Hepatic Debility (Zo'f-e- Kabid)

Introduction

Zo’f-e- Kabid (Hepatic Debility) is a condition in which functions of liver become weak. It is characterized by the yellowish or whitish discolouration of skin, decreased appetite, weight loss and general weakness.

In Hepatic debility (Zo’f-e- Kabid), all the four faculties of liver or some of them become weak. According to Unani Medicine, liver is an organ for production of humours (Akhlat) and its four vital powers (Quwa) namely power of absorption (Quwat-e- Jaziba), power of digestion (Quwat-e- Ghaziya), power of retention (Quwat-e Masikah) and power of excretion (Quwat-e- dafe’a) perform all the functions related to liver.

Liver (Kabid) is the largest organ of the body, considered as source of innate heat (Hararat-e-ghariziya) for body. Jalinoos (Galen) even stated liver counterpart with sun.

The basic functions of liver are conveniently grouped under vascular functions, excretory and secretory functions, metabolic functions and detoxifications functions.

The derangement of function of any of four powers of liver produces derangement in temperament of humours. Moreover, deranged temperament of the humours leads to accumulation of morbid material (mawad-e- fasida) and ultimately pathological changes in the liver. The derangement of temperament of humours may be simple (Saada) which need simple therapeutic measures or it may be compound (Maddi) in which organic disturbance and quantitative changes take place in the liver cells.

A number of liver diseases are mentioned in Unani Medicine, such as Su-e- Mizaj (Abnormal/ Pathological temperament of the Liver), Zo’f-e- Kabid (Hepatic debility), Sudda-e- Jigar (Hepatic obstruction), Dard-e- Jigar (Hepatalgia), Warm-e-Jigar (Hepatitis), Zarba-e- Jigar (Trauma), Dabila-e- Jigar (Hepatic Abscess), Segar-e-jigar (Cirrhosis of Liver), Su-ul- Qinaya (Anemia) and Istiska (Ascites).

Zo’f-e- Kabid (Hepatic debility) is caused by simple/ compound morbid temperament (Su-e- mizaj sada/ maddi), diseases of neighbouring organs (Amraaz-e- A’za-e- Mujaawirah) e.g. stomach, uterus, gall bladder, spleen etc. and other hepatic disorders such as hepatic congestion (Imtila-e- Kabid), hepatic calculi (Hasaat-e- Kabid), hepatic atrophy (Tasaghghur-e- Kabid) and hepatitis (Waram-e- Kabid).

It is characterized by the whitish or yellowish discolouration of skin, decreased/ suppressed appetite, weight loss and general weakness. In hepatic debility condition the stool colour looks similar to the colour of washed water of meat and other features will be related to disease of liver or its neighbouring organs (as per the causative factor).

Principles of Treatment (Usool-e- Ilaj)

To remove the causative factor (Izala-e- Sabab)
To correct the morbid temperament (Ta’deel-e- mizaj)
To reduce the quantity of food (Taqleel-e- ghiza)
To tone up the liver (Taqwiyat-e- jigar)

Pharmacotherapy (Ilaj Bil Dawa)

Oral administration of Murawwaqain with sikanjabin. Murawwaqain is the juice of the medicinal plants, Kasni (Cichorium intybus Linn.) and Mako (Solanum nigrum Linn.) obtained through Tarwiq (the process of cleansing a liquid drug) while Sikanjabeen is a liquid preparation made with vinegar and honey.

Oral administration of decoction of Anisoon (Pimpinella anisum Linn.), Baadiyan (Foeniculum vulgare Gaertn.) and Mstagi (Pistacia lentiscus Linn.) with Gulqand-e- A’sli.
Oral administration of decoction of Badiyan (Foeniculum vulgare Gaertn.) and Mako (Solanum nigrum Linn.) with Gulqand-e- A’sli.

Single Unani Drugs

Gul-e- Surkh/ Ward Rosa damascena Mill.
Hara Chiraitah Andrographis paniculata
Kutki Picrorhiza kurroa
Darchini Cinnamomum zeylanicum
Tukhm-e- Iispast Boerhaavia diffusa Linn.
Asl-us- Soos Glycyrrhiza glabra Linn.
Zafran Crocus sativus Linn.
Neem Azadirachta indica A. Juss.
Zard Chob/Haldi Curcuma longa
Luk Coccus lacca
Bhangra Eclipta prostrata (Linn.) Linn. Syn.: E. alba (Linn.) Hassk.
Shahatraj Fumaria officinalis Linn.
Bhui Aamla Phyllanthus amarus
Achhata/Bhuin Amla Phyllanthus fraternus Webster Syn. Phyllanthus niruri
Aamla Phyllanthus emblica Linn. Syn.: Emblica officinalis Gaertn.
Qaranfal Syzygium aromaticum
Mako Solanum nigram Linn.
Gilo Tinospora cordifolia Miers
Zarishk Berberis aristata DC. Syn.: B. chitria Lindl.
Asgand Withania somnifera (Linn.) Dun.
Chiraitah Swertia chirayita (Roxb. ex Flem.) Karst.
Chai Camellia sinensis (Linn.) O. Kuntze
Ginseng Ginkgo biloba Linn.
Javetri/ Jauz bua Myristica fragrans Houtt.

Compound Unani Dtugs

Ma’joon Dabeed-ul-Ward
Qurs-e- Zarishk
Dawa-ul- Kurkum
Dawa-ul- Luk
Sharbat-e- Afsantin
Sharbat-e- Dinar
Sharbat-e- Kasoos
Jawarish-e- Aamla
Jawarish-e- Anaarain

Regimental Therapy (Ilaj Bil Tadbeer)

Bloodletting through Basilic vein (Fasd-e- Baasaliq)
Bloodletting through Usaylim vein (Fasd-e- Usaylim)
Purgation (Ishaal) in case of Su-e- Mizaj Maaddi

Dietary Recommendations

Maa-ul- Jubn
Maa-ul- A’sl
Apple
Pomegranate
Guava
Zood Hazm Aghziya

Dietary Restrictions

Aghziya Ghaleeza Lazeeza

Note: Unani drugs should be taken under the advice of the qualified Unani physician. The patients are required to follow strict Unani regimen for optimum results.

References