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TREATMENT OF BARS (VITILIGO) WITH ARAB MEDICINE

Mohd. Iqbal Ali, M.M. Ali Khan, Bahauddin and Mastan Ali India

Two Arab drugs, 'Safoof & Zamad' were tried in 1745 cases, orally and topically, in separate groups. In 445 cases, only zamad was used and in 1,300 cases safoof & zamad were tried. The results were found to be satisfactory in both the groups. Zamad alone yielded 75.74% response whereas safoof and zamad, combined yielded 84.15%  response. This study has shown that Safoof and Zamad are very effective in the management of cases of Bars.

INTRODUCTION

Bars is an Arabic term used for Vitiligo, an idiopathic variety of leucoderma. This achromia of the skin may be limited to few patches or it may be extensive and wide-spread. When extensive it is often bilateral and adopts symmetry in distribution. It can appear on any part of the body but the common sites are the face, dorsal portions of fingers, hands, waist, legs, toes and feet. Mucous membranes may also be affected. (Rabban Tabri (1), al-Razi (2), Ibn Sina (3), Azam Khan (4), Lerner (5,6) Behl (7), Savil (8) and Macky (9). Bars was known even in the period of "Aushooryan" in 2200 B.C. (Mahmood'o. The description of Bars is found in Atherveda (1400 B.C.). Al-Razi (2), gave a comprehensive description of Bars. He attributed it to excess of Khilth-e-Balgam, a humoral disturbance, and Zufe-Hazm (weakness of digestion and coldness of blood. Ibn Sina, Tabri, Masihi, Gilani and other eminent Hakims agree with this view (Ibn Sina (3), al-Razi (2), Rabban Tabri (1) and Azam Khan (4). Buqrat and Jalinoos were also of the same opinion about its causation. Ibn Sina in his 'al-Qanoon' said that Bars is hereditary, and it is due to failure of the power which gives shape to tissues (Ibn Sina) 1.

Exact cause of Bars is unknown however, various causes from heredity to viral infection have been attributed to this disease. (Anderson", Behl 7.). Metabolic errors and dietary deficiences are held responsible. (Ibn Sina (3), al-Razi (2), Behl 7.). Gastrointestinal disorders -e.g. intestinal worms, chronic amoebiasis, giardiasis and chronic dyspepsia may be counted as precipitating factors. Mental stress and frequent use of broad-spectrum antibiotics have also been noted as predisposing factors in some cases (Behl 7). Endocrine disorders and auto-immunity are also accused. Trauma and constant pressure may cause depig-mentation in susceptible persons. Use of incompatible food articles such as simultaneous use of milk and fish, is also described as its cause by ancient Hakims. Excess use of Sour things, oranges, lemons and tamarind, and food touched by rats, cats and certain other animals are also held responsible as its cause (Ibn Sina3, al-Razi2, Rabban Tabril, Azam Khan (4). Drinking or bathing in water-warmed by direct exposure to sun rays has been described as one of the causes (al-Hadith).

Intense research has been carried out on vitiligo in different parts of the world. Much has been explored still its etiology remained obscure and the treatment discouraging. "The repigmentation is rare in vitiligo, total response is seen in 10 to 15 p.c. of the cases". (Marcus A -Krupp (12). )

It has been a social scourge since time immemorial and now its incidence is increasing. The subjects suffering from vitiligo develop inferiority complex and avoid societies. They are psychologically disturbed.

The study was taken up considering the un-yielding nature of the disease and social importance of its. treatment with an object to. find out its effective treatment. In this paper the esults on therapy of Bars using two Arab formulae studied at Central Research Institute for Unam Medicine, Hyderabad, A.P. India are presented.

Before Treatment

After Treatment

Before Treatmnet

After Treatment

Before Treatment

After Treatment

DISCUSSION

In majority of cases the depigmented patches turned red after 2 or 3 application of zamad and when continued repigmentation started within 2 to 8 weeks. Bars patches found on chest, arms, face, forehead, scalp, back, neck and legs responded well to the treatment given. The patches found on back of the hands, feet and above the iliac crest showed slow response to the treatment.

Safoof and zamad therapy was found more effective compared to zamad alone, and was well tolerated by majority of patients who gave maximum response to the treatment within 9 to 12 months. No particular toxicity was noted within the use of these two drugs. However, mild to severe erythema and blister formation was seen in small percentage of cases (below 10%) with zamad therapy. Those who showed absolute intolerance to application of zamad were put on oral safoof therapy. In others it was tried in less concentration with a gap of 3 days, week or a fortnight between two applications, with good results.

In some cases, taking safoof orally, nausea, vomiting and gastric discomfort were reported which were controlled either by adding pure ghee in diet or discontinuing the drug for few days. Urticarial rash was also seen in some cases. These side effects were not much severe and were controlled by adjusting the dosage and rarely with anti-allergic drugs.

After Treatment

Before Treatment

After Treatment

Before Treatment

After Treatment

Before Treatment

The follow-up study of the patients was done for 1 to 2 years. Recurrences were noted in negligible number of cases. Recurrences were less in cases of complete cure and more in incompletely recovered.  It can be thus -concluded that safoof and zamad therapy is quite effective in the treatment of Bars (Vitiligo), comparing the results obtained by other disciplines. These two drugs, safoof and zamad, are taken as standard reference, drugs for double blind clinical trials with new coded drugs for Bars which are being conducted in the CRIUM, Hyderabad.

Some of the photographs of the patients having Bars lesions on different parts of the body taken, before and after treatment are presented to show the cure and the duration of treatment.