Kalleeral Noi (Liver Disease)

Kalleeral Noi (Liver Disease)

Introduction

Liver is an important organ actively involved in many metabolic functions. So it is also a frequent target for a number of toxicants. The liver is the key organ regulating homeostasis in the body. It is involved with almost all the biochemical pathways related to growth, immunity, supply of nutrients, production of energy and reproduction. Liver diseases are one of the major causes of mortality and morbidity all over the world. In Siddha system there are enormous medicinal plants as well as medicinal preparations which are used for treating liver diseases. Many medicinal plants mentioned in siddha texts have also been found to possess effective hepato protector activity in recent studies. A siddha text called Agathiyar gunavagadam explains about liver diseases in the heading of “Kalleeral Noigal”.

Siddha concept

Liver disease according to siddha system is defined as the enlargement of liver below the last rib bone producing symptoms like loss of taste and appetite, indigestion, nausea and vomiting, shrinking of skin and visible bones in face, wasting of the limbs and abdominal distension day by day, intermittent fever etc. On the whole, liver diseases are classified in to three types depending upon the humour that is dominant in the disease whose clinical features are given below.

1.      Vali kalleral Noi: Fever, loss of weight day by day, loss of body vigour, distension of abdomen, enlargement of lymph nodes and in course of time makes confined to bed. In advanced stage leads to body turning pale due to decreased blood volume and swelling / oedema in limbs and abdomen.

2.      Azhal kalleral Noi: Due to the loss of function of liver body turns yellow, loss of taste, vomiting, swelling in limbs, body turning pale because of decreased blood constituents followed by ascites.

3.      Iya kalleral noi : Abnormal swelling of the liver and hard in consistency on palpation, high fever, severe vomiting, head ache, diarrhoea, red urine in decreased volume, jaundice, swelling of the body and body turning pale.

Of the above vali and Iyam types are said to be incurable or of poor prognosis.

Cause and Pathology

Excessive intake of food, intake of food substances which are not suitable for the body, alcohol intoxication, diseases that occur because of sexual indulgence (sexually transmitted diseases) and fever (infection) are some of the causes that are mentioned in siddha texts. In addition to life style and environmental causes, genetic (karma vinai) reason is also given in some texts.

According to siddha principles the main humour that gets affected is pitham. As mentioned in the classification above, along with the increased azhal/ pitham, other humours also get increased and result in different types of liver diseases. The affected pitham humour causes affection in the first two physical constituents (Udal thathukal) namely saram (nourishing juice) and kuruthi (blood). This leads to depletion of body tissues, diarrhoea, vomiting and obstruction to the passage of pithu neer (bile) in its natural way. Along with this keezhnokku kal and melnokku kal (types of vatham) are deranged leading to the affection of the function of the organs associated with them and thereby producing the relevant signs and symptoms of the disease.

Management and prevention

The line of treatment is normalizing the vitiated humour pitham and the associated vayus and then treating with suitable medicines to repair the damaged physical constituents. Commonly advocated emetic for normalizing pitham is papaya juice with mustard seeds in warm water.

Some medicinal plants which do have the action of kalleeral thetri (liver tonic)

Ø  keezhanelli (Phyllanthus amarus)

Ø  Karisalai(Eclipta alba)

Ø  Manjal (Curcuma longa)

Ø  Athimadhuram (Glycirrhiza glabra)

Ø  Kadugurohini (Picrorrhiza kurroa)

Ø  Seenthil (Tinospora cordifolia)

Ø  Kadukkai (Terminalia chebula)

Ø  Nerunjil (Tribulus terrestris)

Ø  Thandrikkai (Terminalia bellerica)

Ø  Katrazhai (Aloe vera)

Ø  Aamanakku (Ricinus communis)

Ø  Jeeragam (Cuminum cyminum)

Ø  Chukku(Zingiber officinale)

Some Hepatoprotective Herbs in Siddha system of Medicine

Keezhanelli (Phyllanthus amarus) is an outstanding drug used in Jaundice in siddha system of medicine. Recent studies reveals that chemical component of this plant, inhibits DNA- polymerase activity in Virus (which is responsible for speedy replication of virus) and consequently protects liver from further damage by reducing viral load and cures jaundice. Keezhanelli is also found to produce better results in Hepatitis B and Hepatitis C viral infections if given with butter milk.

Few medicinal preparations…

 Karisalai (Eclipta alba) karkkam, Aya jambeera karpam, Annabedi chenduram, Ayakantha chenduram, Ayabringaraja karpam, Nerunjil (Tribulus terrestris) kudineer and Vedi annabedi chenduram, Vediuppu chunnam and preparations like Mandoorathi adai kudineer, Loga Mandooram, and Sarakkondrai puli patru are found to reduce the size of enlarged liver. Adhathodai (Adathoda vasica), Imbooral (Oldenlandia umbellate), Mathulai odu(Punica granatum) preparations, Naga parpam, Padigalinga chenduram, Papaya leaf juice, Aruvatha (Rutea graveolens), Poovarasilai(Thespesia populnea) karkkam, Aamanakkilai (Ricinus communis) karkkam, Pidangunaari (Premna tomentosa) kudineer are some of simple Siddha preparations found to be efficacious in treating liver diseases by repairing the affected udal thathukkal (physical constituents).

Besides herbs and minerals animal sources like Nathai (snails), Nandu (crabs) are also used as main ingredients in medicinal preparations for liver problems.

Diet & preventive measures

1.      Take easily digestible food items. It is advised to take two times boiled rice while on treatment.

2.      Plenty of vegetables, fruits and green leaves to be added in diet.

3.      Smoking, alcohol, tobacco derivatives etc. strictly to be avoided

4.      Regular exercise and daily practices of yoga- dhyana- pranayama are valuable.

References:

http://siddhaglobal.blogspot.in

1.      Parthiban.P, Ramalingam.S, Saranya.K, Thangaraj, Kanakavalli.K and Thillaivanan.S, A REVIEW ON HEPATOPROTECTIVE HERBS IN SIDDHA SYSTEM OF MEDICINE, International Journal of Pharmaceutical Archive- 3 (9), Sept. – 2014.

2.      Kuppusamy Mudaliar K.N, Mookadaipu, Siddha Maruthuvam, Tamil Nadu Siddha Maruthuva variyam, 1987:317-323