Management of Dubayla al-Kabid (Liver abscess) in Unani medicine: A review

Dubayla al-Kabid (Liver abscess) is a condition in which collection of pus occurs in the liver commonly involving the right lobe. Traditional Unani medicine offers a detailed description of liver disorders alongwith their management. Causative factors of Dubayla al-Kabid include- infection, chronic dysentery, liver injury, cholelithiasis, irregular diets etc. The symptoms are fever with chills, abdominal pain, loss of appetite and difficulty in breathing.  The line of treatment under Usool-e-Ilaj of the disease is based on evacuation of pus, use of medicines with Dāfi‘-i-Ḥummā (Antipyretic) , Daf‘-i-Ta‘affun (Antiseptic), Muḥāfiẓ-i-Jigar (Hepatoprotective) and Muqawwī-i-Jigar(Liver tonic) properties. In contemporary medicine liver abscess is an encapsulated collection of suppurated material within the liver resulting from either fungal, bacterial, or parasitic infection. Although Klebsiella pneumoniae accounts for 50–70% of cases in the Asian subcontinent, Entamoeba histolytica is also frequently seen in routine clinical practice causing liver abscesses. Escherichia coli is the most common bacterium causing liver abscesses. Thus, infection that spreads throughout the biliary system is one of the most frequent causes of liver abscess requiring antibiotics.  The drainage of pus is the treatment of choice in cases of large abscess while small liver abscess of 2-3 cm is conventionally treated with antibiotics. Antimicrobial resistance and persistence are associated with an elevated risk of treatment failure and relapsing infections. Hence there is a need to explore the ages old treatment strategies for the management of small liver abscess laid down in traditional Unani medicine. This paper will further pave the way of developing novel therapies for the effective management of liver abscess. Keywords:  Dubayla al-Kabid, Unani management, Usool-e-Ilaj