JOURNAL OF HERBAL MEDICINE 2 ( 2 01 2 ) 1–5

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Review

Perception of health promotion in Unani herbal medicine

a,*
Azad Hussain Lone , Tanzeel Ahmad a, Mohd Anwar a, Gh Sofi b, Hashmat Imam a,
Shahida Habib c
a
Dept. of Medicine, National Institute of Unani Medicine, Bangalore 91, India
b
Dept. of Pharmacology, National Institute of Unani Medicine, Bangalore 91, India
c
Dept. of Gynaecology, National Institute of Unani Medicine, Bangalore, India

A R T I C L E I N F O A B S T R A C T

Article history: The Unani system of medicine is an age old, time tested system of Greek medicine dating
Received 22 September 2011 back 2500 years. Like any other form of medical science, Unani medicine strives to find the
Accepted 30 January 2012 best possible ways by which a person can lead a healthy life with minimum or zero sick-
Available online 21 March 2012 ness. Unani scholars believe that diseases can be kept at bay by the use of clean and fresh
water, breathing clean air and consuming fresh food. Likewise, a balance should be main-
Keywords: tained between the mind and the body so that the metabolic processes can operate easily
Unani medicine and the body wastes evacuated. Unani medicine believes in promotion of health, preven-
Regimental therapy tion of diseases and cures through regimental and diet therapies.
Dieto-therapy Ó 2012 Elsevier GmbH. All rights reserved.
Health promotion

Contents

1. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
2. Improvement of tabiyat (immunomodulation) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
3. Hippocratic theory of medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
4. Asbaabe sitta zarooriya (six essential factors for life) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
5. Ilaj bil tadabeer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
6. Munzij wa mushil (concoctive and purgative) therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
7. Ilaj bil ghiza . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
8. Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

1. Introduction ness (decline of health). Unani medicine refers to a tradition of

Greeko-Arabic medicine which is based on the teachings of
The name Unani derived from a Greek word Ionian, means the Greek physician Buqrat (Hippocrates; 460–370 BC) and Roman
knowledge of the states of the human body in health and ill- physician Jalinoos (Galen) and developed into an elaborate

* Corresponding author. Address: Dept. of Medicine, National Institute of Unani Medicine, Magadi Road, Bangalore 91, India.
E-mail addresses: drazadnium@rediffmail.com, drazad2008@gmail.com (A.H. Lone).
2210-8033/$ - see front matter Ó 2012 Elsevier GmbH. All rights reserved.
doi:10.1016/j.hermed.2012.02.003
2 JOURNAL OF HERBAL MEDICINE 2 ( 2 0 1 2 ) 1 –5

medical system by Arab and Persian physicians such as Al and purgative) therapy and Ilaj bil ghiza (Dieto-therapy)
Razi (Rhazes), Ibn sina (Avicenna), Al Zahrawi and Ibn Nafis. (Kabeeruddin, 1999, 2009).
It is a popular form of traditional medicine widely practised
in South Asia and draws on the ancient traditional systems 2. Improvement of tabiyat (immunomodulation)
of medicine in China, Egypt, India, Iraq, Persia and Syria (Ah-
mad, 1983; Sina, 2007). According to the Unani discipline as it stands today, the hu-
Health is a common theme in most cultures. In fact, all man body is composed of seven natural and basic compo-
communities have their concept of health as part of their cul- nents called Umoore Tabaiyah which are responsible for the
ture. Among definitions still used, probably the oldest is that maintenance of good health. These are Arkan (Elements), Mi-
good health is the absence of diseases. According to the World zaj (Temperament), Akhlaat (Humours), Aaza (Organs), Arwah
Health Organization, good health is a state of complete phys- (Vital forces), Quwa (Faculties) and Afaal (Functions). For the
ical, mental and social well being and not merely the absence proper functioning of the body, all the above mentioned com-
of disease or infirmity. It can be construed as a feeling of ponents should be present and work in concert with each
wholeness and a happy frame of mind. It is not merely an is- other. The loss of any one of these basic components or alter-
sue of doctors, social services and hospitals but an issue of ation in their physical state could lead to disease, or even
social justice and is not perceived in the same way by all death. It is highly essential to consider all these factors so
members of a community including various professional as to reach the correct diagnosis and consequently the correct
groups (e.g., biomedical scientists, social scientists, health line of treatment (Sina, 1987).
administrators, ecologists, etc.) giving rise to confusion about Unani medicine describes the concept of Tabiyat, which is
the concept of health. The holistic concept recognises the a supreme planner of the body to create a healthy environ-
strength of social, economic, political and environmental ment within the body and prepare to fight against disease.
influences on health. It implies that all sectors of society have If Tabiyat is strong, then a man does not suffer from a disease
an effect on health, in particular, agriculture, animal hus- easily, if it weakens, a man becomes prone to disease. The
bandry, food, industry, education, housing, public works, Tabiyat may be defined as the sum total of structural, func-
communications and other sectors. The emphasis is on the tional and psychological character of the human being.
promotion and protection of health (Mahahan, 2009; Parik, According to Hippocrates, there is a special ability hidden
2010). in every individual called the defensive mechanism of the
Health promotion is the process of enabling people to in- body or in the language of Unani Pathy, Tabiyate Muddabare
crease control over and to improve their health. It is not direc- Badan. This Tabiyat is the best physician, and maintains
ted against any particular disease but is intended to the equilibrium of four body humours. Broadly speaking
strengthen the host via a variety of approaches or interven- Tabiyat is considered as the real healer of the body and the
tions. The well known interventions in this area are health role of the Tabeeb (physician) is to facilitate this Tabiyat
education, environmental modification, notional interven- (Rushid, 1987).
tions, life style and behavioural changes. Unani medicine A well known Unani Scholar, Rabban Tabri in his treatise,
considers many factors in maintaining health and divides Firdousal Hikmat has mentioned that, practically Tabiyat is re-
the body in a number of ways to define this wisdom. The first garded as an administrative power of the body. The function
way that Unani medicine defines the body is to describe it in of administration of the body is accomplished by Tabiyat with
terms of the four humours. It further defines the state of the the help of many powers called Quwwa of the body like Quw-
body into three different stages: health, disease and neutral. wat tabaiyya (Physical faculty), Quwwate haiwania (Vital fac-
In the footsteps of both the Quran and hadiths, Unani Pathy ulty) and Quwwate nafsania (Nervous faculty). Thus the main
sees illness as an opportunity to serve, clean, purify and role of the Tabiyat is to provide the general administration
balance the physical, emotional, mental and spiritual planes. as well as defense or immunity to the body. Immunity is a
Towards this goal, Unani therapies are natural which include part of this Tabiyat. Unani physicians recommended improv-
appropriate fresh food in order to correct the imbalances, ing or strengthening the Tabiyat for restoration of health
herbal medicines, drugs of animal and mineral origin, the and the management of diseases. For this purpose they have
promotion of codes of conduct conducive to positive health mentioned various drugs under the headings of muqawwe
and appropriate rest for prevention and cure. It also empha- azae raisa (tonic for vital organs), muqawwe badan (general
sises compounds that belong to the human body and the body tonic), muqawwe asab (nervine tonic), muqqawwe qalb
avoidance of allergy-rendering foods. The balance between (cardiac tonic), muqqawwe jigar (liver tonic), etc. In contempo-
mind and body is also crucial in the metabolic processes rary systems of medicine, the concept of immunomodulators
and counselling is often offered towards this goal (Mahahan, means the sources of the enhancement of the immunity (Tab-
2009; Unani doctors, 2011). ri, 2003).
The best possible ways of health promotion in this holistic Unani medicine offers a number of drugs of plant, mineral
system of medicine are improvement of Tabiyat (Medicatrix and animal origin that have immunomodulation activity and
naturae or Immunity) by immunomodulators, restoration of efficacy to strengthen the immunity system, hence such
balanced temperament, maintenance of balance in the qual- drugs can be safely used in auto-immune diseases like ulcer-
ity and quantity of humours, moderation of Asbaabe Sitta Zar- ative colitis, Crohn’s disease, cancer, Acquired Immuno Defi-
ooriya (six essential factors for life) and adoption of Ilaj Bil ciency Syndrome, rheumatoid arthritis, etc. Examples of
Tadabeer (Regimental therapy), Munzij wa Mushil (concoctive such drugs are Lehsun (Allium sativum), Kalonji (Nigella sativa),
 JOURNAL OF HERBAL MEDICINE 2 ( 2 0 1 2 ) 1 –5 3

Filfil siyah (Piper nigrum), Chai (Camellia sinensis), Shahed (hon- Sitta Zarooriya. Unani medicine states that these factors
ey), Asalassoos (Glycyrrhiza glabra), Haldi (Curcuma longa), Karela should be balanced in terms of quality, quantity and sequence
(Momordica charantia), Asgand (Withania somnifera), Neem in order to sustain good health. These essential factors are as
(Azadiracta indica), Amla (Emblica officinalis), Piyaz (Allium cepa), follows:
Zanjabel (Zingiber officinalis), Ghikawar (Aloe barbadensis), Sata- Hawae Muheet (Fresh Air): Good and clean air is most neces-
war (Asparagus racemosus), Badam (Prunus amygdalus), Marwa- sary for good health; many diseases occur due to changes in
reed (Margarata), Zafran (Crocus sativus), Gaozban (Borage the air. Ibn Sina, a renowned Unani scholar in his famous
officinalis), Zaitoon (Olea europea), Qaranfal (Eugenia corophyllata), treatise, Canon of medicine, says that the change of environ-
Zehar mohra (Serpentine), Murmakki (Commiphora myrrh), etc. ment relieves the patients of many diseases. He has also
(Sina, 1987; Spelman et al., 2006; Anonymous, 2004; Kirthikar, emphasised the need of open airy houses with proper ventila-
1999). tion, play-grounds and gardens in cities so that everyone has
plenty of fresh air and a proper ecological balance is
maintained.
3. Hippocratic theory of medicine
Makool Mashroob (Food and Drink): The food that we eat
should be fresh, free from putrefaction and disease-produc-
The first fundamental theory of the Unani system established
ing matters. Drinking water should also be pure.
by Greek philosopher Hippocrates (Father of Medicine, 460–
Harkat wa Sukoone Badania (Body Movement and Repose): To
370 BC) is founded in the belief that the body of the individual
maintain perfect health and a good physique, the body re-
is composed of four basic elements collectively described as
quires exercise as well as rest. However, certain diseases
Anasire Arba (Four Elements). Nourishment of the body’s vital
can be cured by giving the body rest while some are cured
fluids is achieved via Akhlat Arba (Four Humours). These fluids
by movement of affected organs. Inflammation and fractures
are in fact those which the human body obtains from food
require complete rest to get properly cured. On the other
which include various hormones and enzymes. The concept
hand, afflictions such as paralysis demand specific quantum
of humours was originally postulated by Hippocrates who col-
of movement. Several exercises help growth of muscles and
lectively referred to all the body secretions/fluids as Akhlat
ensure nutrition, increased blood supply and proper function-
(humours) which depending upon their colour are named as
ing of the excretory system. Exercise also keeps the heart and
Dam – Sanguineous humour (blood), Balgham – Serous hu-
liver in good condition.
mour (phlegm), Safra – Bilious humour (yellow bile) and Sauda
Harkat wa Sukoone Nafsania (Mental Movement and Repose):
– Atrabilios humour (black bile). According to Abu Sahal Mas-
Psychological factors such as happiness, sorrow, fear, anger,
ahi, humours are the body fluids preserved in vessels that
etc. have considerable bearing on the health of a human
are being prevented from flowing. He classified these hu-
being. Unani physicians believe that certain diseases like
mours into three types according to the site of their presence
tuberculosis, hysteria and mental disorders are caused in
viz; Ratoobate Urooqia (Vascular fluid), Ratoobate Ustaqsia (Intra-
most cases by emotional strain and maladjustment and
cellular fluid), Ratoobate Tajaweef (Extra cellular fluid). These
therefore, while dealing with such cases, a physician should
four fluids are responsible for maintaining the moisture of
do his best to take all these factors into account. There is a
different organs of the body and also provide nutrition. These
branch of Unani medicine known as Illaj Nafsania (Psycholog-
humours have their own temperaments as blood is hot and
ical treatment) which deals with the above mentioned factors
wet, phlegm is cold and wet, yellow bile is hot and dry and
and many diseases are treated with psychological means.
black bile is cold and dry. These are generated in the liver
Sometimes this type of treatment cures the disease without
by the nutrient components of ingested food and liquids. Pro-
using drugs and sometimes by administration of drugs to-
vided that these humours exist in normal balance, normal
gether with psychological methods. The curative effect of
quantities and in the normal region of the body, the humour
music, agreeable company and beautiful scenery has also
system will work in the normal way. Thus good health is re-
been recognised by Unani physicians.
garded as a state of body in which there is equilibrium in
Naum wa Yaqzah (Sleep and Wakefulness): Normal slumber
the humours and functions of the body are normal in accor-
and wakefulness are essential for health. Sleep is an ideal
dance to its own temperament and the external environment.
form of rest, physical as well as mental. Lack of sleep causes
This implies the holistic concept of health in Unani pathy.
dissipation of energies, mental weakness and digestive
When the equilibrium of the humours is disturbed and func-
disturbances.
tions of the body are abnormal, in accordance to its own tem-
Ehtibas wa Istafraagh (Retention and Evacuation): Waste prod-
perament and environment, that state is known as disease
ucts of body, if not completely and properly excreted, produce
(Sina, 2007; Hamdani, 2006).
disease. The natural means of excretion are the diuresis, dia-
phoresis, vomiting, defecation, excretion through uterus in
4. Asbaabe sitta zarooriya (six essential factors the form of menses, through eyes, ears and nose or respira-
for life) tion. Proper and normal functioning of the excretory pro-
cesses must be ensured in order to maintain perfect health.
Unani medicine has also given greater importance to the pre- Any disturbance in the normal excretory balances, whether
vention of disease and promotion of health than cure. There it be excess, diminution or blockage, leads to disease. Practi-
is an influence of surroundings and ecological conditions on tioners of Unani medicine have, from time immemorial cured
the health of human beings. There are six factors which are numerous diseases by regulating the excretory processes
essential for the maintenance of good health called Asbaabe (Sina, 1987, 2007; Ahmad, 1983; Kantoori, 2009).
4 JOURNAL OF HERBAL MEDICINE 2 ( 2 0 1 2 ) 1 –5

5. Ilaj bil tadabeer these abnormal humours are evacuated from the body by a
method known as Istifragh. But prior to Istifragh, the process
In Unani medicine, this treatment methodology is based on of Nuzj (concoction) is employed by the administration of
four approaches viz, Ilaj bil Tadabeer, Ilaj bil ghiza, Ilaj bil dawa Munzijat (concoctives) of the specific humour involved. Nuzj
(Pharmacotherapy) and Ilaj bil yad (surgery). The adoption of means that the morbid humour is made easily removable
regimental therapy is one of the best measures of health pro- from the body by changing its consistency. Sometimes the
motion in Unani medicine. It is one of the most popular matter is too thick or too thin to be eliminated, therefore
methods of treatment, practiced by ancient Unani scholars some drugs are used which change the consistency of the hu-
since antiquity. Literally Tadbeer is an Arabic word meaning mour and make it readily suitable for elimination, such drugs
regimen or systemic plan whereas Ilaj means therapy or treat- are known as Munzijjat (concoctives). For each humour there
ment. Thus, Ilaj bil Tadbeer means treatment through regimen, is a specific concoctive and for every disease, specific concoc-
which is a method, through which care of the sick person and tives are used for the evacuation of morbid matter causing
maintenance of general health is attained by the modulation that particular disease. For example, in case of wajaul muffasil
or modification in Asbaabe Sitta Zarooriya. In this way, regi- (arthritis), Sooranjan (Colchium luteum) is used as concoctive
mental therapies are mostly non medicinal procedures by and in case of diseases of nervous system Ustokhudoos (Laven-
which we modulate the life style, dietary habits and habitat dula steochas) is used as concoctive. Once the features of Nuzj
of the patient and practise other therapeutic regimens for are established in the respective humour, the actual method
the treatment of various diseases. Ibn Sina has described 36 of Istifragh is followed through various modes like purgation,
regimes including Irsale Alaq (Leeching), Fasd (Venesection), emesis, cupping, venesection, leeching, diuresis, diaphoresis,
Ishal (Purgation), Qai (Emesis), Idrar (Diuresis), Huqna (Enema), expectoration, enema, exercise, massage etc. The commonest
Hijamat (Cupping), Dalak (Massage), Riyazat (Exercise), Ham- mode of Istifragh employed for the excretion of phlegm is
mam (Bathing), Tareeq (Diaphoresis), Amle Kai (Cauterization), Munzij wa Mushil therapy (Sina, 1987; Kantoori, 2009).
Nutool (Irrigation), Inkebaab (Inhalation), Tanafis (Expectora-
tion), Takmeed (Fomentation), Imala (Diversion of morbid 7. Ilaj bil ghiza
material), Ilam (Counter Irritation), Aabzan (Hydration Ther-
apy), Zimaad wa tila (Ointment and Liniment), etc. These re- Ilaj Bil Ghiza is the hallmark of treatment methodology in the
gimes are actually meant for the Istefragh of Akhlate radiya Unani system of medicine. Unani physicians often suggest
(morbid fluids), from the body. As soon as these morbid hu- dieto-therapy as the first line of treatment or as an adjuvant
mours are removed from the body, normal health is restored therapy with other modalities of treatment. Unani scholars
(Unani doctors, 2011; Kabeeruddin, 1999, 2009; Sina, 2007; have been practising this therapy for prophylactic purposes
Mahahan, 2009). Moreover, Jamaluddin in his book, Aqsarai for the maintenance of health as well for therapeutic pur-
and Allama Qarshi in his book Mojaz alquanoon says that Ilaj poses for the treatment of diseases since ancient times. Die-
bil Tadbeer means the modification and moderation in factors to-therapy is mainly emphasised for the prevention and
for either prophylactic or therapeutic purposes. Blood-letting treatment of cardiovascular, gastro-intestinal, hepato-biliary,
in the form of venesection, leech therapy and cupping with renal, skin, sexual, endocrinal and nervous disorders. Before
scarification is an essential part of regimental therapy. It pharmaco-therapy, Unani physicians advised restrictions or
has been utilised for preventive as well as therapeutic mea- alterations in the daily diet, formulated according to the dis-
sures for thousands of years by ancient Unani physicians. ease with the advice to wait for few days because some dis-
The commonest therapeutic indications of this therapy as eases can be cured merely by diet. During the treatment,
mentioned in Unani classics are Jarabul Ajfaan (blepharitis), specific diets are advised according to the disease. Unani
Dawali (varicose vein), Darde pindali (painful calf muscle), medicine is very popular for the prevention of diseases like
Malankhoonia (mania), Qooruhe khabisa (septic wound, non- gastric ulcer, hepatitis, ischaemic heart disease, hyperten-
healing ulcer), Warm (inflammation) of organs, Khanaazeer sion, diabetes mellitus, sexual debility, renal stones, vitiligo,
(lymphadenitis), Warme Tajaweful Anaf (sinusitis), Warme halq psoriasis and paralysis through its dieto-therapy (Sina, 1987,
(pharyngitis), Bawaseer (piles), Nawaseer (anal fistula), Daaul 2007; Kantoori, 2009).
feel (elephantiasis), skin disorders like Qooba (ringworm), Saafa
(tinea corporis), Namash (chloasma), kalaf (warts), Narfarsi 8. Conclusion
(eczema), Daul sadaf (psoriasis), Bars (vitiligo), Wajaul Mufasil
(osteoarthritis), hypertension, etc. (Sina, 1987, 2007; Kantoori, It is evident from the above discussion that Unani medicine
2009; Baqir, 1989). strives to find the best possible ways by which a person can
lead a healthy life with minimum or zero sickness. It is totally
6. Munzij wa mushil (concoctive and purgative) based on the holistic approach to health and the major ap-
therapy proaches of health promotion include improvement of
immunity by immunomodulators, maintenance of balance
This is the fundamental principle of treatment of all chronic in the quality and quantity of humours, moderation of six
diseases and is actually meant for Istifragh (evacuation or essential factors of life and adoption of regimental and die-
elimination) of morbid humours from the body. These morbid to-therapies which are conducive to the maintenance and
humours are the main culprits of diseases and aggravate the promotion of positive health as well as the prevention and
disease process if remain stagnant in the body. Therefore, cure of disease.
 JOURNAL OF HERBAL MEDICINE 2 ( 2 0 1 2 ) 1 –5 5

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