The term “hepatitis” is actually a catchall for inflammation of the liver.  About 90% of patients with serous liver disease develop jaundice and/or acute liver cell injury.  The most common causes of liver disease are viral hepatitis and alcohol, chemical or toxin-caused liver disease.  (Stobo et al., 1996).  Modern medical science divides viral hepatitis into four strains, based upon the type of virus (A, B, C, or E).  Hepatitis with jaundice is usually found in types A and E, both of which are classified as contagious.  Modern society has experienced a major increase in the incidence of certain viral strains of the disease, particularly hepatitis B and C.  In fact, hepatitis C is now being referred to as a “silent epidemic.” Herbal medicine has much to offer in the way of treatment for these difficult diseases.

TCM and Jaundice

In TCM, Jaundice is divided into two basic groups, called Yin yellow disease, and Yang yellow disease.  Yang yellow disease is actually acute jaundice or acute hepatitis.  Yin yellow disease is chronic jaundice caused either by external toxins and dampness, or excesses of alcohol and greasy food.  These factors weaken the digestive system and eventually block the liver.  The blocked liver backs up, causing jaundice.  TCM doctors formulate based upon whether there is more heat or more dampness.  Capillaris (yin chen hao or Artemisia Capillaris) is used as the main herbal treatment, adding other herbs as needed.  Capillaris is bitter and pungent in taste, and cool in property.  It removes heat and dampness from the liver and gallbladder, increases bile secretion, and is diuretic.  It is used for symptoms such as intermittent fever and chills, bitter taste in mouth, nausea and loss of appetite. For these reasons, it is the number one herb for treating jaundice, gall bladder disorders and hepatitis.  For chronic hepatitis TCM doctors use capillaris in high doses, along with many other adjunct herbs, including dandelion root, isatis root and leaf, bupleurum root, schisandra berry, scute root, turmeric root, white peony root, salvia root, and licorice root (Hu and Tillotson, 1999).

Ayurveda and Jaundice

In general, Ayurvedic texts divide hepatitis into four main conditions called anemic hepatitis (pandu kamala), contagious hepatitis (aupadravika kamala), acute hepatitis (kumbha kamala), and chronic hepatitis (halimaka).  The early Ayurvedic texts include hepatitis as a subset within their chapters on anemia.  As they described it, in an anemic condition the liver becomes overactive as it filters the by-products of the dead red blood cells, leading to liver weakness (Bajracharya, 1999).

With chronic hepatitis, there is no obvious swelling and blockage in the liver.  Only the symptoms of anemia and pallor can be identified.  This condition can stay in the body for many years, with periods of remission and exacerbation of liver inflammation.  Ayurveda diagnoses this condition as a disease of Vata and Pitta, as it involves mild chronic inflammation (Pitta dosha) coupled with “reversed liver nerve function” (yakrit udavarta).  In reversed function of the hepatic nerves, the upper function of the liver becomes more active, while the lower function is relatively inactive or sluggish.  Ayurveda points out that this sort of neurological over-activity usually causes mild pain (Bajracharya, 1999).

According to Ayurveda, the main causes of hepatitis can be classified into three groups as follows:

1.  Overuse of heat-generating foods and behaviors.  In general, heat-generating foods are sour, pungent or salty in taste, and have the physical effect of capillary dilation.  Causative factors thus include excessive or daily use of high fat foods, roasted or fried foods, butter, ghee, alcohol, milk products, coffee, vinegar, alcohol, pickles, chili and other hot spices.  All of these aggravate Pitta.

Heat generating behaviors include heavy physical labor, summer heat, working or living in indoor environments which are excessively hot (such as working over a stove), emotional upset (especially anger), and excessive daytime sleeping.

2.  Improper medical treatment.  Treatment with, or exposure to strong chemical agents, such as astringent drugs to stop diarrhea, exposure to pesticides, and antibiotics can all weaken the liver.

3.  Direct contact with an infected person’s bodily fluids, stool or food.  Transmission rates are much higher at time of epidemic outbreaks.  Control extends to obvious precautions with sexual contact, using the same eating utensils, food, plates, cups, or water, and poor hygiene (Pebody et al., 1998, Mahoney et al., 1997, Deka et al., 1994).

Hepatitis B and C have a relatively low rate of cure with Western medicines at the time of this writing, and the available treatments are very expensive and have strong side effects.  The drug cocktails (combinations), which seemed to offer hope in 1998 in spite of sometimes horrific side effects, are now showing signs of viral recurrence after drug discontinuation. Furthermore, I am not convinced that the drugs themselves do not damage the liver.

There is even some controvery whether or not hepatitis C is truly a virus. It may simply be a sign of chronic liver damage, possibly with multiple causes, leaking RNA particles picked up by the currently inaccurate testing methods.  A science editor of ABC news stated,  “No one’s been able to come up with a hepatitis C virus, purify it, inject it into an animal and cause hepatitis.” Full article here.

Ayurvedic physicians were unaware of the seriousness of the complications of these new forms of chronic hepatitis until this was made clear with the emergence of new diagnostic tests around 1989, and the reports in the literature and press.  Until that time, patients with hepatitis B and C symptoms were treated with basic hepatitis herbs, liver tonics and rasayana (longevity tonics).  Hepatitis B responded well to Ayurvedic treatments, but hepatitis C (originally called non A-non B) responded much more slowly.

When blood tests finally became available around 1991, Dr. Mana began to keep records at his Kathmandu clinic of patients with B and C strains after utilizing his Ayurvedic treatments.  Dr. Mana also noted and spoke out about the emotional shock that awaited patients when told that the diseases were not curable, and could cause liver cancer and cirrhosis.  In Ayurvedic thinking, this type of fear progressively weakens the entire nervous system (Vata).  The fear adds to the burden of the illness, and can speed up progression.

Dr. Mana has developed several complex herbal tonics (containing up to 40 herbs each) for all forms of chronic hepatitis, and has literally treated thousands of patients during his four decades of active practice since 1955.  Some important known herbs include shilajatu, guduchi stem, turmeric root, and triphala .  However, many herbs he uses in his formulas are unavailable outside Nepal.  Patients visit him from all over the world to be treated for chronic hepatitis, with many patients now importing herbs from Nepal utilizing FDA allowances for personal importation (see resource guide).  The treatment takes from six month to up to two years.

Western Herbalists Treating Chronic Hepatitis

At the 1999 American Herbalist’s Guild Annual Symposium, I talked with several prominent herbalists, including Michael and Lesley Tierra and David Winston.  All three of them reported cases with similar results to those I had experienced in the clinic, dropping liver enzymes into the normal range, and viral loads down by as much as 50-90%.  Dr. Terry Willard reported to me in a personal communication getting a high level of complete extinction of hepatitis C at his clinic in Canada.

After reviewing TAM, TCM and Western medicine approaches to this disease, I developed a series of treatment protocols with herbalist/acupuncturist Kirk Moulton of Chicago that also got good results.

The Bottom Line

Hepatitis B and C can be controlled with herbal medicines. Use of milk thistle seed extract, about 3-6 capsules of a good quality standardized extract, along with strict avoidance of drugs and alcohol, and about 5 grams a day of a personalized liver tonic formula, made with selections of herbs from the following list, is very, very helpful. Think of it as a liver multi-vitamin. However, for best results consult with a qualified health practitioner to get a personalized formula designed for your particular needs.

White peony root (bai shao / Paeonia lactiflora)  soothes and calms liver
Salvia root (dan shen / Salvia miltiorrhiza)  reduces inflammation, improves circulation
Bupleurum root (chai hu / B. chinensis) – calming liver tonic
Capillaris herb (yin chen hao / Artemisia capillaris) – removes liver inflammation
Cordyceps mushroom (dong chong xia cao /C. sinensis) – lung tonic, liver tonic
Bromelain enzyme (Ananas comusus) – digestive, antiinflammatory
Eclipta (han lian cao / E. prostrata) – Cools and nourishes blood, heals liver
Ganoderma mushroom (ling zhi / G. lucidum) – strengthens immune system, calms liver
Guduchi stem (Tinospora cordifolia)  – detoxifying liver and energy tonic
Ginkgo leaf (Ginkgo biloba) – reduces liver cirrhosis in animal studies, increases oxygen and blood flow
Licorice root (gan cao / Glycyrrhiza glabra) – soothes stomach, detoxifies liver
Red peony root (chi shao / Peonia rubra ) removes blood congestion
Schisandra fruit (wu wei zi / S. chinensis) – liver tonic
Scute root (huang qin / Scutellaria baicalensis) removes inflammation from blood and liver
Shilajatu complex (bituminous minerals) – liver and kidney tonic
Tien qi root (san qi / Panax pseudoginseng) – wound-healing agen
Turmeric root (haridra / Curcuma longa) liver tonic, antiinflammatory
Vasaka leaf (Adhatoda vasica)  removes liver inflammation