Siddha system of Medicine is evolved based on Ninety-six tools otherwise called Tattuvam, which include physical, physiological, psychological and intellectual aspects of every human being. Among the ninety-six tools, the five elements (Pancaputam) are the fundamental units for everything in the human body and the Cosmos. There are three vital life factors responsible for good health. The three vital life factors are formed by the appropriate combination of elements even from intra uterine life. Vali (Vatam) is formed by the combination of the elements of air and space. Azal (Pittam) is formed by the fire element and Aiyam (Kapam) by the combination of earth and water elements. There are seven physical constituents (similar to tissues) in our body, and the physiological and pathological features of these tissues have been detailed in Siddha literature and they are applied in practice.

The Siddha system is believed to have evolved from 10000 - 4000 B.C. With its Dravidian origin, it serves mostly the people living in southern India, Sri Lanka, Malaysia, Singapore, Mauritius and some of the South-East Asian countries.

The oldest Tamil book ‘Tolkappiyam’ of 1400 BC contains medical information. Tirukkural written in 2nd century B.C. has a separate chapter named Maruntu Atikaram. Some of the ethical works in Tamil have been named after Siddha Medicines like Tirikatukam (Three pungent drugs) and Elati (indicating Cardamom), which talk about healthy living, though they have no direct reference to medicine. In Manimekalai, an ancient Tamil classic literature belonging to 2nd century A.D, the contemporary concepts on atom, soul, almighty and matter are dealt with in a chapter titled: ‘Camayakanakkar Tam Tiran Ketta Katai. In the 10th century A.D, the Caiva Cittanta cult obtained some of the early Cankiyam - Acivakam philosophies which reflected the ancient thoughts of Siddha Medicine. Princess Kuntavai N¡cciyar established a free dispensary in the name of her father Cuntara Co¾an. A 13th century inscription found in Citamparam temple depicts a list of grants given to Siddha Physicians (Vaittiyarkal) and mid-wives.

The highly evolved consciousness, intellect and heightened intuition of Siddhars resulting from their Yogic powers enabled them to explore the world around them and utilise its natural resources for the wellbeing of humanity. Their findings on the characteristics of plants, minerals and animal products and their knowledge of the properties of drugs, their purification, processing, dosage, toxicity, antidote and clinical application have been preserved and handed down.

Significant contributions have emerged from the experiences of various traditional healers who have documented their experiences and knowledge. Siddha, in its present education system, has various branches such as Siddha Pharmacology (Kunapatam), Siddha Toxicology (Nancu Maruttuvam), Siddha Pathology (Noy Natal), General Medicine (Maruttuvam), Obstetrics and Gynaecology (Cal Marrum, Makalir Maruttuvam), Siddha Paediatrics (Kulantai Maruttavam), Surgery (Aruvai Maruttuvam), Dermatology (Tol Maruttuvam), Ear Nose Throat (Katu, Mukku, Tontai Maruttuvam), Ophthalmology (Kan Maruttuvam), Psychiatry (Kirikai noi Maruttuvam), Pressure Manipulation Therapy (Varmam), External Therapy (Pura Maruttuvam), Geriatrics (Mutiyor Maruttuvam), Yogam and Rejuvenation (Kayakarpam).

A well-developed infrastructure of Siddha system exists in India, which includes Educational Institutes, Research organizations, public and private hospitals, dispensaries and registered private practitioners. At administrative level, there is Ministry of AYUSH, Government of India and there are separate Directorates of AYUSH in most of the states and union territories functioning for monitoring regulating and development of the AYUSH health care services and Education system. The health care services through Siddha are being extended to the masses through a huge network of hospitals.

Siddha education was earlier imparted traditionally through teacher – student (Kuru citan Paramparai) relationship but now it is imparted through formal education system. There are eleven educational institutions including one National Institute of Siddha. Among the eleven, two colleges are run by Government of Tamil Nadu conducting postgraduate courses in addition to undergraduate courses. The National Institute of Siddha (NIS), Chennai, an autonomous organization under the Ministry of AYUSH, Government of India, offers postgraduate courses and doctoral research programmes, besides providing medical care and undertakes research to promote and propagate the Siddha Medicine.

Siddha medicine is also practiced in Sri Lanka, Malaysia and Singapore where there is a sizeable Tamil population. Malaysian Government regulates Siddha practice by registering under Traditional and Complementary Medicine (TCM). In Sri Lanka, a Siddha department affiliated to Jaffna University and another Institute in Trincomalee Campus affiliated to Eastern University impart Siddha education (Undergraduate Course). There are also good number of Siddha hospitals and dispensaries providing service in different provinces of Sri Lanka.

Propagation of Siddha system across the world is done by establishing AYUSH information Cells / Health centres in Indian embassies / missions and the cultural centres set up by Indian Council for Cultural Relations (ICCR) in foreign countries and deputation of experts and International AYUSH fellowship programme for foreign nationals in Premier Institutions of India.

The establishment of Central Council of Indian Medicine, Central Council for Research in Siddha and National Institute of Siddha are the major establishments initiated by the Government of India for setting standards for clinical practice, education and research in Siddha

In September 2010, the Central Council for Research in Siddha (CCRS) was created by bifurcation of the erstwhile Central Council for Research in Ayurveda and Siddha (CCRAS). CCRS is an autonomous body registered under societies act in July 2010 under the then Department of AYUSH, Government of India. It is an apex body for research, setting standards for research methodology and preparing standard treatment protocols in Siddha.

Traditional Knowledge Digital Library (TKDL) is a project of Council of Scientific and Industrial Research (CSIR). TKDL involves documentation of the knowledge available in public domain on traditional knowledge from the existing literature of Siddha, Ayurveda, Unani, and Yoga in digitized format and translates the information into the native languages of the patent examiners, including the five international languages -- English, French, German, Spanish and Japanese

The strength of the Siddha Medicine lies in its holistic approach -- the physical, mental, social and spiritual well-being by adapting simple lifestyle practices (postures, breathing exercises, meditation, etc.) dietary regimens relevant to six tastes, usage of safe and effective plant based drugs and drugs of mineral and animal origin. Another aspect of Siddha for its universal adaptability is its unique therapeutic methods-- pressure manipulation therapy i.e. Varmam and physical manipulation therapy i.e. Tokkanam, that are skillfully carried out by trained practitioners.

The process of ageing brings along with it a numerous degenerative physical and mental changes which are managed in Siddha system by the rejuvenative (Kayakarpam) practices involving simple herbal formulations (powerful antioxidants) prescribed with specific dose to be taken for a particular length of period and Yokam techniques.

In Siddha, diagnosis is based on the following eight kinds of diagnostic tools -- Pulse (Nati), Perception by palpation (Paricam), Tongue (Na), Complexion (Niram), Speech (Mozi), Eye (Vizi), Faeces (Malam) and Urine (Muttiram). Examination of pulse and urine are very important because they are helpful not only in arriving at the diagnosis but also in assessing the prognosis of the disease. In the area of diagnosis, the pulse diagnosis, which is predominantly dependent on the clinical acumen of the practitioner, could be carried out in any location.

Treatment procedures in Siddha help in normalizing the altered vital life factors (Mukkurram i.e. Vali, Azal and Aiyam). Therapeutic purgation normalises Vali therapeutic emesis normalises Azal therapeutic instillation of nasal drops and collyrium normalises the Aiyam.

The cornerstone of Siddha Medicine for healthy living is food and life style. ‘Food itself is medicine and medicine itself is food’ is one of the basic principles of Siddha system of medicine. Selection of food according to the landscape where one lives, the climate one is exposed to and the lifestyle that one adopts is essential to lead a healthy life.

Siddhars have recommended certain basic lifestyle guidelines -- preventive measures (piniyanuka Viti) that help to prevent diseases. Rejuvenating procedures (Kayakarpam) increase our immunity.

Siddha Medicine plays a vital role in maintaining the health of the elderly. Significant causes of morbidity among these people are chronic inflammatory and degenerative conditions, metabolic diseases like diabetes, hypertension, musculo-skeletal disorders, psychiatric disorders, urinary problems, etc. Siddha intervention activates physiological processes that influence metabolic and immunological status and offers cost effective palliative care for the elderly patients.

The therapy in any medical system is two-fold-- preventive and curative. In Siddha, a unique class of Kayakarpam therapy emphasizes promotive and rejuvenative health approaches. In addition, Kayakarpam enhances the life span, delays ageing, and improves intelligence and memory.

The classical text Tirumantiram defines medicine as the one that cures physical and psychological ailments, the one that prevents diseases and the one that ensures longevity. Thirty two types of internal medicines and thirty two types of external therapies and treatment procedures are elaborated in Siddha. Source materials for the preparation of Siddha drugs are obtained from plants, minerals and substances of animal origin. The compound drugs consist of poly-herbal, herbo-mineral and mineral preparations. Siddhars were the pioneers in using minerals as therapeutic agents. In search of medicines that could prevent the body from perishing, Siddhars chose minerals and developed inorganic compounds, called Parpam (Calx), Centrum (Calcined red oxide) etc., which are minute particles that can be easily absorbed and assimilated in the body.

Pharmaco-dynamics of Siddha drugs is based on the concepts of Taste (Cuvai), Property of a drug (Kunam), Potency (Viriyam), Post-digestive Transformation (Pirivu) and Specific pharmacological action (Makimai). Adjuvant (Tunai Maruntu), Vehicle (Anupanam) and Dietary regimen (Pattiyam) also play a role in pharmacodynamics.

Siddha drugs are manufactured under drug-manufacturing license issued by the State Licensing Authority of the state where the drug-manufacturing unit is established.

Pharmacopoeia Commission for Indian Medicine and Homoeopathy was constituted by Government of India. It is an autonomous body with main objectives of publication and periodical revision of the Ayurveda, Siddha, Unani and Homoeopathy Pharmacopoeia of India.

Ayurveda Siddha Unani Drugs Technical Advisory Board (ASUDTAB) is a statutory body under the Drugs and Cosmetics Act, constituted by Ministry of Health and Family Welfare, Government of India to provide technical advice in the matters of Ayurveda, Siddha and Unani drugs.

Pharmacovigilance is a key activity relating to collection, detection, assessment, monitoring and prevention of adverse effects with pharmaceutical products. This is applicable to Siddha drugs also.

Certain special therapies/external therapy techniques such as Pressure Manipulation Therapy (Varmam), Physical Manipulation Therapy (Tokkanam), Bone setting (Otivu Murivu Maruthuvam) and Parenteral Administration (Kutori Maruttuvam) reveal the individuality and unique identity of this system.

With the increasing awareness among the public and scientific developments, Siddha system will soon reach greater heights in providing health care delivery to the public.

This document is structured into seven chapters detailing the history, the basic concepts, the holistic health management approach, drugs, specialised therapeutic procedures, research, education and clinical practice of Siddha system of Medicine.