There are 32 types of external management modalities classified in Siddha system of which ‘Pattru’ or poultice is the application of medicinal substances over the affected part as a paste or pancake. The pattru or poultice application is absorbed mainly through transcellular routes through the skin layers. This modality is the main stay of treatment for many Neuro muscular conditions.

This special type of poultice is developed based on the literary evidence of Pulippani-500 text in National Institute of Siddha which employs the herbal application of Cassia auriculata (Aavarai) leaves and black gram as main ingredients. Ground mixture is made into paste by mixing it with egg white or water. The important compounds present in the ingredients of the above poultice are Anthroquinone, Flavonoids, Alkaloids and phenolic compounds.

Aavarai leaves (Cassia auriculata)

Black gram (Ulundhu)

This Aavarai ulunthu pattru (AUP) application holds promise for many skeletal and musculo skeletal conditions and is used especially in conditions of painful lumbar disc disease, disc prolapse, radiculopathy etc. This external application is traditionally used in the fracture healing by bone setters even in conditions of delayed/non union. 

Several thousand patients have been benefited by this external therapy at National Institute of Siddha which is being followed by many other Siddha institutions and private practitioners. Some of the case details of low back pain due to disc disease and spinal nerve root compression are presented here.

Overall, the patients have a faster rate of pain reduction and improvement in the quality of life. In many patients excruciating sciatic back pain are effectively controlled giving a huge sigh of relief to them. Along with bed rest this treatment works synergistically well to effect a pain reduction from the intense distress.   

Both the herbs have anti vatha properties as per the Siddha literature and also they are proven anti inflammatory agents used for various conditions traditionally. Ulundhu (Masham) or black gram is a known nervine tonic in Siddha system and hence it can be used in all the nerve related pains of the limbs.

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