Rua’af (Epistaxis) in Unani Medicine: Classical Insights and Therapeutic Approaches

Abstract

Rua’af (epistaxis) refers to bleeding from the nasal cavity and is among the most common otorhinolaryngological emergencies encountered in clinical practice. Although most episodes are self-limiting, recurrent or severe epistaxis may indicate underlying local or systemic pathology requiring prompt medical intervention. In modern medicine, epistaxis is associated with trauma, infections, hypertension, vascular disorders, neoplasms, and systemic diseases. Unani medicine provides a comprehensive description of Rua’af under disorders of blood and vascular imbalance, attributing its pathogenesis primarily to excess blood (Imtila-i-Dam), increased heat of blood (Hararat-i-Dam), weakness of blood vessels (Za‘f al-Aw‘iya), and derangement of humours (Fasad al-Akhlat).

Classical Unani scholars including Ibn Sina, Al-Razi, Jurjani, and Arzani extensively discussed the causes, classification, clinical manifestations, and management of Rua’af. The therapeutic approach in Unani medicine emphasizes correction of humoral imbalance through Ilaj bil Tadbeer (regimental therapy), Ilaj bil Ghidha (dietotherapy), and Ilaj bil Dawa (pharmacotherapy). Various cooling, haemostatic, and astringent formulations are recommended for controlling nasal bleeding and strengthening vascular integrity. Surgical intervention is considered only in resistant or life-threatening cases.

The present review aims to elaborate the concept of Rua’af in Unani medicine and correlate it with contemporary understanding of epistaxis. The paper highlights classical etiological concepts, symptomatology, preventive measures, and therapeutic interventions described in Unani literature, thereby emphasizing the relevance of traditional approaches in the holistic management of epistaxis.

Keywords: Rua’af, Epistaxis, Nose bleed, Hiddat-i-Dam, Imtila-i-Dam