Child care in siddha- An overview
Sathiya rajeswaran.P1, Kiruthiga.G2. , Patturayan.R3& Anandan.T4.

Siddha system, being the oldest traditional ways of maintaining a healthy life style is still prevalent and emphasizes the importance of physical, emotional, psychological, social well being. Siddha system describes about cycles of birth, death and the need to maintain one’s harmony within which has been later described as motcham or Eternal Bliss.

Healthy seeds yield healthy Generation. Pediatrics being one of the fine focus of Siddhars, they saw the perspective of a healthy seed for an entire life within the child hence meticulously brought out steps to nurture it right from the beginning.

An ancient epic brings out how the children were seen as demy-gods rather than off-springs. There were ceremonies that marked for
1. Birth (Information of Birth and registering in Community)
2. Introduction of Seinei/Urai marunthu by Maternal uncle to Develop Immunity (Sei Nei- consisting of juice of 54 herbs mixed with ricinolic oil administered in drops right from first day of birth. This is referred to as senai vaithal. Urai mathirai- prepared from herbs that are rich in polyphenolic compounds and tannins.)
3. Naming (Authenticating Gene Carriers with surname )
4. Ear-Boring (First Injury to develop Innate Immunity)
5. First solid feeding – Rice Introduction (To Introduce Macro and Micro nutrients)
6. Induction of Knowledge (To develop Cognitive parameters)
Which were celebrated in order to develop Natural immunity, social maturity, emotional bonding, and Social security


Siddha system has classified pediatric illnesses as
1. Agakaarana noigal-due to the deeds of parents-develops congenitally
2. Purakaarana noigal-due to change in environment after birth-is acquired

Detailed description has been given on
Thodam: Thodam speaks about diseases caused due to Improper handling which means infections caused due to external factors such as Zoophilic, Vectors, and Human interventions. Treatment guidelines ranges from tying of Wrist bands made of herbs (Roots of Glycyrrhiza glabra, Acorus calamus) , Fumigations by herbs and resins(Benzoin)and Internal Medications. Ethno practices such as tying ropes from Mosques, Temples and using certain signatures (As in Reiki), chanting Mantras, Tying certain roots as necklaces are the practices documented 3- 4 decades ago. Even though all these claims are roofed under unscientific and unsafe practices still people try these along with proper medication as most of these practices are twined with religious aspects and scientific claims occupy a back seat in accordance with a child’s health. Almost all the thodam have dysentery and Diarrhoea as a common symptoms thodam may be equated to dysentery and Diarrhoea (of viral origin) with dehydrating symptoms
Mantham: Mantham is a group of Gastro intestinal disturbances in which Enzymatic insufficiencies like lactose intolerance (Paal Mantham) and upto Gluten enteropathy is discussed. Mantham is a group of Digestive disorders which leads improper assimilation and Absorption .This in turn leads to Loss of Micro and Macro nutrients. Immunity and normal physiology is questioned.
Around 53 types of Mantham have been explained almost all are comparable with Gastro-intestinal disturbances that can lead to Nervous debility like Janni, valippu (Epilepsy) in children if untreated or inadequately treated leading retardation of mental and physical growth. This hypothesis of relationship between Mantham and Neurological diseases is evident from even recent theories of Gutty leak syndrome and Autism. Symptoms of Mantham vary from indigestion, regurgitation, constipation to diarrhea, vomiting, anorexia, dehydration, febrile conditions and convulsions. Mantham is usually treated with pungent decoctions and drugs which will lead to a proper digestion and reduce the dominating Iyam (Kapham) and deranged Vatham.

Kanam: Kanam represents a group of respiratory illnesses which are classified into 16 types. Mantham precipitates Kanam. As described earlier Loss of Micro and Macro nutrients Leads to Kanam. Mostly occurs from 3 to 7 years of age. Symptoms ranges from soreness of tongue, cough, discoloration of tongue, fever, change in the structure of rib cage (Suggestive of PC /Rickettia rosary), Diarrhoea etc. Lipid based medicines (Ghee) are prescribed in Kanam as they are nutritive and therapeutically encounter microbes. Lipid based drugs also crosses blood brain barriers which will also diminish the neurological symptoms.

Kaamalai (Jaundice), Paandu (Anemia),Acharam(Glossitis/Apthousulcers),Kirumi(Worm Infestation), Valippu (Epilepsy), Karappan (Eczema) are some of the diseases which are given special importance in Siddha. Balavagadam Speaks of infectious diseases in general but not in depth.

Growth and development -Siddha concept:
Growth and development is an important aspect in pediatrics. It says about the motor and cognitive maturity of a child in accordance with its chronologicalage.Pillaitamil describes about the Growth and development of a children from a social spectacle .It extends upto fifth decade of Human race. It also describes the development of both the genders by the way of their culture and social setup.
Kappu, Chenkeerai, Thalam, Sappani, Mutham, Varugai, Ambuli, Chitril, Siruparai and Siru thaer are the paruvangal mentioned for a male child.
Kappu, Chenkeerai, Thalam, Sappani, Mutham, Varugai, Ambuli, Ammanai, Neeradal, and Oosal are the paruvangal mentioned for a female child.

Each and every paruvam is mentioned by the motor activity of a child in response with its chronological age. Kappu and Chenkeerai describe about care of the child and cognitive development at this stage is very little.
Thaalam is a word Meaning tongue. In this age the child makes a lot of sound with tongue and protrudes the tongue on command. Sappani is clapping of Hands by a child on command .Mutham describes about dispersal of flying kiss by a child on command. Varugai says about Movement of a child towards a person on command.chitril says about construction of Sand house by a child. Siruparai explains about usage of small musical drums by a male child and Siru thaer describes about Pulling of a small cart by children.
Ammanai, neeradal and Oosal are a game of a female child.Allthe above said paruvangal explains about Motor/Cognitive Development of A child in accordance with its chronological age.
Reproductive and Child health care in Siddha
Mother and child care even though is primitive still holds a lot of importance as it Focuses on a healthy nation. Rural population is still vulnerable in mother and child care.
Unhygienic environments, Poor Ante natal follow-ups, Malnutrition including Iron deficiency, improper child care and lack of frequent health supervisions take them under vulnerable population. The national projects if addressed properly will reduce the burden faced by the Rural as well as semi urban population which occupies the major population in India.
Ante natal care
The death rate of Indians during Natal period is still a worrying number in under developed states. Siddhars have mentioned proper life style measure to pregnant women
and ante natal care drugs in each and every month. If these drugs are regularly taken along with the herbal based Iron supplements and Folic acid and proper life style if adopted knifeless painless delivery will be possible.




Post natal care
Post natal care deals with effective Lochia removal, Bringing back uterus to its normal shape and size, toning the physiological functions of the delivered mother and enhancing breast milk secretion. Health foods and drug prescriptions like Sowbhagyachunti holds a lot of Medical benefit in post natal area

Breast feeding
Character of Breast milk is highlighted in Gunapaadam –Jeeva vaguppu (Siddha materia medica-Animal kingdom). They have also discussed about substitutions for breast milk. Donkey’s milk is recommended by Siddhars which is further substantiated in scientific studies. Siddhars have also mentioned a fund of Galactogogues which enhances milk secretion.

Weaning
Weaning foods are recommended from Fourth month and lot of prescriptions have been mentioned in Bala vagadam.Folk lore knowledge in Pediatrics add up usage of Kokkattan in the sixth to seven months to satisfy the dentition itch of the children.
Pharmaceutics in Siddha pediatrics:
1. Herbal drugs occupy a larger space (90%).Very less usage of Mineral drugs.
2. Most of The medicines are administered in Breast milk up to 1 yr.
3. Honey is completely avoided up to 1 yr.
4. Medicines for Dysentery and Diarrhoea are safe and will not precipitate Gastritis.
5. Anti emetics are safe and they do not precipitate extra pyramidal symptoms.
Common Pediatric prescriptions for child health care
1. Urai mathirai Immune booster
2. Korochani mathirai Effective in Combating fever
3. Bala sanjeevi mathirai Effective in Combating URTI/LRTI
4. Bhavana kadukkai Effective in Anaemia
5. Vasambu karukku Effective in Dysentry,Diarrhoea
6. Sangu Parpam tablet Tonsilitis, Gastritis,Resp.Infections
7. Vallarai tablet Calms ADHD and Sharpens Memory
8. Anmaiodu parpam Dysentry,Diarrhoea and in Lactose intolerance
9. Asta chooranam Increases appetite
10. Thetran kottai lehyam Tonic for children
11. Vallarai nei Kanam
12. Chundai vatral chooranam Effective Anthelminthic

National projects in Mother and child care including ASHA - Through SIDDHA

National projects in Mother and child care including ASHA.

Sathiya rajeswaran.P.

Objective

The Growing importance of AYUSH Systems Domestic as well as Global areas is evident from various statistics generated in yester years. Inclusion of AYUSH Systems in national/ State/ District/ Taluk level is mandatory in Public Health and proper understanding of national health programmes and preparedness in Inclusive health care delivery is the need of the hour. In listening / Reading these lines will give you a message and prepare the faculties for their inclusiveness in National projects.

Mother and Child care

Mother and child care even though is primitive still holds a lot of importance as it Focuses on a healthy nation. Rural population is still vulnerable in mother and child care.

Unhygienic environments, Poor Ante natal follow-ups, Malnutrition including Iron deficiency, improper child care and lack of frequent health supervisions take them under vulnerable population. The national projects if addressed properly will reduce the burden faced by the Rural as well as semi urban population which occupies the major population in India.

Accredited social health activist (ASHA)

Accredited social health activist play a very important role in NRHM as they access the rural population easily and they are Change agent on health .The first port of call for any health related demands of deprived sections of the population, especially women and children

Roles and Responsibilities

• Create awareness on

Nutrition

Basic sanitation

Hygienic practices.

Healthy living

• counsel on

Birth preparedness,

Importance of safe delivery,

Breastfeeding

Complementary feeding,

Immunization,

Contraception

Prevention of common infections including reproductive Tract Infection /Sexually Transmitted Infection (RTIs/STIs) and care of the young child.

Mobilize the community and facilitate them in accessing health

Services available at the village

Sub-center

Primary health centers

Immunization,

Ante Natal Check-up (ANC)

Post Natal Check-up (PNC),

ICDS and Sanitation.

Primary care by ASHA Activist

1. Diarrhoea
2. Fevers
3. First aid for minor injuries.

ASHA Will Provide Directly Observed Treatment Short-course (DOTS) under Revised National Tuberculosis Control Programme.

ASHA as medical depots

• Oral Rehydration Therapy (ORS)

• Iron Folic Acid Tablet (IFA)

• chloroquine

• Disposable Delivery Kits (DDK)

• Oral Pills & Condoms etc.

• A Drug Kit will be provided to each ASHA

AYUSH ASHA ROLE

• Combating malnutrition with Siddha drugs/ nutrition advices

• Ensuring basic hygiene and train to make use of home garden herbs and home remedies

• Teaching Siddha life style/ yoga for kids

AYUSH KIT WITH ASHA - WILL HAVE

• RCH KIT - Reproductive and Child health Kit

• General KIT - Siddha First Aid Kit.

• Information materials

• Referral addresses

• Wound healing drugs

• Tonic for women

ROLE AND INTEGRATION WITH ANGANWADI

ASHA will integrate with existing Anganwadi workers to

• Organizing Health Day once/twice a month.

• On health day, the women, adolescent girls and children from the village will be mobilized for orientation on health related issues such as importance of nutritious food, personal hygiene, care during pregnancy, importance of antenatal check up and institutional delivery, home remedies for minor ailment and importance of immunization etc

ASHA – PROFILE

• One ASHA per 1000 population.

• Primarily a woman resident of the village - ‘Married/Widow/Divorced’.

• Literate woman with formal education up to Eighth Class

• Effective communication skills, leadership qualities.

Training needs for AYUSH ASHA

• Providing newborn care and management of a range of common ailments particularly childhood illnesses

• Inform about births and deaths any unusual health problems/disease outbreaks in the community to the Sub-Centers/Primary Health Centre.

• Promote construction of household toilets under Total Sanitation Campaign

• Identification of birth defect children and referrals

• YOGA / Day care – Seasonal care and Personal care mentioned in Siddha

• Nutritious Foods and Home remedies in Siddha and Immunization medicines like Urai Mathirai and Sei Nei in Siddha.

SCHOOL HEALTH SCHEME

Sathiya rajeswaran.P.

OBJECTIVE:

The objective of including AYUSH Physicians is to inculcate the Principles of Healthy living from their teen age and to teach children healthy food and healthy practices. Promotion of positive health (Health Education), Prevention of diseases (Including Immunization), early detection, diagnosis and treatment of diseases, referral services to higher Health Centers are the Outcomes expected. There is a constant increase in the number of students over the years without corresponding increases in the School Health clinics after its inception in 1979. 50% of the students are having one or more health problems at any given point of time emphasizing need for an annual checkup. Screening of these students will considerably reduce the burden on secondary (dispensaries) & tertiary (hospitals) health care outlets.

Need of screening is to make the child independent and socially productive

PROCEDURES

• Routine complete physical health checkup of each student
• Curative services through OPD services.
• Immunization against tetanus at the age of 10 and 16 years.
• Referral of students who require attention of a specialist, to referral centers and subsequent follow up of these cases.
• Health Education and Counseling.
• Advising the school authorities for maintenance of healthy and safe environment.

Mass Deworming Programme

A large number of students have hidden burden of worm infestation leading to anemia and growth failure. Therefore the mass deworming of children with a single dose Deworming tab/churnam will give benefit in this programme.

Screening for cardiac diseases

Children and adults have to be watchful when they get a throat infection and attend to it immediately. "If it is a bacterial infection, it causes severe pain of the joints and slowly leads to heart failure," school children have to be screened for a healthy heart. The other ways of preventing heart diseases is by avoiding consanguineous marriages. The identified Children should be referred for higher cardiac centers.

Health Education

Prevention is better than cure. Trained teachers will be giving health education to all the students round the year on common topics like hygiene, environmental sanitation, food hygiene, hand washing, balanced diet and iodine deficiency disorders.

Session of Yoga and Sex Education for classes ten and above should be conducted. AIDS awareness sessions will be conducted for children above 15.

More emphasis will be given on Demographic based and seasonal oriented Indigenous diet.

RECORDS TO BE MAINTAINED

u Cumulative Health Record

u Medical Register

u Referral and Follow-up Register

u Deworming and Immunization register.

u Health Education Register

u OPD Register

u Monthly Report

u Annual Report

u Monthly Schedule Report

u Indent Book

u Main Stock Register

u Sub – Stock Register

u Expiry Register

u Daily Consumption and Balance Register.

CONCLUSION

Strength of Country is the percentage of Younger age group and contrarily there is also increasing statistics of Mortality rate between 3 rd and 4 th decade. Its the need of the hour to identify, Educate and Protect the Mother and Child Sector who will contribute much towards healthy India.

PHARMACOVIGILANCE AN OVERVIEW

PHARMACOVIGILANCE AN OVERVIEW

Dr. M. Kannan¹, Dr. P. Sathiyarajeswaran², Dr. S.Natarajan³

Introduction:

Medicines cannot be claimed as absolutely safe for all people, in all places & at all times.Adverse drug reactions are one of he major cause of death in a hospital. Clinical Research without ensuring patient safety is unethical. Various studies suggest that irrational use of traditional medicines and procedures may lead to negative or dangerous effects.

The drugs were studied in ancient days according to their Properties, Uses, Dose, Drug Reactions / Side Effects, their Management, Compatibilities & Incompatibilities; Interactions etc.The Pharmacovigilance system is prevalent from ancient days. Validation with suitable documentation is the need of the hour. Adverse Drug Reactions are the integral part of drug Pharmacology.

Traditional Medicine is presumed to be Natural, Safe even in Long term usage..Pharmacovigilance includes drug and Therapeutic procedures (Varmam & Thokkanam, Karanool, Detoxification procedures in Siddha).

What is Pharmacovigilance?

Pharmakon (Greek) = drug Vigilare(Latin) = to keep watch; awake, alert; watchfulness in respect of care,danger, caution, circumspection; process of paying close and continuous attention.

Pharmacovigilance is defined as the science and activities concerned with thedetection, assessment, understanding and prevention of adverse reactions to medicines (i.e. adverse drug reactions or ADRs). Pharmacovigilance system is in infant stage in India The ultimate goal of this activity is to improve the safe and rational use of medicines, thereby improving patient care and public health.

Aim:

a. Early detection of Unknown Adverse reactions & Interactions

b. Detection of increases in frequency of Adverse reaction

c. Identification of risk factors and possible mechanisms underlying Adverse reaction

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1 & 2 Research Officer, 3 Senior Research Fellow Siddha Central Research Institute (CCRS), Arumbakkam, Chennai - 60006

d. Estimation of quantitative aspects of benefits / Risk analysis and dissemination of information needed to improve drug prescribing regulation

e. Preventing patients from being affected unnecessarily

Why is Pharmacovigilance important?

A medicine is released into the market after rigorous procedures pertaining to standardisation and safety of the product. Once marketed the medicines are used by patients who have multiple morbidities, and may using several drugs which have different characters do’s and don’ts which may influence the efficacy and safety of a medicine. Different brands of medicines may differ in the SOP’S .The adverse drug reactions and poisonings associated with traditional and herbal remedies are to be monitored in every country. The information we receive on the adverse effects of drugs in one country may not be relevant or applicable to citizens of other countries. In some cases, adverse effects to certain drugs may occur only in certain races .In order to prevent unnecessary suffering by patients and to decrease the economic burden sustained by the patient due to the inappropriate or unsafe use of medicines, it is essential that a monitoring system for the safety of medicine supported by doctors, pharmacists, nurses and other health professionals in thecountry.NPC is improving drug safety through adverse drug reactions ,monitoring adverse reactions should be reported on a dailybasis.Differences in drug use, genetics, diet, tradition of people and excipients etc.

Who should report Adverse Drug Reactions?

All health care workers, including doctors, pharmacists, nurses and other health care professionals are requested to report all suspected adverse reactions to drugs (including vaccines, X-ray contrast media, traditional and herbal remedies),especially when the reaction is unusual, potentially serious or clinically significant. It is vital to report an adverse drug reaction to the nearest and appropriate Pharmacovigilance centre even if you do not have all the facts or are uncertain about the medicine and the ADR reported.

Will reporting have any negative consequences on the health worker or the Patient?

This adverse drug reaction report does not constitute an admission that you or any other health professional contributed to the event in any way. The outcome of the report, together with any important or relevant information relating to the reaction you have reported, will be sent back to you as appropriate. The details of your report will be stored in a confidential database. The names of the reporter or any other health professionals named on a report and the patient will be removed before any details about a specific adverse drug reaction are used or communicated to others. The information obtained from your report will not be used for commercial purposes. The information is only meant to improve our understanding of the medicines we use in the country.

How to avoid ADR’s?

• Medicines of good quality (GMP) and safety .
• Doctors, pharmacists, nurses got good basic education in pharmacotherapy (Good Academic Knowledge & Experience).
• Doctors prescribe sensibly (GPP) Populations knew rational use of medicines.
• Appropriate nosology
• Selection of Adjuvant / Vehicle
• Pathiyam
• Food & drug interaction awareness
• Drug & Drug interaction awareness and Seasonal awareness

What to report?

All adverse reactions / interactions suspected to have been caused by ASU drugs alone or along with any other drugs, any untoward medical occurrence that at any dose Results in death, requires hospitalization or Prolongation of existing hospitalization, Results in persistent significant disability or incapacity.

Where to report?

The reporting on prescribed format will be done to any of the Pharmacovigilance centres. (Visit www.crisiddha.tn.nic.in)

What happens to the ADR’s submitted?

The information in the form shall be handled in confidentiality. Peripheral Pharmacovigilance centres shall forward the form to the respective Regional Pharmacovigilance centres that will carry out the causality analysis. This information shall be forwarded to National Pharmacovigilance Resource centre. The data will be statistically analysed and forwarded to the Dept. of AYUSH, Govt. of India.

Adverse event:

Any untoward medical occurrence that may present during treatment with a pharmaceutical product but which does not necessarily have a causal relationship with this treatment

Adverse Drug reaction (ADR):

A reaction which is noxious and unintended, and which occurs at doses normally used in man for the prophylaxis, diagnosis or therapy of disease, or for the modification of physiological function

Signals:

Signals are Reported information on a possible causal relationship between an adverse event and drug, the relationship being unknown or incompletely documented previously. Usually more than a single report is required to generate a signal, depending upon the seriousness of the event and the quality of the information.

Spontaneous Reporting:

It is a System where case reports of adverse drug events are voluntarily submitted from health professionals and pharmaceutical manufacturers to the national regulatory authority.

Vigibase:

Vigi base is WHO international ADR database.

Vigiflow:

Vigiflow (formerly called Vigibase online) is sophisticated case report management system created by the UMC (UPPSALA Monitoring Committee, Sweden)

Vigi search:

This is custom search service offered by the UMC to third –party inquirers for several types of standard presentations are available.

Vigi med:

E-mail conferencing facility exclusive to member countries of the WHO programme for International Drug Monitoring.

swot analysis of siddha

SWOT analysis of Siddha medicine

Sathiya rajeswaran. P, Kannan.M, & Natarjan.S.

Strength of Siddha Medicine

1. Treatment cost is affordable
2. Treatment is Patient friendly
3. Possess traditional wisdom
4. Physicians are easily approachable
5. Reduces panic of Surgery
6. Empirical and Hear say evidenced
7. Varmam can be applied with no time
8. Emergencies are handled well
9. Confidence level of pts increases Multifold

If treated satisfyingly

10. Treatment duration is lesser

Weakness of Siddha medicine

1. Claimed to be Non Scientific.

2. Lack of Proper training to peers.

3. High rate of Iatrogenic Complications due to non referral.

4. Tall claims lead to PVR’S.

5. Poor Hospital Infection Control

6. Unavailability of Pain Management Drugs

7. Ethical issues go unanswered.

8. Techniques are Transferred only to generations

9. Considered as a native Knowledge than Medical Profession.

10. Equated With a magic remedy and not Validated .

Opportunities

1. Establishment of Departments

2. Availability of Trainers

3. Charisma towards Herbal remedies .

4. Potential to develop as health tourism sector.

5. Paradigm shift of Health scenario.

6. Hear say evidence is mass communicated

7. Institutionalization and Established research.

8. Involvement of Policy makers and Govt.itself

9. CCIM Approval for revised and upgraded curriculum

10. Publications of Literatures by Peers.

Threats to Siddha medicine

1. Budding of Quackery

2. Poor Involvement of Academicians

3. No Insurance for of AYUSH Treatments

4. Non up gradation in Educational policy.

5. No legal protection for Qualified practitioners .

6. Not Permitted to maintain RTA/MLC Cases registry

7. Minimal hospital Standards are not Followed

8. Therapist Unavailability

9. Portrayed as Magical Remedy by Fellow members of Allopathy.

Commercially Non Viable for the

I. Food items and their special medicinal properties
Sl. No
Food Items
Special Medicinal Properties


5
Pepper Rasam/Kolambu
Asthma
Cold &cough
Digestion

6
Nandu (Crab) Rasam/Kulambu
Cold &cough
Arthritis
7
Ragi (a coarse millet) Kanji
Rich in carbohydrates
Gives strength
Good for diabetic patient
2
Kambu (Pearl Millet) and preparations
Nutritional value
Cools the body

1.
Green Leafy vegetables
Increases iron content
Clears the stomach
4
Manathakkali Preparation (Solanum nigrum Linne
Good for stomach ulcer
8
Rice Kitchdi
Stumilates appetite
9
Chatney made from Pirandai (a shrub: cissus qusdraugularis)
Good for Digestion
10
Chutney made from Pudina leaves
Good for Digestion
11
Cooked Samai (a variety of)rice
Increases body weight
12
Sundhaivathal
For worm
13
Thuthurali rasam (rasam made from a shrub: three lobed night shade
Cold & cough
14
Valai Thandu (the internalspadix of a plantain tree)
Best for kidney stone
3
KarunaiKizhangu (Dracontium Linne, its bulb)
No use specified
15
Valaipoo (flower of the plantain tree)
No use specified

Non-response

ANAEMIA IN SIDDHA SYSTEM OF MEDICINE
Introduction:
In Siddha system of medicine all the systemic diseases have been classified under three categories.
I. Based on the vitiation of three humours.
II. Based the predominant symptoms and
III. Based on the line of treatment.
In modern medicine the Nosology which deals with the classification of diseases has grown boundless. No one can easily remember the names. But in Siddha system of medicine all the diseases the human being assailed with can be classified into 147 classifications, though the total numbers of diseases are mentioned as 4448. (Uthamarayan, 1953)
”Veluppu noi” is one among the diseases classified based on the symptoms which literally means the Pallor, that can be exactly correlated with Modern classification of Anaemia. A detailed description of signs and the symptoms, etiological factors and their management have been found to be described in detail (Yugimuni, Annonymous.1965). This clinical entity is classified in to six, four based on vitiation of humours, one under toxic anemia and the last one Anemia due to the consumption of Ashes and the soil.
PAANDU
Definition
The word Paandu literally means pallor. In this clinical condition the conjunctiva, tongue, nail bud turn into pallor and it is has been named as PAANDU NOI.
Syn: Velluppu noi, vemmai noi.
Etiology:
The etiological clusters, like Nutritional deficiency, hemorrhages, worm infestation and the other secondary causes like Tuberculosis, chronic sprue and the disease like piles, metarrhagia and menorrhagia are also found to be described.

· Excessive intake of Salt, sour foods, mud, ashes, toxic drugs.
· Haemorrhagic conditions like Mennorrhagia (Perumpaadu), Hypertension (Pithathikkam), Haemorroids (Moolam), Haematemesis (Kuruthivaandi).
· Worm Infestations.
· Hepatic disorders. (Murugaesa mudaliyar, 2008)
Premonitory symptoms
1. At first instance due to dietary changes, vitiated pitha affects the colour and consistency of the blood, which will prevent the proper supply of the nutrients to the body and leads the body in to pale in colour.
2. Secondly, while walking small distance leads to dyspnoea and weakness of the lower limbs.
3. Anorexia, nausea, giddiness, blackouts, frequent fainting, palpitation and emaciation.
General symptoms
1. Weakness of the body
2. Headache
3. Palpitation
4. Blackouts
5. Giddiness
6. Fainting
7. Dyspnoea
8. Anorexia
9. Vomiting
10. Pallor and Shrinkage of the skin
11. Emaciation and shining of the body
12. Clubbing
13. Fissures, redness and softening of the tongue
14. Sore throat



Classification:
It is classified as 6 types
A. Based on humoral pathology - 4 types
1. Vali paandu – Haemolytic anaemia
2. Azhal paandu – Megaloblastic anaemia
3. Iyya paandu – Pernicious anaemia
4. Mukkutra paandu – Sickle celled anaemia

B. Based on Toxaemia - 1 type
1. Nanju paandu – Thalassemia
Apart from these 5 types it is found to be described the other classification MANUN PAANDU which is caused by consumption of ashes, mud and so on. This can be correlated with iron deficiency anaemia. (Kuppusamy mudaliyar, 2007)
Vali paandu:
The main symptoms are
· Anorexia
· Stomach ache
· Thirst
· Blackish discolouration of blood vessels
· Redness of eye
· Constipation
· Pallor
· Anasarca
Azhal paandu:
The main symptoms are
· Yellowish discolouration of body
· Pallor of tongue, hand and foot
· Eye vision diminished
· Thirst
· Dyspnoea
· Giddiness
Iya paandu :
The main symptoms are
· Whitish colouration of body
· Pylo erection
· Cough with expectoration
· Syncope
· Low back ache
Mukkutra paandu:
The main symptoms are
· Dyspnoea
· Bronchial asthma
· Frequent micturition
· Sneezing
· Anasarca
Nanju paandu:
It is defined due to consumption of toxic materials. The following symptoms are manifested this may be easily correlated with toxic anaemia. Haemolytic anaemia, Thalasemia can be grouped under this classification.
· Excessive thirst
· Vomiting
· Hic cough
· Cough
· Anasarca


Mannun paandu:
Consumption of Mud, ashes induces worm infestations which in turn leads anaemia and pallor. The main symptoms are
· Flatulence
· Indigestion
· Vomiting
· Diarrhoea
Treatment:
The treatment of Anaemia involves three phases.

First phase:
It is a preparatory phase. In this phase purgation is generally given to normalise the vitiated Vayu humour. It also helps to eliminate worms and other accumulated toxins of the body. Generally, the following medicines are prescribed.
Therapy - 1
1. Vitis vinifera - Thiraatchai
2. Phoenix dactylifera - Pereichu
3. Rosa borboniana - Rosa poo
4. Operculina turpethum - Sivathai
Equal quantity of all the ingredients are boiled in water and reduced to 1/8 and administered at bedtime to cleansing the GIT and detoxify the body.
Therapy - 2
1. Sesbania grandiflora - Agathi
10 -15 gms of leaves are boiled with 250 ml of water and reduced to 1/8th that is 30 ml and administered with palm jiggery before bedtime. This will be useful in cleaning the GIT tract and also to expel the worms


Therapy - 3
1. Tinospora cordifolia - Seenthil
2. Feronia limonia - Narivila
3. Mollugo cerviana - Parpadagam
4. Cassia acutifolia - Perungalli
5. Operculina turpethum - Sivathai
Equal quantity of the above ingredients are taken and decoction is prepared using sufficient quantity of Epsum salt. This will be useful in cleaning the GI tract and hepato-biliary system by inducing purgation.

Second phase:
This phase includes the medicines the dosage, vehicles, adjuvants, durations and diet prescription. Siddhar’s intuitions are so high that, the prescription given by them containing herbs, herbo minerals, metallic compounds which are rich in micro and macro nutrients such as calcium, Vit C, zinc and iron.
The modern way of treating anaemia goes in par with their intuitions. Siddhar’s have used iron, ferrous sulphate, magnetite, iron rust predominantly. They have been selected, purified and processed to get the medicine which later evolved as traditional standard operating procedures. The form of iron present in the end product is in the ferrous state which enhances in pharmacokinetics and logistics.
The following drugs are generally prescribed in treatment of the Anaemia with suitable vehicle (Anupana) and Adjuvants( Tunai marunthu)
Karpams
Sl.No
Name of the medicine
1
Aya sambeera karpam
2
Aya pirungarasa karpam




Sl.No
Name of the medicine
1
Aya parpam
2
Kantha parpam
3
Velli parpam
4
Ayanaga parapm
Parpams






Sl.No
Name of the medicine
1
Aya chenduram
2
Kantha chenduram
3
Ekku chenduram
4
Mandoora chenduram
5
Arumuga chenduram
6
Ayaveera chenduram
7
Velli chenduram
8
Thanga chenduram
9
Annabethi chenduarm
10
Ayakantha chenduram
Chendurams









Third phase:
This is the phase followed immediately after the treatment in which prescription is made to change the life style i.e. Iyama, Niyama daily course, seasonal contacts and diet to prevent the recurrence.

Bibliography

Annonymous. (2005). Yugi vaithya chinthamani - 800, 2nd edition.pp 167-169, Chennai: Dept of Indian Medicine and Homeopathy,Govt of Tamilnadu.
Kuppusamy mudaliyar, K. (2007). Siddha Maruthuvam 7th edition. pp 345-352,Chennai: Dept of Indian systems of Medicine and Homeopathy, Govt of Tamilnadu.
Murugaesa mudaliyar, C. (2008). Siddha materia medica Part I 2nd edition pp 229-231. Chennai: Dept of Indian Systems of Medicine and Homeopathy, Govt of Tamilnadu.
Thiagarajan, R. (1981). Siddha Materia medica part II 3rd Edition. pp 394-397 Chennai: Dept of Indian systems of Medicine and Homeopathy, Govt of Tamilnadu.
Uthamarayan, C. (1953). Siddha Maruthuvanga Churukkam.pp 285. Chennai: Govt Press, Tamilnadu.

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