janani et al

Case study on Management of “VathaNoi” - Traditional view

Dr. S. Janani¹, Dr. M.A.M. Ajwad², Dr. N. J. Q. Tharshanodayan³

¹ PG Scholar, Department of Gunapadam, Government Siddha Medical College, Palayamkottai²Ayurveda Medical Officer, Siddha Teaching Hospital, Konesapuri, Trincomalee, Sri Lanka³PG Scholar, Department of Gunapadam, Government Siddha Medical College, Palayamkottai

Abstract

Sri Lanka is a country of rich heritage, one of which is its indigenous system of Medicine, which has been practiced by the people since time immemorial. Most of the indigenous medical practitioners in the island were treating many patients daily. Maximum number of patients was attended by trained practitioners.Therefore this study was carried out to explore the traditional management methods for “Vathanoi” of particular traditional physicianand this was an observational case studyreport.The study was conducted at own clinic oftraditional practitioner. The informationwas collected from a patient. The selectedpatient was63 year old lady presented with severe pain and swelling in her both knee joints for 2 years and back pain for 7 months. After the proper history and examination, the diagnosed arrived by the physician as a type of “Vathanoi” and the drug was given by the traditional practitioner and the patient was instructed about the application method of the drug and follows up / next visit to the hospital. The patient was clearly examined in every visit and measurements were obtained. After 40 days of drug giving, the patient was showed a marked reduction of swelling in the both knee joints and significant improvement in the knee and back pain also. Thus it can be concluded that, theKurunthoddiverthailum and fomentation ( Oththu)are very effective in Management of “VathaNoi” inTraditional view.

Key words: VathaNoikal,Kurunthoddiverthailum, fomentation ( Oththu)

Introduction

Traditional medicine comprises knowledge systems that developed over generations within various societies before the era of modern system of medicine. Traditional ways of healing illnesses originating in ancient societies are called complementary medicine today. The World Health Organization (WHO) defines traditional medicine as:"The health practices, approaches, knowledge and beliefs incorporating plant, animal and mineral-based medicines, spiritual therapies, manual techniques and exercises, applied singularly or in combination to treat, diagnose and prevent illnesses or maintain well-being."The Siddha science is the oldest traditional treatment system generated from Tamil culture. The Siddha flourished in the period of Indus Valley civilization. The word Siddha vaithiyam comes from Tamil word.Most of the practicing Siddha medical practitioners are traditionally trained, usually in families and by gurus (teachers). When the guru is a martial arts teacher, he is also known as an aashaan. They make a diagnosis after a patient's visit and set about to refer to their manuscripts for the appropriate remedies, which a true blue physician compounds by himself or herself, from thousands of herbal and herbo-mineral resources.Thus, the objective of this study isto explore the traditional management methods for “Vathanoi” of particular traditional physician.There were number of traditional practitionerstreating this condition in island wide, among them onetraditional practitioner was selected randomly and the studywas conducted at his own clinic.

Methodology

This was an observational case study report. Thestudy was conducted at own clinic of traditional practitioner.Patient who was selected for this study has selected randomly. Written consent wasobtained from both traditional practitioner and the patient toconduct this study.

63 year old lady presented with severe pain and swelling in her both knee joints for 2 years and back pain for 7 months. After the proper history and examination, the diagnosed arrived by the physician as a type of “Vathanoi” and the drug was given by the traditional practitioner and the patient was instructed about the application method of the drug and follows up / next visit to the hospital. He was prescribed the Kurunthoddiverthailumand Oththu (fomentation) for external use for 40 days.

Kurunthoddiverthailum consist of 43 ingredients and it can be used for different purposes depend on the stage of the oil. Anyhow commonly it prescribed for all types of VathaNoikal. After the application of oil he was prescribed an oththu for reduce the swelling and pain in the joints. Thefomentation (Oththu) containsThompaiseed , Koddathenkaay, Muththaamanakku ilia, Adadaathodai ilia, Nochchi ilia, Thennam poo, Eallu andManchal.

Preparatory method of drug and its usage:-

Ø Kurunthoddiverththailum:–

Kurunthoddiver – 500g

1. Kothumai

2. Nerunchi

3. Kandankaththari

4. Mullukkaththari

5. Eianthaikoddai

Each 10g

(Group 2)

Kollu

7. Orilai

8. Moovilai

9. Vilvamver

10. Munnaiver

11. Peru vaakaiver

12. Kumizhver

13. Paathiriver

Take 500g of kurunthoddiver add 4 l of water and boil until become 1 liter of decoction. Then take group 2 ingredients and add 1 liter of water and boil until become ¼ l of decoction. Then filter the above decoctions separately.

Powder the group1 drugs separately and mixed together. After that mix the above 2 decoctions and sprinkle the powder in to the decoction and grind well. Then add 1 liter of cow’s milk and 1 liter of gingelly oil and mix well. After that heat that mixture until become oil form.

It can be use different purposes according to the stage of oil.

Miruthupaakam – Scalp oil
Maththiyapaakam – internal use
Kataipaakam – external use

Indications – All types of vaathadiseases

Data Collection:

Table 1: Pain scoring scheme

0	No Pain
1	Mild pain bearable in nature, comes occasionally
2	Moderate pain, but no difficulty in walking
3	Moderate pain, but slight difficulty in walking due to pain
4	Severe difficulty in walking, disturb sleep due to severe pain

Table 2: Swelling grading scheme

0	Absent	No Swelling
1	Mild	Less than 10% circumference of affected joint
2	Moderate	More than 10% circumference of affected joint
3	Severe	More than 20% circumference of affected joint

Table 3: Pain on joint movements

0	No Pain
1	Pain without wincing of face
2	Pain with wincing of face
3	Prevent complete flexion
4	Does not allow passive movements

Symptoms were assessed and graded as per the above tables

Figure I: KneeJoints - Before treatment Figure II: X-ray of her knee joints

Result and Discussion

Effectiveness of traditional management for vaathanoi wasevaluated based on improvement of clinical manifestation especially pain, swelling and pain on joint movementsbefore, during and after the treatment. Clinical manifestation of the patient before, during and after the treatment is tabulated (Table 4).

Table 4: Clinical manifestation

Sign and symptoms	Visits
Sign and symptoms	1^st (1^st day)	2^nd (8^th day)	3^rd (15^th day)	4^th (22^nd day)	5^th (30^th day)
Pain	4	3	3	2	1
Swelling	2	2	1	1	0
Pain on joint movements	4	4	3	2	1

Chart I: Clinical manifestation

The above chart indicates that the all three clinical manifestations were reduced gradually and after the completion of treatment (after 30 days) the patient had mild pain in both knee joints but bearable in nature. It indicates that the external application of Kurunthoddiverthailumalong withOththu (fomentation)is a very good treatment method in relieving pain and swelling in the joints.

Figure III: Knee Joints - After treatment

Conclusion:

From this case report, it has become clear thatthe Kurunthoddiverthailumand Oththu (fomentation) has a very crucial and effective role in the management of “VathaNoi ” in Traditional view. The case showed significant reduction in pain,swelling and pain on joint movements was noted after the completion of his one month of traditional management methods. This indicates that the application ofKurunthoddiverthailumalong with Oththu (fomentation) has a very good action on the treatment of Vathanoi. But the study with the large sample size must be done to get more accurate conclusions.

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