i
“NAIDANIKA ADHYAYANA OF AMLAPITTA WITH SPECIAL
REFERENCE TO HYPERACIDITY”
By
Dr. SHRADHA BAMS
Dissertation submitted to the
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
BANGALORE, KARNATAKA
In Partial Fulfillment of the Requirements for the Degree Of
AYURVEDA VACHASPATI
DOCTOR OF MEDICINE (M.D)
In
ROGANIDANA
Under The Guidance Of
DR. RAMESH M. S. M.D. (Ayu)
Associate Professor, Department of Post Graduate studies in
Roganidana, Government Ayurvedic Medical College,
Bangalore - 560009
Department of Post Graduate studies in Roganidana,
Government Ayurvedic Medical College, Bangalore - 560009
2017-2018
List Of Abbreviations
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity”
Sl No Abbreviations Full form
1. Cha. Su. CharakaSutrasthana
2. Cha. Vi. CharakaVimanasthana
3. Cha. Ni. CharakaNidanasthana
4. Cha. Chi. CharakaChikitsasthana
5. Su. Su. SushruthaSutrasthana
6. Ha. Sa. Hareeta Samhita
7. A. Hr. Su. AstangaHridayaSutrasthana
8. Ka. Khi. KashyapaKhilasthana
9. Ma. Ni. MadhavaNidana
10. Bh. Pr. Bhavaprakasha
11. Y. R. Yogaratnakara
12. Ch. D Chakradatta
13. Ba.Ra BasavaRajeeyam
14. Bha.Ra BhaishajyaRatnavali
LIST OF ABBREVIATIONS
List Of Tables
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity”
Table No. NAME OF TABLES Page No.
1. Nidanas Of Amlapitta 17
2. Dosha Involvement According To Nidana 19
3. Prajnaparadhaja Hetu 20
4. Samanya Rupas 33
5. Symptoms Of Ekadoshaja Amlapitta 33
6. Symptoms Of Urdhvaga Amlapitta 37
7. Symptoms Of Adhoga Amlapitta 41
8. Upadravas Of Amlapitta 42
9. Sapeksha Nidana 44
10. Hyperacidity Questionnaire 51
11. Distribution based on Age 52
12. Distribution based on Gender 52
13. Distribution based on Religion 53
14. Distribution based on Education 53
15. Distribution based on Occupation 54
16. Distribution based on Socio-economic status 54
17. Distribution based on Habitat 55
18. Distribution based on Marital Status 55
19. Distribution based on Desha 55
20. Distribution based on Prakriti 56
21. Distribution based on Diet Pattern 56
LIST OF TABLE
List Of Tables
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity”
22. Distribution based on Pattern of Food Intake 57
23. Distribution based on Appetite 57
24. Distribution based on Bowel 57
25. Distribution based on Koshta 58
26. Distribution based on Tea Intake 58
27. Distribution based on Coffee Intake 59
28. Distribution based on Smoking 59
29. Distribution based on Tobacco Chewing 60
30. Distribution based on Alcohol 60
31. Distribution based on Sleep 60
32. Distribution based on Heated Honey 61
33. Distribution based on Curd at Night 61
34. Distribution based on Consuming Cold Water
Immediately After Taking Hot Tea Or Coffee
62
35. Distribution based on Sour fruits with milk 62
36. Distribution based on Milk With Curd 62
37. Distribution based on Unformed curd 63
38. Distribution based on Amlatakra 63
39. Distribution based on Curd 64
40. Distribution based on Sugar Cane Juice 64
41. Distribution based on Pepper 65
42. Distribution based on Unripe And Sour Mango 65
43. Distribution based on Sour Mosambi 66
44. Distribution based on Sour Orange 66
List Of Tables
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity”
45. Distribution based on Citrus Lemon 67
46. Distribution based on Sesame 67
47. Distribution based on Puffed Rice 67
48. Distribution based on Battened Rice 68
49. Distribution based on Black Gram 68
50. Distribution based on Horse Gram 69
51. Distribution based on Chicken 69
52. Distribution based on Fish 70
53. Distribution based on Pork 70
54. Distribution based on Avimamsa 71
55. Distribution based on Ajamamsa 71
56. Distribution based on Atilavana 72
57. Distribution based on Atikatu 72
58. Distribution based on Atiamla 73
59. Distribution based on Deep Fried 73
60. Distribution based on Stale Food 74
61. Distribution based on Viharaja Nidana 74
62. Distribution based on Haritakashaka 75
63. Distribution based on Beetle Leaf 75
64. Distribution based on Atiudakapana/ Antarodakapana 76
65. Distribution based on Manasika Nidana 76
66. Distribution based on Lakshanas 77
67. Distribution based on Hyperacidity Questionnaire 78
List Of Figures
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity”
Graph No. NAME OF GRAPHS Page No.
1. Distribution based on Age 79
2. Distribution based on Gender 79
3. Distribution based on Religion 79
4. Distribution based on Education 80
5. Distribution based on Occupation 80
6. Distribution based on Socio-economic status 80
7. Distribution based on Habitat 81
8. Distribution based on Marital Status 81
9. Distribution based on Desha 81
10. Distribution based on Prakriti 82
11. Distribution based on Diet Pattern 82
12. Distribution based on Pattern of Food Intake 82
13. Distribution based on Appetite 83
14. Distribution based on Bowel 83
15. Distribution based on Koshta 83
16. Distribution based on Tea Intake 84
LIST OF GRAPHS
List Of Figures
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity”
17. Distribution based on Coffee Intake 84
18. Distribution based on Smoking 84
19. Distribution based on Sleep 85
20. Distribution based on Heated Honey 85
21. Distribution based on Curd at Night 85
22. Distribution based on Consuming Cold Water
Immediately After Taking Hot Tea Or Coffee
86
23. Distribution based on Sour fruits with milk 86
24. Distribution based on Milk With Curd 86
25. Distribution based on Amlatakra 87
26. Distribution based on Curd 87
27. Distribution based on Sugar Cane Juice 87
28. Distribution based on Unripe And Sour Mango 88
29. Distribution based on Sour Mosambi 88
30. Distribution based on Sour Orange 88
31. Distribution based on Citrus Lemon 89
32. Distribution based on Puffed Rice 89
33. Distribution based on Battened Rice 89
34. Distribution based on Black Gram 90
List Of Figures
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity”
35. Distribution based on Horse Gram 90
36. Distribution based on Chicken 90
37. Distribution based on Fish 91
38. Distribution based on Pork 91
39. Distribution based on Avimamsa 91
40. Distribution based on Ajamamsa 92
41. Distribution based on Atilavana 92
42. Distribution based on Atikatu 92
43. Distribution based on Atiamla 93
44. Distribution based on Deep Fried 93
45. Distribution based on Stale Food 93
46. Distribution based on Viharaja Nidana 94
47. Distribution based on Manasika Nidana 94
48. Distribution based on Haritaka Shaka 94
49. Distribution based on Beetle Leaf 95
50. Distribution based on Atiudakapana 95
51. Distribution based on Lakshanas 95
52. Distribution based on Hyperacidity Symptoms 96
53. Distribution based on Alcohol 96
List Of Figures
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity”
Sl. No. NAME OF FLOWCHART Page No.
1. Samprapti of Amlapitta 25
Sl. No NAME OF IMAGES Page No.
1. Causes of Hyperacidity 116
LIST OF FLOWCHART
LIST OF IMAGES
Abstract
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity”
Modern era’s changing lifestyle along with changing food culture and also
depending upon one’s body constitution Amlapitta is one of the most common
diseases seen in the society. It is a gastrointestinal tract disorder which closely
resembles with hyperacidity in modern science.
Most of the gastrointestinal disorder are owing to results from abnormal
functioning of Agni(digestive fire), faulty dietary habits like excessive intake of
pungent, spicy food, irregular meals pattern and habits like smoking, alchohol,
psychological stress. It is very troublesome disease and it can give rise to many
serious problems if it is not treated in correct time.
Amlapitta is composed of two word Amla and Pitta. AcharyaSushruta has
mentioned the Prakrita Rasa of Pitta is Katu and Vikritarasa or Vidagdha Rasa of
Pitta is Amla. Hence when the Vidagdhata of Pitta increases the disease Amlapitta
manifest.
Amlapitta is one of the Annavahasrotas vyadhi caused by the vitiation of
Tridoshas when any of the Dosha causing Mandagni leads to Vidagdhajeerna
manifesting as Amlapitta4. Amlapitta are very similar to gastritis or hyperacidity,
characterized by anorexia, acid eructation, heart burn, nausea, abdominal discomfort.
A population-based study, using a validated questionnaire, found that 58.7% of
the population has heartburn or acid regurgitation at least once during the course of a
year and that 19.8% experience symptoms at least once weekly.
ABSTRACT
Abstract
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity”
Hence here an attempt is made here to understand the Naidanikaadhyayana
Of Amlapittaw.S.R To Hyperacidity.
OBJECTIVES OF THE STUDY
1. To study the aetiopathogenesis of Amlapitta according to Ayurvedic classics.
2. To study the Hyperacidity in modern science.
3. To compare and analyze Amlapitta with Hyperacidity.
METHODOLOGY
A minimum of 50 patients who are fulfilling the criteria for diagnosis and
inclusion will be selected for the study randomly irrespective of sex, religion,
educational , professional background and economic status.
A special case proforma will be prepared with details of history taking,
physical signs and symptoms as mentioned in our classics and allied science.
The study will be done using a structured questionnaire which will have the
factors covering Ahara, Vihara, family history, occupation etc
Results
In this study majority of the patients registered were between the age group of
31-40 years indulged in mixed diet. curd, sour butter milk, lemon, pepper, horse
gram, black gram, chicken, fish, flesh of goat and sheep, excess salt, spicy, deep fried
food, drinking more water in between the food, sleeping soon after taking the food,
Atikrodha, alcohol, coffee intake play a significant role in causation of the disease
Amlapitta.
Key words: Amlapitta, Mandagni, Vidagdha, Hyperacidity.
Introduction
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 1
In the 21st century, the era of competition with stress having more speed and
accuracy are the prime demands. People are inclined to earn a lot of money within a
short period leading to their stressful life. Also more attraction towards the junk
foods. Copying the Western life style, they are changing their diet pattern, life style
and behavioral pattern working with stress and strain. So, the people are becoming
stressful with worry, tension, and anxiety causing so many psychological disorders,
which hampers the digestion and is causing acidity, gastritis, dyspepsia, ulcer and
anorexia. All these symptoms can be covered under the broad umbrella of
AMLAPITTA in Ayurveda.
Amlapitta is a disease of Annahava Srotas and is more common in the present
scenario of unhealthy diets & regimens. The term Amlapitta is a compound one
comprising of the words Amla and Pitta Out of these, the word Amla is indicative of a
property which is organoleptic in nature and identified through the tongue while the
word Pitta is suggestive of one of the Tridoshas as well as responsible for digestion
and metabolism in the body. The classical Literature on Amlapitta explains that
Amlapitta is such a condition in which Pitta increased and side by side the sourness of
Pitta is also increased. To indicate this factor Acharya Chakrapani has stated that
“Amlapitta is Amla Guna Yukta Pitta”1.
The first recorded medical literature Charaka Samhita which bases the very
systematic and scientific description has not mentioned the disease Amlapitta. Though
a scattered references and the pathogenesis is found in Grahani Adhyaya that
Annavisha (food poisoning) when associated with Pitta causes burning sensation,
INTRODUCTION
Introduction
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 2
morbid thirst and mouth diseases leads to Amlapitta and such other paittika
disorders2.
Kashyapa Samhita is the first text which describes the disease Amlapitta as a
separate disease entity. It is also the first text which has counted the Manasika
Bhavas(Psychological factors) as a chief cause of the disease and analyses the disease
on the basis of Doshika predominance. Also Acharya Charaka has mentioned that if a
person is under some psychological problem even the wholesome food taken in
proper quantity does not get properly digested3. Kashyapa believed that the disease is
caused by vitiation of Tridoshas leading to Mandagni and Amlapitta4.
Madhavakara describes the pathogenesis of the disease due to Pittaprakopa
which is already increased due to its own causes. He describes the two gatis of
Amlapitta as Urdhvaga and Adhoga.
Amlapitta and its upadravas may consider in gastric syndrome or hyperacidity
according to the modern science. Hyperacidity is a very common dietary disorder that
affects almost 25% of the world's population. Overcoming hyperacidity is a very
important issue. Generally, the problem occurs due to our sedentary lifestyle.
In recent years there has been an unprecedented increase of incidence related
to GI system due to changing in life style, Diet pattern, Behavioral pattern and Mental
stress and strain. The prevalence rate of all digestive disease are 60-70 million (1985),
mortality rate is 191000 (1985) and hospitalization is 10 million (13% of all
hospitalization). Amlapitta is a such type of GI disorder due to Viruddhashana,
Adhyashana, Diwaswapna etc closely resembles with hyperacidity in modern science.
Introduction
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 3
Primarily, hyperacidity can be due to excessive intake of oily and spicy foods,
sour foods, alcohol consumption, smoking, heavy consumption of therapeutic drugs,
coffee or tea and inadequate exercise. Though some secondary and major reason may
also lead to the problem of hyperacidity. These are stomach ulcers, digestive system
related disorders or due to acid reflux, and inadequate exercise5.
OBJECTIVES OF THE STUDY
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 4
OBJECTIVES OF THE STUDY
The present study entitled “NAIDANIKA ADHYAYANA OF AMLAPITTA
WITH SPECIAL REFERENCE TO HYPERACIDITY” was carried out with the
following aims and objectives.
1. To study the aetiopathogenesis of Amlapitta according to Ayurvedic classics.
2. 2.To study the Hyperacidity in modern science.
3. To compare and analyze Amlapitta with Hyperacidity.
Conceptual Review
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 5
To start any type of research work, it is always necessary to study the
historical background of that particular subject. It not only helps to understand the
subject thoroughly, but also provides useful guidelines for the research work. Careful
review of the subject from ancient time to the recent era gives an idea of the total
evolution in research. Here are some of the references of Amlapitta in Indian
literature.
VEDIC PERIOD No direct reference regarding the disease Amlapitta could
not be traced in Vedic literature
SAMHITA KALA
I. CHARAKA SAMHITA :
Acharya Charaka has not mentioned Amlapitta as a separate disease, but
Charaka Samhita has many scattered references of Amlapitta which are as
follows.
1) While describing the indication of 8 types of milk, Amlapitta has also
been listed6.
2) Description of Kulattha as chief etiological factor of Amlapitta has
been mentioned7.
3) Adhika sevana of Lavana Rasa causes Amlapitta8.
4) The Amlapitta has been mentioned under the diseases caused by
Viruddhahara9.
5) Rajamasha has the property of relieving the Amlapitta10.
6) Mahatikta Ghrita has been indicated in Amlapitta11.
HISTORICAL REVIEW
Conceptual Review
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 6
7) The pathogenesis of Amlapitta is described in context to Grahani
dosha12.
8) The list of Paitika Nanatmaja vyadhis includes symptoms dhumaka,
Amlaka, Vidaha which are the symptoms of Amlapitta13.
9) Indications of Kansa-Haritaki also include Amlapitta14.
These references are sufficient to give clear cut indication regarding
the amlapitta in charaka period.
II. SUSHRUTA SAMHITA :
During the description of the Atilavana Sevanajanya Vyadhis Acharya
Sushruta has mentioned a disease called ‘Amlika’ which seems to be similar to
Amlapitta15.
III. ASTANGAHRUDAYA :
While describing Pittaja Hrudroga, Vagbhata has used the term
Amlapitta16.
IV. KASHYAPA SAMHITA :
Kashyapa Samhita is the first text which describes the disease
Amlapitta as a separate disease entity. It is also the first text which has counted
the Manasika Bhavas(Psychological factors) as a chief cause of the disease
Not only detailed description of Amlapitta with its treatment has been
mentioned in it, but also has been advised to change the place of living to get
rid of the disease17.
Conceptual Review
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 7
V. MADHAVA NIDANA :
Madhavakara has described two types of Amlapitta as follows:18.
1) Urdhavaga
2) Adhoga
VI. SHARANGDHARA SAMHITA :
Eventhough Sharangdhara has not explained about the
etiopathogenesis of the Amlapitta, he has given the drugs and their preparatory
methods and indicated it in the disease Amlapitta. He has also explained the
therapy Niruha Basti for Amlapitta19.
VII. HARITA SAMHITA :
Harita has described Amlapitta as a separate disease and the treatment
is also given separately. The special synonym ‘Amlahikka’ to Amlapitta is
contribution of Harita20.
VIII. BHELA SAMHITA :
In Bhela Samhita Amlapitta has not been described21.
IX. BHAVAPRAKASHA :
Etiopathological factors similar as Madhava Nidana have been
described in Bhavaprakasha22.
X. VANGASENA SAMHITA :
Amlapitta is described with chikitsa in Vangasen samhita.
XI. BHAISAJYA RATNAVALI :
Description of Amlapitta with detailed chikitsa is explained in
Bhaisajya ratnavali23.
XII. YOGARATNAKARA :
Description of amlapitta is similar as Madhava Nidana24.
Conceptual Review
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 8
XIII. BASAVARAJIYAM :
This text has included the Amlapitta under 24 Nanatmaja Vyadhi of pitta25.
XIV. VRINDA MADHAVA :
Vrinda Madhava in his Kusumavali Vyakhya mentions Amlapitta as a
separate disease and its treatment. He has mentioned Vamana, Virechana,
Anuvasana and Asthapana as the main Upakramas as well as Avasthika
Chikitsa.
Conceptual Review
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 9
CONCEPTUAL REVIEW (Disease Review)
DEFINITION OF AMLAPITTA
Many definitions have been quoted in the classics of Ayurveda regarding
Amlapitta.
According to Chakrapani
“Amla Pittam Cheti Amla Gunodriktam Pittam”.
That means the pitta possessing excessive Amlata or the excessive Amla Guna
Udrikrita Pitta is called Amlapitta26.
Amla according to Charaka is considered as the Prakruta Rasa of Pitta27
where as Acharya Sushruta says that Katu is the Prakruta Rasa of the Pitta and it
attains Amlata in Vidagdhavastha28. The condition where the prakruta Katu Rasa of
Pitta is replaced by Amlata due to Vidagdhapaka can be called Amlapitta.
Hence, when vidhagda pitta is increased amla guna also increased which leads
to manifestation of amlapitta.
Madhava Nidana has given a clinical definition of Amlapitta that presence of
Avipaka, Klama, Utklesha, Amlodgara, Gaurava, Hrit-Kantha- Daha and Aruchi
should be termed as Amlapitta29.
In Amlapitta, the Pitta gets vitiated by one or all Gunas, causing various
pathophysiological conditions of Anna and Purishavaha Srotasa.
Etymology
Amlapitta is composed of two words. Amla + Pitta = Amlapitta. The term
Amla refers to a particular type of taste equated with the sour taste which causes
Conceptual Review
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 10
excessive salivary secretion. Pitta denotes bodily chemical substance which is mainly
responsible for the maintenance of the process of digestion, transformation and
transmutation. On combining both these words the term Amlapitta implies to a disease
or condition in which the sourness of Pitta gets increased.
Synonyms
Pramilaka
Pitta Visuchika
Pittamlaka - Harita Amlika
Shuktata
Amlaka
Amlika
Dhumaka and vidaha
Prameelaka:
This terminology has been used by commentator Indu on A.S.Su.5/27 under
Kaphaja Vyadhi. The Pachyamana Vidagdha Annarasa immediately vitiates Pittadi
Doshas, there by producing Aruchi, Mukha Vairasya, Praseka, Lavana Tiktamla Udgara,
Chardi, emaciation, Hritshula and Sadana. This state is known as Prameelaka30.
Pitta Visuchika:
This term also used by commentator Indu on A.S. Su.5/27. This may refer to
both the types of Amlapitta i.e. Urdhvaga and Adhoga Amlapitta, where their respective
cardinal features are Urdhvaga Pravrutthi (Vamana) and Adhapravrutthi (Atisara) of
Pitta associated with burning sensation.
Shuktaka:
It is mentioned synonym for Amlapitta in Ka. S. Khi. 16th chapter31.
Pittamla:
Conceptual Review
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 11
The term would imply the sense of the term Amapitta mentioned in Amlapitta
Chikitsa in Y. R. also it has been used in Harita Samhita.
Amlaka:
The word Amlaka has been used by Charaka and Vagbhata in the list of
Pittananatmaja Vyadhi32.
Amlika
Means Amlodgara and would refer to one of the Lakshanas of Samapitta33.
Dhumaka and Vidaha
Charaka has enlisted both these in Pittananatmaja Vyadhi.
NIDANA
Nidana Panchaka i.e. Nidana, Purvarupa, Rupa, Upashaya, Samprapti are
said to be most important diagnostic tools of the disease. Understanding the concept
of Nidana of a disease helps us to diagnose and treat the disease properly. This can be
substantiated by Sushruta’s verse
“Sankshepataha Kriyayogo Nidana Parivarjanam”34.
Kashyapa, Harita, Madhavakara have described the etiological factors of
Amlapitta, Madhavakara has mentioned etiological factors which are mainly Pitta
Prakopaka35. Kashyapa has given etiological factors of Amlapitta, which are Kapha
Prakopaka – which shows his inclination towards the role of Kapha as main cause of
Amlapitta36. All scholars have mentioned Viruddhahara as a causative factor of
Amlapitta, which shows the importance of involvement of Viruddhahara as a
causative factors of Amlapitta.
Conceptual Review
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 12
The etiological factors of Amlapitta can be broadly classified as Aharaja,
Viharaja, Manasika and Aagantuja Hetus37. The brief explanation of these factors
may be presented as under
Aharaja Hetu [Dietary factors]:
Aharaja hetus are said to be the first and foremost group of etiological factors
of Amlapitta. Under this group the intake of food against the code of dietetics i.e.
Ahara Vidhi Vidhana and Ahara Vidhi Visheshayatana is included38. Various type of
viruddha ahara, excess of Pitta prakopaka factors like Katu, Amla, Vidahi, etc. and
irregular time of consumption of food are the factors against the dietetic code and they
are directly responsible for the vitiation of Pitta. Accoding to Kashyapa faulty dietaty
habits leads to agnimandya which further leads to amlapitta39. Whereas Madhavakara
mentioned pitta aggravating factors are responsible for amlapitta40.
Ahara group 41:
A. According to the type of Ahara :
a. Kulattha
b. Pruthuka
c. Pulaka (Husky food)
B. According to the Samskara of the Ahara :
a. Apakwanna Sevana (uncooked food)
b. Bhrishtadhanya Sevana (fried paddy)
c. Ikshuvikara Sevana (Sugar-cane products)
d. Pishtanna Sevana (flour)
C. According to the quality of food :
Conceptual Review
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 13
a. Abhishyandi
b. Atisnigdha (Unctuous)
c. Atiruksha (Very coarse and dry)
d. Gurubhojya (heavy diet)
e. Vidahi Anna-Pana
D. Faulty dietary habits:
a. Akala bhojana (untimely eAting)
b.Antarodaka Pana (drinking of excess water during meal)
c. Adhyashana
d.Visamashana
E. According to the capacity of weakening the digestive power :
i. Ati Snigdha Sevana (excessive oily diet)
ii. Ati Ruksha Sevana (excessive coarse dry diet)
F. According to Dushitanna:
i. Dushta Anna Sevana
ii. Paryushita Anna Sevana
G. According to the Pitta provocative potency of diet :
a. Adhyashana (eating before the previous diet is digested)
b. Ajirnashana (intake of food in indigestion condition)
c. Amapurnata
d. Ati Ushna (Very hot)
e. Ati Amla (intake of excessive acidic diet)
f. Ati Drava (intake of excessive liquid)
g. Ati Tikshna (intake of very sharp substance)
h. Ati Panam (Over drinking)
Conceptual Review
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 14
i. Katu Anna Pana (Pungent diet and drinks)
j. Viruddhashana (incompatible diet)
H. Miscellaneous :
i. Madya Sevana (alcohol drinking)
ii. Gorasa Sevana (milk products)
Viharaja Hetu 42
To maintain the good health one should follow the proper viharas. The
regular habits of eating properly, sleeping on time and excretion must be
followed. Vega dharana should be avoided. If this is not followed regularly,
the whole functioning of the body will be disturbed and in long run, they will
cause the disturbances of the equilibrium of Pitta and digestion, which
ultimately will lead to Amlapitta.
Atisnat (Taking excessive bath)
Ati Avagahanat (Excessive swimming)
Bhuktwa bhuktwa diwasvapnat (Sleeping in day time after meals)
Veganam Dhararam (Suppression of natural urges)
Shayya Prajagaraihi (Improper sleeping schedule)
Manasika Hetu43.
Psychology also plays a great role in maintaining the health and
psychological activities. On the other hand an abnormal psychology, in terms
of Kama, Krodha, Lobha, Moha, Irshya, Shoka, bhaya would affect the
physiology of digestion. Either there would be a lesser secretion of the
digestive juice or secreted at improper times and sometimes it may be secreted
Conceptual Review
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 15
in excessive quantity. All these conditions aggravates Pitta, which ultimately
gives rise to Amlapitta.
The modern investigators have established that Hyperacidity is nothing else but is the
syndrome resulting from stress and strain which shows the important role played by
psychogenic factors in the production of Amlapitta.
Manasa Hetu:
Chinta - worries
Shoka – Sad
Bhaya - Fear
Krodha - Anger
Moha - Over attachment
Agantuja Hetu:
Amlapitta is definitely caused by over use of certain drugs. Over use of
NSAIDs and anticoagulants cure one disease but it can produce Hyperacidity.
Ayurvedic drugs, especially ashodhita and faulty Rasa Aushadhi may cause
Amlapitta. Even Ushna, Tikshna drug if used excessively, without proper assessment
of disease for a long period may produce Amlapitta. Similarly Panchakarmas with
Heena Yoga or Mithya Yoga or Atiyoga lead towards many diseases by attacking on
Agni, hence Amlapitta also can be seen as an Upadrava of some other diseases like
chronic Vibandha, Arsha, Ajirna and Pandu. In this group constant and excessive
Consumption of alcohol, tobacco, beverages, smoking, or other irritant stuffs, etc are
taken. These substances cause local irritation in the stomach, which in turn secretes
more gastric juices, and infection of the stomach, which may be grouped under this
category.
Other causes:
Conceptual Review
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 16
Also Desha, Kala, Ritu takes a great extent in the causation of Amlapitta.
Deshaprabhava:
According to Acharya Kashyap the disease is more predominant in anupa
desha comparing to other desha because of Kapha provocating nature46. In the line of
treatment he gives its importance to change the place in untreated cases44.
Kalaprabhava [Influence of Time]:
Amlapitta is a chirakalina vyadhi.This disease is more prevalent in middle age
due to dominancy of Pitta. Also paittika disorders are more prevalent during Pitta
provocation time that is during midday and mid-night45.
Ritu prabhava [Seasonal Fluctuations]:
This group includes disease which is caused by variations in atmospheric
temperature. hot or cold, humidity or dryness, rain and winter, incidental to changes
in the seasons. The rainy season is responsible for amlavipaka of water and eatables
(due to weakened digestion power and vitiation of Vata and other Doshas) which in
turn vitiates Pitta and Kapha46.
Genetic Factors:
Acidity is seen mostly in persons with blood group ‘O’ and families with such
blood group prove relations of genetic factor, probably the blood group modifies the
oxyntic cell population. In Ayurveda Pitta prakruti persons are also more susceptible
for the process of aggravation of the diseases.
Trauma:
Certain things in diet can damage the gastric mucosa. The intake of spicy
food, solid matter, alcohol and other irritating things may damage the pyloric antrum
and lesser curvature of stomach.
Conceptual Review
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 17
Drugs:
Drugs like corticosteroids, xanthine, aspirin, alkaloids, NSAIDS, reserpine are
reported to be causing Hyperacidity.
Nicotine And Alcohol:
Alcohol can damage the gastric mucosa and produces ulcer. Smoking
(Nicotine) has been responsible to produce the amount of prostaglandin E2 in gastric
mucosa. Madhya sevana is explained as the causative factor for amlapitta.
Table No: – 1 A COMPARATIVE TABLE SHOWING THE CLASSICAL
NIDANAS OF AMLAPITTA
Sl.No Nidanas K.S. M.N. B.P. B.R. G.N. S.S.
1. Ajirna (Indigestion) + - - - - -
2. Abhishyandi Bhojana + - - - - -
3. Adhyashana (To eat before the
previous food is digested)
+ - - - - -
4. Ama (Undigested) + - - - - -
5. Ama Pakwanna(Semi-digested
food)
+ - - - - -
6. Akala Bhojana(Untimely diet) + - - - - -
7. Amla Sevana(Eating of acidic
substances)
+ + + + + +
8. Ame Ame Cha Puranant (To eat
without appetite)
+ - - - - -
Conceptual Review
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 18
9. Antarodaka Prana (To drink
much water during food)
+ - - - - -
10. Ati-ushna Ahara (Very hot diet) + + + + + +
11. Ati-snigdha Ahara (Fatty diet) + - - - - -
12. Ati-ruksha Ahara (Coarse diet) + - - - - -
13. Ati-drava- Sevana(Excess liquid) + - - - - -
14. Atisnana (Lengthy bath) + - - - - -
15. Avagahana (Tub-bath) + - - - - -
16. Bhuktwa – Buktwa Swapnat + - - - - -
17. Bhrista – Dhanya + - - - - -
18. Dustanna - + + + + +
19. Diwaswapa + - - - - -
20. Gorasa (milky product) + - - - - -
21. Guru Bhojana (Heavy diet) + - - - - -
22. Ikshuvikara(Sugarcane product) + - - - - -
23. Kulattha Sevana + - - - - -
24. Madya (Alcohol) + + + + + +
25. Paryushitanna + - - - - -
26. Pitta Prakopaka Annapana - + + + + +
27. Pistanna + - - - - -
28. Pruthuka Sevana + - - - - -
29. Pulaka Sevana + - - - - -
30. Vidhanya - + + + + +
31. Viruddhasana(Incompatible diet) + + + + + +
Conceptual Review
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 19
Table – 2: Dosha Involvement According To Nidana
Nidana Doshika
Involvement
K.S. M.N
.
B.P. S.N. H.S. G.N. Y.R. B.S.
Kulattha Sevana P + - - - - - - -
Pulaka Sevana P + - - - - - - -
Pruthuka Sevana P + - - - - - - -
Guru Ahara K + - - - - - - -
Abhishyandi
Ahara
PK + - - - - - - -
Atisnigdha Ahara PK + - - - - - - -
Ati Ruksha Ahara V - - + + - - - -
Vidahi Annapana P - + + - - + + +
Pistanna Sevana PK + - - - - - - -
Apakwanna
Sevana
PV + - - - - - - -
Phanita Sevana K + - - - - - - -
Ikshuvikara
Sevana
K + - - - - - - -
Paryushitanna
Sevana
VPK + - - - - - - -
Dushtanna
Sevana
VPK - + + - - + + +
Ati-ushna Ahara P + - - - - - - -
Conceptual Review
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 20
Viruddhahara VPK + + + + + + + +
Ati-amla Ahara PK + + + + + + + +
Ati-tikshna Ahara VP - - - + - - - -
Adhyashana VPK + - - - - - - -
Ajeernashana PK + - - - - - - -
Table – 3: Prajnaparadhaja Hetu
Akala Bhojana KP - - + - - - - -
Kale Anashana V + - - + - - - -
Vishamashana V + - + - - - - -
Vegavidharana VPK + - - - - - - -
Bhuktva
Divaswapna
K + - - - - - - -
Bhukta
Avagahanam
VK + - - - - - - -
Bhuktva Snanam VK + - - - - - - -
Ati-madya Sevana VPK + - - - - - - -
SAMPRAPTI:
Samprapti is the process of the formation of the disease starting right from the
contact of the causative factors with the body to complete manifestation of the
disease. It is a course of the formation of the disease beginning from the Dosha
Prakopa.
Acharyas of Ayurveda such as Kashyapa, Madhavakara & Gananatha Sena
have mentioned specific Samprapti for Amlapitta as follows.
Conceptual Review
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 21
Samprapti according to Achrya Kashyapa :-
Acharya Kashyapa has described one separate chapter of Amlapitta in
Khilasthana. Kashyapa explained the as extremely vitiated Pitta condition
“Vatadayah prakupyanti tesham anytamo yada |
Mandikaroti kayagnim agnau mardavamgate ||
Yetani eva tatha bhuyah sevamanasya durmate |
Yat kinchit ashitam peetam dehinah taddhi dahyati ||
Vidagdham shuktatam yaati shuktam amashaye sthitam |
Tad amlapittam eti ahu bhuyishtam pittadushanat. ||” 16/6-9
Acharya Kashaypa said that the Nidana, the Doshaprakopa especially of pitta
Dosh. This Dosha prakopa create mandagni, & Due to mandagni ingested food
becomes vidagdha and shuktibhava. This Vidagdha and shuktbhava of food create
Amlata in Amashaya. This condition is called Amlapitta. Kashyapa has given an
example for explaining the samprapti of Amlapitta47. The vessels containing some
curd or uncleaned vessel which containing Amlarasa, If one adds milk, immediately
milk becomes Amlarasa and converted in to curd same process in Amashaya - due to
vitiated Dosha, the Ahara becomes vidagdha & shuktibhava. The Rasa Dhatu is also
vitiated. It creates more Mandagni. So, a person who intake more vidahi Ahara
generate more shuktibhava of food, which is responsible for the development of
Amlapitta48. Acharya Kashyapa has given the importance to Desha as a main
causative factor of the Amlapitta. He said that Amlapitta is shown mainly in Anupa
Desha. In Anupa Desha the climate is always look like as rainy season. So the Ahara
of this Desha, creates pitta vriddhi just like during varsharitu in other Desha. This
pitta vriddhi is called as sanchaya of pitta. In this condition, if a person take excessive
Conceptual Review
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 22
vidahi, katu & viruddha Ahara, the sanchita pitta becomes prakupita. Amla & Drava
Guna of the pitta are increased and lead to mandagni. So the ahara is not digested
properly and become vidagdha & shuktibhava in Amashaya and this condition is
called Amlapitta.
SAMPRAPTI - ACCORDING TO MADHAVANIDANA.
Acharya Madhava has given more importance to Ritu vishesha in the
pathogenesis of Amlapitta. Varsha ritu & sharad ritu both seasons have relation with
sanchaya and prakopa of pitta. Pitta vriddhi is developed in varsha ritu naturally,
while pitta prakopa occurs in sharad ritu. Pittaprakopa and Vidagdhata of pitta
which was previously stagnated by its own vitiating factors manifest amlapitta49.
ACCORDING TO CHARAK SAMHITA:-
Charaka has not mentioned Amlapitta as separate disease entity like Kashypa,
Bhavprakash & Madhava. The samprapti of Grahani Roga mentioned by charak is
able to explain the pathogenesis of Amlapitta, Charak said that the viruddha, vidahi &
Dushta Bhojana and kamadi Manasika Bhavas lead to Agnimandya. Agnimandya
create Ajirna, Due to Ajirna, Annavisha is produced. This Annavisha mix with pitta
Dosha and creates pittaja disease like Amlapitta. This vitiated pitta has a
Amlagunadhikya and Dravagunadhikya properties. It also vitiates the Rasa Dhatu.
This vitiated Rasa Dhatu and Amlaguna, Dravguna of pitta lead to Agnimandya
again. It produce more Ajirna & Annavisha. So the Ahara even taking in proper
quality or quantity, becomes vidagdha in Amashaya. So the shuktibhava of Ahara
creates Amlapitta. In acute condition gastrointestinal symptoms & signs are developed
just like Amlodgar, chhardi, vidbheda, Avipaka etc. Chronic condition occur due to
this vicious cycle circling more & more. So the Rasadhatu and pitta are vitiated more
Conceptual Review
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 23
and more. In the chronic condition Bharma, Shiroruja, jwara, kandu, klama,
Angasada etc. are developed50.
ACCORDING TO SUSHRUTA:-
Sushruta described six clear-cut stages of samprapti of disease like sanchaya,
prakopa, prasara, sthansanshraya, vyakti and Bheda51.
(1) SANCHAYA :-
Anupa Desha, Varsha Ritu, Vidahi Annapana Sevana, Amla-katu Rasa
Sevana, Dushtanna sevana, Drava ati sevana etc causative factors creates pitta
vriddhi. This stage is called as a sanchayavastha. Pitta is a chief Dosha which is
necessarily vitiated but the associated kapha & vata Dosha are also vitated due to
Nidana sevana.
(2) PRAKOPA :-
Excessive use of Nidana factors, pitta is aggravated more and more. So,
sanchita pitta becomes prakupita, this stage is called as a prakopavastha. In this
stage Agnimandya, Ajirna, Amlodgar, Daha, Trushna, Avipaka etc. symptoms are
produced. The symptoms of this stage may be according to main Dosha involved.
Due to involvement of pita & kapha there may be Amlodgara, pipasa, Paridaha,
Annadvesha, Utklesha & Hrillasa developed.
(3) PRASARA:-
If the prakopavastha is not treated, the prasara avastha may start. In this stage
Ahara become shuktibhava due to Mandagni and Ajirna. So Annavisha is produced.
This annavisha is mixed with the pitta Dosha. Mixture of Annavisha and pitta Dosha
circulates in whole body with the help of Ahara Rasa and Dhamanis. So, Rasa Dhatu
is also vitiated in this stage. This type of Mixture is called as samapitta which has a
Conceptual Review
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 24
property of Amlarasa. This stage is called as prasaravastha. In this stage main
symptoms are Trishna, jwara and Avipaka.
(4) STHANASANSHRAYA:-
Mixture of Annavisha and pitta Dosha is stayed in Annavaha srotas mainly in
Amashaya. So, the Annavaha srotasa is vitiated. Amlarasa and dravaguna of the pitta
are increased more and more. According to kashayap kapha has also important role
in Amlapitta. This vitiated kapha also staying in pittadhara kala of the Amashaya. So,
in sthanasanshraya avastha, pittadhara kala of the Amashaya is vitiated. In this stage
purvarupa of Amlapitta is produced.
(5) VYAKTI:-
At this stage the symptoms of disease Amlapitta may get well
established and further differentiation in Doshik varieties according to
predominance may be established. The three Doshik predominant subtypes of
Amlapitta mentioned by Acharya Madhavakara i.e. Vatika, Kaphaja and
Vatakaphaja. Madhavakara has also given a separate classification according to the
expulsion root of Doshas i.e. Urdhvaga and Adhoga types.
(6) BHEDA:-
When the disease progresses further it reaches to Bheda avastha. In this stage
various upadravas are manifested such as Jvara, Shotha, Dhatu Ksheenata, Pandu
etc. In this stage pittadhara kala is severely vitiated and the disease is going into
incurable condition.
Conceptual Review
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 25
PITTA PRADHANA TRIDOSHA
PRAKOPA
(Increase in Amla and Drava Guna of
Pitta
MANDAGNI
AMA-ANNAVISHA
INCREASED AMLATA IN AMASHAYA
SHUKTA PAKA
VIDAGDHAPAKA
AMLAPITTA
NIDANA SEVANA
AHARAJ
A
VIHARAJ
AA
MANASIK
A
AGANTUJ
A
Conceptual Review
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 26
CHARAKOKTA SAMPRAPTI BHEDA:
(1) SANKHYA SAMPRAPTI :-
In sankhya samprapti, Sankhya means the Roga Bheda.
A. Two types according to Gati:52 .
1. Urdhvaga Amlapitta
2. Adhoga Amlapitta
B. According to Dosha Dusti:
1. Vataja
2. Pittaja
3. Kaphaja
C. Kashyapa has given three types of Amlapitta53.
1. Vatolvana
2. Pittolvana
3. Kapholvana
D. Madhavkar has given four types according to main and Anubandhaja
Dosha Dusti Lakshana54.
1. Vatadhika
2. Kaphadhika
3. Vatakaphadhika
4. Shlesmapittaja
(2) VIDHI SAMPRAPTI :-
a) Nija b) Agantuja
a) Swatantra b) Paratantra
Conceptual Review
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 27
(3) VIKALPA SAMPRAPTI :-
Vikalpa samprapti means Anshansha kalpana of aggravated dosha
1. Vata - Chala & Rukhsa Guna vriddhi
2. Pitta - Drava, Amla, Usma, tikshana Guna vriddhi
3. Kapha - Guru Guna Vriddhi
(4) PRADHANYA SAMPRAPTI:-
Independence or dependence of the aggravated Dosha
1. Pitta - VriddhatamaKapha - Vriddhatara
2. Vata - Vriddha.
(5) BALA & KALA VISHESHA SAMPRAPTI :-
1. Seasonal aggravation – Varsha, Sharad Ritu.
2. Day – Afternoon
3. Night - Mid-night
Samprapti Ghataka:
The different components producing Amlapitta are as follows:
Dosha Pachaka Pitta, Samana Vayu, Kledaka
Kapha
Dushya Rasa
Agni Agnimandya, Vishamagni
Ama Jatharagnimandyajanya Ama
Udbhava Sthana Amashaya and Pittadharakala
Sanchara Sthana Sarva shareera
Adhisthana Amashaya
Vyakta Sthana Uraha, Kantha, Amashaya etc
Conceptual Review
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 28
Srotas Annavaha, Rasavaha, Raktavaha,
Purishavaha
Srotodushti Sanga and Vimarga gamana
Rogamarga Abhyantara
Roga Prakriti Chirakari
DOSHA:
The causative factor for producing the Amlapitta is Pitta. The Amla Guna and
Drava Guna of Pitta is increased and leads to Agnimandya and Ajirna are produced
and finally leads to Amlapitta. According to Shrikanthadutta, the other Doshas like
Vata and Kapha are also involved and responsible for the development of the
symptoms like Gaurava, Klama etc. Kashyapa has mentioned Kapha and Vata dushti
in Amlapitta. Later he described Pitta and Kapha dominancy in Amlapitta.
DUSHYA:
Even though the involvement of Dushya is not mentioned clearly, all the
Acharyas accepted the process of Vidagdhata and Shuktata of the ingested food. Due
to Ajirna and Annavisha, the Rasadhatu is vitiated and produced symptoms like
Klama, Aruchi, Gaurava etc. Kandu, Mandala, Kotha, and Pandu etc. symptoms are
due to vitiation of the Rakta dushti.
AGNI:
Mandagni is the root cause of all the diseases. Various etiological factors like
Aharaja and Viharaja Hetu affect the Jatharagni leading to Jatharagni mandya which
is said to be the initiator for the pathogenesis Amlapitta.
Conceptual Review
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 29
AMA:
Charaka has mentioned the Annavisha as the causative factor for Amlapitta.
Annavisha can be considered as one type of Amadosha. In Amlapitta, Agni remains
Manda so Ama is formed. The Ama vitiates the Rasadhatu and Pitta Dosha leads to
pathogenesis of the disease.
UDBHAVA STHANA:
Kashyapa said that the disease is produced at the Amashaya. Amlapitta is
created by Annavisha mixing with Pitta dosha. The Annavisha is produced by the
Agnimandya and Ajirna. So Mandagni is the root cause of the disease Amlapitta.
Kashyapa has given an example for explaining the Amlapitta as the vessel containing
some part of curd or uncleaned vessel which contains Amla rasa when milk is added
to it; it turns to curd and becomes Amla.
ADHISHTHANA:
Amashaya (Urdhwa and Adho) is the Adhishthana for Amlapitta in general.
Bhavaprakasha and Madhavakara have given these types of Sthanadushti. Urdhwa
Amashaya is the Adhishthana for Urdhwaga Amlapitta whereas Adho Amashaya is
the Adhishthana for Adhoga Amlapitta.
VYAKTASTHANA:
The cardinal symptoms of Amlapitta are Uraha-Kantha Daha, Tikta
Amlodgara, Shirashoola etc. Hence these can be termed as the Vyakta Sthana of the
disease Amlapitta.
SROTASA:
Due to Mandagni and Ajirna, the Ahara rasa is semi-digested; Annavisha or
Amadosha will be formed so the vitiation of Rasavaha Srotas is involved. The main
seat of the origin of Amlapitta is in the Annavaha Srotas. Chhardi, Avipaka and
Conceptual Review
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 30
Aruchi are the symptoms of Amlapitta and are the cardinal symptoms of Annavaha
Sroto dushti also. Vibandha and Vidbheda are found in these patients, so Purishavaha
Srotas is also vitiated.
SROTODUSHTI LAKSHANA:
The type of Sroto dushti in Amlapitta is Sanga and Vimarga gamana. Sanga
because there will be formation of Ama due to the Vidagdha paka of the Ahara caused
by the Mandagni. Hence the Ama leads to the obstruction to the normal path of the
Pitta and hence the Pitta becomes Urdhwagami in case of Urdhwaga Amlapitta and
leads to the symptoms such as Uraha, Kantha daha, Shirashoola etc.
ROGAMARGA:
The roga marga of the disease amlapitta is abhyantara. All the pathogenesis,
prodromal symptoms are seen mainly in the koshta. Koshta is called as the
abhyantara rogamarga.
PURVARUPA OF AMLAPITTA
The symptoms that arising before the disease known as purvarupa that means
the purvarupas are being appeared before the real manifestation or exhibition of the
disease. The importance of purvarupa is to make accurate diagnosis and to provide
appropriate treatment in early stage. Purvarupa of this disease is not mentioned in any
classical text. While going through the Patient’s history, 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 Ajirnn specially vidagdhajirna may be
appearing before the manifestation of disease these may be considered as purvarupa
of Amlapitta. In charaka samhita while describing the samprapti of Grahani, he has
mentioned some purvarupa of Grahani like Trishna, Alasya, Balakshaya,
Conceptual Review
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 31
Annavidaha, heaviness of body etc. These symptoms may be considered as the
purvarupa of Grahani as well as of Amlapitta.
RUPAS (SYMPTOMS & SIGNS) OF AMLAPITTA.
Rupa is the Vyaktawastha in which the signs and symptoms of the
disease will be completely manifested. This is much more useful for the
clinical manifestation of a disease. Ancient Acharyas have given detailed
discription about the Rupas of Amlapitta. They have also given specific rupas
according to different types of Amlapitta.
The symptoms of Amlapitta according to Madhav Nidana are
- Avipaka
- Klama
- Hriddaha
- Kantadaha
- Amlodgara
- Tiktodgara
- Utklesha
- Gaurava
- Aruchi55.
Acharya Kashyapa added extra symptoms like Vibheda, Aantrakunjana,
Udaradhamana and Hridshula etc.
Conceptual Review
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 32
Table – 4: SAMANYA RUPAS (General Symptoms & Signs).
Sl.No SAMANYA RUPA K.S. M.N B.P Y.R B.S G.N. H.S S.N.
1 Amlodgara(sour
eruction)
- + + + + + + +
2 Tiktodgara(Bitter
eruction)
- + + + + + - -
3 Hrit Daha(Heart
buru)
- + + + + + + +
4 Kantha Daha
(Burning in throat)
+ + + + + + + +
5 Avipaka (Indigestion) - + + + + + - -
6 Klama (Lassitude) - + + + + + - +
7 Utklesha (Nausea) - + + + + + - -
8 Aruchi (Anorexia) - + + + + + - -
9 Gaurava (Heaviness
in body)
- + + + + + - -
10 Shiroruk (Headache) + - - - - - + +
11 Angasada (Fatigue) + - - - - - - -
12 Antrakunjana
(Gargling in intestine)
+ - - - - - - -
13 Vidbheda(Diarrhoea) + - - - - - - -
14 Gurukoshtata + - - - - - - -
15 Romaharsha (Horri + - - - - - - -
Conceptual Review
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 33
Pulation)
16 Hritshula (Pain in
heart region)
+ - - - - - - -
17 Urovidaha
(Burning in chest)
+ - - - - - - -
18 Amlotklesh + - - - - - - -
19 Udaradhmana + - - - - - - -
Table – 5: SYMPTOMS OF EKADOSHAJA AMLAPITTA.
No. K.S. M.N. B.P. Y.R. H.S. S.N.
:: Vatika
Angasada + - - - - -
Jrimbha + - - - - -
Shula + - - - - -
Snigdha Upasaya + - - - - -
:: Paittika
Bharma + - - - - -
Sitaupasaya + - - - - -
Svadupasaya + - - - - -
Vidaha + - - - - -
:: Sleshmika
Chhardi + - - - - -
Guruta + - - - - -
Conceptual Review
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 34
Ruksha Upasaya + - - - - -
Usma Upasaya + - - - - -
:: Vatadhikya Amlapitta
Bhrama - + + + - +
Cimcimatva - + + + - +
Gatra Sada - + + + - +
Harsha - + + + - +
Murccha - + + + + +
Moha - + + + - +
Pralapa - + + + -
Shula - + + + - +
Tamodarshna - + + + - +
:: Kaphadhikya
Amlapitta
Aruchi - + + + - +
Agnimandya - - - - - -
Gaurava - + + + - +
Jadyata - + + + - +
Kandu - - - - - -
Kaphanisthivana - + + + - +
Lepa - + + + - +
Nidra - - - - - -
Sada - + + + - +
Sheeta - + + + - +
Conceptual Review
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 35
Vami - + + + - +
:: Pitta - Sleshma
Amlapitta
Amlodgara - + + + -
Aruchi - + + + - -
Alasya - + + + - -
Bhrama - + + + - -
Chhardi - + + + - -
Hritdaha - + + + - -
Kanthadaha - + + + - -
Kukshidaha - + + + - -
Murchha - + + + - -
Mukha Madhurya - + + + - -
Praseka - + + + - -
Shiroroga - + + + - -
Tikta udgara - + + + - -
(1) AMLA / TIKTA UDGARA:-
The most common symptom of Amlapitta is Amlodgar and Tiktodgara. They
are found due to vitiated pitta Dosha. Prakruta pitta has katu Rasa. But when it
becomes Vidagdha, Katu Rasa is converted in to Amla Rasa. The Amla guna and
Dravaguna of pitta are increased. So Agnimandya and Ajirna are produced. The
Ahara becomes vidagdha in Amashaya and Amla/Tikta udgara are developed.
Conceptual Review
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 36
(2) HRIT - KANTHA DAHA:-
The patients of Amlapitta feels burning sensation in the throat, heart and
abdomen. Sometime whole body, palms and soles are also affected. It is due to
vitiated pitta Dosha.
(3) AVIPAKA:-
Mandagni and Ajirna are the roots of Amlapitta. Charaka said that Annavisha
is produced from Ajirna. It mixed with the pitta Dosha and creates the disease.
Avipaka due to Mandagni is automatically generated during and after completion of
the samprapti of Amlapitta and became a symptom.
(4) KLAMA, ANGASADA & GAURAVA:-
Its mean Fatigue without doing any work, lassitude and heaviness in body.
All these symptoms are present due to Amadosha vriddhi in body.
(5) UTKLESHA:-
Utklesha can be correlated with Nausea. It is generated due to Amadosha and
vitiated Kapha - vata Dosha. Aruchi, Avipaka, & Udgara may have some important
role in Utklesha.
(6) ARUCHI:-
Loss of taste of food and loss of interest of food intake both are considered as
an Aruchi. Sushruta said that Aruchi is a disease which has complete loss of interest in
food due to shoka, krodha, Bhayadi manasika Bhavas and vitiated vatadi Doshas that
staying in Jihva and Hridaya.
(7) GURUKOSHTHATA:-
Heaviness in abdomen is called as a Guru Koshthata. It is due to delayed
gastric emptying. Mandagni in Amlapitta is produced by Avipaka and vitiation of
Conceptual Review
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 37
vatadi Doshas. This Avipaka and Dosha Dushti are responsible for producing this
symptom.
(8) VIDBHEDA:-
Mala Pravrutti vegas are increased but the total quantity of Mala is
maintained as in normal. Amlapitta is created from Ajirna. Vata Dushti and Mandagni
are the main responsible factors for developing vidbheda.
(9) UDARADHMANA :-
It is found in Amashaya or in Pachyamanashya. The pain or discomfort may
be due to the sanchara of vata in particular organs. The excessive production of vayu
is due to Shuktata bhava of undigested food. Fermentation is accured due to Avipaka
or chirakala paka. Excessive production of vayu leads to increase force upon the wall
of Amashaya & Pachyamanashaya.
(10) SHIRORUK:-
Acharya Kashyapa has given this symptom. Mainly it is associated with
Bhrama in Amlapitta patient. Headache is produced due to vitiated pitta and vata
Dosha. Ajirna & Amadosha, which produces vibandha, are also responsible for it.
Most of the patient of Amlapitta have constipation, which may give a role for
producing shiroruk.
(B) According to Sthana Dusti:-
Table – 6: URDHVAGA AMLAPITTA.
Sl.No SYMPTOMS & SIGNS M.N. B.P. Y.R. B.S. G.N. H.S.
1. Kukshidaha (Burning in
abdome)
+ + + + + -
2. Karacharanadaha(Burning in + + + + + -
Conceptual Review
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 38
plam & soul)
3. Kandu (Itching) + + - + + -
4. Pidika (Papules) + + - + + -
5. Mandala (Erythema) + + - + + -
6. Avipaka (Indigestion) + + + - - +
7. Utklesha (Nausea) - - + + - +
8. Klama (Lassitude) + + - + - +
9. Kapha pittaja Jvara (Fever) + + - + + -
10. Mahati Aruchi (Anorexia) + + - + + -
11. Hritdaha (Heart Burn) + + + + + -
12. Kanthadaha(Burning in throat) + + + + + -
13. Abhukte Amlodgara + + + + + -
14. Abhukte Tiktodgara (Bitter
eruction on without food
ingestion)
+ + + + + -
15. Bhukte Vidagdhe Amlodgara
(Sour eruction occurs during
digestive process or after food
intake)
+ + + + + -
16. Bhukte vidagdhe
Tiktodgara(Bitter eruction
occures during digestive
process or after food intake)
+ + + + + -
Conceptual Review
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 39
17. Bhuktevidagdhe
Amlavami(Sour vomiting
occurs during digestive process
or after intake of food)
+ + + + + -
18. Bhukte Vidagdhe Tikta Vami + + + + + -
19. Abhukte Amlavami (Sour
Vomiting on empationy
stomach)
+ + + + + -
20. Abhukte Tikta Vami (Bitter
vomiting on empty stomach)
+ + + + + -
21. Vantam Harita
Varnam(Greenish vomiting)
+ + + + + -
22. Vantam peeta
varnam(Yellowish vomiting)
+ + + + + -
23. Vantam Neela varnam(Bluish
vomiting)
+ + + + + -
24. Vantam Krishna Varnam
(Blackish vomiting)
+ + + + + -
25. Vantam Rakta Varnam
(Reddish vomiting)
+ + + + + -
26. Vantam Raktabha Varnam
(Slight reddish vomiting)
+ + + + + -
27. Atyamla vamanam (Excessive
sour vomiting)
+ - + + + -
Conceptual Review
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 40
28. Mamsodakabham vaman
(Mutton wash like vomiting)
+ - + + - -
29. Ati picchilam vantam
(Excessive sticky vomiting)
+ + + - + -
30. Achham Vantam (Colourless
vomiting)
+ + + - + -
31. Shleshmanuja Vantam
(vomiting associated with
mucous)
+ + + + + -
32. Vantam Lavana rasam (Salty
vomiting)
+ + + + - -
33. Vantam Katurasam (Pungent
vomiting)
+ + + + - -
34. Vantam Tiktarasam (Bitter
vomiting)
+ + + + - -
35. Matsyodakabham vamana - + - - + -
Urdhvaga Amlapitta
Urdhvaga Amlapitta is vamana pradhana, in this type vamana is the
presenting symptom. The vomitus may be of various colors.
Harita & peeta varnayukta chardi may be due to the presence of bile.
Krishna varnayukta chardi is due to occult blood.
Raktabh chardi is due to presence of excessive blood. It suggests, hemorrhage
or perforation in Amashaya.
Conceptual Review
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 41
Amla vamana is due to excessive acid.
When Vitiated pitta Dosha combines with Ama in to the Bahya-Rogamarga,
then it produces kandu, pidika & Mandala.
Urdhvaga Amlapitta tends to affect the Annavaha srotas predominantly.
ADHOGA AMLAPITTA
In Adhoga Amlapitta sthanadushti occurs in the Adhoamashaya &
Pakvashaya. All the symptoms of pittaja Grahani are similar to the Adhoga
Amlapitta.
Table – 7: ADHOGA AMLAPITTA
Sl.No SYMPTOMS & SIGNS M.N. B.P. Y.R. H.S. B.S. G.N.
1. Nanavidha Adhah pravrutti
(fluids eliminated through rectum
in various colors)
+ + + + + +
2. Trushna (Excessive thirst) + + + + + +
3. Daha (Burning) + + + + + +
4. Murccha (Fainting) + + + + + +
5. Bhrama (Giddiness) + + + + + +
6. Moha (Fainting) + + + + + +
7. Analasada (poor digestive power) + + + + + +
8. Hrillasa (Nausea) + + + + + +
9. Sweda(Excessive perspiration) + + + + + +
10. Angapeetata (Yellowsh disease-
coloration of body)
+ + + + + +
Conceptual Review
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 42
Nanavidha Adhah pravrutti is the main clinical feature of Adhoga Amlapitta.
Nanavidha Adhah pravrutti means passing of different types of stool in color, smell,
quantity, quality etc. It is due to vitiated pitta Dosha that creates the Dushti of
pakvashaya & Adhoamashaya. It leads to Dhatukshaya. So patient suffering from
other symptoms like Trushna, Bhrama, Kotha, Moha etc.
UPASHAYANUPASHYA OF AMLAPITTA:-
Those factors which relieve and aggravate the signs and symptoms of the
disease are known as a Upashaya and Anupashaya of the specific disease. The disease
which difficult to diagnose can be diagnosed easily by the upashayanupashaya.
Vataja : Snigdha dravyas relieve the symptoms.
Pittaja : Swadu and Sheeta dravyas relieve the symptoms.
Kaphaja : Ruksha and Ushna dravyas relieve the symptoms56.
UPDRAVAS OF AMLAPITTA5 :-
In the progressive stage, if the Nidana sevana continues, samprapti spreads to
other Adhisthana causing different disease or symptoms other than pertaining to
Amlapitta. Kashyapa has given the upadravas of Amlapitta.
Jwara, Atisara, Pandu, Shula, Shotha, Aruchi, Bhrama, Kshina dhatavaha57.
TABLE NO – 8: UPADRAVAS
Sl.No. UPADRAVAS K.S. S.N.
1. Jvara (fever) + -
2. Atisara (Diarrhoea) + -
3. Pandu (Anemic condition) + -
4. Shotha (Odema) + -
Conceptual Review
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 43
5. Aruchi (Anorexia) + -
6. Vibhrama (Hallucination) + -
7. Kshina dhatvah + -
8. Shita - pitta - +
9. Shoola + -
10. Udarda - +
11. Kotha - +
12. Kandu - +
13. Mandala - +
14. vicharchika - +
15. Visphota - +
16. Amashayakshata - +
17. Grahani Kshata - +
18. Grahani Roga - +
SADHYA - SADHYATA OF AMLAPITTA:-
Acharya Kashyapa has given a reference on sadhya asadhyata of Amlapitta.
Kashypa said that when disease is of short duration then it is Sukhasadhya, it is Yapya
when chronic, when patient suffering from jvara, Atisara, Pandu, Shoola, Bhrama,
Dhatukhseenata etc. Updravas, it is incurable stage57. Amlapitta is a chronic disease it
has complicated pathogenesis. Samprapti vighatana 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 kruchrasadhya.
Madhavakara has pointed out that in case the patient has been suffering from
Amlapitta recently and is treated properly the prognosis is good. Chronic cases may
Conceptual Review
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 44
either improve a little or may be relieved completely during the course of treatment.
As soon as the patient deviates from the wholesome diet the disease relapses58.
TABLE NO: 9 - SAPEKSHA NIDANA
Amlapitta
Vidagdhajirna
Annadrava
shoola
Parinama Shoola
- Tikta Amla
udgara
- Hrit kanta daha
-Upashaya by
madhura/sheeta
dravya
- Sadhuma –
Amla udgara -
Upashaya by
shunti/pippali
churna
- Shoola occurs
before
digestion,
during digestion
and after
digestion. ie.
Jeerna jeeryate
ajeerna va yath
shulam
upajayate.
- Pathyapathya
Prayogena
bhojana
Abhojanena cha
na Shamam
yati.
-shoola occurs only
during
pachyamanavastha
and period of food
intake. i.e. bhukte
jeeryate yat shulam
tadeva
parinamajam.
- Relieves after
digestion of food
or by vomiting.
Conceptual Review
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 45
- Sometimes
feels better due
to vomiting of
vitiated pitta
Associated symptoms
Avipaka Klama
Utklesha Aruchi
Gaurava
Bhrama Trishna
Murcha Ruja
Sweda Daha
Amlodgara Hrit
kanta daha
Chardi may be
present Black
stool present
Amlodgara Hrit
kanta daha Chardi
may be present
Black stool present
Others
Mala pravrutti
may be prakrita/
drava/ vibandha
This is a chronic
disease Chardi
may be present
Chardi may be
present Acute
disease
Prognosis-sukha
sadhya
Chronic
disease
Prognosis
– krichra
sadhya or
yapya
Chronic disease
Prognosis –
krichra sadhya
or yapya
Conceptual Review
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 46
Prognosis-
krichra sadhya
Dosha
Pitta (Amla, Drava guna) Kapha
(Manda, Sheeta Guna) Pitta (Ushna)
Tridoshaja
Pitta predominant
tridosha
Dushya
Rasa, Rakta
Rasa
Rasa
Rasa
Srotas
Annavaha
Rasavaha
Raktavaha and
Purishavaha
Annavaha
Rasavaha
Purishavaha
Annavaha and
Raktavaha
Rasavaha
Purishavaha
Annavaha and
Raktavaha
Sroto dushti
Vimarga gamana
Atipravrutti
Vimarga
gamana
Atipravrutti
Vimarga
gamana
Vimarga gamana
Methodology
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 47
MATERIALS AND METHODS:
SOURCE OF DATA:
Patients attending both OPD and IPD of Jayachamarajendra Institute of
Indian Medicine and Hospital, Bengaluru will be screened for study.
METHODS OF COLLECTION OF DATA:
A minimum of 50 patients who are fulfilling the criteria for diagnosis
and inclusion will be selected for the study randomly irrespective of
sex, religion, educational, professional background and economic
status.
A special case proforma will be prepared with details of history taking,
physical signs and symptoms as mentioned in our classics and allied
science.
The study will be done using a structured questionnaire which will
have the factors covering ahara, vihara, occupation etc.
DIAGNOSTIC CRITERIA
Avipaka(indigestion)
Klama(exhaustion)
Utklesha(nausea)
Tiktaamlaudgara(eructations with bitter eructation)
Hrit-kanthadaha(burning sensation in chest and throat region)
Aruchi(anorexia)
METHODOLOGY
Methodology
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 48
INCLUSION CRITERIA
Patients of either sex of age group above 20yrs and below 60yrs.
Patients with signs and symptoms of Amlapitta.
EXCLUSION CRITERIA
Patient of age less than 20 and above 60 years
Chronicity of more than 5 years
Patients having Annadrava and Parinamashula
Pregnancy
Patients who are underwent surgery for GIT lesions.
Patient having any endocrine disorders or chronic complicated
diseases.
ASSESSMENT CRITERIA
Subjective criteria - Lakshanas of Amlapitta W.S.R to Hyperacidity
AVIPAKA:
No Avipaka 0
Prolongation of food digestion period + 1
occasionally related to heavy meals.
Daily after each meals and four to six hours for + 2
Udgara shuddhi Lakshanas
Eats only once in a day and does not + 3
have hunger by evening.
Methodology
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 49
KLAMA:
No Klama. 0
Occasionally feeling of Klama. + 1
Klama daily for short duration. + 2
Klama Daily for long duration. + 3
UTKLESHA:
No Utklesha 0
Presence of Utklesha with contents coming to the throat + 1
Presence of Utklesha with vomiting + 2
TIKTA-AMLAUDGARA:
No Tikta-Amlaudgara 0
Appears on consumption of Sour and Spicy food + 1
Appears on consumption of any type of food + 2
GAURAVA:
No Gauravata 0
Occasionally feeling of heaviness of the body
which do not affect the routine work. + 1
Daily feeling of heaviness over body,
which leads to Akarmanyata. + 2
HRIT-KANTADAHA:
Not present 0
Present Occasionally + 1
Daha occurs daily for one hour or more. + 2
Methodology
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 50
ARUCHI:
Absent. 0
Totally unwilling for meal. + 1
Unwilling for food but could take the meal. + 2
TAMA
No feeling of Tama 0
Occasional feeling of Tama + 1
Feeling of Tama < 2-3 times a day + 2
Many times a day with problem in Maintaining
posture, tries to sit. + 3
ADHMANA
No Adhmana 0
Occasionally feelings of distension of abdomen + 1
Daily distension of abdomen after intake of food
upto 1 hour + 2
Distension of abdomen up to 1 -3 hours after
intake of food + 3
Moderate distension of abdomen up to 6 hours
after intake of food + 4
Methodology
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 51
TABLE NO: 10 - HYPERACIDITY QUESTIONNAIRE
Symptoms Inensity Frequency
Lack of Appetite 0 -- No Symptoms
1 -- Symptoms noticeable, but not
bothersome
2—Symptoms noticeable and othersome,
but not every day
3 -- Symptoms bothersome every day
4 -- Symptoms affect daily activities
5 -- Symptoms are incapacitating, unable
to do daily activities
0 -- none
1 -- once a year
2 -- less than once a
month
3 – once a month
4 – once a week
5 – several times
during the week
6 – daily
Indigestion
Constipation
Sour Belching
Actual Vomiting
Feeling of restlessness
Stiffness in the stomach
Bloating
Flatulence
Headache
Excessive burping
Observation And Result
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 52
In the present study 50 patients fulfilling the diagnostic and inclusion criteria were
registered.
Table No – 11: - Distribution based on Age
Age Number of
Patients
Percentage %
20-30 yrs 14 28
31-40 yrs 20 40
41-50 yrs 11 22
51-60 yrs 5 10
In the present study maximum number of patients i.e. 40% belonged to the age group
of 31-40 years followed by 28% patients belonged to the age group 20-30 years.
Table No – 12: Distribution based on Gender
Gender Number of
Patients
Percentage %
Male 27 54
Female 23 46
The sample taken for the study shows 54% of the patients were males in comparison
to 46% of the females
OBSERVATION
Observation And Result
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 53
Table No – 13: Distribution based on Religion
Religion Number of
Patients
Percentage %
Hindu 39 78
Muslim 8 16
Christian 3 6
The sample taken for the study shows 78% of the patients were Hindu, 16% of the
patients were Muslim, 6% were Christians.
Table No – 14: Distribution based on Education
Education Number of
Patients
Percentage %
Illiterate 6 12
High School 5 10
PUC 6 12
Graduate 13 26
Post graduate 20 40
This study shows that maximum number of patients i.e. 40% were Post graduates,
26% were Graduates, 12% were Illiterate.
Observation And Result
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 54
Table No : 15 - Distribution based on Occupation
Occupation Number of
Patients
Percentage %
House wife 7 14
Service 25 50
Business 12 24
Student 6 12
This study shows that maximum number of patients i.e. 50% belonged to Service,
followed by 24% belonged to Business, 14% were House wife and 12% were
Students.
Table No: 16 - Distribution based on Socio-economic status
Socio-economic
status
Number of
Patients
Percentage %
Poor 6 12
Lower Middle 10 20
Upper middle 21 42
Rich 13 26
This study shows that maximum number of patients i.e. 42% belonged to Upper
Middle class, 26% belonged to Rich 20% belonged to Lower Middle and 12% were
Poor
.
Observation And Result
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 55
Table No: 17 - Distribution based on Habitat
Habitate Number of
Patients
Percentage %
Urban 30 60
Rural 20 40
This study shows that maximum number of patients i.e. 60% belonged to Urban followed by
40% belonged to Rural area.
Table No: 18 - Distribution based on Marital Status
Marital status Number of
Patients
Percentage %
Married 36 72
Unmarried 14 28
This study shows that maximum number of patients i.e.72 % were married and 28% were
unmarried.s
Table No: 19 - Distribution based on Desha
Desha Number of
Patients
Percentage %
Anupa
12 24
Sadarana
32 64
Jangala
6 12
Observation And Result
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 56
This study shows that maximum number of patients i.e. 64% belonged to
Sadaranadesha followed by 24% belonged to Anupadesha and 12% belonged to
Jangaladesha.
Table No: 20 - Distribution based on Prakriti
Prakriti Number of
Patients
Percentage %
Vatapitta
30 60
Pittakapha
8 16
Vatakapha
12 24
This study shows that maximum number of patients i.e. 60% belonged to
Vatapittaprakriti, followed by 24% of patients belonged to Vatakaphaprakriti and
16% of patients belonged to Pittakaphaprakriti
Table No: 21 - Distribution based on Diet Pattern
Diet Number of
Patients
Percentage %
Mixed
33 66
Vegetarian
17 34
In this study majority of the patients i.e. 66% were consuming mixed diet in
comparison to the patients i.e. 34% consuming vegetarian diet.
Observation And Result
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 57
Table No: 22 - Distribution based on Pattern of Food Intake
Pattern of
food
Number of
Patients
Percentage %
Adhyashana
11 22
Vishamashana
13 26
None
26 52
Majority of the patient’s i.e.52% were taking food regularly, followed by 26% of
patients with Vishamashana and 22% of patients with Adhyashana.
Table No: 23 - Distribution based on Appetite
Appetite Number of
Patients
Percentage %
Not Altered
21 41
Reduced
29 56
In the present study maximum number of patients i.e. 56% had reduced appetite and
41% of the patients appetite was not altered.
Table No: 24 - Distribution based on Bowel
Bowel Number of
Patients
Percentage %
Prakruta Mala 20 40
Drava Mala 3 6
Baddha Mala 27 54
Observation And Result
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 58
In this study maximum number of patients i.e. 54% had Baddha mala pravrutti, 6% of
patients had Drava mala pravrutti and 40% of patients had prakruta mala pravrutti.
Table No: 25 - Distribution based on Koshta
Koshta Number of
Patients
Percentage %
Mridu
6 12
Madhyama
31 62
Krura
12 24
Above table shows that maximum number of patients i.e.62% had Madhyamakoshta,
followed by 24% of patients had Krurakoshta and 12% of patients had Mridukoshta.
Table No: 26 - Distribution based on Tea Intake
Tea Intake Number of
Patients
Percentage %
1-3 times/day
14 28
4-6 times/day 2 4
6-8 times/day 1 2
Among 34% of patients consuming Tea, 28% of patients were consuming 1-3
times/day, 4% of patients were consuming 4-6 times/day and 2% of patients were
consuming 6-8% times/day
Observation And Result
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 59
Table No: 27 - Distribution based on Coffee Intake
Coffee Number of
Patients
Percentage %
1-3 times/day
24 48
4-5 times/day 6 12
6-7 times/day 3 6
Among 66% of patients consuming Coffee, 48% of patients were consuming 1-3
times/day, 12% of patients were consuming 4-5 times/day and 6% of patients were
consuming 6-7 times/day.
Table No: 28 - Distribution based on Smoking
Smoking Number of
Patients
Percentage %
1-5 times/day 9 18
6-10 times/day 4 8
15-20 times/day 2 4
21-25 times/day 1 2
25-30 times/day 2 4
Among 36% of patients Smoking, maximum number of patients i.e. 18% were
Smoking 1-5 times/day, 8% were smoking 6-10 times/day, followed by 4% 15-20
times and 25 -30 times/day.
Observation And Result
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 60
Table: 29 - Distribution based on Tobacco Chewing
Tobacco Number of
Patients
Percentage %
1-2
Packets/day
7 14
In this study 14% of patients were chewing Tobacco.
Table No: 30 - Distribution based on Alcohol
Alcohol Number of
Patients
Percentage %
Daily 6 12
Frequently 14 28
Sometimes 3 6
Occasionally 4 8
Among 54% of patients consuming alcohol, maximum number of patients i.e. 28%
were consuming frequently, 12% were consuming daily, 6% were taking sometimes
and 8% occasionally.
Table No: 31 - Distribution based on Sleep
Sleep Number of
Patients
Percentage %
Sound 19 38
Disturbed 31 62
Observation And Result
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 61
In this study maximum number of patients i.e. 62% had Disturbed sleep and 38% of
patients had sound sleep pattern.
Table No: 32 - Distribution based on Heated Honey
Heated honey Number of
Patients
Percentage %
Frequently 4 8
Occasionally 2 4
Among 12% of patients consuming heated honey, 8% of patients were taking
frequently and 4% of patient was taking occasionally
Table No: 33 - Distribution based on Curd at Night
Curd at night Number of
Patients
Percentage %
Daily 5 10
Frequently 11 22
Sometimes 3 6
Occasionally 5 10
Among 48% of patients consuming curd at night, maximum number of patients i.e.
22% were consuming frequently. Followed by 10% of patients were consuming daily
and 6% sometimes.
Observation And Result
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 62
Table No: 34 - Distribution based on Consuming cold water
immediately after taking hot tea or coffee
Consuming cold water
immediately after taking
hot tea or coffee
Number of
Patients
Percentage
%
Daily 4 8
Sometimes 3 6
In this study 6% of patients were consuming cold water immediately after
taking hot tea or coffee sometimes and 8% daily.
Table No: 35 - Distribution based on Sour fruits with milk
Fruits with
milk
Number of
Patients
Percentage %
Frequently 6 12
Sometimes 3 6
In this study 12% of patients were taking sour fruits with milk frequently and
6% were taking sometimes.
Table No: 36 - Distribution based on Milk with curd
Milk with
curd
Number of
Patients
Percentage %
Frequently 2 4
Sometimes 3 6
Observation And Result
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 63
In this study 6% of patients were taking milk with curd sometimes and 4% of
patients were taking frequently.
Table No: 37 - Distribution based on Unformed curd
Unformed
curd
Number of
Patients
Percentage %
Sometimes 1 2
Among 50 patients only 1 patient was consuming unformed curd sometimes
Table No: 38 - Distribution based on Amlatakra
Amlatakra Number of
Patients
Percentage %
Daily 5 10
Frequently 23 46
Sometimes 6 12
Occasionally 16 32
Maximum number of patients i.e. 46% were consuming frequently followed
by 32% occasionally.
Observation And Result
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 64
Table No: 39 - Distribution based on Curd
Curd Number of
Patients
Percentage %
Daily 10 20
Frequently 21 42
Sometimes 12 24
Occasionally 7 14
Maximum number of patients i.e. 42% were consuming curd frequently
followed by 24% were consuming sometimes and 20% daily.
Table No: 40 - Distribution based on Sugar Cane Juice
Sugar cane
juice
Number of
Patients
Percentage %
Frequently 3 6
Occasionally 8 16
Among 22% of patients consuming sugarcane juice, maximum number of
patients i.e. 16% were consuming occasionally followed by 6% frequently
Observation And Result
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 65
Table No: 41 - Distribution based on Pepper
Pepper Number of
Patients
Percentage %
Daily 1 2
Frequently 9 18
Sometimes 11 22
Occasionally 19 38
Among 80 % of patients consuming pepper, maximum number of patients i.e. 38%
were consuming occasionally followed by 22% were consuming sometimes.
Table No: 42 - Distribution based on Unripe And Sour Mango
Unripe and
sour mango
Number of
Patients
Percentage %
Frequently 1 2
Sometimes 3 6
Occasionally 7 14
Among 22% of patients consuming unripe and sour mango, maximum number of
patients i.e. 14% were consuming occasionally followed by 6% sometimes.
Observation And Result
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 66
Table No: 43 - Distribution based on Sour Mosambi
Sour Mosambi Number of
Patients
Percentage %
Frequently 6 12
Sometimes 16 32
Occasionally 3 6
Among 50% of patients consuming sour mosambi, maximum number of patients i.e.
32% were consuming sometimes followed by 12% were consuming frequently and
6% were consuming occasionally.
Table No: 44 - Distribution based on Sour Orange
Among 44% of patients consuming sour orange, maximum number of patients i.e.
22% were consuming sometimes followed by 14% were consuming occasionally.
Sour Orange Number of
Patients
Percentage %
Frequently 4 8
Sometimes 11 22
Occasionally 7 14
Observation And Result
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 67
Table No: 45 - Distribution based on Citrus Lemon
Among 94% of patients consuming citrus lemon, maximum number of patients i.e.
42% were consuming occasionally followed by 38% were consuming sometimes.
Table No: 46 - Distribution based on Sesame
In this study 14% of patients were consuming sesame occasionally.
Table No: 47 - Distribution based on Puffed Rice
Citrus Lemon Number of
Patients
Percentage %
Daily 2 4
Frequently 5 10
Sometimes 19 38
Occasionally 21 42
Sesame Number of
Patients
Percentage %
Occasionally 7 14
Puffed rice Number of
Patients
Percentage %
Daily 1 2
Frequently 4 8
Sometimes 17 34
Occasionally 6 12
Observation And Result
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 68
Among 56% of patients consuming puffed rice, maximum number of patients i.e.
34% were consuming sometimes followed by 12% were consuming occasionally.
Table No: 48 - Distribution based on Battened Rice
Among 62% of patients consuming battened rice, maximum number of patients i.e.
32% were consuming sometimes followed by 26% were consuming frequently.
Table No: 49 - Distribution based on Black Gram
Battened rice Number of
Patients
Percentage %
Frequently 13 26
Sometimes 16 32
Occasionally 2 4
Black gram Number of
Patients
Percentage %
Daily 1 2
Frequently 32 64
Sometimes 9 18
Occasionally 5 10
Observation And Result
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 69
Among 94% of patients consuming black gram, maximum number of patients i.e.
64% were consuming frequently, followed by 18% were consuming sometimes and
10% occasionally.
Table No: 50 - Distribution based on Horse Gram
Among 84% of patients consuming horse gram, maximum number of patients i.e.
46% were consuming sometimes followed by 28% were consuming frequently.
Table No: 51 - Distribution based on Chicken
Among 70% of patients consuming chicken, maximum number of patients i.e. 48%
were consuming frequently followed by 18% were consuming sometimes.
Horse gram Number of
Patients
Percentage %
Frequently 14 28
Sometimes 23 46
Occasionally 5 10
Chicken Number of
Patients
Percentage %
Daily 1 2
Frequently 24 48
Sometimes 9 18
Occasionally 1 2
Observation And Result
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 70
Table No: 52 - Distribution based on Fish
Among 48% of patients consuming fish, maximum number of patients i.e. 26% were
consuming frequently followed by 12% were consuming sometimes.
Table No: 53 - Distribution based on Pork
Among 16% of patients consuming pork, 10% of patients were consuming frequently
followed by 4% were consuming sometimes and 2% occasionally.
Fish Number of
Patients
Percentage %
Daily 1 2
Frequently 13 26
Sometimes 6 12
Occasionally 4 8
Pork Number of
Patients
Percentage %
Frequently 5 10
Sometimes 2 4
Occasionally 1 2
Observation And Result
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 71
Table No:54 - Distribution based on Avimamsa
Among 48% of patients consuming avimamsa, maximum number of patients i.e. 22%
were consuming frequently followed by 14% were consuming sometimes.
Table No: 55 - Distribution based on Ajamamsa
Among 76% of patients consuming ajamamsa, maximum number of patients i.e. 44%
were consuming frequently followed by 26% were consuming sometimes.
Avimamsa Number of
Patients
Percentage %
Daily 3 6
Frequently 11 22
Sometimes 7 14
Occasionally 3 6
Ajamamsa Number of
Patients
Percentage %
Frequently 22 44
Sometimes 13 26
Occasionally 3 6
Observation And Result
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 72
Table No: 56 - Distribution based on Atilavana
Among 60% of patients consuming atilavanaahara, maximum number of patients i.e.
48% were consuming daily followed by 12% frequently.
Table No: 57 - Distribution based on Atikatu
Among 74% of patients consuming atikatuahara, maximum number of patients i.e.
60% were consuming daily followed by 12% frequently.
Atilavana Number of
Patients
Percentage %
Daily 24 48
Frequently 6 12
Atikatu Number of
Patients
Percentage %
Daily 30 60
Frequently 6 12
Sometimes 1 2
Observation And Result
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 73
Table No: 58 - Distribution based on Atiamla
Among 44% of patients consuming atiamlaahara, maximum number of patients i.e.
38% were consuming daily followed by 2% were consuming frequently.
Table No: 59 - Distribution based on Deep Fried
In this study maximum number of patients i.e. 46% were consuming frequently
followed by 30% were consuming sometimes.
Atiamla Number of
Patients
Percentage %
Daily 19 38
Frequently 1 2
Sometimes 1 2
Occasionally 1 2
Deep Fried Number of
Patients
Percentage %
Daily 2 4
Frequent 23 46
Sometimes 15 30
Occasionally 10 20
Observation And Result
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 74
Table No: 60 - Distribution based on Stale Food
Among 48% of patients consuming stale food, maximum number of patients i.e. 22%
were consuming frequently and 18% occasionally.
Table No: 61 - Distribution based on Viharaja Nidana
In this study 10% of patients were doing vegadharana, 54% of patients were sleeping
soon after food, 24% of patients were doing divaswapna and 8% of patients were
doing excess fasting.
Stale food Number of
Patients
Percentage %
Daily 3 6
Frequently 11 22
Sometimes 1 2
Occasionally 9 18
Vihara Number of
Patients
Percentage %
Vegadharana 5 10
Sleeping soon after
food intake
27 54
divasswapna 12 24
Excess fasting 4 8
Observation And Result
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 75
Table No: 62 - Distribution based on Haritakashaka
Among 92% of patients consuming haritakashaka, maximum number of patients i.e.
40% were consuming frequently followed by 26% sometimes.
Table No: 63 - Distribution based on Beetle Leaf
Among 24% of patients consuming beetle leaf, maximum number of patients i.e.10%
were consuming occasionally, 6% were consuming frequently and 4% Daily.
Haritakashaka Number of
Patients
Percentage %
Daily 5 10
Frequently 20 40
Sometimes 13 26
Occasionally 8 16
Beetle leaf Number of
Patients
Percentage %
Daily 2 4
Frequently 3 6
Sometimes 2 4
Occasionally 5 10
Observation And Result
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 76
Table No: 64 - Distribution based on Atiudakapana/ Antarodakapana
In this study 72% of patients were drinking more water in between the food,
maximum number of patients i.e. 60% were drinking daily and 12% sometimes.
Table No: 65 - Distribution based on Manasika Nidana
In this study 44% of patients had Excess Anger, 24% of patients had Excess Grief and
12% of patients had Excess Fear.
Atiudakapana Number of
Patients
Percentage %
Daily 30 60
Sometimes 6 12
ManasikaNidana Number of
Patients
Percentage %
Excess Anger 22 44
Excess Grief 12 24
Excess Fear 6 12
Observation And Result
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 77
Table No: 66 - Distribution based on Lakshanas
The data of the present series reveals that 76% of patients had Amlodgara, 74% of
patients had Hritdaha, 60% of patients had Klama, 60% of patients had Utklesha, 72%
of patients had Avipaka, 18% of patients had Tiktaudgara, 28% of patients had
Aruchi, 14% of patients had Kantadaha, and 20% of patients had Gourava.
Lakshanas Number of
Patients
Percentage %
Avipaka 36 72
Klama 30 60
Utklesha 30 60
Tiktaudgara 19 18
Amlaudgara 38 76
Gourava 10 20
Hritdaha 37 74
Kantadaha 7 14
Aruchi 14 28
Observation And Result
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 78
Table No: 67 - Distribution based on Hyperacidity Questionnaire
In this study 28% of patients had Lack of appetite, 72% of patients had Indigestion,
52% of patients had Constipation, 76% of patients had Sour belching, 22% of patients
had Actual vomiting, 60% of patients had Feeling of restlessness, 52% of patients had
Bloating, 48% of patients had Flatulence, 28% of patients had Headache, 60% of
patients had Excessive Burping.
Symptoms Number of
Patients
Percentage %
Lack of Appetite 14 28
Indigestion 36 72
Constipation 26 52
Sour Belching 38 76
Actual Vomiting 11 22
Feeling of restlessness 30 60
Bloating 26 52
Flatulence 24 48
Headache 14 28
Excessive burping 30 60
Observation And Result
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 79
GRAPH NO.1- DISTRIBUTION OF PATIENTS BASED ON AGE
GRAPH NO.2- DISTRIBUTION OF PATIENTS BASED ON GENDER
GRAPH NO. 3- DISTRIBUTION OF PATIENTS BASED ON RELIGION
0
5
10
15
20
20-30yrs
31-40yrs
41-50yrs
51-60yrs
1420
115
AGEWISE DISTRIBUTION
Number ofPatients
20
22
24
26
28
Male Female
27 23
GENDER WISE DISTRIBUTION
Number ofPatients
39
8
3
RELIGION WISEDISTRIBUTION
Hindu
Muslim
Christian
Observation And Result
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 80
GRAPH NO.4- DISTRIBUTION OF PATIENTS BASED ON EDUCATION
GRAPH NO.5- DISTRIBUTION OF PATIENTS BASED ON OCCUPATION
GRAPH NO.6- DISTRIBUTION OF PATIENTS BASED ON SOCIO
ECONOMIC STATUS
0
5
10
15
20
6 5 6
13
20
EDUCATION
Number ofPatients
7
25
12
6
OCCUPATION WISE DISTRIBUTION
House wife
Service
Business
Student
6
10
21
13
SOCIO-ECONOMIC STATUS
Poor
Lower Middle
Upper middle
Rich
Observation And Result
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 81
GRAPH NO.7- DISTRIBUTION OF PATIENTS BASED ON OCCUPATION
GRAPH NO.8- DISTRIBUTION OF PATIENTS BASED ON MARITAL
STATUS
GRAPH NO.9- DISTRIBUTION OF PATIENTS BASED ON DESHA
3020
HABITAT
Urban
Rural
36
14
MARITAL STATUS
Married
Unmarried
0
10
20
30
40
12
32
6
DESHA
Number ofPatients
Observation And Result
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 82
GRAPH NO.10- DISTRIBUTION OF PATIENTS BASED ON PRAKRUTI
GRAPH NO.11- DISTRIBUTION OF PATIENTS BASED ON DIET
GRAPH NO.12- DISTRIBUTION OF PATIENTS BASED ON PATTERN OF
FOOD INTAKE
0
10
20
30
30
8 12
PRAKRUTI
Number ofPatients
0
20
40
Mixed Vegetarian
33 17
DIET
Number ofPatients
0
20
40
11 1326
PATTERN OF FOOD INTAKE
Number ofPatients
Observation And Result
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 83
GRAPH NO.13- DISTRIBUTION OF PATIENTS BASED ON APPETITE
GRAPH NO.14- DISTRIBUTION OF PATIENTS BASED ON BOWEL
GRAPH NO.15- DISTRIBUTION OF PATIENTS BASED ON KOSHTA
0
10
20
30
Not Altered Reduced
2129
APPETITE
Number ofPatients
0
10
20
30
PrakrutaMala
BaddhaMala
Dravamala
2027
3
BOWEL
Number ofPatients
6
31
12
KOSHTA
Mridu
Madyama
Krura
Observation And Result
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 84
GRAPH NO.16- DISTRIBUTION OF PATIENTS BASED ON TEA INTAKE
GRAPH NO.17- DISTRIBUTION OF PATIENTS BASED ON COFFEE
CONSUMPTION
GRAPH NO.18- DISTRIBUTION OF PATIENTS BASED ON SMOKING
14
21
TEA INTAKE
1-3 times/day
4-6 times/day
6-8 times/day
0
5
10
15
20
25
1-3times/day
4-5times/day
6-7times/day
24
63
COFFEE INTAKE
Number ofpatients
9
4
21
2
SMOKING
1-5 times/day
6-10 times/day
15-20 times/day
21-25 times/day
25-30 times/day
Observation And Result
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 85
GRAPH NO.19- DISTRIBUTION OF PATIENTS BASED ON SLEEP
GRAPH NO.20- DISTRIBUTION OF PATIENTS BASED ON HEATED
HONEY
GRAPH NO.21- DISTRIBUTION OF PATIENTS BASED ON CURD AT
NIGHT
0
20
40
Anupa Sadarana
1232
SLEEP
Number ofPatients
4
2
HEATED HONEY
Frequently
Occasionally
5
11
3
5
CURD AT NIGHT
Daily
Frequently
Sometimes
Occasionally
Observation And Result
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 86
GRAPH NO.22- DISTRIBUTION OF PATIENTS BASED ON
CONSUMING COLD WATER IMMEDIATELY AFTER TAKING
HOT TEA OR COFFEE
GRAPH NO.23- DISTRIBUTION OF PATIENTS BASED ON SOUR
FRUITS WITH MILK
GRAPH NO.24- DISTRIBUTION OF PATIENTS BASED ON MILK
WITH CURD
43
Consuming cold water immediately
after
taking hot tea or coffee
Daily
Sometimes
0
2
4
6
FrequentlySometimes
6
3
SOUR FRUITS WITH MILK
Number ofpatient
2
3
MILK WITH CURD
Frequently
Sometimes
Observation And Result
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 87
GRAPH NO.25- DISTRIBUTION OF PATIENTS BASED ON AMLA
TAKRA
GRAPH NO.26- DISTRIBUTION OF PATIENTS BASED ON CURD
GRAPH NO.27- DISTRIBUTION OF PATIENTS BASED ON
SUGAR CANE JUICE
05
10152025
5
23
616
AMLA TAKRA
Number ofpatients
0
5
10
15
20
25
10
21
127
CURD
Number ofPatients
0
5
10
Frequently Occasionally
38
SUGARCANE JUICE
Number ofPatients
Observation And Result
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 88
GRAPH NO.28- DISTRIBUTION OF PATIENTS BASED ON UNRIPE
AND SOUR MANGO
GRAPH NO.29- DISTRIBUTION OF PATIENTS BASED ON SOUR
MOSAMBI
GRAPH NO.30- DISTRIBUTION OF PATIENTS BASED ON
SOUR ORANGE
02468
13
7
UNRIPE AND SOUR MANGO
Number ofpatients
05
101520
616
3
SOUR MOSAMBI
Number of Patients
02468
1012
4
117
SOUR ORANGE
Number of Patients
Observation And Result
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 89
GRAPH NO.31- DISTRIBUTION OF PATIENTS BASED ON
CITRUS LEMON
GRAPH NO.32- DISTRIBUTION OF PATIENTS BASED ON PUFFED
RICE
GRAPH NO.33 - DISTRIBUTION OF PATIENTS BASED ON
BATTENED RICE
05
10152025
25
19 21
CITRUS LEMON
Number of patients
05
101520
14
176
PUFFED RICE
Number of Patients
0
5
10
15
20
13 16
2
BATTENED RICE
Number of patients
Observation And Result
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 90
GRAPH NO.34- DISTRIBUTION OF PATIENTS BASED ON BLACK
GRAM
GRAPH NO.35- DISTRIBUTION OF PATIENTS BASED ON HORSE
GRAM
GRAPH NO.36- DISTRIBUTION OF PATIENTS BASED ON
CHICKEN
0
10
20
30
40
1
32
95
BLACK GRAM
Number ofpatients
0
20
40
1423
5
HORSE GRAM
Number ofPatients
05
10152025
1
24
9
1
CHICKEN
Number ofpatients
Observation And Result
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 91
GRAPH NO.37- DISTRIBUTION OF PATIENTS BASED ON
FISH
GRAPH NO.38- DISTRIBUTION OF PATIENTS BASED ON PORK
GRAPH NO.39- DISTRIBUTION OF PATIENTS BASED ON
AVIMAMSA
0
5
10
15
1
13
64
FISH
Number of patients
52
1
PORK
Frequently
Sometimes
Occasionally
02468
1012
3
117
3
AVIMAMSA
Number ofpatients
Observation And Result
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 92
GRAPH NO.40- DISTRIBUTION OF PATIENTS BASED ON AJAMAMSA
GRAPH NO.41- DISTRIBUTION OF PATIENTS BASED ON ATILAVANA
GRAPH NO.42- DISTRIBUTION OF PATIENTS BASED ON ATIKATU
05
10152025
2213
3
AJAMAMSA
Number ofpatients
0
5
10
15
20
25
Daily Frequently
24
6
ATILAVANA
Number ofpatients
0
10
20
30
Daily Frequently Sometimes
30
6
1
ATIKATU
Number of patients
Observation And Result
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 93
GRAPH NO.43- DISTRIBUTION OF PATIENTS BASED ON ATIAMLA
GRAPH NO.44- DISTRIBUTION OF PATIENTS BASED ON DEEP
FRIED FOODS
GRAPH NO.45- DISTRIBUTION OF PATIENTS BASED ON STALE
FOODS
0
20
19
1 1 1
ATIAMLA
Number ofpatients
05
10152025
223
15 10
DEEP FRIED FOODS
Number ofpatients
02468
1012
3
11
1
9
STALE FOOD
Number ofpatients
Observation And Result
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 94
GRAPH NO.46- DISTRIBUTION OF PATIENTS BASED ON
VIHARAJA NIDANA
GRAPH NO.47- DISTRIBUTION OF PATIENTS BASED ON
MANASIKA NIDANA
GRAPH NO.48- DISTRIBUTION OF PATIENTS BASED ON
HARITAKA SHAKA
0
20
40
527
12 4
VIHARAJA NIDANA
Number ofpatients
2212
6
MANASIKA NIDANA
Excess Anger
Excess Grief
Excess Fear
05
101520
5
2013
8
HARITAKA SHAKA
Number ofpatients
Observation And Result
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 95
GRAPH NO.49- DISTRIBUTION OF PATIENTS BASED ON BEETLE
LEAF
GRAPH NO.50- DISTRIBUTION OF PATIENTS BASED ON
ATIUDAKAPANA
GRAPH NO.51- DISTRIBUTION OF PATIENTS BASED ON
LAKSHANAS
012345
BEETLE LEAF
Number ofpatients
0
1
2
3
Daily Frequently
23
ATIUDAKAPANA
Number ofpatients
36
30
30
1938
10
37
7 14
LAKSHANAS
Avipaka
Klama
Utklesha
Tiktaudgara
Amlaudgara
Gourava
Observation And Result
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 96
GRAPH NO.52- DISTRIBUTION OF PATIENTS BASED ON
HYPERACIDITY SYMPTOMS
GRAPH NO.53- DISTRIBUTION OF PATIENTS BASED ALCOHOL
Results
In this study majority of the patients registered were between the age group of
31-40 years indulged in mixed diet. curd, sour butter milk, lemon, pepper,
horse gram, black gram, chicken, fish, flesh of goat and sheep, excess salt,
spicy, deep fried food, drinking more water in between the food, sleeping soon
after taking the food, Atikrodha, alcohol, coffee intake play a significant role
in causation of the disease Amlapitta.
14 36
26
381130
26
24
14 30
HYPERACIDITY SYMPTOMS
Lack of Appetite
Indigestion
Constipation
Sour Belching
Actual Vomiting
Feelingof restlessness
Bloating
Flatulence
012345
2 3 2
5
ALCOHOL
Number ofpatients
DISCUSSION
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 97
Any research work without discussion about its nature, utility and importance
is said to be incomplete. Any hypothesis/ principle, if to be proved, must be discussed
from all angles. Discussion is the churning process done to obtain a reasonable and
logical conclusion. Discussion with the Shastra, becomes the base for establishment
of the concept.
Today’s life style is completely changed by all means. Our diet pattern, life
style and behavioral pattern is changed and it is not suitable for our normal
physiology of digestion of body. We had developed western culture, which is more
harmful to us. We adopted their diets, behavioral pattern and this is the reason for
most of the diseases. Especially gastric disorders. Diet which is against Ashtavidha
Ahara Vidhi Vishesayatana, dietetic code and conduct are mostly responsible for most
of the disease. It seems that our old pattern of diet and behavior was up to mark for
nourishing and carrying physiological processes.
The Annavaha srotas is the one that bears a direct impact of all the dietetic
errors that a person indulges. Improperly chewed or hurriedly gulped rough and hard
portions of food are not properly digested. Many a times the simple Agnimandya leads
to Vidagdhajirna (dyspepsia) in the initial stages and if it is neglected, leads to
Amlapitta. This is caused by Jivha-Laulya as patients are aware of the Nidanas and
still he tries to consume it due to Jivha–Laulya. Amlapitta is not a disorder caused
only by the irregular diet and activities, but also as a result of psychological
problems.
DISCUSSION
DISCUSSION
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 98
DISCUSSION ON ROOPA:
1. Hrit-Kanta daha:
In this study 74% of patients had Hritdaha, 14% of patients had Kanta daha.
Due to increased amlodgara, the Annavaha srotas and Kanta will be affected by the
ushna,teekshna and amla guna of pitta. It leads to Lekhana of mucous membrane and
causes erosions of the surface. Hence patient may suffer from Hrit- Kanta daha.
2. Avipaka:
In this study 72% of patient had avipaka. If the person indulges in faulty
dietary habits and activities pitta pradhana tridosha vitiates. Drava guna of vitiated
pitta dosha causes agnimandya there by hindering the normal digestion process which
leads avipaka.
3. Gouravata:
In this study 20% of patients had gouravata. Due to agnimandya ahara is not
digested properly and ama formation occurs. Because of this ama patient may feel
gouravata.
4. Amlodgara:
In this study 76% of patients had Amlodgara,Due to mandagni ingested food
becomes vidagdha and shuktibhava. This Vidagdha & shuktbhava of food create
Amlata in Amashaya. Hence patient may have amlodgara.
DISCUSSION ON OBSERVATION:
AGE:
Majority of patients were belonging to the age group 31-40 years. This
indicates that middle aged patients are affected by the disease more, which is pitta
predominant period and as well as during this period people have more attraction
DISCUSSION
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 99
towards the junk foods, faulty dietary habits like excessive intake of pungent, spicy
food, irregular meals pattern and habits like smoking, alcohol, psychological stress.
SEX:
Among 50 patients 54% were male. This may be due to increased
occupational stress and strain, consumption of outside food. It may also be because of
most of the men are exposed to the habit of smoking, tobacco chewing and alcoholism
OCCUPATION:
As per the occupational wise distribution, 50% of patients belong to service
this may be due to their irregular and faulty dietary habits, disturbed sleep, stress and
strain with their service which might have lead to more incidence of the disease.
Second higher percentage in the occupation wise distribution i.e. about 24% were
business man which may be due to sedentary lifestyle, excessive indulgence in coffee
/tea intake, tobacco chewing, smoking, stress etc.
SOCIOECONOMIC STATUS:
As per the socioeconomic status middle class people i.e. 42% were seen
suffering more with this disease, may be because of the stress induced by the struggle
to become rich and to lead luxurious life.
EDUCATIONAL STATUS:
In this study 88% patients were educated. This incidence is maximum in
educated people due to hurried and worried life, irregular diet habit etc.
HABITAT:
Maximum number of patients i.e 60% were belonging to urban area. This is
because of changing lifestyle along with changing food culture.
DISCUSSION
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 100
MARITAL STATUS:
Majority of the patients i.e. 72% were married. Family involved patients were
under stress due to various reasons.
DESHA:
Majority of the patients i.e. 56% were belonging to the Sadharana desha.
DIET PATTERN:
Mixed diet pattern was observed in 66% of the patients. Non vegetarian food
is spicy, oily, heavy for digestion which leads to Amlapitta.
PATTERN OF FOOD INTAKE:
26% of the patients were doing Vishamashana, 22% of the patients were doing
Adhyashana. This is responsible for vitiation of dosha which leads to agnidushti and
ultimately causes the disease Amlapitta.
APPETITE:
Reduced appetite is found in majority of the patients i.e. 56%. This is because
drava guna of vitiated pitta dosha leads to agnimandya in the Amlapitta patients.
BOWEL HABITS:
As per the bowel movement maximum number of patients i.e.54% of patients
had constipation.
SLEEP:
It was found that maximum number of the individuals were having disturbed
sleep i.e.62% which also hinders proper digestion. When digestion is hindered the
food attains shuktapaka leading to amlapitta.
DISCUSSION
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 101
CURD:
20% of patients took daily, 42% of patients took frequently, 24% of patients
took sometimes and 14% of patients took occasionally. Dadhi is Guru, Abhishyandi,
Ushnaveerya, Amlavipaki, Shleshmapittakara.
AMLATAKR
10% of patients took daily, 46% of patients took frequently, 12% of patients
took sometimes and 32% of patients took occasionally. Amlatakra is Pittakara which
is responsible for the manifestation of Amlapitta.
TOBACCO CHEWING:
14% of patients were chewing Tobacco. Tobacco is having Ushna, Tikshna
and Vyavayigunas which causes and aggravates Amlapitta.
CITRUS LEMON:
Among 94% of patients consuming citrus lemon, 4% of patients took daily,
10% of patients took frequently, 38% of patients took sometimes and 42% of patients
took occasionally. Nimbuka is Amlarasayukta, Pittakara.
SOUR ORANGE:
Among 44% of patients consuming sour orange, 8% of patients took
frequently, 22% of patients took sometimes, and 14% of patients took occasionally.
Naranga is having amla rasa, Pittakara properties.
PEPPER:
[[[[Among 84% of patients consuming pepper, 2% of patients took daily, 14%
of patients took frequently, 28% of patients took sometimes and 40% of patients took
occasionally.]]]]]]]] Maricha is having Katu rasa, Katu vipaka ,Ushna veerya and
Ushna-Teekshna gunayukta.
DISCUSSION
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 102
HORSE GRAM:
Among 84% of patients consuming horse gram, maximum number of patients
i.e. 46% were consuming sometimes, 28% were consuming frequently and 10% were
consuming occasionally. Kulatta is Amlavipaki, Ushnaveerya and Paramapittakara.
Charaka while explaining Agrya said that Kulattaha amlapittajanananaam.
BLACK GRAM:
Among 94% of patients consuming black gram, 64% of patients took
frequently, 18% of patients took sometimes and 10% of patients took occasionally.
Masha produces Amlapitta by its Guru guna, Ushnaveerya and Pittakara properties.
Charaka while explaining Agrya said that Mashah shleshmapittajanananaam.
HEATED HONEY:
Among 12% of patients consuming heated honey, 8% of patients were taking
frequently and 4% of patient was taking occasionally. consumption of heated honey is
considered as Samskara viruddha ahara sevana.
FISH:
Among 48% of patients consuming fish, 2% of patients took daily, 26% of
patients took frequently, 12% of patients took sometimes and 8% of patients took
occasionally. Matsya produces Amlapitta by its Guru guna, Ushnaveerya and
Raktapitta-vardhaka properties.
CHICKEN:
Among 70% of patients consuming chicken, 2% of patients took daily, 48% of
patients took frequently, 18% of patients took sometimes and 2% of patients took
occasionally. Kukkutamamsa is Guru and Ushnaveerya when consumed regularly in
excess quantity produces Amlapitta.
DISCUSSION
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 103
AJAMAMSA:
Among 76% of patients consuming Ajamamsa, 44% of patients took
frequently, 26% of patients took sometimes and 6% of patients took occasionally. Aja
mamsa by its Guru, Abhishyandi, Mandapittakaphakara properties produce Amlapitta
when consumed regularly in excess quantity.
AVIMAMSA:
Among 48% of patients consuming Avimamsa, 6% of patients took daily, 22%
of patients took frequently, 14% of patients took sometimes and 6% of patients took
occasionally. Avimamsa is Guru, Abhishyandi, Snigdha, Atiushna, Tridoshakara.
ATILAVANA:
Among 60% of patients consuming Atilavanaahara, 48% of patients took
daily, and 12% of patients took frequently. Lavana is having Ushna, Teekshna ,
Abhishyandi, Ushnaveerya, Pittakara properties when used in excess quantity
produces Amlapitta.
ATIKATU:
Among 74% of patients consuming Atikatuahara, 60% of patients took daily,
12% of patients took frequently and 2% of patients took sometimes. Katu rasa is
Ushnaveerya, Ruksha, Pittakara, produces Amlapitta when used in excess quantity.
ATIAMLA:
Among 44% of patients consuming Atiamlaahara, 38% of patients took daily,
2% frequently, 2% sometimes and 2% occasionally. Amla rasa is Ushnaveerya,
pittakara when used in excess quantity produces Daha in Kanta, Uras and
Hrudayapradesha.
DISCUSSION
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 104
HARITA SHAKA:
Among 92% of patients consuming Haritakashaka, 10%of patients took daily,
40% of patients took frequently, 26% of patients took sometimes and 16% of patients
took occasionally. Haritakshaka is Guru, Ruksha, Vishtambhi. When consumed regularly
in excess quantity produces Amlapitta.
ATIUDAKAPANA:
72% of patients drinking more water in between the food, 60% drinks daily and
12% drinks sometimes. Atiudakapana /Antarodakapana causes Agnimandya there by
hindering the normal digestion process which leads to Amlapitta.
VIHARAJA NIDANA:
In this study 10% of patients were doing Vegadharana, 54% of patients were
sleeping soon after food, 24% of patients were doing Divaswapna and 8% of patients
were doing excess fasting. These all things are responsible for improper digestion and
vitiation of Doshas, leading to Ama stage.
MANASIKA NIDANA:
In this study 44% of patients had Excess Anger, 24% of patients had Excess
Grief and 12% of patients had Excess Fear. Most of the patients were suffering from
mental tension and this is responsible for improper digestion which leads to Ajirna
like condition as Acharya Charaka has mentioned that if a person is under some
psychological problem even the wholesome food taken in proper quantity does not get
properly digested.
ALCOHOL:
Among 54% of patients consuming alcohol, maximum number of patients i.e.
28% were consuming frequently, 12% were consuming daily, 6% were taking
sometimes and 8% occasionally. Madya is Amala rasayukta, Tikshna, Ushnaveerya,
DISCUSSION
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 105
Ruksha. Hence produces Amlapitta when consumed in excess quantity for longer
duration.
COFFEE:
Among 66% of patients consuming Coffee, maximum number of patients i.e.
48% were consuming 1-3 times/day, 12% of patients were consuming 4-5 times/day
and 6% of patients were consuming 6-7 times/day. Coffee contains caffeine which is
highly acidic and it can stimulate the hyper secretion of gastric acids, decrease
pressure in the lower esophageal sphincter. Hence coffee consumption has been
associated with heartburn.
TEA:
Among 34% of patients consuming Tea, maximum number of patients 28%
were consuming 1-3 times/day, 4% of patients were consuming 4-6 times/day and
2% of patients were consuming 6-8 times/day. The effect of tea was mainly due to its
local chemical action on gastric mucosa and it is a potent stimulant of gastric acid
also.
SUGARCANE JUICE:
Among 22% of patients consuming sugarcane juice, maximum number of
patients i.e. 16% were consuming occasionally followed by 6% frequently. Ikshurasa
produces Amlapitta is Guru, Vidahi, Vishtambi guna.
UNFORMED CURD:
Among 50 patients only 1 patient was consuming unformed curd sometimes.
Unformed curd is Vidahi, Tridoshakaraka. Hence produces Amlapitta.
CONCLUSION
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 106
Conclusion in a nutshell is the essence of any study. Without finding some
conclusion on any study, it would not become successful in its aims. A scientific
discussion on the study gives rise to some fruitful conclusions. Conclusion drawn
from the present study are as follow:
From the historical review of Ayurvedic literature it has found that Kashyapa
Samhita is the first text which describes the disease Amlapitta as a separate
disease entity.
Changing lifestyle along with changing food culture, stress and strain of this
present era are related with the pathogenesis of this disease.
Amlapitta is the Agnimandyajanya vyadhi. The disease takes a longer time to
cure hence it is considered as Chirakari. If the symptoms subside due to Jihva
laulya (greedy) again if the individual involves the Mithyahara-vihara the
disease is provoked.
Rasavaha, Annavaha, purishvaha srotasdushti occur in Amlapitta.
It can be concluded that highest incidence of Amlapitta is seen in middle aged
persons, may be because of Pitta dominancy, stress, irregular food habits and
sleeping pattern.
Incidence of Amlapitta is more in Pitta Prakruti persons.
From this study it can be concluded that the intake of food against the code of
dietetics i.e. Ahara Vidhi Vidhana and Ahara Vidhi Visheshayatana is
responsible for Amlapitta.
CONCLUSION
CONCLUSION
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 107
Ahraja nidana such as excessive intake katu, amla, lavana ahara, Dadhi,
amlatakra, kulatta, masha, chicken, fish, ajamamsa, avimamsa, sour
mosambi, lemon, Adhyashana, Vishamashana plays an important role in
manifestation of Amlapitta.
Viharaja nidana such as Prajagarana, Sleeping soon after food intake have
shown significant role in Amlapitta.
Manasika nidana- atikrodha play an important role in the manifestation of
Amlapiita.
Alcohol consumption and smoking have shown high significance.
Avipaka, Hritdaha and Amlodgara are seen in almost all patients of
Amlapitta.
It was observed that the symptoms of Amlapitta were closely resembles with
hyperacidity conditions.
SUMMARY
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page114
This dissertation work entitled “NAIDANIKA ADHYAYANA OF AMLAPITTA
WITH SPECIAL REFERENCE TO HYPERACIDITY” comprise Introduction, Review of
literature, Conceptual study, Material and methods, Discussion and Conclusion.
INTRODUCTION:
Introduction is the first part, comprising a brief introduction to the disease Amlapitta and
Hyperacidity.
REVIEW OF LITERATURE:
In this part historical aspect of Amlapitta beginning from Vedic period to Sangraha
period has been described.
CONCEPTUAL STUDY:
In this section etymological derivation, Paryaya, Nidana, Samprapti, Purvarupa, Rupa,
Upashaya, Upadrava, Sadhya-Asadhyata, Sapeksha Nidana, Pathyaapathya has been mentioned
according to different Acharyas.
Similarly derivation of the word Hyperacidity has been explained. The different
etiologies, signs and symptoms, incidence and prevalence of the disease have been mentioned.
MATERIALS AND METHODS:
In this section the material and methods of the present work, with complete description of
the assessment criteria were given. The observations were presented with the help of tables and
graphs.
SUMMARY
SUMMARY
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page115
DISCUSSION:
Discussion part consists of discussion about the conceptual part, observational study was
done, including incidence of different observations made during the study.
CONCLUSION:
Lastly in conclusion part, different conclusions have been drawn depending upon the
conceptual as well as on observational study.
BIBLIOGRAPHY
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 108
1. Vaidya Jadavaji Trikamji Acarya, Caraka Samhita - Ayurveda Dipika
Commentary of Cakrapanidatta. Edited; Chaukhamba Sanskrit Sansthana
Varanasi; Fifth Edition, 2001. p 517
2. Agnivesha, Charaka Samhita, Chikitsasthana, Hindi commentary by
Pt.Kashinatha Shastri, Dr.Gorakhanatha Chaturvedi, Chaukhamba Bharati
Academy, Varanasi, 2006, P.460
3. Agnivesha, Charaka Samhita, Vimanasthana, Hindi commentary by Vidyadhar
Shukla, Ravi Dutt Tripathy, Chaukhamba Sanskrit Pratishthan, Delhi, 2013,
P.563
4. VriddaJeevaka, Kashyapa Samhita with vidyotini hindi commentary,
Varanasi:
Chaukhamba samskrita samsthan; 2015.P.514
5. http://www.healtheo360.com/stories/top-7-natural-home-remedies-for-
hyperacidity/
6. Agnivesha, Charaka Samhita Ayurveda DeepikaComentary of
Chakrapanidatta. Varanasi: ChaukambhaOrientalia; 2011.P.22
7. Agnivesha, Charaka Samhita Ayurveda DeepikaComentary
ofChakrapanidatta. Varanasi: ChaukambhaOrientalia; 2011.P.131
8. Agnivesha, Charaka Samhita Ayurveda DeepikaComentary of
Chakrapanidatta. Varanasi: ChaukambhaOrientalia; 2011.P.155
9. Agnivesha, Charaka Samhita Ayurveda DeepikaComentary of
Chakrapanidatta. Varanasi: ChaukambhaOrientalia; 2011.P.151
BIBLIOGRAPHY
BIBLIOGRAPHY
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 109
10. Agnivesha, Charaka Samhita Ayurveda DeepikaComentary of
Chakrapanidatta. ChikitsaSthana, Shloka No.27/25, Varanasi:
ChaukambhaOrientalia; 2011.P.131
11. Agnivesha, Charaka Samhita Ayurveda DeepikaComentary of
Chakrapanidatta. Varanasi: ChaukambhaOrientalia; 2011.P.457
12. Agnivesha, Charaka Samhita Ayurveda DeepikaComentary of
Chakrapanidatta. Varanasi: ChaukambhaOrientalia; 2011.P.517
13. Agnivesha, Charaka Samhita Ayurveda DeepikaComentary of
Chakrapanidatta. Varanasi: ChaukambhaOrientalia; 2011.P.114
14. Agnivesha, Charaka Samhita Ayurveda DeepikaComentary of
Chakrapanidatta. Varanasi: ChaukambhaOrientalia; 2011.P.487
15. SangrahaSushruta, Sushruta Samhita with NibandhaCommentary of
Dalhanacharya. Varanasi: ChaukambhaSurabharatiPrakashan; 2013.P.185
16. Vagbhata, Astanga Hrudaya, Nidanasthana, collated by Anna Moreshwar
Kunte, ninth edition, Chaukhamba Orientalia, Varanasi, 2005, 5/41.
17. VriddaJeevaka, Kashyapa Samhita with vidyotini hindi commentary.
Varanasi: Chaukhamba samskrita samsthan; 2009.P.338
18. Shastri S, MadhavaNidanam with Madhukosha Commentary of Srikantadatta
and Vijayarakshita and Vidyotini Hindi Commentary. Shloka no.51/2,
Varanasi: Chaukhambha Sanskrit Sansthan; 1995.P.171
19. Sharangadhara Acharya, Sharangadhara samhita English translation by Dr.G.
Prabhakar Rao. Madhyama khanda 8/43, New Delhi, Chaukambha
Publications; 2013. P.158
BIBLIOGRAPHY
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 110
20. Harita, Harita Samhita with Nirmala Hindi commentary,
Chaukambhavishvabharat
21. Bhela Samhita - Ed. By Vd. Venkatasubrahmanya Shastri & Sri.Rajeshwar
Shastri, C.C.R.A.S., Delhi
22. Bhavamishra, Bhavaprakasha volume 2 Translated by Prof. K.R.Shrikanth
Murthi Chapt 10, Varanasi, Chaukambha Krishnadas Academy; 2005. P.223
23. Bhaishajya Ratnavali by Sri. Govind Dasji volume 3 Chapt 56, Varnasi,
Chaukhambha Sanskrit Sansthan; 2014. P.112
24. Yogaratnakara with vaidyaprabha hind commentary by Dr. Indra Tripathi, Dr,
Daya Shankar Tripathi Varanasi, Krishnadas Academy; 1998. P.664
25. Basavarajeeyam By Prof. Dr. M.S Krishna Murthi sholka no 7/3 Chaukhamba
Orientalia, Varanasi, 2014, P. 175
26. Agnivesha, Charaka Samhita Ayurveda DeepikaComentary of
Chakrapanidatta. Varanasi: ChaukambhaOrientalia; 2011.P.517
27. Agnivesha, Charaka Samhita Ayurveda DeepikaComentary of
Chakrapanidatta. Varanasi: ChaukambhaOrientalia; 2011.P.16
28. Sushruta, Sushruta Samhita with NibandhaSangraha Commentary of
Dalhanacharya. Varanasi: ChaukambhaSurabharatiPrakashan; 2013.P.101
29. Shastri S, MadhavaNidanam with Madhukosha Commentary of Srikantadatta
and Vijayarakshita and Vidyotini Hindi Commentary. Shloka no.51/2,
Varanasi: Chaukhambha Sanskrit Sansthan; 1995.P.171
30. Vagbhata, Astangasamgraha with sashilekha commentary of Indu. Varanasi:
ChaukambhaOrientalia; 2008.P.159
31. VriddaJeevaka, Kashyapa Samhita with vidyotinihindi commentary. Varanasi:
Chaukhambasamskritasamsthan; 2009.P.338
BIBLIOGRAPHY
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 111
32. Vagbhata, Astangasamgraha with sashilekha commentary of Indu. Varanasi:
ChaukambhaOrientalia; 2008.P.159
33. Vagbhata, Astangasamgraha with sashilekha commentary of Indu. Varanasi:
ChaukambhaOrientalia; 2008.P.159
34. Sushruta, Sushruta Samhita edited with Ayurveda tatva sandipika by Kaviraj
Ambikadutt Shastri Part 2. Shloka no.1/25, Varanasi: Chaukhambha Sanskrit
Sansthan; 2015. P.14
35. MadhavaNidanam with Madhukosha Commentary of Srikantadatta and
Vijayarakshita and Vidyotini Hindi Commentary. Shloka no.51/1, Varanasi:
Chaukhambha Sanskrit Sansthan; 2012. P.285
36. VriddaJeevaka, Kashyapa Samhita with vidyotini hindi commentary. Shloka
no.16/7, Varanasi: Chaukhamba samskrita samsthan; 2015.P.514
37. VriddaJeevaka, Kashyapa Samhita with vidyotinihindi commentary. Varanasi:
Chaukhambasamskritasamsthan; 2009.P.336
38. Agnivesha, Charaka Samhita, Vimanasthana, Hindi commentary by Vidyadhar
Shukla, Ravi Dutt Tripathy, Chaukhamba Sanskrit Pratishthan, Delhi, 2013,
P.557
39. VriddaJeevaka, Kashyapa Samhita with vidyotini hindi commentary. Shloka
no.16/3-5, Varanasi: Chaukhamba samskrita samsthan; 2015.P.514
40. MadhavaNidanam with Madhukosha Commentary of Srikantadatta and
Vijayarakshita and Vidyotini Hindi Commentary. Shloka no.51/1, Varanasi:
Chaukhambha Sanskrit Sansthan; 2012.P.285
41. VriddaJeevaka, Kashyapa Samhita with vidyotini hindi commentary. Shloka
no.16/5, Varanasi: Chaukhamba samskrita samsthan; 2015.P.514
BIBLIOGRAPHY
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 112
42. VriddaJeevaka, Kashyapa Samhita with vidyotini hindi commentary. Shloka
no.16/6, Varanasi: Chaukhamba samskrita samsthan; 2015.P.514
43. Agnivesha, Charaka Samhita, Vimanasthana, Hindi commentary by
Brahmanand Tripathy, Chaukhamba Sanskrit Sansthan, Varanasi, 2001, 2/9
44. VriddaJeevaka, Kashyapa Samhita with vidyotinihindi commentary. Varanasi:
Chaukhambasamskritasamsthan; 2009.P.338
45. Vagbhata, AstangaHridaya with sarvangasundara and Ayurveda rasayana
commentary. Varanasi: Chaukambhasamskritasamsthan; 2013.P.7
46. Vagbhata, AstangaHridaya with sarvangasundara and Ayurveda rasayana
commentary. Varanasi: Chaukambhasamskritasamsthan; 2013.P.47
47. VriddaJeevaka, Kashyapa Samhita with vidyotinihindi commentary.
Varanasi:
Chaukhambasamskritasamsthan; 2009.P.335
48. VriddaJeevaka, Kashyapa Samhita with vidyotinihindi commentary. Varanasi:
Chaukhambasamskritasamsthan; 2009.P.336
49. Shastri S, MadhavaNidanam with Madhukosha Commentary of Srikantadatta
and Vijayarakshita and Vidyotini Hindi Commentary. Varanasi:
Chaukhambha Sanskrit Sansthan; 1995.P.170
50. Agnivesha, Charaka Samhita Ayurveda DeepikaComentary of
Chakrapanidatta. Varanasi: ChaukambhaOrientalia; 2011.P.517
51. Sushruta, Sushruta Samhita with NibandhaSangraha Commentary of
Dalhanacharya. Varanasi: ChaukambhaSurabharatiPrakashan; 2013.P.103-6
BIBLIOGRAPHY
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 113
52. Shastri S, MadhavaNidanam with Madhukosha Commentary of Srikantadatta
and Vijayarakshita and Vidyotini Hindi Commentary. Varanasi:
Chaukhambha Sanskrit Sansthan; 1995.P.171
53. VriddaJeevaka, Kashyapa Samhita with vidyotinihindi commentary. Varanasi:
Chaukhambasamskritasamsthan; 2009.P.336
54. Shastri S, MadhavaNidanam with Madhukosha Commentary of Srikantadatta
and Vijayarakshita and Vidyotini Hindi Commentary. Varanasi:
Chaukhambha Sanskrit Sansthan; 1995.P.172
55. VriddaJeevaka, Kashyapa Samhita with vidyotinihindi commentary. Varanasi:
Chaukhambasamskritasamsthan; 2009.P.336
56. VriddaJeevaka, Kashyapa Samhita with vidyotinihindi commentary. Varanasi:
Chaukhambasamskritasamsthan; 2009.P.338
57. VriddaJeevaka, Kashyapa Samhita with vidyotinihindi commentary. Varanasi:
Chaukhambasamskritasamsthan; 2009.P.338
58. Shastri S, MadhavaNidanam with Madhukosha Commentary of Srikantadatta
and Vijayarakshita and Vidyotini Hindi Commentary. Varanasi:
Chaukhambha Sanskrit Sansthan; 1995.P.172
59. http://www.nejm.org/doi/pdf/10.1056/NEJM191801171780304
60. http://www.hyperacidity/wikipedia/the free- encyclopedia/amp/s
61. https://www.henriettes-herb.com/eclectic/thomas/stomach-hypers.html
62. https://www.jiva.com/diseases/hyperacidity.
63. www.polycrol.in/trends_india.aspx
64. http://digestion.ygoy.com/2010/05/10/hyper-acidity-symptoms-and-causes-of-
hyperacidity/
RESEARCH PROFORMA
DEPARTMENT OF ROGANIDANA
GOVERNMENT AYURVEDIC MEDICAL COLLEGE
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,
KARNATAKA, BANGALORE-562107
Title: NAIDANIKA ADHYAYANA OF AMLAPITTA WITH SPECIAL
REFERENCE TO HYPERACIDITY
Scholar: Dr. Shradha
Guide: Dr. Ramesh M. S.
INFORMED CONSENT FORM
I ------------------------------------- hereby willingly agree to participate in this
dissertation study titled
“NAIDANIKA ADHYAYANA OF AMLAPITTA WITH SPECIAL REFERENCE
TO HYPERACIDITY”
I affirm that there has been no compulsion or monetary inducement in my agreeing
to be volunteer for this study, which I do on my free will. I have been explained the
general purpose of the experiment. I am convinced that it is for the benefit of science
and mankind. I understand that the risk involved is very less. I agree to undergo
required investigations.
I also agree remain under observation for required period.
I can opt out the study at any time.
Signature of the investigator Signature of the Volunteer
Annexure
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 116
DEPARTMENT OF P.G. STUDIES IN ROGANIDANA
GOVERNMENT AYURVEDIC MEDICAL COLLEGE, DHANWANTARI
ROAD, BANGALORE – 560009
Clinical Case Sheet For
“NAIDANIKA ADHYAYANA OF AMLAPITTA WITH SPECIAL
REFERENCE TO HYPERACIDITY”
1) Name Sl.No
2) Father’s / Husband’s OPD RegNo
3) Age IPD RegNo
4) Sex Male Female Date
5) Religion Hindu Muslim Christian Other
6) Occupation Sedentary Active Labor
7) Marital Status Married Unmarried
8) Economical Status Poor
Middle Higher
Middle
Higher
class
9) ADDRESS
10) Contact Number
11) INFORMED CONSENT
I -------------------------------- Son/Daughter/Wife of -----------------------------------am
exercising my free will,
to participate in above study as a subject. I confirm that the study has been explained
to me adequately and I have understood the above study and had the opportunity to
ask questions. The information given by me will be used for medical research only and
I will not be identified in any way in the analysis and reporting of the results. I hope to
complete the study, but I understand that my participation is voluntary and I am free to
withdraw at any time, without giving a reason, and without my medical care or legal
rights being affected.
Patient’s Signature
Annexure
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 117
PRADHANA VEDANA(Chief Complaints with Duration)
Symptoms Duration
Avipaka
Klama
Utklesha
Tiktaudgara
Amlaudgara
Gourava
Hrithdaha
Kantadaha
Aruchi
ANUBANDHA VEDANA(Associated Complaints)
VEDANA SAMUCCHRAYA(History of present Illness)
POORVA VYADHI VRITTANTA(History of Past Illness)
Annexure
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 118
KULA VRITTANTA (Family History)
RAJAH VRITTANTA (Menstrual History)
Menarche Regular Irregular
Menstrual
cycle
Associated
with
Pain Foul smell
Clots White discharge
Heavy
bleeding
Others
Menopause
CHIKITSA VRITTANTA (Treatment History)
VRITTI VRITTANTA ss(Occupational History)
Type of employment
Sedentary Moderate Heavy
Duration of work ______hrs/day _______hrs/night
Intake of food during work
Annexure
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 119
Work involving any mental stress
If yes Mild Moderate Severe
Whether symptoms aggravates during
mental stress
Yes No
Weather symptoms relieved by change
of
place
Yes No
VAYAKTIKA VRITTANTA(Personal History)
Dite Type Veg Mixed
Quantity Les Moderate Heavy
Time Regular Irregular
Pattern Samashan
a
Adhyashana Vishamasha
na
Beverages Coffee/Tea Aerated drinks Others
Appetite Not
Altered
Reduced Increased
Bowel
Regular Irregular
Frequency /24hrs
Koshta Mridu Madhyama Krura
Sama Nirama
Vega dharana Vega udeerana
Associated Pain Discharge
Annexure
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 120
with Burning
sensation
Discoloration
Itching Foul smell
Incontinence Incomplete evacuation
Micturition Frequency Times/day Times/night
Associated
with
Pain Foul smell
Burning
sensation
Incontinence
Discoloration Incomplete
evacuation
Vega dharana Vega udeerana
Sleep
Duration Hrs/day Hrs/night
Nature of
Sleep
Sound Disturbed
Dreams Yes NO
Addiction
Smoking Beedi/Cigarette ______/day
Alcohol
Type ______ _____ml _____yrs
Daily Occasional
Tobacco Chewing Snuff _____yrs
Exercise
Regular Irregular Complete
absence
Mild Moderate
Annexure
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 121
VITAL SIGNS
Temperature Pulse Rate Heart Rate
Respiratory Rate
ASHTASTHANA PAREEKSHA
Nadi
Dosha Mootra Pravritti
Gati Varna
Jihwa
Shuska Ardra Mala Sama
Lipta Alipta Nirama
Shabda
Sparsha Sheeta Ushna
Ruksha Snigdha
Drik Akriti
DASHAVIDHA PAREEKSHA
1) Prakrutia.
a.Shareerik
a
V P K V
P
P
K
V
K
VPK
b.Manasika Satvika Rajasika Tamasik
a
2) Sara
Twaka Raktha Mamsa Medha
Asthi Majja Sukra Stawa
Annexure
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 122
3)Samhanan
a
Pravara Madhya
ma
Avara
4) Satmya Pravara Madhyama Avara
5) Satwa Pravara Madhyama Avara
6) Pramana Pravara Madhyama Avara
7)Vyayama
Shakti
Pravara Madhyama Avara
8)
Aharashakti
Abyavahara
na
Pravara Madhyama Avara
Jarana Pravara Madhyama Avara
9) Vaya Bala Madhayama Jeerna
10)Desa Sadarana Anupa Jeerna
GENERAL EXAMINATION
Consciousness
Appearance
Built
Nourishment
Decubitus
Gait
Height
SYSTEMIC EXAMINATION
Annexure
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 123
Respiratory System
Cardiovascular System
Central Nervous System
Gastro Intestinal System
Examination of oral
cavity
Ulcers
White lesions
Annexure
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 124
Buccal
mucosa
Vesicles Others
Teeth
Discoloration
Decaying
Abnormal
configuration
Others
Gums
Gingivitis
Pyorrhea
Scurvy Others
Tongue
Atrophy of
papillae
Tremors
Ulcers and white
lesions
Enlargement of
tongue
Examination of the
Abdomen
Inspection
Shape
Distended
Scaphoid
Normal
Umbilicus
Inverted
Everted
Surface
Discoloration
Glossy
Scar
Wrinkles
Pigmentation
Striae
Pulsation
Invisible
Annexure
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 125
Visible
Peristalsis Visible Invisible
Palpation
Tenderness
Present
Absent
Site
Guarding
Present Absent Site
Rigidity
Present Absent Site
Rebound
tenderness
Present Absent Site
Organomegaly
Present Absent Organ
Percussion
Tympanic
Dull
Hyper
Resonant
Stony
dull
Auscultation
Borborygmisonds
Succussion
splash
Bruits Rubs
Questionnaire
Sl.No Ahara Daily Frequently Sometimes Occasionally Never
1. Incompatible
foods
Fish with milk
Annexure
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 126
Heated honey
Curd at night
Consuming cold
water immediately
after having hot
tea or coffee
Milk and curd
Ogether
Sour fruits with
milk (milk shakes)
Other
2. Food prepared
from
pista
3. Unboiled milk
4. Unformed curd
5. Milk of sheep
6. Sour butter milk
7. Curd
8. Sugar cane juice
extracted from
machine
Annexure
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 127
9. Molasses
10. Pepper
11. Alcohol
preparations
12. Sour fruits
Unripe and sour
mango
Sour mosambi
Sour orange
Sour grapes
Unripe and sour
jujube fruit
hog plum
Wood apple
Citrus lemon
Others
13. Cereals and pulses
Freshly harvested
grains
Horse gram
Black gram
Sesame
Mustard
Flax seed
Annexure
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 128
14. Parched cereals
Battened rice
Puffed rice
Others
15. Non veg food
Fish
Goat
Sheep
Others
16. Excess salt
17. Spicy food
18. Excess sour
19. Very hot
20. Deep fried food
21. Drinking more
water in between
the food
22. Excess Liquid
food(juice, tea,
coffee etc
23. Stale food
24. Taking food
before digestion of
the previously
Annexure
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 129
taken food
25. Beetle leaf
26. Green leafy
vegetables
Viharaja Nidana
Sl.N
o
Vihara Yes No Occasiona
l
Regula
r
Remarks
1. Withholding the urges
2. Sleeping immediately after
taking the food
3. Day sleep
4. Excess bathing
5. Excess fatigue
6. Excess fasting
7. Others
ManasikaNidana
Sl.No ManasikaNidana Yes No Remarks
1. Excess anger
2. Excess grief
3. Excess fear
Annexure
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 130
4. Others
SAMPRAPTI GHATAKA
Dosha V P K VP PK VK VPK
Dushya
Rasa Rakta Mamsa Meda
Asthi Majja Shukra
Srotas
Rasa Rakta Mamsa Meda Asthi
Majja Shukra Artava Prana Udaka Anna
Srotodushti
prakara
Agni Sama Manda Tikshna Vishama
Ama Sama Nirama
Rogamarga
Udbhava
Sthana
Sanchara
Sthana
Vyakta
Sthana
Roga
Swabhava
Sadya
asadhyata
Annexure
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 131
Purvarupa
Agnimandya
Hrullasa
Hritkantha daha
Rupa
Avipaka
Klama
Utklesha
Tiktaudgara
Amlaudgara
Gourava
Hrithdaha
Kantadaha
Aruchi
Vidbheda
Gurukoshtata
Shiroruja
Romaharsha
Annexure
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 132
DoshicPredominance
Vata Pitta Kapha Shleshmapitta
Shula Bhrama Kaphanishtivana Tiktaudgara
Angasada Vidaha Gourava Amlaudgara
Jrumbha Swaduupashaya Jadata Katuudgara
Kampa Sheetaupashaya Aruchi Hritdaha
Pralapa Sheeta Kukshidaha
Murcha Sada Kantadaha
Chimichimigatra Chardi Bhrama
Avasada Jihvalepa Murcha
Tamasodarshana Dahana Aruchi
Vibhrama Balasada Chardi
Vimoha Kandu Alasya
Harsha Nidra Shiroruja
Snigdopashaya Rukshaupashaya Praseka
Ushnaupashaya Mukhamadhurya
Hyperacidity Questionnaire
Symptoms Intensity Frequency
Lack of appetite
Indigestion
Constipation
Sour belching
Annexure
“Naidanika Adhyayana Of Amlapitta With Special Reference To Hyperacidity” Page 133
Actual vomiting
Feeling of restlessness
Stiffness in the stomach
Bloating
Flatulence
Headache
Excessive burping
Scale:
0 = No Symptoms
1 = Symptoms noticeable, but not bothersome
2 = Symptoms noticeable and bothersome, but not every day
3 = Symptoms bothersome every day
4 = Symptoms affect daily activities
5 = Symptoms are incapacitating, unable to do daily activities
Top Related