RATIONALE BEHIND THE COMPARISON OF KABA SURAM AND OTHER SURAMS WITH CORONAVIRUS DISEASE AND OTHER VIRAL FEVERS – A LITERATURE REVIEW

Objectives: This article intended to discuss about the rationale behind the comparison of coronavirus disease (COVID 19) and other viral fevers signs and symptoms with “Kaba Suram” and others Surams signs and symptoms with available source of Siddha literatures. Materials and Methods: Research Type: Systemic review. Design: Literature review will be done by collection of available text references from authenticated Siddha texts. Reference Authenticated Siddha Texts: 1. Yugimuni Vaithya Sinthamani, 2. Sura Vagadam, 3. Theran Karisal, 4. Theran Yamaga Venba, and 5. Sura Venba. Conclusion: Based on inference derived from Results and Discussion, we came to conclude that signs and symptoms of various viral fevers (COVID-19, dengue, chikungunya, and swine flu) are most commonly matched with the signs and symptoms of Kaba Suram, Pitha Suram, Vatha Suram, and Kaba Pitha Suram which are already mentioned in Siddhar authenticated texts.


INTRODUCTION
Siddha system is one of the traditional medical systems of India which is most popular in Southern Peninsula of India [1][2][3]. Coronavirus disease (COVID-19) is one of the viral infections which is a dangerous infection producing sudden respiratory arrest and leads maximum up to death. This infection is caused by a variety of RNA group of virus, that is, severe acute respiratory syndrome-CoV-2. Like COVID-19, chikungunya, dengue, and swine flu are the viral infections causing causalities as pandemic in the past years throughout the world [4]. These are the major threatening viral fevers to the world community not only in developing countries but also in developed countries. The similarity between all these viruses is all four belong to RNA group of viruses [5]. Health-care communities are trying to find out the apt treatment for these viral infections. Role of traditional medicines throughout the world is notable in the management of all these fevers. Specifically, Indian traditional systems (AYUSH) are contributing lot to community in treatment/prophylactic aspects of all these fevers. Siddha system of medicine also playing an essential role in treatment and management aspects of these viral fevers. In general, "fever" is mentioned in Siddha Text as "Suram," Kaichal," Veppu," Kanal," and "Vedhuppu." [6] There are 64 types of fever classified in Siddhar texts based on causative factors, signs and symptoms, and imbalance of Thirithodam (three humor Vatha-Pitha-Kapham) [7]. This article intended to discuss about the rationale behind the comparison of COVID 19 and other viral fevers signs and symptoms with "Kaba Suram" and others Surams signs and symptoms with available source of Siddha literatures.

Siddha system and pandemics/epidemics
In Siddha system, epidemics/pandemics are mentioned as "Uzhi Noi" or "Kothari Noi" [8]. In general, they are classified under "Kollai Noikal" which are most commonly occurred the time of "Ayana Santhi" [9] months (means end months of Uthara Ayanam and Thatchana Ayanam), fall on Adi and Margazhi month in Tamil Calendar [10]. It is believed that in those days, immunity of human being will be low based on Thirithoda Theory [11,12].
In this context, the signs and symptoms mentioned under "Kaba Suram" and some other Surams can be compared with the signs and symptoms of the COVID-19 and other viral fevers [6,12].

MATERIALS AND METHODS
It is a systemic review done by collection of available text references from authenticated Siddha texts. The following authenticated texts were taken as source of references.

Rengaraju and Kadarkarai
Based on above signs and symptoms of dengue fever classified by the WHO with signs and symptoms of Pitha Suram which are mentioned in Siddha literatures, It is found that 95% (joint or muscle pain) of major signs and symptoms and 95% (excluding blood vomiting) of minor signs and symptoms matched with the WHO classification. Overall, 15 out of 17 signs and symptoms classified by the WHO classification of dengue fever matched with signs and symptoms of Pitha Suram which are mentioned in Siddha authenticated literature.
The following Table 3 comparing with the signs and symptoms of chikungunya declared by the WHO [18] with signs and symptoms of Vatha Suram mentioned various Siddha authenticated literatures [4,5].
Based on above signs and symptoms of chikungunya classified by the WHO with signs and symptoms of Vatha Suram which are mentioned in Siddha literatures, it is found that 95% (excluding oral ulcers) of major signs and symptoms and 95% (excluding swelling) of minor signs and symptoms matched with the WHO classification. Overall, 12 out of 14 signs and symptoms classified by the WHO classification of chikungunya matched with signs and symptoms of Vatha Suram which are mentioned in Siddha authenticated literature.
The following Table 4 comparing with the signs and symptoms of swine flu declared by WHO [19] with signs and symptoms of Kaba Pitha Suram mentioned various Siddha authenticated literatures [4,5].
Based on above signs and symptoms of swine flu classified by the WHO with signs and symptoms of Kapha Pitha Suram which are mentioned in Siddha literatures, it is found that 100% of major signs and symptoms matched with the WHO classification and 100% of minor signs and symptoms matched with the WHO classification. Overall, 13 out of 13 signs and symptoms classified by the WHO classification of swine flu matched with signs and symptoms of Kapha Pitha Suram which are mentioned in Siddha authenticated literature.