Talayuf-e-kabid (liver cirrhosis ) According to unani medicine

1. Talayuf-e-kabid
(liver cirrhosis)
Mohammud Tanvir Ahamed

2. Different types name of liver cirrhosis

3. Definition:
A diffuse process characterized by liver necrosis and fibrosis & conversion
of normal liver architecher into structural abnormal nodules that lack of
normal lobular organization. Ref:WHO
NIZAM-E-HAZAM
EKSEER-E-AZAM
SHOR-E-ASBAB

5. Aksam:
According to conventional medicine; Macroscopically
• Micronodular (<3)
• Macronodular (>3)
According to shar-e-asbab
there are two types
 1.Haad
 2.Mujmeen

6. (Asbab)/causes :
Due to Amraze kabid eg : yearkan (Jaundice ), jufe kabid (weakness
of liver) , warme-e-kabid (hepatitis)
Chronic alcohol abuse
Chronic viral hepatitis
Fat accumulating in the liver
Iron buildup in the body
Cystic fibrosis
Copper accumulation in the liver
Warm-e-Jigar Barid Saudawi”

7. Mahiyat (Pathophysiology)
According to conventional medicine :
Chronic liver injury / inflammation causes production of cytokines by Kupffer cells and hepatocytes.
These cytokines activate stellate cells in the space of Disse
Activated stellatecell then transforms into a myofibroblast-like cell,
These cells produce collagen, inflammatory cytokines and other mediators that promote hepatocyte damage and
tissue fibrosis .
Progressive fibrosis hepatocyte loss lead to distortion of the normal liver architecture that disrupts the hepatic
vasculature, causing portosystemic shunts.
Gross pathology; liver become small , irregular surface , firm ,yellowish color.

8. (Alamat)/symptoms
• Nukshan/ zufe astaha (Loss of appetite)
• Gasaian ( Nausea )
• Ojun may kome (Weight loss)
• yearkan (Jaundice)
• Istaskha (Ascites)
• Hepatic encephalopathy
• Easily bleeding
• Fatigue
• Edema
• ENDOCRINE CHANGES :
Loss of libido ,hair loss
Men :testicular atrophy ,impotence.(due to hyperestrogenemia
Women: breast atrophy, irregular menses.
• Hemorrhagic tendency :
epistaxis.

9. Compensated
cirrhosis
decompensated
cirrhosis
Encephalopathy
Jaundice
Malena
Ascites
Variceal hemorrhage
Still capable to doing
work
Chronic liver disease Death

10. (Taftish)/investigation
• Blood
• liver function test (LFT) ( normally ALT>AST)
ALT
AST
serum bilirubin
alkaline phosphatase
Prothrombin time (PT),
• ultrasonography of abdomen
• CT scan
• FibroScan of liver ( specialized ultrasound)
• viral hepatitis profile
• Liver biopsy

11. Interpretation

12. • Liver insufficiency
Low albumin(<3.8 g/dl
Prolonged prothombin time (INR.1.3)
• Portal hypertension
Low platelet count(<175x1000/microliter
• AST/ALT ratio >1

14. (Usul-e- Elaz)
• Identify the causes of disease and treat accordingly
• Correct the digestive system
• given in this case series included multiple poly-herbal or
compound preparation of medicine. antifibrotic and liver
regenerating effect of treatment.

15. (Elaz )/Treatment:
A.
decoction of 1)earth smoke (Fumaria officinalis),
2) waste land weed (Tephrosia purpurea)
3)chirata (Swertiachiraita),
4) East Indian globe thistle (Sphaeranthus indicus),
5) red sandalwood (Pterocarpus Santalinus),
6)chicory seed(Cichorium intybus),
7)tukhm saddab
8) black nightshade(Solanum nigrum) 5 g each, in the morning before breakfast
B.
1 )Henna (Lawsonia inermis),
2)Indian globe thistle (Echinops echinatus),
3)Indian ebony (Diospyrosebenum),
4) rose flower (Rosa damsecenes),
5) chicory seed (Cichoriumintybus),
6) yarrow seed (Achillea millefolium)
the above decoction formula, 5 g

16. C. A mixture of aqueous extracts of black nightshade
• (Solanum nigrum) 50 mL + chicory (Cichorium intybus) 50
• mL + yarrow (Achillea millefolium) 50 mL, twice daily,
D) Wormwood powder (Artemisia absinthium), chicory
• seed (Cichorium intybus) and costus (Saussurea lappa), 5 g
E) Habbe Kabid Naushadri, two tablets twice daily after
• meal,
F) Habbe Halteet, two tablets twice daily after meal.

17. THANK YOU