IRSĀL-I-‘ALAQ: A CLASSICAL REGIMEN OF THE UNANI SYSTEM OF MEDICINE – A SCIENTIFIC REVIEW

Abstract

The Unani system of medicine, is based on the principle of equilibrium which states health exists when the four akhlāṭ (humours) of the body— dam (blood), ṣafrā (yellow bile), saudā (black bile), and balgham (phlegm)—are in perfect balance and harmony. Any disturbance back to a state of wellness and vitality. Irsāl-i-‘Alaq (Leech Therapy) is effective mode of treatment  in which medicinal leeches are applied to specific body sites for various diseases. It began as an ancient blood-balancing ritual over 2,500 years ago became a sophisticated therapeutic tool in Unani medicine under the name Irsāl-i-‘Alaq, fell out of favour in the early 20^th  century, and has now revived  as strong evidence-supported treatment in both latest  micro-surgery and traditional medical systems. In Unani medicine, leech therapy is classified as a type of Istifrāgh (evacuation). It removes morbid material (Tanqiya-e-Mawād), diverts pathological fluids (Imāla-e-Mawād), restores humoral balance, improves local circulation and tissue nutrition. Over 115 scientifically identified bioactive compounds (anticoagulants, vasodilators, anaesthetics, proteinase inhibitors, etc.), which exerts  Mussakin (analgesic) and Muḥallil (anti-inflammatory) actions. Latest researches validates its unique efficacy in the management of pain in diseases like osteoarthritis, chronic low back pain, venous congestion, and is used as an adjunct therapy to heal chronic wounds, including diabetic foot ulcer. Renowned Unani scholars recommended use of only non-poisonous medicinal leeches for therapeutic purpose. Following the strict protocol related to proper identification and procedure minimises the appearance of adverse effects associated with leech therapy. Leech therapy has now been approved by FDA (2004) and it is commonly used worldwide for management of skin disorders, pain management, and plastic reconstructive surgeries. Irsāl-i-‘Alaq exemplifies successful integration of traditional Unani practice with evidence-based medicine, providing a safe, cost-effective, and often superior alternative or adjuvant treatment in some conditions.