Unani name has been derived from a Greek word Ionian, meaning the knowledge of the states of the human body in health and sickness. The Unani system of medicine pertain to a tradition of Greeko-Arabic medicine based on the teachings of Greek physician Buqrat (Hippocrates; 460-377 BC) and Roman physician Jalinoos (Galen). Arab and Persian physicians like Al Razi (Rhazes), Avicenna (Ibne sina), Al Zahrawi and Ibn Nafis developed this into an elaborate medical system. It has been reported (Sina and Quanoon 2007; Ahmad and Asri, 1983) that traditional medicine system practised in ancient traditional systems of medicine of China, Egypt, India, Iraq, Persia and Syria is widely practised in South Asia and other parts of the world. We know that among all communities, concept of health is part of their culture and is defined as absence of diseases since time immemorial. Heath as per WHO, an issue of social justice, is a state of complete physical, mental and social well-being and not simply the absence of disease. The holistic concept appreciate that the strength of social, economic, political and environmental consequence on health. It was found (Parik, 2009; Kabeeruddin, 2009) that all sectors of society are linked with health and we must stress on the promotion and protection of health. Unani system of medicine also called Unani tibb, Arabian medicine, or Islamic medicine, a traditional method of healing and health maintenance observed in South Asia. It was later developed and refined through systematic experiment by the Arabs, notably by Muslim scholar-physician Avicenna. It was observed that during the Caliphate (the political-religious Muslim state that began in 632 CE), the bulk of Greek knowledge was translated into Arabic, part of that knowledge being the principles of medicine. The Unani system of medicine with additional contributions of medical wisdom from other parts of the Middle East and South Asia, came to be known also as Islamic medicine or Arabian medicine. The history of Unani system of medicine also called Unani tibb, Arabian medicine, or Islamic medicine can be characterized by the work of its practitioners, or hakims, which relied on natural healing based on principles of harmony and balance, uniting the physical, mental, and spiritual realms. Al-Umoor al-tabiyah: basic physiological principles: The health of the human body as per practitioners of Unani system is maintained by the harmonious arrangement of al-umoor al-tabiyah, the seven basic physiological principles of the Unani doctrine. These basic principles include (1) arkan, or elements, (2) mizaj, or temperament, (3) akhlat, or bodily humours, (4) aaza, or organs and systems, (5) arwah, or vital spirit, (6) quwa, or faculties or powers, and (7) afaal, or functions. Interacting with each other, these seven natural components maintain the balance in the natural constitution of the human body. Each individual’s constitution has a self-regulating capacity or power, called tabiyat (or mudabbira-e-badan; vis medicatrix naturae in Latin), or to keep the seven natural components in equilibrium. Arkan and mizaj: elements and temperament: The four simple, indivisible entities—arz (earth), maa (water), nar (fire), and hawa (air)—arkan not only constitutes the primary components of the human body but also makes up all other creations in the universe. To the actions and interactions (imtizaj) of the four arkan, there are predictable consequences as these elements act upon and react with each other. Further, they continually undergo change into various states of “genesis and lysis” (generation and deterioration), due to ulfat-e-keemiyah (acceptance of a medicine by the body) and nafarat-e-keemiyah (rejection of a medicine). It is claimed by skilled hakims that they can perceive, recognize, and observe such states. The four essential mizaj (temperaments) are hot, cold, moist, and dry. Four more are compounded of those single temperaments—namely, hot and dry, hot and moist, cold and dry, and cold and moist. Possessed in different proportion, mizaj is balanced by all entities in the cosmos, including all plants, minerals, and animals. The equilibrium of the individual’s elemental combination and resulting mizaj, as determined by tabiyat, provides a stable constitution to that individual i.e., i health. The elemental balance keeps an individual in a healthy state, changes in natural temperament cause the health of an individual to suffer. Hence, mizaj plays a pivotal role in Unani system in characterizing a person’s normal state (physical, mental, and social), as well as the nature of a disease. Doctrine of akhlate: Greek physician, Hippocrates propounded the doctrine of fluids, or humours, of the body, and he categorized the humours into four groups based on their colour. These groups were refined by Galen and later by Avicenna. They 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 humoral makeup, determined by the predominance of a given humour in his or her constitution. The quality and quantity of the humours in an individual—a person’s unique, proper, and proportionate humoral makeup—is said to guarantee health. The conditions in human other than this balance signal weakness or disease. The theory of humours (nazaria-e-akhlat), which is the essence of the practice of Unani medicine, 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 behavioral well-being, and are most stable in a healthy individual. It is found that there is a relationship between tabiyat and asbab-e-sittah-zarooriah. Tabiyat in the Unani system of medicine, is an individual’s internal power or capacity to withstand or combat disease and to perform normal physiological functions. It is believed that it is only tabiyat that is engaged in actually curing illness, Unani hakims hold that they only assist 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 defense system of the mind and body. The Unani system of 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-zarooriah are:
(a) Hawa (air), in which the quality of the air a person breathes is thought to have a direct effect on his or her temperament and, thus, health.
(b) Makool-wo-mashroob (food and drink), in which the nutritional value and the quality and quantity of one’s food and drink are believed to ensure physical fitness by strengthening tabiyat.
(c) Harkat-wo-sakoon-e-jismiah (bodily exercise and repose), which emphasizes the positive effects of balanced physical exercise on an individual’s internal resistance and tabiyat.
(d) Harkat-o-sakoon nafsaniah (mental work and rest), which emphasizes the simultaneous engagement of the human mind in numerous emotional and intellectual activities. Just as the body needs systematic and planned exercise and rest, Unani medicine holds that the human mind and brain need adequate stimulation and proper relaxation as well.
(e) Naum-o-yaqzah (sleep and wakefulness), in which an individual’s health and alertness are understood as being dependent on a specific amount of sound sleep in the course of a 24-hour (circadian) cycle.
(f) Ihtebas and istifragh (retention and excretion), which considers the metabolism of food and liquid as both affecting and being regulated by tabiyat.
“We know unani system and modern system of treatment are related as Modern system of medicine has built on what nature has to offer and has drawn upon traditional systems of knowledge of how medicinal plants, herbs, roots, and bark were wielded to cure sickness across civilizations. Unani system apart from popular treatments is known for its promising results in the treatments of autoimmune disorders, Lichen Planus and Eczema. Government should provide Unani hospital facility to every area and special efforts should be made to conserve natural resources for the benefit of future generations”.
According to Unani medicine, the assimilation of food and liquid facilitates the elimination from the body of excessive and noxious substances. Therefore, to maintain a harmonic and synchronized tabiyat, certain beneficial end-products of kaun-o-fasad (genesis and lysis) are retained in the body while harmful ones are expelled.It is believed by Unani practitioners that these six factors directly affect the harmony of the human mind and body. In Unani system, Socioeconomic, geographic, and environmental factors are considered secondary factors (asbab-e-ghair-zarooriah), and therefore indirectly influence tabiyat. Primary and the secondary factors, however, must be closely considered in the Unani system of treatment. Modes of treatment in Unani system: In Unani system of treatment, the initial approach to treatment in the entails the establishment of a regimen to normalize and balance the external factors (e.g., air, water, and food) involved in ailments and diseases. If this proves inadequate, then other means, such as treatment with natural medicines, may be recommended. Unani treatment prescribed by any hakim acts as an outside agent to help boost the patient’s tabiyat and thus restore good health and a sense of well-being. We know that there are various therapeutic approaches available to the hakim. Ilaj-bi-ghiza, or dietotherapy, involves recommending a specific diet, which is the simplest and most natural course of treatment by a hakim. For fever, for example, Unani medicine stresses a nutrient-rich, low-roughage diet that might include dalia (porridge) and kheer (a milk broth). Both the amount and quality of food are taken into consideration. Relatively infrequent in modern Unani therapy is ilaj-bi-misla, or organotherapy, a mode of treatment that involves healing a diseased organ with the use of tissue extracts from the same organ of a healthy animal. Ilaj-bi-dawa, or pharmacotherapy, is the use of medicines by Unani hakims, considered to be natural, eco-friendly, and less intrusive and more effective than many other methods. The Unani system’s pharmacopoeia is vast, enriched with more than 2,000 medicines derived from various herbal, mineral, and animal sources. The Unani system of medications are frequently processed by classical methods of preparation as originally described in Greco-Arabic medicine, used singly or are compounded with other substances to achieve synergistic, antagonistic, or detoxifying effects or simply as bases for effective ingestion and assimilation. It was found that Indian physician Ajmal Khan in the 1920s revolutionized Unani system of medicine by advocating that research be conducted on various natural products that were claimed by ancient physicians to effect miraculous cures. Salimuzzaman Siddiqui, in the 1930s Indian-born scientist who was specialized in phytochemistry (the chemistry of plants), isolated potent constituents from a plant known in India as chhota chand (Rauwolfia serpentina). Subsequent pharmacological research determined that the plant was the source of a bioactive substance known as reserpine, which found use in Western medicine as a tranquilizer and as an antihypertensive agent (lowering abnormally high blood pressure). Those uses supported some of the medical applications that had been described by hakims. Siddiqui named the derived medicines, which included ajmaline and ajmalicine, for Khan as a tribute to his groundbreaking research efforts. Having gained recognition from the World Health Organization (WHO) in 1976, the Unani system became increasingly accepted internationally as a system of traditional medicine. In India several institutions engaged in Unani teaching and research. The Central Council for Research in Unani Medicine (CCRUM), an undertaking of the Indian government, for instance, facilitated the translation of classical heritage, the organization of clinical trials, the improvement of drug standardization, and the investigation of toxicological and phytopharmacological properties of natural products that had long been used by hakims. Classical Unani medicine recommended established “regimental” therapies (tadabeer) in the treatment of various chronic and acute diseases. Those therapies include dalak (massage), hammam (bath and sauna), karat (exercise), fasd (venesection, or 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, or bleeding a person by using leeches). The essential function of all those regimens is to remove impure blood or impurities from the body. Surgical interventions, or ilaj-bil-yad, are a last resort. Their practice generally is beyond the realm of the hakim’s expertise. There are many Obstacles in Unani medicine. Although a complete system of treatment, the Unani system of medicine, similar to other systems of medicine, has drawbacks in terms of application and effectiveness. The vast materia medica, from herbal and animal to mineral sources, as described in ancient Unani textbooks, is sometimes so vague that authenticity must be established by modern pharmacognostic assessments (by means of a basic, descriptive pharmacology) before medicines can be put to use. In addition, the use in Unani medicine of precious stones and minerals, the chief ingredients of many polyformulations (medicines containing multiple ingredients), is expensive. Those items often are unavailable as well, thereby hindering effective treatment. 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). Medicines made with those minerals, when used with caution and expertise, may be effective, but they have significant toxic side effects. It is concluded that Unani system of medicine strives to find the best possible ways by which an individual can lead a healthy life with the least sickness. Worldwide millions of people prefer traditional medicine system for treatment of any disease as compared to modern system of treatment. It has been reported that out of 194 WHO Member states, 170 use traditional medicine. People consider it for treatment as its main benefit is that it has less side effects as compared to modern system of treatment. At present, Unani system of medicine is practised in many countries worldwide and India is acting as a global leader in the field of developing pharmacopoeia standards of Unani medicine system. We know unani system and modern system of treatment are related as Modern system of medicine has built on what nature has to offer and has drawn upon traditional systems of knowledge of how medicinal plants, herbs, roots, and bark were wielded to cure sickness across civilizations. Unani system apart from popular treatments is known for its promising results in the treatments of autoimmune disorders, Lichen Planus and Eczema. Government should provide Unani hospital facility to every area and special efforts should be made to conserve natural resources for the benefit of future generations.
( While Dr. Syed Sabahat Ashraf is a freelancer,Dr. Bilal A. Bhat is Professor Statistis at the Department of Statitics at S K University of Agriculture Sciences & Technology-SKUAST Kashmir. The views, opinions and conclusions expressed in this article are those of the authors and aren’t necessarily in accord with the views of “Kashmir Horizon”.)