HUMORAL PRECAUTIONS IN SURGERY WITH SPECIAL REFERENCE TO CIRCUMCISION
*Kehkashan, Ferasat Ali, Iram Naseer, Yasra Farooqui, Amreen Zehra and Maryam Zafar
ABSTRACT
Theory of humors is given by father of medicine ―Hippocrates‖ (460-377 B.C.) and unani system of medicine is based on it. The imbalance of these humors causes diseases and the balance of these keeps the body healthy with a specific Mizāj (Temperament). The body contain four (major kind of) humors; Dam (blood), Balgham (phlegm), Ṣafrā (yellow bile) and Sawdā (black bile). Ṣafrā causes Ḥar Amrāḍ including Yarāqan Aṣfar (Jaundice). Circumcision is the surgical removal of the skin covering the tip of the penis. It is an ancient practice that has its beginning in religious rites. The procedure is typically done at first or second day on a newborn for personal or religious reasons. Circumcision in older children and adults may also be done for the many reasons. Risk of bleeding and infection at the site of the circumcision are the important complication of circumcision. Neonatal jaundice/ Yarāqan Aṣfar (disharmony of Khilṭ-i-Ṣafrā’) is the important problem in first week of life. Nearly 60% of term new born becomes visibly jaundiced in the first week of life. Neonatal jaundice is one of the causes of excess bleeding during circumcision because it impairs the coagulation and blood clot formation (prolong bleeding time). So it is better to postpone circumcision until complete recovery of jaundice because there is considerable risk of bleeding. Coagulation profile must be checked before performing this procedure. In case of pathological neonatal jaundice liver dysfunction occur so it is necessary to treat jaundice first before circumcision. In case of physiological jaundice there is no liver dysfunction so it is not a contraindication to circumcision, but it is better to delay circumcision in it also. Physiological jaundice disappears on itself only by care like proper breast feeding. There is no need to expose the baby to direct sunlight to reduce hyperbilirubinemia. Pathological jaundice is treated with phototherapy.
Keywords: Yar?qan A?far, Neonatal jaundice, circumcision, pathological jaundice, physiological jaundice.
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