Global Journal of Health Science; Vol. 11, No.

10; 2019
ISSN 1916-9736 E-ISSN 1916-9744
Published by Canadian Center of Science and Education

Traditional Arabic and Islamic Medicine

Primary Methods in Applied Therapy
Sara N. AlRawi1 & Michael D. Fetters2
1
Sara AlRawi Consulting, LLC, Ann Arbor, MI, U.S.A.
2
Department of Family Medicine, University of Michigan, Ann Arbor, MI, U.S.A.
Correspondence: Sara AlRawi, Sara AlRawi Consulting, LLC, Ann Arbor, MI 48104-1213, U.S.A. Tel:
1-734-645-8424. E-mail: samis@umich.edu

Received: July 11, 2019 Accepted: August 11, 2019 Online Published: August 16, 2019
doi:10.5539/gjhs.v11n10p73 URL: https://doi.org/10.5539/gjhs.v11n10p73

Abstract
Applied therapy is a commonly utilized method of treatment for preventive and therapeutic measures. Avicenna, a
significant physician of the Islamic golden age, described 36 methods to restore balance of patients’ elements,
humors and faculties. We propose a categorization of these methods within a single theory and framework, as this
has previously been lacking. To be considered under the rubric of TAIM applied therapies, the procedures must
have: 1) proof of use in the Arab and Muslim world; 2) considered an essential component of Avicenna’s
compendium of regimental therapy; and 3) historical lineage according to regional, cultural or Islamic healing
practices. We developed a taxonomy of applied therapies by denoting each as a primary or supportive method and
providing a definition for each category of methods. We define applied therapy as techniques or procedures
involving physical and manual contact with the individual that are aimed at restoring health and preventing illness.
Primary methods describe therapies which when used individually can impact the vital force of the body in order to
preserve or restore health, while supportive methods describe therapies used in conjunction with primary methods
intended to augment or create a synergistic and enhanced effect, exceeding that of primary methods alone. Our
work provides a fundamental step in continuing the evolution of the TAIM conceptual model and advancing our
understanding of the diverse practices under the rubric of applied therapy. Researchers can use this comprehensive
TAIM taxonomy for investigating the respective elements, and systematically exploring the theoretical and
therapeutic applications.
Keywords: aromatherapy, hammam, hijama, hydrotherapy, unani medicine, Avicenna
1. Introduction
The Traditional Arabic & Islamic Medicine (TAIM) model was introduced to define and organize the multiple
intertwined elements within a single conceptual framework (Alrawi & Fetters, 2012). TAIM elements include
medicinal herbs, dietary practices, mind-body therapy, spiritual healing and applied therapy. We define applied
therapy as techniques or procedures involving physical and manual contact with the individual, aimed at restoring
health and preventing illness. Applied therapies are among the most utilized methods of treatment employed by
traditional physicians for preventive and therapeutic measures (Lone et al., 2011).
A taxonomy that unifies and demonstrates the depth and encapsulates the richness of the applied therapies
specifically has been lacking. Absence of a systematic categorization, one that is cohesive and comprehensive,
creates a barrier to the classification of applied methods and research investigating the prevalence of use. Thus, the
primary objectives in this paper are: 1) to define and categorize in a taxonomy the applied therapy element of the
TAIM model and contextualize its application within the scope of practice, and 2) to suggest a hierarchical
organization of the methods utilized as primary or supportive. To achieve these objectives, we first review the
historical context of applied therapies, and known extent of use. We then explain our methodology for creating a
typology and describe each component of the typology based on known origins and current applications. We
conclude with a discussion of the typology including potential limitations.
1.1 History of Applied Therapy and Extent of Use
Since the third millennium B.C., Arab and Muslim physicians have drawn on traditional practices in ancient
Mesopotamia and ancient Babylon (De Bustinza, 2016). They have also practiced medicine with roots in
73
gjhs.ccsenet.org Global Journal of Health Science Vol. 11, No. 10; 2019

Graeco-Roman, Chinese, Persian and Ayurvedic theories and principles. One of the most significant thinkers and
writers of the Islamic golden age, Avicenna, believed that “medicine is the art whereby health is maintained and the
art by which it is restored when lost” (p. 90) (M. A. Khan, Raza, & I. A. Khan, 2015). Physicians believed in
promotion of health, prevention of disease and restoration of health through regimental and dietary therapies (Lone
et al., 2012). Avicenna described 36 methods to restore balance of patients’ various elements, humors and faculties
(Hamid, 2018). Arab and Muslim physicians such as Rhazes and Avicenna believed both physical and spiritual
health is essential, that the body should be treated as a whole entity rather than separate parts and organs, and that
the body possesses the natural ability to heal when provided with rest, a good diet, fresh air, and cleanliness (Saad
& Said, 2011). Illness is viewed as an opportunity to serve, clean, purify and balance the physical, emotional,
mental and spiritual realms (Lone et al., 2012). This core belief can be seen weaved through the methods utilized
for restoring and maintaining health.
Previous research demonstrates widespread use of applied therapies globally, (Hamid, 2018) yet a clear and
encompassing definition and framework illuminating historical roots, religious influences and modern day
applications is lacking. The clinical implications of defining the scope of applied therapy practices are to shed light
on commonly utilized methods, demonstrate potential for integration of methods into health care needs,
understand determinants of care as well as delineate patterns of utilization.
2. Methods
2.1 Methodology for Creating the Typology
For procedures to be considered under the rubric of TAIM applied therapies, we required: 1) proof of use in the
Arab and Muslim world; 2) considered an essential component of Avicenna’s compendium of regimental therapy;
and 3) historical lineage according to regional, cultural or Islamic healing practices. General treatment objectives
follow a three-step pattern specifying elimination of cause, normalization of humors, and normalization of tissues
and or organs. We created a typology of primary and supportive methods to differentiate between the various
therapies in their approach to modulate the patient’s physical, mental, emotional, and spiritual health with the goal
of restoring constitutional balance. We arrived at this categorization of primary and supportive methods based on
careful examination of historical and current use, as well as physiological effect of each applied therapy. Figure 1
illustrates primary and supportive methods of the applied therapy element within TAIM.
2.1.1 Primary Methods
Primary methods describe therapies which when used individually can impact the vital force of the body in order to
preserve or restore health and achieve the goals of recovery. These methods are often considered part of a standard
set of treatments. Primary methods include leeching, venesection, cupping, manual therapy, cauterization,
auricular therapy, fomentation, hydrotherapy, and physical movement. We grouped the aforementioned procedures
under primary methods based on evidence of use in chronic and lifestyle mediated conditions including asthma,
coronary heart disease, type 2 diabetes, digestive disorders, musculoskeletal concerns, rheumatoid arthritis,
chronic skin disorders as well as autoimmune conditions. By virtue of their effect, procedures listed under primary
methods are able to balance the elements inherent in every individual by manipulating innate or acquired, physical
or energetic, deficiencies involving body, mind, and spirit. If primary methods are unable to produce a cure or
cause unwarranted effects, supportive methods are employed.
2.1.2 Supportive Methods
Supportive methods describe therapies used in conjunction with primary methods and are intended to augment or
create a synergistic and enhanced effect, which exceeds that of a primary method alone. As illustrated in Figure 1,
examples include, purgation, emesis, diuresis, enema, diaphoresis, irrigation, expectoration, and counter irritation.
Supportive measures are designed to further aid cleansing, balancing, healing, and rejuvenation if and when
primary methods alone are unable to encourage the goals of recovery (Figure 1). We chose the term supportive
rather than secondary to highlight the interconnectivity (as represented by the arrows in Figure 1) and sometimes
promoting nature of these methods. We turn now to the role of primary methods and expound upon the
understanding of the applied therapy element of the TAIM model.

74
gjhs.ccsenet.org Global Journal of Health Science Vol. 11, No. 10; 2019

Figure 1. Hierarchical categorization of TAIM applied therapy

2.2 Description of the Applied Therapy Typology Componenets

Initial approaches to treatment entail the establishment of a regimen of care, or applied therapy, to correct and
balance factors contributing to ill health. Should this initial course of treatment prove to be ineffective, only then
are additional methods such as diet and natural medicine recommended. The safety and efficacy of applied
therapies have been supported by scientific rigor, however additional studies are needed to standardize and
develop parameters for evaluation of the efficacy of all procedures. Important techniques in applied therapy along
with details regarding its principles, objectives, indications, clinical applications, and contraindications are
described below.
2.2.1 Leeching
The Mesopotamians, Egyptians, Greeks, Mayans, and Aztecs practiced leech therapy (Lone et al., 2011). When
Islamic medical theories began to disseminate through the Latin speaking countries of Europe, leech therapy
became more widespread (Lone et al., 2011). Leech therapy, or Taleeq, relies on the application of medicinal
leeches (Hirudo medicinalis) to an affected area to suck and draw the blood from deeper tissues (Ahmad & Anwar,
2009). Avicenna described the methodlogy of leech therapy according to pre-leeching, proper leeching and post
leeching procedures (Lone et al., 2011). During this process, leeches infuse their saliva into the blood, providing a
complex mixture of biologically and pharmacologically active substances (Singh, 2010). Abdualkader, Ghawi,
Alaama, Awang and Merzouk (2013) indicate that the important advantage of leech therapy is that it may be
advised on those areas of the body where other processes of bloodletting like venesection and cupping are not
possible.
Clinical applications. Jha, Garg, Narang and Das (2015) indicate the use of leech therapy in varicose veins,
chronic skin disease, chronic ulcers, migraines, musculoskeletal and cardiovascular conditions. Contraindications
reported by Parmar and Parmar (2014) include the treatment of medical conditions and diseases including
hemorrhagic diseases, absolute hemophilia, pregnancy, anemia, hypotension, general fatigue, allergy to leech,
active tuberculosis, immune compromised and severely ill, bed ridden and extremely fearful patients. Parmar and
Parmar (2014) further suggest sites of the body where leech application is contraindicated such as the abdomen
around the liver, spleen, stomach and intestine, and report the risk of adverse effects and complications such as
pain during treatment, local itching, hypotension, vasovagal attacks, anemia, infections, allergies, sepsis, scarring,
and slight fever.
2.2.2 Venesection
Venesection, or Faşd, originated in the ancient civilization of Egypt, then continued with the Greeks, Romans,
Arabs, Asians, and eventually spread through Europe during the Middle Ages and the Renaissance (Greenstone,
2010). In this procedure, an incision is made in any of the 32 superficial vessels, and blood containing waste
material is allowed to flow (Sherwani, A. N. Anasari, H. A. Anasari, & I. A. J. A. Anasari, 2004). Historically,
instruments used included thorns, sharp sticks, and pieces of shell (Bergum & Ansari, 2012). Bloodletting is
generally carried out from various veins and arteries; each providing a site for specific indications, i.e. cephalic
vein used for diseases of the head and neck like meningitis, conjunctivitis and pain in the ear (Bergum & Ansari,
2012). The practice of venesection was not recommended by the Prophet Muhammad which explains why general
bloodletting was not a practice early Muslims implemented following the Prophet’s death in 632 AD despite their
awareness of it (El-Wakil, 2011). Bergum and Ansari (2012) considered spring as a suitable time for venesection.
Clinical applications. Faiz and Ali (2018) indicate the use of venesection for removing excess or abnormal humors,

75
gjhs.ccsenet.org Global Journal of Health Science Vol. 11, No. 10; 2019

preventing accumulation of waste material in the blood, excreting waste material from various parts of the body,
stimulating metabolic processes and correcting altered temperaments. Contraindications reported by Khan,
Siddiqui, Itrat and Jamal (2014) include applying procedure in excessively cold temperament and climate, in cases
of severe pain, after coitus, in children less than fourteen years of age, obesity, in elderly persons, with a full
stomach, after resolving baths, and during pregnancy or menstruation.
2.2.3 Cauterization
Cauterization and the use of heat therapy were known to various ancient cultures including Egyptian, Indian,
Chinese, Greco-Roman as well as pre- and post-Islamic and Arab culture (Alsanad, Asim, Gazzaffi, & Qureshi,
2018). The use of cautery, or Kai, was greatly developed by the Arab Muslim physician Albucassis, who described
various techniques, instruments, indications, precautionary measures, and related possible risks to more than 50
cauteries (Alsanad et al., 2018). The number of cautery events in one session vary, and the place of application is
specific to each disease. Treatment further depends on the age and sex of the patient (Farid & El-Mansoury, 2015).
The instrument used for cauterization is called cautery or Mikwāt, and preferably made of gold or iron (Nasir,
Fatma, Ali, & Ahmad, 2018). In a prophetic tradition, it is narrated that the Prophet Muhammad performed cautery
on one of his companions when he had sepsis on his finger, (Nikhat & Fazil, 2013) and on another occasion to stop
bleeding. However, it is believed that the Prophet allowed the use of cauterization only in severe cases, which has
since been maintained according to Islamic law (El-Wakil, 2011). The Prophet advised against the use of
cauterization as a routine procedure, and it’s apparent that the practice of cupping was favored to cauterization
following his teachings (El-Wakil, 2011).
Clinical applications. Nikhat and Fazil (2013) report the use of cauterization in five circumstances: “first to halt
the spread of sepsis; second, to stop the flow of disease-causing humors toward the healthy areas; third, to correct
the abnormal cold temperament in an organ; fourth, to stop hemorrhage, and fifth to remove dead and necrotic
tissue when other methods are not effective” (p. 83). Indications for cauterization also include paralysis, recurrent
cold and cough, migraine, musculoskeletal disorders, vascular bleeding, gangrene, moles, skin outgrowths,
splenomegaly, and ascites. Cauterization is contraindicated in extremely cold or hot weather (Nasir, Fatma, Ali &
Ahmad, 2018). Following the procedure, patients are treated with herbal medicine and prescribed a specific diet to
aid recovery.
2.2.4 Cupping
The earliest recorded references to cupping therapy are found in the Ebers Papyrus, dating back to 1550 B.C
(Qureshi et al., 2017). Cupping therapy has roots among many ancient healing systems including Chinese, Unani,
traditional Korean, Tibetan, African, European, Arabic and Prophetic medicine, with variations in the types of
cups used, methods of cupping, and application sites (Mehta & Dhapte, 2015). Cupping in Arabic is called Hijama,
and derived from the Arabic word ‘ḥajmʼ, which means to suck something out, to collect, or to extract so as to
restore something to its natural state (Qureshi et al., 2017). It is a technique in which a cup is applied over the
surface of the skin by creating a vacuum--this is known as dry cupping or Ḥijāmat bilā Shart (Mehta & Dhapte,
2015). Dry cupping can further be subdivided into two types: fire cupping and cupping without fire (Mohammad,
Fasihuzzaman, & Jabeen, 2015). Sometimes, scarification is done at the location of cupping to draw blood, this
process is known as wet cupping or Ḥijāmat biʼl-Shart (Mehta & Dhapte, 2015). Wet cupping can further be
subdivided into mandatory and optional, depending on the indication. According to Islamic tradition, hijama is
usually explicit to ‘blood cupping’ (El-Wakil, 2011). Hijama was recommended by the prophet Muhammad, who
mentioned cupping in approximately 28 holy instructions or hadith (Saqlain, Ali, & Parveen, 2017). According to
the teachings of the prophet, hijama is recommended on the 17th, 19th and 21st of the month, according to the
Islamic lunar calendar (Saqlain, Ali, & Parveen, 2017). Various sites of the body are indicated for application of
hijama (Mohammad, Fasihuzzaman, & Jabeen, 2015). To date, this method of healing continues to thrive in many
Muslim countries (Deuraseh, 2006).
Clinical applications. Ahmedi and Siddiqui (2014) report indications for cupping such as the elimination or
diversion of morbid material, enhancing circulation, correcting the temperament of a particular organ and
promoting detoxification. Qureshi et al., (2017) reports indication of cupping therapy for the treatment of many
chronic conditions including but not limited to musculoskeletal diseases, cardiovascular disorders, skin diseases,
inflammatory disorders, neuropsychiatric and metabolic disorders. Contraindications of cupping suggested by
Nimrouzi, Mahbodi, Jaladat, Sadeghfard and Zarshenas (2014) include anemia, pregnancy, extreme cold weather,
obesity or frail constitution, children less than 2 years of age or adults over 60, before or after coitus.

76
gjhs.ccsenet.org Global Journal of Health Science Vol. 11, No. 10; 2019

2.2.5 Manual Therapy. Manual Therapy Includes Therapeutic Massage, Reflexology and Bone Setting
2.2.5.1 Therapeutic Massage
Therapeutic massage, also known as dalk, is the manipulation of muscle and connective tissue using various
techniques, to enhance organ function and body mechanics, promote relaxation and well-being thereby enabling
the healing process. The mechanism of action is based on the evacuation or diversion of morbid humors and excess
fluids from the body, thus maintaining homeostasis in the quality and quantity of four bodily humors responsible
for the maintenance of health; black bile, yellow bile, phlegm and blood (Ahmed et al., 2014). Traditional Arab
medicine identifies several varieties of therapeutic massage including strong pressure or friction (dalak e sulb),
soft pressure or friction (dalak e layyin), moderate pressure or friction (dalak e moatadil), long duration (dalak
kaseer), short duration (dalak e qaleel), rough (dalak e khashin); each achieving a certain effect in the body. For
instance, soft pressure massage (dalak e layyin) is considered relaxing in nature, while moderate massage (dalak
moatadil) improves and maintains blood circulation. Two additional types of massage incorporate using a cloth to
facilitate application. The first type, rough (dalak e khashin) uses a rough textured cloth to improve blood
circulation and facilitate nutritive energy to the muscles and organs. A second type, smooth (dalak e amlas), uses
cloths like silk to improve peripheral blood circulation and provide nutrition to adjacent tissue.
Clinical applications. Jamal et al. (2013) reports general indications of massage including musculoskeletal and
chronic pain, weight management, immune system support, reducing inflammation and ameliorating
psychosomatic disorders. Therapeutic massage can be combined with aromatic oils and varies in its application
based on temperament of organ and person, disease as well as condition of patient, season and desired outcome
(Jafar, Ansari, Alam, Khalid, & Mand, 2015). Rough massage has been identified as a treatment for alopecia, while
smooth massage is indicated for conditions such as fatigue (Jamal et al., 2013). Though generally a safe procedure,
Khalique and Siddiqui (2017) report contraindications for massage in inflammatory conditions, bleeding disorders,
skin wounds and ulcers as well as severe osteoporosis, they also suggest that therapeutic massage should not be
performed in any area of the body with a blood clot, fracture, open or healing wound and skin infections.
2.2.5.2 Reflexology
Egyptian hieroglyphics depict the ancient beginnings of reflexology (Cade, 2002). Evidence of reflexology is
found on a wall painting in the tomb of Ankhmahor, illustrating a physician massaging the hands and feet of a
patient (Callaway & Burgess, 2009). Techniques used in the form of massage included thumb and finger pressure,
as well as squeezing and pressing with the fingertips. Today such techniques may be referred to as reflexology
(Embong, Soh, Ming, & Wong, 2015). Reflexology, or Tadlik Alqadam, is based on the notion that there are reflex
areas on the hands, feet and ear auricles that correspond to specific parts of the body (Oleson & Flocco, 1993).
Pressure applied to these specific areas assist in potentiating the normal functioning of the corresponding body part
and thus can be used to restore and maintain the body’s natural equilibrium and encourage healing (Asltoghiria &
Ghodsib, 2012).
Clinical applications. Khuda and Al-Shamrani (2018) report the integration of foot therapy in prescriptions for
sub-acute or chronic strokes noted by Avicenna who recommended massaging the feet in warm salty water and hot
oils. Referenced oils include lily flower, dill seed and chamomile flower (Zargaran, Zarshenas, Karimi,
Yarmohammadi, & Borhani-Haghighi, 2013). Other recommendations include support after a headache or
migraine attack by applying several hours of foot massage with violet essential oil, salt, chamomile oil and clove
gillyflower (Gorji & Ghadiri, 2002). Foot therapy is recommended for the treatment of insomnia as well as
anointing the forehead or feet (Feyzabadi, Javan, Mokaberinejad, & Aliasl, 2014). To combat sexual dysfunction,
massage to the soles of the foot with almond oil before sexual intercourse is recommended daily for a duration of
five minutes (Molkara et al., 2018). Contraindications include foot infections or wounds, some circulatory and
cardiac problems, recent surgery and high-risk pregnancies (Horowitz, 2004).
2.2.5.3 Bone Setting
The Ebers papyrus, one of the oldest and most comprehensive preserved medical documents in ancient Egypt,
contains writings on bone setting (Serageldin, 2013). A notable surgeon of Arab medicine, Albucasis, compiled
writings on cautery and bloodletting as well as bone setting (Anjum, 2013). Bone setting or Al Tajbeer, identifies
procedures related to dislocated and fractured bones. In either of these forms of treatment, herbal remedies and
dietary practices are utilized as an adjunct to treatment. In African countries, the role of bone setters in correcting
fractures and dislocations is pivotal to many communities. Bone setting is a technique commonly recognized in
Traditional Chinese Medicine for the treatment of fractured or dislocated bones by means of various manipulative
therapies in conjunction with herbs (Robinson, 2006). While some value and prefer traditional bone setting to its

77
gjhs.ccsenet.org Global Journal of Health Science Vol. 11, No. 10; 2019

western counter part, evidence indicates it has become less prominent in the Middle East as access to modern
hospitals and private clinics is increasingly available (Ghazanfar, 2011).
Clinical applications. Manipulation techniques are intended to realign the musculoskeletal and ligamentous
relationships. Use of this procedure is indicated for fractures or joint manipulation of limbs and lower jaw as well
as spine, pelvis and shoulder, bed rest is recommended for the latter. Prescriptions noted include a mixture of egg
yolk and certain local herbs molded into a plaster and applied to fractured, dislocated or displaced bones (Hurreiz,
2002). As demonstrated by Ghazanfar (2011), “once a bone fracture is corrected, a plaster is applied made from the
resin of Acacia spp., seeds of tamarind or lentils mixed with egg. The fracture is then bound with cloth and the limb
stabilized with wooden planks” (p. 3). Certain plants are also used in instances when the bone setter may have to
break and reset the bone if it is not set properly. To aid recovery, a diet of date or bee honey is also prescribed. Other
prescriptions include the preparation of poultice using black date and ground sheep fat to assist skeletal pain and
dislocations (Asefzadeh & Sameefar, 2001). To aid swollen joints, preparations of boiled mellow leaf mixed with
egg yolk and salt are used. Complications of bone setting include mal-union and non-union of fractures,
compartment syndrome, tetanus, deformities, chronic osteomyelitis and soft tissue infections, gangrene and
amputation (Manjunath, 2016). Contraindications of bone setting are comparable to those of other manual
therapies including but not limited to inflammatory processes and severe forms of osteoporosis.
2.2.6 Auricular Therapy
Auricular therapy is a treatment modality in which specific points are stimulated on the ear with the goal of
correcting the body's dysfunction (Round, Litscher, & Bahr, 2013). A postulated relationship between external
body points and various effects on the body, is a part of the medical historical record of a number of ancient
societies. In the 16th and 18th centuries, rudimentary knowledge of ear acupuncture and auricular therapy was
found in Arab folk medicine (Landgren, 2008). Medieval Arabic medicine also describes a correlation between
internal organs and at least one external point on the body (Ramey, 2000). The practice of cauterizing a part of the
ear with a hot metal probe has been reported among certain tribes in Arabia, “likely a vestige of the acupuncture
practiced in ancient Egypt and Saudi Arabia” (Gori & Firenzuoli, 2007). The Ebers papyrus of 1550 B.C. describes
a system of channels and vessels in the body; which closely resembles the Chinese system of meridians (Gori &
Firenzuoli, 2007).
Clinical applications. Hippocrates described the method of auricular therapy for the treatment of impotence and
observed that women were less likely to conceive if points on the ear were stimulated (Gori & Firenzuoli, 2007).
Egyptologist Alexandre Varille, documented that women in ancient Egypt had their external ear cauterized with
heat or pricked with a needle as a form of contraception. Clinical and basic research suggests auriculotherapy can
be effective in the treatment of pain, and for anxiety related disorders (Gori & Firenzuoli, 2007). Gori and
Firenzuoli (2007) report the cauterization of the external ear for treatments of sciatic pain and sexual dysfunction.
Contraindications for auricular therapy include pregnancy, those who are immune compromised and in severe
bleeding disorders (Tan, Molassiotis, Wang, & Suen, 2014).
2.2.7 Fomentation
Fomentation, or Takmeed, has been used by many ancient medical traditions (Sinclaire, 2007). Fomentation is the
soothing application of warm substances to the body, expediting the delivery of heat or moisture to the body for
purposes of healing. A poultice or compress is often used, and when herbs are necessary, they are applied to the
skin through a cloth soaked in an infusion or decoction of herbs. Traditionally, wool and cotton material are
commonly used for their ability to retain heat and moisture well. There are several types of fomentation, including
hot, dry, wet, cold, herbal and whole body fomentation (Hamid, 2018). For instance, hot fomentation is whereby a
towel is dipped in hot water or a towel is made hot by steam application, whereas wet fomentation relies on the use
of a towel dipped in water boiled with analgesic or anti-inflammatory herbs (Hamid, 2018). Application of
fomentation varies according to the areas of the body being treated.
Clinical applications. Fomentation enhances circulation, thereby increasing elimination of wastes and toxins from
the body and relieving internal congestion. Indications of fomentation include local swelling and pain, sinusitis,
bloating, nervous tension, sleeplessness, menstrual pain, colic, constipation, cough, congestion, as analgesic, and
muscle relaxant. Hot dry fomentation is beneficial for flatulence whereas hot moist fomentation is beneficial for
arthritis (Baig, Quamri, Khan, AnzarAlam, Maaz, & Ahmed, 2014).
Bitschai (1952) provides examples of prescriptions for the use of pomegranate flowers, celery and coriander.
Manik, Wahid, Islam, Pal and Ahmed (2013) provide indications for fomentation of warmed wheat bran, salt
and/or dill leaves applied to the stomach for the treatment of bloating (Larijani et al., 2016). Tumpa, Hossain and

78
gjhs.ccsenet.org Global Journal of Health Science Vol. 11, No. 10; 2019

Ishika (2014) indicate the use of boiled leaves of Indian ash tree applied as a fomentation for the treatment of local
swelling and pain (Manik et al., 2013). Sultana, Lamatunoor, Begum and Qhuddsia (2017) indicate use of the root
of velvet bean boiled in water, and a sterile cloth soaked in the warm solution and applied for conditions related to
pain in the vagina or enlargement of vaginal tissue due to parturition (Tumpa, Hossain, & Ishika, 2014). Unani
scholars have prescribed hot fomentation with warm water or with decoction of various herbs such as common
wormwood, orris root or leaves of cherry to relieve uterine pain (Sultana et al., 2017). Contraindications include
loss of sensation caused by spinal cord injury, diabetic neuropathy, rash or other skin conditions that could be made
worse by heat, inflammation, swelling, open wounds including burn, sore or cracked skin from eczema or severe
chapping and malignancy (Sinclaire, 2007).
2.2.8 Hydrotherapy. Hydrotherapy Includes the Medicinal Bath or Ḥammām, Sitz bath, Hand & Foot Bath,
Vaporization, Steam & Aromatherapy
The use of water for therapeutic purposes is found amongst many traditions. The Rig Veda, a religious text of
ancient India, as well as prescriptions found in biblical records, describe hydrotherapy treatments used for healing
(Wardle, 2013). Use of ‘gush of waterʼ is mentioned in medical treatise based on writings of Hippocrates, Galen,
Celsus as well as Avicenna and Rhazes. The pouring of water, alone or in combination with other prescriptions,
was applicable in a variety of illnesses such as fever, joint pain, psychic disease and headache but also considered
a general therapeutic method (Jacoby, 2002). Hippocrates described hydrotherapy in his writings noting that “for
the bath soothes the pain in the side, chest and back; cuts the sputum, promotes expectoration, improves the
respiration, and allays lassitude: for it soothes the joints and outer skin, and is diuretic, removes the heaviness of
the head, and moistens the nose” (p.12) (Wardle, 2013). Furthermore, along with lifestyle modifications,
Hippocrates viewed the application of water for healing as an essential component of his regimen (Wardle, 2013).
2.2.8.1 Ḥammām
Hammam, or traditional bath house, was an essential fabric of Islamic society. Following the rise of Islam, rapid
development in the architecture of hammām was observed (Sibley & Jackson, 2012). Centrally located near
mosques, souks and residential areas, a hammām provided a venue for the completion of ablutions necessary
before praying but also served as a platform for social interaction and rituals (Sibley, 2008). A traditional hammam
consists of three consecutive rooms with one room leading to the other furnishing specific provisions and
conditions; the cold (frigidarium), the warm (tepidarium), and the hot (calidarium) (Raftani & Radoine, 2008).
Avicenna compared each chamber to a season; the bather passing through each chamber within a specified
duration of time, so he is amenable and adaptable to the changes of every season (Sherwani, Ahmed, Naaz, Khan
Sherwani, & Khan, 2006). The hammam ritual did not involve a massage, however it began to be performed later
on (Özköse, 2005). Kolb and Dumreicher (2008) completed a case study of hammām traditions in five different
countries around the Mediterranean, and concluded that a vivid social life, specific washing ceremonies and festive
rituals continue to be practiced.
Clinical applications. Several types of baths have been described, including medicinal bath, sea bath, thermal bath
and oil bath to name a few (Nasir et al., 2018). Avicenna describes the positive effects of the hammām, particularly
observing the effect of bathing on promoting circulation, reducing viscosity of the humors, enhancing metabolism
and overall health, aiding detoxification, regulating weight and strengthening vitality. He also appreciated the bath
for its powerful, purifying and cleansing effect both in a physical and spiritual sense. According to Al-Ghazali, a
prominent philosopher and mystic (11th century), a bath facilitates opening of the pores, extraction of superfluous
humors, dissolves flatulence and enables urine flow (De Bustinza, 2016). Use of a hammām is contraindicated on
an empty stomach, during pregnancy, fever and asthenia and should not be recommended for prolonged stay
(Hamid, 2018).
2.2.8.2 Sitz Bath
A sitz bath, or Abzan, is an immersion bath in which an individual will sit in a tub with water covering the hips,
buttocks and lower abdomen (Wardle, 2013). This regimen activates the organs of the abdomen and pelvis by
increasing circulation and thereby reducing muscle congestion and inflammation (Baig et al., 2014; Nayab, 2016).
Evidence exists that Avicenna indicated the use of sitz bath in various diseases, and also used the bath as a means to
deliver local application of herbal medicines (Madinah, 2009). There are four types of a sitz bath; hot, cold, neutral
and alternating between hot and cold (Hamid, 2018).
Clinical applications. Examples of herbs used in conjunction with the bath include olive oil, yarrow and milk
(Baig et al., 2014; Nayab, 2016). Other decoctions used in a sitz bath include preparations of chamomile, yellow
sweet clover, celery, leaves of common marshmallow and maidenhair fern (Hussain, Ahmed, Jahan, & Abida,

79
gjhs.ccsenet.org Global Journal of Health Science Vol. 11, No. 10; 2019

2016). Prescriptions for the treatment of dysmenorrhea include the use of common juniper, rue, chamomile, sweet
marjoram, wild mint and celery (Sultana et al., 2017). Rhazes, a Persian physician, philosopher and alchemist,
advised using a sitz bath with a solution using the skin of pomegranate to treat anal pain (Al-Humadi &
Al-Samarrai, 2009). A sitz bath with warm water and flax was also indicated for the treatment of psoriasis (M. S.
Khan, Lari, & Khan, 2018). Sitz baths are contraindicated in open wounds or active bleeding including vaginal
bleeding, prolapsed organs, acute inflammation, painful conditions with spasm or colic, pregnancy and
cardiovascular concerns (Wardle, 2013).
2.2.8.3 Hand & Foot Bath
During hand and foot bath therapy, a small tub containing water is utilized, hands or feet are placed into the tub
ensuring water covers the forearms or calf muscle. Rhazes prescribed foot baths, or Hammam Alqadam, for the
treatment of gout and observed that the temperature of water and the time of application were essential factors
involved in gout management (Changizi Ashtiyani, Golestanpour, Shamsi, Tabatabaei, & Ramazani, 2012). An
underlying mechanism responsible for the efficacy of foot baths is due to reducing the sympathetic nervous system
and affecting autonomic nervous activity (Yamamoto, Aso, Nagata, Kasugai, & Maeda, 2008).
Clinical applications. Saeki, Y, N Nagai and M Hishinuma (2007) have demonstrated significant effects of hand
and foot baths in relieving stress, combating fatigue and insomnia symptoms in addition to increasing overall body
temperature and white blood cell activity, yielding immune boosting effects and increasing general health and
well-being (Saeki, Nagai & Hishinuma, 2007). Oils, herbal extracts or decoctions are used in conjunction with the
bath. Prescriptions can be found for using mustard and warm water for the treatment of dysmenorrhea (Rehman,
Begum, Anjum, & Tabasum, 2013). For the treatment of dry feet, a warm foot bath is recommended followed by
rubbing the feet with oil or fat including the fat of goat and cattle as well as castor, olive and sesame oil (Jedkareh,
Esmaeili, Alembagheri, & Mortazavi, 2016). Contraindications for a warm hand or foot bath include skin rash and
open wounds, however if a bath is prepared hot then contraindications would include loss of sensation in hands or
feet, diabetes and lymphedema of upper or lower extremities (Sinclaire, 2007).
2.2.8.4 Vaporization, Steam & Aromatherapy.
Inhalation therapy was developed during the Islamic ages, Muslim doctors employed it as part of their treatments
due to ease of preparation and use (Khashan, 2018). Avicenna introduced the process of extracting essential oils by
means of steam distillation (Saffari & Pakpour, 2012). Albucasis believed aromatherapy was greatly beneficial and
developed the medicine of aromatherapy and its applications (Alraghran & Khatib, 2016). Steam & vaporization
therapy, or Bukhoor, involves the inhalation of water vapor from a bowl of boiling water, with the back of the head
covered with a towel to prevent evaporation. This method of treatment is generally applied for 5-10 minutes, and
an essential oil, menthol or incense may be added to the boiling water (Saad & Said, 2011). This method is still
routinely applied in the Arab and Islamic world.
Clinical applications. Vaporization is indicated for colds, headaches, acne, cough and as an air freshener. Common
oils used during vaporization include amber, chamomile, saffron, sandalwood, violet, camphor, mustard, and musk.
Traditional prescriptions of inhalation include raw amber dissolved in chamomile or quince oil, mixed with a small
amount of saffron to treat conjunctivitis. Equal parts of sweet almond oil, viola oil, and women’s milk dissolved in
a small amount of saffron are used to treat weakness of the optic nerve (Khashan, 2018). These preparations are
placed on the hand and patients are advised to inhale the mixture. An alternate preparation for vaporization
includes immersing a thin piece of wet cloth in a preparation of sandalwood and musk dissolved in rose water,
patients are advised to vaporize it by the rods of cardamom (Jalkhi & Kakhshan, 2015). Lavender was known to
Unani physicians and was recognized for its beneficial treatment of melancholy, mania, epilepsy, amnesia, anxiety,
and numbness as it is efficacious for removing morbid matters from the brain and clarifying intellect as well as
providing strength to other organs including the liver, spleen, stomach and intestines (Khan et al., 2015).
Preparation of the leaves of chrysanthemum are used in a steam bath for its sedative and antispasmodic effects,
often used to relieve muscle aches, nervousness, and contractions of the uterus (Abu-Rabia, 2012). Steam
inhalation is contraindicated for inflammatory skin conditions, and injuries to the respiratory tract including burns
have been reported as an adverse effect of application (Balakrishnan, Tijunelis, Gordon, & Prasad, 1996).
2.2.9 Physical Movement. Physical Movement Comprises Exercise and Ritual Prayer
2.2.9.1 Exercise
Noted as an important component of ancient medical theory, physicians emphasized the centrality of exercise and
diet as key components of one’s way of life (Berryman, 2012). Along with food and sleep, Avicenna indicated
exercise, or riyazat, as the third principle in the preservation of good health (Bakhtiar, Gruner, Shah, & Crook,
80
gjhs.ccsenet.org Global Journal of Health Science Vol. 11, No. 10; 2019

2014). He proposed that exercise has a protective effect on health by preventing temperament and humoral
disorders, a notion supported by Hippocrates and Galen (Cetkin, Bahsi, & Orhan, 2016). In addition to the proper
duration of exercise and the best time to commence physical activity, Avicenna expressed that there is an exercise
type for each person, and for various parts of the body. Additional principles of exercise include age and
temperament of a person, present environment and condition of the body (Firdaus & Sultana). For instance, with
vociferation from high-pitched and deep voice, chest and respiratory organs can be made to exercise. The notion of
healing sounds is a similar practice to the six healing sounds found in Qigong (Liu, Schaffer, Herrs, Chollet, &
Taylor, 2015).
Clinical applications. To maintain health and a strong physical constitution, the body requires exercise as well as
rest. Arab and Muslim physicians prescribed moderate exercise to strengthen the organs, increase the vital force of
the body, eliminate waste products and increase appetite (Saad & Said, 2011). Islamic medieval texts reveal
doctors paid close attention to the patient's regimen; especially exercise, a restful environment, and sleep and
believed these factors in addition to the patients’ temperament, age, and present environment should be adjusted as
needed, to ensure the patient's daily life is conducive to recovery (Dols, 1987). Exercise is contraindicated on
either a full or empty stomach as well as in the presence of excess temperaments in the body, namely hot, dry or
cold (Firdaus & Sultana).
2.2.9.2 Ritual Prayer
Islamic ritual prayer, or salat, consists of a set of physical postures, or intentional movements including standing,
bowing, prostrating and sitting, performed a minimum of five times per day (Doufesh, Ibrahim, & Safari, 2016).
Considered to be a mild to moderate form of physical activity, salat provides psychological, musculoskeletal and
neurophysiological effects (Ibrahim, Sian, Shanggar, & Razack, 2013). This ritual prayer can be compared to tai
chi and yoga as it involves the movement of the whole body as well as providing those practicing a meditative
platform (Doufesh et al., 2016). It has been observed, that during this ritual prayer most of the joints and muscles of
the body are engaged with little effort, potentially playing an integral role not only in cerebral blood flow but also
postural reflexes (Reza, Urakami, & Mano, 2002).
Clinical applications. Considered a type of meditation, prayer may convey many of the psychological and
biological benefits associated with improved health including reduction in blood pressure and heart rate, altering
levels of serotonin and melatonin, boosting the immune response, reducing stress and promoting positive mood
states including reduction of anxiety, pain, and enhancing self-esteem as well as promoting a favorable influence
on overall quality of life (Andrade & Radhakrishnan, 2009). Spiritual meditation has been found to impart a
stronger effect on anxiety, spiritual experiences, and tolerance to pain when compared to secular meditation.
Islamic ritual prayer as well as voluntary and congregational prayers, unique in their form and spirit, are believed
to embody spiritual, psychological, physical and moral benefits (Syed, 2003). Many employ this simple, sacred
and spiritual lifestyle to enhance health, happiness and longevity of the individual and community. There are no
contraindications for the performance of salat.
3. Discussion
Applied therapy has long played a significant role in providing health promotive, preventive and curative care.
Based on this research, we have demonstrated a clear and concise definition as well as a logical and systematic
categorization of the applied therapy element. This work provides a definition of applied therapy along with its
components, and typology of primary and supportive methods, as a fundamental step in continuing the evolution
of the TAIM conceptual model and advancing our understanding of the diverse practices under the rubric of
applied therapy.
While creating a typology is an integral step in providing a hierarchal categorization, it presents several limitations.
First, in theory, it is possible that a method can be both primary and supportive. For instance, if two primary
therapies are applied in consecutive order to systematically address an imbalance, one could stipulate that the
second method albeit still primary by definition, acts as supportive. Second, if a primary method utilized induces a
state whereby the resulting effect is similar to a supportive method then it becomes difficult to delineate whether
the efficacy is attributed to the initial or combined effect. This can be illustrated in the following example whereby
a primary method such as hydrotherapy induces diaphoresis, a supportive method. In either case of the proposed
limitations, our typology becomes relevant as we convey an interconnectivity among the methods and therefore a
space where a synergistic relationship is possible. Lastly, while we attempt to highlight the most commonly
utilized methods in accordance with modern use, historical account and Avicenna’s compendium of regimental
therapies, there may be additional and less obvious methods requiring further study.

81
gjhs.ccsenet.org Global Journal of Health Science Vol. 11, No. 10; 2019

This typology opens a plethora of research opportunities about applied therapies. What are clinical patterns of
utilization, and how do they vary geographically? What are socioeconomic factors associated with use? How does
a user’s cultural and religious view impact acceptability of the different types of therapy? To what extent do
practitioners use the different types of applied therapy, and are the different types of therapy used together? Are
there instances where practitioners avoid using a combination of therapeutic approaches? In what ways are
authentic prescriptions being preserved and disseminated? How are the varied therapies integrated into medical
care?
4. Conclusion
By delving comprehensively into the components of the TAIM conceptual model, we have set out to define &
categorize the applied therapy element, to present the proposed therapies in a cohesive and schematic context and
to suggest a hierarchical presentation of the methods utilized. While health practitioners and patients continue to
apply these methods as they endeavor to improve their health care coverage, a deeper understanding of traditional
and indigenous health practices must be an evolving process. Researchers can begin to use this comprehensive
TAIM taxonomy to continue examining the respective elements, and systematically explore the theoretical and
therapeutic applications.
Acknowledgements
The authors declare that they have no competing interests and received no specific funding for this work. Sara
AlRawi conceived of the study, participated in analyses, drafted and final edited the manuscript. Michael Fetters
participated in the design and coordination, assisted with analysis and helped to draft and finalize the manuscript.
All authors read, reviewed, and approved the final manuscript. A special thank you to Rania Ajilat for her
assistance with manuscript preparation.
Competing Interests Statement
The authors declare that there are no competing or potential conflicts of interest.
References
Abdualkader, A. M., Ghawi, A. M., Alaama, M., Awang, M., & Merzouk, A. (2013). Leech therapeutic
applications. Indian Journal of Pharmaceutical Sciences, 75(2), 127-137. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3757849/
Abu-Rabia, A. (2012). Ethno-botanic treatments for paralysis (falij) in the Middle East. Chinese Medicine, 3(04),
157. http://dx.doi.org/10.4236/cm.2012.34025
Ahmad, T., & Anwar, M. (2009). Clinical importance of leech therapy. Indian Journal of Traditional Knowledge,
8(3), 443-445. Retrieved from
http://nopr.niscair.res.in/bitstream/123456789/5069/1/IJTK%208%283%29%20443-445.pdf
Ahmed, K., Jahan, N., Aslam, M., Kausar, H., Khalid, M., & Ali, H. (2014). Dalak (Massage) in unani medicine: A
review. International Journal of Advanced Ayuverda, Yoga, Unani, Siddha and Homeopathy, 3(1), 162-174.
Retrieved from http://medical.cloud-journals.com/index.php/IJAAYUSH/article/view/Med-118
Ahmedi, M., & Siddiqui, M. R. (2014). The value of wet cupping as a therapy in modern medicine-an Islamic
perspective. Webmed Central Alternative Medicine, 5(12), 1-14.
http://dx.doi.org/10.9754/journal.wmc.2014.004785
Al-Humadi, A., & Al-Samarrai, S. (2009). Treatment of anorectal diseases by al-Rāzī. Journal of the Islamic
Medical Association of North America, 41, 122-133. https://doi.org/10.5915/41-3-5116
Alraghran, A., & Khatib, C. (2016). The new information about aromatherapy and scents. International Society for
the History of Islamic Medicine, 64-83.
Alrawi, S. N., & Fetters, M. D. (2012). Traditional arabic & islamic medicine: a conceptual model for clinicians
and researchers. Global Journal of Health Science, 4(3), 164-169. https://doi.org/10.5539/gjhs.v4n3p164
Alsanad, S. M., Asim, A. A. H., Gazzaffi, I. M. A., & Qureshi, N. A. (2018). History of cautery: The impact of
ancient cultures. Journal of Advances in Medicine and Medical Research, 25(9), 1-17.
https://doi.org/10.9734/JAMMR/2018/40370
Andrade, C., & Radhakrishnan, R. (2009). Prayer and healing: A medical and scientific perspective on randomized
controlled trials. Indian Journal of Psychiatry, 51(4), 247-253. https://doi.org/10.4103/0019-5545.58288
Anjum, S. (2013). Al-Zahrawi: A prominent Muslim medical scientist and his impact on west. Revelation and
82
gjhs.ccsenet.org Global Journal of Health Science Vol. 11, No. 10; 2019

Science, 3(2), 51-56. Retrieved from

https://pdfs.semanticscholar.org/bf58/9f5735ab090256eeb19bdb80df6b462157b9.pdf
Asefzadeh, S., & Sameefar, F. (2001). Traditional healers in the Qazvin region of the Islamic Republic of Iran: A
qualitative study. Eastern Mediterranean Health Journal, 7(3), 544-550. Retrieved from
http://applications.emro.who.int/emhj/0703/emhj_2001_7_3_544_550.pdf
Asltoghiria, M., & Ghodsib, Z. (2012). The effects of Reflexology on sleep disorder in menopausal women.
Procedia - Social and Behavioral Sciences, 31, 242-246. https://doi.org/10.1016/j.sbspro.2011.12.049
Baig, M. G., Quamri, M. A., Khan, M. S., AnzarAlam, M., Naaz, F., & Ahmed, N. Z. (2014). Pain alleviation in
Unani medicine – A conceptual analysis. International Journal of Pharmaceutical Sciences and Research,
5(12), 927-934. Retrieved from http://www.ijpsr.info/docs/IJPSR14-05-12-003.pdf
Bakhtiar, L., Gruner, O. C., Shah, M. H., & Crook, J. R. (2014). The canon of medicine (al-Qānūn fī’l-tibb).
Chicago, IL: KAZI Publications.
Balakrishnan, C., Tijunelis, A. D., Gordon, D. M., & Prasad, J. K. (1996). Burns and inhalation injury caused by
steam. Burns, 22(4), 313-315. https://doi.org/10.1016/0305-4179(95)00137-9
Bergum, N., & Ansari, A. A. (2012). Venesection (Fasd). Hamdard Medicus, 55(1), 97-103. Retrieved from
http://applications.emro.who.int/imemrf/Hamdard_Med/Hamdard_Med_2012_55_1_97_103.pdf
Berryman, J. (2012). The art of medicine: motion and rest: Galen on exercise and health. The Lancet, 380(9838),
210-211. https://doi.org/10.1016/S0140-6736(12)61205-7
Bitschai, J. (1952). The history of urology in Egypt. American Journal of Surgery, 83(2), 215-224.
https://doi.org/10.1016/0002-9610(52)90214-6
Cade, M. (2002). Reflexology. The Kansas Nurse, 77(5), 5-6. Retrieved from
https://www.ncbi.nlm.nih.gov/pubmed/12078350
Callaway, K., & Burgess, S. (2009). A history of massage in Lisa Casanelia and David Stelfox (3rd ed.).
Foundations of Massage. Churchill Livingston. ISBN: 9780729578691.
Cetkin, M., Bahsi, I., & Orhan, M. (2016). Evaluation of exercise in canon of medicine. Archives of Iranian
Medicine, 19(10), 743-746. https://doi.org/0161910/AIM.0014
Changizi Ashtiyani, S., Golestanpour, A., Shamsi, M., Tabatabaei, S. M., & Ramazani, M. (2012). Rhazes'
prescriptions in treatment of gout. Iranian Red Crescent Medical Journal, 14(2), 108-112. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3372038/
De Bustinza, V. (2016). How early Islamic science advanced medicine. National Geographic History. Retrieved
from https://www.nationalgeographic.com/archaeology-and-history/magazine/2016/11-12/muslim-
medicine-scientific-discovery-islam/
Deuraseh, N. (2006). The Islamic tradition based on the book of medicine (Kitab Al-Tibb) Of Sahih Al-Bukhari.
Journal of the International Society for the History of Islamic Medicine, 5, 2-14. Retrieved from
https://www.ishim.net/ishimj/910/JISHIM%20NO.9%20PDF/01.pdf
Dols, M. W. (1987). Insanity and its treatment in Islamic society. Medical History, 31, 1-14.
https://doi.org/10.1017/S0025727300046287
Doufesh, H., Ibrahim, F., & Safari, M. (2016). Effects of Muslims praying (Salat) on EEG gamma activity.
Complementary Therapies in Clinical Practice, 24, 6-10. https://doi.org/10.1016/j.ctcp.2016.04.004
El-Wakil, A. (2011). Observations of the popularity and religious significance of blood-cupping (al-hijama) as an
Islamic medicine. Contemporary Islamic Studies. https://doi.org/10.5339/cis.2011.2
Embong, N. H., Soh, Y. C., Ming, L. C., & Wong, T. W. (2015). Revisiting reflexology: Concept, evidence, current
practice, and practitioner training. Journal of Traditional and Complementary Medicine, 5(4), 197-206.
https://doi.org/10.1016/j.jtcme.2015.08.008
Faiz, A., & Ali, F. (2018). Applied part of Kulliyat with reference to Venesection (Fasd): A review. International
Journal of Research and Analytical Reviews, 5(3), 583y-586y. Retrieved from
https://ijrar.com/upload_issue/ijrar_issue_1701.pdf
Farid, M., & El-Mansoury, A. (2015). Kaiy (traditional cautery) in Benghazi, Libya: Complications versus
effectiveness. Pan African Medical Journal, 22, 98. http://dx.doi.org/10.11604/pamj.2015.22.98.6399

83
gjhs.ccsenet.org Global Journal of Health Science Vol. 11, No. 10; 2019

Feyzabadi, Z., Javan, R., Mokaberinejad, R., & Aliasl, J. (2014). Comparing insomnia treatment in Iranian
traditional medicine and modern medicine. History of Medicine Journal, 6(19). Retrieved from
http://journals.sbmu.ac.ir/en-mh/article/view/14878/0
Firdaus, S., & Sultana, N. (2018). Regimental therapy a drugless regimen for well being of a person in USM and its
important place in the mainstream treatment of USM. Journal of Complementary and Alternative Healthcare,
8(1), 1-11. https://doi.org/10.19080/JCMAH.2018.08.555727
Ghazanfar, S. A. (2011). Medicinal and aromatic plants Arabia and Iran. Ethnopharmacology: Encyclopedia of
Life Support Systems (EOLSS), 2, 1-8. Retrieved from http://fliphtml5.com/vvyc/mpjk/basic
Gori, L., & Firenzuoli, F. (2007). Ear acupuncture in European traditional medicine. Evid Based Complement
Alternat Med, 4(Suppl 1), 13-16. https://doi.org/10.1093/ecam/nem106
Gorji, A., & Ghadiri, M. K. (2002). History of headache in medieval Persian medicine. The Lancet: Neurology,
1(8), 510-515. https://doi.org/10.1016/S1474-4422(02)00226-0
Greenstone, G. (2010). The history of bloodletting. British Columbia Medical Journal, 52(1), 12-14. Retrieved
from https://www.bcmj.org/premise/history-bloodletting
Hamid, A. (2018). Ilaj-bil-tadbeer (regimental therapy): A noble method of treatment in Unani medicine: A review.
International Journal of Medicine Research, 3(3), 01-06. Retrieved from
http://www.medicinesjournal.com/archives/2018/vol3/issue3/3-2-38
Horowitz, S. (2004). Evidence-based reflexology: A pathway to health. Alternative & Complementary Therapies,
211-216. https://doi.org/10.1089/1076280041580378
Hurreiz, S. H. (2002). Folklore and Folk life in the United Arab Emirates. London: RoutledgeCurson.
https://doi.org/10.4324/9781315028682
Hussain, M. T., Ahmed, G., Jahan, N., & Abida, M. (2016). Pathophysiology and Treatment or Urolithiasis in
Unani Medicine. Indian Journal of History of Science, 51(2), 217-226.
https://doi.org/10.16943/ijhs/2016/v51i2/48433
Ibrahim, F., Sian, T. C., Shanggar, K., & Razack, A. H. (2013). Muslim prayer movements as an alternative therapy
in the treatment of erectile dysfunction: A preliminary study. Journal of Physical Therapy Science, 25(9),
1087-1091. https://doi.org/10.1589/jpts.25.1087
Jacoby, J. (2002). Pouring water over the body--hydrotherapy prescriptions in the late Middle Ages. Sudhoffs Arch,
86(1), 54-68. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/12168234
Jafar, M., Ansari, A. N., Alam, M. I., Khalid, M., & Mand, D. (2015). Dalk (Massage): A unani therapeutic
manipulative procedure in rehabilitation of psychosomatic and neurological disorders. International Journal
of Hospitality Management, 3(3), 36-38. Retrieved from
https://www.cabdirect.org/cabdirect/FullTextPDF/2015/20153371363.pdf
Jalkhi, B., & Kakhshan, A. (2015). Inhalation therapy in kitab al-Umdah al-kuhliyah fi al-Amrad al-Basariyah.
International Society for the History of Islamic Medicine, 48-51. Retrieved from
https://www.researchgate.net/publication/324068708_Inhalation_Therapy_In_Kitab_al-'Umdah_al-kuhliyah
_fi_al-amrad_al-basariyah
Jamal, A., Siddiqui, A., Sadiq, S. U., & Jamil, S. S. (2013). Therapeutic significance of dalak (massage) in the
management of musculoskeletal disarray. Hamdard Medicus, 56(4), 86-91. Retrieved from
http://applications.emro.who.int/imemrf/Hamdard_Med/Hamdard_Med_2014_56_4_86_91.pdf
Jedkareh, A., Esmaeili, S., Alembagheri, A., & Mortazavi, S. A. (2016). Comparing the etiology and treatment of
skin fissure in traditional and conventional medicine; a brief review. Research Journal of Pharmacognosy,
3(1), 49-54. Retrieved from
http://www.rjpharmacognosy.ir/article_12104_20b54cae6c691c4f030518139b39a7f7.pdf
Jha, K., Garg, A., Narang, R., & Das, S. (2015). Hirudotherapy in medicine and dentistry. Journal of Clinical and
Diagnostic Research, 9(12), ZE05-07. https://doi.org/10.7860/JCDR/2015/16670.6918
Khalique, A., & Siddiqui, M. (2017). Historical background and medical significance of dalk (massage): A review.
International Journal of Unani and Integrative Medicine, 1(2), 15-20. Retrieved from
http://www.unanijournal.com/articles/13/1-1-13-782.pdf
Khan, J. A., Siddiqui, M. A., Itrat, M., & Jamal, M. A. (2014). A review on therapeutic application of fasd
84
gjhs.ccsenet.org Global Journal of Health Science Vol. 11, No. 10; 2019

(venesection) in unani medicine. Journal of Biological & Scientific Opinion, 2(1), 101-102.
https://doi.org/10.1016/S0254-6272(18)30639-3
Khan, M. A., Raza, F., & Khan, I. A. (2015). Ibn Sina and the roots of the seven doctrines of preservation of health.
Acta Medico-Historica Adriatica, 13(Suppl 2), 87-102. Retrieved from
https://pdfs.semanticscholar.org/4b27/7a5e0fb8d0a616724b592cf3ae8488d0f677.pdf?_ga=2.153040446.60
7883443.1565273538-510541118.1565273538
Khan, M. S., Lari, Q. H., & Khan, M. A. (2018). Therapeutic approach of unani medicine in the management of
psoriasis (DA-US-SADAF). European Journal of Pharmaceutical and Medical Research, 5(2), 200-205.
Retrieved from https://www.ejpmr.com/admin/assets/article_issue/1517395147.pdf
Khuda, I., & Al-Shamrani, F. (2018). Stroke medicine in antiquity: The Greek and Muslim contribution. Journal of
Family and Community Medicine, 25(3), 143-147. https://doi.org/10.4103/jfcm.JFCM_8_17
Kolb, B., & Dumreicher, H. (2008). The hammam - A living cultural heritage. ArchNet-International Journal of
Architectural Research, 2(3), 17-28. https://dx.doi.org/10.26687/archnet-ijar.v2i3.278
Landgren, K. (2008). Ear Acupuncture: A Practical Guide. Churchill Livingston: Elsevier. ISBN: 9780702033179
Larijani, B., Esfahani, M. M., Moghimi, M., Shams Ardakani, M. R., Keshavarz, M., Kordafshari, G., Nazem, E.,
et al. (2016). Prevention and treatment of flatulence from a traditional Persian medicine perspective. Iran Red
Crescent Medical Journal, 18(4), e23664. https://doi.org/10.5812/ircmj.23664
Liu, W., Schaffer, L., Herrs, N., Chollet, C., & Taylor, S. (2015). Improved sleep after Qigong exercise in breast
cancer survivors: A pilot study. Asia-Pacific Journal of Oncology Nursing, 2(4), 232-239.
https://doi.org/10.4103/2347-5625.170537
Lone, A. H., Ahmad, T., Anwar, M., Habib, S., Sofi, G., & Imam, H. (2011). Leech therapy- a holistic approach of
treatment in unani (greeko-arab) medicine. Ancient Science of Life, 31(1), 31-35. Retrieved from
http://www.ancientscienceoflife.org/article.asp?issn=0257-7941;year=2011;volume=31;issue=1;spage=31;e
page=36;aulast=Lone
Lone, A. H., Ahmad, T., Anwar, M., Sofi, G., Imam, H., & Habib, S. (2012). Perception of health promotion in
Unani herbal medicine. Journal of Herbal Medicine, 2(1), 1-5. https://doi.org/10.1016/j.hermed.2012.02.003
Madinah, S. (2009). Avicenna’s canon of medicine and modern urology part III: Other bladder diseases. Urology
Journal, 6(1), 138-144. Retrieved from http://journals.sbmu.ac.ir/urolj/index.php/uj/article/view/93/92
Manik, M. K., Wahid, M. A., Islam, S. M. A., Pal, A., & Ahmed, K. T. (2013). A comparative study of the
antioxidant, antimicrobial and throbolytic activity of the bark and leaves of lannea coromandelica
(anacardiaceae). International Journal of Pharmaceutical Sciences and Research, 4(7), 2609-2614.
https://doi.org/10.13040/IJPSR.0975-8232.4(7).2609-14
Manjunath, V. (2016). Patronizing traditional bone setters and its complications- A study in Bangalore. Journal of
Dental and Medical Services, 16(6:1), 125-130. Retrieved from
http://iosrjournals.org/iosr-jdms/papers/Vol15-Issue%206/Version-1/Y150601125130.pdf
Mehta, P., & Dhapte, V. (2015). Cupping therapy: A prudent remedy for a plethora of medical ailments. Journal of
Traditional and Complementary Medicine, 5(3), 127-134. https://doi.org/10.1016/j.jtcme.2014.11.036
Mohammad, S. H., Fasihuzzaman, & Jabeen, A. (2015). Hijamah (cupping therapy): A noble method of treatment
in unani medicine. International Journal of Research in Ayurveda and Pharmacy, 6(2), 207-214.
https://doi.org/10.7897/2277-4343.06243
Molkara, T., Akhlaghi, F., Ramezani, M. A., Salari, R., Vakili, V., Kamalinejad, M., Bordbar, M. R. F., …
Motavasselian, M. (2018). Effects of a food product (based on Daucus carota) and education based on
traditional Persian medicine on female sexual dysfunction: A randomized clinical trial. Electronic Physician
Journal, 10(4), 6577-6587. https://doi.org/10.19082/6577
Nasir, A., Fatma, G., Ali, W., & Ahmad, M. A. (2018). Role of Ilaj-bil-tadbeer (regimental therapy) as non-medical
therapy in unani system of medicine. European Journal of Pharmaceutical and Medical Research, 5(2),
213-218. Retrieved from https://www.ejpmr.com/admin/assets/article_issue/1517395296.pdf
Nayab, M. (2016). Ābzan (Sitz bath)-An effective mode of treatment in “Ilāj bit Tadbīr (regimental therapy). The
Pharma Innovation, 5(12, Part A), 45. Retrieved from
http://www.thepharmajournal.com/archives/2016/vol5issue12/PartA/6-3-23-259.pdf

85
gjhs.ccsenet.org Global Journal of Health Science Vol. 11, No. 10; 2019

Nikhat, S., & Fazil, M. (2013). Kayi (Cauterization): A tribute to unani scholars. Medical Journal of Islamic World
Academy of Sciences, 21(2), 81-88. https://doi.org/10.12816/0001494
Nimrouzi, M., Mahbodi, A., Jaladat, A. M., Sadeghfard, A., & Zarshenas, M. M. (2014). Hijamat in traditional
Persian medicine: Risks and benefits. Journal of Evidence-Based Complementary Alternative Medicine,
19(2), 128-136. https://doi.org/10.1177/2156587214524578
Oleson, T., & Flocco, W. (1993). Randomized controlled study of premenstrual symptoms treated with ear, hand,
and foot reflexology. Obstetrics & Gynecology, 82(6), 906-911. Retrieved from
http://reflexologyresearch.net/RWSFullPublishedStudy.pdf
Özköse, A. (2005). The Bathing Tradition in Anatolia. Islamic Urban Heritage, 113. Retrieved from
https://www.academia.edu/2998079/The_Bathing_Tradition_in_Anatolia
Parma, G., & Parmar, M. (2014). Leech therapy - A miraculous treatment. Unique Journal of Ayurvedic and
Herbal Medicines, 2(6), 37-39. Retrieved from
http://ujconline.net/wp-content/uploads/2013/09/9-UJAHM-14131-Rv.pdf
Qureshi, N. A., Ali, G. I., Abushanab, T. S., El-Olemy, A. T., Alqaed, M. S., El-Subai, I. S., & Al-Bedah, A. M. N.
(2017). History of cupping (hijama): A narrative review of literature. Journal of Integrative Medicine, 15(3),
172-181. https://doi.org/10.1016/S2095-4964(17)60339-X
Raftani, K., & Radoine, H. (2008). The architecture of the hammams of Fez, Morocco. Archnet-International
Journal of Advanced Research, 2(3), 56-68. https://doi.org/10.26687/archnet-ijar.v2i3.282
Ramey, D. W. (2000). A review of the evidence for the existence of acupuncture points and meridians. American
Association of Equine Practitioners (AAEP), 46, 220-224. Retrieved from
https://pdfs.semanticscholar.org/d920/99deece4ead71a1845cb343b135121955d1c.pdf?_ga=2.200793385.60
7883443.1565273538-510541118.1565273538
Rehman, H., Begum, W., Anjum, F., & Tabasum, H. (2013). Approach to dysmenorrhoea in ancient ages and its
current relevance International Journal of Herbal Medicine, 1(4), 88-91. Retrieved from
https://pdfs.semanticscholar.org/f5b2/9293f04accc8d00d69f797eec28bde268ca0.pdf
Reza, M. F., Urakami, Y., & Mano, Y. (2002). Evaluation of a new physical exercise taken from salat (prayer) as a
short-duration and frequent physical activity in the rehabilitation of geriatric and disabled patients. Annals of
Saudi Medicine, 22(3-4), 177-180. https://doi.org/10.5144/0256-4947.2002.177
Robinson, N. (2006). Integrated traditional Chinese medicine. Complementary Therapies in Clinical Practice,
12(2), 132-140. https://doi.org/10.1016/j.ctcp.2006.01.006
Round, R., Litscher, G., & Bahr, F. (2013). Auricular acupuncture with laser. Evidience-Based Complementary and
Alternative Medicine, 2013, 984763. https://doi.org/10.1155/2013/984763
Saad, B., & Said, O. (2011). Graeco-Arab and Islamic Herbal Medicine: Traditional System, Ethics, Safety,
Efficacy, and Regulatory Issues. Hoboken, New Jersey: John Wiley & Sons.
Saeki, Y., Nagai, N., & Hishinuma, M. (2007). Effects of footbathing on autonomic nerve and immune function.
Complementary Therapies in Clinical Practice, 13(3), 158-165. https://doi.org/10.1016/j.ctcp.2006.12.006
Saffari, M., & Pakpour, A. H. (2012). Avicenna's canon of medicine: A look at health, public health, and
environmental sanitation. Archives of Iranian Medicine, 15(12), 785-789. Retrieved from
http://www.ams.ac.ir/AIM/NEWPUB/12/15/12/0015.pdf
Saqlain, M., Ali, F., & Parveen, A. (2017). The value of hijama (cupping) as a therapy in unani system of medicine
– With reference to prophetic medicine. World Journal of Pharmaceutical and Medical Research, 3(8),
133-140. Retrieved from file:///Users/ajilatr/Downloads/article_1504229185.pdf
Serageldin, I. (2013). Ancient Alexandria and the dawn of medical science. Global Cardiology Science and
Practice, 2013(4), 395-404. https://doi.org/10.5339/gcsp.2013.47
Sherwani, A. M. K., Anasari, A. N., Anasari, H. A. H., & Anasari, I. A. J. A. (2004). The Contribution of albucasis
(abul-qasim zahrawi) in venesection. International Society for the History of Islamic Medicine, 3, 6-8.
Retrieved from https://www.ishim.net/ishimj/5/02.pdf
Sherwani, A. M. K., Ahmed, M., Naaz, S. A., Khan, S. A., Sherwani, A. M. K., & Khan, M. Q. (2006). Balneology:
A Concept of Public Health-Bath Houses in Arabian Life. Journal of the International Society for History of
Islamic Medicine. 5, 15-18. Retrieved from
86
gjhs.ccsenet.org Global Journal of Health Science Vol. 11, No. 10; 2019

https://www.yumpu.com/en/document/read/11456276/balneology-a-concept-of-public-health-bath-houses-i
n-arabian-life
Sibley, M. (2008). Editorial: Special issue on traditional public baths- hammams in the mediterranean.
Archnet-International Journal of Advanced Research, 2(3), 10-16.
https://doi.org/10.26687/archnet-ijar.v2i3.277
Sibley, M., & Jackson, I. (2012). The architecture of Islamic public baths of North Africa and the Middle East: An
analysis of their internal spatial configurations. Architectural Research Quarterly, 16(2), 785-789.
https://doi.org/10.1017/S1359135512000462
Sinclaire, M. (2007). Modern Hydrotherapy for the Massage Therapist. Baltimore, MD: Lippincott Williams &
Wilkins.
Singh, A. P. (2010). Medicinal leech therapy (hirudotherapy): A brief overview. Complementary Therapies in
Clinical Practice, 16(4), 213-215. https://doi.org/10.1016/j.ctcp.2009.11.005
Sultana, A., Lamatunoor, S., Begum, M., & Qhuddsia, Q. N. (2017). Management of usr-i-tamth (menstrual pain)
in unani (Greco-Islamic) medicine. Journal of Evidience-Based Complementary Alternative Medicine, 22(2),
284-293. https://doi.org/10.1177/2156587215623637
Syed, A. (2003). Spiritual medicine in the history of Islamic medicine. Journal of the International Society for the
History of Islamic Medicine, 2(4), 45-49. Retrieved from https://www.ishim.net/ishimj/4/08.pdf
Tan, J. Y., Molassiotis, A., Wang, T., & Suen, L. K. (2014). Adverse events of auricular therapy: a systematic
review. Evidence-Based Complementary Alternative Medicine, 2014, 506758.
https://doi.org/10.1155/2014/506758
Tumpa, S. I., Hossain, I., & Ishika, T. (2014). Ethnomedicinal uses of herbs by indigenous medicine practitioners
of Jhenaidah district, Bangladesh. Journal of Pharmacognosy and Phytochemistry, 3(2), 23-33. Retrieved
from http://www.phytojournal.com/vol3Issue2/Issue_jul_2014/13.1.pdf
Wardle, J. (2013). Hydrotherapy: a forgotten Australian therapeutic modality. Australian Journal of Medical
Herbalism, 25(1), 12-17. Retrieved from
http://www.natural-knowhow.com/home/wp-content/uploads/2015/01/Hydrotherapy-article.pdf
Yamamoto, K., Aso, Y., Nagata, S., Kasugai, K., & Maeda, S. (2008). Autonomic, neuro-immunological and
psychological responses to wrapped warm footbaths--a pilot study. Complementary Therapies in Clinical
Practice, 14(3), 195-203. https://doi.org/10.1016/j.ctcp.2008.04.001
Zargaran, A., Zarshenas, M. M., Karimi, A., Yarmohammadi, H., & Borhani-Haghighi, A. (2013). Management of
stroke as described by Ibn Sina (Avicenna) in the canon of medicine. International Journal of Cardiology,
169(4), 233-237. https://doi.org/10.1016/j.ijcard.2013.08.115

Appendix

Applied
Indications Notes
Therapy
Advised on areas of the body where
Varicose veins, chronic skin disease, chronic ulcers, other processes of bloodletting like
Leeching
musculoskeletal and cardiovascular conditions. venesection and cupping are not
possible.
Practice of venesection was seemingly
Removing excess humors, stimulating metabolic processes and
Venesection put to an end by the Prophet Muhammad
correcting altered temperaments.
(PBUH).
Epilepsy, headache, toothache, depression, hemorrhoids, Prophet (PBUH) allowed the use of
paralysis, recurrent cold and cough, migraine, musculoskeletal cauterization only in severe cases – a
Cauterization
disorders, vascular bleeding, gangrene, moles, skin outgrowths, position that has since been maintained
splenomegaly and ascites. in Islamic law.

87
gjhs.ccsenet.org Global Journal of Health Science Vol. 11, No. 10; 2019

Asthma, dyspnea, migraine, palpitation, chronic pain

including headache, knee & low back pain, hemorrhoids, Prescriptions refer to certain
amenorrhea, renal and ureteric colic, plethora, pustules days of the lunar calendar as
Cupping and boils, sciatica, gout, diseases of the liver, spleen and well as specific sites on the
psoriasis, etc., excessive menstrual bleeding, removal of body including head, back
deep swelling, scrotal hernia, sciatica, piles, hydrocele, and shoulders.
gout, renal calculi and epistaxis.
A variety of techniques exist
Manual Therapy Musculoskeletal and chronic pain, weight management and utilized according to
• Therapeutic Massage and psychosomatic disorders. condition.
Herbal therapy and oils often
• Reflexology Chronic pain, insomnia, sexual dysfunction and stroke. accompanied method.
Specific plants and dietary
Dislocated or fractured bones. practices are utilized as an
• Bone Setting
adjunct to the treatment.
Ear was pricked with a
Contraceptive, sciatic pains, sexual dysfunction,
Auricular Therapy needle or cauterized with
generalized pain.
heat.
A variety of techniques exist
Local swelling and pain, sinusitis, bloating, as analgesic and utilized according to
Fomentation
and muscle relaxant. condition, herbal remedies or
oils accompanied method.
Historically facilitated the
Hydrotherapy Reduce viscosity of the humors, promote circulation,
accomplishment of the great
improve metabolism and overall health, promote
• Hammam ablutions necessary prior to
detoxification, weight management, strengthens vitality.
praying.
Activates the internal organs of the abdomen and pelvis by
Used as a means to deliver
• Sitz bath increasing blood circulation to the surfaces and reduces
local application of herbal
congestion of muscle and inflammation.
medicines.
• Hand & Foot bath Relieves stress, combats fatigue and insomnia symptoms
Oils, herbal extracts or
in addition to increasing overall body temperature and
decoctions are used in
white blood cell activity.
conjunction with the bath.
• Vaporization, Steam Colds, flu, acne lesions, paralysis, nervousness, muscle
& Aromatherapy Method often relied on
pain and as a freshener.
therapeutic oils.
Intensity, timing and the
Enhance the vital force of the body, and eliminate waste conditions are all specified,
Physical Movement
products. as is the manner of their
application.

Copyrights
Copyright for this article is retained by the author(s), with first publication rights granted to the journal.
This is an open-access article distributed under the terms and conditions of the Creative Commons Attribution
license (http://creativecommons.org/licenses/by/4.0/).

88