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
sociocultural and 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. Areca nut is the seed of the fruit of
the oriental palm, Areca catechu. Thin slices of the nut, either natural or processed, may
be mixed with a variety of substances including slaked lime (calcium hydroxide) and
spices such as cardamom, coconut, and saffron. Most significantly, they may be mixed
with tobacco products or wrapped in the leaf of the piper betel plant. Areca nut is used by
an estimated 200-400 million people, mainly IndoAsians and Chinese. Betel chewing is
considered as a good and cheep source of dietary calcium.

Major ingredients of “Thamboolam”

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. dr.thomaswalter@gmail.com
**
PG Scholar, Department of Maruthuvam (Medicine), National Institute of Siddha, Tambaram
Sanatorium, Chennai, India. nalinisofia@yahoo.com
 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
 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 220˚C. 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
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.
 3) If kalipakku, 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.
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.
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.
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 or kungilia 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) Buffalo’s butter milk can also be given

Thus the poisonous effects of lime can be removed.

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
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 caries
ii. 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

Tuberculosis

Burning fever and

Head ache

should not take Thamboolam.

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