Kamala Roga Chikitsa: Liver Disorder Causes, Symptoms, Treatment

Article by Dr Raghuram Y.S. MD (Ayu)
Kamala is a term used in Ayurveda to describe a disease which resembles Jaundice. Pandu and Kamala are said to be the diseases which are interrelated. They are also said to be have common origin. Pandu is said to be nidanarthakara for Kamala, i.e. When Pandu is not treated properly it can lead to Kamala. Thus Kamala can be considered as an effect of untreated Pandu or Pandu which runs a chronic course. Pandu and Kamala thus have cause and effect relationship. Pandu Roga and Kamala are treated on same principles and same formulations.

Causes, pathogenesis

Causes, Pathogenesis of Kamala
Paandu rogee tu yo atyarthama pittalaani nishevate
Tasya asruk maamsam dagdhwaa rogaaya kalpate (Ref – Charaka Chikitsaa 16/34)

When the patient who is suffering from Pandu, during the process of recovery or after getting cured, consumes pitta aggravating foods and life activities in excess, the blood gets severely aggravated and burns the muscles.

This leads to the manifestation of Kamala vis-à-vis jaundice. Since the disease manifests on the backdrop of neglected or improperly cured Pandu roga, the same causes which cause Pandu roga are also the causes for Kamala.

Symptoms

Symptoms of Kamala
Haaridra netraha sa bhrusham haaridra twak nakha aananaha
Rakta peeta shakrut mootro bheka varno hata indriyaha
Daaha avipaaka dourbalya sadana aruchi karshitaha
Kaamalaa bahu pitta usha koshta shaaka aashrayaha mataa (Charaka Chikitsa 16/35-36)

• Haaridra netraha – eyes become turmeric coloured
• Haaridra Twak – Skin becomes turmeric coloured
• Haaridra Nakha – nails become turmeric coloured
• Haaridra Aanana – face becomes turmeric coloured
• Rakta peeta Shakrut – Bloody red or yellow colour of faeces
• Rakta peeta mutra – Bloody red or yellow colour of urine
• Bheka varnaha – body looks like that of a ‘frog in rainy season’
• Hata indriyaha – destruction of sense organs and their capacity of perception
• Daaha – Burning Sensation
• Avipaaka – Indigestion
• Dourbalya – Weakness
• Sadana – tiredness, fatigue
• Aruchi – Tastelessness, anorexia
• Karshitaha – Emaciation

Treatment principles

Pandu Roga and Kamala will be treated on same lines. The treatment and medicinal formulations are applicable to only those types of pandu and kamala which are sadhya (curable).

Snehana (oleation, intake of ghee prepared with medicinal herbs) followed by teekshna vamana (strong emesis) and teekshna virechana (strong purgation) in curable Pandu disease

Mridu Tikta Virechana (mild purgation with formulations prepared using herbs which bring about mild purgation) in curable Kamala

Pathya anna – After cleansing with the help of proper vamana and virechana, pathya anna or suitable diet should be administered to the patients of pandu and kamala

Pathya anna includes –

• Purana Shaali – old rice
• Purana Yava – old barley
• Purana Godhuma – old wheat
• Mudga yusha – green gram soup
• Aadhaki yusha – Pigeon pea soup (Cajanus cajan)
• Masura yusha – Lentil soup (Lens culinaris)
• Jangala mamsa rasa – meat soup of animals and birds living in the desert regions

For Snehana, the below mentioned ghritas (medicated ghee) shall be used:

• Panchagavya ghrita
• Mahatikta ghrita
• Kalyana ghrita
• Dadimadhya ghrita
• Draksha ghritam

Formulations

Herbal formulations for Pandu and Kamala
Haritaki kalka – Paste of Terminalia chebula with Gomutra (urine of cow)

Argwadha kalpa –

• Pulp of Aaragwadha (Cassia fistula) mixed with powders of shunti (ginger), pippali (long pepper) and maricha (black pepper)
• Pulp of Aaragwadha (Cassia fistula) mixed with ikshurasa (sugarcane juice
• Pulp of Aaragwadha (Cassia fistula) with vidari rasa (juice or decoction of Pueraria tuberose)
• Pulp of Aaragwadha (Cassia fistula) with Amalaka rasa (juice of Gooseberry fruit)
• Pulp of Aaragwadha (Cassia fistula) with Bilwa patra swarasa (juice of Aegle marmelos)

Trivrit kalka – paste of Trivrit (Operculina turpethum) with Triphala Kwatha (decoction of 3 fruits of Terminalia chebula, Terminalia bellirica and Emblica officinalis)

Triphala kwatha – Decoction of Haritaki (Terminalia chebula), Bibhitaki (Terminalia bellirica) and Amalaki (Emblica officinalis) mixed with honey

Guduchi swarasa – Decoction or juice of Guduchi (Tinospora cordifolia) mixed with honey

Daruharidra rasa – Juice or decoction of Daruharidra (Berberis aristata) mixed with honey

Nimba rasa – juice of neem leaves mixed with honey
Godugdha (milk of cow) mixed with Go mutra (urine of cow)
Mahisha dugdha (milk of buffalo) mixed with Mahisha mutra (urine of buffalo)

Triphala kwatha (decoction of 3 fruits, Haritaki, Bibhitaki and Amalaki) mixed with gomutra (urine of cow)
Gomutra Haritaki – powder of Haritaki (Terminalia chebula) mixed with gomutra (urine of cow)

Mandura yoga– Mandura bhasma (Iron oxide or Ferric oxide calx) mixed with purana guda (old jaggery), shunti churna (ginger powder), tila churna (sesame powder) and pippali churna (long pepper powder)

Darvyadi leha – Powders of Daruharidra (Berberis aristata), Haritaki (Terminalia chebula), Bibhitaki (Terminalia bellirica), Amalaki (Emblica officinalis), Shunti (ginger), Pippali (long pepper), Maricha (black pepper), Vidanga (Embelia ribes) and Loha Bhasma (iron calx or ash) mixed in ghee and honey so as to make their confection

Ayorajadi yoga – ayoraja (iron calx), powders of Haritaki (Terminalia chebula) and Haridra (turmeric) mixed in ghee and honey

Haritaki Churna – powder of Haritaki (Terminalia chebula) mixed with guda (jaggery) and madhu (honey)

Triphaladi Yoga – Powder prepared using Haritaki (Terminalia chebula), Bibhitaki (Terminalia bellirica), Amalaki (Emblica officinalis), Haridra (turmeric), Daruharidra (Berberis aristata), Katuki (Picrorhiza kurroa) and Loha bhasma (ash of iron) mixed in honey and ghee.

Useful Kashaya For Jaundice

Vasa Guluchyadi Kashaya – Contains Neem, Guduchi, Licorice, Vasa, Kataka – Strychnos potatorum and Amrutavalaka / Hribera – Pavonia odorata
It is recommended to be used along with honey.

Nimbadi Kashaya / Nimbatwagadi Kashayam –

Ingredients –

• Nimba twak – bark of Azadirachta indica / neem tree
• Triphala – fruits of Terminalia chebula, Terminalia bellirica & Emblica officinalis
• Patola – Trichosanthes dioica
• Rajani / Haridra – Curcuma longa / turmeric
• Vasa – Adhatoda vasica
• Amruta – Tinospora cordifolia
• Sariva – Hemidesmus indicus
• Shyama – Ocimum tenuiflorum
• Tamalaki / Bhumyamalaki – Phyllanthus niruri
• Palamkasha / Gokshura – Tribulus terrestris
• Bala – Sida cordifolia
• Nili – Indigofera tinctoria
• Sthira / Prishniparni – Uraria picta
• Yashti – Glyzyrrhiza glabra

How to use?
It is should be consumed mixed with honey, powder of long pepper and Shilajatu i.e. Asphaltum for five days.
Indications – Kumbha kamala & Halimaka i.e. complicated stages of jaundice

3. Yashtivasadi Kashaya
Ref – Sahasrayogam, Parishishta Prakarana, Kashaya

Ingredients –

• Yashtimadhu – Glyzyrrhiza glabra
• Vasa – Adhatoda vasica
• Amruta / Guduchi – Tinospora cordifolia
• Balaka / Hribera – Pavonia odorata
• Kataka – Strychnos potatorum
• Hatha / Ardra Amalaki – Emblica officinalis
• Ikshu – Saccharum officinarum
• Gokshura – Tribulus terrestris

Method of administration – The decoction prepared with the above said ingredients should be administered internally early in the morning.

Trayantyadi Kashayam
Ref – Sahasrayogam, Parishishta Prakarana, Kashaya, 111
Read more here – Trayantadi Kashayam – Benefits, Dose, Side Effects And Ingredients

Drakshadi Kashaya – also called Vatapitta Jwarahara kashaya
It is used to treat hangover produced after having excess alcohol.
It also reduces the ill effects of alcohol and helps in quick metabolism of alcohol from liver.
It protects liver.
It is used to treat fever of Vata and Pitta origin.
It relieves tiredness and dizziness.
Click to consult Dr Raghuram Y.S. MD(Ayu)

Yogas for Kamala from Sahasra Yoga Text Book

Vatapitta Jvarahara Kashaya
Panduhara Kashaya
Kamalahara Kashaya
Tiktaka Ghrita
Mahatiktaka Ghrita
Vrisha Ghrita
Mahakusmada Ghrita
Chandanadi Taila
Sudarsana Choorna
Khandasama Choorna
Hapushadi Choorna
Patoladi Choorna
Nimbadi Choorna
Vyoshadi Choorna
Varahyadi Choorna
Dasamoolarishta
Parpatadyarishta
Satavari Guda
Chinchadi Lehyam
Danti Haritakyavaleha
Gandira Rasayana
Pushparaga Lehyam
Trivrit Kulambu
Mandoora Vatakam
Lavangadyam Modakam
Yashtivasadi Kashaya
Tartavaladi Mukkudi
Trayantyadi Kashaya
Arukaladi Tailam
Dasa Swarasa Ghrita
Ardraka Ghrita