Therapeutic Significance of Dalak (Massage) in the Management of Musculo Skeletal Disarray

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1 Hamdard Medicus 86 Therapeutic Significance of Dalak (Massage) in the Management of Musculo Skeletal Disarray Anwar Jamal 1 *, Aisha Siddiqui 1, Sadaqat U. Sadiq 1 and S. Shakir Jamil 2 Jamia Hamdard Campus, Hamdard University, New Delhi , 2 CCRUM, Janakpuri, New Delhi-11058, India. The management of musculo skeletal disorders has been taken as an important subject in modern time. The speedy progress of musculo skeletal disorders has compelled the Scientist to think about ex medical management of these diseases. The changing life style has aggravated the condition. The day by day increasing number of patients of Rheumatoid Arthritis, Gout, Osteoarthritis and others functional musculo skeletal disorders can be better managed in Unani Medicine. The review of classical unani literature reveals that they have very successfully practice in various regimental therapies. Dalak is one of the important methods of management for musculo skeletal disorders. The unani physicians have divided Dalak in two main groups, Dalak-e-Sulb and Dalak-e-Laiyyin. The application of this therapy helps in the mobilization of accumulated morbid material under and around the joints. It may be accompanied or followed by other regimental therapies including Fomentation, Bathing and Sitz Bath which improve the efficacy and early restoration of joint pain and mobility. Keywords: Dalak, Musculo skeletal Diseases, Regimental therapies. Introduction Manual kneading or manipulating the soft tissues to relieve pain, discomfort, stress and to promote health and wellness is called as Massage. In Unani System of Medicine Massage is a process to transfer body faculties by movement and pressure to maintain equilibrium at normal body physique and tends to state of proper health. Dalak is the method of treatment in Unani system of Medicine. It is one of the

2 Hamdard Medicus 87 oldest methods of Regimental Therapy. Massage has been used as a remedial measure from centuries by eminent Unani Physicians. Massaging causes various physiological effects which comfort the body. Aims and Objects Massage is done to increase blood circulation towards body organs. It is also used to liquefy putrid matters deposited in the body parts by the process of Tanqia-e-Mawaad (Evacuation). It is also implies for the nutrition of the body part. Type of Massage Oils Used in Various Disease Condition Disease Raughan (oil) used Duration (min) Faalij (Paralysis) Daarchini, Nardeen min. Joints Pain (Arthralgia) Surkh and Malkanghni min, 2 times in a day Hudaar (Gout) Hanzal 5-10 min Sciatica Hina and Aqar Qarha 30 min, 2-3 times in a day Kasrat-e-Shaham Qust 30 min, Dalak-e- (Obesity) Khashin Sehar (Insomnia) Badam and Banafsha 15 min Istirkha (Tremor) Sausan min, Dalak Istedaad-e-Zaeef Loss of Muscular Tonocity Zaitoon 30 min Besides above cited diseases, Dalak is also useful in Nervine Disorders, Phlebitis, Local inflammation, Hysteria, Melancholic, Fever, Skin ulcer etc. Indications Dalak is useful in Nervine Disorders, Phlebitis, Local inflammation, Hysteria and Melancholic etc. It tones flabby and loose muscles.

3 Hamdard Medicus 88 Maintains body posture. Reduces body pain due to injury, fatigue etc. Improves mobility of the body or part viz. frozen shoulder, sprain and arthralgia. To evacuate the putrefied humours. Enhances better blood circulation and nutrition. Prevent body from skin disease. Reduce excess body fats. Strengthens the Immune System. Enhances Post-Operative Rehabilitation Reduces stress. Opens skin pores. Contraindications Skeletal Disorder Disc Dislocation Inflammatory Conditions Metabolic disorders like Diabetes, Hyperthyroidism and Hypotheyroidism etc. Fever (All kinds) Phlebitis Warm-e-Haad Mafasil Fragility of Arteries Skin wound and Ulcers Methods of Massage Massage should be given from peripheries to Central (Centripetal) part of affected organ. Head and Neck massage should be performed from upper side to lower side. Posture During Massage Good posture for massage makes the patient comfortable. Hard and straight surface is required. Patient should be in supine position. Pillow may be kept below neck and knee Joint. When in prone position, pillow should be under clavicle. Instruction for Masseuse Masseuse should wear soft cloth and Massage room should be warm.

4 Hamdard Medicus 89 Massagist should be wrapped in clean cloth. Massage oil should be warm. Types of Massage and their Therapeutic Indications 1) Dalak-e-Sulb (Powerful massage): It is applied for the muscular development and used with more pressure/power during the course of massage. Therapeutic Indication: Flabby Muscular Body, Debilitated and thin built people and for alignment of body posture. 2) Dalak-e-Iaiyyin (Soft massage): This type of massage is applied for relaxation of muscular system. Smooth and Soothing massage is done for achievement the beneficial effect. Therapeutic Indication: Hard Muscular Structure, Spasmodic Condition, Sprain, Atony and Rigidity of muscles. 3) Dalak-e-Kaseer (Long duration massage): It is done with full power and pressure for long duration in obese person. Therapeutic Indication: Obesity. 4) Dalak-e-Qaleel (Short duration massage) It enhances the blood circulation and give a glow to the part, also produce heat in the body. Therapeutic Indication: Behaq-e-Abyaz (Ptyriasis alba), Tashaqqur-e-Jild (Psoriasis) and Jhaeen (Chloasma) etc. 5) Dalak-e-Moatadil (M oderate massage): Used for muscular development and applied with moderate degree of power and pressure. Therapeutic Indication: Thin built and flabby person. 6) Dalak-e-Khashin (Rough massage): This Massage is done with a rough cloth. It improves the blood circulation and provides nutrition to the part. Therapeutic Indication: Hair fall, Jhaeen (Chloasma), Behaq-e- Abyaz (Ptyriasis alba) and Bars (Leucoderma). 7) Dalak-e-Amlas (Smooth massage): It is carried out by soft hands with smooth cloths like silk to improve peripheral blood circulation and provide nutrition to adjacent tissue. Therapeutic Indication: Burger s Disease, Claudication of muscles, Fatigue, Painful and Cyanotic Condition. 8) Dalak-e-Taweel (Long and gentle massage): This type of massage is done for long period with gentle hands during autumn or beginning of winter season to maintain the body posture at equilibrium. Therapeutic Indication: Firm body, young person and solid organs.

5 Hamdard Medicus 90 09) Dalak-e-Qaseer (short and gentle massage): It is done for short period with gentle hands during summer season. Therapeutic Indication; convalescence stage, children and elderly. 10) Dalak-e-Istedad (preparatory massage): It is done as preparation of exercise with suitable oil. It is two types: a) Qawi: done vigorously for short period in winter b) Zaeef: done sluggishly in summer 11) Dalak-e-Istedad or Dalak-e-Musakkin (soothing massage): It is applied after the exercise to maintain the body faculty which is lost during exercise with suitable oil. Therapeutic Indication: Rejuvenate body parts. Timing of Application Massage should preferably do in morning and evening hours. Duration of Application For non specific problems seven to ten sitting is required. One sitting per day with one day gap after three sitting. For specific problem treatment is to be continuing till patient becomes relieved. Precautions Before Massage: Have a cold shower or wash before a massage. Do not soak in a hot bath, otherwise oils will immediately ooze in to the skin. Don t use deodorant or body part spray before the treatment, as this will block the effect of the oil. Avoid large meal just before the massage. Don t drink alcohol before massage. Avoid massage in fever, flares etc. After Massage: Drink a glass of water immediately after a treatment. Lie still for at least five minutes before getting up. Don t shower for at least 12 hours after a treatment to allow the oils to be absorbed by the skin. During Massage: Massage should be given according to temperament of the patient and affected. Dalak is contraindicated on empty stomach and post meals.

6 Hamdard Medicus 90 Dalak should be done after normal sleep to relax the muscular system. Massage is to be done at optimum room temperature. When back is massaged place a pillow under the knees when supine, and under the pelvis when prone. Masseuse should wear loose and comfortable clothing. Avoid talking play music or remain silent Supportive Medicine Muqawwi-e-Assab (Nervine Tonics), Musakkin-e-Azlaat wa Alam (Muscular relaxant and Analgesic) and other type of oils are required as per the need of the patients. REFERENCES 1. Avicenna, (1965). Al-Qanoon fit Tib, (Urdu Translation), Translated by Hakim Syed Ghulam Hussain Kantoori, Tibb-e-Islami ka Encyclopedia, Vols. I & II, pp Avicenna, (1965). Al-Qanoon fit Tib, (Urdu Translation), Translated by Hakim Syed Ghulam Hussain Kantoori, Tibb-e-Islami ka Encyclopedia, Vols. V and VI, pp Mohammed Ahsanullah, (1972). Ilaaj Bit Tadbeer, Akbari Gate, Lucknow, pp Mubeen Kahn, (1997). Ilaaj Bit Tadbeer, Noor Kuda Publication, pp Rabban Tabri, (1885). Firdaus ul Hikmat, Aijaz Publication House, Kucha Challan, Darya Ganj, New Delhi, pp Ghulam Jilani, (1917). Makhzanul-Hikmat, Matba Nawal Kishore, Lucknow, Uttar Pradesh, pp Azam Khan, (1965). Al-Aksir, Matba Nawal Kishore, Lucknow, pp

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