Article by Dr Raghuram Y.S. MD (Ay) & Dr Manasa S, B.A.M.S
Amajirna is a type of ajirna – indigestion.
The word Amajirna is made up of two terms –
– Ama – byproduct of food formed due to improper digestion which is sticky, unformed, undigested, foul smelling, toxic and tends to clog the channels in the body and cause extreme tiredness and fatigue
– Ajirna – indigestion of food
So, Amajirna = Ama + Ajirna = Indigestion caused by excessive formation or accumulation of ama in the body ‘when the digestive fire is influenced by morbid kapha’ is called amajirna.
Ama – Ama is caused by bad digestion. This happens when the digestive fire in the gut is weak and it has lost its capacity to digest the food. As a consequence, the food is not digested properly. This improperly digested food forms ama. The ahara rasa – essence juice of food thus formed in amashaya – stomach is also in an unprocessed form. As a consequence, the first dhatu which is formed from the essence of food i.e. rasa dhatu is also unformed and unprocessed. The tissue fire of rasa tissue which has got weakened as a result of feedback from the weak central / gut fire will add to this disturbed processing. In the long run, all the other tissues too will get affected.
The kapha relation and mechanism / pathogenesis of amajirna
अजीर्णं च कफादामं…| ॥अ.हृसू.८/२५॥
The definition of amajirna is incomplete without the mention of kapha.
Kapha and ama are similar substances. They share identical properties.
Abnormal Kapha increase in the amashaya – stomach will have a pacifying effect on the agni. The functions of agni are similar to the functions of pitta. Agni resides in pitta and pitta represents agni in the body according to Ayurveda scriptures. To be precise, the pachaka pitta located in the stomach will digest the food with the help and coordination of samana vata. For this to happen they also need the cooperation of kapha located in the stomach i.e. kledaka kapha. This kapha helps in moistening the food coming into the stomach and preparing it to get digested by the action of pachaka pitta / jathara agni along with the help of samana vata. Kapha also acts like a buffer and protects the stomach from the aggressive and corrosive action of pitta and dryness of vata. This balance between the three doshas and mutual cooperation is a must if the food needs to be properly digested, converted and transformed into substances which are acceptable to the body cells.
When this kapha / kledaka kapha increases beyond its normal permissible limits, the coldness and dampness in the stomach exceeds the normal environment of hot and dryness suitable for digestion of food. Now, the kapha will dominate the picture in the stomach and will pacify pitta / agni, both being antagonistic to each other.
This state of pacified pitta / agni is called agnimandya – deficit strength of digestive fire. This would lead to ajirna – indigestion.
Here we can see that the digestive fire is influenced by excessively present kapha in the stomach. So, mathematically the ajirna – indigestion in this case is caused due to the influence of kapha.
To put it into simple words – ‘The indigestion caused due to excessive presence of kapha in amashaya – stomach and its influence on agni – digestive fire is called amajirna’.
This condition is called amajirna because of identical properties of kapha and ama. Also, due to the influence of kapha on the agni and consequent ajirna, plenty of ama – semi digested or improperly processed food (intermediate products of digestion) is formed in the stomach.
Causes of amajirna
– Kapha vriddhikara nidana – etiological factors which would lead to kapha increase
– Ama nidana – etiological factors which might cause formation of excessive ama
– Ajirna nidana – etiological factors mentioned to cause indigestion
– Agnimandya nidana – etiological factors which are mentioned to cause sluggishness of digestive fire
– Manasika nidana – conditions like avasada – depression, increase of tamo guna etc which might cause increase of kapha
Preventive measures
Avoiding the above said etiological factors / causes of amajirna are themselves the best preventive measures.
Symptoms of Amajirna
तत्रामे गुरुतोत्क्लेदः शोथो गण्डाक्षिकूटगः।
उद्गारश्च यथाभुक्तमविदग्धः प्रवर्तते॥मा.नि.६/१०॥
Below mentioned are the symptoms of Amajirna –
– Guruta / Gurutva – heaviness of the body
– Utkleda / Utklesha – water brash / nausea
– Ganda Akshi Shotha – oedematous swelling in the cheeks and around the eyes (orbit)
– Yatha bhuktam avidagdha udgara – belching in accordance to the taste of the food and devoid of sourness
Additional Symptoms mentioned by Master Vagbhata (Vagbhata, A.Hr.Su.8/25)
अजीर्णं च कफादामं तत्र शोफोऽक्षिगण्डयोः।
सध्योभुक्तं इवोद्गारः प्रसेकोत्क्लेशगौरवम्॥अ.हृसू.८/२५॥
– Sadhyobhuktam iva udgarah – belching similar to those which come up immediately after taking the meals i.e. clean belching
– Praseka – excessive salivation
Treatment principles of Amajirna
Nidana Parivarjana
Keeping away the causative factors of ajirna is the key for success in treating these conditions comprehensively.
Langhana
लङ्घनं कार्यमामे तु…॥अ.हृ.सू.८/२७॥
There are 10 forms of therapies which would induce lightness in the body. But in conditions caused due to deficit / weakening of agni and predominant with ama, langhana should be administered in the form of ‘fasting’ or ‘methodically keeping away from food or big portions of food’. This would kindle the digestive fire and also help in combating ama. This is preferred if there are less proportions of ama or dosha / kapha aggravation or in the initial phase of ama or amajirna.
Langhana-Pachana – If the doshas or ama causing ajirna or kapha is moderately aggravated, pachana – medicines and measures which help in digesting ama should be combined with langhana.
Shodhana – In amajirna if the dosha i.e. kapha is excessively aggravated and is in a state of excitation, it shall be expelled by administering therapeutic emesis – vamana.
Deepana Chikitsa
After the symptoms of amajirna have reduced the follow up medications and diet prescribed to strengthen the digestive fire and the gut should be administered in the form of Deepana Chikitsa.
Other considerations
– Ajirna Chikitsa – General line of treatment of ajirna in terms of foods, lifestyle changes and medicines should be considered in the management of amajirna.
– Agnimandya Chikitsa – Line of treatment of agnimandya too shall be considered in this context.
– Kapha Vriddhi Chikitsa – Measures explained to combat kapha aggravation should also be followed.
