pathogenesis of mental disorders in Unani system of medicine
In Unani Medicine, the pathogenesis of diseases has been attributed to three factors viz. Â mizaj (temperament) tarkeeb (structure) and ittesal (continuity of tissues). Abnormalities of these factors are considered as: sue Mizaj (altered temperament), sue Tarkeeb (altered structure), tafarruqe Ittesal (discontinuity in tissues) .
Mizaj is a specific and distinct state of an individual reflecting neuroendocrine, genatometabolic ans somatoenvironmental equilibrium at the optimum functional level of adjustment. The harmony of specific mizaj results in proper and healthy functioning of the body and derangement in this distinct state consequently becomes the cause of ill health, producing different diseased conditions. The derangement of mizaj, results from the shift in the equilibrium of four qualities (kaifiyate arba) i.e. haraarat (hotness), baroodat (coldness), ratoobat (moistness) and yaboosat (dryness) is considered as sue mizaj sada andifthis imbalance is at the level of Akhlat (body fluids/humors) it will be considered as sue mizaj maddi.
Unani medicine, as is well known, based on the Hippocratic humoral theory. This theory supposes the presence in the body of four humuors: blood, phlegm, yellow bile and black bile. The mizaj of persons are accordingly expressed by word safrawi (sanguine), balghami (phlegmatic), safrawi (choleric) and saudawi (melancholic) according to the preponderance in them. Every person is supposed to have a unique humoral constitution which represents his healthy state. Any change in this brings about a change in his state of health.
There are three major quwa (faculties) which regulate human body viz. quwwate nafsania (psychic faculties), quwwate haivania (vital faculties) and quwwate tabiyya (physical faculties). These quwa (faculties) are specific for a particular tissue or organ on which the specific functions of that organ depend. Quwwate tabiyya is concerned with taghzia (nutrition), namu (growth) and tawleed (reproduction) and jigar is considered uzwe raees (epicenter) of this quwwat. Quwwate haivaniya is concerned with tadbeer of rooh, which brings life to the part it supplies. Qalb is uzwe raees of this faculty. Quwwat nafsania is concerned with intellectual, sensory and motor functions and dimagh is supposed to be seat for this faculty.
The organs are the seat of quwa (faculties) and quwa (faculties) give rise to functions. For each functions there is quwat (faculty-power) and where there is quwat (faculty) there is functions. The quwa (faculties) and af'al (functions) are undividable. Since the quwa (faculties) provide the basis for different bodily functions, therefore, their existence is evident through different functions. The maintenance and proper performance of quwa (faculties) depends upon the continuous supply of rooh (pneuma) because rooh produces energy in the body which keeps all the quwa (faculties) functioning. In the opinion of Aristotle first of all mabda' al-awwal or nafs' ula (tabi'at-human nature) pays it attention toward rooh, thereby all the quwa (faculties) of body are produced. Any cessation of the supply of rooh means cessation in the functioning of quwa (faculties).
Quwwate nafsania acquires its matter from roohe qalb or roohe haivaniya. The vessels work as a channel to take this rooh to all parts of body along with quwwate nafsania. The roohe haivaniya which originates in the heart ascends through the vessels arising from the heart. These vessels before enteringin the brain branch extensively and make a large network in which rooh is matured and transformed into roohe nafsaniya. Then roohe nafsaniya gains entry into the ventricles and other parts of brain where it get rid of impurities, purify and becomes fully matured to imports quwwate nafsania to brain. After becoming usable the roohe nafsania enters into nerves and spinal cord and reaches to motor and sensory organ of the body. When any parts of the roohe nafsania dissolves then another part takes its place and motor and sensory system continues in systemic way.
If the mizaj of brain gets deranged consequently the mizaj of rooh also become agitated and did not gets completely decontaminate. This impurity of rooh results in change in homeostasis and produce izterab (Anxiety) in psychic faculty.
Quwae nafsania (psychic or mental faculties) are those faculties which perform intellectual, sensory and motor function of the body. It consists of two main faculties and stand as genus for them. These are quwae mudrikah (perceptive/ cognitive faculties) and quwae muharrikah (motor faculties). Quwae mudrikah (perceptive/ cognitive faculties) is also of two varieties viz. quwae mudrikah zahira (external perceptive faculties) and quwae mudrikah batinah (internal perceptive faculties). External perceptive power is sensory and related to five external senses such as vision, hearing, smell taste and tactile sensation whereas internal perceptive faculties are concerned with the intellectual faculties of the brain.
According to Ibn Sina (Avicenna) and his followers, who accepted the views of ancient philosophers instead of the physicians, the internal perceptive faculties are five in number and are as follows:
- Al hiss al mushtarak (faculty of composite sense)
- Al khayal (faculty of imagination)
- Al wahimah (faculty of apprehension)
- Al hafizah (faculty of memory)
- Al mutasarrefah (faculty of ideation)
Al hiss al mushtarak is the faculty where all sensations converge, which reacts to their form and in which their forms combine. Storage and memorization of the forms of the things is performed by quwat al khayal. Quawat al wahima percepts the meaning of things by process of analysis and the storage of the meaning of the things perceived by Quawat al wahima is performed by quwat al hafizah. Creation of abstract ideas, imagination and thoughts are concern with quwat al mutasarrefah.
Quwae mudrikah batinah (internal perceptive faculties) are also called as quwae siyasiyah or qawae mudabberah (faculty of planning) . Ali Ibn Abbas Al Majoosi and other physicians classified them only into three categories viz: quwwate takhayyul (faculty of thought), quwwate fikr (faculty of thinking) and quwwate zikr or hafiza (retentive faculty), considering first two and last two as a single faculty.
Unani physicians have divided the brain into three functional areas i.e. fore brain (Muqaddam Dimagh), mid brain (Ausat Dimagh) and hind brain (Moakhkhar Dimagh). These areas have particular respective quwwas (Faculties) e.g. the fore brain has the quwwate takhayyul (faculty of thought),mid brain has quwwate fikr (faculty of thinking) and hind brain has quwwate zikr or hafiza (retentive faculty).
As stated by Ibne Rushd in his book kitab al kulliyat.