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Introduction

Agni plays key role in Ayurveda for proper maintenance of human body. All diseases occur due to derangement of most powerful factor Agni. It helps in proper digestion as well as good metabolism leading to healthy growth of body. Ajirna is due to disturbed digestive fire which leads to state of incomplete process of digestion. This undigested food leads to production of Aama a toxic substance. Ajirna is a root cause of many diseases. Ayurveda defines health as “Samadosha Samagni Samadhatu Malakriya Prasannatma Indriya Mana Swastha Abhidayate”1. It means a person is said to be healthy when there is equilibrium in Doshas (Vata, Pitta, Kapha), Agni (Metabolic fire), Dhatu (tissue), Mala (Excretory products), and state of harmony among Atma, Indriyas and Manas. These above verses clearly indicate importance of Agni for achieving the goal of healthy life. Main cause of Ajirna is improper intake of food without considering Kaal(time), Guna(characteristics), or Matra (Quantity)etc. Ajirna is ultimate root cause for many other diseases, directly or indirectly it is involved as a cause for pathogenesis of other diseases. So, if Ajirna gets cured, ultimately other diseases related to it also gets cured2. Aharaj(food), Viharaj (lifestyle), Mansika (related to mind) and some other factors (hetu) leads to weakened state of Jathragni. This attenuated Agni, leads to Annavaha Strotas Dushti as it is unable to digest even pathya and light food taken at proper time which further results in Ajirna3. Excessive quantity (Atimatra), untimely (without considering proper time) and harmful (Ahit), food intake leads to Annavahastrotodushti and malfunctioning of Agni causing Ajirna 4.

Aim and Objectives:

 (1) To understand thoroughly the concept of Ajirna.

 (2) To understand its management and proper line of treatment.

Materials And Methods:

For thorough study and understanding of basic concept of Ajirna, various articles related to topic, websites, and lot of Ayurvedic texts were searched for proper literature.

 

Role of Agni in Ajirna: Agni literally means fire easily understood by layman. Agni under influence of various doshas causes different types of Ajirna like:

• Aamajirna (Mandagni; kapha dosha).

• Vidagdhajirna (Tikshnagni; Pitta.)

• Vishtabdhajirna (Vishamagni; vata).

 Agni is of prime importance as it decides how much food a person can consume as per Acharya Charak 5. Pachaka pitta or Pachaka Agni aids in digestion with the help of various digestive juices (Pachaka Rasas) 6. This Pachaka Pitta located in between the Amashaya and Pakvashay ultimately controls digestion by secreting various digestive enzymes and further separation of nutrient and waste products7. Thus, Ajirna is caused due to state of Mandagni (deficient functioning of the agni) leading to state of improper digestion of food and production of Aama (toxic substance) which is major cause for initial trigger of diseases. This indigested food becomes sour in taste and toxic in nature.

Flowchart for Samprapti (Pathogenesis of Ajirna)

As we can clearly see from above table due to impairment of Jathar Agni, the pathogenesis of Vishmagni, Tikshnagni, and Mandagni starts which ultimately leads to various types of Ajirna.

Samprapti (Pathogenesis of Ajirna):

Due to Excessive consumption of above said Nidanas, Agni become vitiated and is unable to digest food properly manifesting as Ajirna. Person is not able to digest even small quantity of food although food is consumed at the proper time and wholesome. In Ajirna, Tridoshas are involved but mainly saman vaayu, pachak pitta and kledak kapha plays a vital role13. In Tridosha especially Kapha Dosha is dominating14. This undigested food becomes sour and toxic in nature.

Samprapti Ghatak:

Dosha- Tridosha especially Kapha

Dushya- Rasa Dhatu (It is first to get vitiated with Annarasa)

Srotas-Annavaha (Aama formation)

Srotodushti-sanga

Vyadhi Udbhawsthana-Aamashyottha

Adhisthana-Aamashaya, pakwashaya

Agni-Mand Jatharagni

Sadhyaasadhyata: Sadya, Yapya

Swabhava: Ashukari, Chirakari.

Other types of Ajirna are as:

Rassheshajirna: related to indigestion of Ahara Rasa which is characterized by aversion to meals, belching, heaviness in the heart and excessive salivation.

Dinapakiajirna:  It causes no difficulty. It commonly occurs due to overeating. In this Ajirna, food is digested on next day.

 Prakritaajirna / Prativasara Ajirna:  It is state of normalcy, as food remains undigested after it is consumed. After digestion is completed, it manifests various symptoms like excessive hunger, thirst, and defecation etc.

Purvaroopa (Prodromal Features) of Ajirna:17

• Annabhilasha (No desire to take food)
• Aruchi (Aversion to food)
• Avipaka(Indigestion)
• Chardi (Amashya utklesha leading to vomiting)

Rupa/Samanya lakshana:

According to Acharya Vagbhatta 18

• Malavibandha or Atipravriti (Constipated or excess of faeces)

• Bhrama (Giddiness)

• Obstruction of Udgara and Apana Vayu.

•  Sadana (Feeling of Heaviness in body)

• Abdominal distension

• According to Charaka 19

• Angmarda (General malaise)

•  Vishtambha (Abdominal distension or stasis due to undigested food)

• Fever (jwara)

• Shirsoruk (headache)

• Trishna (Feeling of thirst)

• Murchha

• Bhrama (Giddiness)

• Aruchi (Anorexia)

•  Prishta and Kati graha (Stiffness in back & waist)

•  Jrimbha (Yawning)

• Chardi (Vomiting sort of sensation)

•  Avipaka (Indigestion of food)

• This undigested food leads to production of Aama (toxic in nature Aam visha)

Vishishta lakshna: (According to various types of Ajirna)20,21

Amajirna: Causes heaviness of the abdomen or sometimes whole body, Praseka (excessive salivation), Kapola evam Akshikootshotha (swelling of both eyes, cheeks) and Avidagdha udgar (acid eructations) mostly soon after meals.

Vidagdhajirna: In this undigested food attains sourness which is characterized by Trishna (feeling of excessive thirst), Bhrama (giddiness), sometimes fainting, Amala udgara (hot and sour belching), abnormal excess perspiration, and burning sensation in body along with other aggravated symptoms of pitta.

Vishtabdhajirna: It is characterized by severe pain, Aatopa (tympanitis), Vata abnormal movement, obstruction to stool, stasis and Aadhmana (flatulence), general malaise, delusion, and some other symptoms of Vata vrddhi.

Rassheshajirna is related to indigestion of Ahara Rasa which is characterized by aversion to meals even after udgaar shuddhi, belching, heaviness in the heart and excessive salivation (Mukh srava).

Dinapakiajirna:  It causes no difficulty. It commonly occurs due to overeating. In this Ajirna, food is digested on next day. In this no dosha gets vitiated.

Prakritaajirna /Prativasara Ajirna: It is state of normalcy, as food remains undigested after it is consumed.It is found in all healthy individuals. After digestion is completed, it manifests various   symptoms like excessive hunger, thirst, and defecation etc.

Upadrava {Complications of Ajirna}: 22

• Murcha (Fainting)

• Pralapa (Delirium)

• Vamathu(Vomiting)

• Prasek (Excess salivation)

• Debility

• Bhrama (Giddiness)

• Mrityu (death).

Consequences of Ajirna:23

1. Ajirna combined with Pitta: leads to extreme Burning sensation, thirst, Oral cavity diseases and other Pittaj vikaras like Amal pitta.
2. Ajirna combined with Kapha: may cause Rajayakshma, Pinasa roga, Prameha etc and various other kaphaja vikara.
3. Ajirna combined with Vata: cause of various Vataj Vikaras.
4. Ajirna not only combines with doshas but also afflicts Dhatus resulting in various Dhatugat vikaras.
5. Ajirna combined with Mutra(urine) causes various Urinary disorders.
6. Ajirna combined with Purisha mala: cause for various G.I.T. Diseases.

Management of Ajirna:

Nidan parivarjan: Avoiding the etiological factors responsible for Ajirna.

Langhan:  It is recommended as one of the best treatments for all sort of Ajirna

Sanshodhana (Purification) Acharya Charak has mentioned in Grahnidosh Chikitsa24 about Sanshodan in 3 ways: -

• that if there is excessive salivation, heaviness, anorexia then this undigested food which is vitiating doshas should be expelled through Vamana.

• When this undigested food is in pakwashya and continue to adhere colon then patient must be given virechana along with deepaniya dravyas to expel doshas.

• When this Aama pervades some other parts of the body then patient must undergo langhana karma and must be given various pachana dravyas to digest the aama

Discussion

DISCUSSION:

Food is primary requirement which influence both physical and mental health. Due to improper diet and lifestyle Agni (Digestive Fire) gets weak. It leads to undigested food stage finally leading to Ajirna. It is very basic cause of other diseases. So, Ajirna must be cured as a priority. Nidana Parivarjana is first-line of treatment recommended for most of diseases27. To break the pathogenesis of Ajirna, Deepana, Pachana and Vaatanulomana medicines are used in early stage. Later on, panchakarma can be a good option. Following pathya apathya, Ashtahar Vidhi Visheshayatana by Acharya Charak and “Dashvidha Ahara Vidhividhan” by Acharya Sushrut along with medications give good results.

Conclusion

Ajirna is root cause of many diseases as it leads to production of Aama due to deranged Agni. It can be managed by Nidan Parivarjan and considering Agni while consuming food. So, every individual must be advised to follow Diet and Lifestyle regimes (Dincharya, Ritucharya, Aahar vidhi vidhan) mentioned in Ayurveda to prevent condition like Ajirna.