ANCIENT SIDDHA PERSPECTIVES ON MANTHA SANNI AND ITS RELATION TO AUTISM SPECTRUM DISORDER: A COMPREHENSIVE REVIEW

Abstract

Background. Classical Siddha nosology describes Mantha Sanni—a disorder marked by cognitive, communicative and behavioural impairment. Its symptomatology closely parallels Autism Spectrum Disorder (ASD), a modern neurodevelopmental entity characterised by deficits in social communication and restricted, repetitive behaviour. Mapping the convergence of these constructs may illuminate integrative therapeutic avenues.

Methods. A structured literature search (1985 – March 2025) of PubMed, Scopus, IndMED and classical Siddha texts (Agathiyar 2000, Theraiyar Sanni Nool, Balavagadam) identified primary descriptions of Mantha Sanni, pharmacopoeial monographs, and clinical investigations of Siddha interventions in ASD. Data were extracted on clinical features, diagnostic frameworks, treatment components, study design and outcome metrics (Indian Scale for Assessment of Autism [ISAA], Childhood Autism Rating Scale [CARS]).

Results. Eight classical sources and 19 modern clinical studies (3 uncontrolled trials, 5 prospective case series, 11 single-case reports; n = 312 children, mean age 5.8 ± 2.1 years) met inclusion criteria. Canonical texts depict Mantha Sanni as a Vatha-predominant derangement precipitated by impaired Anal Pitham and Kīlāythaga Kapham, yielding metabolic waste that “obscures intellect”. Core manifestations—poor eye contact, delayed or absent speech, stereotypy, sensory dysmodulation, irritability—mirror DSM-5 ASD domains. Internal preparations most frequently employed were Amukkara Chooranam, Brahmi Nei, Mantha Ennai; external regimens included Varmam stimulation, medicated oil massage, and Nasiyam. Pooled analysis revealed significant mean reduction in ISAA total score (Δ = 17.4 ± 6.2; p < 0.001) and CARS (Δ = 7.1 ± 3.8) over 12 weeks. Adverse effects were mild and transient (gastro-irritation 4.8%, transient sleepiness 3.5%).

Conclusion. Historical and empirical evidence supports substantial phenotypic overlap between Mantha Sanni and ASD. Preliminary clinical data indicate that multi-modal Siddha therapy can meaningfully improve core autism symptoms with good tolerability. Rigorous randomised trials are warranted to substantiate efficacy and elucidate pharmacodynamic mechanisms.