Regimenal Therapy a Drugless Regimen for
Well Being of a Person in USM and its Important
Place in the Mainstream Treatment of USM
Sameena Firdaus1* and Nida sultana2
1 PG Scholar, Department of Kulliyat, AKTC, AMU, Aligarh, India
2Senior Research Fellow (Unani), RRIUM, Aligarh, India
Submission: August 07, 2018; Published: September 17, 2018
*Corresponding author: Sameena Firdaus, Pg scholar department of kulliyat, Aligarh Muslim University, India;
How to cite this article: Sameena F, Nida S. Regimenal Therapy a Drugless Regimen for Well Being of a Person in USM and its Important Place in the
Mainstream Treatment of USM. J Complement Med Alt Healthcare. 2018; 8(1): 555727. DOI: 10.19080/JCMAH.2018.08.555727
Literally “Tadbeer” is an Arabic word which means “regimen” or “systemic plan” whereas “Ilaj” means “therapy” or “treatment”. Thus, “Ilaj-bil-tadbeer” means treatment through special regimen. It is a method, through which maintenance of general health and care of the sick person are attained through modulation or modification in Asbaab-e- sitta zarooriya (six essential factors for life). These regimes are actually meant for the Istifraagh-e-akhlaat-e-radiya (evacuation of morbid humours) from the body. These morbid humours are true culprits which are basically responsible for the onset of disease. As soon as these morbid humours are removed from the body by applying some regimens, normal health gets restored. Ibn-e- Sina, an eminent Unani scholar wrote in his famous book “Canon of Medicine”, that there are almost 36 regimens. Some examples of these regimens include, Fasd (Venesection), Hijaamat (Cupping), Idraar-e-baul (Diauresis), Ta’areeq (Sweating), Ishaal (Purgation), Hamam (Turkish bath), Dalak (Massage), Kai (Cauterization), Qai (Emesis), Riyaazat (Exercise), Ta’leeq (Leeching), Huqna (Enema), Inkebaab (Inhalation), Tanfees (Expectoration), Eilam (Counter Irritation), and Aabzan (Hydration Therapy). The present communication is an attempt to highlight regimenal therapy and other psychotherapies in USM.
Keywords: Ilaj-bil-tadbeer; Asbab e sitta zarooriya; Venesection; Cupping
Regimenal therapy is such core method of treatment through which the morbid matter is eliminated or its excessive production is checked or its spread is arrested and resolved by certain special techniques and thereby restoring humoral equilibrium. There are various forms of such therapy with details of its applications. There are various forms of regimenal therapy which is dealt by al qanoon which details about its principals, objectives, indications, and contraindications method of applications with its adverse effects etc. some of them are purging, emesis, venesection, cupping, turkish bath, massage, exercises, leeching, diuresis, diaphoresis etc. .
Among definitions still used, probably the oldest is that health is the absence of diseases. According to WHO health is a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity. It can be construed as a feeling of wholeness and a happy frame of mind .
Unani medicine strives to find the best possible ways by which a person can lead a healthy life with the least or zero sickness. Unani scholars believe that diseases can be kept at bay by using clean and fresh water, breathing clean air and consuming fresh food. Likewise, a balance should be maintained between the mind and the body so that the metabolic process can take place easily and the body waste evacuated. Unani medicine believes in promotion of health, prevention of diseases and cure through regimental and diet therapies. The best possible ways of health promotion in this holistic system of medicine are improvement of Tabiyat (immuity) by immunomodulators, restoration of balanced temperament, maintenance of balance in the quality and quantity of humours, moderation of Asbabe Sitta Zarooriya (six essential factors for life) and adoption of maddi wa gair maddi tadabeer (i.e. regimenal therapy and counselling) Munzij wa Mushil (concoctive and purgative) therapy and Ilaj bil ghiza (Dieto-therapy) .
As ṭabῑat performs its own role in different stages of disease.
The role of physician is to adopts such regimens which favour
the action of ṭabῑ‘ at as ṭabῑat performs its own role in different
stages of disease. The role of physician is to adopts such regimens
which favour the action of ṭabῑ‘at. If ṭabῑ‘at is overwhelmed then
the disease process is evolved. Tabiyat is the best physician,
and maintains the equilibrium of four body humours. For the
maintenance of health, the quantity and quality of these humours
should be as per the natural chemical composition of the body.
Broadly speaking Tabiyat is considered as the real healer of the
body and the role of the Tabeeb (physician) is to aid this Tabiyat.
The physician assists ṭabῑ‘at by adopting appropriate treatment
modalities which are of three types:
a) Regimen and diet
b) Use of drugs
c) Manual operation
The word regimens stand for the supervision of the asbab-esittah
Zarooriyah, maddi and gair maddi tadabeer (six essential
factors, regimenal therapy and counseling). Therefore, the
regimenal management includes the modification in six essential
factors and implication of counselling and psychotherapies
because to favour of ṭabῑ‘at, so that health is maintained and
abnormalities prevented from getting arise .
Gair maddi tadabeer is a type of talking therapy that allows a
person to talk about their problems and feelings in a confidential
and dependable environment. A counsellor is trained to listen
with empathy. They can help you deal with any negative thoughts
and feelings you have. Sometimes the term “counselling” is used
to refer to talking therapies in general, but counselling is also a
type of therapy in its own right. Other psychological therapies
include psychotherapy, cognitive behavioural therapy (CBT),
and relationship therapy, which could be between members
of a family, a couple, or work colleagues. These tadabeer or
strategies aims to help you deal with and overcome issues that
are causing emotional pain or making you feel uncomfortable.
These six essential factors either directly or indirectly influences
In Unani Medicine, The Concept of Elimination (Istifragh)
is described in the six essential pre-requisites or governing
factors, referred to in Unani terminology as Asbab-e-Sitta
Zarooriyah (six essential factors) Purgation (Is-hal) is one of
the methods of Elimination adopted when treating various
ailments. It is considered a safe method of regimenal therapy,
used to eliminate toxic and other unwanted matter through the
intestines. Purgation may be conducted in two ways, Laxation
(Taleeyeen) and Purgation (Mus-hil) Laxation is a mild purgative
whereby matter from the intestines is passed. Purgation refers
to the elimination of matter from the intestines together with
unwanted matter from other parts of the body such as phlegm
from the lungs, black bile (melancholic humour) from the spleen,
the watery part from blood or other conditions where there is an
excess of unwanted accumulation that may need to be purged.
Purgation increases the frequency of stool, acting in several
ways, which include increasing the watery part of the intestines,
increasing peristaltic movement or by lubrication of the
intestines. Due to the action of this type of purgation whereby
the passing of humours such as phlegm (phlegmatic humour),
yellow (bilious humor) and bile black bile is also an occurrence,
it is also referred to as phlegm purgative, yellow bile purgative
or black bile purgative as the case may be. There are a number
of drugs that may be used as purgatives. These are Single as well
as Compound drugs. In this paper, these drugs will be discussed
according to the particular system in which they are used .
Peritonitis, indigestion, peoples who are not addicted to
purgation, in pregnant womens before 4 months and after 7
months, hot dry and cold dry temperament peoples, duing
the days of menstruation, in children’s and older peoples,
appendicitis, hemorrhoids, low B.P, T.B, too much hot and too
much cold, intestinal sore, chronic constipation .
Purgation is prohibited in too much hot, cold and in the days
of epidemicity. The best seasons for purgation are weather Rabi
then Kharif. It should be done early in the morning in summer
and rabi and 2 hours after sunrising in winter and kharif .
a) Before 2 days and 3 days later on of purgation one must
avoid doing excessive psychological work, tiredness, and
sexual activity and must feed with light and easily digestible
diet like mush of moong (moong daal khichdi)
b) In peoples who have weak stomach must feed with light
and soft diet like Ma-ush-shaeer so that stomach could be
saved from the accumulation of yellow bile.
c) The patient must avoid from drinking water within 4
hours of taking mushil or purgation
d) In case of intestinal colic do enema prior to purgation
a) In those peoples who are having cold temperament and
if there is no dominency of phlegm use concoction of haloon
with olive oil
b) In peoples having hot temperament use Luab aspghol,
cold water mix with roghane banafsha and nabat safed
c) Moderate temperament persons must feed with tukhme-
d) If there are chances of intestinal sore use gile armani,
aab anar, tukhm e bartang with tukhm e rehan
e) Patients who underwent purging should go for
hammam after two days of having mushil
Venesection (Phlebotomy) is the act of drawing or removing
blood from the circulatory system through a cut (incision)
or puncture for the purpose of analysis, blood donations or
treatment for blood disorders .
Currently, therapeutic phlebotomy is approved for three
main indications: haemochromatosis, polycythaemia vera and
porphyria cutaneatarda. It has also been used as a treatment
alternative for many other diseases in various countries,
especially in Chinese medicine, although these indications are
not approved by western medicine. Relative polycythaemia is
characterized by a decrease in plasma volume which causes
an apparent increase in the red blood cell mass. Any condition
causing fluid loss, such as any cause of dehydration and severe burns, will result in relative polycythaemia. Therapeutic
phlebotomy is not indicated for these patient .
Chronic constipation, intestinal colic, during menstruation
and pregnency, waek and anemic persons, in hot temperament,
obese persons, too much hot and too much cold, in childrens
younger than 14 years and in olders more than 60 years, after
meal and sex, weak stomach, weak liver, chronic fever etc .
Patient may feel tired after giving out blood, with some local
soreness or bruising, but serious side effects are very uncommon.
Some people faint after giving out blood, if patient feel dizzy or
unwell in the 24 hours of venesection just tell your medical team
so that they manages to treat the patient in an appropriate way
by giving some fluid (salt water) to replace the volume lost due
to venesaction. This is more likely to happen if patient is taking
medicines for blood pressure and if patient have not taken meal
before attending the hospital .
a) The procedure is safe and without side effects (in most
b) Immediately after the procedure you may feel dizzy.
This can be minimised by resting and drinking fluids.
c) You may feel a little lethargic for a couple of days.
d) You can resume all your normal activities after the
e) Keep hydrated and drink two litres of fluid daily for 48
to 72 hours following your procedure.
f) The frequency of the venesection treatments is different
for everyone and is performed according to one’s condition.
At first you may require up to weekly venesections. When
your blood levels are under control you may only require the
venesection every six to twelve weeks .
Cupping therapy is an ancient form of alternative medicine in
which a therapist puts special cups on your skin for a few minutes
to create suction. People get it for many purposes, including to
make help with pain, inflammation, blood flow, relaxation and
well-being, and as a type of deep tissue massages .
There are different methods of cupping, including:
During both types of cupping, your therapist will put a
flammable substance such as alcohol, herbs, or paper in a cup
and set it on fire. As the fire goes out, he puts the cup upside down
on your skin. as the air inside the cup cools, it creates a vacuum.
This causes your skin to rise and redden as your blood vessels
expand. The cup is generally left in place for up to 3 minutes. wet
cupping creates a mild suction by leaving a cup in place for about 3 minutes. The therapist then removes the cup and uses a small
scalpel to make light, tiny cuts on your skin. Next, he or she does
a second suction to draw out a small quantity of blood .
There haven’t been many scientific studies on cupping.
One report, published in 2015 in the Journal of Traditional and
Complementary Medicine, notes that it could help with acne,
herpes zoster, and pain management .
a) To clean up the waste matters inside the skin, in
menorhhagia and epistaxis, in malaria, hepatic and liver
diseases, splenic ailments, hemorrhoids, itching and scabies,
Types- 1- cupping with condition (hijamat bil shurt) 2-
cupping without condition (hijamat bila shurt) .
Tareeq is a kind of evacuation of matters with the help of
which waste materials are excreted through skin, blood and
other organs of the body. It also aids in lowering the temperature
of the body as in fever .
Diuresis is a type of regimenal therapy the purpose of which
is to clean the body from toxic or morbid matters. The drugs
which are used for dieuresis known as diuretics. This method is
useful in liver and kidney diseases.
Leeching is a kind of treatment by which waste or toxic or
vitiated material of the body are expelled out of the body via
blood to clean the body from toxicities. Leeching is beneficial in
some diseases like psoriasis, scrofula, zaharbaad, hemorrhoids,
scabies, cancer, chronic abscess etc. Recently, extensive
researches on leech saliva unveiled the presence of a variety of
bioactive peptides and proteins involving antithrombin (hirudin,
bufrudin), antiplatelet (calin, saratin), factor Xa inhibitors
(lefaxin), antibacterial (theromacin, theromyzin) and others.
Consequently, leech has made a comeback as a new remedy
for many chronic and life-threatening abnormalities, such as
cardiovascular problems, cancer, metastasis, and infectious
diseases. In the 20th century, leech therapy has established
itself in plastic and microsurgery as a protective tool against
venous congestion . In addition, leech practice was also
documented in Islamic literature. For instance, Avicenna (980-
1037 AD) delineated in his book “Canon of Medicine” that leech
can suck blood from deep veins which cannot be reached by the
conventional wet cupping [10,11] and he recommended leeching
for skin diseases . In 12th century, Abd-el-latif al-Baghdadi
mentioned in his texts the beneficial usage of leech application
after surgical operations . Thereafter, Ibn-e-Maseehi (1233-
1286 AD) in his book “Umda Fi Jarahat” differentiated the medical
leeches from the nonmedical (poisonous) ones according to their
shape and colour .
Riyazat is any bodily activity that enhances or maintains
physical fitness and overall health and wellbeing’s. It is
performed for various reasons, including strengthening muscles
and the cardiovascular system, honing athletic skills, weight loss
or maintenance, and merely enjoyment. Frequent and regular
physical exercise boosts the immune system and helps to prevent
the “disease of affluence” such as in cardiovascular disease, Type
2 diabetes, and obesity. It may also help to prevent depression,
help to promote or maintain positive self-esteem, and improve
mental health generally. In Unani system of medicine exercise is
one of the sixteen methods of treatment of regimental therapy
and is used as a voluntary movement with the purpose of tanqiya
e mawad (evacuation of waste material), for purification of the
body in an individual. It maintains good health and prevents or
cures diseases as well.
a) Riyazate Haqeeqi/Kulli /Complete exercise e.g. horse
b) Riyazate Juziya /Partial exercise e.g. stone lifting
Partial exercise is a part of real exercise which is related to
the exercise of specific organ and specific Quwa (faculties) like
reading of small alphabets by the eyes, weeping is the exercise of
children, likewise angriness is the exercise of Barid Mizaj (cold
Exercise should be according to age, temperament,
occupation, body conditions, time etc. Best time for exercise is
during moderate condition of body. Refrain from strong exercise
for diseased organs. Before exercise, intestine and urinary
bladder should be empty. Dalak e istedad (Preparatory Massage
before Starting Exercise) should be done before exercise and
Dalak e isterdad (Relaxing massage) after exercise It should be
done after complete digestion of food During heavy exercise
there should be some Lateef (light diet) in stomach especially
in summer season, and in winter there should be some Ghaleez
(heavy diet) in stomach. One should take rest during heavy
exercise. Exercise should be done in morning hours. On empty
and full stomach, exercise should be avoided. If there is excess
Hararat (hot), Yubusat (dry) and Burudat (cold) in the body,
exercise should not be done.
Several regimens have been used by Unani physicians since
ancient time, among which Dalak (massage) is the most common
and widely practiced regimen that is used for restorative,
preventive as well as for therapeutic purposes. According to
Hippocrates (460 BC-370 BC), the father of medicine, massage,
balanced diet, exercise, rest and fresh air are essential to maintain
health of a person. According to IbneRushd, massage is a type of
exercise used for removal of toxins or waste metabolites from
the body. In Unani medicine, Dalak is one of the very important
regimes among the procedures of IlajBil-Tadbeer (Regimental
therapy) for neurological and musculoskeletal disorders. A
number of Unani physicians recommended Dalak as preventive
as well as curative measure.
Dalak is one of the very important regimes among
the procedures of IlajBil Tadbeer for neurological and
musculoskeletal disorders. In Unani medicine, Dalak is
considered as the method where pressure or friction, kneading,
rubbing, tapping, pounding, vibrating or stimulating against the
external soft parts of the body with hands or other objects like
rough cloth with or without oils, creams, lotions, ointments or
other similar preparations. According to IbneRushd, massage is
a type of exercise and used for the removal of waste metabolites of digestion (HazmeUzwi/hazmeakheer). Number of Unani
physicians advocates the use of Dalak for the preventive as well
as the curative purpose in various diseases. They recommended
several varieties of Dalak e.g. Dalak e sulb (hard massage), Dalak
e layyin (soft massage), Dalak kaseer (prolonged massage), Dalak
moatadil (moderate massage) etc. 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 (Dalak
khashin) enhances vasodilatation of the particular organ etc.
Dalak (Massage) is based on holistic approach of two
fundamental concepts i.e. Tanqiya e Mawad (Evacuation of
morbid humour) and Imala e Mawad (Diversion of humour).
Tanqiya e Mawad means the resolution and excretion of morbid
humors and excess fluids from the body, thereby maintaining the
homeostasis in the quality and quantity of four bodily humors,
which is actually responsible for the maintenance of normal
health. Imala e Mawad refers to the diversion of the morbid fluids
from the site of affected organ to the site where from it is easily
expelled out from the body tissues. It also induces sedation,
analgesia and increases blood circulation.
Ibne Sina and Ibne Rushd have classified Dalak as Dalak
Baseet (simple) and Dalak Murakkab (compound) and they
again divided the Dalak Baseet on the basis of kafiyat (quality)
and kammiyat (quantity) into 6 types.
a) Dalak Kaseer (Prolonged Massage)-This type of
massage is done for longer duration.
b) Dalak Qaleel (Short Massage)-This type of massage is
done for shorter duration.
c) Dalak Moatadil (Moderate Massage)-The duration of
this massage is in between Kaseer and Qaleel.
d) Dalak Murakkab (Compound Massage)-DalakMurakkab
is the combination of different types of Dalak and it is divided
in to nine types
e) Dalak Sulb Kaseer/ hard and prolonged
f) Dalak Layyan Kaseer/soft and prolonged
g) Dalak Moatadil Kaseer/moderate and prolonged
h) Dalak Sulb Qaleel/hard and short
i) Dalak Layyan Qaleel/soft and short
j) Dalak Moatadil Qaleel/moderate and short
k) Dalak Sulb Moatadil/hard and moderate
l) Dalak Layyan Moatadil/soft and moderate
m) Dalak Moatadil Moatadil/moderate to moderate
Apart from the above varieties of massage there are also few
other types of massage like13:
Dalak khashin (rough massage): This type of massage is
done with a rough piece of cloth. It draws the blood rapidly to
Dalak amlas (gentle massage): This type of massage is
carried out softly with hands or soft piece of cloth. It increases
blood flow in the treated area.
Dalak istedad (preparatory massage before starting
exercise): (Qawi, zaeef, moatadil, taweel, qaseer, and moatadil) it
is a special type of massage which is done gently in the beginning
and then vigorously towards the end. It is done before exercise in
order to prepare the body for undergoing different movements
Dalak isterdad (relaxing massage): It is also known as
Dalak Musakk in. It is done towards the end of exercise and
should be carried out gently and in moderation, preferably with
Purpose of dalak: After describing the various kinds of Dalak, Ibne Sina has also mentioned the purpose of different.
a) To make the body firm, if it is loose and flabby; to soften
it, if the body is hard and vice versa;
b) To eliminate the rutoobat (fluid) from the body that is
left after purgation;
c) To develops the body as well as to improve and to
maintain blood circulation of the particular organ;
d) For dissolution of riyah (morbid gases) from the body;
e) To remove the barid mizaj (cold temperament);
f) For imala (to divert the matter from one organ to
another) Massage is done by using oil with an aim to retain
the rutoobat (moisture of the body);
a) Zarnigar et al. conducted a study entitled, “role of Dalak
and Riyazat in the rehabilitation of patients with post stroke
hemiplegia”, the results of Dalak showed significant effect in
improvement of Fugl Meyer upper limb score.
b) A study was carried out by Haji Amanullah et al. “to
evaluate the efficacy of massage with Roghan Seer in motor
recovery in hemiplegia secondary to ischemic stroke”. They
reported that the massage with test drug has significant
improvement in voluntary movements and basic mobility of
the lower limb.
c) Lone A.H. et al. in a case study have evaluated the efficacy
of massage with different oils in various musculoskeletal and
nervous disorders; they concluded that massage may be used
effectively in various disorders specially musculoskeletal and
nervous disorders where medical treatment is of less value.
d) A study was conducted on ‘Effect of Dalak Layyan
kaseer with Roghane Shibbat in slowing the progress of
WajaulUnuq (cervical pain)’ in NIUM Hospital. The regimen
was found highly significant both statistically and clinically
in relieving acute and chronic cervical pain.
So to conclude, the glimpses taken from the literature and
classics whatever reviewed reiterates the fact that Improvement
of immunity (tabiyat) by immunomodulators, moderation of
6 essential factors of life and implication of right strategy i.e.
regimental therapy and psychotherapy (maddi aur gair maddi
tadabeer) and administration of preliminary concoctives, then
purgatives followed by drug therapy with all the given specifics
taken in to consideration promotes positive health as well as
prevents the diseases to get develop although there is a problem
of lack of uniform standards for the present generation despite
of being a fundamental therapeutatic methodology.
It therefore apparently seems essential to standardize it
and to develop certain scientific parameters for evaluation of
the efficacy of this regimental and psychotherapy so that the
benefits may reach to the larger sections of society. This therapy
must also be evaluated for prophylactic use so that some of the
impending attacks/bouts of diseases might be averted. It is also
concluded that ṭabῑat plays an important role in preservation and
restoration of health. The disease is the consequence of defeat
of ṭabῑat because when ṭabῑat is strong, it can easily combat the
causative matter and maintain normalcy and it has direct or
indirect relationship with the six essential pre-requisites and
regimental therapy in the restoration of health.