Waram-e- Kabid (Hepatitis)
Hepatitis (Waram-e- kabid) is a disease condition characterized by inflammation or derailment of normal temperament of liver which can lead to increase in size of liver (inflammation of liver) and other associated symptoms. In Unani medicine hepatitis has been treated effectively by its holistic approach.
Hepatitis (Waram-e- kabid) is caused by a group of viruses known as Hepatitis viruses. It is considered as a serious health problem that challenges not only healthcare professionals but also the pharmaceutical industry and drug regulatory agencies.
Liver (Jigar/ Kabid) is a vital organ. It plays a major role in metabolism and excretion of xenobiotics from the body. It is the largest internal organ in the body. It plays a crucial role in many essential physiologic processes and is vulnerable to a wide variety of toxic, microbial, metabolic, circulatory and neoplastic insults. Because it is highly vascular, 25% of total circulation is within portal area. It provides maximum amount of chemical energy (Hararat-e- ghareezia) as there are large number of mitochondria in liver cells.
Liver (Jigar) has a wide range of functions, including protein synthesis, detoxification and production of biochemical necessary for digestion and synthesis as well as breakdown of small and complex molecules, many of which are necessary for normal vital functions.
Hepatitis (waram-e- kabid/ waram-e- jigar) is most commonly caused by viral infections (Waram-e- kabid vairoosi). Apart from viral infections the liver can also become inflamed as a result of intake of contaminated food and water, excessive consumption of alcohol, faecal matter, infected blood, sexual intercourse, exposure to certain toxic chemicals, accumulation of fat in the liver and metabolic conditions such as Wilson's disease, allergic reactions or overdoses of some prescribed drugs, liver cell injury caused by various toxic chemicals and microbes is well-studied. Liver injury induced by toxins is more common nowadays.
Uses of herbal drugs in the treatment of liver diseases has a long tradition, especially in Unani system of medicine. This system is replete with references both on single and compound formulations in the management of hepatitis (waram-e- kabid/ waram-e- jigar). Various extracts of these drugs were further proved to be hepato-tonic, anti-inflammatory, anti-pyretic and hepato-protective in vitro as well as in vivo studies like Bhui Amla (Phyllanthus fraternus linn.), Tukhm-e- kasni (Cichorium intybus Linn.), Revand chini (Rheum emodi Wall), Sumbuluttib (Nardostachys jatamansi DC), Mako (Solanum nigrum Linn) etc.
Clinical studies demonstrated the efficacy and safety of a number of Unani herbal products in the treatment of liver diseases (Amraaz-e- Jigar). Amongst the most important and proven cases of using these herbs is utilizing them as hepato-protective as well as hepato-tonic agents. Studies revealed the value and worthiness of investigating Latin, Greek and other medical scripts in order to get familiar with herbs and choose them for pharmacological studies.
The 21st century has seen a paradigm shift towards therapeutic evaluation of herbal based products in liver disease models by carefully synergizing the strengths of the traditional systems of medicine with that of the modern concept of evidence based medicinal evaluation, standardization and randomized placebo controlled clinical trials to support clinical efficacy.
In spite of the tremendous advancements made in modern therapeutics, no significant and safe hepato-protective agents are available in them. In Unani medicine, a large number of plants and formulations have been proved to have hepato-protective activity. Therefore, due importance has been given globally to develop plant-based hepato-protective drugs effective against a variety of liver disorders.
Hepatitis (Waram-e- Kabid/ Waram-e- Jigar)- Unani Approach
In Unani system of medicine hepatitis is known as “Warm-e- Kabid” or “Warm-e- Jigar”. Almost all Unani physicians described about hepatitis in their classical texts, its etiology, signs and symptoms, prevention and treatment.
During hepatitis, there occurs excess accumulation of blood in the liver. After that blood oozes out from vessels due to which liver become inflamed, soft and its surface becomes full of rashes (An area of redness and spots).
Ancient Unani scholars were well aware about the significance of liver and considered it to be one of the dynamic organs responsible for the metabolic functions chiefly the production of Akhlat (humors). The Mizaj (temperament) of liver is hot and moist; due to erratic dietary habits, excessive consumption of fatty foods, drugs, its mizaj is altered to barid (cold) or haar (hot), which is antagonistic to the liver, thereby allowing the accretion of morbid matter in the form of fat (Tashahham ul kabid) which affects the normal functioning of liver resulting in Su-e- mizaj baarid or haar.
Types of Hepatitis (Waram-e- Kabid/ Waram-e- Jigar)
According to dominating humours (Akhlat), great and eminent Unani scholars such as Razi, Majoosi, Sheikh, Akbar Arzani, Ibn Hubal, Azam Khan have classified it as:
While according to Modern medicine it has been classified on the basis of causative agents such as viral, bacterial, protozoal etc.
Infective hepatitis are classified as viral hepatitis and bacterial hepatitis. In conventional system viral infections of the liver are classified as hepatitis A, B, C, D and E viruses. Hepatitis A is a milder version of the disease, whereas hepatitis D is more severe.
According to modern medicine Hepatitis is of two types
Some forms of hepatitis are preventable. Symptoms may not occur until liver damage occurs. Prognosis and treatment of viral hepatitis varies and depends upon causative virus.
Fundamentals/ Principles of management (Usool-e- Ilaaj)
Management of Hepatitis (Waram-e- kabid/ waram-e- jigar)
The available synthetic drugs to treat liver disorders in this condition also cause further damage to the liver. Hence, Unani Herbal drugs have become increasingly popular and their use is wide-spread. Unani medicines have been used in the treatment of liver diseases for a long time and the maintenance of a healthy liver is essential for the overall wellbeing of an individual.
These drugs are well-proven in the management of all types of hepatitis, treating different causes of viral or non-viral hepatitis since centuries. Unani herbal treatment has a very high success rate in the treatment. It has been scientifically proven that these Unani drugs are highly beneficial in the management of Acute Viral Hepatitis, infective Hepatitis, Toxic/metabolic Liver Diseases, Chronic-persistent Hepatitis and Chronic aggressive Hepatitis, Cirrhosis of the Liver, Jaundice and Fatty Degeneration of the Liver etc.
In Unani system of medicine, plants as a whole or their parts are extensively used for the cure of liver derangements. The physicians of the Unani system of Medicine have been treating various forms of hepatitis since centuries. The entity “Warm-e- Jigar” in Unani literature, mimic CHB and associated constellation of symptoms. A large number of single and compound drug preparation have been documented in the treatment of hepatitis (Waram-e- jigar).
Few Unani Formulations for Hepatitis (waram-e- kabid/ waram-e- jigar)
The drugs utilized in the treatment of hepatitis (waram-e- kabid/ waram-e- jigar) found to be very effective primarily involves a decoction constituted from six plants namely, shahatara (Fumaria officinalis), sarphokah (Tephrosia purpurea), chiraita (Swertia chirata), gul-e- mundi (Sphaeranthus indicus) and sandal surkh (Pterocarpussantalinus).
Another formulation used in the form of hab (capsule) with ingredients which included Rubia cordifolia,Valerina officinalis, Piper cubeba and Chenopodium album, to be taken twice daily after food.
Single Drugs Recommended in Unani Medicine
Unani Herbal remedies are focused in the pharmaceutical industry to evolve a safe route for liver disorders. some hepato-protective Unani drugs such as Andrographic paniculata, Silybum marianum, Coccinia grandis, Ficus carica, Lepidium sativum, Solanum nigrum, swertia chirata, Phyllanthus emblica, Curcuma longa, Picrorhiza kurroa, Azadirachta indica, Aegle marmelos, Foeniculum vulgare, Trigonella foenum graecum, Eclipta alba, Garcinia mangostana Linn are found to be very effective. These drugs are used in Unani medicine for liver ailments and are an important ingredient of several polyherbal formulations for liver diseases specially hepatitis. Some of the single Unani drugs are as unader:
Compound Drugs Recommended in Unani Medicine