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Unani Tibb is a holistic traditional system of medicine. Ever since 1976, WHO has adopted its policy of promoting traditional medicine, Unani Medicine has enjoyed an upsurge of interest, especially in India, where it has been practiced as one of the Indian systems of medicine. Ali et al (2007) opined that “in Tibb, ‘temperament’ is a notion of primary importance, though a difficult theory as it indicates the properties of an atom, a molecule, a cell, a tissue, an organ and human body as a whole”. Temperament of a person represents its physical constitution and tendencies. It is believed in Tibb that imbalance in temperament predisposes human body to various diseases by producing a biotic imbalance with in body. Causes of initial imbalance in temperament lies in more subtle elements of life like air, water, food, rest, activity, work, evacuation of wastes, sleep etc. To quote Bhika (2006a) “health can be preserved and maintained as long as overall quality of humours is in harmony with overall quality of the temperament of the individual and humoural balance is influenced by lifestyle factors.” Hence temperament acts as a guiding force for maintenance and preservation of individuals' health.
Unani Tibb is one of the ancient systems of medicine of which many believe modern system of medicine has evolved. Greek/ Ionian is translated as Unani and Medicine as Tibb in Arabic. It can be defined as that system of Greek medicine which developed during Arab civilization. (Niamatullah, 1973) observes that “Muslims still call it Unani gratefully acknowledging its place of origin whereas European historians would call it Arabic Medicine or Geeko-Arabic medicine”. Presently, it has been widely practiced in India and Indian subcontinent (AYUSH, 2010) . Tibb has never been static and journeyed through various continents and chronology, Ibn-e-Sina, popularly known a Avicenna (980-1037AD) is considered as immortal along with other scholars who contributed to the system such as Aesculapeus (8th century BC), Pythagorous (580-489 BC),Aristotle (384-322 BC), Hippocrate (460-370 BC), Discorides (70 AD) Galen (131–210 AD), Ibne Raban Tabari (810–895 AD), Abu Bakar Zarakariya Razi popularly known as ‘Rhazes’ (865–925 AD), Jabir bin Hayyan (717–813 AD). Ibn-e-Sina is the author of world known famous book on fundamental treatise of Unani Medicine in five volume populary known as Al-Qanoon-fit-Tibb (Canon of Medicine).In India, Siddiqui (1981) pointed out that Unani medicine was introduced in 1351 AD by Arabs and flourished under the patronage of Mughal Emperors among the masses and spread all over the country. It suffered a setback during the British rule but soon regained its momentum by endless efforts of Nizam of Hyderabad, Azizi family of Lucknow and Sharifi family of Delhi. At present Unani system of medicine has now been regarded and recognized as one of the Indian systems of medicine and forms an integral part of national healthcare delivery system (Siddiqui,2009a)
It is assumed that all things in nature are composed of four primary elements i.e. fire, air, water and earth. (Azmi 1995). It does not mean that the numbers of elements in nature are four. In fact, they represent the basic division of matter which is found in universe. Each of them are associated with compound qualities, fire element is hot and dry, air is hot and moist, water is cold and moist and earth is cold and dry (Encyclopaedia Britannica, 1974). Hence temperament may be defined as “the quality which is produced by actions and reactions of opposite qualities of elements, which are broken in smaller particles in order to facilitate the mixing of all particles. When those components interact among themselves by virtue of their respective powers (qualities), a condition is produced, which is found in equal proportions in all components of the elements” (Sina, 2010). In other words 'constitution' of any matter is tantamount to 'temperament'. Every organism and matter as a whole is furnished with a temperament upon which their properties and functions of life depend. Drugs and foods are classified according to temperament, representing unique structural composition. But the temperament of human body is determined by humours (body fluids) which themselves are composed of different elements.
Hippocrate said that the human body is composed of three parts i.e.(i) Solid known as organs (aza), (ii) Liquid known as humours (akhlat) and (iii) Gas known as pneuma (arwah) (Masihi, 2008). Scholars of the Unani Tibb has mentioned the humours and their associated qualities as: (i) Dam (blood) as ‘hot and moist’; (ii) Safra (yellow bile) as ‘hot and dry’; (iii) Balgham (phlegm) as ‘cold and moist’ and; (iv) Sauda (black bile) as ‘cold and dry’ (Shah, 2007).Galen, one of the ancient Unani physician, used to refer word temperament to bodily dispositions, which determined a person's susceptibility to particular diseases as well as behavioral and emotional inclinations (Wikipedia, 2011). Hence word temperament is often used in psychological sense but in medical sense it implies the blend of humours (biological constitution). Accordingly temperament is created by mixing humours and is named after dominant humour in the body. When a person is said to have a hot temperament it means dam humour has stood dominant over other humours. In the same way cold humour signifies the dominance of sauda, dry temperament demonstrate the dominance of safra, and moist temperament shows the dominance of phlegm.On this assumption, human temperament is also termed as sanguineous (blood), choleric (yellow bile), phlegmatic (balgham), and melancholic (black bile)(Ahmad, 1980).
When humours are normal in quantity and quality and well mixed than condition of eukrasia (in temperament) prevails, man remains healthy. When however, as a result of disturbances, the balance is upset, dyscrasia prevails and individual becomes sick (Henry, 1973). Majusi (2010) stated that the humours mixed in balanced proportions, both in quantity and quality, constitute health and their disproportionate and irregular distribution in quantity or quality, causes disease. This equilibrium is controlled by an innate power of the body called Tabiat. But the state of humours in the body is also affected by external factors like, diet, and environmental influence etc. Tibb recognizes six essential factors (also called lifestyle factors) which affect the composition of temperament (humour) of human body. They are: (i) ambient air; (ii) food and drink; (iii) physical activity and rest; (iv) emotions and feelings; (v) sleep and wakefulness; (vi) retention of fluids and evacuation of wastes. (Siddiqui, 2009b)
Tibb considers the approach towards health and reinforcement of health should be individualistic and based on temperament. Health maintenance and disease prevention can be advocated by knowing constitutional type, knowing how to eat, live and medicate properly. Drugs are also prescribed in relation to the temperament of person. A person having a particular temperament is not prescribed a drug of the same temperament.
Too much of dominant quality associated with a temperament will produce negative effect, is an important guideline for maintenance and preservation of health e.g. Choleric (safra) will be affected negatively by lifestyle factors which increase heat and dryness, as quality associated with this temperament is heat and dryness (Bhika, 2006b). According to the temperament of an individual, following are some of the concrete steps, if adhered to, for the maintenance and preservation of health:
Recent shift in modern medicine has been observed from treatment, towards the maintenance of health. But Unani Tibb from its advent has defined maintenance of health as one of its prime objectives. In Tibb, knowing one's individual constitutional nature and temperament is the primal step towards path of health and healing. This basic notion guides how to stay healthy and avoid diseases. It is equally beneficial for the physician for taking care of his patients and prescribing drugs accordingly.