Standardisation of Siddha Diagnostic method as a
Madras Institute of Technology,
e-mail: [email protected]
Associate Professor, Production Technology,
MIT Campus, Anna University,
e-mail: [email protected]
Abstract— siddhars had a vast knowledge of human anatomy, physiology,
pathology, astrology and treatment. The Diagnostic methodology in Siddha system
is unique as it is made purely on the basis of clinical acumen of the
physician. This evaluation aims determining the sensitivity and specificity of
siddha diagnostic methodology for all diseases. Our main aim is to evaluate and
determine the diagnostic importance of wrist circumetric sign. This
path used to understand a Siddha system of diagnosing pathological conditions
and it can be used for both diagnostic and prognostic purposes which are non
invasive, highly cost effective procedure. When at times there were no technological
advancements around as of today, Siddhar’s tried to convey the art of
diagnosing and the appreciation of prognosis to the contemporary world.
Keywords- Siddha system ; Diagnosis; Wrist
Siddha system is not a system of
medicine, it is a way of life. This traditional tamil system of medicine, which
has been prevalent in the ancient Tamil land, is the foremost of all other
medical system in the world. Its origin goes back to BC.10000 to BC.4000. Siddhars laid the foundation for this system.
Agasthyar is the pioneer in the art of siddha medicine. According to
the siddha system, the individual is a microcosm of the universe and contains
the five primordial elements- Earth, Water, Fire, Air and Space. The human body
is made up of ninety six principles. Among them, the three humors- vatha, pitha
and kapha form the functional units and the seven physical constituents- chyme,
blood, muscle, fat, bone, marrow and semen/ovum form the structural units of
the body. According to siddha pathology, there are 4448 types of disease,
however all of which comes under classification of vatha, pitta and kapha
Figure 1: Timing of
Predominance of triguna
Under equilibrium, the ratio between vatha, pitha and
kapha are 1:1/2:1/4. Certain factors like environment, climatic
conditions, diet, physical activities and stress are said to affect
this equilibrium. This equilibrium of humors is considered as health and
their imbalance leads to a disease state.
METHODS AND MATERIALS
Diagnosis is more important in
treating a disease. Diagnosis in siddha medicine is based on the following
• Poriyaal arithal and pulanaal
arithal (examination of sense organs)
• Vinaathal (Interrogation)
• Ennvagai thervu (Eight types of
• Manikkadai nool (Wrist
• Assessment of deranged
tridosham (humours), 7 udal thathukkal and 96 principles.
Among this Manikkadainool
is one of a unique diagnostic tool.
PORIYAAL ARIDHAL AND PULANAAL
The physician should examine the
patients porigal and pulangal by means of his porigal and pulangal
• Mei – Feel the
temperature, inflammation, skin texture.
• Vaai – Taste.
• Kann – Visualizing the
• Mooku ? Smelling
the odour of urine/sweat/faeces.
• Sevi – Hearing patients complaints.
The physician should interrogate
the patient’s name, age, occupation, hometown, socioeconomic status,
dietary habits, present complaints, past history and aggravating factors.
ENN VAGAI THERVU (Eight types
According to siddha experts,
“Naadiparisam naaniram mozhivizhi
Sara payirchi(8 types ,Examination of Tongue, Speech,
Eye, skin sensation, Motion, Urine, Nadi, Body colour).
vizhina virumalam kaikuri”
1. Naa (Tongue)
The tongue is for taste and
speech. The colour, white coating, pigmentation, taste sensation, fissure,
salivation, deviation are observed in the tongue. In vatha the color of
tongue is black, In pitha conditions, tongue will be yellow or red that is
either bitter or sour in taste. In kapha A white coated tongue
is an indication of constipation and aneamic.
2. Niram (Colour)
The normal colour of the body is observed. Any pigmentation
or patches present all over the body is also observed.
Vatha – Black/Dark Colour
Pitha – Yellow or red Colour
Kapha – White/Pale Colour
Thontha – Mix of two Udal Colours
3. Mozhi (Voice)
Vatha disease – Normal voice
Pitha disease – High-pitched
Kapha disease –
Low-pitched voice/slurred in alcoholism
Any wheezing sound present is also noted.
4. Vizhi (Eyes)
The colour of the conjunctiva
(Black and Muddy in vatha disease, yellowish or red in pitha disease, white/Pale
in kapha disease), palpebral conjunctiva, moisture, burning
sensation is all noted.
The temperature, sweat,
sensation, tenderness are all noted.
Vatha – Warm
Pitha – Hot
Kapha – Chill and sweaty
Occurrence of death
Tail of fish
Like elephant skin
Table 1: Appearance of skin results
The no. of stools per day,
consistency, quantity and colour of the stools are noted.
Vatha – Black, constipated
Pitha – Reduced quantity, warm yellow
or red in colour
Kapha – White and chill
The colour, odour, specific gravity, froth and deposits
are observed as Neerkuri.
Straw Color – Indigestion
Reddish Yellow – Excessive Heat
– Blood Pressure
Saffron – Jaundice
water – Renal Disease
“Aravena neendinakey vaatham
vaithiya rathina surukam.
To maintain uniformity, every patient was advised to sleep
early (before 9 PM) with usual intake (2 to 3 glasses) of water during the
dinner. Before sunrise, around 5 AM, patients were asked to collect the mid
stream urine of the first urination of the day in a clean and neat
bottle. Urine thus collected was poured in a round wide mouthed glass bowl
(4-5 inches in diameter and 1.5 inch depth), kept on a flat surface and is
allowed to settle. After ascertaining that the urine is stable and devoid of
wave or ripples or other influence of the wind, the urine was examined in day
light at 6.30 AM.
Sesame oil was then taken in a
dropper and one drop of the oil was dropped over the surface of urine slowly
(keeping a distance of 1 mm from the surface of the urine to the lower end of
the oil drop) without disturbing/touching the surface. It was then left for a
few minutes, and the oil drop spreading pattern on the urine was observed. The
inferences were then recorded.
A drop of oil is instilled in the bowl of urine and the
spreading pattern of the oil drop is examined.
1. Aravu (Snake like pattern of
spread) indicates Vatha disease
2. Aazhi (Ring like pattern of
spread) and Vattam (Round like pattern of spread)
indicates Pitha disease
3. Muthu (Pearl like pattern of
spread) indicates Kapha disease.
8. Naadi (Pulse)
Pulse was checked on left wrist
of female and right wrist of male and analyses for the strength of Vatham, Pitham
and Kapham. Vatham is identified in the first finger, Pitham in the middle
finger and Kapham under the ring finger. Pulse was regonised for its pulse
appraisal, pulse character and pulse play such as Pitha vaadham, Vaadha pitham
and kapha pitham.
” Vazhangiya vaadham maathirai
Vazhangiya pitham thannil araivaasi
Azhangum kabamthan adangiya kaalotil
Pizhangiya seevirku pisagondrum ilaiye”
Inbalance of Vatta,Pitta,Kapa causes diseases in body, the
process that takes place subsequently is called samprapti or pathogenesis.
Stout, Black, Cold& inactive personality,
Increased vata develops Flatulence, acidity,
dysentery, obesity etc
Headaches, Bodypain, Arthritis, Loss of
appetite, Difficulty in Urination and Skin discoloration.
Lean, Wheatish complexion, hot personality.
Increased pitta results in early graying of
hair, reddish eyes, Insomina, Mental disorders, Yellowishness of eyes and
Burning sensation in stomach, Heart burn,
thirsty, dryness of mouth, Confusion & diarrhea.
Well build, good complexion, good behaved
Increased kappa develops diseases like jaundice,
heart attack, fever, anemic.
Prognosis disease of kidney & cheat,
Heaviness of body , Cold to touch, loss appetite, difficulty in
Pulse changes with the behavior
of triguna. Full nadi- Indicates Asthma. ½ or ¼ nadi – denotes pain , arthritis
& swelling. Abnormal intense pulse shows Tuberclosis. Pulse propagates to
left side it denotes loss of self control. Pulse propagates to right side it
denotes sign of death.
AVAILABLE FOR MANIKADAI DIAGNOSIS(Wrist
This section will give a brief overview on the available
techniques developed across the globe, to diagnose any particular disease using
the concept manikadai. In modern method of analysis Pulse based diagnosis is
done by Naditharangini software. But for Manikadinool there is no device to
diagnosis in modern technique only the earlier method of findings are followed.
“Kamalakai manikaiyil kayaru soothiam
siddhar nadi nool.
Manikadai nool is a traditional diagnosis method used in
the Siddha medicine, with a Vedic origin. What makes Manikadai nool different
is that unlike other diagnosis methods, patients themselves can diagnose their
disease and know the progress. Manikadai nool is best one among many tools used
in practice. It is a Sanskrit word, ‘mani’ means the protuberance of wrist, ‘kadai’
means the finger breadth and ‘nool’ means thread or twine. Detailed information
on this practice is available in Saint Agasthya’s classical medical literary
work Agasthya’s Soodamani Kayaru Soothram. Also this method was used by
Vedhamamuni, a student of Siddhar Agasthya, who was a proponent of the Siddha
“Manikadai naalviral Thali vanmaiyaai
Thanikidaikaiyaru potalandhu parkaiyil
In Manikadai nool, the
doctor measures the circumference of the right/left wrist using a twine, then the twine is removed
from the wrist and is placed on a plain surface and the measurement of the
twine is taken by the patient’s fingers. Count the total length of thread in
terms of finger units. The only thing should be taken care of is that the twine
should be non-elastic. The progress of the disease is calculated by the number
of fingers. Usually, the length of the twine starts with four fingers and ends
with 11 fingers. By this measurement the disease can be diagnosed.
When the Manikkadai nool is 11 fbs, the person will be
stout and he will live a healthy life for many years. When the Manikkadai
nool measures between 4 to 6, it indicates poor prognosis of disease and
the severity of the illness will be high and it leads to death.
C. ALAVU AND INFERENCE
• 10 fbs – Pricking pain in chest and limbs, gastritis and
• 9 ¾ fbs – Fissure, dryness and cough will be resulted.
• 9 ½ fbs – Odema, increased body heat, burning sensation
of eye, fever, mega noi and anorexia.
• 9¼ fbs – Dysuria, insomnia, sinusitis and burning
sensation of eye.
• 9 fbs – Impaired hearing, pain around waist, thigh pain,
unable to walk.
• 8¾ fbs – Increased body heat, skin disease due to
toxins, abdominal discomfort, cataract, sinusitis.
• 8½ fbs – Leucorrhoea, Venereal disorder and infertility
• 8¼ fbs – Stout and painful body, Headache, sinusitis,
and toxins induced cough.
• 8 fbs – Abdominal discomfort, gastritis, anorexia and
• 7¾ fbs – Piles, burning sensation of limbs, headache,
numbness occur. Within 2 years cervical adenitis and epistaxis results.
• 7½ fbs – Osteoporosis, abdominal discomfort, burning
sensation of eyes, increased body temperature.Within 6 days all the joints
of the limbs presents a swelling.
• 7¼ fbs – Lumbar pain, increased pitha in head, anemia,
eyepain, odema and somnolence.
• 7 fbs – Pitham ascends to head, haemetemesis, phlegm,
burning sensation of limbs and constipation.
• 6¾ fbs – Eye ache, dizziness, testis disorder. Within 3
years it causes anuria, pain and burning sensation over limbs, facial
• 6½ fbs – Thirst, anorexia, increased body heat and
• 6¼ fbs – Diarrhea, belching, vomiting and mucous
• 6 fbs – Reduced weight, phlegm in chest. It results in
death within 20 days.
• 5¾ fbs – Delirium dizziness, loss of consciousness. It
results in death even if the patient takes gruel diet.
• 5½ fbs – Severity of illness is increased. Toxins spread
to the head. Tooth darkens. Patient will die in 10 days.
• 5¼ fbs – Patient seems to be sleepy and death results on
the next day.
• 5 fbs – Pallor and dryness of the body. Kapham engorges
the throat and the person will die.
• 4¾ fbs – Dryness of tongue and tremor present. Patient
will die in 7 days.
• 4½ fbs – Shrunken eyes, odema will present and death
result in 9 days.
• 4¼ fbs – Tremor, weakness of limbs and darkening of face
occurs. Finally death results in 2 days.
• 4 fbs – Pedal odema will be present. Patient will die in
and future work
The wrist circumetric sign is the easiest methods for
diagnosing the prognosis of diseases among all types. In modern analysis ther
is no device so the future work of this process is to design the device for
finding the wrist circumetric sign. It is based on detecting and communicating
and transmitting device to the system. Implementation of Manikadinool in
software which is based on the analysis of the cases and the survey.
Agathiya sudamanikaiyaru soothiram.
Shanmugavelan R. Theran Arulseitha Siru Neerkuri
Sothanai. 3rd Edition. Thanjavur:
Saraswathi Mahal Library; 2005.
Part-1. Chennai; Indian medicine homeopathy department; 2009. p. 345-352.
Shanmugavelu. Noi Naadal Noi Mudal Naadal
Thirattu / Part – II. 2nd Edition.
Chennai: Department of Indian Medicine & Homoeopathy; 2003.
Uthamarayan K S. Siddha Maruthuvanga Churukkam
.3rd Edition. Chennai: Department of Indian medicine and Homeopathy; 2003.
Thirunarayanan T. Introduction to Siddha
Medicine. Chennai: Centre for Traditional Medicine & Research; 2012.
Anaivaari R. Anandan. A Compendium of Siddha
doctrine. 1st Edition. Sivakasi:
Department of Indian medicine and homeopathy; 2005.
L. Janani, S. Anusha, S. Elansekaran, M.
Ramamurthy, V. Srinivasan, G. J. Christian et al. Neerkuri by Sage Theraiyar
– A Review on Siddha way of urine examination in the light of contemporary
clinical methods. International Journal of Ayurveda and Pharma Research, IJAPR
| april 2016 | vol 4 | issue 4.
Ramachandiran S P. Theraiyar Neerkuri Neikkuri
Vaithyam. 1st Edition. Chennai: Thamarai
Luciano Bruno de Carvalho-Silva, Anthropometric
wrist and Arm circumference and Their Derivations: Application toAmyotropic
Lateral Sclerosis, Hand book of anthropometry, physical mesures of human form
in health and disease. King’s college London, department of nutrition &
Dietetics, springer newyork Dordrecht Heidelberg London Springer science
+business media, LLC 2012. p. 719.
Shokoufeh Hajsadeghi, Ata Firouzi, Pouria
Bahadoran, Morteza Hassanzadeh. The value of wrist circumference for predicting
the presence of coronary artery disease and metabolic syndrome. S. Hajsadeghi
et al/Indian Heart Journal 68 (2016) S5–S9
Younes Jahangiri Noudeh, FarzadHadaegh, Nasibeh
Vatankhah, Amir Abbas Momenan, NavidSaadat, Davood Khalili, Fereidoun Azizi, J
Clin Endocrinol Metab. Wrist Circumference as a Novel Predictor of Diabetes and
Prediabetes: Results of Cross-Sectional and 8.8-Year Follow-up Studies, J Clin
Endocrinol Metab, February 2013, 98(2):777–784
Marco Capizzi, Gaetano Leto, Antonio Petrone,
Simona Zampetti, Raffaele Edo Papa, Marcello Osimani, Marialuisa Spoletini,
Andrea Lenzi, John Osborn, Marco Mastantuono, Andrea Vania, Raffaella Buzzetti.
Wrist Circumference Is a Clinical Marker of Insulin Resistance in Overweight
and Obese Children and Adolescents. The American Heart Association, April 11,