Course lesson
Ajeerna | Alasaka | Vishuchika | Vilambika
Ajeerna (Indigestion) & Its Acute Complications
Alasaka, Vishuchika & Vilambika – A Complete Ayurvedic Synopsis
Classical sources consulted – • Aṣṭāṅga-Hṛdaya Sū. 13 & Chi. 9 • Caraka Saṃhitā Sū. 26, Chi. 14, 19 • Suśruta Saṃhitā Uttara 64 • Mādhava-Nidāna 6, 51 • Bhāvaprakāśa Madhyama 3
1. Disease–wise Description & Types
| Entity | Literally means | Cardinal idea | Recognised types* |
|---|---|---|---|
| Ajeerna | a-jīrṇa = “non-digestion” | Failure or delay of jatharāgni resulting in persistence / putrefaction of food taken | 1. Āma-jeerna (Kapha) 2. Vidagdha (Pitta) 3. Viṣṭabdha (Vāta) 4. Rasa-śeṣa (trifling residue) 5. Vilambika† (a Kapha-dominated sluggish variety) |
| Alasaka | “Motion-less food” | Vāta dries & arrests ingested food in stomach & intestines without its downward progress | — |
| Viśūchikā | “Sudden stabbing pain like a needle” | Violent Vāta pushes undigested food both upwards & downwards causing simultaneous vomiting & diarrhoea (classical portrait of acute gastro-enteritis / cholera) | — |
*The first three are universal; Rasā-śeṣa & Vilambika are mentioned by later authorities. †Some authors keep Vilambika under Ajīrṇa, others list it separately; both views are accommodated here.
2. Nidāna-Pañcaka (Aetiological Pentad)
The table encapsulates the common Nidāna-pañcaka and highlights variety-specific points.
| Pañcaka limb | Ajīrṇa (general) | Alasaka | Viśūchikā | Vilambika |
|---|---|---|---|---|
| Nidāna (causes) | • Adhyāśana (re-feeding on previous meal) • Viṣama & Viruddhāhāra • Excess Śīta, Guru, Snigdha diet • Divā-svapna after heavy meal • Alcohol, stress | Same as Ajīrṇa + sudden fright/suppression of flatus | Same causes + intake of contaminated water / food, seasonal epidemics | Heavy kapha-producing diet (curd, cheese, sweets) + day sleep |
| Pūrvārūpa | Anorexia, mild nausea, drowsiness | Distension, heaviness | Cramps, uneasiness, chill | Profound heaviness, lassitude |
| Rūpa (signs) | See Type-wise in §3 | • Sudden arrest of voiding • Board-like abdomen • Severe colic, nausea • No belching / flatus | • Explosive emesis & purgation • Burning, cramps • Exhaustion, dehydration | • Persistent heaviness • Thick saliva • Somnolence |
| Upaśaya / Anupaśaya | • Langhana, Dīpana relieve • Heavy, cold intake worsens | Warm fomentation ↑, food intake ↓ | Śīta-jala intake ↑ vomiting; Sunthi-leha ↓ cramps | Rakta-śāli yavāgu (Thin rice gruel) ↓ heaviness |
| Saṃprāpti | Food-induced Āma + Agni-mada → micro-channel blockage → Doṣa-specific manifestations | Udāna–Apāna vāta virodha → sthambana of Āhāra rasa | Vāta urdhva-adhogati → violent expulsion + Pitta-Āma fermentation | Guru & Abhiṣyandi kapha coats food → extreme gastric stasis |
3. Doṣa–wise Clinical Picture (Ajīrṇa)
| Type | Dominant Doṣa | Key manifestations |
|---|---|---|
| Āma-jeerna | Kapha + Āma | Nausea, salivation, heaviness, white coated tongue, aversion to food |
| Vidagdha | Pitta | Sour / bitter eructation, burning epigastrium, thirst, dizziness |
| Viṣṭabdha | Vāta | Distension, gripping colic, gurgling, dry belch, obstipation |
| Rasa-śeṣa | Tridoṣa (mild) | Light residual fullness, improper taste in mouth, passes off with single meal or light fast |
| Vilambika | Kapha (Āma-prāya) | Marked heaviness, drowsiness, cold sweat, sweet belching, sticky mucus in throat |
4. Samprāpti-Vighatana (Therapeutic Break-up)
- Nidāna-parivarjana – stop further ingestion / wrong food.
- Langhana – complete (up to nirāhāra) for Viśūchikā & Alasaka; laghu-upavāsa for others.
- Dīpana–Pācana – ignite jatharāgni, digest Āma (Trikaṭu, Pañcakola, Sunthi etc.).
- Vātānulomana & Doṣa-hara Śodhana • Vamana – Kapha-dominant cases (Āma, Vilambika). • Mr̥du Virecana – Vidagdha, Viśūchikā after initial control. • Niruha / Anuvāsana Basti – Viṣṭabdha & Alasaka once colic subsides.
- Śamana – specific internal formulations + external sveda / abhyanga support.
- Aharādi Saṃskāra – phased saṃsarjana diet, psychic counselling, rasāyana.
5. Doṣa-specific Chikitsā-Sūtra (Ready-reckoner)
- Āma / Kapha predominance Langhana → Tikṣṇa Dīpana (Pañcakola) → Uṣṇa Sveda → Vamana → Hingu-Ārdraka-pāka.
- Pitta predominance Laghu-Langhana → Madhura-Tiktaka Pācana → Śīta Jala-sīpana → Mr̥du Virecana → Takra-Sarpir-sevana.
- Vāta predominance Śīta-Langhana (fasting with warm water) → Sneha-Sveda → Saindhava-Hiṅgu Anupāna → Niruha-Basti → Ajwain-Hingvāstaka anna.
- Āma+Vāta catastrophe (Alasaka / Viśūchikā) Vāta śamana is first, hence – Stomach lavage if needed → Hot Decoction of Sunthi + Saindhava frequent sips → Pippalī-mātra (emesis only if Kapha plugs) → After control, gradual Dīpana & Virecana.
6. Chikitsā-Yojanā – Internal, External & Diet
6.1 Ajeerna (type-wise)
| Type | Prime Classical Yoga* | Average dose & timing | Quick Pathya | Apathya |
|---|---|---|---|---|
| Āma | Jeernī / Ajīrṇāri-vaṭī, Hingu-catur-an̄ga cūrṇa | 1–2 tab or 3 g with warm water, after burping | Hot water, thin dhānyaka-yavāgu, light walk | Curd, cold drinks, day-sleep |
| Vidagdha | Sūtaśekhara rasa, Praval-pancha-mr̥ta, Drākṣādi kvātha | 250 mg + 3 g + 50 ml, b.i.d. | Shāli rice + ghee, cold milk, raisins | Chili, vinegar, hard exercise |
| Viṣṭabdha | Hinguvācādi cūrṇa, Ajwain-ark, Eranda-taila 10 ml h.s. | 3 g thrice daily | Warm water continuously, fennel seeds chew | Beans / cabbage, dry fasting |
| Rasa-śeṣa | Laghu-supa / Yūṣa with Sunthi, Trijāta siddha water | — (dietary) | Single light meal; rest | Re-feeding, excess liquids |
| Vilambika | Pañcakola siddha takra, Agnitunḍī vaṭī | 100 ml + 250 mg t.i.d. before food | Hot, dry gruel (yava), mild exercise | Sweets, cheese, afternoon nap |
*Use GMP pharmacy preparations or authentic home compound; dosage adult unless stated.
6.2 Alasaka
- Emergency: • Lukewarm saline water w. Saindhava 250 ml for gastric wash. • Sunthi-paṭola kvātha fomentation over abdomen.
- Internal (after pain relief) • Hingu-vādi kiṣṭa 15 ml q4h. • Sanna-pānaka (jaggery 5 g + Sunthi 1 g + Saindhava 500 ml warm water).
- If still obstructed – Nirūha basti (Daśamūla + Pañcakola + Eranda taila).
- Pathya – Only hot water sips for 12 h → thin paya-yūṣa → light rice.
6.3 Viśūchikā
- Immediate control of vomiting & purging • Dhānyā-kumārī svarasa 10 ml + Saindhava 1 g every 30 min till it stops. • OR Śuṇṭhī 2 g + Pippalī 1 g + Jīraka 1 g + Saindhava 1 g – licked with honey.
- Re-hydration – Ayurvedic ORS: • 1 l warm water + rock-salt 3 g + jaggery 20 g + roasted cumin 1 g + lemon.
- After control (within 12–24 h) • Trivṛt-lehya 6–10 g for mr̥du virecana (to clear residual doṣa). • Mustā-Parpaṭa kvātha 60 ml b.i.d. for 3 days.
- Diet ladder – Piṇḍa-pāna (clear rice gruel) → Takra-māṇḍa → thin rice with ghee.
6.4 Vilambika
• First line – Uṣṇa-sveda (valuka), Laghu-langhana for 6 h. • Internal drugs: Vyoshādi vaṭī 250 mg t.i.d.; Pañcakola ghana 500 mg b.i.d. before food. • Diet – Dry roasted barley + ginger pickle, warm water only. • When Kapha melts – single Vamana with Ikṣvāku phala or Madana-phalā yoga delivers lasting cure.
7. Pathyā-Apathyā (Common Golden Rules)
DO’s
- Eat only after the clear feel of hunger & complete digestion of previous meal.
- Prefer Laghu, Ushṇa, Sukha-digesta food: shāli rice, yava, green gram yūṣa, ginger-laced soups.
- Sip warm water; practise mild walk after meals (vātapraṇayana).
- Regular evacuation of flatus, belch & stools.
- Mental calmness; light stretching, Prāṇāyāma.
DON’Ts
- Adhyāśana, Viruddhāhāra, night meals after 9 p.m., cold water immediately post-food.
- Guru, kaphakara items (cheese, pastries, ice-cream) in weak agni.
- Day-sleep (especially after lunch), late-night vigil, excessive talking during meals.
- Alcohol, carbonated drinks, smoking.
- Suppression of natural urges and acute mental stress.
8. Follow-up & Rasāyana
After recovery, administer for 30–45 days
- Ama-case: Pippalī rasāyana (for agni deepana)
- Pitta: Āmalakī churna + Madhu morning
- Vāta: Castor-taila 5 ml bedtime on alternate days with strict diet discipline to prevent recurrence.
9. Key Clinical Cautions
- Rule out surgical abdomen, intestinal obstruction, perforation and infective cholera; refer if red flags (persistent vomiting with bile or blood, high fever, shock).
- In children & elderly dehydration can be fatal in Viśūchikā – maintain fluids aggressively.
- Pregnancy – avoid strong Vamana / Virecana; use mild Dīpana (Ajwain-Saindhava) + Pathya.
10. Concise Take-home
- All these conditions stem from Agni-manda & Āma; Vāta determines speed (stasis = Alasaka, hyper-expulsion = Viśūchikā).
- Therefore “Langhana + Dīpana + Vātānulomana” is the non-negotiable therapeutic axis.
- Kapha-loaded cases need Vamana, Pitta ones need Śīta-virecana, while Vāta dominance calls for Sneha-Sveda-Basti.
- A strictly regulated diet & lifestyle is as vital as any medicine for a sustained cure.