Have you ever thought like that?
„Inflammation is a Pitta disorder, just as constipation is caused by increased Vata and obesity by Kapha.“
Unfortunately, none of these three common statements in Ayurveda is completely correct!
A few examples to the contrary: If there is an inflammation dominated by Kaphadosha, lowering Pitta can intensify it. The same applies to Āma-related constipation, which is treated with psyllium, or obesity caused by Samanavata aggravation, which is treated with Agni boosters and Guggulu products. The result in each case is a worsening of the symptoms.
This clearly shows the difference between lay Ayurveda and professional Ayurvedic medicine. While the layman's version relies on generalisations and quick, seemingly universal solutions (cooling inflammation and lowering pitta), therapeutic Ayurveda concentrates on a clear case conceptualisation for a detailed understanding of the samprapti (pathogenesis). For the treatment of diseases, half-knowledge is insufficient and sometimes even dangerous.
How can inflammation be understood and treated Ayurvedically?
The western perspective
Inflammations are complex immune reactions of an organism to an internal or external stimulus. Stimuli can be infections, injuries, foreign bodies, tumours or hypersensitivity reactions.
They can be acute or chronic, local or systemic, mild or severe, affect different organs and tissues and can be recognised nomenclaturally by the suffix „-itis“. Examples are gastritis, dermatitis, cystitis, hepatitis or arthritis. They are categorised according to time course, spread, specificity, macroscopy, histology and causative pathogens.
The aim of an inflammatory reaction is to defend against danger and repair. The reaction is controlled by messenger substances such as histamine, cytokines or prostaglandins. Anti-inflammatory medication and medicinal plants such as Curcuma longa usually target these and thus alleviate symptoms such as pain, burning or swelling.
While Western medicine primarily tries to eliminate the damaging agent (for example through antibacterial therapy), Ayurveda focuses on correcting the environment - true to the motto: inflammation cannot develop or become chronic in a balanced environment.
5 cardinal symptoms - interpreted ayurvedically
Almost 2,000 years ago, the Greek physician Galenos described typical signs of inflammation that vary in intensity:
- Rubor = Redness
- Calor = Heat
- Tumour = Swelling
- Dolor = Pain
- Functio laesa = Functional limitation
Let's compare these with Ayurvedic models:
- Redness and Heat are clear signs of Pitta aggravation and also occur with Raktadushti, the contaminated blood - here especially in the skin.
- The Swelling is a clinical manifestation of Kaphavrddhi (aggravated Kapha) and occurs with Āma and Srotorodha (blocked Srotas).
- Pain (Shula, Vedana) is primarily a manifestation of aggravated Vata and is intensified by blocked Srotas and Āma. Depending on the quality of the pain, Pitta (burning pain) or Kapha (dull, pressing pain) may also be involved.
- The Functional impairment can affect any of the 15 subdosha of Vata, Pitta and Kapha.
Vagbhata in his Ashtangahrdayasamhita described these signs of inflammation in the context of Vata Dosha being blocked by Rakta Dhatu (Raktavrta Vata): Ragi (redness), Daha (burning), Shvayathu (swelling) and Arti (pain).
Let's return to the initial idea: inflammation is therefore then a Pitta disorder when it is red and hot. This applies to many acute inflammations, less so to chronic ones. On the contrary: these are often improved by the application of heat. Think of the Pinda Sveda therapy for chronic joint inflammation and swelling. The cold compress may help with boiling gouty toe, but little else.
Inflammation in classical Ayurveda
The syndrome described in the Ayurvedic classics (Charaka Samhita, Cik. 12) Shotha includes oedema and oedematous inflammation and can best be compared with the modern inflammatory concept. Basic symptoms of Shotha are heaviness, instability, swelling, rise in temperature, thinning of veins, goose bumps and discolouration of the skin. Aetiologically, a distinction is made between intrinsic factors (vataja, pittaja, kaphaja) and exogenous factors such as trauma, infections, burns, toxins, allergies and climatic changes. Numerous causes (Nidana) and symptoms (Lakshana) are named for both factors, which are part of the study of Ayurvedic medicine.
There are basically two ways of dealing with these classic syndromes as a therapist:
- Path 1 search for the closest possible match between the clinical picture and one of the forms mentioned in the classics. Your therapy will then be based on the classical recommendations.
- Path 2 evaluates the clinical picture on the basis of Dosha-Dushya-Samurchana, i.e. the pathological connection between „perpetrators“ and „victims“. It is not the name of the disorder that is decisive, but the understanding of the pathogenesis.
In a modern Ayurveda practice, I always recommend path 2, as it is extremely difficult and often impossible to categorise today's symptoms into classical forms. In addition, we would then be treating according to a kind of „disease management programme“, which we criticise in Western conventional medicine.
The holistic therapy
How can you proceed with inflammatory disorders?
The following three steps will give you a basic orientation.
Step 1 | Make a diagnosis
- Which cardinal symptoms and associated dosha and guna dominate?
- Is it an acute or chronic event?
- Where is the inflammation localised?
Step 2 | Define therapy strategy
- Can direct causes or amplifiers be recognised and switched off?
- Do we need shodhana and if so, which ones?
- Which of the pacifying strategies (Shamana) are required?
Degradative (Langhana - reduction, Svedana - dilation, Rukshana - drying) or constructive measures (Brmhana - nourishment, Stambhana - astringent, Snehana - fattening)?
Step 3 | Select therapy method
- Ahara | Nutritional correction based on the eight factors of Ayurvedic dietetics - the orientation is based on the dominant dosha. Basically, we can alleviate inflammation through a blood-purifying and therefore low-irritant diet. This requires a consistent reduction in acidic, salty and spicy foods.
- Vihara | Lifestyle changes through breathing and movement therapy, sleep hygiene, beneficial daily rhythms, body cleansing and care, balanced impulse control, living space design and tension regulation.
- Aushadha | Phytotherapy with antiphlogistic dravya such as Curcuma longa (Haridra), Boswellia serrata (Shallaki), Commiphora mukul (Guggulu) and Glycyrrhiza glabra (Yashtimadhu). The use of Guggulu Vati (complex formulations) is particularly effective: Triphala Guggulu reduces gastrointestinal inflammation, Kanchanara Guggulu acts on the lymph glands, Yogaraja Guggulu on the joints, Kaishora Guggulu on the skin, Punarnavadi Guggulu on the liver and Gokshuradi Guggulu on the urogenital tract. Always remember to prescribe the appropriate vehicle (Anupana) along with the Guggulu product.
- Antahparimarjana | Detoxification procedures often act as a game changer, especially in the case of chronic inflammation. Whether a complete Panchakarma programme is indicated or individual detoxes such as Virechana or Bastikarma are sufficient must be decided individually based on the diagnosis.
- Bahihparimarjana | Manual therapy is primarily used for chronic inflammatory conditions of the musculoskeletal system. Serial treatments (> 7 treatments at two to three-day intervals) are advisable for lasting effectiveness.
- Shastrapranidhana | Surgery is always the last resort if all other measures are unsuccessful or the inflammatory process poses a serious risk. Through Ayurvedic therapy, we naturally try to avoid surgery - but we are realistic when it is actually necessary and then also advise the patient to undergo surgery.
- Sattvavajaya | The psychologically effective methods of spiritual healing should always be integrated into your holistic programme. In my specialised practice for psychosomatic medicine, I experience on a daily basis how years of chronic inflammation can be influenced by a new, sattva-dominated mindset.
