தமிழ் மருத்துவம்

In ancient India, people of knowledge, science and wisdom were known generally as Siddhars, and they were respected and played a pivotal role in modifying the society. They were the generators and custodians of philosophy and the knowledge base. In Siddha philosophy, the macrocosm and microcosms are reflections of each other. As is the macrocosm, so is the microcosm.

Siddhars believed in this principle and for them studying the body without an understanding of the universe made no sense. Siddha philosophy had its own whole worldview and cosmo-vision. The worldview and the Cosmo-vision in Siddha philosophy went with its own creation story. In contrast with many other creation stories, the creator did not have a prime place, according to the Siddha philosophy.

Siddhars assumed that the primordial universe always is and has always been under the influence of the primordial vibration. This vibration is personified with the sound of OM. The primordial universe created by OM in turn was constructed of the fundamental particles that created the material and conscious universe. The particle Chitta is the building block of matter as well as consciousness. Knowledge of Chitta unites the knower and the known as part of the wholeness in substance and awareness. According to Siddha, everything in the universe —from matter, energy, and consciousness—is part of a continuous spectrum.

COSMOLOGY AND PHILOSOPHY:
The ancient Dravidians (a name coined by Cadwell Bishop, a 19th century English linguistic anthropologist, ‘dravid’ being a Sanskrit word meaning ‘south’—ergo, ‘People of the South’) had a specific idea of who we are as humans, where we are and what is around us: We are made of the same material as the rest of the universe, which exists within us and is projected from us. The universe, according to Siddha Medicine, is an extension of who we are, which is the microcosm of everything.

Siddhars sought a tangible understanding of their cosmos and the fundamental building block of the universe. Their search led them on a quest to find the final indivisible particle, the fundamental unit of the material world.

After an indeterminate period of time, the primordial ocean of Chitta gave birth to matter and energy. The matter is called Shiva and energy is called Shakti. Matter is deemed masculine, energy is deemed feminine. These complimentary opposites did not have an independent existence and had to be in a dynamic union. Their union gave birth to the current structure of the universe with five elements or states of matter. The five states of matter in Siddha philosophy is the same as the four states of matter known to modern physics plus pure empty space. These five states of matter are called elements and are fundamental in the knowable universe. Siddha philosophy considers that life is a union of all the five elements or states of matter in the right proportion. The exact proportion of these elements constituting life is very important because when the proportion is imbalanced, health declines and a wide disparity is incompatible with life. The elements are called “Panchamaha bootham” (Five great elements). Life can only be generated from the living and life sustains on life this is symbolized in many cultures as the snake swallowing its own tail.

Shakti and Shiva can exist only in a dynamic union. From this dynamic union arose the five elements: Earth, Water, Fire, Air and Empty Space. In the human body, specific areas represent each of these elements. The correct ratio, or proportion, of these elements within the body is the basis of physiological order, disorder meaning their proportions have become imbalanced. These elements in harmony manifest health, whereas elements in disharmony lead to illness.

MUTHTHATHU OR THE GOVERNING FORCES :

Siddha medicine describes three major life governing forces or thathus. These life-governing forces were deduced to be the extensions of the component elements that made life. These are not abstract concepts as many authors believe. These thathus—namely vali, azhal and iyam—stand for some fundamental aspects of life: form, energy and movement.
Siddha medicine considers that the body is constituted mostly of the earth element and it is located in the space element. The elements of water, fire and air helps it to function. Theses three elements that confer functions to the body are called Tri Thathum (three functional elements). In general, the health and illness of the body is evaluated as an imbalance of just these three elements of water, fire, and air.

Muththathu Corresponding element
Vali Air
Azhal Fire
Iyam Water

The knowledge about the balances and imbalances of these functional elements are used in disease classification and in preventive health applications. The thathus are further classified into sub-thathus. Vali is divided into ten, Azhal is divided into five, and Iyam is divided into five sub-thathus. When diseases are classified, the thathu that predominantly is involved may be mentioned. Therefore, a particular disorder can be a Vali type, a Azhal type, a Iyam type, or a blend of all three.

THE RELATIVE PROPORTION OF THE FIVE element

the body is composed mostly of the earth element. The location of the body is in space. Think of your hand, the thumb standing for the earth element, the little finger standing for space, then the elements of water and fire and air, which are necessary for bodily functions, are represented by the pointer finger—Vali (air), the middle finger—Azhal (fire) and the ring finger—Iyam (water) , respectively. The basis of Siddha Medicine understanding is body-bases and we can see this knowledge in our hands. Excess or deficiency of one or more of these elements causes diseases and disorders, since it reflects functional disabilities.

There is a ratio between these elements, and this ratio must be a constant in diseases and major disturbances can be fatal. This ratio is the same in all life forms. Having a healthy ratio among the five elements is a pre-request to life and this law is applicable to all life forms—from a bacteria to a tree.


Element Quality/In Nature In the body In plants
Earth Form / Solid Limbs Roots
Water(Iyam) Motion / Liquid Abdomen Stem
Fire (Azhal) Heat / Plasma Chest Leaves
Air (Vali) Breath / Gas Neck Flowers
Space Location / Head Seeds
Emptiness

Siddha Medicine presupposes that the body is primarily stuctured out of the earth element. This body is located in space. Once its structure and location are established by earth and space elements, then its functions are determined by the elements of air (Vali), fire (Azhal) and water (Iyam). It is these three functions that are susceptible to imbalance, which we experience as illness. Siddha Medicine uses these elements, or thathus, in the classification of diseases and disorders.

Most disorders are assumed to start with an imbalance of Vali element (Vali thathu). Once this element is imbalanced, the mobility of the person or organ or system is impaired, leading to an imbalance in functions. The progression of the imbalance happens first in metabolism (Azhal) and finally in transport functions (Iyam). The progression of a disorder is felt usually as a slow progression. During this progression, the disease or disorder can be staged as primarily that of a thathu or as a mix of different thathus. The disorder can be of Vali type, Azhal type or Iyam type. It may also be Vali-azhal type, Vali-iyam type, Azhal-iyam type or tri-thathu imbalances involving all three thathus. Sometimes a particular symptom may be a predominating presentation where the disorder may be preceded by the symptom. A good example is a Rakta Vatha Gunmam

UDARTHATHU OR THE SEVEN TISSUE TYPES:
Siddha Medicine recognizes seven types of essential tissue in the body which supports all other tissues in its life and functions. These tissue types are called the seven dathus, which are the following:
Rasa (lymph): The importance of lymph was recognized by Siddha from very early periods. Lymph is considered to be the carrier of nutrients from the digestive process, and disorders of the lymph is dealt with in a serious manner.
Kurudhi (blood): Blood and human life are interwoven with one another. Disorders of blood or its reduced ability to function is a prime cause of disease according to Siddha Medicine.
Tasai (muscle): Muscles are important to give strength to body activities. Loss of muscle strength causes immobility and imbalance in the body. Conversely, an imbalance of Vali can cause muscle tissue to suffer from immobility imposed on it due to symptoms such as pain.
Kozhuppu (adipose tissue): Fatty tissue plays a very important role in the human body. The human body in balance should have a certain amount of fatty tissue. Fat is part of lipoproteins and many hormones. It is the other half of proteins in the make up of the cell membrane, the most intelligent entity in the cell next to DNA.
Elumbu (bone): Bone provides the primary physical foundation for a human being. Bone also acts as a safe area for the marrow tissue and is a depot of calcium, without which muscular activities are impossible.
Majjai (marrow): A healthy marrow is important not only to manufacture healthy blood but also for a strong immune system, since bone marrow is the area of blood-cell formation—red, white and platelets.
Sukkilam and Artavam: These are highly conserved tissues in the body according to ancient Siddha Medicine teachings. Siddha Medicine maintains that the emission of sperm should not happen more than once a day. This gives rest for the testis and adequately conserves valuable resources. Emissions more than once a day can cause many diseases and disorders generally called disorders of Madam. The same is the case of Arthavam or the menstrual fluids. A heavy menstrual flow or passing clots is considered a sign of imbalance and should be corrected without fail.

NADI OR THE ENERGY MERIDIANS
The human body consists of billions of cells existing for the preservation of individual life. These cells need clear communications about the body’s needs—such as nutritional requirements, its location in space and time, the availability of food, and its defense needs. Many of these signal transfers happen behind the scenes—that is, too subtly for our awareness.

The body, in the course of evolution, developed many signal collection systems. These systems are physical, chemical, electrical, and ionic. Even within each major signal collection method there are variations. Sometimes physical and chemical methodologies combine to convey a signal mode such as taste. One major energy channel in the body is called Nadi, which conveys information in the form of electricity. The Nadis are assumed to be 72,000 in number. Among them are the ten major Nadi trunks which supply electrical stimulus to all our major organs. All the main Nadi trunks pass through or near the spinal cord or originate from it. A similar school of thought is the basis of Acupuncture in China. .

VARMAMS OR THE ENERGY POINTS :
The other basic ingredient of importance in an over view of Siddha philosophy are the Varmams. Varmams are energy points in the body mainly located on the skin and adjacent tissue. Injury to these points is one of the causes of illness in the body according to Siddha sages. The electricity flowing through the individual Nadi is of very low voltage. Given the normal resistance of the skin, it would be impossible for the current to travel very far without the loss of signal strength. Here the Varmams come into play by acting as signal boosting stations! The functions of Varmams go much further than just step up transmitters. Varmams act as routing stations as well.
The branch of Siddha medicine practiced extensively in pockets of Tamil Nadu and Kerala and called Varma is intimately linked with the martial system of Kalari Payat, which was, and still is, taught in specialized schools called Kalari. This branch of science deals more with traumatology and accidental injuries.
Meridians of energy flow exist throughout the body. There are ten major energy trunks (Dasa nadi) and 72,000 minor energy channels (Nadi) that link every single one of the body’s many trillions of cells. The energy that flows through these channels is focused in certain areas of the body. There are 108 of these Varmams where energy is focused. Disruption of energy flow in these Nadi and Varmams can lead to illness. In order to revive the energy flow to its original state, the Siddha physician will apply massages, manipulations and stretches, in addition to external and internal herbal and herbo-mineral formulae.
Marma science was instrumental in Siddha Medicine, developing into the areas of trauma-associated blunt injuries and open injuries. Many local applications are used to address both open and blunt injuries, along with internal mediations. Fixed and removable casts were in use in Siddha Medicine until the development of orthopedic facilities in India.

PHARMACOLOGY:
Siddhars considered that all life is equal, sacred and has parallels in one another regardless of whether a life form is microbial, plant or animal. According to ancient sages, everything alive is composed of all five elements in the appropriate proportions. There are parallels given to animal appendages and body arts of plants, enabling physicians to treat medical conditions suffered on one part of the animal with a corresponding plant appendage. Since the microcosm and the macrocosm mirror each other, every part of the universe is considered medicinal and toxic at the same time. Metals and minerals occupy a very important part in Siddha pharmacology along with plants and animal parts and products. These chemicals are used in homeopathic doses after a thorough detoxification process requiring many days and combining with tens or hundreds of different medicinal plants.

Siddha Medicine, as a curative and preventive medical science, has many internal and external approaches to rectify illness and to promote wellness. Using thousands of plants and plant products and hundreds of animal and mineral products, Siddha Medicine has a pharmacopoeia containing hundreds of thousands of herbal and herbo-mineral formulae. A good outcome after a visit to a physician means the patient receives a good diagnosis and an apt remedy for the specific problem.

Here, disease classification assumes importance. Siddhars have classified diseases and disorders into 4,448 distinct entities. The basis of Siddha Medicine pathology is the understanding of anatomy and physiology. There are written texts describing each of the 4,448 pathological conditions; their salient history, signs, and symptoms in detail; plus a minimum of 64 different herbal and herbo-mineral formulations to heal each of these pathologies. Of these 64 different formulations, 32 are given externally and 32 are administered internally. After considering the causative and developmental factors of each disorder, the Siddha Medicine physician selects the correct formulations. The ease of administration, the taste of the formula, its effectiveness, and other factors are considered in selecting the specific formula.

Every formula was probably born from a simple observation that one plant was useful in successfully managing a condition. In repeating this same treatment on many patients with the same problem, a common observation pattern can emerge as to whether the plant is useful or not in a wide range of the populace. When a plant is accepted as effective by a group of Siddha Medicine physicians, some may combine this specific plant with another one of similar quality to modify the qualities of that primary plant. The whole observation process is repeated over years. This experiential investigation finally leads to the formulation of a complex formula, with a ‘polishing’ process that extends over centuries.

Some treatment modalities are instituted as a result of extensive experiments. The theoretical basis of some of these therapies is a result of thought experiments and inquiries into possibilities. Siddha Medicine offers many external and internal techniques that are therapeutic as well as preventive. The foundation of these therapies is so strong that it can stand its ground even in this age of information and molecular biology. The fact that ‘low-tech’ Siddha Medicine ‘kitchen technology’ can yield sufficient quality and quantities of ‘molecules’ that elude the current limits of hi-tech mass production by modern pharmaceutical industry is awe-inspiring.
Siddha Medicine is essentially against the modern trend of investigating new formulations with just theoretical knowledge about plants. On that note, combining two plants having similar properties into one remedy may not yield a more potent combination. On the contrary, such an assumption can reduce the effectiveness of the combination by the active principles having an interaction within the combination, resulting in the formation of products that may not have any effect on the particular illness, or may well have an adverse effect. Siddha Medicine physicians have had thousands of years of practice to obtain the combinations with the most therapeutic benefit and the least side-effects. For that reason, new formulae are extremely rare in Siddha Medicine. In a lifetime, even a master physician may invent only three or four new formulae.
Siddha physicians generally prefer formulae of herbal origin. The second choice is animal products. The prevalent belief among practitioners is that, when a mineral is given internally or applied externally, an imbalance is created due to its chemical composition. Minerals are considered pure elements, which, by nature, induce an imbalance. Plants contain all five elements, so they are employed to restore balance. If a Siddha Medicine physician uses a mineral-based medicine, a plant-based medicine will also be prepared to restore the balance. In situations when a mineral or herbo-mineral combination needs to be used in spite of known adverse effects, an antidote for the adverse reaction will be used to ensure the health and happiness of the recipient.

The power to heal illness and extend life is attributed not only to plants, but also to animal products—like milk, ghee and musk. In general, Siddha Medicine uses more than 6,000 plants in its pharmacopoeia. In Siddha literature, all available animal products, including meat, are considered for their beneficial and adverse effects. Some plant products, some animal products and all minerals must be detoxified before the medicinal effects can be brought forth. Many commonly used medicinal plants, including ginger, may need detoxification to amplify their medicinal effect and to mask any adverse effect from the use of that particular herb or plant product.

Plants and plant products used in Siddha Medicine may not be available locally. Some must be shipped over long distances. When collecting plants and plant products, the Siddha physician must observe certain rules that govern the collection, preserving, and transport processes. The collection of certain plants can be done on only certain occasions. At another time, the plant may not be as medicinal, or certain toxins may be present in excessive amounts. Some plants are collected at night, and some are collected during the day. Some are collected while the moon is in the ascending phase, while others are collected during the descending phase. Some plants growing in the mountains are used, whereas the same species growing in the plain may not have the same effect. Thus, we can see the precision and care that Siddha Medicine physicians have inherited from the centuries and centuries of keen observation and practice by this longest medical lineage in the world.

NOI NADAL OR PATHOLOGY
Siddhars were keen on understanding the root of disorders. According to mythology and has already been mentioned, sages had the siddhi (‘power’ or ‘perfection’) to become the size of an atom among atoms and a subatomic particle among subatomic particles in order to delve into the fundamental causes and changes associated with a disease. In reality, the ancient researchers left no stone unturned to find causes and the respective solutions for medical problems. According to their observations, the causes of disease and their disorders are many, ranging from genetic predispositions that hound generations to environmental causes.

In Siddha Medicine, the factors that induce disorder in a healthy body are enumerated in detail. Harmony of the humors and elements are essential in maintaining a healthy body. Other factors are health of the tissues and the maintenance of a smooth vital energy flow (prana) through the ten major nadi (meridians) and to the rest of the 72,000 minor meridians. This energy flow is deeply linked to the biochemistry of the body.

In the human body, all organs, tissues, cells and organelles function within carefully determined parameters, which vary from individual to individual. Each and every cell has a specified acid/base balance range, a sodium/potassium balance range, a calcium range, energy carrier molecule ranges, and so on. These indices are carefully maintained by inputs from sensors located all over the body, and the body’s reaction to information received.

A healthy body is manifested through a range of healthy functions, including heart rate, respiratory rate, temperature, acid/base balance, to name a few. Pathogenesis in Siddha Medicine is explained on the basis of the interaction between the human body and external agents. These include pathogenic microbes, parasites, malnutrition, over-nutrition, or polluted air, water or food. The influence of one’s mind on one’s own health and the effect of adversities (stresses) are also recognized as pathogenic factors. In addition, the influence of spells or other spiritual forces are taken into consideration.

From the point of conception to the delivery of a healthy viable baby, the fetus can be exposed to five major health conditions. In addition to the parents’ physical characters and genetic make-up, other causative factors may include the mother inhaling polluted air or other toxins, trauma, inadequate dietary practices, excessive sun exposure, bouts of intense sadness, loss of sleep, or intercourse with partners with transmittable diseases. Physical excess and mental stress can also lead to fetal distress and fetal malformations. All the problems that can affect the fetus may manifest as maternal symptoms or fetal distress experienced by the mother. External and internal remedies can be given to the mother to correct the problems. Details of the intrauterine problems are outlined in Genesis of Life, by Agasthya in 800 poems written thousands of years ago.

After birth, a person is susceptible to 4,443 diseases. Of these 443 are common to humans and other animals. An approximate list is given below. With modern medicines and hygiene, we have eradicated or controlled some of these diseases. In spite of that fact, the remedies offered by Siddha Medicine may still give us an advantage, should the ‘passe’ diseases ever re-appear. A partial list of all the disorders known to Siddha Medicine is given below.
Head 307
Ear 7
Mouth 186
Neck 42
Nose 27
Cheeks 40
Forehead 40
Abdominal distension 30
Upper extremity 130
Back of Neck 10
Connective tissue 84
Convulsive disorders 30
Abdominal gas 8
Skin eruptions 66
Beetle bites 18
Spider bites 81
Skin disorders (other) 28
Prickly heat 20
Snake bites 27
Abdomen 556
Perinium 61
Other bugs 51
Skin parasites 60
Breathing disorders 300
Eczema 4
Burning of palm/ feet 100
Sinus related 96
Low metabolism/
weight gain 83
Feet and legs 190
Thigh 201
Upper back 306
Breast 42
Male reproductive 185
Jaundice 8
Female reproductive 108
Chest 63
Palm 40
Poxes 63