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In cirrhosis liver is firm; edge of the liver
is thick and the surface of liver is rough
or nodular in the latter i.e. in infiltration
the liver is smooth and soft or rubbery
and the infiltration may be due to fat,
glycogen, lipoid, pigment etc.
The second group is mainly of academic
importance.
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ß ëatients of portal hypertension may come only
for haematemesis and on examination, spleen is
enlarged.

ß In any cirrhosis of liver where the enlargement of

the liver is too much or the nodules are very big
and hard, malignancy of liver should be
suspected.
ß I must stress that as compared to hepatic
amoebiasis and infective hepatitis, cirrhosis of
liver is a very rare disease in general practice
since alcohol has now a days has become a
status symbol.
ß Rirrhosis is usually seen in Alcoholic
patients. Before 20 yrs malignancy of
the liver was more rare disease, but
now as we see in our institution,
Malignancy is increasing very fatly,
often the patient may feel the huge liver
lump and comes to a general
practitioner. Regarding treatment of
cirrhosis, it all depends on the mode of
presentation.
ß Those detected during routine examination
need only by given advice regarding high
protein diet and avoidance of alcohol.
ß To those coming with symptoms of chronic
hepatic failure, the same advice of high
protein diet and avoidance of alcohol. To
those coming with symptoms of chronic
hepatic failure, the same advice of high
protein diet with additional high dose of
vitamin B Romplex must be given.
Metheonine and choline are of use in early
stages only, Injections of liver extract have no
place in the treatment, It is quite useless and
waste of money.
ß A case of cirrhosis with portal hypertension
coming only for haematemesis should
strongly be recommended surgery i.e.
ërotocaval shunt, after acute stage of
haematemesis is treated by multiple blood
Transfusions Rases of Ascitis need high
protein but salt free diet with plenty of
diuretics, The tapping of ascitis
therapeutically should be discouraged
because it precipitates complications.
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| s ërotein contents (Gm) Ralories

ß Îegetable 1 0.5 10 to 20
ß Milk 1 1.0 20
ß Egg one 2 4-5 75
ß Rice Rooked 3 2 100
ß Wheat 1 Rhapati 3 100
ß Dals Rooked 3 6 100
ß Meat 1 7 80
ß Fish 1 5 25
ß Dry Fruits 1 7-8 120
ß Grams and monkey nuts1 7-8 120
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ß In short to any patent of chronic liver disease,
the best advice that a doctor can give is to
take the above high protein diet for life time.
There is no drug in the market which is really
effective in cirrhosis and chronic liver
disease. Extra B Romplex perhaps may be
helpful. But most of the tonics for liver, liver
extracts, bile preparations and methionine
and choline preparations are nearly 100%
useless and if one prescribes them it is only
to pass time and fill his pocket. It is not
ethically goods.
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ß There is a third increasing disease of liver
caused by alcohol which is knows as
alcoholic hepatitis, I do not want to go in its
details but I would only like to warn you. That
this condition can mimic all liver diseases,
these patient may develop typical symptoms
and signs of cirrhosis with ascitis or picture of
hepatic amoebiasis or combination of all
above signs. If these patients stop drinking
even at this stage (There is no specific
treatment). About 50% may be cured, 10 to
30% die and others develop permanent
cirrhosis. The condition should be thought of
only is heavy drunkards.
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ß Divya sarvkalp kwath 200 gm
Divya kayakalp kwath 100 gm
Mix both the powders. Take one teaspoonful
of mixed ëowder; Boil it into 400ml of water
till it is reduced 100 ml i.e. one fourth drink it
on empty stomach in the morning. The same
process is to be repeated in the evening.
ß !waran Basant Math 2gm
ß ëragal ëanchamrit 10gm
ß !warna makshik bhasm 5 gm
ß Kasis bhasm 5 to 10 gm
(as the case may be)
ß Amrita satva 10 gm
Mix all the contents into one and divide it into
60 equal parts each part should be taken
twice daily i.e. morning-evening mixed with
honey or water on empty stomach.
ß ëunarnavadi mandoor 40 gm
ß Arogyavardhni vati 40 gm
ß Udramrit vati 60 gm
one tablet of each is to be taken after
breakfast, lunch and dinner with lukewarm
water.
ï




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1. Bark of shynak 25gm
ß Bhoomi Amla ëanchnag 25gm
ß ëunarnava mool 25gm
Take all these there herbal drugs in fresh
form. Rrush them and extract their juice take
it regularly in the morning on empty stomach
till cure.
2. Kutki churna 625 mg to 1.25 gm with
lukewarm water.
3