Inflammation is one of the body’s primary mechanisms for removing
metabolic byproducts, debris and foreign agents. It enables the
body to remove damaged cells, neutralize toxins, and fight bacteria,
fungi and viruses. We have already discussed inflammation in the
section on the liver, and we will discuss it here from a slightly
different angle. When we discuss the immune system, we'll examine
it again from yet another angle.
The main physiological components of inflammation are pain, heat and
swelling. Pain is the nervous system’s response to heat and
irritation when the body initiates the inflammation process to burn
away offending agents. Swelling and redness appear as fluids leak
out of capillaries that have dilated in response to heat.
Inflammation goes through several stages before finally allowing the
body to heal. Like a police force that is prompt and efficient,
inflammation is usually our friend.
Acute Inflammation
When cells sustain damage or tension from infection, wounds or poisons,
allergens or other triggers, they release chemicals that start the
inflammation process. The basic process involves first an
increased flow of blood to the area, followed by an increase in
capillary permeability to allow the immune system access to the area,
and finally the arrival of white blood cells (WBC). The WBC's
release various chemicals, a process called chemotaxis, all of which
cause the heat, redness, pain and swelling. The WBC's and their
chemical weapons destroy invaders and remove debris. The
increased fluids present also contains nutrients to initiate repair
processes as the inflammation hopefully recedes. Acute
inflammation is usually self-limiting.
Chronic Inflammation
Inflammation is always present in our bodies at low, silent levels, and
this is buffered by our nutrient and defensive capabilities. When
our system is in balance, destructive and nutritive processes deal with
foreign agents efficiently and our tissues are protected.
However, moderate or even mild long-term inflammation can be damaging
to our health. Chronic inflammation differs from acute
inflammation in that there is usually less heat present. Also,
there are changes in the balance of immune-messaging molecules towards
unhealthy ratios of WBC's and increases of inflammatory chemicals
(reported in Bland, 1999).
The more obvious signs of long-term inflammation can include fluid
retention, musculoskeletal pain and stiffness, allergies, intestinal
pain, chronic red eyes, chronic post-nasal drip, burning sensations,
poor concentration, and poor digestion. Modern biomedicine
analysis shows us how long-term mild inflammation (at levels just
slightly above normal) can contribute to the development of
arteriosclerosis, arthritis, calcium deposits, chronic fatigue, skin
diseases, cancer and numerous other conditions.
Our cells have their own signaling systems designed for self-protection
during acute inflammation, but they can be overwhelmed if the battle
goes on too long. This is why severe or long-term inflammation
can be damaging to the body (reported in Bland, 1998, reported in
Pizzorno 1996). For example, we now know that various
inflammatory triggers in the blood causes the release of damaging
chemicals, including vascular adhesion molecules (VCAMS) or
intracellular adhesion molecules (ICAMS), both of which help initiate
common forms of heart disease, such as arterial clogging and heart
attacks (Ridker et al., 1998).
Review of Common Sources of Chronic Inflammation
Herbalists offer several explanations for the preponderance of chronic
inflammatory conditions in our modern society, noting that in
traditional societies we see much less of it (Bergner, 1997).
Following is a list of common causes of inflammation.
• Incomplete diet, which leads to basic nutrient deficiencies and eventually immune system weakness or poor repair processes.
• Dietary intake of low quality fats and oils, which leads to increased production of inflammatory chemicals.
• Insufficient dietary intake of fresh fruits and vegetables, which
leads to deficiencies in carotenes, flavonoids and other
anti-inflammatory plant nutrients.
• Digestive imbalances in the intestines, which lead to intestinal
dysbiosis and production of toxic gases and inflammatory compounds that
enter the blood.
• Exposure to environmental toxins, chemicals, or prescription pharmaceuticals.
• Genetic errors of metabolism that alter body chemistry toward inflammation.
• Lack of exercise, which leads to cardiac weakness and eventually to
poor supply of oxygen and nutrients to tissues and failure to
neutralize and carry away wastes.
• Weakness or failure in one of the detoxification organs or systems,
such as liver, lungs, kidneys, skin, urinary system, lymphatic system,
venous system or bowels.
• Congestion or blockage in the vessels or organs, which leads to the accumulation of waste materials.
I could offer numerous examples to support all of the above causative
factors. Instead, I will discuss a single chilling example.
Scientists have been reporting the presence of pesticides in the
amniotic fluids of pregnant women since the early 1980's (Saxena et
al., 1980). In 1996, Bosse's group reported that " We analysed
polychlorinated biphenyl (PCB), DDT, hexachlorocyclohexane (HCH), and
heptachlor in subcutaneous fat tissue and other tissues (placenta,
liver, kidney, lung, brain, thymus, muscle, heart) of 34 fetuses and
dead children. These substances were found regularly in placenta,
in fetal subcutaneous fat tissue and in fetal organs. They
therefore can influence possibly early and sensitive stages of
intrauterine development." (Bosse, et. al, 1996).
Herbal medicines can be of course be of great benefit in reducing
inflammation, as long as you realize that using herbs to block
inflammation without dealing with these causative factors will not work
anywhere as near as well. Since our root causes range from the
subtle (genetic imbalances) to the gross (poor nutrition), we have to
examine different methods. Our solutions must proceed from
understanding both the causal process and the symptoms.
Traditional herbal systems compare this to treating the root and the
branches of an ailing tree.
Detoxification First
To quickly remove toxins from the blood we can use detoxification
methods. It is interesting to note that, in nature, animals fast
when they are ill and sometimes eat grass to induce vomiting.
Detoxification has long been a part of all the major herbal healing
systems. In Ayurveda it was elevated to the status of one of the
original eight branches of medicine (Panchakarma Vidhi). Even
today, the use of emetics to cleanse the stomach of poisons is a
standard ER treatment. All of us recognize the importance of
cleansing our skin by bathing, cleansing our food by washing it before
use, and so forth. In herbal medicine this concept can be
expanded to encompass ideas such as cleansing the colon with laxatives
or washing the sinuses to treat chronic sinusitis. Sweating
therapy is used to stimulate removal of oils and fluids. Fasting
is used to change metabolism at first towards a catabolic phase, where
chemicals and toxins are released from storage and broken down,
eventually leading to an anabolic phase where rebuilding of healthy new
tissue occurs. I should mention that in Ayurvedic medicine, there
are strict rules about who should and should not undertake cleansing
therapy. They had strict rules that the very weak or very ill
should avoid fasting and strong purgatives or laxatives.
Detoxification can be accomplished by short-term use of any herbs that
stimulate one of the eliminative organs, including skin (sweating
agents), lungs (expectorants), kidneys (diuretics), intestines
(laxatives), lymphatic system (oils) or liver (cholagogues and
choleretics).
Fasting
Fasting involves abstinence from all food and drink for a specific
period of time. Fasting has proven beneficial for many
conditions, including heart disease, pancreatitis, PCB and DDT
contamination, autoimmune diseases, arthritis, food allergy, psoriasis,
eczema, IBS, asthma and depression. Immune function is stimulated
in the days and weeks following a fast, as well as a general sense of
well being. (Salloum and Burton 1989).
A short fast (3-5 days) can be implemented on a Wednesday or Friday to
allow for rest on the weekend. Many people like to do this at the
end of winter, calling it "spring cleaning." Make the last meal one of
only fresh fruits and vegetables, or vegetable soup. Drink only
spring or distilled water during the fast. Rest as much as
possible, only doing light tasks such as walking and bathing.
Bathe frequently, but only use warm water, not hot water. Break
the fast with only fruit on the first meal, followed by vegetable soups
the rest of the day. Return to normal foods the following day.
Laxatives such as rhubarb root or castor oil
are easy to use to cleanse the colon. You can also use any
commercial herbal laxative pill, though I prefer balanced herbal
laxative formulas. Laxatives flush out stores of endotoxins from
the bowel, speeding recovery from both chronic degenerative and acute
febrile diseases (Wenlong, 1994). One reason this is helpful in
detoxification may be that endotoxins increase free radical production
in the liver (Thurman et al., 1998).
Traditional Analysis of Inflammation
Ayurvedic doctors focus not on the innumerable specific toxins, but on
restoration of balance to the carrier mechanisms. They call these
mechanisms toxic bile (Pitta dosha), salty mucus (Kapha dosha) and
putrefactive gases (Vata dosha), all identified by direct observation
and by inference. If there is inflammation with toxic gases, the
affected tissue or organ will exhibit more pain, stiffness and gradual
degeneration. If there is inflammation with toxic bile, there
will be relatively more heat and rapid tissue destruction. If
there is more toxic mucus there will be more heavy sensation, swelling
and blockage. By looking for the relative preponderance of these
symptoms in addition to the usual signs of pain, heat, redness and
swelling, it is possible to fine tune herbal choices. If the
inflammation has more swelling, for example, herbs from the heat
removing group would be chosen along with a small amount of herbs from
the diuretic group. If there is more pain and dryness, herbs from
heat removing group would be given along with a small amount of herbs
from the nervine group.
TCM doctors observe that chronic inflammation often involves blood
stagnation or a heat and dampness condition. In cases of blood
stagnation you would mainly use herbs from the blood moving group along
with herbs from the heat removing group. Analyzing still further,
if the blood stagnation is caused by Qi restriction, herbs that release
the restriction, such as bupleurum root, would be most useful. If
the blood stagnation is caused by deficiency of Qi (because Qi moves
the blood), add ginseng root or astragalus root
to the heat removing and blood moving herbs. In the presence of
heat and dampness, choose herbs from the heat removing group along with
a small amount of herbs from the diuretic group or dampness removing
group. There are many more possibilities, but this should give
you a general idea. Obviously, it takes a trained herbalist to
make the best herb choices in each condition.
Removing blood inflammation - Looking at the Process
It is not enough to know the causes and type of inflammation to
formulate the proper treatment protocol. You also have to
understand where you are in the process. For example, if the
inflammation results from external trauma, the initial treatment should
include herbs that focus on the immediate problem, followed by
wound-healing herbs such as tien chi root. If the inflammation
results from an infection, the focus treatment should involve cooling
herbs with anti-microbial properties, such as isatis root or forsythia flower. If the inflammation results from weakness and deficiency, you would use nutrient herbs like flaxseed oil or maitake mushroom or tonic anti-oxidant herbs like amla fruit.
Naturopaths and holistic MD's rely on scientific research and
specialized tests to identify the inflammatory chemicals that are out
of balance in different types of disease, and explain why. For
example, it is important to know that cases of eczema can involve weak
action of the delta-6-desaturase enzyme, which can affect the body’s
levels of prostaglandins. Knowledge of this problem allows the
Naturopath to choose evening primrose oil
as a remedy, because it bypasses the missing chemical link,
neutralizing the inflammatory process (Pizzorno, 1996).
Similarly, knowing that the inflammation of multiple sclerosis relates
to problems digesting dietary fats gives us a clinical treatment
advantage.
It is also very important to identify the location of the
inflammation. This knowledge enables TCM doctors to use specific
plants for specific organs. Originally believed to be something
of a “voodoo” custom this is now a widely accepted herbal
practice. The breakthrough in understanding lies in the concept
of tissue-specific anti-oxidant activity. It turns out that many
plant chemicals such as carotenoids and flavonoids have affinities for
specific tissues. Part of this can be explained by whether the
plant nutrients are fat or water soluble, but there is more to it than
that. For example, milk thistle seed phytochemicals go to the liver (Hikino, 1984), ginkgo leaf chemicals increase glucose and oxygen transport across nerve cell membranes (DeFeudis, 1991), and lycopene from tomatoes
goes to the macula (Abel, 1999). Since my earliest days as an
herbalist I have trusted the observations of traditional doctors
regarding the use of specific herbs to treat tissue or organ-specific
inflammation or deficiency. It’s nice to now know my faith has a
basis in science.
Common Herbal Treatments for Inflammation
Anti-inflammatory herbs can be grouped according to the specific organs
and tissues they treat most effectively. Following are some
common classifications.
•Intestinal Inflammation-
choose from beet root, bromelain, scute root, coptis rhizome, boswellia
gum, licorice root, dandelion root, phellodendron bark, sarsaparilla
root, triphala and turmeric root. To coat and soothe irritation,
use slippery elm bark. To flush out inflammation, use rhubarb
root for one or two days.
• Joint inflammation- choose
from boswellia gum, bromelain, scute root, flaxseed oil, guggul gum,
myrrh gum, phellodendron bark, and turmeric root. If there is
deficiency, choose from deer antler, amla fruit, alfalfa leaf, dry
ginger, raw rehmannia root or wheat sprouts. The nutritional
supplement glucosamine sulfate is also useful for deficiency joint
inflammation as is the traditional Ayurvedic tonic
Yogarajaguggulu. For topical treatment apply castor oil packs.
• Kidney inflammation- choose
from akebia (mu tong or A. trifoliata), alisma rhizome (ze xie or
A. plantago-aquatica), capillaris (yin chen hao or Artemisia
capillaris), phellodendron bark and stinging nettle leaf. If
there is deficiency, choose from astragalus root, cordyceps mushroom,
rehmannia root (cooked and raw), shilajatu and stinging nettle
seed. For topical treatment apply castor oil packs.
• Lung inflammation- choose
from beet root, boswellia gum, scute root, chrysanthemum flowers,
garlic bulb, tulsi, peppermint leaf and turmeric root. If there
is deficiency, choose from American ginseng root, cordyceps mushroom,
reishi mushroom, schisandra berries and wild asparagus root.
• Sinus inflammation - choose
from scute root, echinacea, forsythia flower, honeysuckle flower (jin
yin hua or Lonicera japonica) and wild chrysanthemum flower. To
soothe the sinuses, put a few drops of flaxseed or sesame oil mixed
with white sandalwood oil in each nostril.
• Skin inflammation- choose
from burdock root, dandelion root or leaf, moutan, neem, red clover
blossom, red peony root, sarsaparilla and turmeric root. If there
is deficiency, use dang gui root, gotu kola, raw rehmannia root,
shilajatu or shou wu root. Skin inflammation sometimes yields to
one or two days of bowel flushing with laxatives like rhubarb root or
castor oil. For topical treatment, apply fresh aloe vera gel or
aloe preparations with olive oil, black tea bags, or castor oil.
For itching, use tinctures with menthol crystals derived from mint oils.
• Stomach inflammation - choose
from scute root, coptis rhizome, fresh ginger root, peppermint leaf,
burdock root, boswellia gum, fennel seed, licorice root, kudzu,
triphala and turmeric root. To coat and soothe irritation, use
flaxseed oil (long term) or slippery elm bark (short term).
• Thyroid inflammation - choose
from bugleweed (Lycopus virginicus), capillaris (yin chen hao or
Artemisia capillaris), scute root, gardenia fruit (zhi zi or Gardenia
jasminoides) and prunella (Xie ku cao or P. vulgaris).
• Pancreas inflammation- choose
from moudan bark (Mu dan pi or Paeonia suffruticosa) persica seed (Tao
ren or Prunus persica), carthamus flower, benincasa fruit (dong gua ren
or B. hispida), guggul gum, rhubarb root, bromelain, and
shilajatu.
Treating Serious Inflammation
The general list of herbs offered above only provides a starting
point. There are so many inflammation-related diseases, and we
will be going into greater detail in other sections.