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Preparations of Aloe Vera have long been used to ease
inflammation originating from a wide variety of triggering causes. This article
describes the nature of inflammation, how Aloe Vera works to influence it, and
what clinical problems can be helped as a result.
Both in Folk Medicine and general home medicine in recent
times, a very common use of Aloe Vera has been as a healing balm for cuts,
wounds, burns and abrasions - or anything which has involved penetration or
breakage of the skin surface. For example, among home remedies, the slit leaf
was strapped onto the affected part to expose the surface tissue of the patient
to the inner gel of the leaf. Two separate actions of Aloe are involved here.
One is the alleviation of the painful inflammation which accompanies injuries
and the other is the healing of the injury.
In this article it is
the alleviation of the inflammation which will be reviewed. However, the power
of Aloe to alleviate the effects of cuts, wounds, burns and abrasions does not
restrict its anti-inflammatory powers just to those particular uses. A very
great range of internal illnesses also involve inflammatory processes and we
can expect Aloe to alleviate these also.
The Nature of Acute
Inflammation is the body’s first reaction to damage by
whatever means, physical, bacterial, chemical, or damage of an internal sort
known as “auto-immunity”. Whatever its cause, inflammation is a complex
physiological process with several components to it, all of them aimed at
dealing with a possible invasion by foreign organisms or substances and
preparing the way for healing afterwards. It is accompanied by four
particularly obvious effects which everyone has experienced when they are hurt.
These are redness, heat, swelling and pain, often referred to by the rather
similar sounding quartet of their names in Latin, i.e. they are respectively, rubor,
calor, tumor and dolor.
These effects are basically brought about by chemical
messengers released from the damaged cells. The immediate action is that these
bring about an increase in the diameter of the blood vessels traversing the
area, thus increasing the blood supply or “hyperaemia”. The redness and the
heat largely come from this high blood supply, although heightened tissue
activity probably adds to the generation of heat. The next stage is
“exudation”, in which there is an increased passage of protein rich fluid
through the blood vessel walls into the spaces between the cells. This
naturally causes swelling of the tissues in and around the area of the damage.
At the same time, the increase in the volume of fluid in the area dilutes any
toxins and the lymph flow is increased, carrying toxins away from the area. The
extra proteins which have been brought to the area include immune antibodies
and also fibrin which will tend to precipitate out of solution and solidify in
the area and form a barrier to bacterial spread.
The next stage is that certain types of white blood cells
migrate out from the smaller blood vessels passing through the area into the
tissue spaces between the cells, where they will now be ready to attack
bacteria and mop up damaged cells and debris. For this to happen, these white
blood cells migrate through the tissue spaces towards the exact site of damage
or infection. They do this in response to further chemical messenger substances
called “complement”, “leukotrienes”, “lymphokines” and certain other substances
released from bacteria. These are in highest concentration at the site of
damage and the cells migrate towards the highest concentrations. On arrival at
the scene some important types of white blood cells begin to engulf the
bacteria, debris and effete cells by a process called “phagocytosis”.
This process is one in which the white cells surround the
offending item and draw it into their own cell substance. Thereafter they
digest and oxidize it with powerful chemicals, like nitric oxide and hydrogen
peroxide, so as to effectively destroy it. In this way one's white cells mount
a very potent chemical attack. It is almost like a chemical “incinerator” to
get rid of rubbish including cells and pieces of cells which have been killed
by toxins. However, these potent chemicals can also become detrimental to the
body if they “escape” from the white cells and attack previously healthy tissue
Bacteria resist this attack to varying degrees. When they
are successful, the white cell itself dies, releasing live bacteria which can
infect other cells and tissues. The ability of the white cells to carry out
this work and to overcome the bacteria appears to depend upon their vitality
and activity levels, much of which may depend upon nutrition, dietary
stimulants and a relative lack of long term toxins in the body as a whole.
In addition to the chemical messenger substances mentioned
above, histamine, serotonin, kallikrein and bradykinin are other chemical
messengers involved in orchestrating the processes of inflammation. All the
above processes that have been described are characteristic of “acute
inflammation”, which is a sudden strong reaction to damage which takes effect
quite suddenly. It is followed by another slower sequence of processes known as
“resolution” by which the area of tissue is gradually returned to normal. Where
there is rather more difficulty in overcoming an infection the formation of pus
within an abscess may occur. This may be accompanied by more extensive tissue
damage locally, which demands more in the way of rebuilding and repair.
Action of Aloe in Acute Inflammation
The anti-inflammatory action of Aloe in acute inflammation
is one of its best known actions. It is clearly responsible for all the early
benefits from applying Aloe Gel or Whole Leaf Extract, or various preparations
and ointments and creams of Aloe to wounds, cuts and abrasions of all kinds. It
must also be responsible for the early benefits in sports injuries, frostbite,
burns and radiation burns, in the tissue-damage applications associated with
dentistry as well as its earliest effects upon arthritis and upon infections.
Many kinds of beneficial action which Aloe has been noted to have upon other
conditions which are primarily inflammatory in nature, would also be examples
of this same basis of action, including insect bites and stings of all kinds
and also jellyfish stings. Much skin disease also is associated with a lot of
inflammation and clearly benefits from the same action. It is certainly
reasonable to list the anti-inflammatory action as being one of thie fundamental
beneficial actions of Aloe.
Aloe Vera contains plant steroids and it is well known that
steroids exert an anti-inflammatory effect and are widely used for this in
orthodox medicine in the form of steroid drugs. One theory was that the natural
plant steroids which Aloe Vera contains were capable of acting rather like
steroid drugs. This has been investigated by Dr R.H. Davis and his team.
Several of their papers have inquired into the mechanism of anti-inflammatory
effect. Steroids exert their well known anti-inflammatory effect at the expense
of partially inhibiting the wound healing powers of the tissues.
Moreover, Aloe contains other anti-inflammatory ingredients
as well, not just the steroids, so the actual contribution made by steroids to
Aloe's anti-inflammatory action could be quite small, but this has not yet been
clearly quantified. The fact that Aloe Vera at one and the same time both
alleviates inflammation and also promotes healing is due to the fact that Aloe
Vera also contains very powerful promoters of healing, far stronger and more
effective than the inhibitory effect of the steroids. The principal steroids of
Aloe Vera are called Lupeol, ß-Sitosterol and Campesterol.
Salicylic Acid and
Another theory about anti-inflammatory action is that the
aromatic acid salicylic acid, and its salts, the salicylates, make an important
contribution. Salicylic acid is closely related to aspirin, which does reduce
inflammation by inhibiting the production of some hormones called
“prostaglandins”. While this is entirely possible, it has yet to be shown
whether Aloe contains salicylates in the appropriate concentrations to have
such a significant effect, and whether the salicylates in Aloe are any higher
than their concentrations in numerous other plants which also contain them.
Cherries, currants, dates, prunes and raspberries are among the common foods
which contain quite high levels of salicylates. Most users of Aloe products
would be inclined to assert very strongly and surely, that the benefits they
enjoy from Aloe are far more, and are different from, the mere taking of an
aspirin or the eating of prunes.
It has also been suggested in literature that Aloe Vera
exerts an effect inhibiting the production of histamine - one of the important
chemical messengers in inflammation. In one paper the magnesium content of Aloe
was ascribed to this role, though this seems unlikely because of the low
delivery of magnesium in Aloe compared to other sources.
The Nature of Chronic
Where the cause of the inflammation is continuously applied,
a type of inflammation known as “chronic inflammation” is set up. This may come
about by repeated environmental exposure to an irritant, by a foreign body
within the tissue, by bacteria which resist removal, by internal toxins which
the body lacks the enzymes or the vitality to remove or which enter
continuously while also being removed, or by a disordered immune system
attacking the body's own tissues (auto-immunity). The tissue changes in chronic
inflammation consist of changes in the relative numbers of the different types
of white cell population in the inflamed area, formation of new blood
capillaries in the inflamed area, proliferation of connective tissue cells of a
type which produce protein fibres (fibroblasts) and the laying down of fibrous
connective tissue in amongst the functional tissue, or in place of it in a
process referred to as “fibrosis”.
The fact is that chronic inflammation lies at the root of a
great many pathological processes and is associated with a considerable number
of named chronic illnesses. Therefore, it is a very fundamental process of
tissue damage which needs to be understood and countered by Practitioners. It
means that a very wide range of chronic illnesses can be alleviated or cured by
a non-toxic, non-suppressive medicine which can overcome chronic inflammation.
That is to say, that by exerting one medical effect, that one medicine can have
enormous ramifications and implications across the broad spectrum of chronic
illness. That does not go so far as to make it a panacea - and yet one can
understand people using that term because of the sheer breadth of the medical
consequences involved. That medicine is Aloe Vera. It is not the only natural
medicine which can relieve inflammation - but it may well be the best-- because
of the way it combines powerful anti-inflammatory properties with healing and
Conditions That Benefit from Aloe
This is relatively little researched area and the tendency
has been to investigate the performance of Aloe against named illnesses without
seeking to ascribe the positive results to the exact mechanism of Aloe’s
actions. It can be observed, however that the following conditions, which have
been demonstrated to benefit from Aloe do involve chronic inflammation, peptic
ulcer, leg ulcers, arthritis and Type II diabetes. These conditions most
probably do benefit from relief of the chronic inflammation component which is
part of them. Other illnesses of which chronic inflammation is a component are
longer term inflammatory digestive system complaints, such as Crohn’s disease,
Type I diabetes, psoriasis, eczema, bursitis, tendinitis, lupus erythematosus,
gout, complications of diabetes, myositis (prolonged muscle inflammations),
hyperthyroidism and multiple sclerosis. Some of these illnesses are the subject
of anecdotal reports about the efficacy of Aloe but they do not appear to have
been investigated with regard to their response to Aloe.
Nonetheless, inherently, because of their chronic
inflammation component, one might well expect them to respond. In fact, chronic
inflammation is such a fundamental process occurring in pathology, that a high
proportion of all the chronic illnesses known to medicine will have such a
component, and therefore might well be expected to respond in respect of their
chronic inflammation component.