Dr. Murugusundram, Founder & Medical Director, Chennai Skin Foundation, expounds on the timeless, practical advice offered by Thiruvalluvar in areas such as maintaining physical and mental well-being, making lifestyle choices, and practicing overall health.
During Covid, I started reading Thirukural. Being a doctor, I could find a medical pearl in every couplet. Thirukural is a book beyond comparison and it has gems of wisdom related to every field. It has been translated into so many languages. It covers spirituality, philosophy, ethics, self-discipline, leadership, political diplomacy, management, legality, justice, friendship, family, death, love, lust… and the list goes on and on.
Thirukural is brought out in three parts. The first part talks about virtues, the second part covers wealth and the third part covers love or lust. Even in the third part on love, Thiruvalluvar’s couplets carry a lot of medical wisdom and are more therapeutic in nature. I sincerely wish that Thirukural should be part of every medical curriculum.
Nowhere does the author prescribe a medicine for any disease. He dwells on understanding the root cause of the disease and how one can prevent it. Also, for every aspect of management, there is at least one couplet. I looked at Thirukural from the health care management perspective. Though, every couplet can be interpreted and applied in several fields, I chose to relate its relevance to the field of medicine. So let me dwell on a few couplets from Thirukural and give my own interpretations on the same, using a doctor’s hat.
மலர்மிசை ஏகினான் மாணடி சேர்ந்தார்
நிலமிசை நீடு வாழ்வார்
The flower of the heart is where the flawless lord dwells
That belief ensures long healthy life.
Valluvar has a simple remedy for managing stress. If you firmly believe that God dwells in your heart, you will not hurt that heart by stressful thoughts. This is an antidote of toxic stress.
தனக்குவமை இல்லாதான்தாள் சேர்ந்தார்க் கல்லால்
மனக்கவலை மாற்றல் அரிது
His feet, whose likeness none can find,
Alone can ease the anxious mind.
Valluvar says, ‘Surrender to a person who is unique and has no comparison.’ The unique person can be God, parents, guru, wife, son or daughter, friend or your boss. When you surrender to such a person, you will be free from anxiety. When I get stressed out, I would go to my guru and just sit in front of him. I would not discuss my problem nor would he ask me about it. We would just chat for half-an-hour and at the end of that chat, I would be totally relaxed. Normally we say that when we have a problem, we must transfer our burden to God. Valluvar suggests that you can transfer your stress to a mentor and that mentor could be anybody, who is unique in their own way.
Controlling One’s Senses
ஒருமையுள் ஆமைபோல் ஐந்தடக்கல் ஆற்றின்
எழுமையும் ஏமாப் புடைத்து.
Five senses controlled like a tortoise
Such are protected in seven births.
Tortoise is the longest living creature in the world. Those who can control their five senses like a tortoise will be assured of a long and healthy life in poise, not just in this birth but in all his seven births (This is a belief according to Indian mythology).
சினமென்னும் சேர்ந்தாரைக் கொல்லி இனமென்னும்
ஏமப் புணையைச் சுடும்.
Anger destroys everyone around you like fire
Never spares even your life’s last savior.
When we get angry in office, our colleagues will move away from us. When we lose our temper in home, our children will shy away from us. Slowly, we start losing our friends. When we start drowning in the sea of anger, someone close to us (perhaps, the spouse) may come to our rescue but our anger will destroy even such a savior. So, control your anger, for a healthy and peaceful life.
The Power of Meditation
கூற்றம் குதித்தலும் கைகூடும் நோற்றலின்
ஆற்றல் தலைப் பட்டவர்க்கு.
Meditation imparts mental strength
That mitigates the fear of death.
Meditation, according to Valluvar, gives peace of mind. Today, people get many auto-immune diseases. There may not be any discernable reason for such diseases other than mental stress. Mind relaxation exercises like yoga and meditation are recommended even by doctors for such diseases.
கண்டுகேட்டு உண்டுயிர்த்து உற்றறியும் ஐம்புலனும்
ஓண்டொடி கண்ணே உள.
Not only my senses but also my soul is satisfied by her
Why should my mind wander for more pleasure?
According to Valluvar, a husband should not seek pleasure beyond his wife. The institution of marriage is sacrosanct. This is the reason why Indian marriages survive even in turbulent times, while in the western countries, marriages fail often.
The Power of Digestion
மருந்தென வேண்டாவாம் யாக்கைக்கு அருந்தியது
அற்றது போற்றி உணின்.
After digestion one who feeds
His body needs no medicine.
Today, thanks to apps like Swiggy and Zomato, we order food at the tip of our fingers. We complete one meal and immediately, think of the next meal. This is the cause of many health problems. Valluvar says that you should not take food, unless the food taken earlier is completely digested by your system. Such a person who follows his advice will be free of diseases and they don’t need any medicines.
The concept of gastric-emptying time was propounded only during this century but it is a marvel how Thiruvalluvar knew of itt 2600 years ago. Every food has a certain gastric-emptying time. For example, if you take red-meat, it will take more than 4 or 6 hours to digest. A light vegetarian meal will get digested in one to one and half hours and sometimes, even within 30 minutes. Even water has a gastric-emptying time. All the nutrients are absorbed in the duodenum-jejenum-ileum path. We must give adequate time for the food to get digested and absorbed in this path.
Eat in Moderation
அற்றால் அளவறிந்து உண்க அஃதுடம்பு
பெற்றான் நெடிதுய்க்கு மாறு.
Eat food to digestive measure
Life in body lasts with pleasure.
Valluvar also says that even after your food is digested, you should eat only in moderation. Then only, you can live for long. What we eat should be commensurate with what work we do. If we do just desk work, we don’t need much of carbohydrates.
அற்றது அறிந்து கடைப்பிடித்து மாறல்ல
துய்க்க துவரப் பசித்து.
Know your digestion; with keen appetite
Eat what is suitable and right.
We must know about our digestive system and manage it the right way. Eating the right amount at the right time is paramount. For example, most of the Jains eat their dinner quite early and it is rare to see them obese. No food should be taken unless we are hungry. He also advises against taking foods that are contradictory in nature. Doctors recommend a balanced diet. South Indian food is generally quite balanced. Today, thanks to a sedentary life style that people lead, we recommend less of carbs and more of proteins.
இழிவறிந்து உண்பான்கண் இன்பம்போல் நிற்கும்
கழிபே ரிரையான்கண் நோய்.
As pleasure dwells with one who eats moderately
Disease dwells with the glutton (who eat voraciously)
Valluvar perhaps refers to the junk food that we take. Most people now do binge-eating. They get into depression and take huge bites of pizzas and burgers. Such people will only invite diseases.
Beware of Fake News
எப்பொருள் யார்யார்வாய்க் கேட்பினும் அப்பொருள்
மெய்ப்பொருள் காண்பது அறிவு.
To discern the Truth From everywhere;
From everyone, is real wisdom.
Today, for everything, we do google-search and rely on Google, rather than the authentic sources. Anything and everything that we hear must be vetted for correctness and that is real wisdom.
செய்தக்க அல்ல செயக்கெடும் செய்தக்க
செய்யாமை யானும் கெடும்.
Doing unfit action ruins
Failing to do the right things also ruins.
We are generally advised against doing improper things but Valluvar also stresses on not failing to do the right things. Most of us never walk and never take food on time. To maintain good health, we must exercise and have diet-control.
Beware of the Symptoms
பீலிபெய் சாகாடும் அச்சிறும் அப்பண்டம்
சால மிகுத்துப் பெயின்.
Even the gentle peacock’s plume
Cart’s axle breaks by gross volume.
This is generally interpreted that when a cart is overloaded, even to the extent of a peacock feather, then its axle will break. As a doctor, I feel that the cart refers to the human body. Even when we get a slight symptom, it should not be neglected and we should immediately attend to it. A simple indigestion that is neglected could lead to duodenal ulcer. It could even be a symptom of myocardial infarction. Each and every symptom can indicate a major problem and no symptom should therefore be neglected.
எதிரதாக் காக்கும் அறிவினார்க் கில்லை
அதிர வருவதோர் நோய்.
Never will you face the shock
As long as you predict, protect and act wise.
Those who take precautions against calamities will be saved of any serious trouble. This applies more to health. If one does a master health check-up once in six months, most of the major health problems can be easily resolved at the early stage itself. A disease at a later stage or in advanced stage becomes difficult to cure.
A Capsule for the Doctors
நோய்நாடி நோய்முதல் நாடி அதுதணிக்கும்
வாய்நாடி வாய்ப்பச் செயல்.
Seek the diagnosis; search for the causes
Apply suitable remedies that alleviate the illnesses
This is one of the most powerful lessons for a doctor. A good doctor must first diagnose the patient, look for the root causes of the disease and address those causes. The treatment given should suit the patient. Whenever we find it difficult to ascertain the cause of a disease, we would call it as ‘idiopathic disease.’ My professor used to joke, “If you diagnose some disease as idiopathic, then you are an idiot and patients who come to you are pathetic.” The duty of the doctor is to diagnose and find out the cause.
எண்பொருளவாகச் செலச்சொல்லித் தான் பிறர்வாய்
நுண்பொருள் காண்பது அறிவு.
Speaking out thoughts in clear manner
and having a subtle sense of comprehension is wisdom.
A doctor must patiently listen to the ill and lucidly tell the cure in a simple way. This is a skill and if the doctor explains in a way that the patient understands, then the patient feels as if he is cured.
Face is the Index of Mind
அடுத்தது காட்டும் பளிங்குபோல் நெஞ்சம்
கடுத்தது காட்டும் முகம்.
External images are seen as a mirror’s reflection
Internal damages are shown as facial reaction
As a skin doctor, I interpret this as: If you have any health problems, it will show up in your skin. A doctor who examines skin, hair and nail properly will be able to find out many underlying illnesses.
உற்றான் அளவும் பிணியளவும் காலமும்
கற்றான் கருதிச் செயல்.
Patient parameters, disease severity and timely intervention
Precisely direct a learned doctor to act wisely
A doctor must study the patient’s condition thoroughly, assess the severity of the disease and act in a timely way. We now say that a patient who has suffered a heart attack or a stroke must be rushed to the doctor, within the golden hour. Beyond the golden hour, the body suffers more damage. That is what Valluvar has also said.
Need for Communication Skills
இணரூழ்த்தும் நாறா மலரனையர் கற்றது
உணர விரித்துரையா தார்.
One who doesn’t explain lucidly what he learns
Is like a bunch of flowers without fragrance.
A good doctor must be a good communicator. He must be able to explain clearly what he has learnt and diagnosed.
உற்றவன் தீர்ப்பான் மருந்து உழைச் செல்வானென்று
அப்பால்நாற் கூற்றே மருந்து.
Patient, doctor, medicine and nurse
Are equally responsible in treating a disease.
In treating a patient, not only does a doctor have a role but also, the health care workers play their parts. We observe the Doctors’ Day. I feel it should be observed as ‘Healthcare workers’ day.’
Be Smart with Gadgets
அருவினை என்ப உளவோ கருவியான்
காலம் அறிந்து செயின்
What is hard for him who acts
With proper tools and in a timely way!
Today, so many gadgets have come up in the medical field and it is astonishing how Thiruvalluvar could have envisioned them. We have AI for robotic surgery, CT scan and many other sophisticated technologies. If a doctor is adept in handling the latest gadgets and in a timely way, he will be quite successful. A doctor is a messenger of faith. He should convey the right information to the patients, without losing the principle of compassion.
கற்றுக்கண் அஞ்சான் செலச்சொல்லிக் காலத்தால்
தக்க தறிவதாந் தூது….
A learned ambassador talks impressively, is not afraid of fierce looks
He conveys what is right for that time
When a doctor treats a patient who has serious ailments, he must have the courage to tell the patient about his health condition, without the patient getting into depression. The doctor must show compassion, such that the patient is able to face the problems.
Use Common Sense
செயற்கை அறிந்தக் கடைத்து முலகத்
தியற்கை அறிந்து செயல்….
Though an expert through theoretical knowledge
Act with common sense and in worldly ways
A doctor might have acquired many degrees and certificates but practically, he might be a zero in front of a patient. He must thoroughly understand the patient, his physical, mental and financial conditions and background and act according to that, rather than blindly applying his theory to practice. Mere theoretical knowledge does not make a doctor successful. He needs to have compassion.
தொட்டனைத் தூறும் மணற்கேணி மாந்தர்க்குக்
கற்றனைத் தூறும் அறிவு.
The deep you dig in the sand, the spring flows
The deep you learn, the knowledge grows.
I would argue that for doctors, this relates to continuous learning and thereby gaining knowledge.
Choosing & Cherishing the Doctor
அன்பறிவு தேற்றம் அவாவின்மை இந்நான்கும்
நன்குடையான் கட்டே தெளிவு
Trust him in whom these four you see:
Love, knowledge, clarity and non-greedy
How does one choose the right doctor? Valluvar’s answer is that you must choose one who is compassionate, has knowledge, clarity of vision and thoughts and who is not greedy. When a doctor becomes greedy, the society becomes nasty. Unfortunately, we see that greed has crept into the medical profession today.
வினைக்குரிமை நாடிய பின்றை அவனை
அதற்குரிய னாகச் செயல்.
Spot the person who is fit for duty
Leave him to do the best he can.
Once you select the right doctor, you must trust him. Earlier, we had the concept of a family doctor who knew all about his patients. Now, we always seek a specialist. Valluvar has advocated for the family doctor, so many years ago.
உற்றநோய் நீக்கி உறாஅமை முற்காக்கும்
பெற்றியார்ப் பேணிக் கொளல்.
Protect and Cherish the doctors of skill
Who ward and safe-guard you from ill.
According to Valluvar, a doctor who cures diseases and protects the society must be revered and taken care of. Unfortunately, we see doctors being assaulted by the family members of patients and public, when the patients’ health deteriorates. Post-Covid, people have so many health issues and if anything unfortunate happens to a patient, people think that it is a doctor’s failure. This is a dangerous trend.
Advocating for Organ Donation
அன்பிலார் எல்லாந் தமக்குரியர்: அன்புடையார்
என்பும் உரியர் பிறர்க்கு
The loveless will love to have everything for themselves
But the selfless loving ones will give everything from skin to bones
Today, we have bone-marrow transplantation. We donate heart, kidneys, eyes and liver. It is amazing how Valluvar could think of organ donation even in those days. He says that loveless people amass everything but those who love others will not even hesitate to donate their bones.
In Sleep, we die
உறங்கு வதுபோலும் சாக்காடு உறங்கி
விழிப்பது போலும் பிறப்பு.
Every night we die; Every day we are born
As naturally as we sleep at dusk and raise at dawn
If we understand this couplet, we will have no anxiety from any disease. Every day, when we sleep, we face a temporary death. If we wake up the next day, we are lucky and we should be happy that we are born fresh for that day. We must spend every day happily and purposefully. If we gain this philosophical mindset, we will never have the fear of death.