An Integrative Ayurvedic and Conventional Approach to Clinically Interpreted Ruddhapatha Kamala: : A Case Report

Background

Kamala is an Ayurvedic clinical entity characterized by yellowish discoloration of the eyes, urine, and body tissues. Ruddhapatha Kamala is described in the context of obstruction of the normal movement of aggravated Pitta by Kapha and provides a conceptual Ayurvedic correlation for jaundice associated with impaired biliary flow. This case illustrates the application of this Ayurvedic diagnostic assessment alongside contemporary clinical and biochemical assessment. Case Presentation: A 20-year-old male presented with yellowish discoloration of the eyes and urine, decreased appetite, and leg cramps, with no significant past medical history. Examination revealed icterus and clay-coloured stool. Ultrasonography demonstrated mild hepatosplenomegaly, with a liver span of 15.1 cm and splenic length of 12.8 cm, along with mild pseudothickening of the gallbladder wall. Ultrasonography did not document definite structural biliary obstruction. Initial investigations revealed total serum bilirubin of 10.19 mg/dL (direct 6.48 mg/dL; indirect 3.71 mg/dL), SGOT 311 IU/L, and SGPT 330 IU/L. Urinary bile salts and bile pigments were positive, while HBsAg and HIV were negative. Based on the clinical presentation, Ayurvedic assessment, biochemical findings, and imaging, the condition was interpreted as Ruddhapatha Kamala. The patient received conventional supportive treatment concurrently with Ayurvedic medicines, including Arogyavardhini Vati, Kamdudha Vati, Triphala Churna, Trikatu Churna, Sharpunkha–Amalaki Churna, and Bhumyamalaki Swarasa. By Day 5, total bilirubin decreased to 5.30 mg/dL and SGOT to 67 IU/L, although SGPT was 337 IU/L; urinary bile salts, bile pigments, and urobilinogen were absent. By Day 8, total bilirubin further decreased to 2.94 mg/dL, with marked symptomatic improvement and minimal residual weakness.