According to Unani System of Medicine, human life is categorized into four stages viz; Sinn-e- namu (Temperament is hot and wet (Haar Ratab) and is applicable up to the age of 30 years), Sinn-e- shabab (Temperament is hot and dry (Haar Yaabis) and is applicable from 30 to 40 years of age), Sinn-e- kahoolat (Temperament is cold and dry (Baarid Yaabis) and is applicable from the age of 40 to 60 years) and Sinn-e- shaikhookhat (Temperament is cold and wet (Baarid Ratab) and applies to people above60 years of age).

Sinn-e- shaikhookhat (aged/ older people) is the period in which there is diminished quantity of Ratoobat-e- ghareeziya and it is lesser than the quantity required for the preservation of Hararat-e- ghareeziya (innate body heat) for the continuation of normal body metabolism and is dominated by Ratoobat-e- ghareeba bala (abnormal metabolic products). In this period deterioration in the powers and faculties of the body is noticeable. Ratoobat-e- ghareeziya and Hararat-e- ghareeziya are markedly reduced; hence the temperament (mizaj) becomes cold and wet (Baarid Ratab).

As per Unani concept every stage of life has its own specific temperament (mizaj) and Kaifiyat according to their age. Basically, when Kaifiyat changes; temperament (mizaj) is deranged. When mizaj deviates from normal to abnormal path then, it causes premature ageing.

Ratoobat-e- ghareeziya plays a key role in maintaining equilibrium of Hararat-e- ghareeziya. When quantity and quality of Ratoobat-e- ghareeziya changes, it directly affects Hararat-e- ghareeziya.

All quw’a requires hararat (body heat) for performing afa’al (functions). Deprivation of humours or dryness neutralises ratoobat of the body until it ceases to have a capacity for life. Thus, healthy ageing can be secured by safeguarding of innate moisture from too rapid dissipation, and maintaining it at such a level that the original constitution particular to the person shall not change even up to the last moment of life.

Anti- ageing wisdom is not new in Unani medical philosophy, but it is mentioned by ancient Unani scholars in their ancient classical text books like, Firdaus- al- hikmat by Rabban Tabri (810-895A.D), Kitab Al Hawi- fil- Tibb by Zakariya Razi (850-923A.D), Kamil-us-sana’a by Ali Ibn-e- Abbas Majusi (930-999 A.D), Al Qanoon fil Tib by Bu Ali Sina (980-1037A.D), Zakheera khawaarizam shahi by Ismail Jurjaani (1041-1136A.D), Kitab -al-mukhtaraat -fil-Tibb by Ibn-e- hubal Baghdadi (1121-1213A.D), Kitab-al-Kulliyat by Ibn-e- Rushd (1126-1198 A.D), Kulliyat-e-Nafeesi by Allama Burhanuddin Nafees bin Ewaz kirmani (15thcentury A.D) and Akseer-e- Azam by Mohammad Azam Khan (1813-1902A.D).

Patho-physiological Aspects of age if in Unani Tibb

Certain physiological changes in body occur during the process of ageing. These include diffuse hair loss, reduced neuron capacity, reduced vision, reduced sense of smell and taste, reduced number of sweat glands, high tone deafness, impaired balance, loss of lung compliance, reduced glomerular filtration rate(GFR), reduced stroke volume, systolic hypertension, postural hypotension, constipation, impaired glucose tolerance, muscle wasting, osteoporosis and osteoarthritis etc. Certain factors which play important role by making life of elderly/old aged people difficult are:

Excessive use of the substances which are phlegm producing in nature like milk, vegetables, hareesa, ice water etc.; excessive use of sour foods like curd, tamarind, pickles etc.; frequent use of hammam, excessive coitus, chronic diseases (amraz-e- muzmina) like tuberculosis (sil wa diq), cancer (sartaan), diabetes mellitus (ziabetus shakari). Nervous disorders (amraz-e- a’asab) like epilepsy (sara’), meningitis (sarsaam), sakta, jumood, paralysis (faalij), istirkha weakness of brain (zo’fe dimaagh), inadequate sleep etc. Other important conditions like malnutrition, obesity (siman-e- mufrit), genetic disorders, psychological factors, abnormal temperament (su-e- mizaj) etc.

Preventive measures to slow down ageing process

Do’s

·         Do moderate exercise and massage regularly.

·         Use of easily digestible (zood hazm) and nutritious diet (Jayyadul Kaimus Ghiza).

·         Chew food properly.

·         Daily use of garam roghaniyat (i.e. Roghan-e- amla)- delays ageing.

·         Daily consumption or intake of Itriphal Sagheer, Murabba Amla and Murabba Zanjabeel- delays ageing.

·         Use of meat which are prepared by aromatic spices like; Qaranphal, Jaiphal, Javitry, Zeera Siyah, Khulanjan, Sirka etc. also delay the process of ageing.

·         Use of Chuqandar with Rai- delay process of ageing.

Don’ts

·         Avoid sour taste food items.

·         Avoid excess use of spicy and oily diets.

·         Avoid frequent use of Turkish bath/ therapeutic bath (hammam) and excessive coitus (Kasrat-e- jima’a).

·         Avoid drinking cold water immediately after coitus.

·         Avoid cold drinks early morning (Nehar munh).

·         Avoid rose water (Arq-e- gulab) on face and head.

Ageing and recommended therapeutic regimes

Unani scholars described different regimes (Tadaabeer) for the care of elderly/ old aged people (mashaaikh) (i.e. Riyazat, Dalk, Hammam, Nutool, Hijama, Fasd) and their management through drugs of plant, animal and mineral origin, which may delay the process of ageing.

Ageing and Recommended Compound Unani Drugs

Some common compound drugs with proven efficacy are enlisted here:

Murakkabat (compound drugs) which delay  the process of ageing are Itriphal Ustokhuddus, Itriphal Sagheer, Itriphal Kabir, Itriphal Kishneezi, Majoon Waj, Majoon Bladur, Majoon Barhami, Majoon Bolas, Majoon Falaasfa,Majoon Atyab, Jawarish Jalinus, Tiryaqe Farooque, Tiryaaq-e- Wabai, Khamira Gaozaban Ambari Jawahar wala, Khamira Gaozaban Sada, Habb-e-Azaraqui and Anooshdaru etc.

Single Drugs in Unani Geriatric Care

·         Amla                            Emblica officinalis.

·         Zanjabeel                    Zingiber officinale.

·         Asgandh                      Withenia somnifera.

·         Garlic/Lahsun             Allium sativum.

·         Aakhrot                       Juglans regia.

·         Ajwain Khurasani       Hyoscyamus niger.

·         Aqar Qarha                 Anacyclus pyrethrum.

·         Azaraqui                      Strychnos nuxvomica.

·         Badam                         Prunus amygdalus.

·         Badranj Boya              Mellisa officinalis

·         Balela                          Terminalia belliric.

·         Asl /Shahad (Honey)  Apis indica.

·         Ambar                         Ambra grasea.

·         Marjan                        Corallium rubrum.

·         Sadaf                           Pinctada margaritifera.

Prescribed Food supplements

In food items, Honey, Milk, Meat of chicken and lamb, Olive oil, Small size fish are very useful.

Prescribed Fruits and dry fruits

Muskmelons, Grapes, Haleelah, Walnut, Almond, Mulberry, Large Raisins (Vitis), Prunus, Dates etc. are very effective.

Prescribed Vegetables and Cereals

A lot of vegetables and cereals are mentioned in Unani classical texts like Beet root, Spinach, Rice, Barley, Garlic, Onion, Ginger, Pistacia Galls (Kasni), The Lettuce (Kahu), Common Mallow, Black pepper etc.

(Dr.Altaf Hussain Shah is Senior Medical Officer-Unani Medicine AYUSH Unit, District Hospital Pulwama)