Ayurvedic Management of Vidagdhajirna Janya Raktadushti with Virechana Karma Using Trivrut Avaleha: A Case Report

Background: Food that is hot, pungent, heavy or eaten at the wrong time, especially in a hot climate, can leave Agni unable to digest it properly. Ayurveda calls this Vidagdhajirna, a Pitta-dominant indigestion, and describes how it can go on to vitiate Rakta, whose root seat is the liver (Yakrit). This report describes a young man with raised liver enzymes and bilirubin who was assessed and treated on these principles. Case presentation: A 28-year-old man who had lived in Dubai presented with six months of chest burning, heaviness and bloating in the left abdomen, and low back pain, plus one month of unsatisfactory bowel habit, hair fall and testicular pain. He had had jaundice a year earlier and had not completed treatment. Total bilirubin was 1.80 mg/dl, direct bilirubin 0.76 mg/dl, SGOT 60.5 U/L and SGPT 108.3 U/L. Earlier imaging had shown a small liver hemangioma and renal calculi. He received 15 days of Pachana, Anuloma and Raktaprasadana medicines, Snehapana with Mahatikta Ghrita for five days, Sarvanga Snehana and Swedana, and Virechana with Trivrut Avaleha (22 Vegas), followed by Samsarjana Krama and Rasayana. Outcome: About six weeks after the first report, SGOT was 35.0 U/L, SGPT 33.7 U/L and total bilirubin 0.84 mg/dl, all within the reference range, and his symptoms had improved. Ultrasound still showed mild fatty change in the liver, and a single tiny calculus remained in the left kidney. Conclusion: In this one patient, a Panchakarma-based plan built around Virechana was followed by normal liver enzymes and bilirubin and by symptomatic relief. Because several treatments were given together, the report suggests a direction for further study and does not show that Trivrut Avaleha alone was responsible.