A REVIEW ON THE HAMMAM: A REGIMEN FROM ASCLEPIONS

Abstract

The bathing was almost universally followed practice in antiquity. It was of religious, cultural as well as therapeutic values. Before scientific medicine, Asclepions were the healing temples, which were always built near a river or spring and worked as today's clinic and hospitals, where water was used for therapeutic purposes. Hippocrates also described the different kinds of water as well as the therapeutic property of bathing. In the Roman and Arabic periods, Hammam was too popular and it was social practice. The bathing Houses were highly sophisticated building. The physicians of medieval age also considered hammam as one of the important resigns in the art of healing. They were described as the different kind of Hammam and their therapeutic importance.

Full text

Md Khursid Alam Ansari et al: J. Pharm. Sci. Innov. 2020; 9(6)
167
Journal of Pharmaceutical and Scientific Innovation
www.jpsionline.com (ISSN : 2277 –4572)
Review Article
A REVIEW ON THE HAMMAM: A REGIMEN FROM ASCLEPIONS
Md Khursid Alam Ansari, Azizur Rahman *, Tabish Bashir
Department of Mahiyatul Amraz (Pathology), National Institute of Unani Medicine, Bangalore, India
*Corresponding Author Email: azizalig@gmail.com
DOI: 10.7897/2277-4572.096191
Received on: 9/10/20 Revised on: 23/11/20 Accepted on: 29/11/20
ABSTRACT
The bathing was almost universally followed practice in antiquity. It was of religious, cultural as well as therapeutic values. Before scientific medicine,
Asclepions were the healing temples, which were always built near a river or spring and worked as today's clinic and hospitals, where water was used
for therapeutic purposes. Hippocrates also described the different kinds of water as well as the therapeutic property of bathing. In the Roman and Arabic
periods, Hammam was too popular and it was social practice. The bathing Houses were highly sophisticated building. The physicians of medieval age
also considered hammam as one of the important resigns in the art of healing. They were described as the different kind of Hammam and their
therapeutic importance.
KEYWORDS: Hammam, Asclepions, Unani system of medicine
INTRODUCTION
HISTORICAL BACKGROUND
In antiquity, baths were called holy and Heraclea because the
patient felt the strength and the physical uplift after the bath.
Athena found beauty and youth by taking a bath in the Odyssey
and Hercules regains his lost strength while he took bath in the
springs of Edipsos. Bath has described in Homer's Iliad and
Odyssey. In ancient Greek mythology, baths purified, healed, and
offered strength. Historically bathing practice is traced in
antiquity, much before the origin of organized medicine. Water
was used for therapeutic purposes in Asclepieia. Asclepions were
the healing temples of Asclepius (God of medicine). Asclepions
were always built near a river or spring and worked as a health
care facility like today's clinics and hospitals and the healers-
priests of Asclepius served as physicians (healer). Asclepieia of
Epidaurus and Kos were the most famous. In antiquity, baths were
called holy and Heraclea because the patient felt the strength and
the physical uplift after the bath.1,2
In ancient Greek and Roman civilization, the bathing practice was
much more than the body cleaning and hygiene. It was part of
religious mythology and was also used for therapeutic purposes.3
Thermalism was born in the ancient Greek and experienced its
golden age in the Roman period. Water vapors were used by
women to be more beautiful in Egypt. The co-regent of ancient
Egypt, Cleopatra used to make wraps with mud from the Dead
Sea, to maintain her legendary beauty.4 The emperor Augustus
was treated by the Greek physician Antonius Musa with cold
baths to cure typhoid fever.5 The First Hammam of the Islamic
period was built in Syria during the period of Qusair-e-Amra.6
Figure 1. Hammam of Qusair-e-Amra, Jordan
(https://en.wikipedia.org/wiki/Qusayr_%27Amra)
HAMMAM
Water is one of the four basic constituting elements of the body.
Hammam is an Arabic word derived from Hamm means heat
producer. The word hammam is used to denote bathroom or
toilets in many dialects of vernacular Arabic. But in the Unani
system of Medicine, the term Hammam is used for a hot bath and
used for therapeutic purposes or preventive measures. Hammam
(bath) was has a specific procedure, in which bather use
the frigidarium (cold bath), the tepidarium (warm bath), and the
caldarium (hot bath) and spend sometimes in each one of the bath-
chamber. Bathhouses were had much more facility than hygiene
and body cleaning.
Laconia was the name of the steam bath in ancient Greek. It was
built as a circular room with a conical dome-shaped roof. For
heating, heated rocks placed into a central tray or fires underneath
the floor was used. Then Water was poured onto the hot rocks or
floor to create steam. Sometimes leaves, branches, or oils of
medicinal herbs such as Bay Laurel, Fir, Pine, or Juniper were
used to meet therapeutic purposes.3

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According to the Hippocratic theory of medicine, the disease is
the result of an imbalance in body humour. To restore health, he
advised changing the habits and environment, including bathing,
perspiration, walking, and massages. He described the chemical
and organoleptic property of water in his work "De is, a quiz at
loci".4
Hippocrates has described the therapeutic properties of cold and
hot water in his famous treaty, the Airs, Waters and Places.1
Bathing was the Way of Life; it was incorporated with spots and
entertainment to refresh the tiredness of hard day's work. Few
baths were gender-wise segregated, but many others weren't.
The sweating process could be enhanced by previously
massaging the body with oils medicated with these or other
essences, or by quaffing a cup of hot diaphoretic herb tea
like Peppermint or Elder flowers before entering the steam
bath.3
Hence, a steam bath, aromatherapy, hot baths all were practiced
in ancient Greece and Rome.7
BATH-HOUSES (HAMMAM)
Bath-houses are also called Hammam. These were highly
sophisticated building built by excellent engineering skills. It is
believed that Bath-houses should be ancient building with vaults,
arches, and galleries. It should be spacious and furnished with
sweet water. Its temperature should be adjusted to suit the
temperament of the bather. According to Lane's bathhouse
described in " Arabian Nights," was a sophisticated building with
several apartments, with mosaic or tessellated pavements,
composed of white and black marble, and pieces of fine red tile,
and sometimes other materials. Several rounds, glazed apertures,
for the admission of light were made in the dome of the inner
apartment.8
In “Painting in Islam” 'Sir Thomas Arnold quotes some medical
scholars that The ideal bath " should contain pictures of high
artistic merit and great beauty, representing pairs of lovers,
gardens, beds of flowers, fine galloping horses and wild beasts,
for pictures such as these are potent in strengthening the powers
of the body, whether animal, natural, or spiritual." There are three
vital principles in the body—the vital (quwa Haiwanya), the
spiritual (Quwa Nafsania), and the natural (Quwa Tabbya). The
painted pictures of fighting and war and galloping horses, and the
snaring of wild beasts potentialize the vital power. The pictures
of love, a reflection of the lover on his beloved, and the couple
embracing each other enhance the potential of the spiritual power.
The gardens, beautiful trees, and bright flowers potentialize the
natural power.8
1. The Maslakh (Apodyteriu or Disrobing room or stripping-
place) is the first apartment. This is located on either side of the
caldarium. The temperament of this bath chamber is Moatadil
(Moderate).8,9
2. The Tepidarium, - This is a closed room all around, named
Tepidarium due to tepid dry vapors. It is a warm room to promote
perspiration after undressing. In the Centre, there is a fountain of
cold water. The temperature of this room is kept constant between
37-39 degrees Celsius and with low humidity about 20% to emit
a pleasant temperature. The wide benches or platforms encased
with marble for relaxation. These are furnished with mattresses
and cushions for the higher and middle classes and with mats for
the poorer sort. Bather stayed here to rarify their humors usually
bather stays 30 minutes here but may stay up to 60 minutes broken
into few sessions. 8,10,11
3. The Hararah (Caldarium or Laconicum) the word caldarium is
derived from the Latin word caleo, meaning "to be hot". This
room was similar to the foregoing but higher in temperature,
heated by a hypocaust, an under floor heating system using
tunnels with hot air, heated by a furnace tended by slaves. This
is the main bath chamber in the bath-house used as a hot-water
bath or for saunas or steam rooms. Here hot bath was taken in a
solium (tub) or piscian (basin). The bather enters into the hararah
wearing wooden sole sandals, a large napkin around the loins, a
second-round the head, a third over the chest, and a fourth
covering the back, the attendant removes the towels except the
first. Hence the temperature of this room may less than 50–55 °C
(122–131 °F). The temperament of this bath chamber is Har-
Yabis (Hot and Dry).
There were private rooms along caldarium, which has
multipurpose use like private baths, poetry readings, rhetoricians,
etc. A garden, lounging rooms, gymnasiums, small halls, and
exedrae as (lecture and reading rooms) were attached to it.8,11,12
Lane's description from the "Arabian Nights," that Hararah is
square-shaped, generally in form of a cross, central chief portion
of the hammam in the inner division of the building. A hot water
fountain is in its center, rising from a base encased with marble,
which is used as a seat.8
4. Frigidarium or Cella frigidaria – The word frigidarium derived
from the Latin word frigeo, which means "to be cold".
This was the room where the final cold-water bath was taken or
used as a swimming pool after that the skin was scraped with a
strigilis, rubbed with a linen cloth, and anointed with oil. For
open-air bathing pools, there was a host of smaller baths
connected to the main room. The temperament of this bath
chamber is Barid Ratab (Cold and Wet). 9,11,12
PROCEDURE OF HAMMAM
There is a proper procedure of Hammam, which should be
followed by the bather. The bather should enter the first room and
after that in the second and third rooms gradually, in each room
he must spend some time so that body adapts the temperament of
that room. He must not stay for a long duration on Hararah or
Caldarium. Bather should take food and or drink of cold
temperament either before or afterward Hammam. Bathing is not
allowed just after taking food or on empty stomach. During and
just after Hammam cold water should not drink.6,8
THE ACTION OF THE HAMMAM
The natural action of the bath is Har Ratab (Hot and Wet). The air
of the bathroom has a warming, and the water of the bath has a
moistening effect on the body. But the natural effect of the bath
can be changed by changing the environment and duration of the
bath. The effect of bath is also different for people with different
types of temperament. Long duration stays in Hammam dissolves
heartrate Gharizia (innate heat) and result in a cold temperament
of the body. Bath on empty stomach causes dryness while in the
full stomach causes wetness. A cold air bath disperses the innate
heat and dries the substance of the tissues.
According to Hippocrates Cold bath taken while fasting imparts
warmth and moisture and if taken after a meal, it produces
coldness in the body and removes moisture. A hot bath took while
fasting, its action is attendant and refrigerant and does not impart
moisture, while If taken after a meal, the bath is heating and

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moistens the body. A warm bath is soothing and has a warming
and softening effect. It is beneficial for everyone. The most
suitable time for it is before food, and after exercise. Bath during
fasting conditions will render the body extremely dry and make
the person thin and debilitated. Bath after a heavy meal will make
bather stout, by drawing the humors towards the subcutaneous
tissues bath after the first digestion has completed and before a
sense of hunger returns is beneficial and produces a medium
degree of stoutness. 6,8,9
DISADVANTAGES OF HAMMAM
Every person has their body temperament (Mizaj). The
temperature of air and the timing of Hammam should be decided
according to the temperament of the bather. Hammam is
contraindicated in the person who has a hot temperament,
Tafarruq Ittesal, or Hummae Yufooni or that condition in which
Madda Marz (morbid matter) does not get ready to eliminate from
the body. If the right procedure is not followed in bathing it may
produce certain harmful effects, such as it weakens the heart and
nerves, induces nausea and vomiting, disperses the morbid matter
towards the weaker organ, it may cause sexual debility.6
Hippocrates has described that too cold water may cause serious
intestinal disorders, while too hot or stagnant water often causes
fever.2
TYPES OF HAMMAM
There are various types of Hammam according to temperament
and water used. The desired feature can be obtained by changing
the environment and or adding agents of the therapeutic property.
1. Hammam barid (cold bath) – it is beneficial to the Hot (Har)
temperament person. It causes the movement of Hararat e
ghariziyah towards inside (Jism e Batin) of the body and thus
increases digestive power. It strengthens the nerves and heart
2. Hammam bukhari (vapor bath) - It opens the pores of the skin
and increases the sweating and thus helps to remove the toxins
from the body. It is used to relieve the pain usually of
musculoskeletal origin. It helps to reduce body weight and
strengthens the nerves.
3. Hammam har (hot bath) - It softens the skin and opens the pores
of the skin and causes sweating. This is beneficial for
Osteoarthritis, Amenorrhoea, Renal pain, Obesity.
4. Hammam ramli (sand bath) - In this type of bath some parts of
the body are immersed under the sand or sometimes Sea sand is
sprinkled over the body. Due to the absorptive property of Sea
sand, it is beneficial in ascites.
5. Hammam shamsi (sunbath) - In this type, the body is directly
exposed to sunlight. It facilitates the absorption of calcium and
thus provides strength to the bone. Usually, 15-30 minutes of
morning direct sunlight is advised.6,8
TYPES OF HAMMAM ACCORDING TO WATER USE
Hammam Ma’a Barid - in this type of Hammam Cold water is
being used. It reduces the excess body heat and provides strength
to the heart.
Hammam Ma’a Bahri - in this type of Hammam Seawater is used.
Different types of salts are naturally present in seawater. It acts as
diluents for the vicious matter.
Hammam Ma’a Boriqi - in this type of Hammam salty water
(Ma’a Boriqi) is used. It is beneficial in Ascitis as it acts as a
divergent of morbid matter.
Hammam Ma’a Kibriti – in this type of Hammam sulfur-rich
Water (Ma’a Kibriti) is used. Due to the property of sulfur this
type of Hammam acts as Mohallil and Mulattif. It is useful in Irqe
Madani, Falij, Rasha. It helps in reduction of the intense pain. It
is also used in chronic ulcers, Kalf, Bahaq, Bars. It is also
recommended in the rigidity of the uterus.
Hammam Ma’a Nutruni - In this type of Hammam, Bore Armani
(a type of mineral) is mix in water. It acts as diluents for the
vicious matter.
Hammam Ma’a Ramawi - In this type of Hammam ashes are
being mixed in water. Its benefits are similar to Hammam Ma’a
Boriqi.
Hammam Ma’a Nuhasi - When in this Hammam copper is being
mixed in water, is called Hammam Ma’a Nuhasi. This is
recommended in Amraz-e-Baridah wa Ratbah like Wajaul
Mafasil, Niqras, Istirkha, Ribu, Damamil, Busur, and renal
ailments.
Hammam Ma’a Hadidi – in this type of Hammam Ferrous oxide
rich water (Ma’a Hadidi) is used. It is recommended in Amraz-e-
Baridah wa Ratbah, in renal problems and beneficial in gastric
and spleen problems.
Hammam Ma’a Qafri - In this type of Hammam Hijrul Yahood
(a mineral origin drug) is used in the water of Hammam, it is
thought to be beneficial in strengthening muscle and other organs.
Hammam Ma’a Shibiah - wa Zajiah - in this type of Hammam
water rich in Alum (Ma’a Shibiah wa Zajiah) is used. This is
beneficial in epistaxis, edema, per rectal, and per vaginal
bleeding.
Hammam e wahli (Mud bath). In this case, the body is immersed
in mud or the mud is rubbed on the body. It absorbs toxins from
the body therefore very useful in preventing many diseases. It also
has healing properties. It improves blood circulation and
beneficial in skin diseases e.g. psoriasis, rosacea.6,8
CONCLUSION
Hammam is a well-established regimen of the Unani system of
medicine due to its therapeutic effects. It is practiced since the
pre-Hippocratic era as in temple medicine. To achieve the desired
therapeutic effect, the environment and procedure of hammam
should be maintained accordingly. Its misuse can harm; hence it
should be taken under expert supervision.
ACKNOWLEDGEMENT
All authors are highly thankful to contributors and library staff.
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How to cite this article:
Md Khursid Alam Ansari et al. A review on the Hammam: A
regimen from Asclepions. J Pharm Sci Innov. 2020;9(6):167-
170.
http://dx.doi.org/10.7897/2277-4572.096191
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