Siddha medicine

siddha medicine

siddha medicine

siddha medicine

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The objectives of this website is on the one hand, to present research and activities that I am conducting on siddha medicine since 2005, and on the other hand, to promote exchanges among researchers studying traditional medicines.

Research on siddha medicine

The present research on siddha medicine began in October 2005. It belongs to the international programme 'Societies and Medicines in South Asia. Exploring the social construction of healing' instituted by the Department of Social Sciences of the French Institute of Pondicherry (see axis 4 of this programme)

Description of the scientific project on siddha medicine

The observations conducted during the two first years have permitted to identify some research topics which could favour a collaborative work through multidisciplinary approaches and in different cultural areas:

The research is completed by photographic and film documentaries on the drug manufacturing, on alchemical and iatrochemical processes and on relevant aspects of siddha therapeutic practice, on digitalisation of olaiccuvati and of manuscripts accompanied by thebiodata of the owner(s).

1-Politics and siddha

Siddha differs little from ayurveda in terms of concepts, materia medica and practices. However, unlike ayuveda, siddha texts are writtenin Tamil language and are attributed to a class of yogis or cittarkal, and this medicine is practised in Tamil Nadu and in Indian States and Asian countries having a significant Tamil community. The association of siddha with Tamil identity is clearly expressed in the discourses of siddha practitioners and Tamil people. This anchoring in identity, added to therenewal of interest in traditional medicines, contributes to the revitalization of siddha. Some archetypes defined as ‘tradition’, are quite often mentioned by its supporters to emphasize its antiquity and its position as ‘the mother of all medicines’ (Ramaswamy 2005, Weiss 2003). The reformulation of the tradition and the strong emphasis on identity lead to question the place of siddha in discourses of the leaders of the Dravidian movement.

Siddha has not been institutionalized as much as ayurveda due to the fact that its practice was limited to the southern part of India and it had rather bad reputation because of its extensive use of iatrochemical processes and esotericism of its texts. Moreover, it has not benefited from the revitalization movement led by practitioners against the hegemony of the British medicine and the deterioration of the practice of ayurveda (Panikkar 1992, Sébastia 2008a). This difference has resulted in a number of cittavaittiyar (traditional siddha practitioners) significantly higher than siddha doctors trained in colleges, but also, in the practice of siddha more in conformity with the precepts of the medical texts. Indeed, the institutionalization of Indian medicine, initiated by the British, and then defined by the Government of India, was developed from choices which favoured the theoretical learning to the detriment of technical and empirical knowledge. The objectives were to train students of Indian medicines according to the educational model of ‘English medicine’, and to endow these medicines with scientificity, a quality which has ever been denied to them. The difference between levels of knowledge has provoked a deep split between institutionally trained practitioners and traditionally trained ones. This divide continues existing nowadays, reinforced by laws which deprive the traditional practitioners of exercising medicine without the diplomas instituted by the government. If these regulations regarding institutionalization have the objective to clean up the profession plagued with many impostors who exercise it for the sake of money and prestige inherent to medical profession, they play a large part in the decline of traditional knowledge. However, the cittavaittiyar respond to the degradation of knowledge, and within associations, they develop activities which compensate for, and supplement, those of the governmental institutions. First investigations conducted in 2007 have shown that these associations are able to promote and to preserve siddha medicine, and also, to influence government decisions regarding practitioners (Sébastia 2008a). In the future researches, a greater emphasis will be brought on these political issues on which the interest is reinforced by the repetitive claims of cittavaittiyar to obtain the registration (enlistment) in order to practice legally medicine.

2- Exchange of knowledge between different cultures

The Indian medicines share with Chinese, Tibetan and Arabic medicines, a materia medica based on herbal, mineral and organic products. If the botany is inadequate to compare medicines because of the strong geographical variability of plant species, on the other hand, minerals and metals used in alchemy and iatrochemistry such as mercury, arsenic and their complex, sulfur and salts (Hardy et al. 1995, Ray 1902, 1909) are appropriate to fulfill this objectif. Such a comparative study should be all the more relevant as it could allow to understand the elaboration of siddha and its differentiation of ayurveda, due to the fact that it possesses an important alchemical tradition and that metals hold a wide place in its pharmacopoeia (Lafont 2000, Sambasivam Pillai 1994, Shanmuganvelan 1963, Venkatraman 1990). Comparative studies on alchemy have mostly concerned the medieval period of Occident and the Middle East without really taking into account the Asian knowledge (Hunke 1997; Hutin1995; Lafont 2000; Naraghi 1996; Rashed 1997). This constitutes a serious handicap when one considers the important role that the Middle East has played in the exchange of scientific and technical knowledge between Asia and Occident. A comparison of alchemical processes between Asian (China, India, Tibetan) and Oriental countries should be a research field of great relevance to try understanding how every medical system is developed.
Siddha has not acquired the popularity of ayurveda and is very little known abroad. However, it is practised in some Asian countries where lives a large Tamil community. These countries, such as Malaysia or Singapore, host other migrant communities which have their own medical system. This medical pluralism, well developed, invites to observe if the ethnic relationship between Tamil community and siddha plays a significant role or if this relationship is transcended by contextual factors (long distance to visit a practitioner, preference to another medicine, caste difference). It also invite to question how siddha is practised in these countries in comparison with its practice in India by taking interest in the professional relationships that the siddha practitioners maintain with their country and in the dialogue that this medicine exchanges with the different medical systems present.

3-Transmission of conceptual and practical knowledge:

Studies on the transmission of conceptual and technical knowledge are not numerous either in India or, more widely, in the world. In India, the knowledge of siddha medicine is provided by institutional way in colleges run by the government and by several private institutes recognized by the government, or by traditional transmission within the family from parents or grandparents to children or grandchildren (paramparai),or by a master (guru-sisya, gurukulam). The gurukulam system which means that the disciple lives in the house of the guru so that he is influenced by his lifestyle and his habits is nowadays rarely practised in this form, and the term is quite often used for class sessions provided by a traditional practitioner, or even, for correspondance courses organized by a traditional practitioner. Traditional transmission, although ignored by the Government, seems to enjoy a certain revival from students who are dissatisfied with the curriculum of siddha courses provided by the colleges, and from descendants of traditional practitioners who take again interest in the medicine of their ancestors. It is widespread that students or young practitioners seek to deepen their knowledge by visiting numerous gurus.
How is the transmission today, i.e., what are the criteria to choose a medical practitioner, and what are the qualities of the disciple in order to be accepted by the guru? What are the reasons for which disciples visit many practitioners? How practitioners disseminate their knowledge and determine the stages of learning, and how disciples who have received information from various sources define their own practice? These questions are important because they allow to study the social organization of the work, education and learning of siddha and to observe its evolution which is underpinned by two opposite phenomena: the renewed interest for traditional medicine and the end of certain practices due to the lack of patients who turn to biomedicine. This subject on transmission allows also to observe familial tensions and even ruptures which occur when younger generations seek to innovate in comparison with the knowledge they received according to the tradition, within the family.

4-Siddha medicine development:

Siddha belongs to the traditional medicines recognized and supported by the Indian government which, to improve their development, has created the AYUSH department comprising Ayurveda, Yoga, Unani, Siddha and Homeopathy, within the Ministry of Health and Family Welfare. One of priority domains on which the government is developing researches, concerns the standardization of drugs. These researches are largely incited by WHO which supports the traditional medicines for their fundamental sanitary function in developing countries due to their availibility in remote areas and their low cost, but insists on the necessity to enhance the efficacy, safety, quality and availability of drugs (WHO 2002). Improvement of the efficacy involves the increase of clinical trials; that of the safety, the systematic control of all finished products in order to quantify the traces of toxic substances (heavy metals, pesticides, toxins of plants); that of quality, the control of raw materials and products at every stage of fabrication, and finally, the improvement of the availability of drugs may involve the use of raw materials of substitution or of cultivation. Respecting these criteria which are defined by WHO, is a huge handicap for traditional medicines, because they lead to high expenditures for technical equipment and manpower and the observance of regulations is not always feasible regarding the infrastructure of pharmaceutical units. However, the government, through its research centres of CRIS and CCRAS , launchs programmes in order to fulfill the WHO requirements. It develops siddha formulas in which efficacy and safety are evaluated, publishes pharmacopoeia books and siddha formulations for practitioners, creates an expert system for siddha practitioners and students, amends the Drugs and Cosmetics Act 1940 and Rules 1945, and organizes seminars on standardization of medicines and quality controls.The standardisation of siddha is also a concern for siddha practitioners who try to impose it through associations, training courses, seminars of information, which aim at fostering the uniformity of conceptual and technical knowledges.
For countries which possess one or several traditional medicines, the indices of quality, safety, efficacy constitute new fields of research that can not be neglected because they interfere in the reputation of these medicines which generate huge foreign currency by exportation. These last years, some traditional medicines such as ayurveda and chinese medicine are regularly in the headlines of international health media because of the presence of traces of heavy metals (mercury, lead, arsenic, cadmium) above the permissive level (Sébastia 2008b). If India defends itself against the generalisation of such a reputation, it reacts by amending rules to meet the international regulations and standardisation. How this new legislation is applied, and what are the means implemented by the government as well as by the associations of cittavaittiyar and NGOs to improve the standardisation, are the questions that will continue to be explored in the future researches.
In order to limit the risk of intoxications caused by heavy metals, certain cittavaittiyar prepare drugs only with herbs sometimes mixed with organic constituents (bones, shells, feathers, blood, flesh, skin, bezoard, musk). They justify their choice by the fact that, although the therapeutic power of medicines made with metals is highly higher, these medicines must be prescribed only in case of incurable and severe diseases. This avoidance of metals seems to model the practice of ayurveda in Kerala which, in gerenal, is based on a strict use of plants. However, one of the specificities of siddha is its wide use of iatrochemical processes and thus this change questions about the distinction between the two Indian systems of medicine and the adequacy of the term siddha. However, these findings call for extensive ethnographical researches in various places in Tamil Nadu in order to assess the recurrence of such changes.

Obesity, type 2 diabetes, hyperlipedemia, hypertension, hemiplegia, are metabolic diseases which are sharply increasing in India. According to the World Health Organization, there were 31 705 million Indians with diabetes in 2000 and the number for 2030 is estimated to 79 441, an increase which should be the highest of all other countries. Many diabetic patients are also affected by overweight and obesity. In 2005-2006, among the population aged from 15 to 49, there were 1.3% of obeses people (2.8% of female) and 8.0% of overweight (9.8% of female)(WHO 2006). The women are more affected by this disorder and some studies conducted in urban areas of states such as Andhra Pradesh have revealed that 25% of women are overweight or obese (Griffiths et al 2001). Such evaluations strongly encourage researches favouring multidisciplinary fields. Anthropology, by its focus on conceptual representations, on impact of believes, on the cultural values, has a role to play in the fight against these diseases which represent a real problem of public health. The prevalence of metabolic diseases is linked to urbanization. According to Prabhakaran and his colleagues (2007), “Urbanization is associated with increased consumption of energy-rich food, a decrease in energy expenditure and erosion of traditional social support in the population. This in turn leads to higher levels of body weight, cholesterol and glucose in urban populations (...)”. Nevertheless, some authors have shown that these diseases affect not only rich people of cities, but also, albeit to a lesser degree, the population of slums and villages (Agrawal 2002).
To care these diseases, patients, quite often after recourse to biomedicine, turn to traditional medicines, in the context of Tamil Nadu, to siddha and ayurveda. This has encouraged the research centres for traditional medicines as well as traditional practitioners to develop drugs capable to control and to treat these diseases. The growing interest in this domain is perceptible by the frequency of articles published in the Journal of Research in Ayurveda and Siddha and also in international journals such as Journal of Ethnopharmacology, Phytotherapy Research, Plant Foods for Human Nutrition, The American Journal of Medicine, etc. Like in biomedicine, the drugs represent an important part of the therapy of the Indian medicines, however these medicines propose other methods of treatment which merit attention. They consist in diets (also present in biomedicine, but to a lesser extent), massages, acupressure, yoga.
Therapeutic aspects and the role held by siddha medicine in the control of metabolic diseases constitute the topic that I am exploring today. A large part of this study is devoted to the comparison of treatment between biomedicine and siddha (and ayurveda) in order to evaluate the ability of Indian medicines to complement or to supplement biomedicine. The second part of this reseach analyses some subjects intrinsectly related to the treatment of metabolic disesase and, especially, to the optimisation of the therapy. These subjects concern the cultural representations of the body, the concepts on the food and their links with the various social and religious contexts, and also, the sociological, anthropological and psychological factors which interfere in the changes of lifestyle and nutrition and in the emergence of metabolic diseases.