International Journal of Unani and Integrative Medicine 2018; 2(3): 11-15

Effect of Unani treatment in Sala’ al-Rahim (Leiomyomata):

A case report Arshiya Sultana and Khaleequr Rahman

Abstract:   Sala’ al-Rahim (leiomyomata) is commonest benign gynecologic tumour affecting nearly 20-30% reproductive-age women. Treatment of leiomyomata should be individualized, and symptomatology may be a decisive factor in deciding the treatment. No definite treatment is available except hysterectomy. Therefore, patients are turning towards complementary and alternative medicine.

Case presentation: A 40-year-old, married, parous woman who presented with complaint of severe lower abdominal pain and backache prior and during menstruation since one year came to the hospital and visited the outpatient department (OPD) of Amraze Niswan wa Qabalat (Gynecology). There was no history of abnormal uterine bleeding. Patient had taken allopathic treatment for severe dysmenorrhoea as it was incapacitating her from routine work. However, she did not have relief. Her ultrasonography of pelvis showed anterior (1.4X1.7cm) and posterior (1.5X1.9cm) intramural uterine fibroid (leiomyomata). She was treated with Unani medicine for 16 weeks. Orally, Mundij Balgham (concoction)was administered for 15 days followed by two Mushil and Tarbid alternately. This treatment was followed by oral, Majoon Dabeed ul Ward, 7 gm twice daily, Itrifal Gudaadi 10 gm at bed time. Locally suprapubic and per vaginal Marham Dakhliyun mixed with fine powder of Anisoon, Aftimoon and Izkhar (equal quantity) was applied for 12 weeks. Patient had complete pain relief in the second cycle. Her repeat ultrasonography after 16 weeks showed resolution of anterior fibroid. Conclusion: Unani treatment is useful for resolution of uterine fibroid confirmed by ultrasonography with symptomatic relief without any adverse effect.

Keywords: Leiomyomata, Sala al-Rahim, secondary dysmenorrheal, uterine fibroid, unani treatment 

Introduction :  The tumours are analogous to sala’ in Unani system of medicine and usually belong to Waram Balghami (phlegmatic swelling) . Unani scholars surmised that according to the symptoms, Sala’ are either Salima (benign) or Khabisa (malignant). Sala’ Salima is a well defined, growth is similar to the organ, localized and does infiltrates in the organ and leads to pressure symptoms and curable without reoccurrence. The change in the quality and quantity of Khilt Balgham and its effect on the Mizaj of the organ or person causes disease. Accumulation of Abnormal Balgham (phlegm) in the Rahim (uterus) leads to sala’ al-Rahim, hence it is a Balghami (phelgmatic/cold) benign swelling. Leiomyomata is commonest benign smooth muscle cell gynecologic tumour, affecting nearly 20-30% women of reproductive age. At any given time, nearly 15-25 million Indian women have a uterine fibroid. Estrogens appear to promote their growth. Characteristically, leiomyomata appear as well-defined, solid masses with a whorled appearance. They are monoclonal tumours and consist of collagen, fibronectin, and proteoglycan. They are usually asymptomatic however, can cause a various symptoms such as pelvic pain, a feeling of pelvic pressure, abnormal uterine bleeding, urinary incontinence or retention. The main symptoms often reported are pelvic pain and bleeding symptoms. Pelvic Ultrasonography has been shown to be an adequate, rapid, safe, and cost-effective means of evaluating the size, number, and location of fibroid . The presenting symptoms play a significant role in deciding the suitable form of treatment. Further, the management approach is usually individualized depending on age, the size and location of the leiomyomata/uterine fibroids, severity of the symptoms. Classic treatment options for symptomatic fibroids include medical treatment, embolization of the uterine artery, hysterectomy and myomectomy. Hysterectomy is the most definitive management for leiomyomata. However, it associated with a higher risk of unwanted effects. Hence, patients are turning toward complementary and alternative treatments. Unani scholars opined that firm swelling initially needs treatment with Mundij Balgham (phlegm concoctive), followed by Muhallil al-Waram (resolvant/antiinflammatory), and Qabiz (astringent) property Unani medicines for resolving Sala’ al-Rahim . If the medical treatment fails then surgery should be done .