Manjal Kamalai (Jaundice)

MANJAL KAMALAI (JAUNDICE)

Jaundice is the medical term that describes yellowing of the skin and eyes. This condition forms when there is too much bilirubin in our system. Bilirubin is a yellow pigment that is formed by the breakdown of red blood cells in the liver.

Jaundice in adults is often indicative of:

• alcohol abuse
• liver infections
• liver cancer
• cirrhosis (scarring of the liver, usually due to alcohol
• gallstones (cholesterol stones made of hardened fat material or pigment stones made of bilirubin
• hepatitis (swelling of the liver that decreases its ability to function)
• pancreatic cancer  
• parasites in the liver
• blood disorders, such as haemolytic anemia
• an adverse reaction to or overdose of a medication, such as acetaminophen

Jaundice is also a frequent occurrence in newborns, especially in babies who are born prematurely. An excess of bilirubin may develop in newborns because their livers haven’t fully developed yet.

SIDDHA CONCEPT OF JAUNDICE

Jaundice in siddha system of medicine is referred to as “manjal Kamalai” or   “manjal Noi”.

Manjal means yellow and Kamalai (Kamam Illai) means lack of interest, because the person affected by this disease will lose interest / desire in food, objects and even day today activities.

It is also called “pithu noi” which means the disease is due to increased pitham humour and pithu neer (probably bile/bilirubin).

The disease is defined in siddha texts as a condition in which the eyes, tongue and body turns yellow.

CAUSE AND PATHOLOGY:

The aetiology of this disease according to siddhars is attributed to the excessive intake of food and activity which leads to increase of pitham resulting in the destruction of seneer (blood), one of the seven udal thathhukkal (physical constituents). This happens because the excessive accumulation of pitham causes the pitha neer (probably bile) to mix with blood and stagnate in body tissues and other parts of the body like skin, eyes, tongue etc. Some activities which increase pitham include wandering in hot sun and wakefulness during night.

பண்பான பித்தத்தில் சேத்துமங்கூடிப்  பரிசித்தால் .......

கண் காது மலநீரு மஞ்சள் .....................

These lines say that pitham and kabam humour conglomerate leading to yellowish coloration of eyes, ears and urine. Thus according to siddha philosophy, this disease is due to derangement of pitham and kabam humors.

The early symptoms of this disease mentioned are excess salivation, nausea, loss of taste, indigestion, drynesss of skin, shrinking of skin resembling like a toad’s along with yellowish discoloration of skin, eyes, nail bed and dark urine.

The disease produces the following symptoms as mentioned in the siddha text authored by siddhar Yugi muni.

·         Hand, face, palm, eyes, body turning pale

·         Fatigue

·         Shivering

·         Frequent shortness of breath

·         Constipation

·         Drowsiness

·         Heaviness in the head

·         Yellowish discoloration of skin

CLASSIFICATION IN SIDDHA SYSTEM OF MEDICINE:

The disease is classified in to different types on different patterns by various siddhars. According to a text called Yugi vaidya chindhamani, they are 13 types and as per agathiyar – 2000, 8 types. Balavagadam, a text which deals with paediatric diseases classifies jaundice that occurs in childhood in to three types.

Also according to Yugi, of the 13 types only seven types are curable. The incurable types he mentions are as follows kumba kamalai, kunma kamalai, mukkuta kamalai, vali kamalai, senkamala kamalai and azhagu kamalai. Though these cannot be exactly compared with modern classification of diseases since the basic philosophy of siddha system is different from that of allopathic system, the symptoms that are mentioned under the incurable types reveal that these conditions are advanced state of the disease with complications and/or associated with hepatic failure. The disease is untreatable in these conditions according to siddhars. The common symptoms mentioned under the incurable types are severe pain in abdomen, abdominal swelling, diarrhoea and fatigue, those which are usually associated with liver failure.

MANAGEMENT AND PREVENTION

Some medicinal plants used to treat the disease are as follows:

Some more simple medicinal plants preparations………….

·         Root and leaves of keezhanelli (phylanthus amarus) are ground well and can be given along with buttermilk.

·         Powdered kadukkai (gallnut- Terminalia chebula) can be given with water.

·         Paste of flower of Kontrai (Cassia fistula) can be given with milk.

·         Decoction prepared from leaves of suraikai (Bottle Gourd- Lagenaria siceraria) can be given with added sugar.

·         Juice of leaves of Vilva ilai (Aegle marmelos.Linn.corr) mixed with pepper powder can be given.

·         Powdered both tender and matured leaves of vembu (neem - Azadirachta indica) with half its quantity of omam (Carum copticum) and salt mixture can be given.

·         Sugar Cane can juice can be given both in the morning and evening.

The siddha line of treatment prescribed for this disease is as follows:

Since this disease is caused by increased pitham humour from its normal level due to the increased heat produced by increased consumption of such food constituents /alcoholic beverages or such activity that produces heat, the increased pitham should be normalised and the excessively produced pithu neer (bile / bilirubin) should be expelled out. For expulsion of the excessive pithu neer, proper emetics and purgatives should be administered. But this would be carefully prescribed by a siddha practitioner taking in to account the body and disease condition. After this, proper medication is given to repair the affected udal thathukkal (physical constituents).

Depending upon the disease condition medicines like Nellikai leghiyam, Irumbukitta chendooram, Iruppu chendooram, Silasithu parpam, Vediyuppu chunnam, Navachara chendooram, Klaamega chendooram are given along with suitable anubanam (vehicle) like karisalai chooranam.

Prevention is by avoiding food and activity that increases pitham.

Diet restriction:

During acute stage of the disease, porridge without salt and tamarind is advised. Two times cooked rice can also be given. Non-vegetarian foods, oil, ghee and spices should be strictly avoided. Vegetables can be added without tempering or seasoning (technique in which whole spices and sometimes also other ingredients such as minced ginger root are fried briefly in oil or ghee). 

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Note: Consultation of a qualified siddha medical practitioner is mandatory for optimal results.

References:

http://www.siddhamd.com

http://www.healthline.com

http://www.medicinenet.com

http://ijdd.informaticspublishing.com

1.Kuppusamy Mudaliar, K.N. Siddha Maruthuvam pothu, 7^th edition 2007, Directorate of Indian Medicine and Homeopathy, Chennai-106

2.K.S. Murugesa Mudaliar, Siddha Materia Medica, Directorate of Indian Medicine & Homeopathy, Chennai-106, 2013