Asbabe Sitta Zarooriyah
(Six essential factors)
Unani System of medicine
recognizes the influence of surroundings and ecological condition that
maintaining the health and growth. This influence is based on the six essential
pre-requisites or Asbabe Sitta Zarooriyah. According to Unani medicine “Asbab”
is the precursor that influences on human body to generate a new state or
maintain the persisting state. Unani scholars emphasized these six factors
which are essential for life, without which life of humans would not be vested.
They are:
1. Fresh Air (Hawae Muheet)
2. Food and Drink (Makool wa Mashroob)
3. Physical Movement and Repose (Harakat wa
Sukoone Badania)
4. Mental Movement and Repose (Harakat wa
Sukoone Nafsania)
5. Sleep and Wakefulness (Naum wa Yaqzah)
6. Retention and Evacuation (Ihtibas wa Istifragh)
1.
Fresh
Air (Hawae Muheet)
Unani scholars strongly believed
that the fresh and clean air is necessary for healthy life and their opinion is
that many diseases occur due to polluted air and environment. Therefore, Ancient
scholars emphasized to live in open, well ventilated houses rather than living
in congested and compact dwellings. By the word “air” it is not only meant the
simple element (wind), but it is the atmosphere around us. Ancient physicians
have mentioned different types of seasons which directly have an impact on air
and causes different types or seasonal variations in the air. This seasonal
variation also affects one’s healthy state of body.
Types of Seasons
I.
Fasle
Rabi (Spring season)
Environment of this season is hot
and wet (Har Ratab). This season is favourable for Damavi Mizaj people as their
Mizaj is Har Ratab. On the other hand, this season is favourable for many
diseases like paralysis, infections, melancholia, arthritis, pharyngitis,
haemoptysis etc.
This season is suitable for the
growth, reproduction and multiplication of many pathogenic microorganisms like
bacteria, viruses, fungi and other organisms as they need hot and moist
condition for their multiplications. As a result, air in this season could be polluted
with pathogenic microorganisms which can produce diseases. In case of other
diseases, Unani physicians view is that a man is in stressful, anger and
fearful in this season and also over intakes of spicy food.
II.
Fasle
Sarma (Winter season)
Cold and moist temperament
prevails during winter as the environment becomes more cold and moist. In this
season phlegmatic diseases like joint pain, pneumonia, rhynorrhoea, cough,
lypoma, and rhinitis etc, are very common.
III. Fasle Saif (Summer season)
During summer season hot and dry
temperament is prevailed. As a result production of
Safra (yellow bile)
increases and induces
Safrawi (bilious) diseases
like measles, vomiting, nettle
rash, chicken pox,
ascites, conjunctivitis etc in this season.
Therefore one should
consume cold temperament beverages,
bath with cold
water, avoidance from sun light
and also increase intake of water.
IV. Fasle Khareef (Autumn season)
It is the time of change of
colour in the leaves, and the beginning of their fall from the trees. Summer is
the whole of the hot season, and winter the whole of the cold season. It is the
season opposite to summer, being less or greater duration according to the
latitude. In autumn, the heat subsides and the cold is not yet at its maximum.
Therefore, the predominant temperament of this season is cold and dry.
During this season Safrawi
diseases like ring worm, pruritis, sciatica, impetigo, excoriating scabies,
tonsillitis, intestinal worms, joint pains, back pain etc
are prevailed because of its
coldness which increases the chances of retention of Safrawi Khilt
(yellow bile) occurs in the body; these problems occur due to
indigestion, abundance of fruits, bad articles of diet, etc. therefore it is
very much essential to have appropriate meal and good digestion and to take
plenty of water to moisture the body.
How to Prevent the
Diseases
Change of seasons has to do with
the kind of diseases peculiar to each climate. Consequently the wise physician
will carefully study climate (atmospheric conditions day by day and month by
month) and country in order the better to treat the diseases and maintain his
patient's health by an appropriate mode of life, and the regimenal measures
appropriate to that climate and country.
Rabi (Spring
season)
This season is hot and dry.
Therefore, humours which are produced in this season may be healthy in quality,
and merely superabundant in quantity, so that the channels are over distended
and overfilled. In such a case movements become dangerous, the vascular
channels running a risk of rupture. To relieve such, the local plethora must be
rapidly relieved by venesection, avoidance from bath with hot water, and also
avoidance from excess eating and drinking.
Saif (Summer
season)
In summer season humours are
dispersed, the blood and serous humour are diminished in amount and the bilious
humour is increased in amount. Therefore, the faculties and natural functions
are impaired owing to excessive dispersion.
People should have more rest in
this season with avoidance from exposing to direct sunlight. Intake of Ghizae
Barid (cold temperament foods), citrus fruits like orange, pomegranate, lemon
etc are recommended. To prevent
the problems of digestion;
should take easy
digestible Ghiza (food) and avoid hot and
dry foods.
Khareef (Autumn
season)
This season has the cold and dry
qualities, therefore chances of cold diseases are high. These qualities vanish
the moisture from the body exposed to the air, or from the air itself, unless
there is a continual reinforcement with further moisture. Consequently,
continuous supply of moisture ceases, the state of dryness is rapidly reached. Intake
of dry fruits in autumn season is forbidden, along with abstinence from excess coitus
in this season. Use of cold water for drinking purpose as well as for bath is
prohibited.
Sarma (Winter
season)
During winter, environment is
cold and moist, due to that more phlegmatic disorders are prevailed. It is
advisable to be dressed up properly in winter. Intake of Haleem (pulses with
meat) and meat is advocated for the production of more blood. It is preferable
to do strenuous exercise, Hammam, etc to excrete out the dissipate material
through skin pores.
2.
Food
and Drink (Makool wa Mashroob)
Food and drink is
second important factor in maintaining life and health by replacing the body’s
used-up and broken-down components. Food and drink influence in regard to
quality by their heating and cooling make the body hot in virtue of their own
heat, cold in virtue of their own coldness respectively, and yet these
qualities do not become an integral part of the body.
Keeping in view the importance of
food and drink, Unani Scholars have laid down certain principles on use of diet
both for promotion of health and treatment of disease. A healthy man should use
mainly the food of the temperament similar to his own temperament. However, if he is threatened with a
pathological shift in his temperament, he should use food of the opposite temperament. Thus, in summer, when increasing hotness of air
and environment, threatens to unbalance his normal temperament. Therefore, cold
food like pomegranate preparations and other cooling affect should be used by a
man of hot temperament.
Jalinoos (Galen), a renowned
physician suggested that milk of mother is the best Ghiza for infants, which
should be given to the baby before the teething process after that the light
and liquid diet should be given. Galen has said that soft food should taken first
and then hard food. As per Razi’s purview anyone wants to be healthy should consume
same quality food as per his own Mizaj in small quantity. It is also advised
not to take heavy fatty diets like red meats and Ghizae-Barid (cold diets) like
curd and cold beverages etc together. Obese people should consume excessive amount
of vegetables and fruits.
Water is one of the elements
which has the special property of entering into the composition of food and
drink, not that it is itself nutriment, but rather that it enables the aliment
to penetrate into the human body and permeate and purify its substance. It is
helpful in carrying of nutrients to the unit of the body. Water is really a
"substance" which helps to attenuate the disease matter, so that it
can flow easily into the blood-vessels and out of the excretory channels.
Nutrition cannot be affected without water and which is the handmaid of
nutrition.
Unani scholars combine drinks
with food because, despite lacking nutrition, water is crucial since food
becomes effective only in solution. So,
it provides extensive guidelines for the type of water and the appropriate time
for drinking it. For instance, in order
to ensure proper digestion, people of hot temperament should drink water during
meals, but cold temperament persons should use water only after the digestion
has fully set in. Water which is salty causes dryness and weakness in the body.
Unani physicians have recommended
different admixture of water for various purposes such as alum water for the patient
of bleeding piles, leucorrhoea, haemoptysis etc. Likewise copper
containing water beneficial
in Istisqa (ascites) and
can use it for the betterment of functions of liver in
case of Sue
Kabid (liver disorders). Rain water is good enough for the nervous
disorders.
Unani physicians also have warned
that excessive use of cold water intake
creates the problems
of nervous and respiratory systems
particularly in childhood
period and older age.
Avicenna advocated that
intake of warm water also causes improper digestion,
vomiting and occasionally leading
cause for ascites and as well as weakness.
3.
Bodily
Movement and Repose
(Harakat wa Sukoone Badania)
The Unani system of medicine gives
great importance to both appropriate movement and rest for maintaining health
and for curing disease. Greek-Arab
physicians projected an
ideas regarding physical activity
which is essential
for the activation of innate energy and to excrete the waste products of
the body. Rest is necessary to save the body
temperature, body fluids and to retain nutrients. Unani system of medicine offers a wide
concept of exercise of all organs. It
classifies movement into two types: high frequency and intensity with short
duration, which increases heat and low frequency and intensity with long
duration, which increases metabolism. It
recommends moderate exercise, which produces moderate sweating, but discourages
intense exercise, which produces profuse sweating. It even considers massage (Dalak),
Turkish bath (Hammam), slow horse riding and swinging as moderate exercise, and
prescribes the latter for paralytic persons. Boat ride is prescribed for
treating chronic diseases like leprosy and dropsy.
Excess of
both causes coldness of the body
because motion leads
to decrease the innate
fluids as well
as excess of
rest increases the body
fluid which decreases
the innate energy. In the same
manner, certain diseases can be cured by giving the body rest, while some are
cured by movement of affected organs. Warm (inflammation) and Kasr (fractures) need
complete rest to get properly healed. On
the other hand, paralysis require particular amount of movement. Physical
activities are needed for the growth
of muscles and
ensure nutrition, increased blood supply
and proper functioning
of excretory system.
4.
Psychic
movement and Repose (Harakat wa Sukun Nafsani)
The Unani scholars have mentioned
the role of psychic states in maintaining health and treating disease. They have attributed many illnesses with
psychic factors. Psychic movements increase heat while repose increases cold.
So, excessive psychological factors or excessive repose of psychic movements
causes hot and cold pathologies.
Psychological factors such as happiness, sorrow, fear, anger, etc. have significant effect in producing certain
illnesses like tuberculosis, hysteria, fever, etc. and mental disorders are
caused, in most cases, by emotional strain and maladjustment. Therefore, there
is a branch in Unani medicine known as “Ilaj Nafsania”
(psychological treatment)
which deals with
the above mentioned factors. As such, most of the time
treatment is done by using non pharmacological regimens such as counseling,
music, changing the environment, beautiful scenery etc.
For instance, extreme anger moves
the pneuma to the exterior, making both pneuma and the body abnormally hot,
which may give rise to hot mental and bodily maladies e.g. mania and epistaxis,
respectively. On the contrary, extreme
fear makes the pneuma flee to the interior and the resultant cold can give rise
to loss of consciousness and bradycardia.
Thus, these pathologies can be
managed both by altering the mental states and by administering cold or hot
drugs along with psychological methods.
This is the basis of the unique and successful psychopharmacological
management of psychiatric and psychosomatic diseases in Unani medicine. By
being happy a person can prevents social problems, cardiac problems and gastric
problems etc.
5.
Sleep
and Wakefulness (Naum wa Yaqzah)
The effect of sleep is very
similar to that produced by repose; that of wakefulness or vigilance is very
similar to that produced by exercise. Sleep strengthens all natural functions
(digestion of the food and the elaboration of the digestive products into good
blood), it preserves the vital heat and vital heat will accumulate in the
interior parts, sleep removes all types of lassitude and it restrains strong
evacuations.
Lack of sleep causes dissipation
of energies, mental weakness and digestive disturbances. Proper
sleep and wakefulness
are necessary because it is main
instrument to maintain the
digestion and activeness
of the body.
Excess of sleep causes
coldness, weakness, laziness
in the body, headache, etc
and may develop
the Balgham diseases, likewise excess of wakefulness causes
dryness in the
body and indigestion. The lack of sleep is said to cause indulgence
of energy, mental weakness, digestive disturbances and leads to acute diseases.
Wakefulness is also necessary to
improve the hunger. Excess of
wakefulness produces dryness in the body, indigestion, improper function of
brain, alteration of brain temperament.
Normal wakefulness improves the innate energy, sensory and motor
functions.
6.
Elimination
and Retention (Istifragh wa Ihtibas)
Istifragh means elimination of
matter (Mawad) from the body. Waste products produced in the body during
metabolic changes should be eliminated as important as continuous nutrient
supply for life and normal physiological function. Gaseous waste substances are
eliminated through the lungs; solid wastes are through intestines as
nitrogenous end products and excess water through kidneys and skin.
Absorption and retention of
substances into the body tissues is known as retention (Ihtibas). The main
excretory organs responsible for excretion of waste by products are kidney,
lungs, skin, intestine, and uterus, which excrete these products in the form of
urine (Baul) sweat (Paseena), stool (Baraz), menses (Haiz) and during the
process of respiration, these waste products are very harmful for the body and
their accumulation results in various disease. For this reason their excretion
is essential for the maintenance of health and life.
Proper and
normal functioning of the
excretory processes must
be ensured in
order to maintain perfect
health. Any disturbance
in the normal excretory
balances, whether it
be excess, diminution or
blockage, leads to
disease.
Several types of Istifragh are mentioned
in Unani such as sweating,
urination, vomiting, purgation,
normal defecation, venesection, cupping, leeching, sneezing, coughing, enema,
epistaxis, breast feeding,
coitus, eye secretions etc. Elimination
and retention should be in the equilibrium. If elimination is in excess several
diseases can occur and it will make the body weak and lethargy. It will lead to
coldness and dryness in the body and makes the innate energy to become weak.
Useful substances should be retained
in the body. For example proteins should be retained, if not proteinuria will occur.
Likewise food that we consumed should be retained for some times in order to get
the maximum benefits of the food.
Therefore, evacuation is needed
for removal of waste products which may cause obstructions or embolism and
toxicity. Retention of nutrients is
needed not only for full digestion and metabolism but also to maintain reserves
of nutrients and essential substances.
Above mentioned six essentials of
life are very much important for the healthy life, equilibrium and balance in
Asbabe Sitta Zarooriyah is necessary for the preservation of health. These
factors have direct relationship with Ilaj bit Tadbeer. Therefore, if there is
any dilemma in the Asbabe Sitta Zarooriyah, disease can be prevented by
adopting correct Ilaj bit Tadbeer regimen.
When prevention could not be
adopted or adopted preventive measures are failed, the state of disease
occurs. Hence, treatment is necessary to
regain the healthy state. It is mainly based upon Hetero-therapy (Ilaj bi’l-zid).
Disease, which amounts to the emergence of an abnormal temperament, is treated
by applying pharmacological and non pharmacological factors with opposite temperament. Since, environmental factors, diet and
psychological status etc., either themselves possess a temperament or affect
the temperament, the Unani System of Medicine uses these non-pharmacological factors
very frequently and extensively to treat illnesses.
