A first consultation with a qualified hakim typically lasts 45–90 minutes. The practitioner begins with detailed history-taking spanning the presenting complaint, medical history, family history, and lifestyle. A defining feature of Unani assessment is evaluating your mizaj — individual temperament — through questions about thermal preferences, digestive patterns, sleep quality, emotional disposition, physical build, and response to foods and weather.
The hakim assesses the balance of the four humours through pulse diagnosis (nabz), urine examination (baul), and stool examination (baraz). Pulse diagnosis in Unani is detailed, considering rhythm, rate, volume, and qualitative characteristics that trained hakims read over many years of practice. Physical examination, including inspection, palpation, and auscultation, contributes further. Modern Unani practice in formal institutions integrates these classical diagnostic approaches with appropriate biomedical investigation (laboratory tests, imaging) when clinically indicated.
Treatment recommendations typically proceed in a hierarchy. Ilaj-bil-ghiza (dietotherapy) comes first — specific foods and dietary patterns are prescribed according to your mizaj and the nature of the imbalance. Ilaj-bit-tadbir (regimental therapy) follows if needed, including riyazat (exercise), dalak (massage), hammam (therapeutic bathing), fasd (venesection, rare in modern practice), hijamat (cupping), and taalim (leech therapy, also rare). Ilaj-bid-dawa (pharmacotherapy) uses single herbs (mufradat) and compound formulations (murakkabat) selected for your constitution and condition. These may include qurs (tablets), sharbat (syrups), joshanda (decoctions), roghan (oils), and other classical preparations. Surgical treatment (ilaj-bil-yad) is applied only when conservative approaches fail.
Follow-up sessions occur at intervals shaped by the condition and treatment plan — often every 2–4 weeks initially. The hakim adjusts formulations, monitors response through symptom review and repeat pulse/urine assessment, and coordinates with other healthcare providers when appropriate. Unani training emphasises preventative practice (tahaffuz-e-sihhat) as much as curative treatment; lifestyle and dietary guidance continues across the therapeutic relationship.