As
we rejoice celebrating the World Siddha Day this year, beneath the celebration
lies an under current of uncertainty. We as a community seem to be losing
confidence in our own system of medicine due to various reasons.
The
foremost of this being the thought that heritage or traditional knowledge is
irrelevant in the current scenario. But the science of system biology today
rooted in genomics clearly appreciates the concept of Vata, Pita and Kapha
prakriti which are correlated with genotypes as they are the innate constitutional
characters present at birth itself. The drug selection for an individual in our
system is always ‘tailor made’. This exactly is what current day science calls
as pharmacogenomics. The selection is based not just on the ‘Prakriti’ but also is based on the influence of
the environmental factors – ‘Kala Vanmai’, ‘Thega Vanmai’ which
the current science terms as phonemics.
The
extension of this concept is the area of ‘Noi Nidhanam’ or the
diagnostic methods unique to our system of medicine. Unfortunately we seem to go
in for the glamour of new generation medical gadgets, the availability of which
is very limited and invariably increases the cost of diagnosis and treatment.
Let me share my experience. The venue was ‘Pragati
Maidan’ New Delhi and the occasion
was International Arogya Fair. In the free medical consultation wing,
consultants from different AYUSH systems were sitting in different chambers.
There was a long queue in front of the Siddha consultation chamber. I was a
little surprised why particularly Siddha attracted so many. A simple answer
came from an allopath, who was a curious visitor ‘We have heard that Siddha
physicians are experts in pulse diagnosis, I checked with others, they
confirmed indeed you were checking pulse for everyone, so I came’. I realized how our routine examination of
pulse could fascinate others while it is so helpful for us to decide the
primary line of treatment based on the ‘dosham’ affected. Our diagnostic tools are purely dependant on the
skill and expertise of the physician, which is possible to develop by
constant practice. Applying this is possible even in remote locations. Traditional
Chinese Medicine not only still thrives in that nation but also globally
because they totally trust their basic concepts very strongly.
There
is a wide variety of plant drugs suggested in our classical texts for the same
clinical condition and one of the major criticisms is that in two different
regions, healers recommend different plants and there is no uniformity in treatment. This in reality is strength and not
weakness. They always learnt from their gurus about identifying and using locally
available biological resources and the stress was always on single drug selection.
We need to incorporate in training the local health traditions and also about
the local biological resources.
Our
traditional wisdom has taught us to explore
simple plant based remedies before opting for the inorganic. But today
there is an avoidable over dependence on inorganic medicines. It is like
wielding a sledge hammer to swat a fly. Further many inorganic preparations are
prohibitive in cost, have a long processing time and the personnel trained scant.
Tradition
has always taught us to make our own medicines
and that is the reason why our medical curriculum includes training in pharmaceutics
both at Graduate and Post-graduate level. But again due to various limitations
we have drifted away from this practice and not only in Govt. hospitals and
teaching institutes but even in private practice most of us depend on
industrial products. The number of industries in siddha being too less and also
being small in size, industries are not in a position to truly adopt GMP or do adequate
research in ‘Process Technology’. During our field studies on local health
traditions, we have come across healers who have developed indigenously simple
but effective processing equipment and technology.
Today
with internet there is a general tendency to browse beyond limits for
information but in depth study of our
classical texts, healthy discussion and interpretations, commentaries of
our classical texts either published or palm manuscripts is becoming very rare.
To quote one example, it is a general perception and often we hear that
contraindications are never mentioned for Siddha medicines. But in reality our Gunapadam
clearly mentions contraindication even for a simple, most frequently and widely
used drug like ‘Kadukkaai’ and which variety to be used, and also
when. Critical analysis and commentaries
needs to be made based on in depth studies in each area which would make our
understanding of concepts much better. Even the fallacies of our current day
drug ‘Rasagandhi mezhugu’ and ‘Onan sudar thailam’ are due to not
seriously studying the original text ‘Pulipaani Vaithyam’. In ‘Rasagandhi
mezhugu’ , the drug powders to which eggs are added should be pounded with
equal weight of palm jiggery.But somehow, many of our manufacturing units don’t
take into account the weight of the eggs and lament that the product gets
fungal attack. That is due to lower amount of Palm jiggery. According to the
original text it is ‘Odukkan sudar thailam’ derived from the tortoise and
not the chameleon. The indications
mentioned for the same will help us to correct the fallacy. To considerable
extend we have neglected our Classical texts. Are we greater than the writers
to reject their knowledge accrued over centauries?
It
is also absolutely essential to study
the composition of the classical medicines in depth and appreciate the beauty
of their composition and design. In our over enthusiasm to invent new
proprietary medicines we fail to truly understand the reason for incorporating
ingredients, the plant part used the level of incorporation of each ingredient.
They serve multiple purposes which include enhancing they pharmacological
activity of the primary ingredient, improving bioavailability, reducing the
undesired effect of the primary drug and optimizing the dose. All these are based
on the principles of taste, characteristic feature, potency, after taste and
unique pharmacological activity which are determined by the combination of the
primordial properties. The drifting from this tradition has led to simple drugs
like today’s ‘Nilavagai churnam’ not delivering the
desired effect.
Siddha
literature clearly indicates the stages or conditions which are curable,
curable with greater efforts and which are not curable. Our decision of
referral are not always based on these principles but guided by the thoughts of
biomedicine. We have started considering
‘If
not possible by bio-medicine it is also not possible in Siddha’. The fact is
otherwise. There are many conditions including degenerative conditions and
certain types of cancers where Siddha medicine is really able to improve the
quality of life of the patients if not ensure complete reversal of the disease.
We need to concentrate in areas where other system doctors seek refuge.
The
Daily and seasonal regimen for well being apart from the specific regimen for a
particular disease condition is the prescribed norm of our tradition. Clinical
practice has also reinforced this concept. Similarly the role of the adjuvant
is also proven by several studies. The Traditional Local Heath Practitioners of
Jaundice invariably recommend the herbs be administered with goat’s milk.
Scientific evidence indicates that goat’s milk is low in fat and hence readily
digestible and provides instant energy and promotes immune response. Varying
the Anupanam depending upon prakriti and vikriti needs to be followed for better clinical outcome. Though
many of us are aware of the importance of Anupanam,
Pathyam and Apathyam asuming that
patients will not comply or shy away from Siddha, we fail to insist this in our
practice. In reality the sufferer and their attendant will ensure they adhere
to if adequately impressed upon by the physician.
The
traditional knowledge was preserved and practiced to its full potential by the
traditional healers not only far long before the institutionalization but even
today. In fact the contribution in the form of documenting clinical experiences
as ‘Atma rakshamirtham’ or ‘Sarabendra vaidya muraikal’ or by other
healers like Abdhulla Sahib, cannot be ignored. But unfortunately there is ever
widening hiatus between institutionally trained and the traditional healers.
This is now being slowly bridged. Interactions, knowledge and experience
sharing is slowly happening. The graduate doctors of the younger generations
openly admire the intellectual property inherited by them from the ancient
shastras.
Some
of the traditional healer’s posses great skills in Siddha Pharmaceutics particularly
of the forms like Kattu and Kazhangu, which are currently becoming
a rarity. Expert Traditional healers even now use the ones made six or seven decades
ago. It will be prudent on our part to entrust Pharmaceutics to these
traditional healers and learn from them.
Staying
with tradition does not mean ‘not to understand or present’ our science from
the current advanced scientific knowledge. It is absolutely essential for us to
give rational interpretations based on current scientific knowledge. Today we
have many siddha physicians who have interdisciplinary qualification but
confine themselves to teaching due to the prevailing situation. We need to
create a conducive research environment for this to happen.
We
are conversant with internal medicine but neglect cleansing therapies and
external therapies which are integral part of disease management and healthy
living. For many herbo-mineral drugs prior administration of purgation as
cleansing therapy and post oleation therapy were the order of the day even in
the 1960-70. Emphasis needs to be laid on this.
The
Social, cultural, scientific and spiritual components of Siddha science are
slowly getting separated and jettisoned from medical practice and it is very
difficult for our traditional medical science to be accepted by the society
without these understandings.
We,
the institutionally educated doctors, have attained a basic status by learning
the traditional medical science where we can attempt to successfully master
atleast one branch of the specialties in its entirety.Let us recognize our
identity, be proud of our tradition and stop drifting away from it. Let us stem
this drift and go mainstream henceforth.
