25 cases of Laquwa were treated during the Post Graduation studies at Hyderbad, India, in 1975-76 by a simple, polypharmaceutical recipe of (1) Hebbe-e-Mafassil Faliji (2), Ustukhuddoss (Lavandula Stoechas). The main ingredient of Habb-e-Mafassil Faliji is commiphora Mukul (Muquil or Gugulu) and having the ratio 2:1 in the formula. All the drugs in this specific formula are anti-inflammatory, resolvent and anti-suppurative. This Habb was supplemented by the decoction of Lavandula Stoechas, 6 grams in a glass of water. This complex treatment proved very effective as 76% cases got complete recovery in the maximum duration of 21-80 days.
Laquwa is a name of an eagle (Uqaab). Abu Ubaidah presented his opinion that the name of ‘Luquwa’ has been assigned to this disease, as the patient, whenever his face is paralysed, has similar type of wider angles of his mouth, as the bird possesses. Others have suggested that Uqaab always keeps his head deviated to one side, therefore this resemblance is appropriate to name the disease so. 19 Sir Charles Bell (1774-1842 first published his idea of new anatomy of brain in 1807. In 1823 he described the Bell’s phenomenon, nearly always present in the patients of laquwa. His description and research was so complete that the disease has been named after him as Bell’s palsy. 11
From A.H. Rabban Tabri to Avicenna, every author had shown the phlegm or cold moist viscid serous humour, as one of the cause for producing the disease of laquwa. Avicenna says (1) that some time laquwa was caused by the spasm which occured at one side of the face and this pasm was due to the Yaboosat or dryness. The translator of the book “Sharh-e-Asbad” confirmed his opinion(2). And some times the spasm was due to the cold and viscid humour coming from the brain and filling the nerves of a jaw, which caused the spasmodic side to drag the healthy (other) side towards itself. By this the fairness of the lips and eyes which could be closed evently and properly was lost from the healthy side (3). Another factor was that the angle of the mouth drooped. 18, 19, 28
HK. Azam Khan 21 mentioned that the disease was caused by the spasm or paralysis of the muscles of the face and eye lashes. For this reason it has been named accordingly i.e. Laquwa-e-Isterkhai (Flaccid) and Laquwa-e-Tashannujee (spasmodic) or spastic Facial paralysis 29.
Galen asertained that the disease was due to the indifference of the matter (morbid matter) and the infiltration of viscid matter; which caused spasmodic condition at one side, while the fluid matter produced flaccidity on the other side. Usually Laquwa-e-Tashannuji (Spasmodic) was predominent. The other type Isterkhai (flaccid) was rare. 28-29
The pathogenesis of Bell’s palsy is still not known. It is thought to be due to compression of the nerve fibres from acute inflammation and oedema of the collagenous and elastic tissues in and around the nerve. The nerve may later be reduced to only a fibrous cord. 10-34
Bell’s palsy is a paralysis of the muscles of one side of the face, sometimes preciptated by exposure; chill or trauma 24.
Although it is said that ‘Laquwa’ is due to cold and viscid phlegm and have the influence of cold climate and season and is a disease frequently met within cold countries, but a fairly good number of cases are found in India and had been treated in different ways from centuries.
The purpose for the selection of this topic at the postgraduation studies was that, no special attention has been paid in th emedical field upon this oldest known yet most neglected disease upto this time. Hitherto the different types of single and compound drugs mentioned by the ancient authors are being used without keeping in view the definite criteria.
Though in many cases of ‘Laquwa’ complete recovery occurs after a month or so, but if at the end of 3 weeks from the onset, there is no return of any voluntary power int he face, the recovery is never complete and contracture usually develops later in the paralysed muscles.
The aim of the present study was to evaluated benefits with drug therapy and to assess the efficacy of the selected specific medicines chosen for the trial on the patients of Laquwa.
MATERIAL AND METHODS
- Patients (25): cases of Laquwa were selected during the P.G. studies in 1975-76 at Hyderabad, India. No particular principle has been followed in selection of cases. Besides the aetiological factors, the response of drugs especially selected for the tr eatement of this disease was carefully noted. The case were investigated and followed up.
- Medicines used: After intensive study of the ancient compound recipes, the following drugs were selected (1): -Habbe-e-Mafasil Faliji and (2) The decoction of “Ustukhuddoss” (Lavandula Stoechas).
The ingredients of “Habb-e-Mafasil Faliji” were as follow:
- Dar-e-filfil- (root)/Piper Longum
- Zanjabeel (root)/Zingiber officinalis
- Kababa (dried fruits) / Cubeba officinalis
- Zarambad / Curcuma Zerumbet
- Abhal (Berries) / Juniperis Fructus communis
- Filfilmoya / Piper longum Chavica roxburgil
In 80% patients, eye abnormalities recovered completely and in 76%, forehead wrinkles recovered completely and in 72% deviation of mouth recovered completely.
It is concluded that this complex treatment has proved very effective for cases of Laquwa because the method is simple, drugs are cheap, no complications developed even if the therapy was continues for a longer period and there was no recurrence in any case reported. The therapy was very effective as 76% recovered completely and 16% were relieved.
We are thankful to Dr. Mohd. Fazlur Rahman, Supdt. Nizamia General Hospital and to all the other staff members, who have provided every facility during the studies. Hk. Mohd. Iqbal Ali, Asst. Director, Central Research Institute, Unani, Hyderabad also deserves thanks for his valuable suggestions given in preparing the paper.
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