Application of the concept of mala suddhi with special reference to various

medicines mentioned in Siddha literature

Dr. Senthamizh chelvan,BSMS

Dr.C. Mary Sharmila,BSMS

Based on the classes taken by Dr. L. Mahadevan,BAMS,MD

Mala suddhis is an integral part of Indian classical medicine. In siddha

system, it has been given primary importance. It is done before starting any

therapeutic procedures. It is called virechana in ayurveda. It is a process by which

the toxins or the malas from the body are eliminated through anal route by internal

administration of medicines. Malam denotes excreta or toxins. There are mano

malas or the toxins of the mind. Tamil literature call this as Anavam, kanmam and

mayai. Once the detoxification takes place in the body, there will be automatic

detoxification in the mind also. So while we plan a detoxification or suddhi, cleansing

the body is the primefaca of the treatment.

Considering the anatomical structure of the body the upper stomach is

predominant of kapha, the duodenum is predominant of pitta and the large colon is

the seat of vata. This is an order. The doshas do their physiological activity by being

predominant in these receptors or sites. There are three malas that are produced as

a part of day-to-day physiology. They are sweat urine and fecal matter. It is sweat

through which the mala rupa of pitta is eliminated. When we do sweating therapy like

kizhi we usually do it in vata kapha conditions namely low back ache or osteo

arthritis. Here, the sita guna of vata is reduced by the heat, excess pitta is produced,

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vata and kapha are brought to normalcy. If we take the next mala ,urine, kapha and

pitta are eliminated through that. proteins, ketones acetones, urobilinogen and

leucocytes are eliminated. This is called mutra virechanam. When we give kashayam

prepared out of nerunchil (B.N – Tribulus terrestris), satavari (B.N – Asparagus

racemoses), anai nerunchil (Pedalium murex), saranai ver (Trianthema

portulacastrum), detoxification of urinary tract take place.

Modern medicines talk in terms of acidity and alkalinity of the human body.

Vata pitta predominant is acidic in nature, pitta kapha predominant is alkaline in

nature. When assessing the fecal matter, it is the channel through which vata pitta

kapha, i.e., the tridoshas are eliminated. Evacuation of bowels in a regular interval

and in a regular schedule is considered as a characteristic feature of health in Indian

medicine. It is not only the amount, consistency and the smell of the fecal matter but

also the time taken for the evacuation is also considered to understand the tridosha

suddhi. These questions are asked to the patient by the vaidya in his OPD.

When we perform therapeutic purgation we can see kapha at the end of

evacuation. What does it mean? The virechanam cleanses, large colon, small colon

and cleanses the upper stomach in order. Kapha present in the upper stomach

comes in the end. So seeing kapha in the purgation is considered as a good

characteristic feature for the virechana. But when we do vamana therapy ,kapha will

come first, then pitta will come because in the oesophagus and upper stomach

kapha is predominant and bile is predominant in the lower part of the duodenum that

comes in the end. This has to be observed by the clinician. This is very important. If

this does not happen, it means that a proper suddhi is not done and , the residual

toxins may stay in the body and produce unwanted complications like indigestion,

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itching, etc in the due course. Even though the virechanam is the base therapy for

pitta diseases, it can be given for vata, kapha, etc.,

In siddha medicine, virechanam is considered as a full detoxification because

it handle and remove the endotoxins of all the tridoshic physiology. When we treat a

patient with low back pain, we understand that it is produced by the blockage of

apana vayu, so as vayu is ruksha, we select castor oil based medicines here. What

is the reason? Vata is dry, dryness increases pain, dryness is compensated by

oiliness, oiliness is the opposite quality of dryness, so we select castor oil based

medicines like siddhathi oil here. We get another patient with herpes. The herpes is

produced pitta and kapha. The common gunas between pitta and kapha is snehana

or oiliness. We do not select castor oil in this case. Here we will select a dry

purgative. What is meant by dry purgative? Creating a purgation with raw drug,

churna, svarasa, kashaya is called dry purgative. Peipudal (B.N -Trichosanthes

cucurmerina), katukarohini(B.N-Picrorhiza kurroa), Sivathai ver(B.N-Operculina

turpethum), Kadukkai(B.N -Terminalia chebula), Peithumatti(B.N-Citrullus

colocynthis), Nilavarai(B.N -Cassia obtusa) are the examples.

So we can understand that we have to use intelligently snigda virechana and

ruksha virechana in practice. If there is vata vruddhi, vata is associated with pitta, or

when vata is associated with kapha we have to consider, For example,

Lavanagunadi tailam which is an oily purgative which is selected in the following

conditions.

Lumbar disc prolapse,

Lumbar canal stenosis,

Acute radiculopathy,

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Sciatic neuropathy,

Ankylosing spondylitis,

Rheumatoid spectrum,

Osteo arthrosis,

Endometriosis,

PCOD,

Sub fertility,

Dysmenorrhoea, etc.,

Dry purgative like churnas are selected in following condition.

Renal failure,

Lymphatic oedema,

Hypothyroidism,

Metabolic syndrome X,

Herpes recovery,

Hepatobilliary disorders,

Vesiculo bullous disorders,

Toxic pathology,

Insect bite allergy,

Skin diseases,

Folliculitis,

Eczema.

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In some conditions, we may use both purgatives intelligently. For example,

we will assess bronchial asthma, which is a vata kapha predominant disease. If

expectoration is more and wheezing is more, we select a dry purgative. If dyspnea is

more we understand that vata is the factor behind the dyspnea and we will select an

oily purgative after application of karpura taila in the chest region after warming. In

some conditions like SLE, castor oil is given with sugarcane juice, coconut oil or milk

because there is little bit of pitta predominant along with vata. So we give castor oil

with pitta reducing anupana like milk and coconut water. In conditions like cirrhosis,

ascities, portal hypertension we have to use dry purgative on everyday basis. In

renal failure also, sweating is reduced, urine is not eliminated daily, so the two

pathways of elimination of mala is blocked. The only pathway that is available for the

elimination of mala is the anal route. So we have to do purgation everyday. Here

various medicines are available in Siddha literature like Kausikar kuzhambu,

Agasthiyar kuzhambu, Siddhathi Ennai, etc.

Usually strong purgations are avoided before the age 10 and after the age of

70. Mild laxative can be done. Usually we give purgative medicines at the bed time,

but after bed time when we sleep there is mantha guna vruddhi, that is kapha

vruddhi. So it will be ideal to do purgation in morning around 9’O clock in empty

stomach. There are literary evidences to support this. We have to give medicines by

9.30 in the morning. The patient should get up,he should not take any food. Castor

oil is given with small amount of salt and warm water, we can wait for 2 to 3 hours.

Mala will start evacuating. After evacuation or when the vegas have started, we can

give warm water little by little to felicitate the intestinal movement. Anupanam plays a

major role. Anupanam prevents electrolyte imbalance in virechana. If man is having

Kalkudal(spastic colon) virechanam is avoided or virechanam is given with salt but

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vasti is preferred. After virechana small quantity of kanji with salt and buttermilk is

given. The patient should not take oil bath after that nor sleep in the morning. In the

Night he can take a light kanji diet and sleep. After virechana there will be

constipation for one or two days and the physiology will take at least 48 hours to

come to normalcy. If the patient has not attained a complete suddhi, the next day

another dose can be intellectually applied. If we give virechana in night time with

nervala(B.N Croton tiglium) like medicines and if complication occurs in the mid

night, it will be difficult to manage,so, Virechanam is given in empty stomach, so that

it penetrates and the cleansing of the tract is possible.

The medicines for vata virechana will act on colon. For example, kadukkai

podi(B.N Terminalia chebula) reduces vata. It will take 8 to 10 hours. 20 gms is

needed for the suddhi. The pitta medicines work on the small intestine. Katukurohini

(B.N Picrorhiza kurroa)is the example. It will take 6 hours to produce of the effect. In

kapha conditions, drastic purgatives have to be given. It has to cover large colon

starting from the stomach. Nervala(B.N Croton tiglium) is the better example. This

has to be kept in mind.

Croton tiglium takes about 1 hr to act.

Kadukkai – 12 hrs

katukurohini – 6 hrs.

it varies to the type of the colon. Croton tiglium should not be given for a mrdu

koshta, but can be given for “mathyama and krura koshta”.

Once we give medicines for purgation, some times excess vegas are

produced. Maximum 20 vegas per day is considered as is normal for an ordinary

koshta. In mrdu koshta it may be high, in kalkudal (Spastic colon) it may be less. So

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we may give cold water to stop the purgation. When vegas are less, we give hot

water.

In the case of nervalam(B.N Croton tiglium) ,We have to do the opposite one.

When there is more purgation we have to give hot water. Because hot water helps in

reducing intestinal colic. When there is less purgation, we have to give cold water.

Because of an improper purgation, there will be burning sensation. Many texts of 16 th

century texts quote about this. The word Naga danti, “Naga” is Sanskrit means

elephant, “danti” means tusk. “Naga danti” means it is a plant whose root resembles

the Elephant tusk. It is basically a root. The botanical name is Baliospermum

montanum, But select crotton seed or nervalam. Nervalam is a seed not a root. What

exactly is Nagadanti has to be standardized.

In siddha medicines, virechana medicines can be classified as those

containing Croton tiglium, those with Castor oil, those with kadukkai (Terminalia

chebula) and those with sivathai (Operculina turpethum). peipudal and katukarohini

are not used much.

1. ASTA BAIRAVAM MATHIRAI

This medicine contains Croton tiglium as a major constituent -50%. It is given

for conditions like fever, uncontrollably vitiated doshas and for toxicities. The need

for purgation in fever is very less. Practically, purgations can be performed only in

conditions like pyrexia of unknown origin, hodgkin’s lymphoma, non hodgkins

lymphoma, which are chronic states producing fever. It cannot be done in typhoid

fever, viral infections, considering the weak general health of the individual. It is

contra indicated in conditions like cough, cold, fever, pneumonia, typhoid.

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It can be given along with lavanga kashayam for toxicity.

The term toxicity includes a broad spectrum of conditions like long term usage of

drugs, plant toxicity, lead poison, mercury poison, arsenic poison, sulphur toxicity.

This medicine is best handled in conditions like incompatibility of adverse drug

reactions and toxic conditions.

Dosage – 100 mg tablet,one tablet can be given

2. JALODARI MANI

This medicine contains the drugs which can be given for gulma like dried

ginger, pepper, long pepper, alum, rock salt and asafoetida. It has a similar

composition as that of Ashta churnam. This medicine contains croton tiglium along

with those of Ashta churnam. This medicine has the property to exert it effects on the

abdominal areas. It can be practically used in pathologies where the normal pathway

of the apana vayu is blocked like ascites, portal hypertension, hernia, BPH, liver

cirrhosis, etc.,

Dosage - 200 mg tablet .one or two tablet can be used

Anupanam - water

3. LAVANGADI MATHIRAI

It contains Croton tiglium, rasa karpooram, lingam in the ratio of 12:2:1. It is

generally given for kapha vata diseases like stroke, infarction, Ischemic heart

disease, carotid atherosclerosis, lumbar disc disease, lumbar canal stenosis,

spondylolisthesis, and bronchial asthma. It is not the choice of medicines in

pathologies like kushta, SLE, vasculitis as it contains drugs of hot potency.

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Dosage – 100 mg tablet ,one or two can be used

Anupanam – hot water

4. MEHA NATHA GULIKAI

This contains lingam, vasambu (Acorus calamus), dried ginger, vaividangam

(Emblica ribes), Root of Kattamankku (white variety) along with Croton tiglium. It is

generally a choice of medicine for worm infestations, gulma, sopha.

Since the medicines has the coined term “mega nadhan” and also sivathai

(Operculina turpetum) as an ingredient it can be given for reactive arthritis, second

stage of bacterial arthritis .

When given along with chukku kashayam it arrests the excessive

evacuation of bowel. Chukku (dried ginger) has the property of “Grahi”.

Dosage – 100 mg tablet ,2 or 4 can be given

Anupanam – chukku kashayam (gingiber officinale)

5. MURUKAN VITHAI MATHIRAI

It contains katukarohini (Piccoriza kurrora), murukan vithai (Butea

monosperma), Croton tiglium. It is an anti helmintic with laxative property.

Dosage – 500 mg tablet ,1 or 2 can be given

Anupanam – water or palm jaggery

6. PACCHAI KARPOORAM MATHIRAI

It also contains Croton tiglium. Though it is mentioned in the context that it

can be given for fever as a virechana drug, it also contains ushna virya drugs like

lavangam, jathikai, rasa padangam, gandakam (sulphur) which have the property to

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pacify the sita guna of kapha and vata. Hence it can be implemented in vata kapha

conditions like demyelination, motor neuropathy etc.

It has to be understood that ginger juice mentioned is ushna virya in nature

and acts as a deepana helps reducing kapha vatam.

Dosage – 100 mg tablet ,1 or 2 can be given

Anupanam – extract of inji (gingiber officinale)

7. SOOLAI BOOPATHI

It contains mercury, sulphur, naabi (Aconitum ferox) along with bile of snake

and boar. It can be understood from the name that it cures “Soolai”. Soolai can be

interpreted as abdominal colic.

Virechanam is contraindicated in acute abdominal conditions like appendicitis,

but can be done in the second stage of the pathology when the severity of the

disease has subsided.

It can be used in hepatic flexure syndrome, spleenic flexure syndrome,

Renal colic, abdominal colic, endometriosis, BPH, Proctalgia fugax. As it is a

ushna virya, drug it is contraindicated in peptic ulcer and duodenal ulcer.

Dosage – 100 mg tablet ,1 tablet can be given

8. SANJEEVI MATHIRAI

Contains 50% of Croton tiglium in composition. This is processed with

extracts of veliparuthi (Pongamia daemia).

When given along with Jathikkai churnam it rectifies the block of apana vayu

in bleeding piles. Practically it can be given with lemon juice for urticaria.

Dosage - 100 mg tablet ,one or two can be given

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DRUGS WHICH CONTAIN KUMATTI

How to differentiate the action potential of medicines which contain Croton

tiglium and those which contain kumatti

Croton tiglium eliminates the toxins alone from the body, but kumatti acts as a

purifying agent in

vata rogas diseases of female reproductive system

mind related rogas.

Kumatti is a constituent of Kalyanaka ghrta in Ayurveda.In the ayurvedic text

astanga hrudayam, vata vyadhi, cikitsa thivatha ghrtam contains kumatti.

Kumatti is chosen when vata is vitiated in dhatus

Castor oil for vitiated vata in colon

Croton tiglium for vitiated vata & kapha in colon.

9. LINGA CHENDURAM

Prepared with 2 litres of extracts of kumatti. Although it is given for vata kapha

diseases, it eliminates the toxins in the dhatus, affected by “Kulir vatam” &

“Megam”.

Dosage - 50 mg - 100 mg tablet , one can be given

Anupanam - Honey

10 . KUMATTI MEZHUGU

It is a choice of drug for portal hypertension, liver cirrhosis,

endometriosis, dysmenorrheoa, infertility etc. dosage is carefully determined.

Dosage - 200 mg - 500 mg tablet , one can be given

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Anupanam - Palm jaggery

KUZHAMBU

Anything that has an oily texture is termed as kuzhambu. That which is

unctuous in nature is kuzhambu. It is a stage of process. Lehyam is that which is

licked .

Kuzhambu is used when the dry guna of vata is vitiated. Also used when vata

is associated with pitta or when vata is associated with kapha.

Spastic colon – when vata alone is vitiated

Chronic gastritis – vata associated with pitta

Dyspnoea – vata associated with kapha

Vertigo – pitta associated with vata

Infraction – kapha associated with vata

Medicines with unctuous guna can be given to pacify the dry guna of vata.

Although Agasthiyar kuzhambu is used in a wide spectrum with anupanam

specificity,it is given along with kumatti extract for gulma.

For cough, it is coupled with kadukkai kashayam which reduces vata kapha.

In endometriosis, which is a vata disease, agasthiyar kuzhambu is given with

chukku kashayam.

In bleeding piles which is vata pitta roga, it is given along with buffalo milk

which is sweet in rasa and has unctuous guna.

In kapha related pandu, if is given along with extract of onion.

In fever for ama pachana, it is given with chukku kashayam.

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11. KAUSHIKAR KUZHAMBU

It has purgative property, contains katukurohini, Croton tiglium as key

ingredients. It is given for vata disease (suthaka vayu) with extracts of Pongamia

daemia.

For kapha diseases with hot water and kadukkai kashayam. It is given with

ksheera kashayam for pitta diseases. It is an important drug for toxins like rat

bite, snake bite, etc.

The anupanam designed by the Rishis for a particular disease fulfills three

categories .

It decreases the intensity of the roga (disease) of the patient

Pacifies the vitiated dosha

Increases the bio availability of the plasma half – life of the particular medicine

As it contains katukarohini, manosilai, it can be given for tonsilitis. It has 30% of

the ash of coconut shell. The peculiarity of the composition is that it acts as an

alkalizer, which is not included in any other yogas. zymethicone is given in conditions

where there is increased secretion of pepsin & HCL. Modern medicines pacify the

dosha. Kaushikar kuzhambu pacifies & eliminates the dosha involved.It reminds of

the pre kinetic action of the medicine.

12. MALAKUDARA MEZHUGU

It is a mild laxative drug, can be given even for children. It takes, about 8

hours for the medicine to produce its effect, causes one or two vegas. Does not

produce abdominal cramps, can be taken as a routine laxative drug.

Dosage - 100 mg - 200 mg tablet , one can be given

Anupanam - palm jaggery

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13. NAVA UPPU MEZHUGU

It is also a medicine prepared with Croton tiglium. Can be given for motor

neuron disease, motor neuropathy should follow pathyam without salt when the

medicine is given, as the medicine is composed of varieties of salt as its

composition.

Dosage - 100 mg - 200 mg tablet , one can be given

Anupanam - palm jaggery

14. NEELAVARAI CHURNAM

It is a digestive and dry purgative.

Dry purgative is used in portal hypertension, ascities, liver diseases, hepatitis,

hepatomas, herpes recovery, oedema, hypothyroidism, all the conditions where

agni mandhya is associated with pitta and kapha problems.

Dosage - 1 – 2 gms

Anupanam - hot water

15. SIVATHAI CHURNAM

It is also a mild laxative. A low dose of Sivathai Churnam pacifies pitta. In a

higher dose it eliminates pitta. It can be given upto 15 gms with hot water.

Dosage - 15 gms

Anupanam - hot water

1`6. KARUDANKIZHANGU ENNAI

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It is katu rasam, ushna veeryam, agni deepanam, gulmaharam. It is highly

useful in vata kapha diseases. It contains castor oil as an ingredient. Dosage is 15 to

20 ml. It is useful in endometriosis, dysmenorrhoea, disc problem, benign

prostrate hyperplasia, constipation, non ulcer dyspepsia, etc.,

Dosage - 15 – 20 ml

17 .KAZHARCHI TAILAM

It is a very powerful purgative. It contains a greater of proportion of castor oil

along with Croton tiglium. So a single dose of 5 to 10 ml with specific pathya in

given, Murungai pinchu(B.N Moringa oleifera) and Avarai pinchu(B.N Lablab

purpureus) should be given. Practically it is given for renal failure, udambu veekkam.

Kazharchi tailam is the choice of drug for purgation for suitable conditions in

mechanical intestinal obstruction.

Dosage - 5 to 10 ml

18 . MALAI VEMBADI TAILAM

It contains varikumatti and castor oil. It is a specific purgative for pumsavana

(Sub-fertility spectrum). This is given for 3 days only. This is given during the

menstrual cycle. This is a pre sodhana therapy before starting the treatment for

pumsavana, sub-fertility management. But this can be also used in endometriosis,

PCOD, fallopian tube block, dysmenorrhoea, Premenstrual tension,

Amenorrhoea, secondary amenorrhoea, etc.,

Dosage - 15 – 30 ml

Anupanam - rice water

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19 . MANTHA ENNAI

This is a katu rasa oil. Castor oil is the base. Dosage of 2 to 3 ml can be

given. This can be given in kapha diseases of children. Mal-absorption, worms,

rickets are the common conditions where Mantha ennai is used. In another type of

Mantha ennai, uttama kanya swarasam (veli paruthi) is used.

Dosage - 2 to 3 ml

Anupanam - Milk

20 . MOOLAKUDARA TAILAM

It is a very mild laxative which contains tender haritaki along with castor oil. 2

to 3 spoon at night. Produces one or two vegas.

Dosage - 10 - 15 ml

21 . MERUKULLI TAILAM

It contains Merukan kizhangu, Botanical name a castor oil. It is highly useful in

Rheumatoid spectrum of diseases, gout, psoriatic arthropathy, etc.,

Dosage - 10 - 15 ml

22. MENI TAILAM

It contains Kuppameni with castor oil. It is highly useful in fistula worm

infestations, syphilitic ulcer.

Dosage - 10 - 15 ml

23. SIDDHATHI ENNAI

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It is katu rasam, ushna veeryam, vatakapha haram. It contains croton, tiglium,

Kalli Paal, etc., It has a wide range of utility. This is a choice of drug in our practice in

Schizophrenia. In Schizophrenia it produces specific suddhi. It is useful in uterine

diseases, but in our experiences we use it specifically in psychiatry problem that

needs drastic sodhana.

Dosage - 5 - 10 ml

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