Journal of - International Society for the History of Islamic Medicine

Views of Ibn Sina (Avicenna) on Ifraat Haiz (Menorrhagia)
Arshiya SULTANA(x), Khaleeq ur RAHMAN(xx),
Mazherunnisa BEGUM(xxx), Shafeeq ur RAHMAN(xxxx)
4. Ghalbae khilt safravi (dominance of bile humour)
gives rise to vascular fragility, which causes opening of
sphincters of uterine vessels, thereby leading to excessive
menstrual blood.
5. Hiddat and lazae dam leading to infatahe urooq (vasodilatation).
Ibn Sina said that the causes for the infatahe
urooq (dilatation of channels) are feebleness or weakness
of the quwate masika (retentive faculty), excessive
force of the quwate dafiya (expulsive faculty) and
cleansing and relaxing medicines.
6. Ghair Tabayi Khoon Haiz (abnormal menstrual blood
loss):
Kasrate (Excessive) and Quwate khoon: Excess of
blood in the body and qawi badan patients can
have ifraat haiz. Though the quality and quantity of
blood is normal but due to weakness in the body, it
is not able to utilize the total blood, hence the excess
quantity of blood is menstruated.
Excess of hiddat khoon and tazi khoon
There can be abnormality in riqqat,(decrease in
viscosity) qiwam (consistency) and latafat of khoon
due to hararat (heat) or kasrat mahiyat or ghalbae
rootubat (dominance of liquid) that can lead to ifraat
haiz.
7. Nasfe ddam can also be caused due to excessive rain. 12
Pathogenesis:
In ifraat haiz, initially vasoconstriction leads to dilution
and expulsion of small quantity of blood. This phase
is followed by vasodilatation, which is associated with thick
and excess quantity of blood being menstruated. This phase
persists for few days. Again due to vasoconstriction the
blood quantity and viscosity will be reduced.
Symptoms:
1. When Sailan haiz is due to dafe tabiyat, it will not cause
any harm to the woman but it is useful to the body and
quwat is also not changed. This type is seen in obese
woman.
2. Imtela aam: If sailan haiz is due ghalbae khoon, there
will be imtela (congestion) of face and body, sometimes
it will be with or without pain, prominent vessels with
other symptoms of imtela. This bleeding should not be
stopped unless there is weakness. Patient is comfortable
with heavy menstrual flow, belongs to higher class, well
nourished with least involvement in exercise and physi-
cal activities. Usually this type of menstrual blood loss
can be associated with ghalbae khilt (dominance of humours).
The method to diagnose the dominance of khilt, patient
shall be advised to keep sterile cotton gauze in the vagina
for the whole night. Next morning it is dried in shade and
the colour of the stain should be observed. If it is yellow,
it indicates dominance of khilt safra (bile), if whitish, it is
balgham (Phlegm), if greenish black or banafshi, it is sauda
(black bile) which is dominant in blood. According to ghalbae
khilt (dominance of humours), istrefagh (elimination)
should be done.
3. Sailan khoon caused due to zouf rehm, the menstrual
flow will be clear without pain .
4. Sailan khoon due to hiddat khoon is identified by its colour
and intensity of flow. As there is reduced viscosity,
the menstrual flow is raqeeq, there will be early stoppage.
5. Due to riqqat and latafat, blood will be raqeeq and zard,
comes out quickly with burning sensation and leaving
the body weak and yellow coloured.
6. Due to ghalbae rutubat mayi, blood will be raqeeq, there
will be weakness in the sphincters of uterine vessels.
Qabiz drug should be given as it will cause warmth. All
symptoms of dominance of balgham will be present.
7. Due to ghalbae safra blood will be raqeeq and taez.
8. If sailan haiz is due to rupture of uterine vessels caused
by sue mizaj, respective signs and symptoms of the sue
mizaj will be present. If sailan haiz is due to wounds,
psychological stress or difficult labour, respective signs
will be present.
9. Sign and symptoms of ghalbae khilt will be evident.
Differential diagnosis:
Bawaseer rehm: In bawaseer rehm, the women will have
intermenstrual bleeding and sailan haiz. Black coloured
menstrual blood flow. If the bleeding is from artery then
the colour of blood will not be black. It is associated with
giddiness, headache, hepatic and splenic pain, which subsides
with the menstrual blood flow.
Zouf rehm and infatahe urooq: Painless fresh bleeding associated
with nausea and headache, indicating the relation
between uterus, brain and stomach. If blood comes from
saakin vessel (venous); it will be black in colour. The red,
hot and shining blood indicates the arterial blood.
Quroohe rehm: Ifraat haiz due to quroohe rehm will be purulent
and painful menstruation associated with burning
sensation.
ISHIM 2011-2012
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