Professional Documents
Culture Documents
components of the human body. The four elements are earth, air, water and fire.
These are symbolic expressions. Because all the elements recognized so far
exceeding 100 should correspond to any of these four elements which virtually
encompass all the known elements of today. These four elements have been
assigned four temperamental qualities viz. hot, cold, moist and dry. With the
existence of the matter in the universe, bodies also gain specific shape, and the
quantum of matter a body contains is its mass. Since the body has to do some work,
it should have energy to do so. Moist or dry states of matter shouId be charged with
heat and cold in the form of energy. In theory mass and energy could be spelled out
distinctly but in practice the two are inseparable. In view of the physical conditions
as they are, we could conclude that heat is in fact the total kinetic energy
possessed by the molecules of the body due to their rapid and random motion.
Aristotle has rightly held the hot and cold as active, and dry and moist as passive
qualities. This concept of element with heat and cold as two opposite types of
energy and dryness and moisture as two opposite qualities of matter is the
fundamental hypothesis which proceeds to explain the complicated phenomenon of
human biology and psychology in physical terms.
The four elements are earth and water (heavy), and fire and air (light). In terms of
qualities, the heavy elements are strong, negative, passive, and female. The light
elements are weak, positive, active, heavenly, and male.
The chart below shows various correspondences for elements.
Season
Spring
Summer
Autumn
Winter
Age
Childhood
Youth
Maturity
Old Age
Region
East
South
West
North
Element
Air
Fire
Earth
Water
Humor
Blood
Yellow Bile
Black Bile
Phlegm
Personality
Sanguine
Choleric
Melacholic
Phlegmatic
Earth is an element usually situated at the center of our existence. In its nature it
is at rest, and because of its inherent weight, all other elements gravitate toward it,
however far away they may be. It is said to be cold and dry in nature, and it appears
so to sight and touch, so long as it is not changed by any other elements. It is by
means of the earth element that the parts of our bodies are fixed and held in place;
thus the outward form of the body is due to the earth element.
Water
Tendency
Spreading
Drooping
Bodily system
Skeleton
Muscles
Excretion
Feces
Urine
Sense
Touch
Taste
Bodily function
Form
Nutrition
Mentality
Torpid
Phlegmatic
Mental State
Obstinancy
Fearfulness
Submission
Affection
Air
Fire
Tendency
To and Fro
Rising
Bodily system
Circulation
Liver
Excretion
Saliva
Sweat, Tears
Sense
Hearing
Smell
Bodily function
Respiration
Digestion, Voluntary
Mentality
Cheerful
Emotional
Mental State
Humor
Weeping, Anger
The terms earth, water, air, and fire do not mean literally clods of dirt, buckets of
water, and so forth. The four elements are sometimes referred to as "primary
matter;" which, when admixed, gives rise to the various forms such as mountains
and rivers. Likewise, the burning fire that we see is not the element fire, which is
really the potentiality of fire within the substance. For example, green wood has the
element of fire within, but this may or may not be brought forth as flames,
depending on whether it is ever ignited. All of the elements bear this relation
between capacity within and reality of form.
Thus all of the concrete objects of this world--from the most immense mountain
to the minutest form of submicroscopic life--are related by the four elements. And
through these same four primary elements, all earthly objects are related to (and
influenced by) the planets and stars of the zodiac (which also have primary qualities
within them).
The movement of these four elements is continually taking place, so that change
is a continuous process within the human body. This change can be either cyclical or
Another area which merits attention is the theory of Mizaj. It is often translated in
English as Theory of Temperaments. But this causes much confusion. The Mizaj is a
metabolic constitution and behavioral pattern of an individual. By a careful history
and bedside examination a Hakim can classify patients into four broad
classesDamavi, Balghami, Safravi and Saudavi. In a small experiment at Bombay,
four young Hakims independently assessed the Mizaj of 40 persons and there was
90 per cent agreement among them indicating that Mizaj can be assessed easily
with little training. We also noted that during the year, 70 per cent of our patients
belonged to Balghami Mizaj though in general population they are no more than 30
per cent. Does this mean that persons of Balghami Mizaj are more prone to chronic
diseases? Identification of diseaseprone population is of cardinal importance in
successful prevention of disease. If research in this area proves fruitful, our limited
resources will be used more effectively by concentrating attention on the segment
of population which is most susceptible.
There are other attributes to Mizaj like hot, cold, moist and dry. These attributes
are applied to diseases and drugs also. The study of these factors helps to choose
proper remedies for individual patient. It is only when a remedy is chosen with due
consideration to these attributes that best therapeutic results can be expected. If
the attributes of the drug do not match those of the patient and the disease, not
only the effect may not be adequate but sideeffects may also occur. In modern
medicine sideeffects to drugs occur in five to 15 per cent of the patients but there is
no way of predicting which patient may get adverse effect, except in few cases like
hemolytic anemia in G 6PD deficiency. Would it be possible to assign Unani
attributes to modem drugs also? In that case do the sideeffects occur because the
attributes of the drug do not match those of the Mizaj of the patient? If this can be
The Temperaments
There are nine kinds of temperaments: eight are called nonequable and one is
called equable. Equable means "balanced" or "existing in a state of balance." Of the
eight nonequable, four are single: hot, cold, wet, and dry; and four are compound:
hot and dry, hot and wet, cold and dry, and cold and wet.
The temperament is that quality which exists by the mutual interaction of the
four primary qualities residing within the elements. In other words, blood is
characteristically hot and moist. Now, some conditions may arise--such as
prolonged sleep or exposure to cold--by which the basic quality of heat may be
dissipated, which would allow moisture to build up. Such an event would result in
various signs occurring within the body or its organs or parts. Thus, the physician,
seeing the evidences of excess heat and other signs, would characterize the
imbalance as a cold intemperament of the blood, and he would devise a treatment
to correct this primary, single intemperament.
Each part of the body has been evaluated and assigned its own characteristic
temperament, ranging through degrees of heat, cold, wetness, and dryness. Table 2
summarizes these temperaments.
Heat (1 :Hottest)
1. Breath
6. Spleen
2. Bloodd
7. Kidneys
3. Liver
8. Walls of arteries
4. Flesh
9. Walls of veins
5. Muscles
Coldness (1 = Coldest)
1. Phlegm humor
7. Membranes
2. Hair
8. Nerves
3. Bones
9. Spinal cord
13. Skin
Moisture (1 =Moistest)
1. Phlegm humor
2. Blood
8. Lungs
3. Oil 9. Liver
4. Fat 10. Spleen
5. Brain
11. Kidneys
6. Spinal cord
12. Muscles
13. Skin
Dryness (1 =Driest)
1. Hair
7. Arteries
2. Bone
8. Veins
6. Serous membranes
12. Skin
Imbalance of Temperaments
Let us now consider how these temperaments interact to affect health. In the
Unani system, the first diagnostic feature we look for is an intemperament of a
particular organ or system. There are four main intemperaments:
These four intemperaments are never static, for they are constantly changing
and interacting. For example, if a temperament becomes hotter than it should be
(hot intemperament), it quickly drives off moisture, which will also lead to a dry
intemperament, resulting in a compound intemperament. Thus, there are four
compound intemperaments, which occur when the initial simple intemperament
persists to the point of affecting a second quality of the innate balance. These four
compound intemperaments are: hotter and moister than it should be; hotter and
drier; colder and moister; and colder and drier. (Obviously, an intemperament
cannot be hotter and colder or drier and more moist.)
Red face
Full veins
Tightness of skin
Dull movements and gestures
Full pulse
Colored and dense urine
Poor appetite
Feeling of weight in the limbs
Poor vision
Dreaming that one cannot speak
Cannot lift a heavy object
Sluggishness
Loss of appetite
Feeling of bearing emotional burdens
In dream, sensation of itching, stinging, burning and smelling foul odors.
Excess of Heat:
Excess of Cold:
Weak digestion
Diminished desire for drinks
Laxity of joints
Tendency to phlegmatic type of fevers and catarrhal conditions
Cold things easily upset and hot things are pleasant and beneficial
Suffer greatly in winter
Excess of Moisture:
Puffiness
Excessive salivation (mucous in saliva) and nasal secretion
Tendency to diarrhea and upset stomach
Desire for moist type of foods
Excess of sleep
Puffiness of eyelids
Excess of Dryness: