Shaqiqa (Migraine)

Shaqiqa (Migraine)

Introduction

Shaqiqa (Migraine) is a disease caused by imbalance of humours (Akhlaat) in the body. It is an ancient entity. Concept of “Shaqiqa” is present in modern medicine by the name of Migraine. It this type of headache only one half of head is afflicted with pain. Sometimes it involves the whole head. It is caused by vapours (Bukharaat), arising towards the head from the body or by hot humours (Akhlaat-e- Harra) or cold humours (Akhlaat-e- Baarida). In this case a relatively less quantity of causative matter intervenes.

It is characterized by the episodic throbbing pain in only one half of head, especially in sanguine (Damwi) type, due to lesser quantity of causative matter. There may be relief in pain when the throbbing artery is pressed. In shaqiqa (Migraine), headache is frequently accompanied with tinnitus (Taneen) and nausea (Ghasayaan).

Clinical features of migraine (Alamaat-e- Shaqiqa)

It is characterized by episodes of moderate to severe headache, which is often unilateral and pulsating and typically aggravated by routine physical activities. The duration of untreated migraine (Shaqiqa) attacks is rather long, from 4 hours to 3 days (median duration 18 hours). Pain is accompanied by some other symptoms, the most common symptoms being nausea (Ghasayaan), vomiting (Qai), photophobia and phonophobia. Other associated symptoms, such as osmophobia, pallor, fatigue, difficulty in concentration, blurred vision, or diarrhoea may also be present

Aetiology of migraine (Asbaab-e- Shaqiqa)

There are two main causes of migraine (Shaqiqa):

Morbid vapours (Bukharaat) from entire body or from any organ reaches the part (shaq) of the head which is weakest and accumulate there.
Accumulation of abnormal humours/ morbid humours (Akhlat-e- Radiya) and gases (Riyah) in shaq (affected part). These abnormal humours/ morbid humours (Akhlat-e- Radiya) may be hot (Har) or cold) (Barid) in temperament.
Some other causes:

Migraine (Shaqiqa) is common in women in period of prolonged menses (Istihaza), Due to prolonged breast feeding, prolonged exercise (Kasrat-e- riyazat), fatigues (Ta’ab wa mandgi), insomnia (Baidari), starvation (Faqa kashi), hysteria (Ikhtinaq-ur- Reham), renal diseases (Amraz-e-kuliyah), Indigestion of food (Su-e- hazm), Anaemia (Faqr-ud-dam), excessive use of cupping (Kasrat-e- Hijjama) etc.

Absence of Usool-e- Hifzan-e- Sehat like Unaccustomed smell etc.

Types of Shaqiqa (Migraine): It is usually of two types

Shaqiqa haar (Hot type of migraine)
Shaqiqa baarid (Cold type of migraine)

Shaqeeqa haar (Hot type of migraine): In this type of migraine (Shaqiqa), the symptoms will be heaviness of head, rapid pulse, hotness of the site of pain, constipation, tinnitus, pulsation at the site of pain, relief of pain by using cold items etc.
Shaqiqa baarid (Cold type of migraine): In this type of migraine (Shaqiqa), there will be heaviness of head, coldness at the site of pain, cold and catarrh in cold season relief of pain by using hot items etc.

Unani philosophy of Shaqiqa (Migraine)

It is a type of headache characterised by periodic attack of pain. Pain is usually unilateral, sometimes bilateral. Area of pain is usually in the regions of temporal, ear occipital, parietal, periorbital regions. Dilation and pulsation of extra cranial vessels it can be easily identified. Application of pressure by tight bandage lowers the intensity of pain

Shaqiqa (Migraine) is not a modern entity. Its concept is present since ancient times in Unani classical texts. Many renowned physician have defined shaqiqa (Migraine) in their treatise.

According to Jalinoos (Galen), Shaqiqa (Migraine) pain affects the weakest part of the head and reaches at the midpoint of the head.
According to Najeeb-ud- din Samar Qandi, the pain persists in the weakest part of the head. This pain persists all the time or sometimes it may be episodic. The patient feel severe pain on touching with finger.
Zakariya Razi, Ibn-e- Sina (Aviccena) and Ali ibn-e- Abbas Majusi defind shaqiqa (Migraine) as “This pain either occur in meninges (Aghshiya), in this condition pain is felt deep in the eyes and nightmare are seen. Sometime this pain occurs outside in the muscles of temporal region in this condition pain is intolerable.
According to Ali bin Rabban Tabri “This disease is called Shaqiqa (Migraine) because it occurs in one shaq (part) of the head, matter which produces this pain is small in amount and unable to produces pain in entire head, these matter are small in amount because they are present in arteries”.

Prevention/ Precaution (Tahaffuz)

Sorrow and greef to be avoided in migraine (shaqiqa)

Preventing measures of Shaqiqa (Migraine)

There are a number of ways, which can reduce chances of experiencing Shaqiqa (migraine). One of the best ways of preventing Shaqiqa (migraine) is recognising the things that trigger an attack. Try to avoid them.

Migraine (Shaqiqa) Triggers

Many possible triggers of migraine (Shaqiqa) have been suggested, including hormonal, emotional, physical, dietary, environmental and medicinal factors.

Hormonal changes

Some women experience migraines around the time of their menstrual period. These are known as menstrual-related migraines and they usually occur between two days before the start of period to three days after.
Many women find their migraines improve after the menopause, although the menopause can trigger migraines or make them worse in some women.

Emotional triggers

Anxiety (Izterab-e- nafsaniya)
Depression (Ham)
Stress
Tension
Shock (Sadma)
Excitement

Physical triggers

Poor quality sleep
Poor posture Tiredness
Neck or shoulder tension
Shift work
Low blood sugar (hypoglycaemia)
Strenuous exercise

Dietary triggers

Dehydration
Missed, delayed or irregular meals
Caffeine products, such as tea and coffee
Alcohol
Specific foods such as chocolate, citrus fruit and cheese

Environmental triggers

Bright lights
Flickering screens, such as a television or computer screen
Smoking (or smoky rooms)
Loud noises
Changes in climate, such as changes in humidity or very cold temperatures
Strong smells
A stuffy atmosphere

Principles of Treatment (Usool-e- Ilaaj)

Analgesia (Taskin-e- Dard)
Evacuation of causative humour (Istifraagh-e- Khilt)
Toning up of brain (Taqwiyat-e- Dimaagh)

Regimental Therapy (Ilaj bil Tadbeer)

Bloodletting (Fasd) is useful in case of sanguine (damwi) type of migraine
Purgation (Ishaal) indicated in case of bilious (safrawi), melancholic (Suadawi) and phlegmatic (balghami) type of migraine
Natool (Irrigation) Har (Hot)/ Barid (Cold) is also advisable

Dietotherapy (Ilaaj bil Ghiza)

Dietary Recommendations

Half boiled egg
Easily digestible diet (Zood Hazm Aghziya)
Barley water (Ma-ul- Sha’eer)

Dietary Restrictions

Aghziya-e- Mubakkhirah
Saqil wa Naffakh Aghziya

Pharmacotherapy (Ilaaj bil Dawa)

Local application of following formulation on the affected side

Pterocarpus marsupium. Roxb. (Damm-ul- Akhwain), Crocus sativus Linn. (Zafran/Gumr/ Gumrah), Acacia arabica/ nillotica Willd. (Aqaaqia/Mughilaan/Kikar/Babool/Qaraz), Dried latex of Papaver somniferum Linn. (Khashkhassh/Afyoon) are mixed in egg white , pasted over a piece of paper and applied on the affected side of head.

Application of following liniment (Tila) on the affected side

Hyoscyamus niger Linn. (Bazr-ul-Banj/ Ajwain Khorasani) Q.S, Lactuca sativa Linn. (Tukhm-e- Kahu) Q.S, Atropa belladonna Linn. (Post beekh-e- Luffah/ Yabrooj/ Bateetas) Q.S.

Irrigation (Natool) on temporal region when migraine (Shaqiqa) caused by hot humour (Khilt-e- Haar)

Nymphaea alba Linn. (Nilofer/ Full), Viola odorata Linn. (Banafsha), Althaea officinalis Linn. (Barg-e- khatmi), Lactuca sativa Linn. (Tukhm-e- Kahu), Rosa damascena Mill. (Gul-e- Surkh / Ward / Gulab).

Irrigation (Natool) on temporal region when migraine (Shaqiqa) caused by cold humour (Khilt-e- Baarid)

Matricaria chamomilla Linn. (Baaboonah/ Marahti), Artemisia maritima Linn. (Dermanah Turki/ Sheeh), Zataria multiflora Boiss (Sa'tar Faarsi), Anethum sowa Roxb. ex Flem. (Shibt/ Soya).

Compound Drugs

Qurs Musallas
Itrifal Muqawwi-e- Dimaagh
Itrifal Zamani
Itrifal Kishnizi
Itrifal Sanayi

Note:

Along with medicine the patients have to follow strict regimen as per the concept of Unani system of medicine. The patients are therefore, strongly advised to avoid self-medication.
They are advised to visit the nearest authorized Unani treatment centre for advice and treatment.

References

http://www.journalijdr.com/sites/default/files/issue-pdf/2820.pdf

file:///C:/Users/hp/Downloads/AJPTR%2036020_475.pdf

http://www.ijipls.com/uploaded/journal_files/171204061245.pdf

http://www.journalijdr.com/concept-shaqiqa-migraine-and-its-management-unani-greeco-arabic-system-medicine-review

https://www.nhp.gov.in/nutool-irrigation-pouring-of-medicated-water_mtl

http://medicaljournals.stmjournals.in/index.php/RRJoUSH/article/view/25

https://www.hindawi.com/journals/scientifica/2016/2683403/

http://www.ccras.nic.in/sites/default/files/viewpdf/jimh/JIMH_2009/103%20to%20110.pdf

http://www.ejpmr.com/admin/assets/article_issue/1517395296.pdf

http://advancejournals.org/uploads/0ef0a60d4610021454fabafe590992eaf0f2c1ef47f385714be7675c4bd209a1/Manuscript/6727009JCAM%2003.pdf

https://www.nhp.gov.in/qai-emesis-vomiting_mtl