Nafs-ud- Dam (Haemoptysis)


Hemoptysis (Nafs-ud- Dam) is defined as the expectoration of blood originating from the tracheobronchial tree or pulmonary parenchyma. It is spitting up blood or blood-tinged sputum from the respiratory tract. It occurs when tiny blood vessels that line the lung airways are broken.

In other words it is a condition in which fresh blood comes through mouth while clearing the nose or throat or during coughing. The bleeding may occur from throat, mouth, ovula, trachea, specially form lungs or chest. It can be harmless such as from irritated bronchial tubes with bronchitis, or be serious such as from cancer of the lung.

Hemoptysis (Nafs-ud- Dam) can lead to life-threatening complications and therefore requires careful evaluation of the severity and status of the patient.

If a patient with haemoptysis comes, a proper history has to be taken to narrow down the aetiology of the patient’s symptoms. First of all physician should exclude the possibility of pseudo haemoptysis and then narrow down of causes for true haemoptysis.

During evaluation of a patient with expectoration of blood, we need to determine the source of the bleeding and whether the patient is presenting with true haemoptysis or pseudo haemoptysis. Aetiologies of pseudo haemoptysis include the upper gastrointestinal tract and upper respiratory tract. It is characterized by bleeding through mouth with the related features of affected organ, in case of involvement of lungs blood comes with cough.

Causes of Hemoptysis (Nafs-ud- Dam)

As per Unani medicine philosophy it is caused by congestion (Imtila), injury, trauma, rupture of blood vessels, corrosion and infection of the affected organ. The most important cause is pulmonary tuberculosis.

According to modern philosophy common causes of haemoptysis can be broadly grouped into five main categories: infective, neoplastic, vascular, autoimmune and drug-related. Detailed history-taking and careful physical examination is necessary to provide accurate diagnosis of the disease.

Classification of Hemoptysis (Nafs-ud- Dam)

Although, there are no uniform definitions for these categories. However, based on the volume of the blood lost it is devided in to Two types.

  1. Massive Hemoptysis
  2. Non-massive Hemoptysis

Massive haemoptysis is a term used to describe a large amount of expectorated blood or rapid rate of bleeding, with a serious risk of mortality. In massive type of haemoptysis blood loss during haemoptysis ranges from 100–600 ml.

As per data available with American Family Physician “Non-massive haemoptysis” is a term used to describe when blood loss is less than 200 ml per day.

Principles of treatment (Usool-e- Ilaj)

  • To check bleeding (Habs-e- Dam)
  • Correction of morbid temperament (Ta’deel-e- Mizaj)
  • Physical and psychic rest (Taskeen)
  • To promote healing (Indimaal)
  • Diversion of matter (Imala)
  • To reduce the quantity of food (Taqleel-e- Ghiza) in case of Imtila’
  • To produce cold in the body (Tabreed)

Pharmacotherapy (Ilaj bil Dawa)

  • Oral administration of Sheera-e- Unnab (Zizyphus jujube Mill. & Lamk.). Lu’aab-e- Behidaana (Cydonia oblonga Mill.), Sheera-e- Maghz-e- Tarbooz (Seed kernel of Citrullus lanatus Thunb.), Sheera-e- Khurfa (Portulaca oleracea Linn.) with Sharbat-e- Habb-ul- Aas sprinkled with Tukhm-e- Bartang (Seed of Plantago major Linn.).
  • Oral administration of powder of Dam-ul- akhwain (Pterocarpus marsupium Roxb.) and Samagh-e- Arabi (Gum of Acacia Arabica Willd.) with Sharbat-e- Khashkhash (a compound Unani formulation).
  • Oral administration of Aab-e- Aahan Ta’b (water treated with hot iron rod)

Ilaj Bil Tadbeer (Regimenal Therapy)

  • Bloodletting (Fasd-e- Qeefal) through cephalic vein when source of bleeding is throat
  • Bloodletting (Fasd-e- Basaleeq) through basilic vein when source of bleeding is in lungs and thorax and in case of imtila’.
  • Bloodletting (Fasd-e- Saafin) through saphenous vein

Compoun Unani Formulations

  • Sharbat Anjabar
  • Qurs-e- Gulnaar
  • La’oq-e- Barid
  • Qurs-e- Kehruba
  • Khameera Khashkhash

Dietary Recommendations

  • Maa-us- Sha’ir
  • Aghziya Qaabiza
  • Aghziya Mugharriya

Dietary Restrictions

  • Aghziya Musakhkhina
  • Salty dishes
  • Aghziya Hirreefa
  • Sweet dishes

Prevention/ Precaution (Tahaffuz)

  • Avoid alcohol consumption
  • Avoid excessive sexual indulgence
  • Restrict physical and mental exertion

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.


  • PUBLISHED DATE : Apr 19, 2020
  • CREATED / VALIDATED BY : Dr. Mahtab Alam Khan
  • LAST UPDATED ON : Apr 19, 2020


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