Nutūl as an effective and time tested regimenal modality in Unani system of medicine: An Overview

Ilāj bit tadbīr is one of the treatment plans in the Unani system of medicine which includes the modification in asbāb-i-sitta zarooriya (six essential factors) through certain interventions. Nutūl or irrigation is a classical and effective method in regimenal therapy which refers to pouring or dripping of liquid slowly and steadily over the body part from a pre-fixed height. The benefits achieved are an amalgamation of neurological effect, psychological effect and pharmacological actions of the procedure and the drugs used. For this purpose, usually water, oil or medicated decoction is poured from a height over specific sites of body in certain diseases. Therapeutically, nutūl is effective in various ways such as dispersing the causative morbid matter from the part, normalizing the mal-temperament, relieving pain, increasing the circulation, etc. It is specifically useful as an adjuvant treatment in the management of central nervous system disorders like headache, insomnia, migraine, amnesia, melancholia, vertigo, epilepsy and also in certain other disorders like cystitis, mastitis, arthralgia, etc. These therapeutic effects are expected due to the kafiyat (quality) of liquid and the constituents of the formulation used in the procedure. Nutūl has an analgesic effect also, hence, recommended in several Musculoskeletal problems such as waja-ul-mafasil (osteoarthritis), waja-uz-zahr (low backache), waja-ul-azlat (myalgia), irq-un-nasa (sciatica), etc. The exact mechanism of action of Nutūl therapy is still not known but few preliminary reports suggested that it has an anxiolytic effect through decreasing the plasma noradrenaline and urinary serotonin excretion, decrease in rate of breathing, reduction in diastolic blood pressure and heart rate with lowered sympathetic tone. Keywords: Taḥlīl; Kafiyat; Mizāj; Tadbīr; Joshānda