By Sharukh Vazifdar
Too little is known about Unani, one of the world’s major therapies rooted in a holistic perspective. Founded by Hippocrates, and built on by various cultures including the Arab world, Unani is a sophisticated therapy offering cures for an impressive range of maladies
Ankit and Sudha Jain, a couple from New Delhi, were on heavy allopathic medication for hypertension. Their dosage had increased over the years with no sign of lasting relief or decrease in symptoms. By using Unani medicine as a supportive treatment and observing a few simple diet restrictions, they were able to completely stop the allopathic medicine within six months.
Farooq Ahmed, a 31-year-old shop owner from Mumbai was diagnosed with chronic renal failure in 2008. Since he could not afford hospitalisation, he tried Unani medicine under Prof Sharique Zafar of the Dr Jamkhanawala Tibbia Unani Medical College in Mumbai. Using various herbal formulations, his condition was reversed permanently in less than a year. Now his blood urea and serum creatinine levels are normal with no abnormal fluctuations.
Gurpreet Singh (30) a manager in a Delhi-based media company, turned to Unani when he was diagnosed with jaundice. Admitted to Majeedia Hospital in New Delhi, he was cured in a week and could resume a normal diet.
Unani medicine, whose name we have all heard, but of which most of us know nothing, owes its origins to Greece, and in particular to Hippocrates. Bearing close resemblance to Ayurveda, the Indian system of health care, Unani is based on the theory that the human body has the four elements present within it in the form of four humours. Being a holistic form of treatment, it eradicates the root of the disease and not just its symptoms, preventing recurrence.
Conventional medicine may still swear the Hippocratic oath, but in every other way it has renounced the healing approach founded by Hippocrates.
History of Unani
It was the Greek philosopher-physician Hippocrates who freed medicine from the realm of superstition and magic, recognising the disease process as a natural phenomenon, and established for the first time, a system of diagnosis and proper cure of ailments, giving it the status of science. The theoretical framework of Unani medicine is based on the teachings of Hippocrates. After him, a number of other Greek scholars enriched the system considerably. Of them Aelius Galenus, a prominent Roman physician of Greek origin, better known as Galen stands out as the one who stabilised its foundation, on which Arab physicians like Muhammad ibn Zakariya al-Razi, popularly known as Rhazes, and Ibn Sina or Avicenna constructed an imposing edifice. Avicenna’s book, al-Qanun fi al-Tibb (The Canon of Medicine), is “the single most famous book in the history of medicine, in East or West”, as stated by the Encyclopaedia Britannica. Composed of five long volumes totalling one million words, the Canon drew together all of the medical knowledge that existed in the world up to his time, which he refined and codified into the science of medicine. Unani medicine got enriched by imbibing what was best in the contemporary system of traditional medicine in Egypt, Syria, Iraq, Persia, India, China and other Middle East and Far Eastern countries. It also benefited from the native medical systems in vogue at the time in various parts of Central Asia. That is why this system is known, in different parts of the world, with different names, such as, Greco-Arab Medicine, Ionian Medicine, Arab Medicine, Islamic Medicine, Traditional Medicine, Oriental Medicine and so on.
In India, Unani system of medicine was introduced by the Arabs, and was soon well-established and followed. When Mongols ravaged Persian and Central Asia, scholars and physicians of Unani medicine fled to India. The Delhi Sultanate provided state patronage to the scholars and even enrolled some of them as state employees and court physicians. Unani medicine had its hey-day in India between the 13th and the 17th century. Mughal gardens were designed by Unani herbologists to enhance well-being through the healing effects of various flowers and plants. During British rule, Unani medicine suffered a setback and its development was hampered due to withdrawal of governmental patronage. But since the system enjoyed faith among the masses it continued to be practised. Hakim Ajmal Khan, freedom fighter, president of the Indian National Congress, and founder of the Jamia Millia Islamia University in Aligarh, greatly furthered both Unani and Ayurveda in the pre-independence era.
Apart from India, Pakistan is another country where Unani is extensively practised. Sri Lanka and Bangladesh also feature in this list but to a lesser capacity. Countries such as South Africa have a few well-known Unani doctors with patients coming from all over the globe. In the Middle East, Egypt and Afghanistan, the trend is to pass on the knowledge from father to son, diluting the skill and proficiency, and without any valid authoritative body. Dr Noor Patel, the RMO at the HAR Kalsekar Tibbia Hospital of Unani medicine in Mumbai, states here that many of the so-called hakims who sell medication in vans or stalls on the streets aren’t certified practitioners and give the field a bad name by distributing their own concoctions, which might be ineffective.
Many wrongly believe Unani to be traditional Islamic medicine. Hakim Daljeet Singh and Hakim Ram Lubhaya, two ardent promoters and practitioners of this system, belonged to different religions. Dr Patel points out that both students and patients come from varying backgrounds and religious identities. The reason for this misconception is that most of the earlier texts on the subject were in Urdu, greatly limiting the outreach. The Munshi Naval Kishore Press in Lucknow was the sole publisher of Unani literature until recently, printing only in Arabic, Persian and Urdu.
Unani physicians consider seven basic natural principles (Al Umoor al Tabi’yah) of human physiology. The term ‘al Tabi’yah’ is derived from the word tabi’at or physis which in English would be interpreted as physiology.
The anasir or elements are divided into four major categories based on four states of elements, which contribute to the formation of things in nature, including the human body. The properties of an element are described in terms of their temperament which is expressed in terms of four qualities, heat, cold, moisture, and dryness. Heat and cold are considered active qualities, and moisture and dryness are passive qualities.
The temperament or mizaj is the resultant uniform state or the state of equilibrium emerging after the combination of more than one element. The temperament could be either balanced or unbalanced.
The humoral theory postulated by Hippocrates, describes that the body contains four major kinds of humours, blood, phlegm, yellow bile and black bile. When in the right proportion, according to quantity and quality, the body is healthy. Incorrect proportion and irregular distribution constitutes disease. Blood or dam is a fluid of red colour, hot and wet in nature, whose main function is to provide nutrition to the human body. It promotes growth of the body in adolescence and helps in the generation of innate heat by supplying fuel to the human body. Phlegm or balgham is a whitish fluid, which includes all white humours of different nature possessing different characteristics and functions. Its temperament is cold and wet and is capable of transformation into blood at anytime. It serves nutrition to the organs like cerebrum, lubricates the joints and keeps the tissues and organs moist to permit their smooth movement without causing friction. Yellow bile or safra is hot and dry in nature, and is bright red in colour. It enables the blood to nourish those organs which need the presence of bilious humour (relating to bile), such as the lungs. Being comparatively lighter, it attenuates the blood and thus enables the blood to reach the thinnest channels of the body. Black bile or sauda is the most inferior amongst all humours and is cold and dry. Its main use is that by travelling to the mouth of the stomach, it tickles the site and sets up a sense of hunger and so arouses the appetite.
Tissues and organs
In Unani medicine, the tissues and organs have been divided into two major categories: simple organs and compound organs. A simple organ is homogenous in structure, such as bones, flesh, nerves, arteries, veins, cartilage, tendon, membrane, fat, ligament, hair and nails. The complex organs are divided into natural organs, psychic or mental organs and vital organs.
Breath or arwah is a component of air that helps in all the metabolic activities of the body; it burns the thin humours to produce different energies and heat, and is the source of vitality for all the organs of the body.
Similar to prana or chi, Unani has the concept of rooh as a life force within the body that animates it. Through different bio-field energy measurement methods, there is ongoing research to see the effects of various Unani treatments on rooh. Inhalation of rose and orange oil has been proven to clear up and brighten the rooh.
Faculties or quwa are responsible for specific physiological functions of the body performed by the particular organs and are divided into natural, mental or vital faculties. Organs and organ systems form such faculties.
All the faculties perform their specific functions or af’al in the body.
Health and disease
The Unani system of medicine places much emphasis on the preventive measures for the maintenance of health rather than the treatment of diseases. According to this system there are six causes which are essential for the maintenance of good health. They restore the equilibrium of various elements and faculties of the human body. These causes are:
• Atmosphere or environment
• Foods and beverages
• Physical or bodily movement and repose
• Mental or psychic movement and repose
• Sleep and wakefulness
• Evacuation of waste products and retention of nutrients
Diseases are classified into simple and complex diseases. Simple diseases can either be due to imbalance of temperament, or structural abnormalities such as swellings, varicose veins, spasms and dysentery, or abnormal discontinuities such as wounds, fractures, and hernia. Compound diseases combine two or more of the above-mentioned simple diseases. First of all, the temperament of any matter or humour becomes abnormal when it is collected in any body part and increases its shape, size and appearance, and ultimately causes a tear or damage (discontinuity), and after resolving, it results in adhesion (scarring). An example of such a disease is an abscess in the body.
In addition to the general physical examination, systemic examination and general interrogation, more emphasis is laid on diagnosing a disease through identification of the temperament of an individual through examination of his/her skin characteristics, muscles and fats, hair on the body, body shape, condition of organs, sleep patterns, bodily functions, excreta and psychological behaviour. Pulse, urine and stool diagnosis is also done.
Psoriasis is a disorder for which allopathy has no proven cure. Says Mrs Meera Venkat, a 42-year-old housewife from Mumbai, “I had a terrible case of psoriasis which just kept spreading over my entire body. I was ashamed to go outside and almost stopped social contact for a while. When I came to know that Unani medicine could treat this problem, I immediately tried it. Over nine months using skin creams and oral pills my skin is back to normal and I enjoy my newfound freedom more than before.”
The holistic theory of Unani medicine always emphasises a human-friendly treatment that is safe and without adverse effects on the body. There are four major types of unani treatment: regimental therapy, diet therapy, pharmacotherapy, chiropractic and surgery.
Regimental therapy (Ilaj Bit Tadbeer)
It aims to assist the resistance of the body thereby eliminating the disease factor without medication. Various types of procedures are included in the regimental therapy, such as diaphoresis, purging, emesis, diuresis, hammam (sauna), massage, exercise, and enema.
Diet therapy (Ilaj Bil Ghiza)
Unani physicians first of all prefer the selected procedures of regimental therapy for curing any ailment. If this therapy fails then the second preferable therapy is the diet therapy. It includes the administration of specific diets according to body temperament, as well as regulation of the quality and quantity of the foods.
There is a wide classification of diets in Unani medicine, and the diets are recommended according to their ranks, in different types of ailments. There are three major classifications of diets according to different parameters, which are as follows.
• According to the duration and ability of digestion.
• According to the formation of chyme (fluid in process of digestion).
• According to the nutritional values.
According to the duration and ability of digestion, the diets are divided into three categories, early digestible e.g. half fried egg, late digestible food e.g. cheese, normally digestible food e.g. turnip. According to the formation of chyme, there are two types of foods, those that form good chyme such as meat of goat and calf, and those that form bad chyme such as cabbage, and dry fish. According to the nutritional values the diets are divided into three categories, highly nutritious such as boiled egg, less nutritious such as cabbage, moderately nutritious such as meat.
Pharmaco therapy (Ilaj Bid Dawa)
Pharmaco therapy comes only after regimental therapy and diet therapy fail to solve the problem. The drugs from three natural sources i.e. plant, animal and mineral are used in this form. Pearl, red coral, silk cocoon, ambergris are some of the animal parts used in the drugs. Ruby, emerald, agate, lapis lazuli are some of the minerals used as micro-fine powder in these drugs. Usually single drugs are preferred over compound formulae. The compound formulations are used particularly in complex and chronic ailments, if required.
On the basis of experience and observations, the Unani scholars have determined the physical properties, temperament, actions, indications, contra indications, substitutes of the drugs of natural origin. The most common way of Unani treatment is opposite treatment i.e. treatment of any disease with a medicine whose temperament is exactly opposite to the diseased temperament. For example, any cold disease will be treated with hot type of medicine.
Sometimes, the drugs having the constitution similar to the disease are also used for some other purposes. An example is Saqmooniya, which has hot temperament, and used in safrawi fever which is also a hot type of derangement of temperament. But in such case the purpose is the expulsion of safra through purgation, which is the main action of Saqmooniya. Thus the safrawi fever can be cured by the elimination of abnormal safra from the body. It has been observed that the drugs having similar type of temperament, may differ in their intensity of action. This is because they differ in the degrees of their temperament. Another unique point about Unani drugs is that if any particular compound has a side-effect, a corrective is added to nullify the toxic effect.
Aromatherapy, now well-known and widely practised, is also a part of Unani medicine. Taken from the Egyptians, this is used to treat a wide range of psychiatric disorders. Fumigation and incense is also part of aromatherapy and cleanses the air of microorganisms and other pathogens. This therapy is given through inhalation of essences, baths, massages, powders, sauna, gargles, cosmetics, potpourris, and incense.
Prof Zafar recalls two patients of his, Shabana Ahmed and Tasneem Khan, from Pune, both of whom suffered from severe insomnia. They were addicted to pills and sedatives, and psychiatric work actually worsened the condition. Using special herbs found only in northern India, he restored a normal sleeping pattern for both without a need to continue medication indefinitely.
Chiropractic and surgery (Ilaj Bil Yad)
Chiropractic involves using the hands to set body parts and organs in their right place. It is enjoying a revival of popularity in the West.
Surgical procedure is recommended when all the other measures of treatment fail. A famous Unani surgeon was Abul Qasim al Zahrawi who performed several difficult operations in the eleventh century. At present only minor forms of surgery are practised in Unani system of medicine.
Procedures such as venesection, cupping, leeching for scarring, eczema and acne, cauterization etc. are also included in Unani surgery.
Cupping is a method of treatment in which a jar with a vacuum inside it is attached to the skin surface. Cupping appears to drain excess fluids and toxins, loosen adhesions and lift connective tissue, bring blood flow to stagnant skin and muscles and stimulate the peripheral nervous system, through the suction effect. On a deeper therapeutic level, cupping is very beneficial for many conditions such as high blood pressure, anxiety, fatigue, chronic headache, fibromyalgia and neuralgia. Contracted, congested muscle tissue will soften quickly with only a few minutes of massage cupping.
Thalassaemia is another such disease that is ‘incurable’ according to allopathy. Three-year-old Karan from Pune had to undergo a blood transfusion every week as he had thalassaemia. At a Unani hospital in Pune, he was given a syrup for his condition. Gradually the periodicity of his blood transfusion was reduced to once in two weeks, then once a month, even less than that and finally he did not need them at all.
Unani in modern India
There are more than 40 colleges in India offering degrees in BUMS (Bachelor in Unani Medicine and Surgery). A large number of students in these courses are not of the Muslim community. Apart from this, Unani herbology is taught in MSc Bio-Analytical Sciences and MSc Herbal Sciences courses all over the country. The Department of Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy (AYUSH) and Central Council for Research in Unani Medicine (CCRUM) are two bodies under the Ministry of Health that are responsible for the research, regulation and promotion of Unani. AYUSH lays emphasis on upgradation of educational standards, quality control and standardization of drugs, improving the availability of medicinal plant material, research and development and awareness generation about the efficacy of the systems domestically and internationally.
The pharmaceutical company, Hamdard, which produces Unani medicines, started off as the clinic of Hakeem Hafiz Abdul Majeed in 1906, and grew into the internationally known organisation it is today. Two of their well-known products are the rose syrup, Rooh Afza, known for its cooling, diuretic, and anti-oxidant properties, and Safi, meant to clear and purify the blood. They also produce baby care, hair products, general health supplements and balms, and weight control products. Rex Remedies, a herbal pharmaceutical company, has over 350 herbal supplements and formulations to its name, many of which are based on Unani principles. Even the widely used gripe water, used to ease constipation, gas, and indigestion in children, is a Unani concoction.
Neelam Mehta, a Mumbai-based writer and trainer, swears by a Unani medicine for colds and coughs called Joshina. “It is a bit of a miracle drug,” she pronounces, “It relieves symptoms instantly without side-effects. The other day a bank executive came home and was coughing incessantly. One dose of Joshina and he stopped coughing instantly. I hand out bottles of this medicine to anyone I see suffering from cold or cough.”
Although lesser known than ayurveda, Unani is now catching up as more people are becoming aware of it and finding a cure for chronic or incurable illnesses. Like other holistic forms of medicine, its subjective and inclusive techniques are personalised as per the patient. One of the oldest forms of healing, Unani is a system that cures the disease and not the symptom. At a time when the world is becoming increasingly disenchanted with allopathy and is actively looking for alternatives, Unani has much to offer.
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There are four types of personalities based on the characteristics and the proportion in which the four humours are present in the human body.
• Sanguine or plethoric: They have a hot and moist temperament, and are obese and robust. They are very active, tense and moderately hypersexual. They have a good appetite and a full strong pulse. They have red complexion, and a slight feeling of heaviness in the body.
• Choleretic or bilious: These individuals possess a hot and dry temperament. They get angry quickly. They have a sallow complexion and a lean and hairy body. They are proud, revengeful and shrewd. They are energetic and intelligent individuals, usually with a strong inclination to indulge in sexual pleasures. They are fastidious about food and have a strong and rapid pulse as well as prominent blood vessels.
• Phlegmatic or pituitic: Their constitution is cold and moist. They are flaccid and obese individuals, with white and pasty skin. They have thin and soft hair and narrow (non-prominent) blood vessels. Their movements and activities are sluggish and their intelligence is slow and dull. They are overcome with drowsiness, do not get angry and are not much given to gastronomic or venereal pleasures. They also experience excessive heaviness of the body.
• Melancholic type: Their temperament is cold and dry. They are thin, dark, with narrow blood vessels and slow pulse. They show slight inclination towards sexual activity, and suffer from loss of sleep.