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4.2 Ayurveda System 71
included in Pathya Vyavastha. This is done in an effort
to impede pathologic processes and improve the efficacy of treatment interventions. Actions like following
dietary do’s and don’ts are emphasized in order to
maximize food digestion and absorption and stimulate
Agni, which in turn ensures the strength of tissues.
5. Nidan Parivarjan (Avoidance of Disease-causing
and Aggravating Factors): The patient’s diet and
lifestyle should not include any recognized diseasecausing elements, according to Nidan Parivarjan. It
also includes the concept of avoiding situations that
might aggravate or precipitate the illness.
6. Satvavajaya (Psychotherapy): The field of Satvavajaya
mostly addresses mental health issues. This entails
developing bravery, memory, and focus in addition to
controlling the mind’s desires for undesirable substances. Ayurveda has greatly influenced the study of
psychology and psychiatry, which now provides a wide
range of therapeutic options for mental health issues.
7. Rasayana Therapy (Use of Immune-modulators
and Rejuvenation Medicines): The goal of rasayana
therapy is to enhance strength and vitality. Some of the
favorable effects attributed to this treatment include
maintaining the body’s integrity, promoting memory,
intellect, immunity against sickness, preserving freshness, luster, and complexion, and maintaining the
body’s and senses’ optimum strength. Rasayana therapy serves to prevent the early deterioration of bodily
tissues and to enhance an individual’s overall state of
health.
4.2.5 Ayurvedic Formulations
Drug formation methods have evolved in Ayurveda over a
period of time. The basic five methods are known as
Panchavidha Kashaya Kalpanas (five basic methods of
medicine preparation):
a. Swarasa: juice extract of herbs
b. Kalka: paste of herbs
c. Kwatha: decoctions
d. Hima: cold water extracts
e. Phanta: volatile extracts
All other methods are either combinations or modifica-
tions of any of these.
1. Asava and Arista: Asavas and Aristas are herbal
remedies prepared by immersing medications in
either powdered form or decoction form in a sugar or
jaggery solution, as the case may be, for a certain
period of time, wherein it goes through a fermentation process that yields alcohol, thereby making it
easier to extract the active ingredients of the drugs.
The alcohol that is generated serves as a preservative
as well. Arishta is prepared by boiling the drug in
water (decoction), whereas asava is prepared by the
maceration process.
2. Arka: Arka is a liquid preparation obtained by distill-
ing certain liquids or medications that have been
soaked in water using an Arkayantra or any other feasible current distillation apparatus.
3. Avalehya and Paka: Avalehya or Lehya is a semi-
solid medicinal formulation, prepared by adding
sugar, jaggery, or sugar candy, then boiling it with the
juice or decoction of the prescribed medicine.
4. Kwatha Churna: Kwatha churna is a granular pow-
der of drug or combined drugs that can be used directly
for the preparation of Kwatha or decoction.
5. Ghrita: Ghritas are prepared by boiling ghee (Clarified
butter) with Kashayas (decoctions) and Kalkas (pastes)
of specified medicine according to the formula. This
procedure ensures that the active medicinal components of the substances are absorbed. In other words,
these are preparations having ghee base. Though, the
source of ghee changes according to the formula,
goghrita (ghee which is prepared from cow’s milk) is
used in most of the preparations.
6. Churna: Churna is a fine powder of a single drug or
mixture of drug powders which is mixed with salt,
sugar, or appropriate sources, as mentioned in the
authentic texts. In churnas, any heat-based or waterbased processing stages are avoided. Raw forms of
drugs can be directly consumed through such formulations. In certain cases, the churnas are either boiled
in water or combined with milk, ghee, or honey before
consumption.
7. Taila: Tailas are prepared by boiling oil with pre-
scribed medicine pastes (Kalkas) and decoctions
(Kashyas) according to the formula. This procedure
ensures that the active medicinal components of the
substances are absorbed. These are preparations having an oil base. Though the source of oil changes
according to the formula, Tila Taila (sesame oil) is
used as a base in most of the preparations.
8. Dravaka: Dravakas are liquid preparations obtained
through the distillation process from Lavanas (salts)
and Ksharas (alkalies).
9. Vati and Gutika: Vati and Gutika are formulations in
the form of tablets or pills. These are prepared from one
drug or combination of drugs from the same or different sources, such as plants, animals, or minerals.
10. Pishti: Triturating the medication with the proper liq-
uids and exposing it to sunlight or moonlight is the
method for the preparation of pishtis. Anagnitapta
72 4 Complementary and Alternative Medicinal Systems
Bhasma is the name used to describe them (Bhasma
made without the means of fire).
11. Bhasma: Bhasma is a metallic/mineral preparation in
powder form, which is obtained by calcination.
12. Lepa: Lepa is the formulation in paste form and is
used for external applications. All the ingredients are
finely powdered and packed in dry powdered form
which is supposed to be mixed with the suitable liquid
specified by the physician.
13. Vartti, Netrabindu, and Anjana: Medicinal prepa-
rations that are used externally for the treatment of
eye are categorized as Vartti (eye wicks), Netrabindu
(eye drops), and Anjana (collyrium).
4.3 Unani System
4.3.1 History of Unani System
The Unani medical system has its direct roots in ancient
Greece (Yunani), as suggested by its name [20]. The origins
of this system can be traced to Egypt and Mesopotamia.
The Arabs then advanced its growth and gave it much more
support.
Asclepius (1200 BC), a brilliant medical scientist, started
the Greek era of Unani medicine. The art of medicine was
developed by the Greeks during the Asclepian period, considering Egyptian and Babylonian medical expertise. The
most influential physician in Unani medical history
throughout the classical era was Hippocrates (460–370
BC). He described the current medical knowledge and
placed an emphasis on the natural causes of disease to provide the foundation for the development of medicine as an
organized field of study. Observation, experience, and
rational principles were the three pillars of Hippocratic
medicine, and they are still relevant in the fields of science
and medicine today. Galen, a famous Roman scholar who
lived from 129 to 200 AD, contributed greatly to the last few
years of Greece’s creative age. By performing experiments,
he contributed significantly to medicine. He compiled all
the available medical knowledge and organized it in a systematic manner.
The enormous Arabic-speaking Middle Ages region
made significant contributions to humanity through its scientific and medical advancements after the fall of GrecoRoman civilization. Despite beginning in the Umayyad era,
the systematic Arabic translation of Unani medical writings did not become a movement until the beginning of the
Abbasid era. The Arabian physicians critically analyzed the
old medical knowledge, conducted their own philosophical and scientific investigations, and added new information to it. Arabs made the greatest contributions to
philosophy, general science, technology, and especially
medicine, which particularly helped to revitalize. Abu-al
Qasim Al-Zahrawi, a Spanish Unani scholar, wrote Kitab
al-Tasrif, which explains the extent of advancement in the
field of surgery. In this book, three chapters are devoted to
surgery. Arabs contributed significantly to the development of obstetrics and pediatrics by conducting experiments and writing books on these topics. Ibn Zuhr and Ibn
Rushd, two additional Spanish experts, helped Unani medicine spread and become established in Europe. Following
this, the Unani System emerged in India [21–24].
4.3.2 Principles of Unani
The core of the Unani system lies in the principle of
Tabeeyat, which asserts that every individual possesses an
inherent natural disposition toward health. This innate
tendency toward balance and well-being is believed to be
governed by the individual’s unique combination of
humours (blood, phlegm, yellow bile, and black bile) and
the dominance of certain elements within their constitution. The Unani discipline holds that the human body is
made up of seven natural and fundamental elements that
are essential to its existence and are said to be in charge of
maintaining health. Individual death would result from
the loss of any one of these components. These include elements, humours, temperament, organs, pneuma, faculties,
and functions [25-27].
1. Elements (Arkan): Unani medicine also incorpo-
rates the concept of the “four elements” – earth, water,
air, and fire. These elements are believed to influence
an individual’s physical and psychological constitution. For example, a person dominated by the earth
element may exhibit characteristics like stability and
groundedness. Every element possesses two fundamental qualities: dry or wet and hot or cold.
All things, including people and drugs, are composed
of four fundamental components mixed in various
amounts and ratios. Each thing has a unique quality
that results from the arrangement and interaction of
its component parts. These unique characteristics can
be broadly divided into four categories: hot and dry,
hot and wet, cold and wet, and cold and dry.
2. Humours (Akhlat): At the heart of Unani philosophy
are the four humours, which are vital bodily fluids –
blood, phlegm, yellow bile, and black bile. These
humours are intricately linked to various physiological
and psychological functions, and their equilibrium is
considered crucial for health. Imbalances in the
humours are believed to be the root cause of diseases.
Unani treatments are designed to restore this balance,
4.3 Unani System 73
often through dietary adjustments, herbal remedies,
and lifestyle modifications. The humours are four in
number and characterized by the dominant basic qualities as shown in Table 4.2.
The body’s organs, especially the liver, are responsible
for producing the humors, which then combine in the
blood vessels. Both subtle and gross elements are present in them. Pneuma is created when subtle components combine, whereas the organs and body are
created by the gross components. Each person has a
distinct humoral makeup that reflects his distinctive
disposition. Accordingly, based on the dominating
humor [28], all people are divided into Sanguine,
Phlegmatic, Choleric, and Melancholic.
3. Temperament (Mizaj): The concept of Mizaj focuses
on the individual’s inherent temperament, which is
determined by the relative dominance of the four
humors. Each temperament—warm, cold, wet, and
dry—is associated with specific qualities and characteristics. Ten categories of physical and mental characteristics, such as complexion, texture, build, hair, dreams,
etc. can be used to identify a man’s temperament.
Changes in these characteristics can also be used to
diagnose the abnormal change in temperament in the
entire man or in specific bodily parts and organs.
4. Organ (Ada): Organs and tissues make up the human
body as a whole. Simple and compound are the two
categories. Simple organs are tissues, such as fat,
whereas compound organs are multi-tissue structures,
such as the heart, brain, and liver.
5. Pneumas (Arwah): It is also known as the Rhu, is a
subtle physical substance that is created from the
humours’ subtle constituents. The organism derives life
from it since it is vital. Man has three pneumas, each of
which is produced in a vital organ: vital pneuma: heart;
psychic pneuma: brain; and natural pneuma: liver.
6. Faculties (Quwa): This principle emphasizes the
strength and vitality of an individual’s faculties, including digestion, circulation, and metabolism. Unani
treatments aim to support and enhance these faculties,
ensuring that they function optimally for overall
well-being.
7. Functions (Afal): These are the physiological pro-
cesses and actions that occur in tissues and organs as a
result of the activity of faculties or physiological
powers.
4.3.3 Methods of Diagnosis
According to Unani medicine, disease results from disturbances in the quantity and quality of akhlat (the body’s
humours) that maintain homeostasis, whereas wellness is
linked to these same factors. Every disease has a cause, and
that cause is constantly present. Unani medicine has developed a highly thorough system of classifying asbab (cause),
which nearly covers all common causes of all diseases
under several categories. The term “Asbabdakhilia” (internal
causes) refers to illnesses brought on by sue mizaj (bad temperament) or sue tarkeeb (structural organ abnormality).
A significant category of reasons known as AsbabKharjiya
(external causes) includes practically all factors – emotional,
physical, chemical, microbial, etc. – that have an impact on
the balance of the human body. The Unani system relies on
macroscopic characteristics for diagnosis because of its comprehensive perspective on man and disease. Since the Unani
system is holistic and considers the subtle level of man, it also
incorporates subjective indicators like dreams. Unani medicine offers a unique comprehensive diagnosis that takes into
account the patient’s medical history, physical examination,
pulse examination, and examination of excreta.
By looking at a patient’s pulse, Unani doctors determine the type of functional disruption of the human system empirically. Based on the doctor’s personal medical
experience, this conclusion was reached. Urine examination is very helpful in the diagnosis of other systemic
ailments as well as urogenital problems. Factors, such as
quantity, color, odor, consistency, foam or froth clearness, turbidity, and sediments are considered for it. Stool
examinations aid in the identification of numerous disorders [29].
Table 4.2 Element and humor quality as per Unani system.
Qualities Elements Humors Characteristic of people based on humor
Hot and dry Fire Yellow bile (Safra) Choleric
Hot and wet Air Blood (Dam) Sanguine
Cold and wet Water Phlegm (Balgham) Phlegmatic
Cold and dry Earth Black bile (Sauda) Melancholic
74 4 Complementary and Alternative Medicinal Systems
4.3.4 Treatment
After a disease has been accurately diagnosed, a course of
treatment is tailored and a careful course of treatment is
carried out to eradicate the health ailment. The treatment
is broadly divided into three courses of therapies, namely,
Ilaj-Bil-Tadbeer (regimental therapy), Ilaj-Bil-Dawa (pharmacotherapy), and Ilaj-Bil-Yad (surgical therapy) [30].
4.3.4.1 Ilaj-Bil-Tadbeer (Regimental Therapy)
This method involves the use of various natural agents and
physical treatments to restore the balance of humors. Since
ancient times, regimental therapy has been one of the most
common forms of care used by Unani physicians. Tadbeer
and Ilaj are Arabic words that, when translated literally,
imply “therapy” or “treatment,” respectively. Ilaj-Bil-
Tadbeer, then, refers to a regimen of treatment that takes
care of the sick individual while maintaining overall
health. In this respect, regimental therapy mostly consists
of non-medical techniques that adjust lifestyle choices for
maintaining health and treating disease. These include
dietary adjustments, increased physical activity, lifestyle
adjustments, and methods to remove or redirect the body’s
morbid humours, such as cupping (Hijamat), massage
(Dalak), leeching (Irsalealaq), etc.
1. Cupping (Hijamat): Literally, the word “cupping”
comes from the Arabic verb Hajam (“to suck”). In dry
cupping, a cup is placed over the skin’s surface by producing a vacuum. With wet cupping, internal congestion is relieved by performing scarification at the
cupping location in order to draw blood from the
affected area of the body.
2. Leeching (Irsal-e-alaq): Leeching is a technique for
removing undesirable material from the body. In this
method, leeches are used to draw blood from deeper
tissues by applying them to the area that is injured.
The leeches also introduce their saliva, a complex mixture of several physiologically and pharmacologically
active chemicals, into the blood throughout this
procedure.
3. Venesection (Fasd): The removal of superfluous
humours or pathological material from the body
through venesection is an absolute elimination technique. During this treatment, the superficial veins are
cut, allowing blood to circulate.
4. Massage (Dalak): Massage, also known as “Dalak”
improves body functioning and the healing process to
encourage relaxation and well-being.
5. Physical exercise: Physical exercise, also known as
Riyazat contributes significantly to both preserving
health and preventing sickness, as well as to the treatment of some illnesses.
6. Diuresis (Idrar-e-baul): One of the crucial procedures
used to remove unhealthy material from the body
through urine is diuresis.
4.3.4.2 Ilaj-Bil-Dawa (Pharmacotherapy)
The three laws of the Unani system of medicine that govern the selection of pharmaceuticals for treatment are: (a)
Drug Quality in Terms of Temperament; (b) Drug
Quantity in Terms of its Weight and Potency; and (c) Drug
Administration Time. The type and nature of the disease
condition affect the medicine choice. The right medication is one that works against the pathological temperament or the nature of the disease, as well as its qualitative
pattern. The nature of the organ, the severity of the condition, and other pertinent factors, including sex, age,
weight, habit and habitat, season, build, prior treatment,
and stage of the disease, decide the weight and potency of
the drug [31, 32].
4.3.4.3 Ilaj-Bil-Yad (Surgical therapy)
Since the beginning of the Unani system, surgery has
always been a component of treatment. A book with drawings of surgical tools was written by Arab Unani physician
Abu-al Qasim Al-Zahrawi and contained 30 volumes on
themes related to medicine, surgery, pharmacy, and other
health sciences. The last volume, comprising 300 pages, is
dedicated to surgery. He discussed several techniques,
inventions, and procedures, including tonsillectomy, tracheotomy, craniotomy, caesarian section, dentistry, and
removal of kidney stones and cataracts [33].
4.3.5 Unani Formulations
The foundation of Unani formulations includes ideas, such
as better safety and efficacy, assimilation, stability, and palatability. Four distinct formulations and dosage forms are
available for these medications. To increase the body’s
effectiveness and strength, the majority are exclusively
taken orally. Taken in solid forms are Habib (pill), Qurs
(tablet), and Safoof (powder). Majoon, Jawarish, Khameera
Laooq, itrifal, etc. are among the semi-solid medications.
Liquid forms include infusions (Kheesanda), decoctions
(Joshanda), distillates (Arq), syrups (Sharbat), drops
(Qatur), etc. Bakhoor (fumigation), inkibab (inhaling
steam), perfumes, and Lakhlakha are all examples of steam
or gaseous substances. In addition to oral medications,
some are also available as liniment (Tila), suppository
(Shiyaf ), enema (Abzan-sitz bath), and pessary (Firzaja).
4.4 Siddha System 75
4.4 Siddha System
4.4.1 History
The Siddha system of medicine is originated from Dravidian
culture and is mainly practiced in the southern part of
India [7]. Ancient Tamils and Dravidians of peninsular
South India used Siddha as their primary system of medicine. Before the year 2000, the Tamils’ indigenous medical
system was referred to as Marunthu (medicine) [34]. Due
to the outstanding contributions made by Siddhars, it eventually got the name “Siddha Medicine.” Siddhars are not
restricted to any one race, religion, caste, or creed. A
Siddhar is any holy person who cares about relieving pain
in humanity.
The origin of the Siddha system of medicine dates to BC
10 000 to BC 4000 [35]. The word Siddha has its origin in
the Tamil word “Siddhi” which means attainment of perfection [36]. Siddha also means established truth [37].
According to palm leaf writings, Lord Shiva originally
explained the Siddha system to his wife Parvati. Lord
Muruga learned all this information from his mother
Parvati. He passed on all this information to his disciple,
the sage Agasthiyar. Agasthiyar taught 18 Siddhars, and
they spread this knowledge to human beings. Agasthiyar is
called by many names, such as Agathiya Rishi, Agathiya
Maha Rishi, Agasthiya Munivar, Kumba Mamuni,
Vashister, Guru Muni, Tamil Muni, and so on. He is
referred to as the “father of the Tamil Siddha Medicine
System,” “Hippocrates of Siddha Medicine,” and the
“Prince of Indian Doctors” since he is the main proponent
of the Tamil Siddha Medicine System [38–39]. Siddha concentrated on “Ashtamahasiddhi,” the eight supernatural
powers. Siddhars are those who achieved or attained all
these powers [36]. During ancient times, this system was
developed by 18 notable Siddhars. The Siddhars recorded
their knowledge on palm leaves, and several of these manuscripts have been found in South India.
Siddhar Agasthiyar, who is regarded as the earliest of the
Siddhars, made contributions to the body of materia medica knowledge, which describes in great detail the medicinal properties of dietary components and herbs. The
formulary of Siddha medicine includes herbal and herbalmineral preparations. The comprehension of human
embryology is yet another contribution made by Agasthiyar.
His ophthalmology treatise (Agasthiyar Nayanaviti) is an
important work that continues to influence ophthalmology practice even today. Agasthiyar’s treatise on surgical
practices describes certain procedures and includes a list of
26 distinct types of surgical equipment.
The body and the soul are topics covered in Thirumoolar’s
masterwork, Thirumanthiram. The principal author of the
well-known literary masterpieces 3000 Thirumanthiram
and Saiva Siddhantam, which outlined the fundamental
principles of the Siddha system, is Thirumoolar. Thirumoolar
Vatham 21, Thirumoolar 608, Thirumoolar Valalai Suthiram
300, Thirumoolar Vaithiyam, Gnanam, and Palathirattu are
some of his additional contributions. In recent years, his
theory of the atom has been reinstated as nanotechnology.
Bogar is regarded as a Thirumoolar descendant. Bogar is
thought to have been to China and spread the spiritual philosophy there. It is said that Lord Muruga used nine arsenical substances to make a statue of himself. He made
contributions to alchemy, medicine, and yoga as well. It is
noteworthy that he made contributions to the synthesis of
mercurial chemicals, arsenical compounds, and mercury.
He is thought to have written over 42 works on Siddha
medicine. Bogar Nigandu, Bogar Karpam 300, Bogar 7000,
Bogar Varma Suthiram, Bogar Sarakku Vaippu 800, and
Bogar Vaasi Yogam are some of his accomplishments.
Konganar is considered to be the son of Bogar. He most
likely resided in Tamil Nadu’s Kongunadu. He authored
almost 40 volumes on alchemy and the elixir (muppu) of
life. [40].
The oldest Tamil work, “Tholkappiyam,” is thought to
have been written around 1400 BC. Many medical details
can be found in “Tholkappiyam.” The concept of the five
senses, the five-element theory, and the sixth sense –
human thinking ability – are all explained. A unique chapter in the second-century BC book Thirukkural is devoted
to Maruntu Atikaram (verse outlining medicine and the
three vital forces). An ancient Tamil classic from the second century AD entitled Manimekalai has a chapter that
discusses modern ideas about the atom, soul, supreme
being, and matter.
4.4.2 Principles of Siddha
The ideal state of a person’s physical, psychological, social,
and spiritual components is emphasized by the Siddha system. It is based on the fundamentals of “anda pinda
thathuvam” (the relationship between the universe and the
human body) and 96 thathuvas (basic principles), which
include the concepts of five elements, three humours, and
seven physical constituents [41].
4.4.2.1 Five Elements
The five fundamental elements – Neer (Water), Nilam
(Earth), Kaatru (Air), Thee (Fire), and Vin (Sky) – make up
76 4 Complementary and Alternative Medicinal Systems
all matter in the universe, including humans. As the various structures and functions of the human body change,
these components undergo balanced condensation/rarefaction/transformation in varying quantities. Living and
non-living things are created from these five elements,
which might exist in either a gross or subtle form. Each of
these five elements exists in a subtle stage before manifesting into a gross state and being noticeable. Pancheekaranam
(Mutual Intra Inclusion) refers to this important process of
the five elements manifesting from the subtle level to the
gross state, i.e. the fusion of five elements in various and
suitable proportions. [42, 43]. The five characters that
describe each substance in Siddha medicine depend on the
elements that make up that substance. They are taste, property, potency, post-digestive change, special biological
activity, and pharmacological action. Three vital life factors
and seven physical constituents are also formed by the
combination of five elements. These basic elements are
related to particular sense organs: Earth (Nilam) is associated with the nose, air (Neer) is related to the mouth, fire
(Thee) is related to the eyes, air (Kaatru) is related to the
skin, and sky (Vin) is related to the ears. Through 96 fundamental principles, the five elements manifest as humans,
as listed in Table 4.3.
Table 4.3 Basic principles of the Siddha system.
Five elements (Panchabootham)
Sense organs (Pori)
Five senses (Pulan)
Motor organs (Kanmenthiriyam)
Functions of motor organs (Gnanendiriyam)
Intellect (Karanam)
Self-realization (Arivu)
Channels of life force (Naadi)
Vital nerve force (Vaayu)
Metabolic sheaths (Aasayam)
Five sheaths (Kosam)
Nerve plexus (Aathaaram)
Sheaths of humours(Mandalam)
Impurities related to soul (Malam)
Humours (Thodam)
Qualities of mind (Gunam)
Attachments, desires related to the soul (Edanai)
Emotional status of mind (Raagam)
Status of consciousness (Avasthai)
Physical and mental acts (Vinai)
4.4.2.2 Seven Physical Constituents
According to the Siddha system, every living organism is
supported by seven physical components or fundamental
tissues known as Thathus. They are the following: Elumpu
(bones), Moolai (marrow), Venneer (reproductive tissue),
Kurudhi (blood), Oon (muscle), and Charam (lymph).
Blood has fire and water as basic elements, and it nourishes
the muscles and other tissues, gives the skin color (complexion), and sharpens the mind. Muscle has earth and
water as basic elements and gives shape to the body;
Adipose tissue has water and earth as a basic unit and is
responsible to lubricate joints and maintain balance; Bone
has earth and air as basic elements, and it supports the
structure of the body and controls movement and posture.
Reproductive tissue has fire and air as basic elements, and
it is responsible for reproduction; marrow and nervous tissue have water and air as basic elements, and it provides
bones with strength and endurance, as well as knowledge
and insight.
4.4.2.3 Humours (Uyir Thathukkal)
Uyir thathukkal literally means “life force.” The Three
Humors, also known as the Three Forces, are said by the
Siddha system to mediate and sustain bodily physiological
functions. They are pitham (fire), vaatham (air+space),
and kapham (water+earth) [42]. The ratio of these three
humours (vatha, pitha, and kapha) under normal circumstances is 4:2:1, respectively. [44]. A person is seen to be in
optimal health when their humors are in a state of natural
equilibrium and harmony. The diseases are produced when
they are deranged.
4.4.2.4 Vaatham (Vali)
Air and space are represented by vaatham. It controls all
bodily and mental movements. Vaatham governs motor
and sensory activity. Although vaatham exists throughout the body, it is most prevalent below the navel. Some
characteristics of vaatham are roughness, dryness, lightness, and movement. It also governs breathing, the functions of physical components, and physiological reflexes
in addition to strengthening the five sensory organs.
Based on its function, vaatham is divided into the following 10 types:
a. Naagan: responsible for knowledge and skills
b. Piranan: controls respiration and circulation
c. Devathathan: responsible for emotions like anger
d. Abanan: controls excretory
e. Thananjeyan: gets expelled out from the body on the
3rd day after death
f. Viyanan: spreads all over the body and controls body
movements
4.4 Siddha System 77
g. Samanan: regulates assimilation, absorption, and
digestion
h. Kirugaran: responsible for taste, appetite, and reflexes
i. Koorman: provides strength and vision
j. Udhanan: controls speech
4.4.2.5 Pitham (Azhal)
Pitham is responsible for maintaining our health and
represents the element “fire” (thee) in our body. It controls the chest and abdominal regions and keeps the body
at the proper temperature for appropriate physiology.
Within our body, it manifests itself in five different ways
as follows:
a. Anala Pitham: involved in digestion
b. Aalosaga Pitham: gives color and shine to the skin
c. Ranjaga Pitham: involved in blood cell production
d. Pirasaga Pitham: involved in visualizing and analyzing
process
e. Saathaga Pitham: involved in intellectual acts
4.4.2.6 Kapham (Aiyaam)
Earth and water combine to form the element kapham. It
oversees endurance, body build, strength, and joint movements. It controls the area around the neck and head. The
following are the five forms of kapham.
a. Kilaetham: aids digestion
b. Avalambagam: located in the lungs and coordinates
the other forms of kapham
c. Pothagam: helps in the perception of taste
d. Santhigam: responsible for movements of joints
e. Tharpagam: cools the eyes
Since the universe is the macrocosm while humans are the
microcosm, everything that exists in the universe also exists
in humans. Therefore, it is necessary to consider humans to
be an integral part of the universe. Additionally, the elements
in the microcosm, or the Human, are the same as the elements in the macrocosm, or the Universe. The concept of the
five elements makes up both the largest microcosm physical
level and the macrocosm (universal level). In all cosmological layers, the same pattern is repeated. In this sense, the state
of the universe has a significant influence on the human
body. The solar planets that affect the essential organs of the
human body are linked to those planets. As an illustration,
Venus influences renal function. The following organs also
have distinct connections to other planets: Sun and Moon:
lungs; Jupiter and Saturn: spleen; and Mars are the bodies
that make up the heart, brain, liver, and gall bladder, respectively. In the cosmos, the influence of the planets can occasionally cause anomalous occurrences (natural disasters),
such as storms, lightning, earthquakes, and torrential rainfalls that cause floods. The planet’s forces also behave
strangely and contribute to sickness in people.
4.4.3 Methods of Diagnosis
There are eight methods of examination that are used by
Siddha physicians for the diagnosis of patients as follows:
1. Nadi (pulse examination)
2. Parisam (touch: tactile indicators, such as heat, cold,
etc., including palpation): perspiration in different
body parts; vaatha is dry, pitha is warm, and kapha is
cool
3. Naa (tongue: coating, color, dryness, ulcer, moisture,
and related features interrogation): black in vaatha,
white in kapha, ulcerated in anemia, and yellow or red
in pitha
4. Niram (color of the body: luster, color of the skin, etc.):
dark in vaatha, pale in kapha, and yellow or red in
pitha
5. Mozhi (speech: voice, eliciting history, etc.): normal in
vaatha, loud pitched in pitha, slurred in alcoholism,
and low pitched in kapha
6. Vizhi (eyes: complete ophthalmologic examination):
muddy conjunctiva, pale in kapha, and yellowish or
red in pitha
7. Malam (stool: constipation, diarrhea, color, consist-
ency, etc.): e.g. yellow in pitha.
8. Moothiram (urine: color, clarity, turbidity, density, etc.):
urine is tested early in the morning; straw color denotes
indigestion, reddish yellow indicates elevated blood
pressure and saffron color denotes jaundice [42].
Out of these eight entities, Siddha-specific techniques for
physical examination of the urine (Neerkuri and Neikkuri)
and pulse serve as confirmatory diagnostic tools.
4.4.3.1 Physical Examination of Urine
The urine examination in the Siddha system includes two
methods, i.e. Neerkuri and Neikkuri. Neerkuri is the physical
examination of urine which deals with the frequency, color,
specific gravity, smell, frothiness, quantity, and taste of
urine. A drop of sesame oil is added on the urine sample in
Neikkuri. A signal that confirms the diagnosis of the condition is provided by the way the oil droplet spreads over the
urine’s surface. Neikkuri is essentially used to identify the
body’s vitiated humor(s). When Vaatham is impacted, it
appears as a serpentine-like extension of the oil drop. When
Pitham is impacted, the oil drop spreads out in a ring-like or
sea-like pattern. Kapham appears as a pattern of oil drops
that adhere to the sample surface like pearls.
78 4 Complementary and Alternative Medicinal Systems
4.4.3.2 Pulse
An essential component of Siddha is pulse diagnosis,
which was created by Siddhars to use senses to detect and
confirm ailments inside bodies. It accomplishes the same
task as modern devices like stethoscopes and sphygmomanometers, in other words. It is mostly felt at 10 places, with
the one above the most desirable radial artery found in the
right hand for men and the left hand for women. In order
to evaluate the states of vaatham, pitham, and kapham
simultaneously, it is typically felt with three fingers
(namely, the index, middle, and ring fingers).
4.4.3.3 Wrist Circumferential Sign
Using a thread to measure the circumference of the wrist, it
is possible to diagnose some disorders (preponderance) in an
unusual way. This approach involves measuring a person’s
wrist circumference using an inelastic thread, expressing the
measurement in terms of that specific person’s fingerbreadth, and comparing the results to a chart of health and a
list of disorders from the traditional Siddha literature [45].
4.4.4 Treatment
For healthy living, Siddhars advises adhering to a few fundamental principles. One of these rules is to follow the regimen described in “Pini anugaa vidhi,” which means ”rules
that help to prevent disease.” The “Kaayakarpam” philosophy of the Siddha system is extremely admirable because it
increases body’s resistance to infections.
The following are some ways to prevent illness: drink
boiled water; eat twice a day; take melted ghee, and diluted
buttermilk; consume an adequate amount of milk and
dairy products; never eat anything that has been cooked
the day before; always eat after experiencing hunger; consume sour curd constantly; after eating a healthy diet, take
up walking; after meals, sip water; when taking an oil bath,
use hot water; never repress a natural desire; never go to
bed during the day; take an emetic once every 6 months
and a purgative once every 4 months of the year; utilize
snuff products eight times a year; weekly hair shaving; one
oil bath every 4 days; put eye medicine once every 3 days;
avoid smelling perfume around midnight; avoid excessive
sexual indulgence; avoid sex after consuming heavy food;
never sleep beneath a tree shadow or next to a blazing bulb;
and never live near dust and dust-related items.
When these guidelines are rigorously followed, death is
delayed. Even though these straightforward preventive concepts were created well before the development of contemporary science, they have profound scientific worth. Positive
health is the key concept of the Siddha system. Its fundamental goal is to obtain overall health, which guarantees not
only life but even immortality, by avoiding illnesses via
careful food and mental relaxation [46]. Siddha treatment
is aimed at restoring the original balance of the Three Forces
or Humors so that the patient becomes healthy [42]. The lost
balance is restored by using substances having properties
opposite to the force that is aggravated or using substances
having properties like that force, which is deficient [44].
Siddha treatment consists of divine (Deva Maruthuvam),
rational (Maanida Maruthuvam), and surgical methods
(Asura Maruthuvam). The divine method is highly useful for
treating chronic diseases and involves the use of medicines
like parpam, chendooram, and gurukuligai made of metals
and minerals. Herbal remedies like churana are employed
in the rational approach. Procedures like incision, excision,
leech application, etc. are all part of the surgical approach
[36]. Various therapies in Siddha medicines include physical
sun, bloodletting, fasting, emetic, steam, oilation, and yoga
therapy [44].
4.4.5 Siddha Formulations
In Siddha, materials derived from medicinal plants, minerals, and animals are classified as raw drugs. The medications found in plants, metals and minerals, marine
products, and animal products are all included in the
Materia Medica of Siddha [47].
Siddha medicines are broadly classified into: (i) powdered calcium compounds, saltpetre, and shells that have
been calcined; (ii) products of certain plants in the form
of tablets or fine powder; (iii) reddish-colored powders
containing either mercury or sulfur, and some minerals
or metals that have been heated and treated with specific
plant juices; (iv) compounds with a black color that
include borax, black sulfide of mercury among other elements; (v) certain kinds of rejuvenating elixirs, known as
karpams, that are meticulously made from a combination
of specific plants, minerals, and salts; (vi) medicaments
of metals with mercurials; (vii) sweetened linctuses made
mostly from different plant materials; (viii) medicated
and flavored syrups; (ix) tablets composed of a finely
powdered paste of certain plant components, either with
or without mercuric compounds or minerals; (x) semisolid forms made from certain minerals and plant materials, either with or without sulfur or mercury; and (xi) very
fine powders made by burning or slowly heating processed plant extracts, salts, and metals like mercury.
Additionally, there is a class of medications that sublimate substances containing arsenic or mercuric compounds with plant juices. In addition, plants, salts, and
alkaline substances are also used to prepare herbal oils
and distilled compounds [48].
According to the mode of application, Siddha medicines
are internal and external medicine. Internal medicines are
4.5 Homeopathy System 79
administered by oral route, whereas external medicines
include certain applications like eye and ear drops [36].
4.5 Homeopathy System
4.5.1 History
Hippocrates, known as the “father of medicine,” first suggested treating “like with like” in the fifth century BC. The
German physician “Samuel Hahnemann” (1755–1843) discovered this essential technique via a self-experiment that
he conducted to see how medications worked. Hahnemann
commented critically on various practices in the field,
including dietetics, hygiene, psychiatry, and arsenic poisoning in multiple works. He became so distressed that he
stopped practicing medicine and began translating scientific, medicinal, and botanical treatises. Hahnemann was
struck by an illustration on cinchona bark, which was used
to cure malaria, while translating William Cullen’s book of
the materia medica into German. Cullen explained that its
ability to strengthen the stomach was the reason behind its
mode of action. Rejecting this theory, Hahnemann tried to
describe the action of the quinine-containing bark by taking “four good drams of Peruvian bark, twice a day for several days.” Hahnemann wrote that he started to experience
symptoms that were the same as those of malaria [49].
These symptoms went away when he stopped taking the
medication.
Following this, Hahnemann conducted similar experiments with Cinchona bark on relatives and acquaintances.
In order to find out what signs of disease they could cause in
healthy people, this led him to experiment with a variety of
additional substances. These tests, which he referred to as
“provings,” involved detailed documentation of each subject’s unique response as well as any recurring themes or
patterns of disease brought on by any given chemical. These
discoveries provided the foundation for Hahnemann’s new
therapeutic approach, which he named homeopathy—
derived from the Greek homo-ios, which means “similar,”
and pathos, which means “suffering or disease”—in order to
distinguish it from conventional medicine, which he named
“allopathy,” which translates to “opposite suffering.”
Hahnemann experimented with diluting his drugs in an
attempt to reduce the adverse effects, but he found that
even a basic dilution (while stirring) resulted in the drug
losing all of its effectiveness. He thus developed a brandnew dilution technique in which he diluted the material in
precisely specified portions, giving it a thorough shake in
between each dilution. He referred to the shaking as “succussion” and the liquid that came out as a “potentized remedy.” He discovered that there were no adverse effects and
a greater therapeutic benefit from this novel treatment.
He found that a drug got stronger when it was diluted
and succussed [50]. He put together his findings into a
book known as the “Organon.” The first version, known as
“Organon der Rationellen Heilkunde” (“Organon of Rational
Healing”), was released in 1810. It is known as the “Bible of
Homeopathy” and was hailed as “an epoch-making work”
[51–56]. Hahnemann made five revisions to the Organon,
improving techniques and adding information from his
studies and homeopathic practice with each revision.
“Organon der Heilkunst,” or “Organon of the Medical Art,”
was the new title starting with the second edition published
in 1819. The final edition released during Hahnemann’s
lifetime was the fifth, which came out in 1833 [57].
Homeopathy’s core text is still the sixth edition, which was
released in 1921.
In the homeopathic system, this dilution and potency
debate has emerged as one of the key points of controversy.
The medical establishment was continually skeptical of
this dilution process since they could not comprehend how
something so diluted could have an impact and hence
could not accept it. Homeopathy endured despite this
opposition because it was effective and patients helped
spread the message. Some of those patients were medical
professionals, and many of them trained under Hahnemann
and spread his teachings throughout North and South
America, India, and Europe after personally experiencing
the mild yet potent beneficial power of homeopathy.
4.5.2 Principles of Homeopathy
1. The Law of Similar (simillimum): The selection of
the homeopathic cure is based on the fact that, according to trials known as provings, it produces comparable symptoms in a healthy individual. It is called as a
simillimum remedy.
2. The Law of Single Remedy: In homeopathy, Dr.
Hahnemann promoted the Law of Simplex. Simple,
single-ingredient medications have been proven effective in healthy humans because it is hard to predict
how two or more chemicals would interfere with or
change one another’s effects on the human body when
combined.
3. The Law of Minimum Dose: The term “minimum
dose” refers to the amount of medication that is both
sufficient to cause the required alteration and causes
the least amount of system excitation. The amount is
minimal, but adequate, for a mild corrective effect.
4. Individualization: Two cases of the same ailment are
not the same in homeopathy. There are usually variations in how symptoms and modalities present throughout individuals. These variations are what make every
case unique and necessitate a customized solution. For
80 4 Complementary and Alternative Medicinal Systems
diagnosing patients, it records unfamiliar, unusual, or
startling symptoms. The goal of this system is to encourage own capacity for self-healing [58].
5. Vital Force: The special interaction that humans have
with their surroundings is known as “homeostasis.”
According to Hahnemann, there is an energetic material that exists and is a “vital force” that gives life and
disappears at death. This substance is independent of
physical and chemical processes. In Eastern medicine,
it has been referred to as prana or chi. This essential
force functions in both health and illness in predictable ways. According to Hahnemann, the body, mind,
and spirit are a trinity that together constitute an
energy essence that exists independently of the human
body. Dr. Hahnemann described this material as the
vital energy, and it is responsible for all the varied
expressions of life.
6. Potentization: Potentization makes it possible to use
both inert and fatal, toxic and poisonous substances as
effective and secure remedial agents for medical treatment. Potentization avoids or reduces the negative side
effects and aggravations that come with such treatment, which allows for positive beneficial activity. The
medications are administered as potency (by succussion or trituration) or mother tincture [59].
Soluble materials are steeped in alcohol and strained to create the initial medicine, often known as a mother tincture.
Using a pestle and mortar, insoluble materials are ground up
for many hours in order to make them soluble during the
trituration process. In order to prepare metals and other materials that are difficult to dissolve for dilution and succussion,
this technique is utilized. For diluting chemicals, two scales
are available: the centesimal and the decimal. One-tenth of
the tincture is added and mixed well to nine tenths of alcohol
to make the first dilution for the decimal scale, known as a 1X.
Each homeopathic medicine bears a number indicating the
number of times it has been succussed and diluted. For
instance, 30X has been diluted and succussed 30 times. One
part tincture to 99 parts alcohol is used to dilute the centesimal scale, and the letter C is added after the number.
4.5.3 Methods of Diagnosis and Treatment
Scientific clinical examination and diagnosis of disease
should begin with accurate and impartial observation,
according to homeopathy. It highlights the unique characteristics that set one patient apart from another with
the same condition and emphasizes viewing each patient
as a unique instance of the illness. In order to better
understand the changes brought about by disease, a physician develops an idea of the patient’s pre-illness personality. From the perspective of inherited and familial
susceptibilities to disease, homeopathy recommends
asking about past diseases and the family’s medical history. It requires the medical professional to closely assess
the patient’s mental condition, both intellectual and
emotional, with particular attention to any changes
brought on by sickness. It promotes the identification of
adverse environmental elements and pays particular
attention to those that either exacerbate or lessen the
patient’s problems, in addition to closely identifying the
conditions that lead to the onset and continuation of the
illness. Health is defined in homeopathy as a condition
of balance and harmony among a person’s physical,
mental, emotional, and spiritual aspects. As abnormalities in one area might have an adverse impact on the
others, all these factors are considered throughout the
diagnostic process in homeopathy.
4.6 Conclusion
The goal of medicine is to meet people’s unavoidable
demands for both bodily and emotional recovery. The traditional medicine system has developed over millennia by
utilizing natural resources found in their surroundings,
incorporating elements of many indigenous peoples’ religious and social structures, and, more recently, by applying
the scientific method to the development and validation of
therapeutic and preventive measures. Nowadays, because
to advancements in medical and public health, people can
expect – and even feel entitled to – living longer and higherquality lives than at any other time in human history.
However, a significant portion of the population either
cannot afford the benefits of modern medical technology
or opt not to use it, despite its widespread use, strength,
and promise. Approximately 80% of people on the globe
lack access to modern medical care. The primary method
used by all the major CAM systems to treat sickness is to
promote and facilitate the patient’s natural healing process. If this self-healing is promoted then there is less
chance of negative consequences and less need for expensive, high-impact interventions like allopathy medicines.
The emphasis on self-healing and promoting health is
what makes CAM treatments for chronic illness attractive.
References
1 Pal, S.K. (2002). Complementary and alternative
medicine: an overview. Current Science 82 (5): 518–24.
2 Tabish, S.A. (2008). Complementary and alternative
healthcare: is it evidence-based? International Journal of
Health Sciences 2 (1): V–IX.