A Review of management of Kamala w.s.r to Hepatitis through Shamanaushadi

Akshata; P Punith; I. S. Mathapati

A Review of management of Kamala w.s.r to Hepatitis through Shamanaushadi

Akshata.^1*, Punith P.², Mathapati I.³

DOI:

^1* Akshata, Post Graduate Scholar, Department of Post Graduate Studies in Kayachikitsa, Shri Shivayogeshwar Rural Ayurvedic Medical College and Hospital, Inchal, Karnataka, India.

² P Punith, Assisstant Professor, Department of Post Graduate Studies in Kayachikitsa, Shri Shivayogeshwar Rural Ayurvedic Medical College and Hospital, Inchal, Karnataka, India.

³ I. S. Mathapati, Professor, Department of Post Graduate Studies in Kayachikitsa, Shri Shivayogeshwar Rural Ayurvedic Medical College and Hospital, Inchal, Karnataka, India.

Kamala which is caused by aggrevated Pitta, may occur with or without Pandu Roga (Swatantra and Paratantra Vyadhi). In this Vyadhi, the hunger and appetite is diminished, mala gets discoloured (Peeta, Haridra, Harithadi) In classical texts of Ayurveda, we come across the explanation of Rakta Pradoshaja vikaras. Kamala is a Pittaja Nanatmaja and Rakta Pradoshaja Vyadhi. Most of the people have become used to spicy fast-food day by day. This has taken human being far away from the nature. Nowadays alcohol consumption is also increasing day by day. General symptoms of Hepatitis include, intense abdominal pain, yellowing of eyes and skin, nausea, extreme tiredness and dark urine. This article aims at discussing the about the Kamala (Hepatitis). This paper also discusses the Ayurvedic medicines like Triphala, Guduchi, Nimba, Vasa, Katuki. that can be helpful in curing this infection and their properties are discussed as well.

Keywords: Hepatitis, Kamala, Raktapradoshaja, Pittaja Nanatmaja Vyadhi

Corresponding Author	How to Cite this Article	To Browse
Akshata, Post Graduate Scholar, Department of Post Graduate Studies in Kayachikitsa, Shri Shivayogeshwar Rural Ayurvedic Medical College and Hospital, Inchal, Karnataka, India. Email:	Akshata, P Punith, I. S. Mathapati, A Review of management of Kamala w.s.r to Hepatitis through Shamanaushadi. J Ayu Int Med Sci. 2022;7(11):150-154. Available From https://www.jaims.in/jaims/article/view/2177

Introduction

It has been stated that Raktavaha Srotas take active part in the production of Rakta Dhatu and the Moola of them is Yakrit and Pleeha. Both Yakrit and Pleeha are also the sites of Ranjaka Pitta and store houses for the Rakta Dhatu.

Kamala has been explained in the major aliments such as Kushta, Visarpa, Raktapitta, Rakta Pradara etc. shows its seriousness as per the health is concerned. Kamala is considered as a Paitika Roga caused by Rakta Dusti due to vitiated Pitta and vice versa.^[1] The principal management of Kamala differ in Ayurveda from modern medicine. Yakrit (liver) is supposed to be the seat of Raktavaha Srotas and Pitta is believed to be the Mola of Rakta. Hence the line of treatment adopted comprises of measures used for the pacification of Pitta Dosha. The herbs used for the liver disorder possess properties which pacify the Pitta Dosha. By the causes, pathogenesis and symptoms we can correlate Kamala to hepatitis.

As Kamala is a Rakta Pradoshaja, Raktavaha Sroto Vikara, Yakrit and Pleeha are also involved in the pathogenesis. Acharya Charaka considers Kamala as a later stage of Pandu Roga or else we can say it as an Avastha Vishesha of Pandu. Hence such type of Kamala is also known as Pandu Poorvika Kamala.^[2] Acharya Sushruta opines that Kamala can occur without the pre-existing Pandu Roga as independent (Swatantra) Vyadhi and Acharya Vagbhata also supported Sushrutas view. Acharya Chakrapani clarifies beautifully that, Kamala Roga can be seen with the preceding Pandu Roga or independently without pre-existing Pandu Roga. Just like in case of Prameha Pidakas, these Prameha Pidakas may be seen in Prameha Roga or without Prameha independently. If it is preceded by Pandu Roga, the condition is Paratantra or Bahupitta Kamala. If the Kamala Roga is seen with Alpa Pramana Pitta Prakopa, independently without pre-existing Pandu Roga, it is said to be Swatantra or Alpa Pitta Kamala.^[3] Hence we see two types of Sampraptis here, one is with Pre-existing Pandu Roga and the other is without Pandu Roga excessively due to Pittaja Ahara Vihara or Pitta Paratantra Prakopa.

The Human body is the most complex and advanced system created by the nature. In the body the biggest and most important gland is the liver. Liver is also not only the biggest gland but it is also the biggest and the most crucial organ in the body.

The liver performs various functions that are extremely crucial for life to sustain. Some of the functions performed by the liver are as follows:

The primary function of liver is to facilitate digestion by producing the bile juice that is particularly helpful in breakdown of fats.
Liver is also primarily involved in blood purification and detoxification.
It also produces various enzyme activators.
Liver is helpful in regulating blood iron levels and also regulates presence of various proteins in the blood.
Liver helps in conversion of harmful ammonia into urea and then facilitates the excretory system for removal of this urea from the body.
Liver helps in maintaining glucose level in the body by converting excess glucose into glycogen. The glycogen along with various vitamins and minerals is then stored in the liver.

There are vast numbers of ailments and complications related to liver that either happens due to infection, for example: hepatitis, jaundice etc. or certain lifestyle related complications like liver cirrhosis that happens due to excessive intake of alcohol. Hepatitis in an ailment that happens in the liver and it is marked by swelling or inflammation in the liver. Hepatitis is caused by the Hepatitis virus and this disease is mainly 3 types: Hepatitis A, Hepatitis B, and Hepatitis C, D & E.

Hepatitis Virus: Hepatitis virus is a member of the hepadnavirus family. It has a double-stranded DNA and it replicates by reverse transcription. Hepatitis is a disease that causes both acute and chronic ill effects on the liver. According to World Health Organization in 2015 257 million people were affected with chronic hepatitis and 887000 deaths were reported due to liver cirrhosis and hepatocellular carcinoma caused by complication in hepatitis disease. Hepatitis has become a life-threatening global health problem.

Transmission of the Disease

The hepatitis A virus is primarily spread through the faecal-oral route when the person ingests food or water which has been contaminated with the faeces of the infected person. It can also be transmitted if there is contamination of sewage water in the drinking water.

Since this disease can be spread through physical contact therefore it can be transmitted through sexual activity if done with the infected person. Transmission of hepatitis B and C is mainly done by the body fluids hence it is commonly transmitted from mother to child during delivery of the baby or through breast feeding. It can be transmitted if a healthy person indulges in unprotected sexual activity with the infected person, injection induced drug that involves sharing of needles also makes the person more susceptible for this infection. Exposure of a healthy person to the infected blood or body fluids like saliva, menstrual, vaginal and seminal fluids also leads to the transmission of this disease.^[4]

Incubation Period: The incubation period of the hepatitis A virus is of 14-28 days.^[5] The hepatitis B virus can sustain outside the body of the host for up to 7 days. The incubation period of this virus is 75 days on an average but this time can vary from 30 days to 180 days.^[6] The incubation period for hepatitis C ranges from 2 weeks to 6 months^[7]

Symptoms: The symptoms for this disease appear within 30 days of infection. The symptoms include:

Jaundice
Yellow pigmentation in the eyes and skin
Extreme Abdominal pain, especially in upper right side of the abdomen
Dark urine
Loss of appetite
Nausea and vomiting
Fever
Extreme Fatigue and tiredness
In case of extreme infection hepatitis can develop into acute liver failure which can lead to death. In some cases hepatitis virus can cause chronic liver infections that may later complicate into liver cirrhosis or liver cancer.

Diagnosis

For the diagnosis of the hepatitis virus blood test is generally done. In the blood sample the detection of the HAV IgM antibody test detects the first antibody produced by the body when it is exposed to Hepatitis A. Hepatitis B surface antigen HBsAg is done. Presence of this surface antigen confirms the hepatitis B infection.

A blood test, called an HCV antibody test, is used to find out if someone has ever been infected with the hepatitis C virus. The HCV antibody test, sometimes called the anti-HCV test, looks for antibodies to the hepatitis C virus in blood.

Shamanoushadi for Hepatitis Virus Infections

Nidana Parivarjana, Samshamana, Samshodana this is the protocol for management of Kamala. Charakacharya has mentioned Kamala Tu Virchanam i.e., purgaration therapy with Mrudu and Tikta Dravyas Sushrytacharya mentioned drug and regimens. Vagbhatacharya quoted Kamlayam Tu Pitaghnam. So, drugs which are Katu, Tikta Kashya in nature have the property like Pittarechaka have to give to treat Kamala. Virechana helps in eliminating accumulated Doshas from body. It is considered as the treatment for Pittaja Vikaras. Kamala is one among them and is described as Virechana Sadhya Vyadhi. Therefore, Pittagna drugs are recommamnded.^[8] the main pathology lies in the blood i.e., Asrikmamsa Daghdva (excessive haemolysis of RBC) hence it should be prevented.

In Kamala includes Pitta pacifying Rasas which enable healthy gut and strong digestive system. Generally Katuki, Guduchi, Triphala,Vasa, Patola and Bhumyamalaki etc. are used in the treatment of hepatitis. Details about some of these medicinal plants useful in liver ailments are as follows:

Phalatrikadi Kwath.
Nimbadi Kashyaya.
Vasa Guduchhyadi Kashaya.
Trayantyadi Kashaya.^[9]
Patolakaturohinyadi Kashaya.^[10]
Yastivasadi Kashaya.

Above these formulations contains ingredients like Triphala, Vasa, Nimba, Katurohini, Chandana, Guduchi, Patha, Trivrit which are helpful in treating the Kamala Roga w.s.r to hepatitis.

Discussion

Triphala: It is an Ayurvedic medicine which is a combination of 3 medicinal fruits that are Haritaki, Vibhitaki and Amlaki. The combination of these 3 ingredients has antioxidant properties and it is hepatoprotective in nature and protects liver from free radical damage and from other infections as well.

Vasa (Adhatoda vasica)

It is an Ayurvedic medicinal plant which is useful in treatment of hepatic related ailments and upper respiratory tract infections. The major alkaloid present in this plants extract is vasicine. Various researches have revealed that this compound shows anti-inflammatory effects, antidiabetic effects, antioxidant properties and hepatoprotective properties as well.

Guduchi (Tinospora cardifolia)

This plant is also called Amruta in Ayurveda because of its property to cure number of diseases ranging from heart diseases, orthopedic problems as well as digestive problems. In researches done on Tinospora cordifolia it has been well established that this plant shows immunomodulatory actions, anti-allergic actions as well as hepatoprotective properties.

Nimba (Azadirachta indica)

It has immunomodulatory and anti-inflammatory effects. Neem is also known for its antidiabetic, antiulcer, antimalarial and anti-microbial properties.

Kiratatikta (Swertia chirayita)

This plant is mainly involved in treatment of diseases like diabetes, jaundice and other liver related ailments because of the hepato-protective properties of the bio-active agents present in this plant which are called xanthone and secoiridoid glycosides.

Katuki (Picrorhiza kurroa)

The extracts from this plant are useful as cure for ailments like jaundice, vomiting and periodic fevers. The bioactive compound of this plant called Picroliv is a glycoside compound and it is the main medicinal constituent. The research on this compound shows that picroliv is very effective in curing diseases like acute viral hepatitis, tuberculosis and bronchial Asthma.

Bhumyamalaki (Phyllanthus niruri)

The extracts from this plant are known to show hepatoprotective properties. The extracts from this plant have the ability to suppress the transcription of HBV messenger ribonucleic acid (mRNA) and also suppresses its transcription. This hinders the replication of the virus and thereby preventing its spread in the liver.

Conclusion

The liver is known as the mother of all glands of the human body. It is one of the major organs of the body and it is involved in various life sustaining functions like emulsion of fats during digestion, production of various activating enzymes. Since the liver is functional in many processes of the body, it is also more prone to infectious diseases like jaundice; hepatitis etc. Amongst all the diseases, Hepatitis is one of the most fatal diseases of the liver. Till date hepatitis remains incurable by the western medicine system. The only way forward is vaccination which is now available and more and more people are getting it in time. But if we talk about cure it still has to be worked upon. Indian traditional medicine system can play a big role in producing the cure for this disease. Various Ayurvedic medicines and herbs like Bhumyamalaki, Guduchi, Haritaki, Trivrit, Kutki, Vasa, Nimba, can be used in treatment of liver ailments like hepatitis A, B and C. This paper has made the prospect of producing medicine for hepatitis through Ayurveda more probable. It is found in various researches that above-mentioned medicinal plants have positive effect on the health of human liver and some of these also show liver protective properties. Therefore, medicine from such plants may pose a durable cure for hepatitis but extensive research in this area is still required.

Reference

1. Shastri K.N; Chaturvedi G.N; Charak samhita 8 ed. Chaukhambha bharti academy Varanasi, 1981

2. Agnivesha, Charaka Samhita, chikitsa sthana, chapter 16, verse 35-36, Ayurveda deepika commentary by Chakrapanidatta. Editor: Yadavaji Trikamaji Acharya. Chaukhambha Surabharati Prakashana Varanasi. Edition 2016. Page no.528

3. Agnivesha, Charaka Samhita, chikitsa sthana, chapter 16, verse 35-36, Ayurveda deepika commentary by Chakrapanidatta. Editor: Yadavaji Trikamaji Acharya. Chaukhambha Surabharati Prakashana Varanasi. Edition 2016. Page no

4. https://www.jpsr.pharmainfo.in/Documents/Volumes/vol12issue08/jpsr12082014.pdf

5. https://www.google.com/search?q=incubation+of+hepatitis+a&oq=icubation+of+hepatis&aqs=chrome.2.69i57j0i13l2j0i13i30j0i10i22i30j0i8i13i30l5.11353j0j15&sourceid=chrome&ie=UTF-8

6. https://www.google.com/search?q=incubation+of+hepatitis+b&ei=jgskY9zzBNOTseMPmr2K0Aw&oq=incubation+of+hepatitis

7. https://www.google.com/search?q=incubation+of+hepatitis+c&ei=_gskY6q2E9vgseM

8. Hari Sadashivshashtri Paradkar, Ashtang Hriday, Chikitsa Sthana 17/30, Sarvanga sundara and Ayurved Rasayana tika, Chaukhanbha Prakashana, Varanasi, Reprint, 2014

9. Vaghbata Astanga Hridaya with commentaries, Sarvanga sundari of Arunadatta and Ayurveda Rasayana of Hemadri, annoted by Dr.Anna Moreshwara Kunte edited by Bhishag Acharya Haridasa shiva Shastri Paradakara, Piblished by Krishnadas Academy, Varanasi chikitsastana 13th chapter 11,12 shloka.

10. Vagbhata. Ashtanga Hridaya, with the commentaries of Sarvanga Sundaram of Arunadatta and Ayurveda Rasayana of Hemadri, reprint 2000. Varanasi: Krishnadas Academy; 2000. sutra stana, 15th chapter 15th shloka

Manuscript Received	Review Round 1	Review Round 2	Review Round 3	Accepted
2022-11-05	2022-11-07	2022-11-14	2022-11-21	2022-11-27
Conflict of Interest	Funding	Ethical Approval	Plagiarism X-checker	Note
Nil	Nil	Yes	19%

Review Article

Hepatitis

Journal of Ayurveda and Integrated Medical Sciences