Better Understanding of Disease in Unani Medicine
A Unani Medicine Practictioner (hakim) uses his or her senses, knowledge, reasoning, and experience to arrive at a diagnosis. The hakim, takes into account medical history of the patient, observations from physical examination, to gather physical and mental signs of imbalance. The physical examination comprises of the tongue, nails, pulse, urine, and feces, and the presence of pain and fever.
Unani Medicine - Assessing the Temperament
A hakim determines the patient’s temperament from the following: characteristics:
- appearance (complexion, build, touch, and hair),
- physiological features (movement, diet preferences, seasonal preferences, sleep, and pulse)
- emotions (calm, angry, nervous, etc.).
A disease will often show itself in the patient’s mental status, behavior, and mannerisms. These aspects can be attributed to one of the four emotional states.
- Sanguine Personality: appears usually balanced, stylish, refined, passionate, positive, genial, inquisitive, playful, sensual, and indulgent.
- Phlegmatic Personality: appears calm, good natured, trusting, sluggish, inactive, sentimental, sensitive, loving, subjective, self-absorbed, and steady.
- Choleric Personality: appears forceful, energetic, flamboyant, expressive, dramatic, bold, fidgety, short-tempered, angry, and argumentative.
- Melancholic Personality: appears quiet, cool, aloof, detached, objective, withdrawn, cautious, prudent, frugal, stoic, stiff, inflexible, lonely, unhappy, thoughtful, and grumpy.
A Unani Medicine hakim is always alert towards behavioral signs that may provide a clue to the patient’s illness.
Unani Medicine Examination of Bodily Functions
Examinations of the pulse, tongue, urine, and feces are used as diagnostic tools.
A pulse is essentially two components (systole and diastole). The pulse can be detected at the radial artery near the wrist, where it is closer to the skin surface and easily accessible. A Unani Medicine Hakim places the middle finger on the radial artery, directly between the carpus and the prominence of the radius, with the two adjoining fingers next to it in their natural positions and the index finger proximal to the heart.
(Pulse is examined on the right hand for a female and on the left hand for a male, with the palm turned upward for both.)
A Unani Medicine Hakim examines the tongue in two parts: as body and as coat.
- The tongue body texture is indicative of systemic or chronic conditions that are severe. The texture can be dry or rough, cracked, raw, rumpled, or wet and glossy. These characteristics may indicate lack of body moisture, nervousness, advanced sickness, inefficient digestion, and excess moisture, respectively.
- The coat reflects the health status of digestion, the digestive tract, and metabolism, and the surface location of the coat reflects the affected part of the system (e.g., pancreas, intestine, stomach, liver). An absent or thin coat denotes good digestive and metabolic health, whereas an increase in coat thickness reflects poor digestion, and the thickness is proportional to the accumulation of metabolic toxins in the body. Coat color indicates the nature of the buildup (e.g., phlegmatic, choleric), and its texture reflects moisture content.
Urine is indicative of the health of the liver, urinary tracts, and blood vessels. There are infact guidelines for urine collection to ensure accurate assessment. For example, the sample should be the first collection of the day before the individual eats any food, and the patient should have had no food the night before that may color the urine, should not have had intercourse, and should have been resting for a while before urination.
Unani Medicine Hakims assess the urine within the first hour of its collection by evaluating its quantity, color, foaminess, texture, clarity, and sediment.
Urine in shades of straw yellow to lemon yellow, blond yellow to orange yellow indicate a normal temperament. Whereas fiery yellow (saturated yellow) to saffron yellow with a tinge of red may be generated by extreme exercise, pain, hunger, or thirst.
Foamy floats in urine are attributed to moisture and gases, especially in individuals with gaseous bloating.
Abundance, persistence, and large bubble size of floats indicate an increase in viscosity caused by bad humor and cold.
Unani Medicine Hakims recognize that the urine odor of an ill patient differs from that of healthy individuals.
- Odorless urine signifies cold humor, immature digestion, acute sickness, and diminished metabolic vitality.
- A foul odor of the urine is caused mostly by infections and ulcers in the urinary tract.
- Acidic urine is produced by cold temperament that is affected by abnormal metabolism, but extreme acidity is a sign of death due to diminished innate heat.
Feces or Stool (bouraz)
- Normal feces are yellowish and cohesive with uniform softness similar in consistency to unfiltered honey. They come out easily without burning sensation, air sounds, or foam. The quantity of feces is compared with the amount of food ingested.
- A reduced amount is thought to be due to retention in the intestinal tract, and an increase points to the presence of humors.
- Wet feces (as in diarrhea) indicate weak digestion, weak absorption, or blockage,
- Hard feces (as in dehydration) may point to excessive urination, ingestion of dry food, prolonged retention, or fiery heat within the system.
- The color of the feces specifies the affecting humor; for example, a dark or black color is a sign of maturation of a melancholic disease, but only if one can exclude excessive heat or consumption of colored foods or a drink that produces black bile.
Pain weakens the organs and halts its function. It warms the organ initially but later cools it down and saps its energy. Removal of the cause will halt the pain and is the preferred method of treatment (e.g., by applying a poultice of linseed [Linum usitatissimum] or dill [Anethum graveolens], or by applying wet sedatives [alcohols] or cold anesthetics [all narcotics]).
Fever (homa, homiat)
Fever is an unnatural heat carried throughout the body by blood and the vascular system; it is a disquieting sign of corruption and imbalance that requires attention.
On the basis of cause, there are several classes of fevers:
- fevers associated with infections (waba’yah)
- transient fevers associated with warming effects, foul humor, hyperplasia, and blockage.