Unani battles religious stereotype, rides the wave of herbal medicines

'Without ayurveda, unani isn't complete and without unani, ayurveda isn't complete', says an Unani practitioner

A carpenter from Palwal, Haryana, who identifies himself as Balbir, is pinning his hopes on unani medicine. He has spent Rs 1.5 lakh on allopathy, but couldn’t find a cure for his son’s liver infection. Masroor, a college student battling premature baldness, claims the herbal potion he was prescribed began working wonders on his scalp within 20 days after various medicines failed to yield results. Balbir, his son and Masroor are part of a weekday crowd at the Majeedia Unani Hospital inside the Jamia Hamdard University in Delhi. 

The numbers here are minuscule compared to the hordes of patients at any health centre in New Delhi because patients turn to unani as a last resort.

An alternative medicine with Hellenistic origins (Yunan is Persian for Greece) that flourished in the Arab world, unani has remained an Islamic stereotype although it bears similarities to other herbal systems such as ayurveda.

The present government, under the Bharatiya Janata Party, has focused on alternative medicines, and in November 2014 it elevated the department of ayurveda, yoga and naturopathy, unani, siddha and homoeopathy (Ayush) into a ministry. A conference organised under the ministry as part of Unani Day last week called for the integration of all medical systems to address health challenges.

At a time when people worldwide are becoming increasingly health conscious and leaning towards natural products, is unani medicine finding itself at an inflection point? Or will it continue to be overshadowed by ayurveda and homoeopathy?

Hakim Chhotelal Surender Jain, a fifth-generation unani practitioner near Jama Masjid in Old Delhi, says, “Without ayurveda, unani isn’t complete and without unani, ayurveda isn’t complete.” At his medicine shop, the two traditional medicines have been available to customers since the family business began in 1861. He explains that the medicines were traded between pre-Independence India and the Muslim world in Central and South Asia. Most patients come to him with renal complaints, bodily pain, gastrointestinal issues and sexual problems.

Unani is based on the teachings of Greek physician Hippocrates, the father of western medicine. It recognises the classical four humours — phlegm (balgham), blood (dam), yellow bile (safra) and black bile (sauda). The corresponding temperaments (mizaj) are phlegmatic (cold and hot), sanguine (hot and wet), choleric (hot and dry) and melancholic (cold and dry). In ayurveda, there are three equivalents to the humours. In unani, health is also considered to be based on six essential elements — air, drink and food, sleep and wakefulness, excretion and retention, physical activity, and mental activity and rest. Stressing physical, mental and spiritual health through the equilibrium of the humours, unani revolves around a person’s “aura” and her response to both internal and external environments.

India is the second largest exporter of medicinal plants after China, and they together meet over 70 per cent of the global demand. The organised herbal medicine market is worth Rs 5,000 crore, with more than 250 companies manufacturing herbal/alternative medicines in India, says Mansoor Ali, chief sales and marketing officer, Hamdard Laboratories India. In the herbal medicinal market, ayurveda contributes 70 per cent, with 24 per cent coming from homoeopathy and three per cent from unani, according to conservative estimates.

The dawakhana-turned-wellness centre of Hamdard Laboratories

Hamdard is the leading name in unani. It has more than 450 products, of which nearly 400 are medicinal and the remaining are in the fast-moving consumer goods or over-the-counter category. It is looking to capitalise on the trust people have in the brand.

The century-old company, which boasts household names such as Rooh Afza, Safi and Sualin, was always perceived as a traditional and conservative unani organisation. “The first big initiative taken in the last two years is the opening of Hamdard Wellness Centres. These centres are bringing about awareness and a big shift in the perception of unani,” Ali says. The company has remodelled a decades-old dank dawakhana (pharmacy) into a swank wellness centre next to its main office in the walled city. It has also opened wellness centres in newer parts of Delhi and in a few other cities.

India has over 52,000 qualified hakims across 18 states, about 40 unani medical colleges and 1,200 dispensaries.

Mohammed Zubair, general manager, sales and marketing, Hamdard Laboratories, points out that despite holding unani degrees, the doctors are “tempted or constrained to start allopathic practice” as patients commonly prefer quick treatment of symptoms. He calls for strict government regulation to weed out quacks who make “criminal claims” such as offering a cure for HIV and provide more fodder for biases against the figure of the hakim.

M Akhtar Siddiqui, dean of the School of Unani Medical Education and Research in Jamia Hamdard, says: “Our teaching hospitals don’t offer enough clinical training to give confidence to practitioners. Secondly, unani medicine is not as easily available as allopathy.” The literature on unani is in Urdu, Arabic and Persian, so a majority of those who make it to the colleges are Muslim, he adds.

Unani came to India with the Muslim rulers who established the Delhi Sultanate, and was accepted along with ayurveda. But it was institutionalised only under the Mughals in the 16th century.

Masroor Ahmed Khan, scion of a family of hakims who served the Mughals for 300 years (starting in Agra during Akbar’s reign), says the physician-confidante’s seal of approval was a must before the emperor sat down to his meal. The royal dietician’s supervision ensured the emperor received the right mix of nutrients to keep up his strength as a warrior, besides being a steady dose of aphrodisiac.

Among his ancestors, known as the Sharif Khani hakims, is Mohammad Ajmal Khan, one of the founders of Jamia Millia Islamia University and president of the Indian National Congress, the Muslim League and the All India Khilafat Committee. The family forebear, a disciple of a Sufi saint in Central Asia, came to India with Babur. “Sufi philosophy is human service without discrimination,” says Khan, whose family lives in a heritage building called Sharif Manzil in Old Delhi.

After 1947, Khan rues, “the goat, unani and Urdu became Muslim, while the cow, ayurveda and Hindi became Hindu.”

Over seven decades later, what is the fate of unani and other traditional medicines?

Prachinkumar Ghodajkar, assistant professor at the Centre of Social Medicine and Community Health, School of Social Sciences, Jawaharlal Nehru University, says of the eight kinds of systematised, codified medicines, 97 per cent of our health budget goes to allopathy, and the rest to the others that include Ayush and Sowa-Rigpa (Tibetan). “The government approach to engaging with these alternative medicines has been predominantly for manufacturing and export. So, they are not used for the value of their knowledge base and health of the population.”

He says alternative medicines are now focusing on production of medicines merely to fit the modern model. Within the segment, ayurveda gets preferential treatment owing to a religious angle as well as the sheer number of practitioners. Ghodajkar also argues that standards and definitions of allopathic medicines are being unfairly imposed on branches like ayurveda and unani, given that scientific understanding of diseases and the human body varies for different systems of medicines.