Kalladaippu (Urolithiasis)

                                             Kalladaippu (Urolithiais)

Introduction

The process of formation of stones in the kidney, bladder, and/or urethra (urinary tract) is known as urolithiasis or renal calculi or nephrolithiasis. Typical symptoms of acute renal colic are intermittent colicky flank pain that may radiate to the lower abdomen or groin, often associated with nausea and vomiting. Lower urinary tract symptoms such as dysuria, urgency and frequency may occur as the stone enters the ureter.

The clinical features of Urolithiasis can be correlated to those of ‘Kalladaippu’ found mentioned in siddha literatures.

Siddha concept

In siddha texts, it is described as a disease characterised by pain in the tip of genitalia, sudden intermittent obstruction flow of urine, low back pain, pain in loin and groin and presence of small sand like stones in urine. One of the siddhars named Yugi Munivar in his treatise “Yugi vaidhya chinthamani 800”, elaborately deals with Kalladaippu under the chapter ‘Kalladaippu roga nithanam’. In this work he has documented in an orderly manner the knowledge of this disease all that is available before him and during his time. There are also evidences of this disease in the works of other prominent siddhars like Theran and Agathiyar.

Some of the common clinical features of this disease found in siddha literature  are burning micturition, intermittent flow of urine, nausea and vomitting, fever, low back ache radiating to loin and groin up to the tip of the genitalia and less frequently haemeturia, diarrhea and headache.

Yugi has classified Kalladaippu into four types based upon the clinical features and affected Mukkutram/uyir thathu as follows

1.      Vaatha Kalladaippu

Pain felt just below the umbilical region and penis characterized by severe colic, dyspnoea, abdominal distension, oliguria and constipation.

2.      Pitha Kalladaippu

Urine output is reduced with characteristic burning sensation (portrayed as pain similar to introducing a red-hot iron needle into the urethra), passing out of blood coloured stone which blocks the ureter causing gnawing and pricking pain along with tenderness.

3.      Slethuma Kalladaippu

Excruciating pain in the umbilical region, pain in the joints of upper and lower extremities, low-backache, spasmodic pain, sweating and gradual passing out of white coloured granules in the urine.

4.      Thontha Kalladaippu

It is characterized by severe pain and passing out of small, sand like granules in urine.

Cause and Pathology

According to the principles as found in siddha texts authored by siddhars, the cause for this disease is attributed mainly to dietary factors like intake of

•   muddy and contaminated water
•   food substances adulterated with particles like stones, bone fragments, hair and sand
•   rotten food stuff
•   carbohydrate rich diet frequently and
•   Food substances that cause increase in vatham humor (vayu).

Yugi in his Vaidhya chinthamani also mentions about other factors that make one more prone to this disease such as  particular seasons like mudhuvenil (summer) and karkalam (monsoon) and type of habitation of a person (Neithal and mullai).

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He also adds some other etiological factors like excessive intake of foods substances of salty, sour and bitter taste and unnecessary controlling of the  vegangal (natural urges or reflexes) such as micturition and ejaculation which are regulated by abana vayu  (vatham that is responsible for the downward flow of vatham controlling these reflexes.

One or more of the above mentioned factors of diet and lifestyle causes derangement of vatham and pitham uyir thathukkal (humours). Vatham (vali) produces dryness and Azhal (pitham) produces heat. This derangement of humors resulting in increase of dryness and heat in the body leads to concentration of urine and formation of stones. Due to derangement of vatham, abanan which is one of the components of ten vayu (vali/vatham) is also affected. Abanan, as already mentioned is necessary for the proper functioning of the reflex mechanisms related to excretory and reproductive systems. All these lead to the onset of the disease and the associated signs and symptoms.

Management and prevention

As seen earlier the affected uyir thathukal (humors) namely vatham and pitham are responsible for the predisposition of this disease. So the affected humors should be brought back to their normal levels and then the affected udal thathukkal (physical constituents) should be repaired.

Purgative such as Brami nei are given to normalize vatham and abanan. Since the disease occurs because of the dryness and heat produced by the deranged humors, single drugs or compound formulations which have a coolant property are given. Then medicinal preparation of plant or/and mineral/animal origin are given to dissolve and expel the kidney stones and repair the damaged tissues.

Decoctions like Neermulli kudineer,Nerunjil kudineer,Sirupeelai kudineer and pills like Kalludaikudori mathirai, Jalotharimani mathirai ,Jalamanjari are commonly advised.

Some effective mineral - herbal and sea/animal product medicinal preparations used are Parpams like Viraal meen thalaikkal parpam,Vediuppu chunnam, Palagarai Parpam, Sangu parpam, Silasathu parpam, Nandukkal Parpam and

Chendurams like Vedi annabedhi, Vediuppu chenduram, Velli chenduram, Rasa chenduram.

Some medicinal plants found to be effective in the treatment and prevention is tabulated below. They can be either added in the diet as leafy vegetable, prepared as decoction/powder, as fresh juice or otherwise as per a siddha physician’s advice.

 Along with this the patients suffering from this disease are advised to add any one or more of the following items in their regular diet.

• Kuruvai rice (crops grown in cauvery Delta of Tamil Nadu state) 
• Greens and vegetables like Mullangi (Radish) Vasalai keerai (Spinach), Keerai thandu (stem of Amaranth) Valai thandu (Banana pith), avarai(Bean), vendai (Ladies finger) etc.,

Note: All medicines should be taken under the supervision of a qualified siddha medical practitioner.

References

http://www.tjprc.org

https://www.researchgate.net

1)      Dr.K.S. Uthamarayan, Siddhar Aruvai Maruthuvam, Directorate of Indian Medicine & Homeopathy, 112 -114, Chennai- 106, 2013

2)      K.S. Murugesa Mudaliar, Siddha Materia Medica, Directorate of Indian Medicine & Homeopathy, Chennai-106, 2013