In Ayurvedic medicine the liver is the seat of ranjaka pitta along with the spleen. The
definition of Pitta literally means bile, which is ranjaka pitta. Ranjaka pitta gives color to all the tissues. The Sanskrit word ?ranjaka? means to give color. Ranjaka pitta is responsible for erythrogenesis, the creation of red blood cells in the bone marrow, which are mixed with rasa dhatu, the plasma. Thus, ranjaka pitta is responsible for giving color to the blood.
The function of ranjaka pitta in the
liver is the
disintegration of hemoglobin, which produces heme and globin. From heme, bile is produced, and that bile is ranjaka pitta. Its' job is to give color to the urine, feces and sweat.
Ranjaka pitta in the stomach is intrinsic factor, which is responsible for production of blood in the bone marrow. Ranjaka pitta in the spleen kills bacteria and parasites as well as produces some white blood cells (rasa dhatu), so its job is more protective.
There is a functional integrity between the liver, stomach, spleen, and bone marrow. If the function of the liver is affected the bone marrow will also be affected. If the function of the stomach is affected, it will affect the liver. In a way, the spleen is to filter the blood and to send unwanted heavy, old red blood cells to the liver; the liver destroys them and separates the hemoglobin from the blood. Then the liver utilizes the hemoglobin that is liberated for the production of bile salts, pigment and enzymes. Therefore, when the spleen is enlarged the liver may also be enlarged and vice versa.
The Sanskrit word for liver is "yakrut". "Ya" means circulation and "krut" means action.
Yakrut is an important seat of fire - the seat of anger, hate, envy, and jealousy. These emotions need to be processed and metabolized. These emotions want to come out but, if we suppress them, they accumulate in the tissues and lead to disease. Ayurveda does not separate emotions from the organs. We cannot separate body from mind and mind from consciousness.
Disorders of ranjaka pitta include hepatitis, anemia, chronic fatigue syndrome, and mononucleosis. Excessive bile production or a blockage in the flow of bile usually indicates high pitta, which in turn affects the agni or enzyme activities responsible for absorption, digestion and metabolism. Pitta can be aggravated by many factors of diet and lifestyle. These would include alcohol abuse, eating red meat, eating too much spicy or oily, heavy foods, lack of sleep, too much direct exposure to the sun and smoking. When pitta becomes aggravated liver diseases can result such as hepatitis and cirrhosis. Although viral type hepatitis such as hepatitis C is not mentioned in the classic Ayurvedic texts, similar symptoms are described under "kaamala".
Ayurveda describes two basic types of kaamala (hepatitis or jaundice).
1. Shakhasrita is caused by the minimal aggravation of pitta and kapha, and is easily curable.
2. Kumbha kaamala results from very high pitta and is difficult to cure. It can become incurable if not attended to immediately.
Panaki and haleemaka are two other types of hepatitis or jaundice that are explained in Ayurvedic texts. Panaki is late stage kaamala. Haleemaka is an advanced stage of anemia that occurs when both the vata and pitta are out of balance.
Pathogenesis
Due to the aggravation of pitta by excessive alcohol intake, too much heavy, oily, spicy food, etc. the liver can become diseased. When pitta is out of balance and disease begins in the liver this can result in disease of the blood, muscle tissue, and biliary system. The manifestation of this disease will be ?kaamala' or jaundice.
The symptoms of "kaamala include:
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Loss of appetite and taste
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Generalized weakness
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Yellowish discoloration of the eyes, nails, oral cavity, and urine
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Vague body pains
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Burning sensation
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Weakness in all sensory organs
Once hepatitis is advanced and the immune system is highly comprised emaciation will be present as well. Ayurveda teaches us that hepatitis involves all systems in the body including musculoskeletal, cardiovascular, and the gastrointestinal system as well as the skin.
Symptoms of hepatitis such as generalized edema ( shotha), excessive thirst (atitrishna), bloody stools (krishna varna mala mutra), vomiting blood (rakta yukta chardi), red eyes (rakta netra), dizziness (bhrama), drowsiness (tandra), total loss of appetite (teevra agni mandya), and hepatic coma (nashta sanjna) indicate that the liver disease is at an incurable stage, and the patient is believed to be terminally ill.
Usually liver disease will present itself with certain signs and symptoms. These may include fatigue, jaundice, loss of appetite, mild fever, joint aches and pains, occasional nausea and or vomiting. Through the pulse you will feel many imbalances including but not limited to prana vata, vyana vata, apana vata, samana vata, sadhaka pitta, pachaka pitta, ranjaka pitta, rasa, rakta and medas dhata. The eyes may appear yellowish and burn which will show up as alochaka pitta in the pulse; the skin may have hives or rashes, which can show up as bhrajaka pitta in the pulse as well. The tongue will have a deep redness indicating the heat of rakta and ranjaka pitta. Palpating the abdomen may reveal a swelling or tenderness in the upper left quadrant where the liver resides. There will be other information available as to the type of lifestyle the person has lived, their constitution
i and physical strength. Out of balance pitta, and poor agni play important roles in the symptoms of hepatitis and other liver disorders. In addition, low ojas is the essence of the immune system. Low ojas makes a person more vulnerable to immune system dysfunction or infections such as hepatitis.
According to Vaidya Ranjeet Nimbalkar, hepatic liver disease is caused by "vimargagamana", which is abnormal flow of constituents in other srotas resulting in abnormal accumulation of that constituent in the srota in which it is abnormally flowing. Also, it causes its defiiciency in its own srotasa. In the case of kaamala there is vimargagamana of raktamala pitta into the raktavaha srota, which should be going to the annavaha srota and excreted trough the purishavaha srota. Due to some abnormality of yakruta it flows into the rakta and then to all of the body. In the case of raktapitta, liquid part of various dhatus because of excessive heat of pitta, drains into rakta increasing its quantity. This is vimargagamana of uadaka of various dhatus in rakta, because of some functional abnormality of yakruta. Rasa and rakta, being liquid dhatus are more prone for vimargagamana. Also rasa and rakta dhatus are responsible for nourishment of all the other dhatus."
Ayurvedic Treatment of Hepatitis C
Any diet or lifestyle activity that aggravates pitta can be a contributor to hepatitis. These would include:
1. Alcohol abuse
2. Red meat
3. Spicy, oily, heavy foods
4. Lack of sleep
5. Too much sun exposure
6. Smoking
Treatment would be to balance pitta dosha and should be individually based for each person's imbalances. Herbs, meditation, diet and bodywork would all play an important role in the treatment. Diet should consist of the following:
1. sweet and bitter vegetables
2. sweet, ripe fruits
3. mung dahl, lentils
4. grains - oats, basmati rice, barley
5. dairy - butter, buttermilk, milk, cream
6. spices - coriander (fresh and dried), fennel, cardamom, dill, turmeric
Yoga postures for those strong enough to perform them should include vajraasana, shalabhasana, halasana, padahastasana, savasana, abdomen lift and stomach lift which are helpful in liver disorders. These should be performed early in the morning or evening. Avoid hot showers or baths. Pranayama breathing is effective. Meditation and chanting mantras in a quiet place is important as well. Walks in nature or gazing at the moon are balancing for pitta as well.
The herbs that are important and effective for treating liver disorders are:
Bhumyamalaki
Bhringaraj
Turmeric
Guduchi
Haritaki
Kalmegha
Kutki
Musta
Pippali
Punarnava
Licorice
Panchakarma therapies important for liver ailments and excess pitta would include, poorva karma (pre-purification measures), abhyanga
i, pinda sveda, virechana (using avipattikara churna or triphala churna) pizzhichil, and yapana basti
i (using licorice, guduchi, katuki and manjista with milk and honey). After panchakarma subjects should follow the diet and lifestyle that will establish the balance of pitta. This would include avoidance of afternoon sleeping, exposure to hot sun, exertion, anxiety, alcohol abuse, smoking and irregular eating habits. Diet should be mainly fresh vegetarian food as outlined above.
Rasayana therapies after panchakarma should include pippali for fever fatigue, inflammation, liver and spleen enlargements. The dose would be 1 tablespoon twice a day. Also ashwagandha, sariva, jiraka, draksha would be given in the form of a churna for fatigue, immune enhancer and rejuvenator and to decrease the viral load. The dose would be 1 tablespoon twice a day. Lastly triphala at night would be given for
immunodeficiency and chronic illness. This would be one tablespoon at night with warm water.
