BY DR. SYED SABAHAT ASHRAF and DR. BILAL A. BHAT
The origins of Unani system of medicine are found in the doctrines of the ancient Greek physicians Hippocrates and Galen. It was later developed and refined through systematic experiment by the Arabs, most prominently by Muslim scholar-physician Avicenna as a field.
This system treats a person as a whole not as a group of individual parts. It is aimed at treating body, mind and soul. This system is based on hippocratic theory of four humours viz. blood, phlegm, yellow bile and black bile.
According topractitionersof Unani medicine, the health of thehuman bodyis maintained by the harmonious arrangement ofal-umoor al-tabiyah, the seven basic physiological principles of the Unani doctrine.
These principles include (1)arkan, or elements, (2)mizaj, or temperament, (3)akhlat, or bodily humours, (4)aaza, or organs and systems, (5)arwah, or vital spirit, (6)quwa, or faculties or powers, and (7)afaal, or functions. Interacting with each other, these seven natural components maintain the balance in the natural constitution of the human body.
Further, each individual’s constitution has a self-regulating capacity or power, calledtabiyat(ormudabbira-e-badan;vis medicatrix naturaein Latin), or to keep the seven components inequilibrium. The four simple, indivisible entities,arz(earth),maa(water),nar(fire), andhawa(air)arkannot onlyconstitutesthe primary components of the human body but also makes up all other creations in the universe.
There are predictable consequences to the actions and interactions (imtizaj) of the fourarkan. These elements act upon and react with each other, they continually undergo change into various states of “genesis and lysis” (generation and deterioration), due toulfat-e-keemiyah(acceptance of a medicine by the body) andnafarat-e-keemiyah(rejection of a medicine).
Trained hakims claim that they can perceive, recognize, and observe such states. The four essential mizaj (temperaments) are hot, cold, moist, and dry. Four more are compounded of those single temperaments namely, hot and dry, hot and moist, cold and dry, and cold and moist. Possessed in different proportion, mizaj is balanced by all entities in the cosmos, including all plants, minerals, and animals.
The equilibrium of the individual’s elemental combination and resulting mizaj, as determined by tabiyat, provides a stable constitution to that individual, in other words, health. Mizaj in Unani system plays a pivotal role in characterising a person’s normal state (physical, mental, and social), as well as the nature of a disease.
Hippocrates propounded the doctrine of fluids, or humours, of the body, and he categorised the humours into four groups based on their colour. These groups were later refined by Galen, Avicenna which later appear in Unani practice as dam (blood), balgham (phlegm), safra (yellow bile), and sauda (black bile).
The theory of humours (nazaria-e-akhlat), holds that the four humours are derived from and utilised in the digestive process. Tabiyat in the Unani system of medicine, is an individual’s internal power or capacity to withstand or combat disease and to perform normal physiological functions.
It can eradicate most infections without medical treatment, using what may be thought of as the natural defence system of the mind and body. The Unani system of medicine recognises six physical, or external, factors, called asbab-e-sittah-zarooriah, which are essential in establishing a synchronised biological rhythm and thus living a balanced existence.
The six asbab-e-sittah-zarooriah are: (i) Hawa (air), in which the quality of the air a person breathes is thought to have a direct effect on his or her temperament and, thus, health. (ii) Makool-wo-mashroob (food and drink), in which the nutritional value and the quality and quantity of one’s food and drink are believed to ensure physical fitness by strengthening tabiyat.
(iii) Harkat-wo-sakoon-e-jismiah (bodily exercise and repose), which emphasises the positive effects of balanced physical exercise on an individual’s internal resistance and tabiyat. (iv) Harkat-o-sakoon nafsaniah (mental work and rest), which emphasises the simultaneous engagement of the human mind in numerous emotional and intellectual activities.
Just as the body needs systematic and planned exercise and rest, Unani medicine holds that the human mind and brain need adequate stimulation and proper relaxation as well. (v) Naum-o-yaqzah (sleep and wakefulness), in which an individual’s health and alertness are understood as being dependent on a specific amount of sound sleep in the course of a 24-hour (circadian) cycle. (vi) Ihtebas and istifragh (retention and excretion), which considers the metabolism of food and liquid as both affecting and being regulated by tabiyat.
According to Unani medicine, the assimilation of food and liquid facilitates the elimination from the body of excessive and noxious substances. Therefore, to maintain a harmonic and synchronised tabiyat, certain beneficial end-products of kaun-o-fasad (genesis and lysis) are retained in the body while harmful ones are expelled. Unani practitioners believe that these six factors directly affect the harmony of the human mind and body.
The Unani system uses eight diagnosis methods for effective results which include pulse, stool, urine, tongue, speech, vision, touch and appearance. The first move towards Unani treatment entails the establishment of a regimen to normalise and balance the external factors (e.g., air, water, and food) involved in ailments and diseases.
In case this proves inadequate, then other means, such as treatment with natural medicines, may be recommended. The Unani treatment prescribed by a hakim acts as an outside agent to help boost the patient’s tabiyat and thus restore good health and a sense of well-being. A number of therapeutic approaches are available to the hakim. Ilaj-bi-ghiza, or dietotherapy, involves recommending a specific diet, which is the simplest and most natural course of treatment by a hakim.
For example, in case of fever, Unani medicine stresses a nutrient-rich, low-roughage diet that might include dalia (porridge) and kheer (a milk broth). Both the amount and quality of food are taken into consideration.
In modern Unani therapy, relatively infrequent is ilaj-bi-misla, or organotherapy, a mode of treatment that involves healing a diseased organ with the use of tissue extracts from the same organ of a healthy animal. Ilaj-bi-dawa, or pharmacotherapy, is the use of medicines by Unani hakims.
This treatment method is considered by hakims to be natural, eco-friendly, and less intrusive and more effective than many other methods. The Unani system’s pharmacopoeia is vast, enriched with more than 2,000 medicines derived from various herbal, mineral, and animal sources.
Indian physician Ajmal Khan in the 1920s revolutionised Unani system of medicine by advocating that research be conducted on various natural products that were claimed by ancient physicians to effect miraculous cures.
The Unani system became increasingly accepted internationally as a system of traditional medicine due to its recognition from the World Health Organization (WHO) in 1976. Worldwide several institutions are engaged in Unani teaching and research.
The obstacles in Unani medicine are similar to other systems of medicine. The vast materia medica, from herbal and animal to mineral sources, as described in ancient Unani textbooks, is sometimes so vague that authenticity must be established by modern pharmacognostic assessments (by means of a basic, descriptive pharmacology) before medicines can be put to use.
In addition, the use in Unani medicine of precious stones and minerals, the chief ingredients of many polyformulations (medicines containing multiple ingredients), is expensive. Those items often are unavailable as well, thereby hindering effective treatment.
Disclaimer: The views and opinions expressed in this article are the personal opinions of the author.
The facts, analysis, assumptions and perspective appearing in the article do not reflect the views of GK.