Nutritional treatment of vertigo from view point of Persian medicine

Abstract

The human body needs food at the time of health and during illness. In treatment, according to Hippocrates, the main rule is that the medicine has to be in the shape of food. In the past, the food of each region varied depending on the plants and food in the area however nowadays because of the development of technology all foods are available at any place. Awareness of the text written about nutrition and cooking has a tremendous effect on the attainment of the objective of medical science, which is to keep the health and restore the disease and the effects of recovery. In this essay, in short, the foods that are used in Persian medicine in the prevention and treatment of vertigo are invested and collected. The reason of choosing vertigo is that it is one of the 10 most common causes of emergency referral. At the time of the attack and after it happens, fear of an attack causes the patient to have a disability and dependence. Therefore, using foods that helps in treating vertigo will increase the quality of life of patients.

Introduction

Vertigo is a medical condition that is defined as the illusion of rotation, spinning or swaying in the objects around or in the patient himself Over the past decade, vertigo has been the most common compliant in the general population in need of specialist care and its prevalence increases with age.

Vertigo is widely studied in Persian Medicine (PM). It is named as “Dowar”. (1-3)

Persian scholars explained etiology, clinical manifestations and treatments of vertigo in a clinically oriented approach. Persian scholars have considered three steps in treatment of any organ’s diseases include:

-Nutritional recommendations

-Drug therapy

-Manual interventions

Vertigo in Persian Medicine

“Dowar” is defined as a disease with rotation sensation or spinning objects around the head and body, as a result sitting or standing becomes difficult for the patient.

Etiology of vertigo in PM:

General cause of vertigo is dysfunction of brain and rotation of psychic soul in cranial cavity and ventricles because of accumulation or generation of humors and wind in the brain.

Classification of vertigo based on the origin of attack: (1-3)

• Vertigo due to cerebral and intracranial disorders such as generation or aggregation of four humors (phlegm, black bile, blood and yellow bile) and wind in the skull. This type is named “Dowar-e-Demaghi” and divided to these subtypes:

o When accumulated humor in brain is phlegm; it’s named “Dowar-e-Balghami”. The patient has these symptoms and signs: Head heaviness, drooling of the saliva, white skin, low thirst, drowsiness, muddle-headed, post nasal discharge, slow pulse, white and high dense urine

o When accumulated humor in brain is black bile it’s named “Dowar-e-Sodavi”. The patient has these symptoms and signs: Head heaviness that it is lower than heaviness in phlegm, skinny, insomnia, dark skin, body dryness, slow pulse, dark and high dense urine

o When accumulated humor in brain is blood; it’s named “Dowar-e-Damavi” in Persian. The patient has these symptoms and signs: Head heaviness, red eye and skin, fullness in pulse, warm skin, tearing, drowsiness, red and dense urine

o When accumulated humor in brain is yellow bile it’s named “Dowar-e-Safravi” in Persian. The symptoms and signs are: Dry and warm skin, slimy, yellow eye and skin, mouth bitterness, thirst, dry mouth, insomnia, yellow and low dense urine.

o When accumulation of wind that’s named “reeh” in brain ventricles and vessels occur this type is called “Dowar-e-reehi” in Persian and it can originate from cold humors (black bile and phlegm) so it has high density and is named as cold wind “Reeh-e-Barede”. The sympPM and signs are all signs and symptoms of cold humors without heaviness, or it can originate from hot humors (yellow bile and blood) so it has low density and is named as hot wind “reeh-e-Harre”. The patient has these symptoms and signs: All signs and symptoms of hot humors and sneezing, nasal dryness

• Vertigo that originated from other body organs that is named as participatory vertigo “Dowar-e-Mosharekati”. Persian scholars have believed that brain has association with other body organs like stomach, uterus, bladder, peritoneum and the whole body. Disorders or dysfunctions of these organs can influence and change function of brain. This mechanism is named “Mosharecat” in PM. The most important organ that participates in vertigo is stomach (1-3). In PM text books symptoms and signs of vertigo has discussed very obviously.

Symptoms and signs of brain induced vertigo and stomach related vertigo has listed at table 1

Table 1 Symptoms and signs of each type of vertigo
Types of vertigo	Symptoms and signs
Phlegm in the brain	Head heaviness, drooling of the saliva, white skin, low thirst, drowsiness, sodden and muddle-headed, post nasal discharge, slow pulse, white and high dense urine
Black bile in the brain	Head heaviness, skinny, insomnia, dark skin, body dryness, slow pulse, dark and high dense urine
Cold wind in the brain	all signs and symptoms of cold humors without heaviness, Stretch of the head
Blood in the brain	Head heaviness, red eye and skin, fullness in pulse, warm skin, tearing, drowsiness,  red and dense urine
Yellow bile in the brain	yellow eye and skin, mouth bitterness, thirst, dry mouth, insomnia,  yellow and low dense urine,
Hot wind in the brain	all signs and symptoms of cold humors, sneezing, nasal dryness
Gastric related vertigo
Aggregation or accumulation of cold humors in the stomach	Vertigo begins or get worse after satiety or polyphagia; moreover, clinical manifestation of  weak digestion may be present; such as gastric heaviness, gastric reflux, sour eructation, preference of spicy food eating , drooling, flatulence, nausea, vomiting and Improvement of vertigo after vomiting.
Accumulation or aggregation  of cold wind “reeh” in the stomach	manifestations are similar to accumulation of cold humors in the stomach but in these patients there is nothing to vomit and bloating and stomachache may be present in this condition.
Accumulation or aggregation of hot humors in the stomach	feeling vertigo or getting worse by hunger and relief by eating food, bitterness of the mouth, feeling of dryness in the mouth, excessive thirst and satisfaction by cold water, bad smell of the burp, nausea and vomiting, Loss of appetite,
Production of hot wind “Reeh” in the stomach	stomachache and abdominal pain that is relieved when the patient repels gas.

Treatment of Dowar in PM (1-3)

Persian scholars have considered three steps in treatment of any organ’s diseases include:

-Nutritional recommendations

-Drug therapy

-Manual interventions

Treatment of patient with vertigo have different procedures such as dietary modifications, avoidance of predisposing factors, cleaning brain and participatory organs from causative pathologic substances (humors and wind) and then strengthen the organ with tonic remedies.

In this article nutritional recommendations in types of vertigo is discussed. These foods were named “ghza-ye-davaee” its mean which some food that have therapeutic and nutritional effects at the same time. These foods select according to causative pathologic substances (humors and wind) or weakness of body organ.

General recommendations in treatment of vertigo in PM. (1-3)

• Use of soft foods that is named in PM “ghza-ye-latif”

• General food avoidance is some type of foods that generate abnormal wind and vapor in the body that named as “mobakherat” in PM likes garlic, pepper, onion, cabbage, melon, date

• Use of Coriander in food because it blocks vapor and wind rise to the brain

• Use of some food that strengthen the brain like Almond porridge

• If there is heart weakness use of heart tonic food like jam of and emblic myrobalan (Phyllanthus emblica) that is named amlaj, concentrated juice of apple, concentrated juice of pomegranate concentrated juice of quince (Cydonia oblonga), syrup of lemon.

Nutritional recommendations in treatment of bloody humor in vertigo:

• Reduce of food

• Use of aperients like plum and tamarinds

• barley water and barley soup

• soup with these ingredients as lentil (Lens esculenta) pomegranate juice and Sour grape water

• soup with these ingredients as vetch (Phseolus mungo), Pumpkin (Cucurbita maxima) spinach (Spinacia oleracea)

• soup with these ingredients as lentil (Lens esculenta) and vinegary

• juice of sour orange (citrus aurantium var. amera)-

Nutritional recommendations in treatment of vertigo from view point of PM is listed at table 2.

Table 2 Nutritional recommendations in treatment of vertigo from view point of PM
Types of vertigo
Vertigo because of Blood in the brain	barley water- barley soup- food with these ingredients as tamarind (Tamarindus undica) and plum- soup with these ingredients as lentil (Lens esculenta) pomegranate juice Sour grape water- soup with these ingredients as vetch (Phseolus mungo), zucchini (Cucurbita maxima, C.pepo) spinach (Spinacia oleracea), juice of sour orange (citrus aurantium var. amera)- soup with these ingredients as lentil (Lens esculenta) and vinegary
Vertigo because of Phlegm	very soft boiled egg- Ginger jam- Fried food- grilled meat- very soft boiled egg- soup with these ingredients as chicken-
Vertigo because of Black bile	very soft boiled egg, soup with these ingredients as chicken with spices and Pease (Cicer arietinum)- Almond porridge-Pumpkin with starch sugar and almond oil- stewing meat-
Vertigo because of Cold wind	soup with these ingredients as chicken, spices that reduce wind such as cumin (Cuminum cyminum), cinnamon (Cinnamomum zeylanicum)
Vertigo because of Yellow bile	soup with these ingredients as vetch (Phseolus mungo), spinach (Spinacia oleracea zucchini (Cucurbita maxima, C.pepo) coriander (coriandrum sativum), almond (Amygdalus communis)- soup with these ingredients as lentil (Lens esculenta) and vinegary, almond, sugar- barley water-violet syrup- Syrup or jam of Quince     Safarjal            (Cydonia oblonga)- Soup with these ingredients as plums, flakes and apricots peeled with a little sugar and a soup with these ingredients as barley, pumpkin, spinach and almonds pomegranate juice.
Vertigo because of Hot wind	barley water

 

References

1. Ibn-e-sina(Avicenna) A. Al-Qānūn fī al-Tibb (Canon of Medicine). Beirut: Dare Ehyae al-Torathe al-Arabi; 2005.

2. Aghili S. (Moalejat-e-Aghili) Aghili’s Treatments. Tehran: Research Institute for Islamic and Complimentary Medicine; 2008.

3. Jorjani E. Zakhireye Kharazmshahi (Treasure of the Khwarazm Shah). Qom: Ehya-e Tebb-e Tabiee Institution; 2012.