Imagine a waste treatment unit. Garbage brought in trucks are recycled inside the unit, converted into small packets and moved into a safe storage area through pipes. Recycled and harmless garbage packets are sealed with a “safe” note on it before moving it into the storage area.

One day, when the unit is opened, the whole place is covered with garbage. Till the previous day, the unit was working perfectly, and the place of leakage remains out of sight. Obviously we would request the help of an expert mechanic.

The mechanic arrives and surveys the unit from a distance, then assures us that there is no malfunctioning. He leaves saying all that is needed is a thorough washing and cleaning. What will be our reaction? We will swear at him to go to hell and find someone who really knows the job.

The next mechanic arrives. His priority is to investigate the nature of the spilt garbage, if it belongs to the recycled and safe category or the untreated and toxic category or both. This approach is logical and practical. If the leakage belongs to the un-recycled category, it means that the trouble is either at the raw waste receiving section or at raw waste intake section. If the leakage has only recycled waste, then the pipe that moves the waste to the storage section has malfunctioned. If the wastage include both recycled and un-recycled waste then, both the sections are damaged. It is obvious that the problem cannot be solved without this basic information. Instead, if someone says that the place only requires a thorough washing, it is a clear blunder.

You might be wondering why we are discussing all this here. It is because I am fed up of answering people who text me via Facebook asking if there is a treatment for Jaundice in Modern Medicine or any omnivalent herbal cure (ottamooli).There is no “specially designed” treatment exclusively for jaundice in modern medical science because the available treatment adopts the method of the second mechanic.

We can compare our liver with a garbage treatment unit. The bilirubin in our blood is untreated or unconjugated bilirubin. It undergoes a process called conjugation in our liver and moves into the small intestine via bile duct and gets excreted with the faeces. The process of conjugation can be compared to garbage treatment. Conjugated bilirubin is similar to the treated and safe garbage. The primary concern of doctors is to find out which among the two bilirubin is in excess in the patient’s body. If it is unconjugated bilirubin, then the patient has to undergo detailed examination to find out where the issue lies, prior to the bilirubin reaching the liver. If conjugated bilirubin is in excess, then further examination will focus around the duct to see how and where its function failed. If both forms of bilirubin are there in excess quantity, then various diseases affecting the liver should be considered and investigated accordingly.

Jaundice is a very broad term. There is no disease called jaundice. It may be a sign of different kind of diseases. Doctors examine a patient with jaundice by keeping all these possibilities in mind and select the desired investigations as per the clinical suspicion.

Reasons for each type of Jaundice varies and diagnosis and treatment varies accordingly, as its focus is on the root cause. As a detailed explanation of all these is beyond the scope of this article, I will give an example. Jaundice, in the case of excess conjugated bilirubin, can be the result of cancer in the bile duct, pancreas, small intestine or stomach. Some of them can be cured completely if found at an early stage. I feel pity for those who run after traditional herbs without even trying to find out the real cause of the disease. I recall a young man who brought his aged father for treatment while I was working in Ottapalam (Kerala). The old man was suffering from vomiting, lack of hunger, and loss of weight. It was obvious from first sight that he had Jaundice. He must have had some sort of cancerous growth blocking his bile duct as the blood test showed an excess of conjugated bilirubin.

I told the young man, “your father has Jaundice, it is possible that somewhere in the duct...”,before I could finish, he interrupted- “Oh, is it Jaundice! Then you need not prescribe medicines as we shall take traditional herb treatment.”

“No, it is not what you think”, I tried to clarify by drawing a detailed diagram, but before I could take a pen and paper, he had already helped his father to walk out. I tried one last time, asking him to take an ultrasound scan, in the hope that if I could explain with its results the son might see the light. It was futile! He was least concerned. I did not insist, fearing accusations of trying to loot him by forcing an ultrasound scan. So I gave up, consoling myself saying that nothing can beat fate.

However, I have never had to face such tragic situations during my time in Oman. Patients here show the willingness to listen to the doctor’s diagnosis. Perhaps, an absence of a healer waiting with a mixture of herbs might also be a reason.

Also, for those who run after traditional herbs, healers can cure only a variety of jaundice, caused by Hepatitis A virus. The truth behind this is that Hepatitis A does not actually need any medicine. The patient might suffer from vomiting and lack of hunger for one or two weeks but will get well in time if he takes proper rest. On the other side, people who are taking herbal treatment for years shows a condition called Gilbert Syndrome. It is not a sickness, but a condition that shows fluctuating unconjugated bilirubin level and needs no treatment. If you keep treating a patient with Gilbert Syndrome, all you are doing is creating a concern that he is a chronic patient.

Please don’t repeat the stupid question about the possibility of natural herbal treatments after reading this article. Modern medical science does not treat Jaundice instead it treats its root cause. If someone is so stubborn that he wants to try natural herbs, please have the patience to wait until the root cause of the Jaundice is diagnosed- at least for the sake of the doctor.