Critical review and mechanistic insights into the health-protective and Immunomodulatory activity of Tiryāq (Theriac) from the purview of Unani medicine

Background

The theriac, known in Arabic as tiryāq, is a medicinal panacea and an alexipharmic which was conceptualized during the 2nd century BC. During medieval ages, the Unani physicians employed various theriac formulations as an antidote, health-protective, and therapeutic in various disorders. In general, the theriac formulations contained many drugs having heath-protective, preventive, and restorative effects. Since the advent of COVID-19 pandemic, there has been a renewed interest in theriac formulations, and researches are underway to elaborate the scientific basis of their action mechanism. This article is an attempt to provide a comprehensive overview of theriac in Unani literature, as well as to elaborate on the potential mode of actions.

Methods

Selected authoritative and comprehensive textbooks of Unani medicine and leading scientific websites (MEDLINE, PubMed, ScienceDirect, Springer, and PubMed Central) were explored for information regarding the theriac in Unani classical literature, and its potential usefulness in the present era. No time duration was specified for the search as certain drugs are now relatively obsolete. The keywords used for the search were ‘theriac’, ‘health’, ‘bioactive constituents’, ‘infection’, and ‘antidote’, etc., accompanied by names of drugs.

Results

Pharmacological researches on theriac ingredients have revealed the presence of several bioactive compounds, having anti-inflammatory, antioxidant, antipyretic, antivenin, neuroprotective, hepatoprotective, cytotoxic, etc. activities.‎ An interesting step in theriac preparation is the process of maturation. It is scientifically proven that during maturation, the drugs undergo biotransformation through fermentation. Besides, certain drugs like Saffron, Celery, and Fennel, etc. increase bioavailability of other drugs. Overall, the Theriac formulations are a complex mixture of health-preservative, protective, therapeutic and restorative drugs.

Conclusions

The theriac formulations contain a thoughtful mixture of ingredients, which have health-protective as well as restorative effects. It is known that most toxins as well as biological disease-causing agents damage the vital organs and processes which lead to complications and death. Hence, the theriac formulations can provide the much-needed protection to these organs, and also maintain the physiological processes, and gives the body the necessary time and strength to recover from these adverse effects.