Huqnah (tanqih, imalah, enema)

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Introduction

The same way that having a healthy body relies upon eating useful and healthy foods, it also relies upon the excretion of toxic and excess materials from the body. A healthy body will excrete the excess and toxic materials from itself in a natural fashion but if the body is unable to excrete the toxic materials, it will fall ill. Finding an appropriate way to remove the excess materials from the body by turning to medicines which remove excess materials is called takhliyah (medicine-induced excretion). Huqnah or tanqih is considered as a form of takhliyah. The doctors of traditional medicine use amal yadawi (hand actions) to treat illnesses. Amal yadawi includes hijamah (cupping), fasd (blood-letting), wet cupping etc. Huqnah is one of the amal yadawi which is used to treat a wide variety of illnesses. Huqnah means to send liquid into the body through the colon or the vagina by using special tools. This method has been around for a few thousand years and goes back to the time of Hippocrates and Galen. Nowadays in India and China, huqnah is widespread. In modern medicine, huqnah is referred to as enema. [1] This method isn’t used at first but when the other methods of takhliyah (qayy (medicine-induced vomiting), ishal (laxatives), hijamah, fasd etc.) don’t bring results, it is permitted. Qayy clears the colon and stomach from the top of the stomach and mouth and tanqih clears the colon and stomach from below the colon. [2] Tanqih is the least harmful, best and most beneficial method after hijamah. The best times to do this is in the mornings or nights when the weather is cold and the patient’s body has no important role in its work. Its important characteristics include calming pain (easing the excretion process of faeces and excess materials through the colon) and sometimes, on the contrary, it can be used to prevent severe diarrhoea. In cases in which bleeding from the patient’s colon doesn’t stop, tanqih is a good treatment for this. The reason tanqih is preferred over the rest of the methods of takhliyah is that there is no limit to where you can use it, whether men or women, old or young, day or night etc., one can benefit from its characteristics. [3]

What is huqnah or tanqih?

Huqnah is from the root word haqn which means to emulsify, protect, prevent and stopping something from leaving. The lexical meaning of tanqih is cleanliness, to clean deeply and is used as the same meaning as huqnah and imalah and its terminological meaning is to enter a diarrhoea-causing substance or astringent from the anus with a special pump used for tanqih (a tool which is used to put water or a special liquid used for tanqih in the anus) or a rectal tube to clean the colon of a human or animal. [4] Huqnah means a pourable medicine and they call assets put in a bag and that bag is called a mihqanah. In terminology, huqnah is used mainly to define sending liquids to the colon or womb through using special equipment. [5]

History [6]

The date huqnah was founded goes back before the birth of Jesus. Hippocrates is considered the founder of this method. Galen, who himself was one of the prominent and well-known doctors, mentions the first story of huqnah in the following manner,

“One day, Hippocrates was sitting on a boat. A man was writhing in pain due to overeating and filling his stomach with alcohol and delicious foods. Hippocrates had become worried and couldn’t find a way to help the person. At this time, he noticed a bird which had eaten a lot of fish and had a severe stomach ache go to the sands of the beach and when its pain became severe, it came to the ocean, picked up some water in its beak, poured it into its anus and after that, much excess came out, it was saved from death and flew towards its nest. Therefore, Hippocrates deduced from witnessing this that saltwater has such a characteristic and gave that man who had a stomach ache and colic an enema and after a few hours, the excess was excreted and he was freed from his illness.”

After that, doctors used this method to treat different illnesses.

According to the present sources, this method is from Egypt or Greece. The oldest medical text which mentions using enemas is in the Ebers Papyrus approximately 1500 years before Christ and in the Chester Beatty Papyri approximately 1200 years before the birth of Christ. The coffee enema is a traditional method which was first used in 1930 A.D. to remove poison in treating cancer. From the beginning of the twentieth century, this method has been used to treat systemic diseases (diseases which affect the whole body and not just one part).

The importance of huqnah in the narrations

In the field of huqnah, various narrations have been narrated from the Infallibles which mention the importance and effectiveness of this method of treatment in treating illnesses.

  • It has been narrated from the Holy Prophet who said,

    “The best thing by which one can treat illnesses with is huqnah as it fattens the stomach, cleans the internal illnesses and strengthens the body.” [7], [8]

  • Imam Sadiq said,

    “The best thing by which we treat illness is hijamah, saut (anfiyah: a special ball that is placed in the nose, is smelt and causes sneezing), bathing and huqnah.” [9]

  • Imam Sadiq also said,

    “Cures lie in four things; hijamah, rubbing oils, qayy and huqnah.” [10]

  • In another narration, Imam Sadiq said,

    “Cures lie in four things; saut (anfiyah), hijamah, nurah (a natural substance which removes the hair it is placed on and softens the skin) and huqnah.” [11]

  • Imam Baqir said,

    “Arab medicine lies in three things; the cupping razor, huqnah and the last is heat therapy.” [10]

  • In another narration, Imam Baqir said,

    “Arab medicine lies in seven things; the cupping razor, huqnah, saut (anfiyah), qayy, honey sherbet and the last is heat therapy. One may add nurah to these.” [10]

The effective mechanism

According to the texts of traditional medicine, the mechanism of huqnah is to cause diarrhoea and to loosen the bowels from the upper parts of the body towards the lower parts. As the liquids of the body are connected together, one can bring the excess and faeces from all the parts of the body towards the colon and excrete them. Also, the medicine used in huqnah doesn’t only have a regional effect but rather, by passing the wall of the colon, it can enter the blood flow and show systemic effects. [6] [12]

Effects of huqnah or tanqih

Anal huqnah [4]

  1. Excretion of the remaining excess materials in the colons
  2. Treats resistant constipation (tanqih in order to cure constipation)
  3. Washes out the colon
  4. Treats resistant diarrhoea (tanqih in order to prevent resistant diarrhoea)
  5. Treats colitis (ulcerative colitis is one of the enteric inflammatory illnesses which causes long-term inflammation) and enteric torsion (tanqih in order to calm pain)
  6. Stopping bleeding in the colon through substances which stop bleeding through the anus
  7. Calms pain in the kidneys, bladder and wounds therein (tanqih in order to calm pain)
  8. Bringing excess substances from the main organs at the top e.g. the heart, liver or kidneys to the bottom of the body (tanqih in order to change the path of the excess substances)

Uterine huqnah [6]

Uterine huqnah is one of the forms of huqnah in which the liquid is put into the vagina, not the anus. Uterine huqnah is used for various illnesses such as the disturbed temperaments of the uterus, the leaking of liquid from the uterus, repetitive miscarriages, calming of the pain in the uterus after childbirth, uterine wounds, swelling of the uterus, cervical cancer and the narrowing of the uterus.

Medicines used in huqnah

In huqnah, hot, cold and warm medicines are used with the aim of changing and correcting the temperaments of the adjacent muscles and organs, cleaning out the colon and causing excretion. For example, hot medicines are used for illnesses like cold colic, epilepsy and palsy which causes the removal of a thick discharge. One must take precaution in putting some medicines in the formula of the huqnah which for more information, one must refer to lengthier sources. [13] A doctor must pay attention to the age and physique of the patient and the time of huqnah when choosing the medicines. For example, one must use less medicine for younger and smaller people and must observe the coldness, heat, strength and weakness of the medicine for the elderly. [14]

Time of doing huqnah

The best time to do huqnah is a time when the weather is cold like autumn or winter and also at the coldest times of the day like after sunset until midnight or early morning until before noon. [12] [15]

Method and things to observe before, during and after huqnah

Things to observe before huqnah [14]

In order to do huqnah, one must observe the following:

  1. The patient must not be hungry as one must not do huqnah while hungry or thirsty except for huqnah for colic or illnesses of the head in which the patient must be hungry.
  2. The patient must use heart and stomach strengthening medicine before huqnah.
  3. Huqnah must not be done after exhaustion and complete fullness.
  4. The patient must not be an infant.
  5. In order to carry out huqnah, the main organs of the body must all be healthy (some doctors don’t consider the healthiness of the organs to be a condition).
  6. The patient shouldn’t bathe before huqnah as one of the characteristics of bathing is that it scatters the toxins and one of the characteristics of huqnah is that it gathers the toxins. In reality, these two contradict each other. [12]

Position of the patient during huqnah

The best position is that the patient places their knees on the ground and lifts his buttocks so that the medicine can enter the rectum quickly or to lay on his left. After the medicine is entered, the tool which huqnah is done with is removed and the patient should lay on his back or the side of the pain. [16]

Method of execution

After lubricating the head of the pipe and the anus, the head of the pipe is entered into the anus. One must be careful that the pipe doesn’t reach a dead end in the intestines and that it doesn’t pass the rectum. After the pipe is placed in the appropriate place, the medicine is entered into the body. The pressure of entering the medicine must be to an appropriate limit, not so severe that that the medicine passes the place in question and not so light that it doesn’t enters the body enough. In each huqnah, one can use medicine for four times. Fundamentally, entering the medicine for less than three times has no use. After entering the medicine each time, the patient must stay laying on the floor for a little while so that the medicine doesn’t come back and can be taken in by the body. If the patient feels unsettled or needs to defecate, he must do so. [17]

Things to observe during huqnah [17] [18]

  1. While the medicine is being entered from the anus, the patient must abstain from coughing, sneezing and hiccupping so that the medicine isn’t defecated.
  2. If the medicine which was entered into the intestines first doesn’t come back out, they should put the medicine in the anus again. In the case in which the first medicine comes back out late, putting some salt into the medicine will assist the return of the medicine.
  3. It is vital that the patient should cover their legs during huqnah and also keep the painful body part warm.

Things to observe after huqnah

After huqnah, the patient must consume medicine which strengthens the stomach such as flower syrup (a mixture which is prepared with damask rose, sugar and rosewater), mastic (a resin taken from a small tree by the same name. The medical uses of mastic in traditional medicine are widespread and from its fruit, mastic oil is prepared.), apple syrup, sweet quince syrup, jawarish (a mixture which strengthens and is tasty and sweet-smelling) or sweet frankincense. [17]

Side effects of huqnah

Regarding huqnah, certain side effects haven’t been mentioned in the sources of traditional medicine. In reality, is one of the least harmless treatments as at most, its effects reach the colon, the medicine used in huqnah doesn’t stay in the body for too long and doesn’t harm the main organs (heart, brain and liver). Even the side effects of the other amal yadawi can be cured with huqnah. Of course, one must do precaution when doing huqnah with anal illnesses such as haemorrhoids. [19]


References

  1. Faslnāmeh Tārīkh Pezeshkī, p. 47
  2. ‘al-Ṭibb ‘al-Nabawī, p. 96
  3. Dawreh Tebb Sonnatī va Taghziyeh Shenākht Tabāye’, vol. 2, p. 171
  4. 4.0 4.1 Dawreh Tebb Sonnatī va Taghziyeh Shenākht Tabāye’, vol. 2, p. 170
  5. Faslnāmeh Tārīkh Pezeshkī, p. 48
  6. 6.0 6.1 6.2 Faslnāmeh Tārīkh Pezeshkī, p. 49
  7. Tuḥaf ‘al-`Uqūl, p. 125
  8. Wasā’il ‘al-Shī`aḧ, vol. 25, p. 31
  9. Wasā’il ‘al-Shī`aḧ, vol. 25, p. 225
  10. 10.0 10.1 10.2 Wasā’il ‘al-Shī`aḧ, vol. 25, p. 226
  11. ‘al-Kāfī, vol. 8, p. 192
  12. 12.0 12.1 12.2 ‘al-Qānūn fī ‘al-Ṭibb (Beirut print), vol. 1, p. 263
  13. Faslnāmeh Tārīkh Pezeshkī, p. 52
  14. 14.0 14.1 Faslnāmeh Tārīkh Pezeshkī, p. 54
  15. Faslnāmeh Tārīkh Pezeshkī, p. 53
  16. Faslnāmeh Tārīkh Pezeshkī, p. 55
  17. 17.0 17.1 17.2 Faslnāmeh Tārīkh Pezeshkī, p. 56
  18. Zakhīreh Khwārazmshāhī, vol 3, p. 665
  19. Faslnāmeh Tārīkh Pezeshkī, p. 63