The basic concepts of the Siddha medicine are almost similar to Ayurveda. The only difference appears to be that the Siddha medicine recognizes predominance of vatham, pitham and kapam in childhood, adulthood and old age, respectively, whereas in Ayurveda it is totally reversed: kapam is dominant in childhood, vatham in old age and pitham in adults.

As per the Siddha medicine various psychological and physiological functions of the body are attributed to the combination of seven elements:

1. Saram (Digestive juice). Saram means Prana vayu (Oxygen)
responsible for growth, development and nourishment;
2. Cheneer (blood) responsible for nourishing muscles, imparting
color and improving intellect;
3. Ooun (muscle) responsible for shape of the body;
4. Kollzuppu (fatty tissue) responsible for oil balance and lubricating
joints;
5. Enbu (bone) responsible for body structure and posture and
movement;
6. Moolai (Bone marrow- responsible for the production of RBC,
etc).
7. Sukila (semen) responsible for reproduction.

Concept of disease and their cause

When the normal equilibrium of three humors (vatha, pitha and kapha) is disturbed, disease is caused. The factors which affect this equilibrium are environment, climatic conditions, diet, physical activities and stress. Under normal conditions, the ratio between these three humors (vatha, pitha and kapha) is 1:1/2:1/4, respectively. According to the Siddha medicine system diet and life style play a major role not only in health but also in curing diseases. This concept of the Siddha medicine is termed as pathya and apathya, which is essentially a list of do’s and dont’s

Concept of drugs

In Siddha medicine the use of metals and minerals are more predominant in comparison to other Indian traditional medicine systems. In the usage of metals, minerals and other chemicals, this system was far more advanced than Ayurveda. The drugs used by the Siddhars could be classified into three groups:

Mooligai/Thavaram (herbal product),
Thathu (inorganic substances) and
Jeevam or Sangamam (animal products).

In herbal drugs, the Siddhars not only used herbs, but also herbs that grow in high altitudes of Himalayas along with tropical herbs. It is noteworthy that Siddhar Korakkar was the first to introduce Cannabis as a medicine; he used it as a powerful painkiller. They also used animal products as medicine, for example in mental diseases, peranda bhasma is used which is made of human skull bones and the skulls of dogs. In addition to drugs, pranayama and other disciplines of yoga are necessary for good health and longevity.

The Thathu drugs are further classified as:
1. Uppu (Salts) (water-soluble inorganic substances or drugs that
give out vapor when put into fire),
2. Pashanam (Arsenicals) (drugs not dissolved in water but emit
vapor when fired),
3. Loham (Heavy metals) (not dissolved in water but melt when
fired),
4. Rasam (Mercury and its salts) (drugs which are soft) and
5. Ghandhagam (Sulfur alone) (drugs which are insoluble in water,
like sulfur).

Siddhar Nagarjuna introduced the use of mercury and its compounds to the Ayurvedic system in later periods. The use of more metals and chemicals was justified by the fact that to preserve the body from decomposing materials that do not decompose easily should be used. The other reason perhaps was that the south Indian rivers were not perennial and herbs were not available all through the year.

Concept of physician

In Siddha system of medicine a physician should be spiritual and have an in-depth knowledge. According to Theraiyar (a siddha) in his Theriyar Thyla varga churrukama, the physician should have pure thought and action, love for all human beings, a detailed knowledge about geographical seasonal variations, correct physical and mental state and dietary habits. Agasthiyar Sillaraikkovai further adds generosity, patience, untiring hard work, capability of overcoming greed, anger, knowledge about astrology and numerology as the qualities of a physician. He says that a physician should protect his patient like an eyelid, which protects the eyes and care as a mother who cares for her sick child. A physician should not wear colorful dress, nor use silk, leather rope, cosmetics and should always move around in white dress, using only sandal paste as cosmetics. Theraiyar in his Thylavarka churukkam insists that a physician should clean his hands many times and have bath after examining a patient.

Siddha medicine

‘Siddha medicine’ means medicine that is perfect. Nobody knows when it originated. It evolved when the world started from spiritual life. Vishwa Brahma Dutt meditated for 41,000 years. He could then connect and communicate with the elements air, water, ether, earth and fire and also the plants. Subsequent men and women who dedicated their lives into developing the system were called ‘Siddhars’. They compiled the knowledge and left it for the future generations, without even mentioning their names.

The drugs used in Siddha medicine were classified on the basis of five properties: suvai (taste), guna (character), veerya (potency), pirivu (class) and mahimai (action).

According to their mode of application the Siddha medicine could be categorized into two classes:

Internal medicine and
2. External medicine.
• Internal medicine was used through the oral route and further
classified in to 32 categories based on their form, methods of
preparation, shelf life, etc.
• External medicine includes certain forms of drugs and also
certain applications like nasal, eye and ear drops and also certain
procedures like leech application

The internal medicines are 32 in number. They include medicines with short life period to medicines which could be used even for hundreds of years. The metallic preparations that could be preserved and used for longer duration are considered as higher medicines. They act even in very small quantity and are capable of curing chronic illness.

Surasam – These are extracts of leaves, roots, barks, flowers, rhizomes and fruits, etc, which are boiled so that their water content is greatly reduced. Their duration of life is 3 hours. Example: ginger juice surasa.

Charu – They are extracts of leaves, roots, barks, flowers, etc, obtained by grinding them, or obtained by adding some astringent substances or by direct heat application.

Kudineer – These are decoctions prepared by adding water to dry herbs, or fresh ones and the boiling them so that the water content is greatly reduced to 1/16th or 1/8 of the water added. Some times, some substances are not directly added to the water but instead they are kept in a clean white cloth, tied and immersed in the water. They also could be used for 3 hours.

Karkam – These are pastes obtained by grinding wet drugs or by adding water decoctions to dry powders. The kalvam or the pestle and mortar should be cleaned when the drugs are ground in it. It should be ensured that all drugs added to it are properly mixed. Its life period is 3 hours.

Utkalee – The drugs are added to rice either raw or boiled or to Bengal gram flour, ground properly, sugar or jaggery added to it and then boiled so that it is made in to a paste form, where the outer layer is dry and the inner moist.

Adai – Some leaves are added to rice flour and ground properly and baked in hot oven after applying ghee to it. The life period is 3 hours.

Choornam – The dried drugs are taken separately, purified, either by frying or otherwise and made in to fine powders and sieved in fine cloth and mixed with other powder of the drug. The purification of the choornam is made by baking it either in water or in milk. The life period is 3 months.

Pittu – The drugs are made in to fine powder separately; mixed, baked either in water or in milk and then sugar or jaggery is added to it. The life period is 3 months.

Vadagam – The raw drugs are made in to fine powder separately, and then jaggery or palm sugar is added to it and baked in milk-water combination until the milk is completely dried up. Then it is ground when it is hot and made in to small pills. The life period is 3 months.

Vennai – The powder of the raw drugs are heated by adding ghee to it, so that the powder completely melts and mixes with the ghee. This is poured in to a bigger vessel containing water and churned properly, to get butter like substance, life period is 3 months

Manappagu – Some herbal drugs are made in to decoctions separately, or fruits juices are taken and boiled adding sugar or sugar crystals, till an aromatic smell appears, some drugs could also be added at this stage. This is the syrup form of a drug that has a life period of 6 months.

Nei – Some juices or pastes or decoctions of herbs or tubers are added to cow’s ghee and boiled till the drugs completely mix with the ghee and is in the form of the ghee. This process is used to get fat-soluble components of the drugs

Rasayanam – The raw drugs are made in to fine powder, sugar and ghee are added to it and taken in a semi-solid form.

Ilagham – Some decoctions or juices are mixed together, sugar is added to it and boiled in mild fire. When an aromatic smell appears, fine powders are sprinkled in to it. Ghee is added to it and then, honey is added until it is mixed well.

Ennai – although it indicates gingely oil generally, it includes all oily substances of seeds, climbers, barks, tubers, etc. It is classified in to 12 by its origin and five by its mode of application. Life period is 1 year

Mathirai – The raw drugs are ground by adding juices, decoctions, ginger juice or breast milk and made in to small pills according to its dose and dried. Life period is 1 year

Kadughu – The raw drugs are added to oily substances and boiled till mustard like granules appear. The granules are taken in, while the oil is used for external application. The life period is 1 year

Pakkuvam – Drugs like Terminalia chebula are soaked in rice water or water, after it shrinks it is added wither to butter milk or to juices like that of ginger and lemon, and raw drugs are added to it. Life period is 1 year

Thenural – Drugs like ginger, Indian gooseberry, T. chebula are soaked in water, pores are made in it and then soaked either in sugar syrup or honey. The life period is 1 year.

Theeneer – This is the process in which raw drugs are distilled in water or some salts are distilled in specialized distillery pot. Life period is 1 year

Mezhugu – They are of two types:

a. Obtained by grinding drugs.
b. Obtained by heating them by adding oily substances.
a. Obtained by grinding drugs: Mercurial compounds are
ground separately or with other raw drugs adding juices
or honey, in to a semi-solid form.
b. Obtained by heating them by adding oily substances:
Mercurial drugs or pashana drugs are heated by slowly
adding oily substances or juices and made in to a semi-solid
form and then ground well. Life period is 5 years.

Kuzhambu – Some juices or single juice kept in a vessel and raw drugs are added to it in fine powder form, then heated and taken in a semi-liquid form. Life period is 5 years

Pathangam – This is the process of sublimation. Mercurial compounds are made to sublime in specialized pots by keeping them in small container called “Moosai”, over salt and red soil. Life period is 10 years.

Chenduram – Metallic substances or toxic salts are made
into red colored powders, by the process of either burning
them or frying them or exposing to the sunlight or keeping
them in specialized pudas by adding decoctions, cheyaneers,
dravagams, etc. Life period is 75 years.

Neer or Parpam – Loghas, Uparasas or Pashanas are made in to white powders by the puda process, burning them, frying them, blowing them by adding juices, cheyaneers, dravagas, etc. It is to be remembered, the calcination process or the parpa of the gold alone is yellow in color unlike other parpas. Life period is 100 years.

Puda is the process in which the drugs is kept in a shallow earthern plate, and covered by an identical plate. The mouth is closed by clay paste clothes, in seven layers and kept in a pit and cooked using a given number of cow dung cakes.

Kattu – Some pashanas are made in to solid substances which never vaporize or melt or dissolve in water by adding cheyaneer, dravagam, leaf juice, breast milk, honey and binding them. The other process by which it is made solid is by grinding then adding juices or breast milk after they are made in to parpas or chenduras. Its life period is 100 years.

Urukku – Some Loghas or Pashanas after adding synergetic drugs or antagonistic drugs are kept in “Moosai” and blown using natural charcoal fire. Life period is 100 years.

Kalanghu – Mercurial compounds are kept in pudas after burning them with cheyaneer dravagam or juice and blown till they become beads, then gold and zinc are added to it. Life period is 100 years.

Chunnam – Mercury or Pashana or Logha either individually or combined are ground in Kalvas by adding juices, dravagam or cheyaneer dried, kept in moosai, blown and made in to white powders. They become red when turmeric powder is added to it because of the presence of Lime in it (calcium). Life period is 500 years.

Karpam – Some herbal medicines are taken in prescribed doses with specific instructions over a period of time, similarly logha, uparasa preparations are also taken.

Chatthu – Drugs like iron powder, magnetic iron, uparasa are ground well with white yolk of eggs and kept in moosai and blown. Later mercury, gold and sulfur are added to it, and made in to chenduras by burning them.

Gurukuligai – The sublime mercury is made in to beads in its amalgam forms.

Mercury is used in five forms such as rasam (mercury), lingam (red sulfide of mercury), veram (mercury perchloride), pooram (mercury subchloride) and rasa-chinduram (red oxide of mercury). They are known as panchasutha.