Review Article International Ayurvedic Medical Journal ISSN:2320 5091

CONCEPTUAL STUDY OF KAMALA (JAUNDICE)

Singh Madhu1 Sharma Neelema2 Sharma Umesh Chander1
1
Bundelkhand Government Ayurvedic College, Jhansi, Uttar Pradesh, India
2
Research Officer Incharge, N. V. A. R. I., Jhansi, Uttar Pradesh, India
ABSTRACT
This review article deals with the liver disease Kamala (jaundice). Liver has been
clinically implicated in the pathogenesis of this disease and liver cell dysfunction is accountable
for the various constitutional symptoms. Nidana (cause), Rupa (symptoms), Samprapti
(pathogenesis) and sadhya-asadhyata (prognosis) has been illustrated in accordance with
Ayurvedic classics. Yellow discoloration of eye, skin etc. signals the onset of this disease
Kamala which in parlance is correlated with disease of biliary system in general and jaundice in
particular. Unconjugated and conjugated hyperbilirubinaemia is just compatible with
koshthashrita and shakhashrita Kamala respectively.
Keywords: Kamala, Haridra, Shakhashrita, Koshthashrita, Liver

INTRODUCTION In modern science jaundice is classified in

In Ayurveda, the renowned three types:7
Ayurvedic physician and surgeon Acharya Haemolytic
Charak and Acharya Sushruta obviously Obstructive
recognized the condition like Kamala which Hepatocellular
has great resemblance with the jaundice of Koshthasrita Kamala which occurs
modern medical sciences. Disease Kamala is as a result of pitta vridhi in Rakta dhatu
related to Liver. The liver plays a major role after the use of its aggravating causes has
in the maintenance of metabolic similarity with the mechanism of pre hepatic
homeostasis. The development of clinically jaundice or Haemolytic jaundice in which
important liver disease is accompanied by more bilirubin is found in blood due to
diverse manifestation of disordered excessive destruction of R.B.C and is not
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metabolism . One of such disorders that is excreted. Adequately by liver resulting in
characterized by yellow staining of all the hyperbilirubinaemia responsible for various
tissues due to increased level of bile pigment symptoms like yellow discoloration of eye,
in circulation. Kamala is considered a purely skin etc.
paittik rog caused by Rakta dushti due to Shakhashrita Kamala is produced
vitiated pitta and vise-versa1. due to the obstruction of normal pittavaha
Classification of Kamala: srtotas by kapha and vata, resulting in pitta
Kamala has been classified as: vridhi in the rakta dhatu. In obstructive
Koshthashrita jaundice, there is same mechanism in which
Shakhashrita the bile ducts are obstructed by gall stone or
 Madhu Singh et al: Conceptual Study of Kamala (Jaundice)
other causes and bile is accumulated in liver, koshthashrita Kamala. Therefore the
resulting in elevation of blood bilirubin level mechanism of Hepatocellular jaundice can
responsible for yellowness of eye, skin, be compared to koshthashrita Kamala or
mucous membrane and stool become clay shakhashrita Kamala in different individuals
colored due to lack of bile in the intestine. depending upon the severity of the disease.
In Hepatocellular jaundice, when Nidana (causes) of Kamala:
there is complete obstruction of all the bile Nidana of koshthashrita Kamala:1,2,4,5
canaliculi due to their compression by 1. Aharaj nidana (unwholesome diet)
oedematous hepatocytes, jaundice is 2. Viharaj nidana (unwholesome regimen)
produced just like shakhasrita Kamala. 3. Mansika nidana (psychological factor)
When there is incomplete obstruction or 4. Nidanarthakar Rog (Disease causing
when all the bile canaliculi are not diseases)
obstructed then it is produced like that of 5. Other nidana (miscellaneous )
Table 1: Nidana of Kamala
Mansika
Aharaj nidana Vihara nidana Nidanarthkar roga Other nidana
nidana
Excessive intake of amla
lavan, katu, kshar ushna, Ati vyayam Garvisha (slow
Kama Pandu Roga (anaemia)
tikshna (intake of hot, (excessive exercise) poision)
spicy and junk food)
Some types of fever
Atimaithun Krodha i.e. pitttaj javar, Intake of sneha in
Til, sarshap, alsi tail
(excessive coitus) (anger) visham javar, Rakta contrary peroid
dhatugat jawar
Diwasvapana Chinta Prtikaramritu
Pinyak paittik gulam
(sleeping at day time) (stress) vaishmya
Vega vidharan
Bhay Prakrit pitta prakop
Nishpav (stoppage of natural paittik visarp
(fear) kala
urge)
Irshya
Mans Plihodar
(jealousy)
Shoka
Vidagdha anna Yakritodar
(sorrow)
Virudha anna Hridrog
Madya
Kulath etc.

Nidana of shakhastita Kamala:4,5 Haridra twak Yellowness of Skin

Haridra nakh Yellowness of nails
1. Excessive intake of Ruksha, Shita, Guru
Yellowness of buccal
and Madhur Ahar.(unwholesome diet) Haridra anan
cavity
2. Ati vyayam ( excessive exercise) Peet sakrita,urine Yellow stool and urine
Greenish yellow tinge of
3. Vega nigrah (stoppage of natural urges) Bhenk varna
body
Table 2: Rupa of Kamala (symptoms) Burning sensation of the
Daha
Kamala Rog Jaundice body
Haridra netra Yellowness of conjunctiva Avipak Indigestion

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 Madhu Singh et al: Conceptual Study of Kamala (Jaundice)
Daurbalya Weakness Sadhya-Asadhyata of Kamala (prognosis of
Hrillas Nausea
the disease)1,4,5
Chardi Vomitting
Shotha Edema When Kamala becomes chronic and
Jawar Fever their appearance of ruksha (dryness) in
Bhinna varcha Diarrhoea sharir dhatu, it is called another stage of
Tilpishta varcha Clay coloured stool
Hikka and shwas Hiccough And Bodyache Kamala kumbha kamala. This stage is
Angmarda Bodyache krichyasadhya on the appearance of Shotha
(oedema) and parvabheda (joint pain) due to
Samprapti of Kamala: (pathophysiology of
negligence in the treatment of Kamala.
Kamala): Here the factors which are taking
When there is too much vitiation of
part in the pathophysiology of Kamala are
the doshas in kumbha Kamala, the patient
Agni, Ama, Dosha, Dushya, Srotas.
suffers from yellowish black coloured of his
In koshthashrita Kamala, the
stool and urine, oedema, red colouration of
excessive pitta vridhi due to all the above
eyes, mouth, vomited matter, drowziness,
mentioned nidana, produces abnormality in
loss of appetite, unconsciousness. A patient
the Raktavaha srotas and Raktvaha sroto
of Kamala who develops these symptoms
mula, liver in which dosh dushya
becomes asadhya in treatment.
sammurchana olso occurs. Then ati pravriti
Thus it is obvious from the above
(excessive flow) of pitta occurs through
description that Kamala Roga is sukha-
pitta vaha srotas into the koshtha, resulting
sadhya in the beginning and becomes
in the dark yellow colouration of urine and
krichyasadhya with the appearance of some
stool. Vitiated vata also causes ati-pravriti
other symptoms like oedema, joint pain etc.
of pitta in Rasa-Rakta etc. Dhatus4,5. So
DISCUSSION AND CONCLUSION
when this vridha pitta reaches the sites of
Kamala is a condition where the
the clinical manifestation of Kamala disease
skin, eye and mucous membrane take yellow
via Rasa-Rakta Dhatus, it produces yellow
discoloration. In modern science jaundice is
coloration just like that of Haridra in these
considered as symptom of liver disorder
sites i.e. in eyes skin, face nail, urine etc.
whereas in Ayurveda Kamala is taken as
which is the cardinal signs of Kamala.1,3
disease. In Ayurveda, increased intake of
In shakhasrita Kamala, due to
oily, spicy, hot and alkaline food, are
excessive intake of shkhashrita nidana
depicted for aggravation of pitta dosha. The
srotas sangha of pittavaha srotas occurs.
aggravated Pitta then impairs the blood and
Therefore pitta cannot reach into the koshtha
the muscle tissue of the liver, causing
through its normal pathway and the stool is
blockage in the channels of the liver and
not colored there due to absence of pitta, so
thus Pitta is thrown back into the blood
the patient excretes tilpishtha (clay) colored
leading to discoloration of the eyes and skin.
stool. Due to obstruction of srotas, pitta
Sleeping in the daytime, excessive physical
begins to accumulate in liver, from where it
work, overindulgence in sexual activity,
is sent to the eyes, skin, nails and buccal
suppressing the natural urges of the body,
cavity etc. for yellow discoloration of these
and psychological factors like fear, anger,
sites.
and stress can also be causative factors for

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 Madhu Singh et al: Conceptual Study of Kamala (Jaundice)
Kamala. This disease is pitta dosha 4. Shastri S; madhav nidana with
dominating disease so persons those are madhukosh vyakhya 25ed. chukhambha
having pitta prakriti are more prone for Sanskrit series office Varanasi 1995.
getting this disease. So we can escape 5. Shastri A. D; Sushruta samhita, 8ed.
ourselves from many diseases by taking Chaukhambha Sanskrit series office
pathya (wholesome) ahar vihar according Varanasi 1993.
our prakriti. Types of Kamala and jaundice 6. Cortton; Kumar; Robbins; pathologic
have great resemblance. basic of disease 5ed.W.B. Sanders company
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chaukhambha vidya bhawan Varanasi 1969. Dr. Madhu Singh
3. Singh R.H; Ayurveda nidana chikitsa ke Lecturer,
sidhant1ed. Chaukhambha amar bharti Bundelkhand Govt. Ayurvedic College,
prakashan varanasi1983. Jhansi, Uttar Pradesh, India
Email: mad27jan@gmail.com

Source of support: Nil

Conflict of interest: None Declared

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