The word "Unani" (meaning "Ionian") reflects the strong Greek influence to this tradition of medicine, but the origins of the traditional Oriental medicine known as "Unani-Tibb" begin with the famous physician, Avicenna. Also known by the name Hakim Abu Ali Abdullah Husayn Ibn Sina, this physician and naturalist was so advanced in his insights and dedicated to his studies that he mastered a great deal of the medical knowledge of his day when he was barely a teenager! Understanding Avicenna's writings in depth would tax the resources of the greatest intellects of our time.
The diagnostic skills required by a practitioner of Unani medicine are quite subtle, so studying the style of pulse analysis used by the Hakims is very helpful for practitioners of other Oriental medicines. As with many of the Oriental systems, practitioners are taught to focus on the patient and their particular manifestations of disease. Questioning, palpation, and observation are the three modalities utilized to investigate the nature of the imbalance. As with Tibetan and Chinese theories of disorder, the body in health is hypothesized to be in a dynamic equilibrium, and disorders arise when environmental or intrinsic factors influence a shift out of that equilibrium. The qualities of the blood, complexion, and body substance which need to be analyzed by Unani physicians is quite sophisticated and comparable to the highest levels of physical diagnosis taught in the West.
With regard to one of these sciences of analysis, that of urinalysis, I have observed firsthand the derivation of these practices during my studies with Dr. Yeshe Dhonden. This Tibetan doctor is justly famous world wide for his astonishing skill in interpreting certain characteristics of the urine in order to diagnose or guide treatment. It took several full days of teaching and practice in 1985 by Dr. Dhonden to introduce me to the many factors that a skilled physician needs to consider to make a correct analysis, and I still find these techniques to be extremely valuable in day to day modern practice.
Pulse diagnosis is another area where the Unani lineages have made their own particular contribution. One of the particularly interesting aspects of training for students is the emphasis on producing a clear state of spiritual awareness in order to discern the subtle qualities of the pulse. Particularly in the Sufi lineage of the Chishtiyyah order, control of breathing and voice, as well as particular visualizations specific to exercises in which the pulse is felt, assist the student in clearing the mind of distractions to understanding the nature of the pulse quality.
The most senior and most knowledgable of the Chishtiyyah order in the United States is Hakim Moinuddin al-Chishti. A brilliant theorist and a sound spiritual authority on all aspects of the Islamic foundations of Unani practice, the Hakim has provided a clear and thorough resource on the origins of Unani medicine at Chishti.com. For interested individuals, essays on various important concepts and fundamental doctrines are also available at this outstanding site.
In part as a result of his remarkable efforts to study Unani medicine under difficult and dangerous conditions, and in part due to the application of his own resources to analyze and integrate modern insights with this ancient tradition, many of the Hakim's writings in English are necessary for any serious student of Unani-Tibb. Few will have the opportunity to study with this amazing scholar, but he has the capacity to teach at several levels simultaneously and clarify otherwise murky subtleties of practice. I have been extremely fortunate to have had the experience to listen to medical teachings at the foot of this master.
Hakim Chishti has written several essays and books which are helpful introductions to this vast medical lineage. The Book of Sufi Healing and The Traditional Healer should be an essential reference in the libraries of anyone interested in Islamic medicine in general and Sufi practice in particular.
Food as Medicine
In common with many traditional sources of medicine, Unani-Tibb emphasizes the use of flavors and tastes to adjust the imbalances which contribute to disease. The choices of foods and the manner in which they are prepared are considered to be among the most important issues to consider when choosing a diet to improve or maintain health. Skillful use of warming and cooling spices and herbs contribute heavily to the appropriateness of the meal to correct the root causes of imbalances.
Each ingredient in a meal affects the heat or cold balance of the body differently and may also influence factors of the humoural system. The potency of some foods are mild, and can be used by anyone. Three other levels of potency rise through the moderately medicinal foods, to those highest two levels which are powerful and for which a Hakim or trained practitioner should be consulted.
The strongest level of potency includes poisons which may, in the right hands, be used as medicine. This reality is difficult for Westerners to grasp, as we are taught to think in a concrete way about medicine. Poisons are always poisons to the academic, but practitioners of Oriental traditions understand that skillful use sometimes requires the physician to do something unconventional in order to save the patient.
The tastes, salty, sweet, bitter, pungent, and sour also affect the humoural system, as do various qualities that are more subtle than the five tastes normally considered. The aromas which are given off during the preparation and cooking phase, as well as those emitted during the consumption of the meal, and even some post digestive transformations, contribute to the healing benefit of a well conceived meal. It is in this way that Hippocrates intended physicians to "make food your medicine". To this day, skillful cooking and prescribing the most beneficial diet remains the path of the Hakims.
Food as Poison
Modern urban society accepts the concept of the business lunch, but this type of environment is generally not a conducive atmosphere to digestion. From a traditional perspective, the primary agenda for any meal is to benefit from the medicinal quality of food. Any factor which interferes with this agenda degrades the value of the meal inasmuch as nutrition is concerned. And, because of its central role in determining health or disease, as much emphasis should be placed on diet as on every other aspect of medical care.
When there are business goals, such as making a sale, reviewing performance, or fulfilling social obligations to colleagues, these will often conflict with the necessary focus on health. Patients have told me of situations where disagreeable events and personality conflicts have resulted in a loss of appetite as well as actual physical symptoms of distress either during or soon after such incidents.
In addition, the atmosphere of many restaurants is not conducive to a pleasant experience. Aside from food borne illnesses, the attitudes of the cooking and serving staff can seriously degrade the value of commercial meals. Second or third rate ingredients are often necessary realities in a business where most of the cost of a meal is dedicated to staff salaries, benefits, and taxes. A noisy or disruptive atmosphere is another negative influence on the value of a meal.
Finally, and of significant importance, the food choices and ingredients used in many meals that are commercially available make them unsuitable for medicinal purposes. Portions that are too large, and an overwhelming predominance of sweet and salty flavor contribute to the unhealthfulness of food in the U.S.
Multitasking Does Not Enhance Digestion
Another modern habit which had caused a deterioration in the health value of a meal is attempting to combine the experience with that of work, entertainment, or travel. Eating while reading, watching television, driving, or talking on the phone will all detract from the nutritional value of a meal, according to the traditions of Unani-Tibb. I have also observed that when patients engage in these distractions, they not only fail to observe the pleasure and satisfaction of eating, but there is also a tendency to overeat.
Unani Tibb, as it is primarily a medicine which exists in tribal societies, decrees that the best meals are taken in the company of immediate or tribal family. Of course, even though the family meal has diminished in importance in U.S. culture, it is still a fact that arguments and power struggles at mealtime has disrupted the medicinal value of many appropriately tribal feasts.
Eating together with good character, however, would solve this particular problem. (see the African Medicine pages for some discussion of the role of character in traditional medical systems) In common with the principles of Tibetan tantric medicine and African Ifa medicine, clear intent, undistracted focus, and good character will transform the rituals of cooking and eating into healing experiences, expecially when the correct flavors and energies are incorporated into the dishes.
The Power of Scent
Another fascinating and subtle area of specialty in Unani medicine is the use of fragrance to alter the physiology of mind and body. This is an area which will be expanded in these pages in more detail in the future. Specific attars are extracted from the plant kingdom and are utilized alone or blended as the Hakim directs. Inasmuch as alcohol is not permitted as a medicine in Islamic tradition, these attars are produced without the use of this substance.
For the interested reader, more information is available on this subject from the Chishtiyyah tradition. Skilled as an attari, or blender of scents, Hakim Chishti has created a package of attars and has revealed many of the insights of centuries of experience using these wonderful fragrances to calm the mind and help with various emotional and physical imbalances. As is true of all Unani practitioners, he is also a proponent of utilizing diet and skillfully prepared savory dishes to treat and prevent disease.
For those who are interested to know more, Hakim Chishti has made his course on attars available here.