Administration of Nilavembu Kudineer for dengue stirs a debate

Whenever dengue plagues Tamil Nadu, the government, its doctors and advocates of alternative medicine, come up with Nilavembu Kudineer, a concoction made of various herbs touted as a cure for the disease.

While earlier it was given as a medicine, it has recently attained the status of day-to-day food, wherein it is being consumed like beverages, without any prescription by a physician.

In late 2012, when there was a dengue outbreak in the state, the government had come out with an advertisement saying Nilavembu Kudineer would contain the viral fever.

Nilavembu Kudineer is a liquid prepared from nine kinds of herbs. The herb Nilavembu (Andrographis paniculata) is the primary component and hence the name. Besides Nilavembu, Vettiver (Vetiveria zizanioides), Sandanam (Santalum album), Sukku (Zingiber officinale), Milagu (Piper nigrum), Koraikilangu (Cyperus rotundus), Parpadagam (Hedyotis corymbosa), Vilamichaiver (Plectranthus vettiveroides) and Paipudel (Trichosanthes cucumerina) are used.

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It has been promoted by the Siddha practitioners in the state who claim it has a ‘synergetic effect’ and has anti-inflammatory and anti-pyretic properties. However, it is commonly used for all kinds of ‘Pitha’ fever.

“The liquid can be taken as a preventive measure during dengue outbreaks. It must be consumed twice a day in the morning and evening for 3-5 days. This will improve the immunity of the body. However, if a person tests positive for dengue, he or she should visit a hospital,” says Dr Vikram Kumar, a Siddha practitioner based in Vellore district.

Though consumed as preventive medicine, people having typhoid and ulcers must refrain from taking it, he asserted.

“Once it was taken as a medicine. Now, every other organization and political parties distribute Nilavembu Kudineer on the streets. The liquid will lose its medicinal properties within three hours of preparation. It must be consumed within that stipulated time. Drinking it like tea or coffee will not give any benefits. In general, it is better to consult doctors and take the drink as per the prescribed levels,” Dr Vikram Kumar added.

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The medicine is also given as tablets. But when it is provided in liquid form, the medicine will be absorbed easily and quickly, he says.

Most people think that taking this liquid is enough to fight dengue. Many continue to rely only on this liquid without visiting a doctor. In addition to this, Siddha practitioners also claim that taking Papaya leaf juice will increase platelet count.

While people are running after this ‘magical’ liquid, allopathy doctors counter Siddha practitioners’ claim.

“First of all the government should clear doubts on whether Nilavembu Kudineer can be taken as preventive medicine or curative medicine. If it is considered a curative medicine, then it should have some properties and dosage levels. Have all these been proved scientifically?” asks Chennai-based Dr Amalorpavanathan.

He refutes the claim of Siddha doctors having published a paper on the medicinal properties of Nilavembu Kudineer.

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“The paper could have been published in predatory journals,” he said.

He also added that allopathic doctors in government service should not be forced to dispense Nilavembu Kudineer in primary healthcare centres and other hospitals.
“Doctors have a duty to stand by science and not by the government,” he said.

But there is no report saying that a dengue-affected patient died even after consuming Nilavembu Kudineer, said Dr GJ Christian, a professor in National Institute of Siddha, Chennai.

He is the lead author of the paper titled ‘Protective effect of polyherbal Siddha formulation – Nilavembu Kudineer against common viral fevers including dengue – A case-control approach’ published in International Journal of Pharmaceutical Sciences and Research (IJPSR) in 2015.

“Allopathy doctors criticizing the publication of our papers is wrong in the first place. In the US-based Beall’s list of predatory journals, a journal named ‘Indian Journal of Pharmaceutical Sciences and Research’ (IJPSR) has been listed. Unfortunately, many allopathy doctors come to a conclusion based on the abbreviation of the journal,” claims Dr Christian.

The decrease in platelet counts alone cannot cause dengue deaths. Likewise, it is hard to tell whether the platelet count increased naturally or medicinally, he said.

“We say that Nilavembu Kudineer has helped dengue patients based on the mortality index. Those who are admitted in critical care are being given both allopathy and Siddha treatments. So far, there have been no reports that a dengue patient has died even after consuming Nilavembu Kudineer. It is because of quacks who lack the knowledge on how much herbal liquid must be consumed the deaths occur,” Dr Christian alleged.

Only after conducting a combined public health study by Siddha and allopathy doctors can we come to a conclusion if  Nilavembu Kudineer is a curative medicine, he added.

Meanwhile, the Dravida Munnetra Kazhagam (DMK) has started distributing Nilavembu Kudineer and it has been said that the gesture has created a difference of opinion among party doctors. But senior leaders in the party reject the allegation.Speaking to The Federal, MLA Dr Poongothai Aladi Aruna, who is also the party’s doctors’ wing chief, said that while they are distributing Nilavembu Kudineer, they are also into creating awareness about dengue.

“The herbal liquid is not harmful to human body. Most of the medicines are produced with the help of some kind of natural elements. We all know that neem has medicinal values. Likewise, Nilavembu too has medicinal values. Wherever we are distributing Nilavembu Kudineer, we also give out leaflets which have information on dengue. People must adhere to the information,” she said.