When the agni becomes weak (mandagni), a number of unwanted unripe byproducts of digestion and metabolism start forming and accumulating in the body at different levels from the gross to the molecular level, from a local gastrointestinal tract (GIT) level to the systemic level in tissues and cells. Such products are collectively called ama and act as toxic and antigenic materials, giving rise to many antibodies. The presence of ama (including the production of antibodies) renders an ama state (amavastha) in the body, which is characterised by increasing impermeability and sluggishness of the body channels or srotas resulting in srotodusti. , This allows sanchaya of doshas and is the first kriyakala in the subsequent sequence of events, which follow as a compulsive phenomenon. Hence, Ayurveda emphasises that all diseases are the product of a weak agni and in turn, the main principle of treatment of all diseases in Ayurveda is to restore and to strengthen the agni along with the digestion and metabolism.
This state of morbidity may be compared with the contemporary concept of loss of membrane integrity and membrane pathology, which is considered as the seat of the anchor of the pathology of many diseases as conceived in modern medical sciences. Membrane biology is considered as a vulnerable facet, thus rendering the integrity of the membrane structures at all levels including cell membranes and their pores or permeability (srotamsi) the most important consideration in evolution of a disease. The Ayurvedic concepts of srotas and ama causing srotodusti and srotosanga obviously refer to the above factors.
Thus, mandagni, amavastha and srotosanga are precipitating events for the sanchaya of doshas, which is the first stage of diseases according to Ayurveda.
The Ayurvedic texts describe certain systemic signs and symptoms of the ama state, viz. slow digestion, heaviness in the body, lack of appetite, nausea, salivation, distaste, constipation, heaviness in the belly, lethargy etc. These symptoms may be appropriately graded to evaluate the ama state in a semiquantitative manner. The degree of the symptoms of ama may be compared with the findings of jalatarana-test of the stool. Ama is a kind of autotoxin and acts like a foreign body or antigen in the body to which the body reacts immunologically, releasing nonspecific antibodies in the system. The titre of these antibodies may indirectly indicate the presence and severity of the antigenic state of ama.
For normal functioning of the body, it is essential that these channels, both the gross and subtle, remain intact and do not get blocked. If they get blocked due to stagnation of ama and other malas or due to any morbidity that causes further stagnation of the doshas and malas, the doshas-dusya-sammurcchana and samprapti of a particular disease are precipitated. Hence, it is necessary that these channels are kept clean and competent. Ayurveda advocates a number of therapeutic procedures to clean the channels, a process termed as samsodhana. Panchakarma is the classic example of a set of five therapeutic procedures described for samshodhana. Thus, samsodhana is the important component of
all treatments in Ayurveda. As a matter of fact, every patient needs some or the other form of samsodhana treatment before the prescription of a samsamana (palliative) in the form of a drug or diet. The human body, which is biologically purified by samsodhana, is ready for spontaneous healing even without a medication. However, taking any medication after samsodhana gives that medication a better chance to flow to the target site leading to better efficacy with lesser side effects. Thus, samsodhana or purification is the essential and unique part of Ayurvedic cure.
Ayurvedic texts have vividly described the factor of immunity in terms of ‘vyadhiksamatva,’ which is considered as the natural or acquired biological power of an individual, which protects him /her from disease. This defensive power is attributed to the presence of a biological factor called ojas. Ayurveda also describes a number of methods to promote ojas and vyadhiksamatva. The entire Rasayana tantra of Ayurveda is closely related to this context. On the other hand, Ayurveda also conceives the idea of allergy and intolerance caused by a variety of unwanted endogenous or exogenous materials. The concepts of dusivisa and amavisa are very interesting. Ama is the collective unwanted byproduct of digestion and metabolism, which is retained in the body and acts as an endogenous antigen. Similarly there are possibilities that certain poisonous materials ingested by an individual may be retained in the body leading to chronic allergic manifestations called dusivisa.