. Alternatively the decoction of madana phala mixed with pippali and sarshapa
should be used for emetic therapy.
• If the ama moves downwards and remains adhered to the colon, then the patient should be
given purgation therapy (niruha) with such
 • Drugs as are stimulant of digestion.
• If the dosha in its ama (undigested) stage is converted into rasa (chyle) and pervades other
parts of the body, then the patient should be made to fast (upavasa), and be given drugs
conducive to pachana (metabolic transformation) of the undigested material, e.g. yavagu (thick
gruel).
• In case of Kaphaja and Pittaja Visarpa langhana is used as treatment.
• Pachaka dravyas like vyosha, tvak, bhallataka are used as a treatment of amaja trushna.
• So Apatarpana (Langhana) is very beneficial in Amavastha as said by ayurveda acharyas. It is
also useful in condition occuring today.

So, For treating amavastha of vyadhi first line of treatment is Apatarpana (which creates laghu
guna that is opposite to guru guna of ama). In present era where fast food and junk food is the main
cause of diseases, it is very important to follow Apataroana therapy as a treatment for ama
condition

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