SAMPURNANAND SANSKRIT UNIVERSITY VARANASI (U.P.

An Etiopathological study of “KAMALA” w.s.r. to JAUNDICE

and Its Upshayatmak Parikshana by “LAUHACHURNADI YOGA”
PRESENTED BY

DR. RASHMI SHUKLA

J.R. 1st Deptt. of Roga Nidana Evum Vikriti Vigyan

Under the Supervision of

Guide Co- Guide
Co- Guide Dr. Avadhesh Kumar Dr. Shweta Mishra
Dr. Jaishankar Prasad M.D. (Ay.), Associate Proffessor & HOD M.D. (Ay.), Assistant Professor,
M.D. (Ay.), Assistant Professor, P.G Department of Roga Nidan Evum Vikriti Department of Kayachikitsa.
Department of Kriyasharir Vigyan.

Govt.P.G. Ayurvedic College & Hospital

Sampurnanand Sanskrit University
Chaukaghat, Varanasi-221001, Uttar Pradesh
Academic Year- 2021 - 2024
INTRODUCTION:
Now a days modern culture, advanced technology, fast and sedentary life style have lead to
irregular eating habits. Eating outside has become fashion which has increased the risk of
contaminated food and water. And also there is lack of concern about Dincharya and Ritucharya.
Irregular time of taking meals, ati katu-amla lavan rasa sevan, increase alcohol consumption,
increase anger due to stressful life, All these etiological factor are responsible for vitiation of ‘Pitta
Dosha” by causing increased Dravata, Tikshanata, Sarata, Guna of ‘samyak pitta”. Hence most of
the population suffers from ‘Agnimandhya”, Aruchi,sadana, Avipak, Indriyadaurbalya haridra
varnata, etc. which are the common symptoms of pittaj vyadhi like KAMALA. Most of the times,
patients just come with weakness and tiredness. Later on, it will be diagnosed as Kamala
(jaundice).The incidence of such diseases is increasing day by day.
• In ayurveda ‘kamala” vyadhi is known from ‘vedic kala”. Aacharya's
of bhrihatrayee i.E. Maharshi charak has considered kamala as
pravardhamanawastha of pandu roga. Acharya sushruta has
considered kamala as separate disease as well as further complication
of pandu roga. Acharya vagbhat has described kamala as ‘swatantra
vyadhi’. According to aacharya charak kamala is a ‘nanatmaja
vyadhi’ of pitta dosha and ‘raktapradoshaj vikar.
“ ik.Mqj®xh rq ;®∙R;ZFka fiRrykfu
fu"®or¢A

rL;fiRral`³ekala nXËok j®xk; dYir

¢AA ” ¼pñfpñ16@34½
Kamala is caused by two different ways. The first one is-

Excessive consumption of pitta prakopaka aahar vihar by

pandu rogi then aggrevated pitta burns the ‘Rakta and

Mansa and manifest’ ‘Bahupitta Kamala’ {Kosthashrita

Kamala}.
And the second is-excessive intake of ruksha, seeta, guru and Madhur aahar

vihar , Ati vyayam and vega nigraha, Diwaswapna etc. increases kaph and vata

which obstruct pittavaha shrotasa causes ruddhapath kamala {Shakhashrita

kamala}.Since there is no pitta in pakwashaya, produce Til pishtanibha

varchas.(Ch.chi.16/124)
Kamala can be correlated with ‘JAUNDICE’ in modern medical sciences. Jaundice is
yellowish discoloration of the skin , body fluids, mucus membrane sclera etc. due to
hyperbilirubinemia. Increase serum bilirubin level occur when an imbalance exists between
bilirubin production and clearance. Jaundice may be of different types. In Hemolytic jaundice
more bilirubin is found in blood due to excessive destruction of RBC and is not excreted out.
When bile duct is obstructed by gall stone or other causes and bile is accumulated in liver and
causes hyperbilirubinemia called obstructed jaundice. In Hepatocellular jaundice there is
completely or partially obstruction by edematous hepatocytes.
Need of this research work:-
Kamala is a common disorder seen in urban as well as rural areas with poor hygiene and
sanitization. Individual who indulge in nidana sevana as indicated under kamala become victims
of this disease. Liver diseases is 8th leading cause of death worldwide and kamala may end up
with many fatal complications like kumbhkamala, halimaka, panaki, yakritodara etc. So early
diagnosis of kamala rog is very necessary.

Modern sciences has limitations in treating Kamala Vyadhi (Jaundice) but ayurvedic
Literatures clearly explained Pathology and treatment of Kamala vyadhi.
 Ayurveda literatures have wealth of resource information regarding the nidana, samprapti, and

samprapti vighatan of Kamla roga which is helpful to prevent aggravation of disease and its complications.

By considering all these factors the study is needed at understanding the etiological factors, its

samprapti, Role of different present day causative factors & Investigations in evaluating the disease kamala

and lastly its samprapti vighatana by LAUHCURNADI YOG because it has the properties of Deepan,

Aampachana, mraduvirechaka, Rakta vardhaka, Saraka etc.

Why ‘Lauhchurnadi yog’ is selected:-
“y®gpw.kZ fu'kk;qXe af=Qyk dVqj®g.khe~ A
izfyá e/kqlfiZH;k~ dkeykrZ% lq[kh Òo¢r~ A”¼;®ñjñ½
According to ‘Yogratnakar’ the content of Lauhchurnadi yog is Lauhbhasma, harida,
daruharidra, triphala and chirayata with Sahpaan madhu and sarpi . In this study, selection
of Lauhchurnadi yog is done on the basis of the fact that these ayurvedic herbo-mineral
preparations act on the root of disease i.e. on Vitiated Pitta dosha by their tikta rasa, sheeta
virya, mradu virechak, rakta Vardhan and sarak guna etc. and thus these herbs are pitta
shamaka. Also this herbo- mineral preparation is cost effective as per the socio-economical
status of the patients.
Aim and Objective:-
 To study the literatures pertaining to Kamala and jaundice
in different Ayurvedic samhitas and modern literature.
 Upshayatmak parikshana of Lauhchurnadi yoga in
kamala.
 To evaluate the efficacy of lauhchurnadi yog in
hyperbilirubinemia & elevated SGOT, SGPT levels.
 Plan of Study:-

 Review of Literature
 Clinical study
 Observation and result
 Discussion
 Summary and conclusion
 Conceptual study :-

It is the literary review- the base of any research work. Before performing any practical part of the
research work is needed to go through books.. and published articles regarding the subject.

 Clinical study:-

Source of data:-

For the study total 60 patients which is fulfilling the clinical criteria for the diagnosis of Kamala will
be selected from the OPD and IPD of Govt. P.G. Ayurvedic College, Varanasi.

Material and Methods:-

 Method of collection of data:-

The patients will be diagnosed on the basis of ayurvedic and modern parameters. Clinical sign and
symptoms described in classical texts will be considered for the diagnosis of kamala.
Inclusion criteria:-
1. Patients having signs and symptoms of Kamala as described in ayurvedic
literatures and also having signs and symptoms of Jaundice as per as
modern medicine.

2. Patients having raised serum bilirubin >2 mg / dl .

3. Patients between age group of 16 to 70 years of both sexes.

4. Newly diagnosed patients of jaundice.

5. Pandujanya Kamala.
Exclusion critaria:-
1. Pregnant lady.

2. Age below 16 years and above 70 years.

3. Liver cirrhosis and Liver cancer, Liver abscess and viral hepatitis.

4. Kamala with upadravas and kamala occurring as a upadrava in other diseases.

5. Hyperbilirubinimia due to autoimmune disorder.

6. Patients with uncontrolled diabeties and uncontrolled hypertention.

7. Patients having immune compromised diseases like HIV, T.B. etc.

 INVESTIGATIONS:

 LIVER FUNCTION TEST

 HAEMOGLOBIN
 RANDOM BLOOD SUGAR

DIET AND RESTRICTIONS:

PATIENTS WILL BE ADVISED TO FOLLOW THE PATHAYA-APATHAYA AVAILABLE IN
AYURVEDIC LITERATURE ON KAMALA.
 Assessment criteria:- Assesment of patient was done on the basis of following
aspects:-

Subjective criteria:- On the basis of etiological factors:-

  +   +   + or
Aaharaj Nidana or Viharaja nidana or Mansika Nidana _
_ _
Excessice intake of Amla, Lavan,   Ati Vyayam   Kam  
Katu, Kshar. Ushana Tikta Aahar ((Excessive exercise)
(Intake of hot, spicy & junk food)
Tila , Sarsap, Atasi, Taila ati sevan   Vega vidharana (stoppage of   Krodha  
natural urge)
Vidagadha anna    Diwaswpan   Bhaya  
Viruddha anna       Irshya  
Madya pana       Shoka  
Kulatha, Mansa, Nishpava etc          
sevana
 On the basis of sign and symptoms:-Gradindg of parameters:-

S.N. Grade 0 Grade 1 Grade 2 Grade 3

Netra Pitata Absent Mild Can be seen in Can be seen without
sunlight sunlight
Peet Mutrata Normal in urine Yellowish coloured urine Dark yellow coloured Highly coloured urine
colour urine
Jwara Absent Temp b/w 99-100F Temp b/w 100-102F Temp above 102F
Chardi No vomiting Less then 3 episodes per 3-6 episodes per day More then 6 episodes
(vomiting) day per day
Sadan No weakness Weakness not disturbing Weakness disturbing Weakness required
daily routine work daily routine work complete bed rest
Avipaka Normal stool Heaviness in abdomen Heaviness with sticky Heaviness with
hard stool constipation more than
2-3 days
Udar shool Absent Mild Moderate Severe
Aruchi Normal Less desire to eat Less desire to eat with No desire to eat with
(anorexia) nausea severe nausea
OBJECTIVE CRITERIA:-

 L.F.T values before and after upshayatmaka Parikshana was

assessed.

 The statical analysis of these values were done before the

start of the upashayatmaka parikshana
and finelly after the completion of upshayatmaka parikshana.
POSOLOGY:-
o Drug Name- Lauhchurnadi Yoga
o Reference- Yogratnakar
o Action- Kamala and Pandu Rog nashan
o Route- Orally
o Duration- 30days
o Follow up- 7 days
o Dosage- 4 gms twice a day with Unequal
quantity of Madhu and Ghrit.

 
 Trial Drug Detail ‘LAUHCHURNADI YOGA’
No. Content Latin name Main Work Ras Panchak Part Ratio
Name (family) used
1 Lauh bhasma Iron Rakta vardhak, balya, Ras-Tikta, Madhur, Bhasma  
(Ferrum) rashayana Kashaya Guna-sar, Guru,  
ruksha, 1/8Part
Virya-Sheeta,
Vipaka-madhur
2 Haridra Curcuma longa Kaph- vat shamak, Pitta Ras-Tikta, katu, Guna-Rukha,    
(Zingiberaceae) rechaka laghu Virya- ushna, Vipaka- Rhizome 1part
Katu
3 Daruharidra Berberis aristate Deepan, Pitta sarak, yakrit Ras-Tikta, Kashaya, Kand 1part
(Berberidaceae) uttejak Guna-Laghu, ushna
Virya-ushna, Vipak-katu

4 Chiraita Swetia chirayita Deepan, Pachan, Ras-Tikta, Guna-Laghu, rukha, Pnchang 1part
(Gentianaceae) Sarak, Rkta Shodhak Virya-ushna, Vipak-Katu

5 Triphala Emblica officinalis Deepan      

Amalaki (Euphorbiaceae) Mraduvirechak Phala 1part
Terminalia bellirica Vatanuloman
Vibhitaki (Combretaceae) Antioxident
Haritaki Terminalia chebula)
 
 Criteria for Assessment of overall Effect of Therapy:-The treatment effect will be
assessed weekly on the basis of the relief of sign and symptoms of the disease on
scoring pattern by specially designed performa:-

1 Marked >75% Relief in sign and symptoms and

improvement S.bilirubin within the normal range.

2 Moderate 50%-75% Relief in sign and symptoms

Improvement
3 Poor Improvement 25-50% Relief in sign and symptoms
4 No Improvements <25% relief in sign and symptoms.
Statistical Analysis:
The obtained information will be analyzed on the basis of data obtained from the different observation
parameters.

Presentation of Data:
The collection of data & its analysis will be depicted in the following sequence;
a. General observations viz- Age, sex, Religion etc.

b. Result of therapy, evaluated on the basis of improvement both in complaints as well as biochemical parameters.
 

Discussion:
In this section, obtained result will be discussed on the basis of ayurvedic concepts and modern scientific
parameters.

Summary and Conclusion:

The whole research work will be summarized and conclusion will be made on the basis of the observations,
which will be done on subjective & objective parameters. Result will be analyzed statistically and discussed
Ethical consideration:

IEC Approval:
The clinical study will be started only after getting the clearance from IEC (Institutional Ethics Committee),
Government P.G Ayurvedic collage & Hospital, Varanasi.

CTRI Registration:
The Research study will be started after C.T.R.I. Registration.

Informed Written consent:

Written consent will be taken at the time of registration.

Withdrawal:
During treatment if a patient deteriorates, the patient will be withdrawn from study.
Departmental Collaboration:
1. Pathology laboratory of Government P.G Ayurvedic collage & Hospital, Varanasi.

2. Department of R.S & B.K, Dravyaguna, Government P.G Ayurvedic collage & Hospital, Varanasi.

3. Department of Kaya chikitsa & panchkarma, Government P.G Ayurvedic collage & Hospital, Varanasi

4. Department of Shalya & Salakaya, Government P.G Ayurvedic collage & Hospital, Varanasi.
5. Department of Bal-Roga, Prasuti & Stri roga, Govt. Ayurvedic P.G. College and Hospital Varanasi.

6. Department of Swastha Vritta, Government P.G Ayurvedic collage & Hospital, Varanasi.
7. Department of Samhita and Shiddhanta ,Anatomy, Physiology , Government P.G. Ayurvedic college &
Hospital, Varanasi.
8. If required co-operation of other departments of will be taken Government P.G. Ayurvedic college &
Hospital, Varanasi with the permission from concerned authority.
Total expenditure-(approximately) -For Lauh Churnadi Yog

No. Content Name Rate in kg (rupee) Rate/ Requirement (Rs)

   
1 Lauh bhasma    
2 Haridra    
3 Daruharidra    
4 Chiraita    
5 Triphala    

Total cost

Time Limit:
The study will be completed within stipulated time provided by Government P.G Ayurvedic collage & Hospital, Varanasi.
REFERENCES :
1. Charaka. Charaka Samhita, Part II. Satya Narayana Shastri, editor, 1st ed. Varanasi: Chaukhambha Bharti Academy; 2019.
Panduroga chikitsa, 16/34. .
2. Sushruta. Sushruta Samhita (Uttar Tantra), Ambika dutt Shastri editor. 2nd ed., Varanasi: Chaukambha Orientalia;. Pandu Roga
Pratisedha, 44/4-5. p.729. .
2. Vagbhata. Ashtanga Hridaya. Ashtavaidyan Vaidyamadhom Cheriya, editor. 1st ed. Varanasi: Chaukambha Krishnadas Academy;
2007. Nidan Sthana, Pandwadi nirnayaya Adayaya, 13/15-19. p.274-75.
4. Ram Harsh Singh, editor. Kaya Chikitsha, Part II. 1st ed. Varanasi: Chaukambha Sanskrit Pratishthan;. p.374.
5. Madhav. Madhav nidanam. Yadunandan Upadhayaya, editor. 1st ed. Varanasi: Chaukhambha Bharti Academy; . Panduroga-
kamala-kumbhkamaladi Nidana, 8/19-20. p.262.
6. Kayachikitsa volume (2) by Prof.Ajay Kumar Sharma ,Chaukhambha orientalia prakashan Delhi.

7. Dravyaguna Vigyan volume (2) by Acharya P.V.Sharma Chaukhmbhasubharti prakashan, Varanasi.

8. Harhmohan text book of pathology ,by J.P.brothers medical publisher Ltd.

9 Davidson’s principles of Internal Medicine, Mc Graw-Hill companies.

10. Yogratnaker( Pandu-kamala rog chikitsa)

11. Ayurveda vikriti Vigyan and Rog vigyan -Dr. P.S. Byadgi.