Punarnava (Boerhavia diffusa) has a long history of use in Ayurvedic and traditional medicine systems, particularly in India, for supporting liver health and treating various liver disorders, including cirrhosis. Traditional Ayurvedic texts describe punarnava as a "rasayana" (rejuvenative) herb with properties that help "detoxify" and "revitalize" the liver. It is believed to exhibit "hepatoprotective" and "diuretic" effects, which are considered beneficial in the management of liver cirrhosis, especially to reduce ascites (fluid accumulation) and improve overall liver function.

There are some preclinical studies (in vitro and animal models) that suggest punarnava has hepatoprotective, anti-inflammatory, and antioxidant properties. For example, extracts of Boerhavia diffusa have been shown to reduce markers of liver damage in chemically-induced liver injury in rats. However, clinical evidence in humans is limited, and high-quality randomized controlled trials confirming its efficacy in cirrhosis are lacking. Thus, the use of punarnava for cirrhosis is primarily justified by traditional knowledge and anecdotal reports, rather than robust scientific validation.

Overall, while there is a plausible rationale and some early evidence, the use of punarnava for cirrhosis remains largely traditional, and should be approached with caution, especially as an alternative to evidence-based medical treatments.