Unani Concepts of Urine Formation and Micturition in Relation to Modern Renal Physiology: A Narrative Review
Abstract
Background: Urine formation and micturition are essential physiological processes that maintain fluid, electrolyte, and acid-base balance. While contemporary medicine explains these processes through renal and lower urinary tract physiology and neural regulation, Unani medicine interprets them through the concepts of Akhlāṭ (humours), Quwā (faculties), and Ṭabī‘at (the governing principle of the body). Objective: To review the classical Unani concepts of urine formation and micturition and compare them with modern renal physiology through a functional correlation. Methods: A narrative review was conducted using classical Unani literature, including the works of Al-Razi, Raban Tabari, Ibn Sīnā Al-Jurjānī, along with modern textbooks and peer-reviewed articles on renal physiology. Relevant information was critically analyzed and interpreted to identify functional similarities and conceptual differences between the two systems. Results: Classical Unani literature describes urine as a waste product of hepatic digestion that undergoes further processing in the kidneys through the coordinated action of Quwwat Jādhiba, Quwwat Māsika, Quwwat Hāḍima, Quwwat Mumayyiza, and Quwwat Dāfi‘a. Micturition is explained as a coordinated process involving the kidneys, urinary bladder, urethral sphincter, abdominal muscles, and natural faculties. Functional comparison with modern physiology revealed meaningful parallels between selective separation of useful substances, urinary storage, and controlled voiding. However, differences remain in the theoretical basis of urine formation and the mechanisms regulating renal function. Conclusion: Despite their distinct conceptual frameworks, Unani medicine and contemporary renal physiology share several functional similarities in explaining urine formation and micturition. A functional interpretation of classical concepts provides a scientific basis for understanding Unani physiology while preserving its original principles. This integrative approach may support future interdisciplinary research and strengthen the scientific interpretation of Unani medicine.
Keywords: Urine formation; Micturition; Unani medicine; Renal physiology; Quwā; Akhlāṭ; Narrative review.
Keywords:
Urine Formation, Micturition, Unani Medicine, Renal Physiology, Quwā, Akhlāṭ, Narrative ReviewDOI
https://doi.org/10.22270/jddt.v16i9.7967References
1. Dmitrieva NI, Boehm M, Yancey PH, et al. Long-term health outcomes associated with hydration status. Nat Rev Nephrol. 2024;20(5):275-294. doi:10.1038/s41581-024-00817-1. https://doi.org/10.1038/s41581-024-00817-1 PMid:38409366
2. Edwards A, McDonough AA, Ellison DH. Flow-dependent transport processes 2024: filtration, absorption, and secretion. Am J Physiol Renal Physiol. 2025;328(5):F585-F599. https://doi.org/10.1152/ajprenal.00303.2024 PMid:40094947 PMCid:PMC12053844
3. Chrysopoulou M, Rinschen MM. Metabolic rewiring and communication: an integrative view of kidney proximal tubule function. Annu Rev Physiol. 2024;86:405-427. doi:10.1146/annurev-physiol-042222-024724. https://doi.org/10.1146/annurev-physiol-042222-024724 PMid:38012048
4. Quaghebeur J, Bush M, Shkarupa D, Wyndaele JJ, De Wachter S. A brief physiology and pathophysiology of the bladder. Ann Transl Med. 2024;12(2):24. doi:10.21037/atm-23-1770. https://doi.org/10.21037/atm-23-1770 PMid:38721465 PMCid:PMC11075957
5. Ibn Sina. Al-Qanun fi al-Tibb. New Delhi: Idara Kitab-us-Shifa.
6. Jurjani A. Zakhira Khwarizam Shahi. New Delhi: Idara Kitab-us-Shifa; 2010.
7. Razi Z. Kitab al-Hawi. Vol. 10. New Delhi: Central Council for Research in Unani Medicine (CCRUM); 2002.
8. Arzani A. Tibb-i Akbar. Deoband (UP): Faisal Publications.
9. Majusi A. Kamil al-Sana’a. New Delhi: Idara Kitab-us-Shifa; 2010.
10. Ibn Rushd. Kitab al-Kulliyat. Lahore: Maktaba Danyal; 2017.
11. Baghdadi I. Kitab al-Mukhtarat fi al-Tibb. 1st ed. Vol. 1. New Delhi: Central Council for Research in Unani Medicine (CCRUM); 2004.
12. Larijani FJ, Khatooni E, Amiri S, Saadat SH, Meysamie A, Akhlaghi AA, Arasteh A. Knowledge of general physicians about urine analysis: A cross-sectional study in Tehran, Iran. Shiraz E Medical Journal. 2018;19(10).
13. White WI. A new look at the role of urinalysis in the history of diagnostic medicine. Clin Chem. 1991;37(1):119-25. [PubMed: 1988194]. https://doi.org/10.1093/clinchem/37.1.119 PMid:1988194
14. Armstrong JA. Urinalysis in Western culture: a brief history. Kidney international. 2007 Mar 1;71(5):384-7. https://doi.org/10.1038/sj.ki.5002057 PMid:17191081
15. Broumand B. History of urinalysis by Razi and Avicenna in Iran and their clinical judgment from urinalysis. In CIN 2011: 6th Congress of Nephrology in Internet 2011 Nov (pp. 15-30).
16. Nafis B. Kulliyat-e-Nafisi. New Delhi: Idara Kitab-us-Shifa; 1954
17. Razi Z. Kitab al-Murshid. 1st edn. New Delhi: Taraqqi Urdu Bureau; 2000.
18. Arzani A. Mufarrah al-Quloob. New Delhi: Idara Kitab-us-Shifa; 2002.
19. Aqsarai Jamaluddin. Tarjuma Aqserai ma Sharah Mojaz. Lucknow, India: Maktba Munshi Naval Kishore; 1908.
20. Kabiruddin M. Ifada-i-Kabeer. New Delhi: CCRUM; 2001
21. Chandpuri K. Moojizal Qanoon. 3rd edn. New Delhi: CCRUM; 1998.
22. Masihi I. Kitab al-Umda fi al-Jarahat. Vol. 1. New Delhi: CCRUM; 1986.
23. Anonymous. Standard Unani Medical Terminology. New Delhi: CCRUM; 2012.
24. Razi Z. Kitab al-Mansoori. New Delhi: CCRUM; 1991.
25. Sembulingam K, Sembulingam P. Essentials of Medical Physiology. 5th edn. New Delhi: Jaypee Brothers Medical Publishers; 2010.
26. Chatterjee C charan. Human Physiology. 13th edn. Vol. 2. New Delhi: CBS Publishers; 2020.
27. Tortora G, Derrickson B. The Urinary System. In: Anatomy and Physiology, Indian Edition. New Delhi: wiley; 2015. p. 873-907.
28. Sood R. Medical Laboratory Technology. 6th edn. Vol. 2. New Delhi: Jaypee Brothers Medical Publishers; 2009.
29. Hall J. Guyton and Hall Textbook of Medical Physiology. 12th edn. Philadelphia: Elsevier; 2016.
30. Waugh A, Grant A. Ross and Wilson: Anatomy and Physiology in Health and Illness. 12th edn. Edinburgh: Churchill Livingstone/Elsevier;
Published
Abstract Display: 0 
PDF Downloads: 0 PDF Downloads: 0 How to Cite
Issue
Section
Copyright (c) 2026 Shaikh Mohd Razik , Abid Ali Ansari, Tasfiya Hakeem Ansari, Ansari Sabahat Mansoor , Zeba Saif
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
How to Cite
.