NON-SURGICAL MANAGEMENT OF DAWALI (VARICOSE VEINS) THROUGH TA'LIQ AL-'ALAQ (HIRUDATHERAPY) IN UNANI MEDICINE: A CASE REPORT

Introduction: Varicose veins are named after the Latin word "varix," meaning "dilated vein," and are likely derived from the term "varus," which means "bent." They are defined as subcutaneous dilated veins 3 mm in diameter or larger. They are frequently elongated and tortuous, with intermittent 'blowouts', but are defined by the presence of reflux and may be straight and uniform tubes morphologically. In Unani system of medicine (USM), it is a disease where the veins in the legs become dilated, tortuous, and green due to the buildup of sawdāwa khūn. It is common in persons who stand for a long time. Ta'liq al-'Alaq (Hirudatherapy/Leeching) is a method of evacuation of bad humours from the body with the help of leeches. Clinical presentation: A 47 year old female patient, non-diabetic, non hypertensive, and euthyroid, presented to the OPD, Department of Moalajāt, RRIUM, Srinagar, with complains of visible, superficial, dilated veins accompanied by mild, dull aching pain and a sensation of heaviness in the calf region of her left leg for the past year. The symptoms typically worsen throughout the day, especially with prolonged standing, and are relieved by elevation or compression hosiery. Intervention: The patient underwent hirudotheray on the calf muscle of the left leg with 4 leeches for 20 minutes, drawing 20 ml of blood, following proper pre and post treatment SOPs, fortnightly for 1 month along with lifestyle and dietary modifications. Results: The signs and symptoms were significantly reduced as assessed through Visual Analogue Scale (VAS). Discussion: The therapeutic effect of Ta'liq al-'Alaq is due to both the removal of morbid humours and the saliva, which contains biologically active substances like hirudin, hyaluronidase, and others. These compounds contribute to anticoagulant, anti-inflammatory, analgesic, antiischemic, thrombolytic, immune-stimulant, antibiotic, hypotensive, and anti-edematous effects. Conclusion: The findings from the results and discussion indicate that the Unani system of medicine serves as a viable alternative for managing Dawāli.