Fundamental Principles of Siddha Medical Science

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 Munn (solid), Neer (fluid), Thee (radiance), Vayu (gas) and Aakasam (ether). These five elements (Bhutas) are present in every substance, but in different proportions.

Earth, water, fire, air and ether are manifestations of these 5 elements.

The human anatomy and physiology, causative factor of diseases, the materials for the treatment and cure of the diseases, the foods for the sustenance of the body, all fall within the five elemental categories.

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 Karpam. 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. Pithamis formed by Thee and controls the metabolic activity of the body, digestion, assimilation, warmth, etc. Kapam is formed by Munn and Neer 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 as evident in northern and southern India.

The five elements: Munn, Neer, Thee, Vayu, and Aakasam

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 the 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 Karpam. 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 dhatus are: Rasa (lymph), Kurudhi (blood), Tasai (muscle), Kozhuppu (adipose tissue), Elumbu (bone), Majjai (marrow) and Sukkilam and Artavam (male and female hormones). 

The theory of predominance of the Tridoshas according to age and season varies from that of Ayurveda. Plus in Ayurveda the experts argue that Vatham predominates in old age as in last one third of life contributing to emaciation, dryness, etc.( as opposed to Karpam in Siddha) but as anyone who has been to north and south India will attest to -the extreme weather in the opposite ends of the country will affects individuals differently. Hence both theories could very well be correct.

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 (Air)

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

Daily regimen (Naal Ozhukkam) : Naal Ozhukkam mentions the systematic order of every day activities that every person needs to follow in order to avoid lifestyle disorders and related diseases. It describes the methodology to take good care of our body and mind.

1. Waking up (Kaalai Ezhuthal): Our new day begins as we wake up and it is the first activity of a day. The apt time for wake-up is between 4:00 AM and 5:00 AM. As we wake-up early, we breath fresh air rich in vital respiratory gases and that also helps the three humours or Uyir thathukkal to be in the state of equilibrium. Meditation and worship performed early in the morning brings immense pleasure to one’s mind.

2. Excretion of stools and urine (Mala salam kazhithal) : This is the act (or) function of eliminating the waste products of digestion and other metabolic activities. Excretion of faeces and urine are activities of vaatham and hence it should be performed soon after we wake up. Urine is passed first followed by stools. It is normal to pass faeces twice a day and urine 4 times a day which when disturbed indicates abnormal bowel function. One should not suppress these two physiological reflex activities. Certain methods have also been mentioned for cleaning after the act of defaecation in order to avoid infections. Proper excretion indicates proper digestion and helps the three humours or uyir thathukkal to stay in equilibrium.

3. Brushing of teeth (Pal thulakkal): Oral cavity being the main entrance of our gastro-intestinal tract must be well maintained by taking good oral care. Plaque deposits formed as a result of mastication should be cleaned properly in order to avoid infection. Siddhars have mentioned the use of certain herbal twigs and powders for a good dental care. The herbal twigs are considered best to be used as brush, as they are used and thrown (single use). Also, the act of chewing the herbal twig increases salivation and releases the juice of that particular twig which usually has astringent and disinfectant property. The bristles so formed help remove plaque easily away from teeth. This twig is usually selected without any nodes and from a fresh, well grown tree. In cases where people suffer from ailments like stomatitis, the use of twigs is restricted and instead the use of appropriate herbal powders is advised. 

4. Exercise: Iron rusts when not in use and, similarly, our body becomes a ground for diseases when not involved in proper physical exercise. As a part of daily regimen (naal ozhukkam), Siddhars stressed on the importance of practicing yoga which includes asanas, breathing techniques, meditation techniques, etc. These practices are aimed at developing body strength as well as peace of mind resulting in health and harmony. Early morning is the best time to perform yogic exercises as it help to face the day with great energy and enthusiasm. To refresh oneself after a day’s activity, physical exercises can be done in the evening. Physical exercises must be done in a well-aerated area and before meals or 2 hrs after meals. Yogic and physical exercises practiced under proper guidance along with appropriate diet habits facilitate proper functioning of internal organs, thereby leading to longevity. 

5. Bath: Physical exercise is followed by a bath to clean oneself of the sweat and dirt formed as a result of one’s activities. A bath before sunrise is considered good for health. Oil bath is recommended once in 4 days to bring strength to the five motor organs also known as Panchainderiyangal. The method prescribed is application of gingelly oil/ghee/certain medicated oil, usually followed by use of herbal bath powder (Panchakarpam) for washing. This practice is believed to protect the body against illness in all seasons. Methods for an oil bath, seasonal and diet restrictions while taking an oil bath have also been clearly discussed in ancient Siddha literature. 

6. Dress and Ornaments: A detailed description of dress code for men and women according to seasonal variations have been given due importance in day-to-day life. Influence of planets on humans, their relation to ornamental gems and how these can be used to treat diseases have been described in detail.

7. Diet: Diet plays a major role in our everyday activity. Diet acts as the source of vital nutrients to gain energy and it builds our body. Improper diet habits cause disturbances in equilibrium of the three humours (Uyir thathukkal) and physical constituents (Udal thathukkal) in turn causing several diseases. "Unavae marunthu; marunthae unavu". This verse, meaning diet can act as medicine, explains the importance of diet. The diet concept of Siddhars is based upon taste of foods as it indicates the natural property of the kind of food. A typical diet must therefore include a combination of 6 tastes that is best suited to the prevailing season. Hunger (pasi - one of the 14 physiological reflexes or Vegangal) indicates the need for food. Diet intake nourishes the different physical constituents, viz., Udal thathukkal in a particular sequence and finally provides strength to our body. However, food like milk, water and meat soup provide instant strength to body. According to Saint Thiruvalluvar, 3 main factors decide the structure of a good diet.

Taste: Tastes may have a compatible counterpart or an inimical counterpart and inimical tastes should never be taken together. A particular taste of food when taken in combination with its inimical taste food might yield poisonous effects due to dietetic incompatibilities. E.g. Milk and fish should never be taken together. Similarly, a combination of milk and green leafy vegetables is also harmful. A diet should also include food that normalises the three humours (trithoda sama porul). The concept of inimical and compatible taste in diet is also applied for selection and preparation of Siddha medicines.

The constitution of person: Diet with respect to quantity and quality should be taken according to the gender, age, physical/mental activity and basic body constitution (viz., vaatham, pitham, kabham) of the person

Time, season, and habitat : Selection of proper diet also takes into consideration the period of day (breakfast/lunch/dinner) seasonal variations and geographic locations.

Sleep: Sleep is nature’s way of providing rest to our body. Proper sleep is required when our body feels tired after a day’s work and it is therefore best to sleep at the end of a day. Sleep helps our body to carry out repair activities. The quantity and quality of sleep equally influences one’s good health. A man deprived of sleep develops varied disorders. Siddhars have mentioned certain procedures to follow with regard to sleep. As a part of daily regimen (Naal ozhukkam), good personality traits like silence, sincerity, charity, humanity, humility, honesty, politeness, justice, love and care for others are also encouraged since they result in purity of mind and will better chances of success in achieving eternal bliss.