Inflammation of the air cavities within paranasal sinuses is known as sinusitis.
A sinus is a hollow, air-filled cavity. Humans have four pairs of sinuses. They are:
The four pairs of sinuses are often described as a unit and termed as the "paranasal sinuses." The cells of the inner lining of each sinus consists of mucus-secreting cells and epithelial cells laden with cells of immune system (macrophages, lymphocytes, and eosinophils).
Sinusitis can be caused by infection, but can also be caused by allergy and irritation of the sinuses. A sinus infection occurs when a pathogenic microorganism (virus, bacterium, or a fungus) grows within a sinus. The sinus openings may be blocked by swelling of the tissue lining and adjacent nasal passage tissue due to common cold, allergy and tissue irritants such as cocaine, and cigarette smoke. Sinuses can also become blocked by impaired drainage of mucus, tumours or growths that are near the sinus openings. Sinusitis is one of the common condition that afflict people throughout their lives.
The symptoms of sinus infection include headache, facial tenderness, pain, fever, cloudy or discoloured nasal discharge, and feeling of nasal stuffiness, sore throat and cough.
Some people may have headache when they bend forward. Others may have toothache or ear pain, physical fatigue, or bad breath. In non-infectious sinusitis, other associated symptoms of allergy like itchiness of eyes and sneezing may be common, but may include some of the symptoms listed above, as for infectious sinusitis. Nasal drainage is usually clear or whitish in non-infectious sinusitis.
Sinusitis is mentioned under Mookadaipu (nasal block) which is also known as Peenisam or neerkovai in Siddha (link is external) literature. There are many classifications of this disease; some classify it into 86 types, while others classify 18 types. The generally followed classification of Mookadaipu is into 9 types and is as follows:-
i. Vazhi mookadaipu
ii. Azhal mookadaipu
iii. Iyam mookadaipu
iv. Neer (watery) mookadaipu
v. Kuruthi (bleeding) mookadaipu
vi. Seel (pus) mookadaipu
vii. Sirai (lower) mookadaipu
viii.Moolai (nasal polyp) mookadaipu
ix. Kazhuthu (neck) mookadaipu (that which is associated with throat).
Of these the symptoms of vazhi, azhal, Iyam and neer types closely resemble the symptoms of Sinusitis. The following symptoms are mentioned under these types in siddha literature.
Vazhi: Itching and irritation in nose, frequent sneezing, runny nose, pain in eyes, head or teeth, dryness of mouth, diminished voice and fatigue.
Azhal: Fever, reddening of nasal mucosa, increased thirst, nasal block, purulent mucous from nose, decreased smell sensation and mental instability.
Iyam: Headache, tears, reddening of eyes irritating pain in nose, white nasal drainage, continuous cough, and intermittent expulsion of mucous, purulent or bloody sputum.
Neer: Nasal stuffiness and watery discharge when exposed to cold or dust, mild fever, head ache, laziness, and pain in limbs.
Of these vazhi, azhal, Iyam can be compared to infective sinusitis and neer can be compared to non- infective or allergic sinusitis.
The other types mentioned under peenisam or mookadaipu are more related with the clinical features of rhinitis.
Kuruthi: Redness in nasal lining, bleeding and discharge of mucus from nose, pain and irritation in nose, pain in head, neck or jaws, burning sensation in eyes, tastelessness and less interest in food.
Seel: Nasal block, mucus discharge with bad smell from nose, frequent sneezing, and loss of smell sensation.
Sirai: Ulcers inside nose with discharge of mucus along with decayed nasal tissue, pits in the nasal septum and loss of appetite.
Moolai: Mass inside nose that looks like kambili poochi (caterpillar) and yanai thipilli (Piper longum) resulting in nasal block, headache and discharge of mucus and often blood.
Kazhuthu: It occurs along with sore throat, painful throat, frequent sneezing, and mucus drainage from nose etc.
Siddhars, more than thousand years ago, addressed this disease as mookadaipu, a combination of sinusitis and rhinitis (Rhino sinusitis) than mere sinusitis.
Cause and Pathology
Some major causes mentioned in siddha literature for this disease are:-
It is also considered by some authors that during yoga practice, when body heat (azhal) becomes excessive and travels from lower parts of the body towards head, if Iyam suddenly increases due to any cause; this disease will occur.
Thus according to siddha concept, this disease occurs when a person performs activities which increases Iyam humour, while azhal humour is increased in the body. The azhal humour can be in increased state due to food or any other activity which induces heat.
This disease is the result of derangement of ‘pitham’ and ‘kabam’ humors of the body as said in sadaga nadi
‘பண்பான பித்தத்தில் சேத்துமம் கூடி பரிசித்தால் பீனிசமும்’
‘If kabam increases in pitham peenisam......’
Since the pitham and kabam humours are deranged in this disease, the line of treatment includes normalisation of the increased pitham and kabam as well as treating the diseased parts which are nose and the sinuses.
Accordingly, oral medicines are given to normalise kabam and pitham, medicated oil bath to normalise pitham.
All external therapies should be done in the proper method as mentioned in the literature under the supervision of a siddha physician only.
Some Simple Home Remedies
Food items increasing Iya kuttram (kabam humour) like poosanaikai (pumpkin), suraikai (bottle guard), peerku (lufa), pudalai (snake gourd) should be avoided.
As mentioned earlier, this disease occurs due to sudden increase of Iyam (kabam humour) when the azhal (pitham humour) is increased. So the simple way to prevent this disease is avoiding sudden exposure to cold when body heat is increased. For example, sudden exposure to cold or heat, like entering an air-conditioned room immediately after coming in from hot weather, and vice versa. Likewise, intake of refrigerated and cold items immediately after exposure to sun or exercise, when the body heat is in increased state, also triggers mookadaipu (rhinosinusitis). Yogic practices also should be done by following proper procedure. Kaba and pitha thegi (persons with kabam and pitham body constitution) are more susceptible to this disease. Consulting a siddha practitioner will help to find out the body constitution and the preventive measures to be taken.
Kuppusamy Mudaliar K.N, Mookadaipu, Siddha Maruthuvam, Tamil Nadu Siddha Maruthuva variyam, 1987:192-200