Melancholia Research Articles

Conceptual Parallels: Microbiome Research and Ancient Medicine.

The concepts currently operating in much medical microbiome research bear a curious resemblance to an ancient tradition of Western medicine. This tradition, humoral medicine, is concerned with the four humors: yellow and black bile, phlegm, blood. Both humoral medicine and medical microbiome research use notions of imbalance and balance for broad explanations of disease and health. Both traditions also hold that the composition of humors or microbiomes determines bodily as well as mental states. Causality in each system is often conceived teleologically, meaning that humors or microbiomes "function for" the maintenance of the whole. And ultimately, each framework situates the humors or microbiomes in a multilevel interactionist theory that conceptualizes individual health within a broader environmental context. As well as critically assessing the parallels between these systems, this article sketches some explanations of how they may have arisen. The authors also evaluate the implications of these similarities for the future of medical microbiome research and suggest ways in which the field might move forward.

When DNA Mutations Interplay with Cellular Proliferation: A Narrative History of Theories of Carcinogenesis.

While cancer is one of the most documented diseases, how normal cells become cancerous is still debated. To address this question, in the first part of this review, we investigated the long succession of theories of carcinogenesis since antiquity. Initiated by Hippocrates, Aristotle, and Galen, the humoral theory interpreted cancer as an excess of acid, the black bile. The discovery of the circulation of blood by Harvey in 1628 destroyed the basis of the humoral theory but revived the spontaneous generation hypothesis which was also promoted by Aristotle. In 1859, the theory of microbes promoted by Pasteur demonstrated the irrelevance of this last theory and contributed to the emergence of the germ cancer theory, opposed to the cellular theory of cancer, in which cancer was supposed to be caused by microbes or transformed cells, respectively. These theories were progressively refined by the notions of initiation, promotion, and progression thanks to advances in mutagenesis and cellular proliferation. In the second part of this review, recent discoveries and paradigms in carcinogenesis, notably the role of the protein ATM, a major actor of the stress response involved in both mutagenesis and cellular proliferation, were discussed to better understand the current state of the art of carcinogenesis.

Redefining Classical Theory of Humours (Akhlat) with Emphasis on Khilt-e-Sauda (Black Bile) Through its Physiological Role

Background: According to Hippocrates, Akhlat is of four types, i.e., Dam (Blood), Balgham (Phlegm), Safra (Yellow Bile), and Sauda (Black Bile). The correct proportion of these fluids in the body, in terms of quality and quantity, leads to health, while their irregular distribution leads to diseases. The argument presented in this paper will encompass both Tabayi and Ghair Tabayi Sauda. Objective: However, in light of recent advances in the area of molecular biology and biochemistry of the human body, we aim to discuss Sauda as a Khilt in the context of human physiology. We propose that the chemico-biological / physiological role of the molecule rather than its structure will define its placement in Khilt-e-Sauda. Conclusion: Chemico/biological role of the molecule may change with the physiological context, and hence the placement of the molecule previously included in the Khilt-e-Sauda, may or may not remain in that categorization at that point in time in that physiological state.

Sex differences in the association between peripheral inflammation and melancholia symptoms

Melancholia represents a particular subtype of depressive symptomatology. Unlike Major Depressive Disorder (MDD), Melancholia has not been conclusively associated with peripheral inflammation, although there may be some methodological reasons confounding that finding. To overcome some of those methodological limitations, the correlation between one index of peripheral inflammation (C-Reactive Protein: CRP) and Melancholia was investigated in a community sample of 40 male and 51 female participants (aged 18–75 years) who provided a blood sample and self-report data on an established measure of Melancholia (MEL). Results indicated that females had significantly higher concentrations of CRP than males, and that there were different patterns of association between the MEL items and CRP for males and females. Although the predominant differences were for the MEL symptoms of cognitive confusion (females only) and feelings of low self-worth (males only), each sex had distinct networks of associations between CRP and the eight MEL items used here. These findings may provide some explanation of the lack of clear results regarding the CRP-Melancholia link in the previous literature, and also argue for development of clinical assessment and treatment approaches that differ for males and females.

Study of Fever Presentation in DAE Hospital

Introduction Background-Although earliest fever curves was created in 10th century by Akhawayni, fever was reported by Beeson (1961) as the presence of an endogenous pyrogen in rabbit PMNL. Today the granulocyte factor is the central role in pathogenesis of fever. Normal body temp is 98.6*f and fever is a complex physiological response involving the innate immune system and any temperature beyond the normal. Hippocrates and Kos (377BCE) attributed to pyretos and therme (fever and heat) which arose from 4 elements-blood, phlegm, black bile and yellow bile. Farenheit and Celsius were pioneers in development of thermometer and axillary temperatures were first used for fever Then Mackowiak and collegues described an oral thermometer and they gave 98.6*f as normal and 99.9*f as upper limit of normal. Thermoregulatory behaviours (brown adipose tissue thermogenesis, shivering, sweating, vasoconstriction and vasodilation) are the control loops in response to core and skin temperature. Of the illnesses, infection, neoplasia, inflammatory, miscellaneous and undiagnosed illness form the main group. In India, infections constitute 16-55% of cases. Now in industrialized countries, undiagnosed cases have risen. Among the infections, UTI, TB, viral and protozoal abcess, endocarditis are frequently diagnosed out of which viral infections predominate. In older patients infections are less frequent cause of fever which is opposite to pediatric population. Travel history and vaccination history is important as in COVID era. Lab findings were consistant with clinical presentation in 90% of cases .Mortality out of fever was very negligible only in older patients (1-3%).

A Comprehensive Review of Quba and Its Correlation with Dermatophytosis

Background: In the Unani text, the disease described by the name Quba matches the conventional description of Dermatophytosis, commonly referred to as Tinea or Ringworm. Although there is a slight variation in the disease etiology and pathogenesis, the clinical picture and the individual manifestations are by and large the same. This review elaborates on the Unani description of dermatophytosis (Quba) and highlights the relationship between the two entities. Methods: This review article was compiled after surfing thoroughly the available classical Unani literature and published articles in reputed journals. Result: This article comprehensively analyses both Quba and dermatophytosis as per their etiology, pathogenesis, clinical manifestations and management. Dermatophytosis is a superficial fungal infection whereas Quba is identified to be caused by viscid humours (Ghaleez Ratubaat) and morbid matter (Fasid Mawaad). As per the Unani principles of treatment, the disease Quba is treated using purgatives of black bile (Mukhrij Sauda), resolvent (Muhallil), and moderator (Muaddil) drugs along with some physical modalities like Leeching (Irsale Alaq) and Venesection (Fas’d), which is entirely different from the conventional treatment modality which includes the fungistatic and fungicidal antifungal agents for systemic as well as topical use Conclusion: This article tries to elaborate on various aspects of the disease Quba and dermatophytosis and to establish a correlation between the two terms. It also puts forth a potential alternative to the conventional treatment of dermatophytosis (Quba), provided by the Unani system of medicine.

"Repressed Memory" Makes No Sense.

The expression "repressed memory" was introduced over 100 years ago as a theoretical term purportedly referring to an unobservable psychological entity postulated by Freud's seduction theory. That theory, however, and its hypothesized cognitive architecture, have been thoroughly debunked-yet the term "repressed memory" seems to remain. In this paper, I offer a philosophical evaluation of the meaning of this theoretical term as well as an argument to question its scientific status by comparing it to other cases of theoretical terms that have either survived scientific change-such as "atom" or "gene"-or that have perished, such as "black bile." Ultimately, I argue that "repressed memory" is more like "black bile" than "atom" or "gene" and, thus, recommend its demotion from our scientific vocabulary.

The Solitary Mind in the Anatomy of Melancholy

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P300 event-related potentials in patients with different subtypes of depressive disorders.

To explore the differences in event-related potentials (ERPs) of the subclinical types of major depressive disorders (MDD): melancholic (MEL), atypical (ATY), and anxious (ANX). Patients with MDD treated in the Clinical Department of Shanghai Mental Health Center between September 2017 and December 2020 were prospectively included. This study was approved by the Ethics Committee of the Shanghai Mental Health Center. They were evaluated using the Mini-International Neuropsychiatric Interview (MINI), 17-item Hamilton Depression Scale (HAMD-17), 30-item Self-rated Inventory of Depressive Symptomatology (IDS-30SR), 16-item Quick Inventory of Negative Symptom Scale (QIDS-16SR), and auditory and visual P300 ERPs. Finally, 27, 14, and 20 patients with MEL, ATY, and ANX MDD were included in this study, respectively. There were no significant differences in demographic characteristics and HAMD-17, IDS-30SR, and QIDS-16SR total scores among the three groups (all P > 0.05). On the C3 lead, the latency for patients with MEL MDD was the longest, and the latency for patients with ATY MDD was the shortest (MEL vs. ATY vs. ANX: 373.89 ± 6.60 vs. 344.79 ± 9.78 vs. 359.33 ± 7.62, P = 0.039). On the Pz lead, the latency for patients with MEL MDD was the longest, and the latency for patients with ATY MDD was the shortest (MEL vs. ATY vs. ANX: 376.14 ± 6.51 vs. 347.21 ± 9.42 vs. 362.22 ± 8.63, P = 0.047). There were no differences in visual P300 ERPs among the three groups. There are significant differences in auditory C3 and Pz latency among MEL, ATY, and ANX MDD. These differences could help diagnose the subtype of MDD.

Concept of Waja ál-Mafasil or Hudar (Rheumatoid Arthritis) in Unani Medicine: A review

Rheumatoid arthritis (RA) is a long-standing inflammatory condition of undetermined causative factors with the hallmark of symmetric joint involvement. It is an autoimmune disease in which the body's immune system of the patient innocently targets its own body tissues. A principally attacks the synovial membrane, resulting in inflammation, proliferation, articular cartilage loss, and erosion of bone. The most prevalent inflammatory arthritic condition, rheumatoid arthritis (RA), affects 0.5% to 1% of the global population. It affects 15% (180 million) of the population of India. In the classical Unani literature, Waja ál-mafasil is described in detail for all types of arthritis, and one of its types Hudar has clinical features that are similar to those of Rheumatoid Arthritis (RA) which is mentioned in the modern system of medicine. According to the Unani System of medicine, waja ál-mafasil occurs in various joints caused by derangement of the body’s natural humours i.e., dam (blood), balgham (phlegm), safra (bile), and sauda (black bile) with various explanations mentioned by great scholars in Unani literature. Contrary to modern management, which mostly relies on non-steroidal anti-inflammatory drugs (NSAIDs), glucocorticoids, and disease-modifying anti-rheumatic drugs (DMARDs), which come with many adverse effects, they managed it using a multidimensional approach. The main emphasis of this review article is on the important characteristics of rheumatoid arthritis with reference to waja ál mafasil to understand the status of the disease as described by Unani scholars and to offer a preferable option in terms of adverse effects and affordable treatment.

Représenter la flaua bilis: le portait du colérique dans l’Iconologia de Cesare Ripa

Representing the flaua bilis: the Portrait of the Choleric in Cesare Ripa’s Iconology. The theory of the four humours (blood, phlegm, yellow bile and black bile) forms the basis of ancient medicine. Coming from the Hippocratic corpus and completed by Galen of Pergamum (129–216 AD) in his De Temperamentis by means of individual complexions (blood, phlegmatic, angry, melancholic), this theory is essential in modern Europe after more than two thousand years of transmission, development and practice of medicine. Our article aims to examine its fortune in the Iconology of the Italian scholar Cesare Ripa (1555–1622). Starting with the Roman edition of 1603, he enriched his famous allegorical repertoire with a complex entry encoding the four temperaments: Collerico per il fuoco, Sanguigno per l’aria, Flemmatico per l’acqua, Malenconico per la terra. We work here only with the Choleric and undertake to determine the reasons which governed the choice of the attributes retained by C. Ripa (youth, nudity, sword, shield adorned with a flame, lion, fury in the gaze) to offer poets, painters and sculptors the archetype of a figure dominated by yellow, hot and dry bile. To this end, we analyze the medical, literary and iconographic sources on which the author relies, considering also the richness and complexity of the medical discourse he had at his disposal and the very purpose of his Iconology.

Concept and Management of Bahaq (Pityriasis Versicolor) in Unani Medicine - A Review

Pityriasis versicolor also called Tinea versicolor (Bahaq) is a superficial fungal infection of the skin characterized by hypo or hyperpigmented macules or patches on upper trunk and neck. Most commonly affects adolescents and young adults.According to Unani system, it is humoral disease characterized by alteration in the quality or quantity of phlegm or black bile, resulting in hypo or hyperpigmentation. The treatment of bahaq has been extensively studied in Unani medicine by ancient scholars such as Rabban Tabarī, Zakariya Razi, Ibn Sina, Ajmal Khan and various others have described drugs single as well as compound formulations for its treatment. This review paper is intended to highlight the concept and various treatment methods of Unani in the management of Bahaq Keywords: Pityriasis versicolor, Tinea Versicolor, Bahaq, Unani medicine.

The traditional system of Unani medicine, its origin, evolution and Indianisation: A critical appraisal

Greco-Arab medicine, popular as a complementary or alternative medicine, is based largely on herbs and minerals. This was initiated by Hippocrates (460-377 BC) and his associates in Greece, but its preferred home today is the Indian subcontinent. It believes that every person has its own distinct temperament made up of combinations of four basic humors (blood, phlegm, yellow bile and black bile). A proper balance in quantity and quality of these humors indicates health, while imbalance represents a diseased condition. The temperament of individuals is influenced by a variety of internal and external factors. Treatment is done normally through regimental therapy, dietotherapy and/or pharmacotherapy. The nature of drugs (hot, cool, dry, wet, etc) is also taken into consideration. This therapy is known to have minimal side effects. It received the patronage of Delhi Sultans and Mughal Emperors for over 500 years (13th to 18th century) and is now advancing under the banner of Indian systems of medicine. This review discusses the basic principles and concepts as well as the systematic progress of Unani medicine and critically evaluates the strengths and weaknesses of this therapy in addition to highlighting the contributions of Indian Hakims (Unani physicians) to public health sector in India during the last seven centuries.

Study on Clinical Assessment of Central Blood Pressure in Healthy Volunteers, and its Relation to Clinical Phenotyping

The Unani system of Medicine is a holistic system of medicine and does not confine to molecular approach but refers to knowledge as a total recognition of the person and stresses on health of body, mind and soul. Unani medicine states that disease is a natural process and that symptoms are the reactions of the body to disease. The individual humoural balance is influenced by lifestyle factors. It employs the humoral theory which presupposes the presence of four akhlaat (humours) in the body – dam (blood), balgham (phlegm), safra (yellow bile) and sauda (black bile). The Unani philosophy has 4 humours under clinical phenotyping such as Sanguine (Damavi), Phlegmatic (Balghami), Bilious (Safravi) and Melancholic (Saudavi). The 400 Healthy volunteers with 100 each from four different temperaments (balghami, saudavi, safravi, damavi) were selected.The present study validates some of the Unani concepts of humours or temperament with central hemodynamic parameters or Pulse Wave Analysis (PWA). A specially designed case record form as per the Unani classical text was designed for assessment of humours and the information obtained were recorded from healthy volunteers as subjects and determination of central hemodynamic parameters was performed by SphygmoCor technology (AtCor Medical, Sydney, Australia). The temperament of the present study showed that the Pulse Wave Analysis in healthy volunteers although showed the results in physiological range but the analysis in safravi (bilious) subjects is found to be significant when compared to other clinical phenotypes.

The Change in Mizāj (Temperament) and Its Practical Value According to Jāḥiẓ' s Moral Theory

Mizaç, asıl itibarıyla tıp alanının konusu olmakla beraber zamanla psikoloji, felsefe ve ahlâk gibi ilimlerin içerisinde yer almıştır. Ontolojik olarak insanın yapısını içeren bir konu olması nedeniyle tarihsel süreçte bu ilimlerde değişik açılardan ele alınmış, geliştirilmiş ve genişleyerek günümüze kadar gelmiştir. Köklü ve kadîm bir konu olması, muhtelif ilimlerde incelenmesi nedeniyle de oldukça geniş bir literatüre sahiptir. Kökleri eski Mısır’a kadar uzanan bu teoriyi Hipokrat tıp alanında, Galen biyolojik alanda geliştirmiş, İslâm ilim dünyasında da başta Câhız olmak üzere bazı âlimler eserlerinde ele almıştır. Mizaç, ilk olarak bedendeki yapısına dair ahlât-ı erbaa (dört hılt/karışım: kan, balgam, sarı safra, kara safra) teorisiyle açıklanmıştır. Bu dört sıvının vücutta değişip değişmediği hususu ise tarihi boyunca zamanın ve zeminin koşullarında tartışılan bir mesele olmuştur. Galen’in görüşlerinden etkilenen Câhız’ın, mizaçla ilgili müstakil bir eseri bulunmamaktadır. Bununla beraber o, bazı eserlerinde mizacın değişmesine dair görüşler ileri sürmüş ancak dağınık bir yazı tarzı olduğundan bunları sistematik olarak ele almamıştır. Bu makalede Câhız’la ilgili yapılan çalışmalardan ve bazı eserlerinden tespit ettiğimiz kadarıyla onun bu görüşlerini derleyerek iki aşamada sistematize etmeyi amaçladık. Çalışmamızda mizacın değişmesiyle kastettiğimiz şey, insanda var olan kötü huyun/mizacın ortadan kalkması, yerine iyi mizacın getirilmesi hususudur.&#x0D; Câhız, mizacın değişebilmesi için insanı bir çabanın öznesi olarak görür ve bunu iki aşamada değerlendirir. Ona göre insan, ilk olarak zihinsel bir çaba içerisine girer ve bu aşamada, havâtır, tekellüf ve telkin gibi birtakım süreçlerden geçer. Bu noktada iyi’nin alınması kötü’nün terkedilmesi hususunda aklın önemine dikkat çeker. Peki, Câhız’a göre mizacın değişmesi için bu süreçler yeterli midir? Deney ve gözlem analizlerine dayanarak Câhız, sadece bu yöntemlerle insanın zorlanacağını kabul ederek onu, ikinci bir çabaya davet eder. Bunun için de dışarıdan mutlaka takviye alınmasını uygun görür. Ona göre, din, eğitim, toplum içinde olma, siyasi otorite mizacın değişmesine etki eden unsurlardır. Câhız, özellikle halk arasında âdeta bir tabu olarak kabul edilegelmiş “can çıkar ama huy/mizaç çıkmaz” anlayışını ortadan kaldıracak mahiyette görüşler ileri sürmektedir. Açık ve anlaşılır bir üslupla mizacın/huyun değişebileceğini, günlük hayatta bunun uygulanabilirliğini asırlar öncesinden bizlere aktarmaktadır. Bu çalışmada, Câhız’ın mizaçla ilgili görüşleri diğer çalışmalardan farklı olarak iki aşamada değerlendirilmiş, insanın mizacı tebdil-i ahlâk zemininde ele alınarak kelâm alanına katkısı düşünülmüştür.

A Cross-Sectional Descriptive Study of Relation of Hemoglobin Count and Mizaj in Young Adults

Introduction: In Unani medicine, mizaj is an area of extensive research. Mizaj’s theory is based on the four humor hypothesis from antiquity. Buqrat, a Greek physician (Hippocrates, 460–370 BC), was the one who organized and developed it. Blood, yellow bile, black bile, and phlegm, he thought, are responsible for some human emotions, feelings, and actions. It is therefore important to understand how it relates to functions of the body, which may be influenced by individual mizaj (body type). A diagnostic tool that is suitable for each body type can be selected using this information. Research in this field is limited and conflicting, so young and healthy people were selected for the study. This can be considered a decisive advantage in selecting an appropriate diagnostic tool for treatment in clinical practice if it can be linked to hemoglobin count, which may be affected by individual mizaj (body type). As research in this area is very scarce and inconclusive, participants of young age and clinically healthy have been chosen for the study. Objective: The present study is to find out the nature of mizaj (body type) with hemoglobin count. Methodology:Using simple random sampling in Delhi (India) Sixty (60) college students from Ayurvedic and Unani Tibbia College and Hospital, Karol Bagh were selected as per inclusion and exclusion criteria and asked to complete the Mizaj questionnaire followed by checking of hemoglobin count of each participant face to face under supervision. SPSS statistics software 22.0 was used to establish a database for statistical description. The One-way ANOVA test in SPSS was used to analyze the differences between the groups. P &lt; 0.05 suggested that the difference was statistically significant. Results Based on the results it is found that hemoglobin count is highest in people having Damvi Mizaj and lowest in balghami which is in concordance with the experimental hypothesis of this research work. Conclusion: From this study, it is clear that a possible correlation between haemoglobin count and Mizaj certainly does exist. After that, clotting time could be considered as one of the diagnostic indices of temperament.

Evaluation of relationship of physical fitness index (PFI) with mizaj in young individuals

Mizaj concept in the Unani system of medicine is a wide area of research. Mizaj theory has its roots in the ancient four humors theory. It was the Greek physician Buqrat (Hippocrates 460-370 BC) who systematized and developed it into a medical theory. He believed certain human moods, emotions, and behaviors were caused by body fluids (called “Humor”): blood, yellow bile, black bile, and phlegm. So, it is necessary to find out its relationship with physical fitness which may be influenced by individual mizaj (body type) and it can be considered as a decisive advantage to selecting an appropriate exercise for each athlete. Research in this area is very scanty and inconclusive, therefore the participants of young age and clinically healthy have been chosen as the subject of study. The objective of the present study is to find out the nature of mizaj (body type) with physical fitness. The sample of the present study was drawn from Ayurvedic and Unani tibbia college students, both boys and girls. In the present study, mizaj was assessed by using a mizaj assessment questionnaire based on ten classical parameters described in the Unani classical literature category, and physical fitness was determined by physical fitness index(PFI) using a modified Harvard step bench test. Analysis of data in the current study was done by calculating the mean, standard deviation, and one-way ANOVA in SPSS 22.0 software for all the factors of mizaj and physical fitness. It is observed that PFI, is highest in people having Damvi Mizaj and lowest in people having saudavi Mizaj and it is in concordance with the experimental hypothesis of this research work. From this study, it is clear that a possible correlation between PFI and Mizaj certainly does exist. After that, PFI could be considered as one of the diagnostic indices of temperament.

Differentiating Melancholic and Non-melancholic Major Depressive Disorder Using Fractional Amplitude of Low-Frequency Fluctuations.

BackgroundMelancholic major depressive disorder (MDD) is a network-based brain disorder. However, whether or not network-based changes can be applied to differentiate melancholic (MEL) from non-melancholic (NMEL) MDD remains unclear.MethodsThirty-one MEL patients, 28 NMEL patients, and 32 matched healthy controls (HCs) were scanned using resting-state functional magnetic resonance imaging. Patients were assessed by the Chinese version of Snaith–Hamilton Pleasure Scale (SHAPS-C) and Temporal Experience of Pleasure Scale (TEPS). Fractional amplitude of low-frequency fluctuations (fALFF) and correlation analysis were used to analyze the data.ResultsCompared with HCs, the MEL group had significantly higher fALFF values in the bilateral inferior frontal gyrus and right supplementary motor area (SMA) and significantly lower fALFF values in the right inferior occipital gyrus (IOG), right middle temporal gyrus (MTG)/left IOG, and bilateral superior occipital gyrus (SOG)/MTG. On the other hand, the NMEL group showed significantly higher fALFF values in the bilateral SMA and significantly lower fALFF values in the bilateral posterior cingulate cortex/precuneus relative to HCs. Compared with the NMEL group, the MEL group showed significantly lower fALFF values in the left anterior cingulate cortex (ACC). A correlation was found between the fALFF values of the right SMA and the SHAPS-C in the MEL group. In addition, correlations were observed between the fALFF values of the left ACC and the TEPS contextual consummatory and total scores in all patients.ConclusionOur study uncovered that MDD exhibited altered brain activity in extensive brain networks, including the default-mode network, frontal-striatal network, reward system, and frontal-limbic network. Decreased fALFF in the left ACC might be applied to differentiate the two subtypes of MDD.

Efficacy of Nutūl-i-Ḥār (Hot Irrigation), a Polyherbal Unani Formulation, in the Treatment of Shaqīqa-i-Muzmin (Chronic Migraine): An Open Single-Arm Exploratory Clinical Trial

Shaqīqa-i-Muzmin (chronic migraine) is a type of migraine that is usually caused by cold humours (bārid akhlāṭ), specifically by phlegm (balgham) and to lesser extent by black bile (sauda). The aim of this study was to evaluate the effect of Nutul-i-Ḥār (hot irrigation) in the treatment of chronic migraine. Nutul (irrigation) therapy is widely and successfully used in diseases of head as described in Unānī system of medicine. This open, single-arm, exploratory clinical study was conducted in 30 patients of chronic migraine selected by convenient sampling method. One litre decoction prepared with 12 g each of Astragalus hamosus L. (Iklilul malik), Matricaria chamomilla L. (Babuna), Artemisia absinthium L. (Afsanteen), Origanum vulgare L. (Marznjosh) and Trigonella foenum graecum L. (Hulba) was poured over painful side of head for 45 minutes on every alternate day for a period of 30 days (15 sittings). The patients, thereafter, were followed untill 90th day of the study for various outcome measures comprising headache intensity, headache frequency, Migraine Disability Assessment Scale (MIDAS), and rescue medication. The reduction in headache frequency, MIDAS score and use of rescue medication was significant (p &lt; 0.001) after the treatment. Reduction in headache intensity at 30th day, 60th day and 90th day was significant as compared with baseline values (p &lt; 0.001) but not statistically significant at 90th day with respect to 60th day (p &gt; 0.05). Statistical analysis was done using parametric (paired t-test) and non-parametric tests (Wilcoxan sign ranked test, Freidman with Dunn’s multiple comparison tests). Hot irrigation with medicated decoction was found effective in the treatment of chronic migraine.

Hijama (Wet cupping) an ancient traditional healing: A review

Hijama is an Arabic word that means to suck, it is an ancient traditional healing method that is practiced since antiquity and in today’s scenario, and there is growing evidence of its potential benefits in the management of lifestyle and pain-related disorders. Its use has been documented in early Egyptian and Chinese medical practices. Diverse human civilizations have contributed too much to the development of Hijama (wet cupping). Hijama is one of the important regimens (procedures) of Ilaj Bit Tadbeer (Regimental therapy) to prevent and treat the diseases by diverting (Imala-e-mawad) and evacuating (Istefragh-e-mawad) the disease-causing substances (morbid matter) from the site of application of cups on the body. Ilaj Bit Tadbeer is one of the important modes of treatment of Unani medicine. Unani Medicine is based on the four humoral theory of Akhlate Arba (four-body humor) viz Balgham, Safra, Dam & Sauda (Phlegm, bile, blood & black bile). The imbalance in the quality and quantity of these humor leads an individual prone to diseases whereas restoration of this balance maintains the health of a person. Restoration of the equilibrium and balance of natural body humor is done through evacuation and diversion of morbid matter from the site of the disease. Hijama (wet Cupping) is an Unani mode of treatment which is carried out by application of cup-shaped glass vessels on the skin, from which air has been exhausted by heat or special suction apparatus, to divert and evacuate the morbid humor, from the diseased part of the body, to return a displaced organ to its natural position or to encourage the blood flow to the site of Hijama. In Islamic Prophetic medicine an emphasis was given to go for Hijama for the prevention and management of lifestyle and pain-related disorders. In this paper, a detailed review of Hijama will be discussed.