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Introduction To Module on Emergency Medicine

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Introduction to the Module on Emergency Medicine
In the course of the normal working day, the Tibb Practitioner probably deals predominantly with
patients who are suffering from chronic disorders – diabetes, respiratory problems, musculo-
skeletal disorders, and so on. However, he or she will in all likelihood be called on to treat one or
more acute disorders. For example, a patient could present with severe gastro-intestinal distress,
or epistaxis, or uterine bleeding, or pneumonia. In these cases, the Tibb Practitioner needs to offer
prompt, effective and palliative treatment which is satisfactory to the patient. This treatment has to
be provided from (a) resources which are present in the Tibb Formulary of Products; (b)
application of Regimental Therapy with procedures such as cupping, acupressure and massage;
(c) realistic dietary intervention; and (d) easily accessible herbal remedies.

This module on Emergency medicine covers the main acute disorders or emergency situations –
around 25 in all – which the Tibb Practitioner may encounter during the course of his or her daily
activities. The application of high-tech methods for diagnosis and treatment are not included in the
Tibb interventions, as these fall more into the territory of hospital or clinic based therapies.

In line with other modules in this series, the Outcomes expected for students of the module on
Emergency Medicine are strictly defined. This is the initial phase in the overall assessment of the
student, so ensuring that the information contained within the module has been satisfactorily
assimilated and understood, and will form the basis of emergency treatment in future practice.
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Contents of the Module on Emergency Medicine

Introduction ………………………………………………………………..                          ….. page 1

Outcomes of this Module ………………………………………………..                     ….. page 4

The Tibb approach to emergency medicine …………………………..             ….. page 5

Specific emergencies …………………………………………………….                       ….. page 6

  Abdominal pain – appendicitis ………………………………………                  ….. page 6

  Abdominal pain – biliary colic………………………………………..                ….. page 7

  Abdominal pain – colic………………………………………………..                     ….. page 8

  Abdominal pain – peptic ulcer……………………………………….                  ….. page 9

  Abdominal pain – stomach ache / food intolerance……………….        ….. page 10

  Anaphylactic reaction – urticaria / hives……………………………           ….. page 11

  Anaphylactic reaction – bee / spider / scorpion bites……………..   ….. page 12

  Anaphylactic reaction – hypotension………………………………..              ….. page 13

  Asthmatic attack……………………………………………………….                         ….. page 18

  Back pain……………………………………………………………….                             ….. page 14

  Bleeding – nose bleeding / epistaxis……………………………….              ….. page 15

  Bleeding – uterine……………………………………………………..                       ….. page 15

  Bronchitis/laryngitis …………………………………………………... ….. page 17

  Bronchospasm/ asthmatic attack …………………………………… ….. page 18

  Chest pain / angina / heart attack …………………………………..             ….. page 20

  Constipation …………………………………………………………...                         ….. page 21

  Deep vein thrombosis ………………………………………………... ….. page 22

  Dehydration ……………………………………………………………                            ….. page 23

  Diabetic ketosis ……………………………………………………….                        ….. page 24

  Diphtheria ……………………………………………………………...                          ….. page 25
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  Epileptic attack ……………………………………………………….           ….. page 26

  Haemorrhagic shock …………………………………………………. ….. page 28

  High blood pressure ………………………………………………….. ….. page 29

  Hyperthermia/fever …………………………………………………… ….. page 30

  Hypothermia …………………………………………………………... ….. page 31

  Joint pain /arthritis / gout …………………………………………….. ….. page 32

  Meningitis ……………………………………………………………… ….. page 33

  Miscarriage / abortion ………………………………………………... ….. page 16

  Piles/haemorrhoids …………………………………………………...         ….. page 34

  Placenta previa ……………………………………………………….. ….. page 16

  Pneumonia …………………………………………………………….                ….. page 35

  Urinary obstruction/colic ……………………………………………..     ….. page 36

Hakim’s Healing Soup recipe ……………………………………………       ….. page 37

Ginger Chicken Soup recipe …………………………………………….       ….. page 37

Digestive Tea recipe ……………………………………………………... ….. page 38

Chest Tea recipe ………………………………………………………….            ….. page 38
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Outcomes of this module
The desired outcomes of this module on Emergency Medicine in Tibb are:

   1. An understanding of the meaning of emergency medicine when practiced in the Tibb
      context;
   2. An awareness of the various lifestyle or behavioural changes that can be adopted by the
      patient in order to alleviate his or her disorder;
   3. An ability to detail the use of one or more Tibb medications in the treatment of specific
      emergency disorders;
   4. An ability to apply the Tibb cupping technique to alleviate the symptoms of specific
      emergency disorders.
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The Tibb approach to emergency medicine
In the eyes of many people, the term „emergency medicine‟ conveys a very strong and specific
image.
It is that based on TV and other media productions, in which medical care is offered at roadside
accidents, or the site of a natural disaster, or in the emergency ward of an urban hospital, with its
range of personal trauma, drug overdose, motor vehicle accident victims, etc.
One dominating feature of this scenario is the heavy focus on high-tech medical and surgical
procedures. The equipment for of electric resuscitation, laboratory tests, sophisticated drugs and
the monitoring of vital signs features prominently in these scenarios. Their application is the very
stuff of media drama.
Tibb has a different perspective of emergency medicine. It considers it as appropriate medical
care directed at relieving the pain and suffering being experienced by a person who does not have
immediate access to medical care and attention at the clinic or hospital level. In other words, Tibb
emergency care deals directly at palliative treatment of a patient here and now, without having
access to the range of high-tech techniques and medications routinely employed in the
emergency wards of clinics and hospitals. It means dealing to the best of the Tibb Practitioner‟s
ability with acute disorders, many of which are sudden in onset and are seriously distressing the
patient, employing medications and techniques which are readily available.
In practice, the Tibb Practitioner can call on the following resources for use in emergency medical
care:
         Several Tibb Health Science medications
         The application of both dry and wet cupping
         The application of acupressure and massage
         Relevant advice on dietary matters
         The use of commonly available herbal products
By skilful application of these medications and hands-on techniques, the Tibb Practitioner should
be able to offer substantial and sustained relief to the person suffering from the acute disorder. Of
course, if the disorder requires a more serious intervention, or if it threatens to become a life-
threatening disorder, then the Tibb Practitioner is well placed to refer the patient to the appropriate
medical practitioners.
The treatment of the various acute disorders which are amenable to treatment by the Tibb
Practitioner is described in the following text.
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Abdominal pain – appendicitis

A. Diet advice
   Avoid all solid foods for 3 to 5 days. Consume only soups, steamed vegetables, digestive teas,
and soft fruits/foods (such as pawpaw, pear, banana, and boiled rice).
   Drink “Hakim’s Healing Soup” and “Ginger Chicken Soup”, and sip “Digestive Tea” (see index
for recipes).

B. Tibb medication
 Livotibb
Two tablets every hour (for 3 doses) then two tablets every 3 hours (for 4 doses)
 Tibb- Digest
One tablet every hour (for 3 doses) then one tablet every 3 hours ((for 4 doses)
 Gastrone Syrup
One tablespoon every hour ((for 3 doses) then one tablespoon every 3 hours (for 2 doses)
 Septogard
One tablet every hour ((for 3 doses) then one tablet every 6 hours (for 2 doses)
 Laxotabs
One tablet every 4 hours (for 4 doses)

C. Cupping
(a) Apply dry cupping in the following sequence:
 A1, A2, A6. Use moderate suction, for 2 minutes, then remove.
 A5 (right) Use light suction, for one minute, then remove.
 A3, A4, A5 (left), A7 (left), A8 (left). Use moderate suction for 2 minutes, then remove.
(b) Wait for 5 minutes then re-apply the cups in the same way.
(c) After the second session wait for 15 minutes then repeat a third time in the same way.
(d) Repeat the 4th session after 30 minutes.
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Abdominal pain – biliary colic

A. Diet advice
   Avoid all solid foods for 3 to 5 days. Consume only soups, steamed vegetables, digestive teas,
and soft fruits/foods (such as pawpaw, pear, banana, and boiled rice).
   Drink “Hakim’s Healing Soup”, “Ginger Chicken Soup”, and sip “Digestive Tea” (see index for
recipes).

B. Tibb medication
 Livotibb
Two tablets every 30 minutes (for 3 doses) then two tablets every 3 hours (for 4 doses)
 Renotone
Two tablets every 30 minutes (for 3 doses) then one tablespoon every 3 hours (for 4 doses)
 Calcury
One tablet every 30 minutes (for 3 doses) then one tablet every 3 hours (for 4 doses)
 Melanopurg / Laxotabs
Four hours after starting the above treatment, administer Melanpurg one tablet and Laxotabs
two tablets every 6 hours (for 4 doses)

C. Cupping
(a) Apply dry cupping in the following sequence:
 TH6, A3, TH3, TH5. Use moderate suction, for 3 minutes then remove.
 A1, B8, B9. Use moderate suction, for 3 minutes then remove.
(b) Wait 5 minutes then re-apply the cups in the same way. After the second session wait for 15
minutes and repeat the same way third time.
(c) Repeat the 4th session after 30 minutes.
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Abdominal pain – colic

A. Diet advice
   Avoid all solid foods until the patient recovers. Consume soups, digestive teas, and soft
fruits/foods (such as pawpaw, pears, banana, and boiled rice).
   Drink “Hakim’s Healing Soup” (see index for recipe); “Ginger Chicken Soup” (see index for
recipe); and sip “Digestive Tea” (see index for recipe).

B. Tibb medication
 Gastrone
Two tablets every 30 minutes (for 3 doses), then two tablets every 3 hours (for 4 doses)
 Tibb- Digest
One tablet every 30 minutes (for 3 doses), then one tablet every 3 hours (for 4 doses)
 Gastrone syrup
One tablespoon every 30 minutes (for 3 doses), then one tablespoon every 3 hours (for 4 doses)
 Melanopurg /Laxotabs
Four hours after starting treatment, administer Melanpurg one tablet and Laxotabs two tablets
    every 6 hours (for 2 doses each)
C. Cupping
(a) Apply dry cupping in the following sequence:
 A1, A2, A6. Use moderate suction, for 2 minutes then remove.
 A7 (right), A5 (right), A3. Use moderate suction for 2 minutes, then remove.
 A1, A4, A5 (left), A7 (left), A8 (left) with moderate suction for 2 minutes, and remove.
(b) Wait for 5 minutes then apply the cups in the same way.
(c) After the second session wait for 15 minutes and repeat for a third time in the same way.
(d) Repeat the 4th session after 30 minutes.

D. Massage
In between cupping, massage the abdomen in the directions:
(a) Epigastrium to below the navel
(b) To the right upward at the level of ascending colon
(c) To the left on the left of transverse colon
(d) To the left downward on the level of descending colon, until right down.
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Abdominal pain – peptic ulcer

A. Diet advice
   Avoid all solid foods for 3 to 5 days. Consume soups, boiled milk, and soft fruits/foods like
pawpaw, pear, banana and boiled rice.

B. Tibb medication
 Endemali
One sachet, every 30 minutes (for 2 doses) then one sachet every 3 hours (for 4 doses)
 Qarahine
One sachet, every 30 minutes (for 2 doses) then one sachet every 3 hours (for 4 doses)
 Livotibb
Two tablets, every 30 minutes (for 2 doses) then two tablets every 3 hours ((for 4 doses)
 Vomeez syrup
One tablespoon, every hour (for 3 doses) then one tablespoon every 3 hours (for 2 doses)

C. Cupping
(a) Apply dry cupping in the following sequence:
 TH3, A1, A2. Use light/moderate suction, for 2 minutes, then remove.
 A5 (right). Use light suction for one minute, then remove.
 A3, A4, A5 (left), A7 (left), A8 (left) with moderate suction for 2 minutes, then remove.
(b) Wait 5 minutes and apply the cups in the same way.
(c) After the second session wait for 15 minutes and repeat a third time in the same way.
(d) Repeat the 4th session after 30 minutes.
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Abdominal pain – stomach ache / food intolerance

A. Diet advice
   Avoid all solid foods until the patient recovers. Consume soups, digestive teas, and soft
fruits/foods (such as pawpaw, pears, banana, and boiled rice).
   Drink “Hakim’s Healing Soup” (see index for recipe); “Ginger Chicken Soup” (see index for
recipe); and sip “Digestive Tea” (see index for recipe).

B. Tibb medication
 Gastrone
Two tablets, every 30 minutes (for 3 doses) then two tablets every 3 hours (for 4 doses)
 Tibb-Digest
One tablet every 30 minutes (for 3 doses) then one tablet every 3 hours (for 4 doses)
 Gastrone Syrup
One tablespoon every 30 minutes (for 3 doses) then one tablespoon every 3 hours (for 4 doses)
In case of constipation, four hours after starting the treatment introduce Laxotabs, two tablets
every 6 hours (for 2 doses)
C. Cupping
(a) Apply dry cupping in the following sequence:
 A1, A2, A6. Use moderate suction for 2 minutes, then remove.
 A7 (right), A5 (right), A3. Use moderate suction for 2 minutes, then remove.
 A1, A4, A5 (left), A7 (left), A8 (left). Use moderate suction for 2 minutes, then remove.
(b) Wait for 5 minutes and apply the cups in the same way.
(c) After the second session wait for 15 minutes, and repeat a third time in the same way.
(d) Repeat the 4th session after 30 minutes.

D. Massage
In between cupping, massage the abdomen in the following directions:
(a) From the epigastrium to below the navel
(b) To the right upward at the level of the ascending colon
(c) To the left of the transverse colon
(d) To the left downward at the level of the descending colon, until right down.
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Anaphylactic reaction – urticaria / hives

A. Diet advice
   Avoid all solid foods for 3 to 5 days. Consume soups, boiled milk, and soft fruits/foods like
pawpaw, pear, banana and boiled rice.

B. Tibb medication
 Livotibb
Two tablets, every 30 minutes (for 3 doses) then two tablets every 3 hours (for 4 doses) then one
tablet every 4 hours until the condition improves satisfactorily
 Renotone
Two tablets, every 30 minutes (for 3 doses) then one tablet every 3 hours (for 4 doses) then one
tablet every 4 hours until the condition improves satisfactorily
 Dermacare
One tablet every 3 hours (for 3 doses) then one tablet every 6 hours (for 3 doses) then one tablet
every 12 hours until the condition improves satisfactorily
 Biliopurg / Laxotabs
Four hours after starting the treatment, introduce Biliopurg, one capsule, and Laxotabs, two
tablets every 12 hours (for 3 doses)

C. Herbal treatment
 Sip continuously a mixture of fresh mint leaves (40) and fennel seeds (2 tablespoons) in 0.5
litre boiling water, after cooling.
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Anaphylactic reaction – bee, scorpion sting / spider bite
A. Tibb medication
 Livotibb
Two tablets, every 30 minutes (for 3 doses), then two tablets every 3 hours (for 4 doses), then
one tablet every 4 hours until the condition improves satisfactorily
 Renotone
Two tablets, every 30 minutes (for 3 doses), then one tablet every 3 hours (for 4 doses), then one
tablet every 4 hours until the condition improves satisfactorily
 Dermacare
One tablet every hour (for 3 doses), then one tablet every 4 hours (for 3 doses), then one tablet
every 12 hours until the condition improves satisfactorily
 Melanopurg / Laxotabs
Four hours after starting treatment, administer Melanopurg, one tablet, and Laxotabs, two
tablets every 12 hours (for 3 doses)

B. Herbal treatment
 Sip continuously a mixture of fresh mint leaves (40) and fennel seeds (2 tablespoons) in 0.5
litre boiling water, after cooling.

C. Cupping
Apply wet cupping to the effected area in cases of scorpion and bee stings.
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Anaphylactic reaction – hypotension
A. Tibb medication
 Organoherb
One tablet, every 10 minutes (for 2 doses), then one tablet every 30 minutes (for 2 doses)
 Erqember Syrup
Two tablespoons, every 10 minutes (for 2 doses), then one tablespoon every 30 minutes (for 2
    doses)
 Enerlift Syrup
One tablespoon, every 10 minutes (for 2 doses), then one tablespoon every 30 minutes (for 2
    doses)

B. Herbal treatment
   Cayenne powder, one teaspoon measure in a cup of hot water, every 30 minutes (repeat
once).
   Sip continuously a mixture of cinnamon powder, cloves and ajmo powder, one tablespoon
measure each, in 300 ml boiling water after cooling.

C. Massage
Apply blackseed vapour rub to the patient‟s palms and soles, using hard strokes.

D. Acupressure
 Point 1: located on the upper lip, 2/3 distance from mouth to nose.
Cardiac and respiratory rhythms can be restored by pricking on this point .
 Point 2: located in the depression appearing on the sole when the foot is in planter flexion,
approximately at the junction of the anterior and middle third of the sole. Pressure should start
with medium pressure; build up gradually; lasting one minute; released gradually.
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Back pain
A. Tibb medication
 Rumaflam
Two tablets, every hour (for 2 doses), then one tablet every 3 hours (for 4 doses)
 Tibb Antiflam
Two tablets, every hour (for 2 doses), then one tablet every 3 hours ((for 4 doses)
 Barshasha
One tablet, every hour (for 2 doses), then one tablet every 3 hours (for 2 doses)
 Laxotabs
Six hours after starting treatment, administer Laxotabs 2 tablets every 6 hours (for 2 doses)

B. Massage
Apply a mixture of Rumaflam cream, Antiflam oil and Blackseed vapour rub to the back .

C. Cupping
(a) Apply dry cupping followed by wet cupping.
(b) Cupping can be done directly on the affected area.
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Bleeding – nose bleeding / epistaxis
A. Diet advice
   Avoid all spicy, sugary and oily foods for 3 to 5 days.
   Consume more fruits, steamed vegetables and water.

B. Tibb medication
 Livotibb
One tablet, every 30 minutes (for 3 doses), then two tablets every 3 hours (for 4 doses)
 Clotad
One tablet every 30 minutes (for 3 doses), then one tablets every 3 hours (for 4 doses)
 Livotibb / Clotad
Then Livotibb, two tablets and Clotad, one tablet twice a day for 15 days.

C. Other
 Apply tap water on the forehead and into the nostrils until the bleeding ceases.
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Bleeding – uterine
A. Diet advice
   Avoid all spicy, sugary and oily foods 3-5 days. Consume more fruits, steamed vegetables and
    water.

B. Tibb medication
 Livotibb
Two tablets, every 30 minutes (for 3 doses), then two tablets every 3 hours (for 4 doses)
 Clotad
One tablets every 30 minutes (for 3 doses), then one tablets every 3 hours (for 4 doses)
 Tibb Femecare
One capsule or one tablespoon every 30 minutes (for 3 doses), then one capsule or one
tablespoon every 3 hours (for 4 doses)
 Livotibb / Femecare / Clotad
Then Livotibb, two tablets, plus Tibb Femecare, one capsule, or syrup, one tablespoon, plus
Clotad, one tablet, all twice a day until the improves satisfactorily

C. Herbal treatment
 Boil fennel seeds (four tablespoon) in half-litre boiling water for 10 minutes, strain it, cool to
room temperature and drink ½ cup every hour.
 Note: Avoid this treatment if miscarriage threatens.
D. Other
 Complete bed rest is necessary.
 Patient must lie on the bed with legs slightly up to avoid the flow of bleeding.
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Bronchitis / laryngitis
A. Diet advice
   Avoid all solid foods for 3 to 5 days. Consume only soups, soft fruits/foods (such as pawpaw,
    pears, banana and boiled rice).

B. Tibb medication
 Joshina Tea
One sachet every 30 minutes (for 3 doses), then every 3 hours (for 4 doses)
 Livotibb
Two tablets every 30 minutes (for 3 doses), then one tablet every 3 hours (for 4 doses)
 Chesteez Syrup
One tablespoon every 30 minutes (for 3 doses), then one tablespoon every 3 hours (for 4 doses)
 Septogard Syrup
One tablespoon, every 30 minutes (for 3 doses), then one tablespoon every 3 hours (for 4 doses)
 Sualin Lozenges
One every hour (for 4 doses), then one every 3 hours (for 3 doses)

C. Massage
 Apply blackseed vapour rub applied to the patient‟s chest and back
D. Cupping
(a) Apply dry cupping in the following sequence:
 TH1, TH2, TH4, TH7. Use moderate suction, for 2 minutes, then remove.
 B3, B4, B5. Use moderate suction for 2 minutes, then remove.
(b) Wait for 5 minutes and apply the cups in the same way.
(c) After the second session wait for 15 minutes, then repeat a third time in the same way.
(d) Repeat the 4th session after 30 minutes.
                                              - Page 18 -


Bronchospasm / asthmatic attack
A. Diet advice
   Avoid all solid foods until the condition get recover. Consume soups, teas, etc.
   Drink “Hakim’s Healing Soup” and sip “Chest Tea”. (See index for recipes).

B. Tibb medication
 Septogard
One tablet or one teaspoon every 10 minutes (for 3 doses), then every 2 hours (for 3 doses)
 Tibb Asthma syrup
One tablespoon, every 10 minutes (repeat 2 times), then one tablespoon every 2 hours (for 3
doses)
 Blackseed honey
One tablespoon, every 10minutes (for 3 doses), then one tablespoon every 2 hours (for 3 doses)
 Tibb-Inhaler
Nebulise with this bronchodilator at your clinical discretion.

C. Herbal treatment
   Sip continuously “Chest Tea” with one tablespoon blackseed honey added.

D. Acupressure & Cupping
(a) With the patient lying down, apply finger pressure to the points on both sides of the body,
simultaneously if possible. Hold for about two minutes, or hold for ten seconds, release for ten
seconds, and repeat ten times. The points may be tender. Apply pressure without causing undue
pain.
Point 1: Opens blocked energy in the lungs. Located on either side of the chest in the soft space just
under the lateral head of the clavicle (collarbone) (see cupping points TH4). Dry cupping can also be
used.
Point 2: clears the lungs and disperses congestion. Located in the centre of the chest at the level of
the nipples (see cupping point TH2). Dry cupping can also be used.
Point 3: is a specific point to relieve asthma. Located on the back, just below the most prominent
vertebra C7at the base of the neck (see cupping points B1, B3, B4). Dry or wet cupping can also be
used.

E. Emesis
 Induce vomiting where there is a build-up of phlegm in the chest; especially in children.
                                             - Page 19 -


F. Massage
Apply the Tibb Asthma Relief Massage:
Repetitive massage. Soothing, effective relief, especially for children
 Ring finger: Rub the palmar surface linearly from 2nd knuckle to fingertip.
 Chest: With your thumbs together at midpoint of chest between nipples (TH2) and hands
   wrapped around chest, the thumbs directed towards nipples. Massage points TH1 and TH2.
 Back: Place thumbs on median border of the shoulder blades, and the hands wrapped around
   neck. Push apart the curves of the shoulder blades with thumbs, moving in one direction from
   above to below at level of B4.
 Forearm: For non-febrile children. Massage along the lateral / thumb-side edge of the
   forearm‟s long bone in one direction, from wrist to elbow.

F. Heat therapy
 Apply a hot water bottle to the patient‟s chest.
                                                - Page 20 -


Chest pain / angina / heart attack
A. Tibb medication
 Coronary Care
One tablet, every 5 minutes (for 3 doses), then one tablet every 30 minutes (for 3 doses)
 Tibb-Digest
One tablet, every 5 minutes (for 3 doses), then one tablet every 30 minutes (for 3 doses)
 Gastrone
One tablet, every 5 minutes (for 3 doses), then one tablet every 30 minutes (for 3 doses)
 Erqember syrup
One tablespoon, every 5 minutes (for 3 doses), then one tablespoon every 30 minutes (for 3
doses)

B. Herbal treatment
   Cayenne powder
One teaspoon measure in a cup of hot water every 5 minutes (repeat 2 times), then one teaspoon
every 30 minutes (repeat 2 times).
   Cinnamon powder and ajmo (celery seed) powder
One tablespoon measure each in 300 ml boiling water. Sip continuously after cooling.

C. Massage
 Apply blackseed vapour rub to the patient‟s chest and back.
D. Acupressure
(a) Apply with the patient supine or sitting.
Point 1: located on the wrist, palm side, X2 thumb widths above the wrist crease in centre of arm,
between the two largest tendons. Pressure should start with medium pressure, building up
gradually, and lasting one minute. Pressure should be released gradually.
Point 2: located on the upper lip, 2/3 distance from mouth to nose.
(b) Restoring cardiac and respiratory rhythms can be achieved by pricking on Point 2.

E. Heat therapy
 Apply hot water bottle to the patient‟s chest.
                                               - Page 21 -


Constipation
A. Tibb medication
 Laxotabs
Three tablets (single dose)
 Regulax forte
½ tablet, (single dose)
 Laxotabs
After recovering from acute constipation, continue with Laxotabs (two tablets) every night at
bedtime until normal bowel function returns.

B. Herbal treatment
   30 minutes after Regulax Forte dose, give olive oil, castor oil plus butter (one teaspoon each)
mixed in a glass of warm boiled milk, sweetened with brown sugar.
   For infants and children, the same milk mixture, but adding Hamdard Ghutti (one tablespoon).

C. Massage
(a) Massage with olive oil in the direction from epigastrium to below the navel.
(b) Then turn to right upward on ascending colon.
(c) Then left on transverse colon, downward on the descending colon until the rectum for 5
minutes. (d) Follow with dry cupping.

D. Cupping
(a) Apply dry cupping in the following sequence:
 A1, A2, A6. Use moderate suction for 3 minutes, and then remove.
 A5 (right), A3, A1. Use moderate suction, for 4 minute, and then remove.
 A4, A5 (left), A7 (left), A8 (left). Use moderate suction for 5 minutes, and then remove.
(b) Apply cups on the back B16, followed by 2 cups with 2 fingers gap upwards for 5 minutes.
(c) Repeat the cupping on the abdomen in the same sequence.
(d) Repeat on the back.
E. Other
 Suppositories for infants and small children and instant enema for big children and adults can
be given for rapid relief from constipation.
                                             - Page 22 -


Deep vein thrombosis
A. Diet advice
   Avoid cold and dry foods and drink.

B. Tibb medication
 Piloherb
Two tablets, every 4 hours until the condition improves satisfactorily
 Livotibb
One tablet, every 4 hours until the condition improves satisfactorily
 Coronary care
One tablet, every 4 hours until the condition improves satisfactorily
 Melanpurg / Laxotabs
Four hours after starting the treatment, introduce Melanpurg, one tablet, and Laxotabs, two
tablets every 24 hours.

C. Herbal treatment
   Consume every day: fresh ginger juice, one tablespoon, fresh garlic juice, one-half teaspoon,
mix with fresh mint leaves, 40 leaves, and fennel seeds, one tablespoon, and ajmo (celery) seeds,
one tablespoon in ½ litre boiling water.

D. Other
Apply the following paste for 4 to 5 hours, twice a day:
   Brown flour, two tablespoons, turmeric powder, two tablespoons, fenugreek seed powder, one
tablespoon, stamped yellow raisins, one tablespoon, olive oil, two tablespoons, mixed together in
one cup water. Cook over mild heat to make a thick paste. Spread it onto cotton gauze, add
Piloherb ointment one-quarter teaspoon, and apply warm to the effected area, and bandage.
                                             - Page 23 -


Dehydration
A. Tibb medication
If diarrhoea is the cause of dehydration, then treat with:
 Gastrostop
One tablet every hour until the diarrhoea ceases.
 Organoherb
One crushed tablet every 10 minutes (for 2 doses), then one tablet every 30 minutes (for 2
doses), then one tablet every three hours until the condition improves satisfactorily
 Erqember syrup
Two tablespoons every 10 minutes (repeat once), then one tablespoon every 30 minutes (repeat
once), then one tablespoon every three hours until the condition recovers.
 Enerlift syrup
One tablespoon, every 10 minutes (for 2 doses), then one tablespoon every 30 minutes (for 2
doses), then one tablespoon every three hours until the condition improves satisfactorily

If vomiting is the cause of dehydration, then treat with:
 Vomeez syrup and Gastrone syrup
One tablespoon every 30 minutes until the vomiting ceases.

C. Herbal treatment
   If there are symptoms of poor circulation, cayenne powder, one teaspoon measure in a cup of
hot water, every 30 minutes (repeat once).
   Sip continuously a mixture of cinnamon powder, cloves powder, one tablespoon measure
each, mixed in 300 ml boiling water, and allowed to cool.

D. Accupressure
Point 1: located on the upper lip, 2/3 distance from mouth to nose.
Cardiac and respiratory rhythms can be restored by pricking on this point.
Point 2: located in the depression appearing on the sole when the foot is in planter flexion,
approximately at the junction of the anterior and middle third of the sole. Pressure should start
with medium pressure; build up gradually; lasting one minute; released gradually.
                                            - Page 24 -


Diabetic ketosis
A. Tibb medication
 Glucostop
One tablet, every 30 minutes (for 3 doses), then one tablet every four hours (for 6 doses)
 Livotibb
One tablet every 30 minutes (for 3 doses), then one tablet every four hours (for 6 doses)
 Renotone
One tablet, every 30 minutes (for 2 doses), then one tablet every six hours (for 4 doses)
 Septogard
One tablet every 30 minutes (for 2 doses), then one tablet every six hours (for 4 doses)

B. Herbal treatment
 Sip continuously a mixture of fenugreek seed, cinnamon powder and fennel seed, one
tablespoon measure each, in 300 ml boiling water, allowed to cool.
                                             - Page 25 -


Diphtheria
A. Tibb medication
 Septogard
One tablet every 30 minutes (for 4 doses), then one tablet every 4 hours (for 6 doses), then
continue with one tablet every 6 hours until the condition improves satisfactorily
 Livotibb
One tablet every 30 minutes (for 4 doses), then one tablet every 4 hours (for 4 doses), then
continue with one tablet every 6 hours until the condition improves satisfactorily
 Coronary care
One tablet every 30 minutes (for 4 doses), then one tablet every 4 hours (repeat 5 times), then
continue with one tablet every 6 hours until the condition improves satisfactorily
 Blackseed honey
One tablespoon every 30 minutes (for 2 doses), then one tablespoon every 6 hours (for 4 doses)
, then continue with one tablespoon twice daily until the condition improves satisfactorily

B. Herbal treatment
 Sip continuously a mixture of fenugreek seed and cinnamon powder, one tablespoon measure
each, mix in 300 ml boiling water, and allowed to cool.
 Gargle with the decoction of Sapindus trifoliatus (Soap-nut tree / Indian filbert / Arishtaka /
Reetha) 50 grams in half-litre water.

C. Cupping
 Apply dry and wet cupping on F1, N3, N4, N5, B4.
                                              - Page 26 -


Epileptic attack
A. General
(a) In most cases a seizure lasts less than 3 minutes, so by the time emergency medication is
ready to be given the seizure is over.
(b) The most important thing during a seizure is for you to stay calm and protect the person having
a seizure.
(c) The following guidelines apply to tonic-clonic seizures (convulsions, grand mal) or complex
partial seizures.
   Cushion the head. Banging the head against a hard surface during a seizure may lead to head
trauma. Use any available soft object, and, if needed, use your foot.
   Loosen tight neckwear to ease breathing.
   Turn the person onto his/her side. This position helps the tongue fall to the side of the mouth,
leaving the airway clear for normal breathing.
   Do not insert any object into the person's mouth. In fact, if an object is placed into the mouth,
you may cause more harm by breaking teeth or losing the object in the throat, causing choking.
   Do not restrain a person during a seizure unless there is a danger. They may become
aggressive if you do so. Allow them to do what they want to do. Talk to them in a soft voice to
reassure them.
   Don't perform artificial respiration during a seizure, even if the person is turning blue. Most
seizures are over long before brain damage from lack of oxygen begins.
   You shouldn‟t try to hold the person still because you may injure the individual or yourself.
   Don‟t give the person anything to eat or drink until the person is fully recovered.
   Don't give person medication by mouth until the seizure has stopped and he or she is
completely awake and alert.
   Stay with the person until recovery is complete.

B. After an epilepsy attack
   After the seizure you should gently turn the person's head to the side to let the saliva flow out
of the mouth.
   Let the person rest or sleep. After a seizure ends, most people sleep deeply.
                                             - Page 27 -


C. Tibb medication
 Cognium tablets, Tibb Mentone, Phlemnil, Digest-it Forte
   Administer one tablet every 3 hours (for 4 doses each), then every 6 hours (for 3 doses each)
   for 5 days

D. Acupressure & Cupping
The patient‟s thumbs should be held firmly but not very tightly, right thumb in right hand and left
hand in left hand, in such a way that he should cross his wrists with palms upward and while the
patient‟s palms should be downward
Point 1: located as 1/3 distance from the border of upper lip to nose in the mid-sagital line. Prick
this point with needle to cause bleeding.
Point 2: In the middle of the ankle and the knee on the front, two fingers lateral to the anterior
crest of the tibia, on the both legs.
 Apply cupping to the points H2, B1, B16.
                                             - Page 28 -


Haemorrhagic shock

A. General
   Treat according to the cause of shock.

B. Tibb medication
 Organoherb tablets
One tablet, crushed, every 10 minutes (for 3 doses), then one tablet every 30 minutes (for 4
doses), then one tablet every 3 hours until the condition improves satisfactorily
 Erqember syrup
Two tablespoon, every 10 minutes (for 3 doses), then one tablespoon every 30 minutes (for 4
doses), then one tablet every 3 hours until the condition improves satisfactorily
 Enerlift syrup
One tablespoon, every 10 minutes (for 3 doses), then one tablespoon every 30 minutes (for 4
doses), then one tablespoon every 3 hours till the condition improves satisfactorily

C. Herbal treatment
   Sip continuously an infusion of cinnamon powder, cloves powder, one tablespoon each, mixed
in 300 ml boiling water, and allowed to cool.

D. Acupressure
Point 1: located on the upper lip, 2/3 distance from mouth to nose.
Cardiac and respiratory rhythms can be restored by pricking on this point .
Point 2: located in the depression appearing on the sole when the foot is in planter flexion,
approximately at the junction of the anterior and middle third of the sole. Pressure should start
with medium pressure; build up gradually; lasting one minute; released gradually.
                                            - Page 29 -


High blood pressure
A. Diet advice
   Avoid all solid foods until the condition improves considerably. Consume plenty of soups, teas,
etc.

B. Tibb medication
 Pressure-eeze forte
One tablet every 10 minutes (for 3 doses), then one tablet every 2 hours (for 3 doses). Carry on
with same dosage every 4 hours until the condition improves satisfactorily
 Pressure-eeze plain
One tablet every 10 minutes (for 3 doses), then every 2 hours (for 3 doses). Carry on with same
dosage every 4 hours until the condition improves satisfactorily
 Coronary Care
One tablets every 10 minutes (for 3 doses), then every 2 hours (for 3 doses) times). Carry on with
same dosage every 4 hours until the condition improves satisfactorily
 Tibb Renetone
One tablets or one teaspoon every 10 minutes (for 3 doses), then every 2 hours (for 3 doses).
Carry on with same dosage every 4 hours until the condition improves satisfactorily

C. Herbal treatment
   Sip continously “Hypertension Tea”. Prepare by mixing fennel seeds, three tablespoons with
green tea, two tea bags, cardamom powder, one-half teaspoon, mixed in ½ litre boiling water, and
allowed to cool.

D. Cupping
(a) Apply dry cupping followed by wet cupping on the following points:
 H2 or N2, B1, B5, LE13
(b) Repeat the same if necessary after 3 days.
                                              - Page 30 -


Hyperthermia / fever
A. General
   Remove the patient from the hot environment. The patient must lie down and rest in a cool,
preferably air-conditioned, place. Remove any excess clothing.
   Give the patient plenty of fluids, especially water and fruit juices, continuously.
   Support airway, breathing, and circulation with intravenous (IV) fluids, supplemental oxygen,
and assisted ventilation, as indicated.
 Encourage the patient to shower and bathe, or sponge off with cool water.
   Apply ice packs to the patient's neck, axillae, and groin.
   Apply tepid water to the patient and fan the patient to promote evaporative cooling.
Evaporative cooling is safe, effective, easily accomplished, and well tolerated. Undress the
patient, spray with tepid (not cold) water, and cool by large fans to maximize evaporative heat
loss.
   Ice water or slush immersion is an alternative cooling method. Although ice water or slush
immersion is effective at rapidly lowering body temperature, it is associated with more
complications than evaporative cooling.
   Do not immerse in ice water. This will cause peripheral vasoconstriction, shunt blood away
from the periphery, and may lead to shivering and less heat dissipation. It is also uncomfortable
for the patient, limits access for cardiac and vital sign monitoring, may prove difficult to get in and
out of tub, and may result in hypothermic overshoot.
   Do not apply alcohol sponge baths. These are outdated and dangerous, and should never be
used in children or adults.
   Use antipyretic drugs with caution. No drugs significantly reduce core temperature in patients
with hyperthermia. In contrast to patients with fever who develop high body temperatures because
of an elevated hypothalamic set point, hyperthermic patients do not benefit from antipyretic
therapy.
   Antipyretics such as salicylates can worsen coagulopathies. Paracetamol in large doses can
cause hepatic damage.

B. Tibb medication
Sip continuously an infusion of fennel seeds (four tablespoons) mixed in one litre boiling water for
15 minutes, then cooled to room temperature. Add Livotibb syrup (four tablespoons), Enerlift
                                             - Page 31 -


(four tablespoons), Septogard syrup (one tablespoon), and Tibb-Renotone syrup (one
tablespoon).


Hypothermia
A. Diet advice
   Drink “Hakim’s Healing Soup”, “Ginger Chicken Soup” and sip “Digestive Tea”. (See index for
    recipes).

B. Tibb medication
 Organoherb
One crushed tablet every 10 minutes (for 3 doses), then one tablet every 30 minutes (for 3
doses), then one tablet every 3 hours till the condition improves satisfactorily
 Erqember syrup
Two tablespoons every 10 minutes (for 3 doses), then one tablespoon every 30 minutes (for 3
doses), then one tablespoon every 3 hours till the condition improves satisfactorily
 Blackseed oil
Half teaspoon every 10 minutes (for 2 doses), then half teaspoon every 30 minutes (for 2 doses),
then half teaspoon every 6 hours till the condition improves satisfactorily

C. Herbal treatment
   Cayenne powder, one teaspoon measure in cup of hot water, every 30 minutes, (repeat once),
then one teaspoon every 6 hours until the condition improves.
   Sip continuously an infusion of cinnamon powder, cloves and ajmo (celery seed) powder, one
tablespoon measure each, mix in 300 ml boiling water and allowed to cool.

D. Massage
 Blackseed vapour rub applied to the patient‟s hands, feet, chest and back.
                                            - Page 32 -


Joint pain / arthritis / gout
A. Tibb medication
 Tibb-Antiflam
Two tablets every hour (for 2 doses), then one tablet every 3 hours (for 4 doses)
 Tibb-Renotone
Two tablets every hour (for 2 doses), then one tablet every 3 hours (for 4 doses)
 Barshasha
One tablet, every hour (for 2 doses), then one tablet every 3 hours (for 2 doses)
 Laxotabs
Six hours after starting treatment, administer Laxotabs, two tablets every 6 hours (for 2 doses)

B. Cupping
 Apply dry cupping initially, followed by wet cupping.
                                            - Page 33 -


Meningitis
A. Diet advice
   Avoid all solid foods until the condition improves considerably. Consume soups, teas, etc.
   Drink “Hakim’s Healing Soup”. (See index for recipe).

B. Tibb medication
 Septogard
One tablets or one teaspoon every 10 minutes (for 3 doses), then every 2 hours (for 3 doses).
Carry on with the same dosage every 4 hours until the condition improves satisfactorily
 Fever-off
One capsule or one teaspoon every 10 minutes (for 3 doses), then every 2 hours (for 3 doses).
Carry on with the same dosage every 4 hours until the condition improves satisfactorily
 Livotibbb
One tablet or one teaspoon every 10 minutes (for 3 doses), then every 2 hours (for 3 doses).
Carry on with the same dosage every 4 hours until the condition improves satisfactorily
 Blackseed honey
One tablespoon every 10 minutes (for 3 doses), then one tablespoon every 2 hours (for 3 doses).
Carry on with the same dosage every 4 hours until the condition improves satisfactorily

C. Cupping
(a) Apply wet cupping once the fever has subsided.
 B3, B4. Use first dry cupping with moderate suction for 2 minutes.
(b) Follow this with wet cupping. Repeat after 3 days if necessary.

D. Massage
Apply blackseed vapour rub to the patient‟s spine, chest and back, in a downward direction.
                                            - Page 34 -


Piles / haemorrhoids
A. Diet advice
   Avoid the intake of any kind of meat, chicken and sea-food for 3 to 5 days.
   Consume boiled and steamed vegetables and fruits

B. Tibb medication
 Piloherb
Two tablets, every 2 hour (for 2 doses), then two tablets every 4 hours (for 4 doses), then two
tablets three times a day
 Laxotabs
Two tablets, every hour (for 2 doses), then 2 tablets at bedtime every day thereafter
 Piloherb ointment
Apply ointment every 30 minutes (for 2 doses), then every 2 hours (for 3 doses) and then twice
daily
 Clotad
Add one or two tablets In case of bleeding, according to the condition

C. Cupping
(a) Apply wet cupping on
 B16, LE3, LE4.
(b) In case of bleeding piles, delay the cupping until the bleeding has ceased.
D. Other
 Use a Sitz bath in warm to mildly hot water for 15 minutes.
                                            - Page 35 -


Pneumonia
A. Diet advice
   Avoid all solid foods until the condition improves considerably. Encourage the patient to
consume soups, teas, etc.
   Drink “Hakim’s Healing Soup” and “Chest Tea”. (See index for recipes).

B. Tibb medication
 Septogard
One tablet or one teaspoon every 10 minutes (for 3 doses), then every 2 hours (for 3 doses).
Carry on with the same dosage every 4 hours until the condition improves satisfactorily
 Fever-off
One capsule, tablet or teaspoon every 10 minutes ((for 3 doses each), then every 2 hours (for 3
doses). Carry on with the same dosage every 4 hours until the condition improves satisfactorily
 Tibb Asthma syrup
One tablespoon, every 10 minutes (for 3 doses), then one tablespoon every 2 hours (for 3 doses).
Carry on with the same dosage every 4 hours until the condition improves satisfactorily.
 Blackseed honey
One tablespoon every 10 minutes (for 3 doses), then one tablespoon every 2 hours (for 3 doses).
Carry on with the same dosage every 4 hours until the condition improves satisfactorily.
C. Herbal treatment
   Sip continously “Chest Tea” with blackseed honey, one tablespoon, added.

D. Cupping
(a) Apply dry cupping in the following sequence:
 TH1, TH2, TH4, TH7. Use with moderate suction, for 2 minutes, and remove.
 B3, B4, B5. Use with moderate suction for 2 minutes, and remove.
(b) Wait for 5 minutes and apply the cups in the same way.
(c) After the second session wait for 15 minutes, and repeat the same way for a third time.
(d) Repeat with a 4th session after 30 minutes.

E. Massage
Apply blackseed vapour rub to the patient‟s hands, feet, chest and back.
                                             - Page 36 -


Urinary obstruction
A. Diet advice
   Avoid all solid foods for 3 to 5 days. Encourage the patient to consume liquids, soups,
digestive teas and soft fruits / foods (such as pawpaw, melons, pears, banana and boiled rice).

B. Tibb medication
 Livotibb
Two tablets, every 30 minutes (for 3 doses), then two tablets every 2 hours (for 3 doses)
 Renotone
Two tablets, every 30 minutes, (for 3 doses), then one tablet every 2 hours, (for 3 doses)
 Calcury
One tablet, every 30 minutes, (for 3 doses), then one tablet every 2 hours, (for 3 doses)
 Barshasha
One tablet, every 30 minutes, (for 2 doses), then one tablet every 2 hours (for 2 doses)
 Melanpurg / Laxotabs
Eight hours after starting treatment, administer Melanpurg, one tablet, and Laxotabs, two
tablets, every 6 hours (for 4 doses each).

C. Herbal treatment
   Sip continuously an infusion made from fennel seeds, four tablespoons, in one litre boiling
water for 15 minutes. Add Tibb-Renotone syrup, three tablespoons, and allow to cool.

D. Cupping
(a) Apply dry cupping in the following sequence:
 A5, A6, A7, A8, B12, B13, B14. Use moderate suction, for 5 minutes, and then remove.
(b) Wait for 5 minutes and apply the cups in the same way.
(c) After the second session wait for 10 minutes, and repeat the same way third time.
                                             - Page 37 -


Recipe – Hakim’s Healing Soup

 Ingredients:                                              Method:
  Chicken, 500 gm, cut into serving pieces or:
Method:                                                    1. Boil all ingredients until mixture is
  Mutton, 500 gm, with excess fat trimmed                    reduced to more or less 2.5 litres.

  5 litres water                                          2. Season with salt and pepper, then

  3 cm piece ginger, peeled and chopped                      serve.

  2 cinnamon sticks
  4 cloves
  1 tbls whole dried coriander
  1 tbls whole dried cumin
  10 to 15 whole black peppercorns
  ½ tsp tumeric


Recipe – Ginger Chicken Soup

 Ingredients:                                              Method:
  1 baby chicken, disjointed and cut into                 1. In a soup pot braise the onion and
       serving pieces                                         cumin in ghee until onion is soft and
 or:                                                          transparent, but not brown.
  500 gm chicken breasts, as 2.5 cm cubes                 2. Add the washed chicken, season with

  3 cups water                                               salt, turmeric and pepper.

  1 small onion, chopped                                  3. Add cinnamon and cardamon, and
                                                              cook on medium heat until chicken is
  2 pieces ginger, peeled and sliced
                                                              cooked through.
  1 cinnamon stick
                                                           4. Add ginger, oats and water.
  1 cardamon pod
                                                           5. Before serving, remove excess
  1 tsp each of salt, tumeric, cumin seeds
                                                              ginger, cinnamon stick and
  ¼ tsp fine white / black pepper
                                                              cardamom.
  1½ tsp ghee
                                                           6. Chop fresh coriander, garnish and
  Handful fresh coriander                                    serve.
  2 tbls Jungle Oats
                                    - Page 38 -




Recipe – Digestive Tea

. Ingredients:                                    Method:
  7 mint leaves                                  1. Boil all the ingredients in 3 cups of
  2 black pepper corns                              water until only one cup remains.
  Small piece of fresh ginger                    2. Strain and mix with brown sugar /
  2 crushed cardamom pods                           honey

  Brown sugar or honey                           3. Drink warm




Recipe – Chest Tea

 Ingredients:                                     Method:
  25 gms cinnamon                                1. Crush all the ingredients into a
  25 gms cloves                                     powder.
  25 gms celery seeds (ajmo)                     2. Add ½ tsp of the powder to 2 cups
  50 gms fenugreek seeds (methi)                    of water.

  Lemon juice or honey                           3. Boil the liquid until only 1 cup
                                                     remains.
                                                  4. Strain and mix with lemon juice or
                                                     honey, to taste.
                                                  5. Drink warm.

				
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