A Study on Siddha Diagnostic Methodology and Symptomatology of Ennavagai Thervu for "Pen Maladu”

Observational study on the Siddha diagnostic method and symptomatology of Envagai thervu for Pen Maladuwas carried out in Outpatient Department, Post Graduate of Noi Naadal at Government Siddha Medical College and Hospital, Palyamkottai, Tirunelveli. Non - randomised convenient sampling method was followed in 19-45 age group. 40 married female patients were selected under inclusion criteria from the OPD. Data was collected from patients with the help of proforma designed based on gynaecological case sheet from the textbook of Siddha Maruthuva Magapertriyalum Magalir Maruthuvamum. Assessing Ennvagai thervu and assessment of clinical featureswere followed in collecting data from patients. The results obtained from the study are summarized as follows, 1. Among 40 patients 60.0% were Literate. 2. Mostly affected age group was 19-28 Yrs in 75%. 3. Among the total number, 35 were housewives. 4. 87.5% of the patients were Fieldwork with physical labour. Other 10% were sedentary workers and remaining 2.5% were field workers. 5. Among the patients 75% of were Hindu, 22.5% were Muslim and the 2.5% were Christian. 6. 70% of the patients were being in middle-income family. Remaining 30% having 8 low and high income. 7. 95% of the patients were having mixed diet and the 5% having vegetarian diet. 8. More patients (47.5%) attained puberty in their 13 years, 22.5% in 12 years and 17.5% in 14 years. 9. Among the total patients 75% of patients having irregular menstruation. 10. 65% of the patient’s was moderate flow of menstruation, 20% of the patient’s was severe and 15% of the patient’s was mild menstruation. 11. 62.5% of the patients having white discharge. 37.5% of the patients have no white discharge. 12. 97.5% of the patient has lower abdominal pain. 22.5% of the patient has Moderate pain and 10% of the patient has mild pain during menstruation. 13. 95% of the patient suffering during menstruation. 77.5% of patient severely suffer from mastalgia and 7.5% and 10% of the patient suffer accordingly moderate and mild. 14. 18 numbers affected with PCOS. 9 of affected with Hyperthyroidism 4 of affected with Hypertension and DM 15. Among the 40 patients only 17.5% were had history of abortion. 16. 68.5% of the patients are aneamic and 32.5% of patients present with adequate hemoglobin level. 17. 87.5% of the patients were being in normal weight. 5% of were being in obesity. 18. Results of genitourinary system examination shows Irregular menstruation ,Pelvic Pain, and Painful intercourse were present highly than abnormal hair growth and nipple discharge. 19. 95% of affected individual living in Marutham and 5% living in Neithal. 20. 62.5 % of the patient express Sathuva guna and 37.5 % of the patient express Rajo guna. 21. 22.5% vali yakkai , 15.0% Azhal yakkai, 12.5% Iyam yakkai, 27.5%Valiazhal yakkai and 22.5% Azhalvali yakkai. 22. Mooku was not affected. Response 100% as a normal. In Kann and Sevi 97.5% was not affected, in Vaai 95% was not affected. In Mei 90% was not affected. 23. Among the patients kanma inthiriyam Vaai was not affected. 20% of Kaal and Eruvaai was affected. 24. Manomaya Kosam and Vinganamaya kosam was not affected. 65% of Aanadhamayakosam was affected. 25. Influence of Vali kutram .Naagan , Koorman, Kirugaran and thananjayan were in normal stage. 97.5% of Abanan was affected. 60% of Devathaththan was affected. 26. In Piththa kutram , Aalosaka pitham and Saadhaga pitham was not affected. 52.5% of Ranjaka pitham was affected. 22.5% of Anila piththam was affected. 27. In Iya kutram. Pothagam and Tharpagam was not affected. 97.5% of Avalambagam and Kiledhagam was not affected. 32.5% of Santhigam was affected. 28. Infuence of Udal thathukal of the sample. Saaram Kozhuppu and Moolai was not affected. 50% of Senneer was affected. 92.50% of Suronitham was not affected. 90% of Enbu was not affected. 29. 55% shows Vatha Migu gunam. 35% shows pitha migu gunam .10% shows Kapa migu gunam. 30. Envagaithervu ofNaa shows 17.5% of Maa padithal was present. 25% of Vedippu was present. Niramwas affected in 15%. Suvai was affected in 35%. 22.5% of pigmentation was present. 15% of vaai neer ooral symptom was present. 31. In Envagaithervu of Niram analysis 90% was affected. 32. In Envagai thervu analysis 55% of mozli was represents as an uratha oli. 37.5% represents as samaoli and 7.5% represents as Thaazhntha oli. 33. Vizhi, Niram was affected in 7.5%. Kanneer was affected in 5%. 10% of Peelaiseruthal was present.65% of Erichchal was present. 2.5% of Paarvai kolarugal was present. 34. Envagaithervu ofSparisam only 10% was affected. 35. Envagaithervuof Naadi , 60% represents as a Vatha pitham. Piththa Vaatham in a 22.5%. 2.5% in a Vatha Kapam. 36. Envagaithervu - Neerkuri. In Urine colour 100% shows as Manjal niram. 20% was in abnormal odour. Normal volume is in 50%.Nurai was in 57.5% .Enjal was present in 2.5%. 37. Results ofNei Kurishows, Nature of Spared 15% slowly spread. 40% spread in medium. 45% was Quickly spread. 38. Oil Spreading pattern shows as follows. 50% of oil spreading pattern as Aravil mothiram pattern. 17.5% as Mothirathilaravam patern. 15% as Mothirathilmuthu. 7.5% as Muthilmothiram pattern. 5% as Aravilmuthu pattern. 2.5% as Aravam and muthilaravam pattern. CONCLUSION: Etio pathogenesis of Pen Maladu caused by Agakaranam and the Purakaranam. When piththam increased, Vaatham and kapamis try to compensate Piththam. As a result Kabham decreased Vatham increased. When Vatham increases, Abaanan, Viyaanan, Samanan, Devathathan are affected. When the Pitham increases, Prasagam, Ranjagam, Saadhagam are affected. In addition Supperssion of Vatham, Thummal, Siruneer, Kottavi, Pasi, Neer vetkaiand Suppression of Udal Thathukkal results Pen maladu. This study reveals the diagnosis of PEN MALADU as per siddha parameters mentioned in siddha literatures. Siddha diagnostic methods such as Neikuri for most patients reveal quick spread with shape of Aravil mothiram and Mothirathilaravam, and Vathapitha Naadi. Most patients were Vatha Pitham predominant Thegi showing significantly related to the disease. Further studies will be needed in large populations for the above observation to be cleared and to adopt the Siddha diagnostic methods in disease diagnosis and to treat in an effective way