Tibb al-Nabawi – Medicine of the Prophet ﷺ

Principles in Tibb

The principles in Tibb are an assimilation of the philosophies of Hippocrates, Galen and Ibn Sina. These concepts not only allow for a comprehensive understanding of health promotion, but also provide valuable insights into the causes, pathological processes, management and treatment of illness conditions.

Tibb Principle: Temperament

In the discussion on the Tibb principles of “Creation”, the perfection of creation was highlighted in that everything has been created with an ideal temperament with an appropriate structure to perform specific functions. The concept of temperament is one of the unrivalled features of Tibb.

Hippocrates, the father of medicine, recognised the importance of temperament in his famous quote:

The above quote highlights that an individual’s uniqueness or temperament provides valuable insights on the strengths and weaknesses as well as the predisposition (risk factors) to illness conditions.

An individual’s temperament is a combination of a person’s physical, mental, emotional and spiritual attributes. Just as each person has a unique fingerprint, a person’s temperament is fixed and cannot be changed. We are all aware of the many differences between ourselves. Where someone may never feel cold, another may always be wearing a jersey. One person may hate mornings and can stay up all night, whilst another may love getting up at dawn. Each of us has our own habits, likes, dislikes, interests and skills. All of these features, characteristics and quirks make up our unique disposition or temperament.

In this, Tibb contrasts markedly with Western medicine, which has a generic “one size fits all approach” with little attention paid to the patient’s uniqueness or individuality.

Factors determining temperament

There are numerous factors that determine temperament. Tibb philosophy maintains that conditions in the uterus and diet of the mother during pregnancy can influence temperament.

Also, as individuals born under the same star sign have similar personality traits, the date of birth is another influencing factor. However, hereditary factors have the greatest impact on temperament, obviously dependant on the extent of which parents’ temperament the individual has inherited. Irrespective of this, each individual will have a unique temperament, different to their parents.

Temperamental types

Although each person is unique as his/her fingerprint, Galen categorised people into four main temperamental types:

SANGUINOUS

PHLEGMATIC – sometimes called serous

MELANCHOLIC – sometimes called atrabilious

BILIOUS – sometimes called choleric

We need each temperament for the total functioning of the body. Each part should do its work, to unify the action and produce harmonious results.

The poem also tells us that each of us may have some personality traits of the other temperaments to a lesser extent. In reality, there is a dominance of one type of temperament, and a sub-dominance of a second type. There is also a smaller percentage of a third type, and even less of the last.

 The video clip included in this section on Temperament, includes a presentation by Joey Rasdien, that highlights the personality traits of the four temperamental types reacting to a particular situation.

The poem together with the video highlights the fact that each of the temperamental types has distinguishing personality traits. For example, the Sanguinous is a typical extrovert, fun loving person, Melancholics are analytical and philosophical, the Bilious person is determined and prone to anger, whereas the Phlegmatic type is calm and prefers not to make a scene.

Qualities associated with the four Temperamental Types

As mentioned in the Tibb philosophy on “Creation” human beings have an overall Hot & Moist quality, being at a temperature of ±37°C and with approximately 70% water. However, slight variations exist within this Hot & Moist category, which explains why some of us feel colder or hotter than others.

The qualities associated with each of the four temperamental types are listed below:

• Sanguinous – qualities of Hot and Moist
• Phlegmatic – qualities of Cold and Moist
• Bilious – qualities of Hot and Dry
• Melancholic – qualities of Cold and Dry

It is interesting to note that the qualities associated with the different temperamental types are indicative of their personality traits. For example, the Bilious temperament is associated with Hot & Dry qualities as their temperament is inclined towards a fiery nature and heat (a hot natured person). Similarly, the Phlegmatic temperament is associated with Cold & Moist qualities as their temperament is predisposed to being cool and calm – described as being as cool as a cucumber.

Identifying an individual’s temperamental combination

The adjacent chart reflects that the Sanguinous temperament, with qualities of Hot & Moist, is opposite to the Melancholic temperament with qualities of Cold & Dry. Likewise, the Phlegmatic temperament, Cold & Moist is opposite to the Bilious temperament, Hot & Dry.

As in nature, opposite qualities Hot & Cold nor Moist & Dry cannot exist at the same time – nothing can be hot and cold at the same time. Therefore, as in nature, it is not possible that a person who has a dominant Sanguinous (Hot & Moist) temperament will have a sub-dominant Melancholic (Cold & Dry) temperament. What is possible, however, is that a Sanguinous person may have a sub-dominant of Phlegmatic (Cold & Moist) or Bilious (Hot & Dry) temperament. Similarly, a person with a dominant Phlegmatic temperament will have a sub-dominant temperament which is either Sanguinous or Melancholic.

Having an understanding that each person has a dominant/sub-dominant temperamental combination, identifying this combination from the four different temperamental types is determined by evaluating three (3) broad categories. These include Physical Appearance, Behavioural Tendencies and Personality/Emotional Traits as listed below:

Sanguinous temperament (Hot & Moist qualities):

Physical appearance: Medium to large frame, more muscle, a macho walk, reddish or shiny complexion, warm and moist skin texture; speech: clear and moderate.

Tendencies: As this temperamental type has Hot & Moist qualities, they prefer Cold & Dry weather, cold drinks, have a healthy appetite, require 6-8 hours moderate to deep sleep. He/she will be inclined to illnesses such as hypertension and/or diabetes.

Personality traits: typical extrovert, carefree, persuasive, sociable, talkative, outgoing, optimistic – “a get acknowledged person”. They may also be disorganized and tend to exaggerate.

Phlegmatic temperament (Cold & Moist qualities):

Physical appearance: Medium to large frame, more fat, a slow walk, pale complexion, cold, soft and moist skin texture, speech: slow and soft.

Tendencies: As this temperamental type has Cold & Moist qualities, they prefer Hot & Dry weather, hot drinks, have a low appetite, require at least 8 hours deep sleep. He/she will be inclined to illnesses such as phlegm related disorders

Personality traits: introvert, calm, accommodating, patient, relaxed a good listener, indecisive – “a get along person”. They may also be push over’s and shy.

Melancholic temperament (Cold & Dry qualities):

Physical appearance: Thin/bony frame, quick/anxious walk, cold and dry skin texture, speech: fast – soft or loud.

Tendencies: As this temperamental type has Cold & Dry qualities, they prefer humid (Hot & Moist) weather, hot drinks, fixed mealtimes, require 5-6 hours’ sleep. He/she will be inclined to illnesses such as insomnia, gas related illnesses, bone and joint complaints.

Personality traits: introvert, philosophical, logical, analytical, organized, imaginative – “a get it right person”. They may also be perfectionist, anxious and skeptical.

Bilious temperament (Hot & Dry qualities):

Physical appearance: Medium frame, lean, firm walk, Hot & Dry skin texture, speech: loud.

Tendencies: As this temperamental type has Hot & Dry qualities, they prefer Cold & Moist weather, cold drinks –healthy appetite and cannot skip meals, require 5-6 hours sound sleep. He/she will be inclined to illnesses such as stress, anxiety and hay-fever.

Personality traits: extrovert, born leaders, resourceful, energetic, outspoken, dominant – “a get it done person”. They may also be short-tempered, critical, irritable and impatient.

Having provided the above information about the four temperamental types, listed below is a table that can be completed, to identifying an individual’s or your dominant and sub-dominant temperament. When completing the table below, the following needs to be noted:

• Remember each person is a combination of all four temperaments, with a dominant/sub-dominant temperament – next to each other.
• Physical appearance should be as in the early 20’s – as age and certain medication (cortisone) can change physical appearance.
• Do not confuse habits with tendencies. Certain habits may be acquired due to circumstances.
• Personality and Emotional traits are important criteria and should be noted whilst being relaxed, and also how friends and family members see and know you.
• When determining your temperament, base it on how you really are and not how you wish you were.
• The column containing the most ticks is the dominant temperament whereas the column with the second most ticks will be the sub-dominant temperament.

Download the table to Identify your dominant/sub-dominant temperamental combination

As moistness is the dominant quality associated with both individuals, in the above chart, an increase/excess of moistness will negatively affect this individual the most and to the greatest extent. On the other hand, increase in the quality of dryness (which is the least concentration), will be beneficial to this individual. This is easy to understand knowing that a person with a sanguinous/phlegmatic temperamental combination is uncomfortable in humid weather. Similarly, a person with a melancholic/bilious combination will be negatively affected in dry weather because of their dominant quality of dryness.

Being aware of the dominant quality of a person’s temperamental combination allows individuals to make positive choices in lifestyle that will be beneficial to their health with an improved Quality of Life. The practice of Tibb revolves around the art and skill of identifying a person’s individual temperamental combination and associated qualities, combined with the science and practice of serving his or her physis to maintain their particular ideal state of health.

Remember: The general rule is that an excess of the quality associated with an individual’s temperament will negatively affect him/her the fastest and to the greatest extent.

In summary from the above discussion, we understand that each individual has a dominant and a sub-dominant temperamental combination. In addition, each temperamental combination has an ideal qualitative state made up of the four qualities with one dominant quality and an opposite least quality. The significance of the dominant quality associated with an individual’s temperamental combination will be elaborated on in the Consumer Empowerment – Health Promotion link wherein the Healthy Living Programmes for the different temperamental combinations are listed.

Principles in Tibb

The principles in Tibb are an assimilation of the philosophies of Hippocrates, Galen and Ibn Sina. These concepts not only allow for a comprehensive understanding of health promotion, but also provide valuable insights into the causes, pathological processes, management and treatment of illness conditions.

Tibb Principle: Humours

In the discussion on the Tibb principle of “Temperament” we highlighted that each individual has a unique temperamental combination with an ideal qualitative state made-up from the four qualities. Maintaining this idea qualitative state is essential for an individual to remain healthy and well. The maintenance of this ideal qualitative state is facilitated by the humours. Humours also known as primary body fluids, are produced by the liver after the process of digestion and transformation of food and drink.

In keeping with the Tibb philosophical principles of elements/primary matter, humours exist at both a physical and metaphysical level, each one reflecting a fluid or flow of a biological force or energy in the body. Every level of organisation within the body is infused by and interconnected with the humours.

In addition to maintaining the ideal qualitative state of individuals temperament, humours also have two other important functions:

• Providing nutrition for the maintenance of the body’s complex structure by restoring tissues and organs.
• Provides the energy requirements for the various activities of the body.

Humours similar to temperament are also four with respective qualities:

• Sanguinous humour – also known as blood (Qualities: Hot and Moist)
• Phlegmatic humour – also known as phlegm/serous (Qualities: Cold and Moist)
• Melancholic humour – also known as black bile (Qualities: Cold and Dry)
• Bilious humour – also known as yellow bile (Qualities: Hot and Dry)

Just as each individual has a unique temperamental combination, with an overall qualitative state, each person also has a unique ratio of humours and qualities to match the qualitative state of an individual’s temperamental combination. For example, a person who has a dominant sanguinous temperament will have slightly more of the sanguinous humour to maintain the ideal heat and moisture associated with this temperament. Similarly, this is the case with the other temperamental types.

In Tibb, we understand that for health to be maintained, the overall quality/ies of the humours should be the same as the overall quality/ies of the temperamental combination. For example, an individual with a dominant sanguinous and sub-dominant phlegmatic temperament will have an overall dominant quality of moistness followed by heat, less of coldness and the least amount of dryness. Health will only be maintained as long as the overall quality of the humours are the same as the qualities of the individual’s temperamental combination i.e. dominant quality of moistness followed by heat, less of coldness and the least amount of dryness.

The humoral theory was conceptualised by Hippocrates 2500 years ago – he postulated humours as being:

From the above it is clear that humours are very much involved in the maintenance of health, the origin and development of a particular illness, the diagnostic principles invoked, and the therapeutic approaches adopted in the healing process. The humoral theory covered all aspects of health and/or disease i.e. prevention, aetiology, pathology, diagnosis and treatment – until the end of the 18^th century.

Conducting research and validating the humoral theory has been a focus at the Institute’s clinics over the past few years. The positive results have convinced us that the humoral theory hypothesised by Hippocrates is as relevant today as it was more than two thousand years ago.

Principles in Tibb

The principles in Tibb are an assimilation of the philosophies of Hippocrates, Galen and Ibn Sina. These concepts not only allow for a comprehensive understanding of health promotion, but also provide valuable insights into the causes, pathological processes, management and treatment of illness conditions.

Tibb Principle: Lifestyle Factors

In the discussion of the Tibb principle of Temperament it was highlighted that each individual has a temperamental combination of a dominant and sub-dominant temperament with an overall qualitative state of one dominant quality less of the two adjacent qualities and the least amount of an opposite quality. For example, an individual with a dominant sanguinous and sub-dominant phlegmatic temperament (marked X) will have an overall dominant quality of moistness followed by heat, less of coldness and the least amount of dryness. It was also mentioned that an increase of the dominant quality will negatively affect this individual the most and to the greatest extent.

The principle of Temperament was followed by the Humours wherein it was highlighted that just as each individual has a unique temperamental combination with an ideal qualitative state, each person also has a unique humoral balance, also with an overall quality of the four humours. It was further emphasised that for health to be maintained the qualities of the humours has to be the same as the overall qualities associated with an individual’s temperamental combination. As per the example above, this individual’s ideal humoral balance must have the same qualities as the individual’s temperamental combination i.e. dominant quality of moistness followed by heat, less of coldness and the least amount of dryness.

Whilst the overall qualitative state of an individual’s temperament is fixed, the overall qualitative state of the humours is constantly changing from the influence of the lifestyle factors especially food & drink from which the humours are produced.

Lifestyle factors influence humours by the qualities they exert, for example certain foods such as ginger have heating properties and would therefore increase heat within the body; exercise too, would increase heat; sleep has a cooling effect and emotions such as grief are associated with cold and dryness. Whilst physis is responsible to restore balance to the qualities of the humours to be the same as the overall qualities of the temperamental combination, this is not possible if lifestyle factors are not effectively managed to maintain this qualitative harmony between the humours and temperament. Lifestyle factors are ultimately the cause/s of both health and disease.

An important rule to remember in the implementation of lifestyle factors:

An increase in the dominant quality associated with an individual’s temperamental combination from Lifestyle Factors, will have a negative effect.

Tibb has identified Six Lifestyle Factors, all of which are associated with qualities of heat, coldness, moistness and dryness that can either benefit or be harmful. These include:

•  Environmental Air & Breathing: e.g. the weather is either Hot/Cold/Dry/Moist
•  Food & Drink: e.g. ginger is heating, cucumber is cooling)
•  Movement & Rest: e.g. exercise increases heat
•  Sleep & Wakefulness: e.g. sleep is cooling, wakefulness is drying
•  Emotions and Feelings: e.g. anger increases heat
•  Elimination: e.g. vomiting/diarrhea causes dehydration leading to dryness

Listed below is a brief summary of each of the Six Lifestyle Factors with additional information available on the Read More prompt.

1.Environmental Air & Breathing,

Environmental air refers not only to the air that all living organisms share, but also the effect of seasons and weather patterns. One should always be aware of the seasonal changes and the adverse effects that exposure to extreme climatic changes have. For example, during cold and wet climatic conditions, those with a phlegmatic temperament should take special care to ensure that optimum body heat is maintained. Similarly, a bilious person should avoid too much exposure to summer heat.

With respect to temperamental combinations, a person with a dominant/sub-dominant Sanguinous/Phlegmatic temperament, having a dominant quality of moistness, will be most uncomfortable and negatively affected in weather conditions where excessive moistness is prevalent.  Similarly, an individual with a dominant/sub-dominant melancholic/bilious temperament will be negatively affected during the dry season of autumn.

The air we breathe, is our primary source of nutrition, vital to our health. Tibb advocates correct breathing techniques and encourages breathing exercises and meditation.

Additional information on the benefits of breathing as well as different breathing exercises for the different temperamental types is available on the Read more prompt

2.Food & Drink,

Of all the lifestyle factors, food and drink is the easiest to implement since it is entirely in our control. In addition, as humours are produced from our diet, this lifestyle factor is the most important. Each food type can be classified as being heating or cooling with levels of moistness or dryness – where heating foods increase the metabolic rate and cooling foods decrease the metabolic rate. This classification refers to the inherent temperament/quality associated with the foods and the effect they have. For example, milk is Cold & Moist, chicken is Hot & Dry.

Similar to temperament and humours foods are also classified according to four groups: Hot & Dry foods; Hot & Moist foods, Cold & Dry foods and Cold & Moist foods. Each of these categories are subdivided into: Meats, Vegetables, Fruits, Nuts, Grains & Seeds, Dairy Products, Herbs & Spices, Drinks, Flavourants, Confectionary & Desserts, Cereals, Dishes.

Identifying diet charts for different temperaments

When identifying which diet charts will be appropriate for the different temperamental combinations, it needs to be remembered that foods with the same qualities as the dominant quality associated with an individual’s temperament will negatively influence health. It therefore implies that foods from the opposite spectrum of the temperamental chart will be most appropriate for the maintenance of good health.

For example, an individual with a dominant Sanguinous sub-dominant Phlegmatic temperament – marked X should eat mostly Cold & Dry foods, followed by Hot & Dry foods, less of Cold & Moist foods, and the least amount of Hot & Moist foods.

Similarly, an individual with dominant phlegmatic sub-dominant sanguinous temperament (marked Y), should eat mostly Hot & Dry foods, followed by Cold & Dry, less of Hot & Moist and the least amount of Cold & Moist.

Although the foods have been classified according to the four categories mentioned above, most food ingredients are included in different recipes. Just as ingredients have qualities, we determine the overall quality of a recipe through taste, for example:

• Salty taste – Hot & Moist,
• Pungent taste – Hot & Dry,
• Bitter taste – Dry & Hot,
• Sweet taste – Moist & Hot,
• Sour taste – Cold & Dry,
• Tasteless/Insipid taste – Cold & Moist.

From the above tastes, an individual with a dominant bilious sub-dominant sanguinous temperamental combination should avoid Pungent taste (Hot & Dry) foods and also to a lesser extent Salty taste (Hot & Moist) foods to reduce the heat associated with this temperamental combination. On the other hand, the recipes beneficial for a dominant melancholic sub-dominant bilious temperamental combination should have Salty taste (Hot & Moist) foods and Tasteless/Insipid taste (Cold & Moist) foods.

For more details on the four (4) different food groups: Hot & Dry foods; Hot & Moist foods, Cold & Dry foods and Cold & Moist foods, classification of foods: Tibb/Conventional, the importance of heating foods, drinking enough water as well as other dietary advice, available on Read more prompt

3.Movement & Rest,

Controlled, regular and suitable physical exercise is an important aspect of maintaining good health. Tibb believes that equal attention should be given to the role of exercise and rest. As we are all unique, we each have different requirements for exercise and rest.

It is of the utmost importance to do exercises that are appropriate for an individual’s temperament. Some temperaments are more suited to strenuous exercises than others.

The scenario listed below is a typical example of making the right choice of exercising.

“A couple joins a health club. They both participate in spinning classes (excessive cycling at a heavy pace, for at least 45 minutes). The husband – sanguinous/phlegmatic (dominant quality of moistness), had adequate moisture to balance the increased heat level. On the other hand, his wife (bilious/melancholic) developed an overactive thyroid due to an increase in heat & dryness from the exercise.”

Also, the attitude to movement/exercise differs in different temperaments, for example, the bilious temperamental type prefers competitive activities whereas a phlegmatic individual prefers leisurely walks or gardening.

From the above it is obvious that choice of exercise has to be according to the temperament of an individual. Whilst swimming, walking or pilates is best for all temperamental types, high impact exercises such as jogging is not ideal for the typical melancholic thin/bony frame.

The benefits of exercise as well as different exercises are available on the Read more prompt

4.Sleep & Wakefulness,

Quality and the amount of sleep is essential for restoring harmony in the body. Tibb considers sleep to be cooling and moistening. Wakefulness increases dryness and heat and depletes energy due to physical and mental activity. Sound and peaceful sleep allows Physis an uninterrupted opportunity to restore harmony in the body, repair and heal damage done; strengthen the body’s natural functions and eliminate toxins.

Everyone has a need for sleep, but the hours required differs from person-to-person. The sleep requirements for the different temperamental types are: Bilious: 5 to 6 hours minimum per night; Melancholic: 5 to 6 hours minimum per night; Sanguinous: 6 to 7 hours minimum per night; Phlegmatic: 8 hours per night.

The benefits of sleep are available on the Read more prompt

5.Emotions & Feelings,

Our emotions play a vital role in our well-being. Every emotion has a different qualitative effect on the body. Positive emotions, such as happiness, optimism, love and humour are known to invigorate the body. Negative emotions such as anxiety, frustration, resentment and anger can cause serious health problems.

Tibb associates each emotion with a qualitative effect – e.g. Anger: Hot & Dry; Worry: Hot & Moist; Depression: Moist & Hot; Fear: Cold & Moist; Grief: Cold & Dry; Excitement: Dry & Hot.

Individuals are more prone to the emotions that have the same qualities as their temperament. For instance, a dominant melancholic (Cold & Dry) will be more prone to experience grief, whereas a dominant bilious (Hot & Dry) is prone to anger.

This link to predisposition to emotions need to be managed to avoid negative effects. For example, the bilious dominant individual needs to be find effective ways of avoiding anger with meditation and breathing exercises.

Techniques and exercises to restore emotional balance often include breathing and meditation. Breathing is an important component in restoring emotional states and is always included as part of the meditation process. The most appropriate breathing exercise when meditating is the Tibb slow and deep breathing exercise as it has a calming effect.

Details of the Heart Mediation; Pineal Body Meditation exercises; are available on the Read more prompt

6. Elimination,  

Undigested food and poor elimination puts strain on the body and causes an accumulation of toxins. Optimising efficient digestion and elimination may involve dietary changes, detoxification and fasting.

Whatever it needs for energy and survival, the body takes from the environment. What is not needed is expelled back into the environment in the form of waste products. When the body isn’t able to efficiently remove waste products it is susceptible to many different disease conditions. Waste products are removed from the body through bowel movements, sweating, urinating and other means.

Of all the normal elimination methods, elimination from the colon requires special attention. We know that most of the re-absorption of water from the digestive tract takes place in the colon. Due to the osmotic pressure created from the re-absorption process, a film of matter accumulates on the sides of the colon. Normal peristaltic movement does not remove this accumulation which becomes a reservoir of toxic matter. Although we may eliminate regularly, this build up can only be removed with an appropriate laxative taken on a regular basis. Historically every culture, every nation used to take laxatives on a regular basis. This helps the body to keep the colon free of toxic waste and is an important step to health maintenance.

More information on additional guidelines for assisting elimination is available on the Read more prompt

Other Lifestyle Factors

These lifestyle factors, unlike the Six main Lifestyle Factors which affect every individual, are specific to individual’s depending on their circumstances, and could affect health and wellbeing negatively:

Occupation or career: As occupations vary physically and mentally, a person’s health will be influenced by their occupation. For example, different circumstances present between a young executive behind a desk and a farm worker out in the sun from dawn to dusk.

Place of residence: This refers to the home environment, which may be overcrowded or lack ventilation. It could also be the presence of insects and house dust mites. The levels of pollution in one’s immediate environment also need to be considered, for example, the hazardous effects of industrial toxins can be detrimental to health.

Age and Gender: Whilst a person’s temperament is fixed, (with an ideal qualitative state) the different stages of a person’s life from infancy to old age influences disease conditions that a person may be inclined to. For example, during infancy and early childhood most illnesses are associated with moistness (phlegm disorders, vomiting, diarrhoea etc.), teenagers/early adulthood with heat (acne, inflammation) and late adulthood with dryness (osteoporosis). Gender also influences predispositions as females are more moist than males.

Personal habits and hygiene: Societal impact of unhealthy activities such as screen time, smoking, recreational drugs may hugely and negatively affect temperament. The influence of hygiene is also significant. In underprivileged areas where access to healthy, running water and basic necessities is limited – overall health is also compromised.

Relationship between Physis, Temperament, Humours and Lifestyle Factors

The scheme (below) illustrates the constant interplay between Temperament, Humours, Lifestyle Factors and Physis. Although an individual’s temperament is fixed, humours fluctuate constantly as a result of changes to diet and other aspects of lifestyle, such as sleep, physical activity, breathing efficiency and stress levels. This dynamic relationship influences the humoral balance qualitatively, in relation to the ideal qualitative state required by an individual’s temperament, with Physis constantly striving to restore homeostasis. The inability of Physis to restore homeostasis inevitably leads to pathological processes that manifest as clinical disorders.

From the above, it is evident that Lifestyle Factors are ultimately the cause of both health and if not well managed will lead to disease. However, also note that Lifestyle Factors are just as important in the management and treatment of illness conditions. The role of Lifestyle Factors in Health Promotion and Illness Management are included in the Consumer Empowerment link where comprehensive information is provided.

The Tibb principle of the qualitative effect of Lifestyle Factors on humours in relation to an individual’s temperament, thus working with physis, in maintaining and restoring health, is unique to the Tibb philosophy. Having an understanding of the Tibb philosophical principles, I have no doubt will empower you to take responsibility for your own health and wellbeing.

Principles in Tibb

The principles in Tibb are an assimilation of the philosophies of Hippocrates, Galen and Ibn Sina. These concepts not only allow for a comprehensive understanding of health promotion, but also provide valuable insights into the causes, pathological processes, management and treatment of illness conditions.

Tibb Principle: How Illnesses Develop

The Tibb principles of Creation, Qualities, Physis, Temperament, Humours and Lifestyle Factors as described in the links of the Principles in Tibb, allow for a comprehensive understanding of not only health maintenance but also interpreting how illnesses are caused. Tibb recognises that illnesses do not just happen but are the result of cause/s that can be identified.

Principle of Cause and Effect

Hippocrates established the scientific basis of health and disease when he hypothesised the principles of ‘cause and effect’. The case study below highlights that most illness conditions can arise from different causes.

Mr. Robert M. aged 55, somewhat overweight, smokes 30 cigarettes a day, drinks quite heavily at weekends, exercises very occasionally, and is a mild type 2 diabetic. One day, after a difficult time in the office, and when having an argument with his daughter in the evening, he suffers a non-fatal heart attack.

What caused Robert M’s heart attack?

Was it the emotional stress brought about by his confrontation with his daughter? Was it the atherosclerotic plaque (humoral imbalance) in his coronary artery, preventing adequate blood flow to the heart muscle? Was it a blood clot, formed in the leg, but carried to the heart by the bloodstream, where it became stuck in an artery? Was it his inactive lifestyle (Lifestyle Factors)? Was it his genetic composition (temperament)? There is, in this case, a series of possible causes, any one of which could be responsible for his heart attack.

Interestingly, the above scenario illustrates that most causes of illnesses are linked to the Tibb principles of Humours, Temperament and Lifestyle Factors, beyond the ability of Physis to restore homeostasis.

Illnesses are reversible

From the above it is evident that most illnesses have identifiable causes, and therefore should have a possible cure, dependent on a person’s age, state of health, extent of damage (organs/tissues), and compliance to treatment. In addition, as mentioned in the link on Physis that after the approximate age of forty (40) the ability of physis to restore homeostasis becomes weaker. This could invariably lead to illness conditions especially chronic conditions manifesting itself. Tibb philosophy therefore maintains that most illness conditions acquired after normal healthy birth, should be reversible up to an approximate age of 40.

Temperament: Predisposition to illness conditions

As mentioned in the link on “Temperament”, the dominant quality associated with an individual’s temperamental combination, provides valuable insight into the predisposition to illness conditions. For example,  an individual with a dominant sanguinous, sub-dominant phlegmatic temperament, having an overall quality of moistness will invariably be predisposed to illness conditions being associated with the quality of moistness as in type 2 diabetes. Similarly, someone with a dominant melancholic and sub-dominant bilious temperament will be predisposed to osteoarthritis, associated with qualities of dryness and cold.

This link between the dominant quality and the predisposition to illness conditions having a similar quality – especially from infancy to adulthood, has been confirmed in the research conducted at the Tibb Treatment Centres in Cape Town.

Qualities associated with illness conditions

Most, if not all illness conditions begin with an excess of one of the four qualities of heat, coldness, moistness and dryness, as well as a second associated quality. An example of this is the common cold which typically develops in the cold season of the year. If this cold imbalance is not corrected, colds and flu like symptoms develop and are often associated with an increase in mucous production like a runny or congested nose, productive cough etc. Therefore, colds and flu are associated with qualities of coldness with moistness. Similarly, constipation is linked to qualities of dryness with coldness as intestinal motility slows and the level of fluid is low resulting in the formation of dry, hard, dehydrated stools.

Listed below are some examples of qualities associated with illness conditions with the dominant quality underlined.

Colds & Flu – Cold & Moist; Osteo-arthritis – Cold & Dry (worse in Winter); Hyperacidity/ulcers – Hot & Dry (from spicy foods); Osteoporosis – Cold & Dry (old age – brittle bones); Diabetes type 2 – Moist & Hot (excess carbohydrates); Asthma (phlegm related) – Moist & Cold.

Pathology

Pathology is the study of the processes by which diseases develop.  In Western medicine pathology is concerned with the causes, signs and symptoms and diagnosis of a disease i.e. the focus is on evaluating the pathological processes (either with blood tests, Xrays/CT scans, in relation to the signs and symptoms, as well as structural changes (tissues/organs) in the patient.

Unlike Western medicine, pathology in Tibb begins when the ideal state of the humours in relation to the ideal qualitative state required by an individual’s temperamental combination is changed to an extent that Physis is not able to restore balance/homeostasis.

Pathological processes in Tibb

By means of a) sudden change or excess in qualities from lifestyle factors; b) From an accumulation of excess or abnormal humours; c) From infectious agents – exposure to bacteria or virus; d) Unwanted side effects of conventional/Western medication.

a) Sudden change or excess in qualities

Example of a sudden change in qualities from lifestyle factors –  if an individual goes from a warm environment out into the cold without being warmly dressed, he/she will most likely experience symptoms of the common cold – runny nose, watery eyes, and shivering. Similarly, if an individual partakes in spicy foods that he/she is not accustomed to, they will start perspiring.

Examples of an excess of qualities is when an individual has not slept for more than 24-48 hours or if a person who is not accustomed to outdoors, spends long hours on a hot day. This exposure to an excess of qualities may lead to fatigue, headaches etc.

If these negative influencing factors are removed, then Physis is able to overcome this sudden/excess change in qualities and restore health. Illnesses in this category are mostly self-limiting conditions such as the common cold, mild diarrhoea, indigestion and headaches.

b) Accumulation of excess/abnormal humours

This accumulation of excess/abnormal humours takes place over a period, resulting from poor management of the Lifestyle Factors especially diet. In other words, poor elimination is a major cause.

Hippocrates believed that,

Hippocrates used the word Pepsis to describe digestion and elimination of the environment ( which in essence are the Tibb Lifestyle Factors), highlighting that poor elimination will result in a build-up of excess/abnormal humours beyond the ability of physis to cope with. The term “dyspepsia” is still commonly used for ‘indigestion’ however Hippocrates used the word Pepsis, not only referring to indigestion (Gastrointestinal Tract) but digestion/elimination of the Tibb Lifestyle Factors.

On top of this, our normal ageing process also takes its toll. Research has shown that chronic illnesses increases from the age of 40 onwards from the accumulation of humoral imbalances especially excess/abnormal melancholic humour.

The elimination of excess or abnormal humours is an important consideration in the management and treatment of illness conditions.

c) Infections

Tibb has a different viewpoint on infection than Western medicine. Without today’s advanced technology, Tibb physicians were unable to detect and identify disease-causing agents such as viruses, bacteria, fungi, etc. However, they were well aware of the nature of infection or, as they termed it, putrefaction. They knew that there was something in the air or water that was responsible for causing specific ailments like tuberculosis, pneumonia and meningitis. Tibb considers that any ailment which we succumb to as a result of infection is only possible when our inner healing power, or Physis, is weakened and is overwhelmed.

Infective micro-organisms will only thrive, multiply and infect our body when a change in the humoral balance provides a fertile and welcoming medium for them. This explains why some people are susceptible to bacterial infection and others are not.

d) Unwanted effects of conventional/Western medication

The use of conventional drugs to deal with common acute ailments like pain, headache, insomnia and bacterial infection is widespread. However, many individuals are affected by side effects in the short term (stomach upsets, dizziness and nausea, for instance) or longer-term adverse reactions (like increased risk of diabetes, asthma and hypertension). These days, patients increasingly seek healthcare advice for illness conditions which result from the long-term use of Western medication. This is often aggravated when additional drugs are required to deal with side effects and adverse reactions.

For example, when individuals take an ACE inhibitor to lower high blood pressure, they sometimes develop a chronic irritating cough. Another example is when a diuretic is prescribed for oedema or raised blood pressure, gout may develop. This is then treated with allopurinol, which in turn brings on further side effects. Each time a person takes a new medication, the side effect profile increases.

From the above discussion on How Illnesses Develop there is no doubt that unlike in Western medicine where the causes of many illness conditions are unknown, the Tibb philosophical principles allows for a comprehensive understanding of identifying the cause/s of most illness conditions, based on the temperamental and humoral theories of Hippocrates, Galen and Ibn Sina.

Once again it needs to be noted that most illness conditions have been successfully diagnosed and treated for hundreds of years based on the philosophical principles of Tibb.

Principles in Tibb

The principles in Tibb are an assimilation of the philosophies of Hippocrates, Galen and Ibn Sina. These concepts not only allow for a comprehensive understanding of health promotion, but also provide valuable insights into the causes, pathological processes, management and treatment of illness conditions

Tibb Principle: Treatment

As the philosophical principles of Tibb, makes it possible to identify the cause/s of most illness conditions – Treatment in Tibb has a targeted approach aimed at restoring balance (homeostasis) between the humours and qualities in relation to the temperament of an individual, working with physis. In addition, treatment always include lifestyle factors thus ensuring that not only are the symptoms treated but that the underlying cause/s of illnesses are also addressed. Unfortunately, in Western medicine because of the limited understanding of the cause/s of illnesses, treatment is aimed at treating symptoms.

Tibb is fortunate to have many tried and tested treatment options, that have been developed over centuries. These include:

• Application of Tibb Lifestyle Factors – considered most important in both management and treatment, especially in chronic conditions.
• Eliminative therapies – including, amongst others, healing modes such as cupping, diuresis, massage, purgation,  enemas, nasal inhalation and heat therapy – aimed at eliminating excess/abnormal humours in keeping with the Hippocratic concept of pepsis.
• Pharmacotherapy – The appropriate use of mostly herbal formulations together with minerals and a few animal derived products – which have been time tested over many centuries. Herbal formulations from whole plants or plant extracts are used which makes it safer compared to higher doses of isolated active ingredients from plants, such as curcumin from turmeric – obviously active ingredients from plants have far less side effects compared to chemical based medication used in Western medicine.

A unique approach of Treatment in Tibb is in keeping with the original understanding of ‘allo – pathic medicine’ where the word allo: is a Greek term for opposite. Treatment is based on the concept of opposites, both with respect to lifestyle factors as well as pharmacotherapy.

For instance, medication formulated to treat a cold and flu, will not only include the pharmacological action that will counter/be opposite to the symptoms of a Cold and Flu but also has qualities that are opposite to the signs and symptoms of flu. For example, the pharmacological action of Zingiber officinale (ginger) is often included in common cold formulations, as it counteracts the specific symptoms of runny nose, fever/chills; however, it also has heating qualities which oppose the Cold & Moist symptoms. Similarly, Lifestyle Factors is aimed at increasing the Heat & Dryness to overcome the Cold & Moistness associated with the cold and flu, by keeping warm and having hot chicken soup.

In conclusion, Treatment in Tibb, based on its principles has a targeted approach with therapeutic options, aimed at restoring balance (homeostasis) between the humours and qualities in relation to the temperament of an individual, working with physis. This approach not only addresses the signs and symptoms of illness conditions, but also addresses the underlying cause/s of disease.