Treatment of viral hepatitis by an indigenous drug
Prof. Mukerjee, A.B., M.D. (Cal.), F.R.C.P. (Lond.), Professor and Head of the Department of Medicine, Calcutta National Medical College & Hospitals, Hon. Consultant, Department of Medicine, Ramakrishna Mission Seva Pratishthan, Calcutta, and Dasgupta, M., M.D. (Cal.), Resident Physician, Ramakrishna Mission Seva Pratishthan, Calcutta, India.
Liver biopsy was performed in two cases (Nos. 1 and 13). Both showed the picture of acute icteric hepatitis with cholestasis. At the end of treatment the cholestasis was absent in both of them and slight focal necrosis was present in one. There was no evidence of any architectural damage or portal tract scarring after the treatment.
It will appear from Table I that besides other points patients treated with ‘Liv.52’ alone had minimum weight loss and in certain cases there was actually gain in body weight.
Group II – Treated with placebo: Only 4 cases were treated in this group. Two of them took a long time to recover – 11 and 15 weeks respectively – and the other two took 6 and 7 weeks respectively. The loss in body weight was much more comparison with the group treated with ‘Liv.52’ alone. Residual liver damage when assessed at the end of therapy with B.S.P. test was found to be present in all, and abnormal values indicating persistence of mild degree of liver cell injury were noted in three of them. The detailed results are shown in Table II.
In 2 cases (Nos. 1 and 3) liver biopsy was performed before and after the treatment. At the beginning of the treatment, both the histological pictures were suggestive of acute icteric hepatitis, but at the end of therapy, normal liver pattern was found in one while in the other (No. 3) there was evidence of early portal scarring.
Table II: Cases treated with placebo only |
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Sl. No. |
Name, age/sex |
Period of treatment (weeks) |
Place of treatment |
Clinical diagnosis |
B.S.P. 45 mts. result at the end of therapy |
Body weight changes |
Liver biopsy |
Result |
1. |
P.B.D. 21/F/H |
7 |
Hosp. & O.P.D. |
Viral hepatitis |
5.7% |
Loss by 3 kgs. |
I–Picture of icteric hepatitis II–Normal liver |
Good |
2. |
B.N.S. 30/M/H |
6 |
O.P.D. |
“ |
3.8% |
Loss by 4 kgs. |
Not done |
Good |
3. |
M.D. 30/F/H |
15 |
Hosp. & O.P.D. |
“ |
6.2% |
Loss by 3 kgs. |
I–Picture of icteric hepatitis II–Areas of portal scarring (See Figs. 3 & 4) |
Delayed response |
4. |
K.C.R. 26/M/H |
11 |
O.P.D. |
“ |
6.0% |
Loss by 8 kgs. |
Not done |
Delayed response |
Thus the over-all response was unsatisfactory in Group II and even after clinical cure B.S.P. evidence of persistent liver damage and development of early portal scarring in one of the liver slides points out that these patients might go on to the phase of chronic hepatitis, and later on to hepatic cirrhosis, though they have apparently made a clinical recovery.
Group III – Cases treated with steroid and ‘Liv.52’: Eight cases were included in this group and good response was obtained in most of them within 4 to 5 weeks. Weight gain was a common feature except in two. There was persistent hepatomegaly even after disappearance of jaundice in two cases, one of whom took 16 weeks and the other about 22 weeks for recovery. Detailed observations are given in Table III.
Table III: Cases treated with ‘Liv.52’ and steroid combined |
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Sl. No. |
Name, age/sex |
Period of therapy (weeks) |
Place of treatment |
Clinical diagnosis |
B.S.P. 45 mts. result at the end of therapy |
Body weight changes |
Liver biopsy |
Result |
1. |
P.S. 23/M/H |
16 |
Hosp. & O.P.D. |
Viral hepatitis with pre-coma |
0.6% |
Gained by 2 kgs. |
I–Picture of icteric hepatitis II–Normal liver |
Good |
2. |
S.D. 25/F/H |
5 |
Hosp. |
Pregnancy (24 weeks), viral hepatitis with oedema & early hepatic failure |
3.8% |
Gained by 2 kgs. |
I–Picture of icteric hepatitis with cholestasis II–Normal liver |
Good |
3. |
H.L.M. 35/M/H |
4 |
Hosp. |
Viral hepatitis with deep jaundice |
4% |
Gained by 2 kgs |
I–Picture of icteric hepatitis II–Normal liver Leucocytic infection of parenchyma persisting |
Good |
4. |
N.C.J. 20/M/H |
5 |
Hosp. & O.P.D. |
Viral hepatitis with deep jaundice |
2% |
Gained by 1 kg. |
Not done |
Good |
5. |
K.B. 12/M/H |
4 |
Hosp. & O.P.D. |
Viral hepatitis with deep jaundice |
3% |
Gained by 1 kg. |
I–Picture of icteric hepatitis II–Normal liver except areas of focal necrosis |
Good |
6. |
S.D. 16/M/H |
7 |
O.P.D. |
Viral hepatitis with deep jaundice |
4.2% |
Constant |
Not done |
Delayed Response |
7. |
A.P. 42/M/H |
9 |
Hosp. & O.P.D. |
Serum hepatitis with cholestasis hepatitis |
1.8% |
Gained by 4 kgs. |
Not done |
Good |
8. |
B.D. 27/F/H |
22 |
O.P.D. |
Viral hepatitis (moderately severe case) |
8% |
Loss by 4 kgs |
Not done |
Delayed response |