This article explains Madava nidana 51st chapter “Amlapitta Nidanam”. Causes, pathology and symptoms of Amlapitta are explained in this chapter. Amlapitta means hyperacidity.

Nidana, Samprapti

Etiological Factors and Pathogenesis of Amlapitta
In persons in whom pitta has already undergone increase and excessive sourness; excessive indulgence in foods which are of incompatible combinations, spoiled, very sour, those causing burning sensation inside and such other foods and drinks which cause increase of pitta, produce Amlapitta, so say the wise. (1)
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Amlapitta Lakshana

Symptoms of amlapitta
The disease in which the patient has indigestion, exhaustion without any exertion, nausea, eructation (belching) with bitter or sour taste, feeling of heaviness of the body, burning sensation in the chest and throat and loss of taste – is to be called as Amlapitta. (2)

Adhoga Amlapitta Symptoms

The symptoms of adhoga (downward) amlapitta are – thirst, burning sensation, fainting, giddiness, delusion, movement downwards of different kinds (of diarrhoea), nausea (occasional oppression in the chest), rashes on the skin, poor digestion, horripilation, excessive perspiration and yellowish skin (of parts of the body). (3)
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Urdhwaga Amlapitta Symptoms

Symptoms of ūrdhvaga (upward) amlapitta are – vomiting of green, yellow, blue, black, slightly red or bright red coloured very sour materials, resembling mutton wash, very sticky, thin, followed by kapha (expulsion of kapha) and of different tastes (salty, pungent, bitter etc). Vomiting having a bitter or sour taste occurs during digestion of food or even on an empty stomach, occasionally.
Belching is also of similar nature (as that of vomiting). Burning sensation in the throat, chest and upper abdomen and headache are also present. Apart from this there is burning sensation in the palms and soles, feeling of great heat, severe loss of taste, fever of kapha-pitta type, itching, appearance of circular rashes, studded with numerous small vesicles on the skin, indigestion, watery secretions in the mouth and other troubles of the body. (4-6)
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Prognosis of Amlapitta

This disease amlapitta – which is of recent onset, responds to treatment with difficulty. The amlapitta which is of long duration will be chronic or curable with difficulty in a few people. (7)

Amlapitta Samsarga

The physician should clearly recognise the symptoms of amlapitta caused by vata, vata kapha and kapha as they are likely to create confusion to him (and hence the mastery in understanding these conditions is a must).

• Vata symptoms – Symptoms caused by vata are – tremors, delirium, fainting, feeling of pins and needles, weakness of the body parts, pain, appearance of darkness before the eyes, giddiness, delusion, horripilation.
• Kapha symptoms – Symptoms of kapha are – expectoration of thick phlegm, feeling of heaviness, lassitude, loss of taste, coldness, weakness, vomiting, and coating on the tongue, decrease of digestive strength, itching and excessive sleep.
• Appearance of both the above symptoms together is seen in amlapitta in which both vata and kapha are associated.
• (Eructation / belching having bitter, sour and pungent tastes, burning sensation in the chest, upper abdomen and throat, giddiness, fainting, loss of taste, vomiting, lassitude, headache, excessive salivation, sweet taste in the mouth are the symptoms of amla-pitta caused by kapha and pitta together.(8-12)

Thus ends the chapter on Amlapitta Nidanam in Madhava Nidana text written by Acharya Madhavakara.