EFFECT OF CLASSICAL HERBO – MINERAL SIDDHA FORMULATION AGASTHIYAR KUZHAMBU FUMIGATION THERAPY ON SILAIPUN (VARICOSE ULCER) – A CASE STUDY

EFFECT OF CLASSICAL HERBO - MINERAL SIDDHA FORMULATION AGASTHIYAR KUZHAMBU FUMIGATION THERAPY ON SILAIPUN (VARICOSE ULCER) - A CASE STUDY

S. Sivakkumar^*1, L. Juliet ² and V. Banumathi ¹

National Institute of Siddha ¹, Chennai - 600047, Tamil Nadu, India.

Siddha Central Research Institute ², Chennai - 600106, Tamil Nadu, India.

ABSTRACT: Siddha system is one of the ancient systems of medicine. In this system the herbals, metals, minerals and animal products has been used to prepare the medicines for treating various illness. Siddha medicines are divided into internal medicines and external medicines, in which Pugai maruthuvam (Fumigation therapy) is one of the external therapies. Agasthiyar Kuzhambu is one of the classical herbo mineral Siddha formulations, which has been used for 4448 types of diseases as an internal medicine and also used as external medicine in certain conditions. It is a peculiar medicine used as Pugai (fumigation), nasiyam (nasal drops), kalikkam (eye drops) and kudori marunthu (directly applied in cut vessels).  An attempt has been made to prove the effect of Pugai maruthuvam (fumigation therapy) on Silaipun (non healing varicose ulcer). In this study 47 years old male patient with non healing varicose ulcer has been enrolled. Pugai maruthuvam (Fumigation therapy) was given for this patient with Agasthiyar kuzhambu fumigation by using a specially designed instrument (fumigation box). The outcome of this treatment, the wound was healed well, symptoms like pain, itching, oozing were completely relieved and the size of the wound also significantly reduced. Finally this study concluded that, the Agasthiyar kuzhambu, Pugai maruthuvam is more effective for non healing ulcer like varicose ulcer. Further studies are needed to evaluate the therapeutic effect of Pugai maruthuvam since we are in a need to establish the efficacy of external therapy to the world.

Siddha medicine, Fumigation therapy, Agasthiyar kuzhambu, Pugai maruthuvam, Varicose ulcer

INTRODUCTION: Siddha system is one of the ancient systems of medicine. In this system the herbals, metals, minerals and animal products has been used to prepare the medicines for treating various illness. Siddha medicines are divided into internal medicines and external medicines ¹.

Nowadays most of the practitioners concentrate only in choosing the combination of internal drugs to treat various diseases. At the same time they are not giving equal importance to external therapies even though our Siddha sages gave importance to both internal and external by framing thirty two forms of therapies for each ². Even in external therapy, some types of therapies like Marthanam (massage), Odivu murivu (bone setting), Otradam (fomentation), Patru (poultice) are practised by minimal number of trained practitioners. Pugai maruthuvam is one among the 32 major external therapies of Siddha system.

This type of external therapy is said to be very effective for asthma, piles, fistula, sinusitis, seizure, Vidak kadi (poisonous bite), thodam and ulcers. In this form of therapy, there are very known treatments especially known for its efficacy ³. Those specified medicines are Adathodai pugai (Justicia adhatoda) for Eraippu erumal (bronchial asthma), Manjal kombu pugai (Curcuma longa) for peenisam (sinusitis), Nari eccha pugai (faeces of fox) for pakantharam (fistula in ano), Agasthiyar kulambu pugai for moolam (piles), Manosilai pugai for venkuttam (leucoderma), rasa pugai (mercurial fumigation) for Mega viranam (syphilitic ulcer / genital ulcer) etc. Thus Pugai maruthuvam has been emphasized in Siddha ⁴.

The speciality of Pugai maruthuvam is because of its rapid healing activity, increasing the vascularisation, prevent the gangrene formation and arrest the oozing. In this view an attempt has been made to prove the effect of Pugai maruthuvam with Agasthiyar kuzhambu ⁵ on Silaipun ⁴ (non healing varicose ulcer).

Case Presentation: A 47 years old male patient was enrolled in this study. He is working as contractor / building supervisor. He is having an ulcer in his medial aspect of left leg near the ankle joint with the complaints of pain, itching, oozing and hyper pigmentation. The pain and oozing was tolerated but it worsens when he is standing in long time. This problem has been started six and half years ago as a small vesicle over the tortuous vein. When the itching was severe he scratched over the tortuous vein and it was developed into a small wound with pain and oozing gradually. It was diagnosed as varicose venous ulcer. Then initially he had taken allopathic treatment for 2 years. Then he switched over to take Siddha treatment in National Institute of Siddha hospital, he has been taking our treatment but there was no marked change in wound healing. So he has undergone surgery but there was no satisfactory prognosis even after surgery. Once again the patient returned to our Siddha treatment, so it was a challengeable one. In this situation there was a need to add some special external therapy to treat this patient for non healing wound. In this condition the Pugai maruthuvam has been selected with classical sastric herbo - mineral Siddha medicine Agathiyar kuzhambu which can be used for all 4448 diseases.

Management and Outcome: This patient was treated as per our fundamental line of treatment. On first day the patient has undergone oil both with Citramutty thylam. On second day he has taken Agathiyar kuzhambu internally for purgation.  Third day onwards our special Pugai maruthuvam (fumigation therapy) treatment was started with Agathiyar kuzhambu thiri in specially designed instrument (Fig. 1) along with internal medicine Arumuga chenduram ^{5, 6} with Thunai marunthu (secondary medicine) Thirikaduku chooranam and adjuvant honey two times a day. The routine blood investigation was done periodically.

FIG. 1: PUGAI MARUTHUVA KARUVI (FUMIGATION BOX)

Fumigation Therapy: Fumigation therapy is an external therapy in siddha system of medicine, by which the damaged tissues are cleared and new tissues are regenerated thereby it enhances the wound healing process. Agasthiyar kuzhambu is applied on sterile gauze and it is rolled (Fig. 2). This medicated gauze roll is burnt in a specially designed fumigation therapy box so that fumes reach the wound directly. The process can be repeated. The medicated fumes with mild heat enhance the wound healing in a short period of time.

FIG. 2: AGATHIYAR KUZHAMBU THIRI (MEDICATED GAUZE)

RESULTS AND DISCUSSION: As per the fundamental of Siddha Mukkuttra theory, the derangement of Vatham and Kapham are the causes for pun (ulcer formation). The signs and symptoms of silaipun confirm the derangement of vitiated humours. Pricking pain and hyper pigmentation denotes the derangement of Vatham; and oozing and pus collection indicates the vitiation of kapham. Hence the treatment was aimed to neutralize the vitiated humours. According to the Siddha basic line of treatment Viresanathaal Vaatham thazum ⁷ denotes that the purgation neutralizes the increased Vaatham. So in first day the purgative medicine Agasthiyar kuzhambu was administered.

In Siddha, the Pugai maruthuvam was indicated to treat the complicated chronic diseases like syphilitic ulcer, non healing chronic ulcers, piles, etc. In Siddha sastric text, the drug Agasthiyar kuzhambu has been indicated for fumigation therapy. The fumigation fastens the wound healing process by enhancing the granulation.

In this present study, after using the Agasthiyar kuzhambu fumigation, the pricking pain, oozing, and pus collection and hyper pigmentation were significantly reduced. The size of the wound also tremendously reduced from 4 × 2.5 cm to 0.7 × 0.5 cm. (Fig. 3 - Fig. 14). In haematology the haemoglobin level was increased from 9.9 gm/dl to 10.5 gm/dl (Table 1).  The choice of internal drug Arumuga chenduram which is iron based medicine, basically the iron has strongly astringent taste which helps to increase the haemoglobin, strengthen the blood vessels and enhance the wound healing process. From this study, the above said treatment may give positive prognosis on non healing ulcer.

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FIG. 3 - 14: EFFECT OF AGASTHIYAR KUZHAMBU FUMIGATION THERAPY ON VARICOSE ULCER (DIFFERENT STAGES OF WOUND HEALING)

TABLE 1: EFFECT OF AGASTHIYAR KUZHAMBU FUMIGATION THERAPY ON HAEMATOLOGICAL AND BIOCHEMICAL BLOOD PARAMETERS

CONCLUSION: To propagate our Siddha system for the wellbeing of society, the external therapies has to be bring into practice with clinical evaluation. The present study is an attempt to prove the effect of fumigation therapy in varicose ulcer. From this case study it has been observed that the Agasthiyar kuzhambu, Pugai maruthuvam gave significant result in Silaipun (Varicose ulcer). Further clinical studies are needed to validate its therapeutic effect.

ACKNOWLEDGEMENT: This work was wholly done in Department of Gunapadam, National Institute of Siddha, Tambaram sanatorium, Chennai, India.

CONFLICTS OF INTEREST: Nil

REFERENCES:

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7. Shanmugavelu M: Siddha maruththuva noinaadal, Noimuthal naadal; Published by Directorate of Indian Medicine and Homeopathy, Chennai, 3^rd Edition 2003.
   

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   How to cite this article:

   Sivakkumar S, Juliet L and Banumathi V: Effect of classical herbo - mineral siddha formulation Agasthiyar kuzhambu fumigation therapy on Silaipun (varicose ulcer) - A case study. Int J Pharm Sci Res 2018; 9(3): 1189-93.doi: 10.13040/IJPSR.0975-8232.9(3).1189-93.

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