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Fundamental Principles of Siddha medicine

The universe consists of two essential entities, matter and energy. The Siddhas call them Siva (male) and Shakti (female, creation). Matter cannot exist without energy inherent in it and vice versa. The two co-exist and are inseparable. They are the primordial elements Bhutas, not to be confused with modern chemistry. Their names are Earth, water , fire , air and ether. These five elements are present in every substance, but in different proportions. Earth, water , fire , air and ether are manifestations of these 5 elements .

The human being is made up of these five elements, in different combinations. The physiological function in the body is mediated by three substances (dravayas), which are made up of the five elements. They are Vatham, Pitham, and Kapam.In each and every cell of the body these three doshas co-exist and function harmoniously. The tissues are called dhatus. Vatham is formed by Akasa and Vayu.Vatham controls the nervous actions such as movement, sensation ,etc.

Pitham is formed by fire and controls the metabolic activity of the body, digestion, assimilation, warmth, etc. Kapam is formed by earth and water and controls stability. When their equilibrium is upsets disease sets in. The chart below may help to visualize the different properties. In addition to the influence of the Tridoshas the seasons also affects body constituents.

The five elements:Earth, water , fire , air and ether.

Tridoshas according to Siddha Medicine
The three doshas may be compared to three pillars that support a structure. From the charts below it can be seen that Tridoshas are involved in all functions of the body, physical, emotional and mental. The bodily activities, voluntary and involuntary are linked to Vatham.Pitham is linked to bodily changes involving destruction/metabolism. All constructive processes are performed by Kapam. They function dependent on each other. They permeate every single structure in the body. The maintenance of the equilibrium is health, disturbance is disease.

The seven tissues (dhatus) one of the three doshas predominate as shown in chart above in third column. The seven dhatus are: Rasa (lymph), Kurudhi (blood), Tasai (muscle), Kozhuppu (adipose tissue), Elumbu (bone), Majjai (marrow) and Sukkilam and Artavam (male and female hormones) (4).

Method of Treatment - The treatment for the imbalance of the Tridoshas are made up of the five elements. The drugs are made up of the five elements. By substituting a drug of the same constituents (guna) the equilibrium is restored. The correction of the imbalance is made by substituting the drug which is predominately of the opposite nature. An example is of Vatham imbalance is cold, dry thus the treatment will be oily and warmth. For inactivity of limbs, massage and activity, are prescribed. If Pitham dosha is increased, warmth is produced; to decrease Pitham, sandalwood is administered, internally or externally because of its cold characteristics .

Five types of Vayu
Vatham is considered to be the primary dosha because it activates the other two doshas. Vatham is the outcome of the ether and air of the Panchamaha Bhutas. The location and functions of the air is not much different from that of Ayurveda.

Table of Bhutas ( proportion) and metals

Diagnosis

Nadi Vignanam- diagnosis and prognosis by reading of the pulse.
Nadi in Siddha means two things -one is the pulse and the other is the nerves. In Yoga philosophy there are 72,000 nadis or meridians. They take root from the main sushuma , intertwined by the ida and the pingala. These are three most important nerves in the body along the spinal cord. The sushuma resides inside the spinal cord, and ida and pingala cross at the chakra points along spine. Science has yet to locate these three nerves. They are part of the sympathetic nervous system. The pulse is influenced in health or in a disturbed state by the nerves mentioned above and their minute branches all over the body.

The following pre-conditions are necessary before taking pulse.
The patients should not have oil on his/her head and the body should not be wet.The pulse should not be taken after a meal, running, any physical exercise, emotional disturbances (anger, joy). The general rule is for males , the right hand pulse is taken , female -left hand pulse. But owing to anatomical variations other places for pulse taking can be used, such as ankle, ear lobes .
The pulse should also be read at different parts of the day according to the season.

(NB: Most of these temperature changes are based on Indian weather . This could vary in other countries.)

April to May, the pulse read at sunrise. June to July. October, and November the pulse should be felt at noon. December , January and February the pulse is read while the sun sets. In March , August and September the pulse is read in the right hand. Due to the disturbance of the doshas by the temperature changes, the normalcy of the pulse is affected.

This is due to the increase and decrease of the doshas in the day (warmth, cold), seasons and atmospheric changes. This increases and decrease will affects the life stream or Jeeva dhatu. At noon the heat of the noon sun increase pitha dosha thus normal pitha pulse will not be felt. In the cold season karpa pulse is increased. In the hot season because of the dryness, the vatha increases and in autumn pitha increase. So these natural seasonal changes will be reflected in the pulse. This is the reason in the hot months (April to May) the pulse should be felt before sunrise. As pulse reading is subjective, evaluation, concentration and experience is valuable.

Vatha increases in morning for 4 hours after sunrise. Pitha for the next 4 hours and karpa in the evening. In earlier part of night vatham increases, pitham during middle of night and karpam at end of night
The place for feeling of this pulse is on the lateral aspect of the right forearm, two centimetres up from the wrist -joint. The index, middle and ring fingers are used to feel the vatham, pitha and karpa nadi in this respective order. An experienced Siddha practictoner can read the threedoshas by placing his/her finger on the radial artery. In feling the pulse, the pressure should be on one finger after another. The pressure alternates, on alternate fingers. The pulse is felt in the order of vatha nadi, pitha nadi and kapa nadi.

Vatha nadi imbalance will indicate flatulence of the abdomen , pain and ache all over the body, difficulty in urination, fever, change in voice, constipation , dry cough, discolouration of skin.
Pitha nadi imbalance will indicate eyes, urine, and faeces become yellowish, burning sensation in the stomach, headache, thirsty, dryness of mouth, confusion, diarrhea.
Kapa nadi imbalance will indicate heaviness of the body and head, sweet taste of tongue, cold to touch, loss of appetite, flatulencem cough with phlegm, m difficulty in breathing.

Urine examination (neer kuri)
Water is urine and kuri is signs and symptoms. Theraiyar was one of the latter authors of Siddha medicine who wrote on urine examination and stages of health. He explains the colour and consistency of the urine in different doshas and disease. He also talks of the spreading of a single drop of oil on the surface of the urine indicates imbalance of specific dosha and prognosis of disease. (This practice should only be undertaken by Siddha practitioner) In Ayurveda and Unani medicine the urine is examined mostly for its colour, smell, consistency and deposit. Urine analysis is more important than examination of sweat or faeces. Urine is the waste product of metabolism and has to be eliminated from the body. A person can be constipated for days but if urine is not excreted for a day serious health consequences can result. The waste product from every tissue metabolism are carried in the blood to the kidneys which removes the excessive salts and suspensions and eliminates them. Normal urine is thin straw colour and odourless. The colour of the urine comes under five division, yellow, red, green , dark and white . Each of these are further divided as illustrated below. The time of day and meals eaten will affect the color of the urine.

Yellow
1. Color of urine similar to water which straw has ben soaked- indigestion
2. Lemon colour-good digestion
3. Reddish yellow -heat in body
4. Color similar to forest red or flame colored - extreme heat
5. Color of saffron- heat in body at highest level

Red
1. Red color with slight dark red- the blood has become hot
2. Bright red colour-more hot than above
3. Dark red- blood in urine

Green
1. Green with slight dark colour- cold in the body
2. Green with sky blue - cold and poison in body
3. Green with blue-vatha imbalance
4. Blue color and slimy urine early vatha disease
5. Leaf green -late vatha disease

Dark colour
1. Dark red- jaundice or serious pitha disease
2. Reddish dark-destruction of blood cells (haemolysis)
3. Greenish dark-impurities in the blood
4. Pale white and dark- vatha and kapa disease, feverish with kapa diminishing

White
1. Pale white and clear-reduction of warmth in body, indicates incurable nature of illness
2. Mucous discharge -kapa dosha due to excessive heat
3.Milky white-indicated destruction of marrow and the possibility of wasting disease
4. Pale white with mucous and bad odour- inflammation and ulcer in the urinary passage from kidney to bladder or renal or urethral calculus
5. Semen like urine-highly depleted kapa dosha and disturbance of all doshas
6. Urine with no sediment - incurable disease
7. Urine like milk or buttermilk- incurable disease
8. Urine resembling washings of spoiled meat- bad functioning of kidneys and depletion of blood and kapa
9. Urine like melted ghee or dense- indication of impending death

Density
If urine is light and clear it indicated vitation of kapam and weakness of bladder. Heavy urine indicates disturbance of all doshas. Could also indicate internal ulceration and odema of the body.

Smell
Pungent smell indicates ulcer in the bladder. Acidic smell indicates excessive heat which may lead to coldness in limbs. Honey smell of urine indicates increase of blood in unhealthy state. Smell of raw meat indicates possibility of disease of muscle or adipose tissue.

Froth
Increase froth indicates destruction of muscle and fat. Yellow or reddish indicates jaundice. No froth or little indicates vitation of tridoshas.

The Eyes
The window to the soul and internal health. If vatham is imbalances the eyes will be shifty and dry. Pitham imbalance -eyes will be yellow and sensitive to light. If kapa in excess, watery secretion and oiliness and lack of lustre. In disturbance of all three doshas, eyes will be inflamed and red.

Voice
In kapa vitation -voice is heavy. In pitha vitation -voice will be short. Vatha will be different from the other two. Voice also indicates strength.

Touch
Vatha derangement-touch will be cold. Pitha -hot. Kapa -moist.

Color
Vatha vitiated -body of person becomes rough, skin and hair appear broken. Does not like cold. Memory is affected, self-confidence.
Pitha in excess-cause excess thirst , hunger and burning sensation. The lips, palms, feet and eyes will be red.
Kapa in excess-body is soft and oily. Loss of appetite and thirst.

Tongue
The tongue diagnosis is also used in Traditional Chinese Medicine (TCM). Refer to TCM in AM&M report on organ location and diagnosis.
In vatha derangement, tongue will be cold, rough , furrowed. In pitta, it will be red or yellow. In kapa, it will be pale and sticky. In depletion of tridoshas tongue will be dark, with the papillae raised and dry.

Faeces
Undigested food-the stool will sink. Digested food -stool floats.
Provoked vatham-faeces is hard and dry. Pitta vitation, it is yellow. Kapa disturbance it is pale. Lack of digestion fire the faeces is watery. Foul smelling of varied colour and shining the disease is incurable.

Kalpa
The Siddhas have developed a discipline called kaya kalpa. This discipline address the sections on longevity and fountain of youth with complete freedom from illness. It is similar to rasayana of Ayurveda and gerontology of modern medicine. Kalpa means 'able, competent'. The Siddha were more concerned with quality and longevity of living than with pursuit of sex.

Gold and mercury are administered in rejuvenation. More than medicines it is the discipline led by the individual that ensures longevity and freedom from illness. Breath control (pranayanam) and diet are two important parts of this discipline. Proper diet will promote physical stamina and mental equilibrium. The less ones eats the healthier can remain. In today's world it pays to be mindful of everything that we ingest .