Nar Farsi (Eczema) is an infectious (A’funati) skin disorder with eruptions having severe itching and burning sensation. In other words it is defined as a catarrhal inflammation of a sensitive skin. It is a chronic inflammatory skin disease which affects 2-10% of the world’s population.
“Eczema” is a Greek word comprising two parts “Ec” means ‘out’ and “Zeo” means ‘boil’. The whole word “Eczema” implies to “boil-out”. Literally “Eczema” is meant for "Something thrown out by heat. It is said to have been the name “Eczema” is given by ancient physicians to "any fiery pustule on the skin".
The terms ‘Dermatitis’ and ‘Eczema’ are generally regarded as synonymous. Some authors, however, believe in using the term ‘dermatitis’ to denote all types of cutaneous inflammation, eczema being one distinct pattern of them. Hence, every type of eczema is dermatitis, but not every type of dermatitis is eczema.
According to modern medicine “Eczema” is a non-contagious inflammation of the skin in response to endogenous or exogenous stimuli characterized by oedema, erythema, vesiculation, oozing, weeping and crusting. It is due to an antigen-antibody reaction, and classified depending on aetiology and presentations.
Clinically, eczematous dermatoses are characterized by variable intensity of itching, soreness, and invariable degrees, a range of signs including dryness, erythema, exudation, excoriation, hyperkeratosis, fissuring, scaling, lichenification and vesiculation.
Unani Concept of Eczema (Nar Farsi):
In Unani system, the “Eczema” is known as “Nar farsi”, “Akoota” and “Chajan”. It is called “Nar farsi” means “Faras ki aag” or “Fire of Persia”, since it was more common in the kingdom Persia (Faras) or the person who treated this disease for the first time belonged to the city Persia (Faras).
As per Unani classical literatures, it is caused by Yellow bile (Safra) mixed with small quantity of black bile (Sauda) or acrid yellow bile (Hadd Safra) mixed with sanguine (Dam) and usually occurs during epidemics.
Eczema (Nar Farsi) is a one of the skin diseases with painful eruptions, intense itching and burning on the site of lesion. In addition, lesion ruptures immediately with fast scab formation.
It is characterized by initial appearance of red/ peacock green coloured lines (Surkh/ Taóosi Khutoot) followed by rapidly spreading eruptions (Busoor) which are filled with watery fluid.
There is severe burning sensation and itching with immediate crusting. These eruptions (Busoor) are encircled with a large number of smaller eruptions. Sometimes it is accompanied with fever especially during epidemics.
Muhammad Bin Zakariya Razi, Ali Ibin-e- Abbas Majoosi and Ismail Jurjani in their respective compilations stated that, in eczema, the liquid filled vesicles appear on the skin with intense burning sensation and itching.
According to Ibn-e- Sina, both “Jamra” and “Nar Farsi,” are the terms used for any kind of busoors, or blister or dry scaly skin, accompanied by intense itching and burning sensation. Burning sensation is felt as experienced in burns. Occasionally, the term “Nar farsi,” is used for busoors that are similar to the lesions of Namla (herpes), it is progressive in nature and contains fluid.
Ismail Jurjani also mentioned that, initially red lines appear at the site of eruption, and this redness is similar to the redness of burns caused by the fire. It is followed by vesicles formation and later they get converted into scales.
Ali Ibn-e- Abbas Majoosi described eczema under the causes and symptoms of small pox (chechak). He explained that if small pox is caused by admixture of pus (sadeed) and blood (khoon) and resembles the vesicles of burns, the condition is known as eczema (Nar Farsi).
Abul Mansoor al Hasan al Qamri stated that Nar Farsi is type of itching, which is accompanied with intolerable burning sensation, later blisters develops, which contains fluid.
Ibn-e- Hubal Baghdadi and Ali Ibn-e- Sahal Rabban al Tabari in their manuscripts mentioned that ancient Unani scholars had described “Nar Farsi,” and “Jamra” as single entity, whereas others discussed them separately.
According to “Abi Ibn-e- Saddiq”, endogenous causes (Asbab-e- Khariji) of eczema are general weakness (Zo’af-e- Aam), Nervine weakness (Zo’af-e- A’sab), gout (Naqras), arthritis (Waja-ul- Mafaasil), intestinal worms (Deedan-e- Ama’a), diseases of stomach (Amraz-e- M’eda), Dentition in infants, Extreme heat and Extreme cold etc.
Ismail Jurjani stated that, cause of eczema is ghalba wa hiddat-e- khoon.
According to Ghulam Jilani, causes of eczema is general weakness (Zo’af-e- Aa’m), indigestion (Tukhma), nervine weeknes (Zo’af-e- a’sab), gout (Naqras), Intestinal worms (Deedan-e- ama’a), extreme heat and extreme cold.
Kauser Chandpuri mentioned that cause of eczema is Ghalba-e- safra wa Kami-e- Sauda.
Ali Ibn-e- Abbas Majoosi stated that cause of eczema is madda-e- damvi.
Waseem Ahmad Azmi stated that, cause of eczema can be consumption of diet containing fish, egg, etc., prolong duration of exposure to the sun and extreme cold and warmth.
Hari Chand Multani stated that, diabetes mellitus as also one of the predisposing factor for eczema.
Principles of Treatment (Usool-e- Elaj)
The principles of treatment is aimed at the alteration or removal of morbid material, which is the actual culprit for the genesis of pathology leading to development of eczema (Nar Farsi). Since the disease is chronic in nature which cannot be easily overpowered with a unidirectional onslaught therefore, a multidirectional approach of treatment has been envisaged by Unani scholars for the treatment and the drugs having blood purifier (Mussafi-e- Dam), resolvent (Muhallil), refrigerant (mobarrid).
Once the disease causing substance is removed from the body, inflammation is resolved and proper healing taken places, the chances of recurrence will automatically minimize.
Commonly used single drugs are:
Commonly used compound formulations are:
Ilaj Bil Dawa (Pharmacotherapy)
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.