Even though liver has a marked regenerative capacity, hepatic failure may develop due to severe liver injury with massive necrosis of liver cells. This hepatic failure may manifest as Hepatic Encephalopathy (HE). This neuro-psychiatric syndrome is characterised by disturbance in consciousness and behaviour, progressive drowsiness, irrelevant speech etc. It can be compared with later stages of Kamala and Shonitaja mada where lakshnas like tandra, moha, swalpa asambaddha vachana and personality changes like krodha prachurata etc. are mentioned. The main principle of management of HE is to eliminate precipitating factors such as toxic product like ammonia by using laxative and counteracting complications by using antibiotics, diuretics. Virechana is mentioned for the management of both Kamala and Mada which aims at elimination of nitrogenous waste substance to the present context with other benefits. A case with ALD with jaundice landed in Grade 1HE considered as the later stage of Kamala and also Mada, treated successfully with Virechana and complications are countered by using antibiotics, specified as an example in this conceptual study.