Waja‘al-mafāṣil in Unani medicine: pathophysiological perspectives of mizāj and akhlāṭ and therapeutic approaches

Abstract

Waja‘al-Mafāṣil (musculoskeletal disorders) is a group of ailments that includes muscles, bones, a group of nerves, ligaments and tendons. It is a kind of degenerative disorder that mostly occurs due to not following Asbāb Sitta Ḍarūriyya in their day-to-day life. The designation of diseases according to involvement of their respective organs: Niqris (Gout), ‘Irq al-Nasā (sciatica), Waja‘al-Warik (pain of hip joint) and Waja‘al-Mafāṣil (joint pain), having different manifestations of the same pathological entity. The etiopathogenesis of such diseases mainly revolves around the overwhelming of Akhlāṭ in the joint spaces. This build-up results in obstruction and distension, leading to pain. The most common etiological factor is Balgham (phlegmatic humour) or a mixture of Balgham and Ṣafrā’ (phlegm and yellow bile), and sometimes it may happen due to Khilṭ Sawda. The Balgham (phlegm) is often abnormal, thick, and purulent. With prolonged stagnation, this matter becomes increasingly viscous, sometimes hardening to the extent that it resembles stone. The works related to Waja‘al-Mafāṣil were meticulously reviewed, examined, scrutinised, scanned and summarised based on classical texts and published data in many reliable sources. Unani medicine has rich potential, and it has been focused on since the medicine was in a very primitive stage. It caters for prevention, protection, promotion, and empowerment, and performs the imbibed function. The available information emphasises to explore and develop a protocol for validation of existing knowledge in understanding the underlying pathology and the diagnosis of musculoskeletal conditions with their protocol of treatment.