ADS system of

diagnosis
Ama, Doṣa, Sthāna
 Development of Āma

• Doṣic imbalances weaken Agni and lead to development

of Āma.

• It takes a long time for Āma to develop and accumulate in

the body.
Imbalance of the Doṣas

• As the Āma develops, we can see the signature of the

doṣic imbalance also.

• Even as Āma is assessed, we need to assess the doṣic

imbalance.
Manifestation of Disease

• The Ama that reflects the signature of the doṣas localise

in the Koṣṭha, Śākhā or Marma to manifest different
diseases.

• Thus we have Diseases which are functional, with

imbalance of body elements and with organ based
pathologies.
 Background
• Āma is a key concept in the Ayurvedic understanding of
physiology, pathology and therapeutics.

• Rather than being a single entity or substance, Āma denotes

the deranged process of digestion and metabolism that
leads to build up of metabolic by products in the body,
which cannot be neutralised or eliminated by the body.

• Āma is often loosely translated as indigested food resulting

from a process that is entirely gastrointestinal. A careful
study of the texts, however, indicate that the production of
Āma is a systemic process that extends to metabolic and
other physiological processes in the body.
 Etymology
• ‘Am’ – to go, ‘amati’

• That which moves.

• Āma is that which does not move or transform.

• Technically speaking Āma can be considered as the state

of a substance in which it is not undergoing any further
transformation, either digestion or metabolism that will
help in its assimilation or elimination.
 Definitions of Āma
• In the tradition of Āyurveda, Āma has been defined from
three viewpoints. On a closer examination, it can be
understood that these three viewpoints represent Āma in its
totality. The three positions on Āma are summarised below.

• Āma is the by product of impaired digestion

• Āma is the accumulation of unexpelled wastes in the body

• Āma is the first expression of aberrations in the physiological

processes in the body
 Two classical viewpoints
on Āma
• In the Aṣṭāṅga Hṛdaya, it is mentioned that Āma is formed by
a process of fermentation akin to that which renders the
kodrava grain toxic.  

• This does not mean that there is no gastrointestinal

connection for Āma. The same text primarily defines Āma as
the improperly digested essence of food that is located in the
āmāśaya or stomach. The fact is that Āma is much more
than just indigestion.

• Āma is also understood to be created from Rasaśeṣa, which

means it is not directly created from the food, but rather the
residual rasa that does not get fully transformed.
 Outcomes of Āma
• Retention of an improperly transformed substance or group
of substances in the body.

• Can remain in a latent form in the body.

• Can develop into substances that cause blockages,

functional and structural disturbances.

• Infections, growths, inflammation, structural disintegration

are all outcomes of Āma.

• Āma can also lead to improper formation of physical

structures of the body.
 Classification of Āma

• Based on the quantity - Alpa, Madhya, Bahu

• Based on the quality - Līna, Līnālīna, Alīnācala, Cala

• Based on the signature of doṣa - Āma, Vidagdha,

Viṣṭabdha

• Based on the location - Koṣṭha, Śākhā, Marma

 Preventive Strategies
• Cayāvasthā - Pradveṣo vṛddhihetuṣu - Aversion to
provocative factors

• Prakopāvastha - Viparītaguṇecchā - Craving for pacifying

factors

• Prasarāvasthā - Cleansing

• Sthānasaṃśraya - Neutralising, Pācana, Dīpana,

Utkleśana etc.
 Doṣas with Āma
• When imbalanced Doshas get associated with Ama (a factor of indigestion / false
metabolism), it is called as Saama Dosha. (Sa aama Dosha, Sa means ‘with’). The
features that are seen due to Sama Dosha are –

• Srotorodha –  Obstruction of the channels, pores

• Balabhramsha – loss of strength,

• Gaurava – feeling of heaviness of the body,

• Anila Moodata – inactivity of Anila-vata,

• Alasya – laziness, lassitude,

• Apakti – loss of digestive power,

• Nishteeva – Person spits saliva frequently, more of expectoration,

• Malasanga – constipation or low frequency of urination leading to accumulation of

wastes

• Aruchi – anorexia,

• Klama – exhaustion

• The opposites of the above symptoms are of the Nirama Doshas –Doshas not mixed up
with the Ama. (undigested materials)
 Treatment of Sāma Doṣa
• The Sama Doshas which are spread all over the body, which are lurking in the
Dhatus and which are not moving out of their places of accumulation, should not
be forced out by purification Panchakarma therapies like emesis, purgations etc.

• Just as attempts of extracting juice from an unripe fruit leads to destruction, the
dwelling place itself will get destroyed if Doshas are tried to expel out along with
Ama.

• Right approach in Sama Dosha treatment – Sama Doshas should be treated

• – first with drugs which are digestive and which increase hunger;

• – next with oleation and sudation therapies (Snehana, Svedana) and

• – finally they should be expelled out with Shodhana therapies- emesis, purgation
at the proper time, and in accordance with the strength of the patient.
 Increase of Vāta
Vāta, when increased produces:

•Karshya – emaciation,

•Karshnya – black discoloration,

•Ushnakamitva – desire for hot things,

•Kampa – tremors

•Anaha – bloating, fullness,  distention of the abdomen,

•Shakrut Graha – constipation,

•Bala bhramsha – loss of strength,

•Nidra bhramsha – loss of sleep

•Indriya bhramsha – loss of sensory functions,

•Pralapa – irrelevant speech,

•Bhrama – Delusion, Dizziness giddiness

•Deenata – timidity (peevishness).

 Increase of Pitta
Pitta when increased produces:

• yellow discoloration of the faeces, urine, eyes, and skin;

• excess of hunger and thirst,

• feeling of burning sensation and

• very little sleep

 Increase of Kapha
Kapha,  when increased produces:

• Agnisadana – weak digestive activity,

• Praseka – excess salivation,

• Alasya – lassitude, laziness

• Gaurava – feeling of heaviness,

• Shvaithya – white discoloration,

• Shaithya – coldness,

• Shlathangatva – looseness of the body parts,

• Shwasa – dyspnea, asthma, COPD

• Kasa – cough, cold

• Atinidrata –  excess of sleep.

 Decrease of Vāta
Decreased Vāta produces symptoms like:

• Angasada – debility of the body,

• Alpa bhashite hitam – the person speaks very little

• Sanjna moha – loss of sensation (awareness) and of

consciousness and

• Occurrence of all the symptoms of increased Kapha

 Decrease of Pitta

Decreased Pitta causes:

• Mande anala – weakness of digestive activity,

• Shaitya – coldness and

• Prabha hani – loss of luster (complexion).

 Decrease of Kapha
Decrease of Kapha causes:

• Bhrama – Delusion, Dizziness,

• Shunyatva – emptiness of the organs of Kapha,

• hrudrava – tremors of the heart (palpitation) and

• Shlatha sandhita – looseness of the joints.

 Signs of Aggravation of
Vāta
• Sramsa – Ptosis- drooping down
• Harshana – tingling sensation

• Vyasa – dilation
• Tarshana – thirst

• Vyadha – cutting pain

• Kampa – tremors

• Swapa – loss of sensation

• Parushya – roughness

• Sada – weakness, loss of function

• Saushirya – feeling of empty
• Ruk – pain

• Shosha – dryness
• Toda – continuous pain

• Spandana – pulsating
• Bhedanam – splitting pain

• Veshtana – rigidity, as if tied

• Sanga – Constriction,

• Sthambha – stiffness
• Angabhanga – bodyache,

• Kashaya rasata – astringent taste in mouth

• Sankocha – shrinking of the organ, reduction in size

• Aruna, Shyava Varna  – appearance of

• Varta – twisting, blue or crimson discoloration
 Signs of Aggravation of
Pitta
• Daha – burning sensation

• Raga – reddish discoloration

• Ushmapakita – heat, increase in temperature, formation of pus, ulcers

• Sveda – sweating

• Kleda – inflammation with wetness, moistness

• Sruti – inflammation with pus / oozing / secretions, exudation

• Kotha – putrefaction- decomposition

• Sadana – debility

• Murchana – fainting

• Mada – toxicity

• Katuka Amla Rasa –  bitter and sour taste in the mouth

• Pandu Aruna Varjitaha –  appearance of color other than yellowish white and crimson.
 Signs of Aggravation of
•
Kapha
Kathinya – hardness

• Kandu – itching

• Sheetatva – coldness

• Gaurava – heavyness

• Bandha – obstruction,

• Upalepa – coating, as if tied with a wet cloth

• Staimitya – stiffness, loss of movement

• Shopha – inflammation

• Apakti – indigestion,

• Atinidrata – excessive sleep

• Shveta varna – white discolouration

• Svadu lavana rasa – sweet, salt taste in mouth

• Chirakarita – delay in all activities.

 DOSHA VIKALPA
• It is not possible to decide the specific herbs and
formulations for treatment by the analysis of Ama alone.

• Without understanding the underlying Dosha we cannot

specify the formulations and herbs.

• Ama is produced by Ajirna or indigestion. Ama is

predominantly Kapha. When Pitta is associated, it is called
Vidagdha and when Vata is associated, it is called Vistabdha.

• By analysing the type of indigestion, we can get a fair idea of

the Doshas involved.
 DOSHAVIKALPA
Vata Vatapitta

Pitta Pittavata

Kapha Kaphapitta Vatapittakapha

Pittakapha

Vatakapha

Kaphavata
 DOSA IMBALANCE

• Single

• Dual - Samsarga

• Triple - Sannipata
 VATA

• Increase of Sita and Ruksa Guna in the body

• First there is increase of Ruksa Guna by action of Usna.

• Then when Sita Guna appears, there is imbalance.

 PITTA

• Increase of Usna and Snigdha Guna in the body

• First there is increase of Snigdha Guna by action of

Wetness like Rain.

• Then when Usna Guna appears like in autumn, there is

imbalance.
 KAPHA

• Melting of Sita and Snigdha Guna by action of Usna Guna

in the body

• First there is increase of Sita and Snigdha Guna by action

of cold season.

• Then when Usna Guna appears like in spring, there is

imbalance.
 VATAPITTA

• This is like fire being blown by wind.

• Fire that spreads every where.

 PiTTAVATA

• This is like strong fire sustained by gentle wind

• Fire is focused and strong in one place.

 VATAKAPHA

• This is like wind pushing and throwing the water around.

• There is oozing and secretions.

 KAPHAVATA

• This is like water blocking the wind.

• It is not possible for the wind to move. It gets blocked and

exerts high pressure.
 PITTAKAPHA

• This is like heat evaporating water.

• Body is like is steam. Humid, hot and sweating.

 Kaphapitta

• This is like water controlling fire.

• Fire is inside and deep, not so manifest outside.

 Tridosa imbalance

• Tridosa Imbalance can be in many ways.

• One dosa dominance in tridosa.

• Two dosa dominance in tridosa.

• Increase and decrease in proportions.

 Ojas
Cause for decrease of Ojas:

•Ojas undergoes decrease in quantity by anger, hunger (starvation), worry, grief, exertion
etc.,

Symptoms of Ojas decrease:

•The person becomes fretful, debilitated, repeatedly worries without any reason, feels
discomfort in sense organs, develops bad complexion, negative thoughts and dryness;

Treatment:

Use of drugs of Jivaniya group (Enlivening) (mentioned in chapter 15) milk, meat juice etc.
 Causes for loss of Ojas
• Ativyayama  – too much exercise

• Anashana – fasting for long periods of time

• Alpasana  – eating less quantities of food

• Rooksapana - intake of alcoholic beverages which cause dryness,

• Pramitasana (intake of mixture of good and bad foods),

• Bhaya (fear),

• Prajagara (waking up at night),

• Abhighata (injury),

• Abhishanga (assault by evil spirits; micro organisms like bacteria, virus etc.), Dhatukshaya (depletion of tissues such as by
haemorrhage etc.),

• Ativisarga (too much of elimination) of Kapha, Sonita (blood), Sukra (semen) and Mala (waste products);

• Visha (ingestion of  poison)

Increase of Ojas makes for contentment, nourishment of the body and increase of strength
 Disease Pathways

• Koṣṭha - Alimentary Tract

• Śākhā - The Six Dhatus and Skin

• Marma - The Organs

 Disease Pathways
• The body is divided into three zones to explain different
diseases.

• Antarogamarga – internal path – refers to gastro intestinal

tract.

• Bahi roga marga – external path – refers to Rakta, Mamsa

etc Dhatu (tissues) and skin.

• Madhyama rogamarga – it includes vital organs such as

brain, heart, blood vessels, joints, nerves
 Kostha

• From mouth to anus

• Internal Pathway

• Connected to the external world but inside the body.

 Kostha
• Amashaya – stomach and small intestine,

• Pakwashaya – large intestine

• The above two, along with the entire gastro intestinal

tract is called as Mahasrota. (The big channel). This
constitutes the Anta Koshta.

• Diseases which affect this path are – vomiting, diarrhea,

cough, dyspnoea, enlargement of the abdomen, fever,
dropsy, hemorrhoids, abdominal tumors, Visarpa
(herpes), abscess
 Śākhā

• Skin and the other dhatus except Rasa.

• The external pathway but protected from the external

environment.
 Sakha

• Bahi roga marga – External pathway  –


Raktha- blood and others tissues (Blood, muscles, bone,
fat, bone marrow and sex related secretions) and skin
continue the Bahya Rogamarga – external pathway of
disease.

• It is related with diseases such as moles, discolored

patches on face, Gandalaji- goiter, glandular ulcer on the
face, malignant tumors, hemorrhoids, abdominal tumor,
swelling and other external diseases.
 Marma

• The Marmas are concerned with the vital organs like

Brain, Heart, Bladder etc.

• The Central Pathway.

• The most restricted access.

 Madhyama/Marma

• The head, heart, urinary bladder and such other vital

organs, joints of bones, blood vessels, tendons,
ligaments, nerves constitute the madhyama rogamarga.
From it arise, consumption , hemiplegia, facial paralysis,
diseases of the head and other organs, pain, stiffness-
loss of movement of the joints, bones, waist
 Increase of Rasa

• Rasa when increased in similar to Kapha, produces the

same symptoms of increased Kapha
 Increase of Rakta
• Blood tissue, when increased produces

• Visarpa – Herpes, spreading skin disease,

• Pleeha – diseases of the spleen,

• Vidradhi – abscesses,

• Kushta – skin diseases

• Vatasra – gout

• Pittasra  – bleeding disease,

• Gulma – abdominal tumors,

• Upakusa – a disease of the teeth,

• Kamala – jaundice,

• Vyanga – discoloured patch on the face,

• Agninasha – loss of digestion strength

• Sammoha – Coma, unconsciousness,

• Red discoloration of the skin, eyes, and urine

 Increase of Māmsa

• Muscle tissue, when increased produces

• Ganda – cervical lymphadenitis

• Granthi – tumor,

• Increase in size of the cheeks, thighs, and abdomen,

• over growth of muscles of the neck and other places

 Increase of Medas

• Fat tissue), when produces similar symptoms and in

addition, it causes fatigue, difficulty in breathing even
after little work,

• Drooping of the buttocks, breasts and abdomen.

 Increase of Asthi

• Bone tissues, when increased causes overgrowth of

bones and extra teeth
 Increase of Majja

• Marrow, when increased produces heaviness of the eyes

and the body, increase of size of the body joints and
causes ulcers which are difficult to cure.
 Increase of Śukra

• Reproductive tissue, when increased produces great

desire for the woman (sexual desire) and seminal calculi
(spermolith)
 Decrease of Dhātus
• Decrease of Rasa dhatu produces dryness, fatigue, emaciation, exhaustion without any
work and noise intolerance.

• Decrease of Rakta produces desire for sour and cold things, loss of tension of veins (and
arteries) and dryness.

• Decrease of Mamsa causes debility of the sense organs, emaciation of cheeks, buttocks
and pain in the joints.

• Decrease of Medas causes loss of sensation in the waist, enlargement of spleen and
emaciation of the body.

• Decrease of Asthi causes pain in the joints, falling off of the teeth, hairs, nails etc.

• Decrease of Majja causes hollowness (of the bones inside) giddiness and seeing of
darkness.

• Decrease of Shukra results in delay in ejaculation, ejaculation accompanied with bleeding,

severe pain in the testicles and a feeling of hot fumes coming out of the urethra.
 Organs

• Brain - Prana

• Heart - Cetana, Rasa

• Vasti - Water, Sukshma Mala

• Phuphusa - Breath

• Koṣṭha - Anna, Sthula Mala

 Types of Diseases
• Svatantra Roga – independent/ primary –  have their own specific causes, comforting methods
and clearly manifest features.

• 2. Paratantra Roga – secondary diseases, associated diseases. Those which do not have their
own specific cause.

It is further of two types.

• Purvaja – premonitory symptoms – the symptoms that are seen at the initial stage of a disease

• Upadrava – complications of diseases.

• The secondary disease (Paratantra Roga) usually subsides when the primary diseases is
treated.

• If they do not get subsided then, treatment has to be given- for the secondary diseases as
well.

• If powerful, secondary affections should be treated soon because these- complication cause
more troublers to the body which is already debilitated by the primary disease.
 Disease Nomenclature

• The physician should never feel shy for not knowing the
nomenclature of the disease, for there is no rule/ custom/
state, that every disease has a name.

• The very same Doshas, depending upon the nature of the

causative factors, travels to many parts of the body and
produces many disease, hence treatment of the disease,
its abode- site should be judged very quickly with the
help of knowledge of the disease.
 Assessing strength of
disease
• The symptoms may be affected by the disease and also by the mental
status of the patient. The strength of the disease varies based on
strength and weakness of the mind and body of the patient. Hence the
physician should be very attentive.

• The unintelligent physician, who determines a grievous disease as a

mild one, goes wrong in treatment because of under estimating the
condition the Dosha.

• He will administer drugs/ therapies in small doses. Such mild treatment

causes worsening of the disease because of ineffective treatment.

• On the other hand, if the person over estimates the strength of the
disease and over treats with Panchakarma and oral medicines, it will
also trouble the health of the patient to a very great extent.
 Rasa Rakta Māmsa Medas Asthi Majjā Śukra
Vāta

Pitta

Kapha

Vātapitta

Pittavāta

Vātakapha

Kaphavāta

Pittakapha

Kaphapitta

Tridoṣa
Pause