History and Principles of Tib-e-Yunani
Origin & History of Unani Medicine
Tibb-e-Unani or hikmet as it is famously known in Pakistan is the health system which was intially utilized by Greeks and was improved upon by Muslims. It was later on developed into the modern health systems and its remnants in ancient form are being practiced in Pakistan as Tibb-e-Unani
Unani medicine originated in Greece and is primarily based on the principles propounded by the ancient Greek practitioners Hippo crates and Galen. Over the subsequent centuries, a number of Arab and Persian scholars enriched the system, among them Ibn e Sina an Arab philosopher and physicist, who is also known as Avicenna is the most prominent name whose book "Canon of Medicine" remained the prime text book of medicine in all the major medical schools of East and west till the 19th century. He also wrote Kitab-al-shifa (Book of Healing). This system, earlier known as "Galenics", later became known as Unani Tibb, (Unani being the Arabic word for "Greek" and Tibb an Arabic word for "medicine").
Principles of Unani medicine
Unani medicine states that disease is a natural process and that symptoms are the reactions of the body to disease. It employs the humoral theory which presupposes the presence of four akhlaat (humours) in the body – dam (blood), balgham (phlegm), safra (yellow bile) and sauda (black bile). Each humour has its own temperament: blood is hot and moist; phlegm is cold and moist; yellow bile is hot and dry; and black bile is cold and dry. According to Unani, if the four main humours and the four primary temperaments (hot, cold, dry, moist) are all in a state of mutual equilibrium, the person is considered healthy.
The body is made of four basic elements; Earth, Air, Water, & Fire with different temperaments i.e cold, hot, wet & dry. The body organs get their nourishment through four humors; Blood, Phlegm, Yellow Bile & Black Bile. The concept of health in Tibb-e-Unani is a state of body in which there is equilibrium in the humors, and the function of the body is normal in accordance with its own temperament and the environment. When the equilibrium in the humors is disturbed and the functions of body are abnormal that state is called disease. Tibb-e-Unani takes a holistic approach towards prevention of disease, cure and promotion of health. Tibb-e-Unani relies on drugs made from medicinal plants, herbs, minerals, or of metallic or animal origin, for the treatment of disease.
Seven Essential Constituents
The essential constituents and the working principles of the body, according to Unani, can be classified into seven main groups:
- arkan or elements
- mizaj (temperament)
- akhlat (humours)
- aza (organs); arwah (life, spirits or vital breaths)
- arwah (life, spirits or vital breaths)
- quva (energy)
- af'al (action)
According to Tibb-e-Unani the human body is composed of following four elements:
Each of the four elements has its own special qualities: earth is cold and dry; water is cold and moist; fire is hot and dry; air is hot and moist.
According to Tibb-e-Unani four humours are responsible for transportation of energy in Human body.
- Blood (dam)
- Phlegm (balgham)
- Yellow bile (safra)
- Black bile (sauda)
Physical temperament (Mizaj)
The interaction of the elements produces various states, which in turn determine the temperament of an individual. It is of paramount importance to keep that temperament in mind while prescribing a course of treatment. Each individual has a unique temperament, which may potentially be real equitable, equitable or inequitable.
Following are the nine Temperaments types
- Hot and Dry
- Hot and Moist
- Cold and Dry
- Cold and moist
The state of real equitable never occurs in reality, rather it is a theoretical situation in which the temperaments of the four elements used are equal. The resultant quality of the uniform body is called its mizaj. The temperament of a substance may be a mizaj-e-mutadil (balanced one) or a mizaj-e-ghair-mutadil (imbalanced one).
Different types and shades of imbalanced temperaments are described in Unani, which believes that at birth every person is endowed with a unique and healthy humoral constitution determining the temperament of an individual.
Six Key Factors influencing Health & Disease
In Unani medicine, six key factors are evaluated in relation to health. These six factors are called "al-umoor al-tabiyah". Each has a close relation to, and a direct bearing on, the state of health of an individual. Therefore, it is necessary for a Unani medicine practitioner to take all these factors into consideration in order to arrive at a correct diagnosis and decide how to treat the ailment. Unani medicine stresses the influence of surroundings on the state of health of human beings. It states six essential prerequisites for the prevention of disease and it places great emphasis on the maintenance of a proper ecological balance and on keeping water, food and air free from all pollution. These prerequisites, known as al-asbab al-sitta al-dharuriya (six essentials) follow:
- Food and drink.
- Physical exercise and repose.
- Mental exertion and repose.
- Sleep and wakefulness.
- Evacuation and retention.
Concepts of the stages of digestion
According to the Unani system of medicine, there are four stages of digestion.
- Gastric digestion followed by intestinal digestion, when food is turned into chyme and chyle and carried to the liver.
- Hepatic digestion, when chyle is converted into the four humours in varying quantities, blood being the largest. Thus, the blood that leaves the liver is intermixed with the other three humours; phlegm, yellow bile and black bile.
- Vessel digestion, in which every tissue absorbs nutrition by its attractive power and retains it by its retentive power.
- Tissue digestion is the digestive power that, in conjunction with the power of assimilation, converts the nutritive elements into tissue. The waste material remaining in the humours at this stage is excreted by the expulsive power. Unani practitioners maintain that when any disturbance occurs in the equilibrium of the humours, it causes disease. Therefore the Unani mode of treatment aims to restore the equilibrium of the humours.
Yanani Methods of Diagnosis and Treatment
States of the human body (Haalaat al-jism)
According to Unani medicine practitioners, the states of the body are grouped under three headings:
- Health, in which all the functions of the body operate normally;
- Disease, the opposite of health, in which one or more forms or functions of the bodily organs are at fault; and
- Neither health nor disease, where there is neither complete health nor actual disease, such as in the case of elderly individuals or those who are convalescing. Diseases are of two types, namely simple or complex. A simple disease is one that completes its course without complications.
A simple disease may manifest itself in three forms:
- Imbalance of the humours (dyscrasia);
- Structural or organic diseases;
- Diseases of disharmony.
The unani Physician-called Hakim diagnoses primarily by information obtained through
- Clinical history of patient.
- Muaenah-e-nabz (pulse).
- Mushahidah-e-bol-o-bazaz (Stool and urine examination).
- Assessment of Mizaj (Temperament).
Four types of treatment lines are available:
- Ilaj bil tadbeer (regimental therapy),
- Ilaj bil Ghiza (dietotherapy),
- Ilaj bil dawa (Pharmacotherapy) and
- Jarahat (Surgery).
The regimental therapy includes procedures like venesection, cupping, Turkish bath, massage, exercise and leeching among others. These therapies involves working on specific body reflexes, most commonly by massage. But in case of musculoskeletal problems like arthritis and back pain, application of cold, heat or suction cups is also done. In rare instances, serious and acute diseases are treated by puncturing certain reflex points, during which a few drops of blood are released.
Similarly, dietotherapy involves administration of specific diets or regulation of quantity and quality of food, where as pharmacotherapy deals with administration of drugs derived from plant and mineral sources. In unani system, single drugs or their combinations in raw form are preferred over compound formulations.
"A Unani physician does not prescribe the strongest drug at the beginning of the treatment. He selects the drug according to the degree of variation from the normal healthy condition and observes the effect produced by the treatment. At the same time, he instructs the patient to observe some restrictions in diet and lifestyle."
Since in Unani, health and disease depend upon the equilibrium or imbalance between the four humours, a thorough examination of the pulse is undertaken to determine which humour is dominant at the time. The examination of the urine is the next important step.
Its colour, taste, viscosity, whether it has froth on its surface, if the bubbles formed are large, indicating balgham, or small, indicating safra are scrutinised. The stool is also examined in a similar way.
Scope of Tibb-e-Unani in Pakistan
Tib_e_unani in Pakistan
Traditional Medicines has been a conspicuous component oft he cultural heritage of the Islamic Republic of Pakistan and has played a significant role in providing health care to a large portion of the population.
National Council for Tibb?
National Council for Tube is a body corporate, having perpetual succession and a common seal established under the provisions of Unani, Ayurvedic and Homeopathic Practitioners Act, 1965. It consists of the following members, namely:-
(a) four members, being qualified and registered practitioners of the Unani System of Medicine, to be nominated by the Federal Government after consulting the Provincial Government concerned, of whom one shall be from each Province.
Eleven qualified members, to be elected from amongst themselves by the registered practitioners of the Unani System of Medicine, of whom five shall be from the Punjab, three from Sindh, two from the North West Frontier Province and one from Baluchistan;
Two members, to be elected from amongst themselves by the teachers of all the recognized Institutions of the Unani or Ayurvedic System of Medicine; one member, to be elected from amongst themselves by the registered practitioners of the Ayurvedic System of Medicine; and
Four members, to be nominated by the Federal Government, of whom one shall be a Scientist from the related field and one Deputy Secretary (Budget) Ministry of Health, who shall also bet he Chairman of the Finance Committee.
Functions of the National Council for Tibb?
To consider applications for recognition under this Act made by institutions imparting or desiring to impart instruction in the system of medicine with which the Council is concerned,
To secure the maintenance of an adequate standard of education in recognized institutions;
To make arrangements for the registration of duly qualified persons in accordance with the provision of UAH Act 1965.
To appoint committees or sub-committees, each having due representation of all the Provinces, for a specific period, to perform any specified function connected with the functions of the Council;
To provide for research in the system of medicine with which the Council is concerned; and
To do such other acts and things as it may be empowered or required to do by this Act or the Rules.
Facts regarding Tib-e-Y unani in Pakistan
The duration of the course i.e. Fazil ut Tibb Wai Jarahat unrecognized institutions of Unani or Ayurvedic system of medicine shall be four years and the course shall include the subjects prescribed by regulations
The minimum qualification required for admission to a recognized institution of Tibb-e-Unani for FTJ course shall be Matriculation with Science or equivalent examination of any University or Education Board in Pakistan established by or under any law but those with Intermediate or higher qualification with Science shall be preferred.
The minimum qualification required for admission to a recognized institution of Tibb-e-Unani for BEMS Course shall be FSc. Pre Medical.
There are 30 Tibbia Colleges in the private sector and1 college in the public sector offering 4 years diploma course in Tibb-e-Unani that follow the prescribed curriculum and conditions laid down in the regulations. A five year degree program has been launched by the faculty of Eastern Medicine of Hamdard University, Karachi and the curricula are revised and standardized by the Higher Education Commission.
There are more than 50000 Hakeems/Tabibs and 450 vaid registered with National Council for Tibb as Medical Practitioners (Tabibs/Vaids).
In Pakistan about 457 Tibbi Dispensaries and many private clinics provide medication to the public. About 95 Dispensaries have been established under provincial Governments.
There are 300-350 Herbal/Tibb-e-Unani Manufacturing Companies. Pakistan is amongst the leading exporters of Medicinal Plants. According to the Export Promotion bureau, Pakistan exported 8500 tons of medicinal plants in 1999, and earned US$ 6 million from export compared to US$ 31 million spent on import on herbal products. This is mainly because the technology is not yet developed to export the processed form of herbal product which could be a major source of revenue. There are around 5000 species of wild plants in Pakistan. According to the National Institute of Health.