Siddha Articles

Siddha Research


World Siddha Day Special Issue. 14/04/2016



 www.siddhapapers.org                                                                       Siddha Papers 2016 (1)(1)            
      ISSN 0974-2522                                                                                  Clinical Paper.



POORAGA - ELL – VISAIMAARAL LUMBAR DISC PROLAPSE

- A Case Study

 


K. Elavarasan[1], M.A.Kanimozhi,  N. Shunmugom[2]



[1]  Medical Officer, Thirumoolar Varmam Research & Therapy Center, Coimbatore.

[2]  Associate Professor in Tamil & Varmam Researcher, Sri Ramakrishna Mission Vidyalaya College of Arts and Science, Coimbatore-20.


ABSTRACT

 

          Pooraga – Ell - Visaimaaral [Lumbar Disc Prolapse) is a debilitating entity of lumbar spine. Some patients of severe lumbar cord compression are advised surgical treatment as a last measure.  It is hereby reported that such a patient has been successfully treated with varmam treatment.  The patient has returned to his normal life after treatment. The cost of treatment is also minimal compared to surgery. It is hereby suggested that more patients should be studied with this treatment to prove its efficacy and to fine tune the treatment method.

 

Keywords

 

Disc Prolapse, Varma therapy, Siddha Medicine    


Tamil fonts used in this paper is :       SunTommy. 

 
INTRODUCTION

 

          Lumbar disc prolapse is a debilitating entity of lumbar spine. Patients with severe lumbar cord compression are advised surgical treatment as a last measure. This condition is described as “Pooraga El-Visaimaral” in the book ‘Varma Kaandam’, “Padakkiyam vatham” in Vatha nithanam and “Thandaga vatham” in Yugimuni Vaithya Chindamani.  In this communication we report such a case treated successfully by Varmam method.

 

POORAGA – ELL – VISAIMAARAL:

                  

khWkpe;jG+ufj;ijr; rhh;e;j vy;Ymjpd;

          NkNy ehy;tpuypy; nfhz;lvy;Y

NjWkpe;j cs;%iseuk;G khwp

          tpirtpl;L rf;jpepiy Fd;wyhfp

NrUkpe;j ,ae;jpuq;fs; ,af;fk;

          Fd;wp rpWePUk;NgjpANk ,aq;fhjhNk

Mkpd;dk; vO,Uf;f ,ayjhFk;

th;kfhz;lk; - 550

 

          According to the above verse of Varma Kaandam (verse 550), the bones relating to navel and four finger above this (L1 – L5) are affected the nerve inside these bones (the spinal cord) in these region will get affected and will result in disturbance in action of excretory systems and also the affected person will not be able to sit or stand. This condition was described as pooraga ell visaimaaral.

 

          es;sNt fhy;uz;by; jpkph;Kjyha;

          tpUtpUg;Gk; jsh;r;ir jhpg;ngdNt ghU

fs;skpy;yhj tpirjyq;fs; mwpe;J nra;tha;

          frbd;wp gyKiwAk; fUjpf; nfhs;tha;

cs;sgb ,k;Kiwfs; czh;e;J

          nra;jhy; cah;thd nraKz;L cWjp nfhs;tha;

                                                                   - th;kfhz;lk; - 560

 

          When there is Pooraga – Ell- Visaimaaral, there will be numbness, radiating pain, and weakness in legs (Varmakaandam – verse 560). 

,irthd Fz;lypjhd; tpl;lhy;NfS

                   fhy;typik nfhs;shJ mirf;nfhz;zhJ

          tpirahd ngUtpuiy ,af;f xz;zhJ

                   fhiy ,Of;f ePl;lTkhdJ

-       th;kfhz;lk;-523

          If the patients kundali is not strong, there will be deficiency in motor function of the both lower limbs.  Moving the patients legs and especially the big toe will be difficult.  Flexion and extension of legs will be impossible. (Varma kaandam – verse 523).

 

Vatha nithanam, verse 33 reads as follows,

glf;fpahk; thjk;

jhf;fp clNy GFk; glf;fpahk; thjkjpd; jd;ikaJ NfS kapNy

          jhf;Fk; ,UfhYk; elf;ifapy; Fe;jpNa jsh;e;J typ gpd;dpaUk;

Mf;fKlNd Fdpa epkpu xl;lhjpdp mluNt FWf;fpy; typahk;

          mjpf taW}jp neQ;RisT ,Lg;gpy; gpbAWk; cWfOj;J nel;b jhpf;Fk;

ghf;f ,U gf;fKk; NehTk; gplhptyp gfU fhy; kz;iz jhpf;Fk;

          ghUly; nkypAk; twSk; eiljsUk; ghh;itAk; Fiwe;J maUk;

ePf;fp rpu NehTWk; nrd;dp typ Fd;dpNa jpfo; ehrp nehe;JisAk;

          NeankhL nghjpifKdp $W tiuapd; gb ePdpyj;Njhh; mwpaNt.

 

                                                          - thj epjhdk; 800- 33tJ ghly;

 

          According to this verse the Patakkiyam vatham is characterised by weakness in both the limbs and pain in the limbs. There will be difficulty in forward or backward bending of the back, pain in the back, flatulence of the stomach and discomfort in chest, neck and occipital regions. Other symptoms may include pain in the calf muscles, weight loss, dryness, loss of eye sight, head ache, discomfort in the nostrils.

 

jz;lf thjk;

 

“tOj;jNt %yhjhuj;ijg; gw;wp

          kUtpNa NkNywp KJFkl;lha;

tOj;jNt rpurpy; te;J Tah;Tkhfp

          tpFthf Nehthfp Nkdpfd;wpg;

gOj;jNt Alk;ngq;Fk; gQ;RNghyhk;

          ghq;fhd kyryK kQ;rshFq;

FOj;jNt jz;lfkhk; thje;jd;idf;

          $wpNdhk; Fznky;yhk; $He;JghNu.”

 

“$He;jpl;l kyryq;fs; Jhpjkhdhy;

          nfhz;llf;fpg; gpd;Gjhd; nfhbajha;j;js;sp

CHe;jpl;l rhPuj;jpYjpu kPwp

          cwj;Nja;j;Jj; jiyajdp nyz;nza;thHf;fpy;        

thHe;jpl;l topwlf;fpy; nkj;jTe;jhd;

          thje;jhDw;gtpj;J eilnfhlhky;

ehHe;jpl;l euk;NghL vYk;gpw;#o;e;J

          eZfpNaNkhb neQ;rpNyWe;jhNd”

       

                                                - A+fpKdp itj;jpa rpe;jhkzp  288> 289

         

          The symptoms, resulting when Mooladharam is affected. The vatha noi will raise to the head through the vertebral column and the affected person will have severe pain and inflammatory changes. There will be weakness in the upper and lower limbs and whole body. The patient will not be able to walk.  There will be pathological changes in the bones and nerves (Yugimuni Vaithiya Chinthamani – verse 288 and 289).

 

LUMBAR DISC PROLAPSE:

          According to Modern Neurophysiology, Lumbar disc herniation occur in the lower back, most often between L4 – L5 bodies or between L5 – S1 bodies. Symptoms can affect to lower back, buttock, thigh and region and may radiate into the foot and/ or toe. The sciatic nerve is the most commonly affected nerve. When the femoral nerve is also affected, the patient may experience a numb, tingling feeling throughout one or both legs and even feet or even a burning feeling in the hips and legs.

        The case presented here is unequivocally a lumbar disc prolapse case as seen from Fig.1 with a stenosis.

          The verses state above (Varma Kaandam  523, 550, 560) Vatha Nithanam – 33, and Yugi muni Vaithia Chinthamani 288-289 describe the same condition and hence Lumbar Disc Prolapse  is equivalent to Pooraga – El – Visai maral, which means the affection of Spinal cord actions at bones in the pooraga region (i.e L1 –S1) . (Table – 1)  The vatha dosha produced by this affection is called Patakkiyam vadham (Vadha nithanam 33) or thandaka vatham  (Yugimuni Vayithiya Chinthamani – 288, 289)

 

 

MATERIALS AND METHODS

          A 52 year old male patient was brought to the Tirunelveli ARI centre, Palayamkottai with a history of back pain radiating to both lower limbs, difficulty to stand and walk and to sit in squatting position.  He also reported difficulty to lie in prone and supine positions and was unable to lift heavy objects.

          It was learnt that he was working in a hotel earlier and now a proprietor of his one man hotel and lifting heavy utensils is part of his job.

          He also had a past history of Jaundice and a fall on his back from his bicycle due to a collision with a two wheeler about a month earlier.

          He had earlier consulted a Neurosurgeon after the accident, when he felt his bodily discomforts. The MRI of his Lumbosacral spine revealed degenerative Lumbar spondylosis, disc height reduction and lumbar canal stenosis.

          He was advised for laminectomy and discectomy with interbody fusion by the Neurosurgeon.

           As the patient was not willing for surgery (he was afraid about its prognosis) and could not afford surgery’s expenditure, he approached Varmam centre for treatment.

On examination, his higher functions, all cranial nerves of both sides and the power of neck and upper limb muscles were found normal. He was found to have mild loss of sensation in antero- medial aspects of right upper thigh.

          Straight leg raising (SLR) test revealed inability to raise both lower limbs.

          Flip test, Romberg’s test, Bragard’s test and lasegue’s test were all positive.

          There was notable reduction in the power of lower limb joints, his tendon reflexes on lower limb were absent. There was also sensory loss in the antero medial aspects of right upper thigh.

 

Varmam treatment package given:

          This treatment package consisted of stimulation of varmam points, varmam internal medicine  and external therapy with varmam medicine oils, massage and fomentation

Varmam points given :  Nanganapootu and pinnal method to boost Idaikalai and Pinkalai, Porchai kaalam, Kathir varmam – Choondi kaalam, Annakaalam, Poovadangal, Ulthodai varmam, Veeradangal, Komberi kaalam, Viruthi kaalam, Mannai (Pirithal), Mel Mannai, Ullangal vellai.

Internal medicines: Thirumoolar kashayam, Thanu Manthirathi thailam, Amukkara churanam.

External medicines:  Chitrathi thailam and Vishamushti thailam Thokkanam:      Thadaval + Thirumal

Fomentation:     Ottradam (Fomentation - Izhai Kizhi, Nei Kizhi).

Poultice: a special poultice made up of herbs.

The treatment was given in two courses of 45 days each.


Course – I

          For the first 10 days varmam points were stimulated four times a day (6am, 12 Noon, 4pm and 10.00pm). Thirumoolar Kashayam (30ml) was  given twice a day. 

From 11th to 32nd day, in addition to the above, Thanumanthirathi thailam 5ml at bed time was given orally. Visha musti thailam was used externally for the whole course. Thadaval and Thirumal murai thokkanam followed by Ilaikizhi ottradam (twice a day) was done between 11 and 21 days. Poultice was given twice a day from 22nd to 29th day.  Neikizhi ottradam was given twice a day from 30th to 32nd day.

 From 33rd to 45th day the varmam points were given.

          He was asked to take wheat foods rice based foods and green gram only and was asked to avoid tamarind, curd, pumpkin and tea/coffee.


Course II - Course II is the same as course I; but was given after three months.

 

RESULTS:

          By 10th day of course I, there was reduction in hip pain and the patient was able to sit for 5 minutes with out pain. He was able to flex the left knee freely, but felt pain while flexing the right knee.

          By 20th day, there was great improvement in the power of hip muscles.  The SLR test was negative on left leg and positive at 15º in right leg. There was tenderness in L1 – L5 region on palpation.

          On 30th day, the patient walked with the support of two persons, but was unable to stand on his own.  By 40th day, he was able to stand and walk on his own without support.

          On 45th day, Romberg’s test signs were negative. The patient was able to stand and walk without support.

          At the end of the course I, the power of lower limb muscles were very good (Grades 4 – 5). The SLR was negative on left leg and positive 30º in right leg. At this point of time the patient was able to walk without support but unable to sit in squatting position and could not lift heavy objects. There was a gap of three months before the second course was given as the patient had to attend some urgent personal work.

          Second course was given as stated for the first course. The MRI taken before and after treatment showed improvement in the lumbar canal diameters at L1 –L2, L2 – L3, L3 – L4, L4 – L5 and L5 – S1 were  0.41, 0.70, 0.65, 0.26 and  0.09 centimeters respectively. (Fig 1 and Table I)

 

TABLE I - COMPARISON OF ANTERO POSTERIOR CANAL DIAMETER FROM 1ST MRI TAKEN ON 04.10.2010 AND RECENT MRI TAKEN ON 19.08.2011

 

MRI taken on 19.08.2011

 

ANTERO POSTERIOR LUMBAR CANAL DIAMETER L1 – L5 LEVEL

 

Level

MRI Scan Before Treatment  04.10.2010

(cm)

MRI scan After Treatment  19.08.2011

(cm)

Improvement

(cm)

L1 – L2

0.84

1.25

0.41

L2 – L3

0.81

1.51

0.70

L3 – L4

0.88

1.53

0.65

L4 – L5

1.03

1.29

0.26

L5 – S1

1.30

1.39

0.09

 

 Fig.1 – Magnetic Resonance Image scan of the patient before and after treatment

 

 

 

MRI –Scan Before Treatment                            MRI – Scan After Treatment

 

DISCUSSION :

          Treatment for this condition has also been described in varmam literature

         

nrhd;d vy;ypy; gprfpUe;jhy; ifahy; ghh;j;J

          ftdkha; jhf;fpa Nrh;j;Jg;gpd;G

cd;dNt tpy;Ytpir - jsh;r;ir jPh;j;J Ropapuz;by;

          mkh;j;jpNa Ropj;Jf; nfhz;L

gpd;dy; vd;w euk;Gfis njhpe;J gpd;dp ,UfisAk;

          Nky;RopAk; mkh;j;Jtha; eP.

kpd;dnyd;w rj;jp epiyaq;fs; jd;dpy; nrt;tNd

          njhopy; mwpe;J ,af;FthNa.

                                                          th;kfhz;lk; 557

 

As per this Varma Kaandam verse 557 “ if there is deformity observed in the above bones, it shall be carefully observed by palpation and then the nerves involved shall be accordingly corrected. The nangana pootu (“chuli erandil”) shall be given. Further, by understanding the networks of nerves involved in the area, pinnal method is employed to boost idaikalai and pinkalai nerves. These energy points (varmam points) have be to manipulated as per the requirement

 

Further in the verse 560 (see above), it was stated that while giving this treatment use all other methods which include internal and external medications. If all the consideration were included in the treatment package the treatment will result in success. This was observed from the present condition of the patient.

          This patient after the first treatment course, had to discontinue to attend his personal work in his home and was taking varmam points twice weeks only.  Had he been taking his treatment continuously the duration required for complete recovery may be ascertained.

          The exact location of the disc herniation was found to be at L1 and L2 (Fig 1-2). The comparison of antero posterior canal diameter from first MRI are the second (Table – 1) is a clear indication that there is considerable improvement in the canal diameter.

          These results indicated that even though there was still some neural root compression. The patient was able to stand and move on his own.

          The jaundice experienced by the patient may be an earlier symptom to this condition (Yugimuni Vayithiya Chinthamani – 288, 289) which has to be confirmed in further studies.

 

CONCLUSION:

 

The above mentioned treatment package if used diligently lumbar disc prolapse can be corrected even without surgery.  From the MRI results it was observed that the treatment has to be continued further for complete correction. Modern gadgets available currently shall be used to access the effects of treatment.  For those patients who could not afford and /or those who do not want to undergo surgical methods, this treatment package is a boon. So also in many rural areas where in the surgical facilities are unavailable. Similar case studies in large number of patients in future will throw more light on this method of treatment.

         

REFERENCE:  

  1. Macloeod’s Clinical methods
  2. Varma Kaandam, verses 550, 560, 523 & 557
  3. Vatha nithanam, verses 33
  4. Yugimuni Vayithiya Chinthamani, verses 288 & 289


[1]  Medical Officer, Thirumoolar Varmam Research & Therapy Center, Coimbatore.

[2]  Associate Professor in Tamil & Varmam Researcher, Sri Ramakrishna Mission Vidyalaya College of Arts and Science, Coimbatore-20.

World Siddha Day Special Issue - April 2015

A REVIEW OF GUNMAM (ACID PEPTIC DISEASE) IN SIDDHA SYSTEM

V.R.Sreeraamkrishna1, V.S. Alexander2, V.Balasubramaniyan3, S.Merish4

 

1-3 2nd Year BSMS, Government Siddha Medical College, Palayamkottai, Tamilnadu, India. raamkrish86@gmail.com

4  Final Year BSMS, Government Siddha Medical College, Palayamkottai, Tamilnadu, India. merish@siddhawalter.org  

 

ABSTRACT

Siddha Medicine is one of the ancient traditional medical systems of the World. According to Siddha system human body is made up of five elements (Fire, Water, Air, Earth and Galaxy).  The human body runs on the basis of vatha, pitha and kapha.  Due to changes in the equilibrium of tri-dosha, mankind acquire diseases. The great Siddhars like Agasthiyar and Yugi muni classified the human diseases into 4448 types of disease. Out of these diseases, some clinical conditions gain importance in terms of severity, Recurrence, level of the involvement of morbidity & mortality etc.  In that way, Acid Peptic Disease (APD) known as Gunmam in Siddha, is named after its character of inducing severe stomach pain to the patients to the extent that the patient usually assumes a bent forward position in order to get relief from the pain.  This review paper gives a complete overview of its definition, types, clinical features and management as per the Siddha Science.

Keywords

          Gunmam in Siddha, Acid Peptic Disease, Siddha Herbs, Medications for Gunmam. 

 

INTRODUCTION

India is the largest producer of medicinal herbs and is called as botanical garden of the world .The current review focuses on herbal drug preparations and plants used in the treatment of ulcer in the world. The use of Siddha medicines is common in both adults and children and is increasing in many areas of the world. Gastric ulcer is one of the most prevalent gastrointestinal disorders, which affects approximately 5-10% of people during their life. In recent years, many works has been carried out in herbal medicine to clarify their potential efficacy in gastric ulcer prevention or management. Peptic ulcer disease encompassing gastric and duodenal ulcer is the most prevalent gastrointestinal disorder. The Patho-physiology of peptic ulcer disease involves an imbalance between offensive (acid, pepsin, and H. pylori) and defensive factors (Nitric oxide, Bicarbonate, growth factors, Prostaglandin and Mucin). Indian Medicinal plants and their derivatives have been a valuable source of therapeutic agents to treat various disorders including Antiulcer diseases.

Gunmam in Siddha

          ‘’Vatha bantha thonthamilathu Gunmam varathu’’

The patient suffering from this disease will lean forward due to pain. Hence it is named as Gunmam. The other name for Gunmam in Siddha is Gulmam. The common features of this disease are indigestion, stomach irritation, vomit, decrease in body weight, loss of confidence. It is caused due to consumption of very hot food stuffs, gastritis inducing foodstuffs, water mixed with limestone, high consumption of coconut milk, stress, adequate temper, starvation and insomnia. According to Siddha system the Gunmam is classified into 8 types.

Types of Kunmam

1.     Vaayu kunmam

2.     Vaatha kunmam (Related to ectoderm)

3.     Pitha kunmam (Related to bile, endoderm)

4.     Eri kunmam (Related to gastritis)

5.     Vali kunmam

6.     Satthee (Vaanthi) kunmam (Related to more nausea)

7.     San-nee kunmam (Related to tri-dosha)

8.     Iya kunmam (Related to phlegm, mesoderm, kapha)

 

Classification of Ulcer as per Siddha Literature

 

 

Mechanism of Ulcer

Risk factors*, Helicobacter pylori

¯

Hyper secretion of hydrochloric acid and pepsin

¯

Imbalance Between gastric luminal factors

¯

Degradation in defensive function of gastric mucosal barrier

¯

Histamine is released when acid and pepsin invade a weakened area of mucosal barrier

¯

Histamine stimulate parietal cells to secrete more acid

¯

Continuation of vicious cycle, erosion

¯

Ulcer

 

Risk Factor

1.     Starvation

2.     More use of NSAID

3.     Smoking Habit

4.     Stress due to psychological problems

5.     Intake of caffeine

6.     Alcohol intake

 

Table 1.1 The signs and symptoms of these types of Gunmam

VAAYU KUNMAM

VAATHA KUNMAM

PITHA KUNMAM

Indigestion

Stomach pain

Irritation and mucous along with vomit

Vomiting

Weight loss

Giddiness

Weight loss

Inability to walk

Weight loss

Inability to walk

Constipation

Constipation

More sweating

Malaise, Tiredness

Blood becomes impure and the body colour changes into yellow

Stomach cramps

Headache

Thirstiness

Tiredness of leg

Xerostomia

Hyperthermia

Aversion over food

Blackening of body skin

Eye irritation

Sensation of stomach gases roaming like a ball

Blood vomiting

Headache

 

ERI KUNMAM

VALI KUNMAM

SATTHEE KUNMAM

There will be irritation after a few minutes having food

Indigestion

Vomit due to indigestion

Salivation of mouth will be more

Weight loss

Giddiness

Head ache

Loss of confidence

Irritation of stomach

Stomach enlarges more

Insomnia

Constipation

There will be sweating on the hairs of leg

Aversion over food, Fever

Inability to walk, Loss of strength, Malaise.

Weight loss

Pain at vertebra and wrist joint

Veins emerges to the surface of skin

 

SANNEE KUNMAM

IYA KUNMAM

Enlargement of stomach

Aversion over food

Giddiness

Sadness along with reduce in body weight

Sensation of burning on chest

Body becomes pale

Body becomes cold

Giddiness

Faces will be hot

Sensation of burning on chest

Sensation of saltiness in mouth

Trembling

 

Table 1.2. Herbs Used For Ulcer Classified As Per Siddha Materia Medica.

Tamil name/ Common name

Botanical Name/Family

Parts Used

Actions

Uses in Siddha

Seeragam/ Cumin seeds

Cuminum cyminum/ Apiaceae

Seeds

Carminative, stimulant, stomachic, astringent

Gut motility disorders, kidney stones

Masikkai/ Magic nuts

Quercus infectoria / Fagaceae

Seeds

Astringent, styptic, tonic

Venereal disease, fever, menorrhagia

Abini/ Opium poppy

Papaver somniferum /Papaveraceae

Latex, seeds

Demulcent, nutritive, astringent

 Otitis, insomnia,

Punnaikaali /Common cowitch

Mucuna pruriens / Fabaceae

Seeds

Nervine tonic, aphrodisiac, astringent

Leucorrhea, cholera

Yelam/ Cardamom

Eletaria cardamomum / Zingiberaceae

Dried fruit

Stomachic, Carminative, Stimulant.

Cough, Diarrhoea, Phelgm, Dysuria, Oligospermia, Peptic Ulcer Diseases (PUD)

Milagu/ Pepper

Piper nigrum / Piperaceae

Dried fruit

Carminative, Antispasmodic, Digestive, Expectorant, Laxative, Acrid, Anthemlmintic,

Fever, Anaemia, Phelgm, Piles, Dyspepsia, Cough, Loss of Taste

Brahmi

Bacopa monnieri / Scropulariaceae

Fresh Juice

Tonic, diuretic, mild sedative, antioxidant

headache, asthma, bronchitis, arthritis

Palasu/ Flame of the forest

Butea monosperma / Fabaceae

Seeds

Astringent, tonic, aphrodisiac, diuretic, anthelmintic

Itching, GIT disorders

Chukku

Zingiber officinale / Zingiberaceae

Dried rhizome

Stimulant, Carminative, Stomachic,

 Cough, Asthma, Dyspepsia, Fever, Anaemia, Sinusitis

Aloe

Aloe vera/ Xanthorrhoeaceae

Leaf

Coolant, tonic, anthelmintic, alterative

Dysentry, Psoriasis, eczema, burn

 

Table 1. 3. Medicines Used for specific types of Gunmam


VAATHA GUNMAM

PITHA GUNMAM

Sembu parpam

Vilva ver kudineer

-

Rasa parpathi mathirai

-

Inji pirandai leghyam

 

 

VALI GUNMAM

SATTHEE GUNMAM

Kal uppu choonam

Kunma kudori leghyam

Aya vera chendoram

Naaga parpam

Gunma kudori leghyam

-

Rasa parpathi mathirai

-


Medicines exclusively used for all Types of Gunmam in Siddha:

1.     Gunma kudori

2.     Anda leghyam

3.     Kunma leghyam or Karuvepilai leghyam

4.     Inji rasayanam

5.     Sowbakya sundi

6.     Sangu parpam

7.     Kunma Kudori mezhugu

8.     Nellikai Leghyam

9.     Chitira moola kuligai

10.   Taambira parpathi mathirai

11.   Vera mezhugu

12.    Sembu parpam (Gunma kaalan)

13.   Sembu chendooram

14.  Savveera parpam

15.  Panja soodha mezhugu

16.  Aya chendooram

17.  Uppu chendooram

18.   Nava upu mezhugu

19.  Vedi upu choonam

20.   Bojana kudori mathirai

21.  Panja paana mathirai

22. Gandhaga chendooram

 

    The above listed commercially available medicines can be used for all types of Gunmam according to Siddha Literature.

Food is medicine, medicine is food” is one of the policies of Siddha.

 

Diet restrictions in Siddha for Gunmam:

1.     Should consume double time boiled rice

2.     Should consume fresh vegetables

3.     Brinjal, Drum stick, ladies finger, Ribbed luffa, cucumber are prescribed to consume daily

4.     Should not consume coconut, horse gram, black gram and non-vegetarian foods like fish, dried fish, chicken

5.     If there is indigestion should have only over cooked rice (Kanji)

6.     Should consume Ginger, Adamant creeper, coriander, Mentha Chutneys without adding Chillies.

 

Experimental Pharmacology - a Data collection        

1. Cuminum cyminum                                                                   

          The chief constituent of the volatile oil is cumaldehyde. Cumin seeds contain up to 14.5% lipids. These are reported to contain 14flavonoid glycosides; 7 belong to apigenin, 5 to luteolin and 2 to chrysoeriol group. Major constituents of the essential oil include cuminaldehyde (20-40% of the oil) and p-cymene. Et OH (50%) extract of the fruit exhibits spasmolytic and hypotensive activity. Cumin is considered superior is comforting carminative qualities to Fennel or Caraway. Cuminaldehyde and Cumin oil are reported to exhibit a strong larvicidal and antibacterial activity.

2. Quercus infectoria                                                                                                   

          The galls contain 50-70% gallo tannic acid, gallic acid 2-4%, ellagic acid, nyctanthic acid, rubric acid, besides sugars, starch, an essential oil and anthocyanins. Galls were also found to contain beta-sitosterol, amentoflavone, hexamethyl ether and isocryptomerin. It is used for chronic dysentery, amoebiasis, GIT disorders and mainly ulcer.

3. Papaver somniferum                                                                                                         

          The petals are reported to contain a dark red pigment, namely mecocyanin chloride and another cyanidin derivative. The study has revealed the presence of cyanidin-B and pelargonidin-C in the flowers. Opium contains Isoquinoline alkaloids; the major one is morphine with narcotine, codeine, papaverine and thebaine. Poppy seeds, used in Indian medicine, do not contain alkaloids. The seeds contain thiamine 420, riboflavin 49, folic acid 30, pantothenic acid 2667 and niacin 1877 mcg/100 g. The seed oil (from Turkey) contains gamma-tocopherol 220, alpha-tocopherol 40 and beta-tocopherol 20 mcg/ 100 g. It has demulcent action but should be given with cautious.

4. Mucuna pruriens                                                                                                              

          Its principle constituents are L-DOPA and the bioactive alkaloids mucunine, mucunadine, mucuadinine, prurienine and nicotine as well as sitosterol, glutathione, lecithin, oils, venolic and gallic acids. They contain a number of bioactive substances including tryptamine, alkylamines, steroids, flavonoids, coumarins and cardenolides. Prurieninine slowed downs the heart rate, lowers blood pressure. The spasmolysis of smooth muscles are caused by indole bases. It has best aphrodisiac and anti-ulcer property.

5. Elateria cardamomum

Cardamom decreases gastric secretion. Cardamom is diuretic and flush out accumulated toxins from the body. Cardamom is used in treating digestive disorders relieving hear burn and bloating. The oil is composed amost exclusively of oxygenated monoterpene derivatives: alpha-terpineol 45%, myrcene 27%, limonene 8%, menthone 6%, Beta-phelandrene 3%, 1,8-cineol 2%, sabinene 2% and heptane 2%.

6. Piper nigrum

The fruit yielded piperine, piperatine and piperidine, amides, piperyline, piperoleins A and B, and N-isobutyl-cicosa-trans-2- trans-4-dienamide. The neolignan schmiditin, together with lignin galgravin as well as friedelin, beta-sitosterol and its beta-O-glucoside have been isolated from the extract of aerial parts. The extract exhibited Anti-amoebic activity. It has bacteriostatic, fungistatic, anti-inflammatory and rubefacient properties. It has antidote, expectorant and anti-ulcer property.

7. Bacopa monniera

The major constituents of Bacopa monnieri contains bacoside A and B, brahmine, herpestine, monnierin, hersaponin, D-mannitol, betulic acid, B-sitosterol, stigmasterol, a- alamine, aspartic acid, glutamic acid, saponins, serine. Brahmi has been valued as a cardiac, nerve and brain tonic and widely used by students for improving mental clarity, confidence, intelligence, concentration and memory recall. Brahmi as herbal supplements and tablets have been marketed for super learning, for memory and as a brain tonic.

8. Butea monosperma                                                                                        

          The bark exudes a red juice that dries to form the Butea gum. The gum contains leucocyanidin, its tetramer, procyanidin, gallic acid and mucilaginous material. The gum is a powerful astringent; it is given internally for diarrhea, dysentery, phthisis and hemorrhage of the stomach and bladder. The plant contains flavonoids and glucosides—butin, butrin, isobutrin and palastrin. Flowers contain butrin, coreopsin, monospermoside and their derivative.  

9. Zingeber officinale

It is used as a kaya karpam with it is soaked in honey. It has well stomachic, sialogogue, carminative. It is a constituent of Tri-kadugu. It is used as an accessory drug for gastro-intestinal disorders. It contains gingerol, zingerone, oleoresins, vallinoids, gingerdione, galalnals A and B, (6) shagaol.

 10. Aloe vera

 Latex obtained from this used to cure, dysentery and ulceration of stomach. The Gel obtained from this has coolant action. It maintains the body temperature. Aloe vera contains 75 potentially active constituents: vitamins, enzymes, minerals, sugars, lignin, saponins, salicylic acids and amino acids. It contains vitamins E,C and A (beta-carotene),  which are antioxidants. Aloe has been we known for centuries for its healing properties, and both oral intake and topical dressings have been documented to facilitate healing of any kind of skin wound, burn, or scald even speeding recovery time after surgery. Situations to try it on include blisters, insect bites, rashes, sores, herpes, urticarial, ulcer, athlete’s foot, fungus, vaginal infections, conjunctivitis, sties, allergic reactions, and dry skin.

 

CONCLUSION

Gastrointestinal disorders are one of the major important causes of morbidity in the populations of non-industrialized countries.  This review article clearly deceits Siddhars way of approaching a disease and their command over all the aspects of the disease.  More work are to be done to further explore the wonderful prophylatic and therapeutic activities of siddha medicines and Siddhars principles.  

 

REFRENCES

1.     Dr. K.S. Murugaesa Mudhaliyar 2013, Gunapadam Mooligai “Ninth edition, published by Directorate of Indian Medicine and Homeopathy, Chennai, India.

2.     Dr. R. Thiyagarajan, LIM, 2008, Siddha Maruthuvam- Sirappu, Third edition, published by Directorate of Indian Medicine and Homeopathy, Chennai, India

3.     Dr. K. N. Kuppusamy Muthaliar, HPIM, Dr. K. S. Uthamarayan, HPIM, 2009, Siddha Vaithya Thirattu, Third edition, published by Directorate of Indian Medicine and Homeopathy, Chennai.                                                                                                                                          

4.     Dr. R. Thiyagarajan, LIM. 2013, Gunapadam Thathu Jeeva Vaguppu, Eight edition, published by Directorate of Indian Medicine and Homeopathy, Chennai.                                                      

5.     Dr. M. Shanmugavelu, HPIM, Noi Nadal Part I and II “Fifth edition, published by Directorate of Indian Medicine and Homeopathy, Chennai.                                                                                         

6.     Dr. M. Shanmugavelu, HPIM, Noigaluku siddha parigaram Part I and II “4th edition, published by Directorate of Indian Medicine and Homeopathy, Chennai.                               

7.     C.K.Kokate, A.P.Purohit,S.B. Gokhale , Pharmacognosy” 46 th Edition, Published by Nirali prakashan, Pune.

8.     C.P. Baveja, Text Book of Microbiology, 4 th edition, published by Arya publication, Sirmour (H.P.).

9.     Encyclopaedia of medicinal plants – www.indianmedicinalplats.info , Accessed on March 7,2015.

10. C. P. Khare, Indian Medicinal Plants of Ayurveda and Siddha, India.    

11.  L. Mahadevan, C. Mary Sharmila, B. Senthamil Selvan, Siddha Practical Prescriber published by Saradha Mahadeva Iyer Ayurvedic educational & charitable trust, kanyakumari.

12.  P.S. Kupusami mudhaliyar 2002, Anubhoga vaithiya brahma ragasiyam” First edition, published by Jayam printers, Madurai.

13.   M.Shanmugavelu S.P.I.M., 2004, Noigaluku Siddha parigaram” Fourth edition, published by Directorate of Indian Medicine and Homeopathy, Chennai, India.

S.S. Pills - JUNE 2009

Comparative study of a Siddha formulation for the management of

 

 Azhal Keelvayu (Osteo Arthritis)

 

Meenatchi,[1] M.Krishnaveni,[2] S.Prema.[3]

 

 

ABSTRACT

 

Anti arthritic activity of Santha Sandhirodaya Mathirai (S.S.Pills, a Siddha formulation) was taken up for assessment on Azhal keelvayu (Osteo arthritis) patients. 120 patients were selected and divided into 3 groups. I group received S.S.Pills 3 pills with Thunai marunthu (Adjuvant) 1 gm of Thirikadugu choornam three times a day with honey, II group received Thirikadugu choornam 1 gm three times daily with honey. III group received S.S. Pill 3 tds with honey. Treatment period was 21 days without any interval. The anti arthritic effect of Santha sandirodaya mathirai alone and with adjuvant were assessed and compared with the clinical parameters such as pain, tenderness, swelling by joint circumference. The I group and III group showed more or less equal effect on Azhal keelvayu both clinically and statistically.

 

Azhal Keelvayu in Siddha system of medicine:

 

This is the first system to emphasize health as the perfect state of physical, psychological, social and spiritual components of a human being. The fundamental principle of this medicine is successfully eliminates the evil side effects without losing the beneficial medicinal properties. In India it is estimated that approximately four out of 100 people are affected by Azhal keelvayu (Osteo arthritis). According to Siddha system of medicine diseases are said to be the result of derangement of one or two or all the three humours (Vali, Azhal , Iyam ). Accumulation of vali kutram in poruthu (Joints) is said to be keelvayu. One of the leading causes of illness among aged people is Azhalkeel vayu.. The signs and symptoms of Osteo arthrits is simulate the symptoms described in Azhal keelvayu in Siddha.The goal of Azhal keelvayu therapy is to decrease pain and maintain or improve joint function.. In Siddha large number of medicines is available for the management of Azhal keelvayu. One such medicine is Santha santhirodaya mathirai (Veeramamunivar vagada thirattu)

 

Preparation of the drug ((Veramamunivar vagada thirattu)

 

Ingredients:

 

  • Venkaram (Borax) – 10gm.
  • Rasa Karpooram – (Mercuric sub chloride) – 20 gm.
  • Manjal (Curcuma longa) – 60gm.
  • Elumichai Charu (Lemon Juice) – 110 gm.

 

 Method

 

Purified Rasa Karpooram, Purified Venkaram and manjal were ground with lime juice for 12 hrs, then brought into fine consistency, rolled into 100mg pills and dried in shade.

 

Dosage                           3 pills thrice daily

Thunaimarunthu-              1 gm Thirikadugu chooranam

Anupanam (Vehicle)         Honey

 

Therapeutic uses

 

·       Rasa karpooram (Mercuric subchloride) is useful for vatha thodam, pitta thodam, juram, kamalai,etc. Mercury is widely used in Siddha medicine. Siddhars used Mercury not only to cure innumerable diseases, but also to rejuvenate the body and promote longevity.

 

·       Manjal (Curcuma longa) is useful for many diseases. It has potent anti inflammatory and hepatoprotective property also.

 

·       Vengaram (Borax) is effective in peptic ulcer, skin diseases etc.

.

Atomic absorption spectrometry analysis

 

·       The concentration of Mercury in two marketed samples was analyzed by using atomic absorption spectrometry.

·       Sample I 6.204mg/l

·       Sample II 13.61mg/l

·       Sample I is selected for further studies.

 

 

X-Ray Fluoresecence Spectrometric study

 

XRF study of Santha Santhirodaya mathirai shows that `the presence of Aluminium, Carbon, Calcium, Chlorine, Copper, Iron, Mercury, Potassium, Magnesium, Manganese, Sodium, Phosphorus, Sulphur, Silicon, Titanium, Oxygen, Palladium, Rhenium, And Strontium.

 

RESULTS AND DISCUSSION:

 

The concentration of mercury present in the sample used is 6.204mg/dl. XRF analysis shows the presence of Calcium ,Phosphate,Copper in the drug which is essential for bones. Deficiency of these minerals produces demineralization of bones. The presence of these minerals in the drug may be useful in Azhal keelvayu.

 

Clinical evaluation

 

.           120 patients of both sexes and age group above 50 years were selected randomly with the clinical features such as pain, swelling, and tenderness. Azhal keelvayu can detected either through physical examination for joint changes or X-ray of joints in the affected areas. The circumference of the joint, X- ray knee joint were taken before treatment. The patients were divided into 3 groups according to the administration of the test drug and anupanum. The drug was administered for a period of 21 days for all the three groups.

 

·        Group I  - 40 patients received S.S.Pills (3pills) and Thirikadugu Chooranam (1 gm)

·        Group II  - 40 patients received Thirikadugu Chooranam(1gm)

·        Group III - 40 patients received S.S.Pills.(3 pills)

 

The improvement in signs and symptoms were clinically and statistically observed and compared.

 

Table 1

 

Sl.No

Symptoms

Group I

.

Xc2

 

 

P

Group II

 

Xc2

 

 

P

Group III

 

Xc2

 

 

P

1.

Pain

21.o4

0<0.001

9.09

<0.01

15.05

0<0.001

2

Swelling

23.04

<0.001

16.5

<0.001

32.02

<0.001

3

Tenderness

12.07

<0.001

7.1

<0.01

13.6

<0.001

 

The table shows that the improvements in Pain, tenderness, swelling were statistically significant in all the three groups (Paired chi square).

 

 

Table –II: Reduction in swelling after treatment.

 

Group

Mean Joint circumference

B.T          A.T       Diff

Paired ‘t’

P

Group I

1.02        0.22        0.8

7.2

<0.001

GroupII

1.15        0.77       0.38

0.39

<0.001

GrpupIII

1             0.4         0.6

5.45

<0.001

 

B.T – Before Treatment,  A.T – After Treatment.

 

Table III: Comparison of groups

 

Comparison

Reduction

t

 

P

Group I Vs Group II

3.49

<0.001

Group I Vs Group III

1.9

<0.05

 

Table II and III shows that

 

The reduction in joint circumference in all three groups were statistically significant (Paired‘t’ test).

 

The mean joint circumference reduced by group I was compared with group II. The reduction was about 0.5 cm more in group I than the group II that was statistically significant. Hence we consider that group I was more effective than group II.

 

The reduction in joint circumference was 0.2 cm more in (group I) than S.S.Pill (group III). That was statistically not significant it means both the groups are having more or less equal efficacy.

 

Summary and Conclusion

 

It can be concluded that the Santha santhirodaya pill has got the curative potential to reduce the aggravated vatha which can be evidenced from the pronounced clinical trials. No side effects were observed which suggests that the drug is safe to use therapeutically. This kind of finding can be exploited in the successful treatment of Azhal keelvayu with Santha santhirodaya mathirai.



[1]   Assistant Medical Officer, Villupuram Dist, Tamilnadu, India.

 

[2]   Lecturer, Govt. Siddha Medical College, Chennai, India.

 

[3]   Professor, Tamil University, Tanjore, Tamilnadu, India.

 

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