Liv.52 in Infective Hepatitis Including Precoma and Coma

(Mrs.) Phadke, M.A., M.D., D.C.H., Professor and Head of the Department of Paediatrics,
Alka Datar
, M.D., and Nainesh M. Vora, M.B.,B.S.,
B.J. Medical College and Sassoon General Hospitals, Pune, India.

Liv.52 in hepatitis including precoma and coma


The aim of the study was to evaluate the effects of the drug Liv.52 in the age group of 2-12 years on the course of infective hepatitis, including cases of precoma and coma, and also to find out the side effects of the drug if any.


For the purpose of this study, ‘Liv.52 drops’ were used. Liv.52 is an Ayurvedic medicine, made from 7 herbal plants. Each 5 ml of the syrup contains:
Capparis spinosa 34 mg
Cichorium intybus 34 mg
Solanum nigrum 16 mg
Cassia occidentalis 8 mg
Terminalia arjuna 16 mg
Achillea millefolium 8 mg
Tamarix gallica 8 mg

Processed in Eclipta alba, phyllanthus niruri, Boerhaavia diffusa, Tinospora cordiflia, Berberis aristata, Raphanus sativus, Phyllanthus emblica, Plumbago zeylanica, Embelia ribes, Terminalia chebula, Fumaria officinalis. The current study was conducted on 40 patients who were admitted in the past 2 years to the paediatric ward. Patients who had jaundice or who had abnormal liver-function tests were admitted for the trial. Each patient was interrogated for all the points as per the proforma; and a general and systemic examination was done thoroughly. The drug was administered orally in the following dose:

Upto 5 years ½ tsf t.i.d.
5 to 10 years 1 tsf t.i.d.
10 and above 1½ tsf t.i.d.
(1 tsf = 5 ml. 1 ml = 16 drops approx.)

The patients were followed up daily and after discharge whenever possible. Patients were observed as regards the course of the disease and the development of side effects if any during the course of trial. Whenever possible, the patient’s parent’s consent was obtained and investigations were performed, though it was not possible to perform each and every investigation mentioned in the proforma in all the patients.


The composition of the 40 cases under trial is a s follows:
(1) Infective hepatitis 25 patients
(2) Hepatic precoma 6 patients
(3) Hepatic coma 4 patients
(4) Enteric hepatitis or enteric fever with hepatitis 4 patients
(5) Jaundice with heart disease (S.A.B.E.?) 1 patient
Total 40 patients

Out of 25 patients of infective hepatitis, 15 showed normal liver function tests when they were discharged, i.e. within 4 weeks of admission. The remaining showed abnormal liver function tests, though subsequently all of them showed normal liver function tests, after a period of 2–3 months.

Out of 6 cases of hepatic precoma, 3 patients recovered completely from precoma. They took about 4 days to come out of the precoma from the commencement of the drug therapy. One patient died after 8 days. Two patients were discharged with drug therapy on.

Two patients of hepatic coma recovered completely. One patient died and the other was discharged against medical advice.

Four patients, diagnosed as cases of enteric hepatitis, or hepatitis with enteric fever, were treated with the drug and also given treatment for enteric fever. All the patients recovered completely without any complication.

All the patients tolerated the drug well. Five developed loose motions and two had vomiting though it is difficult to attribute it to any special factor. Almost all patients got subjective benefit in the form of improvement of appetite, decreased irritability and subjective improvement

1. The drug definitely seems to reduce duration of the disease in infective hepatitis and also helps in early reversal of liver function tests to normal.

2. Apart from 1 case of hepatic precoma, the early improvement in five cases of hepatic precoma could probably be attributed to the drug; but a larger study is essential to come to a definite conclusion.

3. The drug appears to be free from adverse reactions in the dosage employed and duration of trial.

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