Maarifat e Tib Course / Umoor e tabiya / Principles of Eastern Medicine Kulliyat

Introduction:

Eastern medicine, practiced in East Asia, encompasses Unani medicine, Traditional Chinese medicine, Traditional Korean medicine, and Kampo. This form of medicine dates back around 5,000 years when ancient physicians experimented with plants to understand their effects on the human body. Through extensive testing, they identified specific plants and substances that helped achieve optimal health.

Eastern medicine emphasizes using plant-based ingredients along with their natural carriers, allowing the body to extract and regulate beneficial components. Studies suggest that the human body recognizes these valuable constituents as whole foods, selectively absorbing what is needed.

The strength and flexibility of Eastern medicine stem from Eastern philosophical views and concepts, which provide unique perspectives on human nature, bodily functions, disease manifestation, and healing processes.

In Pakistan, traditional medicine has been an integral part of cultural heritage and plays a significant role in healthcare for a large portion of the population. Tibb-e-Unani, an Eastern medical system, is widely practiced in the country.

According to Eastern medicine or Tibb-e-Unani philosophy, the body comprises four basic elements: earth, air, water, and fire, each with distinct temperaments—cold, hot, wet, and dry. Organs are nourished by four humors: blood, phlegm, yellow bile, and black bile. Health in Tibb-e-Unani is defined as a state where the humors are balanced, and bodily functions are normal according to individual temperament and the environment. Disease arises when this equilibrium is disturbed. The holistic approach of Tibb-e-Unani emphasizes disease prevention, cure, and health promotion using drugs derived from medicinal plants, herbs, minerals, and animal origins.

Principles of Unani Medicine/Eastern Medicine:

Unani medicine’s history is marked by the work of practitioners, or hakims, who focused on natural healing based on principles of harmony and balance, integrating physical, mental, and spiritual aspects.

Umoor al-tabiyah: Basic Physiological Principles:

  According to Unani practitioners, health is maintained by the harmonious arrangement of seven basic physiological principles: arkan (elements), mizaj (temperament), akhlat (bodily humors), aaza (organs and systems), arwah (vital spirit), quwa (faculties or powers), and afaal (functions). These components interact to maintain the body’s natural constitution. Each individual’s constitution has a self-regulating capacity, or tabiyat (Physis), to keep these components in equilibrium.

Arkan and Mizaj: Elements and Temperament:

  The four fundamental elements—arz (earth), maa (water), nar (fire), and hawa (air)—constitute both the human body and all other creations. Their interactions result in continuous changes, leading to genesis and lysis (generation and deterioration). Skilled hakims can observe and understand these interactions. The essential mizaj (temperaments) are hot, cold, moist, and dry, with combinations such as hot and dry, hot and moist, cold and dry, and cold and moist. These temperaments are balanced within all entities, including plants, minerals, and animals. An individual’s health depends on the balance of their elemental combination and resulting mizaj, as regulated by tabiyat. Changes in natural temperament can affect health, making mizaj crucial in Unani medicine for characterizing a person’s normal state and the nature of diseases. Unani medicine emphasizes the importance of systematic exercise and rest for the human body, asserting that the mind and brain also require adequate stimulation and proper relaxation. 

Naum-o-yaqzah (sleep and wakefulness):  

An individual’s health and alertness depend on obtaining a specific amount of sound sleep within a 24-hour (circadian) cycle.

Ihtebas and istifragh (retention and excretion):

This principle considers the metabolism of food and liquid, which is regulated by tabiyat. The assimilation of food and liquid aids in the elimination of excessive and noxious substances from the body. To maintain a harmonious and synchronized tabiyat, beneficial end-products of kaun-o-fasad (genesis and lysis) are retained, while harmful ones are expelled.

Tibb / Medicine:

Tibb (Medicine) involves the knowledge of the human body’s states in health and disease, aiming to preserve health and restore it when lost. Unani medicine describes the concept of Tabiyat, which is the body’s supreme planner that creates a healthy environment and prepares it to fight disease. A strong Tabiyat helps an individual resist disease, while a weak Tabiyat makes one more susceptible. Tabiyat is defined as the sum total of the structural, functional, and psychological characteristics of a human being. According to Hippocrates, there is an innate defensive mechanism in every individual, referred to in Unani as Tabiyate Muddabare Badan. This Tabiyat acts as the best physician, maintaining the equilibrium of the body’s four humors. To maintain health, the quantity and quality of these humors must align with the body’s natural chemical composition. Essentially, Tabiyat is considered the real healer of the body, with the physician’s role being to support this Tabiyat.

Classification of Tibb:

Knowledge of Tibb is classified into two types:

Theoretical Part: 

Deals with the principles of medicine and is further divided into four parts:

  1. Umoor-e-tabiya’h (Fundamental principles)

  2. States of the human body (Health and disease)

  3. Etiology

  4. Symptomatology

Practical Part: 

Describes various applications of medicine, such as preserving health and treating disease. This part is further divided into:

  1. Preservation of health

  2. Therapeutics

Kuliyat / Principles of Medicine:

Before understanding and treating disease, which is a deviation from the normal healthy state, one must have a clear picture of what constitutes a healthy, normal state. The Unani system of medicine begins with the study of the seven natural factors, also known as fundamental principles or Umoor-e-tabiyah, which define the standards of health and normalcy for the human organism. These are:

1-Arkan (The four elements):  The fundamental components of the body.

2-Akhlat (The four humors):   The metabolic agents of the four elements, whose balance constitutes health and imbalance constitutes disease.

3-Mizaj (The four temperaments):  The qualitative measures of health and homeostasis, or deviations from them, forming the basis of constitutional medicine.

4-Aza (The organs and parts):  The basic units or components of the body and their functions.

5-Quwa (The vital principles/energies):  The energies and essences that give life to the organism.

6-Arwah (Vital force):  The four principal vectors of all bodily functions.

7-Afaal (Functions):  Basic Functions of the Organism and Essential Functions of Life

When all seven natural factors work together harmoniously, the result is health and homeostasis. Dysfunction and disease occur when these factors are not in balance. If any one of these factors or their essential components ceases to function, it leads to death.

The Unani Medicine Wheel

Many traditional healing systems have a medicine wheel teaching that relates the life and health of the individual to the universal life forces and cycles of the natural world. Unani Medicine also has a medicine wheel to illustrate its fundamental correspondences.

Winter: Cold and wet weather produces excessive phlegm, causing colds, coughs, and lung congestion.

Spring:  Moderately hot (warm) and wet (moist) weather; sap rises in trees, and blood becomes lively and exuberant.

Fall: The weather cools but remains dry, aggravating black bile with similar qualities.

Winter: As fall transitions back into winter, the increasing cold condenses atmospheric moisture, completing the cycle.

Concept of Four Basic Qualities:

Classical Greek science and medicine viewed natural phenomena as resulting from the interplay of opposite yet complementary forces. Aristotle identified four central qualities: hot, cold, dry, and wet.

Hot/Cold Polarity: Primary or active polarity that drives change and produces the other two qualities. 

Hot: Denotes high energy or activity, activating, expanding, and moving.

Cold: Denotes low energy or activity, slowing down, contracting, and obstructing.

Dry/Wet Polarity: Secondary or passive polarity usually caused by the primary qualities.

Dry: Denotes low moisture, associated with separation and discreteness.

Wet: Denotes high moisture, associated with coherence and fluidity.

Understanding the Four Basic Qualities:

Hot: Activates, excites, expands, disperses, moves, and circulates.

Cold: Slows down, sedates, contracts, congeals, and obstructs.

Dry: Refers to low moisture, implying separateness and discreteness.

Wet: Refers to high moisture, implying coherence and fluidity.

Temperament and the Four Basic Qualities:

Unani Medicine is based on the concept of temperament, defined by the prevailing balance of qualities within a substance or entity. It recognizes eight possible conditions of temperament—four simple and four compound—plus a balanced or equable temperament.

Simple Conditions:

Hot: Hotter than normal.

Cold: Colder than normal.

Dry: Dryer than normal.

Wet: Wetter than normal.

Compound Conditions:

Hot and Dry: Both hotter and dryer than normal.

Hot and Wet: Both hotter and wetter than normal.

Cold and Dry: Both colder and dryer than normal.

Cold and Wet: Both colder and wetter than normal.

Working with the Four Basic Qualities:

The Four Basic Qualities are dynamic and can be manipulated:

Like Increases Like: To increase a quality, use treatments that possess that quality.

Opposites Balance: To balance an excessive quality, use treatments with the opposite quality.

Heat Produces Dryness: Moderate heat increases heat and reduces cold, while intense heat over time also produces dryness.

Cold Condenses Moisture: Moderate cold cools and reduces heat, while intense cold over time increases moisture.