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Integrated Approach of Majoon-e-Falasfa and Halwa Gheekwar in Geriatric Care

Reesha Ahmed ¹*, Mohammed Wasim Ahmed ², Rameesa Rashid ¹, Sayed Abbas Haider Zaidi ¹, Rashidul Islam Ansari ¹

¹ Regional Research Institute of Unani Medicine, Aligarh, CCRUM New Delhi, Ministry of Ayush, New Delhi, India.

² Regional Research Institute of Unani Medicine, Okhla, New Delhi. CCRUM New Delhi, Ministry of Ayush, New Delhi, India.

 

 

Introduction

Among all ancient medical practices still in use today, Unani Medicine stands out as an influential system utilizing potent remedies sourced from both plants and animals along with minerals. More than two millennia prior, the renowned physician Hippocrates employed this practice; yet, he incorporated substantial elements derived from ancient Egyptian medical knowledge alongside crucial aspects stemming from early Mesopotamian cultural practices. According to the Unani system of medicine, treatments are categorized into four distinct categories: dietary management (Dietotherapy - Ilaj-bil-ghizah), regimen-based therapies (Regimental Therapy - Ilaj-bil-tadbir), surgical procedures (Surgery - Ilaj-bil-yadh), and drug administration techniques (Pharmacotherapy - Ilaj-bil-dawa). When examining pharmaceutical treatments, various types of medications including monotherapies and polytherapies are employed¹. 

The final stage of life, old age, has been a subject on which almost every person has reflected, sometimes with dread, sometimes with acceptance, but always with the need to come to grips with a difficult situation. However, ageing is a necessary and normal aspect of life. It is a process of slow, cumulative, and generalized degradation of functions, which results in the loss of adaptive response to stress and increases the risk of age-related disorders²

An increasing population is one of the most notable aspects of the twentieth century, and the first part of the twenty-first century will be known as "The Age of Ageing." The frightening scenario is that the world's old population is expanding weekly by around one million people^1,3.

Aging-related health difficulties include functional incapacitation owing to senescent alterations in human organs, as well as illnesses induced by free radicals, irregularities in motor function, audio-visual degeneration, and other factors. 
 Most of the elderly have multiple medical problems. Poor mobility, arthritis, poor vision, memory loss, hearing impairment, and urinary issues are quite typical accompanying conditions. Chronic illnesses such as diabetes, hypertension, and high cholesterol levels, together with their consequences, severely impair the quality and quantity of life of the aged population.

Apart from physical sickness, the elderly are more likely to have mental instability. Increasing social isolation, physical, intellectual, and financial reliance on others, as well as worry and fear about their health and social security, are all key variables that make the elderly more vulnerable to psychiatric disease. Depression, whether with or without anxiety, is the most frequent mental disorder among the elderly. Dementia cases are also growing in our neighborhood¹.

Our culture and government must acknowledge the huge increase in the senior population. The government and society as a whole are responsible for providing a safe and healthy living environment for its older citizens.

Unani Concept:

Many ancient Unani physicians recognised the value of old age. Unani books, including Al Qanun Fi 'l Tib, Kamil-us-Sanaah, Kitab-ul-Mansoori, Zakheera Khwarzam Shahi, Firdaus-ul-Hikmat, Ain-al-Hayat, Kitab-ul-Kulliyat, and Kitabul Mukhtarat Fil Tib, have extensive material on geriatric care. Tadabeer-e-Mashaikh provides a complete overview of geriatric care^4,5,6,7,8,40

These medications can successfully treat a variety of typical old-age ailments, including sleeplessness, lethargy, osteoarthritis, palpitation, constipation, backache, and so on. Aside from that, numerous diets and regimens like Dalak (massage), Riyazat (exercise), etc., have been mentioned in Unani literature for the promotion of health and prevention of ailments in the elderly^5,4,6,7,8.

Aging Process in Human Being

According to Unani concept, organism aging is the result of two opposing forces: Tahleele Ratoobate Ghareezia by Hararate Ghareezia to maintain the organism in a functional state, and inadequate compensation of Tahleel by Quwwate Hadima that maintains balance or homeostasis. Human beings originate from Mani of the male (male sperm), which acts as Fa’el, playing the part of a factor, and Mani of the Female (female ovum), which acts as Mafool, providing the matter. Each of these is fluid and moist, but there is more wetness and terrene substance in the female ovum, whereas air and igneity are predominant in male sperm. The earth provides the firmness and rigidity, and the fire provides the maturative power. These give the coagulum certain firmness or hardness. However, our bodies are exposed to two types of injuries, each with an exterior and an interior cause. One of the two kinds of injuries is the Tahleele Ratoobate Ghareezia (dissolution of innate moisture from which we have been created) by Hararate Ghareezia. It takes place gradually. Tabiyat, the resisting force, tries to maintain the balance (harmony) by producing the substitute of Tahleel via Quwwate Hadima. Over a period of time, the quantity of Ratoobate Ghareezia decreases. Due to increased Tahleel of Ratoobate Ghareezia, Hararate Ghareezia weakens because Ratoobate Ghareezia provides matter for Hararate Ghareezia. Quwwate Hadima also gets weakened due to weakness in Hararate Ghareezia, ultimately resulting in decreased formation of Akhlat and Ratoobat, as well as decreased availability of the substitute of Tahleel. Decrease in Hararate Ghareezia changes the Mizaj relatively to Barid; gradual increase with age in Baroodat results in decline of Quwa (faculties), thereby Afaal (functions) of the body. As all Quwa requires Hararat for performing Afaal (function). Depravity of humors or dryness continues neutralizing the Ratoobat of the body until the form ceases to have a capacity for life.

The second source of injury is Taffun (putrefactive breakdown and metamorphosis) of the humors into a form such that the fermentative phenomenon of life is no longer able to proceed. Finally, the Taffun (putrefactive breakdown) disperses the vitality, because it first destroys the Ratoobat (moisture), and then Tahleel (dissolves) it, and simply dry ash is left behind. Each of them takes its origin from extrinsic and intrinsic agents. The extrinsic agents are, e.g., the atmosphere, which causes Tahallul and Taaffun in the Ratoobat. The intrinsic agents are, e.g., the Hararate Ghareezia (innate heat), which causes Tahleel of the Ratoobat (moisture): Hararate Ghareebiya (extraneous heat) generated within us from the elements, diet, and through other agents, which causes Taffun (putrefactive changes) in the Ratoobat. All these agents mutually aid one another in rendering the body dry. And yet it is true that our perfection and soundness and the power to perform various actions depend on a due degree of dryness of the body. But the degree of dryness becomes relatively greater and greater until we die. Hence, this dryness is inevitable. As the dryness increases, the innate heat diminishes. The loss continues unceasingly till death, and the moisture which is lost is not restored. The loss goes on and more. Every Quwwat gradually decreases with age. Tabiyat is also a Quwwat that controls all Quwa and their functions, thus maintaining harmony, which also weakens with an increase in Baroodat. As the Tabiat is the supreme controller of all functions of the body, whenever it becomes weak, it alters all functions of the body^4,9,10,11 

Dynamics of Preservation and Promotion of Health 

All bodies do not have the same degree of innate moisture and heat. There is great variation in regard to them. Every person has their own term of life. Under this view, the art of maintaining health consists in guiding the body to its natural span of life by paying attention to whatever things are conducive thereto. There are two faculties to be fostered by the doctor in striving for this subject:

(1) The Quwwate Hadima (nutritive faculty), whereby that is replaced, which is constantly being lost from the body, namely earthiness and aquosity;

(2) The sensitive faculty- that is, the Quwwate Haiwania (pulsatile faculty), which is concerned with the replacement of that which is lost from the body by breath- namely, “air” and “igneity.”

The art of maintaining health is not the art of averting death, or of averting extraneous injuries from the body, or of securing the utmost longevity possible to the human being. It is concerned with two other things: (a) prevention of putrefactive breakdown, (b) safeguarding of innate moisture from too rapid dissipation, and maintaining it at such a degree of strength that the original type of constitution peculiar to the person shall not change even up to the last moment of life^4,12,13,14.

Mental changes in Old Age:

Neurologic conditions are widespread and extensive and affect millions of people worldwide. Alzheimer’s disease (AD), Parkinson’s disease (PD), and ischemia/stroke are the most common of them. A study published by The Lancet Neurology in 2021 shows that more than 3 billion people live with neurological disorders. 7.4% of adults over the age of 60 in India are currently living with Alzheimer’s dementia¹⁵.

Neurodegenerative disorders are illnesses characterized by structural and functional deterioration due to abnormal protein aggregation, resulting in inflammation and oxidative stress in the central nervous system. In the unani system of medicine, all current brain ailments, including alzheimer’s disease, parkinson’s disease, mania, anxiety, melancholia, and others, are classified under the general category of neurodegenerative disorders. Their pathogenic variables and associated symptoms, and therapeutic modalities are similar¹⁶. Under the heading of old age, a vast list of single and compound drugs has been mentioned by Unani scholars, which are very effective and form an important part of geriatric treatment^{17,18,19,20,21}. Unani scholars have mentioned etiology, pathophysiology, and principles of treatment^22,23. For treatment a variety of single herbs^24,25 and polyherbal formulations^26,27,28  in the form of Itrifal, Khamira, Majoon, and Habb (pills) have been recommended.

Majun Falasfa (MF)

Majoon Falasfa is an Unani medicine used for enhancing mental power. It is also used for phlegmatic diseases. It is also useful in age-related dementia and to counter the effects of ageing.  It is potent in reducing Parkinson’s disease symptoms, being mimicked in the transgenic flies²⁹. This Compound is one of the most reputed poly pharmaceutical preparations of the Unani System of Medicine. It was originally called “Madaat-ul-Hayaat,” i.e., Elixir of life. It is an electuary which is prepared especially for the people engaged in mental work, and that too processed in a semisolid form, hence, renamed as Majoon Falasfa¹..

Composition of Majoon Falasfa varies according to different Qarabadeen. This compound formulation contains thirteen mufrad drugs with different therapeutic actions, which is why it is being used in various age-related dementias as well as to counter the effects of ageing and some other conditions¹.

Therapeutic Action and Uses of Majoon Falasfa

It is a compound formulation, given in classical literature, whose various therapeutic actions were mentioned in classical literature, like liver tonic, antidiuretic, semenagogue, aphrodisiac, digestive, appetizer, carminative, , lithotriptic, deobstruent, general tonic, expectorant, and anti-arthritic^13,30,31.   According to the given therapeutic actions, it is used for stomach aches, in colic pain, treating kidney, joint pains, and urinary tract diseases. There are also some other conditions like backache, generalized weakness, phlegmatic diseases. The given formulation is also helpful in strengthening gums and teeth, enhancing memory in dementia, and in the impairment of memory^8,32,33.34. These functions have also been proven by various scientific studies. 

Halwa Gheekwar:

This compound formulation Halwa-i-Gheekwar, is frequently used by Unani physicians for prophylactic and therapeutic purposes. It contains various single unani drugs, which have been reported to possess antioxidant and immunomodulatory activities³⁵.

Therapeutic Action and Uses of Halwa Gheekwar :

Halwa Gheekwar, an herbal Unani solution crafted from natural extracts. Specifically formulated to alleviate sciatic disease, eliminate joint pain and swelling, and provide anti-inflammatory effects³⁶. It is also beneficial in arthralgia, neuralgia, cough, and asthma in the dose of 12-25 gm^35,37,38

There are 29 single drugs are present in Halwa Gheekwar. But the composition of this compound is also changed according to Qarabadeen.

 

 

Halwa Gheekwar has the following advantages:

S.no.	Disease
1.	Get rid of joint pain	Natural combination of herbal ingredients that helps eliminate joint pain.
2.	Beneficial for muscle strength	Regular use increases blood circulation in muscles, promoting healthy muscle strength.
3.	Healthy digestive source	Useful for reducing joint inflammation, constipation, and improving digestion.
4.	Useful for the immune system	Acts as an energy booster for adults, supporting a robust immune system and overall health.
5.	Control sciatica disease	Natural pack of authentic ingredients designed to eliminate joint swelling and control sciatica disease.34

MAJOON FALASIFA

S.No.	Unani Name	Scientific Name
1.	Maweez Munaqqa	Vitis vinifera L.
2.	Zanjabeel	Zingiber officinale Roscoe
3.	Filfil Siyah	Piper nigrum L.
4.	Filfil Daraz	Piper longum L.
5.	Darchini	Cinnamomum verum J.Presl Syn: Cinnamomum zeylanicum Blume.
6.	Aamla	Phyllanthus emblica L. Syn: Emblica officinalis Gaertn.
7.	Post-e-Balela	Terminalia bellirica (Gaertn.) Roxb.
8.	Sheetraj Hindi	Plumbago zeylanica L.
9.	Zarawand Mudahraj	Aristolochia rotunda L.
10.	Salab Misri	Orchis latifolia L.
11.	Maghz-e-Chilghoza	Pinus gerardiana Wall. ex D.Don
12.	Beikh-e-Babuna	Matricaria chamomilla L.
13.	Maghz-e-Narjeel	Cocos nucifera L.
14.	Tukhm-e-Babuna	Matricaria chamomilla L.
15.	Asl (Animal origin)	Honey

 

HALWA-E-GHEEKWAR

S.No.	Unani Name	Scientific Name
1.	Asgand Nagori	Withania somnifera (L.) Dunal
2.	Ilaichi Khurd	Elettaria cardamomum (L.) Maton
3.	Amba Haldi	Curcuma amada Roxb.
4.	Talmakhana	Hygrophila auriculata (Schumach.) Heine
5.	Taj	Cinnamomum burmanni (Nees & T.Nees) Blume Syn: Cinnamomum cassia Siebold
6.	Salab Misri	Orchis latifolia L.
7.	Khulanjan	Alpinia galanga (L.) Willd.
8.	Darchini	Cinnamomum verum J.Presl Syn: Cinnamomum zeylanicum Blume.
9.	Zanjabeel	Zingiber officinale Roscoe
10.	Satawar	Asparagus racemosus Willd.
11.	Shaqaqul Misri	Leiotulus secacul (Mill.) Pimenov & Ostr. Syn: Malabaila secacul (Mill.) Boiss.
12.	Qaranfal	Syzygium aromaticum (L.) Merr. & L.M.Perry
13.	Qust Sheerin	Saussurea neofranchetii Lipsch. Syn: Saussurea auriculata Franch.
14.	Malkangni	Celastrus paniculatus Willd.
15.	Majeeth	Rubia cordifolia L.
16.	Maghz-e-Akhrot	Juglans regia L.
17.	Maghz-e-Badam Sheerin	Prunus amygdalus Batsch
18.	Maghz Narjeel	Cocos nucifera L.
19.	Musli Safaid	Chlorophytum arundinaceum Baker
20.	Musli Sainbhal	Bombax ceiba L. Syn: Salmalia malabarica (DC.) Schott & Endl.
21.	Gheekwar Sabz	Aloe vera (L.) Burm.f.
22.	Ghee	Clarified Butter
23.	Shakar Safaid	Sugar
24.	Khoya	Concentrated Milk
25.	Khajoor	Phoenix dactylifera L.
26.	Maida Gandum (Wheat Flour)	Triticum aestivum L.
27.	Rooh Keora	Pandanus tectorius Parkinson
28.	Satt-e-Loban	Styrax benzoin Dryand.
29.	Satt-e-Leemu	Citrus limon (L.) Osbeck

 

 

 

Conclusion: 

From the above discussion, it may be inferred that Majoone Falasfa and Halwa Gheekwar are among the best Unani formulations, offering many health benefits. It has proven to be beneficial in counteracting the effects of ageing. However, more scientific studies and clinical trials are needed on these compound formulations to ensure their scientific validation for clinical use in patients in general and in the elderly in particular.

Acknowledgement: The Authors are highly thankful to DG CCRUM, New Delhi, and DD RRIUM, Aligarh, for providing the best possible facilities for this review.

Authors' Contributions: All authors contributed equally.

Funding source: There is no funding agency

Conflict of Interests: There is no conflict of interest.

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