Siddha is one of the oldest medicinal systems originated in Tamil Nadu. The word ‘Siddha’ is derived from a Tamil word ‘Siddhi’ which means ‘achievement’ or ‘perfection’. The Siddha medicinal system not just focuses on treating the disease but it also takes into account the patient behaviour, environmental aspects, age, habits and physical condition. The practice is majorly used in Tamil speaking parts of the world and has been promoted by eighteen siddhars (saintly people who practised Siddha systems).

It is difficult to trace the beginning of the Siddha system. According to the tradition it was Lord Shiva who unfolded the knowledge of Siddha medicine to his concert Parvati who passed it to Nandhidevar and he in turn to the 18 siddhars. Agasthiyar is the prominent one among the eighteen and some of his literatures are still in daily use among the Siddha Medical practitioners.

The knowledge of Siddhars which was orally transmitted initially was later written in palm leaf manuscripts, fragments of which are found in many parts of South India. Till half a century back most of the practicing Siddha medical practitioners were traditionally trained, usually in families, and Guru -Shishya.

After Independence, in order to encourage traditional medical systems, the Government opened schools for teaching indigenous systems of medicine including Siddha. Today, Siddha is taught in Government as well as in private Siddha medical colleges in Tamil Nadu and Kerala. Siddha medicine is also taught in two universities of Srilanka.

Specialties of Siddha medicine

1. Karpa medicines for rejuvenation and prevention of diseases & Yoga practice for physical and mental well-being.
2. Skin disease management
3. Psychiatric disease management
4. Orthopaedic disese management & Varmam therapy
5. Geriatric disease management

Karpa medicines:

The hallmark of Siddha system is KAYAKARPAM i.e., imparting immunity to diseases and counteracting the aging process. A deeper exploration in the areas of kayakarpam of the siddhars can fetch us break-through in combating various incurable diseases. Karpa therapy is inclusive of herbal karpam, Mineral karpam, regulatory procedures for life force Circulation, Yoga and more integrated therapies like muppu, (Vaithyamuppu, Vathamuppu, Yoga muppu).

Siddha medical science most distinctly emphasizes the practice of Kayakarpam to rejuvenate the body and mind, markedly slowing down the biological ageing. The therapy of Kayakarpam is attained through Karpa-aviztham (karpa-medicines) and Karpayogam (regimens of life). The longevity of an organism clearly depends on its individual parts and their effective organization. The intercellular organization can be made effective with help of medicines, specially prepared for this purpose like Amuri, muppu etc and practicing special regimens like pranayama, yoga and meditation. Amuri, Muppu and Guru are highly acclaimed preparations in Tamil Siddha tradition. By regular practice of Yoga stress and strain also gets relieved and lifespan increases. Kayakarpam provides both Spiritual and general benefits. Spiritually, the serpent power or Kundalini is aroused and the super conscious state is attained, when the Jeevatma get united with Paramatma. Karpam like Ashtanga yoga makes this possible.

Karpa Avizhtham:

Karpa avizhtham or medicines include herbal, mineral and animal preparations. They are of two types,

1. Daily prepared or already prepared medicines.Herbal Karpa avizhtham are mentioned in Theraiyyar Yamagavemba, Bohar karpam 300, Bohar 7000, Thiruvalluvar karpam 300, Pulathiar karpam 300etc.
2. Mineral Karpa medicines are present in Agasthiyar chendooram300, Bohar 7000& 700 etc.

Beyond these, there are certain health practice like Amuritharanai, dasadeeksha, iyamam (good character), Niyamam (good conduct). Kayakarpa recipe is to build a strong body. For instance, in the morning, fresh ginger officinalis (ingi) after removing the outer skin, crushed and mixed with hot milk with or without honey. At noon, dried ginger crushed and powdered to be taken with food. Kadukkai, (Terminalia chebula) powder mixed with water to be taken at bed time.

Karpa Yogam:

Patanjali’s writing also became the basis for a system referred to as “Ashtanga Yogam” (“Eight-Limbed Yoga”). This eight-limbed concept derived from the 29th Sutra of the 2nd book, and is a core characteristic of practically every Rajayoga variation taught today.

The Eight Limbs are:

1. Iyamam:Purity of Mind.
2. Niyamam: Purity of Thoughts.
3. Asanam: Literally means “seat”.
4. Pranayamam: (“Suspending Breath”)i.e:Prāna, breath, “āyāma”, to restrain or stop. Also interpreted as control of the life force.
5. Pratyakaram: (“Abstraction”): Withdrawal of the sense organs from external objects.
6. Dharanai:(“Concentration”): Fixing the attention on a single object.
7. Dhyanam:(“Meditation”): Intense contemplation of the nature of the object of meditation.
8. Samadhi (“Liberation”): merging consciousness with the object of meditation.

Skin disease management

777 oil for psoriasis management

Some studies were conducted to find out the effect of 777 oil in suppressing the keratinocyte proliferation by MTT. Wealth of clinical trial findings from different parts of India also proved that the 777 oil can be used for Psoriasis management. The study findings clearly showed that the drug is very effective in retarding the keratinocyte proliferation. CCRAS conducted clinical trial and other studies on the efficacy of 777- oil at CRI-Siddha, at Chennai. This is one among the few Siddha drugs studied scientifically. The study findings were published in JRAS.

Varmam Therapy:

Varmam is the seat of wind, breath or source of life. The word Varmam means that which is hidden. When the flow of this life-force is disturbed, the body becomes insensitive. Varmam has two dividends, one is called varmakalai that deals with self-defense and the other called the varmam therapy which deals with the therapeutic application. The most important junctions in the human body in the trail of ligaments, nerves, bones, blood vessels, joints and nerve-centers has the accumulation of Pranavayu and thus it is called as vital points called Varmam pulligal. They meet, combine and coordinate so as to enables physiological body functions. Even a slight damage (Thoduvarmam) to these vital centers may pose serious adverse effects. The damage may be extensive too. They may even affect the blood vessels passing through an area causing improper blood supply to that area. This leads to pain and unconsciousness. Hence such centers are called vulnerable points and are not visible, as they lie underneath the physical structures of the Human body.

Traditional Orthopedic Practices (TROP) In Indian Context:

It is estimated that there are approximately 60,000 traditional orthopedic practitioners in rural India (Shankar 2006). According to Government of India census (2001), there are close to six lakhs (600,000) inhabited villages in India. This means that for every ten villages there is one orthopedic practitioner. Their practice includes fracture and dislocation management, Varmakalai (understanding and management through vital points in the body), management of injuries and their complications, management of congenital anomalies like club foot, treatment of post-polio paralysis and musculoskeletal disorders using different types of oil therapies and many more to be explored. This knowledge has been passed on through centuries of practice from one generation to another. Mostly the knowledge is inherited as a family tradition and in some cases it is taught as a teacher to student tradition through in formal apprenticeship. There is also vast array of literature available on the subject in the Indian subcontinent as it is an important aspect of our Siddha medical system.

There are many specialized and renowned traditional orthopedic centres in South India. Few examples are Puttur bone setters in Andhrapradesh, and Mamsapuram tradition of Tamil Nadu etc. These centres are catering to large number of patients both from rural and urban areas. In Southern districts of Tamil Nadu, Varmam (management through vital points in body) tradition is common. In Kanyakumari there is even an association of Varmam practitioners with a good number of healers as members. In Kerala, bone setting is also part of the tradition of martial arts (Kalari) which is popular in the state. Typical conditions and injuries treated by akalari master are attributable either to martial-related activities (injuries from exercise or external shocks/wounds) or pathological conditions affecting one’s ability to exercise (weakness or muscular complaints) (Zarilli, 2006). There are also centres of based on classical knowledge of Siddha which are specialized in orthopedic management with excellent facilities.

Psychiatric disease management:

The significance of psychiatric thoughts found in Tamil culture unravels the advanced psychiatric medical knowledge in the Ancient Tamil system of Medicine, the Siddha system. Tholkappiam- Literally the Ancient literature (circa 1 century AD), probably the oldest extant text dealing with customs, habits, polity and grammar of the olden days, describes in detail the psychophysiological aspects of human emotions. Emotions are classified in this text into eight types.

1. Nagai – Laughter
2. Azhugai – Melancholy
3. llivaral – Dejection with guilt and deistic for living
4. Maoitkail – Wonder
5. Achcham – Fear
6. Oovagai -Jubilation
7. Veguli – Anger, Resentment
8. Perumidham – Buoyancy, Elation

There is epigraphic and historic evidence, dating back to the IX century AD, of residential care of the mentally ill. This inscription, found in the walls of the inner sancturary of a temple dedicated to Lord Venkateshwarara at Thirumukkudal, Chengelpet District, TamilNadu. Sage Agathiyar, who was the chief of the Siddha School, was a celebrated philosopher, grammarian and physician. Some of his works are still standard textbooks of medicine in daily use for Indian Medical practitioners. The Kirigainool (diseases of mind-types and treatment). Nayanavathi (Science of Optics), Balavadagam (Treatment of common & serious diseases of children) and Vaithiya Vallathi (pharmacy) are some of his significant titles.

Sage Agathiyar has detailed psychotic, emotional and behavioral disturbances in his treatise called the ‘Kirigainool”. He classified the clinical variety of mental illness based on the phenomenology. Although given separate names majority of the descriptions apply to the disturbed, excited, deteriorated, severely mentally ill. Attempting to classify the description using kraepelininan phenomenology is as follows”.

CATATONIC WITHDRAWAL: Under this head we can include

1. Vaada Kirigai : Fearful insanity
2. Sletpana Kirigai: Phlegmatic insanity
3. Alar Kirigai : Shouting insanity
4. Moodu Kirigai: ‘Light headed’ insanity
5. CATATONIC EXCITEMENT: Herein are included
6. Munanga lKirigai : Muttering insanity
7. Valippu Kirigai: Convulsive insanity
8. Peiyapidi Kirigai: ‘Possessed’ insanity

CHRONIC SCHIZOPHRENIA: Under this head as many as seven categories are included:

1. Anal Kirigai : Flaming insanity
2. Pitha Kirigai : Bilious insanity
3. Echil Kirigai : Spitting insanity
4. Booda Kirigai : Demoniacal insanity
5. Jalal Kirigai: ‘ Water loving’ insanity
6. Kalleri Kirigai: Stone throwing insanity
7. Kumbidu Kirigai: Saluting insanity

MANIAC EXCITEMENT: Under this head we can include

1. NaddavinduKirigai : Masturbatory insanity
2. MohiniKirigai : Erotic insanity
3. MaruttuKirigai: Menacing insanity
4. NeerkudiKirigai: Water- drinking insanity

Treatment of mental illness:

In Manidar Kirigai Nool – 64 Agathiyar describes 18 varieties of medicine for the clinical varieties. The pharmacopoeia include favorite oils, various herbs and esoteric animal preparation according to the route of administration of the medicine he divided them into 6 groups:

1. Thuvalai:Anointing-external application
2. Vethu: Fumigation
3. UllukuKoduthal: Oral route
4. Nasium:Nasal application
5. Kalikkam: Ocular application
6. Mandiram: Psychotherapy

Stress related disorders (Neurotic disorders) are elaborately dealt by Yugi Siddhar in his contribution the Yugi Chitamani 800. This book deals elaborately with both physical and mental illnesses. It describes functional psychoses, neurosis, somatoform disorders and toxic psychosis etc. The catatonic withdrawal symptoms are described under the heading Veri Azhal Noi and Thamadha Azhal Noi. The symptoms of catatonic excitement are described in Peruiya Noi. Chronic Schizophrenia is described in Moodu Pitham. Manic excitement is described in stanzas under the heading Azhal Pitham.Marka Pitham and Verilyam.

The Siddha Classification of The relationship between mental illness (i.e. Kirigai) and epilepsy is well recognized in Siddha treatise were in one of the disorders is called Epileptic Insanity (Vallipu Kirigai).

Epilepsy describes 5 major types:

1. Kumarakandam – an affliction named after hornless animals.
2. Amarakandam – disorder with ghastly features like hell.
3. Bhramakandam – characterised by prolonged stupor.
4. Kakkaivali – named after the crow.
5. Muyalvali – named after the demon, on whichLord Shiva performs his dance.

Geriatric disease management

Geriatrics is the branch of medicine that deals with the diseases of old age. Geriatrics involves treating acute illnesses as well as managing the rehabilitative and long-term care of the aged. As per the 1991 census, the population of the elderly in India was 57 million as compared with 20 million in 1951. There has been a sharp increase in the number of elderly persons between 1991 to 2001 and it has been projected that by the year 2050, the number of elderly people would rise about 324 million (Age Care Statistics). India has thus acquired the label of “an ageing nation” with 7.7% of its population being more than 60 years old. The demographic transition is attributed to the decreasing fertility and mortality rates due to the availability of better health care services.

Siddha system of medicine is one of the primitive medical systems in India. In Siddha system of medicine, geriatrics is called as “Moopuiyal”. Siddha medicine plays as a major role in maintaining health of the elderly and emphasize immortality. Siddha System of medicine is twined with life style of the elderly as they have a traditional fragrance and native approach. Undoubtedly the strength of Siddha in the context of Geriatric care is Kaya Karpam therapy, which is unique because of its ability to promote longevity and influence all aspects of health in a positive way.The main utility of Kaya Karpam therapy is in functional and degenerative disorders that have a chronic or long standing nature. In such cases, in fact, Kaya Karpam is the only solution from the point of view of effective management in any system of medicine. Kayakarpam becomes more fruitful and effective if it is preceded with suitable purificatory therapy.

Global health scenario in geriatrics

The twenty-first century is witnessing a gradual decline in fertility, and with increase in life expectancy, the society will need to grapple with issues of longevity. The cause of morbidity and mortality world over is shifting from communicable diseases a few decades ago to non-communicable diseases. The leading causes of mortality among aged people comprise respiratory problems, heart diseases, cancer and stroke. Significant causes of morbidity among this group is chronic inflammatory and degenerative conditions such as Arthritis, Diabetes Osteoporosis, Alzheimer’s disease, Depression, Psychiatric disorders, Parkinson’s diseaseand age related urinary problems.

Limitations of conventional medicine in the management of non-communicable diseases

The stupendous success of conventional medicine in the management of communicable disease especially in the west was owing to the identification of a single cause in the form of a parasite/causative organism for all communicable disease and a systematic plan of actionwas derived to counter the cause which then cured the disease.However, the biggest challenge with geriatric problem is that in most ofthe cases the condition cannot be attributed to a single cause or incertain conditions like neuro-psychiatric disorders (Senile dementia, Alzheimer’s depression), the structural cause is unknown. In such casesthe conventional medical therapy fails to come out with effective management plan and hence is severely compromised. Another challenge with conventional medical therapy is that it does not have health promoting agents. Siddha, on the other hand has interventions those enhance physiological processes that influence metabolic and immunological status and such interventions are significant in the context of geriatric care.