THE PRINCIPLES AND CLINICAL MANAGEMENT OF ACUTE DIARRHEA (ISHAL) IN THE UNANI SYSTEM OF MEDICINE

Abstract

Background: Acute diarrhea remains one of the leading causes of childhood morbidity and mortality worldwide, and while oral rehydration therapy has become the cornerstone of its modern management, traditional systems of medicine such as Unani offer a parallel and largely under-explored body of clinical experience in managing this condition, referred to as Ishal. Objective: This review aims to examine the conceptual understanding and therapeutic management of acute diarrhea in Unani medicine. Methods: A narrative review was conducted of classical Unani texts, including Al-Qanun fil Tibb, Al-Ikseer, and Kamil us Sana, as well as contemporary Unani pharmacopoeial and formulary sources and relevant published literature. Information on the definition, classification, aetiopathogenesis, and dietary and pharmacological management of Ishal was extracted and organised thematically, with particular attention to descriptions of dietotherapy (Ilaj bil Ghiza) and pharmacotherapy (Ilaj bil Dawa) in both adult and paediatric patients. Findings: The Unani framework understands Ishal as an impairment of the intestinal retentive faculty (Quwwat-e-Masika) relative to the expulsive faculty (Quwwat-e-Dafia), and classifies the condition according to the dominant humour and the character of the causative matter. Management follows a graded therapeutic hierarchy in which dietotherapy precedes pharmacotherapy: dietary restriction (Parhez), gradual reintroduction of easily digestible foods such as Sawiq-e-Sha’ir and Ma’ul Sha’ir, and early attention to fluid replacement feature prominently, followed by single and compound astringent drugs when diet and regimen alone prove insufficient.