Pitha Suram (Dengue Fever)





Dengue fever is a disease caused by a family of viruses that are transmitted by mosquitoes. It occurs in two forms: Classical Dengue fever also known as “break bone” fever and Dengue Haemorrhagic Fever (DHF) which is life threatening. The average incubation period is around 4-7 days.

Symptoms of dengue are sudden onset of fever, headache (typically located behind the eyes), muscle and joint pain, rash, chills (shivering), facial flushing, loss of appetite, sore throat and abnormal bleeding such as nosebleeds, black stools, bleeding gums and/or blood in urine.

The virus is contracted from the bite of striped Aedes aegypti mosquito that has previously bitten an infected person. The mosquito flourishes during rainy seasons but can breed in water-filled flower pots, plastic bags, and cans year-round. One mosquito bite can cause the disease.


Siddha system classifies fever (suram) into 64 types based on the cause, the affected biological humour (kuttram), altered physical constituents (udal thathukal) and presenting clinical features. Each type of suram mentioned in siddha literature is considered as single disease, of which dengue fever can be correlated to pitha suram which is mentioned in siddha texts like Agathiyar sura nool 300, Sura vagadam and others. The major clinical features of pitha suram as given in siddha texts are as below.

Clinical features ( Siddha Text)
English Term


உடல் சிகப்பு நிறம் அடைதல்

Red patches in the body


சிறுநீர் சிகப்பு நிறம் அடைதல்

Red coloured urine


எருவில் சிகப்பு நிறம்

Red colour in faeces


மூர்ச்சை,எழுந்திருந்து ஓடல்

Loss of consciousness and restlessness



Sensation of vomiting


நீர் வேட்கை

Excessive thirst /dehydration


வயிறு கழிதல்

Loose stools


அதிக சுரம் காய்தல்

High grade fever


மெய் வெதும்பல்

Body pain


Siddha system of medicine considers the body as a conglomeration of three humours known as vatham, pitham and kabam. Siddha physiology deals with the subtle mechanism of interactions between the three humours in a normal body.  Equilibrium between the three humours is necessary to maintain perfect health. Any derangement in the synergic action of these humours transforms the body as a fertile ground to pop-up any infection. According to siddha principles of pathology, primarily all the 64 types of fever (suram) occur due to the accumulation of kabam humour in the gastro intestinal tract, which is a result of decrease of pitham humour (manthakini state) in the stomach and intestine. The accumulation of kabam humour occurs due to both external (environmental) and internal (diet and life style) factors, producing indigestion and decreased metabolic functions. This is mentioned in a text called Theran sekarapa,

                                   “குடல்தன்னிற் சீதமலாது சுரமும் வராது திறமாமே”

                            “No fever occurs without accumulation of kabam humour in intestine”

In pitha suram as the name indicates, along with accumulation of kabam in intestine, pitham humour is also deranged. Since pitham humour resides in blood cells (senneer), digestive system (iraipai), skin (thol) and plasma (saram), all these are affected.

Siddha literature, ‘Agastiyar sura nool 300’ says that pitha suram causes bleeding. According to this text,

'சுரமதே வறட்சியாகும் சுரமதே குருதியாகும்', which means haemorrhage (kuruthi azhal) is a complication (thunai noi) of pitha suram.


Siddha system aims to eliminate the root cause rather than treating the symptom. This is true with treating any type of fever in siddha system. Though in siddha drugs, there is no direct antipyretic to bring down fever, they are good at promoting the immune response and minimising the complications of fever. Since according to siddha principles, accumulation of kabam humour in the intestine makes the body favourable for any type of suram (fever), medicines are aimed at minimising the kabam humour and the elevated pitham humour.

Nilavembu Kudineer, a polyherbal formulation is a decoction concentrate widely used in siddha medicine to combat majority of fevers. For centuries, the traditional physicians practicing siddha system of medicine have advocated this for the prevention and treatment of pitha suram. Some research and clinical studies conducted also prove the effect of Nilavembu decoction, in preventing the multiplication of the virus in humans.

Nilavembu decoction consists of nine ingredients of medicinal plants origin, which are as follows:

nilavembu (Andrographis paniculata), Vettiver (Vetiveria zizanioides), Vilamichu ver (Plectranthus vettiveroides),Chandanam (Santalum album), Peipudal (Trichosanthes cucumerina), Koraikilangu (Cyperus rotundus), Chukku (Zingiber officinale), Milaku (Piper nigrum) and Parppadakam (Mollugo cervicana).

It is prepared by taking all the ingredients in equal proportion, ground in to coarse particles and then eight times of water is added, which is boiled and reduced to one fourth of the initial volume, and filtered for use. It is given in dosage of 20ml bid (twice daily) for 3-5 years age group and 30ml bid for age above 5 years.

The chief ingredient in the decoction is nilavembu (Andrographis paniculata). This herb popularly called the Neem of ground, Bile of earth and King of bitters is native to India and Sri Lanka. Anti-viral properties of Nilavembu have been investigated and established through pilot clinical studies, which showed promising results against common cold, and in-vitro studies proved its efficacy against dengue virus and malarial parasite besides having anti-inflammatory and immuno-modulatory properties.

Some other medicines used in siddha system for the treatment of dengue are:

Chitramutti Kudineer (no.1) which consists of chitramutti (Pavonia zeylanica) and chukku (Zingiber officinale).

Chitramutti Kudineer (no.2) Root of vilwam (Aegle marmelos), chitramutti (Pavonia zeylanica), pathiri (Stereospermum colais), stem of churai (Lagenaria siceraria) are taken and made in to decoction. During the process of making decoction kothumalli (Coriandrum sativum) and pachai payiru (Green gram) are added. This decoction should be taken along with honey.

Seenthil kudineer

The ingredients are seenthil (Tinospora cordifolia), parpadagam (Mollugo cervicana), chandanam (Santalum album), vilamichuver (Plectranthus vettiveroides), chukku (Zingiber officinale), iruveli (Coleus vettiveroides), chitramutti (Pavonia zeylanica), korai kizhangu (Cyperus rotundus).

Chukku kudineer:

This decoction is given for dysentery in pitha suram. The ingredients are chukku (Zingiber officinale), iruveli (Coleus vettiveroides), arasampattai (bark of Ficus religiosa), koraikizhangu(Cyperus rotundus), sirukanjori (Tragia involucrate), pangampalai (Oxystelma esculentum).

Adathodai juice:

10-20 drops of adathodai (Justicia beddomei) is mixed with equal quantity of honey and is given for kuruthi azhal noi (Dengue haemorrhagic fever).

Adathodai manapagu

It consists of adathodai (Justicia beddomei) leaves and panai vellam (palm jaggery). It is prepared by cleansing the leaves, cutting them to fine bits and boiling with eight times of water and reduced to one fourth of the initial volume to which purified palm jaggery is added and boiled until the watery content gets evaporated and semisolid (kambi patham) state is obtained.

In addition to this, medicines like Bramhananda bairavam tablet, Santha santhrothayam tablet, Linga pills are advised to be taken to contol fever, Imbural vatakam, Padiga poongavi chenduram and Kavikkal chooranam to prevent haemorrhage and Nellikai leghiyam, Tripala chooranam and Amukkara chooranam for boosting immune system.

Papaya leaf juice 5 ml daily in 6 hours interval is also suggested, which is found to improve thrombocytes (platelets) count.

During the dengue outbreaks in Tamil Nadu in the year 2012 and in the consecutive years, when the state was plagued by dengue, Government of Tamil Nadu came out with public health advertisement promoting siddha medicine like Nilavembu decoction as preventive and controlling the morbidity level of public on contracting viral fever. Further, government made arrangements for the supply of decoction to all patients reporting for this purpose in Primary Health Centers and Government Hospitals. The success rate of the treatment was high and significant increase in platelet count was also observed.

Note: Consultation of a siddha physician is mandatory, for the right choice of drug, depending upon the body constitution of the patient and severity of the illness.


Rice is cooked in traditional manner with tender coconut water instead of water and given during the period of illness and convalescence.








  1. Christian GJ, Subramanian M, Periyasami D, Manickavasakam K, Gunasekaran P, Sivasubramanian S and Nijavizhi M: Protective Effect of Polyherbal Siddha Formulation-Nilavembu Kudineer against Common Viral Fevers Including Dengue - A Case-Control Approach. Int J Pharm Sci Res 2015; 6(4): 1656-60.doi: 10.13040/IJPSR.0975-8232.6 (4).1656-60.
  2. Kuppusamy mudaliyar K N, Siddha maruthuvam pothu, 7th edition, 2007, Directorate of Indian Medicine and Homeopathy, Chennai-106, page - 20.
  3. Leon IC Tang, Anna PK Ling, Rhun Y Koh, Soi M Chye and Kenny GL Voon. Screening of anti-dengue activity in methanolic extracts of medicinal plants. BMC Complement Altern Med 2012, 12:3 

  • PUBLISHED DATE : Sep 25, 2015
  • LAST UPDATED ON : Mar 21, 2016


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