Classical Concepts of Moolam in Siddha system of Medicine, a Review
Jan 2020
1 Dr.S.chandraprasath MD(siddha) lecturer ,Rvs siddha medical college , Coimbatore.
2.Dr. R. Deepika, Lecturer, Sri Sairam Siddha Medical College & Research Centre, Chennai.
3.Dr.H.veda Merlin kumari(MD Siddha)
Associate professor, department of maruthuvam, national institute of siddha, Chennai .
4. Dr.S.Mohan MD(siddha)
Professor, Former HOD department of maruthuvam and former director national institute of siddha.
Abstract
Piles (hemorrhoids) is one the important disease which is commonly seen in people who altered in lifestyles. The siddha system of Medicine offers various simple remedies to piles problem, from prevention to examination to therapy. Our human body is made up of Ninety six thathuvams. Alterations in any thatuvam results in Pathological state. Moolam results from derangement of Vatham and Pitham. This is best illustrated in the verse. "Anila Pithathonthamalathu Moolam Varathu- Tharayarsekarapa. It is fact that 50 – 85% of the world's population has been affected by hemorrhoids at one episode in their life time. Although uncomfortable and embarrassing in nature. The core objective of this work is to collect and review the information available in the disease type, symptoms and Classifications etc. These are well categorized in this review.
Keywords:
Moolam, Hemorrhoids, Piles, Siddha Medicine.
INTRODUCTION
Siddha System led a human healthy life both physically and mentally. They classified the disease on the basis of Thiridhosa theory. Sidhar Agasthiyar classified the diseases as 4448 and one, among them is Eruvai Mulainoi. Siddhar Yugi classified Moola noi as 21 types. Moolam in siddha means, the area Moolathram or root. Moolatharam has been given maximum important in siddha system, as it is energy producing centre of the body (Kundalini).If it is not properly treated, it will not lead to surgical procedures. In Moolanoi, increased, Keel nokukaal stimulates vatha humor and these totally stimulate pitha humor, constipation develops etc. The symptoms like loss of appetite emaciation, mental depression, decreased body fluids and blood volume are developed as per the reference Agatriyar Paripooranam describes 9 types of Moolam, Jeeva Ratchaamirtham describes 4 types of Moolanoi.(1)
Objectives
To list of important concepts of Moolam mentioned in Siddha Classical literature and types. The concepts were discussed from various text.
Methods:
In this, various siddha medical literatures were reviewed and various siddha author books has been reviewed. Siddha system of medicine highlights the practice of medicine as the art of restring the sick to health. Siddha medicine maintained the respectability in keeping the society in normal health and relieving people from common diseases. This system essentially leads towards a new dimension of life helping in the process of flowering of human personality. According to this system the physiological function of human body is regulated by the three vital humours namely as Vaatham, Pittham, Kabham. Derangement of these three humors causes disease.(2)
According to Yugi Vaidhya Chinthaamani,(3) Raththa moolam is one among the twenty-one types of Moola Noi. The literally the world "Moolam" denotes Principle or Important one. In Siddha, "Moolam" means the bodily area Moolaathaaram or Moolathara, one of the six psychic centers in the human body. These centers are considered as six pillars of life.
Moola Noi:
Moola noi, is a disease that occurs in and around Moolaathaaram which is one of six psychic centers. In Moolaroga sigitcha bodhini, the term "Moolam" implies root, out growth, which describes tuber like our growth or root like structures around the anus. Of all the diseases, Moola Noi is the subtle disease that needs special medication. Moola Noi includes a wide variety of Ano-rectal diseases which is synonymed as Adimulai noi, Arippu noi or Mulai noi.(4)
NOI ENN (CLASSIFICATION)
Moolam has been classified into various types by different authors. Some of the
types are described below.
Types of Moola noigal
According to Yugi vaithiya Chinthamani, Moolam is 21 types
Neer Moolam
Sendu Moolam
Mulai Moolam
Siru Moolam
Varal Moolam
Rattha Moolam
Seezh Moolam
Aazhi Moolam
Thamaraga Moolam
Kiranthi Moolam
Kalappu Moolam
Kutha Moolam
Veli Moolam
Churukku Moolam
Savvu Moolam
Vali Moolam
Azhal Moolam
Iyya Moolam
Vinai Moolam
Mega Moolam
Pouthira Moolam
In Anubava vaithiya deva ragasiyam types of moolam described below
Vali Moolam
Azhal Moolam
Iyya Moolam
Thontha Moolam
Thrithoda Moolam
Rattha Moolam
Agasthiyar paripooranam describes nine types Moolam. The types are,
Ul Moolam
Pura Moolam
Mulai Moolam
Rattha Moolam
Seezh Moolam
Vali Moolam
Azhal Moolam
Iyya Moolam
Moola Paandu
Theraiyar describes ten types of Moola Noigal
The types are,
Seezh Moolam
Pun Moolam
Thee Moolam
Neer Moolam
Mulai Moolam
Sathai Moolam
Kaduppu Moolam
Veluppu Moolam
Kattru Moolam
Perumulai Moolam
In Agasthiyar Ayul veetham, moolam classified into 6 types
Vatha Moolam
Pitha Moolam
Kaba Moolam
Rattha Moolam
Thontha Moolam
Vayu Moolam
Naadi Chakkaram, moolam classified into types,
Vatha Moolam
Pitha Moolam
Kaba Moolam
Rattha Moolam
Thontha Moolam
Sootha muni sutthitam, moolam classified into 6 types,
Vatha Moolam
Pitha Moolam
Kaba Moolam
Rattha Moolam
Thontha Moolam
Thirithosa Moolam
Various literatures on Moolam
Moola Noi has been classified into various types by different authors, some of the types are tabulated below. In Yugi Vaidhya Chinthaamani, Yugi munivar describes twenty-one types of Moola Noi, of which Raththa moolam is one among them. Agathiyar Paripooranam describes nine types of moola noi. It includes Raththa Moolam one among them.
Aetiology of Moolam (Noi Varum Vazhi)
Sage Yugi elaborately describes the various causes for all Moola noigal. Although the text do not mention about the causes separately for each type, it deals collectively within two verses the psychological aspects, Karmas, intrinsic and extrinsic factors of aetiology for all moola noigal. With this and other Siddha texts we can lay down the causes of the disease as, Kanma vinaigal and psychological causes, Due to inappropriate diets and acts and due to maintaining wrong postures in Yogasanam.
According to Yugi vaithiya chinthamani
Yugi Vaihiya Chinthamani elaborately describes the various causes Scolding elders, doing harm to others, Indulging in rape, Pretending good with sweet words harboring grudge at the
back of the mind, Leading an extravagant life while neighbors‟ and the relatives are pining with hunger, Always quarrelling with others The vali humour, especially Abana vayu is predominantly vitiated. The above song describes the aetiology of moolam, these are, Exposure to excessive heat, Anger and frustration, Anxiety and depression Increased sexual desire and Heavy intake of salt and pungent food, Scolding the elder people.
According to Agasthiyar Kanmakandam
Agasthiyar Kanmakandam elaborately describes the various causes for Moolam. Karma theory is based on the belief that one is not dissociated from the fruits of the actions in the previous births. The intrinsic causes of inappropriate diet and acts such as Adopting wrong yogic postures like as during practice of Yogasanas continuing in prolonged siting and straining postures, predispose to vitiation of Vali humour, and Azhal and moolaakkini leading to moola noigal. According due to deranged varma nilai, if any injury to the utchi varman cause immediate collapse. If the trauma happens to be mild, the patient may develop difficulty in micturition and defecation. Persistent constipation leads to moola noi.
Clinical Features
Bleeding: The principle and earliest symptom is bleeding. Bleeding is bright red, painless and occurs along with defecation (a 'splash in the pan').(5) At first the bleeding is slight and may continue intermittently for months or years.(6)
Constipation : Longstanding constipation leads to the development of haemorrhoids and hence it is the commonest and prominent feature in the clinical history.(7)
Prolapse: It is a later symptom. In the beginning prolapse is minimal. According prolapse, haemorrhoids can be divided into four degrees.
First degree - Haemorrhoids that bleed but do not come out of the anus
Second Degree - Haemorrhoids comes out only during defecation and are reduced spontaneously after defecation.
Third Degree - Haemorrhoids comes out only during defecation and do not return by themselves but need to be replaced manually and then they stay reduced.
Fourth degree – Hemorrhoids that permanently prolapse. At this stage great discomfort is complained of with a feeling of heaviness in the rectum. Pain: Pain is not a characteristic feature of hemorrhoid unless there is associated thrombosis or there is associated fissure – in – ano.
EPIDEMIOLOGY
Many individuals experience this condition without seeking medical consultation; patients are often reluctant to seek medical help because of embarrassment or the fear, discomfort, and pain associated with the treatment,(5) so the exact incidence of this disease cannot be estimated. Studies evaluating the epidemiology of haemorrhoids showed that 10 million people in the United States reported haemorrhoids, for a prevalence of 4. 4%.
CLASSIFICATION
Haemorrhoids may be external or internal to the orifice. Internal haemorrhoids arise from the superior venous plexus, above the Hilton‟s line are covered by columnar epithelium and External haemorrhoids arise from the inferior venous plexues, above the Hilton‟s line and are covered by squamous epithelium.
Symptoms of other Moolam
RATHA MOOLAM:
The symptoms are Pain in umbilical region, Pallor of the body, Edema in both upper and lower limbs, Chest pain, Headache, Giddiness and Yellowish decolourisation of eyes
NOI KURIKUNAM (SYMPTOMS) :
In Agasthiyar 2000, the symptoms of moola noigal describes in following, The symptoms are, burning sensation and irritating in and around the anus, bleeding occur during defecation followed by pile mass, reduced spontaneously, Pallor in the body and Increased salivation
VATHAMOOLAM
The symptoms are Rectum is like red ripped caper fruit, Inflammation of the anus, internal pain, Itching, Retention of faces from any cause constipation, and Headache.
PITHA MOOLAM
The symptoms are Pile mass presenter like a cotton seed, inflammation and burning sensation in anus, thirst, perspiration,
SILAETHUMA MOOLAM
The symptoms of Silethuma moolam as descent of Pedicle in anal region, Pain in pedicle, Constipation, and Itching in the perennial region.
Moola noi is one amongst the 4448 diseases. This disease is mainly due to aggravated vaatha pitha humors which are evident from the quote mentioned below.
‘’Anila Pitha Thonthamilaathu Moolam varaathu’’ – Theraiyar
Moolam in siddha means the area moolathaaram or the root. Moolatharam has been given maximum important in Siddha system as it is energy producing centre of the body (Kundalini). The power of Kundalini is the form of serpent which lies in the area of Moolathaaram. Sridhar‟s b means of yogic practice attained the state of immortality by stimulating the kundalini power. Any irregular practice or food or lifestyle habits may disturb the balance in moolatharam and results in disease called Moolam. As per Sage Yugi text “Rattha Moolam” is one amongst the 21 types of classification in moolam disease which merely correlates with
the symptoms of “Internal Hemorroids” in modern system of classification. It is believed that symptomatic hemorrhoids affect at least 50% of the population at some time during their lives and around 5% of the population is affected at any given time. Both sexes experience approximately the same incidence of the condition with rates peaking between 25 and 65 years.
In India the incidence of bleeding piles and constipation is more due to the life style modification with the multifactorial etiology and high rate of recurrence, bleeding piles become a medical challenge.
Line of treatment
Line of treatment consist of Purgation and Emetic should be given as the first line of treatment. Administration of internal medicine to stop bleeding to reduce inflammation and relieve constipation.
Siddha system of medicine is able to cure disease by rooting out them once for all. This system envisages methods foe prevention of diseases and it treats not only the disease But the person as a whole. These include, Kaappu, Neekkam, Niraivu & Kaappu (Prevention)
Also food restriction to be provided as to avoid, all tubers (except yam), maida products, baked materials, old food, not to eat when angry which induce haemorrhoids. Although, adviced to eat when hungry, mild work been advised, consumption of more water, fibre diets, etc.
CONCLUSION
Siddhars gave more importance to the disease of moolam due to which primordially arises due to alteration in Moolatharam. It is a disease of anal canal and it is characterized by presence of muscular mass like tuber in anal region. Constipation of the bowels difficulty in defecation discharge of blood from the fleshy growths due to hard stools and pressure exerted are the general symptoms bleeding may also occur while passing urine due to pressure. The description about moolam, types, line of treatment, epidemiology described in this paper in detail.
References
1. Lohsiriwat V. Approach to hemorrhoids. Curr Gastroenterol Rep. 2013 Jul;15(7):332.
2. Iizuka N, Hamamoto Y. Constipation and herbal medicine. Front Pharmacol. 2015;6:73.
3. SP Ramachandran. Yugi Muni Karisal 151. 1st ed. Chennai: Thamarai Noolagam; 2000.
4. K. N. Kuppusamy Muthaliar. Siddhar Pothu Maruthuvam. 2nd ed. Chennai: Department of Indian Medicine and Homeopathy; 2012. 672 p.
5. Lohsiriwat V. Hemorrhoids: from basic pathophysiology to clinical management. World J Gastroenterol. 2012 May 7;18(17):2009–17.
6. Sun Z, Migaly J. Review of Hemorrhoid Disease: Presentation and Management. Clin Colon Rectal Surg [Internet]. 2016 Mar [cited 2020 Dec 24];29(1):22–9. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4755769/
7. Wang X, Yin J. Complementary and Alternative Therapies for Chronic Constipation. Evid-Based Complement Altern Med ECAM [Internet]. 2015 [cited 2020 Dec 24];2015. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4433664/