• Users Online: 133
  • Print this page
  • Email this page

 Table of Contents  
Year : 2019  |  Volume : 2  |  Issue : 2  |  Page : 11-15

Varmam Therapy in Management of Peenisam (Sinusitis) - A Review

Siddha Clinical Research Unit, Bengaluru – 560009, Karnataka, India

Date of Web Publication4-Oct-2021

Correspondence Address:
C Eswaran
Siddha Clinical Research Unit, Bengaluru – 560009, Karnataka
Login to access the Email id

Source of Support: None, Conflict of Interest: None

Rights and PermissionsRights and Permissions

Varmam treatment is one of the unique external manipulation therapies in Siddha system.Varmam is the science which deals with the study of certain vital energy points in the body through which Pranan[life energy] flows normally. It gets blocked in case of any injury to the Varmam points and also in diseased condition. By stimulating these vital energy points in the affected area using fingersblocked,energy gets relieved and regains its normal flow in the body. Peenisam is the term mentioned in Siddha literature that can be correlated with Sinusitis in Modern science. Siddha system of medicine identifies trauma and associated injury in particular Varmam points of body as one of the causes of Peenisam[Sinusitis]. Injuries on Varmam points that cause Peenisam[Sinusitis], Varmam ilakkumuraigal[Therapy] specified for Peenisam [Sinusitis],Internal medicines in various Siddha Varmam literatures are discussed in this review.

Keywords: Peenisam, Siddha system, Sinusitis, Varmam.

How to cite this article:
Eswaran C, Vanmathi K P, Mahadevan M H, Thilagavathi R. Varmam Therapy in Management of Peenisam (Sinusitis) - A Review. J Res Siddha Med 2019;2:11-5

How to cite this URL:
Eswaran C, Vanmathi K P, Mahadevan M H, Thilagavathi R. Varmam Therapy in Management of Peenisam (Sinusitis) - A Review. J Res Siddha Med [serial online] 2019 [cited 2021 Dec 3];2:11-5. Available from: http://www.jrsm.com/text.asp?2019/2/2/11/327518

  1. Introduction Top

Sinusitis can be broadly defined as inflammation of one or more of the paranasal sinuses. Acute symptoms last less than 4 weeks, Sub-acute symptoms last 4 to 8 weeks, Chronic symptoms last longer than 8 weeks[1],[2]with recurrent three or more acute episodes a year. Sinusitis is one of the most prevalent problems encountered in general medical practices. Some patients are predisposed to recurrent bouts of acute sinusitis, and chronic sinusitis may develop that presents as enigmatic facial or head pain.[3],[4],[5],[6],[7]

Chronic Sinusitis is the second commonest disease in USA based on the data collected during National health interview survey for the years-1990, 1991 & 1992.[8] There is no data available on epidemiological survey of prevalence of chronic sinusitis in India. Secondary data from some print media house sreveal that 134 million Indians suffer from chronic sinusitis.[9] According to European Position paper on rhinosinusitis and nasal polyps recommendations 2017and joint task force on practice parameters recommendations, Intranasal corticosteroids, Oral corticosteroids, Antibiotics, Antihistamines and Topical decongestants are recommended for treatment of chronic rhinosinusitis.[10] As the there are many adverse reactions for these medications, there is a need of effective alternative therapy for the management of sinusitis.

1.1. Siddha Varmam therapy

Siddha Varmam therapy is a unique manual therapy in Siddha system. It has its own potential to develop as a bio-energetic science. It is a special kind of treatment in which certain vital energy points in the body are being manipulated by giving pressure with fingers. Varmam therapy is an easily applicable, effective, non-invasive and time saving external therapy in Siddha system. The Varmam points are classified into two main divisions. The main divisions are PaduVarmam [12 points] and ThoduVarmam [96 points].[11],[12]

Injury in the Varmam points causes many diseases. Peenisam (Sinusitis) is one among them. There are specific Varmam therapies for the diseases caused by injury on Varmam points.

  2. Materials and Methods Top

The review process is adapted to collect various references in Siddha Varmam literature about the cause, treatment with Varmam therapy and internal medicines by using Peenisam, Neer Yetram, Mookadaippu, Mookilneervadithal as key words. The anatomical locations mentioned in Tamil are translated into relevant anatomical terms.

2.1 Inclusion and exclusion criteria:

Only Siddha Varmam literatures were taken into account for the review. The symptoms, causes and treatment of Peenisam induced by elevated Kabam were excluded from the review.

2.2 Peenisam in Siddha system

SiddharNaagamuni in the text book Thalainoimaruthuvam described Peenisam[13] in poetic four-line verse as follows,





- NaagamuniThalaiNoimaruthuvam

Siddhar Agathiyar in his text Agathiyar kanmakandam explains in detail about Peenisam.[14] According to the literature work of Naagamuni, Peenisam is generally classified into 18 types. Among them he describes 4 types; 1. Neer Peenisam, 2. Kuruthi Peenisam, 3. Seezh Peenisam, 4. Siraai Peenisam. In the text book Siddha Maruthuvam Pothu, Peenisam is described as 9 types[15] as follows; 1. Vali Mookadaipu, 2. Azhal Mookadaipu, 3. Iya Mookadaipu, 4. Neer Mookadaipu, 5. Kuruthi Mookadaipu, 6. Seezh Mookadaipu, 7. Sirai Mookadaipu, 8. Mulai Mookadaipu, 9. Kazhuthu Mookadaipu. The Siddha text, Pitham Peenisammatrum Suranoithokuthi[16] classifies Peenisam into 9 types as follows; 1. Vatha Peenisam, 2. Pitha Peenisam, 3. Silerpana Peenisam, 4. Neer Peenisam, 5. Raktha Peenisam, 6. Seezhpeenisam, 7. Siraipeenisam, 8. Moolapeenisam, 9. Kanda Peenisam.

2.3 Cause for chronic Sinusitis –Siddha perspective:

Siddha text, ‘Peenisa Nithanam’ describes the cause of Sinusitis as,

‘................................ Thalaiyile than




These lines can be translated as, Peenisam is caused by injury on Varmam points present in important joints of head.

2.4 Symptoms of Peenisam:

The Siddha text, Pitham Peenisammatrumuranoithokuthi[16] characterise the symptoms of Peenisam as follows, with increase in heat from Moolatharam, water (body fluid) accumulates in skull and causes sneezing, headache, pain in neck, Loss of sensation of smell, loss of taste sensation, Rhinitis, accumulation of phlegm in chest, pain in ear, discharge of pus from nose.

2.5 Injury on Varmam points that cause Peenisam (Sinusitis)

The siddha text, ‘Varma Maruthuvam[17] quotes the Varmam points mentioned in palm manuscript, ‘Varma Nithanam 500’, the injury on which causes chronic sinusitis if it is not properly treated [Table 1].
Table 1: Anatomical locations of Varmam points, the injury on which causes Peenisam

Click here to view

2.6 Siddha Varmam points for Peenisam

Varmam points that are manipulated in the treatment of Peenisam (Sinusitis) are mentioned in [Table 2], [Figure 1]. The manipulation of particular Varmam point helps to relieve particular symptoms. The pressure to be applied for manipulation (in Mathirai units) and the method of manipulation are mentioned in [Table 3].
Figure 1: Schematic representation of Varmam points for the management of Peenisam

Click here to view
Table 2: The following table reveals the points manipulated in Varmam therapy for management of Sinusitis[18]

Click here to view
Table 3: Application of Varmam Points in the treatment of Peenisam (Sinusitis)[19]

Click here to view

2.7 Common medicines used in the treatment of sinusitis caused by injury on Varmam points:

1. Chivarathiennai[17] : Used both as internal and external medicine

Dose as internal medicine – 10 ml, twice a day for 9 days

External – Applied on scalp before taking bath. Source Manuscript – Varmagnanaodivumurivusarasoothiram- 2200

2. Vathasannithailam[17] : Internal medicine

Dose – 10 ml, twice a day for 9 days.

Source Manuscript – Varmaodivumurivusarasoothiram – 1200

3. Varmasannipugai[17] : Fumigation for inhalation through nostrils.

Source manuscript – Varmaalavainool.

  3. Discussion Top

Sinusitis is the most prevalent disease worldwide. In Conventional treatment for chronic sinusitis, medicines prescribed are anti-histamines, topical nasal decongestants, Intranasal corticosteroids, Oral corticosteroids and antibiotics. Adverse reactions of Antihistamines and Corticosteroids & Increasing antibiotic resistance envisage the need of alternative therapy that is safe and cost-effective. Peenisam described in Siddha literature can be compared with Sinusitis. Injury on Varmam points is mentioned as one of the causes of ‘Peenisam’. ‘Varmailakkumuraigal’ are manipulation techniques of specific Varmam points and is the treatment employed for the diseases that are caused by the injury on Varmam points. The anatomical locations of the Varmam points that cause Peenisam and the location of the points that are to be manipulated for the treatment of Peenisam are discussed in the paper.

  4. Conclusion Top

Large scale clinical studies can be conducted to study the effectiveness of Varmam therapy in the treatment of Sinusitis and standardization of pressure to be applied on Varmam points.

  References Top

Gwaltney JM Jr, Hendley JO, Simon G, et al. Rhinovirus infections in an industrial Population. II. Characteristics of illness and antibody response. JAMA 1967; 202:494–500.  Back to cited text no. 1
Piccirillo JF. Acute bacterial sinusitis. N Engl J Med 2004; 351:902–10.  Back to cited text no. 2
Gwaltney JM Jr, Hayden FG. Psychological stress and the common cold. N Engl J Med 1992; 326:644–6.  Back to cited text no. 3
Smart BA. Pediatric Rhinosinusitis and Its Relationship to Asthma and Allergic Rhinitis. Pediatric Asthma, Allergy and Immunology 2005;18:88–98.  Back to cited text no. 4
Dibaise JK, Huerter JV, Quigley EM. Sinusitis and gastroesophageal reflux disease. Ann Intern Med 1998; 129:1078–83.  Back to cited text no. 5
Williams JW, Simel DL. Does this patient have sinusitis? Diagnosing acute sinusitis by history and physical examination. JAMA 1993; 270[10]:1242–6.  Back to cited text no. 6
Lindbaek M, Hjortdahl P. The clinical diagnosis of acute purulent sinusitis in general patienceda review. Br J Gen Pract 2002;52:491–5.  Back to cited text no. 7
Collins JG. Prevalence of selected chronic conditions: United States, 1990-1992. Vital Health Stat 10. 1997;[194]:1-89.  Back to cited text no. 8
Meltzer EO, Hamilos DL. Rhinosinusitis -Diagnosis and Management for the Clinician: A Synopsis of Recent Consensus Guidelines. Mayo Clin Proc.2011; 86[5]:427-43.  Back to cited text no. 10
Thiyagarajan R. Sirapumaruthuvam. Commissionarate of Indian Medicine and Homoepathy: Chennai; 2008.  Back to cited text no. 11
Kannan RT, Mohana RT. Varmam108. Siddha Book publisher: Kanyakumari; 2010.  Back to cited text no. 12
Anonymus.NaagamunivarThalainoiMaruthavam; 1976.  Back to cited text no. 13
Anonymus.Agathiyarkanmakandam300; 1995.  Back to cited text no. 14
Shanmugavelu M. PodhuMaruthuvam. Directorate of Indian Medicine and Homeopathy: Chennai; 2012.  Back to cited text no. 15
Mohanraj T. PithamPeenisammatrumSuranoithokuthi. Siddha Medical college& Hospital: Kanyakumari; 2008.  Back to cited text no. 16
Kannan RT, Mohan RT. Varmamaruthuvam. Siddha book publisher: Pudukkadai; 2017.  Back to cited text no. 17
Kannan RT. VarmaPulliIrupidam. A.T.S.V.S Siddha Medical College:Kaniyakumari; 2007.  Back to cited text no. 18
ShunmugomN, Varmamaruthuvam–AdipadaiKalvi. ThirumoolarVarmalogyInstitute: Coimbatore; 2016.  Back to cited text no. 19


  [Figure 1]

  [Table 1], [Table 2], [Table 3]


Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
Access Statistics
Email Alert *
Add to My List *
* Registration required (free)

  In this article
1. Introduction
2. Materials and...
3. Discussion
4. Conclusion
Article Figures
Article Tables

 Article Access Statistics
    PDF Downloaded5    
    Comments [Add]    

Recommend this journal