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Thursday, September 18, 2008

THE SIDDHA SYSTEM OF MEDICINE
T.Thirunarayanan
Siddha Physician
Centre for Traditional Medicine & Research
4A, IV Cross Street, Mahalakshmi Nagar
Adambakkam
CHENNAI-600088
ttn64@sify.com

Knowledge of medicine is of fundamental importance to man’s well being and his survival and so it must have originated with man and developed as civilization. Every race or even every ethnic group has its own system of medicine for maintaining health or treatment for diseases. Researchers have documented as many as five thousand ‘Folklore medical practices’ prevailing in different part of the world. But still only very few systems are being practiced even today. Traditional Indian systems like Ayurveda and Siddha in spite of their antiquity have not only survived but also are highly patronized by mankind even today. The history of Indian traditional medical systems dates back to pre-historic ages and is identified with Indus valley civilization. Siddha medical practice has a lot of similarities to this civilization in the use of certain medicines that are exclusive to it and it is identified with Dravidian culture.

Siddha system of medical practice is associated with the Dravidian landscape more particularly Tamil speaking land of India and other eastern countries. The term ‘Siddha’ is derived from ‘Siddhi’ which means “attainment of perfection” or “one who is accomplished". The origin of this system is associated with the desire of Eighteen Saints who relentlessly took efforts to attain salvation. They realized that a good physical body free from disease is required to attain the Eternal bliss. They evolved a system primarily for healthy living and also for elimination of disease. More significant is that the healthy living indicates not only physical health but also psychological, social and spiritual wellbeing. Siddhars, being followers of the Saiva Siddhanta cult and some of them later adopted some of Buddhist principles, slowly discouraged use of alcohol based drugs and surgical procedures.



Great Siddhar Thirumoolar defines medicine as follows:

“One that cures physical ailment is medicine
One that cures psychological ailment is medicine
One that prevents ailment is medicine
One that bestows immortality is medicine.”
- Thirumandiram

It can be thus summarized that the Siddha System is primarily holistic and is largely focused on promotive and preventive health. The period of Siddha saints like Agasthiar, and Thirumoolar is as early as the 3rd century B.C.

BASIC PRINICIPLES

Siddha system considers the human body as a conglomeration of three humors (Vatham, Pitham & Kapham) - the functional component and seven basic tissues the physical constituents (Lymph, Blood, Muscle, Adipose tissue, Bone, Marrow or the one that lies within the bone- Nerve or the reproductive tissue). Both these are formed by the five primordial elements of Earth, Water, Fire, Air & Space. The five elements combine in different proportion to constitute them. The food is considered to be the basic building material of human body which gets processed into humors, body tissues and waste products. The understanding of the quality of a food material or drug or even the outcome of any physical or psychological activity is based on its impact on the five elements. The equilibrium of humors is considered as health and its disturbance or imbalance leads to disease or sickness. In physiological condition, Vatham, Pitham and Kapham exists in the ratio of . The role of environment in health is greatly stressed as human body is considered as a microcosm made of the same elements that constitute the macrocosm. The equilibrium gets deranged due to many reasons namely environment, climatic condition, diet, physical activity and stress. Similarly each humor may be dominant in different individuals even at birth depending upon the element present, emphasized as Thegapanbu. The physical and psychological features vary accordingly. The disease and treatment modalities also vary on the basis of individual body constitution. The classification of diseases is mainly based on the three humors of Vatham, Pitham and Kapham. It is also classified according to clinical symptoms, causative features, organs affected, infections, accidents and congenital causes.

Another great contribution of Siddha medicine to human kind is Pathyam and Apathyam (Regimental Therapy) which lists many do’s and don’ts during a diseased condition or during seasonal changes. The general criticism of the traditional medical systems for this concept of Pathyam is now proven as unfounded, as the importance of diet and lifestyle is clearly explained not only in metabolic diseases like Diabetes but also in the most common cause of mortality like Carcinoma and Ischemic heart disease. The various dietary habits and lifestyle to be adopted during different seasons of the year and daily regimen to be followed for healthy living are recommended. This preventive aspects form the key advantage of this traditional medical system.

Dरुग्स

The primary aim of Siddha medicine has always been to evolve drugs that could arrest the decay of the body, as preserving the body without disease and ageing is essential for realizing the Truth- ‘Atman’ residing within the body. This could not be achieved by drugs which themselves are subject to decay such as drugs of vegetable origin. Thus the preparation of medicines using ingredients of metal and mineral origin, which do not lose their potency with the lapse of time, is justified. One more reason why early Siddha texts have extensive formulations with mineral ingredients is that the south Indian rivers were not perennial and herbs were not available all through the year. The expertise of Siddhars in Alchemy led them to the finding of therapeutic properties of these metals and minerals. This system has a strong base in pharmaceutics. The wide range of dosage forms, with long shelf life vouchsafe for its strong pharmaceutics base.

Though most of the plants used in Ayurveda are also in Siddha medicine about 150 plants are exclusively used in Siddha medicine, which could be confirmed from comparative study of classical texts of the two systems.

The system has developed a rich and unique treasure of drug knowledge in which use of metals and minerals is very much advocated. From earliest times in Siddha text, there is mention of mercury, sulphur, copper, arsenic and gold those were used as therapeutic agents. Alchemical ideas dominate Siddha medicine. Siddhars have very profound knowledge of Iatrochemistry.

The vast therapeutics of Siddha medicines consisting of metals and minerals is a cut above Ayurveda, as in the earlier Ayurveda texts there is fragmentary evidence of metals and minerals. It is possible that in the course of time this system and the one prevalent in the north supplemented and enriched each other. These medicines can be administered in small doses and that too after treating primarily with plant medicine. They are available in all seasons and can be preserved for many generations. Some of the methods used by the Siddhars still survive under a veil of secrecy. Certain mercury and arsenic compounds are manufactured only by certain families and the methods are a closely guarded secret. In this present scenario these types of medicines can be administered in very little doses (microgram levels) and in chronic degenerative ailments and life threatening conditions with great caution.

Every classical Siddha literature explains about the detailed drug classification, according to their Suvai (taste), Gunam (Physico chemical quality) Veeryam (potency) Pirsuvai (taste after digestion) and Thanithuvam (Unique property). Intricate details of various drugs like water soluble in-organic substances, minerals, metals& alloys, natural stones, their ores, availability, synthetic preparation, purification process, medicine preparation etc. are enumerated in Siddha classics.

In addition to drugs of plant or mineral origin, drugs obtained from animal sources and marine products are also used extensively in this system. The use of animal products suggests Siddhars extensive knowledge of animal proteins and fats in therapeutics.
One of the surprising advancement of this system is the understanding of bio-availability, drug-food compatibility, drug-drug interaction which is of recent origin in Bio-medicine। Detoxification of drugs and enhancing drug potency using Muppu are the other unique features that are in practice even today. Drugs like Chunnam (metallic preparations which become alkaline), Mezhugu (waxy preparations) and Kattu (preparation that are impervious to water and flames) are prepared by vaidyas once in a life time that have a very long shelf life. In facts generations continue to use kattu prepared by their ancestors .

DIAGNOSIS
The diagnosis of diseases involve identifying it causes। Identification of causative factors is through the examination of pulse, urine, eyes, study of voice, skin features including complexion, and sense of touch, tongue and the status of the digestive system by stool examination. The system has worked out unique procedure of urine examination which includes study of its color, smell, density, quantity and oil drop spreading pattern. Theraiyar was one of the latter authors of Siddha medicine who wrote on urine examination and stages of health. He explains the colour and consistency of the urine in different doshas and disease. He also talks of the spreading of a single drop of oil on the surface of urine from which imbalance of specific dosha can be inferred. In this system a very great importance is given for Nadi thervu or Pulse reading. It is holistic in approach and the diagnosis involves the study of the person as a whole as well as his disease.


TREATMENT
The Siddha System of Medicine emphasizes that medical treatment is oriented not merely to disease but has to take into account the patient, environment, the meteorological consideration, age, sex, race, habits, mental frame, habitat, diet, appetite, physical condition, physiological constitution etc.. Different treatment procedures are adopted primarily to bring back the deranged humor to normalcy which includes inducing purgation (Baedhi) in deranged Vatham, Emesis (Sathi) in deranged Pitham, Nasal application (Nasyam) and ophthalmic application (Kalikam) in Kapham. Blood letting, Leech application, Bone setting, Varmam (treatment given using specific body points and disease occurring due to trauma of these body points) and Physical manipulative therapies are some other treatment modalities/ procedures. Ophthalmology and Pediatrics are the other two evolved branches of Siddha medicine.

Medical astrology is a very important component for understanding the prognosis।


KAYAKALPA
Longevity and ageing with elegance is an important specialty of Siddha system. The exponents of this system consider that achievement of this state is possible by medicines and meditation. This discipline addresses the methods and drugs for longevity and for the fountain of youth with complete freedom from illness. It is similar to rasayana of Ayurveda and gerontology of modern medicine. Kalpa means ‘able, competent'. One of the key recommendations is to avoid over indulgence in any activity including procreation.
In this science of longevity about 108 entities comprising of herbs and herbo-mineral medicines are recommended both for healthy living for normal individuals and for restoration of health in sick persons। Many of the herbs thus listed have proven to be anti-aging and powerful anti-oxidants. Some of the Kaya kalpa drugs are used even today in complications of many illnesses. Breath control (pranayanam) and diet are two important parts of this discipline. Vazhalai Kazhatral- removal of mucous secretion from throat with Eclipta alba juice and Malam Kazhatral cleaning of the bowels with Aloe juice are some of the important procedures during this treatment. Many herbal drugs like Milagu-Piper nigrum, Seendhil- Tinospora cordifolia are used during this administration. The use of Indian gooseberry –Emblica officinalis is yet another classical example. Current science confirms the health benefits of many kayakalpha drugs as Anti-Ageing.


CURRENT SCENARIO
Both the Government of India and State Government as a policy promote Siddha medicine and are taking efforts to mainstream this system in public health delivery. Efforts have been taken to create centers of excellence, train the first health delivery contacts - village health nurses in rural areas and provide safe and effective Siddha medicines to the end- users through them, upgrade facilities in Government Hospitals and Upgraded Primary health Centres in the State of Tamilnadu by providing physical infrastructure and training the physicians. Information, Communication and Education materials for promotion of this system have been developed and distributed. Regulations and facilitations for quality education, research, practice and drug manufacture under good conditions have been made to make this system acceptable to all.
The greatness of the system lies in its ready availability, acceptability at affordable cost, particularly in primary health care. The research on maternal anemia and safe delivery have made this system more women and child friendly and is expected to improve key health parameters including reduction of maternal and infant mortality and morbidity.
Siddha medicines are used successfully in various immune related disorders, chronic degenerative disorders, metabolic disorders and chronic geriatric and hormonal dysfunctional diseases. Effective treatment is being given in chronic cases of liver, skin diseases especially “Psoriasis”, rheumatic problems, anemia, prostate enlargement, ano-rectal diseases and peptic ulcer. The Siddha system also has Medicines which contains mercury, silver, arsenic, lead and sulphur that have been found to be effective in treating certain infectious diseases including venereal diseases. These medicines are recommended to be used only in conditions where plant drugs are ineffective and depending on the acute nature of the clinical condition of the patient. Practitioners have claimed that Siddha medicines are effective in reducing the highly debilitating problems that manifest themselves among patients of HIV/AIDS. More research into the efficacy of these medicines is presently in progress. Effective treatments are available to take care of the menopausal syndromes, especially problems related to hormonal imbalance. External therapies like Varmam, Thokanam – Physical manipulative therapy, Fasting, Sauna, Heat therapy are some sophisticated treatment procedures useful in neuro-skeletal muscular disorders.


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Friday, September 12, 2008

Disease Modifying Agents From Natural Products

DMA AND AUTO IMMUNE DISORDER

• Immune effector cells like T and B lymphocytes and macrophages play critical roles in the pathogenesis of Auto-immune disorders

• Autoimmune diseases are a group of illnesses with multiple organ involvement like Rheumatoid Arthritis

• Disease Modifying Agents are the drugs believed to alter the course of the disease particularly in Auto immune Disorders.

• The goal of DMARD therapy is to reach remission or obtain optimal control of inflammatory joint diseases

CURRENT REGIMEN

Antimalarials Hydroxychloroquine and Chloroquine), Sulfasalazine,
• TNF inhibitors (Etanercept, infliximab and Adalimumab),
• Interleukin-1 receptor antagonists, leflunomide Methotrexate,
• Gold compounds, and
• Cytotoxic agents (Azathioprine, Cyclophosphamide, and cyclosporine).

TNF INHIBITORS

• Etanercept and infliximab are TNF inhibitors. These drugs bind to and block the activity of TNF-alpha, which is a cytokine that causes inflammation and joint destruction in patients with Rheumatoid Arthritis
• Though they promise safety and efficacy compared to the earlier DMA’s, therapy cost is prohibitive


HERBS FROM OTHER REGIONS

• URTICARIA DIOTICA- NETTLE LEAF
• PANAX GINSENG
• GINKO BILOBA

INDIAN HERBS

• TINOSPORA CORDIFOLIA
• BOSWELLIA SERRATA
• ZINGIBHER OFFICINALIS
• CURCUMA LONGA
• OCIMUMSANCTUM
• CAMELIA CHINENSIS

TURMERIC- NO MYTH

• Curcumin, a flavonoid from Curcuma longa (turmeric) is a known inhibitor of TNF-alpha. An in vitro study found TNF-alpha increased intestinal permeability and curcumin inhibited the NFkappaB- induced-TNF-alpha-stimulated increase in intestinal permeability

BOSWELLIA SERRATA

• Boswellia serrata is a botanical with significant anti-inflammatory activity. In vitro, this botanical inhibits the 5-lipoxygenase product LTB4, which has been implicated in Crohn's Disease
• This is also confirmed in Randomized Double blind clinical studies carried out in comparison with known drug, Mesalamine

INTERLEUKINS

• Interleukins are the cytokines that act specifically as mediators between leucocytes
• IL-1 often acts synergistically with Tumor Necrosis Factor during the pro-inflammatory process. IL-6 also plays a role in inflammation, mainly as an inducer of acute phase proteins synthesis by hepatocytes.

TULSI- NOT JUST RELIGIOUS

• Ursolic acid, rich in Tulsi -Ocimum sanctum is a major inhibitor of IL-6 responsible for Pro-inflammatory activity
• Ursolic acid suppressed NF-kappaB activation induced by various carcinogens including tumor necrosis factor (TNF)

RASAYANEE DRUGS

• If one looks at the botanicals, we understand that most of them are Rasayanee drugs.
• This is just not coincidence
• More we understand the mechanism of pharmacological action better is our understanding of disease and choice of treatment

Saturday, September 6, 2008

  • Centre for Traditional Medicine & Research
    4A, 4th Cross Street
    Mahalakshmi nagar
    Adambakkam
    Chennai -600 088
    Ph: 43559593/43559573
    dirctmr@sify.com
    ttn64@sify.com





    Profile

    Centre for Traditional Medicine & Research, a registered society under the TN societies registration Act is a ‘Not for profit organization’ operational since 2001. CTMR is working in the area of awareness, advocacy and promotion of research in traditional medicine including cultivation and conservation of Medicinal plants. The NGO has prior experience in carrying out demand supply assessment, and is closely associated with preparation of strategy and action plan for development of propagation material of medicinal plants by seed centers in Forest Department.

    CTMR has written the Strategy paper, action plan and road map for the development of the medicinal Plant sector in Tamilnadu for next five year plan 2008-2013 for State Medicinal Plants Board

    The following experts in the area of traditional medicine and medicinal plant constitute the governing body of CTMR.

    Vaidya.S.Usman Ali, currently the Director, Centre for Traditional Medicine and Research. Chennai, has over 40 years of experience in ISM, Which include positions like
  • Chief Botanist, TAMPCOL, instrumental in establishing medicinal plant farm in Anna nagar and Kolli hills.
  • Asst Director of CCRAS.
  • Instrumental for establishment for the first ever medicinal plant garden –Jawaharlal Nehru medicinal plant Garden, Pune and publications of various ‘Ethnobotanical studies of various tribal and native populations’ including , natives of Andaman, Karjat, Bhimashanker of Maharastra Kanis of Agasthiyar hills, Irulas of chengalpattu, and natives of point calimore (Kodiakarai)
  • As officer on Spl Duty to VC. Gujarat Ayurvedic university. Jamnagar and researched natives of Gir forest of Junagadh.

    Dr.T.Thirunarayanan, Siddha Physician -20 years experience in ISM, teaching, clinical, industry and research with expertise in conservation, cultivation of medicinal plants, working closely with other NGO’s and Govt Departments including Forest Dept, Corporations including TAFCORN,SFRDT.
  • Prepared the ‘Development of ISM’ report for the state under the Tamilnadu Equitable growth initiative programme along with members of the Health sector sub-committee.
  • Has served as expert member in earlier ‘Mother and Child healthcare’ programme and subsequently in designing training module and Kit for RCH programme of Govt. of Tamilnadu and in evaluating, monitoring and review.
  • Has authored two books and translated four traditional works of siddhars in English.
  • Has various research publications including ‘Herbal wealth of Nilgiris tribal and Non tribal’.
  • Documented the local health practices of Traditional healers of Kaniyambadi block and Javadi hills while serving as Physican –ISM in community Health Department of Christian Medical college, Vellore.
  • Dr.T.Thirunarayanan & Dr.S.Usman Ali have been expert members of the Medicinal plant committee of Tamilnadu Siddha Medical Board and co-authored report on establishing large scale Medicinal plant gardens in Tamilnadu.
  • Have actively guided other NGOs in Natu Vaidya conventions and in selection of Natuvaidya awardees.
  • Both of them have actively participated in designing and conduct of Rapid assessment of Traditional Knowledge programs of various NGOs


    Key Projects carried out so far by CTMR.
  • Medicinal Plants Development Area Project at Pulleri in Chengalpattu Dist in Association with Forest Dept and FRLHT -2001-2003
  • Feasibility study and Technology transfer for Select Medicinal Plants of Commercial interest – Tamilnadu Forest Plantation Corporation (TAFCORN) -2002-2004
    Utility Pattern of Traditional Medicine in Industrial township (Kalpakkam) and rural areas around them -2003-2004
  • Anti-fungal property of plant drugs with specific reference to Dandruff causing organism and Efficacy of commercially available Anti-dandruff products -2003-2004
    Establishment of Medicinal Plants Demonstration garden and nursery in 10 acre plot at Annaikatti- AIM for Sewa – Coimbatore 2003-2006
  • Associated with Endangered species gene bank for select Medicinal plants at Annaikatti in association with AIM for SEWA and IFGTB. 2005-2007
  • Techo-economical feasibility study for Cultivation and processing of Medicinal plants in Orrisa and Karnataka and identification of Land for establishing Medicinal Plants Cultivation centre –Industrial Technical Consultancy corporation of Tamil Nadu -2005-2006
  • Implementation of Medicinal Plant Park in PHCs in Tamil Nadu –Tamil Nadu forest department under UNDP scheme -2006-2008
  • Survey for assessment of Demand and supply among Industry, Export houses and Extraction units in Tamil Nadu & Karnataka- NMPB funded project for FRLHT -2006-2007.
  • Intercropping of medicinal plants - Feasibility along with Jatropa plantation for M/s.India cements Limited, India Pottash and Siyarams. -2006-2008
  • Large Scale Nursery and Plantation of Jatropha as alternative income generation and Livelihood for Tribals of Annaikatti- Ongoing
  • Documentations of local health traditions in Darmapuri, Salem., Namakal ,and Krishnagiri Districts under The Department of Ayush scheme -ongoing
  • Training programme on specalised Treatment Procedures in Indian System of Medicne for over 800 Government Siddha doctors under The Department of Ayush scheme -ongoing.
  • Digitalization and translation of siddha medical text books under The Department of Ayush scheme




    Regular activities include
  • Student Research support in various institutes including IIT Chennai, CLRI, Women Christian college, New college, Madras Christian college, DG Vishnava College etc.
  • Many lecture and awareness programme both for students and general public.
    Invited lectures in most university departments in Southern states of Tamil Nadu, Kerala and Karnataka .
  • Organizing Medicinal plant exhibitions in association with institutions/College