Showing posts with label MEDICINES. Show all posts
ABOUT 7 DRUGS THAT CHANGED THE WORLD
#7: Paulescu’s Pancrein?
![insulin, discovery of [Credit: © William J. Clinton Presidential Library]](https://lh3.googleusercontent.com/blogger_img_proxy/AEn0k_sUjTiVcoXtEiuEVXXfmVGXEVh83G7fRj9ngP9eOG32ysccM3G3VvKtptNcKMDP5TN2c2JMc1HjNCNxul74jd_IgCilveHBW8VCWj6S5UYoQseyCvO5vEdkLwMoRisbthEnWO246cxSDw=s0-d "insulin, discovery of [Credit: © William J. Clinton Presidential Library]")
The discovery of insulin was no doubt a major breakthrough in medicine—prior to its discovery, diabetes sufferers often died at a young age. But while Canadian scientists Sir Frederick G. Banting and Charles H. Best, along with their colleagues, often are credited with the hormone’s discovery and isolation, Romanian physiologist Nicolas C. Paulescu appears to have beaten them to it. Paulescu isolated a substance called “pancrein,” presumably insulin, in 1916, but he was soon after recruited to serve in World War I. He finally published his findings in 1921, though they were overshadowed by the release of the Canadians’ report early the following year.
#6: Bayer: Take Two and Call Us in the Morning
![aspirin: Bayer aspirin [Credit: Bayer Corporation]](https://lh3.googleusercontent.com/blogger_img_proxy/AEn0k_swNG0SaDaCwu0GJ1MKnUTj8WmCpHpWZAvRxPzdvPmUloECaxpHkq-GvXG0RkVN-VgD6Fm-wk_A3Pwrus5YjPGSiKBmFN2Lntfv5pcMZc71Zu0pio6wm2UFPeCDBTRIPpEmByPQh5U=s0-d "aspirin: Bayer aspirin [Credit: Bayer Corporation]")
In 1899 Farbenfabriken vormals Friedrich Bayer & Co. (later Bayer AG) introduced aspirin, a pain-reliever that would come to rank high among the world’s most commonly used drugs. The company credits the synthesis of pure acetylsalicylic acid, aspirin’s active ingredient, to Bayer chemist Felix Hoffmann. However, decades after its introduction, former Bayer chemist Arthur Eichengrün cried foul, claiming to have invented the process of the compound’s synthesis himself, with Hoffmann merely carrying out the procedure. Bayer holds by its claim that Hoffmann was the inventor.
#5: Everybody Stay Calm
![Valium [Credit: U.S. Drug Enforcement Administration]](https://lh3.googleusercontent.com/blogger_img_proxy/AEn0k_sYsuzeddbME69Q0cf8gbCjFhKtKskKDNh-FzsG6pA0kubiAqawrT4pBSrSbq4CcNGBcth40fw6QKJPkg9smeR6uRzJ-752AR4dczKE0g1i1qyhqM9WdKGBJkNoyf085PgNbJRcw4Mpdg=s0-d "Valium [Credit: U.S. Drug Enforcement Administration]")
The introduction of the tranquilizer chlorpromazine (also known as thorazine) in the 1950s represented a turning point in psychiatry, one that gave rise to the “psychopharmacological revolution.” Indeed, not only was chlorpromazine successful—by 1964 some 50 million people had taken the drug—but its development also laid the groundwork for the later generation of agents used in the treatment of anxiety and depression. Furthermore, the characterization of its effects on neurotransmitters and their receptors provided insight into how impulses are passed from one neuron to the next in the brain, leading to major advances in scientists’ understanding of mental illness and cognition.
#4: From Chemical Warfare to Cancer
![Burkitt lymphoma [Credit: Ed Uthman, MD]](https://lh3.googleusercontent.com/blogger_img_proxy/AEn0k_uvjKA1lZNenPENOMFRMdMT-kUEpymL8I62OcD1eclcAU82CymZt--apAOVwC-8le4W-py98uVrZDO7aMfbNT17bMWVtLds1D3pBSX0fXy0D0WCBJLru1O-zh6cwk2c1sVwCHZdl82TUw=s0-d "Burkitt lymphoma [Credit: Ed Uthman, MD]")
Nitrogen mustards were developed in the 1920s and ’30s as agents of chemical warfare. By the 1940s, however, it had become clear that at least one of these compounds, HN-2, also known as mechlorethamine, was better suited for use in the fight against cancer, specifically against human lymphomas, than it was in the fight between Axis and Allied powers. In 1949 mechlorethamine became the first drug approved by the U.S. Food and Drug Administration for the treatment of cancer.
#3: So Retro—That Is, Antiretroviral
![AZT [Credit: James Keyser—Time Life Pictures/Getty Images]](https://lh3.googleusercontent.com/blogger_img_proxy/AEn0k_v783oOSX1ipkLDnnpA8e8V1RIg-kHhJyJoceE_WVv-FvqL7q1WjbI2jLLJI2gewVP8zTAZOstkGO7cF467XUO5GBzdZt_FPCEIele4kqw1cV6dhu97kCLKs9EwjorV_XaOl-Mtt-wsaA=s0-d "AZT [Credit: James Keyser—Time Life Pictures/Getty Images]")
The U.S. Food and Drug Administration’s approval in 1987 of zidovudine, more widely known as AZT, was a breakthrough in the treatment of HIV/AIDS. While not able to cure the disease, the drug was found to prolong the lives of AIDS patients. It also was the first of the so-called nucleoside reverse transcriptase inhibitors, a group of antiretroviral drugs that became a cornerstone of HIV/AIDS therapy. Owing to these drugs—and perhaps most significantly to increased access to these drugs in countries worldwide—the annual number of deaths from AIDS declined in the early 21st century.
#2: Population Control
![oral contraceptive; birth control pill [Credit: © cristi180884/Shutterstock.com]](https://lh3.googleusercontent.com/blogger_img_proxy/AEn0k_v3K6Wm0uo5BdwnGw-vorlaI0HMV4S5StiEpn7hIePPBbenPloWBcpZKpQJbjzjYLXgOEPPbs_vwDDQ0cGj3Q_Wrq-Nkn27DhN2g7iMp8fHR0fMJxdBpZXVFN764t0lsLAC39noUC7JWQ=s0-d "oral contraceptive; birth control pill [Credit: © cristi180884/Shutterstock.com]")
In the early 1920s, Austrian scientist Ludwig Haberlandt published a paper suggesting that hormones could be used as an effective means of contraception in animals. While it is unclear, he may have soon after tested a hormone preparation in clinical trials, despite heavy criticism from colleagues who considered contraception to be taboo. Haberlandt’s work, however, came to an abrupt end with his suicide in 1932. Two decades passed before further clinical trials of hormonal contraception were conducted in humans, and then largely at the urging of social activist Margaret Sanger. The first birth control pill was approved in 1960, in the United States.
#1: A Life-Saving Contaminant
![Penicillium notatum [Credit: Carlo Bevilacqua—SCALA/Art Resource, New York]](https://lh3.googleusercontent.com/blogger_img_proxy/AEn0k_tczPx8AZPVJPjVkAAAdhLO0uIhyIShhKW-QGFHg6wXWQYdZ58oFj1aDD7tmAjxZ5VlOOn9WfnvQO5H4_4jdQBrf_pDM8nTvHtKWl5kBBISj5SQ9KjZXhDxdDjgMzPi-PBwSng6vAg=s0-d "Penicillium notatum [Credit: Carlo Bevilacqua—SCALA/Art Resource, New York]")
In 1928 Scottish bacteriologist Alexander Fleming was in the process of sterilizing bacterial culture plates that had become contaminated with mold when he noticed clear zones circling mold colonies. The mold toxin responsible for killing the bacteria turned out to be penicillin, which Australian pathologist Howard Walter Florey and British biochemist Ernst Boris Chain later successfully isolated and purified to produce what became arguably the world’s most effective live-saving antibiotic. Incidentally, Fleming seemed to thrive on contamination—his other major discovery, of the antiseptic enzyme lysozyme in 1921, was made after he had accidentally contaminated a culture plate with his own cold germs.
Tag :
MEDICINES
ABOUT AYURVEDA (A VEDIC MEDICINE)
Ayurveda is a system of medicine thatdeveloped in early India. The Sanskrit word Ayurveda has two components: ayur and veda . The former means "life" and the latter "knowledge", or more precisely, "science". Its earliest concepts are set out in the sacred writings called the Vedas, especially in the metrical passages of the Atharva Veda, possibly dating as far back as the second millennium BC.
The knowledge of this ancient science comes mainly from the surviving treatises (Samhitas). The Charaka Samhita and the Sushruta Samhita, attributed respectively to Charaka, an eminent physician, and Sushruta, a celebrated surgeon, are the two important works that are followed even today. Estimates place the Charaka Samhita in its present form as dating from the first century AD and the Sushruta Samhita probablyoriginated in the last centuries BC andbecame fixed in its present form by the seventh century AD.
The prime object of Ayurveda is the preservation of human, animal, and plant life. In human beings, according to Ayurveda, life is the collective manifestation of the body, mind, and spirit. Ayurveda differs radically from other systems of medicine in its approach to the concept of health. According to Ayurveda health is not just a disease-free state. It is a state in which all the three components of life, that is, body, mind, and spirit, are equally robust and in a harmonious balance. With this integrated vision of health, the physician looks upon the individual as a whole and does not merely focus on the treatment of the separate diseased parts of an ailing body.
Another unique feature of Ayurveda is that its philosophical position holds the soul as an integral and crucial component of the human constitution. It believes that a life of restraint and rectitude, as well as spiritual pursuit, are essential for good health. The celebrated physician Charaka declares "he who has mastered his own senses by the dictates of his soul is the one who is disease-free".
The doctrine of Tridosha Siddhanta is the cornerstone of Ayurveda. It is held that the workings of a living human body can be described with reference to three aspects, or "pillars": the dosha , or vitiation (three in number); the dhatu , or the constituent tissue (seven in number); and the mala , or impurities (three in number). Of these, dosha and mala occur in all living organisms while dhatu is found in both the living and the nonliving. Without these three aspects, there is no life. Dosha is a principle that works for the maintenance of the body. It has, therefore, to operate at an optimum tempo. A decrease below or an increase beyond the optimum level upsets the balance and thus vitiates the body. The principle itself is from the root dush , meaning "to spoil" or "to corrupt" - thus, "to vitiate"; dosha becomes visible diagnostically only when such upsets lead to a characteristic manifestation as a disease. Otherwise it is not noticed at all. Three further overall differentiations are recognized in the dosha and named in accordance to their counterparts in nature: air, fire, and water, or vaata, pitta , and kapha . Such literal reading, however, is too simplistic for each of these represents an important role in the body's functioning. Vaata refers to the endocrinological, neuromuscular, and nervous activities that shape the larger dynamics of life. Pitta refers to the chemical actions, in general, and kapha refers tothe physical forces, such as cohesion andlubrication, acting in a circumscribed region. Of the three, pitta and kapha are essentially local in their reactions, while vaata is mobile, spreading its influence all over. Pain is associated with vaata and is thus a signal of any deviation from the norm anywhere in the body. This is why the Ayurvedic texts always consider in elaborate detail the diseases of vaata, or vaata vyaadhi .
To understand the working of the body apart from the dosha, the two other entities, dhatu and mala, need to be examined. The dhatu are the constituents of the body, such as the several tissues that the science of human anatomy now recognizes.
Seven dhatu have been recognized. They all come ultimately from rasa, the essence of the food taken, which is liquid in nature. These are: blood ( rakta ), flesh ( maamsa ), fat ( medas ), bone ( asthi ), bone marrow ( majja ), and semen ( shukra ) in man and oestrum ( aartava ) in woman. Rasa is the first to be formed. The remaining six dhatu are transmutations of rasa. The several roles played by dhatu in the body are also clearly specified. For example, rasa serves to cause contentment and pleasure, a psychological function, and the nourishment of the blood, which is a physiological function.Rakta (blood) provides colouration to the body, nourishes the flesh, and makes the person alive.
Mala, or impurities, are three in number: puriisha (stools), muutra (urine), and sveda (sweat). Their formation is natural, although they need to be removed or excreted immediately. It is their absence, excessive, or insufficient formation that causes disease and needs to be attended to clinically.
Ayurveda regards disease as an effectof the imbalance in the vitiations (dosha). Restoring the human body to its normaldynamism is the goal of Ayurveda therapy. Its counselling is basically preventiveand mitigative, and its drugs are curative and restorative. How does Ayurveda conceive of the action of these drugs? The explanation lies in its theory of the factors controlling drug action in the body: (1) the physical nature, or dravya , of the drug - for example, its consistency, light or heavy, in digestion or lubricative capacity, as modern medicine would conceive it; (2) the taste, or rasa; (3) the quality, or guna, whether alkaline or acidic; (4) the virility, or viirya , that is, the potency, whether quick, virulent, or active in small doses; (5) the post-assimilative effect, or vipaaka ; and (6) the unique influence or prabhaava . These factors form a progressive sequence of actions.
Ayurveda also employs the concept ofconstitutional medicine. This means thatthe medicine is prepared by the physician himself to suit the specific constitutional needs of the patient - an economic impossibility for most people in the Western system of allopathic (symptom-based) treatment.
In Ayurveda, diet and drugs are also categorized in their two aspects. First, based on their virulence of action, they are classified as mild or severe. The sweet, the pungent, and the astringent are mild, while the bitter, the acidic and the salty are severe. The sweet, the acidic, and the salty are viscous and heavy. The bitter, the pungent, and the astringent are rough and heavy. The mild are cold and the acute are hot. Second, diet and drugs are classified on the basis of the three dosha that predominate in them. This provides the clue for their therapeutic action. For example, brinjal (aubergine, or egg plant), ash gourd, and potato are vaata-promoting foods. They are to be avoided by patients suffering from a predominance of vaata. Garlic and asafoetida run counter to vaata.
The interaction of all these aspects isdeveloped in meticulous detail as dravya guna vignaana , or pharmacodynamics, which is the mainstay of drug action in Ayurveda. It is widely considered an effective system of medicine despite its omission of either the pathogenic microorganisms or the molecular basis of drug action central to modern medicine.
The study of Ayurveda is systematized into eight branches: Shalya (generalsurgery), Shaalaakya (ear, nose, and throat), Kaayachikitsa (general medicine), Bhutavidya (mental disorders), Kaumarabhrutya (paediatrics), Angada tantra (toxicology), Rasaayana (rejuvenation), and Vaajikarna (virilification). This tradition of eight Ayurveda branches is still in use although surgery has almost disappeared.
Ayurveda was the system of healthcare and medication followed by the vast population of India from ancient times till the early British period and the introduction of the allopathy system. In recent years there has been a revival of the popularity of Ayurveda. It serves a large segment of India, both in the rural areas and in urban homes, as common and easily affordable household remedies. Even in the Western world, the science of Ayurveda has caught the attention of modern medical professionals and the lay public.
Tag :
MEDICINES
ABOUT UNANI MEDICINE
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.
Principles of Unani medicine
---------------------------------------------------------------------------------------------------------------------------
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
---------------------------------------------------------------------------------------------------------------------------
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
---------------------------------------------------------------------------------------------------------------------------
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.
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MEDICINES
