Management of Jalodara (Ascitis

of Hepatic origin) with a

Classical formulation ‘Gud-
haritaki’
Dr. Surendra A. Soni
MD PhD (Kayachikitsa)

H.O.D. & Associate Professor

Dept. of Kayachikitsa
Govt. Ayu. College
Vadodara, Gujarat.
 Background
This is a presentation of a type of ‘Kalpa-
chikitsa’ for the patients of Jalodar(Ascitis) of
Hepatic-origin, instructed as per Acharya
Charak; done in routine clinical work at I.P.D.,
Govt. Ayu. College, Vadodara, Gujarat.
 Global prevalence
Global prevalence of cirrhosis from autopsy studies
ranges from 4.5% to 9.5%.
Eestimated that more than fifty million people in the
world, would be affected with chronic liver disease.
Globally, alcohol, NASH and viral hepatitis- most
common causative factors.
Prevalence of cirrhosis is likely to be underestimated
as almost a third of the patients remain
asymptomatic. With the use of non-invasive tests
like transient elastography, a more realistic picture
could emerge in the near future*.
*www.worldgastroentrology.org
 Prevalence in India
• WHO data 2017 - 2.95% of total deaths.
• Death Rate is 22.93 per 100,000 of
population ranks India #63 in the world.
 Top 10 causes of Death in India
1. Coronary Heart Disease
2. Lung Disease
3. Stroke
4. Influnza & Pneumonia
5. Tuberculosis
6. Diarrhoeal disease
7. Diabetes Mellitus
8. Kidney Disease
9. Low Birth Weight
*10.Liver Disease
*Ayurveda accepts the role of Agni in each & every
disease, that we all know.
 Effort to get approach of Charak in
GIT-disorders
• Gulm is the only GIT samprapti mentioned in Nidan-sthan
among the 8 basic primary essential sampraptis.
• Expanded in Chikitsa-sthan-
– Gulm- Deals with obstructive, inflammatory &
abnormal growth pathology.
– Shotha- Orgenofailure pathology mainly
– Udar- Para-luminal pathology mostly
– Arsha- Anal dominant pathology
– Grahani- Intraluminal disturbed functional
pathology
– Pandu- Deficiency pathology mainly
– Atisar- Diarrhoeal pathology
– Initial- In concept of ‘Aam-dosha’ & Vegadharan.

*G.I.T. Symptomatology must be understood clinically on wiser scale.

 Special Highlights of Udar-roga
– Survey/observation-based question asked by Agnivesha to
Punarvasu Atreya… भगवन्नुदरै दुदुःखैर्ददश्यन्ते ह्यर्दद तानराुः|

– Survey-based symptomatology described…

1. शुष्कवक्त्ाुः 2. कृशैगादत्रै 3. राध्मातोदरकुक्षयुः ||५||
4. प्रनष्टार्िबलाहाराुः 5. सवदचेष्टास्वनीश्वराुः| 6. दीनाुः……
– Heaviest Nidanas mentioned.(8 different types)
– A description of Terminal-illness of various disorders…
प्लीहाशोग्रहणीदोषकशदनात् …..क्लिष्टानामप्रतीकारा्र……
…….अशोबालशकृ्रोधादन्त्रस्फुटनभेदनात् …………………. !
– Complication of various therapeutic-procedures…
र्मथ्यासंसर्दना्रू……कमदर्वभ्रमात् |
– Result of Bad deeds(Karmaja-vyadhi)…
पापंकमद च कुवदताम् !
 Haritaki
• Most popular & among the mostly used drug in
Charak.
• Best Pathya, Rasayan, Anuloman, Srotoshodhan
drug.
• Most Kalpas are instructed with Haritaki.
• Included in 7 Mahakashaya among the 50.
– Arshoghna
– Kushthaghna
– Virechanopaga
– Hikkanigrahan
– Kashar
– Jwarhar
– Vayahsthapan
 Famous Haritaki formulations
• Danti haritaki- Gulm 5/154-160
• Gomutra-haritaki- Shotha 12/21
• Kans-haritaki- Shotha 12/50-52
• Gud-abhaya- Shotha 12/27
• Gomutra-abhaya- Udar 13/151
• Gud-abhaya- Udar 13/78
• Gomutra-haritaki- Arsha 14/67
• Takra-haritaki- Arsha 14/67
• Gud-haritaki- Arsha 14/67
• Gomutra-haritaki- Pandu 16/58,68
• Gud-kshoudra-abhaya- Pandu 16/98
• Agastya-haritaki- Kas 18/58
• Takra-abhaya- Vat-rakta 29/157
• Trivritta/Madhu-abhaya- Yoni-vyapad 30/254
Consideration of Jalodar in Ayurveda
• Independent disease or stage rather than a
symptom.
• Terminal stage of all types of Udar-roga.
• Any a type of Udar-roga may convert to jalodar.
• Independent manifestation is mentioned.
• Need specific IPD management with strict
‘Pathya-krama’ in form of ‘Kalpa-chikitsa’.
• Prognosis is described in details.
 Udar-roga nidan
• अत्युष्णलवणक्षारववदाह्यम्लगराशनात् |
विथ्यासंसर्जनाद्रूक्षववरुद्धाशुविभोर्नात् ||१२||

• प्लीहाशोग्रहणीदोषकशजनात्किजववभ्रिात् |
क्लिष्टानािप्रतीकाराद्रौक्ष्याद्वे गववधारणात् ||१३||

• स्रोतसां दू षणादािात् सङ्क्षोभादवतपूरणात् |

अशोबालशकृद्रोधादन्त्रस्फुटनभेदनात्||१४ ||

• अवतसवितदोषाणां पापं किज ि कुवजताि् |

• उदराण्युपर्ायन्ते िन्दाग्नीनां ववशेषतः ||१५||
 Classification of Udar-rog Nidan
1) Aaharaja (Dietery) अत्युष्णलवणक्षारववदाह्यम्लगराशनात् |
……..द्रूक्षववरुद्धाशुविभोर्नात् ||१२||
2) Viharaja (Daily-routine/life-style) द्वे गववधारणात्
3) Panchakarma-apacharaja (Improper Panchakarma)
विथ्यासंसर्जनाद्रू
4) Nidanarthakar Roga (Precipitating diseases)
प्लीहाशोग्रहणीदोषकशजना…….. स्रोतसां दू षणादािात्
5) Karma-vibhram (Improper therapeutic procedures) त्किजववभ्रिात्
6) Klishta-rog-apratikar (Improper Rx of any complicated disease)
क्लिष्टानािप्रतीकारा
7) Aantra-rodhaja (Intestinal obstructive pathology)
अशोबालशकृद्रोधादन्त्रस्फुटनभेदनात्

8) Paap-karmaja (Bad deeds) पापं किज ि कुवजताि्

9) Maanas (Psychological) सङ्क्षोभाद

• उदराण्युपर्ायन्ते िन्दाग्नीनां ववशेषतः ||१५||

 Samanya-samprapti (General pathogenesis)
अवग्नदोषान्मनुष्याणां रोगसङ्ाः पृथक्लिधाः|

िलवृद्ध्या प्रवतजन्ते ववशेषेणोदरावण तु ||९||

िन्दे ऽग्नौ िवलनैभुजक्तैरपाकाद्दोषसियः|

प्राणाग्न्यपानान् सन्दू ष्य िागाज न्रुद्वाऽधरोत्तरान् ||१०||

त्वङ्ां सान्तरिागम्य कुवक्षिाध्मापयन् भृशि्|

र्नयत्युदरं तस्य हे तुं शृणु सलक्षणि्||११||

 Samanya-samprapti (General pathogenesis)
1. अर्िदोषा- Presipitating factors with disturbance in Aahar-
avastha pak
2. मलवृद्ध्या प्रवतदन्ते- Increase/abnormality in accumulation of 3
Malas & 7 Dhatumalas either in form of constipation, oligourea,
cough-expectoration or bilirubinopathy etc.
3. मन्दे ऽिौ मर्लनैभुदक्तै may lead to 1 or 2 further with nutritional
deficiency.
4. रपाकाद्दोषसञ्चयुः result of previous 3 leading to congestion &
distention in Koshtha(GIT). Involvement of Rakta starta
5. प्राणाग्न्यपानान् सन्दूष्य मागादन्रुद्वाऽधरोत्तरान् further in presence
of 1-4 causes Pran-vayu get involved because of disturbed
homeostasis & abdo. Distention being a Moolasthan of Pran-
vah-srotas. Apan is already involved since 2 step.
6. त्वङ्ांसान्तरमागम्य कुर्क्षमाध्मापयन् भृशम् | र्नयत्युदरं ……. This is
not a simple abdominal distension sanchay, prakopa and prasar
Vishishta-samprapti (Specific pathogenesis)
रुद् वा स्वेदाम्बुवाहीर्न दोषाुः स्रोतांर्स सर्ञ्चताुः|
प्राणाग्न्यपानान् सन्दूष्य र्नयन्त्युदरं नृणाम् ||२०||
This is further extension of samanya-samprapti
targeting the basic pathological mechanism ‘Fluid
imbalance’ in presence of…
1. Hypoproteinemia
2. Obstruction in chennal(Srotorodha in Koshtha)
3. Portal & Splanich vein congestion
4. Disturbance in Homeostasis
Poorvaroopa (Prodromal Signs & Symptoms)
क्षुन्नाशः स्वाद्ववतविग्धगुवजन्नं पच्यते विरात् |
भुक्तं ववदह्यते सवं र्ीणाज र्ीणं न वेवत्त ि||१६||
सहते नावतसौवहत्यिीषच्छोफश्च पादयोः|
शश्वद्बलक्षयोऽल्पेऽवप व्यायािे श्वासिृ च्छवत||१७||
वृक्लद्धः पुरीषवनियो रूक्षोदावतजहेतुका |
बक्लिसन्धौ रुगाध्मानं वधजते पाट्यतेऽवप ि||१८||
आतन्यते ि र्ठरिवप लघ्वल्पभोर्नात् |
रार्ीर्न्म वलीनाश इवत वलङ्गं भववष्यताि् ||१९||
 Udar-rog ‘Poorv-roopa’
Signs Symptoms
1. Mild Padal 1. Loss of Appetite.
Oedema. 2. Delayed digestion of
Madhur-guru-snigdha food.
2. Exertional 3. Heart burn after food intake
Dyspnoea. 4. Unaware about digestion &
indigestion.
3. Distended 5. Can’t digest excessive food.
Abdomen. 6. Weakness.
4. Engorged 7. Incomplete evacuation.
Superficial Abdo. 8. Belching.
9. Joints pain.
Veins. 10. Bladder pain.
5. Absence of Normal 11. Abdominal & Bladder
superficial distention.
abdominal skin 12. Abdominal distention &
discomfort after intake of
folds. light food.
 Udar-rog- Signs & Symptoms
(General)
• कुक्षेराध्मानिाटोपः शोफः पादकरस्य ि |
िन्दोऽवग्नः श्लक्ष्णगण्डत्वं कार्श्यं िोदरलक्षणि् ||२१||

Signs Symptoms
1. Abdominal Distention 1. Flatulence
2. Padal Oedema 2. Loss of Appetite
3. Peri-orbital Oedema 3. Weakness
(Puffiness on Face)
 Udar-rog Bhed (Types)
पृथग्दोषैः सििैश्च प्लीहबद्धक्षतोदकैः|
सम्भवन्त्युदराण्यष्टौ तेषां वलङ्गं पृथक् शृणु||२२||

Types of Udar-rog-
1. Vatodar 2. Pittodar
3. Kaphodar 4. Sannipatodar
5. Plihodar 6. Baddhodar
7. Kshatodar 8. Jalodar
 Vatodar Nidan-samprapti (Vishishta)
रूक्षाल्पभोर्नायासवेगोदावतजकशजनैः |
वायुः प्रकुवपतः
Vayu- Dravyat, Gunat, Karmat Sthanasanshraya at
कुवक्षहृद्बक्लिगुदिागजगः||२३||
generating pressure-originated signs & symptoms
हत्वाऽवग्नं कफिुद्धूय due to similarity in Sheet-guna
तेन रूद्धगवतितः| obstruction because of Shleshma
आविनोत्युदरं र्न्तोस्त्वङ्ां सान्तरिावितः||२४||
Abdominal-distention due to Srotoradha by
Kapha and Sthan-sanshrita-prakupit-vat involving Ras-
rakta & Mansavah-srotas.
 Vatodar- Signs & Symptoms
तस्यरूपावण-
1.-4.कुवक्षपावणपादवृषणश्वयथुः,5. उदरववपाटनि्,
6. अवनयतौ ि वृक्लद्धह्रासौ, 7.-8.-11. कुवक्षपाश्वजशूलो
दावताज ङ्गिदज 12. पवजभेद 13.शुष्ककास 14.कार्श्यज
15.-17. दौबजल्यारोिकाववपाकाः, 18. अधोगुरुत्वं,
19.-21. वातविोिूत्रसङ्गः, 22.-27. र्श्यावारुणत्वं ि
नखनयनवदनत्वङ्िूत्रविजसाि् , अवप 28. िोदरं
तन्ववसतरार्ीवसरासन्तति् , 29. आहतिाध्मात
दृवतशब्दवद्भववत, 30. वायुश्चोवजिधक्लियजक् ि 31.
सशूलशब्दश्चरवत, एतद्वातोदरविवत ववद्यात्||२५||
•
 Pittodar- Signs & Symptoms

कट्वम्ललवणात्युष्णतीक्ष्णाग्न्यातपसेवनैः |
ववदाह्यध्यशनार्ीणैश्चाशु सिाविति् ||२६||
प्राप्यावनलकफौ रुद् वा िागजिुन्मागजिाक्लथथति् |
वनहन्त्यािाशये ववनं र्नयत्युदरं ततः ||२७||
 Cirrhosis of Liver in Ayurveda
1. Vatodar 2. Pittodar
3. Kaphodar 4. Sannipatodar
These are presentation as per Prakruti-sam-
samvet pattern
6. Baddhodar 7. Kshatodar
Concerned with Shalyavid mainly
Plihodar(Yakritudar) is topic of our concern,
where Management of pre-ascitic Liver-cirrhosis
instructed in details.
Jalodar- may be a complication of all but mainly it
is concerned with Plihodar(Yakritudar).
Plihodar(Yakritudar) Nidan-Samprapti

• एविेव यकृदवप दवक्षणपाश्वजथथं कुयाज त्,

तुल्यहे तुवलङ्गौषधत्वात्तस्य प्लीहर्ठर
एवावरोध इवत; एतत् प्लीहोदरविवत
ववद्यात् ||३८||
 Pleehodar(Yakritudar)-
Nidan & Samprapti
अवशतस्यावतसङ्क्षोभाद्यानयानावतिेवष्टतैः |
अवतव्यवायभारावविनव्यावधकशजनैः ||३५||
Final triggering factors-
वािपाश्वाज वितः प्लीहाच्युतः थथाना्प्रववधजते |
शोवणतं वा रसावदभ्यो वववृद्धं तं वववधजयेत् ||३६||
Indicates the reactive congestion caused by
sroto-rodha(Hepatocyte-necrosis) leading to
initial-phase of cirrhosis in form of hepatomegely.
 Pleeh-yakridudar(H.Cirrhosis)-
Signs & Symptoms
• दौबजल्यारोिकाववपाकविोिूत्रग्रहतिःप्रवेशवपपासा
ङ्गिदज च्छवदज िूच्छाज ङ्गसादकासश्वास
िृदुज्वरानाहावग्ननाशकार्श्याज स्यवैरस्यपवजभेदको्ठववात
शूलावन, अवप िोदरिरुणवणंवववणं वा
नीलहररतहाररद्र रावर्िद्भववत; एविेवववद्यात् ||३८||
Classification of Symptomtology-1
Koshthashrita Symptoms- 12
Arochak, Avipak, Varcho-mutragraha, Pipasa,
Angamarda, Chchhardi, Aanah, Agninasha,
Aasyavairasya, Koshtha-vat/shoola, Udar-
vaivarnya.

Shakhastha Symptoms- 5
Dourbalya, Angasad, Parvabheda, Mridu-jwar,
Karshya.

Marmasthisandhi Symp.- 4
Tamah-pravesha, Moorchchha, Kas, Shwasa,
Classification of Symptomtology-2
Dhatu/Srotas involvement Symptoms
1. Ras- • Daurbalya, Mridujwar
2. Rakta- • Agninasha, Udar-vaivarnya
3. Mansa- • Angamarda, Angavasad
4. Meda- • Karshya
5. Asthi- • Parva-bheda
6. Majja- • Tamah-pravesha, Moorchchha
7. Shukra • None
8. Udak-vah- • Pipasa
9. Pran-vah- • Kas, Shwas
10. Mutra-vah- • Aanah,
11. Purish-vah- • Varchograh, Koshthavat, Shoola
12. Anna-vah- • Chchhardi, Arochak, Aasyavairasya, Avipak
 Jalodar- Nidan-Samprapti(Specific)
1.िेहपीतस्य िन्दाग्नेः क्षीणस्यावतकृशस्य वा |
Pre-existing Mandagni/Ksheen/Atikrisha>Snehapan=Jalodar.
2.अत्यम्बुपानान्नष्टेऽग्नौ िारुतः िोवि संक्लथथतः ||४५||
Same Mandagni/Ksheen/Atikrisha>Atyambupan=Jalodar.
Final triggering Nidanas- manifest Jalodar, No. 2 is commonly seen.
स्रोतःसु रुद्धिागेषु 1.कफ 2.श्चोदकिूक्लच्छजतः |
वधजयेतां 3.तदे वाम्बु स्वथथानादु दराय तौ ||४६||
1. Kapha- Kapha(Ras-albumin)- Osmotic Pressure
2. Udak- Ingested Water- Hydrostatic Pressure
3. Ambu- Transudative ascitic fluid result of स्रोतुःसु रुद्धमागेषु
in form of Hepatic-necrosis originated Portal-hypertension.
 Jalodar- Signs & Symptoms
• तस्य रूपावण-
अनन्नकाङ्क्षावपपासागुदस्रावशूलश्वासकासदौबजल्यावन, अवप
िोदरं नानावणज रावर्वसरासन्ततिुदकपूणज दृवतक्षोभसंस्पशं
भववत, एतदु दकोदरविवत ववद्यात् ||४७||
Signs Symptoms
1. Engorged Veins 1. Anorexiea
2. Ascitis 2. Thirst
3. Dull sound on percussion 3. Anal secretion
4. Pain
5. Dyspnoea
6. Coughing
7. Weakness
 Jalodar- Needs Quick & cautious
Management before its manifestation
• तत्र अविरोत्पन्निनुपद्रविनुदकिप्राप्तिुदरं
त्वरिाणवश्चवकत्सेत्; उपेवक्षतानां ह्येषां दोषाः
स्वथथानादपवृत्ता पररपाकाद् द्रवीभूताः सन्धीन्
स्रोतां वस िोपिेदयक्लन्त, स्वेदश्च बाह्येषु स्रोतःसु
• प्रवतहतगवतक्लियजगववत्ठविानिदे वोदकिाप्याययवत;
 Jalodar- Ajatodak Avastha
तत्र वपच्छोत्पत्तौ िण्डलिुदरं गुरुक्लिवितिाकोवठतिशब्दं
िृदुस्पशजिपगतरार्ीकिाक्रान्तं नाभ्यािेवोपसपजवत |
 Jalodar- Jatodak Avastha
तस्य रूपावण-
1. कुक्षेरवतिात्रवृक्लद्धः,-
Excessive abdo. distention
2. वसरान्तधाज नगिनि् ,-
Disappearance of engorged superficial veins
3. उदकपूणजदृवतसङ्क्षोभसंस्पशजत्वं ि||४८||
On percussion fluid thrill.
 Complication of Jalodar
तदाऽऽतुरमुप्रवाुः स्पृशक्लन्त-
1.छर्द्द 2.तीसार 3.तमक 4.तृष्णा 5.श्वास 6.कास
7.र्हक्का 8.दौबदल्य 9.पाश्वदशूला 10.रुर्च 11.स्वरभेद
12.मूत्रसङ्गादयुः;तथार्वधमर्चर्कत्स्यं
र्वर्द्ार्दर्त||४९||
 Prognosis of Udar-rog

वातात् वपत्तात् कफ़ात् प्लीन: सवन्नपातात् तथा

उदकात् !
परं परं कॄच्छ्रतरम् उदरं वभषक् आवदशेत् !!
पक्षात् बद्धगुदं तु ऊवं सवं र्ातोदकं यथा !
प्रायो भववत अभावाय क्लच्छद्रान्त्रं ि उदरं नृणाि् !!
ि. वि. १३/५०-५१
 Signs & Symptoms of Incurable
Udar-rog
शूनाक्षं कुवटलोपथथिुपक्लिन्नतनुत्विि् |
बलशोवणतिां सावग्नपररक्षीणं ि वर्जयेत् ||५२||
श्वयथुः सवजििोत्थः श्वासोवहक्काऽरुविः सतृट् |
िूच्छाज च्छवदज रतीसारो वनहन्त्युदररणंनरि् ||५३||
र्न्मनैवोदरं सवं प्रायुः कृच्छ्रतमं िति् |
बवलनिदर्ाताम्बुयत्नसाध्यं नवोक्लत्थति् ||५४||
Management of Yakritudar(Cirrhosis)
• Pleehodar/yakridudar line of treatment is
unique description by Charak.
• Management is based on name of organ which
is not common in Ayurveda.
• Symptomatology as per Doshaja as well as
Raktaja dominance is given to decide specific
step.
• Role of Rakta is also accepted.
• This management is also applicable on hepatic
disorders.
 Line of treatment of
Yakritudar(Cirrhosis)-1
• उदावतजरुर्ानाहै दाज हिोहतृषाज्वरै ः |
गौरवारुविकावठन्यैश्चावनलादीन्यथाक्रिि् ||७५||
वलङ्गैः प्लीह्न्यवधकान्दृष्ट्ट्वा रक्तं िावप स्वलक्षणैः |
विवकत्सां सम्प्रकुवीत यथादोषं यथाबलि् ||७६||
Step 1.
This is symptomatology that guides the pleehodar
management first. ‘Yathadosham yathabalam’ indicates
doshaja pattern of management.

• Vatik dominance- Udavart(Belching), Ruja(Pain), Aanah

(Constipation).
• Paittika dominance- Moha(Stupor), Trisha(Thirst), Jwar(Fever).
• Kaphaja- Gaurav(Heaviness), Aruchi(Anorexia), Kathinyai(.
• Rakta dominance- as per mentioned in vidhi-shonitiya chapter.
 Line of treatment of
Yakritudar(Cirrhosis)-2
िेहं स्वेदं ववरे कं ि वनरूहिनुवासनि् |
सिीक्ष्य कारयेद्बाहौ वािे वा व्यधयेक्लत्सराि् ||७७||
षट् पलं पाययेत् सवपजः र्पप्पलीवाज प्रयोर्येत् |
सगुडामभयां वाऽवप क्षाराररष्टगणां िथा ||७८||
Step 2.-
After the Doshaja-management, generalised
‘Pleehodar’ line of treatment is instructed.
• Snehan Swedan
• Virechan Niruh
• Anuvasan Raktamokshan from left Arm.
Shat-pal ghrita Pippali-rasayan,
Gud-haritaki & Kshararishta etc. instructed
in generalised manner.
 Line of treatment of
Yakritudar(Cirrhosis)-3
• प्लीहावभवृक्लद्धं शियत्येतदाशु प्रयोवर्ति् ||८५||
तथा गुल्मोदरश्वासवक्रविपाण्डु त्वकािलाः |
अवग्नकिज ि कुवीत वभषिातकफोल्बणे ||८६||
पैवत्तके र्ीवनीयावन सपींवष क्षीरबियः |
रक्तावसेकः संशुक्लद्धः क्षीरपानं ि शस्यते||८७||
यूषैिां सरसैश्चावप दीपनीयसिायुतैः|
यकृवत प्लीहवत् सवं तुल्यत्वाद्भे षर्ं िति् ||८८||
लघून्यन्नावन संसृज्य दद्यात् प्लीहोदरे वभषक् |८९|
Step 3.- Again Charak describes the management of complicated
Pleehodar.
• Agnikarma- Gulm, Udar, Shwas, Krimi & Vat-kapha- dominance-
• Pandu, Kamala- Jeevaniya ghrita, Ksheer- vasti, rakta-mokshan, Ksheer-
pan(Siddha)
• Gulm, Udar, Shwas- Deepaniya Yush.-mansa-ras
• Said all ‘Pleehodar-management’ is applicable in ‘Yakridudar’.
 Line of treatment of
Yakritudar(Cirrhosis)-3
• अपां दोषहराण्यादौ प्रदद्यादु दकोदरे ||९३||
िू त्रयुक्तावन तीक्ष्णावन ववववधक्षारवक्लन्त ि |
दीपनीयैः कफघ्नैश्च तिाहारै रुपािरे त् ||९४||
द्रवेभ्यश्चोदकावदभ्यो वनयच्छे दनु पूवजशः|९५|
• Apam-doshahar-chikitsa- Kapha(Drava-guna)dosha
Nashak Chikitsa with use of
Mutra-yuktateekshna-kshar, Deepaniya, Kaphaghna
Anna & Aahar.
• Whatever the fluid accumulated in the Peritonium
cavity that must be withdrawn gradually with
systemic correction, Sudden drainage is not instructed
because it doesn’t break the vicious cycle of
Pathogenesis.
 Line of treatment of
Yakritudar(Cirrhosis)-3
• अपां दोषहराण्यादौ प्रदद्यादु दकोदरे ||९३||
िू त्रयुक्तावन तीक्ष्णावन ववववधक्षारवक्लन्त ि |
दीपनीयैः कफघ्नैश्च तिाहारै रुपािरे त् ||९४||
द्रवेभ्यश्चोदकावदभ्यो वनयच्छे दनु पूवजशः|९५|
• Apam-doshahar-chikitsa- Kapha(Drava-guna)dosha
Nashak Chikitsa with use of
Mutra-yuktateekshna-kshar, Deepaniya, Kaphaghna
Anna & Aahar.
• Whatever the fluid accumulated in the Peritonium
cavity that must be withdrawn gradually with
systemic correction, Sudden drainage is not instructed
because it doesn’t break the vicious cycle of
Pathogenesis.
 Kheer-vritti(Milk-diet)
अतः परं तु षण्मासान् क्षीरवृवत्तभजवेन्नरः ||१९१||
त्रीन् िासान् पयसा पेयां वपबेत्त्ींश्चावप भोर्येत् |
र्श्यािाकं कोरदू षं वा क्षीरे णालवणं लघु ||१९२||
नरः संवत्सरे णैवं र्येत् प्राप्तं र्लोदरि् |
06 Months- Only milk intake.
03 Months- Peya prepared in milk only.
03 Months- Shyamak, Kor-doosha with milk
without Salt(Practically we use Mudga)
 Pathya in Jalodar
व्यायािाववदवास्वप्नं यानयानं ि वर्ज येत् |
तथोष्णलवणाम्लावन ववदाहीवन गुरूवण ि ||१००||
नाद्यादन्नावन र्ठरी तोयपानं ि वर्जयेत् |१०१|
Nirjal
Nirlavan
Niranna
Chikitsa strictly IPD management instructed.
 Haritaki v/s Pippali

1. Ras 5 Rasas except Katu

Lavan
2. Guna Ruksha Snigdha, Laghu
3. Veerya Ushna Anushna
4. Vipak Madhur Madhur
5. Prabhav Rasayan, Rasayan
Anulaman
6. Vishesha Pathyanam- 1 of drug ‘Treeni-dravyani na
shreshtha upyunjit
Few treated/cured Cases
 Management Plan as per Charak
• Main Drug used-
• Haritaki Choorna- 6 to 12 gms
• Sah-pan- Gud(Jeggary) 5 gms to 20 gms as per
agni.
• Dose- OD/Some time BD as per condition
• Other drugs- as per requirement & availability
in IPD.
 Case No. 1
• Ashok Kumar Thakur- 43
• Jalodar- Alcoholic Cirrhosis
Case No.-1 Ashok Thakor- Pre-treatment reports- USG
Case No.-1 Ashok Thakor- Pre-treatment reports- S. Protein
Case No.-1 Ashok Thakor- Pre-treatment reports- CBC
Pt. Ashok Thakor 43 During Rx
Case No.-1 Ashok Thakor- Post-treatment reports-
USG
Case No.-1 Ashok Thakor- Pre-treatment reports- LFT
Pt. Ashok Thakor 43 after Cure
Case No. 2 Mr. Nitin
Case N0. 2 Nitin
Case No. 2 Mr. Nitin
Case No. 3- Shankar Parmar- Alcoholic Cirrhosis
Pre-treatment
Case No. 3- Alcoholic Cirrhosis Pre-treatment
Case No. 3- Shankar Parmar- Alcoholic Cirrhosis
Post-treatment
Case No. 3- Shankar Parmar- Alcoholic Cirrhosis
Post-treatment video
Case No. 4- Shankar Machhi- Alcoholic Cirrhosis
Case No. 4- Shankar Machhi- Alcoholic Cirrhosis
Pre-treatment
Case No. 4- Shankar Machhi- Alcoholic Cirrhosis
Case No. 4- Shankar Machhi- Alcoholic
Cirrhosis-Cured
Case No. 5- Mr. Mistri-DM/HTN/Nephropathy
• Please visit for Kayachikitsa learning.

• www.kayachikitsagau.blogspot.com

• Kayachikitsa webpage of Gujarat Ayurved

University, Jamnagar, Gujarat.
Thank
you