Prof. Dr. Manish Patel (IND)

Ayurveda - a fascinating concept that bridges the gap between medicine and lifestyle in both the East and the West. As a holistic system of healing and living, it offers us an alternative approach to health promotion and disease prevention.

Ayurvedic physicians and professors discuss in this round why Ayurveda is also gaining more and more followers outside India, both among the general public and in medical circles. Together, the experts will shed light on the potential of Ayurveda to fill gaps in health care - also complementing modern medicine. Special attention is paid to an optimal interaction between patient and doctor, in which both self-responsibility and a professional treatment plan play an important role.

Nowadays, cancer is a much attention seeking topic in the medical field due to its high mortality and treatment limitations, although cirrhosis of the liver is also a clinical entity with a higher mortality rate than the five major cancers i.e. lung, colorectal, stomach, liver, and breast cancers [1]. Treatment limitations for liver cirrhosis are more than cancers. A significant number of patients with cancer concomitantly suffer from liver cirrhosis for several reasons. Liver cirrhosis causes 1,221,000 deaths yearly worldwide, ranking as the 14th and 10th leading cause of death in the world and in most developed countries, respectively [2]. Approximately 170,000 people die from complications of cirrhosis per year in Europe [3]. In addition, the socioeconomic implications may be greater when more men and younger patients are subject to death from liver cirrhosis than from cancer. This suggests that we need to prioritize the development of appropriate health interventions for liver cirrhosis in the same way we are doing for cancer.

The natural history of liver cirrhosis is characterized by initial compensated stage followed by decompensated stage, defined clinically as the development of ascites, jaundice, variceal bleeding, or hepatic encephalopathy. Cirrhosis and its complications not only impair quality of life but also decrease survival. Most of the medical therapies still do not yield satisfactory outcomes in patients of liver cirrhosis. Hepatic transplantation is only the option for decompensated liver cirrhotic patient which is not affordable for all. Its success rate is varying in patient to patient and also not fully satisfactory. However, Ayurveda classical textbooks have described this disease with its Ayurveda treatment in details under the heading of ‘udara roga’. Vardhamāna pippalī, one of the rasāyana treatment and other herbal compounds are found very effective in the patients of decompensated and complicated liver cirrhosis. We are treating this type of decompensated liver cirrhosis patients in our P D Patel Ayurveda Hospital, Nadiad, India since more than three decades with good success rate. We have treatment and followed up data (last 12 years) of more than 300 patients of decompensated cirrhosis of liver with good success rate. The outcomes suggest improvement in liver functions through specific clinical features, laboratory parameters and by evaluating the Child-Pugh prognostic grade score. Most of the patients had more than 3 years of follow-up period with the outcomes showed statistically significant and clinically relevant improvements. All treatment and its effect will be presented in details in the symposium. The results of few clinical research articles published in reputed international journals will also be discussed.
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References: [1] Wankyo Chung, Changik Jo, Woo Jin Chung, Dong Joon Kim. Liver cirrhosis and cancer: comparison of mortality. Hepatology International (2018) 12:269–276. https://doi.org/10.1007/s12072-018-9850-5(0123456789().,-volV)(0123456789().,-

Kleda is a body component with physiological, pathological and therapeutic importance. It has different meanings in different context. According to the texts, kleda is a factor responsible for moisture. Thus it may be considered as water in the body, present in various forms. Generally, water (udaka) is moisturizing agent. Kleda and udaka may be synonymous but water when performs a specific function of kledana (moisturizing, wetting or liquifying) then it is known as kleda. Water which is absorbed from the alimentary canal and remains in different body compartments is udaka. Transitional part of it which moisturizes the tissues is kleda. Transportation of electrolytes, nutrients and waste products at cellular level is because of this function. Hence, it is the moisture which useful for replenishment and nourishment of every dhātu. The importance of kleda as water in the body is well established. Kleda is mentioned as one of the essential factors for digestion of food as well as metabolism in tissues.

According to Ayurveda, mūtra and sveda are the malas. Kleda is eliminated through mutra while sveda holds it in the body tissues. Thus the status of kleda, sveda and mūtra is interdependent. If kleda is water portion then in this context, sveda is solute part in sweat and mūtra is solutes in the urine. Hence, the term ‘mūtra’ mentioned in Ayurveda classics can be considered as the solutes in the urine such as creatinine, uric acid, electrolytes, urea and other nitrogenous wastes. Similarly, sveda can be considered as mainly sodium, chlorine and other wastes inside the sweat. Sveda (the solid contents of sweat) is considered to retain kleda while mūtra (solutes in urine) to eliminate. This concept is applied practically in the treatment.

In classics, word “kleda” also used for secretion or oozing from wound or skin lesions as a symptom in various disorders. Because in diabetes, excessive urine is an important feature, kleda is considered one of the dūṣyas. Exudates which are inflammatory products are also common in skin diseases (kuṣṭha and visarpa), therefore kleda is considered dūṣya in these clinical conditions too. Excess of kleda suppress the agni (factor responsible for digestion and metabolism), obstructs the srotas and produce various disorders. Mūtrala auṣadha, apatarpaṇa in the form of rukṣaṇa, śoṣaṇa or saṁśodhana are the main line of treatment to reduce and correct the kleda.