Standardisation of Siddha Diagnostic method as aPrognostic ToolYazhini.A Research Scholar,Madras Institute of Technology, Anna University,Chennai, Tamilnadu. e-mail: [email protected]
SakthinathanAssociate Professor, Production Technology,MIT Campus, Anna University,Chennai, Tamilnadu.e-mail: [email protected] Abstract— siddhars had a vast knowledge of human anatomy, physiology,pathology, astrology and treatment. The Diagnostic methodology in Siddha systemis unique as it is made purely on the basis of clinical acumen of thephysician. This evaluation aims determining the sensitivity and specificity ofsiddha diagnostic methodology for all diseases. Our main aim is to evaluate anddetermine the diagnostic importance of wrist circumetric sign. Thispath used to understand a Siddha system of diagnosing pathological conditionsand it can be used for both diagnostic and prognostic purposes which are noninvasive, highly cost effective procedure.
When at times there were no technologicaladvancements around as of today, Siddhar’s tried to convey the art ofdiagnosing and the appreciation of prognosis to the contemporary world. Keywords- Siddha system ; Diagnosis; Wristcircumetric sign. I. Introduction Siddha system is not a system ofmedicine, it is a way of life. This traditional tamil system of medicine, whichhas been prevalent in the ancient Tamil land, is the foremost of all othermedical 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 tothe siddha system, the individual is a microcosm of the universe and containsthe five primordial elements- Earth, Water, Fire, Air and Space. The human bodyis made up of ninety six principles. Among them, the three humors- vatha, pithaand kapha form the functional units and the seven physical constituents- chyme,blood, muscle, fat, bone, marrow and semen/ovum form the structural units ofthe body. According to siddha pathology, there are 4448 types of disease,however all of which comes under classification of vatha, pitta and kaphadiseases.
Figure 1: Timing ofPredominance of trigunaUnder equilibrium, the ratio between vatha, pitha andkapha are 1:1/2:1/4. Certain factors like environment, climaticconditions, diet, physical activities and stress are said to affectthis equilibrium. This equilibrium of humors is considered as health andtheir imbalance leads to a disease state. II.
DIAGNOSTICMETHODS AND MATERIALSDiagnosis is more important intreating a disease. Diagnosis in siddha medicine is based on the followingby • Poriyaal arithal and pulanaalarithal (examination of sense organs)• Vinaathal (Interrogation)• Ennvagai thervu (Eight types ofexamination)• Manikkadai nool (Wristcircumference sign)• Assessment of derangedtridosham (humours), 7 udal thathukkal and 96 principles.Among this Manikkadainoolis one of a unique diagnostic tool.PORIYAAL ARIDHAL AND PULANAALARIDHALThe physician should examine thepatients porigal and pulangal by means of his porigal and pulangal• Mei – Feel thetemperature, inflammation, skin texture.• Vaai – Taste.
• Kann – Visualizing theabnormalities.• Mooku ? Smellingthe odour of urine/sweat/faeces.• Sevi – Hearing patients complaints.VINAADHAL (INTERROGATION)The physician should interrogatethe patient’s name, age, occupation, hometown, socioeconomic status,dietary habits, present complaints, past history and aggravating factors.ENN VAGAI THERVU (Eight typesof examination)According to siddha experts,”Naadiparisam naaniram mozhivizhi Malam moothiramivaimaruthuvarayum”- TheraiyarSara payirchi(8 types ,Examination of Tongue, Speech,Eye, skin sensation, Motion, Urine, Nadi, Body colour).
“Meikuri niranthonivizhina virumalam kaikuri”1. Naa (Tongue)The tongue is for taste andspeech. The colour, white coating, pigmentation, taste sensation, fissure,salivation, deviation are observed in the tongue. In vatha the color oftongue is black, In pitha conditions, tongue will be yellow or red that iseither bitter or sour in taste. In kapha A white coated tongueis an indication of constipation and aneamic.2.
Niram (Colour)The normal colour of the body is observed. Any pigmentationor patches present all over the body is also observed.Vatha – Black/Dark ColourPitha – Yellow or red ColourKapha – White/Pale ColourThontha – Mix of two Udal Colours3. Mozhi (Voice)Vatha disease – Normal voicePitha disease – High-pitchedvoiceKapha disease -Low-pitched voice/slurred in alcoholismAny 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/Palein kapha disease), palpebral conjunctiva, moisture, burningsensation is all noted. 5. Sparisam(Skin)The temperature, sweat,sensation, tenderness are all noted.Vatha – WarmPitha – HotKapha – Chill and sweaty S.
No Skin Appearance Occurrence of death 1. Crocodile 65 days 2. Tortoise’s shell 12 days 3. Tail of fish 45 days 4. Extreme hot 9 days 5. Extreme cold 2 days 6. Like elephant skin 41/2 days 7.
Tree 23 hours 8. Lotus 12 seconds 9. Sun 2 months 10. Moon 3 months 11. Golden color 5 months 12. Fire 4 months 13. Silver 6 months 14.
Black 7 months 15. Green 8 months 16. Glittering Sudden death Table 1: Appearance of skin results 6. Malam(Stools)The no. of stools per day,consistency, quantity and colour of the stools are noted.Vatha – Black, constipatedPitha – Reduced quantity, warm yellowor red in colourKapha – White and chill 7. Siruneer(Urine)The colour, odour, specific gravity, froth and depositsare observed as Neerkuri.
Straw Color – Indigestion Reddish Yellow – Excessive Heat Rose color– Blood Pressure Saffron – Jaundice Meat washedwater – Renal Disease “Aravena neendinakey vaatham Aazhipol paravinagthey pitham Muthothu nirkinmozhivathan kabame” -Agathiyarvaithiya rathina surukam.To maintain uniformity, every patient was advised to sleepearly (before 9 PM) with usual intake (2 to 3 glasses) of water during thedinner. Before sunrise, around 5 AM, patients were asked to collect the midstream urine of the first urination of the day in a clean and neatbottle. 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 isallowed to settle. After ascertaining that the urine is stable and devoid ofwave or ripples or other influence of the wind, the urine was examined in daylight at 6.30 AM. Sesame oil was then taken in adropper 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 ofthe oil drop) without disturbing/touching the surface.
It was then left for afew minutes, and the oil drop spreading pattern on the urine was observed. Theinferences were then recorded. “Arunthoorithamum Avirothamaai Akkal Alardhalagaalavoon thavirinththaakar Kutralavarunthi urangivaikarai Aadikalasath thaaviyekaadhu neerin Nirakuri neyikkurinirumithal kadane”A drop of oil is instilled in the bowl of urine and thespreading pattern of the oil drop is examined.1.
Aravu (Snake like pattern ofspread) indicates Vatha disease2. Aazhi (Ring like pattern ofspread) and Vattam (Round like pattern of spread)indicates Pitha disease3. Muthu (Pearl like pattern ofspread) indicates Kapha disease.8. Naadi (Pulse)Pulse was checked on left wristof female and right wrist of male and analyses for the strength of Vatham, Pithamand Kapham.
Vatham is identified in the first finger, Pitham in the middlefinger and Kapham under the ring finger. Pulse was regonised for its pulseappraisal, pulse character and pulse play such as Pitha vaadham, Vaadha pithamand kapha pitham.” Vazhangiya vaadham maathiraiondragil Vazhangiya pitham thannil araivaasi Azhangum kabamthan adangiya kaalotil Pizhangiya seevirku pisagondrum ilaiye”Inbalance of Vatta,Pitta,Kapa causes diseases in body, theprocess that takes place subsequently is called samprapti or pathogenesis.Vatta Guna:- Stout, Black, Cold& inactive personality,- Increased vata develops Flatulence, acidity,dysentery, obesity etc- Headaches, Bodypain, Arthritis, Loss ofappetite, Difficulty in Urination and Skin discoloration.Pitta Guna: – Lean, Wheatish complexion, hot personality.- Increased pitta results in early graying ofhair, reddish eyes, Insomina, Mental disorders, Yellowishness of eyes andurines.
– Burning sensation in stomach, Heart burn,thirsty, dryness of mouth, Confusion & diarrhea. Kapa Guna:- Well build, good complexion, good behavedpersonality.- Increased kappa develops diseases like jaundice,heart attack, fever, anemic.- Prognosis disease of kidney & cheat,Heaviness of body , Cold to touch, loss appetite, difficulty inbreathing.
Pulse changes with the behaviorof triguna. Full nadi- Indicates Asthma. ½ or ¼ nadi – denotes pain , arthritis& swelling. Abnormal intense pulse shows Tuberclosis.
Pulse propagates toleft side it denotes loss of self control. Pulse propagates to right side itdenotes sign of death. III. TECHNIQUEAVAILABLE FOR MANIKADAI DIAGNOSIS(Wristcircumetric sign)This section will give a brief overview on the availabletechniques developed across the globe, to diagnose any particular disease usingthe concept manikadai.
In modern method of analysis Pulse based diagnosis isdone by Naditharangini software. But for Manikadinool there is no device todiagnosis in modern technique only the earlier method of findings are followed.A. MANIKADAINOOL “Kamalakai manikaiyil kayaru soothiam Vimalane nokiyevedamaamuni Thimilaam piniyathusera seppiye Amalana munikumunnaluei seithadhey” -Pathinensiddhar nadi nool.Manikadai nool is a traditional diagnosis method used inthe Siddha medicine, with a Vedic origin. What makes Manikadai nool differentis that unlike other diagnosis methods, patients themselves can diagnose theirdisease and know the progress. Manikadai nool is best one among many tools usedin practice.
It is a Sanskrit word, ‘mani’ means the protuberance of wrist, ‘kadai’means the finger breadth and ‘nool’ means thread or twine. Detailed informationon this practice is available in Saint Agasthya’s classical medical literarywork Agasthya’s Soodamani Kayaru Soothram. Also this method was used byVedhamamuni, a student of Siddhar Agasthya, who was a proponent of the Siddhamedicine.B. NOOIYINSARAM”Manikadai naalviral Thali vanmaiyaai Thanikidaikaiyaru potalandhu parkaiyil Kanithidum viralthanaikandu solavey Pinithidum noigalaipirinthuraikumey” In Manikadai nool, thedoctor measures the circumference of the right/left wrist using a twine, then the twine is removedfrom the wrist and is placed on a plain surface and the measurement of thetwine is taken by the patient’s fingers.
Count the total length of thread interms of finger units. The only thing should be taken care of is that the twineshould be non-elastic. The progress of the disease is calculated by the numberof fingers.
Usually, the length of the twine starts with four fingers and endswith 11 fingers. By this measurement the disease can be diagnosed.When the Manikkadai nool is 11 fbs, the person will bestout and he will live a healthy life for many years. When the Manikkadainool measures between 4 to 6, it indicates poor prognosis of disease andthe 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 andulcer result.• 9 ¾ fbs – Fissure, dryness and cough will be resulted.• 9 ½ fbs – Odema, increased body heat, burning sensationof eye, fever, mega noi and anorexia.• 9¼ fbs – Dysuria, insomnia, sinusitis and burningsensation of eye.
• 9 fbs – Impaired hearing, pain around waist, thigh pain,unable to walk.• 8¾ fbs – Increased body heat, skin disease due totoxins, abdominal discomfort, cataract, sinusitis.• 8½ fbs – Leucorrhoea, Venereal disorder and infertilitywill occur.• 8¼ fbs – Stout and painful body, Headache, sinusitis,and toxins induced cough.• 8 fbs – Abdominal discomfort, gastritis, anorexia andvenereal diseases• 7¾ fbs – Piles, burning sensation of limbs, headache,numbness occur.
Within 2 years cervical adenitis and epistaxis results.• 7½ fbs – Osteoporosis, abdominal discomfort, burningsensation of eyes, increased body temperature.Within 6 days all the jointsof 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 3years it causes anuria, pain and burning sensation over limbs, facialsweating results.• 6½ fbs – Thirst, anorexia, increased body heat andvatham results.• 6¼ fbs – Diarrhea, belching, vomiting and mucousdysentery.• 6 fbs – Reduced weight, phlegm in chest. It results indeath within 20 days.• 5¾ fbs – Delirium dizziness, loss of consciousness.
Itresults in death even if the patient takes gruel diet.• 5½ fbs – Severity of illness is increased. Toxins spreadto the head.
Tooth darkens. Patient will die in 10 days.• 5¼ fbs – Patient seems to be sleepy and death results onthe next day.• 5 fbs – Pallor and dryness of the body. Kapham engorgesthe throat and the person will die.• 4¾ fbs – Dryness of tongue and tremor present.
Patientwill die in 7 days.• 4½ fbs – Shrunken eyes, odema will present and deathresult in 9 days.• 4¼ fbs – Tremor, weakness of limbs and darkening of faceoccurs. Finally death results in 2 days.• 4 fbs – Pedal odema will be present.
Patient will die in5 days. IV. Conclusionand future workThe wrist circumetric sign is the easiest methods fordiagnosing the prognosis of diseases among all types. In modern analysis theris no device so the future work of this process is to design the device forfinding the wrist circumetric sign. It is based on detecting and communicatingand transmitting device to the system.
Implementation of Manikadinool insoftware which is based on the analysis of the cases and the survey. References1 Agathiya sudamanikaiyaru soothiram.2 Shanmugavelan R. Theran Arulseitha Siru NeerkuriSothanai. 3rd Edition. Thanjavur:Saraswathi Mahal Library; 2005. 3 Sanmugavelu M.Noinaadalnoimudhalnaadalthirattu.
Part-1. Chennai; Indian medicine homeopathy department; 2009. p. 345-352. 4 Shanmugavelu. Noi Naadal Noi Mudal NaadalThirattu / Part – II. 2nd Edition.Chennai: Department of Indian Medicine & Homoeopathy; 2003.
5 Uthamarayan K S. Siddha Maruthuvanga Churukkam.3rd Edition. Chennai: Department of Indian medicine and Homeopathy; 2003. 6 Thirunarayanan T. Introduction to SiddhaMedicine. Chennai: Centre for Traditional Medicine & Research; 2012.
7 Anaivaari R. Anandan. A Compendium of Siddhadoctrine. 1st Edition. Sivakasi:Department of Indian medicine and homeopathy; 2005.
8 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 contemporaryclinical methods.
International Journal of Ayurveda and Pharma Research, IJAPR| april 2016 | vol 4 | issue 4. 9 Ramachandiran S P. Theraiyar Neerkuri NeikkuriVaithyam. 1st Edition. Chennai: ThamaraiNoolagam; 2000. 10 Luciano Bruno de Carvalho-Silva, Anthropometricwrist and Arm circumference and Their Derivations: Application toAmyotropicLateral Sclerosis, Hand book of anthropometry, physical mesures of human formin health and disease. King’s college London, department of nutrition , springer newyork Dordrecht Heidelberg London Springer science+business media, LLC 2012. p.
719. 11 Shokoufeh Hajsadeghi, Ata Firouzi, PouriaBahadoran, Morteza Hassanzadeh. The value of wrist circumference for predictingthe presence of coronary artery disease and metabolic syndrome. S.
Hajsadeghiet al/Indian Heart Journal 68 (2016) S5–S9 12 Younes Jahangiri Noudeh, FarzadHadaegh, NasibehVatankhah, Amir Abbas Momenan, NavidSaadat, Davood Khalili, Fereidoun Azizi, JClin Endocrinol Metab. Wrist Circumference as a Novel Predictor of Diabetes andPrediabetes: Results of Cross-Sectional and 8.8-Year Follow-up Studies, J ClinEndocrinol Metab, February 2013, 98(2):777–784 13 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 Overweightand Obese Children and Adolescents.
The American Heart Association, April 11,2011; 123:1757-1762.