Preventive Healthcare (Ḥifẓān-i Ṣiḥḥat )
The Unani System of Medicine includes the Science of Maintaining Health (Ḥifẓān-i Ṣiḥḥat). It has the methods of understanding and maintaining health in a positive and individualized manner, with different guidelines for different temperaments, genders, age- groups, geographical regions, seasons, occupations etc. Some of the more commonly used guidelines are summarized as: Regimens for Seasons (Tadābīr-i Mavsam), Regimens for Age-groups (Tadābīr-i Asnān), Regimens for Pregnancy (Tadābīr-i Ḥaml), Regimens for Travellers (Tadābīr-i Musāfir) etc. The section on maintenance of health is followed by methods for preventing disease. It should be noted that it describes not only Prevention of Disease (Taqaddum bi’l-Ḥifẓ) but Promotion or what it calls Maintenance of Health (Ḥifẓān-i Ṣiḥḥat) as a separate discipline, which should be used even before Prevention of Disease. This is because, being holistic, it possesses a positive concept and description of health. Though understandably quite elaborate, the section on treatment of diseases comes only after promotive and preventive guidelines.
HOLISTIC APPROACH TO HEALTH AND DISEASE
Unani System of Medicine is known for its remarkably effective and safe healthcare. One of its unique characters is to take into account a very wide and comprehensive range of factors: biological, sociological, geographical, psychic etc., and secondly, to integrate them into its basic classification and correlative scheme by determining their Temperament (Mizāj), so that the type and quantity of each of these factors, which is appropriate for an individual person, can be determined.
Thus, a Hot & Dry person will become more Hot by living in a warm region and having an occupation involving heat. So, he should take only a moderately Hot diet, indulge in only moderate exercise, and take more of sleep which is a cooling factor. The Arabian scholars who finally developed the basic principles of Unani System of Medicine were keen discoverers and open minded. So, they could discover a large number of factors by observation, as well as adopt factors discovered by other people, without any prejudice. Besides, they were highly intuitive and rational, and developed parameters for applying the principle of Temperament, originating in Greece, to newer and newer factors.
SIX ESSENTIAL FACTORS (Asbāb Sitta Ḍarūriyya)
The observational and philosophic genius of Unani System of Medicine found one of its best expressions in the Six Essential Factors (Asbāb Sitta Ḍarūriyya), whose appropriate deployment in the life of a person, determined by their Temperament, ensures health. In fact, Unani System of Medicine describes all the Factors affecting health and disease, of whom those affecting all human beings perpetually are called Essential (Ḍarūriyya), while, the rest are called Non-Essential (Ghayr Ḍarūriyya). The Essential Factors cover a very wide range, and their creatively thoughtout applications or rectifications are even more numerous. For instance, pure and profuse air is essential for health. So, houses should be spacious, and cities should have gardens. On the other hand, unavoidable problems can be managed by using corrective factors, e.g. Health hazards of living on damp river-banks can be avoided by including anti-phlegmatic herbs as spices in the diet.
These Six Essential Factors are remarkable in providing such six categories that can include a very large number of factors, which may outwardly be quite distant to each other. Thus, one of the six Factors is ‘Movement and Rest,’ health being dependent on movement and rest appropriate to the Temperament of a person. Movement is both active and passive, practices like Swinging (Urjūḥa) also serve as exercise, which even a paralytic person can undertake. Further, exercise is needed not only for muscles but for the senses also, in fact for all organs: the exercise of vision being to gaze at beautiful objects and scenes and at intricate patterns, while, the exercise of Hearing being listening to music and songs. This shows the genius of Unani scholars to discover very large number of factors as well as simple schemes that could classify them into a very small number of categories, thus allowing easy application.
It should be noted that the ‘Six Essential Factors’ are used not only for maintaining health and preventing diseases, but also for treating diseases. Departing from principles of these factors results into disease, and following them through various modes of Regimenal Therapy (‘Ilāj bi’l-Tadbīr), including Massage (Dalk), Exercise (Riyāḍat), Turkish Bath (Ḥammām), Cupping (Ḥijāmat), Venesection (Faṣd), Leeching (Ta‘līq) etc., Pharmacoltherapy (‘Ilāj bi’l-Dawā’) and Dietotherapy (‘Ilāj bi’l-Ghidhā’), helps to restore health.
Air is the most crucial factor for life. It helps in the production and maintenance of Pneuma, which is the source of Vitality. The discovery of oxidative energy production, dependent on atmospheric oxygen, has revealed one aspect of vitality at the molecular level. Secondly, Air is the medium of most of the external factors affecting life and health, e.g. the Seasons with their different heat and cold, influence human beings by affecting the Temperament of Air which is taken in by breathing. Similarly, subtle, gaseous and even particulate things like chemical and biological pollutants etc. alter the Temperament of Air to harm the health of man.
Unani System of Medicine uses Air in Prevention and Treatment chiefly by taking into account the seasonal variations in Air. For instance, in summer, Air becomes more hot, so cold food and moderate movement and exercise should be adopted to remain healthy.
Food and Drinks (Ma’kūl o Mashrūb)
Food is second only to Air in maintaining life and health by replacing the body’s used-up and broken-down components (Badal mā Yataḥallal). Keeping in view the importance of Food, Unani System of Medicine makes extensive use of Diet both for the promotion of health and treatment of disease. It has been very successful in identifying the appropriate Food by using the principle of Temperament. A healthy man should use mainly the food of the Temperament similar to his own Temperament. However, if he is threatened with a pathological shift in his Temperament, he should use food of the opposite Temperament. Thus, in spring, when increasing Hotness of Air threatens to unbalance his normal Temperament; cold Food like Pomegranate Preparations (Rummāniyya) should be used by a man of Hot Temperament.
Unani System of Medicine brackets drinks with Food because, despite lacking nutrition, water is crucial since Food becomes effective only in solution. So, it provides extensive guidelines for the type of water and the appropriate time for drinking it. For instance, in order to ensure proper digestion, people of Hot Temperament should drink water during meals, but cold Temperament persons should use water only after the digestion has fully set in.
Bodily movement and Repose (Ḥarakat o Sukūn Badanī)
The Unani System of Medicine gives great importance to both appropriate Movements and Rest for maintaining health and for curing disease. Movement is necessary for evacuating waste products, and Rest is needed for retaining Nutrients till the completion of digestion. Unani System of Medicine offers a wide concept of Exercise of all organs. It classifies Movement into two types: high frequency and intensity with short duration, which increases Heat; and low frequency and intensity with a long duration, which increases metabolism. It recommends Moderate Exercise, which produces moderate sweating, but discourages Intense Exercise, which produces profuse sweating. It even considers Massage (Dalk), Turkish Bath (Ḥammām), slow horse riding and Swinging (Urjūḥa) as Moderate Exercise, and prescribes the latter for paralytic persons. Boat Ride is prescribed for treating Chronic Diseases like Leprosy and Dropsy.
Psychic movement and Repose (Ḥarakat o Sukūn Nafsānī)
The Unani System of Medicine fully recognizes the role of psychic states in maintaining health and treating disease. Unani Medicine describes the Mental States basically in terms of the Movement and Repose of Pneuma. Its Movement increases Heat while Repose increases Cold. So, excessive Movement or Repose of Pneuma causes Hot and Cold pathologies. For instance, extreme anger moves the Pneuma to the exterior, making both Pneuma and the Body abnormally Hot, which may give rise to Hot mental and bodily maladies e.g. Mania and Epistaxis, respectively. On the contrary, extreme fear makes the Pneuma flee to the interior and the resultant Cold can give rise to Loss of Consciousness and Bradycardia.
Thus, these pathologies can be managed both by altering the mental states and by administering Cold or Hot drugs. This is the basis of the unique and successful Psychopharmacological management of Psychiatric and Psychosomatic diseases in Unani Medicine.
In addition to considering the Pneuma as basic to the Mental States, Unani Medicine considers the Heart and the Brain to be especially relevant, as Heart is the seat of Pneuma (Rūḥ) and the Soul (Nafs), while, Brain is the seat of Psychic Faculties (Quwā Nafsāniyya). So, Mental States - described by Unani Medicine in terms of Psychic Movement and Repose – especially affect Heart and Brain Function. It must also be appreciated that, since, Unani Medicine considers Heart Function to be basically the maintenance of Vitality (Energy and Immunity), therefore, it describes the close correlation of Mental States with Immunity.
Avicenna (Ibn Sīnā) also states that in addition to affecting Hot or Cold Quality of man, some Psychic states have specific effects also, e.g. observing a sour food can make the teeth feel this taste. This phenomenon is used as the basis of Psychotherapy, e.g. ending hysterical paralysis by making a provoking statement.
Sleep and Wakefulness (Nawm-o-Yaqẓa)
Sleep is necessary for preserving Pneuma and Vitality and providing replacement of wear and tear (Badal mā Yataḥallal), while Wakefulness is necessary for voluntary functions. Since, they resemble Repose and Movement, respectively, an excess of Sleep increases Coldness and Wetness, while an excess of Wakefulness increases Hotness and Dryness. Therefore, moderation should be exercised with regard to them. Just as Wakefulness helps voluntary functions, particularly intellectual functions, Sleep helps digestion. So, the Digestion of Hot Food is more dependent on Sleep.
Evacuation and Retention (Istifrāgh o Iḥtibās)
Evacuation is needed for removal of waste products which may cause obstructions or embolism and toxicity. Retention of nutrients etc. is needed not only for full digestion and metabolism but also to maintain reserves of nutrients and essential substances. Evacuation takes place by defecation, micturition, coitus, sweating etc. Unani System of Medicine puts great emphasis on proper evacuation and prescribes mild laxatives like beet root soup for managing mild constipation. It also encourages all those activities in moderation that lead to evacuation, e.g. coitus, Turkish Bath etc.
The Unani System of Medicine puts great emphasis on Lifestyle Management for promotion of health and prevention and treatment of disease. Therefore, it is of immense relevance to present times as lifestyle diseases like Hypertension, Diabetes, Depression etc. are imposing the greatest burden on healthcare. Unani Medicine provides very comprehensive, specified and individualized guidance for this purpose.
The Unani System of Medicine integrates both external environment like Seasons, Air Purity, Food and Drinks, as well as internal environment i.e. movement and rest, sleep and wakefulness, evacuation and retention etc. It regulates both bodily states as well as psychic and mental states. It has invented very ingenious interventions in these areas, such as Swinging (Urjūḥa) and Boat Riding as an exercise for weak persons and paralytics. It has given a wide concept of Exercise by including under it the use of the Five Senses and undertaking the function of all organs and systems, such as, thinking, imagining, breathing, coitus etc. Most importantly, it has correlated all these factors with each other and with human beings by discovering their Temperament (Mizāj). Thus, it can individualize the appropriate quality and quantity of Diet, Bodily Movements, Mental Activity etc. for each individual, period of life i.e. Childhood, Old Age, Gender, Season etc. Assignment of Temperament to all factors also allows substituting one factor by another if the former is not under control, e.g. the effect of Seasons or Psychic States can be moderated by Diets, Drugs, Clothing, Exercises, Massage, Bathing etc. So, by describing the Healthy State and Disease in terms of a Normal Temperament and a Pathological Temperament, and by assigning Temperament to Drugs and to a very wide range of environmental factors, such as Diet, Season, bodily and mental activity etc. Unani Medicine provides multifactorial guidelines to successfully maintain health by using same Temperament factors in Health and opposite Temperament factors in Disease.
Both promotion of health and treatment of disease can be done to a great extent by non- drug factors, which are safer, cheaper and more easily employed than drugs. On account of its ability to undertake health promotion and disease prevention by non-drug lifestyle factors, the Unani System of Medicine is of great relevance to present-day healthcare, as lifestyle related diseases like Hypertension, Diabetes, Depression etc. make up great burden for healthcare in these days.
Source: Kulliyat-e-Nafeesi, Usool-e-Tibb, CCRUM & NHP data