How to Clear Ama: The Ayurvedic Protocol

Ama, the sticky residue of incomplete digestion, is cleared in three steps taken in order: nidana parivarjana, removing what produced it; langhana, lightening the body through fasting or a very light diet so that agni, the digestive fire, can catch up; and pachana, giving hot water and pungent, bitter herbs that digest what has already lodged. Only when the tongue is clean and hunger has returned does deepana, rekindling the fire, and any building treatment begin. The Ashtanga Hridaya lays out this order in its teaching on ama, and the whole of it can take from three days to several weeks depending on how deep the residue has gone.

Step one: remove the cause

No amount of herb clears ama while its cause continues. The first instruction is to stop what is dulling agni: eating before the last meal is digested, eating late at night, cold drinks and iced food, heavy sweets and dairy taken in quantity, incompatible combinations, daytime sleep, and eating in agitation. Meals are reduced to two a day, at noon and before sunset, with nothing between them. Water is taken warm or hot and sipped, never cold and never in volume with the meal. This alone clears a mild ama of a few days' standing.

Step two: langhana

Langhana means lightening, and its simplest form is fasting. For a strong person with a thick tongue coating and heaviness, a day of warm water alone, or of warm water with a little dried ginger, gives agni nothing new to work on and lets it burn what is present. For a weaker person, a Vata constitution, or an ama of long standing, the fast is replaced with a light mono-diet: peya, thin rice gruel, or kitchari of split mung and rice cooked soft with cumin, ginger, and turmeric, taken warm and small. The measure of langhana is the return of true hunger, lightness, and a clear tongue; fasting past that point aggravates Vata and is a fault, not a virtue. Charaka's rule is that lightening suits Kapha and Pitta disorders and the strong, and is used briefly and gently in Vata and the weak.

Step three: pachana

Pachana substances digest ama that has already formed. The plainest is ushna jala, water boiled for some minutes and sipped hot through the day. The classical plants are pungent and bitter.

Shunthi, dried ginger, Zingiber officinale, is pungent in taste, light and unctuous, heating, and sweet in vipaka, which makes it the one pungent that digests ama without drying Vata. The classical dose of the powder is 1 to 2 grams with warm water before food, or a slice of fresh ginger with rock salt and lime taken just before a meal.

Trikatu, the three pungents, is Shunthi, Maricha, Piper nigrum, and Pippali, Piper longum, in equal parts. It is heating, sharp, and pungent in vipaka, and it is the standard deepana-pachana for Kapha ama. The dose of the churna is 1 to 3 grams with honey or warm water before food. It is not given to a Pitta-predominant person, in bleeding disorders, or over long periods; Charaka names Pippali among the substances not for habitual use.

Chitraka, Plumbago zeylanica, root powder, 1 to 2 grams with warm water, is the sharpest of the fire-kindlers and is reserved for deep Kapha ama with real mandagni.

Hingvashtaka churna, eight substances led by Hingu, asafoetida, with the three pungents, cumin, ajwain, and rock salt, is the choice when ama is joined with Vata and there is gas and colic. The dose is 1 to 3 grams with the first mouthful of food, mixed into ghee or warm rice.

Pachana is continued until the stool floats and is formed, the tongue is clean, and the body feels light. In amavata, ama in the joints, the same protocol is extended with Rasna, Pluchea lanceolata, and dry heat, and with castor oil for its purging.

Step four: deepana and rebuilding

Once the ama is gone, agni is rekindled and protected. Meals return to a regular rhythm with the largest at midday. Ghee is reintroduced in small quantity, because ghee kindles agni when the fire is clean and feeds ama when it is not. Triphala at night keeps the bowel clear. A rasayana such as Chyawanprash or Ashwagandha is not begun until this point, and a person who has cleared a deep ama is a candidate for panchakarma, which removes the aggravated dosha at its root rather than the residue alone.

What the protocol is not

The protocol is not a juice cleanse, a raw diet, or a purgative taken over a coated tongue. Cold and raw food dull agni further. Strong purgation given on ama drags a sticky dosha through the channels and worsens the condition; purgation belongs to panchakarma, after preparation. And a diet that is simply less of the same heavy food does not lighten; lightening means warm, cooked, spiced, and small.

Not medical advice.