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Liver is the largest organ in the body. It is very much important in carrying our different functions related to metabolic process, haemopoietic process, immunological functions, etc.
Functional strength of the liver cells is up to such extent that even after 80% of their destruction , They can regenerate and maintain their proper functioning . All of the functions of the liver are very much related to healthy life.
As per Ayurveda Yakrit is considered as one of the organs situated in kostha. There is no separate classification as yakrdroga in Ayurvedic texts. All the basic Ayurvedic classics described diseases like Pandu, kamala, udara, etc.which are the main presenting features of yakratroga.
Liver is a seat of Bhutagni. Many functions happen in liver like: Metabolic function, Storage function, Secretion of bile, Synthetic function, Excretory function, Heat production, Haemopoietic function, Haemolytic function, Inactivation of hormones & drugs, Defensive function and Detoxification function. Liver is considered as an important organ in Ayurveda. It is a seat of rakta vaha srotas. Kamala is the main disease of liver in which kama or desire is lost. Desire or abhilasa is controlled by pitta. Liver is also a seat of Ranjaka pitta. Udara is also a disease in which liver is involved.
Liver disease can manifest in many different ways. Manifestations of liver diseases that are particularly important include Jaundice, Cholecystitis, portal hypertension, ascitis, liver encephalopathy and liver failure.
Cirrhosis of the liver is a chronic and progressive condition in which the liver gets damaged and healthy liver tissue is replaced with scar tissue, ultimately causing dysfunction of the liver. Liver damage obstructs the circulation to the liver and also hinders the processing of nutrients, hormones, drugs, toxins as well as the production of proteins and other substances made by the liver. Liver cirrhosis is caused due to hepatitis C, fatty liver, alcohol abuse, viral infections, inherited diseases, and as a toxic reaction to drugs and environmental waste products. The modern management of this condition involves diet modification, reduction in salt intake, total abstinence from alcohol, and avoiding all the causative factors of this condition.
Cirrhosis of liver causes multiple symptoms in the body including fluid collection in the abdomen, bleeding varices in the stomach, chronic heart failure, damage to the central nervous system, and various metabolic disorders in the body. Advanced cirrhosis of liver is ultimately fatal.
It is therefore of prime importance to commence treatment at the earliest possible. It is of utmost importance to treat the known cause of the condition. Ayurvedic herbal medicines have a definite action on the hepatic cells and can effectively treat inflammation within the liver. Ayurvedic medicines can also treat infection as well as metabolic dysfunction of the liver, and protect it from the toxic effects of drugs and environmental wastes. Ayurvedic medicines can therefore be effectively used to treat all the known causes of liver cirrhosis.
Liver damage causes healthy cells to be replaced with scar tissue. This is preceded by a process of inflammation, swelling and gradual death of the liver cells. Early institution of Ayurvedic treatment can help dramatically reduce inflammation and swelling and thereby preserve the liver cells and prevent unnecessary damage. Even in the early phase of scar deposition. Ayurvedic herbal medicines can help remove scar tissue, minimize permanent liver damage, and help regenerate damaged or near-dead cells Ayurvedic herbal medicines therefore form a comprehensive treatment therapy for liver cirrhosis.
The other symptoms resulting from liver cirrhosis such as ascites, esophageal varices, congestive cardiac failure and metabolic disorders start improving automatically when the obstruction in the liver is treated and removed. However, Ayurvedic medicines can treat these symptoms independently too, if these are observed to be severe in the affected individual and require urgent medical care. Improved functioning of the liver also helps to improve the overall metabolism and nutrition of the body and metabolize toxic substances within the body. Prompt and aggressive Ayurvedic treatment therefore helps comprehensively treat liver cirrhosis and significantly reduce morbidity and mortality resulting from this disease.
Cirrhosis can also adversely affect the central nervous system and cause psychotic symptoms and permanent nerve damage. Prompt treatment with Ayurvedic herbal medicines also helps to preserve the brain function and treat the associated symptoms. If required, brain damage can be treated separately with herbal medicines which strengthen the nervous system and help rejuvenate nerve cells. Medicines which act on the nervous system also help improve confidence and self-control and are therefore equally useful in helping the affected individual abstain completely from alcohol, which is a known and predominant cause of cirrhosis.
Depending upon the severity of the condition, most individuals affected with cirrhosis require regular and aggressive Ayurvedic herbal treatment for periods ranging from six to eighteen months, in order to obtain significant benefit and a possible complete cure from the condition. Ayurvedic treatment thus has a definite role to play in the management and treatment of cirrhosis.
Ascitis is the accumulation of free fluid in the space between the lining of the abdomen and the abdominal organs. Ascitis tends to occur in the long –standing (Chronic) rather than in short-lived disorder. It occurs most commonly in cirrhosis (severe scarring of the liver) or diseases that can cause severe liver damage these include long term hepatitis C or B infection and alcohol abuse over many years.
People with certain cancers in the abdomen may develop ascitis; these are cancer of the colon, ovaries, uterus, pancreas, and liver. Some other conditions can cause are Clots in the veins of the liver( Portal vein thrombosis),Congestive heart failure, Pancreatitis ,kidney failure and tuberculosis affecting the lining of the abdominal cavity.
In people with liver disease, ascetic fluid leaks from the surface of the liver and intestine. A combination of factors is responsible, including portal hypertension, decreased ability of the blood vessels to retain fluid, fluid retention by the kidneys and alterations in various hormones and chemicals that regulate bodily fluid.
Ascitis is comes under Udararoga, eight type udara roga are described in Ayurveda as vatadara, pittodra,kaphodra,sannipatodara,plihodara, baddodra,ksatodra ans udakodra. Out of these plihodara is called Yakratdalyudara( Hepatospleenomegaly). Udakodara or jalodara ( Ascitis) is one of the types of udara and is fatal of all types of udararoga.
Udara is said to be caused by factors such as intake of excessive usna, ksra, vidhai, amla food improper samsarjana karma, intake of ununctuous, viruddahara, emaciation as a consequences of diseases like Plharoga, Arsas,and Grahani; improper administration of Panchakarma therapy, suppression of natural urges, vitiation of the channels of the circulation, continued presence of Ama in the body, intake of irritating foods and drinks, over nourishment, etc.
Normally a liver contains a certain amount of fat, but if fat counts over 5-10% of the weight of the liver, the individual must be suffering from “fatty liver” or steatosis. Fatty liver has accumulation of triglycerides and other fats in the liver cells characterized by enlarged and swollen liver with fat. In some of the patients, fatty liver may be accompanied by hepatic inflammation and liver cell death (steatohepatitis).
The most common cause of fatty liver is alcoholism, Obesity, diabetes and elevated triglyceride levels.In some peoples, a fatty liver is not due to alcohol abuse or drugs and toxins but associated with obesity, diabetes mellitus and raised serum triglycerides will progress to scarring (fibrosis) and cirrhosis, possibly of underlying inflammation. This type of fatty liver is sometimes referred to as nonalcoholic steathohepatitis.
Normal, healthy liver tissue becomes partly replaced with fatty tissue and fat starts to body fat stores, which means that the liver burns fat less efficiently, resulting in weight gain and inability to lose weight. However some people can have a fatty liver without being overweight.Fatty liver can exist without causing symptoms or getting worse in some people. In others, fatty liver can lead to additional health problems
Most patients with nonalcoholic fatty liver (NAFLD) are asymptomatic. However, if questioned, more than 50% of patients with fatty liver report persistent fatigue, malaise or upper abdominal discomfort.
In accordance to Ayurveda, it is a Kaphaja yakrit Roga. There will be kapha vriddhi in pitta sthana and the patient will be having kapha vriddhi and pitta kashaya lakshana. Fatty liver is a reversible condition that can be resolved with changed behavior, diet and lifestyle.
Hepatitis, an inflammation of the liver, is originally an infectious disease, but wrong diet and other mainly pitta provoking factors increase the possibility of contracting it. The viral form is the most dangerous and has a more rapid onset. The bacterial form is not easily transmittable or as quick to show symptoms, but has long-term debilitating effects. Bad food and water lack of sanitation mainly cause this disease. When severe, it results in jaundice, with yellow discoloration of skin, eyes, urine, feces and mucus.
Symptoms of hepatitis are fever, loss of appetite, nausea and vomiting, pain and tenderness in the liver area or hypochondriac region, yellow discoloration of skin, eyes, nails and west materials, fatigue and diarrhea.
Provoking factors includes too much oily, greasy food, meat (particularly red meat), or sweets. As liver is responsible for sugar and fat metabolism, these foods tax its powers. Smoking, drinking alcohol and the use of recreational drugs (marijuana amphetamines) are also very damaging to the liver. A history of infectious diseases such as herpes or mononucleosis also makes one susceptible. Psychological factors are anger, resentment, depression and suppressed emotions.
Includes Liver fibrosis (Scaring of liver), Liver cirrhosis, Liver cancer, Liver failure, Hepatic encephalopathy, Glomerulonephritis, Portal hypertension, Viral Co-infection etc.
Herbal medicines are helpful in both acute and chronic hepatitis; particularly chronic hepatitis. Western medicine has little to offer for hepatitis except bed rest. Ayurveda offers a lot for hepatitis patients.
Jaundice is a yellowish discoloration of the skin and the whites of the eyes caused by abnormally high levels of the pigment bilirubin in the bloodstream. It is a clinical sign of many liver diseases. The common cause of jaundice is “Hepatitis” (swollen liver) mostly occurring due to infection by hepatotropic viruses. The viral agents causing hepatitis are designated viral Hepatitis A, B, C, and E. Of these Hepatitis A and E are transmitted by the faco-oral route (through contaminated food and water) and many occur in either sporadic form or as epidemics.
Hepatitis B and C are transmitted through the parenteral route and a certain percentage of the affected individuals are not able to clear the viruses from their body and become carriers of virus B or C. Some of these carriers will develop chronic liver diseases including chronic hepatitis, cirrhosis or even liver cancer if they live long enough with the disease. If these cases are detected in time before cirrhosis develop, they can be treated by anti –viral medications and Ayurvedic medications. Once Cirrhosis sets in at present there is no way to cure such patients in modern medicine unless liver transplantation is successfully preformed. But in Ayurveda there is a ray of hope. Through strict diet restriction and special Ayurvedic protocol even Cirrhosis can be treated successfully.
Sickle cell anemia, Malarial fever, Thalasseamia and Gilbert’s syndrome, Autoimmune hepatitis, Alcoholic liver disease, Drug misuse, Pancreatitis, Gall stones etc.
As per Ayurveda Viruda aahar and vihara like excessive intake of katu, amla, lavana rasa, usna, tikna, vidahi dravya ( pickles, carbonated drinks), excessive intake of madya (alcohol), indulgence in excessive sex and labor, day sleep, keeping awake at night, suppression of natural urges and mental causes are excessive hunger, fright, fear, grief etc. In Ayurveda visa( Poisons) – over use of hepatotoxic drugs and Dusita jala( polluted water) is important cause of kamala.
According to pathogenesis kamala is described to be of different types as
Treatment principles of kamala can be considered as the general line of treatment for all kind of yakratroga. Though in different conditions treatment line may differ according to the dosa-dusya sammurcchana involved in the causation.
The general principles given in kamala chikitsa can be followed in all yakratroga as the dusya is same for all conditions and all yakratroga involve Ras, Rrakta, Pitta and Agni as the major factor of vitiation.
Treatment of kamala can be summarized as:
Nidan parivarjanam – there should be strict avoidance of pittavardhikara diet and regimen and this is the first line of treatment.
Sodhana ( cleansing procedures like Panchakarma therapy)
Samana – This therapy is applicable to pacify the remaining dosa after sodhana and also when the patient is durbala and alpadosa.( only used oral medicines and minor treatment protocol).
Kamala or Jaundice can be treated very effectively and safely through Ayurvedic medicines and Panchakarma Therapy.