Jaundice (Kamla) Written by Ruchi Bhagotia

Jaundice

Jaundice, also known as icterus (attributive adjective: icteric), is a yellowish discoloration of the skin, the conjunctival membranes over the sclerae (whites of the eyes), and other mucous membranes caused by hyperbilirubinemia (increased levels of bilirubin in the blood). This hyperbilirubinemia subsequently causes increased levels of bilirubin in the extracellular fluids. Typically, the concentration of bilirubin in the plasma must exceed 1.5 mg/dL[1], three times the usual value of approximately 0.5mg/dL[1], for the coloration to be easily visible. Jaundice comes from the French word jaune, meaning yellow.. Types

• Haemolytic Jaundice - It results from increased destruction of RBCs, causing increased bilirubin production,

• Congenital Non-Haemolytic hyperbilirubinaemia
  It includes

1. Gilbert’s syndrome
2. Crigler Najjar syndrome
3. Dubin-Johnson syndrome
4. Rotor’s syndrome

• Hepatocellular jaundice - It results from an inability of the liver to transport bilirubin into the bite, because of liver cell disease.
• Cholestatic Jaundice - In this condition, bilirubin is unable to enter the bile canaliculi and passes back into the blood.

Management

• Complete Bed rest
• Treatment is divided under 2 main heading.

Internal Purification (Sodhana Chikitsa)

• It is done in obstructive jaundice (cholestasis) where patients passes white stools like sesamum paste.
  Patient should be prescribed diet of cereals with rough, sour pungent soups like soup of dried radish and horse gram. It should continue till bile pigments appear in stool.
• Then mild purgation is done with bitter drugs.

Sansamna Chikitsa

Different drug formulations are used
Powder and tablets

1. Yakritaplihari rasa
2. Punarnavamandura
3. Manduravataka
4. Shatavari mandura
5. Arogyavardhini vati
6. Kamlanta lauha
7. Dhatri Lauha

Decoctions and juices
Decoctions:

1. Phaltrikadi Kvatha
2. Vasadi Kvatha
3. Decoction of daruharidra with the paste of Kaliyaka
4. Decoction of Vasa, Guduchi, Triphala, Katvi, Bhunimba and nimba consumed with honey

Juices

1. Juice of grapes and Amalaki
2. Juice of bilwa leaves with shunthi, Marich, Pippali

Asava and arista

1. Lohasva
2. Rohitakarista
3. Dhatryarista
4. Bijakarista

Anjana and nasya

1. Anjana with Haridra, gairik and Amalaki
2. Dronpuspi rasa for Anjana
3. Powder of tary used for nasya

Ghrta

1. Draksa Ghrta
2. Haridra Ghrta

Single Drugs
Kutki, Kalmegha, Bhrngraja, Punarnava, bhumyamlaki guduchi any drug containing Astringent rasa.

Compatible Diet

Spinach, Lauki, Radish, Unripen papaya, Unripen banana, Amalaki, pomegranate, raisin, fig, apple, old rice, wheat, barley, kidney bean, lentil, diet with minimum fat and oil.

Incompatible diet

Heavy and spicy foods, mustard oil urad excessive oil and fat’s.

Incompatible Daily Regimes 

Sleeping in day time, excessive heat or sun exposure smoking exertion.