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A BRIEF LOOK AT SAMPRĀPTI: AYURVEDIC STAGES OF DISEASE

7/10/2017

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1. Accumulation - Sañchaya
2. Aggravation - Prakopa
3. Overflow - Prasara
4. Relocation - Sthāna Samshraya
5. Manifestation - Vyakti
6. Diversification - Bheda.
 
Accumulation, or Doshic Sañchya denotes the first level of imbalance. In this stage an excess of Vāta, Pitta, or Kapha accumulate in their own sites, the colon (Vāta), small intestine (Pitta) and stomach (Kapha) respectively. As this disturbance is in this very early stage, symptoms tend to be mild and intermittent, so it may not be obvious.
 
Vāta accumulation may show itself as mild constipation or abdominal distension due to excessive gas in the colon. Pitta excess may be noted by symptoms such as dark yellow urine, yellow discoloration in the sclera of the eyes and excessive heat. Kapha buildup may manifest as full stomach, low appetite, heaviness in the limbs and general lethargy.
 
At this stage, one can tune into what is happening by simply listening to one's own innate body intelligence. You are not ill just slightly out of balance. For instance it could have been the case that for the past few days you have been eating too much ice cream, Kapha has built up in the stomach and started to cause an imbalance. If you listen to your body’s innate intelligence, there may be a desire to eat hot spicy food to burn off the Kapha and counteract this. 

 
Aggravation or Prakopa is the next level down the scale of wellbeing. If the aggravating influences are not noticed in the accumulation stage of illness and allowed to go unchecked, the doshas become overloaded in their respective sites and disturbance occurs. An example of this is indigestion and mild gut provocation. You may go out and eat a heavy meal rather late in the evening. Next day you wake up and feel congestion and fullness in the alimentary canal. When the telephone rings and your best mate asks you down the pub for pies and pints, you are still feeling the effects from the day before. It is little wonder that you end up feeing more overstuffed and bloated, other physical symptoms may also concurrently arise. Cough and congestion may occur as Kapha moves upwards into the respiratory tract. Excess Pitta may lead to indigestion and excess Vāta, can lead to back pain, hyperperistalsis and wind. This can generally be solved without consulting a health professional, as all you need to do is remove the cause, which in this case is too much of the wrong foods and nature should reward you by letting you get back to good health. It is when you don’t listen to nature that the problem worsens. If the warnings are not heeded and the disease process has gone too far, it cannot be contained in the primary Doshic sites and it spreads around the body to other areas.

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Overflow or Prasara is the next stage. If the Doshas continue to be subjected to further stress, disorder can start to spread around the whole body. The Doshas leave their respective sites in the gut and start to spread to sites in other parts of the body to which they have an affinity. This leads to the individual experiencing prodromal signs and symptoms known in Sanskrit as Purva Rupa. Purva Rupa forms the junction between the three less serious stages of disease and the three more worrying ones. When the Doshas are in the early stages of accumulation and provocation, they can be dealt with by listening to the body’s innate intelligence and reversing the effects by doing the opposite to settle things down. For instance, if you have eaten too much spicy food you will normally crave a cooling influence such as yogurt. But as soon as we enter the Prasara or spreading phase of disorder, the Doshas start to behave in a naughty way and actually create like cravings, so if you have indulged in too much spicy food you will want more of it! Matters become paradoxical. One problem with the western diet is too much refined sugar. Sugar cravings can have both physiological and psychological elements to them. If gut dysbiosis has arisen because of an excess of candida, then as the candida proliferates more and more, the person will crave more sugar, as this is what the yeast infection requires to feed and sustain itself. It literally tricks the body into craving sugar to continue it's parasitic existence. Obviously this further aggravates the situation and you end up feeling even worse. So in a nutshell, during Prasara your bodily wants and perceived needs are perverted away from balancing things out and towards feeding the progress of the disease. The old and often utilized piece of advice - “don’t beat yourself up”, immediately comes to mind.
 
During Prasara, the question is where do the unbalanced disturbed Doshas specifically travel to? Well Vāta will leave the colon and enter the general circulation. It gravitates towards its associated secondary sites, such as, the skin, ears, bones and thighs. Typical prodromal symptoms that present are dry skin, goose bumps, cold hands and feet, ringing in the ears, tingling, numbness and quivering thighs and other “dry” symptoms. Pitta moves from the small intestine to secondary sites such as the stomach, eyes, sweat glands, skin, heart and subcutaneous fat. This can cause heartburn, burning eyes, acidic sweat, hives, rashes, urticarial burning sensations and other “hot” prodromal symptoms. Kapha travels from the stomach to the lungs, sinuses, lymphatic system, breast tissue, mouth and head. This leads to “wet” prodromal symptoms, factors such as water congestion, sinus congestion, lymphatic congestion, heavy breasts, excessive salivation, heaviness in the head and cold clammy skin. Vāta is always involved in Prasara whatever Dosha has become fundamentally unbalanced, as Vāta’s energy and movement is essential at carrying Pitta and Kapha to their respective secondary sites.
 
The next stage is Relocation, known in Ayurveda as Sthāna Samshraya. This is when the aggravated Dosha seeks out the weakest point in the target area to settle. Ayurvedic physicians refer to these weak spots as Khavaigunyas. The weakness may have arisen from either genetic or environmental trauma and weakened through deficiency of nutrition, toxicity of the tissues, or a mixture of both. The weakness can be a result of physical and emotional trauma disrupting the physiology in numerous ways. We can liken Khavaigunyas to open doors, where the Doshas can just walk in as they wish and cause damage. This amalgamation of Doshas and body tissues (Dahatus) is the forth stage of ill health and disease begins to proliferate. The immune system must be really strong to counteract this and pacify the Dosha sufficiently, so it will return to its respective seat in the GI tract. If this doesn’t happen and the Dosha is stronger than the body defenses, then disease will manifest as the condition worsens and increasing damage to the tissues results. Prodromal signs and symptoms are clearly seen at this stage. An alert person can feel that something is starting to go wrong with them and an alert practitioner can address this holistically, support the immune system and try to regress the progress of disease and disorder.
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Manifestation or Vyakti is the fifth stage of disease. Cardinal signs and symptom of disease can be observed. The unleashed Doshas suppress the natural qualities of resistance in the tissues resulting in recognizable pathology. The pathology may be mono, dual or tri Doshic. An example of this can be seen by studying different presentations of arthritis:- Vāta arthritic symptoms are pain and joint stiffness and deformation of the articular surfaces of the joints. Pitta arthritic symptoms are inflammation, irritation and burning. Kapha symptoms will present as stagnation, congestion and swelling in the joint and within the surrounding soft tissues. Some people will have all of these symptoms and have tri- Doshic arthritis, whereas others have either a single Doshic arthritis, or demonstrate Doshic duality. One thing however is certain, proper intervention and the skills of a competent professional are certainly needed.
 
The final stage of disease is known as Diversification or Bheda. In this stage, it is not only the initially disturbed tissues that are affected and structurally compromised; the disease has started to spread deeper with severe complications, function is compromised. For instance if there is Vāta arthritis, not only the joint space suffers, but there are also complications to the surrounding soft tissues, leading to such problems as muscle wasting, frozen joints and deformity. In this stage, both structure and function are affected and the individual is without doubt very ill and in need of intervention to rectify matters. Vãta during the Bheda stage of disease can cause structural changes depending on the disorder manifested and the part of the body that is undergoing advanced affliction. Symptoms that may be observed include, severe dehydration, emaciation, degeneration, osteoporosis and muscle wasting. The tissues show a tendency to being stiff, dry and hard. Pitta during Bheda shows up symptoms such as ulceration, hemorrhage, perforation, suppuration and pus formation. Kapha will display tumor formations, engorgement of tissues and cells become bloated with interstitial fluid. Lipoma, fibroma, myoma and osteoma are all Kapha phenomena.
 
To explore this concept in more detail, see Volume 2, Textbook Of Ayurveda - published 2006 Ayurvedic Press by Dr. Vasant Lad. Or e-mail myself and discuss.
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JUST A FEW THOUGHTS ABOUT CORTISOL

7/3/2017

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The Psycho-Neuro-Endocrine-Immune System is a common language for the whole body. It is the fundamental system of physiological functioning. It is the common interface of the gut, body metabolism, psychological wellbeing and the immune system. They all have a common interface which can be disturbed by disease. If the gut is not functioning properly, nutrients are not metabolized as they should be and the immune system becomes weakened. If one element of the PNEI is not working as it should do, the rest of the body can be compromised. This can be appreciated if we take a short look at the chronic stress hormone cortisol.
 
The physiological role of cortisol as a stress hormone is complex. In the short term, acute stress is mediated via the adrenergic system, but this cannot be sustained indefinitely. The body switches to cortisol to try to moderate the stress response. Prolonged levels of cortisol are, however, detrimental and any advantages from switching from the adrenal response to cortisol will not be sustained for long. Excess amounts of cortisol have adverse effects on the mitochondria, immune system, matrix regulation, brain tissue, immune system, insulin metabolism, gut and liver. In the immune system we see a shift toward TH1 (T-helper cell 1) action in the short term, but the continual secretion of high levels of cortisol from the adrenal glands will eventually induce a TH2 (T-helper cell 2) state rigidity. This can result in higher incidences or skin problems such as eczema, fungal infections, persistence of intractable infections such as verrucae and can cause Chronic Fatigue Syndrome, which can result in poor metabolic functioning of the whole body. At its most extreme TH2 rigidity can eventually result in serious conditions such as cancer. The skeletal tensegrity of the body is disrupted which inter alia compromises the bones, nerves, joints, fascia, muscles and ligaments.
 
The hypothalamic hormone, corticotrophin-releasing hormone has receptors in the gut. Over secretion can cause an increase of permeability of the gut resulting in vicious cycles of allergy, intoxication, liver overload and systemic disease triggered by antigens leaking through the gut lining and causing imbalance within the body.
 
Cortisol also plays a role in cardiovascular disease and metabolic syndrome. Chronic obesity can lead to insulin resistance type 2 diabetes. Cortisol is a catabolic hormone sharing a receptor with the anabolic hormone testosterone within the muscles. If cortisol is constantly excreted at high levels over long periods of time, there will be displacement of testosterone in the muscles. This will then result in muscle atrophy and under performance. Diabetes, obesity and muscle atrophy all cause potential health problems.
 
From a holistic health viewpoint, the effect of stress on the extracellular matrix (ECM) is very important as cortisol plays a dominant role in the natural degradation and repair process of the ECM. The diurnal rhythm of cortisol should be such that it ebbs around midnight where a slight inflammatory state clears up any diseased tissue that has been excreted from within the cells and thus transferred into the ECM. These unwanted toxins can then be drained by the blood and lymph. Insomnia due to stresses such as domestic and occupational worry will disturb this vital cycle, keeping cortisol levels too high at night. The important matrix cleansing action cannot take place. If degradation and repair are disturbed in the ECM, we will see matrix rigidity that will prevent proper cell to cell and matrix to cell communication. This will result in cellular disease and eventually dedifferentiation. Cortisol may also adversely alter the correct mitochondrial function and its prolonged secretion can interfere with ATP production thus reducing cellular efficiency. High levels of cortisol over prolonged periods can deplete neurons and cause memory loss. Cortisol shares receptors in the brain with aldosterone, a balance between the two is needed to lay down long-term memory. So cortisol excess may play a direct role in dementia.
 
Naturopathy has various ways of holistically assisting stress. Homotoxicology can help to detoxify and drain the ECM.  Adaptogenic and nervine herbs can also help control stress. Ayurveda and other traditional forms of medicine have been used to balance emotions and cleanse and tone the body for thousands of years. Meditation can often reduce stress and anxiety. Prevention is always better than cure. It is clearly our duty to help ourselves and others avoid adverse stressful situations as much as possible by giving love and laughter.
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    Author:
    ​Dr. Colin Perry

    Traditional Doctor of Naturopathy, Master Herbalist and Podiatrist.

    TELEPHONE
    01481 822778 and
    ​make an appointment.

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