“To understand the complexity of disease and death one has to understand the origin of life.”

The founders of the ancient Siddha Tradition are known adepts in the philosophy of Life. They have been revered as the greatest scientists of ancient times and it is the splendor of their antiquity that gave birth to one of the oldest known traditions.

A Siddha lives in full-awareness of Nature, the activity of all objects/subjects of the Universe, and of Time – past, present and future. The Siddhas shared this wisdom and knowledge through different dimensions like Astronomy, Astrology, Occultism, Tantra, Yoga, Alchemy, Medicine and healing etc.

Siddha Medicine

The Siddhas were pioneers in investigating cosmogenesis and the origin of biological existence in the Universe and demystified the complex phenomena of disease. Ever since, Siddha medicine has been in continued service to humanity for over many thousand years. Combating disease and maintaining physical, mental and spiritual health has been the central pillar of it’s holistic approach.

The 1978 Alma Ata declaration at the WHO international conference on primary healthcare advocated the integration of traditional practices and ascertained Health as a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity. This definition bears striking synergy to the Siddha’s policy of health and wellness as mentioned by Siddha Thirumoolar some millennia back.

“One that cures physical ailment is medicine 

One that cures psychological ailment is medicine 

One that prevents ailment is medicine and

One that restores immortality is medicine” 

Siddha medicine has evolved over three to four millennia in its unique world views, concepts and theoretical framework as described in their elaborate codified literature. Although it is a very ancient system of traditional medicine, it has been professionalized since the last century and has been integrated into National health programs, indicating it’s ongoing and uninterrupted efficacy up to the present day.

Perception 

There is more than one way to learn physiology and pathology.

Modern medicine understands the human body by studying its individual parts – like cells, tissue, organ, etc. This approach has given groundbreaking benefits like surgery, antibiotics and molecular medicine. On the other hand the ancient approach views the body as a whole. In Siddha system of medicine the holistic interaction of the human form (body, mind and spirit) with its environment, internal and external, is taken as the field of diagnosis. This is a systemic approach that helps decipher the complexity of the biological system we are and help find ways and means to treat disease with minimal/simple intervention.

Unlike modern medicine, the Siddha system has evolved along with the socio-cultural passage of time starting from the origin of Man. This ancient medicinal system remains connected with its historical context and so its epistemic framework, principles, it’s concepts, practices quite rightfully stand apart from those of western biomedicine.

Fundamentals 

The human body is based on what the Siddhas define as 96 tattwas or principles. This physiological concept is unique to the Siddha system and is fundamental in understanding body-systems. The 96 tattwas bear ecological, somatic, neurological, neuro-endocrinological and psychic aspects that explain the dynamics and networking nature of health and disease.

According to Siddhas, the Universe is made up of five basic primordial elements (theory of panchabhootham). Physiological constituents identical to various tissues are called ‘udal thathukal’. Both physiological and pathological processes of the human body are mediated by three humors namely vatham, pittam and kapham which are called ‘uyir thathukkal’. The Taste constituent of drug materials forms the basis for pharmacological intervention which, with its specific five elemental combination balances the vitiated humor. The network of the five elements, uyir and udal thathukal level and the individual level are intact and seamlessly integrated. A change in one produces a change in the other.

Pharmacological intervention includes products derived from plant, mineral and animal origin. Drug therapy is based on the pancha bootha and six taste constituents of the substances. Drugs are classified based on the five Siddha pharmacokinetic properties viz suvai (taste), gunam (character), veeriyam (potency) and pirivu (bioavailability) and magimai (intrinsic activity). Thousands of years ago with no sophisticated technique to understand pathological processes, our forefathers the Siddhas deciphered the complexity of pathogenesis by their systemic approach, namely panchaboothangal, udal thathukkal, uyir thathukkal and naadi. The basis of all physiological processes is understood by the panchabootha combination. Deviation of humors is diagnosed through naadi and other examinations. And treatment protocol includes administering drugs to balance the vitiated humor(s).

Potential 

The Siddha medicinal dimension has a well-defined system of physiology, pathology and pharmacology developed on the concept of systems biology. Treatment usually begins with simple herbal remedies and for more advanced and chronic disease complex herbominerals and other modalities are used. Treatment strategy is classified into sixty four types with thirty two internal medicine forms and another thirty two external methods. The route of administration is mostly enteral. External therapy involves special forms of non-pharmacological and non-invasive treatment modalities, two of which evolved into separate entities, namely Thokkanam (Massage therapy) and Varmam (manipulation by pressure over subtle energy flow points). Another vital principle of Siddha medicine is the preventive maintenance of health by attention to components of lifestyle, diet, exercise, stress management and emotional wellbeing by natural and minimally invasive management methods.

Prevention 

The Siddha system provides curative intervention and advocates prevention of disease. According to the Siddhas, the two information systems, the system of internal genetic information and the system of environmental information, impinge on all biological systems. This information affects the phenotype by modifying molecular mechanisms that execute the function of Life.

Rejuvenation 

Their search toward maintaining perfect health led the Siddhas to the next level – rejuvenation and extension of life expectancy through yoga practice and a special group of medicine known as Kayakarpam. Kayakarpam medicines are classified into two groups – pothu karpam (taken by healthy individuals for the purpose of longevity) and sirappu karpam (taken by those suffering disease).

Today 

One can see diverging rural and urban trends of health seeking behavior. While accessibility, availability, and cost are important aspects in rural areas, limitation of conventional medicine, concerns of chemical drug, questionable assumptions of allopathic medicine, greater public access to information, changing values and reduced tolerance for paternalism, fitness and ecological consciousness etc., are the urban reasons for accessing Siddha medicine. Other reasons include emerging postmodern trends, renewed interest in diversity of choice, ecological concern, increased access to native systems by ethnic minorities, popularity of the emerging system-biology approach, customized care, need for body-mind medicine and economic factors. The focus is on treating disease that represents the greatest burden for the poor population. Some key resolutions of the World Health Assembly 2005 were directed to addressing the crisis of human resources, assuring health of poorest people, health of women and children, healthy ageing, addressing microbial resistance and cancer prevention and control.

Challenges in present scenario

The major challenges are

• Quality control and standardization
• Scientific validation of the therapeutic claims
• Safety
• Patient satisfaction and confidence

Various parameters required for quality evaluation of Siddha drugs are regulated by competent authorities. Some of the  approaches to preserve and promote Siddha medicine include documentation, building of databases, assessment through community based approaches, self-help approaches through home/community herbal gardens, community health workers training on various aspects, organizing and training local healers, interventions and research initiatives on specific conditions (such as malaria, HIV, anemia), orientation of conventional health professionals on Siddha, consumer watch, livelihood promotion through economic activities, conservation and sustainable use of resources, multi stakeholder participation and evolving guidelines on benefit sharing and knowledge protection.

The challenges ahead is two-fold; one is technical, as mentioned above, that we can sort out easily; the other is the regulatory issues, which may slow down the utility of this system.

Conclusion

Within the state one can see a divergence of reasons in rural and urban trends in the health seeking behavior. While accessibility, availability, cost are important aspects in rural areas, limitations of conventional medicine, concerns about chemical drugs, questionable assumptions of allopathic medicine, greater public access to information, changing values and reduced tolerance for paternalism, fitness and ecological consciousness etc., are reasons for accessing Siddha medicines in urban areas. Other reasons include emerging trends of post modernity, renewed interest in diversity of choices and ecological concerns, increased access of native systems by ethnic minorities, emerging system biology approaches, customized care, body-mind medicine and economic factors. While much of the attention in Siddha system has been given to address clinical, regulatory and supply oriented issues, there is a general neglect of wider public health dimensions. Quantitative research to ascertain levels of existing access (both financial and geographic) and qualitative research to clarify constraints to extending such access are important. The focus should be for those diseases which represent greatest burden for poor populations. An integrative system of health comprising Siddha and other traditional medicines with conventional medicine is the need of hour. This has to be done at all levels of the health system with the aim of delivering quality services equitably and efficiently to the whole population.