Clinics in Dermatology (2008) 26, 62–78

Siddha Medicine—background and principles and the

application for skin diseases
J. Joseph Thas, MBBS, MSc, PhD, DSc⁎
Friends of Siddha Medicine 78, Trivandrum Road, Tirunelveli, Tamil Nadu 627 002, India

Abstract Siddha medicine is one of the most ancient medical systems of India. Siddha is the mother
medicine of ancient Tamils/Dravidians of peninsular South India. The word Siddha means established
truth. The persons who were associated with establishing such a Siddha school of thought were known
as Siddhars. They recorded their mystic findings in medicine, yoga, and astrology in Tamil.
Fundamental Principles of Siddha include theories of Five Elements (Aimpootham), and Three Forces/
Faults (Mukkuttram). The Eight Methods of Examination (Envakai Thervukal) is used to determine
diagnosis, etiology, treatment and prognosis. Siddha has safe herbal and herbo mineral treatment for
psoriasis, eczema, alopecia, diabetic ulcer, warts, vitiligo, pemphigus, pompholyx, leprosy, and many
more very common and rare diseases. Lifestyle modifications including diet are important.
© 2008 Elsevier Inc. All rights reserved.

Introduction called a Siddhar. For instance, Saint Francis of Assisi can be

Siddha medicine is one of the 2 most ancient medical
systems of India. Ayurveda is the other one. Siddha is the
mother medicine of ancient Tamils/Dravidians of peninsular
South India. Before 2000 years the traditional medical
system of the Tamils was known as Marunthu (Medicine).1
It got the proper name of Siddha Medicine in course of time
due to the extraordinary contributions made by Siddhars.
The word Siddha means established truth.2,3 The persons
who were associated with establishing such a Siddha school
of thought were known as Siddhars. Siddhars were upright
people and mystics who acquired supernatural powers.3
Siddhars recorded their mystic findings in medicine, yoga,
and astrology in Tamil. Siddhars do not belong to any narrow
spectrum of race, religion, caste, or creed. Any holy man
who is concerned about relieving human suffering can be
⁎ Tel.: +91 0462 2580982.
E-mail address: emmuthas@sancharnet.in.
URL: http://www.drjosephthas.com.
called a Siddhar. Saiva Siddhantam is fundamental for
Siddha.4 Many of the Siddhars were devout Saivaites. Yet,
Poonaikannar, a French priest, was a Siddhar.5 Yakobu, a
Muslim, was a Siddhar; Joseph Constantine Beschi, an
Italian priest who called himself Veeramamunivar in Tamil,
was a Siddhar. Arabs, Chinese, and Sinhalese also form part
of Siddha School. Although Siddha is essentially a Tamil
medicine many for the benefit of the whole human race
developed it from time immemorial. Siddhars believed in the
universal brother hood. They were social reformers. Some of
them were staunch atheists. The reason why Siddha is less
known in the West is due to 2 facts. One, most of the Siddha
literature is still in Tamil. Two, when western scholars like
Max Müller were provided with translated versions of
Sanskrit literature, including that of Ayurveda, no such effort
seems to have been taken to introduce Tamil works to
western scholars. Thousands of Siddha literature still remain
in the form of palm leaf manuscripts. Of late, Siddha is
slowly gaining recognition in the world of complementary/
alternative medicine. Modern medicine recognizes Siddha

0738-081X/$ – see front matter © 2008 Elsevier Inc. All rights reserved.
doi:10.1016/j.clindermatol.2007.11.010
Siddha medicine
medicine as an alternative East Indian Medical System
prevalent among Tamil speaking people.6
Fundamental principles
Five Elements (Aimpootham)
Siddha propounds that the physical structure of the
universe and man are basically made up of Five Elements.
They are Nilam (Earth), Neer (Water), Thee (Fire), Kaatru
(Air), and Vin (Sky). These names denote the properties of
the elements and not the exact substances they mean. Hence,
we have to take them as earthlike, waterlike, firelike, airlike,
and skylike. These Five Elements are present in different
proportions in all living and nonliving things, including
drugs and diet articles. Various tissues of the body are the
combination of these elements.7
Three forces/faults (Mukkuttram)
The physiological function of the body is mediated and
maintained by Three Forces. They are Vali (Vatham), Azhal
(Piththam), and Aiyam (Kapam). The terms given in
parenthesis are common to Siddha and Ayurveda. As any
other substance of the body, these Three Forces are also made
up of Five Elements. Vali is made up of Sky and Air. Azhal is
made up of Fire. Aiyam is made up of Earth and Water. In
each living cell, these Three Forces coexist and function
harmoniously. When these Three Forces are in balance one is
healthy. Any imbalance will result in diseases. In disease,
these Three Forces are called Three Faults (Mukkuttram).7
Seven pillars or fundamental tissues called Thathus
support every living body. They are Charam (lymph), Kur-
udhi (blood), Oon (muscle), Kozhuppu (adipose tissue),
Elumpu (bones), Moolai (marrow), and Venneer (reproduc-
tive tissue).8 In these tissues, one or the other of the Three
Forces predominate. For instance, Vali is predominant in
bones, Azhal in blood, and Aiyaam in other tissues. When
the Three Forces are vitiated, the tissues with which they are
associated are also diseased.7
Siddha method of diagnosis
Eight methods of examination (Envakai Thervukal)
Thirukkural1 tells
Noi nadi Noi mudal nadi athu thanikkum
Vai nadi vaippa cheyal
“Diagnose the disease, its etiology, determine the
treatment, and apply it appropriate to the patient.”
To arrive at a correct diagnosis and etiology, the Siddha
physician uses 8 methods of examination of a patient.8 They are
63
Nadi (pulse examination), Parisam (touch: tactile indications
such as heat, cold, etc, including palpation), Naa (tongue:
color, coating, ulcer, dryness, moisture and related features,
interrogation), Niram (color of the body: lusture, color of the
skin, etc), Mozhi (speech: voice, eliciting history, etc), Vizhi
(eyes: complete ophthalmologic examination), Malam (stool:
constipation, diarrhea, color, consistency, etc), and Moothiram
(urine: color, lusture, clarity, turbidity, density, etc). It is
accepted even by Ayurvedic stalwarts that this way of
examining the patient was perfected by Siddhars.7 Examination
of pulse seems to have been cultivated with special assiduity by
Siddha physicians who look upon Nadi as indicative of the
activities of Uir (Life Principle) in the individual body.9 Study
of the pulse was necessitated as a method of diagnosis in
comatose as well as deaf and dumb patients.8
Neer kuri (study of urine) to diagnose diseases is another
speciality of Siddha.7 A drop of sesame oil is poured over a
small cup containing patient's urine. The speed of spreading,
shape, and drop of urine takes are studied to diagnose the
disease. Surface tension of urine is the basis of this study.7
Siddha treatment
The treatment in Siddha is aimed at restoring the original
balance of the Three Forces so that the patient becomes
healthy. Restoring the lost balance is logically simple. When
any one of the Three Forces is aggravated causing a disease,
one should use a substance, which has properties opposite to
its own, so that the Force will be reduced or brought to its
normal state. When a Force is deficient, some substance
having properties similar to that particular Force may
augment it. This is possible because the Three Forces are
also made up of Five Elements as already stated.
Role of taste
The Five-Elemental composition of a substance is
determined by its taste. As per Siddha, there are Aaru (Six),
and Suvai (Tastes), namely, Sweet (Earth and Water), Sour
(Water and Fire), Saline (Earth and Fire), Pungent (Air and
Fire), Bitter (Air and Sky), and Astringent (Air and Air).8 The
Five Elemental compositions are given in parenthesis. By
ascertaining the taste of a substance through tongue one will
be able to judge the Five Elemental composition of the
substance and decide the suitability of that medication or diet.
Siddha has already established the taste of drug and diet
articles of day-to-day use and recorded them in texts.
Skin diseases
Skin diseases are known as Thol Noikal in Siddha. Today,
we do not have any ancient text book of Siddha devoted
entirely to dermatology. We have to pool the information from
several sources to present a comprehensive account. Details of
the conditions differ according to the source. There are
64
Fig. 1 Psoriasis.
occasions when even synonyms are considered as separate
entities by different authors. For instance, psoriasis is equated
to mandai karappan and kutta karappan under karappan
diseases and chori kiranthi under kiranthi diseases.10 Often a
symptom or sign may be explained as a disease. Chori
(itching) is mentioned as a disease.11
Siddha describes the skin conditions under the following
broad headings, namely, Karappan, Punkal, Amman, Kut-
tam, Vida kadikal, and miscellaneous.12 It is difficult to
equate these Siddha technical terms into correct English or
any other language.
Fig. 2. After 45 days treatment.
J.J. Thas
Fig. 3. Chronic stable psoriasis.
In this article, the author who is qualified in allopathy and
Siddha tries to present a comprehensive account of the
relevance of Siddha in the contemporary dermatological
practice with evidences from his clinical experience wher-
ever possible.
Karappan
Karappan is a term used frequently by local people to
describe eczemalike conditions.
Karappan is the major classification under which many of
the skin conditions are explained in Siddha.13 Simple
conditions like eczema to complicated cancer penis are
discussed under the heading of Karappan.14 The definition
for Karappan is so broad that it is possible to describe any skin
condition under this term. Psoriasis, eczema, fungal, bacterial
infections, and a variety of other skin conditions can be
considered under Karappan.
Classification
Uki,15 a Siddhar, classifies Karappan into 7 types.
Perhaps he denotes the types often seen in adults. In Siddha
Fig. 4. During treatment.
Siddha medicine
Fig. 5. After 7 months.
pediatrics 18 types of karappan are explained.14 29 types are
mentioned by another author.10
Etiology
Allergic as well as inflammatory response of the skin to
several endogenous as well as exogenous factors are
considered as the etiological factors for karappan. The
broad thinking that any skin disease is due to some poisonous
bite (Vida kad) is worth considering. Eating karappan-
inducing diet12 is another etiological factor.
Signs and symptoms
Thimir (loss sensation), thinavu (irritation), chori (itch-
ing), pun (ulcer), thadippu (wheal/papule), vedippu (burrow/
fissure), neer kasithal (oozing), and niram maruthal (change
of color/erythema), and change of texture of the skin are some
of the common signs and symptoms of karappan.12
Psoriasis
Kanda karappan and Kutta karappan denote generalized
plaque type of psoriasis10 all over the body.
Fig. 6. Psoriatic scalp.
65
Fig. 7. 1 month after treatment.
Manda karappan means psoriatic scalp. Vata karappan/
Thimir Vata Karappan denote psoriatic arthritis. Signs and
symptoms of Vata karappan and Thimir vata karappan body
pain, fever, skin lesions, purities, pain, stiffness, and
immobility of finger and toe joints correlate well with
psoriatic arthritis. Similarly the condition explained under
kalanchaka vatam also fit into psoriatic arthritis.10 That is
why some call psoriasis as kalanchaka padai.12,15
Treatment of psoriasis
Psoriasis is one of the skin conditions for which Siddha is
very popular. Several herbal and herbomineral drugs are used.
Vetpalai thailam is the main stay of Siddha treatment.
Vetpalai Thailam is made with Vetpalai ilai (leaf of
Wrightia tinctoria) soaked in coconut oil and sun heated.12
When ready, it is filtered. This oil is extensively prescribed
externally in Siddha. Practitioners of other native systems of
medicine also now use this oil. Chirattai thailam, an oil
derived by destructive distillation of dry coconut shells, is
used as a keratolytic.11
A variety of Siddha drugs are prescribed when external
application alone fails. Relapses are less frequent with
Siddha treatment. If the patient keeps the recommendations
Fig. 8. Eczema.
66
Fig. 9. During treatment.
given by the doctor regarding diet and lifestyle, the disease
can be kept away very easily.
A 26-year-old young man, married since 45 days, came to
the author. He had developed psoriatic lesions all over the
body 1 week after his marriage. A Siddha physician treated
him intensively in the conventional way. The condition did
not respond. He was referred to the author. He became all
right within 6 weeks (Figs. 1 and 2).
A 31-year-old young man was suffering from chronic
stable psoriasis for more than 10 years. He did not get
adequate relief from allopathic as well as native treatment. It
took 7 months for the author to clear his lesions (Figs. 3-5).
Psoriatic scalp gets healed with in 15 days (Figs. 6 and 7).
Eczema in adults
Laxatives are given initially for 3 days and the specific
drugs are started on the fourth day. Herbomineral drugs like
Rasaganthi mezhuku are extensively used.11 Smilax china
formulations in the form of decoctions and powders are also
used. Arukanpul Thailam is often used for external
application. It is prepared by heating expressed juice of
Arukan pul (Cyanodon dactylon) with coconut oil and
filtered. Karappan thailam is also used (Figs. 8-10).11
Fig. 10. After treatment.
J.J. Thas
Fig. 11. Impetigo contagiosa.
Eczema in children
As per Siddha pediatrics, Karappan is said to occur in the
age group of 1 to 3 years.14 Eczema equates more to pediatric
Karppan than psoriasis and other skin conditions.) Allergic
dermatoses also easily fit into many of the karappan
conditions. (Impetigo contagiosa may be considered under
karappan in children.) Several herbal formulae are given
for treating eczema in children (Figs. 11, 12).14
Karappan also denotes some specific skin conditions.
Pitha karappan denotes skin condition in liver cell failure. In
Pori karappan reddish plaques all over the body, which
would open and ooze fluid, edematous, hot to touch, are
some of the manifestations and denotes childhood psoriasis.
Punkan oil14 is given orally. Vetpalai oil externally is
effective. InAri karappan cancer of the penis, cancer of
female genitalia, incurable ulcers, pruritis, and change in
shape of the body are described.14
Erysipelas (Chenkarappan)
Before the advent of antibiotics, this was a serious cause
of infant mortality in India. Oil made from Vetchipoo
(flowers of Ixora coccinea) in Siddha is widely used.
Fig. 12. Treated with Pachchai ennai.
Siddha medicine 67

Fig. 15. Fissure foot.

A boy 9 years of age and a known case of psoriasis, who

had taken treatment elsewhere, suddenly presented with
classical signs and symptoms of psoriatic erythroderma.
With Siddha treatment, the patient was relieved of the
Fig. 13. Erythroderma.
emergency and psoriasis (Figs. 13, 14).

Impetigo Pruritis (Ooral/Chori)

Punka thailam and Chirattai thailam are used.11

Pachchai ennai is prepared by heating coconut oil, datura
leaf extract, and copper sulfate. The oil is externally applied
in several skin conditions, including ulcers and wounds. Scabies (Chori chiranku)

Erythroderma (Chattai karappan) Ransa thailam, milakai thailam are applied externally. Iru
nelli karpam, and Elathi chooranam are prescribed orally.11
Skin peeling off, like removing a chattai (shirt) from the body
or moulting where the present skin cover is completely shed. Burning sensation (Udal Erivu/Kanthal)

Elathi chooranam, Puliarai nei, Nilavakai chooranam

orlly and Chirattai thailam, Punka thailam,11 and Chanda-
nathi Thailam, an oil prepared with Sandal wood, are applied
externally. When there is a burning sensation on the face,
Shorea robusta gum is used as a paste.

Fig. 14. After 15 days treatment. Fig. 16. Siddha paste application for fissure foot.
68
Fig. 17. Tenia interdigitale.
Fissure foot (Kal Vedippu)
Kilinjal mezhuku is used. This is a combination of
powdered shell of fresh water mussel, amla juice, and castor
oil ground well.11 Nandi mezhuku, Kausikar kuzhampu11
are also given orally in severe cases (Figs. 15, 16).
Dry skin (Thol Varatchi)
Amukkara (Withania somnifera) and Cheenthil (Tinospora
cordiflia) powders are prescribed orally, and emollient oils, for
external application.16
Pediculosis (Paen)
Paste of Paen kottai is applied. This is prepared by
grinding 20 g Anamirtha cocculus seed kernel, with 40 ml
sesame oil, kept in hot sun for about 30 minutes and
used.16
Fig. 18. The author used to infiltrate the area with local
anesthetic and prick with a hypodermic needle under aseptic
conditions and apply drugs.
J.J. Thas
Fig. 19. Hair growth after Siddha surgery.
Dandruff (Poduku)
An oil made with Poduthalai (Phyla nodiflora), an herb
meaning antidandruff is used in this condition. The fresh
paste of Poduthalai is applied to the scalp before bath.
Ring worm infections tinea corporis
(Padar thamarai/Padai)
Thakarai (Cassia occidentalis) seed is soaked in
expressed juice ofllai kalli (Euphorbia ligularia) for some-
time and made into a paste by grinding with cow's urine. It is
applied to the lesions.
Padai Sankaran, another drug used, is prepared by
grinding equal quantities of root bark of Azhinchil (Alangium
salvifolium) and root bark and seed of Marukkarai (Randia
dumentorum) with lime juice. This drug is administered
orally as well as applied to the lesions with lime juice.
As per Siddha, the fungal lesions should be scratched well
before drug application.13
Tinea interdigitale (Chettru pun) (Fig. 17). Amirtha
vennai prepared by grinding 5 g of mercuric chloride with
350 g of butter is the drug of choice.11,17
Fig. 20. Alopecia totalis.
Siddha medicine 69

Fig. 21. During treatment. Fig. 23. A 65 years old diabetic man had a perforating ulcer.
With full modern surgical treatment including insulin, antibiotics
and dressing the ulcer did not heal. He was dressed with Pachchai
Icthyosis ennai and yellow medicated gauze by the author.

The lesions may be camouflaged with Pinda thailam.17

Phrynoderma
Chirattai thailam and Vangaa vennai are applied
locally.11 Nutritious diet is to be taken.
Premature graying hair (Ilam Narai)
Ayabrinkraja karpam11 as well as some kayakalpa
(rejuvenating) drugs are given orally. Ayabrinkaraja karpam
is a combination of powdered iron filings, processed with
the juices of Eclipta prostrata and lime juice. Any oil
prepared with Indigofera tinctoria– and Eclipta prostrata–
like plants is applied externally. Thirty grams of fresh curry
leaf paste taken with buttermilk in the early morning has
also added effect.
Alopecia areata (Puzhu Vettu)
Avuri (Indigofera tinctoria) leaf paste are added to 200 mL of
castor oil, heated, cooled, and filtered. The oil is applied to
the affected spot.
Seed kernal of Valam (Croton) is ground with water and
applied. The author is very successful in treating alopecia
with Siddha treatment.
Siddha surgery for alopecia
In resistant cases of alopecia, the author uses an
ancient Siddha surgical method with some modifications.
This method is not known to many and not in
contemporary practice. According to the original method,
the denuded area is pricked with Sankan mul (thorn of
Azima tetracantha). This is followed by application of a
paste of Arsenic penta sulfide ground with fresh juice of
Eclipta prostrata (Figs. 18, 19).18

Latex of Arali (Nerium oleander) is applied to the

lesions.12 Powdered 10 g of Mysatchi (Guggul) and 200 g of

Fig. 24. With in a week the ulcer became clean and under aseptic
conditions it was closed with silk sutures. The Siddha way of
Fig. 22. After treatment. dressing was continued.
70
Fig. 25. The ulcer healed with in 3 months.
Bald (Vazhukkai)
Alopecia totalis and alopecia universalis come under this
category. Several drugs are used to treat these conditions.
A woman 20 years of age engaged to a man and
shortly to be married lost her hair from her head gradually
and became bald within a month. Allopathic dermatolo-
gists and physicians treated her for more than a year
without any success. She had been given a lot of steroids
and vitamins along with minoxidil for external applica-
tion. No improvement could be made. With the use of
Siddha treatment, she had luxuriant growth of hair within
6 months (Figs. 20-22).
Ulcers (Punkal)
Siddha deals ulcers due to faulty urine (Meka Noikal).
Venereal diseases (Kiranthi Noikal) and other chronic ulcers
(Punkal).13 Vippuruthi in Siddha means abscesses. The
following portion deals with some skin conditions where
ulcer is a predominant presenting sign.
Fig. 26 A 75-year-old diabetic man came with the complaint
of ulcer and boring pain in his big toe. The author removed
30 maggots from that ulcer.
J.J. Thas
Fig. 27 The maggots had made several furrows in his toe.
Diseases due to faulty urine; STD (Meka Noikal)
Mekam means faulty urine. As per Siddha, some diseases
arise because of pathology of urine. These diseases are called
Meka noikal. Apart from diabetes mellitus, venereal diseases
are also grouped under Meka noikal.
Diabetic ulcer
Siddha considers diabetes mellitus as a meka noi because
urine is faulty. Siddha treatment given by the author has
prevented several amputations. Medicated gauzes (Kara
cheelai) are mentioned in Siddha to dress ulcers. Apart from
the work conducted by the author, there is no other report
regarding their use in contemporary practice.19 The medi-
cated gauzes are named by their color such as green, yellow,
red, etc (Figs. 23-29).
Other types of ulcers in faulty urine
Inguinal bubo (Arai appu) and genital ulcer (Paranki pun,
Meka pun, and Meka Vedippu) are treated with Agastiar
kulampu, Siddhathi ennai and Parankipattai rasayanam.11
Fig. 28 Pachai ennai and green gauze were used to dress the ulcer.
Siddha medicine 71

Fig. 29 The patient was saved from amputation.

Karudan kilanku ennai, an oil prepared with Corollocarpus

epigaeus are some of the oral drugs for several skin
conditions due to sexually transmitted diseases.11 Meka
virana kalimpu is an ointment applied externally in cases of
some skin conditions as well as venereal ulcers.11 Fig. 31 During treatment.

Vesiculo bullous disease (Koppula Noi) these cases as victims of bums and blisters. As the cases
were already under allopathic treatment, immunosupres-
Pemphigus vulgaris
sives, glucocorticoids, and other modern drugs were slowly
withdrawn (Figs. 30-33).
In a short span of 6 months, the author had the chance of
treating 3 cases of pemphigus vulgaris. Before the
availability of glucocorticoids, the outcome of pemphigus Pompholyx (Kai Kaal Koppula Noi/
vulgaris was death. Mortality rate in India is fairly high.20 Koppula Karappan)
Common causes of morbidity and mortality are infection and
complications of treatment. Occasionally, the condition is not This is another blistering disease. This condition is
controlled even with intensive treatment. Rarely such cases characterized by bilateral symmetrical vesicular eruptions
come for Siddha treatment.
The disease is not directly mentioned in Siddha
literature. Blistering (Koppulam) diseases are mentioned.11
The Siddha principle adopted by the author was to treat

Fig. 30 A young man with pemphigus vulgaris lying over

plantain leaves after complete failure of allopatic treatment in his
village house expecting death. Fig. 32 During treatment.
72 J.J. Thas

Fig. 35 During treatment.

Collor stud ascess (Kanda malai)

Treatment is available in Siddha.

Chronic Folliculitis
Fig. 33 Recovered within 3 months. The whole treatment was
given in his house.
Treatment is given to this condition is more satisfying
than that of allopathic treatment.
of the palms and soles. Mostly, it is a type of eczema.
Treatment of this condition is considered a problematic one Bed sore (Paddukai pun)
in modern dermatology.21
A 22-year-old college girl suddenly developed bullous
Elathi chooranam orally and Pachai ennai externally are
eruptions in both palms and soles (Fig. 34). Initially, she
used.11
underwent the usual native treatment given to exanthematous
eruptions in Tamil Nadu villages. Then, an allopathic
dermatologist gave her treatment without any satisfactory Gangrene (Un ezhukal)
result. She had no relief. Finally, she was given Siddha herbo
mineral drugs internally and andpachai ennai for external Nandi mezhuku11 is used.
application by the author. The condition came under control
with in a week. The treatment lasted up to 1 month. This Mouth ulcer (Vai pun/Akkaram)
frequently relapsing bothersome disease has not troubled the
girl for the past more than 6 years (Figs. 34-36). Kunkiliya Mouth wash made from Muppalai (Three myrobalans)
vennai, Nandi mezhuku are some of the drugs mentioned in powder. Cooked Manathakkali (Solanum nigrum) leaf and
Siddha for blistering diseases.11 berry is advised as food supplement.

Fig. 34 Pompholyx. Fig. 36 After treatment.

Siddha medicine 73

Fig. 39 After treatment.

Corn foot (Kal ani)

Unni marunthu is used.

Fig. 37 Prurigo nodularis. Paronychia (Naka chuttru)

Incision and drainage, dressing with yellow gauze give

Boils (Katti)
In boils, a laxative is firat given. Siddhati ennai is
used for this purpose which is laxative as well as curative
of boils.11
Lichenoid papules (Karanai)
In Prurigo nodularis (Figs. 37-39) Rasaganthi mezhuku
orally and chirattai thailam externally.11
Prickly heat (Verkuru)
Sandal wood paste in water is applied externally.
excellent results. In chronic fungal paronychia long term
treatment with herbomineral preparations is essential.
Acne (Mukaparu)
Kunkiliya vennai11,12 a cream with 175 g Shorea robusta
gum dissolved in 350 mL sesame oil by heating and cooling,
is applied externally. This may also be administered orally in
3 to 6 g twice daily.
Vasampu (Acorus calamus), Nakanam (Operculum), Vel-
laruku (Enicostemma littorale), leaves of Aal (Ficus
benghalensis), and Chirattai (coconut shell) are also
powdered, made into a paste and applied.22
Another preparation found in an ancient palm leaf
manuscript is given below. 30 g each of tender leaves of

Fig. 38 During treatment. Fig. 40 Warts.

74 J.J. Thas

Fig. 41 Two days after removal.

Thuththi (Abutilon indicum), Vasampu (Acorus calamus)

and garlic are taken and ground into a paste, boiled with
650 mL sesame oil, allowed to cool, filtered, and
applied locally.
In cases of acne, the author prescribes laxatives to
relieve chronic constipation before starting the treatment. Fig. 43 The warts disappeared with in 2 months and treatment
was continued for 1 more month.

Viral diseases (Ammai Noikal)

Ammai in Siddha denotes pox diseases caused by viral
infections. The meticulous hygiene advocated and practiced in
South India has prevented and kept the morbidity and mortality
due to pox diseases in the past several centuries very low.
Warts (Unni)
Siddha calls wart as unni. Caustic chemical preparation
such as unni marunthu (an ointment made of well ground
mercuric chloride, copper sulfate, lead sulfide, limestone,
arsenic trisulfide, and bees wax in equal quantities) is used to
remove warts, corns, and molluscum contagiosum. It
removes warts with in one or 2 applications with out leaving

Fig. 42 A shepherd boy 17 years of age with widespread warts for

more than 2 years came for treatment. He had no relief from the
previous treatment he had taken. In this situation, the author used some
drugs mentioned in Siddha. These are herbomineral preparations such
as Kausiakar kuzhampu and Kauri chinthamani chendooram. Fig. 44 Type II reaction.
Siddha medicine 75

Fig. 47 After treatment.

Herpes zoster (Akki)

Pachai ennai applied externally and powder made of

Fig. 45 After treatment.
any scar (Figs. 40, 41) Widespread warts found all over the
body also respond to Siddha treatment (Figs. 42,43).
Smilex china orally give excellent results. The author used to
administer Kungiliya parapm made from Shorea robusta
gum and tender coconut water.11
Application of red ochre (kavikkal) paste is advocated by
Siddha and widely practiced in Tamil Nadu by many. Mud
potters (Kuyavar) use red ochre and areca nut powder in
equal quantities and apply in herpes zoster.

Chicken pox (Chittamman)

Leprosy (Kuttam)
Application of neem leaf and turmeric paste to the lesions
is soothing and prevents secondary infections and provides Syn Thozu Noi, Kurai Noi. Siddha explains 18 types
early healing. of kuttam.15 It is generally held that the word Kuttam

Measles (Mannan)

Bland diet without spices and avoidance of Karappan food

are the mainstay of the treatment. In the above conditions,
Sirunki parpam made from deer horn is advocated.11

Fig. 46 Vitiligo thumb. Fig. 48 Vitiligo, November 2005.

76
Fig. 49 During treatment.
denotes all major and minor skin diseases including
leprosy.12 The author clearly differs from this opinion and
believes that the word stands for different manifestations
of leprosy caused by Mycobacterium leprae. The
influence of modern medicine is so profound that no
leprosy patient usually comes for Siddha treatment. The
author has so far treated 2 leprosy patients.
Resistant leprosy
A 50-year-old man, with resistant Hansen's disease after
several years of multidrug therapy came for treatment. He
had large anesthetic patches bilaterally in the axilla as well
as in his right cheek. Skin clipping for acid fast bacilli was
positive. He was put on some Siddha drugs. Remarkably,
the patches in his axilla disappeared with in 3 months, and
the skin smears also became negative by this time. The
patch on his cheek disappeared after 6 months. He
continued the drugs for 1 year. Liver function tests, blood
parameters, and his general clinical condition were not
affected by the treatment.
Type II reaction in leprosy
The second patient was a 40-year-old man who was
diagnosed as borderline leprosy with Erythema Nodosum
Leprosum or type ii reaction (Fig. 44).
The patient had crops of painful nodules, fever, arthritis,
uveitis, and sheets of brownie thickened skin lesions. He was
under dapsone, clofazamine, prednisolone (oral), as well as
daily injections of dexamethazone. Yet his condition was not
controlled. He was given Siddha treatment. His condition
J.J. Thas
came under control with in a month with Siddha drugs, and
he is free of the reaction now (Fig. 45).
Vitiligo (Ven Kuttam)
In brown- or dark-skinned individuals, depigmentation
resulting in vitiligo is a social stigma in India. These
unfortunate ones are looked upon and discriminated as lepers
by some. The author used to treat small lesions of vitiligo
(Figs. 46, 47) successfully with Karpoki (Psoralia coryle-
folia), Karum Cheerakam (Nigella sativum), and Kaattu
Cherakam (Centratherum anthelminthicum)–containing for-
mulations. These plants contain psoraleinlike compounds in
variable amounts. Karpoki paste, a preparation of Psoralia
corylefolia in butter base, is used for external application.
Hundreds of preparations for vitiligo are mentioned
in Siddha.
Treating widespread vitiligo with drugs alone is still a
problem. It is an accepted fact that there are a variable
number of lesions which do not get repigmented in spite of
all the latest modern treatment.21 Only after exhausting all
the avenues in Allopathy people come to Siddha practi-
tioners. In one such case, even after giving treatment for
nearly 5 months, no progress could be made by the author.
New lesions were regularly appearing. The author modified
the so-far established line of Siddha treatment. It was a great
success. Now, treating vitiligo has become very simple. The
treatment consisted of pure herbal and herbomineral drugs.
The progress made in a patient with widespread vitiligo from
November 2005 to February 2006 is shown in Figs. 48-50.
Siddha practitioners also advise light exposure of the
lesions. The author came across a collection of ancient
Fig. 50 February 2006.
Siddha medicine
formulations in which exposure of vitiligo lesions to light
and heat is recommended. In that method, fresh leaf juice of
Vellai kakkanam (Clitoria ternatea) is to be applied and the
lesions are to be exposed over burning fire wood from
Tamarindus indica tree.13
Poisonous bites (Vida kadikal)
Some sort of allergic etiology is attributed to all skin
conditions. It is a common belief in Tamil Nadu that any skin
disease is due to some venomous bites or stings or ingestion
of some toxins. Many people even today first go to some
traditional healers who are believed to detoxify them. When
this treatment fails they come to qualified doctors in Siddha or
allopathy Urticaria (Seetha pittam) and Angioedema (Vida-
pakam) can be managed with Siddha treatment.
Miscellaneous Siddha drugs
Siddha drugs are all natural products derived from plant,
animal, and mineral sources. Siddhars were great alchemists;
hence, they developed many inorganic and herbomineral
(inorganic as well as herbal combination) formulations. In
treatment, Siddha medicine believes in the usage of herbal
drugs first. When plant drugs fail the usage of inorganic
preparations is recommended.
Siddha diet in skin diseases
Dietetics plays a major role in the success of treating skin
diseases in Siddha. Siddha gives equal importance to diet and
drugs. The terms diet and drug are interchangeable. Pros and
cons of day-to-day diet articles are detailed in Siddha
literature. Nutritional therapeutics of these substances in
various health and sick conditions are given. Equal impor-
tance is given to vegetarian and nonvegetarian diet articles.
Thirukkural1 says that one should not eat incompatible diet
even when very hungry. This is the basis of Pathyam and
Apathyam in Siddha medicine. Pathyam governs what one
should do and Apathyam tells what one should not do.
Pathyam and apathyam are all about lifestyle one should adopt
including diet in health and disease. By observing Pathyam,
one gets maximum therapeutic benefit from the drug with least
adverse effects. In pharmacological terms, it helps to avoid
unwanted drug-drug and drug-diet interactions.23 Siddha has
perfected the art of dietetics in the form of Pathyam. It tells
what one should consume or avoid in a particular disease, as
well as when taking certain drugs. Similarly, lifestyle
modifications such as exercise, type of bath, and sexual
intercourse–like details also come under Pathyam.
Karappan diet
Karappan (skin disease) inducing food are to be avoided.
Brinjal, tomato, palmolein, sesame oils, pickles, beef, salted
77
dry fish, squid, prawns, crabs, great millet, maize, pear
millet, finger millet, unripe banana fruit, bitter gourd, ray fish
are some of the few examples.12 Karappan-inducing as well
as karappan-relieving properties of each and every drug and
diet articles are explained in Siddha Materia Medica.24
Intense desire (Itcha pathyam)
On seeing tamarind- or raw mango-like substances, there
is immediate salivation in the mouth. Such substances that
provoke intense desire to enjoy are called itcha pathya
substances and must be avoided. Bitter gourd, brinjal, cluster
beans, ash gourd, agathi, mustard, sesame seeds, and oil are
classified under this category. Sexual intercourse is also
considered under this heading.25
Gas forming articles (Vayu Pathartham)
Food articles such as bitter gourd, tubers, mango, cluster
beans, and agathi are considered gas-forming and must
be avoided.
Simply avoid
It is often difficult to enumerate the substances one has to
avoid. So, it is simplified by asking the patient to avoid
substances with certain tastes. In skin diseases, the patients
are asked to avoid diet articles with salt, sour, and bitter
tastes. Practically speaking, the patient with skin disease has
to avoid salt, tamarind, alcohol, bitter gourd, sesame oil,
mustard, vinegar, tobacco, etc.
Additives
Drum stick leaf and drumstick, tender leafy vegetables,
amaranthus, fresh onion and nonsalted dry fish, boiled rice
gruel without salt, shark, pepper, dhal, cows milk, curd, ghee,
a lot of green gram, and parched rice flour can be taken.13
Bath powder
Herbal powders to scrub the body during bath are
prescribed depending on the skin condition. In skin ulcers
Usilam (Albizia odoratissima) powder in pruritis Iluppai
pinnakku (oil cake of Madhuca longifolia) are used. To
remove medicated oil applied to the body, Manipunku
(Sapindus laurifolius) as well as soap nut powders are used.
To remove medicated ghee Pachaipayaru (green gram), to
remove fat of pig, crow and Indian Monitor Siru karai chedi
(Plectronia parviflora) powders are used.24
The author used to advise his patients to use Kadalai
(Bengal gram) powder instead of soap. In rural Tamil Nadu,
dry Peerku (Luffa acutangula) fruit is used to scrub the body
during bath. This is a natural medicated scrub.
78
Arappu (Albizia amara) powder is another commonly
used powder. Shoe flower is another wonderful medicinal
plant to be used by skin patients for bath. The author has
found this to be very effective in all sorts of skin diseases.
Medicated water for bath
In some skin conditions, the water used for bath is
medicated by adding some medicinal plants. Chemmuli
(Barleria prinoides) and Kiranthi nayakam (Ruellia patula)
and mango leaves are added to water, boiled, and used in
children with skin diseases.14
To beautify normal skin
Application of oil to the head and body before taking a
bath will promote growth of hair and remove dry skin and
make it shine.24 Rubbing of curcuma paste during bath
removes foul body odors and prevents skin diseases of the
face and excessive sweating.24
In Tamil Nadu, serving food on plantain leaves is an age-
old yet still popular practice. Siddha says that eating food
served on plantain leaves is highly nutritious and medicinal
and imparts good complexion.24
Conclusions
The relevance of ancient Siddha medicine in the
contemporary skin conditions has been explained with
suitable examples from the experience of the author who is
a qualified practitioner in allopathy and Siddha. Siddha is a
treasure trove for skin diseases. With the help of research, it
can be unravelled and popularized for the benefit of the
whole human race.
Acknowledgment
The author gratefully acknowledges the Invitation of Prof
Uwe Wollina, MD, chief editor, Kosmetische Medizin,
Dresdon, Germany to contribute this article and for what he
has done for Siddha Medicine.
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