Regimental Therapy(ILAJ-BIT-TADBEER)

Ilaj-Bit-Tadbeer (Regimental therapy) is one of the four methods of treatment in the Unani system of medicine. The other three methods are Ilaj-Bil-Ghiza (Dietotherapy) Ilaj-bil-Dawa (Pharmacotherapy) and Ilaj-bil-Yad (Surgery).

Literally Tadbeer is an Arabic word meaning Regimen (Systemic plan) whereas Ilaj means therapy or treatment. So Ilaj-Bil-Tadbeer means treatment through regimen, which is a method, through which care of the sick person and maintenance of general health is performed with the help of certain procedures, tools and equipments described by eminent Unani physicians e.g. Buqrat (Hippocrates), Jalinoos (Galen), Zakaria Razi (Rhazes), Ibne Sina (Aviccena) and Abu-al-Qasim Zahrawi (Abulcassis)

Ilaj-Bil-Tadbeer is used independently or in combination with other methods of treatment like Ilaj bil Dawa (Pharmacotherapy), Ilaj Bil ghiza (Dietotherapy) and Ilaj Bil Yad (Surgery). Ilaj-Bil Tadbeer (Regimental Therapy) consists of Hijamat (cupping), Fasd (venesection), Taleeq (leeching), and Kai (cauterization).

The following are the different types of methods used for the treatment:

1. RIYAZAT (Exercise)

2. DALAK (Massage or Friction)

3. TAKMEED (Fomentation)

4. NUTOOL (Pouring of medicated lukewarm water on affected part)

5. ZIMAAD Wa TILA (Ointment and Liniment)

6. TAREEQ (Sweating)

7. IDRAR-E-BAUL (Diuresis)

8. HAMMAM (Bath)

9. ISHAAL (Purgation)

10. QAI (Emesis)

11. HUQNA (Enema)

12. IMALA (Diversion of morbid material)

13. HIJAMAT (Cupping)

14. FASD (Venesection)

15. TALEEQ (Leeching)

16. KAI (Cauterization)

Each of the above mentioned methods have been briefly explained below along with their broad indications.

Riyazat (Exercise):- Riyazat is a voluntary movement with the purpose of Tanqiya-e-Mavad (evacuation of waste material) for an individual. It plays an important role not only in maintaining good health and prevention of diseases but in curing certain ailments as well.

The objective of performing Riyazat are enumerated below:

To improve Istehala (metabolism) for proper functioning of body.

To remove waste products from the body.

To tone up individual organs

To maintain or improve flexibility, co-ordination and balance of the musculoskeletal system and thus strengthen the body as a whole.

To relieve anxiety, insomnia and depression.

Dalak (Massage or Friction):- Dalk is a systematic manipulation of body tissues with the hands. Several varieties of Dalk have been recommended in Unani system of Medicine e.g. Dalak e sulb (hard), Dalak e layyan (soft), etc. prolonged or moderate massages. Hard friction or massage is Mufatteh-e-Sudad (deobstruent) and makes the body firm. Soft massage is sedative and relaxes the body while prolonged massage reduces the fat of the body; moderate massage develops the body as well as improves and maintains blood circulation of the particular organ; rough friction with a rough cloth enhances vasodilation of the particular organ etc

The objective of performing Dalk are enumerated below:

In the premature infants, it is found to enhance weight gain and females who were given massage therapy during labour have less agitation, faster delivery and less post partum psychosis.

Relief from symptoms of anxiety, tension, depression, insomnia and stress as well as back pain, headache, muscles pain and some form of chronic pain.

Takmeed (Fomentation):- Takmeed is the process, which keeps the body or part of the body warm.

The objective of performing Takmeed are enumerated below

To relieve localized or generalized pain.

To subside the inflammatory conditions.

To increase the penetration of massage lotion.

Nutool (Pouring of medicated water):- Natool (Pouring of medicated water) is a procedure in which the affected part is washed by a stream of water or medicated decoction from a height. Natool (Irrigation) is done with the purpose of acceleration of Ikhraaj-e-mawaad (excretion of morbid material) and Tabdeel-e-Mizaj-e- a’za (alteration of the temperament of an organ)

The objective of performing Nutool are enumerated below

To disperse the matter from affected part.

To alter the temperamental state of the organ.

To achieve the astringent effect

To relieve several chronic diseases like Paralysis, Sinusitis, Salpingitis, Arthritis, mastitis, Sleeplessness, Migraine, meningitis, Depression, Tension, Polio and even certain mental disorders.

Zimaad/ Tila (Medicated Paste/ Liniments):-

Tila (Liniments): a kind of medicated oil used externally for massage whereas

Zimaad (medicated paste): semisolid preparations of the crude drugs in powder forms used for local application.

The objectives of Zimaad/ Tila are given below:

To combat pain of a particular organ e.g. Suda’a (headache), Waja us sadr (chest pain) etc.

To cure swelling of a particular organ e.g. Kabid (liver), Tihaal (spleen) etc.

Tareeq (Sweating):-Tareeq (Sweating or diaphoresis) is the process to acceelrate the secretions of the sweat glands of the skin.

The objectives of Tareeq are given below:

To excrete the Mawaad-e-Fasida (waste matter) from the skin, blood and other parts of the body

To reduce the Hararat-e-Mufrit (excessive heat).

To transfer the morbid matter (Imala-e- Mawaad)

To purify blood

To improve dermal nutrition and enhance body texture.

Idrar-e-baul (Diuresis):- Idrar-e-baul (Diuresis) is one of the important process for evacuation. Specific methods as well as drugs have been mentioned in classical Unani literature to achieve the target.

The objectives of Idrar-e-baul are given below:

To excrete poisonous matters, waste products and excess of humours through urine.

To purify blood and evacuate deranged humours.

To cure diseases of heart.

To cure hepatic ailments.

To cure pulmonary diseases as well as renal disorder.

Hammam (Bath):- It is a place used for bathing, consisting of several rooms with one room leading to the other with specific provisions and conditions customized according to the disease to be treated.

The objectives of Hammam are given below:

To reduce Lazoojat-e-Akhlat (viscosity of the humors).

To improve health of the debilitated individuals

To strengthen body

To cure obesity

To increase Hararat-e-Ghariziya (innate heat of the body).

To improve Istehala (metabolism).

To evacuate waste products through skin.

In the treatment of Falij (paralysis) and Zubool (muscular wasting)

Ishaal (Purgation):-

Ishaal is the process used for expulsion of the waste matter through the bowels.

The objectives of Ishaal are given below:

To resolve the morbid matter.

To activate the derivative effect.

To achieve antispasmodic and detoxicating effect.

Qai (Emesis):-Qai (emesis) is the evacuation of gastric contents through mouth. The main purpose of vomiting is to eliminate toxic/morbid material from the gastro-intestinal tract.

The objectives of Qai are given below:

To cure disease like Sudaa’ (Headache), Shaqeeqa (Migraine), Iltehaab-e-Lauzatain

To resolve (Tonsillitis).

To cure Zaat-ur-Riya (Pneumonia).

To cure Zeequn Nafs Shu’bi (Asthma).

To cure mental disorders, e.g. Junoon (Mania) and Maali Kholia (Melancholia).

Huqna (Enema):-

Huqna (enema) is an excellent process for the removal of superfluities from intestine. In which, liquefied drugs are introduced per rectum by an instrument. This is one of the best methods for elimination of vitiated humors and waste material from the intestine.

The objectives of huqna are given below:

To get rid of the superfluities from intestine.

To relieve kidney and bladder pain.

To resolve inflammatory condition of the adjacent organs.

To relieve colic pain.

To relieve constipation particularly in the case of intestinal atony.

Imala (Diversion of morbid material):-

Imala means ‘diversion’ of matter from one part of the body to another. For this purpose, different techniques are used for treatment of conditions where Imtala-e-Damvi (hyperemia) causes certain problems.

Through this method, the flow of matter is diverted to the other side. As a result, the congestion of the affected part is reduced in a natural way.

The objectives of Imala are given below:

To relieve pain and nervous irritability.

To relieve burning sensation.

To relieve the Qai-e-Hawamil (hyperemesis gravidarum).

To dissolve (subside) inflammation.

To dissolve lipoma and tumours.

To absorb fluids or matter accumulated in hypodermic spaces or cavities.

Hijamat (Cupping):-

Hijamat (cupping) is a method used for local evacuation or diversion of morbid humors in which a horn is attached to the surface of the skin of the diseased part through which negative pressure is created by vacuum. The vacuum is created by the introduction of heat or suction.

Cupping is divided into two categories

1. Hijamat bilshurt i.e. cupping with bloodletting

2. Hijamat bilashurt i.e. cupping without bloodletting

The objectives of Hijamat are given below:

Istifragh (evacuation) of morbid matters

Imala(diversion) of matter from one part of the body to another

Fasd (Venesection/Blood letting):-

Fasd is a procedure in which an incision is given to any of the superficial veins, and blood, containing Madda-e-Fasida (waste material) is allowed to flow. The purpose is evacuation of Madda-e-Fasida (waste material). It removes excess humours in the same proportion as present in the blood vessels or the abnormal humour or both. It is applied for purification of vitiated humors in Sarsaam (Meningitis), Zaat-ur-Riya (Pneumonia), Zaat-ul-janb (Pleurisy), Irqun Nisaa (Sciatica), Niqras (Gout), Waja-ul Mafasil (Rheumatic Arthritis), Subat Coma, Maalekholia (Melancholia), Khunaaq-e-wabaai (Diphtheria), Bawaseer (Piles), Nisyaan (Amnesia), Waja’-ul-Qalb (Angina Pectoris) etc.

The objectives of Fasd are given below:

To maintain normal volume of blood in people who are predisposed to develop the diseases due to excess of blood.

To stimulate Istehala (metabolism).

To check Kasrat-e-Tams (menorrhagia) and Ru’af (epistaxis).

To cure Humma-e- Ajaamiya (malaria) and splenic disorders, Bawaseer-e-Damvi (haemorrhoids), Waram-e-Khusiya (orchitis), Iltehab-e-Rahem (metritis), Jarb-o-Hikka (scabies and pruritis), Khuraj (boils),Iltehab-e-Kabid (hepatitis).

Taleeq (Leeching):-

Taleeq is a unique method of removal of Mawaad-e-Fasida (morbid matters). Leeching draws blood from deeper tissues. The selected point of treatment should be washed with a solution of borax and rubbed until get red. Leeches should be washed first and then applied. A little clay or blood should be smeared in the selected point to enable them stick better.

fter achieving the target and when they get distended, leeches should be detached by dusting salt borax or the ashes of burnt cloth, wool or sponge.

The objectives of Taleeq are given below:

To cure Sa’fa (baldness and favus), Qooba (ringworm), Mawad-e-Fasida (bad matter), saleel (moles), filariasis(Da-ul-feel), meningitis(Sarsaam), pneumonia(Zaat-ur-riya)

Kai (Cauterization):-

Cauterization is an effective method of treating several conditions e.g. destructive lesions, removal of putrefactive matter and bleeding etc. Unani physicians have preferred mikwa (cauterant) made of gold.

The place to be cauterized must be visible so that the cauterization is done satisfactorily after good observation. However, in the case of deep located organs e.g. mouth, nose and anus, suitable speculum is required. It should be coated with talcum and Armenian bole, soaked in vinegar, wrapped with a piece of cloth. The speculum should be subsequently cooled with rose water or several other juices

The objectives of Kai are given below:

To prevent the spread of putrefaction

To alter the cold temperament or to rectify the temperament of a particular organ

To disperse and remove the putrefactive matters, firmly adherent to the particular organ

To arrest haemorrhage as it retains the flow of blood

To prevent the accumulation of catarrhal matter

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