HEPATITIS-B THROUGH AYURVEDIC MEDICINES
Summary: Clearance of HbsAg from the serum of Hepatitis B patient by the judicious application of "Arogyavardini Rasa" and a tablet containing "Bhumyamalaki" has been studied in this case. This combination has considerably reduced the clearance time and re-established the Liver function with complications. Hence this has opened an alternative vista for the management of Hepatitis B. 'Hepatitis B' and 'HbsAg+ve' are the much familiar and honyfying words among the public and medical fraternity now a days. Hence an attempt has been made to treat the 'HbsAg+ve' patient through Ayurvedic medicines.
Liver is the largest organ in the human body with wide range of integrated functions. This vital organ is the soft target for many pathogens. Viruses are one among them. These viruses causes both morphological and physiological changes in the Liver. The process of change may be slow or rapid, leading to various clinical manifestations. HBV is one of the dangerous virus which cause severe alterations in the liver and some times leads to death. This is the only hepedna virus which cause infection in humans. They enter the hepatocytes of liver and replicate to cause hepatitis which is a diffuse microinflammatory disease, where in liver parenchymal cells face the wrath of the virus. Depending upon the severity of the infection and clinical features, person is treated either at O. P. D. or I. P. D. Faliure of clearance and virus from the serum is mainly due is lack of an adequate immune response.
Materials & Methods
A serologically confirmed HbsAg strongly positive (++++) case has been referred for the management through Ayurvedic medicines. The management of "Hepatitis B" cases is mainly supportive and aimed at speedy regeneration of damaged hepatocytes, inhibition of the vital replication and stimulating immune system to produce an adequate immune response. Clinical features such as Icterus, Anorexia (Aruchi), Dark urine & stools (Raktapeeta Shakruth, mootra), yellow tint of Sclerae, loss of appetite (Agni sada), Debility (dourbalya). Skin rashes (Kandu, twak vikara) are taken as parameters. L. F. T. value and serological clearance/presence of HbsAg are taken as prime evidence of assess the progress of the disease.
Notes from history
The probable mode of infection as per history was a blood transfusion done about four months prior to the manifestation of clinical features, when the patient underwent a surgery for urinary calculus.
Signs & symptoms
The presenting signs and symptoms were icterus, fever, loss of appetite, debility, dark urine and stools, yellow tints of sclerae, joint pain and pruritis since ten days and liver was slightly palpable on examination. Ultrasonography report has favoured slight hepato-splenomegaly.
- Arogyavardhini Rasa, one tablet three times a day after food.
- Two tablets "Bhumyamalaki" three times a day after food.
Medication should be continued till HbsAg becomes negative in serum. Later tablet of 'Bhumyamalaki' three times a day after food may be given as prophylaxis for one to three months.
Patient was advised to take Laghu Aahara, more Dravyapadartha. Phalarasa (fruit juices), boiled vegetables and diet more of carbohydrate and moderate quantity of proteins.
Discussion & Conclusion
This combination of drugs has proved once again the supremacy of Ayurvedic drugs in hepatoprotective activity, and also given reassurence to the suffering humanity against HBV. Some of the other factors in the management of HBV are protecting other persons who came in close contact with infected person viz. wife/husband, children and relatives through vaccination. Usually patients needs counselling and reassurance along drug therapy.
Patient recovered rapidly during first two months of treatment, and became very weakly positive from the strongly positive. At the end of the third month patient become HbsAg negative which was confirmed by two different laboratories. " Better the immunity of the persons faster the recovery and clearance". One important factor observed during the treatment was no complications Patient well tolerated the medication.
This study has suggested that this combination of drugs has a definite role in the play in providing adequate immune response against HbsAg. Since study sample is too small, this needs further evolution.
HOLISTIC MANAGEMENT OF BRONCHIAL ASTHMA
Bronchitis is one of the most common respiratory diseases, significantly seen in the tropical areas. Bronchiolitis, acute bronchitis, chronic bronchitis/bronchial asthma bronchiectesis and bronchial fibrosis are the progressive advanced stages of a pathological stage characterised by dyspnoea (krichra swasa) cough with or without expectoration (ardra kasa or shushka kasa), and wheeze (Ghur ghurayana with thamaha pravesha).
In Ayuvedic texts, the symptoms and sings of bronchial asthma has been described under the title Tamaka swasa a variety of swasa (respiratory disorder). Acharya Caraka has described five varieties of swasa namely Mahaswasa, Urdhwa Swasa, Chinna Swasa, Thamaka Swasa and Prathamaka Swasa.
The etio-pathological and clinical features of Thamaka shwasa corelated with that of the Bronchitis/Bronchial ashtma. The present study is a documentation of 60 cases of well established Bronchial asthma and its management through an integrated approach. It comprises of the selective line of treatments and drugs of modern systems of medicine Ayurveda, Yoga and Naturopathy. The present study is a record of cases and their management over a period of 10 years.
Materials and Methods
Selection of patients: Patients with complaints of difficult breathing, cough with or without expectoration and wheezing who visited 'Sumana Arogya dhama' were treated according to the requirement through an integrated approach of different systems of medicine and drugs. Patients were subjected for a thorough clinical examination and findings were recorded in a specific case proforma. Patients were also investigated with relative and equired Biochemical, Haematological, Microbiological and Roentogenographical procedures. All the dates were analysed by giving due importance to the differential diagnosis and the final diagnosis of Bronchial asthma was arrived. Cases were divided in to two groups for the convenience of treatment namely Acute asthmatics and Chronic Asthmatics based on the history, symptoms and sings. Cases between the age group of 4 to 40 years were selected for the study. Both female and male; adults and children were randomly selected. The cases selected were Bronchial asthmatic and were free from the associated diseases, such as Pneumonia, Cardiac problems, Pulmonary kochs, Emphysema, Corpulmonale and also Diabetes mellitus and Congenital deformities. The Acute and severe stage Bronchial asthma was managed with modern line of treatment, and the chronic stage of Bronchial asthma was treated with the alternative lines of treatment which included administration of 'Vardhamana pippali rasayana yogi' as aushadha (Medicine). Dietary restrictions (Ahara), practises such as Yoga, Pranayama, Honey pulling, Fasting etc., (Vihara) and meditation (Vichara) with an objective of preventing relapse by regulating the whole immune system.
Vardhamana pipplai Rasayana yoga
This is a course of administration of pippali (Piper lomgu) in the prescribed quantity for a prescribed period by altering the dosage in and ascending and descending order described by Acharya Charaka in the third chapter of chikitsasthana known as Kara Prachithiyam Rasayana pada. According to the texts, fruits of pippali should be administered over a period of twenty days, beginning with 10 fruits on the day one; increasing 10 fruits every day upto the 10th day and later decreasing with same number till it reaches to ten on 20th day. This dose is for people who have good tolerance (uthama Mathra). The author has recommended to start with 6 fruits and 3 fruits of pippali for people having moderate and low tolerance (Madhyama and Alpa matra) respectively. It has been adviced to administer pippali in the form of kshira paka. Acharaya charaka has attributed immunostimulants, growth promoting, geriatric, strength promoting, vitalizing, vivifying, rejuvenating, lifespan increasing and memory boosting pharmacological actions and therapeutic effects to pippali. In the present study a slight modification has been done from the classical 'Vardhamana pippali Rasayana yoga' of Charaka with regard to the ingredients, dosage and duration of the course of treatment by keeping in view the specific purpose of providing relief and specific immunity among Bronchial asthmatics. Tolerance of the patients and convenience of administration. Pippali was administered along with 2.5 gm, turmeric rhizome powder (Curcuma longa) 2.5 gm. liquorice root powder (Glycerrhiza glabra) one fruit of cordamom (Elettaria cordamomum) and sufficient quantity of Jaggery in the form of medicated milk (Kshira paka). The treatment course was start with six fruits of pippali on day one and increased one fruit every day upto 24th day and later decreased by one fruit of pippali a day till the number reached six, completing one Mandala (48 days) and administration of 900 fruits of pippali in a course. However, the quantity of turmeric, liquorice and cordamom were kept constant but the quantity of Jaggery was altered and adjusted depending upon the number of fruits of pippali, the needs of individual patients. Children below the age of 12 years were administered half the dose of Adults.
Management of Bronchial asthma through an Integrated approach comprises of the following:
Patients with acute bronchial asthma and severe chronic bronchila asthma were treated and managed with the conservative line of treatment depending upon the severity of disease and response of the patients. The line of treatment and drugs included the following:
- Broncho-dilators: Theophylline, Salbutamol, Terbutaline sulphate, Amino phylline, Adrenaline, Ephedrine hydrochloride, Kanakasava, Vasakarista. Mruthasanjeevini sura, Shwasa kuthara, Shwasananda.
- Antibiotics: Penicillin, Amoxycillin, Tetracycline, Pefloxacin, Cepholosporins, Septilin.
- Anti-Inflammatory and Anti Allergic/Steroids: Betamethasone, Dexamethadsone, Prednisolone, Hydrocortisone, Trimacinaline aceta manide (Oral, Parenteral and Aerosal form).
- Anti-histamines: Cetrizine di-hydrochloride, Phenaramine maleate, Chloro phenaramine maleate Haridra kanda Karpuradi churna, Gorochanadi vati, Kasturyadi vati.
- Mucolytics: Bromhexine hydrochloride, Taleesadi curna, Dasamula katutrayadi kasaya, Balajeerakadi kasaya and Gudapippali.
- Expectorants: Ammonium chloride, Ginaphansein, Pushkaramulasava, seems to be rendering the same. This is seen based on the percentage of cure, no relapse and less significant relapse even after an year.
Diet restrictions, practises such as pranayama, yoga, meditation, listening to music etc., help in quality of mental and physical health by improving both physical and mental resistance. Honey pulling is like oil pulling (which is being practised widely) is administrated with an objective of easy expectoration of sputum and mucolysis.
Since no particular system of medicine has been able to provide total cure for Bronchial asthma which has been revealed in the various studies, it is advisable to augment all the good and beneficial factors from the available different systems of medicine with an objective of establishing Asthmatic free society. This conclusion is very much in accordance with the slogan of Holistic medicine and also the Rigveda 'Anobhadhraha kanthavoyantha vishwathaha'-'Let noble thoughts come to us from every side.' Because we are interested in Lokaha samasthaha sukhinobhavanthu sarvesanthu niramayaha.' 'Let the entire world remain in pleasure and happiness and let there be a society free from all sorts of diseases.'