Treating an Acute case of Koshtashrita Kamala (Viral Hepatitis) with Classical Virechana – A Case Report

Kamala is a Raktapradoshaja[1] Vyadhi involving Rakta and Pitta. When a Pandurogi follows Pittavriddhikara Ahara[2] and Vihara, the vitiated Pitta along with Rakta hampers the functioning of Prakruta Pitta, leading to Peeta Twak, Mutra, and Netra, associated with other Lakshanas like Aruchi, Dourbalya, Avipaka, Balakshaya, Tandra, Bhekavarnata and Indriyadourbalya. It is classified into 2 types Koshtashrita (Bahu Pittakamala) and Shakashrita[3] (Alpa Pittakamala) Kamala based on the Lakshanas. Considering the Avastha of Pitta, Virechana[4] is said to be the treatment of choice to eliminate the vitiated Doshas. Viral hepatitis[5] is generally a self-limiting disease but when it turns chronic leads to complications. Often acute hepatitis is characterized with anorexia, fatigue, hyperbilirubinemia, nausea, and vomiting. Here is a case of 30-year-old women with complaints of reduced appetite, abdominal bloating, yellowish discoloration of sclera and urine since 4 days, with a history of fever and elevated bilirubin levels along with other components of the liver function test. She was initially treated with Shamanoushadhi followed by Udwartana, Snehapana and classical Virechana, for a period of 15days, followed by which the liver function tests were repeated. It showed marked changes in the Liver panel. Also, in addition to this it showed changes in certain blood parameters like lipid profile and HbA­­1C. Snehapana followed by Virechana aids in elimination of the aggravated Pitta Dosha in Kamala, which can be interpreted using the investigation reports. Also, the action of Virechana on other blood parameters can be understood in the present study.