Faalij (Paralysis) is a condition involving loss of muscle function in the body/ motor power of muscle that may be accompanied by sensory loss. It is also referred to as loss of feeling. It can affect any part of the body.
Faalij is an Arabic word meaning “to halve”. In specific meaning, it indicates paralysis (Istirkha) of longitudinal half of the body either starting from the neck sparing head and face or the entire longitudinal half of the body from head to foot. Since it affects one half of the body and leaves the other half unaffected (healthy), it has been named so because of the virtue of dividing the body into two halves; one healthy and the other diseased.
As per Unani medicine classics, it is mainly caused by drifting of Phlegmatic humour (Rutoobat-e- balghami) from brain on the nerve origin resulting in loss of sensory and motor function of the affected part of body on account of related A’asaab (nerves) being afflicted with weakness.
It can also occur due to predominance of cold (Buroodat) and wetness (Rutoobat) on the affected organ. It is characterized mainly by loss of motor power of the affected part with some other symptoms varying with the causative factor.
In Unani classical literature description of paralysis (Istirkha) is same as that of word Hemiplegia (Faalij or Faalij-e- Nisfi). It is described as a disease causing loss of movement and sensation in longitudinal half of the body because the penetration of Rooh-e- Hassas wa Muharrik (Active Pneuma) into the organs may either be arrested or the Rooh (Pneuma) may penetrate but the organs may not respond due to Su-e- Mizaj (dystemperament).
It is a well-known since Greeco-Arab period and was first described by Hippocrates (Father of Medicine). Some other Unani physicians like Galen (Jalinoos) (129-200AD), Rabban Tabari (770/780-850AD), Sabit Bin Qurrah (836-903AD), Ali Ibn-e- Abbas Majoosi (930-994AD) and Ibn-ee Sina described it in detail and mentioned its pathophysiology, aetiology, clinical features and the management in their treatises.
Rabban Tabari described that, it is caused by an obstruction in any part of the brain.
Causes of Paralysis (Faalij)
Paralysis (Faalij) is mostly caused by damage in the nervous system, especially the spinal cord. Other major causes of paralysis (Faalij) are trauma with nerve injury, cerebral palsy, lyme disease, stroke, peripheral neuropathy, anaemia, poliomyelitis, prolonged exposure to cold, botulism, haemorrhage, parkinson's disease, amyotrophic lateral sclerosis (ALS), also known as motor neurone disease (MND, spina bifida, environmental factors, multiple sclerosis, and Guillain–Barré syndrome.
Temporary paralysis occurs during REM sleep (Rapid eye movement sleep), and dysregulation of this system can lead to episodes of waking paralysis.
Drugs that interfere with nerve function, such as curare, can also cause paralysis. If not treated properly, Paralysis (Faalij) may cause death.
In Unani literature causes of paralysis (Faalij) have been grouped into two principal categories.
Ismail Jurjani has mentioned 5 causes of obstruction (Sudda) leading to paralysis (Faalij)
Hakeem Akbar Arzani has added two more causes of obstruction (Sudda)
Hippocrates (Buqrat) stated that “people who often have common cold and coryza are at a risk of developing paralysis (Faalij)”.
Galen (Jalinoos) mentioned that “people having superfluous cold humours in their brain, when exposed suddenly to excessive heat or cold, develops paralysis (Faalij)”.
Ibn-e- Sina has revealed that paralysis (Faalij) is more common in severe cold of winter season and in spring. In spring it is due to haemorrhage (Jiryaan-e- khoon) and qualitative dystemperament in humours (Haijane akhlaat). He also added that it is more common in people living in southern countries, who attained 50 years of age or somewhat near it, due to excessive secretion from their heads.
Mohammad Azam khan added in this context that this disease is common in people with cold temperament especially in weak and old people and those having excessive phlegm in their body. He also described exposure to cold air and drinking enough cold water as predisposing factors for paralysis (Faalij). He further stated that people with apoplexy; epilepsy and hysteria are more susceptible to develop paralysis (Faalij).
Ancient Unani Scholars used words Istirkha and Falij synonymously to indicate paralysis irrespective of the part involved. The word Paralysis (Falij) is used for paralysis of longitudinal half of the body sparing head and face.
Hakeem Mohammad Azam Khan has classified Faalij according to its causes into following 5 types.
This type of Falij is caused by ‘excess of phlegm.’ Phlegm descends from the brain to the nerves and obstructs the routes or passages of Roohe Hassas and Muharrik leading to loss of movement and sensation. This type of Falij is characterized by sudden onset and presence of symptoms of excess of phlegm.
This type of Falij is caused by ‘excess of blood.’ It is also sudden in onset and the symptoms of excess of blood are present.
This type of Falij is caused as a result of buhran in diseases like meningitis, apoplexy, epilepsy, colic, Hysteria and acute fever. It is also sudden in onset.
The underlying cause of this type of Falij is inflammation; hot, cold, gaseous or hard inflammation; and is characterized by gradual onset and accompanying symptoms like fever and pain or palpable swelling in the nerves.
This type of paralysis (Faalij) affects many people in the same season at the same place and is believed to be caused by ‘infected air’ and often involves left side of body and is characterized by symptoms like redness in eyes, halitosis, vomiting, unconsciousness followed by delirium, incontinence of urine and faeces and sudden death within days.
Modern Classification of Paralysis (Faalij)
Usool-e- Ilaj (Principles of Treatment)
Ilaaj bil Tadbeer (Regimenal Therapy)
Ilaaj Bil Ghiza (Dietotherapy)
Ilaaj Bil Dawa (Pharmacotherapy): Unani medicines in the form of crude herbal extracts of single plant or combination of plants, with or without additional minerals have been used in alleviating and curing diseases related to problems of nervous system specially paralysis (Faalij).
Light diet comprising of Ma-ul- asl and whole grain bread during administration of concoctive drugs (Munzij advia)
Single Unani Drugs
Several herbs, root vegetables, condiments, and fruits can help in treating paralysis in the most natural way and without any side effects. The patient can be administered herbal drinks made from these ingredients or in some cases, given with food to effectively heal their paralytic symptoms.
some of which includes Annona squamosa, Calotropis procera, Coridothymus capitatus, Thunbergia laurifolia, Annona reticulate, Cassytha filiformis, Plumeria rubra, Crateva magna, Crateva religiosa, Argyreia osyrensis, Alocasia macrorrhizos, Murraya koenigii, Suregada multiflora, Satureja thymbra,Oxyceros horrid, Hyocyamus niger, Citrus aurantifolia, Citrus medica, Cissus repens, Aloe vera, Ricinus communis, Cissus hastate. Gardenia ternifolia, Tamarindus indica, Lygodium flexuosum, Cassia occidentalis, Datura metel, Phyllanthus reiculatus, Aerva persica, Calotropis procera, Cymbidium aloifolium, and Mikania hirsutissima. Other natural herbs include Blueberries, Cayenne, Goldenseal, Asparagus, Ginger Root, Sugarcane Root and Liquorice Root.
Compound Unani Drugs (Unani Advia Murakkaba)
Tahaffuz (Precaution/ Prevention)