Case Report

International Research Journal of Ayurveda & Yoga

Vol. 6 (4),38-48, April,2023
ISSN: 2581-785X : https://irjay.com/
DOI: 10.47223/IRJAY.2023.6406

Ayurvedic Management of Yakrit Vidradhi (Liver Abscess) – A Case

Report
Jitendra Varsakiya, Divyarani Kathad,2 Ritu Kumari3, Sourava Nayak4
1-Assistant Professor, PG Department of Kayachikitsa Chaudhri Brahma Prakash Ayurved Charak Samsthan Khera
Dabar,Najafgarh, New Delhi
2-Director and Chief Consultant, Punarvasu Ayurveda Health Care & Panchkarma Center, New Delhi.
3- SRF, ITRA, Jamnagar Gujarat.
4-PG Scholar, PG Department of Kayachikitsa Chaudhri Brahma Prakash Ayurved Charak Samsthan Khera
Dabar,Najafgarh, New Delhi

Article Info ABSTRACT:

Article history: The liver abscess is the most frequent visceral abscess caused by a
Received on: 15-03-2023 parasite or bacterial infection in low and middle-income countries. A
Accepted on: 22-04-2023 liver abscess can cause fever, chills, night sweats, malaise, nausea or
Available online: 30-04-2023 vomiting, right shoulder ache, right upper quadrant pain, cough,
dyspnea, anorexia, etc. A 20 years old male patient presented with
Corresponding author- symptoms of fever, chills, malaise, right shoulder pain, and right upper
Jitendra Varsakiya, Assistant Professor, PG quadrantpain.The patient was treated with Virechan Karma (therapeutic
Department of Kayachikitsa Chaudhri purgation) followed by oral Ayurvedic medicines such as Varunadi
Brahma Prakash Ayurved Charak Samsthan Kwatha, Kanchanar Guggulu, and Aarogyavardhini Vati. Pathya-
Khera Dabar,Najafgarh, New Delhi. apathy (wholesome-unwholesome diet) based on Ayurveda perspectives
was also advised to the patient. The total duration of the treatment was
four months, and follow-up was done for one month. Improvement was
assessed based on relief in the symptoms and abdomen USG. Complete
Email: [email protected] relief in all symptoms was noted after completion of the treatment. The
USG findings revealed a reduction in hypoechoic lesion to size 5.1*5.1
cm with calcified margins in the right lobe segment VIII of the liver.
Any complications or adverse events due to treatment were not observed
during the treatment period. This case report demonstrates the
effectiveness of Ayurvedic approaches in managing Liver abscesses.
Keywords – Ayurveda, case report, Liver abscess, Virechana, Yakrit
Vidradhi,

INTRODUCTION
A liver abscess is a pus-filled mass in the liver that can tissue debris.3 Because the liver receives blood circulation
occur due to hepatic injury or an intra-abdominal infection from both the systemic and portal circulations, it is more
disseminated by the portal vein.1 Liver abscess can be vulnerable to infections and abscesses.4 Another risk factor
broadly divided into categories such as amoebic and for the liver is proximity to the gallbladder. Abscesses
pyogenic.2 A pyogenic abscess is a collection of pus having could also be caused by parasites, malignancies, foreign
numerous inflammatory cells, primarily neutrophils and material, or complications from liver transplantation. 5,6

This work is licensed under a CC BY 4.0 License

 Jitendra et.al, “Ayurvedic Management of Yakrit Vidradhi (Liver Abscess) – A Case Report.”: 2023; 6 (4):38-48

Pyogenic Liver Abscesses (PLAs) have a global organomegaly was noted. On percussion dull sound was
distribution; however, the incidence differs considerably present over right hypochondriac region. There was normal
between regions, spanning more than 900 incidences in bowel sound heard on the auscultation over
Asian countries in the last ten years.7 The annual incidence abdomen. Ashtavidha Pariksha (eightfold examination of
rate has been estimated to be around 2.3 cases per 100,000 the patient) was done and mentioned in Table
individuals. Males are more prone to be affected by PLAs no.1.Timeline: The timeline of the case report is depicted
than females.8 Diabetes, cirrhosis, male gender, the elderly, in table 2.
immunocompromised conditions, and people using proton Diagnostic Assessment
pump inhibitors are all risk factors for developing liver The diagnosis was made by laboratory investigations such
abscesses.9 Symptoms of a liver abscess include fever, as USG abdomen, Complete Blood Count (CBC), and
chills, night sweating, malaise, nausea, vomiting, right Liver Function Tests (LFT). The USG findings revealed a
shoulder pain, right upper quadrant pain, cough, dyspnea, hypoechoic lesion of size 8.7*7.7*7.3 cm; a volume of
anorexia, and recent unexplained weight loss. An 259.9 cc in the right lobe, segment VIII of the liver. Bio-
abdominal ultrasonography (USG) is the initial diagnostic markers of CBC and LFT were in the normal range. Based
test of choice to detect hyper or hypoechoic lesions in the on the USG findings, the diagnosis of the liver abscess was
liver with occasional debris or septation. Abscess drainage decided. Due to the patient's financial constraints, a fine
and antibiotic therapy are the main lines of treatment for needle biopsy could not be performed to differentiate
PLAs.10 between PLAs and amoebic liver abscesses. From
The disease PLAs can be correlated with Yakrit Vidradhi, Ayurveda's perspective, this condition correlates
one of the ten Antarvidradhi (internal abscess) narrated in with Yakrit Vidradhi (liver abscess). (Tables 4 and 5)
Ayurveda. In Sushruta Samhita, diagnosis and treatment of Therapeutic Intervention
liver abscess have been described with sufficient details.11 As the liver is the site for Pitta Dosha and Rakta
A case report of a patient suffering from a liver abscess and Dhatu, treatment was planned according to Pitta/Raktaja
treated with Ayurvedic therapies is presented in this study. Vidradhi (abscesses due to vitiated Pitta/Rakta). The
This case resembles Pittaja/Raktaja Vidradhi (abscess due therapy includes Virechana Karma (therapeutic purgation)
to perturbed Pitta/Rakta). The uniqueness of this case [Table 3; Figure 2] followed by oral medications such
report is that the patient with a liver abscess was treated as Varunadi Kwath 20 ml to be taken on an empty stomach
following the guidelines suggested in the Ayurveda in the morning; Aarogyavardhini Vati (250 mg), two
treatise. tablets twice daily with lukewarm water, after the meal
Patient Information and Kanchanar Guggulu (250 mg), two tablets twice daily
A 20 years old male patient was suffering from fever, with lukewarm water, after dinner [Table 2]. The total
chills, nausea, excessive thirst ,abdominal pain, and duration of treatment was four months. Follow-up was
occasional vomiting for a week. The symptoms were taken after every two weeks for a month. Advises related
initially mild, but their severity increased gradually. The to Pathya-Apathya (wholesome-unwholesome diet) were
sickness had a severe manifestation when the patient came given during the treatment and follow-up period.
for Ayurvedic treatment. The patient had taken analgesic Pathya (wholesome dietary regimen and activities):
and antispasmodic drugs (Mefenamic acid 250 mg and The patient was advised to take an ample amount of green
Dicyclomine HCL 10 mg; as and when needed) without gram (Vigna radiata (L.) R. Wilczek) boiled and roasted
consultation with a physician. The patient worked as a form with Trikatu Churna (powder made up of dried
driver and occasionally drank alcohol. The patient had no rhizome of Zingiber Officinalis Ros., dried fruit of Piper
reported history of any chronic disease or surgeries. longum L., and Piper nigum L.), soup made from green
Clinical Findings: gram (Macrotyloma uniflorum (Lam.) Verdc.), Saindhav
On examination, the patient's body temperature was 102.3 Lavan (rock salt) and barley (Hordeum vulgare L.) or
℉; his blood pressure was 118/82 mmHg, and his pulse rate wheat (Triticum aestivum L.). The patient was advised to
was 86/min. During the examination, the patient was well eat a dish prepared from drumstick (Moringa oleifera Lam)
conscious and responded satisfactorily. On inspection there and Indian plum (Ziziphus mauritiana Lam.) and to take
was no scar , protrusion or prominent vein shown over jaggery with Shunthi Churna (Zingiber officinale Ros.) in
abdomen. On palpation of the abdomen, mild tenderness 1:1 proportion after the meal. Advises were also given to,
was observed in the right hypochondriac region, though no the patient is to take sufficient rest and

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 Jitendra et.al, “Ayurvedic Management of Yakrit Vidradhi (Liver Abscess) – A Case Report.”: 2023; 6 (4):38-48

perform Pranayama (control of breath) such as Anuloma predicting Doshik involvement in the pathogenesis
Viloma, Bhramari, and chant Omkara for 10 minutes in the of Antartvidradhi based on similarity with
morning. characteristics of Bahya Vidradhi (external abscess). Since
Apathya (unwholesome dietary regimen and activities): the symptoms in the studied case were similar
The patient was advised to strictly prohibit sour, salty, oily to Paittik/Raktaja Vidradhi (abscess due to
food items which are heavy to digest, green leafy perturbed Pitta/Rakta), it was treated based on the
vegetables, meat, milk, and curd. The patient was likewise principles of Paittika/Raktaja Vidradhi.
recommended to avoid traveling and performing strenuous Virechana is appreciated in Shashtiupkrama (sixty
physical activities, and day sleep was also proscribed. therapeutic measures for wounds) for both Pitta Pradhana
[Figure 1] Vrana (wound due to perturbed Pitta Dosha)13 as well
Method of Virechana Karma (therapeutic purgation): as Vidradhi Chikitsa (treatment of abscess).14 In this case,
Deepana (appetizer) and Pachana (digestives) there were two medications, Kanchanar
with Hariatki Churna (Terminalia chebula Retz.)- Guggulu and Varunadi Kashayam,16 which were
15

2gm and Shunthi Churna (Zingiber Officinalis Ros.) 2 prescribed for Vidradhi Chikitsa. Aarogyavardhini Vati is
gm twice a day, half an hour before meals, with lukewarm another well-known remedy for liver disorders.
water, were done for three days; from the fourth Cholangitis is responsible for almost half of all bacterial
day, Snehapana (internal oleation) was done cases of liver abscess.17 Bacteraemia of the hepatic artery
with Panchatikta Ghrita (30ml) for the next five days in an or portal vein, diverticulitis, cholecystitis, or penetrating
increasing dose (10ml per day) as per Koshtha and Agni. trauma are less likely reasons.18 Despite E. coli, Klebsiella,
On the 9th day, Sarvanga Streptococcus, Staphylococcus, and anaerobic organisms
Abhyanga and Swedana (external oleation and being the most widespread, infections are very often
fomentation) were performed for the next three days. On polymicrobial. Pyogenic liver abscesses are commonly
the 12th day, Virechaka Kashaya was administered on an associated with bowel content leakage and peritonitis.
empty stomach. The total number of Vega (defecation) was Bacteria travel to and lodge in the liver via the portal vein.
26 [Kaphanta (when Kapha is expelled at the end)] with Furthermore, the infection can emerge in the biliary
appropriate Samyak Virechan Lakshana (signs of proper system.19,20
therapeutic purgation). After Virechana, Kanchanar Guggulu is primarily composed
Sansarjana Krama (post-therapy dietetic regimen for of Kanchanara and Guggulu. Additionally, it
revival) was advised for seven days. [Figure 2] (Table 3) has Triphala (combination of three myrobalans viz. T.
Follow-Up And Outcomes chebula, T. bellarica, and E. officinalis)
Follow-up was taken for one month on a fortnight basis, and Trikatu (combination of Z. Officinalis, P. longum,
during which clinical assessment was done based on the and P. nigrum). Guggulu (C. mukul) possesses substantial
improvement of the patient's symptoms and the findings of antibacterial activity against Gram-positive bacteria.21,22
the USG abdomen. These parameters showed improvement Myrrhanol A, a triterpene isolated from Guggulu, has a
at the end of four months (Tables 3 and 4). On 20th August potent anti-inflammatory effect on exudative pouch fluid,
2021, the size of the hepatic lesion was 8.7*7.7*7.3 cm, angiogenesis, and granuloma.23 Kanchanar (B.
and the volume was 259.9 cc; on 13th October 2021, it variegata L.) possessed excellent antibacterial properties.24
reduced to 6.0*5.8*5.7 cm; the volume was 105.6 cc. An The ethanolic extract of B. variegata stem bark exhibited
old healed abscess with calcified margins was observed on antimicrobial activity.25 The anti-inflammatory efficacy of
29th December 2021 (Figure 3). No complications, new a novel flavonol glycoside (5,7,3,4-tetrahydroxy-3-
symptoms, or adverse events were observed during the methoxy-7-o—L-rhamnopyranosyl (13) –o—d-
entire treatment and follow-up period. Clinical adherence galactopyranoside) of B. variegata has been
26
was assessed using the medicine dosage history provided observed. Triphala aqueous extracts are potent against E.
by the patient. coli and S. aureus.27 Triphala suppressed the
proinflammatory cytokines Tumor Necrosis Factor- α
DISCUSSION (TNF- α). Furthermore, it decreased hepatic damage, as
Sushruta has described ten types of Antarvidradhi (internal revealed by decreased ALP, ALT, and AST levels and
abscess) and included Yakrit Vidradhi (liver abscess) as substantiated by histological observations.28 Triphala is
one.12 In the same context, Sushruta has mentioned remarkably efficient when used topically and has been

40
 Jitendra et.al, “Ayurvedic Management of Yakrit Vidradhi (Liver Abscess) – A Case Report.”: 2023; 6 (4):38-48

shown to aid wound healing.29 Triphala also have 5. Guzmán-Silva MA, Santos HL, Peralta RS, Peralta JM, de
antimicrobial, anti-inflammatory, and wound ameliorative Macedo HW. Experimental amoebic liver abscess in
effects.30 hamsters caused by trophozoites of a Brazilian strain of
Katuki is half of the content of Aarogyavardhini Vati. The Entamoeba dispar. Exp Parasitol. 2013 May;134(1):39-47.
aqueous extract of Kutki (P. Kurrah) roots exhibited 6. Costa CA, Fonseca TH, Oliveira FM, Santos JF, Gomes
moderate antibacterial activity against Staphylococcus MA, Caliari MV. Influence of inflammation on parasitism
aureus, salmonella typhi, and significant attenuation of E. and area of experimental amoebic liver abscess: an
coli.31 Its anti-inflammatory effects are ascribed to the immunohistochemical and morphometric study. Parasit
apocynin in element, which has been found to exhibit Vectors. 2011 Feb 28;4:27.
potent anti-inflammatory properties in addition to limiting 7. Ko WC, Paterson DL, Sagnimeni AJ, Hansen DS, Von
neutrophil oxidative burst.32 The hepatoprotective effect of Gottberg A, Mohapatra S, et. al, Community-acquired
a hydroalcoholic extract of the Varuna plant (C. nurvala) Klebsiella pneumoniae bacteremia: global differences in
against hepatotoxicity induced by carbon tetrachloride clinical patterns.Emerg Infect Dis. 2002 Feb; 8(2):160-6.
reveals enhanced antioxidant enzymes in granuloma tissue 8. Kaplan GG, Gregson DB, Laupland KB. Population-based
promoting wound repair and regeneration. 33 study of the epidemiology of and the risk factors for
pyogenic liver abscess. Clin Gastroenterol Hepatol. 2004
CONCLUSION Nov;2(11):1032-8.
Ayurvedic medicines, Virechana Karma, and 9. Chan, K.S., Shelat, V. (2022). Pyogenic Liver Abscess. In:
proper Pathya-apthya effectively treat a liver abscess. , et al. The IASGO Textbook of Multi-Disciplinary
Further research with a large enough sample size and Management of Hepato-Pancreato-Biliary Diseases.
detailed research methodologies is required to verify and Springer, Singapore. https://doi.org/10.1007/978-981-19-
substantiate the role of Ayurveda interventions in treating 0063-1_66.
a liver abscess. 10. Akhondi H, Sabih DE. Liver Abscess. [Updated 2022 Jul
6]. In: StatPearls [Internet]. Treasure Island (FL):
Acknowledgment- Nil StatPearls Publishing; 2022 Jan-. Available from:
Conflicts Of Interest- Nil https://www.ncbi.nlm.nih.gov/books/NBK538230/
Source of finance & support – Nil 11. Shastri AD, editor-translator. Sushruta Samhita of
Sushruta, Part–I, Nidana Sthana, ch. 9, Ver. 19-23 1st ed.,
ORCID Varanasi: Chaukhambha Sanskrit Sansthan; 2012. p. 343.
Jitendra Varsakiya , https://orcid.org/ 12. (Shastri AD, editor-translator. Sushruta Samhita of
0000-0002-5009-2738 Sushruta, Part–I, Nidana Sthana, ch. 9, Ver. 24 1st ed.,
Varanasi: Chaukhambha Sanskrit Sansthan; 2012. p. 343)
13. Shastri AD, editor-translator. Sushruta Samhita of
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22, 1st ed., Varanasi: Chaukhambha Sanskrit Sansthan; antibacterial activity. Indian journal of Pharmaceutical
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Ethnopharmacology, vol. 99, no. 2, pp. 253–257, 2005. 33. Asuti N. Wound healing property of alcoholic extract of
24. Kimura I, Yoshikawa M, Kobayashi S, Sugihara Y, Suzuki root bark of Crataeva nurvala. Journal of Pharmacy
M, Oominami H, et al.,New triterpenes, myrrhanol A and Research 2010; 3(5): 1121-3.
myrrhanone A, from guggul-gum resins, and their potent
anti-inflammatory effect on adjuvant-induced air-pouch How to cite this article: Varsakiya J, Kathad D, Kumari
granuloma of mice, Bio org Med Chem Lett, 11(8) (2001) R, Nayak S, “Ayurvedic Management Of Yakrit Vidradhi
985. (Liver Abscess) – A Case Report” IRJAY.
25. Parekh Jigna, Karathia Nehal, Chanda Sumitra., Screening [online]2023;6(4); 38-48.
of some traditionally used medicinal plants for potential Available from: https://irjay.com
DOI link- https://doi.org/10.47223/IRJAY.2023.6406

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 Jitendra et.al, “Ayurvedic Management of Yakrit Vidradhi (Liver Abscess) – A Case Report.”: 2023; 6 (4):38-48

Table No.1: Ashtavidha Pariksha (eightfold examination of the patient)

Sr. No Examination Findings
1 Nadi (pulse) Vatika
2 Mootra (urine) Peeta Varna (reddish yellow in colour)
3 Mala (faeces) Samaja (associated with Aama)
4 Jhwa (tongue) Kaphaja (white, sticky)
5 Sabdam (voice) Aspashta (weak)
6 Sparsham (touch) Ushna (hot), Ruksha (dryness);
7 Druka (eyes and vision) Arun Varna (pinkish discoloration), Antarpravishta (sunken)
8 Akriti (general body built) Madhyam (moderate).

Table 2: Timeline of the studied case

S.N. Date Signs & Symptoms Investigations Managements
1. August 2021 The onset of rising body
temperature, chills,
- -
nausea, abdominal pain,
and occasional vomiting
2. th
18 August 2021 Symptoms- • Varunadi Kwath 20 ml. empty
[First visit to the The intensity of the all the stomach in the morning
hospital] above symptoms • Aarogyavardhini Vati (250 mg) - 2
increases tablets twice daily with lukewarm
-
Signs- water, after meals.
• Mild tenderness in • Kanchanar Guggulu (250 mg) - 2
right Hypochondric tablets twice daily with lukewarm
region water after meals.
3. 20th August 2021 • USG (Abdomen)-
Hypoechoic lesion of
size 8.7*7.7*7.3 cm.
- -
vol. 259.9 cc in right
lobe of liver segment
VIII
4. 23rd August 2021 • SGOT- 21.44 mg/dl
- • SGPT-28.63 mg/dl -
• TLC – 7,600/mm3
5. 25th August 2021 • No relief in The patient got IPD admission for
symptoms, and the - Virechana Karma (therapeutic
sign also persist. purgation)
6. 13th September • Fever and chills • Varunadi Kwath 20 ml. empty
2021 subsided. stomach in the morning
[discharged from • Relief in nausea, • Aarogyavardhini Vati (250 mg)- 2
hospital] frequency of tablets twice daily with lukewarm
abdominal pain, and - water, after meals.
vomiting. • Kanchanar Guggulu (250 mg)- 2
• Tenderness in the tablets twice daily with lukewarm
right hypochondriac water after meals.
region was relived.

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 Jitendra et.al, “Ayurvedic Management of Yakrit Vidradhi (Liver Abscess) – A Case Report.”: 2023; 6 (4):38-48

7. 27th September. • Vomiting subsided. • Varunadi Kwath 20 ml. empty

2021 • Occasional stomach in the morning
abdominal pain and • Aarogyavardhini Vati (250 mg)- 2
nausea. tablets twice daily with lukewarm
• Tenderness in the water, after meals.
right hypochondriac • Kanchanar Guggulu (250 mg)- 2
region was subsided. tablets twice daily with lukewarm
water after meals.
8. 13th October 2021 • USG (Abdomen)-
Hypoechoic lesion of
size 6.0*5.8*5.7 cm.
- -
vol. 105.6 cc in right
lobe of liver segment
VIII
9. 14th October 2021 • Occasional mild • Varunadi Kwath 20 ml. empty
abdominal pain and stomach in the morning
nausea • Aarogyavardhini Vati (250 mg)- 2
tablets twice daily with lukewarm
-
water, after meals.
• Kanchanar Guggulu (250 mg)- 2
tablets twice daily with lukewarm
water after meals.
10. 28th October 2021 • Occasional mild • Varunadi Kwath 20 ml. empty
abdominal pain and stomach in the morning
nausea • Aarogyavardhini Vati (250 mg)- 2
tablets twice daily with lukewarm
-
water, after meals.
• Kanchanar Guggulu (250 mg)- 2
tablets twice daily with lukewarm
water after meals.
11. 11th November • Occasional mild • Varunadi Kwath 20 ml. empty
2021 abdominal pain and stomach in the morning
nausea • Aarogyavardhini Vati (250 mg)- 2
tablets twice daily with lukewarm
-
water, after meals.
• Kanchanar Guggulu (250 mg)- 2
tablets twice daily with lukewarm
water after meals.
12. 25th November Relief in abdominal pain • Varunadi Kwath 20 ml. empty
2021 and nausea stomach in the morning
• Aarogyavardhini Vati (250 mg)- 2
tablets twice daily with lukewarm
-
water, after meals.
• Kanchanar Guggulu (250 mg)- 2
tablets twice daily with lukewarm
water after meals.

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 Jitendra et.al, “Ayurvedic Management of Yakrit Vidradhi (Liver Abscess) – A Case Report.”: 2023; 6 (4):38-48

13. 99th December Relief in abdominal pain • Varunadi Kwath 20 ml. empty
2021 and nausea stomach in the morning
No fresh complaints. • Aarogyavardhini Vati (250 mg)- 2
tablets twice daily with lukewarm
-
water, after meals.
• Kanchanar Guggulu (250 mg)- 2
tablets twice daily with lukewarm
water after meals.
14. 23rd December • Pain in the abdomen • Medications ceased.
2021 and nausea subsided. - • Only Pathya-apathya continues
• No fresh complaints.
15. 29th December USG (Abdomen)-
2021 Hypoechoic lesion in
liver of size 5.1*5.1 cm.
- -
with calcified margins.
Old healed abscess at
right lobe of the liver .
16. 6th January 2022 No fresh Advised to continue Pathya-apthya
(First follow-up) complaints/complicatio - for two more weeks.
ns.
17. 20th January 2022 No fresh Treatment terminated.
(Second follow- complaints/complicatio -
up) ns.

Table 3: Drugs and dosage forms used in Virechana Karma.

Procedure Drug & dosage form Duration
Deepana and Pachana Hariatki Churna (T. chebula Retz.)-2gm + Shunthi Churna Three days
(Improvement of digestion and (Z. officinalis Ros.) 2 gm thrice a day with lukewarm water
metabolism) after meal.
Snehapana (therapeutic internal Panchatikta Ghrita (as per Koshtha and Agni) in increasing Five days
oleation) dose.
Abhyanga and Vashpa Svedana Laghu Visagarbha Taila, For Vashpa Sveda Dashamoola Three days
(therapeutic external oleation and Kwatha was used.
therapeutic fomentation)
Virechana Karma Nishotha Churna (Operculina turpethum (L.)10gm
(Bio-purification therapy) Triphala Kwatha 100ml
Draksha Kwatha (Vitis vinifera Linn.) 100ml
Sansarjana Krama Regulatory diet regimen as per Shuddhi Seven days
(post-therapy dietetic regimen for
revival)
Table 4: Criteria of the symptomatic assessment.
Severity level Gradation Scale
0 Absent 0
+ Mild 1
++ Moderate 2
+++ Severe 3
++++ Agonising 4

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 Jitendra et.al, “Ayurvedic Management of Yakrit Vidradhi (Liver Abscess) – A Case Report.”: 2023; 6 (4):38-48

Table5 : Assessment of symptoms of the patient during the study.

Symptoms 18th 25th 13th 27th 14th 28th 11th 25th 9th 23rd First Second
Aug. Aug. Sep. Sep. Oct. Oct. Nov. Nov. Dec. Dec. follow follow
2021 2021 2021 2021 2021 2021 2021 2021 2021 2021 up up
Fever 3 3 0 0 0 0 0 0 0 0 0 0
Chill 3 3 0 0 0 0 0 0 0 0 0 0
Abdominal pain 3 3 2 1 1 1 1 1 1 0 0 0
Tenderness in 3 3 2 0 0 0 0 0 0 0 0 0
right
hypochondriac
region
Nausea 2 2 2 1 1 1 1 0 0 0 0 0
Vomiting 2 2 1 0 0 0 0 0 0 0 0 0

Flow Chart Treatment.

•Grains-Barley, Wheat
•Pulses- Green gram, Horse gram
Pathya •Vegetable- Drumstick
•Fruit-Indian Plum
•Activities- Proper rest, Pranayama

•Sour, salty, oily, heavy food items

Apathya •Vegetable- Green leafy vegetables

•Milk, curd, ghee, meat
• Activities- Traveling, strenuous physical activities, day sleep

Figure 2: Details of Virechana Karma (therapeutic Purgation

for the next three
days)

Virechana Karma

Sansarjana Krama (For seven days)

Deepana and Pachana (For three

Abhyanga and Vashpa Svedana

Snehapana (For five days)

days Virechana Yoga of Regulatory diet

Panchatikta Ghrita
Hariatki Churna- (as per Koshtha and Abhyanga (whole Nishotha Churna regimen which
2gm + Shunthi Agni) started with body massage) was 10gm, Triphala including Peya (thin
Churna 2 gm thrice 30 ml and increased done with Kwatha 100ml, gruel of rice), Vilepi
a day with by 30 ml on each Laghuvishagarbha Draksha Kwatha (thick gruel of rice),
lukewarm water consecutive day, Taila, twice a day 100ml was given Akrita Yusha
before meal early morning for 20 minutes. empty stomach (9 (nonprocessed soup
empty stomach, Sarvanga Vashpa AM approx.). of vegetables
with lukewarm Sweda (steam The patient had an and/or pulses), and
water. fomentation) with urge for the first Krita Yusha
Dashamoola Vega (natural urges (processed soup of
Kwatha was (for elimination)) vegetables and/or
performed for 10 after 70 minutes. pulses) in a
minutes or until the sequential manner
The total number of as per Shuddhi
patient feels Vega was 26.
comfortable. (cleansing), i.e., for
seven days.

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 Jitendra et.al, “Ayurvedic Management of Yakrit Vidradhi (Liver Abscess) – A Case Report.”: 2023; 6 (4):38-48

Figure 3: Improvement in USG (abdomen) with date.

20th August 2021

13th October 2021
Hypoechoic lesion of 29th December 2021
size 8.7*7.7*7.3 cm., Hypoechoic lesion of
vol. 259.9 cc in the size 6.0*5.8*5.7 cm. Hypoechoic lesion of
right lobe of liver. vol. 105.6 cc in the size 5.1*5.1 cm. with
right lobe of liver. calcified margins in
the right lobe of liver
Old healed abscess

Before Treatment USG Report.

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 Jitendra et.al, “Ayurvedic Management of Yakrit Vidradhi (Liver Abscess) – A Case Report.”: 2023; 6 (4):38-48

After treatment USG Reports

48