Siddha medicine

siddha medicine

siddha medicine

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Workshop organized at the French Iinstitute of Pondicherry on the 23rd and 24th August 2007:
“Siddha Medicine: historical, Social and Medical perspectives”

Programme: Thursday 23rd August 2007

09.30 Welcome to the participants
10.00 Welcome Address by Jean Pierre Muller, Director of FIP
10.10 An overview: ‘Societies and Medicines in South Asia’by Laurent Pordié, Head of Social Sciences Department
10.20 Presentation of the workshop by Brigitte Sébastia, researcher in Social Sciences at FIP
Session 1 - Siddha medicine in the texts
10.45 Body and self: non-dualism in Siddha medicine by V. Sujatha (Jawarlal Nehru University, New Delhi)
11.30 The Tamil Siddha medical tradition: a biographical note on Pokar, the alchemist by Kanchana C.V. Natarajan (University de Delhi)
12.15 A Pathway to Eternal Bliss: Kayakarpam in Siddha Medicine by S. Jega Jothi Pandian ( CRIS , Chennai)
14.15 A Few German Diary Reports on Siddha medicine in the Halle Mission Archives by C.S. Mohanavelu (U.G.C. New Delhi)
Session 2 - Siddha medicine and its materia medica Part I
15.00 Social use of materia medica in Siddha system of medicine by G Veluchamy (Director of CRIS )
15.45 Systematization and identification of botanical materia medica of Siddha medicine Sources, methods and implications by J. Soundrapandi (PhD Christian College, Tambaram)
16.45 An effective tool in organising digital knowledge on Siddha medicine by G.Gnana Sekari ( CRIS , Chennai)

Programme: Friday 24th August 2007

Session 2 - Siddha medicine and its materia medica Part II
09.30 Minerals in Siddha medicine by Stanly Paul (Gt Siddha College Palaiyamkottai)
10.15 The transformation in the practice, education and research on Siddha system of medicine consequent of the social changes by T. Anandan ( CRIS )
Session 3 – Siddha medicine in practice
11.15 Varma point induction experiences with traditional practitioners by T. Rajendran (Siddha practitioner, KK District)
12.00 Varmakkalai: A historical perspective by T. Rajendran (Siddha practitioner, KK District)
14.00 Traditional Siddha practitioners in Tirunelveli : their strategies, techniques and experiences by M. Ramakrishnan (Manonmanian Sundaranar University, Tirunelveli)
14.45 Siddha practices in Kongu region, Tamil Nadu by R. Maruthakutti (Manonmanian Sundaranar University, Tirunelveli)
Session 4 – Siddha medicine and the manufacturing and marketing of its drugs
15.30 Manufacturing Siddha Medicines: Issues in Standardisation and Procurement by N. Lalitha (GIR, Ahmedabad)
16.15 A clash of practices: Siddha medicine exportation and foreign laws on drug quality by Brigitte Sébastia (IFP/EHESS Toulouse)
17.15 Conclusion of the workshop

Report of the workshop: Siddha Medicine: historical, Social and Medical perspectives

In the past, Siddha medicine has suffered from a lack of interest due to a combination of various factors: language barrier, inaccessibility of texts and their esoteric content written in poetical form, and dominance of Ayurvedic medicine in the field of traditional medicines. Nowadays, however, it is enjoying a renewal of popularity. Some Siddha practitioners, encouraged by the success of Ayurvedic medicine, are seeking to promote their medicine on the national and international market: they develop websites, write books, and apply for patenting drugs produced from their hereditary formulations or from their own researches. The government, following the policies of WHO, supports the practice of traditional codified medicines in general hospitals and primary health centres; the creation in 2005 of the National Institute for Siddha, in the south of Chennai is the best example. In the same vein, Siddha medicine takes part in governmental research programmes on traditional codified medicine, whose the objective is to increase the knowledge of materia medica, pharmacopoeia and therapy. An important part of the work consists in listing, digitalizing, transcribing, publishing, translating medical manuscripts in order: to preserve them as a part of the Tamil cultural heritage, to discover new formulations capable of controlling epidemics, of relieving or curing ailments which fail to respond to biomedicine treatment, to diffuse the siddha knowledge inside and outside the country.
This renewed popularity encourages to undertake a wide-ranging study of siddha which will explore various aspects. The perspective is to comprehend the originality of siddha in comparison with ayurveda by examining its concepts and philosophical influences, its place in the field of Indian medical pluralism, its contemporary practices at different levels of knowledge and competence, its future development, not only in Tamil Nadu and in India, but also in the International market, and its participation in fighting epidemics and treating incurable and chronic diseases.

These various topics were tackled during a seminar organized by the department of social sciences of the French Institute of Pondicherry which was held on the 23rd and 24th August 2007. The seminar comprised four sessions entitled respectively: ‘Siddha Medicine in the texts’, ‘Siddha Medicine and its materia medica’, ‘Siddha Medicine in practice’, ‘Siddha Medicine and the manufacturing and marketing of its drugs’.

The first session was opened by Venki Sujatha (JNU, New Delhi) who presented a communication entitled “Body and self: non dualism in Siddha medicine” in which she defined the approach of the body in siddha medicine in confrontation with that in biomedicine which gives a mapping representation emphasizing the organs. If the gross body and its functions are well known thanks to exploratory techniques created by biomedical experts, subtle elements such as mind, emotions, feelings, intelligence, remain unexplored because of their immateriality. On the other hand, siddha takes account of these subtle elements because it was founded by yogis called cittarkal. Their objectives aiming for increasing the lifespan in order to develop their yogic powers and thus to put an end to the cycle of rebirth, they paid attention to prevention and immortality of the body. They created rules to control the body and the life, a medication for fighting ailments and death and for developing physiological parameters ensuring immortality (control of hunger, breathing, sleep, sexuality, etc), and they expressed consideration for the mind that they defined as being endowed with a materiality as concrete as that of the gross body. However, from her ethnographical observations, Sujatha stresses that the practice of siddha tends to ignore theories and concepts. It merely consists in the prescription of drugs and neglects the importance of communication between patient and doctor and the empirical data necessary for determining the good treatment.
The second communication, “The Tamil siddha medical tradition: a biographical note on Pokar, the alchemist”, presented by Kanchana C.V. Nataraja, was interested in the text ‘Pokar elayiram’, a text of Pokar, one of the 18 cittarkal defined by the Tamil tradition. Some historians who studied the texts of Pokar agreed that they were written by three authors who lived at different periods: Pokartevar who is mentioned in the text Tirumantiram of Tirumular and considered a disciple of Kalanki, Pokar who resided in Caturagiri and was involved in kayasiddhi, and the third who lived in 17-18th century at Palani and deemed the author of statue of Dandapani made with navapasanam (nine sorts of arsenic salt). The communication concerned the third Pokar who, like Iramatevar, another cittar previously studied by Nataraja, creates a link between India and foreign countries. Whereas Iramatevar would have been to Mecca in the expectation to find the ‘tank of mercury’, Pokar, thanks to his supernatural powers (siddhi) for ‘flying’ obtained by ingestion of kulikai (pill of solidified mercury), would have travelled in China and in Arabic countries in order to perfect his knowledge on medicine and alchemy. However, Nataraja notices that apart from numerous references of the extraordinary powers of the cittar and his numerous travels in China, the geographical, environmental and sociological quotations on this country are extremely rare. About philosophy, the text ‘Pokar elayiram’ considers that there are three achievements which are complementary: art to immortalize the body (kayasiddhi); art to use alchemical material for manufacturing drugs (vatasiddhi); union with Brahman (yogasiddhi). The contributor points out that the text often refers to tantrism, philosophical system linked to alchemical concepts in Siddha tradition, and also to alchemy through metals, poisons and salts whose the famous muppu, used to manufacture drugs and to control the ageing of the body.
Jothi Pandian (Central Research Institute for Siddha CRIS , Chennai) then, intervened to present a communication entitled “A Pathway to Eternal Bliss: Kayakalpam in Siddha Medicine” which compared the kayakappam treatment proposed by three manuscripts allotted respectively to Tirumular, Pokar and Konkanavar. Kayakalpam is defined as a process of conversion of the body ‘kaya’, matter destructible, in ‘kalpam’ matter comparable to stone. This process is carried out by bodily techniques (kalpa yogam) and drugs (kalpa aviltam) whose the properties are to lengthen the life and to increase the activity of organs. Although Tirumular is considered as one of the most productive cittarkal regarding medical writings, his manuscript on kayakalpam explores mainly kalpa yogam and there are the texts of Pokar and Konkanavar which are involved in medication for kayakalpam. The text of Pokar mentions 45 herbs for kayakarpam and recommends consuming black plants (karuppu mulikaikkal), certain minerals, and his own urine (amuritaranai). It presents some formulations made up of herbs and of metals and plants, but in fact, the combination of minerals and herbs in the kayakalpam pharmacopoeia is more elaborated by Konkanavar who is the author of a lekiyam composed of minerals and tonic plants.
The last communication of this session entitled “A Few German Diary Reports on Siddha medicine in the Halle Mission Archives” was proposed by C.S. Mohanavelu (U.G.C., New Delhi) who went through the Archives of Halle. Arrived in Tamil Nadu at the beginning of the 18th century, the missionaries of Halle, especially, German and Danish, were confronted with the diseases which prevailed under the tropical climate of this area. This encouraged them to take interest in the medicine practised by vaittiyarkal. In the archives, the medicine is never defined under the term of ‘Siddha’, but the details they give on concepts, diagnostic and nosological classification are very similar to those of siddha medicine. Admittedly, the references on the medicine in the writings of the missionaries concern only a small part of the study of Mohanavelu whose the objective aimed to explore the interests of the missionaries in Tamil language and culture, but the richness of this field calls for a specific research on medicine in manuscripts and archives of Halle Mission.

The second session comprised five communications whose the first one, “Social uses of materia medica in Siddha system of medicine” was prepared by V. Veluchamy (Director, CRIS ). It introduced the subject by presenting the elements of vegetable, organic and mineral kingdoms used in Siddha medicine, the pharmacological properties of these elements, as well as the classification of metals and minerals determined by their properties of dissolution and sublimation.
The second communication, “Systematization and identification of botanical materia medica of Siddha medicine Sources, methods and implications” , was presented by J. Soundrapandi (PhD in botany Christian College, Chennai) . On the basis of data made up of secondary sources on materia medica and pharmacopoeia (kunapatam, nikantu, malai vakatam, kalpa suttiram), practices of cittavaittiyar, census of botanical species collected by tribes of Western Ghats and herbs sold on the market, Soundrapandi focused its presentation on the medicinal plants used in siddha. The number of plants identified in siddha medicine is weaker than that of ayuveda: 1121 against 1769; among these plants, 763 are common to both medicines and 56% are common to siddha and folk medicines, a percentage more important than for ayurveda where 41% of botanical species are used in folk medicines. In addition to these data, J. Soundrapandi presented tables on the classification of plants according to siddha (trees, shrubs, creepers, grass), on the parts of plants used for drugs (whole plant, root, bark, resin, flowers, sheets, non ripe and ripe fruits, seeds), on the pharmacological properties of plants and the species commonly the most used, on the origin of plants through which one observes that a small percentage of species comes from Himalayan areas, but also from Mediterranean and South-American regions. G. Gnana Sekari ( CRIS ) then, intervened to present a communication entitled “An effective tool in organising digital knowledge of Siddha medicine”. It concerned the creation and development of an illustrated expert system on siddha medicine in English and Tamil language, whose the objective is to collect and organize the knowledge on siddha and to enhance the information flow by making them available to a large public. The expert system fed by old and contemporary sources (manuscripts and medical texts, cittavaittiyar, researchers) defines 25 diseases and disorders through a general description, symptomatology and treatment, and describes plants used to prepare medicines and some licensed drugs. The system integrates, in addition of this information, interactive educational functions devoted to the students so that they test and improve their knowledge, to siddha doctors so that they find some help in their practice and to non-siddha experts and researchers interested in traditional medicine.
The forth communication on the materia medica was presented by Stanly Paul (Gvt Siddha college, Palaiyamkottai). Entitled “Minerals in Siddha medicine”, this communication was interested in the change of minerals used in siddha medicine and its implication on the point of view of therapeutic properties. This change would have been carried out in the 18th century with the development of chemistry. To manufacture their drugs with metals and minerals, the practitioners would have gradually given up the gross material, less and less marketed, to the benefit of pure ore. The communication shows that this substitution implies a fall of therapeutic properties because the impurities such as minerals and microorganisms which were present, had therapeutic properties. Obviously, this study relating to siddha is also valid for other Indian medicines such as ayurveda and unani and, more largely, for all traditional medicines incorporating minerals in their pharmacopoeia.
The last communication on the materia medica of siddha entitled “The transformation in the practice, education and research on Siddha system of medicine consequent of the social changes” was prepared by T. Anandan ( CRIS ). After having introduced the subject by defining the various types of medication and the traditional techniques of manufacturing medicines, the communication presented the objectives of research on the medicinal products carried out by the Central Research Institute for Siddha, Chennai. These aim at improving the safety and efficacy of drugs and facilitating their adaptation to the international market, to increase the data on the plants used in siddha, to enhance the quality and the value of siddha research and to popularize this medicine besides the consumers of any socio-demographic profile. To carry out these objectives, the CRIS privileged four specific fields: the botanical study (source, collection, identification, culture), phytochemical research, pharmacological research (pharmacognosy, pharmacokynetic, toxicology) and clinical test evaluation.

The third session regarding the practice of siddha medicine was introduced by a particular therapy which is the varmakkalai (accupressure). This therapy, very widespread in the extreme south of Tamil Nadu, was presented by T. Rajendran (traditional practitioner) through two communications “Varma point induction experiences with traditional practitioners” and “Practice of varmatherapy”. The varmankal are defined as centres where pranic energy is concentrated. The art to identify them would have been taught by Shiva: walking in the forest accompanied by Sakti, he discovered the body of a wounded hunter and helped Sakti to revive him by telling her what particular points (varmam) of the body she had to press with her gold stick. According to the tradition, Shiva is the creator of siddha medicine and thus the supreme guru in the educational system guru/sisya. In this system, the training, in principle, lasts twelve years and the transmitted knowledge depends on qualities of the disciple (intelligence, discipline, humility, generosity, determination) and of the benevolence of the master to reveal his secrecies. Rajendran, who sought to improve his knowledge from many gurus or acan specialized in varma therapy, kalari payattu (martial arts based on the knowledge of varma points), yoga, preparation of drugs, presented some strategies used by his masters to prevent the diffusion of their secrecies on which they build their reputation of healer. His second communication presented the principles of varmakkalai which concern three fields: therapy, fighting and yoga. Regarding the therapy, its fundamental principles consist in eliminating toxins from the body and in controlling the flow of pranic energy by using internal therapies based on specific medication, diet and processes of purification, and external therapies made up of various types of massage and acupressure.
The two following communications, “Bonesetters in Tirunelveli region” and “Siddha practices in Kongu region, Tamil Nadu” were presented respectively by M. Ramakrishnan and R. Maruthakutti (Manonmanian Sundaranar University, Tirunelveli). The bone setting is a popular medicine which is associated with siddha medicine due to the fact that the experts are specialized in rheumatic diseases whose the main cause is allotted to imbalance of the vata humour (air), and it is practised by specialists in varma therapy. This communication concerned a comparison of practices between five bonesetters in order to observe the changes and innovations. It attempted to show the important role that these experts play in the remote areas due to their accessibility and their tariffs applied only to medication. The low cost of siddha medicine is also a point raised by Maruthakutti in his communication on practitioners of Coimbatore-Palani-Erode region. Siddha is seldom selected in first recourse, but very often when no attempts of treatment by biomedicine succeeded. The ailments for which patients consult the cittavaittyarkal are as varied as skin diseases, ulcers, rheumatism, headaches, in fact, all kinds of chronic and somatic disorders. Siddha possesses its own diagnostic methods whose the pulse reading is the most important. However, these do not exclude the biomedical tools and the practitioners use stethoscope and order laboratory exams, radiographies, etc. If the practitioners still give importance to the diagnostic tools of their medicine, one observes a deep gab between the recommendations given by the medical texts and contemporary practice. To take two examples: diagnosis is never established on eight criteria as defined by the tradition, but often on the pulse reading only; suitable hours to read the pulse are rarely respected due to the fact that the timing of consultation in clinics or private practitioners are similar to this followed by biomedicine.

Lastly, the fourth and last session on siddha medicine comprised two communications on pharmaceutical industry and exportation. The manufacture of the drugs was approached by N.R. Lalitha (GIR, Ahmedabad) in a communication entitled “Manufacturing Siddha Medicines: Issues in Standardisation and Procurement”. Firstly, this communication was interested in the means that the Good Manufacturing Practices of the Drugs and Cosmetics Act, 1940 and Rules, 1945, are respected in siddha pharmacy. These practices regulate the construction and fitting of buildings, control and storage of raw materials, hygiene and safeguard from contaminations, management of water and waste, packing and the storage of finished products, regulation for staff, quality controls etc. Their objective is to adapt the pharmaceutical products to the international standards. However, the strict observance of this regulation is often impossible because of restrictive factors such as high cost of quality control and inadaptability according to the size of some companies. The second part of the communication was focused on one of the important regulations of the GMP aiming at the raw material and the availability of the long-term plants in the perspective to enhance the standardization of drugs. From the methods of acquisition of raw material by two main manufactures TAMPCOL and IMPCOPS, financially supported by the government of Tamil Nadu, Lalitha underlines the absence of a firm policy regarding the plants used in pharmacology and the cultivation of certain endangered species, to ensure the market with stable-quality products. The initiatives from the government as well as ONG or manufacturers in cultivating species widely used in manufacturing and sold on local and international markets remain too weak and concern too few species.
Last communication “A clash of practices: Siddha medicine exportation and foreign laws on drug quality” presented by Brigitte Sébastia (IFP/EHESS Toulouse) concerned the exportation of siddha drugs in spite of two obstacles: competition of the ayurveda whose trade-circuit is well organized and use of metals in the pharmacopoeia. The second point is particularly important because, these last years, ayurvedic products are regularly subject from foreign countries of sanitary alarms due to their high level of heavy metals such as mercury, lead, arsenic and cadmium. The denunciations on the bad quality of medicines forced the Indian government to harden its policy of the GMP rules and it amends the text to improve the labelling of the products. The siddha drugs manage to cross the frontiers and are exported in Asian and Arabic countries where reside a large Tamil community. They are also sold through commercial websites and directly to foreign patients who consult the practitioners. It is difficult to quantify the exportation of drugs by this system called ‘suitcase export’, but it is important and in expansion due to the attraction for traditional medicines and the development of medical tourism. If intoxications by ayurvedic medicines bought directly in India are reported, it is remarkable that the practitioners sold siddha drugs which are free of metals, a necessary precaution to preserve their reputation. Lastly, another means making exportation possible is through ashrams developed by siddha practitioners. Their number is not very important but their role is certainly not negligible if one considers their financial possibilities and the speed of expansion of some of them.

Bringing together contributors from various disciplines of sciences and from medical world, the seminar made possible for each participant to supplement its knowledge on siddha medicine and to feed the debate with many exchanges of ideas and information. The subject which particularly emerged during these two days concerns the materia medica, and this topic has been proposed for a future meeting around siddha medicine which would invite to widen the research through a confrontation with other Indian medicines, Chinese and Arab medicines.