UNANI

Introduction:
Unani System of Medicine is a Medical system that deals with the management of Health and Diseases.  It provides preventive, promotive, curative and rehabilitative health care with holistic approach.  It comprises the various branches like Medicine, Science, Philosophies, Logic and Psychology etc. It is one of the ancient medicines ever practiced in the world like Bangladesh, Pakistan, Sri Lanka, Nepal, China, Iraq, Iran, Central Asia and Middle East countries and Central Africa etc.

Nomenclature:
The Unani System of Medicine originated in Greece.  It belongs to a place called IONIA, which is in Greece. The Arabs called the IONIA as UNAN hence the system named after its place of origin i.e. IONIAN Medicine as UNANI Medicine.

History
Unani System of Medicine was started around  460 B.C. The great Unani Philosopher and Scholar BUQRAT (Hippocrates 460 – 370 B.C.) was the over arching physician of the classical period of Greek (Unani) Medical history.He freed realm of superstition and magic are gave it to status of science. He emphasized the natural cause of diseases and recorded the existing medical knowledge to set the ground for medicine to develop as a systemic medical science . He gave the status of science by declaring the cause of diseases are not due to supra-natural causes or spirits but environmental factors like Air, Food, Seasonal changes and earthly bodies.

The fundamentals of Hippocratic medicine were Observation, Experience and rational principles which still hold valid in the field of medicine and science .The theoretical framework of unani medicine is based on his teaching. Alexandrian school established in the 3rd century B.C. needs the especial mention for being the first institution to deal with the dissection of Human Body.

HEROPHELUS, ERASISTRATUS were given great contribution in the field of Anatomy cannot be ignored. DIOSCORIDES (40 – 90 A.D.) had tremendous knowledge of medicinal herbs. He is the first person to write and illustrate the book comprising of 600 herbal drugs i.e. De Metria Medicawhich is known as “Kitab Al Hashasish” in Arabic. The closing years of creative age of Greece graced by the great Roman scholar JALINOOSE (Claudius Galen 129 – 200 A.D.), he is the illustrious scholar of the history of medicine gathered all the knowledge of his time, arranged it systematically in the way that continued to be authoritative in the next 15th century.

After the collapse of Greco-Roman Civilization, the Arabian physician performed critical study of inherited medical knowledge carried out scientific researches and made original additions to it. During the period of Arabic enlightenment certain schools came into prominence. This is the period wherein creative activity in different fields of medical sciences started.

The Arab physicians and scientist were  great thinkers, writers and men of insight. They made outstanding contribution to the advancement of the medical sciences not only in the Eastern and the Western Caliphates but also in the Western world later when their works were translated into Latin. In this connection the names of ZAKRIYA AL RAZI (Rhazes), ABUL QASIM ZAHRAWI (Abulcasis), IBN SINA (Avicenna), IBN AL HAYTHAM (Haythem), IBN AL BAITAR (Baitar), JABIR BIN HAIYYAN (Gaber), and ALI IBN ABBAS AL MAJUSI (Haly Abbas) etc. are worth mentioning.

ABU BACKER MOHAMMED BIN ZAKRIYA RAZI (Rhazes 865 – 925 A.D.) was the father of Modern Clinical Medicine and Epidemiology. He was the first physician to differentiate the communicable diseases like Small Pox and Measles. The work most highly regarded today is his compilation on “Small Pox and Measles”, which is known in Arabic as “Kitab Al Judri Wal Husbah.”He was also well acquainted with the art of Surgery. He described for the first time, the suturing of wounds by using silk threads and use of alcohol. He was the first to observe pupillary reaction to light. He is the first person to publish the first known book on children’s diseases and its treatment. The most famous book of Rhazes is “Kitab Al Hawi Kabeer Fi’l Tibb.” All the historians’ tribute this book and is regarded as an Encyclopedia of Tibb (Medicine). It comprises of 23 volumes.

ABUL QASIM ZOHRAWI (Abulcasis 936 – 1013 A.D) was the father of Modern Surgery, unrivalled in his art of Surgery. He invented and designed the modern instruments for his surgical cases, which are prepared with metals and materials of animal origin. He compiled the famous book on Modern Surgery called “Kitab Al Tasreef Liman Aajaza An Al Taleef.” It comprises the diagrammatic view of modernized surgical instruments designed by him for the cases of surgery.

IBN SINA (Avicenna 970 – 1037 A.D) was a renowned physician, and known to the western world and Europe as “Father of Modern Medicine.” His medical impact on the Western Medicine has been overwhelming. One of his famous compilations “Al Qanoon Fi’l Tibb” (The Canon of Medicine of Avicenna) in five volumes was assigned a high status both in the Eastern and Western world up to the eighteenth century.

ABU SAHEL MASIHI (1009 A.D) was one of the famous   philosopher of his time and also a court physician of Caliph Maimonides. His compiled book “Kitab Al Miaah Fi’l Tibb” contributes 100 chapters on Medicine.

IBN NAFIS AL QARSHI (1288 A.D) was very famous for his commentary on Ibn Sina’s works Al Qanoon Fi’l Tibb (The Canon of Medicine). The discovery of Lesser Circulation (Pulmonary Circulation) of Blood is credited to him. This discovery not only corrected the Galenic view about blood circulation but also paved the way for the discovery of Greater Circulation by “William Harvey” in the 18^th century.

The above mentioned Greco Arabic scholars and their researches contributed to the development of Unani System of Medicine in the world over. Other Spanish scholars Ibn Zohr, Ibn Rushed contributed to the development of Unani System of Medicine in Europe. After this Unani System of Medicine reached India.

UNANI SYSTEM OF MEDICINE IN INDIA:

In  India, the Arabs introduced the Unani system of medicine  in 12-13^th centuries. Due to its wide acceptance among the masses and the patronage of Sultans and Khiljis of Delhi and Mughal Emperors it took firm roots in the Indian soil. During the period between the 13^th and 17^th century this medicine got established in India.

UNANI SCHOLARS OF INDIA:

Mohammed Ibn Yousuf Harwi – Compiled a book on “Ayn Al Hayath” (Geriatric Care and Anti-Aging Therapy).

Ali Geelani (1610 A.D.) – Great Commentary of Avicenna’s “Canon of Medicine.”

Hakeem Alvi Khan (1669 – 1747 A.D.) Hakeem Akber Arzani (1721 A.D.). They were the key contributors of through teaching practice and writing of books. H?ak?m Akbar Arz?n? was the first compiler of curriculum-based books on Unani System of Medicine in Persian known as Tibbe Akber.

The Unani physicians settled in India subjected Indian drugs to clinical trials. After research and experimentation numerous native drugs were added to Unani System of Medicine and therefore enriched the treasure of Unani System of Medicine.

Fundamental Principles of Unani System of Medicine:

The principles and concepts related to human biology are seven natural factors that make up the human being. These are called as Umoore Tabi’yah (Integral Factors of Body Physique).

1. Arkan (Human Elementology)
2. Mizaj (Temperament)
3. Akhlath (Body Humours)
4. A’za (Body Organs)
5. Arwah (Pneuma)
6. Quwa (Faculties / Powers)
7. Afa’al (Body Functions)

DISEASE PROCESS ACCORDING TO UNANI SYSTEM OF MEDICINE:

Unani system of medicine defines Health and Disease as well as the intermediate state i.e. called Halathe Salisah (Covalence State or Latent Period of Disease).

Disease:

Disease is an abnormal state of the human body which primarily and independently but not secondarily disturbs the normal functions of the body. According to Avicenna “Disease is an altered state and not an entity, and it is morbid to that extent that it disturbs the normal functions of the body.

The disease is basically an imbalance in the normal temperament, disorganisation and discontinuity of the structure. There are three basic pathologies may exist independently or in combination causing a compound disease.

1. Su Al Mizaj (Altered Temperament).
2. Su Al Tarkeeb (Morphological Changes or Disintegration).
3. Tafaruq Al Ittesal (Discontinuity of Structures).

1. Su Al Mizaj (Altered Temperament):
   Basically the altered temperament (Dyscrasia) has two major division Su Al Mizaje Sada (Simple or Qualitative Altered Temperament) and Su Al Mizaje Maadi (Humoral Altered Temperament). A simple altered temperament never remains constant but it gets converted into Su Al Mizaj Maddi (Humoral Altered Temperament).

2. Su Al Tarkeeb (Morphological Changes – Disorganisation):
   It usually occurs in compound organs which are composed of simple organs. These diseases are related to the structures of the organs or morphological disorders.

3. Tafaruq Al Ittesal (Discontinuity of Structures):
   Loss of continuity affect both simple as well as compound organs directly, while in the later case (dislocation) loss of continuity involves compound organs directly and independently and not through the involvement of simple organs which compose them.

PRINCIPLES OF DIAGNOSIS:

The Unani System of Medicine emphasized on rntire personality of a patient is taken into account because each individual patint has his or her own basic structure, psychic, makeup,self defense mechanism,reaction,to environment factor likes and dislike. The unani physician recognise the purpose of biology and that matter of energy can not be regarded as separate function each other.

As far as the clinical diagnosis is concern it is well described in Unani classical literature that, the clinical diagnosis is usually made by the following meticulous scientific observational methods.

1. Nabz (Arterial Pulse) especially the Radial Arterial Pulse.
2. Baul (Urine Analysis).
3. Baraz (Examination of Stools).
4. Fuzlathe Badaniah (Excreta’s of the body):

Nowadays modern diagnostic procedures like laboratory investigations, radiological investigations and other biochemical investigations are being used for making confirmatory diagnosis of the diseases and to understand the internal environment of the body in a better manner.

Preventive & Promotive Health Care:

Unani System of Medicine deals with both Preservation of Health and Prevention from Disease. It has the method of maintaining health in a positive and individualized manner with different guidelines for different temperaments, genders, age groups, season, occupation and geographical regions. e.g.

1. Regimens for Seasons.
2. Regimens for Pregnancy.
3. Regimens for age groups.
4. Regimens for travellers etc.

Asbabe Sittah Zarooriyah (Six Essential Factors):
For maintenance of health, Unani System of Medicine especially emphasizes the six essential factors. They are known as Asbabe Sittah Zarooriyah

1. Hawae Muheeth (Ambient Air).
2. Makulat Wa Mashrubat (Diets / Foods and Drinks).
3. Harkat Wa Sukoon Al Badaniyah (Movements and Repose of Human Body – Physical).
4. Harkat Wa Sukoon Al Nafsaniyah (Movements and Repose of Mind – Mental).
5. Naum Wa Yaqzah (Sleep and Wakefulness).
6. Istefragh Wa Ehtebas (Elimination or evacuation and Retention of Body Excreta).

Therapeutic Approach:
Treatment is adopted when prevention fails and disease occurs. There are four modalities of treatment mentioned by the Ancient Unani Physicians, which can be adopted for therapeutic purpose according to the nature of the diseased condition, these are as follows.

1. Ilaj Bil Taghziya (Dieto-Therapy).
2. Ilaj Bil Dawa (Pharmacotherapy).
3. Ilaj Bit Tadbeer (Regiminal Therapy).
4. Ilaj Bil Yad (Manual Therapy or Manipulative Therapy / Surgery).
   

The Unani line of treatment for all morbidities consists of the following four main components:

1. The first component is activities leading to the reduction in the excess of abnormal humour, and evacuating the accumulated toxins, associated with the illness.
2. The second component is encouragement of the concoction and elimination of the abnormal humour through evacuation like Purgation or Laxation etc.
3. The third component is the strengthening of the organs and system affected by the morbidities by application of an appropriate lifestyle management programme.
4. The use of Ilaj Bit Tadbeer (Regimenal Therapies).

 Ilaj Bil Taghziya (Dieto-Therapy):
The ways and methods which the ancient physician adopted to help the Tabiy’at (Body Physique) are treatment modalities of Unani System of Medicine. Sometimes disease is mainly concerned with and caused by the indiscriminate use of certain food items and thus such diseases can be cured by modulating the diet appropriately.

Disease may also result from digestive and metabolic product of diet and of course such disease requires more dietary modulation than therapeutic intervention – this modulator of treatment called as Ilaj Bil Ghiza (Dieto-Therapy).

Ilaj Bil Dawa (Pharmacotherapy):
According to Unani System of Medicine treatment is governed by three laws.

1. Quantity of Drugs in terms of Temperament.
2. Quantity of Drugs in terms of its Weight and Potency.
3. Time of Administration.

Forms of Drugs:
Unani drugs are used in different forms.

1. Jamid (Solid): e.g. Habb (Pills), Aqras (Tablets), Sufoof (Powder) etc.
2. Sai’yal (Liquid): e.g. Joshanda (Decoctions), Khaisanda (Infusions), Sharbath (Syrups) etc.
3. Bukhari (Aerosols): e.g. Inkebab (Vaporization), Bukhoor (Fumigation) etc.
4. Neem Munjamid (Semi Solids): e.g. Majune, Ithrifal, Khamirah etc.

Drug Source:
Only natural substances are used in Unani drug formulations. They are classified in three categories based on their origin.

1. Plant Origin: Fruits, Gums, Barks, Stems, Leaves, Resins, Seeds, Roots, Flowers, Latex etc.
2. Mineral Origin: Metals, Metal ores, Non-Metals in natural form.
3. Zoological Origin: like Milk, Ghee, Honey, Musk, Silk Cocoon etc.

Preparation of Unani Medicine:
Drugs are used externally and internally. Drugs which are used internally either single or compound form in combination with other drugs for its delicacy and its proper digestion. There are many external applications of drugs. These are effusions, compresses, dressings, embrocations, fomentations, frictions, ointments, powders, softening agents and spreads.

Ilaj Bil Tadbeer (Regiminal Therapy):
It is one of the most popular methods of treatment practiced by Unani physicians since ancient times. It comprises non medicinal or least drug procedures.

Literally the “Tadbir” is an “Arabic” word which means “Regimen” (Systematic plan) whereas “Ilaj” means “Therapy” or “Treatment.” So “Ilaj Bi’l Tadbir” means “Treatment through Regimens.”

“This is a method through which the elimination of morbid matter in a diseased person and maintenance of health by eliminating the excretas’ in general healthy individuals is performed with the help of certain procedures, tools and equipment”.

Procedures in Ilaj Bil Tadbeer (Regimenal Therapy):
These regimens are as follows:

1. Aab’zan (Sitz Bath).
2. Amle Kai (Cauterization).
3. Amle Qasateer (Catheterization).
4. Bukhoor (Fumigation).
5. Dalak (Massage).
6. Eay’lam (Inducing Pain / Injure).
7. Fasd (Phlebotomy / Venesection / Blood Letting).
8. Gararah, Madhmadhah, Masmashah (Gargle).
9. Hijamah (The Cupping Therapy).
10. Huqna, Amal Al Ehteqan (Enemata / Enema).
11. Idrar Al Baul (Diuresis).
12. Idrar Al Tams (Emmenogogue).
13. Idrar Al Labn (Galactogogue).
14. Imalah (Counter Irritation / Diversion of Matter).
15. Inkebaab (Vaporization / Steam Bath).
16. Irsal Al Alaq (Leeching / Hirudotherapy).
17. Isha’al (Purgation).
18. Istehmam (Bathing / Medicated Bath).
19. Ightesaal (Washing / Cleaning of Body Parts).
20. Lakh’lakha, Nushooq (Steam Inhalation / Smelling).
21. Nutool, Sukoob, Tarnai (Douching).
22. Pashoya (Foot Bath).
23. Qai (Emesis / Induced Vomiting).
24. Riyazat, Kasrat (Exercise).
25. Sa’uot (Nasal Drugs).
26. Shiyaf, Kuhl (Antimony / Ocular Suppository).
27. Sanoon (Medicated Tooth Powder / Dentifrice).
28. Talai’yun (Laxation of Bowels).
29. Tareeq (Diaphoresis / Induced Sweating).
30. Tanfees (Expectoration).
31. Tanweem (Tranquilization / Inducing Sleep).
32. Taskeen Al Waja’a (Alleviation of Pain).
33. Tadh’ha Al Shams (Sun Bath).
34. Tadheen (Oiling / Dipping in Oil).
35. Tikoor, Takmeed (Fomentation).
36. Zimad, Tila, Marham (Paints, Liniment and Ointment etc.).

Ilaj Bil Yad (Manual Therapy / Surgery):
Surgery (Ilaj Bil Yad or Jarahath) has always been a part of treatment in Unani System of Medicine since ancient times

Surgical procedures performed in the ancient Unani Medicine:
Abul Qasim Zohravi (Abulcasis) described several surgical procedures, invented several surgical instruments, and described several surgical techniques and the Arabian scholars like Ibn Al Qaff, Abu Bakker Mohammed Bin Zakria Razi (Rhazes), Ibn Haithem and other physicians and surgeons of the ancient time performed the following procedures in clinical surgery for the their own patients.

• Thyroidectomy in Goiter.
• Extraction of cataract in Mature Cataract cases.
• Lithotripsy from the Ureter, Bladder and Urethra.
• Tonsillectomy in Tonsillitis.
• Tracheotomy in Acute Respiratory Obstruction and Asphyxia.
• Craniotomy in Space Occupying Lesions.
• Caesarian section in complicated labour.
• Many more procedures in Dentistry.

Successful Treatment for Certain Disorders:
The Unani System of Medicine offers successful treatment for certain ailments particularly Non-communicable Diseases viz, metabolic, autoimmune and lifestyle disorders, which are scientifically proven by the clinical and preclinical trials with classical Unani formulations. Those compound formulations are being used since several hundreds of years. The diseases which can successfully be treated with Unani medicines are as follows.

Dermatological Disorders:

• Bars (Leucoderma).
• Behaq Abyaz (Pityriasis Alaba).
• Behaq Aswad (Pityriasis Nigra).
• Nar Farsi (Eczema).
• Da’us Sadaf (Psoriasis).
• Chumbal (Ring worm infestation)

Hepatic Disorders:

• Warme Jigar (Hepatitis).
• Izmul Kabid (Hepatomegaly).
• Sighrul Kabid (Cirrhosis of liver).
• Tasammume Kabidi (Alcoholic liver disorder).
• Tashahhume Kabid (Fatty liver).
• Yerquan (Jaundice – Obstructive, Hepato-cellular and haemolytic).
• Taleeful Kabid (Fibrosis of liver in chronic alcoholism).

Gastro-Intestinal Disorders:

• Qarha Inhezami (Peptic ulcer).
• Qulae Dehan (Stomatitis).
• Aphthus Ulcers.
• Warme Meda Muzmin (Chronic Gastritis).
• Wajul Fuad (Heart Burn).
• Su Al Hazm (Dyspepsia).
• Warme Quloon Quroohi (Ulcerative Colitis).
• Warme Quloon Mizmin (Irritable Bowel Syndrome)

Uro-Genital Disorders:

• Hisathul Kulliya (Renal Calculi).
• Hisathul Halib Wa Masanah (Uretric & Cystic Calculi).
• Salis Al Baul (Incontinence of Urine).
• Taqteer Al Baul (Dribbling of Urine).
• Zoaf Al Kulliya (Chronic Kidney Disease or CRF).
• Sighrul Kulliya (End Stage Renal Disease).
• Baul Fi’l Farash (Nocturnal Enuresis).
• Zoafe Bah (Lack of Libido).
• Uqar (1^o & 2^o Infertility).

Cerebro-Spinal Disorders:

• Falije Nisfi (Hemiplegia).
• Laqwa (Facial Palsy).
• Warme Asab (Neuritis).
• Sar’a (Epilepsy).
• Ummus Sibiyan (Infantile Convulsions).
• Tamaddud (Muscular Spasm).

Cardio-Vascular Disorders:

• Imtelaye Suqootul Qalb (Congestive Cardiac Failure).
• Marz Shiryanul Akleeli (Coronary Artery Disease).
• I Flasul Qalb (Ischemic Heart Disease).
• Zaghtatul Qalb (Hypertensive Heart Failure).

Pulmonary Disorders:

• Ribu (Bronchial Asthma)
• Bohar (Cardiac Asthma).
• Zeequn Nafas Hissasi (Allergic Asthma).
• Zatur Riya (Pneumonia).

Gynaecological Disorders:

• Ikyas Khusiyatur Reham (PCOS).
• Sula’a Reham (Uterine Fibroid).
• Uqar (1^o & 2^o Infertility).
• Kasrate Tams (Menorrhagia/Metrorrhagia).
• Ihtebase Tams (1^o & 2^o Amenorrhea).

General & Metabolic Disorders:

• Samne Muffarrath (Obesity).
• Huzal Mufarrath (Cachexia).
• Ziabetes Sukkari Har Wa Barid (Diabetes Mellitus Type I & II).
• Fisharuddam Qawi (Hypertension).
• Shiyab (Early Graying of Hair).
• Inteshare Sha’ar (Alopecia Areata).