Amlapitta : A Critical Review Study

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IRJAY IS THE OFFICIAL JOURNAL OF BALA G PUBLICATION 60 VOLUME- 3 | ISSUE- 8 AUGUST 2020 VOLUME- 3 | ISSUE- 8 AUGUST 2020 Amlapitta : A Critical Review Study Dr. Lokesh Singh Bhati 1 , Dr. Madan Mohan Sharma 2 ,Dr. Rohit R. Porwal 3 1-Assistant Professor, Dept. of AgadtantraEvumVidhivaidyaka, M.J.F. Ayurved Collage Jaipur. 2 - Professor, Dept. of Kriya Sharir, K.S.V. Ayurved medical collage, Saharanpur, U.P 3 - Assistant Professor, Dept. of Dravyaguna, M.J.F. Ayurved Collage, Jaipur SJIF Impact Factor : 5.69 ISRA Impact Factor : 1.318 ISSN:2581-785 X Review Article Volume: 3 Issue: 8 ABSTRACT: In Veda no indicative situations were found about Amlapitta as a illness. Charak, Sushruta and Vagabhata has not described the Amlapitta as diseases article. Firstly Aacharya Kashayap , Harita, Madhav described the Amlapitta . Amlapitta is stomach oriented, and Kapha Pitta are the dominating Dosha . Amlapitta is disease, which is characterized by the cardinal symptoms like Avipak, klam,utklesh, tikta-amla udgar, hrudakantha dah and aruchi . Dietary pattern of Indian people has been changing and upto certain extent by the influence of western culture. Irregular and untimely eating habits along with certain variations of recipes can be included under the Viruddhahar. Ashatang harudyakar quotes that the effects of Viruddhahar consumption are likely that of Garavish . Amlapitta has been included in the list of diseases of caused by Virudhaasan . Amlaguna property of the pitta is exaggerated. Amlapitta is described as a disease generally resulting after ajeerna . It is quite common disease prevailing all over the world. In this article the all information related to Amalpitta has been compiled. Keywords – Amlapitta, Virrudhaahar

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IRJAY IS THE OFFICIAL JOURNAL OF BALA G PUBLICATION 61 VOLUME- 3 | ISSUE- 8 AUGUST 2020 VOLUME- 3 | ISSUE- 8 AUGUST 2020 INTRODUCTION: Historical review– In Vedic literature no suggestive references were found about Amlapitta as a disease. Acharya Charak has not mentioned amlapitta as a separated entity but Charak Samhita many scattered references of amlapitta which are as below. Amlapitta has been listed as indication of 8 types of milk 1 . Kulattha has been considered as a chief causative factor of amlapitta 2 . Excessive use of Lawan ras has been also considered as a causative Factor of amlapitta 3 . Irregular and untimely eating habits along with certain variations of recipes can be included under the Viruddhahar 4 . Vagbhatacharya quotes that the effects of Viruddhahar consumption are likely that of Garavish 5 . Amlapitta has been included in the list of diseases of caused by Virudhahar 6 . Rajmasha has the property of relieving the amlapitta 7 . Amlapitta has been mentioned as an indication of Kansa Haritaki 8 . Sushruta has mentioned symptom known as Amlika , results from excessive use of Lavan ras, is similar to Amlapitta. "Amlika " word has found in sushrutasamhita 9 . Kashayapa samhita is a first available Samhita describing Amlapitta. Not only vivid description of Amlapitta with its treatment has been mentioned in it but suggestion to change the place, in case where medicine does not work out has also given 10 . A separated chapter for Amlapitta is available in Harita Samhita 11 . Vagabhata has not described the Amlapitta as diseases entity. But the description of Paittika Hridroga How to Site the Article : Dr. Lokesh Singh Bhati, Dr. Madan Mohan Sharma,Dr. Rohit R. Porwal, Amlapitta : A Critical Review Study, IRJAY, August: 2020 Vol- 3, Issue-8; 60-69 https://doi.org/10.47223/IRJAY.2020.3810 Article received on-3 August Article send to reviewer on-4 August Article send back to author on-19 August Article again received after correction on -26 August Corresponding Author : Dr. Lokesh Singh Bhati , , Assistant Professor, Dept. of Agadtantra Evum Vidhivaidyaka, M.J.F. Ayurved Collage Jaipur Email id,bhatisingh 27@gmail.com

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IRJAY IS THE OFFICIAL JOURNAL OF BALA G PUBLICATION 62 VOLUME- 3 | ISSUE- 8 AUGUST 2020 VOLUME- 3 | ISSUE- 8 AUGUST 2020 seems very nearer to the Amlapitta. Madhava Nidana is the first available text which describes Amlapitta and with its aetiopathogenesis and symptomatology in detail along with two clinical sub types viz. (1) Urdhvaga and (2) AdhogaAmlapitta 12 . Two separate chapters (Upadrava & Arista) on Amlapitta have been devoted in Bhavaprakasha. Derivation and Definition - The Amla has been said a natural property of Pitta along with katu-rasa according to Charaka 13 . Sushruta has enlisted katu as its original rasa and mentioned that when pitta becomes vidagdha then it changes in the Amla 14 . According to Dalhanacharaya the commentator of Sushruta, Ranjit Rai Desai has given two types of pitta (1) Sama pitta (2) Niram pitta. He said that sama pitta has an Amla Rasa while Niram pitta has a katu rasa there for in Amlapitta sama pitta is there - means a condition created by sama pitta is called as an Amlapitta (Ranjit Rai Desai – Nidhan chikitsa Hastamalaka ). Chakrapani said that Amlapitta is a condition in which Amla guna property of the pitta is exaggerated. Madhukoshakara has also accepted this definition. He has given the vidagdha formation of pitta as a causative factor for increasing the Amlaguna of pitta . S hrikanthadatt a in his commentary on the relevant chapter has defined. Nidana- Nidana means the causative factors of the disease. They may helps to cure the disease. Acharya Sushruta said that Nidana Parivarjan is the first line of treatment. AharajaHetu- Under this group the intake of food against the code of dietetics i.e. Aharavidhividhana and Aharavidhi viseshayatan is inclued, excess use of pitta, aggravating factors like katu, Amla, vidahi etc. virudhaahar are the factors against the dietetic code and they directly disturb the pitta equilibrium. ViharajaHetu - To keep the health undisturbed is required to have regular habits of defecation to eat properly and to sleep in time. He has not to suppress the natural urges, maintaining the equilibrium of the body constituents and If this is not functioning followed regularly, they will

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IRJAY IS THE OFFICIAL JOURNAL OF BALA G PUBLICATION 63 VOLUME- 3 | ISSUE- 8 AUGUST 2020 VOLUME- 3 | ISSUE- 8 AUGUST 2020 cause the disturbance of the equilibrium of pitta and digestion which ultimately will lead to Amlapitta. ManasikaHetu - Kama, krodha, lobha, moha, irshya, bhaya etc. would affect the physiology of digestion either there would be a lesser secretion of the digestive juice or secreted at improper times and sometime it may be secreted in excessive quantity. All these conditions lead to indigestion which ultimately gives rise to Amlapitta. Bhedas - According to the vitiated Doshas :- Kashyapa has given three types 1 Vataja Amlapitta 2 Pittaja Amlapitta 3 Kaphaja Amlapitta 15 Madhavkar has given four types. 1 Vatadhika Amlapitta 2 Kaphadhika Amlapitta 3 Vatakaphadhika Amlapitta 4 Shleshmapittaja Amlapitta According to sthanadusti of the srotasa:- Madhavkara and Bhavamishra both have described mainly two types of Amlapitta. 1. Urdhavaga Amlapitta 2. Adhoga Amlapitta 16 Purvarupa- Purvarupa of this disease are not mentioned in any classical text. Ajirna is the common symptom reported before the actual symptoms of Amlapitta started. The lower intensity of the cardinal symptoms may be considered here as the purvarupa of Amlapitta . Some of the symptoms of Ajirna and specially vidagdhajirna may be appearing before the manifestation of disease may be considered as their Purvarupa. In Charaka Samhita while describing the samprapati of Grahani , he indicates Amlapitta also Charaka has mentioned some purvarupa of Grahani like Trishna, Alasya, loss of Bala, Annavidaha, heaviness of body etc. These symptoms may be considered as the purvarupa of Grahani as well as of Amlapitta 17 .

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IRJAY IS THE OFFICIAL JOURNAL OF BALA G PUBLICATION 64 VOLUME- 3 | ISSUE- 8 AUGUST 2020 VOLUME- 3 | ISSUE- 8 AUGUST 2020 RUPAS - Ancient Acharyas have given detailed discription about the Rupas of Amlapitta No. SYMPTOMS & SIGNS K.S. M.N. B.P. Y.R. B.S. G.N. H.S. S.N. 1 Amlaudgar (sour eructation) - + + + + + + + 2 Tiktaudgar (Bitter eructation) - + + + + + - - 3 Hruddah(Heart burn) - + + + + + + + 4 Kanth dah (Burning in throat) + + + + + + + + 5 Avipak (Indigestion) - + + + + + - - 6 Klam (Exhaustion without any exertion) - + + + + + - + 7 Utklesh (Nausea) - + + + + + - - 8 Aruchi (Tastelessness) - + + + + + - - 9 Gaurav (Feeling of heaviness) - + + + + + - - 10 Shiroruk (Headache) + - - - - - + + 11 Angasada (Fatigue) + - - - - - - - 12 Antrakunjana (Gargling in intestine) + - - - - - - - 13 Vidbheda(Diarrhoea) + - - - - - - - 14 Gurukoshthata + - - - - - - - 15 Romaharsha (HorriPulation) + - - - - - - - 16 Hritshula (Pain in heart region) + - - - - - - - 17 Urovidaha (Burning in chest) + - - - - - - - 18 Amlotklesh + - - - - - - -

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IRJAY IS THE OFFICIAL JOURNAL OF BALA G PUBLICATION 65 VOLUME- 3 | ISSUE- 8 AUGUST 2020 VOLUME- 3 | ISSUE- 8 AUGUST 2020 Samprapti- NIDAN SEVAN (VIRUDDHAAHAR) AGNIDUSHTI VISHARUPANNA AJEERNA AMAVISH DOSHDUSHTI (PITTAPRADHAN) (Garavish) AAMASHYASTH STHANSHNSHRYA DOSHOTKLESH AVIPAK, UTKLESH, UDGAR AMLAPITTA 18

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IRJAY IS THE OFFICIAL JOURNAL OF BALA G PUBLICATION 66 VOLUME- 3 | ISSUE- 8 AUGUST 2020 VOLUME- 3 | ISSUE- 8 AUGUST 2020 In Grahani Roga Chiktsha mentioned by charak is able to explain the pathogenesis of Amlapitta, Amlapitta is described as a disease generally resulting after Ajeerna . Repeated consumption of viruddhaahar leads to agnidushti and such dushtagni is unable to digest even light food. lead to Agni mandhya . Agnimandhya create Ajirna, Due to Ajirna, Aamvisha is produced. Aamvisha probably has the nature of Garavisha 1 9 . This Aamvisha combines with vitiated pitta dosha and create pittaja disease like Amlapitta 18 . Sadhya-asadhyata- Kashypa said that when Amlapitta's patient suffering from Jvara, Atisara, Pandu, Shoola, Bhrama, Dhatukhseenata etc. Updravas, it is incurable stage 20 . Amlapitta is a chronic disease It has complicated pathogenesis. Samprapativighatana is so difficult. So, curability of Amlapitta has getting great efforts. Vangsena said that when Amlapitta is in acute condition it is curable when it becomes chronic it is yapya or kruchshadhya . Chikitsa Sutra - Ayurveda has 3 basics of chikitsa regarding any types of disease (1) NidanParivarjan - Withdrawing of the allevilating factors of the disease. Nidanparivarjana and PathyaPalana both are responsible to stop the formation of Vishama Dhatu and both are promoted the formation of Sama Dhatu . So Nidanaparivarjan has important role in removing the disease It is to be advised to patient to avoid such type etiological factors which are responsible for the manifestion of disease Katu Amla ras Anna Pana, Viruddha Aharasevan . Vegavidharana , Vishamasana Bhukte Divaswapa etc. (2) Apakarshana – Apakarshana mean pacification of Doshas either by Shodhana or Shamana or by both. So far Amlapitta is concerned, it is originated in Amashaya and mostly the Doshas are localized there. For this condition Vamana is the best treatment. If Doshas are localized in Pachyamanashaya , then Virechana is the ideal therapy. In Shodhana therapy Vamana is advocated in Urdhaga Amlapitta and Virechana in case of Adhoga Amlapitta use of Niruhabasti is stated by Chakrapani, Vrinda Madhava and Govind Das whereas Vangasen a nd Yogaratnakar has mentioned the use of Raktamokshana .

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IRJAY IS THE OFFICIAL JOURNAL OF BALA G PUBLICATION 67 VOLUME- 3 | ISSUE- 8 AUGUST 2020 VOLUME- 3 | ISSUE- 8 AUGUST 2020 3) Prakritivighata – It means use of drugs resuscitation of Dhatus. Such treatment is termed as shamana therapy. According to Kashyap – Amlapitta is stomach oriented, and Kapha Pitta are the dominating Dosha, Vamana should be first administered. After Vamana, Shamana drugs should be used. At the same time Pachana drugs should be given. When the Samsarga Doshas are elevated and stomach becomes clear, deepana drugs should be administered. If Doshas have shifted into pakwashaya, virechana and shamasana drugs should be used to eliminate the Doshas 2 1 . Drugs used in Amlapitta- Shatavari, Parpataka, Musta, Amalaki, Dhanyaka,Yastimadhu, Patola, Bhringaraja, Narikel, Guduchi, Vasa, Kusmanda , Kiratatikta, Nimba,Yavasa , Trivrita, Vidanga, Draksha, Shankha, Shukti, Abhraka, Mandoora, Swarna, Lauha, Raupya, Swarnamakshika, Varatika, Kaparda, Avipattikarchurna, Bhunimbadi Kwath, Chinodbhavadikwath, Patoladikwath, Dashangkwath, ShatavariMandura, NarikelaKhanda, ShatavariGhrut, Kushmanda Avaleha, Kamdugdha Rasa, Sutashekhara Ras, AvipattikaraChura. Pathyapathya – Pathyaahara – a) Annavarga – Yava, Godhuma, PurnaSali, Mudga Yusha, Lajja b) Saka varga – Karavellaka, Patola, Kushmanda etc. c) Phalavarga – Dadima, Amalaki, Kapittha etc. d) Dugdhavarga – Godugdha e) Mamsavarga – Jangala Mamsarasa f) Miscellaneous – Sarkara, Madhu, Narikelodaka Pathya vihara – Shitopachara, Vishrama etc. Apathya – Ahara – Guru, Vidahi, Viruddha, Kulatha, Udada, Navanna, Tila,Fermented Foods Like Bread. Vihara – Vegavidharana, Atapasevena, Chinta, Krodha, Shoka etc 22 Acknowledgement:- Nil Financial Assistant:- Nil Conflict of interest :- Nil

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IRJAY IS THE OFFICIAL JOURNAL OF BALA G PUBLICATION 68 VOLUME- 3 | ISSUE- 8 AUGUST 2020 VOLUME- 3 | ISSUE- 8 AUGUST 2020 REFERENCES 1 Agnivesh, Charak Samhita Vol-I, Varanasi,2009.; Choukhambha Sanskrit Sansthan; (Sutra Sthana) 1/111 2 Agnivesh, Charak Samhita Vol-I, Varanasi; 2009. Choukhambha Sanskrit Sansthan; (SutraSthana).25/40 3 Agnivesh, Charak Samhita Vol-I Varanasi; 2009. Choukhambha Sanskrit Sansthan; Sutra Sthana).26/43 , 4 Agnivesh, Charak Samhita Vol-I Varanasi; 2009. Choukhambha Sanskrit Sansthan; (SutraSthana).26/103 , 5 Vagbhat, Astangahridaya Varanasi; 1999 Choukhambha Sanskrit Sansthan; (Sutra Sthana). 7/29, 6 Agnivesh, Charak Samhita Vol-I Varanasi; 2009. Choukhambha Sanskrit Sansthan; (SutraSthana).26/86-87 , 7 Agnivesh, Charak Samhita Vol-I, Varanasi; 2009 Choukhambha Sanskrit Sansthan;. (Sutra Sthana).26/102 8 Agnivesh, Charak Samhita Vol-I Varanasi; 2009. Choukhambha Sanskrit Sansthan; (Sutra Sthana). 12/52, 9 Ambikadutt Shastri, Sushrut Samhita Vol-I Varanasi; 2010. Choukhambha Sanskrit Sansthan; (Sutra Sthana). 21, 22/32, 10 Vruddha jivak, Kashyapa Samhita Varanasi; 2006. Choukhambha Sanskrit Sansthan; (Khilasthana) 16/4,5 11 Harita sam.- 24 cha. 3 rd section 12 Madhavakara, Madhavnidan Part -2 nd Varanasi; 2001. Choukhambha Sanskrit Sansthan; 51/3,4 13 Agnivesh, Charak Samhita Vol-II, Varanasi; 2009. Choukhambha Sanskrit Sansthan; (ChikitsaSthana) 15/44, 47 14 Ambikadutt Shastri, Sushrut Samhita Vol-I, Varanasi; 2010. Choukhambha Sanskrit Sansthan; (Sutra Sthana). 21, 22/32 15 Vruddha jivak, Kashyapa Samhita Varanasi; 2006. Choukhambha Sanskrit Sansthan; (Khilasthana) 16/4,5

IRJAY IS THE OFFICIAL JOURNAL OF BALA G PUBLICATION 69 VOLUME- 3 | ISSUE- 8 AUGUST 2020 VOLUME- 3 | ISSUE- 8 AUGUST 2020 16 Madhavakara, Madhavnidan Part -2 nd Varanasi; 2001. Choukhambha Sanskrit Sansthan; 51/3,4 17 Agnivesh, Charak Samhita Vol-II Varanasi; 2009. Choukhambha Sanskrit Sansthan; (Chikitsa Sthana). 15/55, 18 Agnivesh, Charak Samhita Vol-II Varanasi; 2009. Choukhambha Sanskrit Sansthan; (Chikitsa Sthana). 15/42-47, 19 Vagbhat, Astangahridaya Varanasi; 1999 Choukhambha Sanskrit Sansthan; (Sutra Sthana). 8/13,14, 20 Vruddha jivak, Kashyapa Samhita Varanasi; 2006. Choukhambha Sanskrit Sansthan; (Khilasthana) 16/49 21 Vruddha jivak, Kashyapa Samhita Varanasi; 2006. Choukhambha Sanskrit Sansthan; (Khilasthana) 16/18-21, 22 Vruddha jivak, Kashyapa Samhita Varanasi; 2006. Choukhambha Sanskrit Sansthan; (Khilasthana) 16/38-40

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