Siddha Reviews

Independence Day Special Issue - 15/08/2017

A REVIEW ON MEDICINAL BENEFITS OF PIPER LONGUM

G.Kiran1, S.Umera2, K.Balagurusamy3

1. FINAL YEAR BSMS, VELUMAILU SIDDHA MEDICAL COLLEGE, SRIPERUMBUDUR.

2., ASSISTANT PROFFESSOR, VELUMAILU SIDDHA MEDICAL COLLEGE, SRIPERUMBUDUR.

3., VELUMAILU SIDDHA MEDICAL COLLEGE, SRIPERUMBUDUR.

 

ABSTRACT

Piper longum (thippili) is an important plant used in treating respiratory ailments such as cough (irumal), asthma (iraippu), tuberculosis (illaippu). It is also potential in curing organ related disease such as throat disease, ear and eye disease. As it possess carminative property, it is a best one in treating abdominal related disorder such as indigestion, peptic ulcer (kunmam) and abdominal discomfort (porumal). It has a powerful aphrodisiac action for men which increases sexual desire. As it possess anti-diabetic activity, it is used in controlling diabetes. It also acts as anti-asthmatic, anti-carcinogenic, anti-amoebic, anti-bacterial, anti-snake venom, cardio protective, hepatic protective which will be discussed in this article.

  KEYWORDS

            Thippili, aadhi marunthu, respiratory ailments, hepato protective, aphrodisiac action, anti-diabetic activity.

  

INTRODUCTION

Piper longum is majorly cultivated in southern India and some lower parts of Bengal(1). It is called as Indian long pepper, well known for its fruit which is dried and traditionally used as spice(2). The fruit of piper longum in fresh form (without drying) has a greenish brown colour, after drying it attains brown colour(3). Piper longum can be used as a rejuvenator in treating white patches (themal) a type of skin disease(1). Thippili rasayanam which has a thippili has a major constituent has a powerful therapeutic action in curing respiratory ailments(4). In combination with other herbs piper longum helps in curing vaginal discharge (vellai) and menorrhagia (paerumpadu)(1). It is also used in treating neurological disease such as hemiplegia and sciatica(5).

 

BOTONICAL DESCRIBTION

Botanical name(2): piper longum

Family(2): piperaceae

Common names(2): long pepper, Indian long pepper.

Tamil names(1): aadhi marunthu, ambu, vaithaegi, kaaman, aargathi.

Sanskrit name(1): pippali. 

PLANT DESCRIPTION(5)

Piper longum is a small shrub. It has large woody root and the leaves are alternate, spreading, without stipules and blades varies largely in size. The lowest leaves size about 5-7 cm long and the upper most size about 2-3 cm long. The flowers are in solitary spikes. The fruits are berries, arranged in fleshy spikes which is thick, oblong and blunt.

 VARIETIES OF THIPPILI

According to siddha literature there are two types of thippili, they are arisi thippili and yaanai thippil(1).Scindapsus officinalis(6)which belongs to araceae family(6)is called as yaanai thippili. In present the arisi thippili is called as dried fruit of piper longum and kanda thippili is called as the root of the same plant(7).The fruit of Helicteres isora is called and sold as murukku thippili(8) which belongs to malvaceae family(9).                                                

Parts used (5)

Fruit and root.

Siddha pharmacodynamics (1):

The fruit (fresh) without drying has following pharmacodynamics,

Taste (suvai): sweet (inippu) i.e less pungent

Sub-taste (pirivu): sweet (inippu)

Natural property (thanmai): coolant (thatpam), so it induces kapha which pacifies pitha.

The fruit (dried) after drying has following pharmacodynamics,

  Taste (suvai): strong pungent (kaarppu)

   Sub-taste (pirivu): sweet (inippu)

Natural property (thanmai): heat stimulator (veppam), so it induces pitha which pacifies kapha.

Action(1)

It has following therapeutic action (seigai),

                       -Stimulant (veppam undaki)

                       -Carminative (agatuvayu agatri)

 

Chemical constituents(5)

The fruit contains major chemical constituents such as piperine, piperanine, pipermonaline, piperundecalidine, guineensine, piellitorine, brachyamide A and brachyamide B. The root contains piperlongumine, piperlingumine and sesamin.

Medicinal uses

Piper longum in combination with Strychnos potatorum is used in treating vaginal discharge (vellai) and menorrhagia (perumpadu) (1). The powdered fruit of piper longum and terminalia chebula (kadukai) with honey is helpful in treating tuberculosis (1). The leaf extract of piper betle and powdered fruit of piper longum with honey eliminates cough with sputum and fever (1). The powdered fruit of piper longum with sugar and ghee act as an aphrodisiac for males which increases sexual desire (libido) (1). The powdered fruit of scindapsus officinalis is also used in treating respiratory ailments, abdominal discomfort and dysphonia (kural kammal)(10). The decoction of root of piper longum used in treating sciatica, hemiplegia and it also given for eliminating snake poison(5). The fruit decoction is used as aremedy for gonorrhoea and menstrual pain(5).Helicteres isora is used in treating diarrhoea and eliminating intestinal parasites(11). The paste of the fruit of scindapsus officinalis is applied for curing rheumatism and also possess aphrodisiac action(12). The dried fruits of piper nigrum, piper longum and dried rhizome of zingiber officinale in powdered form is called as thirikaduku chooranam which promotes a better digestion and prevents stomach ailments(1) (5). Thippili rasayanam which has a piper longum as a major constituent is used in treating respiratory disease such as asthma and tuberculosis(4).

 

PHARMACOLOGICAL ACTION

-Hepatic protective(13)

The ethanol extract and butanol fraction of fruits of piper longum has proved to have a stabilizing effect on hepatic cells in wistar rats of carbon tetrachloride induced liver injury in which they decreased the levels of serum glutamic oxaloacetic transaminase and serum glutamic pyruvic transaminase.

-Cardio protective (14)

 The methanolic extract of fruit of piper longum has proved to have a effective cardio potential against myocardial oxidative stress induced in male wistar rats by preventing iso preterenol-induced cellular damage in heart tissue.

               -Anti-diabetic activity (15)

            The aqueous extract of fruit of piper longum has a anti-hyperglycaemic effect on streptozotocin induced diabetes in wistar albino rats as it reduced the blood glucose level to minor point.

               -Anti-asthmatic activity (16)

                The petroleum ether extract, alcoholic extract and decoction of fruit of piper longum has a inhibitory effect on histamine induced bronchoconstriction in guinea pigs.

               -Anti-carcinogenic activity (17)

               The alcoholic extract of piper longum has a growth inhibitory effect on solid tumour which is induced by Dalton’s lymphoma ascites (DLA cells) in male swiss albino mice. 

               -Anti-amoebic activity (18)

 The methanol extract of piper longum has proved to act as anti-amoebic activity against caecal amoebiasis induced by entamoeba histolytica in mice.

               -Anti-bacterial activity (19)

                            The ethyl acetate extract of fruit of piper longum has a sensitive effect on staphylococcus aureus, vibrio cholera and pseudomonas aeruginosa which is done by using disk diffusion method.

               -Anti-snake venom activity (20)

  The ethanolic extract of fruits of piper longum has a anti-snake venom action as it inhibited haemorrhage, defibrinogenation and inflammatory paw edema in mice and mast cell degranulation in rats.

 

Some sasthric preparations – Thippili as main ingredient

 

S .no  

Name of the preparation

Indications

1.

Thippili leghiyam(21)

Respiratory aliments

2.

Thippili rasayanam(4)

Cough , Tuberculosis, Asthma

3.

Thippili urundai(22)

Thimiram( it is an eye disease causing darkness of vision due to prevailing of  vayu in the layers of membrane)(21)

4.

Kankasa mathirai(4)

Pterygium

5.

Yemadhanda kulligai(4)

Pneumonia ( kabavatha suram)

6.

Korosanai thugal (4)

Anemia (pandu),

Ascites (peruvairu)

Sinusitis ( peenisam)

Fever (suram)

7.

Sivanar amirtham(4)

Haemorrhoids(moolam)

Ascites (peruvairu)

Scorpion sting ( theal kadi)

Fits ( sanni)

8.

 Kunma kudori melugu(4)

Dysmenorrhoea ( soothaga vayu)

Peptic ulcer ( kunmam)

Indigestion (ageeranam)

 

 

CONCLUSION:

Thus piper longum is traditionally important plant in curing respiratory ailments because of its natural heat stimulating action (veppam viryam) which pacifies kapha kutra, the main cause of respiratory problems. Because of its strong carminative property, it is the best one in treating abdominal related disorder such as indigestion, dysentery and abdominal discomfort. As it possess anti-hyperglycaemic and anti-hyperlipidaemic activity, it can be given for diabetes in the name of venthamarai chooranam which contains piper longum as one of the constituent in it. Piper longum in combination with other herb will be best one in treating vaginal discharge and menorrhagia. Further research should be made to bring out aphrodisiac action of piper longum which can be given as a promoter of fertility for patients who suffer from sex related disorder.

 

REFERENCES

1. K.S.Murugaesa mudhaliyar; siddha material medica (gunapadam-muligai vakuppu),Dept of Indian Medicine and homeopathy, 1st edition; 2013,(pg.no:514-517).

2. https://en.m.wikipedia.org/wiki/Long_pepper ; (last edited on 15 feb 2017).

3. Sharma vinay et al., pharmacognostical and phytochemical study of piper longum l. and piper retrofractum vahl; journal of pharmaceutical and science innovation; 25th jan 2012.

4. K.N.Kupuswamy muthaliyar, K.S.UIthamarayan; siddha vaithiya thirattu,Dept of indian Medicine and homeopathy, 5th edition; 2014, (pg.no:235-236, 234, 9, 7, 161, 162, 201).

5. S.Sankaranarayanan; medical taxonomy of angiosperms, 1st edition; 2009, (pg.no:719-720).

6. https://en.m.wikipedia.org/wiki/Scindapsus ; (last edited on 6 dec 2015).

7. www.rasakitchen.com/kanda-thippili-arisi-thippili-rasam-remedy-cold-tiredness/ ; (nov 21, 2016).

8. http://www.zaapr.com/impex/data/search/murukku-thippili-helicteres/hscode/all/country/all/india-port/all/unit/all/time-period/all/date/all/exports/page/1

9. https://en.m.wikipedia.org/wiki/Helicteres_isora ; (last edited on 26 jan 2017).

10. K.S.Murugaesa mudhaliyar; siddha material medica (gunapadam-muligai vakuppu),Dept of indian Medicine and homeopathy, 1st edition; 2013, (pg.no:518).

11. http://easyayurveda.com/2015/06/03/helicteres-isora-avartani-uses-dose-research-side-effects/

12. Kaushik pawan et al., Scindapsus officinalis: A Comprehensive review; international journal of pharmaceutical erudition; aug 2012, 2(2), 18-27.

13. S.S.Jalalpure et al., hepatoprotective activity of the fruit of piper longum linn; indian journal of pharmaceutical sciences; 2003, 65(4):363-366.

14. Archana r.juvekar et al., protective effect of piper longum fruits against experimental myocardial oxidative stress induced injury in rats; journal of natural remedies; vol.9/1 (2009) 43-50

15. md.Suban ali et al., antidiabetic and antioxidant activities of piper longum root aqueous extract in STZ induced diabetic rats; journal of pharmacy and chemistry; vol 6; issue 3; sep 2012; pg.no:30-35.

16. Dhirender kaushik et al., in vivo and in vitro antiasthmatic studies of plant piper longum linn.; international journal of pharmacology,2012.

17. E.S.Sunila ‘anticancer,antimetastatic and immunomodulatory activity of medicinal plants-piper longum and thuja occidentalis’,amala cancer research centre,university of Calicut,2006.

18. Nongyao sawangjaroen et al., effects of piper longum fruit, piper sarmentosum root and quercus infectoria nut gall on caecal amoebiasis in mice; journal of ethnopharmacology 91 (2004) 357-360.

19. Chandan singh et al., in vitro antibacterial activity of piper longum l. fruit; international journal of pharmaceutical sciences; 2013, 89-91.

20. P.A.Shenoy et al., anti-snake venom activities of ethanolic extract of fruits of piper longum l. (piperaceae) against russell’s viper venom: characterization of piperine as active principle; journal of ethnopharmacology, 20 may 2013, vol.147(2) :373-382.

21.T.V. Sambasivam pillai; siddha encyclopedic dictionary; Dept of indian Medicine and homeopathy; vol 4(II); 2nd edition; (pg.no:1041, 1045).

 

22. Dr. K.S. Uthamarayan; siddhar aruvai maruthuvam; Dept of indian Medicine and homeopathy;6th edition; 2013; (pg.no:221).

 

 

 World Siddha Day Special Issue.  14 April 2017

 

MANAGEMENT OF ERAIPPU NOI {BRONCHIAL ASTHMA} IN SIDDHA MEDICINE – A SYSTEMATIC REVIEW.

*F.MOHAMAD ASHIF, *S.SANGEETHA, *R.PREETHI, **K.ELAVARASAN, ***R.GEETHA.

*UG scholar, **Lecturer, *** Associate Proffessor, Dept.of Sool Magalir Maruthuvam.

RVS Siddha Medical College, Coimbatore. 

 

ABSTRACT:

     Asthma is a chronic disease characterized by recurrent attacks of breathlessness and       wheezing, which vary in severity and frequency from person to person. Symptoms may occur several times in a day or week in affected individuals, and for some people become worse during physical activity or at night. During an asthma attack, the lining of the bronchial tubes swell, causing the airways to narrow and reducing the flow of air into and out of the lungs. Recurrent asthma symptoms frequently cause sleeplessness, daytime fatigue, reduced activity levels and school and work absenteeism. Asthma has a relatively low fatality rate compared to other chronic diseases. In Siddha system of medicine there are so many herbals and herbal formulations are indicated as a valuable drug for asthma. This present paper review and analyse the therapeutic value of some Siddha herbals  such as Andrographis panniculata , Curcuma longa ,Piper longum ,Justiciaadathoda, Glycyrrhizaglabra, Zingiberofficinaleetc, with their research findings for the management of asthma.

Key words: Asthma, Herbals, Siddha medicine, chronic bronchitis.

 

INTRODUCTION

            Asthma is common long term inflammatory disease of airways of the lungs . It is characterized by  variable and recurring symptoms,reversible airflow obstraction ,and bronchospasm .symptoms include episodes of wheezing ,coughing,chest tightness and shortness of breath. These episodes may occur a few times a day or a few times per week. Depending  on the person they may become worse at night or with exercise.

           Asthma is thought to be caused by a combination of genetic and environmental factors. Environmental factors include exposure to air pollution and allergens. Other potential triggers include medications such as aspirin and beta blockers. Diagnosis is usually based on the patens of symptoms, response to therapy overtime , and spirometry .

Symptoms may occur several times in a day or week in affected individuals, and for some people become worse during physical activity or at night.

Asthma attack

During an asthma attack, the lining of the bronchial tubes swell, causing the airways to narrow and reducing the flow of air into and out of the lungs. Recurrent asthma symptoms frequently cause sleeplessness, daytime fatigue, reduced activity levels and school and work absenteeism. Asthma has a relatively low fatality rate compared to other chronic diseases.

 

Key facts

  • Asthma is a chronic disease of the bronchial, the air passages leading to and from the lungs.
  • Some 235 million people currently suffer from asthma. It is the most common chronic disease among children.
  • Most asthma-related deaths occur in low- and lower-middle income countries.
  • The strongest risk factors for developing asthma are inhaled substances and particles that may provoke allergic reactions or irritate the airways.
  • Chronic inflammatory disease of the airways and most common childhood chronic disease470,000 hospitalizations/yr
  • Medication can control asthma. Avoiding asthma triggers can also reduce the severity of asthma.
  • Appropriate management of asthma can enable people to enjoy a good quality of life.

 

The causes

The fundamental causes of asthma are not completely understood. The strongest risk factors for developing asthma are a combination of genetic predisposition with environmental exposure to inhaled substances and particles that may provoke allergic reactions or irritate the airways, such as:

  • indoor allergens (for example, house dust mites in bedding, carpets and stuffed furniture, pollution and pet dander)
  • outdoor allergens (such as pollens and moulds)
  • tobacco smoke
  • chemical irritants in the workplace
  • Air pollution.

Other triggers can include cold air, extreme emotional arousal such as anger or fear, and physical exercise. Even certain medications can trigger asthma: aspirin and other non-steroid anti-inflammatory drugs, and beta-blockers (which are used to treat high blood pressure, heart conditions and migraine).  Urbanization has been associated with an increase in asthma. But the exact nature of this relationship is unclear.

Reducing the asthma burden

Although asthma cannot be cured, appropriate management can control the disease and enable people to enjoy a good quality of life. Short-term medications are used to relieve symptoms. People with persistent symptoms must take long-term medication daily to control the underlying inflammation and prevent symptoms and exacerbations.

Medication is not the only way to control asthma. It is also important to avoid asthma triggers - stimuli that irritate and inflame the airways. With medical support, each asthma patient must learn what triggers he or she should avoid.

Although asthma does not kill on the scale of chronic obstructive pulmonary disease (COPD) or other chronic diseases, failure to use appropriate medications or to adhere to treatment can lead to death.

PHARMACOLOGICAL INTERVENTION OF HERBS AND ITS USE FOR ASTHMA

MANAGEMENT:

            In Siddha literatures, there are so many herbals are indicated as a valuable drug against the symptoms of asthma. Here some herbals for managing asthma are going to discuss with their research findings.

1)      1.Justicia adathoda:

i)        Vasicinone is an active principle has been isolated from adathodavasica possess

      bronchodilator activity.

ii)      Some mucolytics such as benzylamines, bromhexine and ambroxol have been isolated from this plant are very effective in the management of asthma.  This plant shows anti inflammatory, antispasmodic activity and it has some active principles such as phenols, tannins, alkaloids,anthraquinones,saponins,flavonoids,amino acids and reducing sugar.

 

Use:The dried leaves are used in smoking  in the treatment of bronchial asthma.

2.Glycyrrhiza glabra:

                        This plant contains active principles such as a saponin named Glycyrrhizin is a mixture of potassium and calcium salts of 18 beta glycyrrhizic acid also known as glycyrrhizic or glycyrrhizinic acid and a glycoside of glycyrrhhetinic acid. This plants has some triterpenes called liquiritic acid,  glycyrretol, glagrolide, isoglaborlide and liquorice acid. It also has some flavonoids and coumarins,phenols and sterols. Glycyrrhiza produce demulcent and expectorant effects by stimulating tracheal mucus secretions. Glycyrrhia compounds are very effective in reducing chemokine production. It also acts as a bronchodilator and plays an effective role in the management of asthma.

3.Zingiber officinale:

                        Research studies found that through blockade of plasma membrane ca channels,ginger inhibits airway obstruction and associated ca 2 signalling in murine airway smooth muscle cells. Research evidence shows that rhizomes of Zingiber officinale act as a bronchodilator.

         Use:Fresh ginger juice with a cup of fenugreek and honey act as an expectorant in relieving asthma.

4.Taxus buccata:

            Research evidence shows that the alcoholic extract of  Taxusbuccata not only hasbronchodilatingactivity,by decreasing the infiltration of inflammatory cells in the airway and inhibiting the result of histamine it decreases bronchial hyperactivity. In Siddha literatures, this plant and the formulation of this plant acts as an expectorant and plays a significant role in the management of chronic obstructive pulmonary disease.

          Use:The leaf powder of Taxus buccata mixed with adathoda leaf extract and small quantity of honey helps in curing asthma.

5.Andrographis panniculata:

            Andrographolide is an active principle has been isolated from this plant has been shown to activate the nuclear factor erythroid 2 related factors and promoted inductions of glutathione peroxidise (GPx) and glutathione reductase activities in lungs from cigarette smoke exposed mice. Research evidence shows that via agumentation of Nrf 2 activity I possess antioxidative properties against cigarette smoke induced lung injury. It shows some beneficials effects in treating the symptoms of asthma.

6.Curcuma longa:

            Based on research findings curcuma longa and its constituents possess bronchodilator activity. It is found that in NTHi( non-typeablehemophilusinfluenzae) induced mice circumin effectively suppresses asthma like airway inflammation through dietary administration.

          Use:The combination of turmeric powder and honey is an effective method for the treatment of asthma.

7.Piper longum:

            In Siddha literatures , this plant indicated as an expectorant. And also research findings shows that piperineis an active constituent from piper longum possess anti tussive and bronchodilator activity.  On Endothelial cells piper longum and its analogues inhibit TNF alpha induced expression of ICAM-1.so, it shows anti inflammatory activity. This herb showing progress in the management of asthma exacerbations.

        Use: The dried part of the plant is used for the treatment of asthma.

8.Piper nigrum:

            On rat models the milk extract of Piper nigrum was found effective in passive cutaneous anaphylaxis. Methanolic extract of this plant shows an in vitro inhibitory effect on compound 48/80-inducedhistamine release from rat peritoneal mast cells. In Siddha texts this herb indicated as a best remedy for asthma. It possess bronchodilator activity.

        Use:The powder of black pepper mixed with turmeric powder and small quantity of ghee helps for the removal of asthma.

9.Boerhaevia diffusa:

            The flavonoids isolated from Boerhaeviadiffusa immune suppressive property which are associated with asthma. In Siddha texts this plant is indicated as an effective drug for kapha related diseases.

        Use: The aqueous extract of the root is used for thetreatment of asthma.

10.Ocimum grasstimum:

            In airway epithelial cell BEAS-2B the aqueous extract of Ocimumgrasstimum inhibits lipopolysaccharide induced interleukin-6 and interleukin-8 expression. This plant shows an effect in asthma management.And also some herbals such as Albiziaodoratissima, Elaeocarpussphaericus,Terminaliabellerica,Anisochiluscarnosus ,Leucasaspera, Allium cepa,Tylophoraindica ,Nyctanthes arbour tristis, Solanumtrilobatum, Solanum xanthocarpum,Mukiamaderaspatana,Borassu flabellifer,Calotropisgigantea, Crocus sativus are indicated as an effective in the management of kapha diseases. These plants and their acive constituents shows effectiveness in the management of asthma.

         Use:The aqueous extract of the leaf has an anti-asthmatic effect

TREATMENT:

         In siddha system, purgatives should be given before starting the treatment. [sanjeevi tablet (1 or 2) is also given with the Daemia extensa juice (4 or 5) drops for purgation.].

            

   SIDDHA HERBO- MINERAL FORMULATIONS TO MANAGE ASTHMA:

SL.NO

 

            FORMULATION

      MAJOR INGREDIENTS

                          INDICATIONS

1.

Thalisathichooranam

Thalisam,thirikadugu,thiripala,

Saathipathiri,lavangapathiri,elam

Athimadhuram,perungayam,sirunagapu

Vaivilangam,kottam

Hoarseness of voice, coryza

 

2.

Thirikadugu

Sukku,milagu,thippili

Cold, cough,dyspnea

 

3.

Korosanaimathirai

Korosanam,kungumapu,pachaikarpuram,

Sathikkai,elam,koshtam,akkiragaram,

Karpooram,rasa chendooram,appiraga

Parpam.

Breathlessness,

 

4.

Suwasakudorimathirai

Vellerukkampoo,milagu.

Dyspnea, cold

 

5.

Aadathodaimanappagu

Aadathodai ilai.

Reduces phlegm

 

6.

Thudhuveelainei

Thudhuvalai,mulli,kandangathiri,

Kanchori,adathodai,thirikadugu,

Thirpala,kirambu,seeragam,thalisam.

Chronic Cough,

 

7.

Pavalaparpam

Thipillirasayanam

Pavalam,karumbu rasam.

Wheezing,reduce excessive sputum production

 

8.

Gowrichindhamani

Rasam,kanthagam,porigaram,

Thirikadugu.

Wheezing,dyspnea

9.

Kasthurikaruppu

Kasthuri,Pachaikarpooram,kungumapu,

Korosanam,lingam,pooram,kandhagam,

Thalagam,manoseelai,rasam,thippili

Cold, cough, wheezing

 

10.

Purnachanthrodhayam

Rasam,kanthagam,thanga rekku.

 Chronic cough, Wheeze

 

 

CONCLUSION:

            The present scenario of the world in which many non communicable diseases play a threatful role in affecting the quality of life. Though many currently available drugs for the management of asthma, there is a need of drug for asthma with lesser adverse effects. This research results in the discovery of many medicines which were used traditionally. Among the above listed Siddha herbals and Siddha herbo mineral formulations provide the right path for the management of the disease.  Many scientific researches and pharmacological studies related with the above preparations support in the treatment of asthma. This article might be helpful in evaluating the mode of herbals and herbo-mineral formulations indicated in Siddha system of medicine for the management of asthma.

 

ACKNOWLEDGEMENT:

       My sincere thanks to the Principal, RVS Siddha medical college and hospital.

 

REFERENCES:

1)      Sundeep S Salvi, Roslina Manap, Richard Beasley, Primary care respiratory journal,vol 21,issue 3,sep 2012 pages 249-251.

2)      D.R.Mehta,J.S.Narovane,R.M.Desai, J.Org.che,1963,28(2),pages:445-448.

3)      John  M.Grange, Noel J.C.Snell ,journal of ethnopharmacology,vol.50.issue1,jan 1996,pg:49-53.

4)      A.Karthikeyan, V Shanthi, A.Nagasathaya, international journal of green pharmacy, year 2009/vol.3, issue: 1, pages 78-80.

5)      Sachiko Matsui,Hiroatsu MatsumotoYoshiko SonodaKumi Ando,   Eriko Aizu-Yokota, Toshitsugu Sato, Tadashi Kasahara, international immune pharmacology, vol.4, issue 13, 2004,page 1633-1644.

6)      Muhammad N. Ghayur, Anwar H. Gilani, Luke J. Janssen, Canadian journal of physiology and pharmacology, vol.80,N.o.5 may 2008.

7)      Thitiyamangprayol, sanjeevkupittayanant, nuannoichudapongse, fitoterapia, vol.89 sep 2013, pages 68-73.

8)      Pkpatel, k v patel and T R Gandhi, journal of young pharm.2011, jan-mar;3(1):41-47.

9)      Guan SP, Tee W, Ng DS, Chan TK, Peh HY, Ho WE, Cheng C, Mak JC, Wong WS,Br J Pharmacol. 2013 Apr;168(7):1707-18. doi: 10.1111/bph.12054.

10)  S.J. MoghaddamP. BartaS.G. MirabolfathinejadZ. Ammar-AouchicheN. Torres GarzaT.T. Vo, Robert A. NewmanBharat B. Aggarwal,   Christopher M. EvansMichael J. Tuvim, Reuben Lotanand   Burton F. Dickey,Oxford Journals ,Life Sciences & Medicine, Carcinogenesis Volume 30,Issue 11 Pp. 1949-1956.

11)  Dr. K.N.Kuppusamymudhaliar, Dr.K.S.Utthamarayan, Siddha vaidhyathirattu.

12)  Vaidyarathnam Dr. K.S.Murugesamudhaliar, mooligai –gunapadam.

13)  Dr. M. Shamugavelu,HPIM., Line of treatment in siddha part-1pages-151-155.

 
 
 
 

 SEIZURES IN SIDDHA SYSTEM OF MEDICINE - A REVIEW

*N.SOWMYA, *G.NAVEENA, **K.ELAVARASAN, ***M.MENAKA, ****M.KARTHIKEYAN

* UG Scholars, ** Lecturer, *** Associate Professor, Dept of External therapy, varmam and puramaruthuvam, **** Principal, RVS Siddha Medical College and Hospital, Coimbatore, Tamilnadu.

E-mail: drsowmyaiyengar@gmail.com

ABSTRACT:

Seizures called as Valippu in siddha traditional system of medicine is one of the most common serious neurological disorders. The descriptions, etio-pathology and some aspects of treatment of the Seizure disorders in Siddha System of Medicine mentioned as

‘If more or less,three humors cause disease

                The learned count the wind is the first of these.’

-Medicine,Thirukkural.

              In prevalence, about 1% of people worldwide have epilepsy and nearly 80% of cases occur in infants and elderly in developed countries. Epilepsy is characterized by recurrent,episodic,paroxysmal involuntary clinical events associated with alternation of cerebral function.An Epileptic attack is an abrupt and excessive electric discharge of cerebral neurons,where there is a transient loss of consciousness in the patient which may vary from few seconds to few minutes.Siddha explains imbalance in the three humors vatham,pitham and kabham singly or al together can cause Valippu.A modern anti-epileptic drug suppresses the seizures but do not cure the disorder and having adverse effects, contraindications and sometimes requires life-time treatment. On the other hand,Siddha believes in balancing humors to remove the root causes of the disorders and normalize the brain activity.

KEY WORDS:

Seizures, Valippu, Siddha system of Medicine.

 

INTRODUCTION:

A Seizure can be defined as the occurrence of signs and symptoms due to abnormal,excessive or synchronous neuronal activity in the brain.Epilepsy is the tendency to have unprovoked seizures.Epilepsy can occur both in children and adults.  In most Siddha texts,Epilepsy has been mentioned as Valippu and has been described as one of the earliest diseases known (diagnosed)that can be controlled only with medical therapies and can sometimes be incurable and remain uncontrolled.  Epilepsy is a condition where there is a transient loss of consciousness in the patient for a certain period of time which may vary from few seconds to few minutes with or without falling down.

Siddha explains Epilepsy as Valippu as the imbalance in three humors vatham,pitham, kabam singly or all of them together can cause Valippu.Aggravated humours get accumulated in heart and produce the features based upon humoral predominance,which cause illusion of the mind and visual hallucination and seizures(tonic spasms & clonic jerks).Often it is presented with outwarding tongue,deviation of the eyes, drooling of saliva with froth,tonic and clonic movements of limbs.

ETIO-PATHOLOGY:

ACCORDING TO MODERN SCIENCE:

In the normally functioning cortex, recurrent and collateral inhibitory circuits limit synchronous discharge amongst neighboring groups of neurons.Epileptic Cerebral Cortexexhibits hyper-synchronous repetitive discharges involving large groups of neurons. Intracellular recordings shows bursts of rapid action potential firing,with reduction of transmembrane potential.  Hyper synchronization -means that a hyper excitable neuron will lead to excessive excitability of a large group of surrounding neurons excessively fired leading to clinical manifestations of seizure.Cells undergoing repetitive epileptic discharges undergo morphological and physiological changes which make them more likely to produce subsequent abnormal discharges (kindling). It is likely that both reduction in inhibition systems and excessive excitation play a part in genesis of seizures activity.

Hyper-excitability results due to increased excitatory neuro-transmissiondecreased inhibitory neuro-transmission.Alteration in voltage gated ionic-channels,intra-extracellular ionic alternations in favour of excitation.

Excitatory neuro-transmitters: Glutamate

Inhibitory neuro-transmitters: GABA-two types: A& B.

 

 

ACCORDING TO SIDDHA MEDICINE:

Siddha explains Valippu as that of  the reason where the humor, Kabam distributes all over the body especially in the chest region and trachea and affects the pancha-pulangal (taste, vision, sense, sound, smell) leading to disturbance of actions of hands, legs, anus, vagina, mouth.

CAUSES:

ACCORDING TO MODERN SCIENCE:

IDIOPATHIC: In primary generalized seizures, simple partial seizures,focal motor seizures of childhood the cause is unknown.Some genetic predisposition may be a factor.

SECONDARY CAUSES:Seizures occur due to cerebral disorder or non-cerebral disorder. i.e.,

Infective causes-Encephalitis

                            Cerebral malaria,

                            Aseptic,

                            Tubercular pyogenic meningitis,

                             Intracerebral abscess,

                             Neurocysticercosis,

                              Toxoplasmosis,

                               HIV.

Metabolic disorders-Hypoglycemia,

                                  Hyponatremia,

                                  Hypocalcemia,

                                  Hypokalemia,

                                  Hypomagnesimia and hepatic encephalopathy,

                                  Ketoacidosis,Non-ketotic hyperosmolar coma.

Cerebro-vascular disorders-Cerebral infarction

                                             Cerebral hemorrhage,

                                              Vasculitis syndrome

Tumors

                                              Asphyxia.

Trauma (including neuro-surgery).

ACCORDING TO SIDDHA SCIENCE:

Increased body heat,

                                              Walking for a long distance,

                                              Angerness,

                                              Bad behavior and worse thoughts,

                                              Increased sexual activity,

                                              Not following the seasonal regimen,

      Taking food against humoral equilibrium such this increases the kabam.

CHARACTERISTICS:

The characteristic features of seizures are commonly:

                                                Loss of consciousness,

                                                Feeling of entering into darkness and hallucination.

       It is often presented with falling down suddenly,outwarding tongue,deviation of eyes, drooling of saliva with tonic-clonic movements of the limbs

       This stage may last for few seconds to few minutes till dhoshas present in the vitiated places and then passes to relaxation phase when they diminish.

PREMONITORY SYMPTOMS:

      MODERN MEDICAL SCIENCE

SIDDHA MEDICAL SCIENCE

   Deviation of eyes

Kan sorugal

   Auditory hallucinations

Arivu kedu

   Loss of interest in food

Unavil veruppu

   Excessive salivation

Vai neer urral

  Gurgling sound in stomach

Vayir iraidhal

  Feeling of darkness

Kan erulal

  Giddiness

Mayakam(thalai sutral)

SYMPTOMS/SIGNS:

 

   MODERN MEDICAL SCIENCE

SIDDHA MEDICAL SCIENCE

 Unstable clonic and tonic movements of limbs,constriction of fingers

Kai kaal thalardhal

Eye and head deviation to one side

Thalai oru pakam eluthal

Teeth biting

Parkalai kadithal

Drooling of frothy saliva

Vaiyil nurai thallal

Involuntary speech or murmuring

vaai pidhatral

Convulsion expiratory dyspnoea

Moochadaippu

 

SEIZURESIN ADULTS:

CLASSIFICATION:

ACCORDING TO MODERN SCIENCE(2010 ILAE CLASSIFICATION).

Modern science classifies Seizures depending on the characteristics as follows:

1. GENERALISED SEIZURES:

#Tonic-clonic (in any combination)

              Absence

                     -typical

                     -atypical

                     -absence with special features

#Myoclonic absence

#Eyelid myoclonia

#Myoclonic

                       -myoclonic

                       -myoclonic atonic

                       -myoclonic tonic

  #Clonic

- Tonic

-Atonic

2.FOCAL SEIZURES:

# without impairment of consciousness or awareness (was ‘simple partial’)

                          -focal motor

                          -focal sensory

# with impairment of consciousness or awareness (was‘complex partial’)

# Evolving to a bilateral, convulsive seizures(was ‘secondarily generalized seizure’)

                         -tonic

                         -clonic

                          -tonic clonic

3.UNKNOWN:

              Epileptic spasms.

 

ACCORDING TO SIDDHA SCIENCE:

Siddha classifies Valippu into 21 types depending on the cause as follows:

1. Amarakanda vali -                           Disorders with ghastly features like hell.

2. Kumara kanda vali -                        An affliction named after horned animals.

3. Bhrama kanda vali -                        Characterized by prolonged stupor.

4. Kakkai vali -                                    Named after the crow.

5. Muyyal vali -                                   Named after the demon,on which Lord Shiva performs his          dance.

6. Thimir vali -                                     Stubbornness.

7. Konnu vali -                                    Dyskinetic fits.

8. Chandala vali -                                Lethal fits.

 

 9. Marana vali -                                  Terminal fits.

10. Mano vali -                                    Fits associated with tension,hysteria.

11. Nanju vali -                                   Fits caused by external toxins.

12. Sanni vali -                                    Associated with lust.

13. Kaba vali -                                     Associated with suspicion.

14. Thanur vali -                                  The bodycontorts like a bow

15. Soora vali -                                    Febrile fits.

16. Vikkal vali -                                  Associated with hiccoughs.          

17. Thalai vali -                                   Associated with headache.

18. Kozhai vali -                                  Associated with phlegm.

19. Odu vali -                                      Fits produced by fever and exhaustion.

20. Maarbu vali -                                 Associated with chest pain.

21. Thamaraga vali -                            Associated with secretions of respiratory tract.

 

Of these, the first five types of Valippu are more common.Many of these confirm to symptomatic fits either physical or mental along with associated features.

EPILEPSY IN CHILDRENS:

CLASSIFICATION-ACCORDING TO MODERN SCIENCE:

1. Generalized seizures:(onset in both hemispheres)

                                             -absence

                                             -myoclonic

                                             -tonic

                                             -tonic clonic(Febrile seizures)

                                             -astatic.

2. Focal seizures: (onset in one of the hemispheres)

                                              -simple partial seizures

                                              -complex partial seizures

                                              -partial seizures with secondary generalization.

They may be frontal seizures

Temporal lobe seizures

Occipital seizures

Parietal lobe seizures.

3.Epilepsy syndromes:

                                               -Generalized epilepsies

                                                   Infantile spasms

                                                   Childhood absence epilepsies

                                                   Lennox-gastaut syndrome

                                                   Juvenile myoclonic epilepsy.

 

  -Partial epilepsies

                                                    Beningn rolandic epilepsy (BCECTS)

                                                     Occipital epilepsy.

 

ACCORDING TO SIDDHA SCIENCE:

                                                   Valippu in children according to siddha science is mainly classified into four types namely:

                                           1.Mandha vali

                                           2.Kakkai vali

                                           3.Allu vali

                                           4.Pura vali

CLINICAL FEATURES:

                                          -Whole body:Fainting or fatigue

                                          -Muscular spasms

                                                 -Mental confusion or amnesia

                                                 -Depression or fear

INVESTIGATION:

ACCORDING TO MODERN SCIENCE

                                          -Standard EEG

                                          -Sleep EEG; EEG with special electrodes(for ovale,subdural)

METABOLIC DISORDER

                                            -Urea and electrolytes

                                            -Blood glucose

                                            -Liver function tests

                                           -Serum calcium,magnesium

INFLAMMATORY OR INFECTIVE DISORDER

                   -Full blood count,Erythrocyte sedimentation rate,C-reactive protein

                  -Chest X-ray

                 -Serology for Syphilis,HIV,Collagen disease

                  -CSF Examination

ARE THE ATTACKS TRULY EPILEPTIC

                  -Ambulatory EEG

                  -Videotelemetry

 

INDICATIONS FOR BRAIN IMAGING IN EPILEPSY:

    -Epilepsy starting after the age of 16

      -Seizures having focal features clinically

  -EEG showing a focal seizure source

 -Control of seizures difficulty or deteriorating

 

ACCORDING TO SIDDHA SCIENCE :

In Siddha System of Medicine, theinvestigations are carried out by envagai thervu,naadi parisodhanai,and physical features.

Envagai thervu:

1.Tongue- Dropping of saliva and froth from mouth.

 2. Speech- Disturbed.

3. Eyes- Directed upwards .

Naadi:

     Vatham,pitham and kabham disturbed singly or together.

FIRST AID MANAGEMENT:

                -Move person away from danger(fire,water,machinery,furniture)

             -After convulsions cease,turn person into recovery position(semi-prone position)

               -Ensure airway is clear but do not insert anything in mouth(tongue biting occurs at seizure onset and cannot be prevented by observers)

               -If convulsions continue for more than 5 minutes or recur without person regaining consciousness,summon urgent medical attention

               -Do not leave person alone until fully recovered(drowsiness and confusion can persist for up to 1 hour)

FIRST AID IN SIDDHA:

According to Siddha literature, medication in the form of fumigation is better absorbed than liquids,and ghee and oil medication both internally and externally can be absorbed better than fumigation.Hence applicaction of external oil and fumigation method can be effective to treat seizures.

     During the time of seizure,the following can be done to reduce the effect:

                           -Fumigation with cumin seeds

                           -Fumigation with Agasthiar Kulambu

              Along with the external therapies mentioned above,the following oils can be applied all over body externally: 

Oil application decreases the rigidity of muscles and controls the tonic and clonic movements and hence used as a first aid.

Melugu thailam

                                                Muttai thailam- Especially applied beneath the tongue, acts as a nerve stimulent thereby reducing the tonic and clonic movements.

                                                Sadamanjil thailam

                                                Vidamutti thailam

                                                Arkashiradhi thailam

                                                Alakala thailam

Ainkuttu thailam.

                                                 Karpurathy thailam (especially for reducing the heat)

TREATMENT:

1.      PURGATION:

  According to The Siddha system of Medicine,the first and foremost measure for awakening of heart channels and mind blocked by humours by the following procedures:

                                          -Medicated enemas(kalikam,nasiyam)

               -Purgation (viresanam)

                                          - Emesis(vamanam).

              The purgative drugs that can be administered are:

                                          -Kalarchi nei

                                          -Merugan nei

                                          - Siddhadhi nei

                                          -Agasthiar kulambu

                                         -Kumati Melugu

2.FORMULATORY MEDICINES:

S.NO

TYPE OF THE FORMULATION

NAME OF THE FORMULATION

 

1.

 

TABLETS

 

 

 

 

 

 

 

 

Poora mathirai (1)

Swarna mathirai(3)

Navaspoora mathirai(1)

Kasturi Mathirai(3)

Panjikarana mathirai(2)

Mahavatha musambara kuligai(3)

Abraha mathirai(3)

Kumara kanda mathirai(5)

 

 

2.

 

PARPAM

 

Veera parpam(1)

 

 

3.

 

 

CHENDHURAM

 

 

 

 

 

 

Lingadhi uba sanda marutha chendhuram(1)

Raghu rama-bana chendhuram(1)

Sanda marudha chendhuram(1)

Linga veera chendhuram(1)

 

4.

 

 

 

 

 

THAILAM

 

Linga thailam(1)

Anju-ennai thailam(2)

Kadugu thailam(2)

Sodhirisha thailam(3)

Kumara kanda valippuku thailam(5)

Mandha dhosha thailam(3)

 

 

5.

 

NEI

 

Valippuku nei(2)

 

 

6.

 

RASAYANAM

 

Chithira moola rasayanam(2)

 

 

7.

 

KUDINEER

 

Korai kilangu kudineer(3)

Valippuku kudineer(4)

Mandha valippuku kudineer(5)

Kakkai valippuku kudineer(5)

Muyal kanda valippuku kudineer(5)

 

 

8.

 

KATTU

 

Sadhi-linga kattu(2)

 

HERBALS IN THE TREATMENT OF SEIZURES:

 

S.no

BOTANICAL NAME

TAMIL NAME

ACTIVITY

1.

Bacopa monnieri

Brahmiya-vazhukkai

Anti-convulsent

2.

Cannabis sativa

Ganjah

Stimulant

Anti-spasmodic

3.

Anethum graveolens

Chatha-kuppai

Stimulant

Anti-spasmodic

4.

Nardostachys grandiflora

Jadamanji

Stimulant

Anti-spasmodic

5.

Coccinia grandis

Kovai

Anti-convulsent

6.

Piper nigrum

Melagu

Stimulant

7.

Zingiber officinale

Inji

Stimulant

Anti-spasmodic

8.

Spheoranthus amaranthoicdes

Sivakaranthai

Anti-convulsent

9.

Asparagus racemosus

Thannirvittan

Anti-convulsent

10.

Elettariacardamomum

Elam

Stimulant

Anti-spasmodic

11.

Santalum album

Chandanam

Stimulant

Anti-spasmodic

12.

Capsicum minimum

Milagai

Stimulant

13.

Cuminumcyminum

Chiragam

Stimulant

Anti-spasmodic

14.

Pandanusodoratissimus

Thazhai

Anti-spasmodic

15.

Datura metal

Umattai

Anti-convulsent

16.

Justiciabeddomei

Adatodai

Anti-spasmodic

17.

Carumcopticum

Omam

Anti-spasmodic

18.

Moringaoleifera

Murungai

Stimulant

Anti-spasmodic

19.

Nicotianatabacum

Pugaiyilai

Anti-spasmodic

20.

Menthaarvensis

Pudhina

Anti-spasmodic

Stimulant

21.

Ferunlaasafetida

Perungayam

Anti-spasmodic

22.

Terminaliaarjuna

Marudhu

Cardiac stimulant

23.

Caesalpiniabonduc

Kazhairchikodi

Anti-spasmodic

24.

Crocus sativus

Kunkumappu

Stimulant

Anti-spasmodic

25.

Rutachalepensis

Aruvada

Anti-spasmodic

Stimulant

 

CONCLUSION:

On the basis of the above study,it is concluded that a detailed description regarding etiology,pathogenesis,signs and symptoms along with management of seizures(Valippu) is given.Modern epileptic drugs suppress the seizure, but do not cure the disorder and require life time treatment.Siddha believes in balancing humours to remove the root cause of the disorder and normalize the brain activity.

ACKNOWLEGEMENT:

Iheartily feel thankful for our Principal and all our Lectures,all our HOD’s and batch mates who gave the all kind of valuable guidance regarding this review.

REFERENCES:

1. Hakkim P.M.Abdullah sayub, Anuboga Vaithiya Navaneedham, Part4, Thamarai noolagam, Chennai.October1995.

2.  R.S.Mohan , Pulipani Vaithiam- 500 , Thamarai noolagam , Chennai. February 2013.

3. P.S.Kuppusamy Mudaliar ,Anuboga Vaithiya Brahma Raga siyam , Jayam print ,Madurai. April 2002.

4. K.N.Kuppusamy Mudaliar ,H.P.I.M.,, Siddha Maruthuvam (Podhu) , Indian Medicine and Homeopathy,Chennai.,2016.

5. Kandhasamy Mudaliar , Vaithiya Sarasankiragam , B.Rathna Nayagar & sons ,Chennai.

6. R.Thiyagarajan , Sirappu Maruthuvam , Indian Medicine and Homeopathy, Chennai.

7. Davidson’s principles and practice of Medicine Edited by Edward C.R.W.et al.,22nd Edition,published by Churchill Livingstone,Great Britain.

8. Indian Journal of Psychiatry,2001,43(1),12-15

9. International Journal of Applied Ayurveda Research ISSN:2347-6362

 
 
 

World Siddha Day Special - April 2015.

 Kalikam – The ‘’Non-Invasive Siddha Speciality’’

M. Dharani1, J. Alamelu1, R. Dhivya1, M. Gowthami1, C. Kuttrala Vadivu1

1 Second Professional BSMS, Government Siddha Medical College, Tirunelveli, Tamilnadu, India. dharanimurugesan1995@yahoo.in   

 

 Abstract

         

     With the advancement of Science & Technology, more and more non-invasive methods of treatment are made available to the general public.  Instead of causing morbidity and sometimes mortality due to conventional treatment methods such as surgery etc, non-invasive treatment options are real blessings upon mankind.  The traditional system of medicine are also having such specialities – especially Siddha medicine has authoritative non-invasive methods which are less known to the public and even to practicing Physicians.  According to our traditional Siddha Medicine the total number of diseases is divided into 4448. Various forms of Medicine are prescribed for treating those diseases. Out of 32 internal and 32 external dosage forms, Kalikam is one of the external forms of Medicine that is applied in the eyes for curing diseases. This paper documents the efficacy of Kalikam, Methods of application, shelf life, effect of Kalikam in treating Sanni (Mukkutra noi – an amalgam of all the three humors, namely Vatha, Pitha & Kapha) and other diseases.  The list of single herbs & compound drugs that can be used as Kalikam and their methods of application are also discussed in detail.  

 

Key words:

Puramarunthu, Kalikam, Medicated eye drops

 

Introduction

 

          Kalikam is one of the 32 forms of  Pura Marunthu (external applications).  Pura Marunthu plays a major role in Siddha system of Medicine. Kalikam is the one of the way for the systemic absorption through occular route.  Apart from treating eye diseases, Kalikam is also having proven records in treating conditions such as Sanni, Kaamalai etc.  Kalikam – cures the abnormalities of the disease causing three dosas Vatha, Pitha, Kabam and their imbalance.

 

Method of Application

The juice extract / infusion of single drugs are taken in a pure cloth and soaked in medicated fluids and then used as eye drops, more significantly in Intensive care treatments. These eye drops can be applied by dipping with cotton (or) by using special pipettes. The eye drops should be applied on the inner angles of the eyes near the nose. 1 to 5 drops can be used during one application.

 

The specialty of Kalikam as per Agathiar pazhu Irunooru

          Using medicated eye drops sometimes remains as a life saving technique especially in some emergencies. 

 

KAZHIKAM FOR DIFFERENT VARIETIES OF DISEASES

 

1.      Table 1. Sanniku KazhikamAgathiar Pallu Irunooru (Page. No – 39)

Botanical Name

Common Name

Parts Used

Albizia lebbeck

Siriya Tree

Vakai seed Powder

Zingiber officinale

Dried Ginger

Sukku Powder

Brassica juncca

Indian Mustard

Kadugu

Sodium Chloride impura

Rock Salt

Induppu

Moringa oleifera

Drum Stick tree

Bark Juice of Murungai

Citrus limon

Lemon

Ellumichai

 

Indication: Sanni moorkam.

Usage : The tablet is mixed with Mother’s Milk and used as eye drops

Dosage : Grain Size (mhprp msT)

 

2.      Table 2. Kalikam for Sanni

Botancial Name

Common Name

Ingredients

Piper Longum

Long Pepper

Pepper Powder

Ferula asafoetida

Asafoetida

Fried Asofoetida Powder

 

 

Butter

 

Dosage                 :         Grain Size

Adjuvant             :         Lemon Juice

Indication            :         Sanni

 

3.      Kalikam for the speedy recovery from Jaundice - Eliya vaithiya muraikal-800

          The inner nut of castor is taken and used together with cow’s butter.

 

4.      Table. 3. Pala Sannikkum Vishathirukum Kalikam (Kalikam for many types of Sanni & Toxins)

Botanical Name

Common Name

Parts used

 

Croton tiglium

Purging Croton

Nervalam Seeds

Ricinus communis

Castor oil Seeds

Amanaku seeds

Zingiber officinale

Dried Ginger

Sukku

Then above drugs are grinded together with honey and taken in a small vessel. Mixed with lemon juice and applied on the eye.

Indication : Pala Sannikkum, Vishathirukum

Advice: Buffalos curd (or) Cow’s Ghee (or) Mothers Milk (or) Extract from Palm’s Bark are used to wash the eyes.

 

5.      Sanniku Kalikam

                    Gingerly oil is taken in the vessel and 17.5g of Savukkaram is mixed along with it, juices of 3 lemons are also added. The above product is stored in a small vessel and applied on the eye.

Indication: Sanni, Head ache, Dryness of tongue.

 

6.      Table.4. Kalika Mathirai (Pills) - Anuboga  vaithya muraigal

Botancial Name

Common Name

 

Mimusops  Ilangi

Pointed leaved ape flower.

Magilam Vidhai

 

Inthuppu              _        Sodium Chloride impure

Seenakkaram                 -        Alumen

Preparation

          The above three drugs is grinded in the grinding Machine for ½ hour. Vetrilai Juice is added drop by drop and grinded for 3 hours.  Long capsules are made from that place it in the sun until it gets dry.

Adjuvant              :         Vetrilai charu (Juice of betel leaves)

Indication             :         Head ache, Sinusitis, Fainting.

 

Table 5. Single Drugs Used for Kalikam

S.No

Name

Botanical Name & Family

Parts Used

Phyto chemistry

Use in Siddha

Reference

1

Amanakku (Castor oilplant)

Ricinus Communis (Euphorbiaceae)

Seeds

Ricinine, b - Sitosterol

Eye Disease, Disease of Vatam, Constipation,

Data Base on medical plants used in Ayurveda and siddha. Vol - IV

2

Ell (Sesame)

Sesamum indicum (Pedaliaceae)

Flower

Pedalin, Sesamolin, Sesamol

Ulcer, Abcess, eye disease, Piles.

Medicinal plants of the world Vol – III

3.

Katralai

(Indian Aloe)

Aloe Barbadensis (Lilliaceae)

Fleshy Part

Aloe Emodin, Aloesin, Aloesone

Eye Disease, Leprosy, Piles, metal Disorders

Kan Maruthuvam – V. Mathavan.

4.

Karisalai

(Trailling eclipta)

Eclipta Prostrata

(Asteraceae)

The whole plant

Terthienyl aldehyde, ecliptal, Flavanoid.

Jaundice, Skin Disease, inflammation, anemia, eye disease,

Indian Herbal Pharmacopoeia

5.

Nelli

(Indian gooseberry)

Phyllanthus emblica (Euphorbiaceae)

Fruit

Phyllembic acid, Covilagin.

Disease of pittam, Coryza, Eye disease.

Medicinal Plants of India Vol – II

S.N.Yoganarasimman

6.

Nanthiavattum (East Indian Rose bay).

Ervatamia Divaricta

(Apocynaceae)

Flower

Indole alkaloid ervaticine, ervatinine.

Eye Disease, wound healing, Anti microbial, Asthuma

Sarapenthira Vaithiyamuraigal.

7.

Arugan (Barmudagrass)

Cynodon dactylon

(Poaceae)

The Whole Plant

b - Sitosterol,

b - carotene.

Disease of  eye, hypertension, poisoning

Medinal plants of India. (An encyclopaedia).

8.

Agathi

(Sesban)

Sesbania grandiflora

(Papillonaceae)

Leaf, flower

cyanidin -3 - glucoside, Leucyanidianiain.

Food Poisoning, Intermittent fever, Headache

Elliya Vathiya Muraigal – 800

9.

Kuppaimeni (Indian acalypha)

Acalypha Indica (Acanthaceae)

Leaves

Acalyphine, Triacetoneamine.

Ophthalmia, Worm intestation

Medicinal Plants of India Vol-I

10.

Adathoda (Malabar nut)

Justicia Beddomei

(Acanthaceae)

Flower

Adhatodine, Vasicolinone, b - Sitosterol

Conjunctivosis, ophthalmia, Cough, Dyspnoea.

Hand book of Medicinal herbs.

 

 

Table 6. Compound Drugs Used for Kalikam

S.No

Name of the Medicine

Main Ingredients

Indication

Reference

1

Kalika Urundai

-         Sukku (Zingeiber officinale)

-         Thipili (Piper longum)

-         Poondu (Allium sativum)

Sanni, Soolai, Headache.

Agathiar Irrantayiram

Vol - III

2

Milagu Kalikam

-         Milagu (Piper nigrum)

-         Vetrilai (Piper betle)

 For Varma Mayakam

Formulary of Varma Medicines.

3.

Olivathi Tablet

-         Milagu (Piper nigrum)

-         Elumichai (Citrusl limon)

Eye Disease

Kanmaruthuvam

4.

Padikara Neer

-         Padikaram (Alum)

-         Neer (Water)

Madras eye

Siddha Vaithiya Thirattu

5.

Kankasa Tablet

-         Sukku (Zingiber officinale)

-         Milagu (Piper nigrum)

-         Thipili (Piper longum)

Catract, inflammation of cornea

Siddha Vaithiya Thirattu

6.

Rama Pana Kuligai.

-         Kirambu (Syzygium aromaticum)

-         Elumichai (Citrus limon)

Catract

Kanmaruthuvam.

7.

Kanpoovukku Marunthu

-         Kadukkai (Terminalia chebhula)

-         Induppu (Sodium chloride impura)

Presbyopia

Uyire Kakkum Siddha maruthuvam.

 

 

 

 

 

Conclusion

 

          The traditional systems of medicine are having many specialities – especially Siddha medicine has authoritative non-invasive methods which are less known to the public and even to practicing Physicians.  Kalikam is one such speciality where medicated drops are applied in the eyes through special techniques for the management of eye diseases and other clinical conditions such as Sanni, Kaamalai etc.  Through this review we are able to observe the supremacy of the Siddha Medicines in treating emergencies in its own way -  the non-invasive Kalikam method.

 

Reference

 

1.     R. Thiyagarajan, LIM. 2006, Gunapadam Thathu Jeeva Vaguppu‟ Sixth edition, published by Directorate of Indian Medicine and Hoemopathy, Chennai, India.

2.     Murugesa Muthaliar, Siddha Materia Medica (Vegetable section), (1988) Volume I, Fourth edition, Publisher; Tamilnadu Siddha Medical Council, Chennai.

3.     Dr. K.M. Nadkarani, Indian Materia Medica Vol: I Publisher: Popular Prakash, Mumbai, India.

4.     “The Wealth of India”, Vol 10, Publication and Information Directorate, CSIR, New Delhi, 281, (1985).

5.     K. S. Uthamarayan, HPIM, 1999 „Siddhar Aruvai Maruthuvam‟ Third edition, published by Directorate of Indian Medicine and Hoemopathy, Chennai, India.

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

7.     TV Sambasivam Pillai. 1991, Dictionary Based on Indian Medical science, Second edition, Vol. 2, published by Directorate of Indian Medicine and Homeopathy, Chennai, India.

8.     M. Muhammed Abdulla Saibu, Anuboga Vaithiya Navaneedham,  

9.     Agathiar Pallu Irunooru (Page. No – 39)

 

 

Literary Reviews.

         Siddha Reviews      GSMC Palayamkottai – Golden Jubilee Special Issue.

 

January 2015. 

 

 

A REVIEW OF THE EFFICACY OF SIDDHA MEDICINES IN TREATING PILES AND FISTULA

 R. Venkatesh[1], G. Dharuman2, S. Harish Titto3, M. Murali4.

 

Abstract

Ano-rectal conditions produce a lot of concern on the patient’s side since it causes a lot of pain and suffering. The incidence of ano-rectal diseases is on the raise because of diet habit, life style modifications etc. Approximately 2 million people in U.S receive medical care for haemorrhoids each year based on National Health care survey. It is estimated that as many as 40% of population have experienced symptomatic haemorrhoids and as many as 75% of people older than 45 are affected. A complete medical intervention for ano-rectal conditions such as piles, fissures and fistula has not been established in Modern Scientific Medicine. Patients are often advised surgical intervention for these conditions. On the other hand, Traditional Siddha Medicine offers effective Medical management. Symptoms such as pain, spasm, bleeding are easily alleviated by Siddha drugs of herbal and herbo-mineral origins.

The role of Siddha Medicines such as Karunai legyam, Moolakudora thylam, Nagaparpam, Chundai vatral chooranam, Kodiveli thylam, Siddhathi ennai etc are documented. Single herbs such as Karunai (Amorphophallus paeoniifolius), Thuthi (Abutilon indicum), Chundai (Solanum tarvum), Kadukkai (Terminalia chebula), Karkadagasingi (Rhus succedanea) which are effective in treating piles and fistula are also discussed.

Key words

           Fistula-in-ano, Hemorrhoids, Siddha wound healing, Herbal treatment for piles, Naga parpam.            

 

INTRODUCTION:

            Piles and Haemorrhoids are the varicosities of the haemorrhoidal veins. They are called ‘Internal piles’ if dilatation is of superior haemorrhoidal plexus covered over by mucous membrane, and ‘External piles’ if they involve inferior haemarrhoidal  plexus covered over by the skin. They are common  lessions in elderly and pregnant women. They commonly result from increased venous pressure. Thin walled and dilated tortuous veins are seen under the rectal mucosa (InternalPiles ) or anal skin (External piles).  Fistula in ano is a well known and common condition in which one or more fistulous tracts pass from the internal opening at the pectinate  line through the internal sphincter on to the skin surface. The condition probably results from infection of the anal glands.

 

 

 Styptics and Wound healing

 

         The Styptic action is defined as ‘Contracting the tissues or blood vessels’. It is also known as astringent and haemostatic which tends to check bleeding by contracting the tissues or blood vessels. Wound healing is an intricate process whereby the skin (or another organ-tissue ) repairs itself  after  injury. In normal skin, the epidermis (outermost layer) and dermis (inner or deeper  layer ) exist  in steady-state equilibrium and shield from the external environment. When the skin is broken, the normal (physiologic) process of wound healing begins. The classic model of Wound Healing comprises three or four sequential, yet overlapping phases: (1) haemostasis, (2) inflammation, (3) proliferation and (4) remodeling. Upon injury to the skin, a set of complex biochemical events takes place  in a closely or chestrated cascade to repair  the damage.        

 

Etiology:

·         Portal hypertension

·         Chronic constipation and starting at stools

·         Cardiac failure

·         Venous statis pregnency

·         Hareditary perdisposition      

·         Tumours of rectum

      (Ref:HARSH MOHAN PATHOLOGY,6 th EDITION,PAGE 581)

 

MOOLAM IN SIDDHA

            The Siddha system of Medicine has described 21 types of Moolam, its signs and symptoms along with specific medications. 

 

 Single herbs effective in treating piles and fistula:

Table 1. Single Herbs that are effective in the management of Piles and Fistula.

 

Tamil name/common name

Botanical name /Family name

Phytochemistry

Action 

Uses in Siddha

Karunai /Yam

Dioscorea spp/ Dioscoreaceae

Saponin, flavonides

Anti- inflamatory

Piles

Kadukkai /Ink nut

Terminalia chebula/ Combretaceae

Tannin,tri-terpines,phenolic compounds

 

Anti- inflamatory

Molum,vekkal pun,fistula,anti tumor,mouth ulcer,

Kodiveli/ Ceylon lead -wort

Plumbago zeylanica / Plumbaginaceae

Glycosides, steroles, saponion.

Wound healing, Anti- inflamatory

Fistula, Fissure, Tumor, Ulcer.

 

 

Kalappai kizhngu/Superblily

Gloriosa superba/ Liliaceae

 

Flavonoids, ethanolic, phenol

Wound healing, Anti -inflamatory, Styptic, Laxative,

Anal-Piles, Leprosy, Antidote,

 Ati Maduram/ Jamaica liquorice

Glycyrrhiza glabra/ Fabaceae

Glabrin A&B, coumarin, glycyrrhizin

Laxative

UTI, Jaundice,

Thuthi/ country mallow

Abutilomn indicum

/ Malvaceae

Terpenoides, glycosides, aminoacids

Wound healing, Anti- inflamatory, Laxative

Laxative, Wound healing, Piles, Tumor

Chundai/ Turkey berry

Solanum torvum/ Solanaceae

Rutin, kaemptuol, querutin

 

Anti-inflamatory, wound healing

Piles, Fistula

Karkadaga shingi/ Galls

 

Rhus succedanea/ Anacardiacae

Biflavannone, saponine, phenols

 

 

Anti-inflamatory

Bleeding piles

 

 

Table 2. Medicines prescribed in Siddha Medicine for Piles and Fistula:

NAME OF THE MEDICINE

MAIN INGREDIENTS

USES

REFERENCE

Karunai lagyam

Karunai, kadukai

Piles

 

Siddha vaythiya thiratu

 

Moolakudora thilam

Kadukai pinchi, aamanaku ennai

Laxative, piles

Marundhu sei eayalum kalium

Siddhadhi ennai

Kadukai ,  aamanaku ennai

Fistula

Siddha vaythiya thiratu

Kodiveli thilam

Kodiveli ver, kadukai

Anal fissure

Gunapadam   mooligai

Kadukai legyam

Kadukai, inji

Piles

Gunapadam  mooligai

Nagaparpam

Kalapaikilangu, nagam

Piles, fistula

Gunapadam  thathu jeevam

Idivaladhi melugu

Serankottai, kodiveli

Piles

Siddha vaythiya thiratu

Malakudora melugu

Atimaduram,  kadukai

Piles, fistula

Siddha vaythiya thiratu

Thuththi pattru

 

 

Thuththi,  Aamanaku ennai

Piles, fistula

Siddha vaythiya thiratu

Sundai vattural churanam

Sunndaivattral,  Nelli vattral

Piles, fistula

Siddha vaythiya thiratu

                                                                                                                                        

Thuthi (Abutilomn indicum)

   Anti Inflmmatory

The present study, the analgesic and anti‐inflammatory activity of plant extracts of Abutilon Indicum  was studied. The anti‐inflammatory activity was found out by Carragenan induced   paw edema method  by using standard Diclofenac sodium.  Carrageenan  induced  hind paw oedema in the standard experimental model of acute inflammation. Carrageenan in the phlogisti agent of choice for testing anti-inflammatory drugs as it is not known to be antigenic and is devoid of apparent systemic effects. It seems safe, however to conclude that these parts do possess biological activities following oral administration.

Ref:

1.R.Saraswathi1, Lokesh Upadhyay2, R.Venkatakrishnan3, R.Meera4, P.Devi5. Phyto Chemical Investigation, Analgesic And Anti Inflammatory Activity Of Abutilon  indicum  Linn.  Int J Pharm Pharm Sci, Vol 3, Suppl 2, 2011, 154156

 

Wound Healing

A study was conducted  to evaluate the wound  healing activity of  Abutilon indicum Linn in Wister Albino Rats using two different models Viz., excision and  incision. the evaluation of wound  healing activity, Wister albino rats were selected for this experiment. The progressive changes in the wound area were monitored by tracing the wound  margin every day. From the result, it is concluded  that the petroleum  ether extract of “Abutilon indicum” Linn. had greater wound healing activity than the Ethanolic extract.

Ref:

2.P Ganga suresha* , R Ganesana , M Dharmalingama ,S Baskar a , P.Senthil kumarb. Evaluation of Wound Healing Activity of “Sbutilon Indicum” Linn, In Wister Albino Rats.

Ganga suresh et.al / Int J Biol Med Res. 2011; 2(4): 908 - 911

Kadukai (Terminalia Chebula) Anti Inflammatory:

          The present study was undertaken to evaluate the analgesic and anti-inflammatory activities of ethanolic extract of Terminalia chebula ( commonly  known as Haritaki ) fruits in experimental animal models. In carrageenan induced paw edem method, considerable  results were found after determining the percentage change in paw volume in extract. In both cases of analgesic and anti-inflammatory study, % inhibition of pain and inflammation  were evaluated. Comparing with control, largest inhibition was found in inhibiting  inflammation 5 hours after treatment, while the largest  inhibition of  pain was obtained in 30 minutes and  60 minutes after treatment of doses. The present study suggests that ethanolic extract of Terminalia chebula fruits has significant analgesic and anti-inflammatory activities.

Ref:

  3. Md. Safkath Ibne Jami1, Zakia Sultana2, Md. Ershad Ali3, Mst. Marium Begum2, Md.Mominul Haque4* Evaluation Of Analgesic And Anti-Inflammatory Activities On Ethanolic Extract Of Terminalia Chebula Fruits In Experimental Animal Models.  American Journal Of Plant Sciences, 2014, 5, 63-69 Published Online January 2014.

 

Wound Healing:

            The hydroalcoholic extract of T.Chebula fruit was evaluated  for its  wound healing activity in alloxan induced diabetic rats using excision and  dead space wound models. Extract treated animals exhibited 82% reduction in the wound area when compared to controls which was 40%.T.Chebula promotes significant wound healing in diabetic rats and further evaluation of this activity in humans is suggested.

Ref:

4. Manish Pal Singh1* and Chandra Shekhar Sharma2. Wound Healing Activity of Terminalia Chebula In experimentally Induceddiabetic Ratsmanish Pal Singh Et Al /Int.J. Pharmtech Res.2009,1(4)

 

Karunai (Dioscorea  spp) Anti-Inflammatory

             The tubers of Amorphophallus paeoniifolius are anti-inflammatory in nature and traditionally used in inflammations. For the assessment of the anti-inflammatory activity of the extracts at the dose of 200 and   400  mg/ kg. used carrageenan  induced  paw edema model  in rats. Results sho that only the  methanol  extracts have got prominent anti-inflammatory activity.

Ref:

5. Shankhajit De1, Yadu Nandan Dey2 And Ajoy KumarGhosh1*.Anti-Inflammatory Activity of  Methanolic Extract Of Amorphophallus Paeoniifolius and Its PossibleMechanism. International Journal Of Pharma And Bio Sciences. Vol.1/Issue-3/Jul-Sep.2010. Issn 0975-6299

 

Kodiveli-( Plumbago zeylanica )Anti Inflammatory

The study of anti inflammatory and  cytotoxic effects of Plumbago zeylanica. The  methanolic extracts at 300 and 500 mg/kg produced 31.03 and 60.3% inhibition of acute inflammation, respectively, in Carrageenin induced raw paw oedema confirming that P. zeylanica roots are effective against acute inflammation.

Ref:

6. Kantha D. Arunachalam1 , P. Velmurugan2 And R. Balaji Raja2*.Anti-Inflammatory And Cytotoxic Effects Of Extract From Plumbago Zeylanica. African Journal Of Microbiology Research Vol. 4(12) Pp. 1239-1245, 18 June, 2010

 

Wound Healing

Methanolic root extract of Plumbago zeylanica are having significant wound healing activity in rats. The wound healing effect of Methanolic root extracts of Plumbago zeylanica may be due to the presence of more than one active principle mentioned above. Further pharmacological and biochemical investigation will clearly elucidate the mechanism of action and will be help full in projecting this plant as an therapeutic target in wound healing and other diseases.

Ref:

7. Devender Rao Kodati*, Shashidher Burra And Kumar Goud P. Evaluation Of Wound Healing Activity Of Methanolic Root Extract Of Plumbago Zeylanica L. In Wistar Albino Rats. Asian Journal Of Plant Science And Research, 2011, 1 (2): 26-34. ISSN : 2249 – 7412

 

Atimaduram- ( Glycyrrhiza glabra )Anti Inflammatory

          The present experiment was focused on the anti-inflammatory activity of hydro alcoholic extract of G. glabra (HAEGG) root against carrageenan induced rat paw oedema at dose levels of 100, 200, and 300 mg/kg orally.Maximum of 46.86% inhibitory action on carrageenan induced paw oedema at the dose of 200 mg/kg.

 

Ref:

8. Nirmala, P.1 And Selvaraj, T.2*.Anti-Inflammatory And Anti-Bacterial Activities Of Glycyrrhiza Glabra L. Journal Of  Agricultural Technology 2011 Vol. 7(3): 815-823. ISSN 1686-9141

 

Wound Healing: (Glycyrrhiza glabra aqueous)

Glycyrrhiza glabra aqueous extracts alone and in combination for antimicrobial and wound healing activities in MRSA - infected excision and incision wound models in mice. 2.5% G. glabra and combination of the two were prepared and tested for their influence on wound infection, wound contraction and epithelization phases of wound healing.

Ref:

9. Abdulghani - Ameri, B B Rajive, J G Vaidya, K Apte, S S Deokule. Anti-Staphylococcal and Wound Healing Activities Of  Ganoderma Praelongum and Glycyrrhiza  glabra Formulation In Mice.  International Journal Of Applied Research In Natural Products, Vol 6, No 1(2013).

 

Kalapai-( Gloriosa superba )Anti Inflammatory:

.            We evaluated the analgesic and anti-inflammatory activities of hydroalcoholic extract (50% v/v) of dried aerial parts of G. superba. . The anti-inflammatory activity was evaluated by using the cotton wool granuloma model and the carrageenan-induced paw edema model. . The rats exhibited 9.59%, 28.72% and 45.8% inhibition of granuloma mass formation after 7 days treatment with 100, 200 and 400 mg/kg body weight of the extract when compared with control. However, it exhibited dose-dependent anti-inflammatory activity

Ref:

10. Jomy C John1Jennifer Fernandes1Tanaji Nandgude2Samir R Niphade3Alok Savla4Pradeep T Deshmukh1. Analgesic and anti-inflammatory activities of the hydroalcoholic extract from Gloriosa superbaLinn. . Int J Green Pharm 2009;3:215-9

 

Chundai(Solanum torvum )Anti Inflammatory

             Solanum torvum is used in Cameroonian traditional medicine for the management of pain and inflammation. The present work assesses the pain-killing and anti-inflammatory properties of the aqueous extracts of Solanum torvu  leaves. Acetic acid- and pressure- induced pains were reduced by this extract while carrageenan-induced inflammation was inhibited at various doses of the extract. The extract therefore has both analgesic and anti-inflammatory properties.

Ref:

11. E. J. Ndebia1, R. Kamgang1 and B. N. Nkeh-Chungaganye1* Analgesic and Anti-Inflammatory Properties Of Aqueous Extract From Leaves Of Solanum Torvum (Solanaceae)

 Afr. J. Trad. Cam (2007) 4 (2): 240 – 244.  ISSN 0189-6016©2007

 

Woundhealing:

              The effects of topical application of S. torvum fruit extract on the rate of excision wound healing and histology of healed wound were assessed. In conclusion, placebo containing 5% or 10% S. torvum extract- dressed wounds significantly accelerates the rate of wound healing in rats.

Ref:

12. Azaman, Nooriza; Abdulla, Mahmood Ameen; Ismail, Salmah. Wound Healing Activity of Solanum Torvum Aqueous Fruit Extract in Rats. January 2009. Annals of Medicine & Healthcare  Research; 2009, p385.

 

Karkadaga Shingi (Rhus succedanea)

Anti Inflammatory

             To evaluate the anti-inflammatory activity of Rhus succedanea galls. Aqueous extract of Rhus succedanea galls (50 and 100 mg/kg i.p.) showed a highly potent and dose–dependent anti–inflammatory activity comparable to diclofenac sodium (10mg/ kg i.p.) on carrageenin induced paw oedema in rats. The present results indicate the potential usefulness of aqueous extract of Rhus succedanea galls in the treatment of inflammatory diseases.

13. Ref:

V. Kumar2, G. B. Shah2, N. S. Parmar1*.Anti-Inflammatory Activity Of Aqueous Extract Of

Rhus  succedanea  Galls. V. Kumar Et Al. / Journal Of Natural Remedies, Vol. 3/2 (2003) 202 – 204

 

Discussion &Conclusion

            The role of single   her as potent remedies for chronic diseases are being widely discussed now. This is true in the management of ano-rectal condition such as piles and fistula .As a next step prepared medicine of Herbal, Minerals, and Animal origin are advised for Therapeutic and Prophylactic purposes. Through this review we have come to the Conclusion that Siddha Medicine are effective in successfully handling acute and chronic Ano -rectal conditions.

Acknowledgement

            Authors wish to thanks our Guide Dr. Thomas M.Walter MD(s), Lecturer and Staffs, Department of Gunapadam, Government Siddha Medical College, Palayamkottai, for giving kind guidance from time to time.

 



[1] to 4  IInd Professional BSMS, Govt. Siddha Medical College, Palayamkottai, Tamilnadu.  

 

 

 

 

 

 

Managing Diabetes-The Siddha Way.

 

Thomas M.Walter·

 

Note:  This review is taken from the online class conducted by Dr. Thomas M.Walter at the Universalclass.com ( http://www.universalclass.com/ ) during 1999-2000.  This review is written for International audience keeping the lay men in mind – Editor-in-Chief, Siddha Reviews.

 

 

Aim of the treatment and dietary management of diabetes:

 

Aim of treatment:

             1. Adequate control of hyperglycemia (excess sugar in the blood) and glycosuria.

             2. Prevention of complications.

             3. Disappearance of diabetic symptoms.

             4. Maintenance of appropriate body weight.

Three methods of treatment are available for diabetic patients:

                 Diet alone
                 Diet and an oral hypoglycemic drug
                 Diet and insulin.


Approximately 50% of new cases of diabetes can be controlled adequately by diet alone,
20-30% will need an oral hypoglycemic drug and
20-30% will require insulin.

Dietary management:

Dietary measures are required in the treatment of all diabetic patients to achieve the overall therapeutic goal: normal metabolism.

The actual height and age of the patient are to be noted. From the nomogram, expected standard weight is to be calculated from the actual age and height. Obese diabetics are to be given a reducing diet, on the other hand lean and thin diabetics should receive a weight gaining diet. In cases of mild diabetes with obesity, diet control alone is required.

Alcohol:

In general, diabetic individuals should take the same precautions regarding alcohol intake as the general population. However, account must be taken of:

1.  The energy and sometimes the carbohydrate content of alcoholic drinks.
2.  The fact that alcohol may potentiate the hypoglycaemic action of oral hypoglycaemic       drugs and of insulin.
3.   The fact that alcohol can induce drug interactions.

Salt:

Diabetic patients should follow the advice given to the general population, namely to reduce sodium intake to no more than 6 gm daily. Further restriction of sodium intake (to less than 3 gm daily) is important in the management of hypertensive diabetic patients.

Diabetic foods and sweeteners:

Low calorie and sugar-free drinks are useful for patients on low calorie diets. These drinks usually contain non-nutritive sweeteners. Many diabetic foods contain sorbitor or fructose which may have stomach side effects, are relatively high in energy, may be expensive and are therefore not particularly recommended as part of the diabetic diet.

Non-nutritive sweeteners (saccharin, aspartame, sucramate) are the most widely used non-nutritive sweeteners and provide means for reducing energy intake without loss of palatability.
Nutritive sweeteners, sorbitol and fructose are particularly useful in baking. They contain as many calories as sucrose and their total intake should not therefore exceed 50 gm daily.

Note:
Oral hypoglycemic drugs and insulin should be prescribed by doctors alone. These drugs are to be taken under medical supervision. So, we have not mentioned much about them.

 

 

Herbal treatment for Diabetes.

In my observation, herbal drugs are very effective in the initial stages of the newly identified diabetic patients before they take any oral anti-diabetic drugs or insulin. In the later stages, they lower and maintain the blood sugar level effectively without any side effects or complications.

Following are some important herbs used in the treatment of diabetes. The plants are described in the following manner:


1. Their common English name.
2. Their Botanical name (consisting of a Genus name and a species name)
3. The family to which they belong.
4. Parts used for therapeutic purposes.
5. Their important constituents (phyto chemistry, alkaloids etc)
6. The form in which it is to be given to diabetic patients.

1. The Tanners - cassia:


This is Cassia auriculata, linn. of the family Leguminosae. The bark is astringent. Seeds are useful in diabetes and are given in the form of decoction. Bark contains nearly 20% tannin. It grows wild in dry scrub jungles and sometimes cultivated.

2. Almonds:


This is Prunus amygdalus, batsch. of the family Rosaceae. There are two varities - bitter and sweet. The bitter variety is poisonous because of its hydrocyanic acid content. Sweet almonds are demulcent and highly nutritive. Useful as a nonstarchy diet for diabetics.


3. Jambul:

This is Eugenia jambolana, of the family Myrtaceae. Seeds are used in diabetes. Seeds contain a glucoside and an essential oil. Aquous extract of seeds shows marked and prolonged decrease in blood sugar level upon hypodermic injection into dogs. This is administered in decoction form.

4. Nut grass:

This is Cyperus rotundus, Linn. of the family Cyperaceae. Its tuber or bulbous roots are used. It contains fat, gum, carbohydrates, essential oil, albuminous matter, starch, fibre and ash. There are traces of an alkaloid. This is also given in a decoction form for diabetic patients.

5. Cephalandra indica:

This is familiarly known as the “Indian substitute for Insulin ". The leaves, fruit and the tubers are used for treating diabetes. The juice extracted from the tubers is given for diabetic patients and the results are very encouraging. This juice can also be given as an adjuvant along with other anti-diabetic drugs.

6. The Curry-leaf tree:

This is Murraya koenigii, of the family Rutaceae. The bark, root and leaves are used. Leaves contain a volatile essential oil, resembling the oil of Aegle marmelos, a resin and a crystalling principle glucoside named Koenigin; seeds yield oil, whose properties are not yet ascertained. The infusion and decoction of the root-bark is useful in diabetes.

7. Heart leaved moon seed:

This is Tinospora cordifolia, Miers. or Cocculus cordifolia of the family Menispermaceae. The thick stems and roots are employed in medicine. It contains Berberine, giloin and giloinin and a bitter substance. The parenchymatous cells are charged with starch.

From the mature and thick stems of Tinospora, the starch is extracted by pulping and setting after straining the fibrous materials. It is given for patients with diabetes.

8. Bitter gourd:

This is Memordica charantia, Linn. It contains essential oil, clarotene, glucoside, saponin and alkaloid memordicine. It is used in diabetes and shown to be hypo glycaemic in rabbits. This is also recommended to be taken daily along with diet for diabetic patients.

9. Costus root:

This is Costus speciosus, Sm. of the family Scitaminaceae. Root and tuber are the parts used. This is given in the form of decoction for diabetic patients.

10, Indian Gooseberry:

This consists of the ripe fruits of Emblica officinalis, Gaertn of the family Euphorbiaceae. Fruit is refrigerent, diuretic and laxative. It contains tannin, pectin and ascorbic acid. The fruit is a main ingredient in the medicine prepared for diabetic patients.

 

 

Foods to be taken, avoided and some practical suggestions for diabetic patients.

 

Diet control:

Foods to be totally avoided:

All concentrated sources of sugar such as sugar, glucose, jam, chocolates, sweets, sweet drinks, sweetened milk, canned fruits, sweet biscuits, cake, pie, pudding, peppermint and alcohol.

Foods to be taken in limited quantity:

Cereals, pulses, potatoes, peas, dry fruits, cheese, milk, butter, ghee, oil, meat, eggs, fish, curd.

Foods that can be taken freely:

Most fruits, vegetables, drinks (tea, coffee etc. sweetened with artificial sweeteners like saccharine, source from phenylalanine etc.

Special Medicinal foods:

Certain foods like Bitter gourd, Black berry, Fenugreek, Garlic and Neem are considered natural medicinal foods for controlling diabetes. Hence patients of diabetes should consume them often.

Fibre foods:

Fibres lower the rate of glucose absorption from the gut and thereby lowers glucose level in the blood and therefore it aids in treating diabetes. Fibre helps in reducing insulin dosage administered to the diabetic patient. For fibres whole grain cereals and pulses along with fruits and vegetables can be taken.

Some practical suggestions for diabetic patients:

1. Diabetics should take more number of smaller meals scattered over the day rather than taking few heavy, concentrated meals so that the blood sugar level doesn't shoot up suddenly as the smaller amount of insulin (or that injected as a medicine) is insufficient to metabolize large amount of blood sugar.

2. Diabetics should avoid fasting and missing their meals to prevent low blood sugar. Even if you don't have appetite, don't abstain from food. Have light food at regular intervals.

3. While on a tour, keep fruits like apples, oranges or sweet limes to prevent low blood sugar.

4. Artificial sweetening agents are more preferable to sugar. Although it is sweeter than sugar but it has no calorie content.

5. Maintain your meal timings properly to maintain blood sugar at normal levels all the time.

6. Have variety in your food so that all necessary vitamins, minerals and other nutrients reach to body to keep it fit.

7. Spices can be taken by a diabetic as they possess no calorific value. However, restrict the use of salt.

8. The diabetic should increase his awareness about the disease - how body controls blood sugar, the effects of insulin and other drugs, and the effect of exercise, different foods and other diseases in body.

9. Make sure that friends and associates know that you are diabetic and understand that you cannot take irregular meals or drinks.

10. Avoid operating machinery or driving unless you have eaten in the previous two hours.

11. Young adults and those particularly prone to hypoglycaemic attacks should carry a card giving details of their condition and instruction for treatment in an emergency.

 

Exercises that will be helpful for diabetic patients, breathing exercise and acupressure.

Exercises:

Exercise helps the diabetics in many ways. Exercise increases the receptivity of muscles to insulin and greater amount of glucose will be transferred from the blood stream to the muscles by the same amount of insulin. Further during exercise more oxygen is sent to pancreas and thus pancreas is stimulated to function better.

Physical activity will burn blood sugar and lower its level. In the body, glucose can't be metabolized without oxygen. Exercise provides lot of oxygen to metabolize the sugar. With consistent physical activity, the ability of cells to respond to insulin gradually increases.

There are other indirect good effects of exercise on a diabetic e.g., it reduces triglycerides and LDL cholesterol in the blood. Further, it decreases extra fat which (obesity) is one of the important contributing factors in diabetes.

Isometric exercises involving lifting of weights etc. are not recommended. Aerobic exercises like walking, cycling, and swimming are more useful. However, when the blood sugar level is very high and pulse rate becomes very high even in little exertion, exercise should be planned in consultation with a medical expert.

Pranayama (Three state Breathing exercise) is also very useful for diabetic patients because it provides a lot of oxygen to metabolize the sugar.

 

Acupressure:

There are acupressure points in palms and soles of the leg corresponding to pancreas. The points in palms are situated about 2cms below the ring fingers. The points in soles of the leg are situated laterally in the 2/3rd of leg straight below your last little finger. Pressing these points regularly and frequently will activate pancreas and gradually it will start functioning better. These acupressure or reflex points are like switches or buttons. When you press them, current or life energy starts running to that part.

Frequently Asked Questions (F.A.Q)

 

Here are some of the frequently asked questions and their answers for Diabetes.

 

  1. Is diabetes inherited?


Yes. If both parents have diabetes, the probability is that their children will develop the disease at some stage in their life. If a diabetic marries a non-diabetic, who has family history of diabetes, there is a chance of their children getting this disease.

2. Does infection cause diabetes?


Coxsackie B-4 virus may cause islet cell dysfunction and some other known viruses of rubella and encephalo-myocarditis may cause similar lesions of islet cells and ultimately diabetes.
Infection will aggravate or intensity a pre-existing diabetes and make the condition more apparent. Such infections are usually those of skin (boils), respiratory passages (cough and colds) or urinary tract (burning on passing urine).

3. Will the eating of an excessive amount of sweets cause diabetes?


Usually not, but it may aggravate and bring to light an underlying tendency towards the disease.

4. How does emotional strain affect diabetes?

Diabetes may become worse or get out of control by emotional or psychological strain. Sometimes diabetes for first time is brought to light during such a stress.

5. Is diabetes contagious?

No. By mere contact or living with person suffering from diabetes, one cannot get this disease.

6. Can be there be diabetes without symptoms?

Yes. Mild case may have no symptoms whatsoever. The disease in such a case may be discovered accidentally by the finding of sugar on routine urine analysis or by blood sugar determination.

7. Must all people who have diabetes take insulin?

No. This depends on the severity and age of onset of the diabetes. Many patients can be controlled adequately by diet alone while some, in addition, by the oral medications.

8. Has one to take the special diabetic diet always?

The principles of diet remain the same. Certain articles have to be avoided. Intake of calories is adjusted depending on the body weight. Those who are overweight must reduce; underweight individuals are given additional calories to make up for their small weight.

9. Can a diabetic eat more than his allowance and cover this with increased dosage of oral drugs or insulin?

No. It will start a vicious circle. The control of diabetes in such patients will become very haphazard. Diabetic restrictions may at no stage be relaxed especially in obese persons.

10. Can diabetics keep a fast?

Overweight diabetics will certainly reduce weight by fasting and it is good for them. Those who are underweight and on large doses of insulin should not do so; or else should reduce the dosage of insulin on such days.

11. Can all diabetics derive benefit from the oral medications for control of their diabetes?

No. Only a few patients will respond to this treatment. Usually they are over forty years in age and have an insulin requirement of less than 40 units per day. A prior test can indicate if a patient will respond to the oral tablets available.

12. Can insulin be taken by mouth?

No. it must be injected under the skin, because if taken orally, it is destroyed in the gut before getting absorbed.

13. Once a patient has had to take insulin for his diabetes, does it mean that he will have to take it for the rest of his life?

Generally speaking, this is so, although there may be exceptions to this rule. This is however, not like an addiction to opium.

14. How can a patient tell if his diabetes is being controlled?

a). By examination of his own urine for sugar
b) By having a blood sugar test done at regular intervals.
c) By noting the presence or absence of diabetic symptoms such as excessive hunger, excessive thirst, weight loss, weakness etc.

15. Are diabetics particularly prone to infection?

Yes, in addition their ability to combat infection is poorer if untreated than that of non-diabetic patient. For this reason, a diabetic must be particularly careful in his personal hygiene and consult his physician as soon as any infection takes place.

16, Should diabetics have children?

If both parents are diabetic, they should realize that their children can have this disease. If they decide to have children, they should know of their responsibility to keep a careful watch for early symptoms of the disease in their offspring whose future may depend on its prompt recognition.

17. Can diabetic patients be operated upon safely?

Yes, with modern methods of management, the diabetic patient can be operated upon with almost as much safely as the non-diabetic patient.

 

 

FACTS ABOUT DIABETES**

 

  • 16 million Americans suffer from diagnosed diabetes; one third do not know they have it. Diabetes is the seventh leading cause of death in the U.S.
  • The prevalence of diabetes–including gestational diabetes--among adults rose 33 percent between1990 and 1998. The increased rates of diabetes correlate with increased rates of obesity during the same period.
  • During the last decade, the prevalence of diabetes increased among men and women of all ages and ethnic groups and in nearly all states. Among individuals aged 30-39, the prevalence of diabetes increased 76 percent.
  • Diabetes is the leading cause of new cases of blindness in adults aged 20-74.
  • Approximately 65 percent of people with diabetes have high blood pressure.
  • People with diabetes have up to 4 times the rate of heart disease as people without diabetes.
  • Preventive care services can minimize diabetes-related complications such as blindness, cardiovascular disease, high blood pressure, and amputations.
  • Preventive care is lowest among people living in the South, people with less than a high school education, and people without health insurance.
  • Diabetes is the leading cause of end-stage renal disease (ESRD, i.e., chronic kidney failure). Among Native Americans, diabetes accounts for 60 percent of the new ESRD cases each year.
  • Since 1990, incidence of end-stage renal disease attributable to diabetes has increased by 24 percent among Native Americans with diabetes.
  • Type 2 diabetes (formerly called adult onset) is increasing rapidly among children and adolescents, particularly in minority populations, and may account for up to 45 percent of new cases of childhood diabetes.

**Source: U.S. Centers for Disease Control and Prevention, October 27, 2000.





·  Lecturer, Dept. of Pharmacology (Gunapadam), Govt. Siddha Medical College, Palayamkottai, Tirunelveli, Tamilnadu, India. dr.thomaswalter@gmail.com

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