A STUDY ON THE SYMPTOMATOLOGY AND DIAGNOSTIC METHODOLOGY OF NETRISOOLAI VATHAM Dissertation submitted to THE TAMIL NADU Dr. M.G.R. MEDICAL UNIVERSITY CHENNAI - 32 For the partial fulfilment of the degree DOCTOR OF MEDICINE (Siddha) By Dr. PARVATHY. P PG Scholar National Institute of Siddha Tambaram Sanatorium, Chennai - 47 Under the guideship of Dr. G. J. CHRISTIAN M.D (S) Associate Professor National Institute of Siddha Chennai - 47 Study Centre Dept. of Noi Naadal, National Institute of Siddha Tambaram Sanatorium, Chennai - 47. October - 2018 DECLARATION BY THE CANDIDATE I hereby declare that this Dissertation entitled “A STUDY ON THE SYMPTOMATOLOGY AND DIAGNOSTIC METHODOLOGY OF NETRISOOLAI VATHAM” is a bonafide and genuine research work carried out by me under the guidance of Dr. G. J. Christian M.D (S), HOD, Dept of Noi Naadal, National Institute of Siddha, Chennai – 47, and the dissertation has not formed the basis for the award of any other degree, Diploma, Fellowship or other similar title. Place: Chennai - 47 Signature of the Candidate Date: (Dr. Parvathy. P) BONAFIDE CERTIFICATE Certified that I have gone through the dissertation submitted by Dr. Parvathy. P (Reg.No : 321515202 ) a bonafide student of final year M.D (s), Branch - V, Department of Noi Naadal, National Institute of Siddha, Tambaram Sanatorium, Chennai - 47, and the dissertation work has been carried out by the individual only. This dissertation does not represent or reproduce the dissertation submitted and approved earlier. Place: Chennai - 47 Date: Name and Signature of the Guide Name and Signature of the HOD with seal with seal Name and Signature of the Director with seal ACKNOWLEDGEMENT I express my sincere thanks to the Vice-Chancellor, The Tamilnadu Dr.MGR Medical University, Chennai-32. I express my profound sense of gratitude to Prof. Dr.V.Banumathi M.D (s), Director, National Institute of Siddha, Chennai-47. I take this opportunity to express my profound gratitude and deep regards to my HOD Dr. G.J. Christian M.D(s), Department of Noi Naadal, National Institute of Siddha, Chennai-47, for his excellent guidance, monitoring, constant encouragement and guidance given by him time to time throughout the course of this dissertation. I express my sincere thanks to Dr.M.Kanniyakumari M.D(s), Associate Professor, Department of Noi Naadal, NIS, Chennai - 47, for her suggestions, hopeful support and encouragement of my whole study I express my sincere thanks to Dr.S.Elansekaran M.D(s), PhD., Lecturer, Department of Noi Naadal, NIS, Chennai - 47 for his valuable suggestions, hopeful support and encouragement during the whole study. I express my sincere thanks to Dr.M.Ramamurthy M.D(s), Lecturer, Department, of Noi Naadal, NIS, Chennai - 47, for his suggestions, hopeful support and encouragement of my whole study. I express my sincere thanks to Dr.V.Srinivasan M.D(s), Lecturer, Department of Noi Naadal, NIS, Chennai - 47, for his suggestions, hopeful support and encouragement of my whole study. I express my sincere thanks to Chairman and Members of Institutional Ethical Committee (IEC), National Institute of Siddha, Chennai - 47, for their valuable inputs. I express my sincere thanks to Mr.M.Subramanian M.Sc., (statistics) Senior Research Officer, National Institute of Siddha, Chennai - 47. I express my gratefulness to All My Colleagues, My seniors and My Juniors for lending their helping hands whenever needed during the course of the study. I express my thanks to each and every faculty of NIS, Library staff and Lab staff. Last but not least, I would like to pay high regards to all my family members for their sincere encouragement and inspiration throughout my research work and lifting me during this uphill phase of life. I owe everything to them. Besides this, several people have knowingly and unknowingly helped me in the successful completion of this project. I record my sincere thanks to all of them. INDEX S. No. CONTENTS PAGE No. 1 INTRODUCTION 1 2 AIM AND OBJECTIVES 3 2.1. AIM 3 2.2. OBJECTIVES 3 3 REVIEW OF SIDDHA LITERATURE 4 3.A SIDDHA PHYSIOLOGY 4 3.B SIDDHA PATHOLOGY 21 3.C DIAGNOSTIC METHODOLOGY 28 LINES OF NETRISOOLAI VATHAM - FROM 40 4 YUGI PHRASES TO MODERN LITERATURE 4.1 BREAKUP SYMPTOMATOLOGY 40 ANALOGY BETWEEN THE LINES OF YUGI VAITHIYA 43 4.2 CHINTHAMANI AND MODERN TEXT READING BETWEEN THE LINES OF YUGI VAITHIYA 46 4.3 CHINTHAMANI 5 REVIEW OF LITERATURE NETRISOOLAI VATHAM 48 6 PATHOGENESIS OF NETRISOOLAI VATHAM 60 7 DIFFERENTIAL DIAGNOSIS 65 7.1 KABAALA IYA AZHAL 65 7.2 KABAALA PARISA VALI 67 7.3 KABAALA SILETHUMAM 68 7.4 PEENISAM 69 8 MODERN ASPECTS 70 9 LINE OF TREATMENT & DIETARY REGIMEN 86 10 MATERIALS AND METHODS 93 11 OBSERVATION AND RESULTS 100 11.1 AGE DISTRIBUTION 100 11.2 SEX DETERMINATION 101 11.3 FOOD HABITS 101 11.4 SOCIO-ECONOMIC STATUS 102 11.5 ETIOLOGY OF NETRISOOLAI VATHAM 103 11.6 CLINICAL FEATURES 104 11.7 YAKKAI 106 11.8 NOI UTRA KAALAM 107 11.9 NOI UTRA NILAM 108 11.10 GNANENTHIRIYANGAL 109 11.11 KANMENTHIRIYANGAL 110 11.12 UDAL THATHUKKAL 111 11.13 UYIR THATHUKKAL - VALI 112 11.14 UYIR THATHUKKAL - AZHAL 113 11.15 UYIR THATHUKKAL - IYYAM 114 11.16 ENVAGAI THERVUKAL - NAA 115 11.17 ENVAGAI THERVUKAL - NIRAM, MOZHI AND VIZHI 117 11.18 ENVAGAI THERVUKAL - NAADI 119 11.19 ENVAGAI THERVUKAL - SPARISAM 121 11.20 ENVAGAI THERVUKAL - MALAM 123 11.21 ENVAGAI THERVUKAL -MOOTHIRAM 124 11.22 MANIKKADAI NOOL 127 12 DISCUSSION 132 13 SUMMARY AND CONCLUSION 139 14 BIBILIOGRAPHY 140 15 ANNEXURE 141 S. No. TABLES PAGE No. 1 POZHUTHU 19 2 CHANGES OF UYIR THATHUKKAL 22 3 CHANGES OF UDAL THATHUKKAL 23 4 SUVAIKAL 24 CHANGES IN CLIMATORY CONDITIONS AND ITS 24 5 CORRESPONDING EFFECT ON THE HUMAN BODY 6 THINAI 25 7 BREAKUP SYMPTOMATOLOGY 40 8 LIGHT FROM LEXICONS 41 9 CHARACTERS OF VALI 49 CLASSIFICATION OF VATHAM IN CLASSICAL 50 10 LITERATURE 11 DERANGEMENT OF VATHAM 63 12 DERANGEMENT OF PITHAM 63 13 DERANGEMENT OF KABAM 64 14 YOGA POSES FOR SINUSITIS 91 15 GANNT CHART 99 16 AGE DISTRIBUTION 100 17 SEX DETERMINATION 101 18 FOOD HABITS 101 19 SOCIO - ECONOMIC STATUS 102 20 ETIOLOGY OF NETRISOOLAI VATHAM 103 21 CLINICAL FEATURES 104 22 YAKKAI 106 23 NOI UTRA KAALAM 107 24 NOI UTRA NILAM 108 25 GNANENTHIRIYANGAL 109 26 KANMENTHIRIYANGAL 110 27 UDAL THATHUKKAL 111 28 UYIR THATHUKKAL - VALI 112 29 UYIR THATHUKKAL - AZHAL 113 30 UYIR THATHUKKAL - IYYAM 114 31 ENVAGAI THERVUKAL - NAA 115 32 NIRAM, MOZHI AND VIZHI 117 33 NAADI 119 34 SPARISAM 121 35 MALAM 123 36 MOOTHIRAM 124 37 MANIKADAI NOOL 127 S. No. FIGURES PAGE No. 100 1 AGE DISTRIBUTION 101 2 SEX DETERMINATION 102 3 FOOD HABITS 102 4 SOCIO - ECONOMIC STATUS 103 5 ETIOLOGY OF NETRISOOLAI VATHAM 105 6 CLINICAL FEATURES 106 7 YAKKAI 107 8 NOI UTRA KAALAM 108 9 NOI UTRA NILAM 109 10 GNANENTHIRIYANGAL 110 11 KANMENTHIRIYANGAL 111 12 UDAL THATHUKKAL 112 13 UYIR THATHUKKAL - VALI 113 14 UYIR THATHUKKAL - AZHAL 114 15 UYIR THATHUKKAL - IYYAM 116 16 NAA - THANMAI AND NIRAM 116 17 NAA - SUVAI AND VAINEEROORAL 118 18 NIRAM, MOZHI 118 19 VIZHI 120 20 NAADI 121 21 SPARISAM 122 22 THODUVALI 123 23 MALAM 125 24 MOOTHIRAM - THANMAI AND NIRAM 125 25 MOOTHIRAM - NURAI, EDAI AND ENJAL 126 26 NEIKKURI 128 27 MANIKADAI NOOL 1. INTRODUCTION Siddha system of medicine is an integrated part of Indian system of medicines which is very potent and peculiar in its own way, by providing healing of the body, mind and soul. Siddha is the first system to emphasis health, as a perfect state of physical, psychological social and spiritual component of human being. According to Siddha our body is constituted by three humours Vali, Azhal and Iyyam (Vatham, Pitham and Kapham respectively). The maintenance of its normal proportion gives vitality to the organs or it regulates all vital functions of the body and assures the longevity of life. When there is any derangement in the ratio it will lead to diseases. Fundamentals of human body composed of uyirthathu, udalthathu, panchabhootham. Any alteration in these principles can result in disease which is revealed in humours like Vali, Azhal, Iyam.Humoural basis of disease diagnosis is needed to select humour based treatment, which can result in better prognosis. The diagnosis of a disease and eliciting the origin for the ailment is very important for a physician before selecting medicines for the ailment. The diagnosis of the disease involves identifying its causes and pathology of the disease. This is well defined by Sage Thiruvalluvar as follows: "§¿¡ö ¿¡Ê §¿¡öÓ¾ É¡Ê Âо½¢ìÌõ Å¡ö¿¡Ê Å¡öôÀî ¦ºÂø" Sage Yugi classified the diseases on the basis of symptomatology in Yugi Vaidhya Chinthamani. Yugimuni was the first person to classify diseases based on clinical signs and symptoms. His classification of diseases are very clear and are followed by Siddha physicians even today. Yugi Vaidya Chinthamani describes about 80 types of Vatha diseases, 40 types of Pitha diseases and 20 types of Kapha diseases. Netrisoolaivatham is one among the eighty types of Vatha diseases mentioned by Sage Yugi in Yugi Vaidya Chinthamani, as a clinical condition characterized by Pain in between the eyebrows, forehead and nose, throat pain, weariness of the body, giddiness, fatigue, and head ache. The signs and symptoms of Netrisoolai Vatham mentioned in Siddha literature may be correlated to Frontal sinusitis in Modern disease of classification. The comparative studies of diseases in Siddha System of Medicine bring to light high level of medical knowledge and wisdom the Siddhars had at that time. 1 Sinusitis is a major health care issue that affects a larger proportion of population.