Role of Krimi (Pathogen) in Aupasarkika Yakrit Vikara (Infective Liver diseases) - A Narrative Review
Infective liver diseases are more than 18% of total Chronic Liver Diseases and been ranked as the fifth most common cause of death worldwide. Krimi can create systemic infection like - Jvara, Vibarnata (skin rash), Shula (Pain), Bhaktadwesa (anorexia), Krimija Pandu (Anaemia) etc. to organ specific disorders like - Krimi Danta, Krimi Karna, Asadhya Pratisyaya, Krimi Granthi, Krimija Hrudroga, Krimija Shira Roga But Krimijayakrit Vikara/Roga is not found in classical literature. A considerable number of Infectious liver disease patients came to various Ayurveda Hospital and expert Ayurveda physicians either feed up with conventional treatment or cannot bear the expenses of conventional therapy. Therefore, it is an attempt to establish the role of Krimi in Aupasarkika Yakrit Vikara through reviewing Ayurveda and modern literature with some experience-based inputs. Virus, bacteria, protozoa can be Adrisya Krimi (not visible in necked eye), Anu (minute) and Suksma and Nematodes and fungus are Drisya (Visible) Krimis. Purisaja and Raktaja Krimi can produce Krimija Yakrit Roga as near to Liver and through gut - liver axis and rich circulation of liver. Jvara (Fever), Shula (abdominal pain), Mandagni (low digestive power), Pita Netrata (Jaundice) are cardinal symptom of Krimija Yakrit Roga. In three dosas, Kapha Dosa is more aggravated in Krimija Yakrit Roga. Rakta Vaha Srotas and Purisha Vaha are mostly affected Srotas in Krimija Yakrit Roga. Sahaja Krimi or Avaikarik Krimi are said to be gut microbiota which are more than 100 trillion microorganisms in the gut show high metabolic activity and are continuously helping with the host immune system through gut-liver axis. Krimija Yakrit Roga can be a type of Yakrit Roga which clinically manifested as Yakritdalludara (Hepato megaly) and Yakrit Kshyaya (Cirrhosis of Liver). Successful diagnosis of type of Krimi can be possible though careful history and appropriate microbial and radiological studies for proper treatment of liver diseases.
G.S.Lavekar entitled Concept of Microbes, Infection and infestation in Ayurveda, chapter in Microbes: Health and Environment, I K International Pvt.Ltd 2006, 78-85.
Harita Harita samhita, English translation by Pandey Gyanendra, Pratham sthana 5/2-11, Chaukhambha Sanskrit series office, Varanasi. 2016, 1,
Talwani R, Gilliam BL, Howell C. Infectious diseases and the liver. Clin Liver Dis. 2011;15(1):111-130. doi:10.1016/j.cld.2010.09.002
Patterson J, Hussey HS, Silal S, et al. Systematic review of the global epidemiology of viral-induced acute liver failure. BMJ Open. 2020;10(7):e037473. Published 2020 Jul 20. doi:10.1136/bmjopen-2020-037473
Adams DH, Hubscher SG. Systemic viral infections and collateral damage in the liver. Am J Pathol. 2006;168(4):1057- 1059. doi:10.2353/ajpath.2006.051296
Jost S, Altfeld M. Control of human viral infections by natural killer cells. Annu Rev Immunol. 2013;31:163-194. doi:10.1146/annurev-immunol-032712-100001
Peng Y, Yang T, Huang K, Shen L, Tao Y, Liu C. Salvia Miltiorrhiza Ameliorates Liver Fibrosis by Activating Hepatic Natural Killer Cells in Vivo and in Vitro. Front Pharmacol. 2018;9:762. Published 2018 Jul 16. doi:10.3389/fphar.2018.00762.
Nair PK, Rodriguez S, Ramachandran R, et al. Immune stimulating properties of a novel polysaccharide from the medicinal plant Tinospora cordifolia. Int Immunopharmacol. 2004;4(13):1645-1659.
Wyke RJ. Bacterial infections complicating liver disease. Baillieres Clin Gastroenterol. 1989;3(1):187-210. doi:10.1016/0950-3528(89)90052-3
Hawash Y. (2020) Parasitic Liver Diseases. In: Radu-Ionita F., Pyrsopoulos N., Jinga M., Tintoiu I., Sun Z., Bontas E. (eds) Liver Diseases. Springer, Cham
Mohamed AE, Al Karawi MA, Ghandour Z, Parasitic diseses of Liver and biliary tree. Saudi J Of Gastro enteral, 1997;3:22-28.
Das AK. Hepatic and biliary ascariasis. J Glob Infect Dis. 2014;6(2):65-72. doi:10.4103/0974-777X.132042
Fiore M, Cascella M, Bimonte S, et al. Liver fungal infections: an overview of the etiology and epidemiology in patients affected or not affected by oncohematologic malignancies. Infect Drug Resist. 2018;11:177-186. Published 2018 Jan 29. doi:10.2147/IDR.S152473
Righi E. Management of bacterial and fungal infections in end stage liver disease and liver transplantation: Current options and future directions. World J Gastroenterol. 2018; 24(38): 4311-4329.
Harita Samhita 3rd sthana, chapter 5 verse 12,13 , Asha Hindi commentary by Ramavalamba Shastri, Published by Prachya Prakashan, Varanasi, 1985.
Bhela Samhita Sutra Sthana; Krimijatya; Chapter 26 verse 31- 33, Bhela Samhita edited by V.S. Venkatasubramania Sastri and C. Raja Rajeswara Sarma; CCRIMH, New Delhi; 1977
Dr. Pragati Y. Chougule, and Dr. Sujata P. Jadhav. (2017). “KRUMIROGA: LITERARY REVIEW.” International Journal of Research - Granthaalayah, 5(10), 168-174. https://doi.org/10.5281/zenodo.1040283.
Saliha Siddiqui and Kalpana Patni. A review on Ayurvedic concept of Krimi & its management. Int. J. Res. Ayurveda Pharm. 2018;9(5):19-23 http://dx.doi.org/10.7897/2277- 4343.095147.
Minemura M, Tajiri K, Shimizu Y. Liver involvement in systemic infection. World J Hepatol. 2014;6(9):632- 642.doi:10.4254/wjh.v6.i9.632
Konturek PC, Harsch IA, Konturek K, et al. Gut⁻Liver Axis: How Do Gut Bacteria Influence the Liver?. Med Sci (Basel). 2018;6(3):79. Published 2018 Sep 17. doi:10.3390/medsci6030079
Journal of Ayurveda and Integrated Medical Sciences (JAIMS) retains the copyright of the contents of this journal but grant the readers the right to use the contents with terms and conditions under a creative common attribution licenses 4 of Attribution, Share Alike and Non-commercial type (CC BY-NC-SA) that allows copy, distribute, display, and perform the work and make derivative works based on it only for non-commercial purposes.
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.