E-ISSN:2456-3110

Case Report

Jaundice

Journal of Ayurveda and Integrated Medical Sciences

2023 Volume 8 Number 9 September
Publisherwww.maharshicharaka.in

Management of Kamala (Jaundice) with Ayurveda Treatment - A Case Study

Vyas O1, Dixit A2*, Tyagi A3
DOI:10.21760/jaims.8.9.31

1 O P Vyas, Professor and HOD, Department of Kayachikitsa, Govt Dhanwantari Ayurveda College, Ujjain, Madhya Pradesh, India.

2* Arti Dixit, Post Graduate Scholar, Amo Govt Of Mp Department Of Kayachikitsa, Govt Dhanwantari Ayurveda College, Ujjain, Madhya Pradesh, India.

3 Abhishek Kumar Tyagi, Post Graduate Scholar, AMO Govt of MP Department of Kayachikitsa, Govt Dhanwantari Ayurveda College, Ujjain, Madhya Pradesh, India.

Jaundice is a yellowish pigmentation of the skin, sclera, mucous membrane and intestinal fluid due to high bilirubin levels. In Ayurveda, Jaundice and their treatment are very well described under the heading of Kamala Vyadhi. Jaundice can develop in all age of peoples. Clinically sign of jaundice occur when the serum bilirubin level exceeds 2.5 to 3 mg/dl. Level of bilirubin in blood are normally below 1.0 mg/dl. Most of the people have become used to spicy food, fast food, alcohol consumption day by day. This has taken human being far away from nature. Ayurvedic text has mentioned hepatocellular jaundice as Kamala. Kamala due to frequently intake of Pittakara Aahara (Spicy and fast food). Its leads to vitiation of Pitta Dosha. Kamala is such a disease where in the Rakta Dhatu is vitiated primarily by Pitta Dosha. Kam means different type of desire of body and mind desire especially regarding the diet and physical activity of body are minimised in Kamala. In Kamala disease there is loss of desire to do anything. This paper discusses a patient in the OPD of Kayachikitsa department in Dhanwantari Ayurveda Hospital, Ujjain. His chief complaint is yellow discolouration of skin, Icterus, yellow discolouration of urine (Pittamootrata), Anorexia, since 7 days. Here is a case report of 12 years old child was having Kamala who was treated with some Ayurvedic internal medicine and mild purgative, after 15 days we got effective result by Ayurvedic management.

Keywords: Kamala, Jaundice, Ayurvedic management, Case Study

Corresponding Author How to Cite this Article To Browse
Arti Dixit, Post Graduate Scholar, Amo Govt Of Mp Department Of Kayachikitsa, Govt Dhanwantari Ayurveda College, Ujjain, Madhya Pradesh, India.
Email: 		Vyas O, Dixit A, Tyagi A, Management of Kamala (Jaundice) with Ayurveda Treatment - A Case Study. J Ayu Int Med Sci. 2023;8(9):187-190.
Available From
https://jaims.in/jaims/article/view/2776

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2023-07-13 2023-07-17 2023-07-24 2023-07-31 2023-08-24
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
None declared Nil Yes 20.95%

© 2023by Vyas O, Dixit A, Tyagi Aand Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

J Ayu Int Med Sci 2023;8(9)187
O.P. Vyas et al. Management of Kamala (Jaundice) with Ayurveda Treatment

Introduction

Jaundice refers to the yellow appearance the skin, sclera and mucous membrane resulting from an increased formation or decreased hepatic clearance of bilirubin. Yellowing of the skin can also occur in carotenoderma with use of quinacrine and with excessive exposure to phenols.[1] High bilirubin is divided into two types: unconjugated (indirect), conjugated (direct). conjugated bilirubin can be confirmed by finding bilirubin in the urine.[2]

Presence scenario industrialization brings a lot of change in our lifestyle and especially in our food habit spicy and fast-food day by day also there is increased prevalence of hepatitis due to increased population living in congested area, poor sanitation, polluted water, and consumption of unhygienic food. Most of time patient just come with “sick & tired” later it got diagnosed as Kamala (Jaundice). According to Acharya Charak as Pittaja Nanatmaja Vyadhi[3] and Raktapradoshaja Vyadhi[4] and Acharya Charak also described Kamala as advance stage of Pandu Roga. When Pandu Rogi who cured from Pandu continue to take Pitta Vardhak Aahar then this cause excessive aggravation of Pitta Dosha this further leads to Kamala.[5] The sign and symptoms of Kamala according to Acharya Charak is Haridra Netra, Haridra Twak Nakhanana (eyes, skin, nails and face become yellow), Bhekvarno (develop complexion like frog), Hatendriya (his sense get impaired), Daah, Avipak, Dourbalya etc. Acharya Charak has mentioned “Kaamli Tu Virechanam” as Chikitsa Sutra.[6] The basic concept behind that the Rakta and Pitta Dushti are responsible for Kamala and timely interval Virechan and Shamana Chikitsa help to get rid of vitiated Rakta and Pitta.

History of present illness
A 12 years old child patient OPD No. 23296 visited in OPD of Kayachikitsa Department of Dhanwantari Ayurveda Hospital, Ujjain during the month of July 2022. Patient belong to middle socio-economic community. The patient has already been diagnosed with Jaundice and admitted in allopathy hospital from 18/7/22 to 21/7/22 after no improvement he visited Ayurveda hospital on 21/7/22 for better management. He has blood investigation report which was already done on same day (21/7/22) total bilirubin = 16.53, direct bilirubin = 11.04 and indirect bilirubin = 5.49.


History of past illness
Jeerna Pratishyaya (Chronic Rhinitis)

Chief complaints
1. Yellowish discoloration of urine
2. Icterus
3. Yellowish discolouration of skin
4. Anorexia
5. Nausea
6. Generalized weakness

Systemic examination
CNS - well oriented to person place and time
Respiratory system - no added sound present, no obvious deformity
Digestive system - loss of appetite
Urogenital system - yellowish discoloration of urine

Astha Vidha Pariksha
1. Nadi (Pulse) = 76/min
2. Mala (Stool) = Vibandh (Constipation)
3. Mutra (Urine) = Pitavarniya
4. Jihwa (Tongue) = Ishat Pita
5. Shabda (Speech) = Prakrut (Normal)
6. Sparsh (Skin) = Pitavarniya
7. Druka (Eyes) = Netrapitata
8. Akriti (Shape) = Prakrit

Treatment plan
1. Patient was managed on OPD basis
2. Mild purgative medicine
3. Internal Ayurveda medicine

Treatment given for 15 days

1. Virechana Karma (Mild purgative)

Due to frequently intake of Pittakara Aahara (spicy and hot food), it leads to vitiation of Pitta Dosha and Virechana (purgation) is the first line of treatment for Pittadushti. Patient was given Erand Tail 15ml with milk for at every 7th day.

2. Internal medication

A. Tab. Nirocil 1x2
    Tab. Livomyn 1x2
    Cap. Bactica 1x2
    Syp. Jaundex 10ml x3

B. Avipattikar Churna 30gm
    Panchkol Churna 30gm 3gmx2
    Balchaturbhadra Churna 30gm

C. Lakshmivilas Ras 5gm
    Kravyad Ras 5gm
    Rohitak Lohh 5gm 500mgx2
    Jwarankush Ras 400mg


J Ayu Int Med Sci 2023;8(9)188
O.P. Vyas et al. Management of Kamala (Jaundice) with Ayurveda Treatment

Result

The result was appreciable in both the clinical and laboratory criteria. Statistically relief in yellowish colour of eyes and urine, loss of appetite, weakness and reduction in serum bilirubin level.

Serum BilirubinBefore TreatmentAfter Treatment
Total16.534.24
Direct11.043.14
Indirect5.490.83

Discussion

During the treatment patient was kept only on oral medication for a period of 15 days. Thus, after the 15 days of treatment patient had got significant improvement of all symptoms. Now patient is gradually improving and there is no recurrence of symptoms after the 3 months of follow-up.

Tab. Nirocil - it contains Tamalaki, Guduchi, Erand and Yashad Bhasma, so its acts as Yakrituttejaka, immunomodulator, Jwaraghana and Rechaka.

Tab. Livomyn - it contains Kalmegha, Bhoomiamlaki, Punarnava and Kutaki, so it promotes normal liver function, normalizes inflation of liver, strengthens liver and stimulates appetite.

Tab. Bactica - it contains Neem, Amla, Shudh Guggal, Manjijishtha and Shankh bhasma etc. so its acts as liver protectant, Rasayana, improve liver function, Rakta Shodhaka and Pittasaraka.

Syrup Jaundex - it contains Rohitaka, Daruharidra, Haritaki, Yavakshar, Navsadara etc. Katuki, Rohitak and Haritaki possess hepatoprotective property and reduce increased bilirubin. Guduchi is an excellent immunity-boosting herb and helps in the detoxification and rejuvenation of the liver.

Avipattikar Churna - it contains Trikatu, Triphala, Nishotha etc. so it regulates of Pitta secretion, Agni Deepana, Mala-Mutra Vibhandhanasak.

Panchkola Churna - it contains Pippali, Pippalimoola, Chavya, Chitraka, Shunthi, so its acts as Pachana, Deepana and Kaphavatahara.

Balachaturbhadra Churna - it contains Nagarmotha, Pipali, Ativisha, Karkatshringi, so its acts as Jwaraghana, Kaphahara and Aampachana.

Kravyad Ras - it contains Parada, Gandhak, Marich and Tankana etc. so it eliminates toxins from the body and improves digestion and absorption.

Rohitaka Loha - it contains Rohitak, Triphla, Trikatu,

Chitrak, Loha Bhasma etc. so its act as Yaktituttejaka, Shothahara, Vednastahapana and Rasayana.

Jwarankush Ras - it contains Parada, Ghandhaka, Vatsanabha, Shunthi and Tankana, Hartala. so, its act as Jwarghna, Swdjanana, Aampachana and Shothahara.

Conclusion

From the above description it appears that the drug exerts an effect in breaking the pathogenesis of Kamala. They act as Raktashodhaka, Tridoshaghna, Jwaraghna, Depana, Pachana, Anulomana and act as a Rasayana so improve Dhatu formation. These drugs reduce bile in blood circulation and normalize the other blood parameters. In short Virechana Karma and Shamana Chikitsa including above said medication gave good result in management of Kamala. Virechana procedure remove toxin from the body and promote immune system and after Virechana internal medication work better and provide additional relief and eradicate the disease.

References

1. Davidson, Edited by, Davidsons Principles and Practice of Medicine,19th Edition

2. Munjal YP, API Text book of Medicine, 10th Edition Vol-1.

3. Pandey KN, Chaturvedi GN, Charak Samhita of Agnivesh Elaborated Wit Part 1 Sutra Sthan; Mahrogadhyay: Chaper 20 Verse no. 14 ed. 19 Varanasi, Choukhambha Bharti Academy 2021 Page no. 351

4. Pandey KN, Chaturvedi GN, Charak Samhita of Agnivesh Elaborated Wit Part 1 Sutra Sthan; Vividhashitiyapitiyadhyay: Chaper 28 Verse no. 12 ed. 19 Varanasi, Choukhambha Bharti Academy. 2021 Page no. 502

5. Shukla VD, Tripathi RD, Charak Samhita of Agnivesh Elaborated Wit Part 2 Chikitsa Sthan;Pandu Rog Chikitshitam:Chaper 16 Verse no. 34 ed. 2007 Varanasi Choukhambha Sanskrit Pratishthan Page No. 399

6. Shukla VD, Tripathi RD, Charak Samhita of Agnivesh Elaborated Wit Part 2 Chikitsa Sthan; Pandu Rog Chikitshitam:Chaper 16 Verse no. 40 ed. 2007 Varanasi Choukhambha Sanskrit Pratishthan Page No. 401


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