Anaemia is one of the most common manifestations of disease throughout the world. It constitutes a major public health problem in underdeveloped countries and tropical areas. Indeed in some developing countries the majority of apparently normal people in certain population groups are anaemic. Even in advanced nations a third or more of patients admitted in hospital are anaemic. Globally about one thousand million people are anaemic. In India this problem is more common in rural than urban areas.
Anaemia is extremely common in pregnant women and infants. A high rate of maternal mortality is therefore influenced by the prevalence of anaemia. Among all types, iron deficiency anaemia is most common. It is most important single nutrient deficiency in the world.
According to Unani medicine, various synonyms of anaemia are: Faqr-ud-dam, Soo-ul-qinya, Qillat-ud-dam, Kami-e-khoon, Bhus and Fasad-e-dam.
The term Faqr-ud-dam was coined in 20th century. Before this period the term Soo-ul-qinya was used as its synonym.
Faqr-ud-dam is an Arabic word which means shortage of blood. The Arabic word ‘’Soo-ul-qinya’’ means alteration or deficiency in storage, attributed to the iron deficiency anaemia. Some unani physicians describe Soo-ul-qinya as “Zof-e- jigar” (Weakness of liver) with the description of “Soo-e- mizaj” (Alteration in the temperament of individual). Others have described it as “Ridhayat-e- dam” meaning alteration in qualities of blood i.e. concentration, odour, viscosity and colour.
Ibn-e- sina (1927) explained that alteration in the temperament of liver causes its weakness which leads to soo-ul-qinya. Azam Khan (1940) described that the alteration in the qualities of the blood of liver either in colour, odour, concentration or viscosity is nothing but soo-ul-qinya. According to Kabiruddin (1927) and Arzani (1923), the pre ascetic state which is called Fasaad-e- mizaj results in soo-ul- qinya. Jurjani (1903) claimed that when the liver is affected it produces the general weakness which is the indication of the early stage of ascites. This condition is commonly described as ascites by other scholars.
Considering various views and opinions of Unani scholars “Faqr-ud- dam” or “Soo-ul- qinya” is shortage of red blood cells in the circulating blood i.e either there is alteration in the haemoglobin (Hb) or defect or there is shortage of Hb% in the blood or there is marked increase in other components of blood resulting suspect of shortage of Hb%.
When there is condition of indigestion of stomach and intestine for a long time, it results in disturbances in liver digestion. This results in the formation of impure blood. Thus, the impure blood comes into circulation for the supply of nutrition to the body organs and tissues. This impure blood specially serum accumulates in the body tissues and organs resulting in puffiness of face, oedema on lower and upper extremities. Body becomes pale/ yellowish. Simultaneously other conditions of weakness of lever develop. This whole episode is known as soo-ul- qinya.
Types of Anaemia
Following three types of anaemia have been described by Unani scholars
1. Soo-ul- qinya sawiul kurriyatee (Normocytic Anaemia)
2. Soo-ul- qinya Kurria kibriya (Macrocytic Anaemia)
3. Soo-ul- qinya Fauladi (Hypochromic Anaemia)
In Unani classical literature following causes of anaemia have been described.
1. Amraz-e- kabid (Liver Disorders)
Soo-e- mizaj jigar: resulting slow or impure blood formation
2. Amraaz-e- Meda wa Amaá (Gastrointestinal disorders)
Soo-e-mizaj medi (Distemperament of stomach)
Zof-e- meda (Weakness of stomach)
Zarb wa khilfa (Frequent motions/ diarrhoea)
Deedan-e- Amaá (Intestinal worms)
Meda ka amal-e- jarrahi (Stomach surgery)
Qabz-e- muzmin (Chronic constipation)
Soo-e- mizaj barid (Abnormal cold temperament)
3. Amraz-e- Kuliya (Renal Diseases)
Baul-ud- dam (Haematuria)
Iltehab-e-kuliya muzmin (Chronic nephritis)
4. Hadd/Mutaáddi amraaz (Acute and infectious diseases)
Diq wa sil (Tuberculosis)
Humma-e- ejamia (Malaria)
5. Amraz-e- Aaza-e- Tanasul (Genital Disorders)
Kasrat-e- Jimaa (Excessive Coitus)
Usrut tams (Dysmenorrhoea)
Kasratut tams (Menorrhagia)
6. Amraz-e-Sadr (Cardio-Pulmonary diseases)
Zof-e- Qalb (Cardiac Weakness)
7. Adwia wa Sammiyat (Drugs and Poisons)
Para ke murakkabat (Compounds of Mercury)
Kasrat-e- Mai Noshi (Excessive use of alcohol)
Hawaam Gazeedgi (Insect Bite)
8. Mutafarreqat (Miscellaneous)
Faqr wa faqa (Poverty and Starvation)
Ghair mamooli mehnat wa Riyazat (Extreme exertion and Exercise)
Shadeed Jiryaan-ud-dam (Severe haemorrhage)
Ghair Sehat Bakhsh Rehaish (Unhygienic living condition)
Mitti Khane ki Aadat (Clay chewing habit) specially in children
Faulad ke injezab pe asar hone wale awaamil (Factors affecting the absorption of iron)
Lahmeen ka naqse taghzia (Protein malnutrition)
Ghair tabai tehali meekaniyat (Abnormal spleen mechanics)
Namaloom khalal (Unknown interventions)
Hayateen A, B12 & C ki kami ya fuqdaan (Deficiency of Vitamin A, B12 & C)
Quwat-e- muallide dam ki kamzori (Haematopoietic weakness)
Ghair munazzam ghiza (Improper diet)
Bad hazmi (Dyspepsia)
Ghair mamooli harkat (Over activity)
Nafsiatee awaamil (Psychogenic disorders)
9. Amal-e- inhezam mein khalal (Disturbances in digestive process)
According to Unani concept the food materials pass into four stages after ingestion. Disturbances in any of these four digestive processes may result in faqr-ud-dam (Anaemia), which impairs the normal liver function.
1. Hazm-e-medi (Gastric digestion)
2. Hazm-e- kabidi (Hepatic digestion)
3. Hazm-e- urooqui (Vascular digestion)
4. Hazm-e- uzwi (Cellular digestion)
Signs and Symptoms
As per Unani classical literature, the commonest signs and symptoms of faqr-ud-dam (Anaemia) are as follows.
1. Face and body looks pale and white
2. Puffiness of face and eyelids specially on the extremities. Sometimes it may be on the whole body.
4. Alternate diarrhoea and constipation
7. Loss of appetite, sometimes increased appetite
9. Weakness on mild exertion
10. Pyrosis (Heart burn)
12. Delayed healing of wounds or ulcers
13. Excessive sweating
15. Sleep disturbances
16. Pitting oedema on feet
17. Vertigo and giddiness
18. Cold extremities
19. Syncope (sometimes)
20. Prominent veins on peripheries (at times)
21. Palpitation (at times)
22. Extreme loss of weight (at times)
24. Hepatomegaly (at times)
25. Spasm and tremors
26. Defective vision (at times)
27. Jaundice and ascites (at times)
Unani physicians have been treating anaemia successfully from very ancient times. Unani drugs are highly popular in the treatment as they are easily available, cost effective and have least side effects.
As per Unani philosophy the basic principles followed for the management of anaemia are:
Removal of underlying cause
Improvement of digestion and appetite
Correction of hepatic insufficiency
Supplementation of nutritious diet
Medication to improve the quality of blood
Some Commonly Recommended Unani Single drugs
Several experimental as well as clinical trials have been conducted on antianaemic properties of some commonly used Unani drugs and the efficacy of these drugs have been proven. These are as under.
Punica granatum Linn.
Cuscuta reflexa/ indica
Maluss ylvestris/ pumila
Some commonly used Unani Compound Formulations
Majoon Dabeed-ul- Ward
Majoon Khubs-ul- Hadeed
Majoon Aarad khurma
Khamira Gaozaban Ambari