Agnimandya is considered a primary initiating factor in the formation of Ama, a metabolically immature and obstructive pathological entity described in Ayurveda. Although classical texts extensively discuss Agni and Ama, their pathophysiological correlation requires systematic reinterpretation in the context of diagnostic reasoning and staged therapeutic correction. To analyze the pathophysiological basis of Ama formation due to Agnimandya and to examine its diagnostic and therapeutic implications within a structured clinical framework. A conceptual analytical study was undertaken based on classical Ayurvedic sources, including Charaka Samhita, Sushruta Samhita, and Ashtanga Hridaya. Descriptions of Agni, Agnimandya, Ama, Srotorodha, and Sama–Nirama avastha were critically examined and synthesized. Therapeutic principles of staged Agni correction were interpreted in relation to the pathophysiological sequence. Impairment of Pachaka Pitta leads to Mandagni, resulting in incomplete digestion (Ajirna) and formation of immature metabolic intermediates. Persistent metabolic insufficiency culminates in Ama, which induces Srotorodha and promotes Sama Dosha, ultimately leading to systemic dysfunction. The cyclical suppression between accumulated Ama and weakened Agni explains chronicity and relapse. A graded therapeutic framework consisting of Agnisandhukshana, Agnidhaapana, and Agnisthirikarana provides a rational approach for metabolic restoration and long-term stabilization. Agnimandya-induced Ama formation represents a functional metabolic disturbance that precedes structural pathology. Early recognition of Sama states and stage-wise correction of Agni enhance diagnostic precision and therapeutic sustainability. The classical model offers a coherent metabolic framework with potential relevance for contemporary integrative research. Keywords: Agnimandya, Ama, Agni, Srotorodha, Ayurvedic pathophysiology
Gadade et al. (Sat,) studied this question.