A STUDY ON ORUTHALAI VAATHAM Dissertation Submitted To THE TAMIL NADU DR.M.G.R MEDICAL UNIVERSITY CHENNAI - 32 For the Partial fulfillment for The Award of Degree of DOCTOR OF MEDICINE (SIDDHA) (Branch – V, Noi Nadal) DEPARTMENT OF NOI NADAL Government Siddha Medical College Palayamkottai – 627 002 March – 2009
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A STUDY ON
ORUTHALAI VAATHAM
Dissertation Submitted To
THE TAMIL NADU DR.M.G.R MEDICAL UNIVERSITY
CHENNAI - 32
For the Partial fulfillment for The Award of Degree of
DOCTOR OF MEDICINE (SIDDHA) (Branch – V, Noi Nadal)
DEPARTMENT OF NOI NADAL Government Siddha Medical College
Palayamkottai – 627 002
March – 2009
CERTIFICATE
I certify that I have gone through the dissertation submitted by
Dr.M.Mahendiran,(Reg.32063004) student of final M.D(S) Branch – V Post
Graduate Department of Noi Nadal, Govt. Siddha Medical College & Hospital,
Palayamkottai, and dissertation work has been carried out by the individual
only. This dissertation does not represent or reproduce the dissertation
submitted and approved earlier.
Place : Palayamkottai Head of the Department Date : Post graduate Department Branch – V,
Noi Nadal Govt. Siddha Medical College & Hospital, Palayamkottai, Tirunelveli – 627 002.
ACKNOWLEDGEMENT
First and foremost, author immensely grateful to the God who
has always been a source of strength, knowledge, and guide through
the process of bringing out this project successfully.
Author very much thankful to the Vice Chancellor of Tamil
Nadu Dr.M.G.R.Medical University.
Author would like to express my sincere gratitude to our
Principal I/C Dr.R.Devarajan M.D.(s)., I/C Head of the Department
Post Graduate, Noi Naadal Department, Government Siddha Medical
College, Palayamkottai for permitting and providing the necessary
facilities to do this work.
Words hardly help up in expressing the gratitude. Author owe
to our professor and Vice Principal Dr.Soundar Rajan M.D.(s)., for
his valuable guideness and suggestions in bringing out this
dissertation whole successfully.
Author would liken to express my profound gratitude to
Dr.A.Vasukidevi M.D.(s)., for her guidance, suggestions and ideas
for completing this work.
Author would like to express my profound gratitude to
Dr.S.K.Sasi M.D.(s)., for her guidance, suggestions and ideas for
completing this work who has been helping me is every step of this
work.
Author express heart full thanks to Dr.R.Rajasekaran M.D.(s).,
Dr.S.Sundarajan M.D.(s)., and for his valuable suggestion to select
the dissertation topic.
It is author privilege to record my deep sense of gratitude to
Dr.Alagesan M.D. Neuro., Palayamkottai, for his constant strategic
support and encouragement in completing this work.
Author deeply interested in thanking to his family and friends
for support and encouragement during this work.
Last but no means the least, author express my cordial thanks to
St.Jude’s Computer Research Institute, Palayamkottai, for their
co-operation is bringing of this dissertation book in successful
manner.
CONTENTS
Page No
Acknowledgement
I. Introduction 1
Siddha Physiology 3
Siddha Pathology 8
II. Aim and Objectives 21
III. Elucidation about Dissertation Topic 23
IV. Review of Literatures 26
V. Detailed Pathological view of the 29
dissertation topic
VI. Theoretical view of dissertation topic 35
VII. Evaluation of the dissertation topic 51
Materials and Methods 51
Observation and Results 54
Differential Diagnosis 60
VIII. Discussion 63
IX. Conclusion 68
X. Annexure
XI. Bibliography
1
INTRODUCTION
The word “Siddha” comes from the word “Siddhi” which
means ‘an object to be attained’ or ‘prefection’ or heavenly bliss’.
Siddhi generally refers to Astama siddhi (m\;lkhrpj;jp) i.e., the eight
great supernatural powers which are enumerated as Anima (mzpkh)
etc.. Those who attained or achieved the above said powers are
known as siddhars.
The siddhars were further the greatest scientists in ancient
times. They were men of highly cultured intellectual and spiritual
faculities combined with supernatural powers. Their works in tamil
are supposed to be more valuable than many that have been written
in Sanskrit. They contain a large number of valuable formulae and
exhibit further minute enumerations of morbid symptoms.
As per siddha text, man is said to be the microcosm and the
world the macrocosm, because what exists in the world exists in man,
so man must be looked upon as an integral part of nature and not as
anything separate from the latter. Further, the forces in the
microcosm or man are identical with the forces of macrocosm or the
world the natural forces acting in and through the various organs of
the human body are intimately related is the similar or corresponding
force acting in and through the organisms of the world.
“mz;lj;jpJs;sNj gpz;lk;
gpz;lj;jpYs;sNj mz;lk;
mz;lKk; gpz;lKk; xd;Nw
mwpe;Jjhd; ghHf;Fk; NghNj”!
! ! - rl;lKdp Qhdk;
2
In the organisms of man, these forces may act in an abnormal
manner and cause disease thereby.
Humoral pathology explains that man is mixture of the three
cardinal humours viz Vali, Azhal, Iyam and that the relative
proportion of these humours are responsible for person’s physical
and mental qualities and dispositions.
Disease, according to modern science is only a departure from a
state of health and more frequently a kind of disturbance of the
healthiness of ten body to which any particular case of sickness is
assigned. According to Sidhar’s philosophy, disease in man do not
originate himself, but influence which act upon him. As already
stated, man is compared to the world, so any change in the
elementary condition of external world has its corresponding change
in the human organism. There is the feeling of oneness between the
external and the internal world of man, and its is upon this oneness
that the doctrine of humoural pathology i.e. the theory of Thridoshas
(Kg;gpzp) is based. This may occur through different causes viz.
1. Derangement of the three humours
2. Astral influences
3. Poisonous substances
4. Psycholigical causes
5. Spiritual causes
6. Disease originating from the soul
In Yugi Vaithiya chindamani, Yugi described 80 types of vadha
disease, “Orutahalai Vaatham” is one of the entity of the vadha
disease.
3
SIDDHA PHYSIOLOGY
Man is not merely made up of muscle, bones and nerves as we
think. According to siddhar’s thought.
Man (Microcosm) is having himself all the things in the
universe (macrocosm)
Earth (Purthivi) - kz;
Water (Appu) - ePh;
Fire (theyu) - jP
Air (Vayu) - fhw;W
Space (Aagayam) - tpz;
The basic elements exists in two forms.
i. Sthula form (gUepiy) - Recognized by our senses
ii. Sukkuma form (Ez;epiy) - Not recognized by our senses.
Human body is made up of 2 kinds of bodies.
i. Sthula Sariram (Visible body)
ii. Sukkuma Sariram (invisible body)
Sthula Sarriram includes Bones, Muscles, Blood vessels, Nerves and all functional
systems of human body. It is known as functional units of body.
Sukkuma Sariram, This is the basic for the Suthala Sarrirma. It makes the Sthula
Sariram to be active.
4
A basic thing for functioning of human beings explained by siddhars includes.
96 Thathuvangal
7 Udal Kattukal
6 Suvaigal
The factors which influences the functioning of human body are,
Udal Vanmai
Udal Thee
Siddhars explained physiology on the basis of 96 thathuvangal
(or) Structural units. Thus explains the physical and chemical factors
that are responsible for the origin, development and progression of
life.
5
Human Body [Built by Panchapoothas] [96 thathuvangal]
ii) Pori 5 Hearing iv) Vayu – 10 [Functions of five Touch Sense Organs] Vision v) Aasayam – 5 Smell Taste vi) kosam – 5
iii) Kanmaenthiryam – 5 Mouth vii) Aatharam – 6
[Functional Organs] Leg Arm viii) Mandalam – 3
Anus Genital ix) Malam – 3
iv) Kanmavidayam x) Thodam - 3
[Functions of Kanma enthruyam] xi) Edanai – 3
xii) Gunam – 3
xiii) Vinai – 2
xiv) Raagam – 8 xv) Avathai – 5
Speech Movements throw legs
Flexion and extension of arm Daefication
Evacuations of semen and ovum and contributes coitus
6
7 Udakkatukal 1. Saaram - It enriches the functions of body and mind
(Energy through food stuffs)
2. Senneer (Blood) - It makes the basic functions of body perfectly 3. Oon (Muscles) - It gives structure to our body and gives supports
to the joints 4. Kozhuppu (Fat) - Gives lubrication to our body organs to move. 5. Enbu (Bone) - It gives skeletal structure to the body and also
protection. 6. Moolai(Bone marrow) - It gives stability to bone. 7. Venneer (Sexual fulid) - It helps to produce the new generation Arusuvaigal – We get from foods
It has linked to uyirthathu, panchapootham and body functions
,dpg;G (Sweet) - Mann + Neer Vali - Vayu + Mann
Gspg;G (Sour) - Mann + Thee Azhal - Thee
cg;G (Salt) - Neer + Thee Iyam - Neer
ifg;G (Bitter) - Vayu + Aagayam
fhh;g;G (Pungent) - Vayu + Thee
Jth;g;G (Astringent) - Mann + Vayu
Any alteration takes place in suvaigal. It affects the uyirthahu and
body functions.
Altered Arusuvai
Uyirthathukkal (Alterations)
Diseases (Noi Nilai)
7
Udal Thee It is our body’s core temperature or BMR (Basal Metabolic Rate)
Udal Thee (Core Temperature)
Increase Normal Decreases
Thin body built Healthy body Indigestion
Increased appetite are related disease
Types:
Samakkini
Vishamakkini
Deekshakkini
Mandhakkini
Udal Vanmai (Innate immunity) It is genetically transmitted from parents and also get throw our
environment.
When any alteration takes place in immunity diseases occur.
8
SIDDHA PATHOLOGY INTRODUCTION :-
NOI:-
According to siddhars both human body and environment
(universe) are functioning on the basis of Pancabootha theory
“mz;lj;jpJs;sNj gpz;lk;
gpz;lj;jpYs;sNj mz;lk;
mz;lKk; gpz;lKk; xd;Nw
mwpe;Jjhd; ghHf;Fk; NghNj”!
! ! ! - rl;lKdp Qhdk;
The three vital forces namely Vatha, Pitha and Kabha are
responsible for the physiological and pathophysiological state of the
human body. So the pathological condition which affected the human
body is called noi.
!! kpfpDq; FiwapDq;Neha; nra;Ak; E}NyhH
tspKjyh vz;zpa %d;W . jpUf;Fws;
The following factors are responsible for the causes of the noi :-
(1) The abnormal dietary habits which affects the normal
physiology of the human body.
(2) The life style and habits which exacerbate (or) suppress
the normal functions of Vali, Azhal and Iyam leads to
Noi.
(3) Seasonal and environmental changes
(4) Genetic factors (Kanma Vinaikal)
(5) Immoral factors
(6) Suppression of reflexes
(7) Microorganism (Kirimi & Pulukkal)
9
Above these factors will cause the disease (Changes in
Uyirthathu). These changes are reflected in 7 Udalkattukkl and
Exaggerated Cough Fullness of stomach Excessive sleep Dysphonic Destruction of joint Giddiness
Decreased Decreased Iyam in all body fluids Increased sweating Palpitation
7 Udalthathukkal When food enters the body, it enriches Udalthathukkal one by one.
Food 1st Day (Saaram) - Plasma
2nd Day (Seneer) - Blood
3rd Day (Oon) - Muscles
4th Day (Kozhppu) - Fat and lymph
5rth Day (Enbu) - Bones and Cartilages
6th Day (Moolai) - Bone marrow
7th Day (Skukilam) - Reproductive fluids
Give energy to body
16
If any causes affect this process, disease will occur.
1. Saaram (Rasa)
It is the essence of digested food, circulating all over the
body and gives energy to body.
Increased State
Excessive Salivation
Sound intolerance
Excessive sleep etc.
Decreased State
Wasting of muscles Weakness etc.
2. Senneer (Raktha)
It is produced from rasa. It is responsible for substance of
life and provides color and complexion to the skin.
Increase state
Haemangiomas
Spleenomegaly
Leprosy
Jaundice
Nervous weakness
Mental disorders
Blood dyscariasis
Hyper pigmentation
17
Decreased State
Anaemia
Dry skin
Nervous weakness
Desire to intake of sour food
3. Oon (Mamisam)
Muscular tissues are produced from Rakata
Increased state
Tumors
Carcinamo
Goiter
Cyst
Decreased State
Wasting
Dryness
Crackling sound in movement of joints etc
4. Kozhppu
Increased state Associated with mamsa diseases
Obesity
Hyper cholesteremia
Decreased State
Wasting of muscles
Decreased stability of joint
Lethargy
18
5. Enbu (Asthi)
Increased State
Hyper calcinosis
Extra tooth formation
Hypertrophy of bone tissue
Decreased State
Osteporosis
Rickets
6. Moolai (majjai) Increased State
Bone and joint disorder
Ulcers
Heaviness of eye and body
Decreased State
Demyelination
Deliusion
Giddiness
7. Sukklathathu
Increased State Calculi formation (Urethra)
Sexual pervasion
Decreased State Impotency
Infertility
Weakness
19
Diagnosis
According to siddha aspect they are 8 stools of diagnosis “nka;Fwp epwj; njhdp tpop ehtpUkyk; iff;Fwp…”!!
!! ! ! ! ! ! - NjiuaH ehb - Pulse ghprk; - Touch or palpation ehf;F - Examination of tongue epwk; - Examination of colour of the skin nkhop - Examination of speech tpop - Examination of eye kyk; - Examination of stools %j;jpuk; - Examination of urine
Other Diagnostic in siddha ePHFwp!! .!! (Examination of urine it includes ! ! ! ! ! quantitative and qualitive analysis) nea;Fwp - (Examination of urine by dropping gingelly oil)
Neerkuri
Neikuri
20
In our siddha system of pathology includes.
Noi muthal naadal
(Find out the causes
For disease)
Noiarithal (Find
out the nature
of the diseases)
Noi Kanippu
karuvigal
(Diagnostic
Stools) Ennvagai
thervu
manikkadainool
Symtoms
Noi muthal naadal
(Find out the causes
for disease)
Siddha system of
Pathology (Noi
Naadal)
21
AIM AND OBJECTIVES The author had selected the disease Oruthalai Vaatham for
dissertation work because in this disease, the patients are disturbed
by both functionally and psychologically.
ORUTHALAI VAATHAM As mentioned in Pararasasekaram gw;wpa thjNgjQ; rpurpdpw; ghjp jd;dpy;
cw;WNk nehe;J gpd;DKr;rpiag; gpse;jhg; Nghyr;
nrw;wpLq; fz;zpH gha;e;J jpUfpNa typFj;Jz;lhk;
kw;wpJ thje;jd;dpnyhU jiyNeh ntd;Nguhk;
- 291> - guuhrNrfuk;> vl;lhtJ thjNuhf epjhdk <!
AIM
The main aim of this study is to evaluate the pathology of the
disease oruthalai vaatham with the help of siddha and modern
parameters.
To study the disease on the basis of Siddha physilogoy (Iyarkai
thathuvam) and Siddha pathology (Noi-Naadal) emphasizing more
impotance to Mukkutram, Suvaigal, Panjaboodha theory, Aayul
thoda nirnayam, Udal thadhukal and dignosis the patient, on the
basis of Ennvagai thervugal and confirm the prognosis of the disease.
22
OBJECTIVES
The objectives marked out to aspire the above said words
To collect all literary evidences above Oruthalai Vaatham
in the topic of its synonyms of definitions, aetiology
classifications, signs and symptoms, humoral
pathogenesis, fate of the disease from various literature
in siddha aspect.
To concentrate the clinical course of the disease
Oruthalai Vaatham by observing carefully the aetilogy,
______________________________________________________________________________ 17. Personal History: ______________________________________________________________________________
Habits 1.Yes 2.No 18. Tea : __________________ 19. Coffee : __________________ 20. Milk : __________________ 21. Smoking : __________________ 22. Alcohol/ Drug : __________________ 23. Food habits : V NV M __________________ GENERAL ETIOLOGY FOR ORUTHALAI VAATHAM 1. Yes 2.No 24 Excessive intake of bitter and salt __________________ 25 Sleeping in day time __________________ 26 Sleep disturbances in night time __________________ 27. Stress __________________ 28. Repeated Starvation __________________ 29. Increased weight __________________ 30. Excess Alcohol in take __________________ 31. Increased Angryness __________________ 32. Trauma __________________ 33. Biological causes (any infection) __________________ 34. Congential causes __________________ 35. Idiopathic. __________________ GENERAL EXAMINATION 36. Conciousness : _____________________________ 37. Posture : _____________________________ 38. Nourishment : _____________________________ 39. Weight : 40. Temperature : .
1. I.Paadham 2. II. Paadham 3. III. Paadham 4. IV. Paadham
169. RAASI
1. Mesam 2. Rishabam 3. Mithunam
4. Kataham 5.Simmam 6. Kanni
7. Thulaam 8. Viruchiham 9. Thanusu
10. Maharam 11. Kumbam 12. Meenam
13. Not Known
EXAMINATION OF CENTRAL NERVOUS SYSTEM
170. Handedness Right Left
Higher function test
171. Consciouseness Yes No
172. Orientaion Normal Affected
173. Memory Normal Affected
174. Mental function Normal Affected
175. Sleep Normal Affected
Cranial Nerve Examination Right Left Normal Affected Normal Affected 176. Olfactory Nerve (I CN) 177. Optic Nerve (II CN) 178. Occulomotor Nerve (III CN) 179. Trochlear Nerve (IV CN) 180. Trigeminal Nerve (V CN) 181. Abducent Nerve (VI CN) 182. Facial Nerve (VII CN) 183. Vestibulocochlear Nerve (VIII CN)
184. Glossopharyngeal Nerve (IX CN)
185. Vagus Nerve (X CN)
186. Spinal Accessory Nerve (XI CN)
187. Hypoglossal Nerve (XII CN)
EXAMINATION OF MOTOR SYSTEM
Right Left Normal Affected Normal Affected
Nutrition: 188. Arm ________ _________ 189. Forearm ________ _________ 190. Thigh ________ _________ 191. Leg ________ _________ Tone Rigidity Spasticity Right Left Right Left 192. Upper limb __________ __________ __________ __________
193. Lower limb __________ __________ __________ __________ Power Right Left Upper limb
194. Shoulder 195. Elbow
196. Wrist 197. Hand Grip
Lower limb
198. Hip 199. Knee 200. Ankle
Reflexes: Superficial Reflexes Right Left 201. Abdomen ________________ __________________ 202. Cremasteric ________________ __________________ 203. Plantar ________________ __________________ Deep tendon Reflexes Right Left 204. Biceps ________________ __________________
CLINICAL SYMPTOMS OF ORUTHALI VAATHAM Present Absent 235. One side head ache 236. Stabbing pain 237. Lacrimation 238. Burnning Sensation of the Eye 239. Deep expiration 240. Trembling of the body due to fear 241. Short and frequent feeble cough 242. Lose of appetite 243. Horripillation