Guidelines for Siddha Practitioners for COVID-19

PREVENTIVE CARE:

Common Advisory:

•  Drinking water- Herbal water infusion made up of half teaspoon of Chukku (Dried Ginger) / boiled in two liters of water can be used as drinking water.
•  Inji thenooral / Inji (Ginger) Tea / Adhimaduram (Licorice) tea may be taken as hot beverages.
•  Avoiding Milk at bedtime is advisable if needed for children to add a quarter teaspoonful of Manjal (Turmeric) with Milagu (Pepper).
•  Steam inhalation – With Tulasi/ Nochi (Vitex negundo) leaves / Manjal (Turmeric) Ÿ Gargling – water boiled with a pinch of Salt and Turmeric should be used not less than 3 times 
•  All karappan pandam (allergic foodstuff) should be avoided in the diet.
•  Diet may include Nandu kanji (Crab soup), Pancha mudichi kanji (5-grain gruel) and Irumurai vadittha kanji (double-cooked gruel).
•  Environmental sanitation - Neem leaves fumigation is advocated.

ANTI VIRALS:

Anti-viral Siddha Formulations:

•  Kaba Sura Kudineer - 60 ml twice a day after food
•  NilaVembu Kudineer– 60 ml twice a day after food
•  Visha Sura Kudineer- 60 ml Twice a day after food
•  Pavala Parpam -100 mg twice a day with Honey
•  Velli parpam - 50 to 100 mg twice a day with Honey
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Anti-Viral Siddha Herbs:

•  Inji (Zingiber officinale): Injisurasam– 10 ml Once a day
•  Thulasi (Ocimum sanctum): Thulasi Kudineer– 60 ml Twice a day
•  Milaku (Piper nigrum): With Thulasi as Kudineer said above
•  Karunjeerakam (Nigella sativa): Karunjeeraka Chooranam1gm BD
•  Keezhanelli (Phyllanthus niruri): Keezhanellisamoolam– 2gm Twice a day
•  Athimadhuram (Glycyrrhiza glabra): Athimadhura Chooranam- 1 gm BD
•  Vellaipoondu (Allium sativum): Poonduthaen
•  Cittra mutti (Sidacordifolia): Cittramutti Kudineer-30 ml Twice a day
•  Seenthil (Tinospora cordifolia): Seenthil Chooranam– 1gm Twice a day
•  Manjal (Curcuma longa) Ÿ Elumitchai (Citrus limonia) Volatile oil
•  Vembu (Azadirachtaindica)

Note: Antiviral activity of the above mentioned drugs and formulations against COVID 19 is not established and not being claimed.

IMMUNITY ENHANCERS SPECIFIC TO RESPIRATORY CARE:

Details of Siddha Medicines for Boosting Immunity:

S. No.	Immunity Enhancer	Usage	Remarks
1.	Karpam – Korai Kizhangukarpam Thoothuvelai Karpam	With sugar	Internal
2.	Vatral – Kovaikkaivatral Manathakkalivatral Nellivatral	As fryums	It can be taken along with regular food.
3.	Vadagam Inji Vadagam	1-2 tablets, with water, thrice a day.	Internal
4.	Adai – Mumumusukkaiadai	Leaves grind with boiled rice flour.	Internal
5.	Others -
6.	Seenthil Chooranam	1-2 gm, with ghee, twice a day.	Internal
7.	Thiripala Chooranam	1-3 gm, with honey, ghee or hot water, twice a day.	Internal
8.	Vallarai Choorana Mathirai	2-4 tablets, with hot water, twice a day.	Internal
9.	Urai Mathirai	50 mg (Depend upon the age group)	Internal for children
10.	Amukkara Chooranam	1-2 gm, with honey, hot water or milk, twice a day.	Internal
11.	Nellikaillagam	2-4 gm, twice a day.	Internal
12.	Ennai Muzhukku – Thulasithailakarpam	Oil Bath	External

DETAILS FOR VARMAM POINTS STIMULATED FOR BOOSTING IMMUNITY:

Varmam	Point	Finger Selection	Procedure	Duration
Vilangu Varmam	A dimple at the lateral end of the clavicle	Middle three fingers.	Place the tip of the middle three fingers over the varmam point and do a clockwise rotation	30 sec
Ullangaal Vellai Varmam	At the junction of the big and second toe in the plantar region.	Both thethumbs (Central part (pulp) of the thumb).	Place the Central part (pulp) of the thumb over the Varmam point and then press and release (both sides).	30 sec
Nadi Soothira Varmam	Four finger breadths above the wrist joint (radial aspect).	Both the thumb (Medial 1⁄4 part of the thumb).	Place the middle of the thumb (palmar aspect) over the Varmam point; press and release.	30 sec
Savvu Varmam	Four finger breadths distal from the shoulder joint on the medial side of the upper arm.	Both the thumb (Medial 1⁄4 part of the thumb).	Place the middle of the thumb (palmar aspect) over the Varmam point; press and release.	30 sec

SYMPTOM SPECIFIC APPROAH IN COVID-19

Interventions for Preventive Category:

Prevention for Fever and Respiratory Illness
Interventions	Dose Recommendations as per Age Group									Direction of Use	Remarks
	Pediatric (<12 years)			Adolescents (13-18 years)			Adults (19-65 years)		Geriatric Age Group (>65 years)
	< 5 years	5-12 years
Nilavembu Kudineer / Kaba SuraKudineer	5ml		10ml		30ml	60-90ml		60ml		Twice a day	After food
Seenthil Chooranam	200mg		500mg		1g	1-2g		1-2g		Honey/Twice a day	After food
NellikkaiIlagam	1-2g		3g		5g	5-10g		5g		Twice a day	After food

Interventions for Mild and Moderate Symptoms:

Symptom

Interventions for Mild and Moderate Symptoms

Interventions

Dose Recommendations as per Age Group

Direction of Use

Remarks

Pediatric (<12 years)

Adolescents (13-18 years)

Adults (19-65 years)

Geriatric Age Group (>65 years)

< 5 years

5-12 years

Cough

Kaba Sura Kudineer

5ml

10ml

30ml

60-90ml

60ml

Twice a day

After food

AdathodaiMana pagu

2ml

5ml

10ml

10-20ml

10-15ml

Warm Water

After food

NellikkaiIlagam

1-2g

3g

5g

5-10g

5g

Twice a day

After food

VasanthaKusum akaram

-

1 nos

1nos

1-2nos

1nos

Twice a day

After food

Sore Throat

ThalisathiVadag am

1/4nos

1/2nos

1/2nos

1nos

1nos

Twice a day

After food

Kaba Sura Kudineer

5ml

10ml

30ml

60-90ml

60ml

Twice a day

After food

AdathodaiNei

1ml

5ml

10ml

10-15ml

5-10ml

Twice a day

After food

High Fever

NilaVembu / Kaba Sura Kudineer

5ml

10ml

30ml

60-90ml

60ml

Twice a day

After food

BramanandaBair avam

-

1nos

1nos

1-2nos

1nos

Twice a day

After food

AdathodaiMana pagu

2ml

5ml

10ml

10-20ml

10-15ml

Warm Water/BD

After food

Thirithoda Mathirai

-

1nos

1nos

1-2nos

1nos

Twice a day

After food

Difficulty in Breathing

NilaVembu / Kaba Sura Kudineer

5ml

10ml

30ml

60-90ml

60ml

Twice a day

After food

Seenthil Chooranam

200mg

500mg

1gm

1-2gm

1-2gm

Honey/twice a day

After food

PachaiKarpoora Mathirai

-

1/2nos

1nos

1-2nos

1nos

Honey/Only in the morning

After food

SwasaKudori Mathirai

-

1/2nos

1nos

1-2nos

1nos

Honey/Only in the morning

After food

ThippiliRasayanam

200mg

500mg

1gm

1gm

1gm

Twice a day

After food

External Therapy:

• Neerkovai Mathirai for headache.
• Fomentation - betel leaf over the chest

Nasiyam:

• Thumbai poo, Thulasi leave juice for Sore throat, Nasal obstruction

Pugai:

• Kandangathiri Pugai
• Manjal Kombu Pugai for rhinitis, nasal obstruction

Varmam:

• Thivalai Kalam, Adapa Kalam, Kavuli Kalam, Mudichu Varmam, Sakthi Varmam, and other energizing Varmam points for immune enhancing, fever and respiratory illness.

Rationale:

In Siddha System, the Diseases are raised based on the derangement of Mukkutram. Usually, Thottru Noigal (communicable diseases) associated with Aiya kutram (Respiratory related Illness), are gets affected due to its Sthiram gunam (stability factor). In Guru Naadiquoted, Thottru Noigal generally caused by Kirumi(Pathogens). The symptoms are due to Noiyinan vanmai (Immunity of individual), if it is good, he/she will not be affected. So, the Medicines are used to neutralize the Aiya kutram.

General Measures for Control of Fever and Respiratory Illness:

General hygiene & sanitation measures are to be continued.

Padigara Neer for Handwash.

Turmeric water washes for sanitizing hands and legs.

Environmental sanitation:

Fumigation of the house every evening with Kungiliyam (Shorea robusta), Sambrani (Styrax benzoin), Manjal (Curcuma longa), Vembu (Azadirachtaindica) are advocated.

Isolation & Quarantine of elderly people who are vulnerable:

• Stress management is very essential among the subjects under isolation / quarantine.
• The Yogam practices such as Naadi sutthi Pranayamam as given in Thirumoolar Thirumanthiram. Literature will help to increase the elasticity of bronchioles as well as rejuvenate the lung tissues.
• Pranayamam, Naadi suthi pranayamam, Suriya namaskaram, Savasanam, Makarasanam, Meenasanam, Artha meenasanam.

Varmam:

• Thivalai Kalam, Adapa Kalam, Kavuli Kalam, Mudichu Varmam, Sakthi Varmam, and other energizing Varmam points are advised for self-stimulation.
• Coarse powder of coriander seeds with palm jiggery made as a decoction and can be taken in the morning.
• Take 500 mg of powdered Amukkara with milk or Hotwater.
• Advised to take oil bath twice a week with medicated oils like Karisalai Thailam, Santhanathy Thailam.

Diet Advisory:

• Foods can be easily digestible should be advocated.
• Plenty of Boiled Water Intake
• Take lemon juice daily Ÿ Barley gruel, Panchamutti kanji gruel, Raggi gruel.
• Rasam with pepper and jeera, star anise and cinnamon, Ginger and Garlic
• Daily green smoothie like Avaraipinju (Broad beans), KathaiPinju (Brinjal), Murungai (Moringa Leaves)to improve prebiotics in Gut and for detoxification
• As above with diet for co-morbidities, like Low Glycemic index and Low Glycemic diet

BIBLIOGRAPHY:

• 1. https://www.thehindu.com/news/national/india-coronavirus-lockdown-april-3- 2020-live-updates/article31243605.ece Ÿ https://www.covid19india.org/
• T.V.Sambasivam Pillai,1991, Directorate of Indian Medicine & Homeopathy, Chennai, Dictionary of Medicine, Chemistry, Botany and Allied Science ,Vol 2, 1724.
• Smith KB, Locklear HW. Ginger Root and its Benefits.
• 2. Widyaningsih TD, Siska AI, Fanani R, Martati E. Traditional drink of black cincau (Mesonapalustris BL)-based wedanguwuh as immunomodulator on alloxan-induced diabetic rats. Nutrition & Food Science. 2020 Feb 20.
• 3. Balasubramanian S, Roselin P, Singh KK, Zachariah J, Saxena SN. Postharvest processing and benefits of black pepper, coriander, cinnamon, fenugreek, and turmeric spices. Critical reviews in food science and nutrition. 2016 Jul 26;56(10):1585-607.
• 4. Maurya H, Rao V. The Favorable Role of Alkaloids from Vitex negundo in the Management of Human Ailments.
• Saxena RC. Practical applications of neem against pests of stored products. In Annual International Research Conference on Methyl Bromide Alternatives and Emissions Reductions, Orlando, Florida, USA 2009 (pp. 110-114).
• 5. Jain J, Kumar A, Narayanan V, Ramaswamy RS, Sathiyarajeswaran P, Shree Devi MS, Kannan M, Sunil S; Antiviral activity of ethanolic extract of Nilavembu Kudineer against dengue and chikungunya virus through in vitro evaluation. J Ayurveda Integr Med. 2019 Jan 23. pii: S0975-9476(18)30073-1. doi: 10.1016/j.jaim.2018.05.006.
• Shailaja et.al. A Review on Poly herbal Formulation — Visha Sura Kudineer Chooranam — A Classical Anti —Viral Used in Siddha System, European Journal of Pharmaceutical and Medical Research, 2017, 4 (9)184-192.
• 6. Moghadamtousi SZ, Nikzad S, Kadir HA, Abubakar S, Zandi K. Potential antiviral agents from marine fungi: an overview. Marine drugs. 2015 Jul;13(7):4520-38
• Mori Y, Ono T, Miyahira Y, Nguyen VQ, Matsui T, Ishihara M. Antiviral activity of silver nanoparticle/chitosan composites against H1N1 influenza A virus. Nanoscale research letters. 2013 Dec 1;8(1):93.
• 7. Vitiello, M.; Galdiero, M.; Galdiero, M. Inhibition of viral-induced membrane fusion by peptides. Protein Pept. Lett. 2009, 16, 786–793.
• 8. Galdiero S, Falanga A, Vitiello M, Cantisani M, Marra V, Galdiero M. Silver nanoparticles as potential antiviral agents. Molecules. 2011 Oct;16(10):8894-918. BIBLIOGRAPHY
• Chang JS1, Wang KC, Yeh CF, Shieh DE, Chiang LC; Fresh ginger (Zingiber officinale) has anti[1]viral activity against human respiratory syncytial virus in human respiratory tract cell lines.J Ethnopharmacol. 2013 Jan 9;145(1):146-51. doi: 10.1016/j.jep.2012.10.043. Ÿ G. JOSHI, S. SHARMA, J. ACHARYA, M. PARIDA;ASSESSMENT OF IN VITRO ANTIVIRAL ACTIVITY OF Ocimum sanctum (TULSI) AGAINST PANDEMIC SWINE FLU H1N1 VIRUS INFECTION; World Research Journal of Antimicrobial Agents, 3 (1), 62-67.
• CE Mair, R Liu, AG Atanasov, M Schmidtke, VM Dirsch, JM Rollinger; Antiviral and anti[1]proliferative in vitro activities of piperamides from black pepper; Planta Med 2016; 82(S 01):S1- S381DOI: 10.1055/s-0036-1596830
• 9. Umar, S., Tanveer Munir, M., Subhan, S., Azam, T., un Nisa, Q., Irfan Khan, M., Umar, W., ur Rehman, Z., Sattar Saqib, A., Ali Shah, M., Protective and antiviral activities of Nigella sativa against avian influenza (H9N2) in turkeys, Journal of the Saudi Society of Agricultural Sciences (2016), doi: http://dx.doi.org/ 10.1016/j.jssas.2016.09.004
• Sau Har Lee, Yin Quan Tang, Anusyah Rathkrishnan, Seok Mui Wang, Kien Chai Ong, Rishya Manikam, Bobby Joe Payne, InduBala Jaganath & Shamala Devi Sekaran ; Effects of cocktail of four local Malaysian medicinal plants (Phyllanthus spp.) against dengue virus 2; BMC Complementary and Alternative Medicine volume 13, Article number: 192 (2013)
• Fiore C, Eisenhut M, Krausse R, Ragazzi E, Pellati D, Armanini D, Bielenberg J. Antiviral effects of Glycyrrhiza species; Phytother Res. 2008 Feb;22(2):141-8.
• Mehrbod P1, Amini E1, Tavassoti-Kheiri M1 Antiviral Activity of Garlic Extract on Influenza Virus Iranian Journal of Virology 2009;3(1): 19-23 ©2009, Iranian Society for Virology ; Availablefrom: https://www.researchgate.net/publication/287841390_Antiviral_activity_of_garlic_ex tract_on_Influenza_virus [accessed Apr 04 2020].
• 10. Investigation of Antiviral Properties of Medicinal Plant Extracts Research Scholar: Wadhwani Ashish Devidas Guide: Dr. P. Vijayan Department: Pharmaceutical Biotechnology College: JSS College of Pharmacy, Ootacamund University: JSS University, Mysore; https://shodhganga.inflibnet.ac.in/bitstream/10603/30854/13/13_summary & conclusion. pdf
• 11. Chetan B, Nakum A. (2010) Use of natural compounds, chitin and tinosporin for the treatment of the targeted viruses (retroviruses) (HIV-1, HIV-2) all subgroups, HTLV and other viral disease. Indian patent Appl. IN 2010MU01350 A 20100730.
• 12. M Ichsyani, A Ridhanya, M Risanti, H Desti, R Ceria, D H Putri, T M Sudiro and B E Dewi; Antiviral effects of Curcuma longa L. against dengue virus in vitro and in vivo; IOP Conf. Series: Earth and Environmental Science 101 (2017) 012005 doi:10.1088/1755-1315/101/1/012005
• 13. Battistini R, Rossini I, Ercolini C, Goria M, Callipo MR, Maurella C, Pavoni E, Serracca L; Antiviral Activity of Essential Oils Against Hepatitis A Virus in Soft Fruits. Food Environ Virol. 2019 Mar;11(1):90-95. doi: 10.1007/s12560-019-09367-3. Epub 2019 Jan 25.
• 14. Badam L, Joshi SP, BedekarSS.'In vitro' antiviral activity of neem (Azadirachtaindica. A. Juss) leaf extract against group B coxsackie viruses. J Commun Dis. 1999 Jun;31(2):79-90.