Interview with Prof. Dr. K. Kanakavalli, Director General, CCRS

Nearly 8,000 Covid patients cured through Siddha medicine in Tamil Nadu – the recent headline in a recent newspaper probably needs a detailed fact check. But what cannot be ignored is the fact that hundreds of Tamilians, not only in India, but across the world turn to Siddha medicines for their treatment needs. A medicinal practice that is promoted by the Ministry of AYUSH but is still not recognized by the Indian Medical Association and is practiced majorly within a specific ethnic group. Why? We speak to Prof. Dr. K. Kanakavalli, Director General, Central Council for Research in Siddha (CCRS) to understand the growth of Siddha medicinal practice in recent days.

What is Siddha medicinal practice?

Siddha system emphasizes health as the perfect state of physical, psychological, social and spiritual components of a human being as quoted by Siddhar Thirumoolar. The Siddha system of medicine owes its origin to medicinal ideas and practices of a class of Tamil sages called the Siddhars. They had firm faith in the “deathless” physical body being in tune with the spiritual immortal “soul”. Significantly, one of the definitions of Siddha medicine is conquest of death: “that which ensures preventive against mortality”. They were well aware that the physical body is transient, that is, the only instrument by which a person can reach the ultimate goal, to become one with the Lord. So, they found Siddha system of medicine.

The hallmark of Siddha system of medicine is customized tailor-made medicine according to one’s constitution and presenting symptoms. Siddha medicines improve one’s immunity, responsiveness to disease and provided recovery without post viral sequelae. Many modern private hospitals dispensed Siddha decoction/potion as part of hospital diet to willing patients. Such was the strength and impact of Siddha medicine which capitalized the current pandemic through comprehensive approaches mentioned in AYUSH systems. Therefore, the Covid-19 has enabled people to revisit the natural ways for disease prevention (defence) and to enhance one’s immunity.

Even in India the practice of Siddha is heavily concentrated only in the state of Tamil Nadu. Despite AYUSH ministry bringing the Siddha medicinal practice under its fold, Indian Medical Association has refused to recognize the Siddha system of Medicine. Are the internal differences preventing the growth of the medicinal field?

The need of the hour is integration of medical systems rather than highlighting the differences especially during this global healthcare crisis. Even though, south India is the hub for Siddha medicine, this system of Medicine is popular among Tamil-speaking people in all parts of the globe especially in South-East Asian countries – Sri Lanka, Malaysia, Singapore, Mauritius, etc. As on date, neither a vaccine nor medicine from modern medicine is available as a sure cure for Covid-19. However, the Covid-19 pandemic has created a platform to look for solutions from Siddha system of Medicine. It is pertinent to mention that recognition of Siddha Medicine is not under the purview of Indian Medical association. The best of each system should be integrated for the betterment of the health of mankind.

Since 2014, the Ministry of AYUSH has taken major initiatives to uphold the spirit of Siddha system by

(i) developing research through the establishment of Central Council for Research in Siddha (CCRS) and its peripheral institutes/units in many parts of the Country i.e., Kerala, New Delhi, Karnataka, Andhra Pradesh and Goa (to be commissioned shortly)

(ii) developing Siddha education by establishing and supporting Siddha educational institutions like National Institute of Siddha (NIS)

(iii) rendering medical service to the public through NRHM (National Rural Health Mission) by posting many Siddha Physicians in the rural parts of Tamil Nadu, Puducherry and Kerala and

(iv) creating a widespread awareness by propagating it through Arogya Health Melas organized in various parts of our country.

(v) Swasthya Raksha Programme (SRP) launched by the AYUSH Ministry to promote health awareness and hygiene through medical camps in villages.

(vi) National AYUSH Mission (NAM) with a vision to (a) provide cost effective and equitable AYUSH health care throughout the country by improving access to the services. (b) To revitalize and strengthen the AYUSH systems making them as prominent medical streams in addressing the health care of the society. (c) To improve educational institutions capable of imparting quality AYUSH education. (d) To promote the adoption of Quality standards of AYUSH drugs and making available the sustained supply of AYUSH raw-materials.

How much of these ancient texts are digitally transcribed? Are there researches done to test the efficacy against modern day diseases?

The Traditional Knowledge Digital Library (TKDL) is a database currently containing codified/published literature from Indian Systems of Medicine. TKDL contains more than 3.6 lakh formulations from the texts of traditional medicine systems of India including Ayurveda, Unani and Siddha. To protect traditional knowledge from bio-piracy, this database can be accessed by patent examiners at International Patent Offices for patent search and examination.The authoritative books in Siddha system of Medicine are mentioned in the Schedule – I of the Drugs and Cosmetics act 1940 and rules 1945. Further, steps are being taken to add more books to this list as Siddha literature is vast and extensive.

The research programme of CCRS mainly focuses on clinical research including safety and efficacy studies of Siddha drugs, validation of the fundamental principles, drug standardization and quality control, survey and cultivation of medicinal plants and literary research. The clinical research programme of the council mainly aims at validation of the therapeutic efficacy of Siddha medicines and therapies. Some research findings are mentioned hereunder
The trial on psoriasis conducted at SCRI, Chennai, with 777 oil, gained much reputation for Siddha and proved a highly appreciable and effective remedy for psoriasis. Among the 3542 cases prospectively continued in the trial, 1609 patients showed a good response and 1200 patients showed a fair response. PASI (Psoriasis Assessment and Severity Index) is the measurable index. The period of remission before relapse was extended. The symptoms recorded during the recurrence were very mild when compared with those at the onset. The drug was patented through the National Research Development Corporation (NRDC).

Moreover, a clinical trial on breast cancer with coded formulations was conducted and the study outcome showed reduction in pain, growth, and size of malignant ulcers. There was also a reduction in the foul smelling discharge and bleeding in cases of cervical cancer. There was a noticeable increase in the body weight in stage I and stage II of cancer. The overall wellbeing of the patients was maintained.The outcome of the clinical trial on D5 Chooranam (Siddha coded polyherbal formulation) for Diabetes Mellitus enabled to file a patent. This product has been introduced in the OPDsof peripheral institute/units of CCRS and steps are being taken for its commercialization.
A module for Varmam treatment has been developed by CCRS and provided to Govt. of Malaysia in order to establish and propagate the specialty therapies in Siddha system of medicine in Malaysia, which is having a considerable Indian population especially Tamils. A Siddha medical centre has been opened in Sungoi Buloh Government Hospital in Malaysia with an expert sponsored by Government of India. This is the sign of growing visibility and demand of the Siddha system abroad.

We often hear against the Siddha medicinal practice is its use of heavy metals in medicines. How safe is that?

Siddhars (Siddha doctors) have used minerals mostly in chronic conditions and as life saving agents. A proper purification process and strict adherence to the Standard Operating Procedure (SOP) laid down by Siddhars in preparing the medicine, correct dosage, adjuvant and duration of administration will ensure safety of Siddha formulations. Thus, perfectly processed drugs can be safely used as therapeutic agents.By these methods, the active principles therein are modified into therapeutic potential and non-toxic. The standard pharmacopeial guidelines are crystal clear and enable those trained to master the preparation methods of Siddha formulations.

How have the Siddha practitioners reacted to COVID-19 pandemic? Have they been able to learn from the situation or contribute to it?

Even Prior to Covid-19, Siddha medicine has been found useful to mitigate the epidemic outbreaks of viral fevers like Chikungunya, Dengue and Bird flu, where the efficacy of the Siddha drugs were evaluated in research laboratories as well as the clinical centres and the findings led to administration of these Siddha drugs along with allopathy drugs in all the Government hospitals. For the management of COVID-19, Siddhars have recommended certain basic lifestyle guidelines – preventive measures that help to prevent diseases. Rejuvenating procedures known as Kaya Karpam increase our immunity. Siddha intervention activates physiological processes that influence metabolic and immunological status and offers palliative care even for patients with comorbidities. Therefore, Siddha medicine showed promising efficiency in combating COVID-19.

The symptomology of Covid-19 can be correlated to KabhaSuram including specific symptoms such as loss of taste mentioned in the Siddha classics.
A Guidelines for Siddha practitioners was published by Ministry of AYUSH for the management of Covid-19. In this regard, the Interdisciplinary AYUSH Research and Development task force was established who further provided the framework and protocol to conduct three types of studies:

(1) Population health study – Observation of people’s social behaviour patterns regarding the Immune boosting measures of AYUSH/ Siddha system of Medicine through AYUSH Sanjivani app.

(2) Prophylactic intervention study on healthcare workers, people at Quarantine and Isolation facilities and (3) Add-on therapy on COVID-19 patients.

Recently, a campaign on “AYUSH for Immunity” has been launched by the Ministry of AYUSH. With the aim to create awareness about various AYUSH-based solutions and their efficacy in enhancing immunity and preventing diseases, the campaign was rolled out during a webinar with over 50 thousand participants and was streamed onthe ministry’s new digital communication platform AYUSH Virtual Convention Centre(AVCC)
Prior to population based studies, in-silico studies and in-vitro studies of Kabasura Kudineer (KSK) exhibited high affinity for binding with SARS-COV2 protein spike and showed significant activity more or less to inhibit virus replication similar to standard drug Remdesivir. Immuno-modulatory, thrombolytic and anti – viral activity of KSK has been established.
The interim results of prophylactic study entitled “a prospective Non-randomized Open label Controlled Interventional study on the effect of Siddha intervention – Kabasura Kudineer (KSK) as a Prophylactic measure among high risk population (Health Care Workers / Containment Zone population) exposed to COVID-19 (SIDDHALION)” reveals a positive trend, which will be published in a peer reviewed journal.

The preliminary results conducted at Govt. Stanley Medical College, Chennai in 2 groups with 30 subjects each comparing Siddha intervention and vitamin C, zinc supplementation are promising and the manuscript has been communicated to the Project Monitoring Unit for COVID-19 studies, Ministry of AYUSH for approval before submitting it to the peer reviewed journal. Many more studies are being carried out in CCRS, Government Institute of Medical Sciences, Noida, Sri Ramachandra Deemed University, Chennai and Govt. Medical College, Theni and so on.

Effective functioning of Siddha Covid Care Centres (SCCC) and its outcomes in successfully treating more than 8000 patients as on 10 th September, 2020 with no mortality has created an impact in the state of Tamil Nadu. The successful model developed in Chennai has been replicated in other parts of Tamil Nadu and so far 28 exclusive Siddha Covid Care Centres (CCC) are providing holistic in-patient care at free of cost to Covid-19 positive patients. Siddha system is gaining unabated popularity among the masses, which has given a major boost to Siddha system of medicine that will help to mitigate this pandemic in an integrative manner.

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