Thamboolam

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Effects of Consumption of Thamboolam (Conventional Betel

Chewing) in Traditional Siddha Medicine

Thomas M.Walter*

H.Nalini Sofia**

Introduction

Thamboolam is a name referred to betel leaf, areca nut and slaked lime taken

together or considered as a whole. Sometimes cardamom, long pepper, clove,

calophyllum aromaticum, nutmeg, mace and dried ginger are also added with them and

chewed. Areca nut has

a long history of use and is deeply ingrained in many

socioculturaland religious activities. The use of betel leaf can be traced as far back as

two thousand years. It is described in the most ancient historic book of Ceylon, the

Mahavasma, which is written in the Pali language. Arecanut is the seed of the fruit of

the oriental palm, Areca catechu. Thin slices of the nut, either natural orprocessed, may

be mixed with a variety of substances includingslaked lime (calcium hydroxide) and

spices such as cardamom, coconut,and saffron. Most significantly, they may be mixed

with tobaccoproducts or wrapped in the leaf of the piper betel plant. Arecanut is used by

an estimated200-400 million people, mainly IndoAsians and Chinese. Betel chewing is

considered as a good and cheep source of dietary calcium.

Major ingredients ofThamboolam

1. Kammaru betel - Dark coloured pungent betel leaf.

2. Areca nut (Areca catechu)

3. Lime (Calcium hydroxide)

* Asst. Lecturer, Dept. of Gunapadam (Pharmacology), Govt. Siddha Medical College, Palayamkottai,

Tamilnadu, India. [email protected]

** PG Scholar, Department of Maruthuvam (Medicine), National Institute of Siddha, Tambaram

Sanatorium, Chennai, India. [email protected]


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Properties of the Ingredients and its traditional uses

1. Betel leaf

Betel leaves have a strong pungent aromatic flavor and is widely used as

masticators. The presence of a fairly large quantity of diastase in the betel leaves is likely

to play an important part in starch digestion. Large quantities of saliva produced by

chewing betel leaf act as digestive and probably the presence of diastase enhance this

activity. The leaves contain good amount of B vitamins (particularly nicotinic acid)

ascorbic acid and carotene.

Kammaru betel leaf consists of more juice which cures pharyngitis, abdominal

pain and abdominal distension. Ordinary betel leaf cures urticaria and the effects due to

the derangement in the equilibrium of the three humours namely Vatha, Pitha and

Kabha. It gives a pleasant odour in the mouth. Betel leaves possess an anti-oxidant

action. The anti-oxidant effect is due to the presence of phenols particularly hydroxyl-

chavicol (4- allyl pyrocatechol). The leaf produces an aromatic volatile oil containing a

phenol called chavicol which has powerful antiseptic properties. The essential oil

present gives rise to a sensation of warmth and well being in the mouth and stomach. It

is also known to produce a primary stimulation of the central nervous system, followed


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by a kind of inebriety in large doses. The betel leaf is believed as a common household

remedy for various ailments.

Traditional uses

1. A paste of betel leaves mixed with salt and hot water can be administered for filariasis.

2. For treating obesity one betel leaf mixed with piper nigrum is prescribed for two months.

3. Juice with honey or a liquid extract is useful in coughs, dyspnoea, deranged phlegm and

indigestion, common in children.

4. The application of leaves smeared with oil is said to promote secretion of milk when

applied on the breasts of lactating women.

5. A local application is recommended for inflammatory swellings such as orchitis, arthritis

and mastitis.

6. In pulmonary affections of childhood and old age, leaves soaked in mustard oil and

warmed are applied to the chest in order to relieve cough and dyspnoea.

2. Areca catechu (Betel nut)

The nut is used as a masticatory by the people of India and East Asia. The betel

nut contains several alkaloids, the chief of which is arecoline, an oily liquid, which is

soluble in water and most of the organic solvents, and boils at 220C. It is highly

poisonous and resembles pilocarpine in action.

The quality of areca nut

If one chews areca nut, it removes kapham (phlegm) and relieves constipation. It

destroys the germs and cures hemorrhoids and fissure in ano. If taken in excess it will

cause anasarca. Dried nut is stimulant, astringent and taenifuge. It increases the flow of


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saliva; lessens perspiration; sweetens the breath, strengthens the gum and produces mild

exhilaration. Raw nut produce vertigo and a sense of intoxication resembling that

experienced after alcohol; with old nuts these effect are not clearly so marked. The

variation in the effects produced is due to differences in the arecoline content of the nuts.

The quality of tender areca nut

Tender areca nut removes the kapham (phlegm) formed in throat, neutralizes

deranged vatham and kapham removes staunch Anorexia. But it will never reduce the

digestive fire.

The quality of worm eaten areca nut

The worm eaten areca nut should be made into pieces and soaked in water. They

should be washed several times, dried, spices are added and powdered. One should pass

stool after eating and chewing recants which improves digestion.

Exclusion criteria in the selection of Areca nuts.

1) Unripe areca nut, much ripened areca nut, dampened nut, insects laden nuts with

holes should be avoided.

2) Fresh, tender, immature, over ripen or rotten areca nuts should not be chewed.


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3) Ifkalipakku, the dried and coloured areca nut, is consumed, chest congestion due

to sputum and diarrhea will be caused.

4) If the areca nut alone is consumed it cause anaemia and so it should not be taken

alone.

5) Fresh nut is some what intoxicating and produces giddiness in some persons.

Traditional uses

Powder of the dried nuts in 10-15 grain doses with equal parts of sugar will check

diarrhea due to debility.

One forth tola of the powder rubbed in o a paste with two tolas of fresh lemon

juice makes an excellent vermifuge.

4-6 drachms of the powder stirred up with 2 or 3 ounces of milk is generally

administered for the expulsion of the tape- worm.

The nut is useful in checking the heart burn of pregnancy.

The nut is used as an astringent for bleeding gums.

Toxic symptoms of betel nut

Some individuals are very sensitive to betel nuts, and develop poisonous

symptoms soon after taking even a small fragment of a betel nut. Acute poisoning may

be caused by chewing unripe betel nuts.


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The chief symptoms are,

Flushing of the face

Profuse perspiration

Bronchial spasm

Contraction of the pupils

Thirst

Colicky pain in the abdomen

Diarrhoea

Tetanic spasms

Difficult breathing

Slow pulse

Collapse

3. Lime (Chunnambu)

In the animal kingdom lime is found in the hard part of Corals and in Oyster

shells. It is obtained from lime stone; Calcined cowries; Conch shells; Bivalve shells and

Snail shells. These shells are purified by being soaked in lemon juice and are prepared

for use by being calcined with in covered crucibles.

The lime is employed to neutralize the astringent effect of the acid nut. In

addition to the above two main ingredients, the alkaline reaction of the lime plays an

important part in liberating the alkaloid arecoline from areca nut. In this way lime also

plays an important role in enhancing its nervous effects. Using lime stone variety helps

in the digestion of food. It cures the indigestion caused by ghee, diarrhea, centipede

poison and other poisons. It increases spermatogenesis and strengthens the teeth.

Using pearl lime cures chronic diarrhea, phlegm, worms and diseases of the

stomach and anorexia caused by vatha humour. The other types of lime should be

avoided.


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Traditional uses

Lime water given internally forms a good antacid in dyspepsia and heart burn.

1) One to four drachms is given with ilk to children in acidity of the stomach.

2) In the diarrhea and vomiting of infants and young children, resulting from

artificial feeding one part of lime water diluted with four to six parts of milk is

suitable and the saccharated solution of lime internally is also of great service.

3) Obstinate vomiting, diarrhea, in consumption, in poisoning by mineral acids,

vomiting attendant on the advanced stages of fever, even the black vomit of

yellow fever and pyrosis or water brash sometimes yield to a few doses of lime

water four or five ounces being added to a pint of milk.

4) In poisoning by any mineral acids, and also arsenic, lime water given plentifully

in milk is an antidote.

5) Externally calcium popularly used in the form of lime-water, is a well known

remedy in all inflammatory swellings.

6) Scrofulous and other ulcers with much discharge have been found to improve

under the use of lime water as a local application.

7) For syphilitic ulcers or chancres one of the best applications is a mixture of lime

water half a pint and Calomel 30 grains (commonly known as black wash).

8) To burns and scalds lime liniment called carron oil, composed of equal parts of

lime water and a bland oil (olive oil or sesamum oil, preferably linseed oil)

thoroughly shaken well together so as to form a uniform mixture is a popular

remedy.

9) A paste made of quick lime and pearl ash equal parts is a useful application to

remove warts.


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Toxic features of lime

Lime is used along with betel leaves and areca nut. If it consumed in excess it

causes oral ulcers, inflammation of gastro intestinal tract, stomatitis, glossitis, pharyngitis

and burning sensation of the stomach, diarrhea and vomiting.

It acts as a caustic, when used externally and acts as a corrosive poison when

taken in a large quantity. The action is due to the alkalinity and not due to calcium.

Lime may be taken accidentally or with a suicidal intent. If inhaled, it may cause

irritation of the respiratory tract. The toxic symptoms such as severe burning pain in the

throat and stomach, nausea, vomiting, thirst, cold and clammy skin, rapid and feeble pulse are seen. Collapse and death may occur with in 24 hours. In the post mortem

appearance there may be congestion of the mucous membrane of the stomach and

intestine.

Anti dote

1) Coconut milk, butter and ghee are given to neutralize the toxic effects;

Navaneetha parpam orkungilia vennai (Siddha medicines) or decoctions with

astringent tastes are also given.

2) Turmeric paste is applied on the tongue.

3) Turmeric powder is dissolved in water and filtered water is given.

4) Buffalos butter milk can also be given

Thus the poisonous effects of lime can be removed.


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Method of preparation and consumption of Thamboolam

The betel leaf is consumed in a fresh state; the old deteriorated leaves are

believed to loss their properties. Plain betel leaf should be chewed first. After removing

the pedicle, veins and the tip of the betel leaf, lime is rubbed on the reverse of the leaf

lightly, folded and then chewed. Then areca nut should be taken. In the process of

chewing, the morsel is pushed from one side of the mouth to other, it is masticated,

pressed against or between the teeth in order to remove the juice, and it may protrude

between the lips. The areca nut constitutes one half or even more of the total weight of

the morsel, the balance being made up with betel leaf spices and lime. Generally one

large betel leaf or one and a half of the smaller leaves are used in making one morsel to

which half to one grain of lime is added.

The saliva secreted immediately after chewing betel nut in the first stage causes ill

effects and the saliva secreted in the second stage causes insanity. The saliva secreted in

the third stage is considered as ambrosia and the saliva secreted in the fourth stage is very

good and sweet. The saliva secreted in the fifth and sixth stage is not useful as they cause

the derangement of pitham, indigestion and anaemia. Hence the saliva secreted in

between the first two and the last two stages (i.e. 3rd

and 4th

stages only) must be

swallowed and the rest should be split out. This is good for the brain and eyes.

One who is in the habit of chewing betel nut in the morning should take areca nut

in excess which relieves constipation, less of betel leaves and lime. After lunch more lime

may be added with the betel nut which helps in the digestion. If betel leaf is consumed in

excess in the night it gives a pleasant odour to the mouth and prevents the offensive

odour.

Effects of Thamboolam

Chewing betel leaf with areca nut which has pungent and astringent taste

removes derangement of humors in the body. Germs will die; it removes thirst and

kapham, prevents several diseases, reduces hunger, endears women; improve taste and


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cleans the abdomen. One becomes wise and able; righteousness prevails and adds

splender of countenance.

They sweeten the breath, improve voice, and remove foetor from the mouth. Also

they increase salivary secretion. Betel chewing is considered as a good and cheap source

of dietary calcium. The calcium ingested is reported to be well absorbed by the system.

Pathological changes produced by betel chewing (Side effects)

Excessive indulgence in chewing for long periods is liable to produce,

i. Dental cariesii. Deposition of black tartar

iii. Recession of gums

iv. Partial or complete loss of sensibility of buccal mucosa

v. Pyorrhoea alveolaris

vi. Atrophy of the alveolar process

vii. Oral sepsis

viii. Cancer of the mouth

ix. Dyspepsia

x. Palpitation

xi. Neurosis

xii. Giddiness

xiii. Slow cerebration.

Contraindications for consuming Thamboolam

Persons who suffer from Haemoptysis

Hypertension

Eye congestion

Unconsciousness

Psychological disorders


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Tuberculosis

Burning fever and

Head ache

should not take Thamboolam.

Reference:

1. Dr. C.S.Uthamarayan, A compendium of Siddha Doctrine, 1st

edition, Department of

Indian Medicine and Homeopathy, Chennai-106.

2. Dr. G.Durairasan, Siddha principle of Social and Preventive Medicine, 1st

edition,

Department of Indian Medicine and Homeopathy, Chennai-106.

3. Dr. Pon.Gurusironmani Siddha Toxicology, 1st

edition, Department of Indian

Medicine and Homeopathy, Chennai-106.

4. A.K. Nadkarni, Materia Medica, Vol I & II, 3rd

edition, Popular Prakashan pvt. Ltd.

Bombay.

5. C.P. Khare, Encyclopedia of Indian medicinal plants, 1st edition, Springer-verlag

Berlin Heidelberg New York.

6. The Wealth of India, Raw materials, Vol. VIII Ph-Re, 1st

edition, Council of

Scientific and Industrial Research, New Delhi.

7. Rev. Fr. Jean Ferdinand Caius, The Medicinal and Poisonous plants of India, 5th

Reprint 2003, Scientific publishers, Jodhpur (India).


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8. K.R. Kirtikar, B.D. Basu, Indian Medicinal plants, Vol IV, 2nd edition, & An I.C.S,

Bishen Singh Mahendra pal singh, Dehra Dun (India).

9. R.N Chopra, I.C.Chopra, K.L.Handa & L.D. Kapur, Chopras Indigenous drugs of

India, 2nd edition, Academic publishers, Calcutta ( India )

10.Dr. K. Mathiharan, Prof. Dr.Amrit K.Patnaik, Modis Medical Jurisprudence and

Toxicology, 23rd edition, Lexis Nexis, New Delhi.

11.T.V. Sambasivam Pillai, Tamil-English Dictionary of Medicine, Chemistry, Botany

and Allied Sciences by Volume IV Part: I and page: 982, publisher: Department of

Indian Medicine and Homeopathy, Chennai, India. IInd edition, March 1998.

12.Saman Warnakulasuriya, Chetan Trivedy, Timothy J Peters, Department of Oral

Medicine and Pathology, Dental Institute, London SE5 9RW, Areca nut use: an

independent risk factor for oral cancer, Editorials, British Medical Journal, BMJ

2002;324:799-800 ( 6 April )

13.Williams SA. Betel-quid chewing: a community perspective. In: Bedi R, Jones P, eds.

Betel-quid chewing among Bangladeshi community in the United Kingdom. London:

Centre for Transcultural Oral Health, 1995:11-25.

14.Gupta PC, Warnakulasuriya S. Global epidemiology of areca nut usage. Addiction

Biology 2002; 7: 77-83 [CrossRef] [ISI] [Medline].

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