Vardhamana Pippali: Long Pepper Fruit With Steroid Like Action

Article by Dr Raghuram Y.S. MD (Ay)
This article is to give a comparison between the ‘extensive and broad-spectrum action of Pippali or long pepper to that of a steroid’. This is not to prove that Pippali is equal to Steroid, because Pippali is not a steroid. Pippali is a naturally occurring herb, which has healing effect on ‘multi-system disorders’. 

Pippali or Piper longum (long pepper) is one of the best medicinal herbs in Ayurvedic practice, since ages. Studded with immense medicinal and disease modifying property, Pippali is used as both preventive as well as curative medicine. Pippali has been praised to have good Rasayana properties (Rasayana = immune-modulators, anti-ageing, rejuvenators, disease modifiers, longevity promoters). Pippali used as a single herb, or as a part of compound, yields good cure in many systemic diseases, including stubborn and chronic ones.

Properties

Properties of Pippali –
Rasa (taste) – Katu (pungent)
Guna (quality) – Laghu (light), Teekshna (intense, deep penetrating)
Vipaka (post digestion effect) – Madhura (sweet)
Veerya (potency) – Ushna (hot)
Read related: Pippali – Long Pepper Fruit – Uses, Dose, Side Effects

Vardhamana Rasayana

Vardhamana = orderly increasing
Rasayana – any herb, medicine or compound which enhances immunity (immune-modulators), prevents ageing, rejuvenates, promotes longevity and cures many diseases).

Vardhamana Rasayana is a procedure of administering certain herbs / medicines in gradually (orderly) increased doses and later tapered to the beginning dosage by the end of the procedure. While doing so, a particular strict diet regimen will be advised to follow. Rasayanas aim at enriching the quality of tissues (dhatus).

The Vardhamana Rasayana aims at increasing and enriching the quality of the tissues or dhatus with the active components of the herb or compound. This strengthens them structurally (anatomical) and functionally (physiological). For this to happen, large quantity of a particular herb needs to be administered. But it cannot be administered in one shot.

Therefore the Vardhamana Krama is followed so as to gradually load the tissues with medicinal properties. Vardhamana Pippali is one such procedure wherein Pippali or Long pepper is used in gradual increasing and decreasing doses so as to saturate the tissues.

Vardhamana Pippali Rasayana

Ref – 3^rd Pada (section) or Karaprachitiya Padam of Rasayana Adhyaya of Charaka Samhita, Chikitsa Sthana
Vardhamana = orderly increasing
Pippali = Long Pepper

Vardhamana Pippali is a procedure of administering ‘Pippali’ in orderly increasing dose. The long pepper is used in the form of powder, paste or decoction and its dose is gradually increased for certain number of days and later tapered so as to reach the beginning dose on the final day.

This procedure of administering pippali is called Vardhamana Pippali. This method of giving Pippali is said to induce Rasayana effect. Therefore this procedure is also called ‘Vardhamana Pippali Rasayana’.

How to use?

10 Pippalis should be consumed on first day. Later, the number of Pippalis should be increased by 10 numbers every day. Example, on 2^nd day – 20 Pippalis should be consumed, On 3^rd day – 30 Pippalis should be consumed and so on. This ascending order shall be followed for 10 days. On the 10^th day, 100 Pippalis should be consumed. From 11^th day onwards, the number of Pippalis should be decreased in the same pattern. The decreasing pattern (by 10s) should be continued for the next 10 days. Thus, 1000 number of Pippalis would be consumed within a span of 20 days.

Form of administration

In which form it should be administered?
Kalka or paste – Those having uttama bala (good physical and mental strength, tolerance, and courage) should take Pippali in the Kalka or Pishta (paste) form.

Kashaya or Decoction – Those having madhyama bala (moderate physical and mental strength, tolerance, and courage) should take Pippali in the Shruta or Kashaya (decoction) form.

Churna or Powder – Those having hrisva bala (less physical and mental strength, tolerance and courage) should take Pippali in the Churna (powder) form.

Dose of Pippali

Dose or number of Pippalis as related to Bala (strength and tolerance of an individual)
Those having very good strength should start with 10 pippalis. The dose should be increased by 10 pippalis everyday, until 10 days. The number of pippalis should be decreased in the same pattern for the next 10 days. The procedure should be finished with 10 pippalis (same as starting dose) on the 20^th day. In this format, 1000 pippalis would be consumed within 20 days.

Those having moderate strength should start with 6 pippalis. The dose should be increased by 6 pippalis everyday, until 10 days. The number of pippalis should be decreased in the same pattern for the next 10 days. The procedure should be finished with 6 pippalis (same as starting dose) on the 20^th day. In this format, 600 pippalis would be consumed within 20 days.

Those having low strength should start with 3 pippalis. The dose should be increased by 3 pippalis everyday, until 10 days. The number of pippalis should be decreased in the same pattern for the next 10 days. The procedure should be finished with 3 pippalis (same as starting dose) on the 20^th day. In this format, 300 pippalis would be consumed within 20 days.

Diet restrictions

Diet restrictions to be followed during administration of Vardhamana Pippali
When Vardhamana Pippali procedure is being done, Shashtika Shali Odana (rice or porridge prepared using shashtika shali or the rice grown in 60 days) should be taken along with cow’s milk and ghee. This will help in proper digestion and utilisation of the medicine (pippali).

Benefits

Benefits of Vardhamana Pippali Rasayana
Pippali taken in vardhamana krama is said to bestow many benefits as mentioned below –

• Rasayana – rejuvenates and strengthens the tissues, provides immunity, enhances life span, promotes longevity and reduces ageing process
• Brimhana – Promotes bulk, induces strength
• Swara bheda nashaka – alleviates hoarseness of voice, strengthens voice, makes it bold and resonant
• Ayu hitakari – Good for life, enhances life span, enables one to live a long, disease-free life
• Pliha Nahsini – Cures hepatomegaly (enlargement of liver) and spleenomegaly (enlargement of spleen)
• Udara Vinashanam – Alleviates abdominal disorders, especially ascitis (accumulation of fluid in the abdominal cavity
• Vaya sthapanam – Delays ageing process, restores youth and energy
• Medhya – brain tonic, tones the brain, improves intellect and memory

Could Vardhamana Pippali have been the first ever ‘steroid-like-acting-multifaceted’ compound put into practice?
Steroids, especially corticosteroids such as predinisolone have been an essential and mandatory part of modern day prescription. Steroids are indiscriminately prescribed so as to hasten the recovery from diseases, quick recovery I mean. They are also combined with anti-inflammatory and other disease modifying medicines. They are used to combat wide range of diseases including rheumatoid arthritis, allergies, bronchial asthma and other respiratory disorders, gastro-intestinal diseases, inflammatory and auto-immune disorders, lupus, rashes, and many other serious disorders.

Steroids are prescribed in a gradual increasing dose for certain number of days (depends on the severity and nature of disease) and later it is gradually tapered over the next few days. Indiscriminate and prolonged use of steroids without the medical advice can lead to serious consequences and ill effects on health. Most of the times, their usage is short term and well monitored by consulting physician.

Anabolic steroids have a male hormone like action (testosterone) and help in building tissues but have its own ill-effects on long use.

Comparison of action with corticosteroid

Vardhamana Pippali action versus Corticosteroid action
If not steroid, the steroid like action of an herb was well explained in the context of Vardhamana Pippali, in ancient Ayurveda treatises. Vardhamana Pippali Rasayana appears to be the first and oldest description of the concepts of a medicine being used in an increasing and tapering form, mimicking that of the modern day use of corticosteroids.

Vardhamana Pippali also appears to be the earliest explanation of metering and monitoring the dose of a herb (medicine) especially when they are supposed to be used in large doses (and could not have been used in a single shot).

Vardhamana Rasayana provides us the earliest evidences of the knowledge of divided doses. Charaka Samhita is one of the oldest written books of medicine (Ayurveda treatise). Similarly Pippali is the first herb, whose usage has been explained in an ascending and tapering form (in Charaka Samhita). Therefore it can be inferred that Pippali could have been the first ever known medicine with action and effect ‘resembling steroidal effect’. Pippali has a multi-dimensional role on various systems of the body and cures many diseases effectively, in quick time, just as the steroid does.

Steroids have anabolic effect, similarly being a Rasayana Pippali, and being used in loading doses, Vardhamana Pippali too have an anabolic effect (Rasayana has anabolic effect).

It is said that the corticosteroids should not be used for a longer duration or in excessive doses. Similar indication is given with respect to Pippali in Ayurveda texts.

Three things should not be used in excess (dose) and for longer duration. They are – Pippali, Kshara (Alkali) and Lavana (salt).

This suggests that all these 3 have really good medicinal properties but should not be used in large doses and for long durations. It also means that they should be used for short period of time and in small doses. Therefore though 1000, 600 or 300 Pippalis are indicated as loading dose so as to produce an immune enhancing effect and curative effect in the body, they are not advised to be consumed in one shot. They are skilfully distributed over a period of 20 days, in divided dose.

A counter-acting diet (if any intolerance due to the strength and intensity of medicine occurs by chance) in the form of shali odana with milk has been advised on all the days of administration of Vardhamana Pippali.

Restriction to excessive usage of Pippali (in terms of dose and time) and its use in Vardhamana krama also indicates that less time is adequate for Pippali to act comprehensively and destroy the disease process. This explains the quick action of Pippali.

Use of steroids is associated with wide array of complications if it is not used under supervision. Side effects include – glaucoma (elevated pressure in the eyes), high blood pressure, weight gain, fat deposit around abdomen, face and neck, fluid retention, swelling in legs, mood-memory-behaviour related problems, high blood sugar, increased risk of infections, osteoporosis (thinning of bones), thin skin, bruising and slow wound healing etc.

Use of Pippali in Vardhamana krama might not have complications, except mild to moderate intolerance due to the strength and intensity of the medicine. This is counteracted by the diet advised in Ayurveda, i.e. shali odana with milk.

There are different ways of taking steroids like oral (by mouth), by inhaler and intra-nasal spray, topical application and injection. Vardhamana Pippali too is given in various forms i.e. powder, paste and decoction.

All these show that Pippali with special reference to Vardhamana Pippali Rasayana might have been the earliest description of a medicine which has ‘steroid like effect, broad-spectrum action’ and a multi-system healing effect.

Other worth-noting points about Vardhamana Pippali Rasayana
Bala (strength and tolerance of the patient) has been given importance in prescribing Pippali Vardhamana Rasayana. Consideration of bala and careful planning and assessment of dose of medicine (pippali) according to bala, shows the mastery of Ayurvedic physicians over ‘analysis of disease and diseased to the depth’, even in primitive times.

Indication of stringent diet while administering Vardhamana krama indicates the extensive knowledge of food-medicine interactions in ancient times.

Shodhana or purificatory measures (including vamana, virechana etc) are mandatory before any Rasayana therapy. Since Vardhamana Pippali is also a Rasayana procedure, it is not exempted from the general rule. Shodhana should be given prior to Vardhamana Pippali Rasayana for better results.

Different forms of pippali have been used according to bala (churna, kalka, kashaya). This may be the earliest description of the ‘medicine tolerance’ in various people. Kalka, Kashaya and Churna are lighter in that order.

Just before finishing –
This article is not to tell that Pippali is a steroid. It is not. I have not tried to equate Pippali and steroid, but have tried to put forth a hypothesis which puts both of them in a similar balance of comparison. The comparison I have done is only restricted to the way they work, and their multi-faceted role in disease healing. The concept was to tell that ancient Ayurveda teachers and scholars too knew some methodology of administering medicines, in a way the modern day steroids have been explained. May be Ayurveda would have influenced the modern science to derive such a concept!! 

Modern day steroids are used to tackle chronic and stubborn diseases. Pippali, I feel might have been the first ever known and identified herb with steroidal and quick pace action in modifying a disease pathology (disease modifying pathology). It may be the first natural herbal steroid (I am not equating the terms though; I am strictly going by the basis of their action).

Modern medicine may have steroids, but we, in Ayurveda have Pippali, a golden remedy for wide array of problems and also a Rasayana and a natural one too!! Without damaging or insulting the other weapon, I am claiming that our weapon called Pippali is highly effective, safe, powerful and natural!!
Pippali is a herb, and is quiet natural, as we all know it to be, let us not try to conceptually alter its naturality!!
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