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The World liver day is observed every year on April 19 to build awareness and understanding importance of liver in human body and how liver diseases are treated. The liver is the second largest organ in body after the skin. it is also the second most complex organ of body after the brain. It is situated in the right upper abdomen largely under the right lower ribs. It is a dark brown, highly vascular soft organ and retains the shape of a blunt wedge. It weighs 1200 gm. to 1500 gm. or about 2% of the total adult body weight.
Liver related diseases
Hepatitis
Hepatitis means inflammation of the liver. It is due to infection or toxic substances. Infectious agents include viruses, bacteria (Klebs Loeffler bacillus, Salmonella, and Streptococcus), Rickettsia (Q fever), Spirochete (Leptospirosis, Canicola fever, and Relapsing fever), Parasites (Liver fluke in Africa and China), Toxic agents including drugs, anesthetics, industrial chemicals, insecticides, aflatoxin, yeasts, metallic compounds and alcohol. Simple hepatitis be developed also following the congestion which occurred after emphysema, right ventricular failure, bile duct obstruction or by auto immune reactions. Deficiency type hepatitis may be occurred (rarely) due to either lack of lipotropic factors like choline (Fenugreek, Cumin) and sulphur containing amino acids (cysteine and methionine- milk), or following malabsorption syndrome. It will be developed in alcoholics due to Magnesium (green vegetables), Zinc, and Thiamine deficiency.
Viral hepatitis is the 4th among the 30 leading communicable diseases. Several viruses can cause hepatitis. The most common types are classified alphabetically as HAV, HBV, HCV, Delta virus and HEV. Arboviruses (Yellow fever, Dengue fever and Kayasanur fever), Epstein Barr virus (infective mononucleosis), Cytomegalovirus, Rubella virus, Herpes simplex virus, Cox - Sackie virus etc. can cause hepatitis in susceptible individual.
Hepatitis
A
VAH is a common disorder in India. HAV present in stool and semen during pre icteric and early icteric phases of disease. Transmission of HAV usually occurs following fecal contamination of water and milk. Infusion of infected blood obtained from a virimic donor may cause sporadic infection. It may be carried by flies. Its occurrence is dependent on the susceptibility of exposed population and distribution of infected material. Epidemics are common in poverty groups, military forces, summer camps, and poor institutions. Outbursts may also take place following the consumption of polluted shellfish or sea foods. Recovery generally will occur within 4 weeks. There is no carrier state following VAH. Mortality rate is about 2/1000. Incubation period is 2 to 4 weeks.
Hepatitis
B
Hepatitis B is the most serious form of hepatitis found throughout the world. It is spread as HIV through sexual contact, blood transfusion, infective blood products (Albumin solutions, Plasminogen, and Gamma globulin are free of risk), exposure to an infected person’s blood via surgical and dental instruments, immunization, acupuncture, ear piercing, tattooing, shared needles, piercing tools, cuts, bites, open wounds, tooth brushes, razors etc. It presents in about 85% of homosexual men. Other potent sources are massive transfusions such as those used in a heart lung bypass, renal dialysis, pooled human plasma, or through blood products like fibrinogen and anti - hemophilic globulin. Inoculation of as little as 0.01ml of infected blood may transmit HBV. HBV can survive in blood, all physiological fluids with the exception of stool, urine, vomit, sputum, nasal secretion, sweat and tears. HBV can survive outside the body for at least 7 days and can be still capable of causing infection. HBV replication may follow after immunosuppressive drugs or chemotherapy. VBH in children occurs through vertical transmission from mother, and through the injection procedures in early childhood. VBH may take for 6 months to produce symptoms. About 50% of adults with VBH have no jaundice when the infection first develops. Individuals who remain HBV surface antigen positive for at least 6 months are considered to be HBV carriers. The children will become active carriers in early adulthood. Incubation period: 1 to 6 months.
Hepatitis
C
Hepatitis C is the most common cause of chronic hepatitis. It is transmitted by blood transfusion (90%) and blood contact. Incidence is more common in developing countries. Vertical and sexual spreads are uncommon. VCH may take 6 months to produce symptoms. About 80% of these people have no jaundice when the infection first develops. They develop chronic hepatitis and show no specific symptoms for up to 20 to 30 years. It is estimated that there are > 300 million carriers.
Hepatitis
D
Hepatitis D is an ongoing infection of HBV, and it is required before HDV is capable of replication. It is the most serious and the rarest form of hepatitis. VDH takes 1 - 2 months to produce symptoms.
Hepatitis
E
Hepatitis E is generally contracted from drinking sewage contaminated water, consuming shellfish or fishes. The mortality rate among pregnant women is high, at about 20%.
Symptoms
of hepatitis
Acute hepatitis - Pre icteric phase
Early symptoms are tenderness in the liver region, anorexia, nausea and vomiting. Fever lasts 3 to 7 days. Skin rashes, pruritus, arthralgia, arthritis, neck stiffness also may occur in pre icteric stage. Pain in upper abdomen occurs due to over stretching of liver capsule by passive congestion. Urine may show bilirubin before the patient is icteric.
Icteric
phase
Fever and jaundice occur more when the liver is apparently damaged. Temperature returns to normal on jaundice develops. Jaundice disappears shortly after 10 days, but it may last longer in older patients. Spleen, and lymph glands at the right side of neck may be enlarged. Symptoms of obstructive jaundice may be developed in some cases of viral hepatitis due to the bile thrombi blocking in biliary ducts. Early stage of hepatitis may be evidenced by enlargement of the liver but atrophy is the common feature later. Acuteness of diseases is less marked in VBH. Viral hepatitis is more infective in the early days of acute symptoms. Mortality rate is about 10 - 20%.
Complications are cholestasis, fatty liver, chronic active hepatitis, liver failure, cirrhosis (20% HCV), hepatocellular carcinoma and death. VAH does not lead to chronic hepatitis or a carrier state, and it only rarely does cause massive liver necrosis. All individuals with chronic liver disease are more susceptible to viral hepatitis.
Sub-acute
hepatitis
Usually
occurs in the right lobe.
Symptoms
Fever, anorexia, nausea, abdominal pain etc. lasts up to few weeks at the icteric stage. Patient remains icteric for a long time. Hypoalbuminemia, hyperglycemia, and hyperbilirubinemia are seen. Hepatic failure may be developed within 12 months. Aplastic anemia (due to changes in bone marrow) and neurasthenia are also common.
Cholestatic
hepatitis (Post gall stone or Fatty liver)
Other common causes are allergies, eosinophilic infiltration, and toxicity due to Arsenic, Testosterone, Para amino salicylic acid etc. Frothy, bulky and clay colored stool (due to absence of bile salts), increased serum cholesterol, conjugated hyperbilirubinemia, raised alkaline phosphatase, absence of urobilinogen in urine, itching, xanthelasma are the main features. Hypo gammaglobinaemia, raised SGOT, A.N.F and L.E cell tests may be positive in allergic individuals.
Fulminant
acute hepatitis (1%)
Acute hepatitis is developed in certain adults within 4 weeks of onset of initial illness. It is manifested as acute encephalopathy without history of pre - existing liver diseases. This type of acute hepatitis occurs more in association with VCH. Predisposing factors are multivocal infections, leptospirosis, septicaemia, liver abscess, malaria, hepatotoxins, amino oxidase inhibitors, Halothane anaesthetic, overdose of paracetamol, drug hypersensitivity, certain foods which include mycotoxin, seneciosis etc.
Symptoms
Pre icteric symptoms are short with a high fever, abdominal pain, and vomiting. The icteric phase is with rapid onset of coma, hyperpyrexia, cramps, focal fits, flapping tremor, plantar extension, dilated pupil, changes in electrolyte balance, generalized bleeding, ascites, hypotension, hypoglycemia, leucocytosis, and hypoxia. Prothrombin time is increased. Urine may show crystals of leucine and tyrosine. The liver shrinks rapidly. This illness may last 6 - 8 weeks. Mortality rate in this group is about 70 % to 80 %. The victims of fulminant hepatitis may die within 2 weeks of onset of illness.
Toxic
hepatitis
The degree to which the liver was exposed to toxins determines the amount of damage. Toxins also make a favorable environment for the replication of viruses within hepatic cells. Long consumption of antibiotics and steroids can promote the opportunistic infections. Chloroform and Arsenic can affect the liver enzyme system by neutralizing the lipotropic amino acids (Cysteine and Methionine).
List
of hepatotoxic drugs
Hepatitis
Paracetamol, Phenytoin, Halothane, Carbon tetra chloride, Iproniazid, Phenylbutazone, Acetazolamide, Sulpha group.
Cholangitis
Chlorpromazine, Arsphenamine, Thiouracils, Para amino salicylate.
Fatty
degeneration (Fatty liver)
Steroids.
Encephalopathy
Ammonium
salts (They can pass through damaged liver cells and precipitate coma).
List of other hepatotoxic drugs
Pethidine,
PABA, and Chloramphenicol.
List of other hepatotoxic agents
Phosphorus, Benzenes, Aluminium, Mercury, Phenol, Picric acid, Sulphuric acid, Benzoic acid, Barium salts and Lead.
*
Liver
cirrhosis & Chronic liver diseases
Liver
cirrhosis is the 12th leading cause of death by disease.
Causes
of cirrhosis
VBH & VCH, Alcoholism, Autoimmune liver disease, Hepatotoxins, Haemochromatosis, Inherited alpha - 1 antitrypsin deficiency, Galactosemia, Glycogen storage diseases, Wilson diseases; Cardiomyopathy, Corticosteroids, childhood biliary atresia, biliary obstruction, Chronic venous congestion, Schistosomiasis, Diabetes, Protein malnutrition and Obesity.
Clinical
features
Feature
of portal hypertension
Haematemesis, Splenomegaly with pancytopenia, and Ascites.
Other
features
Parotid enlargement, Thyroid enlargement, Prostatic enlargement, Opportunistic infection, Female breast atrophy, Testicular atrophy, Gynecomastia, Scanty body hair, Dupuytren’s contracture, Xanthomatosis, Steatorrhoea, Osteoporosis, Osteomalacia due to vitamin D deficiency, Fluid retention, Odema, Low serum sodium, Clubbing, and Hyperkinetic circulation.
Features
of hepatic failure
Fatigue, low grade fever, weight loss, indigestion, offensive breath, white nails, palmar erythema, spider naevi, firm hepatomegaly, jaundice in later stage, bleeding tendency.
Features of encephalopathy
Lethargy, slurred speech, flapping tremor, dementia, delirium and coma. Lymphocytes and monocytes may be lowered in peripheral blood owing to excessive infiltration of the same at the portal zone of lobules. Acetylcholine esterase is decreased in hepatic injury. So, symptoms of parasympathetic over activity (sinus bradycardia) may develop. Persistent swelling of liver cells may obstruct the hepatic capillaries and aggravate the hypoxia. The hyperthyroidism can worsen this condition if present.
Liver cancer
Liver cancer is the 5th most common cancer globally. It may originate either as solitary nodules which spread to other lobules, or as multifocal nodules simultaneously. Multinodular hyperplasia is seen more in post viral cirrhosis (20%) than alcoholic cirrhosis. The adenocarcinoma originating from bile duct epithelium is not associated with cirrhosis. The course is more rapid in this case. Secondary liver nodules are developed more in surface of the liver and are originated directly from the stomach or the gall bladder. It is also developed through the portal vein, hepatic artery, and retrograde lymphatic permeations. These nodules are more than 2 cm in size and have an umbilication in the center. Sinusoidal hepatic circulation provides a favorable site for the growth of malignant cells. Melanoma in liver also be developed as metastasis.
Metastasis
It usually occurs to the lymph glands of the right supra clavicular fossa, lungs, ribs, spinal column or brain.
Predisposing
causes
Inborn susceptibility, Elevated hereditary alpha fetoglobulin level, Chronic serum hepatitis, Cirrhosis (20%), Alcohol use, Aflatoxin (The incidence is highest in oriental races due to aflatoxin which is a product of mold found in soybeans, wheat, peanuts, coffee, rice and corn), Pesticides, Industrial toxins, Thorium dioxide, Male gender (It is less in female due to iron loss through the menstrual blood), Hemochromatosis ((20 %), Tobacco smoking, Steroid abuse, Fatty liver, Hypothyroidism, Old age, Nutritional deficiency, Schistosomiasis, Clonorchiasis (Chinese fluke) etc.
Common
symptoms
Weight loss, nonspecific fever, abdominal pain, sudden appearance of ascites, symptoms of portal hypertension, and jaundice. Pain is due to peri hepatitis. Deposits on the hepatic porta can also cause jaundice. Pressure symptoms are developed by obstruction on the inferior vena cava or on portal vein. Some children may show precocious puberty in hepatoma. Other features are similar to symptoms in chronic hepatitis. Pruritus usually occurs due to presence of histamine, bile salts or insufficiency of circulating testosterone. A vascular noise may be heard over the tumor.
Differential diagnosis
Hepatic artery thrombosis, Cirrhosis, Yellow fever and Toxic hepatitis. Homeopathic herbal medicines and potentised minerals have some influence on healing of liver cancer.
Treatment
for liver diseases
Morbidity due to serum hepatitis and toxic hepatitis is increasing all over the world. 90 % of Viral B Hepatitis can be cured in 6 months.
Prevention of VAH
Improve sanitary habits and personal hygiene.
Eat only fresh and cooked foods.
Restrain from eating processed foods.
Water should be boiled before using in epidemic.
Other
measures are isolation of the patient and proper disposal of night soiling.
Prevention
of VBH
This can be achieved by increasing healthy life style, a better diet and hygiene. Don’t share personal items like drug solutions, syringes, needles, shavers, masks, gloves, tooth brushes and manicure tools.
Use deep
breathing exercises (Exhale through lips slowly and deeply first, then inhale
through nose rapidly and repeatedly) to get adequate oxygen to the center part of liver lobules and
reduction of hepatic congestion.
Practice body massage and physical exercise.
Promote measures for periodic elimination of all body toxins (macro toxin) through the nearest natural orifices.
Abstain from alcohol, toxic drugs, processed foods, pickled foods and bakery items.
Disinfect contaminated materials, and sterilize all surgical instruments properly.
Keep monogamous.
Practice
safe sex.
Use
barrier contraceptive if a carrier.
Avoid injectable drugs.
Avoid blood and blood products by hospitals.
Avoid the professional blood donors.
Chronic
liver diseases
Treatment in acute hepatitis and chronic hepatitis are different than the other liver diseases. Treatment should be in proportion to the degree of liver damage, causes and its complications. Viral hepatitis become chronic due to lowered immunological activity. Integrity of the immunological system may be adversely affected by morbid diet style, nutritional deficiency, stress, poor sanitation, toxins, allergy, chronic medication, physical inactivity, overwork, endocrinal disorders etc. Germs do not cause the disease. But an unfavorable environment in the system allows the germs to flourish. The susceptibility to the virus may be increased by the consumption of excess of refined sugar & salt and alcohol.
Take
lipotropic factor rich items like goatmilk, egg yolk, fenugreek etc. to
prevent fat infiltration.
Correct
the protein malnutrition in children early.
Include vitamin C, glucose, calcium and protein rich vegetables in the daily diet.
Organically grown food is advisable.
Include curry leaf and gooseberries in the diet for one year.
Acidify the entire system for a 2 week period by using lemon juice in water (before meals). It would be repeated 3 times with 2 week interval. Fasting for 3 days with green juice containing Magnesium and Vitamin E is one of the best methods to eliminate the hepatic toxins especially the iron.
Include coriander in cooking (Iron chelation).
Practice
fasting twice in week.
Eat a
balanced diet including milk, fruits and white meat.
Consume only a good and dry quality of cashew nuts (Insecticide, Fungus), peanuts, almonds, and barley.
Include
flavonoid containing items in diet like citrus fruits, red onions, paprika,
pepper, capsicum, red wine, chocolate etc.
Prefer cumin, beans, carrot, spinach, buttermilk, lemon juice, cauliflower, mustard, selenium rich item like rice, potato, garlic; rain water, green papaya, pomegranate.
Identify the factors promoting stress in daily life, and restrain from it.
Enjoy night sleep for average of 8 hours.
Avoid overeating, excesses of ghee and alcohol.
Reduce saturated fat and animal protein.
Avoid
spices in excess.
Avoid carbohydrate fasting because of causing mobilization of triglycerides from fat deposits and deposit in liver.
Forbidden
items in liver diseases
Saturated fat, ghee, hydrogenated fat added nickel, trans fat, potato chips, fried items, spices, tomatoes, coffee, refined sugar, corn, maida, salt, horsegram, brinjal, high acidic diet, young mangoes, fish, red meat, sour curd, cycad nuts, tobacco, shellfish, food contaminated with pesticides, coloring agents, preservatives; vinegar, alcohol (It can inhibit neoglucogenesis), smooth muscle relaxant drugs, Sun bath, and regular day sleep.
Liver
cancer
Spontaneous cure in liver neoplasm may take place in some individuals after a febrile attack (Filarial infections, Chicken pox). The chance for developing liver carcinoma is more likely in those who consume iron in higher level. Iron level in body is controlled by regulating its absorption, and not by excretion. Mucin in the stomach inhibits its absorption. Alkali foods, vegetables (chlorophyll- Magnesium) and calcium can retard iron absorption. Blood transfusion, excess of copper rich food (Tomatoes, Organ meat like liver), phosphorus rich items (Curcuma, onions, capsicum, and milk powder), alcohol (kaffir beer), nicotinic acid deficiency etc. can enhance the iron deposition in organs and blood vessels . Total iron in the body is about 4 to 5 gm, and in RBC is about 2 gm. Normal serum iron level is about 55 -160 ug / dl. Iron is stored in liver binding with protein known as transferrin. The stored form of iron is called ferritin. Normal level of ferritin is about 12 ng / dL - 300 ng / dL. Iron (It is less in milk and butter) present in meat, liver, egg, lentil, green beans, coconut, Coriander, sesame seeds, and peas. Nicotinic acid rich foods (Unpolished rice, wheat and cumin) can inhibit the absorption of iron through the gastrointestinal tract. Thus, it may helpful to prevent both liver cancer and pellagra.
Avoid
iron intake more than the average daily requirement (15mg - 30 mg / day).
Arsenic
containing items like Sinapis nigra, Rice, and Chicken can eliminate the excess
of iron in body.
Avoid fungus contaminated corn and its products.
Exclude
hepatotoxins
Normally the liver cells (Lysosomes) are the major site of detoxification. The liver gets toxins through the portal vein (65%) and hepatic artery. Food that containing allergic or toxic factors first stimulate histamine formation in the gastrointestinal tract. The Liver would detoxify this histamine, otherwise later it may lead to degeneration and fibrosis of hepatic and connective tissues.
Avoid all the toxins and unnecessary drugs that normally filter through the liver cells like Carbon tetrachloride, Alcohol, Chloroform, Copper (Kinnier wilson disease), Phosphorus, Arsenic, Mercury, Gold, Benzene, Barium sulfide, Lead acetate, Isoniazid, Iproniazid (MAO inhibitors), Phenothiazines, Chlorpromazine, INH, Cinchophen, Oral contraceptive pills (Cholestasis), Paracetamol, Iron, Sulphonamide, Chlorpropamide, Acetazolamide, Methotrexate, Phenytoin, Phenylebutazone, Mepacrine, Corticosteroids, Valproic acids, Warfarin, Phenindione, Dicoumarol, Tetracycline, Chloramphenicol, Prothionamide, Rifampicin, Para amino salicylic acid, Butazolidin, Amiodarone, Diltiazem, Tamoxifen, Indinavir. Vitamin A, Selenium, Yellow butter, Mushroom, Senecio alkaloids, Aflatoxins etc.
Acute liver diseases - Pre icteric phase
Take bed
rest until the acute stage has gone. Lie down in a prone position for few hours
daily.
Wash
hands with soap after using the toilet and before making food or eating.
Sterilize utensils after each meal.
Take
plenty of fluids.
Prefer
diet with light, palatable and a non-fatty item.
Drink fresh
juice of apple, pear, grape, or pineapple.
Try a grapefruit mono diet for 7 days.
Take Epsom salt 10 gm in 150 ml of warm water.
Drink
sweet and slightly sour fruits or beverages (Fresh buttermilk).
Avoid bitter items if severe nausea present.
Icteric
stage
Prefer bitter and astringent foods.
Ensure adequate nutrition and hydration.
Drink
barley, coconut or rice water.
Avoid salt and spicy foods.
Avoid physical exertion.
Avoid application of oil to the scalp.
Avoid hot humid environment.
Avoid sleeping during daytime in the acute phase.
Food
items allowed
Ribbed
gourd, bitter gourd, snake gourd, ash gourd, green gram, unpolished rice, ripe
mango, grapes, banana, yellow fruits, figs, and cumin seed.
Contraindications
Stop alcohol for one month in acute hepatitis.
Stop hepatotoxic drugs like oral contraceptive pills, non steroidal anti - inflammatory drugs, oral hypoglycemic medicines, anticoagulants, diuretics, Valproic acid, anti tubercular drugs, hepatic activators in acute hepatitis.
Fulminant
hepatitis
Vigorous supporting management is essential including rapid attention to complications as the fluid overload and coagulation defects.
Correct hypokalemia, hyponatremia, hypoglycemia, thrombocytopenia and low blood urea.
Restrict diet rich in protein transiently. The bacterial flora in the intestine may produce excess of ammonia, and thus hepatic coma may be precipitated. Sterilize the intestine by using monosaccharide.
Herbal extracts are helpful to relieve the symptoms, purify blood and body fluids, and early healing the injured cells. They are helpful to minimize the damages by toxins. They are also helpful to upgrade the immune system. They are helpful to prevent disease complications by promoting elimination of toxins, and assimilation of cell's nutrition. Purified herbals are also helpful to keep optimum Ph balance, formation of antibodies, and homeostasis.
Therapeutics in liver diseases
Hepatic antimicrobial
Piper nigrium, Allium sativa, Colchicum, Asafoetida, Capsicum, Artemisia vulgaris, Azadirecta Indica, Cinchona, Camphor, Embelia ribes, Ginseng, Glycyrrhiza, Holarrhena antidysentrica, Ipecac, Star ansi, Phyllanthus niruri.
Hepatic congestion
Berberis vulgaris, Gentiana, Chelidonium, Taraxacum, Digitalis, Picrorhiza.
Chlolertics
Cardus
mar, Chionanthus.
Gall stones.
Chelidonum
majalis, Fel tauri.
Portal hypertension
Aloe socotrina, Ricinus communis, Senna, Argemona mexicana, Calotropis gigantea.
Portal thrombosis
Lobelia,Tabacum.
Hepatic insufficiency
Asafoetida, Garcinia gummi gutta, Piper nigrim, Zingiber, Uranium nitrate.
Hepatomegaly
Kalmegh, Stelleria media, Taraxacum, Ferrum ars.
Hepatic diabetes
Amloki, Azadirecta Indica, Fenugreek, Glycyrrhiza glabra, Alfalfa, Ficus religiosa, Phyllanthus niruri.
Liver purifier
Phyllanthus niruri, Ginseng, Tinospora cordifolia, Picrorhiza.
Blood purifier
Myrrh commiphora, Trifolium prunus, Gallium aparine, Arctium lappa, Crocus sativa, Echinacea, Juglans regia,
Hepatic
anorexia
Zingiber, Embelia ribes, Tinospora, Cinchona, Quassia, Gentiana, Cyperus rotundus.
Hepatic dyspepsia
Haemorrhoids
Aloe socotrina, Cascara sagrada, Taraxacum, Glycyrrhiza glabra, Ricinus communis, Senna, Aesculus glabra, Holarrhena antidysentrica, Aegle marmelosa, Terminalia chebula.
Hepatic
cough
Phyllanthus niruri, Aconitum napellus, Emblica officinalis, Ocimum sanctum.
Right
heart weakness
Digitalis.
Hepatic
pruritus
Azadirechta Indica, Holarrhena antidysentrica, Sinapis alba, Terminalia chebula.
Hepatic
arthritis
Boerhavia diffusa, Nuxvomica, Tinospora, Cinchona, Ricinus communis, Picrorhiza.
Hepatic
ascites
Zingiber, Strophanthus, Tinospora cordifolia, Terminalia chebula, Tribulus terrestris,Aegle marmelosa, Asafoetida, Azadirechta Indica, Baptisia, Boerhavia diffusa, Curcuma longa, Eupatorium purpureum.
Hepatic
bleeding diathesis
Alfalfa, Fagopyrum.
*
Hepatic fever
Emblica officinalis, Terminalia
chebula.
Catarrhal hepatitis
Acute jaundice
Berberis vulgaris, Bryonia alba, Chelidonium, Hydrastis, Lycopodium, Sanguinaria, Curcuma longa.
Acute hepatitis
Bryonia, Capsicum, Cardus mar, Gentiana, Kalmegh, Lobelia, Melilotus, Phytolacca, Ptelea trifoliata, Ricinus communis, Viscum album, Alfalfa, Curcuma longa, Chaparro, Ephedra, Euoymus atropurpura, Scutellaria laterifolia, Tabacum.
Recurrent hepatitis
Cinchona.
Toxic
hepatitis
Curcuma
longa.
Post
hepatitis debility
Glycyrrhiza, Phyllanthus niruri, Terminalia chebula, Tinospora, Trigonella foenum, Withania somnifera.
Post
hepatitis cachexia
Withania somnifera, Quassia, Secale cor.
Hepatic fatigue
Boerhavia diffusa, Cinchona, Kali mur.
Hepatic obesity
Calcarea carb, Phytolacca.
Alcoholic liver disease.
Quercus, Sulphuric acid, Nuxvomica.
*
Anti
miasmatic medicines
Childhood
liver congestion: Aurum mur, Alfalfa,Aloe socotrina, Ricinus communis.
Adult
liver congestion: Azadirechta Indica.
Old age liver congestion: Terminalia chebula.
*
Constitutional medicines in chronic hepatitis.
Cinchona, Cinnamon, Nuxvomica, Thuja, Star ansi, Ferrum phos, Arsenic album, Alumina, Calcarea fluoricum, Sulphur, Aurum mur, Phosphorus, Mercurius.
*
Fatty liver
Crataegus, Allium sativa, Aloe socotrina, Fucus vesiculosus, Chelidonium, Taraxacum, Lycopodium, Andrographis paniculata; Picrorhiza (cold).
Liver fibrosis
Nuxvomica, Alfalfa, Cardus mar, Berberis vulgaris, Chionathus, Leptandra, Myrica cerifera, Rumex crispes, Taraxacum, Aloe socotrina, Gelsemium, Symphytum officinale, Cimicifuga, Iris versicolor, Magnesium phos, Natrum sulph, Selenium, Baryta carb.
Hepatic cirrhosis
Alfalfa.
Aloe socotrina.
Nuxvomica.
Acorus calamus.
Phyllanthus niruri.
Azadirechta Indica.
Andrographis paniculata.
Cinchona.
Gentiana.
Hydrocotyle.
Cinnamon.
Podophyllum.
Zingiber.
Taraxacum.
Terminalia chebula.
Viscum album.
Picrorhiza (Kadukaroohini).
Allium sativa.
Selenium.
Mercurius.
Hepatic carcinoma
Alfalfa, Lycopodium, Myrica cerifera, Phytolacca, Podophylum, Taraxacum, Senecio aureus, Viscum album, Thuja, Arsenicum, Baryta carb, Calcarea flour.
*
List of antidotes
Iron Arsenic, Calcium, Magnesium.
Tobacco Arsenic.
Copper Tobacco, Coffee.
Lead Alumina.
Cadmium Calcarea carb.
Arsenic Pepper, Veratrum album.
Phosphorous Magnesium sulphate, Alfalfa.
Nuxvomica Physostigma.
Coffee Camphor.
Petrochemicals Fenugreek.
*
Hepatic tonic
Glycyrrhiza glabra, Zingiber, Picrorhiza, Desmodium gagenticum, Cinchona, Podophyllum.
List of some home medicines
Polydipsia: Lemon juice.
Offensive stool: Sesamum Indica.
Icteric phase: Eclipta alba (Kayunni), Operculina (Trikolpanna), Phyllanthus niruri, Piper longa, Saccharum officinarum, Argemona mexicana, Lawsonia inermis (Henna).
Hepatic insufficiency: Garcinia gummi gutta.
“Food is medicine, medicine is not food”.