Understanding the concept of Purgation (Ishal) in Unani Medicine: A Review
The theory of humours (akhlat) is one of the fundamental pillars of the Unani System of Medicine (USM). The concept of health and disease depends on the quality (kaifiyat) and quantity (kammiyat) of humour (khilt). Health (sehat) lasts when humours remain in equilibrium and the main determinant of health is the balance in six essential factors (asbab-e-sittah zarooriya). These factors are highly modifiable and deviation in any of them leads to disequilibrium in humours either qualitatively or quantitatively which ultimately manifests in the form of the disease. Elimination (istifragh) of these morbid humours from the body becomes mandatory to treat the diseases or to restore health. One of the effective methods of elimination is purgation (ishal). It is a method by which morbid humours from the body are eliminated through the anal route. Before the elimination of any pathological humour especially in chronic diseases, it is mandatory to make the humour easily eliminable. This process of making the pathological humour eliminable is known as concoction (nuzj). The process of concoction is a regular and continuous process of the tabiyat (mediatrix naturae) of the body. In case of a minor deviation in humour, tabiyat itself eliminates it from the body after concoction. When the causative pathological humours are in abundance or grossly deviated from normalcy, tabiyat needs help from outside the body. This help of tabiyat can be done with some humour specific drugs which are known as concoctive medicines (munzij advia). Once, the humours become eliminable, the process of evacuation can be started. Classical Unani literature and published papers were explored to find the rationale of purgation therapy. Purgation is found to be advisable in the treatment of many chronic diseases. Tabiyat is the ultimate healer in the body and purgation helps it to overcome the diseases. Keywords: Istifragh; Munzij; Nuzj; Akhlat; Humours; Concoction