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Application of the concept of mala suddhi with special reference to various
medicines mentioned in Siddha literature
Dr. Senthamizh chelvan,BSMS
Dr.C. Mary Sharmila,BSMS
Based on the classes taken by Dr. L. Mahadevan,BAMS,MD
Mala suddhis is an integral part of Indian classical medicine. In siddha
system, it has been given primary importance. It is done before starting any
therapeutic procedures. It is called virechana in ayurveda. It is a process by which
the toxins or the malas from the body are eliminated through anal route by internal
administration of medicines. Malam denotes excreta or toxins. There are mano
malas or the toxins of the mind. Tamil literature call this as Anavam, kanmam and
mayai. Once the detoxification takes place in the body, there will be automatic
detoxification in the mind also. So while we plan a detoxification or suddhi, cleansing
the body is the primefaca of the treatment.
Considering the anatomical structure of the body the upper stomach is
predominant of kapha, the duodenum is predominant of pitta and the large colon is
the seat of vata. This is an order. The doshas do their physiological activity by being
predominant in these receptors or sites. There are three malas that are produced as
a part of day-to-day physiology. They are sweat urine and fecal matter. It is sweat
through which the mala rupa of pitta is eliminated. When we do sweating therapy like
kizhi we usually do it in vata kapha conditions namely low back ache or osteo
arthritis. Here, the sita guna of vata is reduced by the heat, excess pitta is produced,
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vata and kapha are brought to normalcy. If we take the next mala ,urine, kapha and
pitta are eliminated through that. proteins, ketones acetones, urobilinogen and
leucocytes are eliminated. This is called mutra virechanam. When we give kashayam
prepared out of nerunchil (B.N – Tribulus terrestris), satavari (B.N – Asparagus
racemoses), anai nerunchil (Pedalium murex), saranai ver (Trianthema
portulacastrum), detoxification of urinary tract take place.
Modern medicines talk in terms of acidity and alkalinity of the human body.
Vata pitta predominant is acidic in nature, pitta kapha predominant is alkaline in
nature. When assessing the fecal matter, it is the channel through which vata pitta
kapha, i.e., the tridoshas are eliminated. Evacuation of bowels in a regular interval
and in a regular schedule is considered as a characteristic feature of health in Indian
medicine. It is not only the amount, consistency and the smell of the fecal matter but
also the time taken for the evacuation is also considered to understand the tridosha
suddhi. These questions are asked to the patient by the vaidya in his OPD.
When we perform therapeutic purgation we can see kapha at the end of
evacuation. What does it mean? The virechanam cleanses, large colon, small colon
and cleanses the upper stomach in order. Kapha present in the upper stomach
comes in the end. So seeing kapha in the purgation is considered as a good
characteristic feature for the virechana. But when we do vamana therapy ,kapha will
come first, then pitta will come because in the oesophagus and upper stomach
kapha is predominant and bile is predominant in the lower part of the duodenum that
comes in the end. This has to be observed by the clinician. This is very important. If
this does not happen, it means that a proper suddhi is not done and , the residual
toxins may stay in the body and produce unwanted complications like indigestion,
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itching, etc in the due course. Even though the virechanam is the base therapy for
pitta diseases, it can be given for vata, kapha, etc.,
In siddha medicine, virechanam is considered as a full detoxification because
it handle and remove the endotoxins of all the tridoshic physiology. When we treat a
patient with low back pain, we understand that it is produced by the blockage of
apana vayu, so as vayu is ruksha, we select castor oil based medicines here. What
is the reason? Vata is dry, dryness increases pain, dryness is compensated by
oiliness, oiliness is the opposite quality of dryness, so we select castor oil based
medicines like siddhathi oil here. We get another patient with herpes. The herpes is
produced pitta and kapha. The common gunas between pitta and kapha is snehana
or oiliness. We do not select castor oil in this case. Here we will select a dry
purgative. What is meant by dry purgative? Creating a purgation with raw drug,
churna, svarasa, kashaya is called dry purgative. Peipudal (B.N -Trichosanthes
cucurmerina), katukarohini(B.N-Picrorhiza kurroa), Sivathai ver(B.N-Operculina
turpethum), Kadukkai(B.N -Terminalia chebula), Peithumatti(B.N-Citrullus
colocynthis), Nilavarai(B.N -Cassia obtusa) are the examples.
So we can understand that we have to use intelligently snigda virechana and
ruksha virechana in practice. If there is vata vruddhi, vata is associated with pitta, or
when vata is associated with kapha we have to consider, For example,
Lavanagunadi tailam which is an oily purgative which is selected in the following
conditions.
Lumbar disc prolapse,
Lumbar canal stenosis,
Acute radiculopathy,
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Sciatic neuropathy,
Ankylosing spondylitis,
Rheumatoid spectrum,
Osteo arthrosis,
Endometriosis,
PCOD,
Sub fertility,
Dysmenorrhoea, etc.,
Dry purgative like churnas are selected in following condition.
Renal failure,
Lymphatic oedema,
Hypothyroidism,
Metabolic syndrome X,
Herpes recovery,
Hepatobilliary disorders,
Vesiculo bullous disorders,
Toxic pathology,
Insect bite allergy,
Skin diseases,
Folliculitis,
Eczema.
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In some conditions, we may use both purgatives intelligently. For example,
we will assess bronchial asthma, which is a vata kapha predominant disease. If
expectoration is more and wheezing is more, we select a dry purgative. If dyspnea is
more we understand that vata is the factor behind the dyspnea and we will select an
oily purgative after application of karpura taila in the chest region after warming. In
some conditions like SLE, castor oil is given with sugarcane juice, coconut oil or milk
because there is little bit of pitta predominant along with vata. So we give castor oil
with pitta reducing anupana like milk and coconut water. In conditions like cirrhosis,
ascities, portal hypertension we have to use dry purgative on everyday basis. In
renal failure also, sweating is reduced, urine is not eliminated daily, so the two
pathways of elimination of mala is blocked. The only pathway that is available for the
elimination of mala is the anal route. So we have to do purgation everyday. Here
various medicines are available in Siddha literature like Kausikar kuzhambu,
Agasthiyar kuzhambu, Siddhathi Ennai, etc.
Usually strong purgations are avoided before the age 10 and after the age of
70. Mild laxative can be done. Usually we give purgative medicines at the bed time,
but after bed time when we sleep there is mantha guna vruddhi, that is kapha
vruddhi. So it will be ideal to do purgation in morning around 9’O clock in empty
stomach. There are literary evidences to support this. We have to give medicines by
9.30 in the morning. The patient should get up,he should not take any food. Castor
oil is given with small amount of salt and warm water, we can wait for 2 to 3 hours.
Mala will start evacuating. After evacuation or when the vegas have started, we can
give warm water little by little to felicitate the intestinal movement. Anupanam plays a
major role. Anupanam prevents electrolyte imbalance in virechana. If man is having
Kalkudal(spastic colon) virechanam is avoided or virechanam is given with salt but
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vasti is preferred. After virechana small quantity of kanji with salt and buttermilk is
given. The patient should not take oil bath after that nor sleep in the morning. In the
Night he can take a light kanji diet and sleep. After virechana there will be
constipation for one or two days and the physiology will take at least 48 hours to
come to normalcy. If the patient has not attained a complete suddhi, the next day
another dose can be intellectually applied. If we give virechana in night time with
nervala(B.N Croton tiglium) like medicines and if complication occurs in the mid
night, it will be difficult to manage,so, Virechanam is given in empty stomach, so that
it penetrates and the cleansing of the tract is possible.
The medicines for vata virechana will act on colon. For example, kadukkai
podi(B.N Terminalia chebula) reduces vata. It will take 8 to 10 hours. 20 gms is
needed for the suddhi. The pitta medicines work on the small intestine. Katukurohini
(B.N Picrorhiza kurroa)is the example. It will take 6 hours to produce of the effect. In
kapha conditions, drastic purgatives have to be given. It has to cover large colon
starting from the stomach. Nervala(B.N Croton tiglium) is the better example. This
has to be kept in mind.
Croton tiglium takes about 1 hr to act.
Kadukkai – 12 hrs
katukurohini – 6 hrs.
it varies to the type of the colon. Croton tiglium should not be given for a mrdu
koshta, but can be given for “mathyama and krura koshta”.
Once we give medicines for purgation, some times excess vegas are
produced. Maximum 20 vegas per day is considered as is normal for an ordinary
koshta. In mrdu koshta it may be high, in kalkudal (Spastic colon) it may be less. So
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we may give cold water to stop the purgation. When vegas are less, we give hot
water.
In the case of nervalam(B.N Croton tiglium) ,We have to do the opposite one.
When there is more purgation we have to give hot water. Because hot water helps in
reducing intestinal colic. When there is less purgation, we have to give cold water.
Because of an improper purgation, there will be burning sensation. Many texts of 16 th
century texts quote about this. The word Naga danti, “Naga” is Sanskrit means
elephant, “danti” means tusk. “Naga danti” means it is a plant whose root resembles
the Elephant tusk. It is basically a root. The botanical name is Baliospermum
montanum, But select crotton seed or nervalam. Nervalam is a seed not a root. What
exactly is Nagadanti has to be standardized.
In siddha medicines, virechana medicines can be classified as those
containing Croton tiglium, those with Castor oil, those with kadukkai (Terminalia
chebula) and those with sivathai (Operculina turpethum). peipudal and katukarohini
are not used much.
1. ASTA BAIRAVAM MATHIRAI
This medicine contains Croton tiglium as a major constituent -50%. It is given
for conditions like fever, uncontrollably vitiated doshas and for toxicities. The need
for purgation in fever is very less. Practically, purgations can be performed only in
conditions like pyrexia of unknown origin, hodgkin’s lymphoma, non hodgkins
lymphoma, which are chronic states producing fever. It cannot be done in typhoid
fever, viral infections, considering the weak general health of the individual. It is
contra indicated in conditions like cough, cold, fever, pneumonia, typhoid.
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It can be given along with lavanga kashayam for toxicity.
The term toxicity includes a broad spectrum of conditions like long term usage of
drugs, plant toxicity, lead poison, mercury poison, arsenic poison, sulphur toxicity.
This medicine is best handled in conditions like incompatibility of adverse drug
reactions and toxic conditions.
Dosage – 100 mg tablet,one tablet can be given
2. JALODARI MANI
This medicine contains the drugs which can be given for gulma like dried
ginger, pepper, long pepper, alum, rock salt and asafoetida. It has a similar
composition as that of Ashta churnam. This medicine contains croton tiglium along
with those of Ashta churnam. This medicine has the property to exert it effects on the
abdominal areas. It can be practically used in pathologies where the normal pathway
of the apana vayu is blocked like ascites, portal hypertension, hernia, BPH, liver
cirrhosis, etc.,
Dosage - 200 mg tablet .one or two tablet can be used
Anupanam - water
3. LAVANGADI MATHIRAI
It contains Croton tiglium, rasa karpooram, lingam in the ratio of 12:2:1. It is
generally given for kapha vata diseases like stroke, infarction, Ischemic heart
disease, carotid atherosclerosis, lumbar disc disease, lumbar canal stenosis,
spondylolisthesis, and bronchial asthma. It is not the choice of medicines in
pathologies like kushta, SLE, vasculitis as it contains drugs of hot potency.
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Dosage – 100 mg tablet ,one or two can be used
Anupanam – hot water
4. MEHA NATHA GULIKAI
This contains lingam, vasambu (Acorus calamus), dried ginger, vaividangam
(Emblica ribes), Root of Kattamankku (white variety) along with Croton tiglium. It is
generally a choice of medicine for worm infestations, gulma, sopha.
Since the medicines has the coined term “mega nadhan” and also sivathai
(Operculina turpetum) as an ingredient it can be given for reactive arthritis, second
stage of bacterial arthritis .
When given along with chukku kashayam it arrests the excessive
evacuation of bowel. Chukku (dried ginger) has the property of “Grahi”.
Dosage – 100 mg tablet ,2 or 4 can be given
Anupanam – chukku kashayam (gingiber officinale)
5. MURUKAN VITHAI MATHIRAI
It contains katukarohini (Piccoriza kurrora), murukan vithai (Butea
monosperma), Croton tiglium. It is an anti helmintic with laxative property.
Dosage – 500 mg tablet ,1 or 2 can be given
Anupanam – water or palm jaggery
6. PACCHAI KARPOORAM MATHIRAI
It also contains Croton tiglium. Though it is mentioned in the context that it
can be given for fever as a virechana drug, it also contains ushna virya drugs like
lavangam, jathikai, rasa padangam, gandakam (sulphur) which have the property to
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pacify the sita guna of kapha and vata. Hence it can be implemented in vata kapha
conditions like demyelination, motor neuropathy etc.
It has to be understood that ginger juice mentioned is ushna virya in nature
and acts as a deepana helps reducing kapha vatam.
Dosage – 100 mg tablet ,1 or 2 can be given
Anupanam – extract of inji (gingiber officinale)
7. SOOLAI BOOPATHI
It contains mercury, sulphur, naabi (Aconitum ferox) along with bile of snake
and boar. It can be understood from the name that it cures “Soolai”. Soolai can be
interpreted as abdominal colic.
Virechanam is contraindicated in acute abdominal conditions like appendicitis,
but can be done in the second stage of the pathology when the severity of the
disease has subsided.
It can be used in hepatic flexure syndrome, spleenic flexure syndrome,
Renal colic, abdominal colic, endometriosis, BPH, Proctalgia fugax. As it is a
ushna virya, drug it is contraindicated in peptic ulcer and duodenal ulcer.
Dosage – 100 mg tablet ,1 tablet can be given
8. SANJEEVI MATHIRAI
Contains 50% of Croton tiglium in composition. This is processed with
extracts of veliparuthi (Pongamia daemia).
When given along with Jathikkai churnam it rectifies the block of apana vayu
in bleeding piles. Practically it can be given with lemon juice for urticaria.
Dosage - 100 mg tablet ,one or two can be given
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DRUGS WHICH CONTAIN KUMATTI
How to differentiate the action potential of medicines which contain Croton
tiglium and those which contain kumatti
Croton tiglium eliminates the toxins alone from the body, but kumatti acts as a
purifying agent in
vata rogas diseases of female reproductive system
mind related rogas.
Kumatti is a constituent of Kalyanaka ghrta in Ayurveda.In the ayurvedic text
astanga hrudayam, vata vyadhi, cikitsa thivatha ghrtam contains kumatti.
Kumatti is chosen when vata is vitiated in dhatus
Castor oil for vitiated vata in colon
Croton tiglium for vitiated vata & kapha in colon.
9. LINGA CHENDURAM
Prepared with 2 litres of extracts of kumatti. Although it is given for vata kapha
diseases, it eliminates the toxins in the dhatus, affected by “Kulir vatam” &
“Megam”.
Dosage - 50 mg - 100 mg tablet , one can be given
Anupanam - Honey
10 . KUMATTI MEZHUGU
It is a choice of drug for portal hypertension, liver cirrhosis,
endometriosis, dysmenorrheoa, infertility etc. dosage is carefully determined.
Dosage - 200 mg - 500 mg tablet , one can be given
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Anupanam - Palm jaggery
KUZHAMBU
Anything that has an oily texture is termed as kuzhambu. That which is
unctuous in nature is kuzhambu. It is a stage of process. Lehyam is that which is
licked .
Kuzhambu is used when the dry guna of vata is vitiated. Also used when vata
is associated with pitta or when vata is associated with kapha.
Spastic colon – when vata alone is vitiated
Chronic gastritis – vata associated with pitta
Dyspnoea – vata associated with kapha
Vertigo – pitta associated with vata
Infraction – kapha associated with vata
Medicines with unctuous guna can be given to pacify the dry guna of vata.
Although Agasthiyar kuzhambu is used in a wide spectrum with anupanam
specificity,it is given along with kumatti extract for gulma.
For cough, it is coupled with kadukkai kashayam which reduces vata kapha.
In endometriosis, which is a vata disease, agasthiyar kuzhambu is given with
chukku kashayam.
In bleeding piles which is vata pitta roga, it is given along with buffalo milk
which is sweet in rasa and has unctuous guna.
In kapha related pandu, if is given along with extract of onion.
In fever for ama pachana, it is given with chukku kashayam.
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11. KAUSHIKAR KUZHAMBU
It has purgative property, contains katukurohini, Croton tiglium as key
ingredients. It is given for vata disease (suthaka vayu) with extracts of Pongamia
daemia.
For kapha diseases with hot water and kadukkai kashayam. It is given with
ksheera kashayam for pitta diseases. It is an important drug for toxins like rat
bite, snake bite, etc.
The anupanam designed by the Rishis for a particular disease fulfills three
categories .
It decreases the intensity of the roga (disease) of the patient
Pacifies the vitiated dosha
Increases the bio availability of the plasma half – life of the particular medicine
As it contains katukarohini, manosilai, it can be given for tonsilitis. It has 30% of
the ash of coconut shell. The peculiarity of the composition is that it acts as an
alkalizer, which is not included in any other yogas. zymethicone is given in conditions
where there is increased secretion of pepsin & HCL. Modern medicines pacify the
dosha. Kaushikar kuzhambu pacifies & eliminates the dosha involved.It reminds of
the pre kinetic action of the medicine.
12. MALAKUDARA MEZHUGU
It is a mild laxative drug, can be given even for children. It takes, about 8
hours for the medicine to produce its effect, causes one or two vegas. Does not
produce abdominal cramps, can be taken as a routine laxative drug.
Dosage - 100 mg - 200 mg tablet , one can be given
Anupanam - palm jaggery
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13. NAVA UPPU MEZHUGU
It is also a medicine prepared with Croton tiglium. Can be given for motor
neuron disease, motor neuropathy should follow pathyam without salt when the
medicine is given, as the medicine is composed of varieties of salt as its
composition.
Dosage - 100 mg - 200 mg tablet , one can be given
Anupanam - palm jaggery
14. NEELAVARAI CHURNAM
It is a digestive and dry purgative.
Dry purgative is used in portal hypertension, ascities, liver diseases, hepatitis,
hepatomas, herpes recovery, oedema, hypothyroidism, all the conditions where
agni mandhya is associated with pitta and kapha problems.
Dosage - 1 – 2 gms
Anupanam - hot water
15. SIVATHAI CHURNAM
It is also a mild laxative. A low dose of Sivathai Churnam pacifies pitta. In a
higher dose it eliminates pitta. It can be given upto 15 gms with hot water.
Dosage - 15 gms
Anupanam - hot water
1`6. KARUDANKIZHANGU ENNAI
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It is katu rasam, ushna veeryam, agni deepanam, gulmaharam. It is highly
useful in vata kapha diseases. It contains castor oil as an ingredient. Dosage is 15 to
20 ml. It is useful in endometriosis, dysmenorrhoea, disc problem, benign
prostrate hyperplasia, constipation, non ulcer dyspepsia, etc.,
Dosage - 15 – 20 ml
17 .KAZHARCHI TAILAM
It is a very powerful purgative. It contains a greater of proportion of castor oil
along with Croton tiglium. So a single dose of 5 to 10 ml with specific pathya in
given, Murungai pinchu(B.N Moringa oleifera) and Avarai pinchu(B.N Lablab
purpureus) should be given. Practically it is given for renal failure, udambu veekkam.
Kazharchi tailam is the choice of drug for purgation for suitable conditions in
mechanical intestinal obstruction.
Dosage - 5 to 10 ml
18 . MALAI VEMBADI TAILAM
It contains varikumatti and castor oil. It is a specific purgative for pumsavana
(Sub-fertility spectrum). This is given for 3 days only. This is given during the
menstrual cycle. This is a pre sodhana therapy before starting the treatment for
pumsavana, sub-fertility management. But this can be also used in endometriosis,
PCOD, fallopian tube block, dysmenorrhoea, Premenstrual tension,
Amenorrhoea, secondary amenorrhoea, etc.,
Dosage - 15 – 30 ml
Anupanam - rice water
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19 . MANTHA ENNAI
This is a katu rasa oil. Castor oil is the base. Dosage of 2 to 3 ml can be
given. This can be given in kapha diseases of children. Mal-absorption, worms,
rickets are the common conditions where Mantha ennai is used. In another type of
Mantha ennai, uttama kanya swarasam (veli paruthi) is used.
Dosage - 2 to 3 ml
Anupanam - Milk
20 . MOOLAKUDARA TAILAM
It is a very mild laxative which contains tender haritaki along with castor oil. 2
to 3 spoon at night. Produces one or two vegas.
Dosage - 10 - 15 ml
21 . MERUKULLI TAILAM
It contains Merukan kizhangu, Botanical name a castor oil. It is highly useful in
Rheumatoid spectrum of diseases, gout, psoriatic arthropathy, etc.,
Dosage - 10 - 15 ml
22. MENI TAILAM
It contains Kuppameni with castor oil. It is highly useful in fistula worm
infestations, syphilitic ulcer.
Dosage - 10 - 15 ml
23. SIDDHATHI ENNAI
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It is katu rasam, ushna veeryam, vatakapha haram. It contains croton, tiglium,
Kalli Paal, etc., It has a wide range of utility. This is a choice of drug in our practice in
Schizophrenia. In Schizophrenia it produces specific suddhi. It is useful in uterine
diseases, but in our experiences we use it specifically in psychiatry problem that
needs drastic sodhana.
Dosage - 5 - 10 ml
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