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Hepatitis
Similar disease in Ayurved- Kamala                                            
What is viral hepatitis?
What your liver does for you?
How does hepatitis occur?
How does hepatitis A occur?
How does hepatitis B occur?
What Ayurved has to say about hepatitis?
What are the symptoms?
What are the symptoms according to Ayurved?
Which laboratory investigations are to be carried?
What are the preventive measures and treatments?
Which diet and conduct is advisable?
What I should avoid?
How can I prevent viral hepatitis?
What is viral hepatitis?

Viral hepatitis is inflammation of liver caused by virus. Its symptoms resemble with most of the
other liver damaging ailments. In India hepatitis occurs throughout the year, and attacks primarily
children and young adults. When you suffer from hepatitis, your skin turns dark yellow and you feel
miserably sick. It is an infectious disease and mode of spread is different in different types of viral
hepatitis.
What your liver does for you?

The liver is the biggest and the heaviest organ in the body. It is your metabolic organ, which is
essential for the metabolism of carbohydrate, protein and fat. Chemically it is the busiest organ and
it processes (metabolizes) all the food we eat. It stores glucose as glycogen and breaks down this
glycogen into glucose to maintain the blood glucose level. It manufactures new protein, it converts
some amino acids from protein into glucose; it also converts other amino acids into fatty acids. It is
the main organ involved in fat processing. It is also associated in cholesterol formation in your
body.
It filters out toxic substances every day from your body. Every day red blood cells break down and
bile pigments (bilirubin) are formed. Further it aids in digestion and absorption of fat. It also gives
colour to the stool. In viral hepatitis, due to inflammation of liver, your liver enables to eliminate all
the excess pigments from the blood and this gives rise to jaundice.
Liver is essential in forming blood protein such as albumin, globulin. It also forms substances
essential for the blood clotting mechanism.
How does Hepatitis occur?

In Indian subcontinent and all over the world, hepatitis spreads havoc. It affects people through
various routes such as - drinking contaminated water, consuming foodstuffs from roadside vendors,
poor sanitation etc. Crowded city (or dense population) harbours the greatest number of victims.
All types of virus enter in portal circulation and then target liver.
How does hepatitis A occur?

Virus of hepatitis A attacks the human body mainly through oral route. Contaminated food / water
is the main mode of propagation of the infection. The spread of this disease in a population is
directly related to the sanitation and the sanitary practices. It simply means that if you do not
ingest anything that contains the virus, you won't get the infection. If the person is infected with
hepatitis A and proper disposal of food waste and excreta is taken care of, it cannot spread to
another person. Spread of hepatitis A via sexual route is also common.

How does hepatitis B occur?

Entirely different virus causes hepatitis B. Hepatitis B virus cannot enter the body through the oral
route. The virus must gain the access to blood circulation.

Hepatitis B virus spreads through the transfusion of infected blood. It also spreads through the use
of infected / non-sterilized needles to perform medical, dental or surgical procedures.
There are several other reasons, which contribute towards the propagation of the infection viz.,
precutaneous drug abuse (drugs taken through injection), immunisation, laboratory accidents,
acupuncture, tattooing. In any of these cases even the minute amount of blood inoculation makes
you susceptible enough to catch the infection. Accidental inoculation with the object like razors,
contaminated with the infected blood, can cause hepatitis B.

Hepatitis B is frequently transmitted by personal contact, by sexual activity.  Various body fluids
such as saliva, menstrual and vaginal discharge, seminal fluids, breast milk and serous exudates
have been implicated in the spread of the infection. 

It can be transmitted from mother to her new born infant particularly if the mother has been
suffering from hepatitis B in the last months of her pregnancy.

Health care personnel are often at the risk of getting hepatitis B by accidental inoculation.
There are many more versions of the virus hepatitis, other than hepatitis B, is available viz.,
hepatitis C, D & E.
Hepatitis C is spread through blood transfusion and is a major cause of post transfusion viral
infections.
Hepatitis D is the piggyback virus and you get the infection only if you already had hepatitis B.
Hepatitis E is mostly found in Southeast Asia, India and North Africa.  It is another virus
transmitted through fecal oral route, but it is more dangerous than hepatitis A virus and may even
be fatal.
What Ayurved has to say about hepatitis?
In Ayurvedic text symptoms resembling to hepatitis are found in the disease 'Kamala'.
In Ayurved the understanding of the disease is based on the belief that it occurs by the altered
physiology owing to different influencing factors. Presence or absence of a particular virus may not
necessarily affect the course of the disease.  

According to Ayurved bile or pitta is the end product (mala) of rakta dhatu (~blood) production.
This process can be compared with the decomposition of haemoglobin, in which bilirubin is produced
as the end product. Bilirubin is the main constituent of the bile that is secreted through the liver. 
Digestion of food is carried out in grahani (duodenum) with the help of bile, which also contains
bilirubin. The mala pitta (bile), which is secreted by liver, is carried to the grahani where it
contributes in food digestion; it also gives specific color to urine and stool.

Properties of pitta dosha, according to Ayurved, are sasneha, ushna (hot), teekshna, drava
(liquidity), sara and katu (pungent). When all these properties of pitta are in proper relative
equilibrium, it performs its normal functions. When etiological factors such as excessive salt, sour
food, excessive consumption of alcohol and exercise, excessive sexual intercourse, penetrating
food such as pickle, very spicy and hot food and junk food, etc., vitiates pitta.

All these factors vitiate pitta by disturbing its relative quantum of dravatva or fluidity. Jala
mahabhoota in pitta is relatively increased. When water content or jalatva of pitta increases, it
affects the main functions of digestion.

Agni, which has innate relations with pitta, becomes weak and hence food is not digested properly.
Because (mala) pitta is the end product of blood, when it gets vitiated blood also gets deranged in
turn and vice versa.

Increase in the fluidity of pitta also quantitatively increases Rakta dhatu but numbers of R.B.C. that
are present in the blood are decreased. Hence anaemia (Pandu) occurs.

If the patient continues in the diseased state with the same dietary regimen and conduct that are
predisposing to panduranga or anaemia, the pitta vitiates further and gives rise to jaundice.
Ayurved describes two types of jaundice
1.Bahu pitta kamala: Jaundice in which pitta is increased and vitiated greatly (bahupitta). When
the patient consumes diets that vitiate pitta. The water contained in the pitta burns (diminishes)
and concentrates i.e. dravatwa reduces. This consequently increases tikshnata and ushnata.
2.Alpa pitta kamala: Symptoms of alpa pitta kamala resembles with the symptoms of viral hepatitis.
Kamala or jaundice in which pitta remains in normal state but due to obstruction it does not enter
in duodenum and gets absorbed again in to systemic circulation. It then gives rise to yellow tint to
skin, sclera, etc. Due to obstruction it is unable to enter in duodenum, and also unable to offer
stool its normal color. Stool becomes clay colored. The main cause of this obstruction is
inflammation of the liver cells due to viral or chemical hepatitis or any other obstructions, present in
course of billiary tract.
What are the symptoms that indicate hepatitis?

1.In some cases you may not have any symptoms of hepatitis virus, still, you may be carrying the
infection since long. While assaying the blood you may find the antibodies.
2.Hepatitis often begins as a non-specific illness and may give symptoms, which are similar to
influenza. Temperature suddenly, rises and remains in-between 101 and 103 degree Fahrenheit.  In
some instance the fever could be mild.
3.Digestive symptoms such as loss of appetite, anorexia etc., is usually present. Anorexia may
increase vomiting.
4.Fatigue or weakness.
5.You may complain of joints pain, skin rashes may also appear.
6.You may continue to work till jaundice is noticed.
7.First sign of jaundice is a light yellow tint in the white portion of the eyes (icterus).  As your liver
function deteriorates jaundice appears.  Skin becomes yellowish, jaundiced stool may become light
in color.  Urine becomes highly colored.
8.You may get pain in the region of liver (right upper quandrium).
9.Liver enlargement and tenderness if often present.
10.Pruritis or itching is the symptom, which irritates you for a long.
All these symptoms vary in different types of hepatitis. Hepatitis A is usually a mild illness and the
same is jaundice, if it occurs. Person infected with hepatitis A do not become carrier and it does
not aggravate to chronic hepatitis that leads to cirrhosis of liver. If you are suffering from hepatitis
B you are likely to be ill for a longer time than hepatitis A and you may lead to the chronic state or
become a carrier.  In future you may develop massive hepatic necrosis or cirrhosis of liver (fatty
infiltration). 
Hepatitis C behaves like hepatitis B but antibody test is not positive until 15 weeks after the onset
of clinical symptoms.
What are the symptoms according to Ayurved?

Bahupitta kamala:
1.If you are suffering from bahupitta kamala your nails, eyes (sclera - white portion of the eye),
skin, urine and stool will become dark yellow.
2.You are surely going to have the symptoms such as - heart burn, loss of appetite, anorexia,
indigestion etc., these all symptoms indicate that the liver and the digestive system is disturbed
because of the deranged pitta.
3.Symptoms of general debility caused by improper metabolic function of liver are prominent in this
kamala, such as - body ache, malaise, weakness and general debility.
Alpa pitta or Ruddha patha kamala :
1.Stool becomes whitish or light in colour due to obstruction in bile duct, which restrains pitta from
going through its passage.
2.This accumulated pitta when enters in blood circulation gives dark yellow color to your nails, skin,
eyes and urine.
3.All other symptoms, which are mentioned in bahupitta kamala are also present in ruddha patha
kamala.
Which laboratory investigations are to be carried?

Routine blood investigation such as - CBC, ESR, liver function test are the tests that refer to a
group of biochemical investigation in revealing or confirming the liver pathology.  It includes
bilirubin, aminotransferases, alkaline phoshphatase, plasma protein(albumin/globulin), coagulation
test etc. Antibody and antigen test (serological tests) are also important in order to identify
various types of viruses.
What are the preventive measures and treatments?
Consult your doctor immediately. Hepatitis can be fatal if not treated properly.  For the sake of
information only, we are presenting few aspects for the treatment of kamala according to
ayurveda.
In bahupitta kamala the treatment of jaundice must start with purgation.  For purgation you can
take decoction of aragwdha, draksha, nishottar etc.  The basic theory is to avoid the burden on
liver, for the same daily laxative is recommended.  Trivritta and katuka are the drugs of choice in
the treatment of hepatitis.
Drugs such as arogyardhini vati with avipattikar choorna can be taken under medical supervision.
In Ruddhapatha kamala measures to remove the obstruction in bile duct are preferred. For this
purpose pungent, penetrating, salty medicinal drugs such as saindhava, trikatu etc., are
recommended till stool regains its color. Later, the treatments that are described in bahupitta
kamala should be administrated. Other drugs used in the treatment of jaundice are vasaka, triphala
etc.
When symptoms do appear, bed rest should be advised to the patient.  Bed rest should be
continued until the signs and symptoms disappear, and liver function tests return to normal.
What diet and conduct is advisable?

Your diet should be nutritious and light (or which is not heavy to digest) old shasthi rice or chapati
made of wheat, millet that is roasted properly can be a mainstay of your diet.
Vegetable such as guard, serpent gourd, parwar, punarnava are recommended.
Soup of green gram (mudga), lentil is recommended. Juice of sweet lime, sugarcane, lemon, and
pomegranate can be taken. You can have ghee in less quantity, mastu (watery part of curd),
ginger etc.
You should drink boiled water always. If excessive thirst persist sugar water, glucose water, water
prepared with plums will give you relief.

What I should avoid?

1.Avoid spicy, pungent, oily, sour and salty food. Pickles, vineger, sour curd and sour buttermilk
should be strictly avoided. Fermented food such as idli, dosa. dhokla and bread etc is very heavy
to digest ,so avoid it.
2.Some vegetable such as leafy vegetables, tomato, tamarind, red pumpkin, potato, sweet potato,
sago, drumstick, red radish, chilies and Grains such as Maize etc.
3.Black gram, bean, pea nuts, horse gram, chicken, pork, meat of pigeon, buffalo's milk and curd.
4.Watermelon, banana, guava, custard apple, tamarind, fig fruit, chicoo.
5.Chilled water and aerated cold drink and other beverages like tea, coffee.  
6.Exertion, sexual intercourse, physical stress and sleep during daytime.

How I can prevent viral hepatitis?

Hepatitis A
1.If you don’t ingest any thing that contains the virus you don’t get hepatitis A.
2.One who is suffering from hepatitis A should properly dispose of his urine and stool, which will
prevent further spread of the disease.
3.Use boiled water for drinking purpose.
4.Passive immunisation for hepatitis A.
5.And follow the dietary measure and conduct which are mentioned earlier.

Hepatitis B
1.Unnecessary blood transfusion, plasma transfusion should be avoided.
2.Blood donors with history of jaundice should be rejected. Donor’s blood should be screened for
hepatitis B antigen, antibodies, and positive reactors should not be accepted.
3.Use of disposable syringes and needles, will prevent you from this disease.
4.Contaminated articles should be heated or sterilized or incinerated.
5.Passive immunisation for hepatitis B.