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ORIGINAL ARTICLE

10.21276/iabcr.2017.3.4.22
Clinical Study on Falij-E-Nisfi (Hemiplegia) with A Combination Therapy of Munzij (Concoction); Mushil (Purgation); Dal’k (Massage); and Riyazath (Exercise)
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October - December 2017 | Vol 3 | Issue 4 | Page : 88-92

Afshan Jabeen 1, Syed Abrar 2, Abul Hasan Ashraf 3*, Fazlul Mohsin Khan 4

1 Head, Clinical Research Dept., (N.T.R. University of Health Sciences). 2Medical Superintendent, (Gen. Medicine in Unani, Osmania University), Retd. Principal, Govt Nizamia Tibbi (Unani Medical) college, Hyderabad. 3Hony. Director, M.D (Unani, N.T.R. University of Health Sciences. 4Rajiv Gandhi University of Health Sciences.

How to cite this article: Jabeen A, Abrar S, Ashraf AH, Khan FM. Clinical Study on Falij-E-Nisfi (Hemiplegia) with A Combination Therapy of Munzij (Concoction); Mushil (Purgation); Dal’k (Massage); and Riyazath (Exercise). Int Arch BioMed Clin Res. 2017;3(4):88-92

ABSTRACT

Background: Falij-e-Nisfi (Hemiplegia) is one of the major neurological disorder usually caused by the occlusion of blood vessels to atherosclerotic thrombosis and embolism .other Causes are cerebral hemorrhage; neoplasms and infections. Methods: A Clinical study to assess the effect of MUNZIJ (concoction) and MUSHIL (purgation) internally along with DAL’K (Massage) and RIYAZATH (exercise) externally was conducted on 24 patients in the inpatient department of Dr. Ahmed Ashraf Memorial Unani Specialty Treatment Center for paralysis, Hyderabad; a Center of Excellence by Ministry of AYUSH, Govt. of India. Results: The Observations of the Study indicated that in between 55 to 65 years of age; the disease is more common. In this Study 46% of cases showed good response; 12% of cases Showed poor response. Conclusions: These results indicated that further more study would be carried out to provide a clean picture.

Keywords: Falij-e-Nisfi; Munzij; Mushil; Dal’k; Riyazath.

INTRODUCTION

Falij-e-Nisfi (Hemiplegia) is one of the major neurological disorder; usually caused by the occlusion of blood vessels to atherosclerotic thrombosis and embolism. Other causes are cerebral haemorrhage; neoplasms and infections.[1,2]

According to Unani system of medicine; Falij-e-Nisfi (Hemiplegia) occurs due to the accumulation of morbid non-functional Humours (especially phlegm-Balgham)[3] in the nerves causing obstruction in the path of rooh-e-hassas (sensory pneuma) and Rooh-e-Muharrik (motor Pneuma).[4] The nerves gets affected due to this sue-mizaj-ebarid ratab; which inturn results in the loss of motar and sensory functions.[5,6]

Accumulation of this Ghair Tabai balgham (abnormal phlegm) invades half of the body[7] causing dryness of cerebral vessels, looseness in tendons and joints4. Ultimately it damages half side of the body5. This disease is mainly manifested as paralysis/paresis (weakness of one side of the body affecting the functions of upper and lower limbs).[3] It may also affect the functioning of speech; facial muscles and control on defecation and urination.[7]

As the prevalence of disease is increasing, lots of research work is also been carried out worldwide in different systems of medicine. There are encouraging results in Unani lines of treatment. As falij is considered one of the major hormonal disorder caused due to Ghair Tabai Balgham (Abnormal Phlegm) which producers Sue mizaj maddi in the body.[2] This madda (matter) needs to be eliminated to restore tabai Mizaj this Eliminations is Known as Tanqia[4] (Evacuation) and Restoration is Known as Taadeel (normalization).[3] Munzij-Mushil Therapy is the fundamental principle of treatment of falij and is actually meant for Istifragh (Elimination) of Morbid humours from the body ;But prior to Istifragh ; the process of Nuzj (concoction) is employed by administration of Munzzijat (concatives) of respective humours involved.[8] Nuzj means the of Morbid humours is made easily removable from the body[3] Sometimes the madda (matter) is too thick or too thin to be Eliminated; therefore some drugs are used to change the consistency and make it ready for Elimination ;Such drugs are Known as Advia-e-Munzijah (concoctive drugs).[9] after the administration of munzij course as soon as the nuzj appears in urine; mushil –e-balgham Advia[9] (purgative drugs) along with Tabreed are given for the purpose of Tanqia (Evacuation) of Ghaleez Khilt (Viscid humour)3.After purgation of Ghaleez khilt;which produces the sudda (obstruction) causing falij;the nerves Structures becomes receptive to regain the lost vigour ;vitality and normal functions.[2] This phase of rejuvenation is called as Taadeel (Normalization) This Taadeel is accomplished by using various regimental Therapies like Dal’k[3] (massage) Riyazath (exercise) etc3;for the purpose of potentiation of physiological functions of an organ and restoration of mizaj-e-Motadil (Normal temperament). Considering the importance of above mentioned therapies in the treatment of Falij;[10] I worked on the combination therapy of internal and external medicines.

The results of the Study are encouraging and further studies in this treatment for hemiplegia; may provide concluding results.

METHODS

a) Criteria for Selection of Patients
The patients for trail have been selected on the basis of following criteria:
1. Loss of function /weakness/paralysis of one side of the body.
2. Hypotonia/ Hypertonia of the muscles of affected limb.
3. Absent / Exaggerated reflexes.
The patients detailed history including the chief complains; other clinical parameters like subjective symptoms and objective signs have been noted in the prescribed Performa.
The patients were subjected routine for routine investigations.
b) Type of study:- Single blind.
c) Usool-e-Ilaj (principles of treatment):-
I. Munzij-Mushil Therapy for the purpose of istifragh of fuzlat-e-Blaghamiyya (Evacuation of Phlegmatic waste products)[11,18]
II. Taadeel-e-Mizaj to maintain Mizaj-e-Motadil (tempermental Equilibrium).[5,6]
III. Taqwaiyat-e-Asab (Strengthening of nerves).[5,6]
IV. Taqleel-e-Ghiza (Diet moderation).[5,6]
Administration of Ilaj bil Dawa :-
-Munzij is administered to attain concoction with following drugs:-
1. Beeq-e-Kasni. 5gm [9,12]
2. Beeq-e-Karfas. 5gm [10] >
3. Beeq-e-Kibr. 5gm [10]
4. Beeq-e-Azqar. 5gm[10]
5. Ustuqudoos. 5gm[10]
6. Aslasoos. 5gm[13]
7. Parsiyashan. 5gm[10]
8. Barg-e-Gauzaban. 5gm[13]
9. Gule-e-Banafshan. 5gm[13]
These ingredient are soaked overnight in 120ml of water; boiled and Strained in the morning. This Joshanda (decoction) is given on empty stomach early in the morning for 12 days. on 13th day nuzj-e-Boul (masturation of urine) is observed; as the nuzj appeared in urine8 Mushil drugs like Turbud; sana-e-Makki; Khayar-e-Shambar[9] are included in the Nuskha of Munzij and is administred for three days each alternating with Tabreed) Habb-e-Ayarij & Arq Badiyan) [14] and thereafter Morbid humours are purgated/expelled out. ILAJ BIL TADBEER (Regimental Therapy):-

After the completion of Munzij and Mushil Dal’k layyan (soft massage) with Roghan Shifa[15] (or) Roghan-e-Haft barg is employed externally twice daily for strengthens the nerves (Taqwiyat-e-Asab)[5,6] and Riyazat (exercise) for regaining the mobility of joints & normal Movements[3]

ILAJ-Bil-Ghiza:- (Dieto-Therapy):-
Light diet comprising of ma-ul-Asl; Ma-ul-Shair11; Aghziya ya bissa eg Khushkari Roti (whole grain bread) during the administration of munzij and after mushil meat of partridge;Sparrow or pegion is adviced[5,6]
Aghziya-e-Mughalliza16 and Murattiba are avoided[9].
Thaffuz (Prevention/precaution):-
Exposure to extreme cold and alcohol is to be avoided.[11]
CRITERIA FOR THE ASSESSMENT OF RUSULTS:-
Assessment of results is done based on the clinical parameters (subjective symptoms and objective sings). The Score can be counted before and after the treatment and results are noticed by the improvement in the scores obtained17. The results have be classified in the following way:-
1. Good Response:-Above 75 % relief and patient can resume normal duties.
2. Fair Response: - Above 50% relief in Symptoms .
3. Poor Response: - 25 to 49% relief in symptoms.
4. No Response: - No improvement (Or) Marginal improvement below 25%.

RESULTS

Observation in 24 patients indicated that the disease affects males more frequently than the females. The incidence of the disease is higher above 40 years of age and the incidence of disease is at its peak level in between 41 to 60 years of age (Table-?).

The observation also indicated that majority of cases had come to hospital within one month (or) after 6 months to 1 year from the onset of disease (Table-??). It is observed that majority of cases were suffering from paralysis of upper and lower limbs; facing difficulties in locomotion. All patients were having numbness on affected side. Majority of patients were having difficulty in speech and head ache. Rigidity; burning sensation and mental confusion were comparatively less (Table-???). The effect of the treatment was mainly assessed by the improvement in patients symptomatology.


Table 1 Table 1: Showing the incidence of age and sex
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Table 2 Table 2: Showing the Duration of the illness
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Table 3 Table 3: Showing the involvement of chief complain
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Table 4 Table 4: Showing the effect of the treatment in subjective symptoms
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Table 5 Table 5: Showing the effect of the treatment in facial paralysis
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Table 6 Table 6: Showing the Effect of the Treatment in Power of Movements in Shoulder Joints
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Table 7 Table 7: Showing the effect of the treatment in power of movements in elbow joint
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Table 8 Table 8: Showing the effect of the treatment in the ability to hold and lift weight with hand
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Table 9 Table 9: Showing the effect of the treatment in posture
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Table 10 Table 10: Showing the effect on walking speed (20 mts)
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Table 11 Table 11: Showing the effect on tone of the muscles
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Table 12 Table 12: Showing the effect on Sensory changes
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Table 13 Table 13: Showing overall effect in objective signs
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Table 14 Table 14: Showing overall effect in objective signs
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DISCUSSION

Falij-e-Nisfi (Hemiplegia) is one of the major neurological disorders caused due to humoural derangement.[1,2] Present study has been carried out to evaluate the better line of treatment for hemiplegia.

Over all symptoms were reduced to minimum in many patients where as in 12 patients speech difficulty was reduced .In objective signs 65.78% relief was found in facial paralysis; 66.6% improvement in power of movements of Shoulder joints; 66.1% in elbow joints .Ability to hold and lift weight with hand was increased to 54%; 61.8% improvement in posture; 78.64 % walking speed; 61.74% improvement in tone of the muscles and 100% improvement in the sensory changes and overall effect in objective sings is 63.29 %. Though all therapies under study are having effects on all symptoms; but observing the results it can be presumed that munzij and mushil therapies had effect at higher levels as it is considered to be the best Humoural manager and Subjective.[8] Symptoms might be relieved due to it and improvement in the objective signs might be due to Dal’k & riyazath.[3]

Therefore; Showing the overall results of the about said treatment out of 24 patients who were included in the study;[11] no. of patients attained complete relief; 10 no of patients attained fair relief and 3 no. of patients attained poor relief. The observations of the Study indicates that in between 55 to 60 years of age; the disease is more common and In this study 46% of Cases Showed good response and 12% of Cases Showed Poor Response.

By the above results it can be concluded that the combination therapy of munzij mushil; Dal’k and Riyzath Selected for the Study are effective in falij-e-Nisfi (Hemiplegia). As it is a preliminary study it is felt worth that the further detailed study is more beneficial.

CONCLUSION

The outcomes of this study with combination therapy proved very effective in the treatment of falij and therefore it is essential to carry out further trails on the same line of treatment; so as to obtain more benefits.

REFERENCES
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