Hamdard Majun Sang Sarmahi: The Classical Unani Kidney Stone Formula Built on Fish Otolith — and What the Published Research Actually Says

Kidney stones affect an estimated 12% of South Asian men and 5% of South Asian women over their lifetime — rates significantly elevated above global averages — driven by the dietary risk factors prevalent in Indian cooking (high oxalate spinach and legumes, high salt, relatively low hydration) and the genetic predisposition of the Indian metabolic constitution toward calcium oxalate crystal formation. The experience of a kidney stone — the acute, severe flank pain radiating to the groin that physicians describe as one of the most intense pain experiences known to medicine — is familiar to many in the Indian diaspora, either personally or through family members.

Hamdard Majun Sang Sarmahi is the classical Unani pharmacopoeia's answer to this challenge: a Majun (semi-solid electuary paste) formulation of 15 ingredients built around the two classical Unani lithontriptic agents — Sang Sarmahi (fish otolith) and Hajrul Yahood (silicate of lime) — combined with the diuretic and stone-dissolving botanicals Kulthi (horse gram) and Gokhru Khurd (Tribulus terrestris), seed kernels that support kidney nutrition, and Alu Balu (sour cherry) with its uricosuric properties. What makes this particularly worth attention is that Sang Sarmahi specifically has a published peer-reviewed clinical study in PubMed (PMID 8500839) documenting spontaneous stone voiding in 36% of stone patients treated for 5 days — one of the few traditional stone remedies with any published clinical data.

Hamdard's Majun Sang Sarmahi (125g), available on Swadesiicart, is the classical Unani lithontriptic formulation — fish otolith, Hajrul Yahood, Kulthi, Gokhru, Alu Balu, and nine more ingredients — for the supportive management of renal and bladder calculi through urinary expulsion and stone-breaking action. For use alongside, not instead of, appropriate urological care.

What Is a Majun? The Classical Unani Preparation Form

Majun (from the Arabic ma'jun — 'electuary') is one of the classical preparation forms of Unani medicine — a semi-solid confection made by cooking herbs and minerals with sugar or honey to form a thick, paste-like preparation. The Majun form has a long history in both Islamic medicine and European pharmacy (the electuary was a standard European pharmacy preparation until the 19th century). The advantages of the Majun form over tablets or powder are absorption efficiency (the semi-solid base with sugars facilitates rapid gastrointestinal absorption), palatability (the sweet base masks the bitterness of active herbs), and the synergistic action of honey or sugar with the herbal actives in classical Unani pharmacology. Majun Sang Sarmahi is taken as a 10g dose — approximately one tablespoon of the paste — in the early morning with Sharbat Bazoori (a classical Unani diuretic syrup of cooling seeds and herbs that amplifies the Majun's urinary expulsion action).

The Majun Form: Semi-solid electuary with active herbs cooked into a sweet sugar base — the same preparation form used in both classical Islamic medicine and European pharmacy for a thousand years. Absorbed more efficiently than tablet or dry powder forms; the sugar base facilitates urinary elimination of the medicinal compounds.

Sang Sarmahi: The Fish Stone at the Heart of the Formula

The formula's name contains a beautiful and precise etymology. In Persian/Urdu: Sang = stone, Sar = head, Mahi = fish. Sang Sarmahi is therefore 'the stone in the head of the fish' — a literal description of the fish otolith, the calcium carbonate structures found in the inner ear of bony fish (teleosts) that function as balance, orientation, and sound detection organs, analogous to the inner ear of mammals.

Fish otoliths are hard, dense calcium carbonate (aragonite) structures — concentric layered rings of calcium carbonate and protein matrix that grow throughout the fish's life. They have been used in Unani medicine specifically for kidney stones for centuries, based on the classical 'doctrine of signatures' observation that hard calcium structures from living organisms might have the ability to act on calcium stones in the human urinary system. What makes this interesting is that this traditional rationale has some published clinical support:

•      The PubMed Clinical Study (PMID 8500839): A published peer-reviewed study titled 'Effectiveness of a Unani therapy (sangesarmahi) in management of urinary stone disease' documented that fish stones given to stone-bearing patients in 25mg capsule doses three times daily for 5 days resulted in spontaneous voiding of the stone in 36% of patients during the 5-day therapy period. This is a modest but meaningful result — comparable to the spontaneous passage rate for small stones in many urology studies — and represents one of the very few published clinical studies on any traditional stone remedy

•      The calcium carbonate mechanism: Fish otolith is composed of calcium carbonate in the aragonite crystal form. Published research on calcium carbonate in the urinary environment documents that exogenous calcium can affect urinary calcium oxalate crystal formation dynamics — the mechanism through which Sang Sarmahi may influence stone behaviour is an active area of research in mineral metabolism

Hajrul Yahood: The Second Lithontriptic Mineral

Hajrul Yahood (Lapis judaicus — 'Jew's stone') is a fossil echinoid spine — the calcified spine of a prehistoric sea urchin found primarily in the limestone formations of the Levant and Mediterranean regions. The name 'Jew's stone' reflects the fact that the deposits are most abundant in areas of historical Judea (modern Israel/Palestine). The mineral is composed primarily of calcium silicate, with calcium, magnesium, and iron components. In both Unani and Ayurvedic medicine (where it is used as Hajrul Yahood Bhasma), this fossil mineral has a centuries-long clinical history as a lithontriptic — a stone-breaker for renal and bladder calculi. The silicate minerals in Hajrul Yahood are proposed to interact with calcium oxalate crystal surfaces, interfering with crystal growth and aggregation.

The Botanical Actives: Kulthi, Gokhru, and the Seed Kernels

Kulthi (Horse Gram / Dolichos biflorus) — The Best-Researched Natural Stone Remedy

Of all the ingredients in Majun Sang Sarmahi, Kulthi (horse gram — the legume also known as Dolichos biflorus, Macrotyloma uniflorum, or Gahat dal in north India) has the most substantial modern published evidence base for kidney stone management. Multiple published studies have documented:

•      Calcium oxalate crystal inhibition: Published in vitro research demonstrates that horse gram seed extracts inhibit calcium oxalate monohydrate crystal aggregation — the specific crystal formation process that produces the most common form of kidney stone (calcium oxalate stones comprise 70-80% of all kidney stones). The polyphenols in horse gram bind to crystal surfaces and prevent them from aggregating into larger stones

•      Diuretic action: Horse gram has documented diuretic properties that increase urinary flow and reduce urinary concentration of stone-forming minerals — dilution of urine is the most effective preventive and therapeutic measure for calcium oxalate stones

•      Phytic acid content: Horse gram's phytic acid content chelates (binds) calcium ions in the urinary tract, reducing their availability for calcium oxalate crystal formation

•      Clinical tradition: Gahat dal soup is a traditional North Indian household remedy for kidney stones — the grain is used medicinally in Uttarakhand, Himachal Pradesh, and Nepal specifically for kidney stone management, a tradition that the Kulthi content of Majun Sang Sarmahi formalises into a standardised preparation

Gokhru Khurd (Tribulus terrestris) — The Unani Diuretic

Gokhru (Tribulus terrestris, the small caltrops) is one of the most consistently prescribed herbs in both Unani and Ayurvedic medicine for urinary conditions. Published pharmacological research confirms its diuretic activity (increasing urine output), anti-urolithic activity (reducing crystal formation in experimental models), and specific activity on the urinary smooth muscle that facilitates the passage of small stones and crystal aggregates. The fruit spines of Tribulus terrestris have a structural resemblance to kidney stone crystals that may have guided early Unani physicians to its use — the doctrine of signatures observation that proved, in this case, to have genuine pharmacological basis.

Alu Balu (Sour Cherry / Prunus cerasus) — Uricosuric Action

Alu Balu (sour cherry, tart cherry) is included for a different mechanism from the calcium stone-breakers: its anthocyanins and phenolic acids have documented uricosuric properties — they increase urinary uric acid excretion and reduce serum uric acid levels. This is specifically relevant for uric acid kidney stones, which are the second most common stone type and are particularly prevalent in South Asian populations where purine-rich diets (meat, certain legumes, high fructose intake) drive elevated uric acid levels. Published tart cherry research in gout management — where uric acid crystal deposition in joints parallels uric acid stone deposition in kidneys — provides the pharmacological basis for Alu Balu's inclusion in a stone-dissolving formula.

The Seed Kernels — Nourishment for the Kidney

The three seed kernels in the formula — Maghz Akhrot (walnut kernel), Maghz Kharbuza (muskmelon seed kernel), and Maghz Kadu (pumpkin seed kernel) — represent the Unani approach to kidney support through nutritive Muqawwi (strengthening) ingredients alongside the active lithontriptic and diuretic agents. In the Unani framework, the kidney's strength (Quwwat-e-Kulya) must be maintained during the stone-expulsion process — aggressive diuresis without nutritive support can weaken the kidney's function. Walnut, muskmelon seed, and pumpkin seed kernels all have documented nutritional value (essential fatty acids, zinc, magnesium) and mild diuretic properties that support the kidney's function.

Why Kidney Stones Are a Specific Indian Diaspora Health Concern

•      Dietary oxalate burden: The traditional Indian vegetarian diet is rich in high-oxalate foods — spinach (palak), nuts, tea, chocolate — that elevate urinary oxalate excretion and drive calcium oxalate stone formation. The palak paneer, the kadhi, the masala chai — all contribute to the oxalate load that makes vegetarian Indian diets paradoxically stone-promoting despite their health credentials

•      Dehydration patterns: South Asian dietary culture does not emphasise water consumption as prominently as some other food traditions — meals are often consumed with chai, juice, or lassi rather than water, and the hot Indian climate historically drove adaptation to lower fluid intake. In the US, air conditioning reduces perspiration but the fluid intake habits from India persist — insufficient water remains a primary kidney stone risk factor

•      Salt intake: Indian cooking is generally high-salt, and sodium promotes urinary calcium excretion — the dietary pathway that elevates urinary calcium concentrations and drives calcium oxalate stone formation

•      Genetic predisposition: Indian populations show higher rates of calcium oxalate stone formation through genetic variants in calcium transport and vitamin D metabolism that are more prevalent in South Asian genetic backgrounds

•      Metabolic syndrome link: The South Asian metabolic syndrome predisposition (insulin resistance, elevated triglycerides, central adiposity) is associated with uric acid stone formation through the hyperuricemia that accompanies metabolic syndrome

Majun Sang Sarmahi Complete Composition

Dosage and the Sharbat Bazoori Protocol

STANDARD DOSAGE: 10g (approximately one tablespoon) in the early morning on an empty stomach, taken with 25ml of Sharbat Bazoori diluted in a full glass (250ml) of water. Sharbat Bazoori (bazouri syrup) is a classical Unani cooling diuretic preparation of cucumber seed, muskmelon seed, and other cooling seeds — it amplifies the Majun's diuretic and cooling action. If Sharbat Bazoori is not available, take with a full glass of plain water or barley water. Continue for the duration directed by a qualified Unani physician. Drink copious water throughout the day (3+ litres) to support urinary elimination.

INTERNAL LINKING SUGGESTIONS:

•      Link [https://swadesiicart.com/products/hamdard-majun-sang-sarmahi] 

Frequently Asked Questions About Hamdard Majun Sang Sarmahi

Q1. Can this dissolve and pass a kidney stone that has already been diagnosed?

This requires careful, honest framing. Majun Sang Sarmahi is indicated for urinary calculi — the classical Unani claim is that it 'breaks the stone into small particles that pass through the urinary tract.' The published PubMed study (PMID 8500839) on Sang Sarmahi specifically documented spontaneous stone voiding in 36% of stone-bearing patients treated for 5 days with fish stone preparation — a result that is clinically meaningful. However, the critical variable is stone size. Small stones (under 6-7mm, particularly in the ureter below the iliac vessels) have significant spontaneous passage rates with conservative management alone — in these cases, Majun Sang Sarmahi's diuretic and lithontriptic support is most likely to be helpful. Larger stones (>10mm) typically cannot pass safely regardless of any preparation and require urological intervention. If you have been diagnosed with a kidney stone, discuss Majun Sang Sarmahi with your urologist as a complementary support measure alongside appropriate urological management — not as an alternative to it.

Q2. How is this different from drinking barley water or coconut water for kidney stones?

Barley water and coconut water are beneficial for kidney stone management primarily through their diuretic (increasing urine volume) and alkalising effects — both reduce urinary concentration of stone-forming minerals and coconut water's potassium citrate content specifically inhibits calcium oxalate crystal growth. These are valuable and well-supported dietary approaches. Majun Sang Sarmahi operates through additional mechanisms that plain diuretic beverages cannot provide: the lithontriptic (crystal-disrupting) action of Sang Sarmahi and Hajrul Yahood, the specific calcium oxalate crystal aggregation inhibition of Kulthi, the uricosuric action of Alu Balu for uric acid stones, and the anti-spasmodic effects of Gokhru on the urinary smooth muscle. The Majun is a complement to high fluid intake (barley water, coconut water, plain water — ideally 3+ litres daily) rather than an alternative to it.

Q3. I have calcium oxalate stones. Are there specific dietary changes I should make alongside this?

Yes — dietary modification is essential for kidney stone management and is specific to stone type. For calcium oxalate stones (the most common, affecting 70-80% of stone patients): reduce dietary oxalate (limit spinach, nuts, tea, chocolate, beets — significant reductions in these specifically), ensure adequate calcium intake from food sources (paradoxically, dietary calcium actually reduces stone risk by binding oxalate in the gut before it reaches the urinary tract), reduce sodium (high salt drives urinary calcium excretion), maintain adequate fluid intake (3+ litres daily to achieve urine output above 2 litres), and limit animal protein (drives urinary uric acid and calcium excretion). For uric acid stones: reduce purine-rich foods (meat, organ meats, shellfish), avoid high-fructose corn syrup, and maintain alkaline urine through high fruit and vegetable intake. Majun Sang Sarmahi's Kulthi component addresses calcium oxalate specifically; the Alu Balu addresses uric acid — a useful dual coverage for mixed stone presentations.

Q4. Is there an Ayurvedic equivalent for people who prefer Ayurveda over Unani for kidney stones?

Yes — the Ayurvedic tradition has specific formulations for kidney stone management, most commonly centred on Punarnava (Boerhavia diffusa), Gokshura (Tribulus terrestris — the same Gokhru in this formula), and Varunadi Kwath. Cystone by Himalaya is the most widely available Ayurvedic stone formula, containing Shilapushpa (Didymocarpus pedicellata), Pasanabheda, Gokshura, and other lithontriptic herbs. For patients who prefer Ayurvedic medicine, Cystone is the standard first-line Ayurvedic stone preparation. For patients comfortable with Unani medicine or from households with a Hamdard tradition, Majun Sang Sarmahi's Kulthi and Sang Sarmahi combination provides a different mechanistic approach. The two can be used under physician guidance — they do not significantly overlap in mechanism.

The Stone in the Head of the Fish. The Classical Formula That Passed Peer Review.

The name Sang Sarmahi describes, with the precision that classical Unani naming always aimed for, exactly what the formula's primary active is: the calcium carbonate otolith from the inner ear of fish — a biological calcium carbonate structure that the Unani tradition believed could interact with the pathological calcium carbonate structures accumulating in the kidneys and bladder. That this belief, based on centuries of clinical observation and the doctrine of signatures, produced a preparation with published PubMed evidence of 36% stone voiding in 5 days is one of the more remarkable stories in traditional medicine's encounter with modern clinical research.

Majun Sang Sarmahi from Hamdard — the charitable waqf that has been serving patients since 1906 — is the classical compound formulation of this tradition, in the Majun form that the Unani pharmacopoeia has prescribed for kidney stones across centuries of South Asian medicine. For the Indian diaspora managing the elevated kidney stone risk that comes with the Indian dietary pattern, the Indian metabolic constitution, and the insufficient hydration that the Indian immigrant's daily routine often perpetuates, it is the Unani preparation that both tradition and published research can support.

Fish otolith (Sang Sarmahi). Hajrul Yahood silicate. Kulthi horse gram. Gokhru Tribulus. Alu Balu sour cherry. 3 seed kernels. 15 ingredients. Classical Unani Majun. Lithontriptic, diuretic, stone-breaking. PubMed PMID 8500839 published evidence. Hamdard (WAQF) India. 125g. Shop Hamdard Majun Sang Sarmahi on Swadesiicart now — free shipping on orders above $55, SSL-secured checkout, and 14-day hassle-free returns. Use alongside urological care for diagnosed kidney stones.

Hamdard Laboratories (WAQF) India, Ghaziabad   |   Majun Sang Sarmahi   |   125g   |   15-Ingredient Classical Unani Formula   |   Fish Otolith + Hajrul Yahood + Kulthi + Gokhru + Alu Balu   |   Renal and Bladder Calculi   |   10g Daily with Sharbat Bazoori   |   AYUSH Unani Registered   |   Urological Consultation Required for Diagnosed Stones