Tamil: மிளகு ரசம் — Milagu rasam
English: Black-pepper rasam
Traditional use: Colds, coughs, blocked nose, sore throat, poor appetite, body aches and recovery after illness
Evidence rating: Evidence-supported as a warm, hydrating supportive food during mild illness; no good clinical evidence that rasam or black pepper cures or shortens a respiratory infection
Preparation type: Thin, spiced broth made with black pepper, cumin, tamarind and other household ingredients
Important limitation: Milagu rasam may provide temporary comfort and light nourishment, but it is not an antiviral medicine or a substitute for medical treatment
Key points
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Warm fluid and hydration: Milagu rasam contributes to fluid intake and may be easier to consume when appetite is reduced.
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Temporary symptom relief: Research suggests hot drinks can make people feel less congested and soothe several cold symptoms, even when nasal airflow has not objectively improved.
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Limited soup research: Early studies suggest soup may modestly support recovery from respiratory infections, but research is limited and has not specifically tested Tamil rasam.
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Piperine is not a cure: Black pepper contains biologically active piperine, but laboratory findings do not prove that eating pepper treats infections in humans.
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Other ingredients: Garlic, cumin, turmeric and curry leaves add flavour and nutrients but have not been proven to make rasam an antiviral treatment.
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When to seek help: Breathing difficulty, chest pain, coughing blood, rapidly worsening illness or a cough lasting longer than three weeks requires medical advice.
When illness enters a Tamil household, milagu rasam often follows.
The smell of pepper, cumin, garlic and curry leaves may fill the kitchen before the person has regained enough appetite for a proper meal. Rasam may be poured over soft rice, served in a tumbler or sipped by itself as a thin broth.
For some families, it is the food given after a fever. For others, it appears at the first sign of a cold, blocked nose or sore throat.
Milagu rasam is sometimes described as medicine. Scientifically, it is more accurate to call it supportive food.
It may help someone drink, eat and feel temporarily more comfortable. It cannot reliably kill the virus causing the illness.
What is milagu rasam?
“Milagu” means black pepper in Tamil.
“Rasam” refers to a thin, usually sour and spiced liquid preparation commonly eaten with rice or consumed as a broth.
There is no single universal recipe. Depending on the household and region, milagu rasam may include:
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Black pepper
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Cumin seeds
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Tamarind
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Garlic
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Tomato
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Curry leaves
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Coriander leaves
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Mustard seeds
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Turmeric
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Asafoetida
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Dried chillies
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Cooked lentil water
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Salt
Some Sri Lankan Tamil versions are heavily peppered and may contain little or no lentil. Other families use the water left after cooking dhal to give the broth more body.
These are family and regional variations rather than right and wrong versions.
Does milagu rasam actually work for a cold?
The honest answer
Milagu rasam may relieve discomfort and support hydration, but it has not been clinically proven to cure or shorten the common cold.
Colds are caused by viruses. NHS guidance recommends rest, adequate fluids and healthy food while the illness resolves. Antibiotics do not treat an ordinary cold because they work against bacteria rather than viruses. (nhs.uk)
No good clinical trial has shown that Tamil pepper rasam:
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Eliminates cold viruses
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Prevents flu
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Stops a chest infection
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Reliably shortens the duration of a cold
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“Boosts” the immune system enough to prevent illness
However, not being a cure does not make it useless.
Its warmth, liquid content, aroma and light texture can make it a sensible food during a mild illness.
What benefits are genuinely plausible?
It contributes to fluid intake
Rasam is mostly water.
A bowl or cup therefore contributes towards hydration, which can be useful when a fever, sore throat, tiredness or reduced appetite causes someone to drink less.
The NHS advises drinking plenty of fluid during a common cold to help prevent dehydration. Soup and other water-rich foods can also contribute to overall fluid intake. (nhs.uk)
This benefit is real, although it is not unique to rasam. Water, soup, tea and other suitable drinks can also provide fluid.
The warmth may ease symptoms temporarily
A randomised study compared a hot fruit drink with the same drink served at room temperature in people experiencing cold or flu symptoms.
The hot drink produced immediate and sustained subjective relief from symptoms including:
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Runny nose
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Cough
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Sneezing
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Sore throat
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Chilliness
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Tiredness
However, objective testing showed that the hot drink did not measurably improve nasal airflow. People felt less blocked even though their nasal passages had not physically opened more. (pubmed.ncbi.nlm.nih.gov)
That distinction fits milagu rasam well.
A warm bowl may make someone feel clearer, warmer and more comfortable without directly treating the infection or physically removing nasal obstruction.
It may be easier to eat when appetite is poor
Illness can reduce appetite. A thin broth served alone or with soft rice may be easier to tolerate than a heavy or oily meal.
Rasam can provide small amounts of energy, salt and nutrients depending on its ingredients. A version made with lentil water may provide more carbohydrate and protein than a very thin pepper-and-tamarind broth.
The nutritional value varies significantly between recipes. Rasam should therefore not automatically be described as a complete meal.
Soup research is promising—but preliminary
A 2025 systematic review examined four randomised trials involving 342 adults with acute respiratory infections. The soups varied and were not specifically rasam.
The review reported modest improvements in symptom severity and possible reductions in illness duration. However, the studies were small, used different recipes and methods, and were difficult to blind properly. The authors described the evidence as preliminary rather than definitive. (pubmed.ncbi.nlm.nih.gov)
This supports saying:
Warm soups may provide useful supportive care during a respiratory illness.
It does not support saying:
Scientific trials have proven that milagu rasam cures colds.
Does black pepper clear a blocked nose?
Black pepper creates heat and sharpness through compounds including piperine.
Its aroma and irritation may make someone feel as though mucus is moving or the nose is becoming clearer. Spicy foods can also temporarily increase nasal secretions.
However, there is no good clinical evidence that the quantity of black pepper found in rasam:
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Opens blocked airways
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Treats sinusitis
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Removes infection from the lungs
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Shortens a cold
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Prevents respiratory disease
Piperine has demonstrated antioxidant, anti-inflammatory and antimicrobial activity in laboratory and animal studies. Reviews also describe potential effects on numerous biological pathways.
Most of this is preclinical evidence and cannot be applied directly to a household portion of rasam. (pubmed.ncbi.nlm.nih.gov)
The responsible wording is:
Black pepper contains biologically active compounds, but pepper rasam has not been proven to treat respiratory infections in humans.
Does pepper kill germs?
Laboratory researchers may expose bacteria or other microorganisms directly to highly concentrated plant compounds.
When microbial growth slows in a laboratory dish, the result may justify further investigation. It does not mean eating the ingredient will produce the same concentration inside the throat, bloodstream or lungs.
The human body digests, absorbs, changes and removes substances in ways that do not occur inside a laboratory dish.
Therefore:
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Laboratory antimicrobial activity is not the same as an antibiotic.
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Computer models suggesting antiviral activity are not proof that eating pepper treats infections in humans.
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Animal research is not proof of clinical effectiveness in people.
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A concentrated extract is not equivalent to culinary black pepper.
Milagu rasam should never replace prescribed antibiotics, antiviral treatment, asthma medication or medical assessment.
What do the other ingredients contribute?
Cumin
Cumin provides aroma and flavour and has a long-established place in Tamil cooking.
Its compounds have demonstrated antioxidant and digestive effects in experimental research. There is not enough strong human evidence to conclude that cumin in rasam treats a cold, cough or fever.
It is best understood as a culinary ingredient rather than the active medicine in the bowl.
Garlic
Garlic is often added whole, crushed or lightly fried.
It contains sulphur-based compounds that have attracted considerable research interest. Garlic supplements are frequently marketed for immunity and colds, but reliable clinical evidence remains limited.
The US National Center for Complementary and Integrative Health notes that very little research has examined garlic for preventing colds and that the available studies are small and have important weaknesses. (nccih.nih.gov)
Garlic may make the rasam fragrant and appetising. It should not be described as a proven cold medicine.
Concentrated garlic supplements may also interact with medicines that affect blood clotting. Culinary garlic used in food is different from taking a high-dose supplement.
Tamarind
Tamarind provides rasam’s characteristic sourness.
It adds flavour and small amounts of nutrients and plant compounds, but there is no good evidence that household tamarind water cures respiratory infections or removes mucus from the lungs.
Its acidity may aggravate heartburn, acid reflux or an already irritated throat in some people.
Tomato
Some recipes include fresh tomato.
Tomatoes contribute fluid, flavour and nutrients, including vitamin C and carotenoids. However, the amount varies and cooking can alter some heat-sensitive nutrients.
A bowl of tomato rasam should not be marketed as a high-dose vitamin treatment or as a cure for illness.
Turmeric
Turmeric may add colour and flavour.
Concentrated curcumin products have been studied for inflammatory conditions, but culinary turmeric is not equivalent to a standardised clinical extract.
The small quantity used in rasam has not been shown to shorten a cold or treat a chest infection.
Curry leaves and coriander leaves
These leaves contribute fragrance, flavour and small amounts of micronutrients.
They are nutritious culinary ingredients, but there is no strong human evidence that the quantities used in tempering or garnishing rasam treat respiratory disease.
Asafoetida
Asafoetida is traditionally associated with digestion and relief from gas.
Human clinical evidence supporting the small amount used in rasam for indigestion, infection or coughing is weak.
It may also cause a reaction in someone with a specific allergy or sensitivity.
A simple milagu rasam recipe
This is a gentle household version suitable for sipping or eating with rice.
Ingredients
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750 millilitres of water
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1 teaspoon whole black peppercorns
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1 teaspoon cumin seeds
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3 garlic cloves
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A small lime-sized piece of tamarind, or 1–2 teaspoons of tamarind paste
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1 small tomato, crushed or chopped, optional
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¼ teaspoon turmeric
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8–10 curry leaves
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A small handful of coriander leaves, optional
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Salt to taste
For the tempering
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1 teaspoon oil or ghee
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½ teaspoon mustard seeds
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1 dried chilli, optional
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A pinch of asafoetida, optional
Method
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Soak the tamarind in a little warm water for approximately 10 minutes.
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Squeeze out the liquid and discard the hard fibres and seeds. Skip this step when using paste.
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Coarsely crush the peppercorns and cumin seeds.
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Lightly crush the garlic.
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Add the tamarind water, remaining water, pepper, cumin, garlic, tomato and turmeric to a saucepan.
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Bring the mixture to a gentle boil.
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Reduce the heat and simmer for approximately 10–15 minutes.
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Add salt to taste.
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Heat the oil or ghee in a small pan.
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Add the mustard seeds and allow them to pop.
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Add the curry leaves, dried chilli and asafoetida if using.
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Pour the tempering into the rasam.
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Turn off the heat and add the coriander leaves.
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Allow the rasam to cool until comfortably warm before serving.
Rasam does not need to be painfully peppery to be worthwhile.
More pepper has not been shown to cure illness faster and may worsen throat irritation, stomach discomfort or reflux symptoms.
A gentler version for illness
When preparing rasam specifically for somebody who is unwell:
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Use less pepper and chilli.
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Keep the broth thin.
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Avoid excessive oil.
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Use only enough salt for flavour.
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Leave out tamarind or tomato if acidity worsens reflux.
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Strain the rasam if the person finds whole spices or leaves difficult to swallow.
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Serve it warm rather than scalding.
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Offer it with soft rice when more energy is needed.
The goal is comfort and tolerability—not proving the family can manufacture edible fire.
Is rasam an oral rehydration drink?
No.
Rasam provides water and may provide some sodium, but its composition is not standardised.
Oral rehydration solution uses specific proportions of salt and glucose to maximise water and sodium absorption through the intestine. Correctly prepared ORS also provides a controlled electrolyte concentration.
Rasam does not reproduce this balance.
When someone has substantial vomiting or diarrhoea, properly mixed pharmacy ORS is more appropriate for preventing or treating dehydration.
Rasam may be eaten as light food alongside rehydration, but it should not replace ORS during significant fluid loss.
Can children have milagu rasam?
A mild version may be offered as food to a child who is already eating ordinary family meals.
For children:
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Use very little pepper and chilli.
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Ensure the temperature is safe.
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Remove whole peppercorns, mustard seeds, hard spices and large curry leaves.
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Do not give whole spices to babies or very young children because they may present a choking risk.
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Do not force the child to eat.
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Continue offering ordinary fluids.
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Monitor their breathing, hydration and general behaviour.
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Do not use rasam instead of prescribed medicine.
NHS guidance advises giving children with colds plenty of fluids. Saline nose drops may help a blocked nose, while suitable children’s paracetamol or ibuprofen may be used for discomfort according to professional or packet guidance. (nhs.uk)
A child who is working hard to breathe, unusually sleepy, not drinking or passing substantially less urine needs medical assessment.
Pepper, reflux and sensitive stomachs
Black pepper, chilli, tomato and tamarind can aggravate symptoms in some people with:
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Acid reflux
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Heartburn
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Gastritis
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Mouth ulcers
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A very sore throat
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Irritable bowel symptoms
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Diarrhoea
For these people, a mild cumin-and-garlic broth or plain rice kanji may be easier to tolerate.
A remedy is not helpful when every sip feels like the oesophagus has been personally insulted.
Salt, blood pressure and kidney disease
Rasam can become salty, particularly when stock cubes, packaged rasam powder and additional table salt are used together.
A high-salt diet can contribute to raised blood pressure. People with kidney disease may also be advised to restrict sodium to help manage blood pressure, swelling or fluid retention. (northerncarealliance.nhs.uk)
Someone following medical advice to limit sodium or fluids should prepare rasam according to their personalised healthcare plan.
Possible adjustments include:
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Using less salt
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Avoiding stock cubes
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Checking packaged spice mixtures for sodium
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Increasing flavour with curry leaves, cumin and coriander instead
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Measuring salt rather than pouring it by eye
Sea salt, pink salt and rock salt still contain sodium. Their prettier origin stories do not cancel chemistry.
Can rasam reduce a fever?
Rasam does not directly lower a dangerous body temperature.
A warm drink may provide fluid and comfort, but the management of fever depends on:
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The cause
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The person’s age
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How unwell they appear
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Other symptoms
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Their hydration
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Existing medical conditions
Do not attempt to “sweat out” a fever by forcing extremely hot or spicy food.
Seek medical advice when a fever is persistent, unusually high or accompanied by a rash, breathing difficulty, confusion, severe pain or significant deterioration.
What milagu rasam cannot do
Milagu rasam cannot be relied upon to:
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Cure the common cold
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Cure flu or COVID-19
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Kill viruses inside the body
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Treat pneumonia
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Treat tuberculosis
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Replace asthma inhalers
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Replace antibiotics when they are clinically required
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Stop serious breathing difficulty
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Treat dengue
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Correct significant dehydration
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Remove mucus from the lungs
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Prevent every respiratory infection
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“Detox” the body
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Guarantee faster recovery
It is supportive food—not a drug, diagnosis or complete treatment plan.
When to seek medical advice
Speak to a pharmacist or GP when:
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Symptoms are worsening instead of improving
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A high temperature lasts longer than three days
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Cold symptoms have not improved after approximately 10 days
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A cough lasts longer than three weeks
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The person repeatedly develops respiratory symptoms
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The person has a weakened immune system
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The person has diabetes or long-term heart, lung or kidney disease
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A child is not improving as expected
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Eating and drinking have become difficult
Seek urgent medical help when:
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Breathing is difficult
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There is chest pain
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The person coughs up blood
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The lips or skin appear blue or grey
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The person is confused or difficult to wake
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Symptoms are becoming severe very quickly
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A child is breathing rapidly or pulling in beneath the ribs
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The person cannot keep fluids down
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There are significant signs of dehydration
The NHS advises seeking assessment for shortness of breath, chest pain, rapidly worsening symptoms and coughs lasting longer than three weeks. (nhs.uk)
If you remember only three things
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Milagu rasam can provide warmth, fluid and light nourishment when someone has a mild respiratory illness.
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Pepper and the other spices have not been proven to make rasam an antiviral treatment.
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Breathing problems, chest pain, coughing blood or worsening illness require medical care—not a stronger batch of rasam.
Tradition and science: the final verdict
Milagu rasam deserves its place in Tamil and Sri Lankan household care.
Its value lies partly in what it practically provides:
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Warm fluid
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A light and tolerable meal
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Strong flavour when appetite is reduced
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Temporary relief from throat and cold discomfort
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A familiar ritual of care
The evidence supports saying:
Milagu rasam is a warm, hydrating broth that may provide temporary comfort and light nourishment during a mild cold or recovery from illness.
The evidence does not support saying:
Pepper rasam kills viruses, cures fever or treats respiratory infections.
Rasam does not become culturally less meaningful when its medical claims are kept realistic.
It may not be medicine in the pharmaceutical sense. But a warm bowl brought to somebody who cannot face a full meal is still care—and care does not need fake science to matter.
Preserve your family’s version
How was milagu rasam prepared in your home?
Some families crushed pepper and cumin by hand. Some used garlic generously. Others added dhal water, tomato, tamarind—or no tomato at all.
Readers may wish to record:
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Who normally prepared it
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Whether pepper and cumin were crushed together
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Whether garlic was included
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Whether lentil water was used
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Whether it was drunk alone or poured over rice
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How spicy the illness version was
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Whether children received a milder bowl
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When it was traditionally served
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What the family believed it helped
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Whether the recipe changed after migration
The history of milagu rasam is carried not only in ingredients, but in the sound of pepper being crushed, the steam rising from a metal cup and the person who knew that illness sometimes required food that asked very little from you.
Medical note
This article provides cultural and educational information. It is not a substitute for diagnosis, prescribed treatment or personalised advice from a doctor, pharmacist, dietitian or another qualified healthcare professional.
Always follow the advice of your own healthcare provider, particularly if you have a long-term health condition or take regular medication.
Sources and Further Reading
Hot Drinks and Cold Symptoms
- Sanu, Andrew, and Ron Eccles. "The Effects of a Hot Drink on Nasal Airflow and Symptoms of Common Cold and Flu." Rhinology 46, no. 4 (2008): 271–275. pubmed.ncbi.nlm.nih.gov — The study referenced in the article; found that a hot drink made subjects feel less congested and soothed several cold symptoms even when nasal airflow had not objectively improved. Supports the article's claim about perceived rather than measured benefit.
- Hao, Qiukui, et al. "Chicken Soup and Respiratory Infections: A Systematic Review." JMIR Formative Research (2025). pubmed.ncbi.nlm.nih.gov — The 2025 systematic review of four randomised trials (342 adults) examining soup for acute respiratory infections; found limited and low-quality evidence. The article correctly notes this research has not specifically tested Tamil rasam.
Black Pepper: Pharmacological Evidence
- Butt, Masood Sadiq, et al. "Black Pepper and Health Claims: A Comprehensive Treatise." Critical Reviews in Food Science and Nutrition 53, no. 9 (2013): 875–886. pubmed.ncbi.nlm.nih.gov — The review referenced in the article; documents piperine's antioxidant, anti-inflammatory and antimicrobial activity in laboratory and animal studies, while noting the gap between preclinical evidence and clinical application.
Clinical Guidance
- National Health Service (NHS). "Common Cold." NHS, UK. nhs.uk — NHS guidance on common cold symptoms, management and when to seek medical advice; used in the article for clinical framing.
- National Center for Complementary and Integrative Health (NCCIH). "Garlic." US National Institutes of Health. nccih.nih.gov — NIH summary of the evidence on garlic for colds; referenced in the article's discussion of additional ingredients.
