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39; s milk. The decoction for about 60ml is made by reducing the 200ml of milk mixed with the two ingredients. Finally jaggery is added to taste and given to patient for twice a day after food for 1 week. There was a significant
KEYWORDS: Siddha, Adhimadhuram, Sombu
INTRODUCTION
Siddha is one of the oldest and the unique traditional system of medicine followed in southern parts of Tamilnadu. This civilization dates back to 12,000 years B.C1.The treatment in this system of medicine is based on balancing three humours (Vadam, Pitham and Kabam) and seven thathus like saaram(digestive fluid), seneer(blood), oon(muscle), kozhuppu(fat), Enbu(bone), Moolai(bone marrow) and sukkila(semen).
Migraines are typically associated with moderate to severe headaches that only affect one side of the head. People usually describe the pain as pulsating, throbbing or pounding. It often gets worse during physical activity or even if you move a little. The headaches may be accompanied by nausea or vomiting2.
In Siddha it is correlated to Otraithalaivali where the three humours gets imbalanced which is manifested with the symptoms of severe headache associated with nausea and vomiting. In modern medicine, usually the treatment is analgesics3. Although analgesics are used to control disease flares and were once acceptable as a maintenance drug, still the prognosis of the disease is very poor.
By looking into these limitations in the treatment and prognosis a single case of Migraine was observed by using Athimadhuram Sombu Paal Kashayam to analyze its effect in the management of disease4.
Patient Information
A 55 years old Male came to Srihari Siddha Clinic, Ammapet, Salem on 17/7/2018 with the complaint of severe headache on one side since 10 days associated with nausea, vomiting on and off and sleeplessness. In his past history he had same complaints since childhood from the age of 10 years on and off. He was under allopathy medication where he was given analgesics. He is not a diabetic and hypertensive. He is a vegan and in his personal history he is not habituated to smoking and alcohol. In family history he is married and has three children.
Clinical Assessment
In General examination the patient’s conjunctiva was in red colour and his Vital signs was normal with Pulse-74/min, Temperature-98.4F, Respiration rate-18/min, Blood pressure-130/80 mmHg and wt-62kg. His CVS and RS signs were also normal. He has good appetite and has no history of any surgery. The patient’s bowel habits were also good.
According to Siddha the patient’s constitution is Vadha type and his naadi is Pithavadham. He was diagnosed as Otraithalaivali (Migraine) and the drug was chosen to alleviate the aggrevated Pitham. Based on the clinical presentation the patient was diagnosed as case of Otraithalaivali excluding the differential diagnosis like Suryavartham and Chandiravartham where the patients’ headache varies upon the timings of sun and moon.
Therapeutic Intervention
The Medicine was advised for 1 week twice a day after food.
Table 1. Ingredients of therapeutic Medicine
Ingredients |
Quantity |
Adhimadhuram (Glycyrrhiza glabra) |
5gms |
Sombu (Foeniculum vulgare) |
5gms |
Cow’s milk |
200ml |
Jaggery |
Quantity sufficient - to taste |
By using the above ingredients decoction is made by reducing the milk from 200ml to 60 ml. Finally jaggery is added to taste. The ingredients were procured from the reputed Siddha Medicine store in Salem. After a single dose of Adhimadhuram Sombu Paal Kashayam the patient was releaved with the severe headache and the associated symptoms got reduced in a period of one week.
FOLLOW UP AND OUTCOMES
The patient was on follow up for a period of one year without a single episode of relapse. The patient felt mentally free and was able to do day to day activities in a pleasant manner.
DISCUSSION
Based on Siddha the patient was diagnosed as a case of Otraithalaivali. The special feature of Siddha medicine lies on the humours (Vadam Pitham and Kabam) hence the choice of medicine was with the ingredients which balance the humour. Here in this patient according to the pattern of Naadi as Pithavadham the drug of choice was made as Adhimadhuram Sombu Paal Kashayam which alleviates the vitiated Pitham and hence the patient got cured from the symptoms like one sided headache associated with nausea and vomiting, in a simple manner of treatment. Many review papers are cited for Adhimadhuram (Glycyrrhiza glabra) and Sombu (Foeniculum vulgare) which shows its ethno pharmacology, chemical constituents and medicinal uses5,6.
CONCLUSION
Based on the clinical signs and symptoms Otraithalaivali was correlated with Migraine. In this study Adhimadhuram Sombu Paal Kashayam was found to be safe and effective in the treatment of Otraithalaivali.
ACKNOWLEDGEMENTS
I pay my sincere thanks to my Siddha doctors in Telegram group for their wonderful sharing of knowledge in basic concepts who made this treatment possible in simple and effective manner.
CONFLICT OF INTEREST
None declared.
REFERENCES
1.Shukla SS, Saraf S, Saraf S, Fundamental Aspect and Basic Concept of Siddha Medicines, Systematic Reviews in Pharmacy;2011;2(1):48-54.
2.Informed Health Online, Migraine:Overview, Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006. Available from https://www.ncbi.nlm.nih.gov/books/NBK279373/
3.Becker WJ Acute Migraine Treatment in Adults. Headache. 2015 Jun;55(6):778-93.
4.K.S.Murugesa mudhaliar, Gunapadam Mooligai Vaguppu Part-I, Indian Medicine and Homeopathy, Chennai- 106, Edition-2013.
5.Dastagir G, Rizvi MA, Review - Glycyrrhiza glabra L. (Liquorice), JPharmSci.2016 Sep;29(5):1727-1733.
6. Badgujar SB, Patel VV, Bandivdekar AH. Foeniculum vulgare Mill: A review of its botany, phytochemistry, pharmacology, contemporary application, and toxicology. Biomed Res Int. 2014.
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KEYWORDS: Siddha, Adhimadhuram, Sombu
INTRODUCTION
Siddha is one of the oldest and the unique traditional system of medicine followed in southern parts of Tamilnadu. This civilization dates back to 12,000 years B.C1.The treatment in this system of medicine is based on balancing three humours (Vadam, Pitham and Kabam) and seven thathus like saaram(digestive fluid), seneer(blood), oon(muscle), kozhuppu(fat), Enbu(bone), Moolai(bone marrow) and sukkila(semen).
Migraines are typically associated with moderate to severe headaches that only affect one side of the head. People usually describe the pain as pulsating, throbbing or pounding. It often gets worse during physical activity or even if you move a little. The headaches may be accompanied by nausea or vomiting2.
In Siddha it is correlated to Otraithalaivali where the three humours gets imbalanced which is manifested with the symptoms of severe headache associated with nausea and vomiting. In modern medicine, usually the treatment is analgesics3. Although analgesics are used to control disease flares and were once acceptable as a maintenance drug, still the prognosis of the disease is very poor.
By looking into these limitations in the treatment and prognosis a single case of Migraine was observed by using Athimadhuram Sombu Paal Kashayam to analyze its effect in the management of disease4.
Patient Information
A 55 years old Male came to Srihari Siddha Clinic, Ammapet, Salem on 17/7/2018 with the complaint of severe headache on one side since 10 days associated with nausea, vomiting on and off and sleeplessness. In his past history he had same complaints since childhood from the age of 10 years on and off. He was under allopathy medication where he was given analgesics. He is not a diabetic and hypertensive. He is a vegan and in his personal history he is not habituated to smoking and alcohol. In family history he is married and has three children.
Clinical Assessment
In General examination the patient’s conjunctiva was in red colour and his Vital signs was normal with Pulse-74/min, Temperature-98.4F, Respiration rate-18/min, Blood pressure-130/80 mmHg and wt-62kg. His CVS and RS signs were also normal. He has good appetite and has no history of any surgery. The patient’s bowel habits were also good.
According to Siddha the patient’s constitution is Vadha type and his naadi is Pithavadham. He was diagnosed as Otraithalaivali (Migraine) and the drug was chosen to alleviate the aggrevated Pitham. Based on the clinical presentation the patient was diagnosed as case of Otraithalaivali excluding the differential diagnosis like Suryavartham and Chandiravartham where the patients’ headache varies upon the timings of sun and moon.
Therapeutic Intervention
The Medicine was advised for 1 week twice a day after food.
Table 1. Ingredients of therapeutic Medicine
Ingredients |
Quantity |
Adhimadhuram (Glycyrrhiza glabra) |
5gms |
Sombu (Foeniculum vulgare) |
5gms |
Cow’s milk |
200ml |
Jaggery |
Quantity sufficient - to taste |
By using the above ingredients decoction is made by reducing the milk from 200ml to 60 ml. Finally jaggery is added to taste. The ingredients were procured from the reputed Siddha Medicine store in Salem. After a single dose of Adhimadhuram Sombu Paal Kashayam the patient was releaved with the severe headache and the associated symptoms got reduced in a period of one week.
FOLLOW UP AND OUTCOMES
The patient was on follow up for a period of one year without a single episode of relapse. The patient felt mentally free and was able to do day to day activities in a pleasant manner.
DISCUSSION
Based on Siddha the patient was diagnosed as a case of Otraithalaivali. The special feature of Siddha medicine lies on the humours (Vadam Pitham and Kabam) hence the choice of medicine was with the ingredients which balance the humour. Here in this patient according to the pattern of Naadi as Pithavadham the drug of choice was made as Adhimadhuram Sombu Paal Kashayam which alleviates the vitiated Pitham and hence the patient got cured from the symptoms like one sided headache associated with nausea and vomiting, in a simple manner of treatment. Many review papers are cited for Adhimadhuram (Glycyrrhiza glabra) and Sombu (Foeniculum vulgare) which shows its ethno pharmacology, chemical constituents and medicinal uses5,6.
CONCLUSION
Based on the clinical signs and symptoms Otraithalaivali was correlated with Migraine. In this study Adhimadhuram Sombu Paal Kashayam was found to be safe and effective in the treatment of Otraithalaivali.
ACKNOWLEDGEMENTS
I pay my sincere thanks to my Siddha doctors in Telegram group for their wonderful sharing of knowledge in basic concepts who made this treatment possible in simple and effective manner.
CONFLICT OF INTEREST
None declared.
REFERENCES
1.Shukla SS, Saraf S, Saraf S, Fundamental Aspect and Basic Concept of Siddha Medicines, Systematic Reviews in Pharmacy;2011;2(1):48-54.
2.Informed Health Online, Migraine:Overview, Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006. Available from https://www.ncbi.nlm.nih.gov/books/NBK279373/
3.Becker WJ Acute Migraine Treatment in Adults. Headache. 2015 Jun;55(6):778-93.
4.K.S.Murugesa mudhaliar, Gunapadam Mooligai Vaguppu Part-I, Indian Medicine and Homeopathy, Chennai- 106, Edition-2013.
5.Dastagir G, Rizvi MA, Review - Glycyrrhiza glabra L. (Liquorice), JPharmSci.2016 Sep;29(5):1727-1733.
6. Badgujar SB, Patel VV, Bandivdekar AH. Foeniculum vulgare Mill: A review of its botany, phytochemistry, pharmacology, contemporary application, and toxicology. Biomed Res Int. 2014.
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