Unani Medicine

Greek foundations and the Arabic and Persian tradition

A review by researchers at Jamia Hamdard and the Indian research council CCRUM states that Unani medicine traces its origin to the Greek physician Hippocrates (460-377 BC) and his associates, and that it progressed and became established under Persian and Arab patronage. A historical review describes it as Greco-Arabic medicine based on the teachings of Hippocrates, Galen and Arab physicians. Both are summaries by authors within or close to the tradition, not a full scholarly history of how texts were transmitted.

Ibn Sina, known in Latin as Avicenna (c. 980-1037 CE), wrote the Canon of Medicine, a five-book work covering medical principles, materia medica, diseases by body part, systemic conditions and compound remedies. A paper in the Journal of the Royal Society of Medicine says it remained the main medical textbook for about six centuries, and a review in a traditional medicine journal calls it a fundamental treatise of Unani medicine.

Arrival and development in India

Sources differ in precision on when the system reached South Asia. The Jamia Hamdard and CCRUM review says it came to the Indian subcontinent around the middle of the 14th century. A review by a Unani author gives 1351 AD, states that Arabs introduced it, and says it flourished under Mughal patronage. A historical review concludes that Hippocratic principles were assimilated in a country with a different philosophy and worldview, and that the Greek system was enriched with local elements.

Unani medicine in India is therefore the product of centuries of regional adaptation and not an unchanged Greek or Arabic system. The sources reviewed do not trace the history of modern institutions or the nineteenth and twentieth-century revival in detail, so no dates for them are given here.

Names in use

The system is called Unani, Unani-tibb or Unani Tibb, and several authors describe it as Greek medicine or Greco-Arab medicine. In India it is one of the systems grouped under the acronym Ayush, which stands for Ayurveda, Yoga and Naturopathy, Unani, Siddha, Sowa-Rigpa and Homoeopathy. Grouping under one acronym does not make the systems equivalent, and Unani rests on a Greek humoral vocabulary that is distinct from that of Ayurveda.

Temperament and humours

Within the tradition, mizaj means temperament. The Jamia Hamdard and CCRUM review states that Unani scholars hold that each person has a distinct temperament built from four basic humoral combinations, influenced by age, mental state, local climate and environment. A review of health preservation names the four humours as dam (blood, hot and moist), safra (yellow bile, hot and dry), balgham (phlegm, cold and moist) and sauda (black bile, cold and dry), and states that health is preserved while the overall quality of the humours is in harmony with the temperament. These are concepts of the tradition and not measured biomedical constructs.

The Canon's drug-assessment rules assign medicines paired qualities such as hot or cold and dry or moist, in line with classical humoral medicine. A historical review adds that the system also treats the body as made of four elements, with simple and compound organs, and aims at equilibrium among its aspects.

Terms for therapies

Authors within the tradition divide treatment into regimenal therapy (ilaj bit tadbeer), dietotherapy and pharmacotherapy. A trial of wet cupping in cervical spondylosis uses the term hijama bish sharṭ for wet cupping and translates the condition as waja' ur raqaba. Names for conditions and procedures in this literature are Unani categories and may not match biomedical diagnoses one to one.

Treatment modes and temperament

The Jamia Hamdard and CCRUM review states that the system emphasises health promotion and manages disease through regimenal therapy, dietotherapy and pharmacotherapy, and that diet and drugs are chosen to suit the patient's temperament. A review of health preservation describes the maintenance of health as a central aim. The sources reviewed do not describe a typical consultation, so this page does not set out an assessment sequence.

Regimenal therapy: a cupping example

In a 2024 trial, wet cupping was given in three stages on days 0, 7 and 14, and the comparison group received 12 sittings of transcutaneous electrical nerve stimulation (TENS) over two weeks. This is one trial protocol and not a standard schedule. Regimenal therapy in the tradition also includes other procedures that these sources do not describe.

Drugs, mineral preparations and training

Pharmacotherapy uses single herbs and compound formulations. A laboratory study of the herbal-mineral preparation Kushtae Shangarf describes one classical method, in which cinnabar (mercury sulfide), alum and nutmeg are incinerated, and compares it with a muffle furnace method. The Jamia Hamdard and CCRUM review states that standardisation, quality control and toxicity profiling of many herbal drugs, and validation of formulations in the Unani Pharmacopoeia of India, have been carried out.

The World Health Organization (WHO) published benchmarks for the training of Unani medicine in 2022, an update of a 2010 version. They set minimum training requirements for WHO Member States, cover practitioners and associate providers, and address safety in clinical application and in the preparation of medicines. They are guidance for national authorities, not a registration scheme.

Uses stated in the tradition

The Jamia Hamdard and CCRUM review states that Unani medicine aims to promote health and to manage disease, and describes a wide set of clinical studies as showing effectiveness with minimal side effects. That statement comes from authors affiliated with Unani institutions, and the studies behind it were not individually assessed for this page. A historical review adds that the system has a record in India and, in its authors' words, a worldwide upsurge of interest.

Conditions named in trials

Trial reports describe Unani interventions for vitiligo, where the investigators say the formulations had been repeatedly prescribed by Unani physicians but not scientifically explored, for cervical spondylosis, and for type 2 diabetes mellitus. A systematic review of Ayush interventions for cervical and lumbar spondylosis found that Unani accounted for 15.9% of 113 included studies. Appearing in these studies shows that the uses are being tested, not that they are supported.

Scope of the search

PubMed title and abstract searches run on 5 October 2026 for Unani with systematic review, meta-analysis or risk of bias returned 23 records, and for Unani with trial or efficacy in the title returned 81, many of them narrative reviews, protocols or Ayush-wide COVID-19 reviews. No Cochrane review specific to Unani medicine was found. Evidence therefore has to be read formulation by formulation and condition by condition, and no result can stand for the system as a whole.

Type 2 diabetes: a systematic review

A 2024 systematic review of Unani medicines in type 2 diabetes mellitus included five randomised controlled trials. Its meta-analyses reported lower fasting and postprandial blood glucose than in control groups, but no statistically significant effect on HbA1c, a measure of average glucose over about three months. No adverse effects were reported. The authors call for better study quality and longer follow-up. The abstract does not give effect sizes or a certainty grade, and the medicines pooled were different formulations, so the result cannot be applied to any single product.

Vitiligo and cervical spondylosis trials

An open-label non-inferiority trial randomised 82 adults aged 18 to 40 with non-segmental vitiligo to Unani formulations (42) or a control treatment, PUVAsol (psoralen with sunlight, 40), for 16 weeks. Per-protocol analysis covered 30 per group. The mean vitiligo area scoring index fell from 4.09 to 3.13 in the Unani group and from 5.50 to 4.29 in the control group, and the authors concluded the Unani response was not inferior. The small sample, loss of 22 participants from analysis, open-label design and modest score changes limit what this shows.

A 2024 open-label trial randomised 44 people with cervical spondylosis to wet cupping (22) or TENS (22). At day 21 the cupping group had lower pain on a visual analogue scale, lower Neck Disability Index scores and better range of motion, with p below 0.001. Outcomes were short term and self-reported or clinician-assessed in an unblinded design, so the finding is preliminary.

What has not been tested

None of the sources reviewed tests humoral theory or temperament typing itself. The trials compare particular formulations or procedures with comparators, so a positive result in one trial does not validate the framework behind it. A paper on drug assessment records that Ibn Sina set out rules for testing drugs by experience, but that is a historical account and not a modern trial.

Design and reporting limits

The two trials summarised above were open-label and used active comparators rather than placebo, and the diabetes review itself says study quality needs to improve. The vitiligo investigators stated that the formulations had not been scientifically explored before the trial, which indicates that prescribing preceded testing. Follow-up in the cupping trial ended at day 21, and neither trial reports long-term outcomes.

Authorship and what was not verified

The general reviews of concepts and quality were written partly by staff of Unani teaching and research bodies, among them Jamia Hamdard's School of Unani Medicine and CCRUM. This does not show bias, but the supporting literature is not independent of the tradition. No government source on the structure of Unani education or registration in India could be opened for this draft, so those facts are not given.

Adverse-event reporting

The 2024 diabetes review reports no adverse effects across its five trials. A systematic review of adverse events in Ayush interventions for spondylosis found that only 13% of 113 studies described any adverse event, and that this was true of 1.8% of Unani studies, which its authors say may reflect underreporting. An absence of reported harms in small trials therefore does not show that none occur.

Cupping

A systematic review of 16 studies of cupping therapy in Korea, with searches to April 2013, found that adverse events were rare. The most often reported were anaemia (5 reports), factitial panniculitis (2) and herpes viral infection (2), and the authors state that most complications were avoidable when qualified practitioners followed safety protocols. The review covers Korean studies only and not hijama as practised in Unani settings, so it cannot be transferred directly.

Mineral-containing preparations and care boundaries

In the laboratory study of Kushtae Shangarf, mercury was below 0.1 mg/kg in both samples despite the cinnabar source, while arsenic was detected in parts per million and approached the stated limit of 3 ppm, higher with the classical method than the muffle furnace method. The study tested one formulation, did not test toxicity in living organisms and does not describe marketed products. No source reviewed surveys contamination or drug interactions across Unani products, so those questions remain open. This information is educational. Unani treatment should not delay or replace necessary medical assessment, and a person using any traditional preparation can tell their doctor about it.

Training and standards

The 2022 WHO benchmarks set minimum training requirements and treat safety in clinical practice and medicine preparation as core content. A historical review says that Unani practitioners are registered in India, a statement this draft could not check against an official register. National requirements for practitioners and for medicines differ, and none are verified here.