• This introduction includes aim of Siddha medicine, Concepts of Siddha Medicine, 96 Thathuvankal, Diagnostic Methods in Siddha system of Medicine and Treatment Modalities in Siddha system of Medicine. It gives you an excellent insight into what is Siddha medicine, its concepts and treatment methodology.

In our effort to share information on Alternate Therapies we had shared articles on Ayurveda: The Science of Life, What is common to and difference between Ayurveda and Unani medicine, What is Orthopathy and Indian Origin of Tibetan Medicine. eSamskriti is grateful to Ayurvedacharya Dr G G Gangadharan for introducing us to the respected author. - Editor

Author is Dean, National Institute of Siddha, Chennai.

Introduction

The art of medicine in this universe has its origin even when the living organisms came in to existence in it. Though various systems of medicine are in practice at worldwide, all systems have their ancestral roots from nature only. It is nature which taught and provides everything, not only to the human race but also to every life in this earth.

Hence forth, a system of medicine is not a discovery, but it is a gradual evolution from nature with a long historical development.

The ultimate goal of each life in this world is to lead a perfect life and to unite with this nature. In other words, each life has to get amalgamated with the perfect thing from which it originated. But it is disturbed by obstacles like death, diseases, ageing, wrinkling or shrinking of tissues of the body and greying of hair. Siddha system paves the way for overcoming these obstacles in consonance with nature and is one of the solutions to this endeavor.

“Health is Wealth” – a very common phrase of the common man which is in usage for centuries. Though it appears simple, it gives valuable meaning, imparting significance to the healthy way of living. Keeping this in the background, different civilizations and cultures have developed their own system of medicine. Siddha system of medicine is also one of the pioneering systems which developed among the Dravidian civilization and culture. 

The “Tamils" who inhabit the Southern Peninsula of the Indian sub-continent undertook a systematic analysis of nature and its elements and developed a highly systemized medical system which is now known as “Siddha system of Medicine”. Medicine is not merely a science of experiments, but an art of nature. Generally, this system is full of treasures given by a number of spiritual scientists, called “Siddharkal”. They are the founders of this system. They had realized that if the body could be made strong and perfect they could get rid of birth, death and diseases.

1

Siddha system of Medicine has derived its name from the root word, “SIDDHI”, which gives the meaning “Perfection” or “Eternal Bliss”, which is the ultimate goal of life to be achieved. Siddharkal are those people, who had achieved this goal by attaining eight types of siddhikal (Attama siddhikal – eight fold supernatural powers - Anima, Mahima, Lahuma, Karima, Prabthi, Prakamiyam, Vasithuvam, Easathuuvam) through eight types of yogic practices (Attanga yogam – Iyamam, Niyamam, Athanam, Pranayamam, Pratiyakaram, Tharanai, Thiyanam, Samathi).

They believed they could achieve “Eternal Bliss” with the help of physical body and they tried to get rid of the obstacles of life. They learnt many truths and facts from Nature which they practised in their life and achieved their goal. Since they achieved Siddhi, they were called as “Siddharkal”. Hence, Siddha system of Medicine is a by-product of Siddhar’s aim of achieving Eternal Bliss. Siddhar’s hallmark tenets are- 

i) control over breath,

ii) control on sex energy and

iii) control over mind.

Siddhars were well aware that the physical body alone is the only instrument to achieve eternal bliss, to unite with the Lord. But it is transient and is easily susceptible to get diseases and sufferings which may be an obstacle to attain GOD. The regular practice of attanga yogam helped them to raise the quality of GOD hood in them and made their body immortal to attain their ultimate aim.

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As the definitive aim of Siddhars was to achieve perfection of the body and soul, they tried to achieve it through the following ways;

1. Universal love

2. Yogic practices

3. Mani (mercurial amalgamations)

4. Mantiram (incantation)

5. Oudatham (Medicine).

The term “Maruthuvam” is derived from the root word “Marundhu” (Medicine) which has the following synonyms, viz., cure, antidote, management, treatment, medical practice etc., The definition for “Marundu” (Medicine) is described in such a way that the thing which heals and prevents not only the physical and psychological ailments, but also death. 

In this path also, Siddha system of Medicine aims for immortality and hence the system is a complete Medical system.

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4

Siddha system of medicine describes health as a state of happiness which is free from sufferings. The happiness and the sufferings are because of the twin Karmic deeds of good and evil of the living beings in this world. Sufferings are caused by two factors which may be either internal or external. Both happiness and the sufferings are experienced by the living body i.e. the body with the life force (soul).

In other words, it is the life force and physical body, acting together, that acknowledge or enjoy the pleasure and pain of life. Prevention, cure and contentment are the three main goals of the Siddha system of Medicine to the mankind. Hence, the system is aiming at happiness by removing the sufferings which is driven towards the complete health.

Siddha system of Medicine emphasizes more on a system that primarily focuses for a healthy and promotive livelihood by eliminating the sufferings, diseases etc., Furthermore, healthy living is pointing out not only the physical health but also the social, psychological and the spiritual wellbeing of humanity.

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Siddha system of Medicine is based on 96 Thathuvankal (96 Philosophies) which are considered to be the basic principles. These 96 principles are universal to all particularly the human beings. These 96 principles and their functions are responsible for the physical, mental, intellectual components of our body. Literally, these form the anatomy and physiology of human beings according to Siddha system.

Among these principles, the Iymboothangal (Five elemental theory), Mutthathukkal (Three humoral theory), Ezhu Udal Thathukkal (Seven body constituents), Aaru Suvaikal (Six tastes) are the most vital principles based on which the Siddha system of Medicine laid its foundation and spreads its uniqueness for the wellness of humanity. Though its age was dated back even to the origin of civilization, the principles of this system are serving the society of scientifically mastered people. These principles may even be applicable for the generations to come in future also.

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Iymboothangal Theory (Five Elemental Theory):

Every worldly object in this universe, either living or nonliving, are formed by classical basic elements that are five in number. They are-

1. Nilam (Earth)    

2. Neer (Water)

3. Thee (Fire)                            

4. Vayu (Wind/Air)

5. Vinn (Space/Ether).

and are called as “Iymboothangal” and they are combined with one another or each other in a predetermined different permutations and combinations to form the earthly things. These undergo the following processes viz., Creation, Protection and Destruction thereby maintaining the vicious cycle of nature.  

All the creations of the world including the human body are made up of these five basic elements and that upon destruction or death of these creations; disintegrate again in to these five elements. This is the base for the Siddhar’s view of “Ullathu pokaathu, Allathu Vaaraathu” which means nothing is created nor destroyed. Each of the five elements is associated with one of the five senses and acts as the gross medium for the experience of sensations. 

The five basic elements are existed or exhibited in two different forms.  They are,

1. Gross state

2. Subtle state       

Gross state elements are recognizable and subtle state elements are not perceivable. These five basic elements are initially formed as primordial elements in subtle form. The subtle state elements are formed from one another in the following order,

Then, they manifest in to its gross state and become visible. The manifestation of the five elements from the subtle state to the gross state is called as “Pancheekaranam”. As the grosser state elements combine one another, all the objects in the universe form with a definite shape and characteristic feature, which constitutes the Macrocosm. 

Similarly, the human body (Microcosm) is also constituted by these five elements into his seven physical body constituents (saaram, cheneer, oon, kozhuppu, enbu, moolai, sukkilam/suronitham), three biological humours (vali, azhal, iyam) and also the food we consumes to nourish them.

Again, the reproductive physiology of human being is also explained on the basis of these five basic elements as follows,

The semen (vindhu) is the combination of vali and thee while the ovum (naatham) is neer. The uterine wall where the fertilized ovum gets implanted is nilam and the uterine cavity where the fertilized ovum grows is the vinn.

Thus, the five basic elements are the basis of the Macrocosm and the Microcosm and hence any changes in the Macrocosm (Universe) will also be reflected in Microcosm (human body). In other words, the physiology, the pathology, diagnosis, pharmacology and the treatment in Siddha system of Medicine are based on these five basic elements.

Mutthathukkal theory (Three humoral theory)

The Siddhars have found that there is integrity between the functions of the Macrocosm (Universe) and Microcosm (Human Body) and are relative to each other. They called it the Three humors i.e. Vali, Azhal and Iyam. These three basic factors are responsible for the functional integrity between the environment and the living ecosystem. The three processes viz., creation, protection and destruction can be attributed to these three basic factors respectively.

It is again the five basic elements that unite in the following way to form these three humors,

Vinn + Vayu   = Vali

Thee                = Azhal

Neer + Nilam  = Iyam

These three humors along with the other remaining 96 principles constitute our body. When these three humours are in equilibrium or in normal state, they are called as “Uyir Thathukkal” and maintain our body physiologically. When the normalcy or equilibrium is altered, then it leads to pathological conditions and at that time, these factors are called as “Kutrankal”. 

Briefly, it can be concluded that these three humors rule our body biologically and alter it pathologically.

Siddha system of Medicine explain the uyir thathu Vali as the creative factor and is attributed to the first phase of human life, Azhal as the protective factor and is attributed to the middle phase of human life and the Iyam as the destructive factor and is attributed to the last phase of human life. These three factors are nourished by their respective elements in the food what a man consume.

Though these three humors are the life forces that drive our body healthy, Vali predominantly exists below the naval, Azhal between the naval and the thorax and Iyam in the head and neck regions.

The three humors combine among themselves in nine different combinations in such a way that one of the humors might be more and the other might be less. Not only that, the predominance of a particular humor may be constituted at the time of fertilization that results in the temperament of a particular person accordingly. In this way, the following temperaments are described in the Siddha literatures-

1. Vali

2. Azal

3. Iyam

4. Vali Azhal

5. Vali Iyam

6. Azhal Vali

7. Azhal Iyam

8. Iya Vali

9. Iya Azhal

10. Mukkutram

The body constitution of a person must be taken into account during diagnosis, treatment, diet planning, seasonal environmental changes etc.

These Uyir Thathukkal Vali, Azhal and Iyam are further subdivided individually into 10, 5 and 5 subdivisions respectively depending upon their physiological functions exerted by them in our body.

If the three humors remain in their sites in the body it is known as the natural state of the humor (Thannilai). When the humors increase or aggravate in their sites individually, it is the state of aggravation (Thannilai Valarchi). When the humors aggravate not only in their sites but also in their adjacent sites, then it is called as state of aggravation of humor in neighboring sites (Vetrunilai Valarchi). These variations are attributed to factors like food, activities, daily and seasonal variations. Vali is aggravated in its sites during summer, influencing the other humors during monsoon and is normal during spring. Azhal is aggravated in its sites during monsoon, influencing the other humors during spring and is normal during early winter. Iyam is aggravated in its sites during late winter, influencing the other humors during early summer and is normal during late summer.

In the universe, three factors that maintain the ecosystem are the sun, the moon and the wind. Vali is represented by the wind which is responsible for the movement is a combination of Vinn and Vayu. Azhal is represented by the sun which is responsible for energy of conversion and is formed by Thee. Iyam is represented by the moon which is a cooling agent formed by the combination of Neer and Nilam.

Aaru Suvaikal Theory (Six tastes theory)

The things or objects in this universe are all the products of the five basic elements and are existing in different forms i.e. living or non-living. Human beings can identify them through their sensory organs. These sensory organs function through the five basic elements as described in the following table.

From this table, it is clear that the bond between man and worldly things is established by the five basic elements (Iymboothankal) only. Siddhars have utilized the sense of taste in most of the times to identify the drugs for treatment. Not only that, the taste sense also provides certain diagnostic criteria to identify the diseases of the person. With this background, the Aarusuvaikal theory (six tastes theory) plays a vital role in Siddha system of Medicine.

Siddha system of Medicine classified the tastes into six types viz.-

1. Inippu (Sweet)

2. Pulippu (Sour)

3. Uvarppu (Salt)

4. Kaippu (Bitter)

5. Kaarppu (Pungent)

6. Thuvarppu (Astringent).

Each taste is the result of combination of two basic elements as that of the three humors. The formation of six tastes is explained below.

The relationship between Six Tastes and Three Humors

The promoting and pacifying tastes of each and every humors are classified based on the combination of the five basic elements in both tastes and humors and its relative property with each other. This forms the basis for the treatment plan for a disease in Siddha Medicine. Moreover, depending upon the presence of the element Thee (fire) in an object, the things and tastes can be further classified in to two Veeriyams (potencies), viz., Veppam and Thatpam. The objects that have predominant Thee element are usually having salt, sour and pungent tastes and are classified under veppa veeriyam (Hot). The others are brought under thatpa veeriyam (Cold).

Concepts about Diseases

According to Siddha system of Medicine, diseases are caused due to imbalance in the normal ratio of three humors (Vali, Azhal and Iyam). The ratio is altered by the food and activities of the person and due to the changes in the environment.

Not only the derangement of three humors, the astral influences, poisonous substances psychological causes, spiritual causes are also the important factors for the occurrence of diseases. Siddha system of Medicine identifies the diseases in to 4448 numbers. These diseases are broadly classified on the basis of three humors as Vali noikal, Azhal Noikal and Iya Noikal. Further the diseases are sub classified into many types on the basis of various factors like treatment modalities, clinical features, anatomical locations etc., Additionally, the diseases are classified into Saathiyam (curable), Asaathiyam (incurable) and Arithil theerum (curable with extra efforts) based on the prognosis of the diseases.

The changes that occur in a disease are taking place in a sequential order. Initially, a particular humor increase or decrease in its site (thannilai piralthal) which influences the other humors (vetrunilai valarchi) to produce the premonitory symptoms (murkurikal). Later on, the specific signs and symptoms are exhibited. If the disease is properly treated at this stage, the deranged humor is turned back to its normal state (thannilai adaithal) and the symptoms disappear. If it is left untreated or ignored, the complication of the disease results which leads to a state called mukkutra nilai or sannipatham.

Diagnostic Methods in Siddha system of Medicine

Diagnostic methods in Siddha medicine is divided into three as follows-

1. Examination by the sensory organs (Poriyal arithal)

2. Examination by the senses (Pulanaal Arithal)

3. Examination by interrogation (Vinaathal).

The Physician examines the patient using his sensory organs and senses and arrives at a diagnosis. He also interrogates the patient about the history, duration, symptoms etc., to diagnose a disease.

The system approaches the patient in a unique method of using eight fold diagnostic tools like Naadi (Pulse reading), Parisam (Palpation), Naa (Tongue examination), Niram (Complexion), Mozhi (Speech examination), Vizhi (Eye examination), Malam (Faeces examination), Moothiram (Urine examination). Apart from these tools, the system has described the clinical features of each and every disease clearly in various Siddha texts and a specialised unique technique called “Manikkadai nool” which measures the wrist of the patient interpreting the disease by which a man is affected.  The urine examination in Siddha Medicine is unique and it consists of two parts i) characteristics of urine in different diseases (Neerkkuri) and ii) examination of urine by instilling a drop of gingelly oil on the surface of the urine (Neikkuri).

In neerkkuri, the following factors are to be noted, 1. quantity, 2. colour, 3. froth, 4. odour and 5. specific gravity. In Neikkuri, the pattern in which the instilled oil drop spreads paves the way for diagnosis and prognosis of a disease. Generally, if the instilled oil drop spreads like a snake, it indicates the presence of Vali disease in the body. Similarly, the shape of a ring indicates Azhal disease and pearl like appearance indicates the Iya disease in the body.

Apart from these, examinations of the saliva, semen have also been explained in this system for diagnostic and prognostic purposes.

Pulse reading in Siddha system is called as “Nadi paritchai” which an important diagnostic tool is providing lots of information to the Physician. It is a non- invasive technique of Siddha method of diagnostic tool in practice. Though it requires very high expertise and knowledge, it can be used as an inexpensive and quick method for diagnosing a disease at bedside. Usually the radial pulsation is read by the Physician for diagnostic purposes. But Siddha texts have described nine more sites in our body where pulse can be read. They are-

1. Inner side of the ankle

2. Genitals

3. Umbilicus

4. Chest

5. Ears

6. Nose

7. Neck

8. Eyebrows

9. Scalp

The naadi is felt through the three fingers of the examiner which is placed over the radial artery (wrist) just one inch below the thumb along the lateral border of the hand of the patient. The pulsation on Physician’s index, middle and ring fingers indicates the vali, azhal and iya naadi respectively. The pulse is examined in the right hand of males and the left hand for females. The units of measurement for vali, azhal and iyam are 1: ½ : ¼ respectively which is found in a healthy person. The unit is equivalent to the size of a grain (wheat). Alteration in this ratio indicates the presence of diseases in the body. 

Treatment Modalities in Siddha system of Medicine

The treatment methods in Siddha system is focusing at complete restoration of the deranged humors into its normal physical state or in equilibrium. Appropriate food and performing activities according to daily and seasonal regimen of lifestyle are the prime aim in treating the diseases. Then selection of medicines based on six tastes, three humors and five elemental theory is vital to treat the diseases. The treatment must be initiated as soon as the cause and the course of the disease are assessed.

In order to restore the deranged humors to its normal state, various cleansing therapies are recommended specifically. It is otherwise called as detoxification process. They are-

1. Purgative Therapy – To neutralize the deranged Vali

2. Emetic Therapy - To neutralize the deranged Azhal

3. Nasal instillation and Collryium application – To neutralize the deranged Iyam.

Apart from the above mentioned therapies, there are some more cleansing therapies are described. They are-

1. Fasting therapy – To treat all types of fever

2. Steam therapy – specific preparations indicated for specific diseases

3. Oleation therapy – specific oil preparations indicated for specific ailments

4. Solar or heat therapy – Diseases connected with vali humour

5. Blood-letting therapy – Conditions of accumulated blood 

6. Physical therapy – Used mainly in vali diseases performed in 9 different ways.

The significance of cleansing therapies is aimed at the elimination of excesses and toxins from the body, restoration of the natural processes through vital forces and reduction of the duration of treatment. Even the dosage required for a particular disease can also be reduced if prior cleansing therapies are performed. Cleansing therapies are cost effective approach in treatment modalities.

Following the cleansing therapy, pharmacotherapy with drugs and surgical methods are recommended according to the condition of the diseases. These therapies are further classified into-

1. Deva maruthuvam – Divine treatment

2. Manuda maruthuvam – Rational treatment

3. Asura maruthuvam – Surgical treatment.

1.  Deva maruthuvam – Divine treatment: 

In this treatment, medicines like parpam, chenduram, chunnam, kattu, kalangu, guru, kuligai prepared using mercury, sulphur, pashanams are given. Mostly higher medicines (Uyar marundhukal) are used to treat chronic diseases which are not responding to other modalities. The medicines prescribed are inorganics that follow strict SOP’s during preparation including the purification of raw drugs. 

2.  Manuda maruthuvam – Rational treatment:

In this treatment, mostly the herbal medicines are used to initiate the baseline treatment in the beginning stages of disease. The medical preparations like churnam, kudineer, charu, surasam, legyam, manappagu, mathirai, thylam etc, are prescribed as drug of choice.

All the 32 types of internal drug dosage forms described in Gunapadam (Pharmacology) text are being included in these two treatment classifications which may also include some of 32 types of external medicines in Siddha like pattru, ottradam, poochu, kattu, pottanam, podithimirthal, mai, etc.,

3. Asura maruthuvam – Surgical treatment:  

Surgical procedures in Siddha system indicated for diseases which are not cured alone by internal medicines are included in this treatment. About 25 procedures are given in this classification. It is further subdivided in to three categories viz.-

1. Aruvai or Surgical application

2. Agni or Heat application

3. Karam or Caustic application.

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1. Aruvai or Surgical application: 

Performing surgical procedures with 26 types of surgical instruments like knife, blade, ear scoop, forceps, etc., About 13 types of surgical procedures are explained under this application. They are-

1. Aruvai or Excision

2. Keeral or Incision

3. Kuruthivangal or Blood letting

4. Attai vidal or Leech application

5. Salagai idal or Probing

6. Vardhi vaithal or Inserting medicated cloth pieces or Medicated wicks

7. Oothal or Blowing method

8. Peechal or Enemanormal

9. Urinjal or Sucking method

10. Kombu kattal or Splinting

11. Murichal or Resetting of bones

12. Thokkanam or Physical manipulations including Massage, varmam etc

13. Kattuthal or Bandaging.

2.  Agni or Heat application

In this modality, surgical procedures are performed with the help of heat or thermal applications. They are of 5 types, viz.-

1. Suttigai or Cauterisation

2. Vedhu or Steam or vapour inhalation

3. Ottradam or Fomentation

4. Pottanam or Heated medicated pouches

5. Pugai or Fumigation

3. Karam or Caustic applicatio:  

In this application, procedures are performed with caustic substances to remove unwanted growth, slough and debris from the affected lesions or sites. They are seven in number viz.-

1. Kaaram or Medicated Caustic ablation

2. Seelai Medicated gauze or plaster

3. Kalimbu or Ointment/paste by adding butter

4. Podi or Dusting powders

5. Neer or Medicated liquid for wash

6. Kali or Drugs cooked with rice flour/any cereals/pulses

7. Pasai or Creams (Semisolid lipids/resins).

Twenty five types of 32 external medicines in Siddha system of medicine are dealt with in the Asura Maruthuvam methods.

Though the main treatment modalities in Siddha system are brought under the above categories, there are some unique specialized treatment modalities which are gaining popularity in recent decades. The kayakalpam (rejuvenation therapy), yogam (yogic postures) including vasi yogam (Pranayamam – breath control) and varmam (Life force/ energy concentric points) are the most popular treatment modalities of Siddha system.

Kayakalpam (Rejuvenation Therapy)

This therapy is the art of bestowing immortality which is a classical example for promotive health mechanism apart from curative and preventive health mechanisms of any medical system in the world. It is of 2 types.

1. Pothu Karpam: Promotion of rejuvenation, healing and regeneration of living tissues in normal health.

2. Sirappu Karpam: Promoting the health of an individual even at the time of a diseased condition by fighting against the specific diseases.

Varmam Therapy 

It is a set of procedures adopted to pacify or release the varmam in afflicted patients. Varmam or Varmam points are the Life force/ energy concentric points in the body where Pranic energy remains concentrated. 108 Varmam points are defined and these are used to stimulate energy, heal disease or stimulate the immune mechanism.

Yogam Therapy including vasi yogam (Pranayamam – breath control)

The word ‘Yogam’ means ‘union’. Siddhars have defined yogam as an art which controls the mind by preventing it from distractions through sense and sense organs and make it concentrating on a divine work. The regular practice of yogasanams becomes a kayakalpam and promotes longevity and youthness.

Vaasi yogam is a branch of science dealing with the practice of controlled breathing which enables one to utilize the oxygen breathed in completely. This method also promotes one’s health and vitality. 

In a nutshell, it can be clearly and strongly stated that Siddha system of medicine deals not only with curative and preventive health strategy but also directs for promotive health of the human beings.

References

1. Uthamarayan CS: Thotrakirama Araichiyum Siddha Maruthuva Varlarum, 3rd edition, Department of Indian Medicine & Homoeopathy, Chennai, 2003.

2. Uthamarayan, C.S., Siddha Maruthuvanga Churukkam (2nd Edition), Tamilnadu Arasu Siddha Ariviyal Membattu kuzhu. Chennai. 1983.

3. Uthamarayan, C.S., A Compendium of Siddha Doctrine: 2005; First edition; Directorate of Indian Medicine and Homoeopathy, Chennai – 106.

4. Sambasivam, T.V., Introduction to Siddha Medicine: 1993; Second edition; Directorate of Indian Medicine and Homoeopathy, Chennai – 106.

5. Shanmugam,S., Siddha Principles of Social and Preventive Medicine, I edition, Directorate of Indian Medicine and Homoeopathy, Chennai – 106.

6. Kandasamy N, History of Siddha Medicine, second edition, Directorate of Indian Medicine and Homoeopathy, Chennai, 1998.

7. Shanmugavelu M. Noi Naadal Noimudhal Naadal, Part 1. 3rd edition. Department of Indian medicine and Homoeopathy, Chennai.

8. Thiyagarajan R.,Anandan R, Thulasimani M, Siddha Materia Medica (Mineral & Animal sections), Directorate of Indian Medicine and Homoeopathy, Chennai, First edition, 2008.

9. Mohammed Iqbal, P.A., Pharmacy and Pharmaceutics of Siddha Medicine, First edition, 2016, National Institute of Siddha, Chennai, 2016.

10. Sornamariammal, I., Siddha Marunthukalin Ilakkanamum – vilakkamum, World Siddha Medical trust, Chennai, First edition.

11. Kuppusamy, K.N., Uthamarayan, C.S., Siddha Vaidya Thirattu (I Edition),Chennai, Department of Indian Medicine and Homoeopathy. 2009.

12. Thiyagarajan R.,Anandan R, Thulasimani M, Siddha Materia Medica (Mineral & Animal sections), Directorate of Indian Medicine and Homoeopathy, Chennai, First edition, 2008.

13. Murugesan, K.S. Gunapadam – Mooligai Vaguppu, Dept of Indian Medicine & Homeopathy, Chennai. 1988.

14. Sornamariammal,I., Siddha Marunthakkiyal Vithikalum Seimuraikalum, (1^st Edition), Chennai, Department of Indian Medicine and Homoeopathy. 2010

15. Thirunarayanan T., Introduction to Siddha Medicine, revised edition, Centre for Traditional Medicine and Research (CTMR), Chennai, 2012.

16. Shanmugavelu P, Natarajan K, Anandan R., Principles of Diagnosis in Siddha part – I, First Edition, Department of Indian Medicine and Homoeopathy. 2009.

17. Uthamarayan, C.S., Siddhar Aruvai Maruthuvam, II Edition,  Tamilnadu Siddha Maruthuva Variyam,  Chennai. 1983.

18. Kalyanasundaram, T.K., Gandhimathy, S., MeenakshiSundaram, M., Siddha Maruthuvam Vol–7; Kuzhandai Maruthuvam, (1^st Edition), Tamil Valarchi Kazhakam. Chennai,2011.

19. Kuppusamy, K.N., Siddha Maruthuvam, (2^nd Edition), Tamilnadu Siddha Maruthuva Variyam. Chennai, 1987.

20. Sambasivam, T.V., Siddha Tamil Dictionary, Vol.II – Part I, Second edition, 2006, Department of Indian Medicine and Homoeopathy, Chennai.

Author Dr M Sundaram is a Dr of Medicine (Siddha-KuzhandaiMaruthuvam)(Paediatrics) from The TN Dr. M.G.R. Medical University, Chennai. He was awarded Ph.D in Siddha - Paediatrics from the TN Dr.M.G.R Medical University, Chennai. Currently is working as Professor and HoD in the Department of Kuzhandhai Maruthuvam in National Institute of Siddha, Chennai and Dean (i/c) from January 2020 onwards. Dr Sundaram has more than 25 years of teaching experience which also include 3 years of experience as Principal in Sri Sai Ram Siddha Medical College, Chennai.

eSamskriti is grateful to Dr Meenakshi Sundaram for writing this piece and to SMART for co-supporting the eSamskriti effort.