Role of Unani medicine in Lifestyle Disorders

1. Role of Unani System of
Medicine in Lifestyle Disorders
by
Abdul Rafeh Wani
M.S [Amraze Uzn, Anaf
wa Halaq (E.N.T)]
SUMC Prayagraj,
Uttar Pradesh

2. Contents of Discussion
• Introduction
• Epidemiology
• Risk factors and Etiology
• Prevention through Unani
• Sakta
• Saratan
• Zaght al-Dam Qawi
• Conclusion

3. Introduction
• The traditional Korean word “Borigogae” (pass of barley) refers to situation of the scarcity of
food during the spring when they depended on rice until barley was ready for harvest.
• The reason many people today have health problems such as obesity, diabetes, metabolic
syndrome, hypertension, etc. is related to this historical background.
• Through the evolutionary history of limited food conditions, the bodies of our ancestors
adapted to accommodate for this scarcity. Thus, the human body’s storage capacity
developed to conserve energy sources.
• Disease pattern shifted from acute infectious ones to chronic diseases (Golub in ‘Limits of
Medicine’).
• The insistence that insufficient food supply would cause a population reduction (Thomas
Robert Malthus), was proved wrong.
• Since the end of World War II, the food supply have become more and more abundant, and
the population has increased.

4. • Greek physician Hippocrates (about
2,500 years ago) stated, “in order to keep
well, one should simply avoid too much
food, too little toil”.
• Both Chinese and Greek philosophers
have said “Use moderation” and “All
things in moderation.” These attitudes are
also important to maintain individual
health.
• Hippocrates is considered to be father of
lifestyle medicine as he had advised
measures for the prevention of life-style
diseases and modification of life-style
habits through diet and exercise, in his
famous treatises.

5. Definition
• The diseases that primarily occur due
to imprudent personal behaviour are
termed Lifestyle diseases.
• They result from an inappropriate
relationship of people with their
environment.
• Common examples include Zaght al-
Dam Qawi (hypertension), Saratan
(cancer), Dhayabitus (diabetes
mellitus), Sakta (stroke) etc.

6. Epidemiology
• They are long-lasting and often progress slowly.
• Chronic non communicable diseases are rapidly increasing an important global public
health problem.
• NCDs kill 41 million people each year, equivalent to 74% of all deaths globally, 77% of
which being in low- and middle- income countries (WHO).
• By 2030, the proportion of total global deaths due to chronic diseases is expected to
increase to 70 per cent and the global burden of disease to 56 per cent.

7.  In India, NCDs are a big health problem being responsible for sizeable mortality and
morbidity. According to WHO estimation, NCDs accounted for 5.9 million deaths (60%
of total deaths) in the country in 2012. The probability of dying prematurely (between
the ages 30 and 70 years) due to the four main types of NCDs is 26%.
 The contribution of most of the major non-communicable disease groups to the total
disease burden has increased all over India since 1990. Bad dieting habits i.e. diets low in
fruit, vegetables, and whole grains, but high in salt and fat are the primary factors for rise
in NCDs (ICMR’s 2017 report).

8. Picture Credit: https://timesofindia.indiatimes.com/photo/48460636.cms

10. Controllable Risk Factors

11. Uncontrollable risk factors
Risk factors that cannot be
changed or controlled
– Age
– Gender
– Ethnicity
– Heredity

12.  Tobacco accounts for over 8 million deaths every year (including from
the effects of exposure to second-hand smoke).
 1.8 million annual deaths have been attributed to excess salt/sodium
intake.
 More than half of the 3 million annual deaths attributable to alcohol
use are from NCDs, including cancer.
 8,30,000 deaths annually can be attributed to insufficient physical
activity.
 In terms of attributable deaths, the leading metabolic risk factor
globally is elevated blood pressure (19% of global deaths).

13. Etiology
The etiology of lifestyle diseases is attributed to:
 Su-e Hazam (dyspepsia)
 Ifrat naum (excessive sleep)
 Ifrat sakun (excessive rest)
 Qillate harkat-e-badani (sedentary life style)
 Martoob-wa-ghaliz Ghiz’a (meat, fatty / oily food and sweets)
 Balgham (dominance of phlegm)
 Mizaj Barid (cold temperament)
 Ghalba-e-Ifrat-e-Sharab bad-e-Ghiz’a (excessive alcohol after meal)
 Virasat and Khilqui (hereditary and congenital)
 Hawa-e-Ghaliz (polluted air)
 Aa’b-e-Ghaliz (contaminated water)
 Farhat (excessive gratification)
 Narm-wa-mulaim- bister (soft couch).

14. Prevention
Earliest description by Ali Ibn Abbas Majusi in Kamil al-Sana.
To abide by the following principles of Asbab Sitta Zarooriya (Six Prerequisites of Healthy
Living):
1. Hawa (Air)
· Fresh and pollution free air for breathing.
· Avoid exposure to excessive heat or excessive cold.
2. Makool o Mashroob (Food & Drink)
· Take healthy diet in three to five servings of fruits and vegetables a day and reduce
sugar and saturated fat intake.
· Restrict consumption of common salt upto 5 gm/day. Restrict pickles, papad, chutney
and salty processed foods.
· Stop tobacco chewing and smoking.
· Avoid sweets, junk and smoked foods, preserved foods, alcohol, carbonated drinks, etc.
· Avoid excess of non-vegetarian diet. Take diet rich in fibre (20-30 gm/day).

15. 3. Harkat o Sukoon Badani (Bodily Movement & Repose)
· Avoid sedentary lifestyle.
· 30-45 minutes regular exercise of moderate intensity, at least five days a week.
· Encourage outdoor activities like cycling, gardening, etc.
4. Harakat o Sukoon Nafsani (Psychic Movement & Repose)
· Avoid mental stress and anxiety
· Avoid extreme emotions, e.g. anger, fear, sadness
· Lead a spiritual peaceful life
5. Nawm o Yaqza (Sleep and Wakefulness)
· Six to eight hours sound sleep
6. Ihtibas o Istifragh (Retention and Evacuation)
· Avoid constipation
· Ensure proper evacuation, urination, perspiration
· Avoid spending long hours in front of electronic media like TV, computers, etc.
· Avoid dehydration, and ensure retention of electrolytes and minerals

16. Sakta (Stroke)
Sakta is a condition caused by disruption in blood supply to the brain leading to
Fäliji Nisfi (hemiplegia).
Prevalence:
Leading cause of disability worldwide
Second leading cause of death
 Lifetime risk of developing a stroke has increased by 50% over the last 17
years and now 1 in 4 people is estimated to have a stroke in their lifetime (The
Global Stroke Factsheet 2022).
From 1990 to 2019, there has been a 70% increase in stroke incidence, 43%
increase in deaths due to stroke, 102% increase in stroke prevalence and 143%
increase in Disability Adjusted Life Years (DALY).

17. · Ilaj –bil- dawa (Pharmacotherapy):
Single drugs
· Filfil Siyah (Piper nigrum Linn.)
· Azaraqi (Strychnos nux-vomica, Linn.)
· Sudab (Ruta graveolens Mill)
· Qaranful (Syzygium aromaticum (Linn.)
· Nakchikni (Centipeda minima Linn.)
· Seer (Allium sativum)
· Badranjboya (Nepeta hindostana Haines)
· Arjun (Terminalia arjuna (Roxb.) Bedd.)
· Ustukhudoos (Lavandula stoechas Linn.)
· Zanjbeel (Zingiber officinale Roscoe)
· Zardchob (Curcuma longa)
· Honey
Compound drugs
· Kushta Hartal
· Maa- ul asl
· Maa- ul Usool
· Maa-ul Buzoor
· Gulqand
· Habb-i Ayarij
· Hab Muntin
· Dawa-e Sardaaru
· Habb-i Muqil
· Majoon Jograj Gugul
· Majoon Azraaqi
· Sikanjabeen
· Kushta Gaudanti
· Roghan Surkh
· Roghan-i Naardeen
· Roghan-i Qust
· Roghan-i Seer
Management

18. Ilaj bi’l Tadbeer (Regimenal therapy)
• Fasd (Blood letting) through Qaifal (Cephalic) vein
• Hijamah (Cupping)
• Natool (Irrigation) on the affected part with lukewarm
decoction of drugs
• Dalk (Massage) with oils on affected part
• Takmeed Haar (Hot fomentation) with drugs
• Huqna (Enema)

19. Saratan (Cancer)
 An abnormal, uncontrolled, autonomous
growth of the cells with the potential to
invade or spread to other parts of the body.
 Usually characterized by a new lump,
unexplained anorexia, weight loss, anaemia,
abnormal bleeding, prolonged cough, fever,
change in bowel habits, etc. depending upon
the organ involved.
 In Unani System of Medicine it is described
as a type of tumor which comes under the
category of Awram Sawdaviya.
 It is caused by the production of Sawda Ghair
Tabayee (Abnormal melancholic humour).

20. Facts:
• Cancer is a leading cause of death worldwide, accounting for
nearly 10 million deaths in 2020, or nearly one in six deaths.
• In India, 900,000 people die due to tobacco related diseases
per year.
• Many cancers can be cured if detected early and treated
effectively.

21. Management
Early detection leads to better prognosis. Unani treatment may be used as an
adjuvant therapy for the following purposes in cancer patients:
· To restore the healthy lifestyle by observing Asbab Sitta Zarooriyya.
· To enhance the immunity of the patient, e.g. Khameera Marwareed,
Jawarish Jalinoos, Jawahar Mohra, etc.
· To reduce the complications associated with cancer, e.g. Majoon
Dabidul Ward, Dawaul Kurkum, Arq Hara Bhara, etc.
· To prevent the side effects of the conventional therapy, e.g. Jawarish
Anarain, Jawarish Amla, Jawarish Tamar Hindi, Habb Tursh Mushtahi, etc.
· To improve the quality of life of the patients- Hammam (Turkish
Bath), Dalk (Massage), Fasd (Venesection) and Ishal (Purgation).

22. Diet:
• Dietary Recommendations
Murattib wa Mubarrid Aghziya (moist and cold diets) like Maa al-Jubn (Whey),
Maa us Shaeer (Barley Water), Bajra (Millet), Daliya, Soyabean, Pulses (with
skin), Khurfa (Parsley), Paalak (Spinach), Bathwa, Kaddu (Pumpkin), Kheera
(Cucumber), Lauki (Bottle Gourd), Tori (Ridge Gourd), Tarbooz (Water Melon),
Khajoor (Dates), Leemu (Lemon), Angoor (Grapes), etc.
• Dietary Restrictions
Avoid Muwallid-i Sawda (melancholic humour producing) dietary items like
red meat, Adas (Lentil), Baqla (Horsebean), Baigan (Brinjal), Matar (Pea), etc.

23. ZAGHT AL-DAM QAWI (Hypertension)
Zaght al-Dam Qawi
(Hypertension) is defined
clinically as a systolic blood
pressure at or above 140
mmHg and/or a diastolic blood
pressure at or above 90 mmHg.
Unani physicians described the
condition as Imtila-e-Dam.

24. Concept of Hypertension in Unani System of
Medicine
• Imtila bi Hasb al-Aw‘iya (Repletion in regard to vessels): due to
excessive accumulation of metabolic products, whether mahmooda
(beneficial) or ghair-mahmooda (harmful), and this type of
congestion is common among obese people.
• Imtila bi Hasb al-Quwa (Repletion in regard to power): due to
disturbance of quwwat-e-nafsaniya, quwwat-e-mudabbira badan and
quwwat-e-tabia of the body.

25. Facts about HTN
• An estimated 1.28 billion adults aged 30–79 years worldwide have
hypertension (two-thirds in low- and middle-income countries).
• An estimated 46% of adults with hypertension are unaware that they
have the condition.
• Less than half of adults (42%) with hypertension are diagnosed and
treated.
• Approximately 1 in 5 adults (21%) with hypertension have it under
control.
• Hypertension is a major cause of premature death worldwide.
• One of the global targets for noncommunicable diseases is to reduce
the prevalence of hypertension by 33% between 2010 and 2030.

26. Management
Get blood pressure checked at
regular intervals. When the blood
pressure of a person remains
beyond normal range of 140 mmHg
(Systolic) or 90 mmHg (Diastolic),
he/she should be treated according
to the underlying condition.

27. Ilaaj-bil-Ghiza (Dietotherapy)
• Diets containing high potassium may slightly lower blood pressure. E.g,
Bananas, Oranges, Apricots, Dried fruits etc.
• Maintain a healthy weight as per age, height and sex
• Reduce salt intake to less than 5 g daily
• Eating fibre rich diet with fruits and vegetables
• Cessation of tobacco use
• Reduce alcohol consumption
• Reduce intake of foods rich in saturated fats

28. Ilaj bi’l dawa (Pharmacotherapy)
The following drugs are frequently used in the management of hypertension:
Mudirrat (Diuretic): Tukhm-e-Kharpaza (Cucumis milo Linn.), Tukhm-e-
Kheyarain (Cucumis sativa), Parshiaoshan (Adiantum capillus).
Compound formulations; Habbe-Mudirr, Sharbat-e-Buzoori Motadil.
Musakkinat (Sedative): Sankhaholi (Evolvulus alsinoides Linn.), Asrol
(Rauwolfia serpentina), Tukhm-e-Kahu (Lactuca sativa Linn.), Gul-e-Neelofar
(Nymphaea lotus).
Compound formulation; Habb-e-Musakkin.
Mufattihat-e-Urooq (Vasodilator): Lahsun (Alium sativum Linn.), Chaal Arjun
(Terminalia arjuna Linn.).
Compound formulations; Dawa-Ul-Kurkum.

29. Mufarrihat (Exhilarant): Abresham (Silk coccoon), Sandal Sufaid
(Santalum album), Sankhaholi (Evolvulus alsinoides Linn.).
Compound formulation; Dawa-ul-Misk.
Munawwimat (Hypnotic): Asrol (Rauwolfia serpentina), Ood e
Saleeb (Poenia officinalis), Naremushk (Mesua ferrea).
Compound formulations; Ikseer-e-Shifa, Roughane-Laboob Sab’a,
Roughn-e-khash’khash, Roughn-e-kahu, Roughn-e-kadoo, Asrofeen.
Mubarridat (Refrigerant): Tukhm-e-Khurfa (Portulaca oleracea
Linn.), Kishneez (Coriandrum sativum Linn.), Tukhm-e-Kahu
(Lactuka sativa), Gul-e-Neelofar (Nymphaea lotus).
Compound formulations; Qurs Tabasheer Kafoori, Sharbat-e-Nilofar.

30. Ilaj bi’l Tadbeer (Regimenal therapy):
• Riyazat zaeefa (Light exercise)
• Idraar (Diuresis)
• Hammam (Turkish bath)
• Fasd Basaliq (Venesection of basilic vein): recommended by
Zakariyya Razi (Rhazes)

31. Some Studies on HTN
• Evaluation of anti-hypertensive activity of Saad Kufi
(Cyperus scariosus) in adrenaline induced hypertensive rats:
[a] 50% ethanolic extract of ‘saad kufi’ was used in Wistor
albino rats. Dosage: 15-25mg/100g p.o
[b] Showed dose dependent & statistically significant
inhibition of adrenaline induced HTN.
[c] The antihypertensive effect increased over 4 days.

32. Percent inhibition in systolic blood pressure:
day 1 day 2 day 3 day 4
Normal control _ _ _ _
Negative control _ _ _ _
Standard group 52.63 57.82 60.34 61.92
Saad Kufi (15 mg/100
g)
16.73 25.16 31.03 36.53
Saad Kufi (25 mg/100
g)
35.07 41.74 46.84 51.95

33. • Ibn Sina has given a detailed description of saad kufi in ‘Risala
Adviya Qalbia’.
• Functions of Saad Kufi: Muqawwe Qalb (cardiotonic), Muffarah
(exhilarant), Muffatah Sudad (deobstruent), Mudir Boul (diuretic),
and Dafesumoom (antidote) and it has been used in Khafqan
(palpitation) and Zof-e-Qalb (weakness of the heart).
• Constituents: alkaloids, glycosides, tannin, flavonoids, phenols,
resins.

34. • Anti-Hypertensive Activity of Some Selected Unani Formulations:
An Evidence-Based Approach for Verification of Traditional Unani
Claims Using LC-MS/MS for the Evaluation of Clinically Relevant
Blood Parameters in Laboratory Rats.
• Drugs used were: Khamira Abreesham Sada, Dawaul Misk Motadil
(DMM), Mufarreh Shaikhur Rais, Khamira Gaozaban Sada (KGS) &
Habb-e-Jadwar.
• DMM showed a significant reduction in SBP with decreased plasma
nitrite. KGS also showed promising results.
• Misk/Mushk/Musk: cardiac tonic, brain tonic, aphrodisiac.

35. Conclusion:
The scope of Unani medicine is increasing day by day as people are becoming
more interested in herbal and organic world. Lifestyle disorders are increasing at
an alarming rate and Unani has a potential to be of great use in the management of
such diseases. Most of the lifestyle disorders are linked to certain common risk
factors and Unani targets those factors at the first instance. Correction of Asbabe
sitta zarooriyyah as and when required is the basic step in the prevention and
treatment of nearly all lifestyle disorders. The wide variety of drugs and therapies
that Unani provides for tackling these diseases need to be coupled with scientific
documented research done to verify their efficacy. Many researches are
undergoing and many need to be done. As for the present hour, whatever literary
knowledge Unani holds needs to be given practical form on a larger scale so that
the burden of these disorders be lifted and the complications minimized.