UNANI MEDICINE also called Unani tibb (medicine; literally, nature), system of healing and health maintenance observed today in India, which has its origins in ancient Greek and Arabic practices and philosophy. Originating in the doctrines of the ancient Greek physicians Hippocrates and Galen, Unani medicine was developed, nurtured, and refined through systematic experiment by the Arabs, most prominently, perhaps, by the scholar-physician Avicenna (Hakim Abu Ali Abullah Husayn Ibn Sina). During the Caliphate (the political-religious Muslim state that began in AD 632), the bulk of Greek knowledge was translated into Arabic, part of that knowledge being the principles of medicine. With additional contributions of medical wisdom from other parts of the Middle East and South Asia, Unani medicine came to be known also as Arabian, or Islamic, medicine.
Principles of Unani medicine
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The history of Unani medicine divulges it to be a system whose practitioners, or hakims, rely on natural healing based on principles of harmony and balance, uniting the physical, mental, and spiritual realms as opposed to the Western germ theory of disease.
Al-umoor-al-tabiyyah : Basic physiological principles
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Maintaining the health of the human body by the harmonious arrangement of al-umoor-al-tabiyyah, the seven basic physiological principles of the Unani doctrine, include: (a) arkan , or elements; (b) mizaj , or temperament; (c) akhlat , or bodily humours; (d) aaza , or organs and systems; (e) arwah , or vital spirit; (f) quwwa, or facilities or powers; and (g) afaal , or functions.
Interacting with each other, these seven natural components maintain the balance in the natural constitution of the human body. Each individual's constitution has a self-regulating capacity or power, called medicatrix naturae, or tabiyat, to keep the seven components in equilibrium.
Arkan and mizaj : Elements and temperament
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As four simple, indivisible entities, arkan not only constitutes the primary components of the human body but also makes up all other creations in theuniverse. Arkan comprise the four possible states of matter, and there are predictable consequences to their actions and interactions ( imtizaj ). The four arkan are arz (earth), maa (water), nar (fire), and hawa (air). As these elements act upon and react with each other, they continually undergo change into various states of "genesis and lysis" (generation and deterioration) due to their intended ulfat-e-keemiyah (acceptance by the body of a medicine) and nafarat-e-keemiyah (rejection of a medicine). Perceptible as different qualities, the change-states can be recognized and observed in the body by a skilled hakim.
Exercised to classify the qualities produced by an individual's elemental changes, the four essential mizaj, or temperaments are hot, cold, moist, and dry; and four more are compounded of those single temperaments, namely, hot and dry, hot and moist, cold and dry, and cold andmoist.
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 (the vital force, or psyche), provides a stable constitution to that individual - in other words, health. Just as elemental balance keeps an individual in a healthy state, changes in natural temperament cause the health of an individual to suffer. Therefore, mizaj plays a pivotal role in Unani instudying a person's normal state (physical, mental, and social), as well as the nature of a disease.
Doctrine of akhlat (fluids or humours)
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Recognized by many cultures as the "father of medicine", the Greek physician Hippocrates, propounded the doctrine of fluids, or humours, of the body. Categorizing these essences into four groups based on their colour, which, as refined by Galen and later by Avicenna, appear in Unani practice as dam (blood), balgham (phlegm), safra (yellow bile), and sauda (black bile). The human dispositions corresponding to these humours are, respectively, sanguine, phlegmatic, choleric, and melancholic. Each human being is considered to have a specific humoural makeup, determined by the predominance of a given humour in his or her constitution. The quality and quantity of the humours in an individual - that is, a person's unique, proper, and proportionate humoural makeup - is said to guarantee health. Conditions other than this balance signal ailment or disease.
The essence of the practice of Unani medicine, the theory of humours ( nazaria-e-akhlat ) holds that the four humours are derived from and utilized in the digestive process. Their continuous action and reaction results in the breakdown of complex macromolecules into simpler molecules, which are then incorporated throughout the body in the form of fluid. These humours, the akhlat, suffuse the body's cells, interstitial spaces, and vascular channels, affecting physical and behavioural wellbeing, and are most stable in a healthy individual.
Relationship between tabiyat and asba-e-sittah-zarooriah
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In the Unani system of medicine, the tabiyat (also called mudabbira-e-badan ) is an individual's internal power or capacity to withstand or combat disease and to perform normal physiological functions. Believing that it is only the tabiyat that is engaged in actually curing a disease, Unani hakims hold that they only assists from "outside" by prescribing therapeutic relief. If not adversely affected, tabiyat can eradicate most infections without medical treatment, using what may be thought of as the natural defence system of the mind and body.
Unani medicine recognizes six physical or external factors, called asbab-e-sittah-zarooriah , which are essential in establishing a synchronized biological rhythm and thus living a balanced existence. The six asbab-e-sittah-zaroori-ah factors are:
Hawa (air). The quality of the air a person breathes has a direct effect on human temperament and, thus, on a person's health.
Makool-wo-mashroob (food and drink). The nutritional values as well as the quality and quantity of one's food and drink ensure physical fitness by strengthening tabiyat.
Harkat-wo-sakoon-e-jismiah (bodily exercise and repose). A balanced physical exercise assures positive effect on an individual's internal resistance and tabiyat.
Harkat-o-sakoon nafsaniah (mental work and rest). Simultaneously engaged in numerous emotional and intellectual activities, the human mind thinks, plans, speaks, works, and feels. Just as the body needs systematic and planned exercise and rest, the human mind and brain need adequate stimulation and proper relaxation.
Naum-o-yaqzah (sleep and wakefulness). To be healthy and substantially alert an individual requires a specific amount of sound sleep in the course of a 24-hour (circadian) cycle.
Ihtebas and istifragh (retention and excretion). As a result of metabolism, the food and liquid that human beings consume are variously compounded into necessary bodily elements (through anabolic, or constructive, processes) or broken down into innumerable by-products (through catabolic processes). Unani medicine sees these processes as both affecting and regulated by tabiyat. From the products thus assimilated, the excessive and noxious substances are eliminated from the body. Therefore, to maintain a harmonic and synchronized tabiyat, certain end-products of kaun-o-fasad (genesis and lysis) are retained in the body while the harmful ones are expelled.
These six factors directly affect the harmony of the human mind and body. Socio-economic, geographic, and environmental factors are considered secondary factors - asbab-e-ghair zarooriah - in the Unani system, and these can indirectly influence tabiyat. Both the primary and secondary factors must be closely considered in the Unani process of treatment.
Modes of treatment
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Establishing a regimen to normalize and balance the external factors like air, water, food, and other factors outlined above, ailments and diseases are initially treated in the Unani system. If this proves inadequate, then other means, such as pharmacotherapy (treatment through drugs), may be recommended. Any Unani medical treatment is prescribed by a hakim that acts as an outside agent to help boost the patient's tabiyat and thus restore good health and a sense of well-being. The following are some of the therapeutic approaches available to the hakim:
Ilaj-bi-ghiza (dietotherapy). Recommending a specific diet is the simplest and most natural course of treatment by a hakim. For fever, for example, Unani medicine stresses a high-nutritional-value, low-roughage diet that might include dalia (porridge) and kheer (a milk broth). Both the amount and quality of food are taken into consideration.
Ilaj-bi-misla (organotherapy). Relatively infrequent in modern Unani therapy, this mode of treatment involves healing the patient by catalyzing the diseased organ.
Ilaj-bi-dawa (pharmacotherapy). Drugs used by Unani hakims have provided a treatment method considered natural, eco-friendly, and less intrusive and more effective than many others. The Unani system's pharmacopoeia is vast, enriched with more than 2,000 drugs from various herbal, mineral, and animal sources.
Unani medications are often processed by classical methods of preparation as originally described in Graeco-Arabic medicine. Unani drugs are used singly or are made into compounds with other drugs to achieve synergistic, antagonistic, or detoxifying effects or simply as bases for effective ingestion and assimilation.
In the early 1930s the renowned Indian physician Hakim Ajmal Khan revolutionized the Unani pharmacotherapy by advocating that research programmes be conducted on various drugs that were claimed by ancient physicians to affect miraculous cures. A well-known scientist, Salimuzzaman Siddiqui, joined him in his efforts. Through phytochemistry (the chemistry of plants), Siddiqui isolated some potent constituents from a plant known as chhota chand, or asrol (Rauwolfia serpentina). Subsequent pharmacological research validated the claims of ancient hakims that the plant - the source of the twentieth-century drug reserpine - is effective as a tranquillizer, and helps control dysentery and hypertension. He named the derived medicines after Ajmal Khan as a tribute to his groundbreaking research efforts - hence the Unani medicines Ajmalin, Ajmalincine, Ajmalinine, and Neo Ajmaline.
Gaining recognition from the World Health Organization (WHO) in 1976, the Unani system has become increasingly accepted internationally as a responsive and cost-effective system of traditional medicine. In India several institutions are engaged in teaching and research. An undertaking of the Government of India, the Central Council for Research in Unani Medicine (CCRUM), is working on many research and development programmes, including the translation of classical heritage, clinical trials, standardization of drugs, and toxicological and phytopharmacological studies.
Tadabeer (therapeutic regimens). Classical Unani tibb recommended old-established "regimental" therapies in the treatment of various chronic and acute diseases, which includes dalak (massage), hammam (bath and sauna), karat (exercise), fasd (venesection, that is, opening a vein to let out blood), hijamat (cupping, a process of drawing blood to the surface of the body by using a glass cup or tube), and amat-e-kai (leeching, that is, bleeding a person by using leeches). The essential function of all these regimens is to remove impure blood or impurities from the body.
Ilaj-bil-yad (surgery). Resorting to surgical interventions as a last resort, this practice is less in the realm of the hakim's concern.
Obstacles in Unani medicine
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Although a complete system of treatment, the Unani system of medicine does have some drawbacks in terms of application, as do all other systems.
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 pharmacognostical assessments (by means of a basic, descriptive pharmacology) before drugs are put to use.
The use in Unani medicine of precious stones and minerals, the chief ingredients of many polyformulations, is expensive, and often unavailable, making treatment difficult for practitioners and patients.
Intense research is important for the use of kushta , the incinerated finely powdered substance prepared from known toxic metals such as seemab (mercury), sam-al-far (arsenic), sangraf (mercuric chloride), and khubs-al-hadid (iron rust). Drugs with these minerals, when used with caution and expertise, can be very effective, but their possible toxic side effects must be carefully looked into.
Despite these concerns, however, the Unani system of medicine can provide a wide range of therapeutic natural agents - some as near as the kitchen spice and condiment rack, such as honey, saffron, olive oil, and clove - for health maintenance and the treatment of disease.
Thursday 13 June 2013
