Indian Journal of Traditional Knowledge
Vol 7(1)- October 2007- pp 678-686

Herbs used in Siddha medicine for arthritis – A review

Eugene Wilson*1, GV Rajamanickam1, Neera Vyas2, A Agarwal3 & GP Dubey3

1Centre for Advanced Research in Indian System of Medicine (CARISM),

SASTRA University, Thanjavur 613 402, Tamil Nadu; 2Escorts Heart Institute and Research Centre, New Delhi 110 025; 3Centre for Psychosomatic and Biofeedback Medicine, Banaras Hindu University, Varanasi 221 005, Uttar Pradesh

E-mail: willeuge@yahoo.co.in

Received 18 November 2005; revised 22 January 2007

Plants used in Siddha system of medicine for arthritis has been studied from various Siddha literatures and are presented hereunder. The particulars of herbs used with its botanical name, vernacular name (Tamil), family, parts used, administration form and indication are tabulated. This information provides immense potential for studying their activity for arthritis both in pre-clinical and clinical stages, which lead to the preparation of useful pharmaceutical products.

Keywords: Siddha medicine, Arthritis, Medicinal plants

——————

*Corresponding author

 

 

IPC Int. Cl.8: A61K36/00, A61P19/00, A61P19/02, A61P19/06, A61P19/08, A61P19/10, A61P21/00

Attention of scientists all over the world is focused towards the alternative systems of medicine in the recent past. The reason being, none but for the currently practiced medical system is not complete for all the ailments encountered till date. The various therapeutic agents / approaches aim mostly at symptomatic relief rather than a definite cure. Hence, there is growing importance in traditional health systems in providing healthcare for a wider population across the globe, especially in the developing countries. WHO currently encourages, recommends and promotes traditional as well as natural remedies in national healthcare programmes, as they are easily available at low cost, comparatively safe, and are culturally acceptable. Since time immemorial, Siddha System of Medicine, the heritage of the family practice of South India, is a special, scientific, significant, most respectable and of high order one. In Bogar Nikandu, about 4,448 diseases are described and various herbs are indicated for these diseases1. Herbs, minerals and products of animal origin are basic raw materials of the Siddha system2. Siddha System of Medicine caters a totality of herbs, and is unique in exhibiting fewer side effects. Secondly, Siddha medicine has a better answer for curing refractive diseases like arthritis, cancer, bronchial asthma, etc.3 The name Siddha, owes its origin to medicinal ideas and practices of a class of Tamil sages called the Siddhar— perfected or holy immortals, who had firm faith in the deathless physical body being in tune with the spiritual immortal soul. Significantly, one of the definitions of Siddha medicine is conquest of death or that of which ensures preventive against mortality. This statement is attributed to Tirumoolar, a revered Siddhar whose treatise called Tirumantiram, has 3,000 stanzas and is regarded as a classic text on the basic philosophy of Siddha medicine. According to Tamil tradition, Siddha medicine is associated with 18 Siddhars, with Agastiyar, Tirumoolar, and Bhogar being the most important. The dates of these Siddhars are uncertain, although Tamil tradition accords remote antiquity to them. However, only the later Siddhars like Agastiyar, Tirumoolar, and Bhogar who lived in fifth to sixth century, could able to record it systematically4.

The materials used by the Siddhars as drugs could be classified into herbal (Mooligai or thavaram), inorganic substances (Thathu) and animal products (Jeeva vaguppu). In Tamil literature, the word Marunthu (drug) itself means or denotes scented root or leaf. In general, among the Indian Systems of Medicine, Siddha uses herbs prominently. Great emphasis is given to herbs by our ancient Siddhars. It is stressed by the Siddha sutra as follows:

Ver paru thazhai paru minginikal

Mella mella parpa chenduram pare

Accordingly, it is advised to administer first pure herbs in the form of liquid, powder, pill or paste. If it is not controlling, then, the physicians use mixture of herbs, metals, minerals and animal products in addition to herbs5. In view of this uniqueness, there was a dire need to identify the medicinal plants prescribed in Siddha literature and standardize the herbal drugs for some refractive diseases, and to make the international community aware of such distinctions. In the pursuit of such a venture, arthritis, the commonly affecting disease afflicted by many people due to change in food habits, life style, etc. was selected for the study. In spite of the efficiency of eradicating both rheumatoid arthritis as well as osteoarthritis in Siddha System of Medicine, it is not popular other than Tamil Nadu. Siddha system primarily uses herbal products as well as animal and mineral matters, too. As the system is started and practiced in the Tamil speaking area, it had no opportunity to spread out until and otherwise, the most useful medicine in this system is brought to light in other languages, the effective drugs of this system may not be enjoyed by others. Of late, the FDA Clause No. 312.23(a) (3) (ii), (9)), has clearly projected that any drug of traditional system can be exempted from rigorous clinical trial in case, one establishes the historical continuity of a particular drug practiced from the ancient period6. In view of such applicability, it is worth to bring out the excerpts of the original texts and the combination of the drugs particularly herbal drugs to the common mass. Moreover, such outreach in a particular language may not be possible for everyone. So, this review will be of great use is not only establishing the historical continuity but also to spread the knowledge on such drugs to the regions of other than Tamil Nadu.

 

In addition, this review will be much valuable to a researcher in any system of medicine to unravel the selection of better medicine. As the Siddha system, though much older in period, the approach to the texts for any other researcher who has no versatility in Tamil language, is difficult. The review like this will be instrumental to the researchers in other languages and other systems of medicine to compare and appreciate the wisdom of Siddha system. Nevertheless, once this practice of a particular medicine to arthritis is known to others, their feedback may help the local practitioners to refine their own medicine in a better form and applicable to the present times. In this direction, an effort to unearth the traditional knowledge on arthritis was taken up as Siddha system provides a complete cure to this challenging debilitating disease. Hence, the Siddha literature available with local trained Siddha practitioners and people practicing herbal drug therapy from generations to generations were contacted in and around Thanjavur district, Tamil Nadu, and collated here to appreciate the richness of Siddha system.

 

Methodology

The traditional books and palm leaf manuscripts available at the Saraswathi Mahal library, at the Raja Serofoji palace, Thanjavur, collections of the Siddha Medicine, Department of Tamil University and The Tamil University library, personal collections of a consultant Siddha medical practitioner in Thanjavur and oral discussions with a few other local practitioners were executed to get sufficient information about the traditional knowledge of treating arthritis. The observations presented herein are only pertaining to the herbs used for the treatment of arthritis. The various forms in which they are administered and the parts used involving herbomineral and animal origin were collected.

 

Results and discussion

The details of various plants, their parts used and route and the form of administration with botanical name, vernacular name and family are given for all plants. Details of plants used internally as single and polyherbal formulations have been presented (Tables 1 & 2) along with details of herbs used externally as single or polyherbal formulations (Tables 3 & 4). From the detailed survey of the traditional literature, discussions with local trained Siddha practitioners and people practicing herbal drug for generations to follow, it has been established that there exists a wide range of treatment for treating arthritis. The treatment for arthritis varies from practitioner to practitioner and also their methods and modes do so. In Siddha, treatment of a particular ailment depends on the type, severity of the ailment and the individual getting the treatment, his body constitution, the season, etc.

Though, there are many herbs earmarked for arthritis, Siddha system takes in to account the availability of a particular herb, its properties, its action, etc. Each herb varies depending upon the soil, geomorphology, climatic conditions and more so its phytoconstituents. So, Siddhars according to the availability of herbs in each locality and season, adapted unique therapies both internally as well as externally. The practice of single herbal therapy in Siddha is called  Aga mooligai prayokam with an idea


Table 1—Plants used internally as single herbal formulation

 

Plant name

Local name (Tamil)

Family

Uses

 

Adenanthera pavonina Linn.

Anai - kunri

 Leguminaceae

Leaf potion is used for frozen joints14.

Alpinia galanga Willd.

Srit-arattai

 Scitaminaceae

Root powder is used for arthritic syndrome14

Aristolochiaindica Linn.

Ich-churamuli

Aristolochiaceae

Root powder is used for joint disease14.

Boerhaavia diffusa Linn.

Mukka- rattai

Nyctaginaceae

Root potion is used for joints pain9.

Cardiospermum halicacabum Linn.

Mudakkathan

Sapindaceae

Leaf is used for joints pain11, 13.

Clerodendron phlomoides Linn.

Thazhuthazhai

Verbanaceae

Leaf is used for frozen joints12.

Cocculus villosus DC.

Kattukodi

Menispermaceae

Root potion is used for chronic joints disease14.

Corallocarpus epigaea Hook.

Akashagarudan

 Cucurbitaceae

Root, root powder and potion are used for frozen joints14.

Curcuma zedoaria Rosc.

Kich-chili -kizhangu

Scitaminaceae

Root potion is used for crippling arthritis & frozen joints14.

Enicostemma littorale Blume.

Vellarugu

Gentianaceae

Root powder is used for frozen joints11, 14.

Indigofera tinctoria Linn.

Avuri

Papilionceae

Leaf, root powder and potion are used for joints pain9, 11, 13.

Myristica fragrans Houtt.

Sathikai

Myristicaceae

Fruit, oil is used for joints pain14.

Ocimum gratissimum Linn.

Elimichan tulasi

Labiatae

Leaf potion is used for joints pain14.

Premna integrifolia Linn.

Munnai

 Verbanaceae

Leaf and root potion are used for joints pain14.

Randia dumetorum Lamk.

Marukarai

 Rubiaceae

Bark and root powder are used for joints pain14.

Sida acuta Burm.

Ponmusuttai

 Malvaceae

Root potion is used for joints pain13.

Withania somnifera Dunal

Amukkara

Solanaceae

Root powder is used for pain13, 14, 16.

 

Table 2—Plants used internally as polyherbal formulation

 

Plant name

Local name

Family

Uses

 

 

 

 

Acalypha fruticosa Forsk.

Chinni

Euphorbiaceae

Plant Powder & potion is used for joints pain14.

Anacylus pyrethrum DC.

Akkara karam

Compositae

Root potion is used for joints pain10.

Andrographis paniculata Nees

Nila vembu

Acanthaceae

Leaf & stem potion is used for frozen joints & joints pain14.

Argyreia speciosa Sweet.

Kadarpalai

Convolvulaceae

Root powder is used for joints pain13.

Asarum europoeum Linn.

Nilakadambu

Aristolochiaceae

Root potion is used for joints pain14.

Azima tetracantha Lam.

Sangamchedi

Salvadoraceae

Root, leaf potion is used for joints swelling14.

Balsamodendron myrrha Nees

Vellaip-polam

Burseraceae

Resin powder is used for frozen joints14.

Boswellia serrata Roxb.

Parangi-sambirani

Burseraceae

Resin powder is used for joints pain14.

Celastrus paniculatus Willd.

Valuzhuvai

Celastraceae

Seed powder is used for severe joints pain14.

Cephalandra indica Naud.

Kovai

Cucurbitaceae

Root potion is used for joints pain14.

Citrullus colocynthis Schard.

Attru thumatti

Cucurbitaceae

Root powder is used for joints pain14.

Cleome viscosa Linn.

Nay-velai

Leguminaceae

Leaf powder is used for joints disease14.

Clerodendron inerme Gaertn.

Pinasangam–koppi

Verbanaceae

Root powder is used for joints pain9,18.

Clerodendron serratum Linn.

Kanduparangi

Verbanaceae

Root potion is used for chronic joints disease14.

Crataeva reliogiosa Hook & Forst.

Mavalingam

Capparidaceae

Leaf potion is used for crippling arthritis8.

Cuminum cyminum Linn.

Chirakam

Umbelliferae

Seed potion is used for joints disease12.

Daemia extensa R. Br.

Uttamani

 Asclepiadeae

Leaf, root powder and oil are used for joints pain8, 9.

Glycyrrhiza glabra Linn.

Athimathuram

Papilionaceae

Root powder is used for frozen joints14.

Gmelina asiatica Linn.

Nila kumizh

Verbanaceae

Root powder is used for joints pain13.

Heliotropium indicum Linn.

Thel-kodukku

Compositae

Leaf potion is used for joints pain14.

Indigofera aspalathoides Vahl.

Sivanar vembu

Papilionaceae

Whole plant powder & potion is used for joints pain14.

Pavonia zeylanica Cav.

Chirtamutti

Malvaceae

Whole plant potion is used for joints pain14.

Plumbago zeylanica Linn.

Kodiveli

Plumbaginaceae

Root potion is used for joints pain9.

Ricinus communis Linn.

Amanakku

Euphorbiaceae

Seed oil is used for joints pain with swelling12.

Semecarpus anacardium Linn.

Cherangkottai

 Anacardiaceae

Seed powder, electuary, ghee is used for severe crippling arthritis12,15.

Shorea robusta Gaertn.

Kungiliyam

Dipterocarpaceae

Resin powder is used for joints pain14.

Smilax china Linn.

Parangi pattai

Liliaceae

Root potion is used for

crippling arthritis14.

Sphaeranthus indicus Linn.

Kottai karanthai

Compositae

Whole plant powder & potion are used for joints disease14.

Terminalia chebula Retz.

Kadukkai

Combretaceae

Seed powder and oil is used for joints pain12.

Trianthema decandra Linn.

Saranai

Ficoidaceae

Root, leaf potion is used for joints swelling14.

Tribulus terrestris Linn.

Nerujil

Zygophyllaceae

Whole plant potion is used for crippling arthritis14.

Withania somnifera Dunal

Amukkara

Solanaceae

Root powder is used for joints pain13,14,16.

Zingiber officinale Roxb.

Chukku

Scitaminaceae

Root potion is used for joints pain8,16.

Zizyphus jujuba Lam.

Elanthai

Rhamnaceae

Root and bark potion is used for joints pain9.

 

Table 3—Plants used externally as single herbal formulation

 

Plant name

Local name

Family

Uses

 

 

 

 

Abutilon indicum (Linn.) Sw.

Thuthi

Malvaceae

Leaf fomentation is used for joints pain7.

Adansonia digitata Linn.

Anaipuliyamaram

Malvaceae

Leaf fomentation is used for joints pain14.

Alangium salviifolium (Linn.f) Wang.

Azhinjil

 Cornaceae

Root, bark oil is used for joints pain13.

Anisomeles malabarica R.Br.

Rattai-paeymaruti

Labiatae

Leaf fomentation is used for joints pain14.

Anthocephalus cadamba Miq.

Kadambu

Rubiaceae

Bark, seed fomentation is used for crippling arthritis14.

Azadirachta indica A.Juss.

Vembu

Meliaceae

Ghee fomentation is used for joints pain12,14.

Brassica alba Rabenh.

Venkadugu

Cruciferae

Seed poultice is used for crippling arthritis10.

Cadaba indica Lamk.

Vizhuthi

Capparidaceae

Leaf poultice is used for joints swelling & antiarthritic14.

Calophyllum inophyllum Linn.

Punnai

Guttiferae

Seed poultice is used for joints pain14.

Calotropis gigantea R. Br.

Erukku

Asclepiadaceae

Leaf, latex poultice is used for joints pain with swelling7,8.

Cassia fistula Linn.

Sara konrai

Caesalpinaceae

Fruit poultice is used for frozen joints14.

Chrysanthemum indicum Linn.

Shamanthippu

Compositae

Flower oil is used for joints pain with swelling14.

Crinum asiaticum Linn.

Visha mungil

Amaryllideae

Root poultice is used for joints pain14.

Erythrina indica Lam.

Kaliyana murukku

Papilionaceae

Leaf poultice is used for joints pain14.

Euphorbia antiquorum Linn.
Shadurakalli

Euphorbiaceae

Latex and oil is used for crippling arthritis12. Milk poultice is used for joints swelling14.

Excoecaria agallocha Linn.

Thillai

Euphorbiaceae

Seed poultice is used for crippling arthritis14.

Ficus glomerata Roxb.

Athi

Urticaceae

Milk poultice is used for joints pain with swelling14.

Jatropa curcas Linn.

Katt -amanukku

Euphorbiaceae

Seed poultice is used for frozen joints14.

Justicia adhatoda Linn.

Adhatodai

Acanthaceae

Leaf poultice is used for frozen joints14.

Nigella sativa Linn.

Karunchirakam

Ranunculaceae

Seed poultice is used for joints swelling10.

Ocimum gratissimum Linn.

Elimichan tulasi

Labiatae

Leaf poultice is used for joints pain14.

Peucedanum Graveolens Benth.

Sathakuppai

Umbelliferae

Seed, root poultice is used for joints pain14.

Ricinus communis Linn.

Amanakku

Euphorbiaceae

Leaf fomentation is used for joints pain with swelling12.

Sapindus trifoliatus Linn.

Manipungu

Sapindaceae

Root poultice is used for joints pain14.

Tamarindus indica Linn.

Puli

Caeselpiniaceae

Leaf poultice is used for joints pain with swelling14.

Thespesia populnea (L.) Soland. ex. Correa

Puvarasu

Malvaceae

Latex poultice is used for joints swelling14.

Vitex negundo Linn.

Notchi

Verbanaceae

Leaf fomentation is used for joints pain with swelling14.

Zingiber officinale Roxb.

Chukku

Scitaminaceae

Root poultice is used for joints swelling8,16.

Ziziphus jujuba Lam.

Elandai

Rhamnaceae

Root, bark poultice is used for joints pain9.

 

Table 4—Plants used externally as polyherbal formulation

 

 

 

Plant name

Local name

Family

Uses

 

 

 

 

 

 

Acacia leucophloea Willd.

Vel veli

Mimosaceae

Bark oil, fomentation is used for joints disease14.

 

Acalypha indica Linn.

Kuppaimeni

Euphorbiaceae

Whole plant poultice, oil is used for joints swelling12.

 

Acorus calamus Linn.

Vasambu

Aroideae

Root poultice is used for joints pain14.

 

Aeschynomene aspera Linn.

Atru- netti

Leguminaceae

Leaf fomentation is used for joints swelling14.

 

Albizzia lebbeck Benth.

Vaghai

Mimosaceae

Leaf, root poultice, fomentation is used for joints swelling7.

 

Allium cepa Linn.

Vengayam

Liliaceae

Root poultice is used for joints pain14.

 

Artemesia absinthium, Linn.

Masi-patri

Compositae

Leaf fomentation is used for joints pain14.

 

Atalantia monophylla DC.

Kattu-elumichai

Rutaceae

Fruit oil is used for joints pain9.

 

Bacopa monnieri (Linn.) Wettst.

Nir-brahmi

Scrophularinaceae

Leaf poultice is used for chronic arthritis11,16.

 

Cardiospermum halicacabum Linn.

Mudakkathan

 Sapindaceae

Leaf, root oil is used for joints pain11,13.

 

Clerodendron inerme Gaertn.

Pinasangam–koppi

Verbanaceae

Root oil is used for joints pain9,18.

 

Clerodendron phlomoides Linn.

Thazhuthazhai

Verbanaceae

Leaf, root oil is used for frozen joints12.

 

Corallocarpus epigaea Hook.

Akashagarudan

Cucurbitaceae

Root poultice is used for joints pain14.

 

Cymbopogon citratus (DC.) Stapf.

Karpoorapul

Graminaceae

Leaf oil is used for joints pain14.

 

Datura metel Linn.

Umattai

Solanaceae

Leaf poultice, oil is used for joints pain with swelling7,11.

 

Euphorbia neriifolia Linn.

Ilaikalli

Euphorbiaceae

Leaf poultice is used for joints disease14.

 

Hemidesmus indicus R.Br.

Nannari

 Asclepiadaceae

Root oil is used for joints pain14.

 

Lawsonia inermis Linn.

Maruthondri

Lythraceae

Leaf oil is used as antirheumatic7,10.

 

Lepidium sativum Linn.

Aliverai

Cruciferae

Seed poultice is used for joints pain with inflammation14.

 

Michelia champaca Linn.

Shanbagam

Magnoliaceae

Flower oil is used for joints swelling14.

 

Mollugo cerviana Ser.

 Parpatakam

 Ficoidaceae

Root oil is used for joints pain14.

 

Nardostachys

jatamansi DC.

Sadamanjil

Valerianaceae

Root oil is used as antirheumatic14.

 

Nerium odorum Soland.

Alari

Apocynaceae

Leaf poultice is used for joints pain14.

 

Phaseolus mungo Linn.

Uzhundu

Papilionaceae

Seed oil is used for crippling arthritis14.

 

Piper nigrum Linn.

Milagu

Piperaceae

Leaf, fruit oil, fomentation is used for joints pain with swelling7,12.

 

Plumbago zeylanica Linn.

Kodiveli

Plumbaginaceae

Root oil is used for joints pain9.

 

 Pongamia glabra Vent.

Pungu

Papilionaceae

Root poultice is used for joints pain8.

 

Rubia cordifolia Linn.

Manjitti

Rubiaceae

Root oil is used for joints pain14.

 

Salvadora indica Royle.

Perungkalarva

Salvodoraceae

Fruit, flower oil is used for joints disease14.

 

Sesbania grandiflora Pers.

Sev-agathi

Leguminaceae

Root, bark poultice is used for joints pain with swelling10.

 

Solanum xanthocarpum Schrad & Wendll.

Kandankhatri

Solanaceae

Leaf oil is used for joints pain7.

 

Strychnos nux-vomica Linn.

Yetti

Loganiaceae

Seed oil is used for joints pain8,17.

 

Terminalia chebula Retz.

Kadukkai

Combretaceae

Seed oil is used for joints pain12.

 


to alleviate a particular disease using minimum resources effectively. Further, in earlier days the treatment was administered then and there. Many medicines were prepared fresh only after understanding the patient’s problem. Depending upon the severity of the illness and the patient’s constitution, the practitioner starts to prepare the medicine and administer them. Moreover, the root cause of a particular disease is none other than the derangement of humours. To counteract not only the disease but also the root cause, Siddhars introduced polyherbal formulations. Since, Siddhars have greatly believed in synergism, the number of polyherbal formulation used internally is more than the number of single herbal formulations (Tables 1 & 2). External preparations both single and polyherbal formulations are of equal number (Tables 3 & 4). Siddha literature claims that there exist 80 varieties of Vali diseases19. There is different school of thoughts pertaining to the number of Vali diseases 84, 85 and 8720-21. The nomenclature of Vali diseases is based on the concerned organ/system associated with clinical signs and symptoms along with the vitiated humours namely, vali, azhal and iyyam. Vali disease is a generic name comprising a number of clinical entities associated with deranged vali humour, pain, loss of function, etc.

 

Originally diseases are classified according to the three humours as vali noi, azhal noi and iyya noi22. Yugimamunivar have classified diseases authentically on the basis of clinical signs, symptoms, humoural and regional pathology. His classification of disease is so extensive and very clear. It could be compared to present day classification of disease in modern medicine and the one followed by Siddha physicians, even today. The insight and experience of Yugimamunivar is astonishing that he has described intestinal obstruction as (Uthara vali) and neoplasm of oesophagus as (Orakari vali). Some other examples of vali diseases that can be compared to current day clinical manifestations are psoriatic arthritis (Kalanjagam), synovitis or synovial arthritis (Narithalai vali) and inflammation of the origin of joint (Uthiravatha sronitham/Vali Azhal Keel Vayu). Various synonyms have been used in Siddha literature to explain arthritis23 as: Santhu vali - Santhu (Joint), Vali (Pain) Muttu vali - Muttu (Joint), Vali (Pain) Mudakku valiMudakku (Crippling arthritis), Vali (Joint). Moreover, Keel vayu is a common term used to describe different types of arthritis in Siddha pathology. Siddha defines Keel vayu as deranged or vitiated vali humour (vayu) in the joints (keel), which bring about diseased condition. There are 10 varieties of Keel vayu mentioned in Siddha writings, namely: Vali Keel Vayu, Azhal Keel Vayu, Iyya Keel Vayu, Vali Azhal Keel Vayu, Vali Iyya Keel Vayu, Azhal Vali Keel Vayu, Azhal Iyya Keel Vayu, Iyya Vali Keel Vayu, Iyya Azhal Keel Vayu, and Mukkutra Keel Vayu.

Each type of Keel vayu presents with a group of symptoms, which can be correlated with the diagnosis of modern medicine. Firstly, Vali Keel Vayu manifests with joints pain, swelling, throat pain, fever, headache, palpitation, chest pain, arthritis affects mainly joints, and of migrating nature, Subcutaneous nodules, etc. coinciding with rheumatic fever. Secondly, Azhal Keel Vayu is caused by the vitiation of Azhal humour in the joints presenting with increase in swelling day-by-day correlating with osteoarthritis. As a result of the increase in Azhal humour, the lubricating fluid, i.e. Synovial fluid is reduced resulting in crepitations mentioned in Siddha as Claluk sound. Iyya Keel Vayu resembles tubercular arthritis with symptoms such as evening rise of temperature, loss of weight, swelling of the joint with pus formation and sequestration resulting in crippling arthritis, finally morbidity. Vali Azhal Keel Vayu mimics rheumatoid arthritis manifesting with malaise, fatigue, swelling with intense pain mainly affecting smaller joints with periods of recurrence and remission. Vali Iyya Keel Vayu presents with hyperpyrexia, pain and tiredness of upper and lower extremities, heaviness of the limbs, with urogenital symptoms, which at last leads to disability. Azhal Vali Keel Vayu is formed by the derangement of both Azhal and Vali humours resulting in haemorrhage into joints, which resembles haemophilic arthritis. Azhal Iyya Keel Vayu exhibits symptoms such as giddiness, vomiting, swelling in the larger joints with immobility of the joints. This type of arthritis is spread through sexual contact and hence can be correlated with syphilitic arthritis.

When Iyyam and Vali humours are deranged due to immoral sexual contact there is every chance for gonococcal arthritis known as Iyya Vali Keel Vayu in Siddha. It affects primarily the big joints of knees, ankles, elbows, shoulders, etc. It is described as if the affected joints take the shape of Fox’s head. Iyya Azhal Keel Vayu is correlated with pneumococcal arthritis where Iyya humour is vitiated, and then it combines with Azhal humour to manifest as a disease. Symptoms include fever, cough and severe cold, vomiting and swelling of joints leading to inability to flex and extend.

Mukkutra Keel Vayu is a condition where toxic symptoms prevail like severe sweating, dyspnoea, incoherent speech, vomiting, coma with absence of bowel movements and anuria with severe presentation of arthritis in the joints. In Siddha pharmacopoeia, various herbs and their parts have been widely used for the different types of Keel Vayu since 5,000 yrs. In Siddha system, equal importance has been given to internal as well as external medicine because Siddha medicine advocates 32 types of internal and 32 types of external medicine with their shelf life24. Medicated powder from herbs is a common type of internal medicine and is used as a baseline treatment for all ailments including arthritis, eg. root of Withania somnifera Dunal. powder (Choornam). Another type of internal medicine is potion, which gets absorbed quickly within our system and facilitates faster action that is of greater importance in arthritis treatment, eg. seed of Cuminum cyminum Linn. potion (Kudineer). Furthermore, internal medicines are administered in the form of pill (Mathirai), electuary (Legiyam), oil (Ennai), ghee (Nei), etc., eg. fruit of Piper nigrum Linn.–pill, seed of Terminalia chebula Retz. - oil, seed of Semecarpus anacardium Linn.–ghee25. External therapy includes fomentation (Ottradam), poultice (Pattru), oilation (Thailam), etc. This type of therapy is applied to the skin to release swelling or pain so as to alleviate the deranged vali humour by bringing in fresh energy by improving cutaneous circulation and neural conductivity, eg. leaf of Vitex negundo Linn. – fomentation, root of Zingiber officinale Roxb.–poultice & seed of Strychnos nux-vomica Linn. –oilation.

Even though, there are wide arrays of treatment modalities in the Siddha System of Medicine practiced by a number of physicians, well-organized, preclinical and clinical trial evidences are not adequately available in order to advocate their scientific merit and supremacy over the existing therapies. Hence, scientific validation of the safety and efficacy of the Siddha drugs both individually as well as formulations have to be studied in a systematic and organized manner to compete in the international market.

 

Acknowledgement

Authors sincerely acknowledge the Drugs and Pharmaceuticals Division, especially Dr GJ Samathanam, Advisor, Department of Science and Technology (DST), Government of India for their concrete support. Authors express deep sense of gratitude to Hon’ble Vice-Chancellor Prof R Sethuraman, SASTRA University for providing all necessary facilities to undertake the study. Authors thank the library Staff of Saraswathi Mahal and Tamil University library for their kind cooperation. Moreover, authors thank all the local traditional Siddha practitioners for their support in the successful completion of the study. Authors thank Dr S Prema, Dean, Faculty of Sciences, Tamil University, Thanjavur, Dr C Eleza, Siddha Consultant, Siddha Consulting Centre, Nagerkoil, Dr A Hannah Rachel Vasanthi, Department of Biochemistry, Sri Ramachandra Medical College & Research Institute, Chennai and Mr A Antony Thangadurai, Scientific Officer, CARISM, SASTRA, Thanjavur for their timely help.

 

References

1         Somasundaram S, Maruthuva Thavaraviyal, (Elangovan Publishers, Palayamkottai), 1997, 3.

2         Deivanayagam CN, Krishnarajasekhar OR & Ravichandran N, Evaluation of Siddha medicare in HIV disease, J Assoc Physicians India, 49 (2001) 390.

3         Swaminathan G, Role of R & D institution and pharmaceutical industries, Proc Nat Seminar Siddha Medicine, Thanjavur, 2002, 1.

4         Subbarayappa BV, Siddha medicine: An overview, Lancet, 350 (1997) 1841.

5         Eugene Wilson, Hannah R Vasanthi, GV Rajamanickam & GP Dubey, Siddha system of medicine and herbal remedies, Proc 2nd Int Conf Herbal Drugs Health Tourism, New Delhi, 2003, 111.

6         Guidance for Industry Botanical Drug Products, (US Department of Health and Human Services, Food and Drug Administration, Center for Drug Evaluation and Research,CDER), 2000.

7         Sirumanayoor Munisamy Mudaliar, Uyireluthu Mooligai Marmam, Munram Pagam, Ist ed, (Sivagami Vilas Publishers, Chennai), 1910, 15, 47, 54, 57, 61 & 63.

8         Chinnaswamy TP, Mooligaikalin Maruthuva Payankal, Revised ed, (Srikavi Publications, Madurai), 1989, 24-26, 27-30, 35, 61, 94, 95,100-102 & 122.

9         Muthuvelu Vaithiyar, Payantharum Pachilai Vaithiyam, Revised ed, (Narmada Publishers, Chennai), 1989, 25, 36, 43, 45, 109, 111 & 114.

10      Thirumalai Natarajan, Mooligaikalin Maruthuva Gunamkal, IInd ed, (Tamilselvi Nilayam Publishers, Tirunelveli), 1987, 11, 20-21, 35, 65- 66 & 69-70.

11      Janarthanan N, 500 Mooligaikalin arum payankal, Revised ed, (Narmada Publishers, Chennai), 1989, 13-14, 16-17 & 40.

12      Vasudev Sastri K, Sarpendra Vaithya Muraikal, IIIrd ed, (Sivagami Vilas Publishers, Chennai), 1979, 2, 3, 12, 42, 44, 72, 119-120 & 165.

13      Kasimugideen, Pathartha Guna Chindamani, Ist ed, (Sivagami Vilas Publishers, Chennai), 1888, 11,16-17,24,29,32,27,50,51,59,63,72-75,80-83, 85,92, 99,103-105,111,123,132 &145.

14      Murugesa Mudaliar CS, Gunapadam Mooligai Vaguppu, IVth ed, (Tamil Nadu Siddha Medical Council, Chennai), 1988, 1-680.

15      Dheenadayala Mudaliar A, Agasthiya Magamunivar Aruliya Vaithiya Vallathy 600, Ist ed, (Tamilselvi Nilayam Publishers, Tirunelveli), 1924, 51.

16      Ambai Arunachalam, Mooligaiiyal, (Elangovan Publishers, Palayamkottai), 1989, 88-90 & 117.

17      Uttamarayan CS & Kuppuswamy Mudaliar KN, Siddha Vaithiya Thirattu, (Directorate Indian Medicine and Homeopathy, Chennai), 1998, 292.

18      Sambasivam Pillai TV, Dictionary of Medicine, Chemistry, Botany & Allied Sciences, Vol 3, Revised ed, (The Research Institute of Siddhar’s Science, Chennai), 1992, 1770.

19      Yoogimamunivar, Yoogi Vaithya Chinthamani, Revised ed, (Directorate Indian Medicine and Homeopathy, Chennai), 1998, 76 – 108.

20      Shanmugavelu M, Noi Naadal, Noi Mudal Naadal Thirattu, Part II, (Tamil Nadu Siddha Medical Council, Chennai), 1987, 347-392.

21      Subramaniya Pandithar, Jeeva Ratchamirtham-Vatha Rogam, Ist ed, (Srikavi Publications, Madurai), 1923, 120-147.

22      Thirunarayanan T, An Introduction to Siddha Medicine, (Thirukumaran Publishers, Tiruchendur), 1988, 7-17 & 54-63.

23      Kuppuswamy Mudaliar KN, Siddha Maruthuvam, IInd ed, (Tamil Nadu Siddha Medical Council, Chennai), 1987, 545-592 & 595-615.

24      Thiyagarajan R, Gunapadam Thathu-Jeeva Vaguppu, IVth ed: (Directorate Indian Medicine and Homeopathy, Chennai), 1992, 43-63.

25      Vijayalakshmi T, Muthulakshmi V & Sachdanandam P, Toxic studies on biochemical parameters carried out in rats with Serankottai nei, a Siddha drug–milk extract of Semecarpus anacardium Linn. nut, J Ethnopharmacol, 69 (2000) 9–15.