Waram-e- Kabid Damwi (Sanguineous Hepatitis)

Waram-e- Kabid Damwi (Sanguineous Hepatitis)

Introduction

Unani Medicine (Greco-Arab Medicine) is one of the ancient systems of medicine. A vast array of literature about liver diseases has been documented in this system of medicine. Liver (Kabid) is an organ for origin of Natural powers (Quwaa). Galen, (129-217 AD) even stated liver as counterpart with sun, which is a source of energy for others planets.

Liver (Kabid) is also an organ for production of humours (Akhlat) for nourishment, growth and development of the human body. Each of the four humours named dam (sanguine), balgam (Phlegm), safra (Yellow bile) and sauda (Black bile) carries their own normal temperaments. The derangement in quality and quantity of humours, leads to liver pathologies. Waram-e- kabid damwi (Sanguineous Hepatitis) is one of them.

According to dominating humours (Akhlat), eminent Unani scholars such as Muhammad Bin Zakariya Razi, Ali Ibn-e- Abbas Majoosi, Sheikh Bu Ali Sina, Muhammad Akbar Arzani, Ibn-e- Hubal and Muhammad Azam Khan have classified hepatitis (Waram-e- kabid) as:

Waram-e- Kabid Damwi (Sanguineous Hepatitis)
Waram-e- Kabid Safravi (Bilious Hepatitis)
Waram-e- Kabid Balgami (Phlegmatic Hepatitis)
Waram-e- Kabid Saudawi (Melancholic Hepatitis)

Waram-e- kabid Damwi (Sanguineous hepatitis) is a disease condition characterized by inflammation or derailment of normal temperament of liver which can lead to increase in size of liver (inflammation of liver) and other associated symptoms. In Unani medicine Sanguineous hepatitis has been treated very effectively by its holistic approach. It is an acute inflammatory condition of liver due to predominance of blood (Dam).

Signs and symptoms of Waram-e- Kabid Damwi (Sanguineous Hepatitis)

It is characterized by acute fever sometimes with and sometimes without chills and rigors, in mild condition of the disease fever is not a compulsory symptom. Along with fever, excessive thirst, pain and heaviness in right hypochondriac region. Oliguria, sometimes diarrhoea and sometimes constipation, loss of appetite, indigestion along with other features of predominance of sanguine (Dam) are also seen. After touching/ pressing ribs pain will be felt beneath the ribs. Facial redness, dry and coated tongue is also seen. Occasionally it is also associated with hiccup and dry cough. When size of the inflamed liver is big in size. Urine of the patient becomes reddish and concentrated.

In the last stage of the waram-e- kabid damwi (sanguineous hepatitis), syncope is also seen along with cold extremities. Patient feels difficulty in laying at left side. This type of fever is seen in age group between 25- 35 years.

Types of Sanguineous hepatitis (Waram-e- kabid Damwi)

Waram-e- Jigar Moqaár: Sometimes inflammation develops in the concave part of the live
Waram-e- Jigar Mohaddab: Sometimes inflammation develops in the convex part of the live

In earlier types symptoms of hiccup are more along with vomiting, loss of appetite and severe pain at the site of liver. While in later type symptoms like cough, dyspnoea, heaviness and pain at the site of liver.

Causes of Sanguineous hepatitis (Waram-e- kabid Damwi)

Excessive heat
Impure and imbalance diet
Excessive alcoholism
Trauma at the site of liver
Excessive use of sweet and oily items.
Excessive use of water at the time of high grade fever
Impurity of blood
Sometimes it develops after seasonal fever and dysentery

Principles of treatment (Usool-e- Ilaj)

Dietary control (Taqleel-e- ghiza) is one of the basic principle of treatment found to be highly beneficial.
Detoxifying the liver with the deleterious effects of daily encounters with air-water and food-borne toxins is also one of the principle of treatment in Unani system of medicine.
Relieving congested and catarrhal conditions of liver and controlling bile secretion has a great role.
Evacuation (Istifraagh) through Fasd (Venesection/ Bloodletting) is also basic principle of treatment of Waram-e- kabid Damwi (Sanguineous hepatitis).
Resolution of inflammation (Tahleel-e- waram) through purgation (Ishaal) and deterrence of causative matter (Rada-e- mawaad) in case of inflammation, being in lower part of liver and diuresis (idraar), when the inflammation is in the upper part of liver.

Management/ Treatment of Waram-e- kabid Damwi (Sanguineous hepatitis)

Regimental Thaerapy (Ilaj Bil Tadbeer)

Fasd-e- Baasaleeq (Bloodletting through basilic vein) of fasd-e- akhal (Bloodletting through Median cubital vein) of right hand.

2. Pharmacotherapy (Ilaj Bil Dawa)

Oral administration of Luaab-e- asapghol (Mucilage of seed of Plantago ovata, Frosk.)
Oral administration of Luaab-e- behdana (Mucilage of seed of Cydonia oblonga, Mill.)
Oral administration of pomegranate juice with sikanjabeen
Oral administration of Maghz-e- Faloos Khayar shanbar (Fruit pulp of Cassia fistula, Linn.) mixed with Sheera-e- tukhm-e- kasni (Cichorium intybus Linn.)

Local application of following paste (zimaad)

Aard-e- Jau (Flour of seed of Hordeum vulgare Linn.), Sandal (Santalum album Linn.), Gulab (Rosa damascene, Mill.), Aab-e- kasni (Fresh) (juice of Cichorium intybus Linn.) and Vinegar.
Local application of a mixture of fresh juice of leaves of Mako (Solanum nigrum Linn.) Roghan-e- gul and vinegar in the early stage of disease.
Boil the following ingredients in water filter it add Sharbat-e- deenar 24 gms, Sharbat-e- Bazoori 24 gms and use in morning.

Gul-e banfsha (Leaves of Viola odorata Linn.) 7gms, Maweez munaqqa (Vitis vinifera Linn.) 9 gms, Baadiyan (Foeniculum vulgare Mill.) 7 gms, Gaozubaan (Onosma bracteatum) 5 gms, Mako khushk (Dried Solanum nigram Linn.) 7 gms, Tukhm-e- kasni (Seeds of Cichorium intybus Linn.)

3. Dietaotherapy (Ilaj Bil Ghiza)

Dietary Recommendations

Always give food less in quantity, light and easily digestible diet is to be recommended.
Juice of fruits, especially of pomegranate (Punica granatum Linn.)
Sattu (Flour of roasted seed of Hordeum vulgare Linn.) mixed with sugar
Ma-us- shaeer (Barley water) is best option for the patient of waram-e- kabid damwi (Sanguineous hepatitis)

Dietary Restrictions

Avoid fruits having constrictive and retentive properties (Fawakehe qaabiza wa habisa)
Avoid use of sweet and oily items

Prevention/ Precaution (Tahaffuz)

Strong diuretics and purgatives are to be avoided in sanguineous hepatitis (waram-e- kabid damwi)
Advise complete bed rest. Sometimes mild walk is beneficial if the condition is good.

Few Homemade Unani Formulations for Sanguineous Hepatitis (waram-e- kabid Damwi/ waram-e- jigar damwi): The drugs are found to be very effective.

Mix Aab-e- mako sabz murawwaq 48 gms, Aab-e- kasni sabz murawwaq 48gms, Sarbat-e- buzoori mo’atadil 48gms and use twice daily. In case of fever use Khaksi (Sisymbrium altissimum Linn.) alongwith this prescription.
A decoction constituted from six plants namely, shahatara (Fumaria officinalis), sarphokah (Tephrosia purpurea), chiraita (Swertia chirata), gul-e- mundi (Sphaeranthus indicus) and sandal surkh (Pterocarpussantalinus).
Another formulation used in the form of hab (capsule) with ingredients which included Majeeth /Foowah (Rubia cordifolia Linn.), Fu/Basuridoos /sunbul Suri Valerina officinalis, Kababchini/ Kankol (Piper cubeba Linn.) and Bathwa/Qataf (Chenopodium album), to be taken twice daily after food.

Single Unani Drugs recommended

Inab-us-Salab / Makoh / Mako Solanum nigram Linn.
Kasni Cichorium intybus Linn.
Amaltas Cassia fistula Linn.
Gul-e- surkh/ Gulaab Rosa damascena Mill.
Shaahtara / Shaahtraj Fumaria indica Pugsley
Baboonah Matricaria chamomilla Linn.
Ajmod Apium graeolens Linn
Za’faran Crocus sativus Linn.
Mastagi Roomi/ I'lk-al-Butm Pistacia lentiscus Linn.
Daarchini Cinnamomum zeylanicum Blume
Ood Hindi/ Agar Aquilaria agallocha
Sunbul ut teeb/Baalchhar Nardostachys Jatamansi (D.Don) DC.
Banafsa Viola odorata Linn.
Saleekhah/Taj Cinnamomum aromaticum (Bark)
Toot Aswad/ Toot Shaami Morus nigra Linn.
Grape Seeds Vitis vinifera Linn.
Hulhul Cleome icosandra Linn. Syn. C. viscosa Linn.
Kasaundi Cassia occidentalis Linn.
Sazaj Hindi/ Patraj Cinnamomum tamala Nees
Afsanteen Artemisia absinthium Linn.
Shalgam Brassica rapa Linn.
Gajar Daucus carota Linn.
Mooli/ Fujl Raphanus sativus Linn.
Kadu Cucurbita moschata (Duchesne) Poir.
Turai Luffa acutangula (Linn.) Roxb.
Khurfa Portulaca oleracea Linn.
Moong Vigna mungo Linn. Syn. Phaseolus mungo Linn.
Palak Spinacia oleracea Linn.
Baranjasif Leonurus cardiaca Linn.
Mastagi Pistacia lentiscus Linn.
Asal-us- soos Glyccerrhiza glabra Linn.
Bhui Amla Phyllanthus amarus
Kasoos Cuscuta reflexa Roxb.
Ambar baaris Berberis aristata DC. Syn.: B. chitria Lindl.
Balsan Commiphora opobalsamum
Aobee/Achaoo Morinda citrifolia Linn.
Baae-Khumbha/Baao Khambha Careya arborea Roxb.
Asebra Adeemat-al-Laun Leucas aspera (WILLD.) SPRENG.
Sheetraj Hindi/Chita Lakdi Plumbago zeylanica Linn.
Karela Momordica charantia Linn.

Compound Unani Drugs Recommended

Aab-e- Murawwaqain
Arq-e- Mako
Arq-e- Kasni
Arq-e- Anarain
Sharbat-e- Deenar
Majun Dabeedul ward
Dawa- ul-luk kabeer
Dawa- ul-luk sagheer
Dawa - ul- kurkum
Jawarish Anaarain
Sharbat-e- Neelofar
Sharbat-e- Anaarain
Qurs-e- Zarishk
Sikanjabeen Sada
Sikanjabeen Tursh
Maa-ul- Usool

References

http://www.nhp.gov.in/waram-e-kabid-hepatitis_mtl

http://nopr.niscair.res.in/bitstream/123456789/8540/1/IJTK%204(4)%20416-420.pdf

http://www.unaniherbal.org/hepatitis-treatment-unani-medicine.html

http://stmjournals.com/sci/index.php?journal=RRJoHS&page=article&op=view&path%5B%5D=942

http://www.scopemed.org/?mno=188396

http://innovareacademics.in/journals/index.php/ajpcr/article/viewFile/6175/3708

http://www.hepatitiscentral.com/hcv/herbs/products/challenge/

http://nopr.niscair.res.in/bitstream/123456789/8540/1/IJTK%204(4)%20416-420.pdf

http://www.henriettes-herb.com/articles/hepatit.html

http://www.irjponline.com/admin/php/uploads/2328_pdf.pdf

http://applications.emro.who.int/imemrf/Hamdard_Med/Hamdard_Med_2012_55_1_97_103.pdf

Note:

Along with medicine the patients have to follow strict regimen as per the concept of Unani system. 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.

PUBLISHED DATE : Jul 26, 2016
PUBLISHED BY : Zahid
CREATED / VALIDATED BY : Dr. Mahtab Alam Khan
LAST UPDATED ON : Jul 26, 2016