INTERRELATIONSHIP BETWEEN FOOD, MEDICINE AND HEALTH AS REFLECTED IN THE ANCIENT TAMIL SOCIETY

 

Dr. M. Suresh ¹, Dr. M. Ramakrishnan ²

 

¹ Assistant Professor of Chemistry, Tamil Nadu Open University, Saidapet, Chennai, Tamil Nadu, India  

² Assistant Professor of Folklore, Department of Anthropology & Tribal Studies, Central University of Jharkhand, Ranchi, Jharkhand, India

 

1. INTRODUCTION

‘Food as medicine’ is a fashionable concept in modern society, and the article by Jillian Levi (2017) entitled “Food is Medicine: The Diet of Medicinal Foods, Science & History” testifies to it. Hippocrates, who had been treated as the founder of medicine as a ‘rational science,’ says, “Let food be thy medicine and medicine be thy food.” (2017:1). Being an “influential figure in the history of medicine and healing” (2017:1) around 400 BC, his appeal that “people to prevent and treat diseases first and foremost by eating a nutrient-dense diet” (2017:1). has its cognitive appeal, that is, it reflects people’s practice and perception too. In a similar line of thinking of Hippocrates and the Ancient Greeks, every community from time immemorial has had its experiments with nature for food as well as medicines, and during the course, a vast amount of traditional knowledge for the community’s purpose. The local medicinal practices/healing methods helped human beings manage their survival in a particular environment by exploiting the available resources. The idea of healthy food can be understood, if we look at food as a source of energy as well as curative medicine not only for humans but also for animals and other living organisms. While thinking about nutritional food, along the lines of Hippocrates, one can come across texts from ancient Indian society. One such is Tirukkural, which vividly presents the interconnection between food, disease and medicine. The first couplet mentions the cause of disease by tracing the problem to the quantity and quality of food. Citing the existing medicinal writings, available during that period, the Tirukkural mentions that if food is excessive or deficient, three things (flatulence, biliousness, and phlegm) will be enumerated that is the cause of any disease. The imbalance in quality and quantity is highlighted in the second couplet. Medicine is not necessary for those who eat after assuring that what is eaten has already been digested. Even modern science could acknowledge this point that indigestion could be the cause of problems. Once consumed food is digested and one eats in moderation and it is the way to prolong life. Once the food is digested, then one must wait for feeling hungry. The next couplet is very important as it talks about the food that is suitable for the body. One must ensure that the food has been digested and eat the bodily acceptable food after feeling very hungry. What is the agreeable food? Or is there any food prescribed by the text? No. Therefore, we understand that agreeable food is the one that is accepted by the body. The text has given a separate chapter on both the avoidance of meat and toddy-like drinks. There will be no disease if one eats bodily acceptable food in moderation. Though we are talking about poverty and starvation, obesity has become an inevitable problem in modern society. It metaphorically presents that as pleasure dwells with one who eats moderately, so disease dwells with the glutton who eats voraciously. One will be afflicted with several diseases, those who eat immoderately, and be ignorant of the rules of health. Finally, the text proffers a standing instruction for physicians on what to observe, finalizing the disease and method of treatment. Let the physician enquire into the (nature of the) disease, its cause and its method of cure and treat it faithfully according to (medical rule). The learned (physician) should ascertain the condition of his patient; the nature of his disease, and the season (of the year) and (then) proceed (with his treatment). The text points out the four kinds of elements associated with medical practices: ‘patient, physician, medicine and compounder; and each of these (again) contains four sub-divisions’ (https://kural.page/english/chapter-medicine). The wisdom, worldview, the stories of their encounter with the environment, knowledge systems, beliefs, sentiments, etc., of ancient society have been well documented in the literary works of ancient Tamil society, which must be explored for the welfare of the forthcoming generations. Likewise, several literary texts of ancient Tamil society have presented a vivid account of the nature of food that has to be consumed for a healthy life. Though we have briefly outlined the reflection of this notion in Tirukkural, this paper deals with the idea of food as medicine as reflected in the ancient Tamil literature. Aravindan (2018)

 

Ancient Tamil society: Towards understanding ancient Tamil society and also drawing inputs for the betterment of present society, one has to look into the literature and literary works, particularly, those left by the society, and they are not merely imaginary creations, but rather a vast amount of knowledge is found to be embedded in them that needs to be tapped for the betterment of the present society as well as to reassure continuity of the tradition. Though there is literature and comprehensive studies available on the nature of ancient Tamil society, as a customary practice, this brief introduction may be treated as a way of giving another dimension from the traditional knowledge point of view. Falling under the Dravidian linguistic family by origin and one of the 22 scheduled languages of India, Tamil is spoken around the world almost in 143 countries by Indian Diaspora with its humongous Diaspora. According to the recent findings by the Max Planck Institute for the Science of Human History, Germany, the Dravidian language family may be approximately 4000-5000 years old. The Tamil community is proud of their language for the simple reason that the language is ancient as well as modern with unbreakable continuity in terms of its form and content. Importantly, it is the first language in the world to be given a classical tag by the Union Government in 2004, and the other languages such as Sanskrit have been assigned with the classical tag later. Based on the minimum criteria laid down by the Government of India (Press Information Bureau, Ministry of Culture, “Criteria for Declaring Classical Language”) the classical tag was first given to Tamil and later to other Indian languages, the criteria include the following points: “high antiquity of its early texts/recorded history from 1500 through 2000 years; a body of ancient literature/texts, which is considered a valuable heritage by generations of speakers; the literary tradition be original and not borrowed from another speech community; the classical language and literature being distinct from modern, there may also be a discontinuity between the classical language and its later forms or its offshoots.” (https://pib.gov.in/, Naresh Burla and Ramakrishnan 2024). After the declaration of Tamil as a Classical Language by the Union Government and the establishment of the Central Institute of Classical Tamil subsequently, a list of forty-one Tamil texts belonging to the period up to 600 A.D. has been identified to explore the nature of language, culture and society of ancient Tamil society. The list consists of the following texts: “1) Tholkappiyam; 2) Ettutthokai (Eight Anthologies - Natrinai, Kurunthokai, Ainkurunuru, Pathitruppatthu, Paripatal, Kalitthokai, Akananuru and Purananuru; 3) Patthuppattu (Ten Idylls - Thirumurugatruppatai, Porunaratruppatai, Cirupanatruppatai, Perumpanatruppatai, Mullaippattu, Mathuraikkanji, Netunalvatai, Kurinjippattu, Pattinappalai, Malaipatukatam; 4) Pathinenkilkkanakku (Eighteen Didactic texts - Nalatiyar, Nanmanikkatikai, Innanarpathu, Iniyavainarpathu, Karnarpathu, Kalavalinarpathu, Ainthinai Aimpathu, Ainthinai Elupathu, Thinaimoli Aimpathu, Thinaimalai Nutraimpathu, Palamoli Nanuru (Proverbs four hundred), Cirupanjamulam, Tirukkural, Tirikatukam, Acarakkovai, Mutumolikkanji, Elathi and Kainnilai; 5) Cilappathikaram; 6) Manimekalai; 7) Mutthollayiram; and 8) Iraiyanar Kalaviyal. Among these texts, Tholkappiyam, the earliest extant grammatical work available in any Dravidian language, is considered to have been written as early as the seventh century B.C., but Ettutthokai and Patthuppattu, which together form the corpus of Sangam literature, might have been written well before the first century A.D.” (Naresh Burla and Ramakrishnan 2024). Casson (1983)

On the importance of Sangam poems, we can say that the very significant aspect of Sangam literature lies in its neutralness in addressing the concept or any issue, and this could be the reason that in other words, the magnanimity of Sangam literature is celebrated for its universality of portraying human emotions by crossing all the geographical and social boundaries, for example, the Kuruntokai poem (40) titled as Red Earth and Pouring Rain metaphors the eternal bond between lovers beyond any barrier: “What could my mother be to yours? / What kin is my father to yours anyway? / And how / Did you and I meet ever? / But in love, our hearts have mingled /like red earth and pouring rain.” (“Tamil Sangam Poetry,” Trans. A. K. Ramanujan. http://www-personal.umich.edu/~pehook/226.sangam.html) Considered as the golden era in terms of socio-cultural life and literary contribution, the Sangam age was the period the ancient Tamil country was ruled by the Cheras, Pandyas and the Chola. It was due to the natural structure of the landscape that it had not witnessed any major threat from external forces, and King Asoka did not make any impact on the life of the Tamils who were then busy with literary activities. The kings and small chieftains in ancient Tamil were also involved in wars of different ranges between themselves and also with others. However, the wars had been planned and moral and ethical frameworks had been effectively followed to avoid major causalities and damage to properties, cattle populations, women and children, etc. The greatness of Sangam age poetry, as mentioned elsewhere, is elaborated with the help of the elements present in the texts themselves. Since the Sangam texts are understood as the document for studying the socio-cultural life of the ancient society, a multi-disciplinary approach could be the right choice for exploring the vital components that can help us to construct the historical past and its continuity. For example, Tolkappiyam, an extant ancient grammatical text of the Tamil language, gives an account not only of the language use but also of the socio-cultural life concerning life, land and environment. Moreover, the Tolkappiyam is not merely the portrayal of the grammar of ancient Tamils, because it also portrays emotions, feelings, reflects feelings, musical compositions, the language used in the social and cultural settings etc. Thus the Tolkappiyam can be used as an effect text for exploring the historical value of the text. Kailasapathy (1968)

The Sangam literature, as part of the classification, is understood in terms of akam and puram, while the former is considered as part of subjective or personal life, and the latter is associated with the objective or social life. And, these poems are treated as compositions for reflecting the “moods, emotions, and socially accepted conventions including deviations, music, occupation, supernatural beings, fauna and flora of the landscape and associated life.” (Naresh Burla and Ramakrishnan 2024). The people of the Sangam age, like their predecessors, had a better understanding of life which cannot be possible without a substratum which is an influencing factor. What is that substratum? How does it influence human life and their cultural expressions, that is, the human experience was materialized solely because of the substratum. This substratum one calls as environment which is the backbone of Sangam literature. The Sangam poems classify the Tamil land into five genres (thinai) or landscapes such as mountains and regions associated with the mountain (kurinji), forest and its adjacent landscape (mullai), agricultural plains and associated life (marutham), sea and seashore life (neithal) and wasteland and the life associated with (palai). (Naresh Burla and Ramakrishnan 2024). However, the corpus points out that the landscape is not merely a physical space because it is associated with the images of birds, beasts, flowers, gods, music, people, weather, seasons, etc., and it could convey subtly the mood associated with an aspect of life.’ (www.en.wikipedia.org). Thus, the Sangam literature must be treated as a treasure of Tamil society which contains invaluable information that needs to be mined out for the construction and reconstruction of the ancient Tamils and its continuity.” (Naresh Burla and Ramakrishnan 2024). Kosambi (2006)

The special feature of the Sangam literature is that the poems are composed in akaval metre, the first and oldest metrical pattern in prosody. More importantly, as far as the structure of poems including style, tone, treatment order and language is concerned one can find a considerable likeness in Ettutthokai and Patthuppatu, except Paripatal where there is a description of aspects of devotion and glorification of God to a certain extent, the themes of both of them are either secular or silent on this aspect of godliness and devotion. The corpus of Sangam literature has been celebrated for its uniqueness and universality in presenting the concepts and worldview. Based on the themes and emotions, the Sangam literature can be classified broadly into two categories akam and puram. The characteristics of akam poems lie in their vivid presentation and deep generalization of the deep emotions derived from the love life or social life of the ancient Tamils. The following essence can be drawn by those who read the akam poems: ‘the first meeting of the lovers; the happiness of the lovers when they are in each other’s company; the fear of them when they think of their separation; the twinge of separation; the love affairs came to be known by the confidante; confidante’s assistance for the secret meetings of the lovers; the parents of the lady imposing restrictions; settlement of marriage; elopement of the lovers in some cases; the happy married life; the pain of the young wife when the newly married husband goes away in search of wealth; the feelings of joy when the husband returns home; etc., whereas, the puram poems depict the political life of kings including their achievements and contributions to the development of culture and civilizations, etc.’ (Naresh Burla and Ramakrishnan 2024). In South India, following Kamil Zvelebil (1975), ‘we can say that there grew up an independent and characteristic literary tradition (quite independent in its root and beginnings of the Sanskrit tradition) which along with other branches of artistic expression, notably music, the visual arts and dancing, points to the marked specific character of the oldest South Indian culture, within the framework of all Indian development and pan Indian civilization, whose basic features have often characterized as a harmony of contracts and a synthesis creating unity out of diversity.’ (cf. Naresh Burla and Ramakrishnan 2024). Thus, with the help of Sangam texts, we can get a complete picture of the domestic, the ancient Tamil’s private and love life, as well as public and political life. Marr, John Ralston. (1985)

Another important corpus included in the list of forty-one is Pathinenkilkkanakku, comprising eighteen didactic works, the Patinenkilkkanakku is considered to have been written during the post-Sangam age, a period up to the 500 A.D.  These texts are primarily dealing with morals (aram), which is a prerequisite for the existence of any society and the deviation by individuals or a group can affect the harmonious life of the society. The Tirukkural is a famous work by Thiruvalluvar, who according to some scholars, belonged to the before Christian era, however, others dispute the claim by saying that the Tirukkural might have been written later in the second century A.D. The poem is in the form of couplets in kural-venpa format and it deals with the virtues one has to adapt to live in a society with moral principles. While each couplet is a gem by itself as it delineates the concept more thoughtfully, one can find that each chapter has a parallelism of emotional trajectory. In other words, the first couplet in a chapter begins with the emotional equilibrium, then, it slowly progresses towards achieving the peak, that reaching the highest of emotion, such as anger. That is, Thiruvalluvar describes the concept, presents other salient features of the concept and finally insists on the necessity of accepting the concept. It is the only text to be translated into more languages in the world after the Christian Bible, which shows the greatness of the text as well as the universality of its validity. Nedunjeziyan (2009)

The curiosity for new things fulfills the formation of narratives which is essential for storing information and effective recollecting process. The narrative has a fixed structure with different formulas for both input and output activities which are different because they are the vital elements for memory recalling which is unique and varies from individual to individual. For instance, those who are good at remembering events may not be good at recalling the events based on date or year. In the same way, people who are known for remembering details related to land, landscapes or geography may not have the same remembering skill for personal details. It is very important in this work that not all the members of a community are good and effective storytellers or tradition bearers. Though the Sangam and post-Sangam ages had witnessed many poets, some of them had a better understanding of proverbs for effective communication. The authors of the didactic texts must be appreciated for admiring proverbs which had helped him to make use of the proverbs that were vogue during his age. His knowledge about the structure and function of proverbs made him make use of them to develop them as a cultural framework for guiding society for its well-being. The embodied nature of cultural knowledge is embedded in proverbs, i.e., studied in this work under the theoretical framework of the-taken-for-granted cultural models or schemata. Schemata are conceptual “abstractions that serve as the basis for all human information processing.” (Casson 1983:430) Schemata are organized as hierarchical structurally and sequentially. “Schemata at higher levels represent the most general concepts,” (Casson 1983:437) and schemata at a lower level represent more and more specific concepts. Schank and Abelson argue that “we understand many situations by fitting them into structural frameworks or schemata that include characters, settings, sequences of events, causal connections, goals and so forth, that are how we organize on knowledge of the world.” (R. Schank and R. Abelson 1977: 41) Rumelhart states that “schema  is a data-structure for representing the generic concepts stored in memory, and that there are schemata representing our knowledge about all concepts: those understanding objects, situations, events, sequence of events, actions and sequence of action.” (D.E. Rumelhart 1980: 34) Schemata differ in their distribution, some are universal, some idiosyncratic, and some are cultural. The universal schemata are uniform in human beings because of innate faculties of the mind and inherent division in the natural world. Idiosyncratic schemata are unique to particular individuals as the result of personal histories and life experiences. Cultural schemata are shared by members of particular societies. This brief introduction makes it clear that literary texts are great sources for understanding not only the language use but also to imbibe the cultural knowledge embedded in it. Though some of the texts have been taken from the published work of one of the authors, it is used here simply to highlight the point that most of the didactic texts function as cultural models or frameworks that function to guide the everyday activities of the community members. Therefore, this paper aims to provide an example with which can understand how didactic literary texts can be treated as conceptual metaphors or at least as cultural models or frameworks or schemata which guide and mould our everyday life. Ramanujan (1999)

Ancient Tamil Society and Its Reflection on Food as Medicine: Disease is always a haunting element in the history of human civilization. Each society individually or collectively is trying to understand the cause of disease, and its other dimensions. In the long run with cognitive development, people have developed a better understanding of many diseases and their impacts on humanity. However, looking at the complications that human beings face, the development in the field of health and related fields seems to be insufficient to solve the problems or make human beings disease-free. It shows that our quest for a disease-free human society or human beings is unending and has a long way to go. However, there is progress in understanding the human body and its functioning in infections and diseases. Conversely, the understanding of human bodies has also hurt the human health system as there are human-made diseases are around the corner, another fact is that through the changing pattern of food practice and the imposition of junk food – the health system of human beings. Kosambi (2006)

Food-medicine products are important resources for daily health management and are increasingly popular in the global healthy food market. Many foodstuffs are also with health-promoting effects, therefore, ‘food as medicine’ or ‘medicine as food’ are commonly seen, which have been recognized as almost the same as the one. However, medicine is very different from the first. Materials used as both food and medicine are considered to be important in sustaining human health, especially for the prevention of chronic diseases. In recent years, using of local or regional healthcare products has steadily increased. In turn, many regional or locally used food and medicinal products have been seen in global markets. However, the cultural knowledge differences among the people of the north, east, and west have different understandings of food and medicine which is a continuum. Additionally, people’s culture, landscape, forestry, agricultural practices and environmental differences, in the understanding of food-medicine knowledge may differ among regions, which limits the sharing of health strategies to other regions or the globe. Specifically, the type of regional plants used in culinary, usage of leaves, stems, or fruit bodies of plants may differ among different regional people. These differences are the main barrier to understanding the food and medicine knowledge between different groups and regional peoples. To remove such barriers, not only study or analyse the differences in understanding the food and medicine of various groups and regions but also study the historical root of peoples and their food practices. This may facilitate understanding the historical route and cross-cultural communication among different regions of food and medicine. Duraisamy Pillai, Avvai. Ed. (1962)

During this pandemic or after the pandemic diet-related diseases have immediate experimentation using traditional food medicines as a part of patient care and treatment. An effective diet and good food practices can overcome chronic disease. Adhering to a disease-specific diet or food via changing the lifestyle is preventing and modifying the risk of chronic diseases. Food and medicine-related clinical guidelines help in treating obesity, heart disease, diabetes, and chronic kidney disease. These diseases are prominent due to the intake of low-nutrient, sugary foods, and processed meals. It is well documented that the cause of chronic illness is not adherence to healthy food or a prescribed diet. This may be attributed to multiple reasons that diet complexity, challenges in their daily lives, and uncertainty in selecting preferred food. If people are adherent to dietary food that improves the overall health and outcome of decreased hospitalization. So what we eat has a great effect on our overall health. The topic, food and medicine or food as medicine, gets in popularity among health care providers and policymakers. Providing nutritional food to patients improves their health and prevents the progression of diseases. Hence, many healthcare professionals and providers see food as a complementary form of medicine and not an alternative to medicines.  Registered Dietitian Nutritionists, who are experts in food and nutrition, designed a meal called medically tailored meals and evidence shows that these meals reflect appropriate nutrition.  These medically tailored meals are prepared via culinary medicines which combine evidence-based medicine and nutrition to develop the diet recommendation. Once the healthcare provider determines the patient's needs, (s)he can then work with the patient to prescribe the best diet to accomplish mutual goals. In the North, East and West, the knowledge of using herbs as food or medicine can be found in the historical medical texts.  Food also plays an important role in Ayurveda, a traditional medical system from the South Asia subcontinent. Kailasapathy (1968)

Primary example from Tirukkural: Tirukkural does not need any introduction. However, Tirukkural is one of the ancient scriptures in Tamil literature and it is universally accepted for its content and appeal. The verses present in the text are known for their highly philosophical with metaphysical outlook. Because of its universal appeal but with cultural variation, the book is praised with epithets. Some of the values highlighted by the texts such as “truthfulness, self-restraint, gratitude, hospitality, kindness, the goodness of wife, duty, giving, etc and so forth, besides covering a wide range of social and political topics such as king, ministers, taxes, justice, forts, war, the greatness of army and soldier's honour, the death sentence for the wicked, agriculture, education, abstinence from alcohol and intoxicants” are some of the topics, that are treated on par world literature on ethics, and they are applicable in the modern context. The universal appeal on the construction of ethical and moral society, and the individual well-being are the two traits the text is praised worldwide. Apart from its ethical and moral appeal, the text is well recognized for its influence on social, political, economic, religious, philosophical, historical and spiritual fields. That is seeing human beings both as individuals as well as social beings with universal habits shows that Tirukkural is more contemporary. It is surprising to know some of the conceptualization of Tirukkural is precise and accurate, even modern science could not have a deviation, on many of the issues. For example, modern science can tell us that there are four types of diseases – infectious diseases, deficiency diseases, hereditary diseases and non-genetic hereditary diseases which are almost related to or can be considered as physiological diseases. But considering the period which had no modernized society, Thirukural focuses on deficiency diseases and provides medicines for that. The chapter on medicine (Chapter 95 Marunthu/Medicine) is considered more meaningful and denotatively and connotatively referring to different things that are part of social and cultural life. This chapter consists of ten couplets and they are presented in the order that is more logical and has an ascending tendency to understand something in its gradual progression. Let us see all these couplets (Translation by Rev. Dr. G.U. Pope, Rev. W.H. Drew, Rev. John Lazarus and F.W. Ellis, First published W.H. Allen, & Co 1886. Project Madurai 2002 www.projectmadurai.org): Casson, Ronald, (1983)

1)      mikiṉum kuṟaiyiṉum nōyceyyum nūlōr / vaḷimutalā eṇṇiya mūṉṟu.

The learned books count three, with wind as first; of these,

As any one prevail, or fail; 'twill cause disease. (Kural 941)

(If (food and work are either) excessive or deficient, the three things enumerated by (medical)

writers, flatulence, biliousness, and phlegm, will cause (one) disease.)

2)      marunteṉa vēṇṭāvām yākkaik karuntiya /taṟṟatu pōṟṟi uṇiṉ.

No need of medicine to heal your body's pain,

If, what you ate before digested well, you eat again. (Kural 942)

(No medicine is necessary for him who eats after assuring (himself) that what he has (already) eaten has been digested.)

3)      aṟṟāl aḷavaṟin tuṇka aḵtuṭampu / peṟṟāṉ neṭituykku māṟu.

Who has a body gained may long the gift retain,

If, food digested well, in measure due he eat again. (Kural 943)

(If (one's food has been) digested let one eat with moderation; (for) that is the way to prolong the life of an embodied soul.)

4)      aṟṟa taṟintu kaṭaippiṭittu māṟalla / tuykka tuvarap pacittu.

Knowing the food digested well, when hunger prompteth thee,

With constant care, the viands choose that well agree. (Kural 944)

((First) assure yourself that your food has been digested and never fail to eat, when very hungry,

whatever is not disagreeable (to you)).

5)     māṟupā ṭillāta uṇṭi maṟuttuṇṇiṉ / ūṟupā ṭillai uyirkku.

With self-denial take the well-selected meal;

So shall thy frame no sudden sickness feel. (Kural 945)

(There will be no disaster to one's life if one eats with moderation, food that is not disagreeable.)

6)     iḻivaṟin tuṇpāṉkaṇ iṉpampōl niṟkum / kaḻipēr iraiyāṉkaṇ nōy.

On modest temperance as pleasures pure,

So pain attends the greedy epicure. (Kural 946)

(As pleasure dwells with him who eats moderately, so disease (dwells) with the glutton who eats voraciously.)

7)     tīyaḷa vaṉṟit teriyāṉ perituṇṇiṉ / nōyaḷa viṉṟip paṭum.

Who largely feeds, nor measure of the fire within maintains,

That thoughtless man shall feel unmeasured pains. (Kural 947)

(He will be afflicted with numberless diseases, who eats immoderately, ignorant (of the rules of health).

8)     nōynāṭi nōymutal nāṭi atutaṇikkum / vāynāṭi vāyppac ceyal..

Disease, its cause, what may abate the ill:

Let leech examine these, then use his skill. (Kural 948)

(Let the physician enquire into the (nature of the) disease, its cause and its method of cure and treat it faithfully according to (medical rule)).

9)      uṟṟāṉ aḷavum piṇiyaḷavum kālamum / kaṟṟāṉ karutic ceyal.

The habitudes of patient and disease, the crises of the ill

These must the learned leech think over well, then use his skill. (Kural 949)

(The learned (physician) should ascertain the condition of his patient; the nature of his disease, and the season (of the year) and (then) proceed (with his treatment).)

10) uṟṟavaṉ tīrppāṉ maruntuḻaic celvāṉeṉ / ṟappāṉāṟ kūṟṟē maruntu.

For patient, leech, and remedies, and him who waits by patient's side,

The art of medicine must fourfold code of laws provide. (Kural 950)

(Medical science consists of four parts, viz., patient, physician, medicine and compounder; and each of these (again) contains four sub-divisions.)

 

Discussion on the couplets: These ten couplets present a vivid account of many associated concepts or notions concerning not only disease but also social and cultural attributes towards the body, health and the process of healing. The use of language is the secondary concern in this paper as Tirukkural is the masterpiece in terms of language use and words used in each couplet are apt and there are no alternatives to them. For example, the chapter entitled Medicine, not as Disease symbolizes the metaphorical use of the term marunthu- while the whole Tirukkural is considered as a marunthu for social diseases, now here the word is used in a larger context, sometimes metonymically also. Another interesting feature and generosity of Thiruvalluvar can be found in the way he admits that what is told is already told by the learned persons, and it can be compared with the way Tolkappiyar admits about what is being practised/told. It reflects that there is a long tradition well before Thiruvalluvar and Tolkappiyar. When we hear modern dietitians and doctors’ use of a “balanced diet” could be an exciting one if we are ignorant of what Kural says. The body is treated as a container metaphor where the quantity it holds must be as exactly at the normal, an increase or a decrease in the level of quantity will harm the balance of the container. Here, these three elements - flatulence, biliousness, and phlegm – (Vata, Pitta and Kapha - respectively) decide the condition (or level) of the body or functioning of the body. The second couplet is about what quantity of food must be taken and when it has to be taken – all are discussed in the second and third verses. The next Kural directly relates to the cause of the problem by giving a way to food eating practice that once the previous food is digested (after assuring that it is digested), a limited or moderate quantity of food intake must be done. Food must be taken when there is hunger, that is, one cannot junk the food into the body which will disturb the balance. The third one necessitates that one must ascertain whether digestion is completed or not. A moderate quantity of food which is not disagreed by the body can protect the body from any imbalance. Again moderate eating is highlighted in the next Kural that equates moderate eating with the source of pleasure, whereas excessive is associated with the cause of disease. Happiness will prevail with a person who eats moderately, whereas disease will approach the one who eats uncontrollably. This Kural does not need more elaboration. It has current validity and modern medicine promotes a balanced diet. Unlike the previous Kural which talks about a person who will not be affected by the disease, the next offers a formula by which one can understand who will get the disease. The greatness of Tirukkural is that it offers multidimensional details on the issue. That is, one who does not know about the level of hunger and wants to eat without knowing the rules of any disease will get the disease. Now the Kural is moving towards a peak in the trajectory of understanding. The next level of the state of disease and here it offers a three-fold formula to handle it: an enquiry must be done on the nature of the disease – its cause and its methods to cure, and to treat it faithfully - according to the rule available in the medical history. A physician, detecting disease, finding the cause of the disease, finding the methods to cure and curing it faithfully are the four components of the discipline of medicine. The efficiency of the doctor or physician is highly insisted by mentioning that one has to treat the patient to cure with faith in their discipline or about their skill or knowledge. The next Kural presents an advanced level of handling the disease by the learned physician: in stage one the learned physician should ascertain the condition of his patient, then the nature of his disease, then the season of the year and finally to proceed with the treatment process. It is the most appealing Kural because it integrates many different elements on the common issue: the role of a physician is highly demanded as per his knowledge of the whole scenario, particularly, he should be aware of the timings for treatment. (For some commentators timing or kaalam may be referred to as the knowledge of climate/weather/season in the local environment, that is, the local environment is considered as a platform or medium that can disturb the curing process). Finally, in the advanced stage of medical development, this Kural offers the salient elements that are considered important as far as disease is concerned. Here also Tirukkural comes to refer to the medical science prevalent in that time. The parts are: patient, physician, medicine and compounder/ medical attendant/caregiver; and a treat is the combination of all of these four elements. Even though there is tremendous growth and development have taken place in the medical field with the incorporation of both physiological and psychological aspects of human diseases, Tirukkural reflects the worldview of the Tamil society that had a detailed understanding of the human body and its composition. Thus, each Kural within a chapter is not merely an arrangement or listing but symbolically represents the attitude of the Tamil society in nurturing the natural body and its disease in terms of maintenance of levels, along with indicators and warnings. Marr (1985)

Examples from other Tamil literature:

The importance of food is always highlighted by ancient Tamil literature, and the example (Chapter on Medicine) from Tirukkural indicates the point. However, there are other examples, given as indicative of the point that the ancient Tamil society had a better understanding of the complexity of health and the human body in terms of food. The following are a few noteworthy examples: Nedunjeziyan (2009)

The Purananuru verse lines 18-23 (nīr iṉṟu amaiyā yākkaikku ellām / uṇṭi koṭuttōr uyir koṭuttōrē, / uṇṭi mutaṟṟē uṇaviṉ piṇṭam, / uṇavu eṉappaṭuvatu nilattoṭu nīrē / nīrum nilaṉum puṇariyōr īṇṭu / uṭampum uyirum paṭaitticiṉōrē). The verses point out the complexity and interrelationship between elements found in nature. However, the prominence of water is explicitly highlighted almost in all the literary works like Tirukkural. These Puram lines also meant the point that all bodies cannot survive without water, and food is important for life. That is, those who are giving food meaning they are giving life to the living organisms. Food is the product of water that is mingled with earth. That is, the relationship between water and earth and food cannot be separated. That is, those who are putting them (water, earth) together live if created on the earth. However, those who put those who unite the earth and water, create the means for bodies to live in this world.  Barren fields which are sown, which look to the skies for water, are of no use to an able king, even if they are huge. Another verse from Puram (189:5) uṇpatu nāḻi, uṭuppavai iraṇṭē, / piṟavum ellām ōrokkumē gives the human necessity of food and two sets of clothes. Here one could see how both culture and nature occupy a conflicting position, and they occupy different dimensions within everyday activities: food is symbolized as part of the essential item and the clothes are treated as the symbolic reflection of culture. However, ancient Tamil society treated both nature and culture as part of human necessity. Further, it talks about the quantity of food and the amount of dress one needs for a person to live on the earth for a day. There are instructions on how to eat food like sitting on the ground east facing, and the forbidden are either standing while eating or sitting on cot. A hundred feet walk after the consumption of food is considered to be good. ceḻuṅkōḷ vāḻai akal ilaip pakukkum (Puram 168: 13) shows that they share their food on wide leaves of plantain trees that put out large clusters of fruits. “kumari vāḻaiyiṉ kuruttakam virittīṅku amutam uṇka aṭikaḷ īṅkeṉa.” (cilampu-16: 41-42). This line from Silappathikaram offers evidence to the use of plantain leaves for food consumption and it is considered as good in the ancient Tamil society. The practice is being continued in modern times also. Plant-based food products are storehouses of several bioactive constituents such as phenolics, flavonoids, terpenes, and sterols. Phytochemicals from these plant-based food products have been evaluated for their biological and antibacterial effects. These bioactive substances helped for further development of plant-based pharmaceutically important compounds. The World’s 80% of the population is largely reliant on plant-based products and natural products as a primary source for treatment. Since the last decade, using of traditional medicinal practices, herbal medicine and switching to traditional food are unprecedentedly grown among people all over the world.  In ancient literature,  the use of goose berry as reported in Kurunthokai (“nelli ampuḷi mānti”), Akananuru (“puṉkāḻ nellip paiṅkāy tiṉṟaṉar’), Cirupanattruppatai (“kaviṉiya nelli amiḻtu viḷai tīṅkaṉi”), Nattrinai (“cuvaikkāy nelli”), and Purananuru (“ciṟiyilai nellit tīṅkaṉi”, “nellit tīṅkaṉi kuṟiyātu / ātal niṉṉakat taṭakkic / cātal nīṅka emakkīttaṉaiyē.” (91). The concept of egai – charity is identified with Adhiyaman (among others) because of the reason that instead of eating the life-saving goose berry he gave it to Avvaiyar which is considered as the token of greatness of egai. Because of its medicinal properties, the gooseberry is considered by the ancient Tamil society as precious. Gooseberry has an important role in the traditional medicine of India to reduce anxiety and burning sensation in the skin and eyes, improve anaemic conditions, favour the health of the male reproductive system and reproduction, facilitate digestion, improve liver health, and also exert a tonic effect in the cardiovascular system. Gooseberry is rich in antioxidants such as gallic acid, ascorbic acid and phenolic compounds and thus helps the body’s immune systems and digestion. Ramanujan (1999)

The major component polyphenols, and vitamin C in gooseberry play a potential role in assisting the promotion of health and prevention of diseases.    Black pepper, possessing potential application in traditional as well as current medicinal practices, has been reported to have a gastrointestinal activity to increase appetite, to antidote cough, cold, dyspnea throat diseases, discontinuous fever, dysentery, stomachache, worms and piles and is used as anti-inflammatory, antipyretic, and to treat epilepsy and snakebite. Dried black pepper seed is one of the vital spicey ingredients in food, particularly in Asian countries. Piperine, a major bioactive compound found in pepper, displays various therapeutic benefits and improves the therapeutic value of many drugs, vaccines and nutrients. Black pepper is rich in minerals and has significant concentrations of vitamins such as Vitamin C, B1, B2 and B3. Pepper (Tamil proverbs: “If you carry ten peppers you can eat in enemy’s house” and “Carry ten peppers even you go to enemy’s house”) has highly medicinal value and even Malaipadukatam (520) mentions the use of it in cooking (“karuṅkoṭi miḷakiṉ kāyttuṇar pacuṅkaṟi.”)  and it is also used as antidote for poison. Ginger, Turmeric (“iñci mañcaḷ paiṅkaṟi piṟavum” – Malaipadukadam), salt (“nelliṉ nērē veṇkal uppeṉac / cēri vilai māṟa kūṟaliṉ maṉaiya.” (Kural 140; “uppu amaintaṟṟāl pulavi atuciṟitu /  mikkaṟṟāl nīḷa viṭal.” (Kural 1302)); honey (“pāṟpey puṉkan tēṉoṭu mayakki”(Puram 34:10); “pālōṭu tēṉ kalantaṟṟē paṇimoḻi / vāleyiṟu ūṟiya nīr.” (Kural 1121), toddy (treated as food. For example, “ilaṅkuvaḷai iṭuñcērik / kaṭ koṇṭik kuṭippākkattu / nal koṟkaiyōr” – Maduraikkanji; “naṟavu”(to drive away cold and give hotness to bodies, soldiers have consumed toddy as food - Purananuru 2077); also used to reduce pain during a long walk – Porunarattruppadai 85-88) (“kumari kaṇṭa nōykku kumari koṭu”- proverb on the importance of aloe vera – kattralai) are some of the items that have been used in food practices for their medicinal values. Similarly, the ancient Tamil society had an understanding of the wrong combination of food, like the present generation having food combinations such as fish and curd, honey and ghee eaten in disproportionate quantity will turn into poison (Kural 944). Interestingly, there are remedies for avoiding any allergies due to food intake, for example, to avoid any allergy due to jack fruit dry ginger has to be consumed. (Kural 945) [Some of the examples mentioned here had been based on the article Food as Medicine in Literature Jan 2018 by Dr. S. Narendran, Unkal Nulagam, keetru.com.]. Hunger is considered a disease in Manimekalai. Aravindan (2018)

Concluding remarks: Such a huge topic like this finds it difficult to conclude in a few pages, but there is a need to end it by consolidating some of the ideas. Modern life is filled with things promoted as essential by corporate sectors with the help of media, which has resulted in the loss of health on the one hand and the getting of new diseases on the other hand. There is a constant appeal by the modern generation for a healthy life, but not knowing how to escape from the unwanted food habits and change in the lifestyle that are promoted by the globalization agenda. However, there is a contradiction between the present generation and the ancient Tamil society in terms of health – while the former thinks that food is a disease, the latter celebrates food as medicine. In both cases, the perception of the body as a natural construction is being understood differently. While ancient society had treated the body as a container having elements that one has to maintain at a normal level to avoid any diseases related to deficiency, the present generation treats the body as merely a container where anything can be dumped to get pleasure and comfort. However, this dichotomy in understanding could be avoided if the present generation had access to ancient Tamil literature that has enormous information to create better awareness - at least to minimize the evil effect on the health system of the present society. In this article, it is pointed out that if the body is the composition of chemicals, then we have to carefully add to balance the loss due to functioning, that means that, the addition or supplementation has its limitation because the excess amount will lead to further complication in terms disease. Further, whenever or wherever, things are not avoidable; the quantity must be minimized to avoid the risk. With the help of literary references cited here, this article drives home the point that the corpus of ancient Tamil literature has its contemporary relevance and thus, the ideas, notions and concepts found in the literature must be made available for the current society to save the future generation as well as to carry forward the continuity of Tamil tradition. Thus, through this article, the idea of the ancient Tamil society that food and food habits are the decisive factors of body health is reiterated here.

 

CONFLICT OF INTERESTS

None. 

 

ACKNOWLEDGMENTS

None.

 

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