Pakkavatham (Hemiplegia)

Pakkavatham (Hemiplegia)

Introduction:

Hemiplegia is a condition where one side of the body is paralysed. It can affect either side of the body. It is caused by damage to the brain, such as a stroke that is localized to the cerebral hemisphere opposite to the side of weakness.  

 SIDDHA CONCEPT

In siddha system this is defined as a disease which affects the functions of arms, legs, fingers, tongue, mouth and eyes. The early symptoms that manifest are given as heaviness of body, constipation, irritable mood, rapid pulse and fainting.

The common signs and symptoms associated with this disease are sudden fainting followed by paralysis of one side of the body. Sometimes facial deviation and drooping of eye lid may also be present on one side. Loss of speech and dripping of saliva can also be seen. In some cases numbenesss in foot and legs, difficulty in walking are present before the manifestation of usual symptoms.

In children if it occurs it is known as ‘ilampilai vatham’.

CAUSE AND PATHOLOGY

The cause of this disease is attributed to factors such as excessive intake of foods which causes an increase in the level of vatham humour, alcoholic beverages and excessive rage. The vatham humour thus increased, in association with pitham and kabam, stimulates keezh nokku kal, mel nokku kal, paravu kal and nadukal (which are different types of vatham) which affects the organs, they are related to as follows.

The nadi nadai (pulse reading) of the patients affected by this disease is stated as Kabam with vatham.

Some forms of this disease are mentioned to show poor prognosis in siddha literatures. The conditions if present tend to have poor prognosis.

1.      Right side paralysis in males and left side in females.

2.      Loss of speech

3.      Wasting of affected side

4.      Seizures

5.      Tremors

6.      Sensory loss

7.      Oedema

MANAGEMENT AND PREVENTION

The dominant deranged humour in this disease is vatham and it should be normalized first. This is done by purgation. Then oral medicines which normalize vatham as well as repair the damaged tissues and physical constituents (Udal thathukkal) are given. Then external therapies like Kizhi (medicated bundle), ottradam (medictated fomentation), thattuthal (patting) in proper methods as described by a siddhar called Theran in his texts are followed. These external therapies help to reduce the pain, swelling, stiffness, spasms gradually which in turn reduces the weakness, wasting and loss of functions of the affected part.

Some preparations used for purgation are Vatha nasa thylam, Kazharchi thylam,Meganatha ennai, Vatha kesarithylam, Sithathi ennai etc. The dose is based on the severity of the disease and condition of the patient.

Oral medicines commonly include one of these from Van mezhugu, Rasaganthi mezhugu, Veera mezhugu, Nanthi mai, Pancha sootha mezhugu, Nava uppu mezhugu, Idivallathi mezhugu, Chitthiravallathi along with suitable   the dose is calculated taking in to account the severity of the disease and health condition of the patient. All these medicines are advised to be taken with suitable anubanam / thunai marunthu (vehicle/co drug).

Oils that are used for massaging and external therapies include Mezhugu thylam, Erukkampal ennai, Saranaikalli ennai, Vathakesari thylam etc.

Kizhi (medicated bundle) made from leaves of one of these like nochi (vitex negundo), thazhuthalai (Clerodendrum phlomoidis), vathanarayanan (Delonix elata) is dipped in warm oil and fomentation is done on the affected part.

To restore the impaired movements of the tongue, a special preparation called anda thylam is applied over the tongue which has been found effective.  

Diet:

Food that helps in mitigation of vatham (Vali) humour like two times drained cooked rice, young fruit of brinjal, beans and fig, goat’s meat, kadai (quail), kowthari (partridge), udumbu (Iguana) and leaves of mudakkaruthan (Cardiospermum Halicacabum), arukirai (Amarantus tristis), ponnankaanni (Alternanthera sessilis), thuthuvelai (Solanum trilobatum),mookiratai (Boerhaavia diffusa) are advised. If Iyam (kabam) is also present with vatham, leaves of thumbai (Leuces aspera) and karisalai (Eclipta alba) are advised. Only thuvaram paruppu (red gram) is advisable in cereals and pulses.

Surai (bottle gourd), vellari (cucumber), pudalai (snake gourd), peerku (ridge gourd) as well as mustard seed should be avoided.

Prevention is by avoiding the factors which cause the accumulation of vatham humour including food habits and lifestyle.

Reference:

Kuppusamy Mudaliar K.N, Kuruthiazhal, Siddha Maruthuvam, Tamil Nadu Siddha Maruthuva variyam, 1987:201-210.