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Abstract
Kamala is Pittaja Nanatmaja as well as Raktapradoshaja Vyadhi. Kamala has been classified as
Koshthasrita (Bahupitta Kamala) and Shakhasrita (Ruddhapath Kamala). Ruddapatha Kamala
(Shakhashrita Kamala) is produced due to the obstruction of normal Pittavaha strotas by Kapha and Vata,
resulting in Pitta vridhi in the Rakta dhatu.Kamala can be correlated with jaundice in modern medical
science according to their resemblance in signs & symptoms. In a CT scan, obstructive jaundice
(Ruddhpath kamala) appears as dilated bile ducts within the liver and along the common bile duct
(CBD). A CBD diameter greater than 10 mm suggests dilation, indicating obstruction, and the scan will
also reveal the location and potential causes of the blockage, such as a mass, gallstones, or inflammation.
Keywords: Ruddhapath Kamala,Obstructive Jaundice,CT Abdomen
P
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INTERNATIONAL JOURNAL OF DIAGNOSTICS AND RESEARCH
Corresponding author: Dr. Deepali Amale
Article Info: Published on : 15/10/2025
Impact Factor : 1.013
Sangatmak Vikriti (Gall Stones) In Ruddhapath Kamala
(Obstructive Jaundice) By Evaluating CT Abdomen.
Dr. Deepali Jeetendra Amale
1
, Dr.B.D.Dharmadhikari
2
, Dr.Vaibhav Kishanrao Dhage
3
1
Professor, Guide & H.O.D. of Rognidan Evum Vikruti Vigyan. C.S.M.S.S. Ayurveda Mahavidyalaya and
Rugnalaya, Kanchanwadi, Chh. Sambhajinagar.
2
Associate Professor, Rognidan Evum Vikruti Vigyan. C.S.M.S.S. Ayurveda Mahavidyalaya and Rugnalaya,
Kanchanwadi, Chh. Sambhajinagar.
3
PG Scholar, Rognidan Evum Vikruti Vigyan. C.S.M.S.S. Ayurveda Mahavidyalaya and Rugnalaya,
Kanchanwadi, Chh. Sambhajinagar.
Cite this article as: - Dr.Deepali Amale (2025) ; Sangatmak Vikriti (Gall Stones) In Ruddhapath Kamala (Obstructive Jaundice) By
Evaluating CT Abdomen..;Inter .J. Dignostics and Research 3 (1) 57-64 , DOI : 1 0 . 5 2 8 1 / z e n o d o . 1 7 3 5 9 115
G
A
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Introduction :
Ayurveda is the oldest system of medicine and
philosophy of life. The aim of this science is to
maintain Swasthya through Swasthavritha &
protect human beings from various diseases. In
Ayurveda, Trividha Pariksha refers to the three-part
examination method of Darshana (inspection),
Sparshana (palpation and percussion), and Prashna
(questioning/interrogation) used to diagnose
diseases and assess the patient's condition.Kamala
is Pittaja Nanatmaja as well as Raktapradoshaja
Vyadhi.
[1]
Charakacharya has considered kamala
as advanced stage of Panduroga. Sushrutacharya
has considered kamala as a separate disease and
also may be due to further complication of
panduroga.Vagbhatacharya described kamala as a
separate disease. Kamala can be correlated with
jaundice in modern medical science according to
their resemblance in signs & symptoms.
[2]
Kamala
has been classified as Koshthasrita (Bahupitta
Kamla) and Shakhasrita (Ruddhapath Kamala).In
modern science jaundice is classified in three types
Haemolytic, Obstructive, Hepatocellular.
[3]
Ruddapatha Kamala (Shakhashrita Kamala) is
produced due to the obstruction of normal
Pittavaha Strotas by kapha and vata, resulting in
Pitta vridhi in the Rakta dhatu. In obstructive
jaundice, there is same mechanism in which the
bile ducts are obstructed by Gall stone or other
causes and bile is accumulated in liver, resulting in
elevation of blood bilirubin level responsible for
yellowness of eye, skin, mucous membrane and
stool become clay coloured due to lack of bile in
the intestine.
[4]
In a CT scan, obstructive jaundice
(Ruddhpath kamla) appears as dilated bile ducts
within the liver and along the common bile duct
(CBD). A CBD diameter greater than 10 mm
suggests dilation, indicating obstruction, and the
scan will also reveal the location and potential
causes of the blockage, such as a mass, gallstones,
or inflammation.
[5]
According to Charakacharya,
Kamala is a clinical syndrome which develops after
the Pandu Roga. When a patient of Pandu Roga
takes excessive Pittakar Ahara vihara develops
Bahupitta kamala.According to Sushrutacharya,
when patient of Pandu Roga or person affected with
other diseases consumes Amla Ras Pradhana and
Apathyakara ahara develops kamala.
Hetu (Nidana) of Ruddhaptha kamala :
1.Excessive intake of Ruksha, Shita, Guru and
Madhur Ahar. (unwholesome diet)
2. Ati Vyayam (excessive exercise)
3. Vega Nigraha (stoppage of natural urges).
Hetu Sevan
Vata and Kapha Prakopa
Ruksha Guna Pradhan Vata Dosha gets
Kaphasammurchita
Obstruction of Pitta Nalika
Obstruction of Passing of Pitta in Kostha
Vimarggamana of Pitta all over the body
Haridra Twacha,Netra & Mutra
Ruddhapatha Kamala
Samprapti
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According to Ayurveda Kapha Sammurchito Vayu
involved in pathogenesis of Ruddhapath
Kamala.Normal Kapha Gunas i.e
Snigdhata,Shlakshnata,& Mrutsnata mainly get
vitiated in Ruddhpath kamla causing obstruction to
Pitta Vahan Karm.Due to this Samanya Pitta cannot
function in Annavaha Strotas & appears aggrevated
in Shakha (Koshtha).
Ruddapatha Kamala Lakshanas :
Haridra Netra, Haridra Twaka, Haridra Mutra,
Shweta varchas,
Tilapishta varchas, Aatopa, Vishtambha, Hridaya
Guruta, Daurbalya, Alpagni, Parshwa Arati, Hikka,
Shwasa, Aruchi, Jwara.
Modern View of Obstructive Jaundice :
Obstructive jaundice occurs when there is blockage
of bile flow from the liver to the intestine, leading
to retention of bile pigments in blood.
Clinical Features :
1) Yellow discoloration of skin, sclera,
mucous membranes (Pitta-Varnata)
2) Dark urine (bilirubinuria)
3) Pale/clay-colored stools i.e absence of
stercobilin (Shweta Varchastwam)
4) Abdominal Pain (Atopa)
5) Weakness (Daurbalya)
6) Jwara ( Fever )
Computed tomography (CT scan or CAT scan) is a
non-invasive diagnostic imaging procedure that
uses a combination of x-ray and computer
technology to produce horizontal, or axial, images
(often called slices) of the body. A CT scan shows
detailed images of any part of the body, including
the bones, muscles, fat, organs, and blood vessels.
CT scans are more detailed than standard X-rays.
[6]
CT scans of the abdomen can provide more
detailed information about abdominal organs and
structures than standard X-rays of the abdomen,
thus providing more information related to injuries
and/or diseases of the abdominal organs.
[7]
In a CT scan, obstructive jaundice (Ruddhapath
kamala) appears as dilated bile ducts within the
liver and along the common bile duct (CBD). A
CBD diameter greater than 10 mm suggests
dilation, indicating obstruction, and the scan will
also reveal the location and potential causes of the
blockage, such as a mass, gallstones, or
inflammation.
Aim:
To evaluate the correlation between radiological
features observed on CT Abdomen and the
Ayurvedic concept of Ruddhapath Kamala.
Objective:
1)To study and correlate Ruddhapath Kamala with
obstructive jaundice in details.
2)To study CT Abdomen findings in Obtructive
jaundice in details.
Inclusion Criteria :
1. Diagnosed patient of Obstructive Jaundice.
2. Patient selected irrespective of religion , sex ,
occupation , socioeconomic
3. Status.
Exclusion Criteria :
1. Patient having Systemic diseases like
Uncontrolled Diabetes ,Hepatitis , Other
metabolic disorders and other severe systemic
diseases.
Subjective Criteria :
1. Pita-Varnata ( Yellowness of
Netra,Mutra,Twacha)
2. Daurbalya (Weakness)
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3. Jwara (Fever)
4. Atopa (Abdominal Pain)
5. Aruchi (Loss of Taste)
6. Agnimandya (Loss Of Apetite)
7. Swetha Varchastwam (Clay-coloured stool)
Objective Criteria :
1. CT Abdomen
Assessment Of Subjective Criteria :
1.Pita-Varnata ( Yellowness of Netra, Mutra,
Twacha )
Grade
Pita-Varnata
( Yellowness of Netra, Mutra, Twacha )
1
Mild yellowish discolouration
2
Yellowish discolouration
3
Dark yellowish discolouration
2. Daurbalya (Weakness)
Grade
Daurbalya (Weakness)
1
Mild weakness after routine work
2
Performed routine work with difficulty
3
Cannot perform routine work
3. Jwara (Fever)
Grade
Jwara (Fever)
1
slight rise of body temperature,minimal
symptoms,easily manageable
2
Persistent fever with weakness and loss of
apetite
3
high grade persistent fever with severe
burning and delirium.
4. Atopa (Abdominal Pain/Bloating)
Grade
Atopa (Abdominal Pain/Bloating)
1
Slight fullness with Pain,discomfort after
meals
2
Regular bloating with heaviness,distention
with moderate pain not relieved easily.
3
Constant abdominal
distension,pain,inability to digest food.
5. Aruchi (Loss of Taste)
Grade
Aruchi (Loss of Taste)
1
Occasional aversion to food
2
Persistent tastelessness,reduced food intake
3
Complete loss of desire for food,associated
with nausea,aversion even on seeing food.
6. Agnimandya (Loss Of Appetite)
Grade
Agnimandya (Loss Of Appetite)
1
Slight delay in digestion,reduced apetite
2
Persistent loss of apetite with abdominal
heaviness
3
Almost absent digestion,complete anorexia
7. Swetha Varchastwam
Grade
Swetha Varchastwam
1
Slightly pale stool
2
Persistent pale/clay – coloured stool,loss of
natural yellow colour.
3
Completely whitish or clay like stools.
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Assessment Of Objective Criteria :
Grade
CT Findings
Interpretation
Grade I.
–
Mild
Slight
intrahepatic duct
dilation, CBD 7–
9 mm
Early or partial
obstruction
Grade II
–
Moderate
Moderate
intrahepatic
dilation, CBD
10–15 mm
Established
obstruction
Grade III
–
Severe
Marked
intrahepatic
dilation, CBD
>15 mm,
upstream liver
changes
Long-standing or
high-grade
obstruction
Methodology :
Study type :An Observational Study.
Study Design :
Diagnosed patient of Ruddhapath kamala
⇓
Patient enrolled in study and written informed
consent obtained
⇓
Patient assessed for subjective and objective
criteria
⇓
Obtained data correlated
⇓
Discussion
⇓
Conclusion drawn
Study Design
Case Study :
Patient Information:
Name: XYZ
Age: 43 years Sex: Male
History of present illness :
A 43 years old male patient having complaints of
Yellowish discolouration of Eyes, skin, fever,
generalised weakness, loss of apetite,abdominal
discomfort with reduced food intake and loss of
natural yellow colour of stool since last 6-7 days.
he had taken allopathic medication but did not get
satisfactory relief hence admitted in Ayurved
Rugnalaya.
Past History :
No any h/o DM/HTN and other metabolic
disorders.
General Examination :
ï‚· Built : Moderate
ï‚· Height : 172 cm
ï‚· Weight : 64 kg
ï‚· Blood Pressure : 130/80 mmhg
ï‚· Pulse Rate : 86/min
ï‚· Respiratory Rate : 20/min
ï‚· Icterus : Present.
Systemic Examination :
 CVS – S1S2 Normal,No added sound
 RS – Normal vascular breathing sounds
 CNS – consiouss well oriented
 P/A – Mildly distented with Tenderness in
Right Upper Quadrant.
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Observations:
Subjective Criteria
Observation
In Patient
Grade
Pitta-Varnata
( Yellowness of
Netra,Mutra,Twacha)
Yellowish
discolouration
of Eyes,skin
since 6 Days
2
Daurbalya
(Weakness)
Generalised
weakness with
difficulty to
perform routine
work.
2
Jwara (Fever)
Persistent fever
with weakness
and loss of
apetite
2
Atopa (Abdominal
Pain/Bloating)
Abdominal
fullness,regular
bloating with
Moderate Pain
and discomfort
after meals
2
Aruchi (Loss of Taste)
Reduced food
intake since 6-7
days
2
Agnimandya
(Loss Of Apetite)
Loss of apetite
since last 6-7
days.
2
Swetha Varchastwam
(Clay- coloured
stool)
Clay coloured
stool from last
5 days.
2
CT Abdomen Findings:
Observation In
Patient
Interpretation
Grade
Moderate
intrahepatic dilation,
CBD 10–15 mm
Established
obstruction.
2
Discussion :
Ruddhapath Kamala, though described in ancient
Ayurvedic texts, continues to have relevance in
modern pathology. Ayurveda perceives diseases
through Doshic and Dhatu-based alterations.
Radiological science, particularly through tools like
CT Abdomen, gives a clear visual access to such
pathologies.This interdisciplinary evaluation allows
several key insights:
a. Holistic Understanding of Pathology
Ayurveda identifies the root cause through Doshic
imbalance and tissue dysfunction. Modern imaging
identifies the location, size, and extent of
pathology. Together, they offer a complete view —
internal cause and external manifestation.
b. Importance of Vata, Kapha and Rakta Dushti
Yakruta is Moolasthana of Raktavaha Srotas. In
kamala Vyadhi kha Vaigunya at Yakrut causes
Avarodha (Sangatmak vikruti) of Srotas due to
Kapha Vata Sammurchana.Modern imaging
identifies the location, size, and extent of
Sangatmak Vikruti. Together, they offer a complete
view — internal cause and external manifestation.
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c. CT Abdomen Role in Ayurvedic Practice
Though Ayurveda does not originally include
imaging, modern practitioners can adopt CT
Abdomen as a supportive diagnostic tool to
visualize Shotha,Ashmari -like conditions. This
brings better documentation, prognosis, and cross-
referral with modern medicine.CT useful in
Sthanastha Dhatu Vikruti & stage,pathogenesis can
be clearly seen with the help of CT and it helps for
better understanding of disease through Ayurvedic
perspective.
Conclusion :
The correlation of Ruddhpath kamala — a classical
Ayurvedic concept of obstruction in normal
Pittavaha Strotas by Kapha and Vata — with
radiological findings seen on CT Abdomen images
opens a new realm in diagnostic integrative
medicine. CT Abdomen serves as a modern
extension of Darshana Pariksha, offering visual
confirmation of Doshic changes described in
Ayurvedic texts.This approach not only increases
clinical clarity for Ayurvedic practitioners but also
fosters interdisciplinary respect and
communication. Through conceptual
understanding, clinical pattern recognition, and
modern radiological validation, Ruddhpath kamala
can be interpreted, managed, and researched with
greater depth and evidence.The future lies in
embracing tools like CT Abdomen as supportive,
not contradictory, to Ayurvedic thought — thereby
building a bridge between Shastra and Science.
References :
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Samhita, ChikitsaSthana, panduroga Chikitsa
Adhyay, ChikitsaStana, 2011; 16/34 -38: 528
2. A review on Ruddhapath kamala with special
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Declaration :
Conflict of Interest : None
ISSN: 2584-2757
DOI : 1 0 . 5 2 8 1 / z e n o d o . 1 7 3 5 9 115
Dr.
Deepali Amale
Inter. J.Digno. and Research
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