What is Ammenorrhoea? 
Amenorrhoea is the absence of menstruation for more than 3 menstrual periods, or menstruation that has not yet begun in girls older than 16 years.

 What causes ammenorrhoea? 
There are numerous causes of amenorrhoea. Natural causes include pregnancy, breastfeeding and menopause. Women taking the contraceptive pill may also experience amenorrhoea. Certain medications, such as antipsychotics, antidepressants, chemotherapy and blood pressure lowering medication may cause amenorrhoea as a side effect. Lifestyle factors include high stress levels and excessive exercise. Hormonal imbalances from polycystic ovaries, premature menopause, tumours and thyroid disease can also lead to amenorrhoea. Structural abnormalities may prevent menstrual bleeding.  These include uterine scarring, which may block the production of uterine lining, absent / underdeveloped reproductive organs, an obstruction of the vagina.

 The Tibb View of Amenorrhoea
According to Tibb, these conditions are associated with excessive qualities of coldness generally throughout the body, specifically affecting the brain, pituitary gland, ovaries, uterus and thyroid gland. Amenorrhoea may either be linked to qualities of coldness with moistness which arises due to excessive intake of cold and moist foods, dairy and refined sugar products and a sedentary lifestyle. Amenorrhoea linked to coldness with dryness can result from excessive dieting, excessive weight loss and over-exercising. Phlegmatic/Melancholic temperamental combinations are most predisposed to developing ammenorrhoea due to their innate coldness.

Treatment and Management of menstrual disorders
Treatment and management is aimed at reducing the excess coldness associated with amenorrhoea, by implementing Tibb Lifestyle Factors that will increase the quality of heat.This will assists Physis in addressing both the symptoms and the causes of amenorrhoea.

Tibb Lifestyle Factors 
Food and Drink

• Eat mostly Hot & Dry – such as chicken, oily fish, garlic and celery, followed by Hot & Moist – such as ginger, turmeric, spinach and black pepper.
• Eat less of Cold & Dry – like naartjies, oranges, beans and yogurt, and the least amount of Cold & Moist – such as milk, cucumber, broccoli, and rice.
• Avoid dairy products, carbonated beverages, refined sugar, white flour and chocolates.
• Eat one or two handfuls of roasted chickpeas for breakfast and 20 grams of walnuts or hazelnuts daily.
• Do not eat or drink foods that are cold. Allow them to reach room temperature before consumption.

 Other Lifestyle Advice

• Exercise regularly. Partake in mild physical activities such as walking. Exercise increases heat in the body.
• Keep warm in cold conditions. Avoid the use of air conditioners.

Herbal Remedies

• Make a tea using 1gram of cinnamon and 1 gram of cloves. Add 1 tsp of honey and drink daily.
• Mix together 25 grams each of the following – cinnamon, cloves, celery seeds and carrots seeds. Grind together to form a powder. Take 1tsp of this powder 3 times daily 30 minutes before meals.

What is Asthma?
Asthma is a condition of the lungs that causes the bronchi (airways) to narrow. The airways are tubes that carry air into and out of the lungs. When the airways narrow, less air can flow into the lungs. This results when the airways are obstructed with phlegm, inflamed with heat or become hard and brittle with coldness with dryness. For the lungs to function well, a balance of heat, moistness and dryness needs to be maintained. If not breathing difficulties arise. Asthma may affect all age groups, except newborn babies, and typically develops during early childhood. An asthma attack can be fatal if not treated appropriately. One long term complications of asthma is permanent narrowing of the airways.

 Types of Asthma
Tibb has identified 3 main types of asthma:

• Allergic asthma: due to excess of heat.
• Phlegmatic asthma: due to an excess of coldness with moistness causing an increased phlegm production.
• Melancholic asthma: due to an excess of coldness with dryness causing hardened, fibrosed airways.

Allergic Asthma 

Signs and Symptoms
Breathing difficulties; itchy and red watery eyes; allergic rhinitis with post-nasal drip.

What Causes Allergic Asthma?
Allergic asthma is caused by an irritation of the mucous membrane by airborne toxins.

The Tibb View on Allergic Asthma
According to Tibb, this condition is linked to excessive heatwith either moistness or dryness. This excessive heat results in the hyper-sensitization of the immune system which causes inflammation of the mucous membrane when exposed to certain airborne stimuli. Individuals with a bilious/sanguinous temperament are more inclined to develop allergic asthma, due to the dominance of heat associated with this temperamental combination.

Treatment and Management of Allergic Asthma 
Treatment and management is aimed at reducing the excess heat associated with allergic asthma by implementing Tibb Lifestyle Factors that will increase the qualities of coldness. This will assist Physis in addressing both the symptoms and the causes of allergic asthma.

Tibb Lifestyle Factors 
Food and Drink

• Eat mostly Cold & Moist – such as carrots, cucumber, rice and pumpkin, followed by Hot & Dry  – like yogurt, potatoes, apples and mielies.
• Eat less of Cold & Dry – such as white flour products, sugar, and cheese, and the least amount of Hot & Dry  – like garlic, chicken, eggs and onions.
• Cut out hyper-allergenic foods from the diet, such as eggs, dairy, nuts and wheat products.
• Avoid any known triggers. Avoid heavily spiced, fried or grilled foods, as well as sugary and refined foods;
• Eat foods with low allergenic properties, such as apples, apricots, barley, beets, carrots, lettuce, millet, plums, rice, sweet potatoes and tapioca.

Herbal Remedies

• Make an infusion using 1tsp Marshmallow (flower, root or leaves) in one cup of boiling water. (This can also be used for bronchitis and dry coughs). This is high in mucilages which soothes the mucous membrane.
• Add ½ tsp liquorice root powder (not suitable for people with hight blood pressure) to some water and stir. This is good when the mucous membrane inflammation.
• If the cause of allergic asthma is related to the upper respiratory system, infuse 1tsp lavender leaves in 1 cup of water.  Strain and drink.

Note: do not discontinue the use of conventional medication, without consulting your practitioner. 

Phlegmatic Asthma 

Signs and Symptoms
Coughing; wheezing; a feeling of tightness in the chest; difficulty in breathing.

What Causes Phlegmatic Asthma?
Risk factors for the development of phlegmatic asthma includes genetic factors or a phlegmatic dominant or sub-dominant temperament, having a low birth weight, respiratory infections, and exposure to cold air.

The Tibb View on Phlegmatic Asthma
According to Tibb, phlegmatic asthma is associated with excessive coldness with moistness resulting from an accumulation of phlegm that may be thick and/or sweet. Symptoms often worsen in cold conditions. Children are more likely to develop phlegmatic asthma as well as people with phlegmatic dominant or sub-dominant temperaments due to the innate coldness and moistness linked to these individuals.

Treatment and Management of Phlegmatic Asthma
Treatment and management is aimed at reducing the excess coldness with moistness associated with phlegmatic asthma by implementing Tibb Lifestyle Factors that will increase the qualities of heat and dryness. This will assist Physis in addressing both the symptoms and the causes of phlegmatic asthma.

Tibb Lifestyle Factors 
Food and Drink

• Eat mostly Hot & Dry  – such as chicken, oily fish, celery and garlic, followed by Hot & Moist – like olive oil, ginger, turmeric and spinach.
• Eat less of Cold & Dry  – such as citrus fruit, yogurt and beans, and the least amount of Cold & Moist  – like milk, cucumber, broccoli and sprouts.
• Soak fruits in hot water for a few minutes before eating.
• Include garlic and onions in the diet.
• Eat plenty of raw fruits and steamed vegetables.
• Avoid simple sugars and white flour products. Avoid dairy products, as these increase the coldness and moistness in the body.
• Avoid cold foods and drinks and eating or drinking foods straight from the refrigerator.  Allow it to reach room temperature before consumption.

Other Lifestyle Factors

• Keep warm at all times as the cold can cause broncho-constriction.
• Partake in regular moderate exercise during the day.

Herbal Remedy

• Take one cup of very hot water and add one teaspoon of powdered fenugreek seeds, cover for 20 minutes. Strain and mix with two teaspoons honey. Drink 3 times a day and also during an attack.
•  Blackseed (Nigella Sativa) is excellent for respiratory conditions. Make tea by pouring one cup of boiling water over 1 tbsp of blackseed letting the mixture steep for about 10 minutes. Keep the tea covered until you are ready to drink so as not to lose the aroma.

Note: do not discontinue the use of conventional medication, without consulting your practitioner.

Melancholic Asthma 

Signs and Symptoms
Marked breathing difficulty; mucus or phlegm expectorant is absent; coughing is rare.

What Causes Melancholic Asthma?
Genetic factors; or a melancholic dominant/sub-dominant temperament; certain medication; smoking and exposure to cold air.

The Tibb View on Melancholic Asthma
According to Tibb, melancholic asthma occurs from excessivecoldness with dryness causing the bronchi to become thick and hard. Melancholic asthma may result from chronic phlegmatic asthma or as a result of the use of certain medications and smoking, both of which causes phlegm to harden. A person with a dominant/sub-dominant melancholic temperament is more inclined to develop melancholic asthma.

Treatment and Management of Melancholic Asthma
Treatment and management is aimed at reducing the excess coldness with dryness associated with melancholic asthma by implementing Tibb Lifestyle Factors that will increase the qualities of heat and moistness. This will assist Physis in addressing both the symptoms and the causes of melancholic asthma.

Tibb Lifestyle Factors 
Food and Drink

• Eat mostly Hot & Moist  – such as ginger, turmeric, spinach and olive oil, followed by Hot & Dry  -like chicken, oily fish, celery and garlic.
• Eat less of Cold & Moist  – such as milk, cucumber, broccoli and sprouts, and the least of Cold & Dry – like yogurt, citrus fruit, and beans.
• Soak fruits in hot water for a few minutes before eating.
• Include garlic and onions in the diet.
• Eat plenty of raw fruits and steamed vegetables.
• Avoid simple sugars and white flour products.
• Avoid cold foods and drinks and eating, or consuming foods straight from the refrigerator.  Allow it to reach room temperature before consumption.
• Avoid gas-producing foods such as the brassicas (broccoli, cauliflower and cabbage) and large amounts of bran. Gas can irritate an asthmatic condition by putting pressure on the diaphragm.

Other Lifestyle Factors

• Keep warm at all times as cold surroundings can trigger broncho-constriction.
• Quit smoking, as this increases dryness
• Partake in regular moderate exercise.
• Avoid exposure to cold & dry conditions.

Herbal Remedy

• Take one cup of very hot water and add one teaspoon of powdered fenugreek seeds, cover for 20 minutes. Strain and mix with two teaspoons honey. Drink 3 times a day, and also during an attack.

Note: do not discontinue the use of conventional medication, without consulting your practitioner.

What is backache? 
Back pain is a common problem that affects most people at some point in their life. Backache describes pain experienced in the lower back or lumber region that can feel like an ache, tension or stiffness. Pain in the lower back is referred to as lumbago. The pain can be acute, occurring suddenly and of severe intensity, or chronic (lasts for more than 3 months).

Signs and Symptoms
Muscle pain in the lower back, which can radiate into the backside and back of the legs; shooting or stabbing pain; muscle tension in the lower back, resulting in the feeling of stiffness; limited flexibility and range of motion of the back especially when leaning forward and bending back; pain is worse on movement; severe backache may cause the back to tilt to one side, causing a limp or a change in posture.

Causes and Risk Factors 
There are multiple causes of backache including: muscle or ligament strain which results from incorrect lifting of heavy objects; from arthritis which causes the joint spaces to narrow; from osteoporosis, which results in brittle and porous bones; and also direct exposure to cold.  Historically, people wore vests to keep the back warm and dry. In today’s times the lower back area is very often exposed. When we perspire, the evaporation of the sweat brings about coldness which reduces the blood flow to the lower back, so leading to backache.

The Tibb View of Backache
According to Tibb, backache is associated with qualities of coldness with dryness. The reduced heat and decreased blood supply can lead to chronic inflammation and chronic backache.  Although persons with a melancholic dominant/sub-dominant temperament are predisposed to backache, other temperamental types are also at risk from lack of exercise and being overweight.

Treatment and Management of backache
Treatment and management is aimed at reducing excess coldness associated with backache, by implementing Tibb Lifestyle Factors that increase the qualities of heat. This will assist Physis in addressing both the symptoms and causes of backache.

Tibb Lifestyle Factors 
Food and Drink

• Eat mostly Hot & Moist  – such as banana, mutton, ginger, olive oil, turmeric, and honey, followed by  Hot & Dry  – like egg, garlic, chicken and mustard.
• Eat less of Cold & Moist  – such as rice, broccoli, milk and cucumber and the least amount of  Cold & Dry – like citrus fruit, yogurt and beef should be eaten.
• Drink lukewarm water until symptoms subside. Consume plenty of fruit and vegetables.
• Avoid red meat. It is acidic, so contributes towards pain and inflammation.
• Avoid dehydrating drinks (coffee, tea, alcoholic drinks), and sugar-rich fizzy drinks.
• Follow a detox programme, consisting only of vegetables and fruit, herbal teas and water.

Other Lifestyle Advice

• Practice light exercise, like walking daily. However, if this aggravates the pain, stop walking until there is better resolution of the symptoms.
• Exercises to strengthen the core back muscles are advised. Pilates should be considered to strengthen abdominal and muscles.
• Apply a heat pack over the affected area.
• Keep the area warm by wearing a vest or other appropriate clothing which covers the lower back area.
• At night, sleep with a pillow between your knees.
• Avoid lifting heavy objects. When the condition resolves practice proper bending and lifting techniques. Bend with the knees keeping the object as close to the body as possible before lifting.

Herbal remedies

• Add ¼ – ½ tsp turmeric to 1 cup of hot milk. Add a pinch of black pepper and honey to taste. Drink twice daily.
• Detox – Add Epsom salts to bathwater to soothe inflamed muscles.

What are Boils?

Boils, or furuncles, are painful pus-filled bumps that form under the skin when bacteria infect and inflame one or more of the hair follicles.

Signs & Symptoms

A small hard swelling (abscess) containing pus forms on the face, neck, scalp, armpit or buttock. The swelling becomes itchy, painful to the touch, and inflamed. Swellings become visible on the lymph nodes on the neck, or in the armpit or groin.

Complications

The main complication associated with boils is tissue scarring. However, if they are not treated properly the infection can spread to other areas of the skin, as well as into the blood stream. In this case there may be serious consequences.

What Causes Boils?

Boils are caused by blockage of the skin pores or deep in the hair follicles, usually due to poor hygienic habits. This provides a welcomed environment for bacteria, Staphylococcus aureus, to thrive, invade tissues and cause infections. Risk factors for the development of boils include chronic illness conditions and compromised immunity as in diabetes. This makes it more difficult for the body to fight infection, making it susceptible to developing boils.

Stress – increases heat in the body and this can increase the risk of developing boils.

The Tibb View on Boils 
According to Tibb, boils are associated with qualities of excessive heat which makes the skin susceptible to infection and results in painful inflammation. Boils are more common in individuals with a sanguinous/bilious temperamental combination, where the quality of heat is dominant.

Treatment and Management of Boils
Treatment and management is aimed at reducing the excess heat associated with boils, by implementing Tibb Lifestyle Factors that increase the quality of coldness.  This assists Physis in addressing both the symptoms and the causes of boils.

Tibb Lifestyle Factors 
Food and Drink 

• Eat mostly Cold & Moist  -such as carrots, cucumber, lettuce, and rice, followed by  Cold & Dry  – like citrus fruit, yogurt, fish and beans.
• Eat less of  Hot & Dry – such as eggs, chickpeas, onion and chili, and the least amount of Hot & Moist  – like sugar, white flour products, cheese, and mutton.
• Drink at least two litres of water daily.
• Select a high fibre diet of fruit and vegetables to encourage regular bowel movements.
• Eat plenty of raw/steamed vegetables and fruits.
• Avoid heavily spiced, fried foods, as well as sugary and refined foods.
• Avoid cashew nuts, pecan nuts, peanuts, eggs, cheese, pickles, processed meats and chocolates.
• Partake in a cleansing fast monthly to rid the body of accumulated toxins.
• Drink rooibos tea with lemon juice, instead of milky tea and coffee.

Other Lifestyle Advice

• Clean the skin around the boils with hydrogen peroxide (10 vols).
• Repeated attacks of boils can be prevented by cleansing the skin area regularly with antiseptic liquid.
• After the boil has drained, apply a mixture of blackseed honey to prevent further infection and promote healing.
• Shower instead of bathing. This reduces the chance of the boils spreading to other parts of the body.
• When dealing with boils, keep the hands scrupulously clean.
• Adhere to strict hygienic measures if you are involved in food handling and preparation.
• Reduce stress by performing slow and deep breathing exercises daily.

 
Herbal Remedies

• Apply a hot compress to the affected area. This will encourage a head to form on the boil, and help it to drain.
• Cover the boil with a thin cloth envelope containing a slice of onion or tomato, or a crushed garlic clove, or a used cold teabag.

What is BPH? 
BPH, also known as an enlarged prostate, is a common complaint amongst men over fifty. The middle section of the gland enlarges, partially blocking the flow of urine through the urethra.

Signs and Symptoms 
Increased frequency of urination, usually first noted at night (nocturia); difficulty in urination; dribble or overflow incontinence; inflammation of the urethra and bladder due to stagnant urine; aching and burning feeling on urination and complications such as malaise and even mental disorders.

What Causes BPH? 
In most men, the prostate continues to grow throughout life. The exact cause of this is unknown; however it may be due to changes in the balance of sex hormones.

The Tibb View of BPH
According to Tibb, BPH is due to excessive moistness with cold. This excessive moistness results from an improper diet which is rich in carbohydrates, refined sugar and cold and moist foods. With age, the metabolism slows down resulting in insufficient heat to process moist foods. Although sanguinous/phlegmatic temperamental types are more at risk other temperaments can also be affected from poor lifestyle.

Management of BPH
Treatment and management is aimed at reducing excess moistness with coldness, associated with BPH, by implementing Tibb Lifestyle Factors that will increase the qualities of heat and dryness.  This will assist Physis in addressing both the symptoms and the causes of benign BPH.

Tibb Lifestyle Factors 
Food and Drink 

• Eat mostly Hot & Dry – such as bittergourd, chickpeas, avocado, and cinnamon, followed by Cold & Dry  – like beef, cabbage, lemon and peanuts.
• Eat less of  Hot & Moist  – such as mutton, banana, fennel and sweet potato, and the least amount of Cold & Moist – like rice, butternut and cucumber.
• Avoid alcohol, as it decreases the body’s ability to produce testosterone.
• Avoid dairy products, white flour products, carbonated beverages, chocolate, refined sugar and products containing artificial food colouring.
• Follow a diet which includes plenty of fruit, vegetables, nuts, and whole grains.
• Eat 20g of pumpkin seeds daily. Pumpkin seeds are helpful for almost all kinds of prostate troubles, because they are rich in zinc.
• Eliminate from your lifestyle such items as alcoholic beverages (especially beer and wine), caffeine, fluoridated water and spicy and junk food.
• Have one bitter gourd in the morning.

Other Lifestyle Advice

• Get regular exercise. However, cycling should be done with a special seat so as not to put added pressure on the prostate gland. Walking is a preferred exercise.
• Quit smoking.
• Avoid constipation – regular bowel movements will relief symptoms of BHP as constipation can put pressure on the prostate gland.

Herbal Remedy

• Add 1tsp Parsley, 1tsp celery seeds, 1tsp fennel seeds, 1tsp aniseed, 3 crushed black pepper corns and 1tsp saw palmetto. Add to 1 cup of boiling water. Allow to stand for 3 minutes, strain and drink.

What is bronchitis? 
Bronchitis is inflammation of the lining of the bronchial tubes or airways, which carry air to and from the lungs. Bronchitis may be either acute or chronic.

Signs and Symptoms 
Painful coughing and wheezing; throat and chest pains; feeling feverish and generally unwell; poor concentration; excessive production of thick, sticky and/or pus-containing sputum; difficulty in breathing or breathlessness which interferes with daily activities.
Although a single episode of bronchitis usually isn’t cause for concern, it can lead to pneumonia in some people.

What Causes Bronchitis? 
Inflammation due to infection or irritation of the airways is the underlying cause. Risk factors include: cigarette smoking which dries and irritates the airways; exposure to air pollution, such as dust; and sudden changes in temperature such as moving from a hot environment to a cold one.

The Tibb View on Bronchitis
According to Tibb, bronchitis is associated with qualities of dryness, either with heat or coldness. This results in painful inflammation and constriction of the airways. Individuals with a bilious/melancholic temperamental combination are more susceptible to developing bronchitis, due to their dominance of dryness.

Management of Bronchitis
Treatment and management is aimed at reducing the excess dryness associated with bronchitis, by implementing Tibb Lifestyle Factors that will increase the qualities of moistness. Treatment and management for bronchitis includes getting adequate rest, breathing in moist air and keeping hydrated. This assists Physis in addressing both the symptoms and the causes of bronchitis.

Tibb Lifestyle Factors 
Food and Drink

• Eat mostly Hot & Moist – such as sweet potato, ginger, turmeric and brown bread followed by Cold & Moist  – like carrots, cucumber, rice and pumpkin.
• Eat less of Hot & Dry – such as egg, garlic, chili and onion and the least amount of Cold & Dry  – like beef, tomato, cabbage, and peanuts,
• Drink plenty of water either warm or at room temperature, or decaffeinated tea if preferred.

Other Lifestyle Advice

• Get plenty of bed rest, preferably with a humidifier in the room.
• For those who smoke, now is a good time to stop.
• Steam inhalation which are warm and moist, helps to cough up obstinate mucus.
• Do light exercises like stretching if fever is absent. Avoid exercising if fever present.
• Avoid inhaling passive smoking in social environments.

Herbal Remedy

• Use a vapour rub containing camphor, eucalyptus, menthol, nutmeg oil, or turpentine oil Apply frequently during the day, and especially before sleep.

What is Chronic Fatigue? 
This is a common, almost constant state of weariness that develops over time. It diminishes energy levels and mental capacity. Chronic fatigue has a major impact on a person’s emotional and psychological well-being.

Signs and Symptoms 
Unusual physical or mental tiredness following intense activity; deep tiredness lasting through the day; difficulty in concentrating. This form of fatigue can last anything from a few days to several weeks.

What Causes Chronic Fatigue?
Fatigue is attributed to a number of causes, including lifestyle factors, medical and psychological conditions.
Risk factors include over-exerting the skeletal muscles and the consumption of inadequate or poor quality food. It is also a common side effect of a weight-reduction diet, from too-frequent skipping of meals, or from eating regularly ‘on the hoof’; Certain medical conditions such as thyroid problems, anaemia, cancer, heart disease, depression, obesity and asthma often include fatigue as a symptom.

The Tibb View on Chronic Fatigue
According to Tibb, fatigue is associated with qualities of cold and moistness, which slows bodily processes by dampening the heat of metabolism. This leaves the person affected feeling tired and sluggish. Fatigue is aggravated by a lifestyle that increases qualities of cold and moistness in the body.
As there are numerous causes of chronic fatigue, both mental and emotional, all temperamental types are at risk of chronic fatigue.

Treatment and Management of Chronic Fatigue
Treatment and management is aimed at reducing the excess cold/moistness associated with fatigue, by implementing Tibb Lifestyle Factors that increase the qualities of heat and dryness.  Treatment and management of fatigue often includes rectifying the underlying condition or faulty Lifestyle Factor. A balanced diet and regular exercise is also recommended. This assists Physis, in addressing both the symptoms and the causes of chronic fatigue.

Tibb Lifestyle Factors
Food and Drink

• Eat mostly Hot & Dry  – such as oily fish, chicken, celery, and garlic, followed by  Hot & Moist – like olive oil, ginger, turmeric and spinach.
• Eat less of  Cold & Dry  – such as citrus fruit, yogurt and beans, and the least amount of  Cold & Moist  – like milk, cucumber, broccoli, and sprouts.
• Start the day with a good high-fibre breakfast. Eat plenty of fresh fruits and vegetables and whole grain foods.
• Avoid fried foods; junk foods; processed foods; stimulants such as coffee; tea and soft drinks; sugar; products containing yeast and/or white flour such as bread or pasta; chocolate.

Other Lifestyle Advice

• Breathing – Practice deep breathing exercises, as they help to energise and relax.
• Exercise – Regular, mild or moderate physical exercise, followed by plenty of restoring rest, is known to help. Exercises such as yoga and Pilates should be practiced as they encourage deep breathing. This promotes increased oxygen supply to the brain and muscles.
• Sleep – Try to develop beneficial, regular and long-term sleeping habits, by practicing good sleep hygiene.
• Meditation – Allow time for meditation and breathing exercises, early in the morning and the evening.
• As stress often goes with fatigue, take up stress-reducing techniques (deep breathing, yoga, meditation).
• Get into positive leisure activity – not watching TV or the computer, but reading, DIY, knitting or a similar hobby.
• Do not overdo things. Be realistic about what can be achieve, and when.
• In the morning, plan your day, and prioritise the activities. Start with the worst, heaviest chores.
• Try to shake the smoking habit if applicable, as it reduces the amount of available oxygen for energy production.
• If possible, reduce your workload. Learn to say: “No thank you”.
• If overweight, taking measures to reduce body mass. This will help reduce periods of fatigue.

 
Herbal Remedies

• Licorice or gingko biloba powder (500mg) sprinkled on food.
• Take 2 teaspoons each of Poppy seeds and honey plus 10 almonds and liquidised in 200ml of milk. Drink first thing in the morning.

What is a cold? 
Common Cold (Coryza) is an acute condition that affects only the upper respiratory tract (mainly the nose).  It is the most common respiratory disorder in many parts of the world.

Signs and Symptoms of a Cold
Runny nose (with clear mucus); blocked nose; sneezing; sore throat; watery eyes; coughing; headache (sometimes); and slight fever (sometimes).

What is the Flu?
Flu (Influenza) is also an acute and contagious condition that affects the respiratory system. It is often confused with the common cold, but flu is much more severe.  Flu usually lasts for four to five days, but the complications can be longer lasting and more serious, especially with lung infections such as bronchitis and pneumonia.

Signs and Symptoms of Flu
Fever and extreme coldness (chills/shivering/shaking); body aches (especially joints and throat); nasal congestion (with yellow – green mucus); runny nose; coughing; headaches; fatigue; irritated, watery eyes; and diarrhea (usually in children).

What Causes Colds and Flu?
The common cold and flu are due to infection from certain viruses.
Risk factors include exposure to cold and rainy weather, and an immature immune system, especially in children.

The Tibb View on Colds and Flu
According to Tibb, colds and flu are associated with coldness with moistness as they typically develop in cold months of the year. Symptomatically colds and flu presents with excessive mucous production such as a runny or congested nose, and productive coughing. Due to the weakened immune system, Physis is unable to prevent the virus infection, but actively fights it in order to restore the body back to health within 4 days (for a cold) or 21 days (for the flu).  Although all temperamental types can be affected with colds and flu, people with a phlegmatic dominant/sub-dominant temperament are more at risk due to their innate qualities of coldness and moistness.

Treatment and Management of Colds and Flu
Treatment and management is aimed at reducing the excess coldness with moistness associated with colds and flu, by implementing Tibb Lifestyle Factors that will increase the qualities of heat and dryness.  This assists Physis in addressing both the symptoms and the causes of colds and flu.

Tibb Lifestyle Factors 
Food and Drink

• Eat mostly Hot & Dry  – such as chicken, oily fish, garlic and onion, followed by Hot & Moist  – like flavoured with spices like ginger, turmeric and black pepper.
• Eat less of Cold & Dry  – such as lemon, oranges and yogurt and the least amount of Cold & Moist  – like milk, cucumber and rice.
• Avoid dairy products, margarine, fried foods and all sugars;
• Avoid solid foods for three days.
• Sip hot chicken, beef or mutton soup spiced with garlic, ginger, black pepper and salt for three days.
• Drink at least 2 litres of warm water per day.

Other Lifestyle Advice

• Remain as active as possible unless you have a fever in which case bed rest is strongly advised.
• Mix a solution of 1 cup warm distilled water, ½tsp of sea salt and a pinch of bicarbonate of soda. Use a squeeze spray bottle to instil the solution in the nostrils, one side at a time. Repeat this procedure 3-4 times a day as necessary for relief from stuffiness.
• Avoid exposure to cold and wet weather.
• Use steam inhalations to promote drainage and ease pressure. Use a pot of hot water and add a few drops of eucalyptus or rosemary oil. Put your face over the pot and cover with a towel. Breathe in deeply. Do this several times a day for 5-10 minutes.
• Massaging the chest and throat with a heating ointment (such as Blackseed Rub) will ease congestion and help eliminate phlegm.

Herbal Remedies 

• 2 grams fenugreek seeds, 1 gram cinnamon, 1 gram cloves, 2 grams fresh ginger. Boil in 2 cups of water until 1 cup remains. Strain and mix in 2 tsp of honey and drink. Repeat the same 3 times a day.
• Ginger and honey tea: Grate 2 cm piece of ginger to a pot of 2 cups of water. Bring to the boil, then add 1tbsp of honey. Drink it whilst hot.

What is constipation? 
Constipation is infrequent bowel movements or difficult passage of stools that persists for several weeks or longer.

Signs and Symptoms 
Bowel movements are less frequent than usual (fewer than three times a week); passing the stool is difficult, painful, takes a long time, and feels incomplete; the faeces are like pellets – small, dry and hard, and often very dark brown in colour; the abdomen may feel swollen and uncomfortable; if constipation has been present for some time, there may be bleeding during defaecation. Constipation can result in the development of piles (haemorrhoids) or tears in the anus (anal fissures).

What Causes Constipation?
Constipation most commonly occurs when waste or stool moves too slowly through the digestive tract. This is due to a lack of heat and moistness, causing the waste to become hard and dry.
Risk factors includes poor eating habits, especially where there is not enough fibre (roughage) which is present in vegetables and fruit; and not drinking enough water. A lack of exercise may make constipation worse. Bad bowel habits, such as ignoring the call of nature can lead to constipation. The repeated use of certain medications like some painkillers, antacids, anti-allergy drugs can also lead to constipation.

The Tibb View on Constipation
According to Tibb, constipation is associated with qualities ofcoldness with dryness due to an improper lifestyle. Included in this is an excessive intake of cold and dry foods which results in stool moving slowly through the digestive tract, causing dry and hard stools. Although people with a melancholic dominant/sub-dominant temperament are mostly likely to develop constipation due to their innate qualities of coldness and dryness, other temperamental types can also suffer from constipation from a faulty diet and other lifestyle factors.

Management of Constipation
Treatment and management is aimed at reducing excess coldness with dryness associated with constipation, by implementing Tibb Lifestyle Factors that will increase the qualities of heat and moistness. This will assist Physis in addressing both the symptoms and the causes of constipation.

Tibb Lifestyle Factors
Food and Drink

• Eat mostly Hot & Moist  – such as dates, mangoes, honey and brown bread, followed by Hot & Dry  – like celery, red pepper, onion and oily fish.
• Eat less of Cold & Moist  – such as litchis, watermelon, cucumber and broccoli, and the least amount of Cold & Dry  – like beans, beef, citrus fruit and yogurt.
• Avoid sour foods and drinks, fried foods, spicy foods, soft drinks, meat, processed foods, white flour products, salt, coffee, alcohol and sugar. These foods are difficult to digest and contain little or no fibre.
• Maintain a high-fibre diet of fresh fruits, raw green leafy vegetables, brown rice, oatmeal, sprouts, carrots, and whole-grains. Eat fruits that contain soluble fibre such as apricots, bananas, blackberries, blueberries, cranberries, figs, grapes, peaches and dried prunes.
• Drink at least 8-10 glasses of warm water daily.
• Drink a cup of warm water with 1 tbsp honey and 1 tbsp olive oil 30 minutes before meals.

Other Lifestyle Advice

• Try to exercise more. Regular exercise increases rhythmic bowel movement (peristalsis). A brisk 20 to 30 minute walk daily is often effective in relieving the problem, especially for pregnant women.
• Practice daily breathing exercises to help sort out any emotional problems like stress.
• Go to the toilet at the same time every day even if the urge doesn’t exist. Try to relax as stress tightens the muscles and can cause constipation. Many people find reading a helpful way to relax.
• Never repress the urge to defecate.
• Take a natural laxative as and when necessary.

 
Herbal Remedies

• Grind 2 parts of psyllium seeds, and 1 part each of flaxseed and oat bran and mix with some water to make a paste. Take 1 teaspoon in water before bedtime.
• Take 2 tablespoons of aloe vera juice every morning. Alternatively make it by boiling 3 or 4 aloe vera leaves in 1 litre of water for 30 minutes. This softens the faeces, and heals and cleans the digestive tract.
• Drink a glass of warm water with 1tsp of honey and 1tsp of olive oil 30 minutes before meals.

What is the reason for coughing?
Coughing protects the airways from irritants which can cause inflammation. However, too much coughing can damage the breathing passages, and make sleep and daily activities difficult.

Types of Coughing 
There are two main types of coughing:

• Wet coughs, which usually occur with colds or respiratory infections.
• Dry coughs, which are usually due to chemical irritants, pollutants, fumes or dust.

What Causes Coughing?
Coughing is the body’s way of removing foreign material or excess mucus from the lungs and upper airway passages. This occurs due to sudden exposure to a cold environment resulting in irritation and inflammation of the airways, or of reacting to an irritated airway.
Excessive intake of cold foods and drinks (like refrigerated milk and beverages) can trigger coughing.
Risk factors for coughing include: irritants in the breathing passages; air pollutants like smoke from cigarette and wood-burning stoves; lung infection due to microbes. Diseases like tuberculosis and cold typically produce coughing.
Several breathing disorders result in coughing, such as asthma, bronchitis, and post-nasal drip.
Other disorders like anxiety, heartburn, ear problems and early heart failure feature coughing as a symptom.
Certain conventional drugs, like ACE inhibitors for hypertension often have coughing as a side effect.

The Tibb View on Coughing
According to Tibb, wet coughing is associated with qualities ofcoldness with moistness as phlegm is present. On the other hand, dry coughing is associated with qualities of coldness with dryness, where phlegm is notably absent. People with a phlegmatic dominant/sub-dominant temperament are more likely to develop a wet cough, whereas those with a melancholic dominant/sub-dominant temperament are more likely to develop a dry cough.
Treatment and Management of Coughs
Treatment and management is aimed at reducing the excess coldness either associated with moistnessin the management of a wet cough or dryness in the management of a dry cough, by implementing Tibb Lifestyle Factors that will increase the qualities of heat and dryness or heat and moistness respectively.   This assists Physis in addressing both the symptoms and causes of coughing.

Tibb Lifestyle Factors
Coughing Associated with Qualities of Coldness with Moistness (Wet Cough):
Food and Drink

• Eat mostly Hot & Dry – such as  eggs, chicken, garlic and mustard, followed by Hot & Moist  like  ginger, black pepper, turmeric and honey.
• Eat less Cold & Dry – such as yogurt, citrus fruit and mealie meal, and the least amount of Cold & Moist  – like rice, milk, cucumber, and watermelon.
• Drink lots of water. Try for at least 8 glasses of warm water daily, to replace fluid lost from coughing.

Coughing Associated with Qualities of Coldness with Dryness (Dry Cough):
Food and Drink

• Eat mostly Hot & Moist  – such as ginger, black pepper, lamb, and spinach, followed by  Hot & Dry  – like egg, chicken, garlic, and turmeric.
• Eat less of  Cold & Moist  – such as rice, milk, butter, and watermelon, and the least amount of Cold & Dry  – like beef, yogurt, cabbage, and beans.
• Hot beverages, like tea with honey, and broths work well to soothe the throat affected by a dry cough.

Other lifestyle factors 

• Pour hot water into a basin or bowl. You may add blackseed winter oil or any other ointment that contains menthol or eucalyptus. Throw a towel over your head and inhale the vapour. (Take caution when doing this).
• Take slow and deep breaths in and out through the nose for five minutes, several times daily.

Herbal Remedies 

• Steep several slices of fresh ginger root in boiling water, add honey to taste.
• Echinacea (10 to 12 drops tincture, four times daily) can lessen the severity of a troublesome cough.
• Consuming raw garlic can help improve a cough.

What is depression? 
Depression is a mood disorder which causes a constant feeling of sadness and a loss of interest in life. Depression affects the way one feels, think and behave and can make carrying out daily activities difficult.

Signs and Symptoms 
Feeling of constant sadness or unhappiness; loss of interest in daily activities; an inability to feel pleasure; sleeping too much (hypersomnia) or lack of sleep (insomnia); loss of appetite or excessive eating; slow thinking, speaking or body movements; loss of concentration and memory; frequent onset of physical symptoms, such as backache and headaches; and thoughts of death and suicide.

Causes and Risk Factors 
There are a number of possible factors that contributes towards the development of depression.
Depression is more prevalent in women, linked probably to an imbalance of brain chemicals or hormones.
Depression is considered an inherited or temperamental condition, as it is more common in people whose biological relatives also have it. Traumatic events such as death of a loved one, divorce or financial problems can trigger depression.
Poor weather, especially in winter, can lead to a form of depression called Seasonal Affective Disorder.

The Tibb View on Depression
According to Tibb, depression is associated with qualities of coldness, with either moistness or dryness. Phlegmatic depression includes feelings of general unexplained sadness, withdrawal from society, excessive sleep and eating, and is more prevalent in people with phlegmatic temperaments.
Melancholy common to people with a melancholic temperament includes a loss of pleasure in almost all activities, insomnia and a loss of appetite. Phlegmatic depression increases qualities of coldness with moistness and can be detrimental to the brain and the digestive system, as it results in sluggishness and mental dullness. Melancholy is harmful to the brain and heart as it causes excessive coldness with dryness which increases the risk of strokes and heart attacks.

Treatment and Management of Depression
Treatment and management is aimed at reducing the excess coldness either associated with moistness in the management of phlegmatic depression or dryness in the management of the melancholic form, by implementing Tibb Lifestyle Factors that will increase the qualities of heat and dryness or heat and moistness respectively.   This will assist Physis in addressing both the symptoms and causes of depression.

Tibb Lifestyle Factors
Phlegmatic Depression Associated with Qualities of Coldness with Moistness:
Food and Drink

• Eat mostly Hot & Dry – such as eggs, chicken, oily fish, garlic and mustard, followed by  Hot & Moist – like ginger, black pepper, turmeric, lamb and dates.
• Eat less of  Cold & Dry – such as yogurt, citrus fruit, and beans, and the least amount of  Cold & Moist – like milk, cucumber, rice and watermelon.
• Eat complex carbohydrates. This helps stimulate serotonin, a mood enhancer.
• Avoid sugar and foods and drinks that contain high amounts of sugars like cool drinks, cakes and chocolates etc. These foods cause quick mood highs but results in feeling sluggish and depressed thereafter.

Other Lifestyle Factors 

• Exercise regularly by partaking in exercises like walking, swimming or any other exercise that you might enjoy.
• Practice mind-body exercise such as meditation to counter stressful situations.

Herbal Remedies 

• Add a pinch of saffron to meals daily.

Melancholy Associated with Qualities of Coldness with Dryness:
Food and Drink

• Eat mostly Hot & Moist – such as ginger, black pepper, turmeric, lamb and dates, followed by Hot & Dry  – like eggs, chicken, oily fish, garlic and mustard.
• Eat less of Cold & Moist – such as milk, cucumber, rice and watermelon, and the least amount of  Cold & Dry – like yogurt, citrus fruit, and beans.
• Eat of complex carbohydrates. This helps stimulate serotonin, a mood enhancer.
• Avoid refined sugar, and foods and drinks that contain high amounts of sugar like cold drinks, cakes and chocolates. These foods cause quick highs but leave you feeling down, sluggish and depressed thereafter.

Other Lifestyle Factors 

• Exercise regularly by partaking in exercises like walking, swimming or any other exercise that you might enjoy.
• Practice mind body exercise such as meditation to counter stressful situations.

Herbal Remedies

• Take 1 tsp of cashew nut powder (crushed cashew nuts) in 1 glass of milk daily.

What is Diabetes?
Diabetes is a chronic condition that occurs when the body cannot produce enough insulin, or use it effectively. Insulin is a hormone produced by the pancreas that allows glucose from food to enter the body’s cells, where it is converted into energy which is needed by muscles and tissues to function. As a result, a person with diabetes does not absorb glucose properly, and glucose stays circulating in the blood and reaches high concentrations (hyperglycaemia), and this damages tissues and organs over time, even leading to life-threatening health complications.

Types of Diabetes 
There are two main types of diabetes:
Type 1 diabetes – Insulin dependent diabetes
Type 2 diabetes – Non-insulin dependent diabetes

Type I Diabetes 
Type 1 diabetes occurs when the insulin cells in the pancreas are destroyed. As a result the body can no longer produce the insulin it needs. It is still unclear why this happens. The onset of type 1 diabetes usually develops in children and young adults. People with this form of diabetes are dependent on the use of daily insulin injections to control their blood glucose levels. Without insulin, serious complications and death will result.

Type 2 Diabetes 
Type 2 diabetes is the most common type of diabetes. It usually occurs in adults, but is increasingly seen in children and adolescents. In type 2 diabetes, the body is able to produce insulin, but it is either not sufficient or the body is not responding to its effects. This leads to a build-up of glucose in the blood.

Signs and Symptoms of Diabetes 
Abnormal thirst and dry mouth; frequent urination; extreme tiredness/lack of energy; constant hunger; sudden weight loss; slow-healing wounds; recurrent infections; blurred vision.

Complications of Diabetes 
Deteriorating vision; foot ulcers; sexual impotence; skin infections; increased risk of heart attacks and strokes.

Prolonged Complications
Kidney damage (nephropathy); nerve damage (neuropathy); blindness (retinopathy); amputations.

What Causes Type 2 Diabetes?
Risk factors for developing type 2 diabetes include being overweight or obese; a lack of regular physical activity; unwisely food choices (eating too much carbohydrate rich foods, for example); and a genetic predisposition. These risk factors increase moistness in the body.

The Tibb View on Type 2 Diabetes
Diabetes is linked to qualities of moistness. Heat is needed for the pancreas to function well. Excessive moistness dampens heat and results in insufficient production of insulin. Excessive moistness may also affect the tissue cells’ sensitivity to insulin, resulting in increased levels of glucose circulating in the blood stream.
Individuals with a sanguinous dominant/sub-dominant temperament are most likely to develop diabetes. This is due to the innate qualities of moistness associated with this temperamental type and their predisposition to overeating. A person with a sanguinous/phlegmatic temperament is at even greater risk of developing diabetes, due to the dominance of moistness in this combination type.

Treatment and Management of Type 2 Diabetes 
Treatment and management is aimed at reducing the excess moistness associated with diabetes, by implementing Tibb Lifestyle Factors that will increase the qualities of heat and dryness. Lifestyle advice includes decreasing the intake of carbohydrate-rich foods and increasing levels of physical activity. This will decrease the level of moistness produced in the body and increase heat, which is needed for the proper functioning of the pancreas.  This assists Physis in addressing both the symptoms and the causes of type 2 diabetes.

Tibb Lifestyle Factors
Food and Drink 

• Eat mostly Hot & Dry – such as bittergourd, avocado, chickpeas, fenugreek and cinnamon, followed by Cold & Dry – like beef, fish, cauliflower and mushrooms.
• Eat less of Cold & Moist – such as carrots, pumpkin, rice and butternut, and the least amount of Hot & Moist – like bread, pasta, bananas and wheat cereals.
• Avoid hydrogenated fats, high-glycaemic, refined, processed or refrigerated foods.
• Avoid alcohol and tobacco.
• Avoid salty and sweet foods and drinks.
• Avoid fried, sugary and oily foods.
• Avoid refined sugar and fizzy drinks.
• Avoid icy and cold foods.
• Avoid high-glycaemic foods such as white rice, white flour products, starchy vegetables and many processed foods.
• Avoid eating carbohydrates like rice, bread or pasta, especially late in the date. Vegetables are acceptable.
• Eat 5 small meals per day instead of a few larger meals, especially supper. This should consist of three main meals and two snacks in between.
• Boiled/steamed/grilled steak, chicken or fish should be preferred;
• Increasing the intake of dietary fibre helps to reduce surges in blood sugar levels.
• For snacks eat fruit, vegetables or yogurt. Biltong and popcorn are also acceptable, but portion sizes should be small.
• Low carbohydrate foods such as cabbage, green beans, cauliflower leafy greens, beans, mushrooms and oranges should be included in the diet.
• Foods such as berries, eggs, fish, garlic, kelp, and most vegetables help stabilize the blood glucose levels.
• Vegetarian food should replace meats once weekly with vegetable sources of proteins such as legumes. Nuts and seeds (sesame flax and sunflower) in the diet should be increased.
• Minimize liquid intake during a meal.  Drink water (preferably warm) 30 minutes before and 30 minutes after eating.
• Drink fresh vegetable juice instead of fruit juices.

Other lifestyle advice

• Exercise has an insulin-like effect on the body.  Start with 10 minutes per day of cardiovascular exercises such as walking, running, cycling, or swimming.  Gradually build up to 45-60 minutes at least three times a week;
• Foot hygiene: to avoid foot ulcers keep feet dry, and massage regularly with heating oils;
• Avoid emotional stress through breathing exercises, counseling and other appropriate measures.

Herbal Remedies 

• Regular use of cinnamon (1 tsp daily added to food), cloves, and turmeric helps the body use insulin more effectively.
• Add a handful of stinging nettle to a litre of boiling water. Cover overnight. Strain and drink throughout the day.
• 100 grams each: ajmo/carrom seeds, fenugreek seeds, dried bitter gourd and 250ml bitter gourd juice. Mix the juice with the powder and pour it into a tray. Place the tray in a warm, dry and well ventilated place until completely dry. Use 500-1000mg 3 times a day of the powder. For children, reduce the dose by half.

Note: do not discontinue the use of conventional medication, without consulting your practitioner.

What is diarrhoea? 
Diarrhea is the condition of having three (3) or more loose or liquid bowel movements per day – may also be accompanied with gastro-enteritis. Diarrhoea is not a disease itself, but a symptom of several underlying diseases.

There are 3 types of diarrhoea

• Acute watery diarrhoea – lasts several hours or days
• Acute bloody diarrhoea – also called dysentery
• Persistent diarrhoea – lasts 14 days or longer

Signs and Symptoms 
Frequent, loose and watery stools, often accompanied by vomiting, stomach cramps, thirst, abdominal pain; and moderate fever.

Complications
Dehydration; malnutrition; and death.

What Causes Diarrhoea?
Diarrhoea is caused when there is inflammation of the intestines which does not allow for the absorption of nutrients and liquid. Some of the causes include:
Infection: resulting from contaminated water, poor sanitation and improper hygiene.
Food intolerance: from milk and dairy products, over eating, and consuming too many different foods. Medication: side effects from conventional medication.
From chronic illnesses: these include Irritable Bowel Syndrome, Inflammatory Bowel Disease including Crohn’s disease and Ulcerative Colitis, chronic pancreatitis, celiac disease, colon cancers and certain tumours of the small intestines.
Incomplete digestion of food: eating meal upon meal can result in undigested food remaining in the gastrointestinal tract.

The Tibb View of Diarrhoea
According to Tibb, diarrhoea is a physis response to eliminate the contents of the colon from food that is undigested, spoilt or contaminated.  Diarrhoea is in most cases associated with qualities of excessive moistness either with coldness or heat as the body eliminates toxic fluid. Excessive moistness with coldness results from too much cold & moist and Hot & Moist foods such as dairy products. This type of diarrhoea is common in children because of the innate quality of moistness.  Diarrhoea with qualities of moistness with heatresult from infections as well as from certain chronic diseases that increases heat, resulting in increased gastric motility. As there are numerous causes that can lead to diarrhoea, all temperamental types can be affected.

Treatment and Management of Diarrhoea
Treatment and management is aimed at reducing the excess qualities associated with diarrhoea, by implementing Tibb Lifestyle Factors that will increase the qualities of dryness and heat in patients with symptoms of excess moistness with cold, and dryness and cold in patients with excess moistness with heat. This will assist Physis in addressing both the symptoms, and the causes of diarrhoea.

Tibb Lifestyle Factors
Diarrhoea Associated with Qualities of Moistness with Cold:
Food and Drink

• Eat mostly Hot & Dry  – such as avocado, chickpeas, cinnamon and cloves, followed by  Cold & Dry  – like yogurt, potatoes, and mealie meal.
• Eat less of Hot & Moist  – such as bread, pasta, almonds, and spinach and the least amount of Cold & Moist  – like milk, margarine, rice, and squash.
• Avoid high fibre foods, which may stress the digestive system. Also fried, junk and processed foods.

Diarrhoea Associated with Qualities of Moistness with Heat:
Food and Drink 

• Eat mostly Cold & Dry  – such as yogurt, potatoes, and mealie meal followed by  Hot & Dry – like avocado, chickpeas, cinnamon and cloves.
• Eat less of Cold & Moist  – such as cumin, cardamom, rice, and squash and the least amount of Hot & Moist  – like bread, pasta, almonds, and spinach.
• Drink 3 cups of rice water daily. To make rice water, boil ½ cup of brown rice in 3 cups of water for forty five minutes. Strain out the rice and drink the water.

Other Lifestyle Advice

• Avoid solid food for a few hours until you feel better;
• Avoid dehydration. Drink water or a rehydration drink regularly, or liquids such as clear broth, weak tea, and clear fruit juices. Avoid very hot or cold liquids;
• Do not exercise strenuously until free of symptoms.

 
Herbal Remedies for diarrhoea associated

• Mix cinnamon powder, cumin powder, ginger powder (1 part) and honey (3 parts) in hot water.  Use 1tsp three times a day in adults and ½ tsp in children.
• If the diarrhoea does not have an offensive odour, or is the result of intake of antibiotics, then 1tbsp psyllium husk added to 5 tbsp Greek style yogurt and 2 tsp brown sugar. Mix thoroughly and eat. The yogurt will increase the probiotics in the digestive tract.

What is Dry Skin?
Although dry skin is not generally a serious condition, it may be uncomfortable, leaving the skin looking unsightly. When the condition is serious or severe, it is called ichthyosis.

Signs and Symptoms 
Dull looking, scaly and flaky skin, with fine lines and wrinkles; the skin feels unusually tight and uncomfortable, especially after washing; itchiness; a grey, ashen skin is evident in people with a dark complexion. Exposed areas of skin, like hands and face, are mostly affected. Chapped and cracked skin are signs of severely dehydrated skin.

What Causes Dry Skin?
There are many factors that may contribute towards dry skin:
Environment: long-term exposure to extremes of high and low temperatures.
Air-conditioners and heaters: these reduce the moisture present in the air, and contribute towards skin dryness.
Hot baths and showers: taking baths and showers in very hot water for long periods of time causes skin dehydration.
Harsh soaps and detergents: these strip natural oils from the skin.
Medications: dry skin may result from side effects of certain medications.

The Tibb View of Dry Skin
According to Tibb, dry skin is associated with dryness with coldness, as the skin lacks moisture. Most peoples’ skin becomes thinner and drier with age because of a natural increase in cold and dryness qualities. Dry skin is more prevalent in people with a melancholic dominant/sub-dominant temperament, with people with a melancholic/bilious temperament being at greatest risk due to their inherent qualities of dryness.

Treatment and Management of dry skin
Treatment and management is aimed at reducing the excess dryness with coldness associated with dry skin, by implementing Tibb Lifestyle Factors that increase the qualities of heat and moistness.  This assists Physis in addressing both the symptom and the causes of dry skin.

Tibb Lifestyle Factors 
Food and Drink

• Eat mostly Hot & Moist – such as sweet potato, banana, almonds and brown bread, followed by Cold & Moist – like butternut, carrots, pumpkin seeds and rice.
• Eat less of Hot & Dry – such as bittergourd, grapes, chickpeas and cinnamon, and the least amount of Cold & Dry – like beef, tomatoes, lemon, peanuts and beans.
• Eat a balanced diet that includes vegetables, fruits, grains, seeds, and nuts – raw wherever possible.
• Consume plenty of yellow and orange vegetables. (These are high in beta-carotene, a precursor of the skin-improving vitamin A).
• Drink at least two litres of water every day to keep the skin well hydrated.
• Do not drink soft drinks or eat sugar, chocolate, potato chips, or other junk foods.
• Avoid regular or excessive alcohol and caffeine intake.

Other Lifestyle Factors 

• Always moisturise the skin after cleansing. Apply pure olive or almond oil liberally to the skin.
• Avoid cigarette smoking, and exposure to second-hand smoke.
• Avoid harsh soaps, cold creams, or cleansing lotions.

Herbal Remedies 

• Mash two ripe bananas. Add two tbsp of honey. Mix well. Apply on dry skin. Leave it for 20 min. Wash off with warm water.
• Take one tablespoon of aloe juice in a glass of water daily.

What is Eczema?
Eczema is an itchy inflammation of the skin. It is a chronic disorder which may be associated with asthma or hay fever.

Signs and Symptoms
Red to brownish-gray colored patches form on the skin, most commonly in the skin folds; thick, cracked or scaly skin; severe itching, especially at night; small, raised fluid filled bumps appear when the skin is scratched.

Complications
Scratching frequently results in the skin becoming hard, leathery, raw, darker than normal, and permanently scarred; infections can appear on the skin. Scratching can also result in open sores developing, which are sensitive to the touch, and susceptible to infection. Eczema may affect the eyes, resulting in itching in and around the eyelids. This may lead to permanent eye damage.

What Causes Eczema?
The exact cause of eczema is unknown, but its predisposition is thought to have a hereditary or temperament component. Stress and other emotional disorders may worsen eczema. Eczema is more common in children.

The Tibb View of Eczema 
Eczema is linked to qualities of heat with either dryness or moistness as it is an inflammatory skin condition which present with itchy skin either associated with dry, scaly skin, or the presentation of discharge through damaged skin. Eczema may affect children of any temperament. The presentation of the eczema often differs according to the temperament. Melancholic children present with dry flaky skin, phlegmatic/sanguinous temperamental combination are more likely to develop “wet” eczema, and bilious children present with red, raw and highly inflamed skin.

Treatment and Management of eczema 
Treatment and management is aimed at reducing the excess qualities associated with eczema, by implementing Tibb Lifestyle Factors that will either increase the qualities of cold and moistness in patients with symptoms of excess heat and dryness, and cold and dryness in patients with excess heat with moistness. This assists Physis in addressing both the symptoms and the causes of eczema.

Tibb Lifestyle Factors 
In Eczema associated with qualities of heat with dryness:
Food and Drink 

• Eat mostly Cold & Moist – such as cucumber, watermelon, carrots and broccoli, followed by Cold & Dry – like yogurt, citrus fruit and coconut oil.
• Eat less Hot & Moist – such as ginger, white flour products, cheese and sugar, and the least amount of Hot & Dry – like eggs, fish, walnuts and garlic.

In Eczema associated with qualities of heat with moistness:
Food and Drink 

• Eat mostly Cold & Dry – like yogurt, citrus fruit and coconut oil, followed by  Cold & Moist – such as cucumber, watermelon, carrots and broccoli,
• Eat less Hot & Dry – like eggs, fish, walnuts and garlic and the least amount of Hot & Moist – such as ginger, white flour products, cheese and sugar.

Additional dietary Advice for Eczema associated with both heat with dryness and heat with moistness

• Avoid cashew nuts, pecan nuts, peanuts, cheese and other dairy products, pickles, processed meats, chocolate, wheat, strawberries, fats and fried foods.
• Try a gluten free diet for six weeks. Slowly reintroduce gluten foods one at a time back into your diet, and note any changes.
• Drink Rooibos tea (without milk and sugar). This has cooling properties and is rich in antioxidants.
• Avoid simple sugars and white flour products. Opt instead for brown variants and use honey, xylitol or Stevia to replace sugar.
• Camomile can be taken internally, as it strengthens and calms nerves. It can be used as well as on the skin to reduce skin inflammation.

Other Lifestyle Factors 

• Use non-perfumed moisturising lotions for bathing, such as aqueous creams or Episone-E. Add a half cup of boiling water to five Rooibos teabags, add to Episone-E lotion, and apply to the affected skin as a moisturiser. This helps reduce itchiness and inflammation. A tablespoon of honey can be added.
• Keeping the home humidified helps relieve symptoms of eczema linked to heat with dryness.
• Taking fewer showers and baths reduces the loss of the natural skin protective oils.
• Take measures to keep the colon clean. Use regular enemas to help rid the body of toxins.

Herbal Remedy 

• Drink two to three tablespoons twice daily of pure Aloe Vera juice. This can also be applied directly over the skin.

What is Erectile Dysfunction?
Erectile dysfunction (impotence) occurs when a male can no longer get or keep an erection firm enough for sexual intercourse.

Signs and Symptoms 
Inability to get or keep an erection firm enough for sexual intercourse.

What Causes Erectile Dysfunction?
Erectile dysfunction is the result of a problem with one or more of the brain, hormones, emotions, nerves, muscles or blood vessels. There are many physical causes for ED including heart disease, hypertension and diabetes.
Risk factors for ED include increasing age, being overweight or obese, heavy tobacco use, certain conventional medications, and recreational drug abuse.

Tibb View of Erectile Dysfunction
According to Tibb, ED is associated either with qualities of moistness with cold or heat with dryness. Moist & Cold imbalance typically exists in older men or in obese or diabetic patients. In these their metabolism slows down and moistness accumulates. Hot & Dry imbalance is often present in men who suffer from performance anxiety, stress and who abuse alcohol. Moist & Cold ED is linked to individuals with phlegmatic dominant/sub-dominant temperament, as they have innate qualities of coldness and moistness. Individuals with a bilious dominant/sub-dominant temperament are more inclined to develop ED linked to qualities of heat with dryness.

Treatment and Management of ED
Treatment and management is aimed at reducing the excess qualities associated with ED, by implementing Tibb Lifestyle Factors that will either increase the qualities of heat and dryness in cases of ED which are linked to excess moistness with coldness, or increase the coldness and moistness in cases of ED which are linked to excess heat with dryness.

Tibb Lifestyle Factors
Erectile Dysfunction (Associated with Qualities of Moistness with Cold):
Food and Drink

• Eat mostly Hot & Dry – such as bittergourd, avocado, eggs and cinnamon, followed by  Cold & Dry – like beef, tomatoes, lemon and beans.
• Eat less of Hot & Moist – such as bread, pastas and bananas, and the least amount of  Cold & Moist – like milk, butter, and rice.
• Avoid foods which promote fatty deposits in the reproductive organs. Cut down on saturated fats, especially saturated ones.

Other Lifestyle Factors 

• Exercise – A weight training programme will reduce the chance of ED, restore self-esteem, and probably diminish performance anxiety. Regular physical exercise, such as 30min moderate physical exercise at least three times per week,  will also help

Medication 
Herbal Remedy

• Mix a small fresh egg yolk, 2 teaspoons of honey, and 1 teaspoon each of fresh ginger juice and onion juice. Take twice a day

Erectile Dysfunction Associated with Qualities of Heat with Dryness:
Food and Drink 

• Eat mostly Cold & Moist – such as broccoli, cucumber, watermelon and milk, followed by  Cold & Dry – like oranges, yogurt and coconut oil.
• Eat less of  Hot & Moist – such as mutton, ginger, cheese and sugar, and the least amount ofHot & Dry foods – like alcohol, egg, walnuts and alcohol.

Other Lifestyle Factors 

• Breathing.  ED may respond to practicing deep breathing exercises, as this is known to counteract stress.
• Cutting down or stopping smoking, as nicotine lowers sexual desire
• Emotional support. The person affected should learn to relax, as ED often arises from performance anxiety.

Herbal Remedies

• 2 teaspoons of poppy seeds, 2 cardamom pods, and 10 almonds. Soak overnight in 100ml of water, liquidise in 150ml of boiled milk and add 2 teaspoons of sugar. Strain and drink twice daily on an empty stomach.
• Consume watermelon regularly, as it contains agents which boost blood flow to several body organs.

What is Flatulence? 
Flatulence is the result of excess intestinal gas being passed through the anus from the lower intestine.

Signs and Symptoms 
Excessive or unwelcome passage of gas from the anus; embarrassing wind breaking during coughing, sneezing or laughing, or during exertion; disagreeable and uncomfortable bloating of the abdomen due to gas accumulation; a feeling of urgency similar to the one signaling the need to defaecate; and the most serious (embarrassing) complication is breaking out in public.

What Causes Flatulence?
Flatulence is a by-product from the normal intestinal flora’s (bacteria) action of hard to digest foods that passes into the colon such as beans. Food sensitivities or intolerance, as with ingesting foods containing gluten or lactose can also cause excessive buildup of intestinal gas, which is sometimes painful. Ailments such as IBS often feature excessive flatulence as a symptom.

The Tibb View of Flatulence
According to Tibb, the qualities associated with flatulence are dependent on the underlying cause. Eating gas-forming, cold and dry foods like beans, produces flatulence linked to qualities of dryness with cold. Although people with a melancholic dominant/sub-dominant temperament are most inclined to suffer with flatulence, other temperamental types can also suffer from it, due to a faulty diet or a poor lifestyle.

Treatment and Management of Flatulence
Treatment and management is aimed at reducing the excess dryness with cold associated with flatulence, by implementing Tibb Lifestyle Factors that will increase the qualities of heat and moistness.  Treating the underlying condition and avoiding certain foods should also be adopted. This assists Physis in addressing both the symptoms and the causes of flatulence.

Tibb Lifestyle Factors 
Food and Drink 

• Eat mostly Hot & Moist  – such as banana, sweet potato, and brown bread, followed by Cold & Moist  – like butternut, carrots, pumpkin and pears.
• Eat less of Hot & Dry  – such as avocado, garlic, onion and chickpeas, and the least amount of Cold & Dry  – like beef, tomato, beans and mealie meal.
• Try to eat more fresh vegetables, fruit and whole meal bread, as these will increase roughage in the diet.
• Drink at least 6-8 glasses of warm water per day.
• Drink at least 2 liters of warm water daily.
• Use rice instead of potatoes, corn or noodles wherever possible.
• Avoid gas-promoting foods, especially apricots, beans, cabbage, brussels sprouts, broccoli, cauliflower, lentils, onions and radishes.
• Avoid food combinations that upset your stomach, such as consuming fruit with a heavy meal or milk with fermented products.

Herbal Remedies 

• Add 1 teaspoon of fennel seeds to 1 cup of boiling water. Drink after cooling and straining.
• Adding the spices cumin, coriander, caraway and turmeric when preparing meals counteracts intestinal gas production.

What are Gallstones?
Gallstones are hardened deposits of bile and other material that forms in the gallbladder. Gallstones can range in size from a grain of sand to that of a golf ball.

Signs and Symptoms
Gallstones may present with no signs and symptoms, depending on the size; a colicky pain in the upper right side of the abdomen that may radiate to the right shoulder; intensifying pain in the abdomen just below the breast bone; and pain between the shoulder blades.

Complications
Inflammation of the Gallbladder: Inflammation may result when a gallstone becomes lodged in the neck of the gallbladder.
Blockage of the Bile Duct: Gallstones may lodge in the common bile duct, resulting in jaundice or an infection of the bile duct.
Blockage of the Pancreatic Duct: A gallstone may lodge in the pancreatic duct, increasing the risk of developing inflammation of the pancreas.

What Causes Gallstones? 
Bile is responsible for dissolving cholesterol. If the liver secretes too much cholesterol for the bile to dissolve, the cholesterol hardens and form stones. Gallstones may also form if too much of the chemical bilirubin is produced. Bilirubin is responsible for breaking down red blood cells. Too much of it is produced in certain illness conditions, especially liver cirrhosis.
If the gallbladder fails to empty completely or often enough, bile may become very concentrated, and this contributes to the formation of gallstones.
Risk factors include being female; being obese or overweight; being over the age of 60; eating a rich, high fat, low fibre diet; rapid weight loss; and diabetes.
Certain medications such as cholesterol-lowering medication and hormone therapy also increase the risk of developing gallstones.

The Tibb View on Gallstones
Gallstones are linked to qualities of coldness with dryness as digestive fluid solidifies to form stones. Individuals, especially women, as their predominantly phlegmatic temperament are more likely to develop gallstones, due to their innate quality of coldness. Irregular eating patterns and skipping meals, which are associated features of the phlegmatic temperament, result in an imbalance of chemicals in the gallbladder. This frequently goes on to form gallstones.

Treatment and Management of Gallstones
Treatment and management is aimed at reducing the excess coldness with dryness associated with gallstones, by implementing Tibb Lifestyle Factors that increase the qualities of heat and moistness. Lifestyle changes such as exercising and eating a healthy diet are strongly advised.

Tibb Lifestyle Factors 
Food and Drink

• Eat mostly  Hot & Moist – such as olive oil, turmeric, dates and mutton, followed by  Hot & Dry – like oily fish, garlic, chicken and mustard seeds.
• Eat less of  Cold & Moist – such as litchis, watermelon, cucumber, milk and broccoli, and the least amount of  Cold & Dry – like beef, tomato, yogurt and citrus fruits.
• Avoid sour foods and drinks.
• Avoid animal products, especially pork.
• Avoid fried fatty, sugary or refined foods.
• Avoid all hydrogenated and hardened fats, and oils such as margarine, lard and butter.
• Drink juices such as pear, beet, and apple for 3 days.
• Boiled/steamed chicken and fish should be preferred over red meat.
• Avoid cold and icy foods and drinks.
• Drink at least two to three litres of warm water a day.

Other Lifestyle Factors

• Colonic cleansing or irrigation is recommended to assist in eliminating waste from the body.
• Daily moderate exercise such as moderate walking is advised.

Herbal Remedies

• Take 3 tablespoons of olive oil with the juice of a lemon (3 tablespoons) before bed and upon wakening. Stones are often passed in the stools with this technique. Substitute lemon with grapefruit if desired.

Detox Programme 

2. During treatment, eat normally, but avoid red meats, dairy and fried foods completely.
3. On Day 1, take 1 tablespoon olive oil plus 1 tablespoon of lemon juice at bedtime.
4. On Day 2, carry on with the apple juice. Take 2 tablespoons olive oil plus the same amount of lemon juice at bedtime.
5. On Day 3, carry on with the apple juice. Take 3 tablespoons olive oil plus the same amount of lemon juice at bedtime.
6. On Day 4, carry on with the apple juice. Take 3 tablespoons olive oil plus the same amount of lemon juice at bedtime.
7. On Day 5, carry on with the apple juice. Take 4 tablespoons olive oil plus the same amount of lemon juice at bedtime.
8. On Day 6, carry on with the apple juice. Take 5 tablespoons olive oil plus the same amount of lemon juice at bedtime.
9. On Day 7, carry on with the apple juice till midday, then take a light lunch. At 6 pm, take a teaspoon of Epsom Salts (magnesium sulphate) with a glass of warm water.
At 8 pm, repeat the same. Epsom Salts open the gallbladder ducts.  
At 10 pm, take a half-cup olive oil with same amount of lemon juice. Mix it well and drink it.
After this, sleep or at least lie down on the right side and rest. Do not engage in physical activity.  
To avoid nausea and vomiting suck grapefruit with salt or chew mint leaves.
The next morning, you will pass a loose stool.
Check the stool for toxins, worms, and green coloured gallstones. 

What is Gastritis?
Gastritis is a group of symptoms that arise from inflammation of the stomach lining.

Signs and Symptoms 
A gnawing or burning ache or pain in the upper abdomen; it may become better or worse with eating; nausea; vomiting; a feeling of fullness in the upper abdomen after eating.

Complications
Stomach ulcers; internal bleeding; an increased risk of developing stomach cancer.

What Causes Gastritis?
The stomach is lined with a mucous barrier which protects it from the acid secreted to digest food. It develops when the stomach lining becomes weak or damaged. Weakness in this mucous barrier results in acid attacking the lining of the stomach. A number of ailments make the protective layer susceptible to damage, and so increase the risk of developing gastritis.

The Tibb View of Gastritis
According to Tibb, gastritis is linked to qualities of heat with dryness. These lead to the burning abdominal pain experienced. A lifestyle that promotes this heat and dryness, such as the excessive intake of heavily spiced foods, poorly managed stress and alcohol abuse, increases the risk of developing gastritis. People with a bilious dominant/sub-dominant temperament are most likely to develop gastritis, due to their inherent qualities of heat/dryness.

Treatment and Management of Gastritis 
Treatment and management is aimed at reducing the excess heat with dryness associated with gastritis, by implementing Tibb Lifestyle Factors that increase the qualities of coldness and moistness. This assists Physis in addressing both the symptoms and causes of gastritis.

Tibb Lifestyle Factors
Food and Drink

• Eat mostly Cold & Moist – such as rice, cucumber, watermelon and milk, followed by Cold & Dry – like yogurt, potato, citrus fruit and coconut oil.
• Eat less of Hot & Moist  – such as mutton, ginger, spinach and sugar, and the least amount of Hot & Dry – like chicken, eggs, garlic and onions.
• Drink a large glass of water rapidly to relieve pain. This dilutes excess stomach acid, flushing it into the duodenum, where it is neutralised;
• Eat frequent small meals, including well cooked white rice, yoghurt and cottage cheese.
• Eat vegetables such as carrots and broccoli occasionally.
• Allow hot beverages, such as rooibos tea, to cool before drinking. This avoids triggering gastric discomfort.
• Avoid fried foods, tea, coffee, alcohol, chocolate, strong spices, animal fats and carbonated drinks.

Other Lifestyle Advice

• Avoid non-steroidal anti-inflammatory drugs, especially aspirin.
• Quit smoking.
• Practice slow and deep breathing exercises twice daily.
• Keep the colon clean by consuming a high-fibre diet. The use of a gentle and natural laxative monthly is recommended.

Herbal Remedies

• Drink 25ml of Aloe Vera juice two to three times per day.
• 1tsp of licorice root powder mixed in 100ml of warm water and taken three to four times per day on an empty stomach promotes the healing of the mucous barrier.
• Take 1teaspoon of psyllium husk with warm water before retiring at night.

What is GORD? 
Gord is a chronic disease where stomach acid occasionally flows back into the oesophagus. The acid irritates the lining of the oesophagus and causes the signs and symptoms of GORD.

Signs and Symptoms 
A burning sensation behind the breastbone; a sour taste in the mouth; regurgitation of food or acid/bile; chest pain; difficulty swallowing; dry cough; and a sensation of a lump in the throat.

Complications
Narrowing of the oesophagus. This is due to damage by the acid reflux. Scar tissue might form, causing the oesophageal space to narrow.
Oesophageal Ulcers. The stomach acid erodes the mucous barrier in the oesophagus. This causes an open sore to form.
Barrett’s Oesophagus. Damage caused by the acid reflux may result in abnormal/precancerous cells developing.

What Cause GORD?
GORD results from frequent episodes of heartburn or acid reflux, due to stomach acid moving into the oesophagus. During digestion the muscles above the stomach relaxes to allow food in and then closes again. With GORD, the frequent muscle relaxation allows stomach acid back up into the oesophagus, causing heartburn.

The Tibb View on GORD
According to Tibb philosophy, GORD can either result from an excess of heat with dryness which produces an excess amount of stomach acid, or from an excess of moistness, which causes the muscle to relax abnormally. The form of GORD linked to heat with dryness is more prevalent in people with a bilious dominant/sub-dominant temperament, due to their innate qualities of heat and dryness. The form of GORD linked to moistness is more commonly found in people with a phlegmatic/sanguinous temperament, due to the inherent dominance of moistness.

Treatment and Management of Heartburn
Treatment and management is aimed at reducing the excess qualities associated with GORD, by implementing Tibb Lifestyle Factors that will increase the qualities of coldness with moistness in patients with symptoms of excess heat with dryness and by increasing the quality of dryness in patients with symptoms of excess moistness. This assists Physis in addressing both the symptoms and causes of GORD.

Tibb Lifestyle Factors
GORD associated with Qualities of Heat with Dryness:
Food and Drink

• Eat mostly Cold & Moist – such as rice, cucumber, watermelon and milk, followed by  Cold & Dry – like yogurt, potato, citrus fruit and coconut oil.
• Eat less of Hot & Moist  – such as mutton, ginger, spinach and sugar, and the least amount of Hot & Dry  – like chicken, eggs, garlic and onions.
• Drink a large glass of water rapidly to relieve pain. This dilutes excess stomach acid, flushing it into the duodenum where it is neutralised;
• Eat frequent small meals, including well-cooked white rice, yoghurt and cottage cheese.
• Occasionally eat vegetables such as carrots and broccoli.
• Allow hot beverages, like rooibos tea, to cool before drinking, to avoid triggering gastric discomfort.
• Avoid fried foods, tea, coffee, alcohol, chocolate, strong spices, animal fats, and carbonated drinks.
• Avoid eating and drinking at the same time. Fluids should be taken 30 minutes before or after a meal.

Other Lifestyle Advice

• Avoid lying down immediately after a meal.
• Wear loose, comfortable clothing.
• Avoid non-steroidal anti-inflammatory drugs, especially aspirin.
• Quit smoking.
• Practice slow and deep breathing exercises twice daily.
• Keep the colon clean by following a high-fibre diet. The use of a gentle and natural laxative is recommended monthly.
• Drink a glass of chilled milk to reduce discomfort caused by stomach acid.

Herbal Remedy

• Grind 2 cardamom pods, add 250ml of water boil for 15minutes, strain, and drink three times daily.

Tibb Lifestyle Factors
GORD (Associated with the Quality of Moistness):
Food and Drink

• Eat mostly Hot & Dry – such as chicken, avocado, bittergourd and chickpeas, followed by Cold & Dry – like beef, potato, and yogurt.
• Eat the less of Hot & Moist – such as bread, pasta, sugar and bananas, and the least amount of Cold & Moist  – like squash, butter, cucumber and pears
• Avoid triggers such as fatty or fried foods, tomato sauce, alcohol, chocolate, mint, garlic, onion and caffeine. These often make heartburn worse.
• Eat smaller meals.

Other Lifestyle Advice 

• Avoid lying down immediately after a meal.
• Wear loose, comfortable clothing.
• Lose weight if overweight.
• Quit smoking.

Herbal Remedies

• Chew five to six basil leaves after meals.
• Chew a clove of garlic to lessen discomfort.

What is Gout? 
Gout is a recurrent acute, painful inflammatory disease that affects the person’s joints, especially in the big toes. It is a metabolic disorder resulting from the accumulation of uric acid in the blood and other body fluids.  The uric acid forms crystals in the joints, which trigger an acute inflammatory response. It can also develop into a chronic or recurring condition.

Signs and Symptoms
Severe, throbbing, excruciating pain in a joint, particularly in the big toe (50% of cases), ankle or knee. The affected joint is inflamed – red, swollen, hot and very tender to the touch. Flu-like symptoms may appear, such as muscle aches and fever; hard nodules form on the joint surface; and physical movement is painful and difficult. Gout can also affect the ankles, knees, wrists, tendons and surrounding tissues.

Complications 
Untreated gout may cause urate crystals nodules (tophi) to form under the skin. Tophi can develop in several areas such as the fingers, hands, feet, elbows or Achilles tendons along the back of the ankle. Tophi themselves are not usually painful, but they can become swollen and tender during gout attacks. Another complication that may occur is the development of kidney stones due to urate crystals forming in the urinary tract.

What Causes Gout?
Gout occurs when urate crystals accumulate in joints, causing the inflammation and intense pain typical of a gout attack. The uric acid is a normal waste product of the body’s metabolism, but is not excreted properly in gout.
Gout often results from long-term consumption of rich, high-protein food, especially cold and dry foods like beef. Other risk factors include: side effects of certain medications such as diuretics, and a genetic or temperamental predisposition.

The Tibb View on Gout
According to Tibb, gout is linked to coldness with dryness. It develops in the peripheral areas of the body which do not receive as much heat as the core organs and tissues. Physis is unable to regulate the high uric acid levels circulating in the blood, resulting in these crystals depositing and “freezing” in the joint spaces. The body’s reaction to this is the origin of the signs and symptoms of gout. Although individuals with a melancholic dominant/sub-dominant temperament are predisposed to gout, people with dominant/sub-dominant sanguinous temperaments are also at risk. This is the result of the oxidation of the sanguinous humour into abnormal melancholic humour.

Management of Gout 
Treatment and management is aimed at reducing the excess coldness with dryness associated with gout, by implementing Lifestyle Factors that will increase the qualities of heat with moistness. This assists Physis in addressing both the symptoms and causes of gout.

Tibb Lifestyle Factors 
Food and Drink

• Ideally eat only fruit and vegetables (juiced), and avoid nuts, eggs, meats and fried foods for several days during an acute attack;
• Eat mostly Hot & Moist – such as spinach, dates, mango, and turmeric, followed by Hot & Dry – like oily celery, green or red peppers, avocados and parsley.
• Eat less of Cold & Moist – such as milk, pineapples, and broccoli, and the least amount of Cold & Dry – like beef, tomatoes, sour milk, and beans.
• Cut down on tea and coffee, and restrict alcohol consumption, especially beer.
• Do not eat purine-rich foods, which include brains, herring, anchovies, liver, kidneys, sardines and pilchards.
• Drink at least three litres of warm water daily to dissolve and flush out uric acid deposits.
• Drink caffeine-free herbal teas to increase fluid intake; peppermint, rose hip and yarrow, for example.
• Avoid frequent sugary soft drinks, as they contain much fructose, which can increases recurrence.
• Avoid eating protein-rich foods
• A light fast for a couple of days is often beneficial.

Other Lifestyle Factors
Try steam bathing or sauna (for short sessions) daily. Heat helps to soften the uric acid crystals.

Herbal Remedy

• Infuse in 1 cup of boiling water with ½ tsp cinnamon powder, ½ tsp fenugreek powder, and a ¼ tsp celery seeds powder. Add honey to taste.

What are Haemorrhoids/Piles? 
Hemorrhoids are swollen and inflamed veins located in the region of the anus and lower rectum.

Signs and Symptoms
Itching, pain and burning feeling around the anus; heavy feeling within the rectum; soft swelling or a lump protruding from the anus; and bleeding of bright red blood from the anus during defaecation.

Complications
Haemorrhoids which bleed can lead to chronic anaemia due to excessive blood loss. Strangulation of the blood supply to an internal haemorrhoid may be cut off, causing severe pain and tissue death (gangrene).

What Causes Piles?
The veins around the anus tend to stretch under pressure, and may bulge or swell. Swollen veins (haemorrhoids) develop from an increase in pressure in the lower rectum. There are a number of risk factors that may contribute to this by reducing blood circulation.
Physical factors, such as chronic constipation, pregnancy, lifting heavy weights, obesity, enlarged prostate (in men); poor diet, especially from  low fibre foodstuffs, cold and dry food items;, food allergies; faulty habits, especially lack of physical exercise, frequent use of chemical laxatives, sitting or standing still for long periods of time, so encouraging poor blood circulation.

The Tibb View on Piles
According to Tibb, haemorrhoids are associated with qualities of dryness with cold as it is often results as a complication of constipation. Bleeding piles are associated with dryness with heat. People with a melancholic dominant/sub-dominant temperament are more predisposed to developing piles due to their dominance of dryness and cold.

Management of Piles
Treatment and management is aimed at reducing the excess quality of dryness associated with haemorrhoids, by implementing Tibb Lifestyle Factors that either increase the qualities of heat and moistness in haemorrhoids which are linked to excess dryness with cold, or increase the qualities of coldness and moistness in haemorrhoids which are linked to excess dryness with heat. This assists Physis in addressing both the symptoms and causes of piles.
Lifestyle modification is often a simple and effective approach to treating haemorrhoids. It includes drinking more water, adding more fibre to the diet, and increasing the level of physical activity.

Tibb Lifestyle Factors 
Haemorrhoids Associated with Qualities of dryness with coldness: 
Food and Drink

• Eat mostly Hot & Moist – such as banana, sweet potato, and brown bread, followed by  Cold & Moist – like butternut, carrots, pumpkin and pears.
• Eat less of Hot & Dry  – such as avocado, garlic, onion and chickpeas, and the least amount of Cold & Dry  – like beef, tomato, beans and mealie meal.
• Slowly build up to eating more fresh fruit, vegetables and high-fibre foods, and drink plenty of warm water.

Haemorrhoids Associated with Qualities of dryness with heat: 
Food and Drink

• Eat mostly Cold & Moist – such butternut, carrots, pumpkin and pears followed by  Hot & Moist – like banana, sweet potato, and brown bread.
• Eat less of Cold & Dry  – such as beef, tomato, beans and mealie meal and the least amount of Hot & Dry  – like avocado, garlic, onion and chickpeas.
• Slowly build up to eating more fresh fruit, vegetables and high-fibre foods, and drink plenty of warm water.

Other Lifestyle Factors for haemorrhoids linked to both dryness with coldness and dryness with heat

• Exercise: Regular light/moderate exercise (brisk walking 20-30 min daily). Avoid standing/sitting for long periods.
• Detox: A 15min sitz bath in hot water will bring relief.
• Hygiene: Keep the anal area clean by regular use of a plain warm water enema. Apply warm water washing of the anal area after defaecation.
• Others: Lubricate the anus with Vaseline or olive oil to help with constipation.
• Avoid lifting heavy weights, or learn to apply proper lifting techniques.

Herbal Remedies 

• Herbal – consume more dark coloured berries. These contain natural flavonoids, which strengthen the walls of veins around the anus
• Avoid constipation by using a mild laxative regularly like aloe vera or prune juice. Avoid strong or harsh chemical laxatives. Eat two to three dried figs, previously soaked in water, daily
• Take one or two tablespoons of flaxseed daily to help soften the stool. Flaxseed is rich in omega-3 fats which have useful anti-inflammatory activity.

What is Hayfever?
Hay fever, also called allergic rhinitis, is the result of an allergic response to outdoor or indoor allergens, such as pollen, dust mites or pet dander.

Signs and Symptoms
Itchy eyes, nose and palate; watery discharge from nose and eyes; sneezing; nasal congestion; sinus pressure and facial pain; discoloured bluish-black skin under the eyes; and a decreased sense of taste or smell.

Complications
Ear infections in children; infection or inflammation of the sinuses; increasing asthma attacks; disturbed sleep.

What Causes Hayfever?
Hay fever occurs when the immune system becomes hyper-sensitive. This triggers the release of antibodies towards these harmless substances. Later, when there is further exposure to these substances, the immune system releases chemicals like histamine which leads to the signs and symptoms typically associated with hay fever.

The Tibb View on Hayfever
Hay fever results from an excess of the quality of heat, with either moistness or dryness. This leads to irritation and inflammation of the epithelial membranes lining the nose and throat. Bilious/Sanguinous temperamental combinations are most susceptible to developing hayfever due to their innate qualities of heat.

Management of Hayfever
Treatment and management is aimed at reducing the excess qualities associated with hayfever, by implementing Tibb Lifestyle Factors that will increase the qualities of coldness with dryness in patients with symptoms of excess of heat with moistness and by increasing the qualities of cold with moistness in patients with symptoms of excess heat with dryness. This assists Physis in addressing both the symptoms and causes of hayfever.

Tibb Lifestyle Factors 
Hayfever associated with Qualities of Heat with Moistness:
Food and Drink

• Eat mostly Cold & Dry – such as beef, fish, cauliflower and mushrooms, followed by Hot & Dry – like bittergourd, avocado, chickpeas and garlic and  Cold & Moist – such as carrots, pumpkin, rice and milk, and the least amount of Hot & Moist – like bread, pasta, bananas and wheat cereals.
• Increase the consumption of fruits, vegetables, grains, raw nuts and seeds.
• Eat yogurt and soured or fermented products three times a week. This significantly reduces the incidence of hay fever attacks, especially in people with a dominant or sub-dominant bilious temperament.
• Foods which are rich in magnesium, such as kidney beans, soya beans, brown rice and peas are very beneficial and protective during the allergy season.
• Avoid cake, chocolate, coffee, dairy products (except yogurt), processed foods, pies, fizzy drinks, sugar, tobacco, white flour products, junk foods and synthetic juices.

Hayfever associated with Qualities of Heat with Dryness:
Food and Drink  
Eat mostly Cold & Moist  – such as carrots, pumpkin, rice and milk followed by  Cold & Dry – like beef, fish, cauliflower and mushrooms and  Hot & Moist  – such as bread, pasta, bananas and wheat cereals and the least amount of Hot & Dry  – like chicken, oily fish, green pepper, eggs and garlic.

Herbal Remedies 

• Take 1gram of licorice root powder three times a day for seven days. However, avoid this if you have high blood pressure.
• Soak 1tbsp of poppy seeds and about seven almonds in 200ml of water overnight. In the morning, liquidise and drink.

The Tibb View on Headaches
According to Tibb, headaches are a sign of an underlying imbalance in the body. There are four main types of headaches linked to the four different temperaments – Bilious Headache, Sanguinous headache, Phlegmatic headache and Melancholic headaches. Each of these headaches result from qualitative imbalances that present with specific signs and symptoms.

Bilious Headache/Migraine
This headache starts from the left half of the cranium and left eye spreading throughout the head. This headache normally starts at sunrise and gradually increases in intensity by midday. The headache is accompanied by nausea and sometimes vomiting. There is also intolerance to noise and light. In the later part of the afternoon, some relief from the intensity of pain may be experienced.

What Causes Bilious Headaches? 
There are many factors that can contribute towards the development of a bilious headache. This includes: a hot environment or hot weather; inadequate sleep; excessive wakefulness; excessive intake of hot and spicy foods; and emotions such as stress, anger and irritability.

The Tibb View on Bilious Headaches
Bilious headaches are due to excess qualities of heat with dryness. People with a dominant/sub-dominant bilious temperament are most likely to suffer with chronic bilious headaches/migraines due to their innate qualities of heat and dryness.

Management of Bilious Headaches
Treatment and management is aimed at reducing the excess heat with dryness associated with bilious headaches, by implementing Tibb Lifestyle Factors that increase the qualities of coldness and moistness. Treating the underlying source of the headache, and avoiding certain food-triggers and gas producing foods in the diet should also be adopted. This assists Physis in addressing both the symptoms and causes of bilious headaches.

Tibb Lifestyle Factors 
Food and Drink

• Eat mostly Cold & Moist – such as carrots, cucumber, lettuce, watermelon and rice, followed by Cold & Dry – like yogurt, fish and citrus fruit and  Hot & Moist – such as bread, pasta, sugar and cheese, and the least amount of Hot & Dry like – chicken, egg, garlic and onion.

Other Lifestyle Advice 

• Practice good sleep hygiene to ensure adequate rest and sleep at night.
• A high- fibre diet should be adopted to promote regular bowel movements. The use of a gentle laxative may be used every two weeks.
• Avoid strenuous exercise. Partake in light exercises like yoga and Pilates. Swimming is also an acceptable form of exercise.

Herbal Remedy

• Soak one tsp of lavender, two pinches of black pepper, ½ tsp coriander powder and about seven almonds in 150ml of hot water for 30 minutes. Liquidise and strain. Add 1tsp of honey and drink two to three times a day.

Sanguinous Headaches 
A sanguinous headache is the result from an increase in blood volume. The accumulation of this excess blood in the region of the head results in a sanguinous headache. Signs and symptoms include throbbing pain in the temple region; elevated blood pressure; dizziness; and heaviness behind the eyes.

What Causes Sanguinous Headaches?
Hot and humid weather, improper diet and the excessive intake of Hot & Moist such as white flour products, sugar and salt, stress, and certain medications, such as oral contraceptives.

The Tibb View of Sanguinous Headaches
Sanguinous headaches are due to an excess of heat and moistness resulting from an increase in blood volume that is common with sanguinous temperamental types. Sanguinous types are most likely to develop sanguinous headaches due to their inherent qualities of heat and moistness.

Management of Sanguinous Headaches
Treatment and management is aimed at reducing the excess qualities associated with sanguinous headaches, by implementing Tibb Lifestyle Factors that increase the qualities of coldness and dryness. Treating the underlying source of the headache, and avoiding certain food-triggers and gas producing foods in the diet should also be adopted. This assists Physis in addressing both the symptoms and causes of sanguinous headaches.

Tibb Lifestyle Factors 
Food and Drink

• Eat mostly Cold & Dry  – such as beef, potato, yogurt and citrus fruit, followed by Hot & Dry  – like eggs, garlic, chicken and onion, and  Cold & Moist  – such as cucumber, carrots, pears and rice, and the least amount of  Hot & Moist – like mutton, salt, sugar, bread and pasta.
• Eat mostly broccoli, garlic, green leafy vegetables, melons and squash. Eat grains like brown rice.
• Drink two litres of lukewarm water daily.
• Avoid all animal fats, bacon, beef, liver, corned beef, dairy products, pork, sausages and smoked or processed meats.
• Skinless chicken and mutton should be consumed in moderation only.
• Avoid foods such as avocado, chocolate, beans, pickled herring and sour cream.
• Avoid fried foods, coffee, black tea, fizzy drinks, alcohol and tobacco.

Herbal Remedy

• Mix together 20g of lavender powder, 50g of cardamom powder, 20g of coriander powder and 10g of fine black pepper. Take 1g of this powder 3-4 times a day. During an attack, take 0.5g every 15 minutes for 4-6 doses.

Phlegmatic Headache/Migraine
This headache starts above the eyebrows, moving horizontally all the way around to the back of the head like a band, and then spreads throughout the head. It starts in the late afternoon or early evening and worsens during the night. The intensity lessens after sunrise and during the day.

What Causes Phlegmatic Headaches? 
Causes may include a cold and rainy environment, winter seasons, excessive intake of Cold & Moist such as dairy products, and the use of air conditioning.

The Tibb View on Phlegmatic Headaches
Phlegmatic headaches are associated with the qualities of moistness with coldness. People with a phlegmatic dominant/sub-dominant temperament are most susceptible to the development of phlegmatic headaches due to their innate qualities of coldness and moistness.

Management of Phlegmatic Headache/Migraines 
Treatment and management is aimed at reducing the excess moistness with coldness associated with phlegmatic headaches, by implementing certain Tibb Lifestyle Factors that increase the qualities of heat and dryness.   Treating the underlying source of the headache, and avoiding certain food-triggers and gas producing foods in the diet should also be adopted. This assists Physis in addressing both the symptoms and causes of phlegmatic headache.

Tibb Lifestyle Factors 
Food and Drink 

• Eat mostly Hot & Dry – such as chicken, chickpeas, avocado, and cinnamon, followed by Cold & Dry  – like beef, tomato, potato and citrus fruit and  Hot & Moist  – such as white flour products, sugar, bananas and cheese, and the least amount of Cold & Moist – like milk, cucumber, rice and pears.
• Drink plenty of fresh warm water; Consume hot liquids like soups and herbal teas, which promote the elimination of phlegm.
• Eat plenty of fruit and vegetables.
• Eat food which is rich in garlic and horseradish. Also pepper-rich dishes, which contain capsaicin or cayenne. Eat plenty of protein, especially chicken, fish and meat.
• Avoid wheat, sugar-rich and salty foods, and ice-cold drinks.
• Restrict dairy or milky foods, except yoghurt.

Other Lifestyle Advice

• Avoid exposure to cold environments and rainy weather.
• Avoid day time napping.

Herbal Remedy

Boil 2tsp of lavender, ¼ tsp of fenugreek seeds, ¼ tsp of cinnamon, 2 crushed cloves in 2 cups of water. Boil down until one cup remains. Strain and add 1tsp of honey and drink while still warm. Repeat this two to three times a day, especially at the onset of an attack.

Melancholic Headache
Melancholic headaches present with the following symptoms: pain  at the back of the skull, with a pulling of the neck muscles; a dull feeling in the head; flatulence and stomach wind; indigestion; hiccoughs; constipation; or irregular liquid bowel movements.

What Causes Melancholic Headaches? 
These headaches are caused by an excessive intake of Cold & Dry like sour products, cold and dry weather, excess tea, coffee and alcohol. Fermentation of food in the gut produces gas due to insufficient heat in the body.

The Tibb View on Melancholic Headaches
Melancholic headache is due to an excess of the qualities dryness with cold. People with a dominant/sub-dominant melancholic temperament are predisposed to developing this type of headache due to their innate coldness and dryness.

Management of Melancholic Headaches
Treatment and management is aimed at reducing the excess dryness with cold associated with melancholic headache, by implementing certain Tibb Lifestyle Factors that increase the qualities of heat and moistness.  Treating the underlying source of the headache, and avoiding certain food-triggers and gas producing foods in the diet should also be adopted. This assists Physis in addressing both the symptoms and causes of melancholic headaches.

Tibb Lifestyle Factors 
Food and Drink 

• Eat mostly Hot & Moist – such as banana, brown bread, sweet potato and mutton, followed by Cold & Moist – like carrots, butternut, rice and milk, and  Hot & Dry – such as egg, bittergourd, avocado and garlic, and the least amount of Cold & Dry – like yogurt, beans, beef and lemon.
• Avoid the excessive intake of coffee, tea, smoking and alcohol.

Other Lifestyle Advice 

• A cleansing enema should be used on a monthly basis, especially in cases of headache where constipation and indigestion occur as well.

Herbal Remedy

• Add 1 teaspoon of fennel seeds with one cup of boiling water. Drink after cooling and straining.

What is Heartburn? 
Heartburn is a burning sensation just behind the breastbone. It is often worse when lying down.

Signs and Symptoms
A burning sensation behind the breastbone or a burning feeling in the throat; it usually occurs after eating; it is usually worse at night.; it may be accompanied by a sour or bitter taste in the mouth or the sensation of food being stuck at the back of the throat.

What Causes Heartburn?
Heartburn is caused by stomach acid moving back up into the oesophagus. When we eat, the muscle above the stomach relaxes to allow food in and then closes again. With heartburn, the muscle relaxes abnormally or is weakened, and this allows stomach acid back up into the oesophagus.

The Tibb View on Heartburn 
According to Tibb philosophy, heartburn either results from an excess of heat with dryness, caused by increase production of stomach acid; or it results from an excess of moistness which causes the muscle to relax abnormally.
Heartburn linked to heat with dryness is more prevalent in people with a dominant/sub-dominant bilious temperament, because of their innate qualities of heat and dryness. However, heartburn linked to moistness is more commonly found in people with a phlegmatic/sanguinous temperament, because of their inherent dominance of moistness.

Management of Heartburn
Treatment and management is aimed at reducing the excess qualities associated with heartburn by implementing Tibb Lifestyle Factors that will increase the qualities of coldness and moistness in cases of heartburn linked to excess heat with dryness; or increase dryness in cases of heartburn linked to excess moistness. This assists Physis in addressing both the symptoms and causes of heartburn.

Tibb Lifestyle Factors
Heartburn Associated with Qualities of Heat with Dryness:
Food and Drink

• Eat mostly Cold & Moist – such as rice, cucumber, watermelon and milk, followed by  Cold & Dry – like yogurt, potato, citrus fruit and coconut oil.
• Eat less of  Hot & Moist – such as mutton, ginger, spinach and sugar, and the least amount of  Hot & Dry – like chicken, eggs, garlic and onions.
• Drink a large glass of water rapidly for pain relief. This dilutes the stomach acid, flushing it into the duodenum, where it is neutralised;
• Eat frequent small meals, including well cooked white rice, yoghurt and cottage cheese.
• Eat vegetables such as carrots and broccoli occasionally.
• Allow hot beverages, like rooibos tea, to cool before drinking, to avoid triggering gastric discomfort.
• Avoid fried foods, tea, coffee, alcohol, chocolate, strong spices, animal fats, and carbonated drinks.
• Avoid eating and drinking at the same time. Take in fluids 30 minutes before or after a meal.

Other Lifestyle Advice

• Avoid lying down immediately after a meal.
• Wear loose, comfortable clothing.
• Avoid non-steroidal anti-inflammatory drugs (especially aspirin).
• Quit smoking.
• Practice slow and deep breathing exercises twice daily.
• Keep the colon clean by adopting a high-fibre diet. The use of a gentle and natural laxative is recommended monthly.
• Drink a glass of chilled milk to reduce discomfort caused by stomach acid.

Herbal Remedy

• Grind up two cardamom pods. Add 250ml of water. Boil for 15 minutes. Strain and drink three times daily.

Tibb Lifestyle Factors
Heartburn Associated with Qualities of Moistness:
Food and Drink

• Eat mostly Hot & Dry , such as chicken, avocado, bittergourd and chickpeas, and Cold & Dry like beef, potato, and yogurt.
• Eat the least amount of Hot & Moist , such as bread, pasta, sugar and bananas, and Cold & Moist  like squash, butter, cucumber and pears.
• Avoid triggers such as fatty or fried foods, tomato sauce, alcohol, chocolate, mint, garlic, onion, and caffeine, as these may make heartburn worse.
• Eat smaller meals.

Other Lifestyle Advice

• Avoid lying down immediately after a meal.
• Wear loose, comfortable clothing.
• Lose weight if overweight.
• Quit smoking.

Herbal Remedies

• Chew 5-6 basil leaves after meals.
• Chew a clove of garlic to lessen stomach discomfort.

What is High Cholesterol (Hypercholesterolaemia)? 
Hypercholesterolaemia is the presence of abnormally high levels in the blood of cholesterol and triglycerides (a type of fat in the blood used for energy) that can lead to obstruction of blood flow in the arteries. This inhibits blood flow to the brain, kidneys, genitals, heart and other areas of the body.  Cholesterol is considered high if it is greater than 5mmol/l.

Signs and Symptoms
High cholesterol has no symptoms. A blood test is the only way to detect whether you have it or not.

Complications 
Angina pectoris, transient Ishcaemic attacks (mini-strokes), deteriorating kidney function, low exercise tolerance, atherosclerosis and heart attack.

What Causes High Cholesterol?
Poor lifestyle behaviours such as physical inactivity and unhealthy diet are responsible for increasing LDL (“bad”) cholesterol and decreasing HDL (“good”) cholesterol levels in the blood. However, other factors such as genetic/ temperament may prevent the removal of LDL cholesterol from the blood, so causing the liver to produce too much cholesterol.
Risk factors include:

• Diet – An excessively cold diet, hydrogenated fats like margarine, processed and refined foods.
• Poor liver function.
• Low production of bile (in the gall bladder) which is produced by the liver to aid digestion of fats.
• Lack of Exercise – Regular physical exercise increases HDL levels, so assisting the removal of LDL.

The Tibb View on High Cholesterol
According to Tibb, high cholesterol results due to excessive coldness. This lack of heat impairs blood circulation and allows saturated fats to gather in the blood vessels. This results in fatty plaques being deposited inside the vessel walls. The arterial bore or lumen narrows, and this reduces blood circulation even further. The reduced blood circulation increases the risk of heart attacks and strokes.
Individuals with a melancholic dominant/sub-dominant temperament are innately more susceptible to developing high cholesterol due to their inherent cold and dry nature. However, due to a faulty diet and improper lifestyle, other temperaments can also develop high cholesterol. People with sanguinous temperaments, who indulge in over-eating and lead a sedentary lifestyle, may also develop high cholesterol. Phlegmatic individuals are also at risk, as they have innate qualities of coldness and sluggish metabolism linked to their temperament.

Management of High Cholesterol
Treatment and management is aimed at reducing the excess coldness with dryness associated with high cholesterol, by implementing Tibb Lifestyle Factors that will increase the quality of heat. This assists Physis in addressing both the symptoms, and the causes of high cholesterol.

Tibb Lifestyle Factors 
Food and Drink

• Eat mostly Hot & Moist  – such as olive oil, ginger, turmeric and spinach followed by  Hot & Dry  – like oily fish, chicken, celery and garlic.
• Eat less of  Cold & Moist  – such as cucumber, broccoli, milk, and sprouts and the least amount of  Cold & Dry  – like citrus fruit, yogurt and beef.
• Add fresh garlic to meals where appropriate. Garlic is commonly used in the management of conditions of the heart and circulatory system and is indicated for hypertension and high cholesterol. Other heating herbs and spices like chilli, turmeric and ginger should be added to meals. These help in lowering blood cholesterol and promoting better blood circulation.
• Avoid eating and drinking refrigerated foods and drinks. Allow the food to reach room temperature before consumption.
• Reduce the intake of red meat like beef. Chicken and oily fish like tuna and salmon are preferred.
• Include the following cholesterol lowering foods in your diet: almonds, bananas, garlic, oats, olive oil, salmon, and walnuts.
• Water soluble dietary fibre is important for reducing serum cholesterol. It is present in barley, brown rice, fruits, and oats.
• Use vegetable oils which are liquids at room temperature such as olive and flaxseed oil. Boiled/steamed/grilled chicken and fish should be preferred.
• Eat only raw unsalted nuts, especially pecan, almonds and walnuts. Almonds are rich in the amino acid arginine which has cholesterol-lowering properties.
• Reduce the amount of saturated fats and cholesterol-containing foods in your diet.  Saturated fats include coconut and palm oil. Eliminate hydrogenated fats and hardened fats such as margarine and butter.
• Avoid pork or pork-containing products, fried and fatty foods.
• Do not consume alcohol, cakes, candy, carbonated drinks, coffee, gravies, pies, processed or refined foods, refined carbohydrates, tea, tobacco or white bread.
• Drink at least 2 litres of warm water a day.

Other Lifestyle Advice

• Regular physical exercise such as brisk walking should be carried out several times weekly.
• Quit smoking as this contributes to the hardening of the arteries.

Herbal Remedies

• Turmeric – Add ¼ to ½ tsp to rice or couscous.
• Mix ¼ teaspoon red chillies, ½ teaspoon ginger root, 3 black pepper and 4 garlic cloves as chutney.

Take this with meals 3 times a day.

• Take 1tbsp psyllium husk/whole seeds mixed in 1 cup of water.
• Make an infusion using 2tsp fennel seed with 20 mint leaves in 1 cup of boiling water.

What is the Human Immunodeficiency Virus (HIV)? 
The HI Virus weakens the immune system by targeting CD4 Lymphocytes (White Blood Cells) also called T-Helper Cells.  This will result in antibodies to the virus being present in the blood of persons who are identified as being HIV + (positive).  This virus may take many years to damage the immune system resulting in AIDS.
Types of HIV
There are 2 types transmitted in exactly the same way:

• HIV-1 – This is the worldwide predominant type
• HIV-2 – Found mainly in West Africa; less easily transmitted and the period between initial infection and illness is longer.

What is Acquired Immune Deficiency Syndrome (AIDS)
AIDS is a term used for a group of diseases that results from a weakened immune system.  A person is identified as having Aids when their CD4 count is less than 200/ml blood.

How is HIV spread? 
Risk factors for the transmission of HIV includes having unprotected sex with multiple partners; Sharing needles and syringes with drug users may also expose individuals to the blood of other infected people; A pre-existing STI – may cause open wounds and sore on the genital region which may act as an entryway for HIV.

Signs and Symptoms 
Sore throat (coldness with moistness); mouth ulcers (moistness); diarrhea (moistness); thrush (moistness); weight loss (coldness with dryness); fever and night sweats (hot & dry); dry cough (dryness); shortness of breath (dryness); swollen glands (TB – heat; weight loss (heat towards dryness); infections due to weak immunity; recurrent herpes infections; recurrent bacterial infections; and genital ulcers.

The Tibb View on HIV & AIDS
Tibb recognizes that an immune system compromised with the HI Virus, will result in signs and symptoms related to the HI Virus and/or AIDS.  Tibb does not attempt to eliminate the HI Virus, but rather to boost the person’s immune system and thereby assist the body in staying healthy and delaying the symptoms of HIV and AIDS.  According to Tibb the temperament of a person influences what symptoms the HIV positive person will most likely be affected with.  For example a person with a dominant/sub-dominant bilious temperament, will most likely suffer with symptoms associated with qualities of heat and dryness, including a dry cough, swollen glands, night sweats, and tuberculosis.  Similarly persons with a dominant/sub-dominant phlegmatic temperament will be inclined to symptoms of vomiting, diarrhea, weight loss and thrush as these symptoms are associated with qualities of moistness (and or cold).
Because of the increase moistness associated with the phlegmatic temperamental combination, these individuals are more likely to develop AIDS related infections as their moist temperament increases the risk of infections.
As Tibb takes into account the influence of a person’s temperament in HIV & AIDS, treatment cannot be the same for all HIV & AIDS patients.

Management of HIV & AIDS
Treatment and management is aimed at reducing the excess qualities associated with HIV & AIDS, by implementing Tibb Lifestyle Factors that will either increase the qualities of heat and dryness in patients with symptoms of excess moistness with coldness, and coldness and moistness in patients with symptoms of excess heat with dryness. This will assist Physis in addressing both the symptoms, and the causes of HIV & AIDS.  Tibb Lifestyle Factors will also benefit people who are on ARV medication.

Tibb Lifestyle Factors 
HIV associated with Qualities of Moistness with Coldness:
Food and Drink

• Eat mostly Hot & Dry – such as egg, chicken, garlic and cinnamon, followed by  Cold & Dry – like beef, tripe, cabbage, potatoes, beans and mealie meal.
• Eat less of Hot & Moist – such as white flour products, sugar, banana and cheese, and the least amount of  Cold & Moist – rice, squash, butter and milk.
• Sip hot chicken, beef or mutton soup with added garlic, ginger, black pepper and salt for three days;
• Avoid dairy products, margarine, fried foods and all sugars;
• Drink at least 2 litres of room temperature or warm water per day
• Eat plenty of in season fruit and vegetables per day
• Avoid refined carbohydrates such as sugar and white bread. Choose whole wheat options instead.

Other Lifestyle Advice 

• Remain as active as possible. A brisk walk or any type of moderate exercise should be done on a daily basis.
• Wash your hands often. Viruses can survive for several hours on your hands, tissues or hard surfaces.

Herbal Remedy

• 2 grams fenugreek seeds, 1 gram cinnamon, 1 gram cloves, 2 grams fresh ginger. Boil in 2 cups of water until 1 cup remains. Strain and mix 2 tsp of honey and drink. Drink daily

HIV associated with Qualities of Heat with Dryness:
Food and Drink

• Eat mostly Cold & Moist – such as rice, cucumber, lettuce and carrots, followed by Cold & Dry – like yogurt, citrus fruit, beans and potato.
• Eat less of Hot & Moist – such as white flour products, sugar, cheese and salt, and the least amount of Hot & Dry – like eggs, garlic alcohol and onions.
• Avoid heavily spiced, fried or grilled foods;
• Avoid sugary and refined foods;
• Drink plenty of fluids. Herbal teas and soups are good choices.
• Avoid mucous forming foods such as dairy products, processed foods, sugar, sweet fruits, and white flour;

Other Lifestyle Advice 

• Do not smoke and avoid second hand smoke. Cigarette smoke is very harmful.
• Add moisture to the air by using a humidifier or vapourizer.
• Avoid strenuous exercise until recovery.
• Rest in bed in the early stages, when the fever is present. Once the fever subsides and you are feeling better, alternative periods of rest with periods of moderate activity to prevent secretions settling in the lungs.
• Do not swallow mucous.

 
Herbal Remedy

• Make an infusion with 1 tsp of Sage and 3tsp of Chamomile tea in 1 cup of boiling water.

What is Hypertension?
Hypertension, commonly known as high blood pressure is the force needed by the heart to pumps blood through the blood vessels in order to deliver essential nutrients to all parts of the body.
The factors that influence blood pressure include: the volume of the blood in circulation; resistance to blood flow by the walls of the blood vessels; and the strength of the heart.
Normal Blood Pressure is 120/80 mmHg, systolic/diastolic. These figures vary according to age and gender, and fluctuate markedly throughout the day.

What is High Blood Pressure? 
High blood pressure, or hypertension, results if the blood pressure rises above the range which is normal for the person, and stays there for some time. This can cause severe, even deadly, damage to several body organs if it not reduced.
Hypertension can be classified in different levels:

Types of High Blood Pressure

• Primary Hypertension 
• Resistance Hypertension 

Primary Hypertension 
Signs and Symptoms 
Constant headache mostly in the temple region: redness and heaviness in the eyes; dizziness; and bleeding from the nose and gums.

Resistance Hypertension 
Signs and Symptoms 
Constant headache at the back of the head; tightness in the neck muscles; muscle cramps in the legs; and shortness of breath.

Complications of High Blood Pressure
Creates strain on the heart; weakens the walls of the arteries; increased risk of heart attack or stroke; and kidney failure.

What causes Hypertension?  
As a person grows older, a poor diet, lack of exercise and being overweight lead to an increase in the volume of blood in circulation (blood volume). This results in the more common type of hypertension known as Primary or Essential Hypertension.
Another form of hypertension arises from increased resistance developing in the blood vessels, due to a hardening and narrowing of the arteries due to fibrous and fatty deposits, or arteriosclerosis. This form is known as Resistance Hypertension.
Hypertension can also result from other causes, such as kidney disease, a number of tumours, and certain conventional medications.

The Tibb view of Hypertension 
Tibb medicine clearly identifies the two different types of hypertension from the causes and also the symptoms associated with each type.
Primary hypertension results from an increase in blood volume either from an excess of moistness and/or heat, caused from poor lifestyle, especially being overweight and lack of exercise.  This hypertension is more prevalent in persons with a dominant/sub-dominant sanguinous temperament as they have qualities of heat/moistness.
Resistance hypertension also results from poor lifestyle especially from an excess of cold and dry foods such as beef and fish, which leads to a buildup of plaque in the arteries.  Persons with a dominant/sub-dominant melancholic temperament will be more predisposed to this type of hypertension as their temperament has qualities of coldness/dryness

Management of Hypertension
Treatment and management is aimed at reducing the excess qualities associated with high blood pressure, by implementing Tibb Lifestyle Factors that will increase the qualities of coldness and dryness in people with primary hypertension, and increase the qualities of heat and moistness in people with resistance hypertension.
This assists Physis in addressing both the symptoms, and the causes of both forms of hypertension.

Tibb Lifestyle Factors
Primary Hypertension Associated with Qualities of Heat and Moistness:
Food and Drink

• Eat mostly Cold & Dry – such as beef, fish, cauliflower and mushrooms, followed by Hot & Dry – like bittergourd, avocado, chickpeas and garlic.
• Eat less of Cold & Moist – such as carrots, pumpkin, rice and coriander, and the least of Hot & Moist  – like bread, pasta, bananas, salt and wheat cereals.
• Good advice is to eat more skinless chicken, fish and vegetable proteins such as legumes. Also generally more fruits and vegetables, such as apples, cabbage, eggplant, garlic, grapefruit, green leafy vegetables, peas, prunes, raisons, and sweet potato.
• Avoid salty and sweet foods and drinks, and limit overall salt intake. Reduce consumption of animal fats such as bacon, beef, chicken liver, corned beef, dairy products, pork, sausages and smoked and processed meats. Avoid hydrogenated and hardened fats such as margarine and lard. Cut down on alcoholic drinks, cakes, candy, fizzy drinks, coffee, pies, processed or refined foods, tea, tobacco, coffee or white bread.
• Drink fresh “live” juices, especially those containing celery, citrus fruits and parsley.
• Add two tbsp of flaxseed oil to meals daily.

 Other Lifestyle Advice

• Commit to exercising regularly, and becoming more physically active generally. Brisk walking, cycling, jogging are usually effective.
• Give up or cut down smoking.

Herbal Remedies

• Add two tbsp of flaxseed oil to meals daily.
• Sprinkle freshly chopped garlic over foods and salads.  Try to eat two to three cloves per day.

Note: do not discontinue the use of conventional medication, without consulting your practitioner. 

Tibb Lifestyle Factors
Resistance Hypertension Associated with Qualities of Coldness and Dryness:
Food and Drink

• Eat mostly Hot & Moist – such as banana, sweet potato, and brown bread, followed by Cold & Moist – like butternut, carrots, pumpkin and pears.
• Eat less of Hot & Dry  – such as avocado, garlic, onion and chickpeas and the least amount of Cold & Dry  – like beef, tomato, beans and mealie meal.
• Reduce the intake of red meat like beef and lamb. Chicken and oily fish like salmon should be preferred instead.
• Add fresh garlic to meals. Garlic is commonly used in the management of conditions of the heart and circulatory system and is effective in reducing high blood pressure and raised cholesterol levels.
• Include heating spices like chilli, turmeric and ginger in meals. These herbs help to lower blood cholesterol and promote better blood circulation.
• Avoid eating and drinking refrigerated foods and drinks. Consume food at room temperature or above.

Other Lifestyle Advice

• Give up or cut down smoking. Counseling, nicotine patches and e-cigarettes are effective ways of doing so. Practice deep breathing exercises daily. This usually helps to reduce stress and so lower blood pressure.

Herbal Remedies

• Green Tea helps to reduce raised blood pressure. Also an infusion with 1tsp yarrow, and 1tsp Green Tea in a cup of boiling water, strained and drunk hot.
• Sprinkle freshly chopped garlic over foods and salads.  Try to take in two or three cloves a day.
• Mix ¼ teaspoon red chilies, ½ teaspoon ginger root, 3 black pepper and 4 garlic cloves as chutney. This should be taken with meals three times a day.

Note: do not discontinue the use of conventional medication, without consulting your practitioner. 

Signs and Symptoms
Recurrent infections of the respiratory and gastrointestinal systems; boils and other skin infections; swollen glands in the neck; fevers.

Causes and Risk Factors 
The immune response can be suppressed or compromised due to the influence of a number of internal and external factors, such as emotional stress; lack of sleep; excessive physical activity; poor dietary habits (including excessive fat and refined sugar intake, inadequate amounts of dietary fibre, protein and water; alcohol abuse; the use of certain medications like steroids; and exposure to chemicals or radiation.

The Tibb view on Immune Boosting
According to Tibb, a person’s temperament determines which signs and symptoms appear as the result of compromised immune system. Ailments such as respiratory infections and swollen glands are linked to coldness with moistness. These are associated with a dominant or sub-dominant phlegmatic temperament. Ailments like high fevers, inflammatory disorders and boils are linked with heat with dryness. These are associated with a dominant or sub-dominant bilious temperament. All temperamental types can be affected with compromised immune system.

Management of Immune Boosting 
Tibb accepts that a person’s temperament will determine the outcome of treatment for ailments linked to a compromised immune system. The Tibb approach to boost the immune system is aimed at supporting Physis with appropriate lifestyle to maintain homeostasis. Management includes the elimination of toxins from the person’s body by means of a detoxification programme. The elimination process is supported by a correct diet. Once the person’s body has been effectively cleansed, a specific diet and lifestyle are selected which suites a person’s temperament. Special attention should be given to foods with high nutritious value.

Tibb Lifestyle Factors 
Food and Drink

• Phlegmatic temperament – eat mostly Hot & Dry  – such as garlic, onion, fenugreek and mustard, followed by Hot & Moist – like mutton, ginger, turmeric and black pepper, and Cold & Dry – such as  citrus fruit, beans, yogurt and mealie meal and the least amount of Cold & Moist  – like milk, rice, cucumber and watermelon.
• Sanguinous Temperament – eat mostly Cold & Dry  – such as yogurt, citrus fruit, legumes and basil followed by Cold & Moist – like coriander, rice, beetroot and broccoli, and Hot & Dry – such as garlic, onion, chicken and eggs,  and the least amount of Hot & Moist  – like white flour products, sugar, cheese and bananas.
• Melancholic Temperament – eat mostly Hot & Moist  – such as ginger, olive oil, turmeric and honey, followed by Hot & Dry – like garlic, onion, chicken and eggs,   and Cold & Moist – such as coriander, rice, beetroot and broccoli and the least amount of Cold & Dry  – like yogurt, citrus fruit, legumes and tomatoes.
• Bilious Temperament – eat mostly Cold & Moist  – such as rice, coriander, cucumber and beetroot, followed by Cold & Dry – like citrus fruit, beans, yogurt and mealie meal, and Hot & Moist – such as ginger, olive oil, turmeric and honey, and the least amount of Hot & Dry  – like onion, eggs, alcohol and garlic.

Other Lifestyle Advice

• People with a dominant/sub-dominant phlegmatic/sanguinous temperament should partake in regular moderate physical activity. This increases body heat levels which will counter the build-up of moistness which is responsible for compromising their immunity.
• People with dominant/sub-dominant bilious/melancholic temperament should practice regular mind/body techniques. These reduce stress and tension, which are known to suppress immunity.
• All temperaments should assist elimination by following a suitable detox programme, possibly supported by a mild, gentle laxative.
• People with suppressed immunity should practice sleep hygiene to ensure good quality sleep.

Herbal Remedies

• People with a sanguinous/phlegmatic temperament: 2 grams fenugreek seeds, 1 gram cinnamon, 1 gram cloves, 2 grams fresh ginger. Boil in 2 cups of water until 1 cup remains. Strain and mix 2 tsp of honey and drink. Repeat the same three times a day.
• People with bilious temperaments: recommended to drink a glass of milk daily.
• People with a melancholic temperament: consume ginger and honey tea: Grate 2 cm piece of ginger to a pot of 2 cups of water. Bring ginger and water to a boil. Add 1tbsp of honey and drink while hot.

What is Indigestion?
Indigestion, also known as dyspepsia, describes an upset stomach characterized by discomfort in the upper abdomen.

Signs and Symptoms 
Abdominal pain; feeling bloated; intestinal gas build-up; rumbling noise in the abdomen; belching; nausea (sometimes retching or vomiting); abdominal discomfort and fullness after eating; and a burning sensation in the upper abdomen.

What Causes Indigestion? 
Indigestion is often caused by unhealthy lifestyle behaviour, which include: overeating; eating too quickly; eating spicy, greasy, carbohydrate-rich or fatty foods to excess; smoking; excessive intake of caffeine, alcohol, chocolate or carbonated beverages; underlying anxiety; swallowing air due to faulty eating habits; talking while chewing; eating and drinking at the same time; consuming cold foods like dairy and products; consuming gas-producing foods.
Certain medications like antibiotics, pain killers and iron supplements may cause indigestion. It is often a symptom of other ailments such as: constipation, gastritis, peptic ulcers, coeliac disease and inflammation of the pancreas.

The Tibb View on Indigestion
Any food which is not digested properly ferments in the intestines. This produces the gases hydrogen and carbon dioxide. Psychological factors such as stress and anger can disturb the mechanisms that control contractions of the stomach and intestinal muscles. A lack of digestive enzymes in the gut can also cause intestinal problems. Indigestion may be a symptom of imbalance in the stomach or the intestines, mostly due to reduced digestive heat. As there are so many possible causes associated with indigestion, including poor eating habits, a faulty lifestyle and certain medications, it can affect people of all temperamental types.

Management of Indigestion
Treatment and management is aimed at reducing the qualities associated with the person’s temperament, by implementing a lifestyle, especially diet, that is best suited for the different temperaments. This assists Physis in addressing both the symptoms and the causes of indigestion.

Tibb Lifestyle Factors
Food and Drink

• Phlegmatic temperament – eat mostly Hot & Dry  – such as garlic, onion, fenugreek and mustard, followed by Hot & Moist – like mutton, ginger, turmeric and black pepper, and Cold & Dry – such as  citrus fruit, basil, yogurt and mealie meal and the least amount of Cold & Moist  – like milk, rice, cucumber and watermelon.
• Sanguinous Temperament – eat mostly Cold & Dry  – such as yogurt, citrus fruit, beef and basil followed by Cold & Moist – like coriander, rice, beetroot and broccoli, and Hot & Dry – such as garlic, onion, chicken and eggs,  and the least amount of Hot & Moist  – like white flour products, sugar, cheese and bananas.
• Melancholic Temperament – eat mostly Hot & Moist  – such as ginger, olive oil, turmeric and honey, followed by Hot & Dry – like garlic, onion, chicken and eggs,   and Cold & Moist – such as coriander, rice, beetroot and broccoli and the least amount of Cold & Dry  – like yogurt, citrus fruit, legumes and tomatoes.
• Bilious Temperament – eat mostly Cold & Moist  – such as rice, coriander, cucumber and beetroot, followed by Cold & Dry – like citrus fruit, basil, yogurt and mealie meal, and Hot & Moist – such as ginger, olive oil, turmeric and honey, and the least amount of Hot & Dry  – like onion, eggs, alcohol and garlic.

Dietary advice to be followed by all temperamental types

• Consume well-balanced meals containing fibre-rich foods such as fresh fruit, vegetables and whole-grains.
• Eat slowly, and chew the food well and thoroughly.
• Avoid drinking liquids during meals, as this prevents proper digestion. The drink dilutes the digestive stomach juices.
• Avoid lentils, peanuts and soybeans, because they ferment and produce intestinal gas. They also contain an inhibitor of gut digestive enzymes.
• Avoid junk food, bakery products, caffeine, fizzy drinks, citrus juices, fried and fatty foods, pastas, potato chips and other snack foods; red meat, tomatoes, processed foods, and salty or spicy foods.
• Avoid foods containing sugar and simple carbohydrates (white flour products). Concentrate on complex carbohydrates such as whole grain or brown products.
• Eat smaller meals and more frequently.

Other Lifestyle Advice

• Avoid eating when upset, overtired or exhausted.
• Avoid constipation by regularly use of a mild natural laxative.
• Partake in regular moderate exercise, as this increases body heat and so promotes better digestion.

Herbal Remedies

• Drink a ¼ cup aloe vera juice on an empty stomach, first thing in the morning and last thing at night.
• Boil the following in 200ml of water until 100ml remain: ½ tsp fennel seeds, ½ tsp fenugreek powder, about 10 mint leaves, small piece of fresh ginger, and ½ tsp of aniseed. Strain and mix with honey. Drink three to four times per day.

What is Infantile Colic? 
Colic is usually defined as the situation where an otherwise well-fed, healthy baby cries for more than three hours a day, at least three times weekly, for more than three weeks.

Signs and Symptoms 
During a colic episode the baby cries at the same time every day, usually in the late afternoon or evening; crying may be intense and inconsolable; changes in posture may be evident, such as curled up legs, clenched fist and tensed abdominal muscles.

What Causes Infantile Colic? 
The exact cause of colic remains unknown. However, many digestive system complaints have been linked to infantile colic. These include constipation, diarrhoea, acid reflux, indigestion, lactose intolerance and flatulence.

The Tibb View on Infantile Colic
According to Tibb, Colic is associated with qualities of coldness and moistness. This results in an immature digestive process, with improper digestion of milk and other foods. Heat is needed to facilitate the proper functioning of digestion, as the excessive coldness associated with colic decreases the heat available. Infantile colic can affect infants of all temperaments.

Management of Colic
Treatment and management is aimed at reducing the excess coldness and moistness associated with colic, by implementing Tibb Lifestyle Factors that will increase the qualities of heat.  This assists Physis in addressing both the symptoms and the causes of infantile colic.

Tibb Lifestyle Advice 

• Feeding: Breast milk is preferable, unless the infant is lactose intolerant.
• Abdominal massage: This should be practiced as often as possible, especially before crying episodes are expected. The massage should follow a clockwise motion, starting on the right lower abdomen. The use grape seed oil or olive oil for the massage is advised.
• Baby exercises: Gently move the legs around in a bicycle motion. Raise both knees to meet the chest whilst the infant lies down. This assists the movement of faeces or gas along the digestive tract.
• Routine: A sleep and eating routine is advised to ensure that the infant is getting the necessary amount of sleep and food for his/her age.

What is Insomnia?
Insomnia is a sleep disorder that makes falling asleep, staying asleep or both difficult, waking up too early or experience poor sleep quality, leaving you feeling unrefreshed and having low energy.

Signs and Symptoms
Difficulty falling asleep at night; difficulty staying asleep during the night; waking up too early; feeling unrefreshed and not rested after a night’s sleep; lack of physical or mental energy; feeling tired and sleepy during the day; irritability, depression, anxiety; lack of concentration and memory problems; and tension headaches.

What Causes Insomnia? 
A number of factors that contributes towards insomnia. Common ones include: Psychological: Mental or physical stress, especially anxiety and depression; Medical Conditions: over-active thyroid, acid reflux, chronic pain, arthritis and frequent urination. Poor sleep hygiene: Mental overstimulation at night, for example from reading books or watching TV; an inappropriate or unsuitable sleep environment; using the bed for activities other than sleep or sex. Medication: Regular use of certain antidepressants, anti-histamines, Ritalin, steroids and nasal decongestants.  Stimulants: Caffeine, nicotine, and alcohol; certain foods and drinks; eating before bedtime or eating a big meal at supper time.
Insomnia is also more prevalent with increasing age, as there is a shift in quality towards dryness.

The Tibb View on Insomnia 
According to Tibb philosophy the quality associated with the brain is moistness. This is essential for the proper conduction of electrical impulses. Insomnia is associated with an excess of dryness in the body, especially that of the brain and its nerve pathways. If the weather and living environment are predominantly dry; if there is an excessive intake of spicy foods, meat; or if a hight level of mental stress from active thinking at night time exists, then insomnia is most likely to develop. Consuming coffee and caffeinated tea late in the day increases dryness in the body, and these habits predispose the person to insomnia. Although everybody will experiences bouts of insomnia sometime in their lifetime, people with a dominant/sub-dominant melancholic or bilious temperaments are most predisposed to it, due to their inherent dominance of dryness.

Management of Insomnia 
Treatment and management is aimed at reducing the excess dryness associated with insomnia, by implementing Tibb Lifestyle Factors that will increase the quality of moistness. This assists Physis in addressing both the symptoms and the causes of insomnia.

Tibb Lifestyle Factors 
Food and Drink

• Eat mostly Hot & Moist  – such as banana, sweet potato, and brown bread, followed by Cold & Moist  – like butternut, carrots, pumpkin and pears.
• Eat less of  Hot & Dry  – such as avocado, garlic, onion and chickpeas, and the least amount of Cold & Dry  – like beef, tomato, beans and mealie meal.
• Eat a light supper at least three hours before going to bed.
• Avoid alcohol, tea, coffee and tobacco and spicy foods in the late afternoon and evening.
• In the evenings eat bananas, figs, dates, milk, and whole grain crackers. These foods are high in the essential amino acid tryptophan which promotes sleep.
• Avoid bacon, cheese, chocolates, eggplant, potato, sausages, tomatoes and wine close to bedtime. These foods contain the chemical tyramine, which increases the release of nor-epinephrine, a brain stimulant.
• Eat carrots, cucumber and lettuce with plain yogurt in a salad.

Other Lifestyle Advice 

• A small amount of alcohol can help induce sleep initially, but invariably disrupts sleep cycles later. While smoking may seem to have a calming effect, nicotine is actually a neuro-stimulant, and can cause sleep problems.
• Avoid taking nasal decongestants late in the day
• Establish a set of habits and follow them consistently to establish healthy sleep cycle.
• Go to bed only when you are sleepy.
• Do not stay in bed if you are not sleepy. Better to get up and read, watch TV, or do something quietly until you are feeling really sleepy.
• Use the bedroom only for sleep and sex, not for iPhones, tablets, reading, working, eating, or watching TV.
• Keep a regular sleep-wake cycle. Try to go to bed and wake up at the same time every day.
• Set an alarm clock and get out of bed at the same time every morning, no matter how you slept during the night. Once normal sleep patterns are re-established, there may be no need for an alarm clock.
• Sleep in a dark, quiet room with a comfortable temperature.
• Do not nap in the afternoon if this isn’t a normal thing for you to do. Avoid napping, especially later than later afternoon.
• Keep the bedroom comfortable and quiet. If the room is too quiet, a running fan or quiet background music helps.
• Exercise regularly in the late afternoon or early evening, but not within 2 hours of bedtime. Physical exertion is an excellent way to tire the body, so sleep comes about more easily. Exercising five to six hours before bedtime can help you sleep more soundly.
• Breathe: inhale through left nostril slowly, hold for as long as possible, and breathe out through the mouth slowly. Repeat 5 times.
• Empty the bladder immediately before going to bed.
• Take a hot bath one hour or two before bedtime. For further relaxation, put several drops of soothing essential oils such as lavender or camomile in the bath water.
• Learn to put worries out of your mind by practicing meditation or visualisation.

Herbal Remedies
Drink 1 cup warm milk with 1tsp honey and two pinches of nutmeg powder, 30 minutes before bedtime.
Apply lavender oil to the soles of the feet.

What are Kidney Stones? 
Kidney stones (renal lithiasis) are small, hard deposits that form inside the kidneys. The stones are made of mineral and insoluble organic salts. They develop due to several causes, and appear in the urinary tract, mainly in the kidneys, but also in the bladder and ureters.

Signs and Symptoms 
Severe stabbing pains, occurring in waves which usually last 20 to 30 minutes; nausea/vomiting; fever; painful urination; blood appearing in the urine. The pain is located in the back or between ribs and hips.

What Causes Kidney Stones? 
No single cause is evident for the development of kidney stones.
Several factors increase the risk of developing kidney stones: Consumption of calcium-rich food and drink over time; alkaline urine, which encourages solid calcium salt formation; low water intake; living in a hot climate; repeated kidney infections.
The formation of crystals in the urinary tract results in the onset of inflammation, which leads to pain.

The Tibb View on Kidney Stones
According to Tibb, kidney stones are associated with qualities of dryness with coldness, as calcium deposits collect and harden to form stones. This dryness with cold often results from an improper lifestyle, such as a low water intake. People with the melancholic dominant or sub-dominant temperament are most likely to develop kidney stones, due to their innate dominance of dryness. However, people with other temperamental types are also at risk of kidney stones due to a poor lifestyle, especially from a faulty diet and low fluid intake.

Management of Kidney Stones
Treatment and management is aimed at reducing the excess dryness with cold qualities associated with kidney stones, by implementing Tibb Lifestyle Factors that will increase the qualities of heat and moistness. This assists Physis in addressing both the symptoms and causes of kidney stones.

Tibb Lifestyle Factors 
Food and Drink

• Eat mostly Hot & Moist , such as banana, sweet potato, and brown bread, followed by Cold & Moist  like butternut, carrots, pumpkin and pears.
• Eat less of Hot & Dry  such as avocado, garlic, onion and chickpeas, and the least amount of Cold & Dry  – like beef, tomato, beans and mealie meal.
• Drink plenty of warm water.
• Calcium-rich foods like dairy products (cheese, cream, and butter), fish (sardines, pilchards and anchovies) and animal protein should be selected.
• Restrict the intake of refined sugars, fructose (especially corn syrup), cola drinks and apple juice.
• Decrease the intake of spinach, strawberries, nuts, rhubarb, wheat germ, dark chocolate and tea.
• Excessive alcohol intake leads to dehydration, so cutting down should help sufferers from kidney stones.

Herbal Remedy

Sip an infusion made from four tbsp fennel seeds in one litre of boiling water.

What is Menopause? 
Menopause is the permanent end of menstruation and fertility. It is defined as occurring 12 months after your last menstrual period. Menopause usually happens between the ages of 40 and 55 years of age.

Signs and Symptoms 
The monthly periods have stopped or has become increasingly irregular; hot flashes and night sweats; headaches; heart palpitations; dizziness; mood swings; anxiety; depressed mood; insomnia; irritability; dry skin; frequent urination; dryness of the vagina, with discomfort and painful intercourse; physical and mental fatigue; noticeable decrease interest in sex, or reduced libido; breast tenderness; a reduced ‘zest for life’, with little enthusiasm for exercise, hobbies, social events, etc.

Complications 
After menopause, the risk of certain medical disorders increases. Examples include: heart and blood vessel disease; urinary incontinence; osteoporosis; weight gain

What Causes Menopause? 
Once a woman reaches a certain age, usually between 40 and 55 years, major changes to her hormones begin. These result in the ovaries failing to produce eggs every four weeks or so. The monthly periods stop, and hormone levels in the body fluctuate markedly. These changes may occur suddenly, or develop slowly over several months. Many of the symptoms of the menopause are the direct result of these hormonal changes.

The Tibb View on Menopause
According to Tibb, menopausal symptoms are associated with qualities of heat with dryness. Women are innately moist, but as women get older they lose moistness and progress towards dryness. This is evident when the levels of estrogens decrease in preparation of cessation of ovulation. This results in hot flashes, dry skin, vaginal dryness and increased anxiety, amongst other.  Women with a bilious dominant/sub-dominant temperament will most likely suffer with more severe symptoms of menopause due to their innate qualities of heat and dryness.

Management of Menopause
Treatment and management is aimed at reducing the excess heat with dryness associated with menopause, by implementing Tibb Lifestyle Factors that will increase the qualities of coldness and moistness. This assists Physis in addressing both the symptoms and the causes of menopausal.

Tibb Lifestyle Factors 
Food and Drink 

• Eat mostly Cold & Moist – such as cucumber, milk, soybeans, carrots and watermelon,followed by Cold & Dry – like yogurt, beans, and citrus fruit.
• Eat less Hot & Moist – such as dates, mangoes, mutton and sugar, and the least amount of Hot & Dry – like chicken, eggs, garlic and onion.
• Consume more fresh fruits, vegetables, and high fibre, whole grain products. Eat alfalfa, soybeans, soy sprouts, crushed flaxseeds, green beans, sesame seeds, wheat, pumpkin seeds, cucumbers, corn, apples, anise seeds, cabbage, beets, olive oil, olives, papaya, oats, peas, and sunflower seeds. These are all important sources of natural estrogen.
• Avoid red meats (beef, pork, liver etc.), fatty foods as well as processed foods (sausage, bacon, etc.).
• Cut down on chocolate, fried foods, caffeine beverages, cold drinks, and alcohol intake.

Other Lifestyle Advice 

• Breathing exercises: Tibb deep breathing exercises lower irritability and anxiety, and dampen mood swings
• Physical exercise: Any form of regular light/moderate exercise, such as walking in the morning or evenings, helps to alleviate symptoms. It boosts mood, reduces emotional stress, helps control appetite and regulate blood sugar levels. Strenuous physical activity should be avoided.
• Sleep: Active measures should be taken to ensure a regular good night sleep.
• Relaxation: Emotions like anger and excitement should be avoided, and any niggling worries resolved. A journal should be kept in which the events and activities of the day are recoded, including worries and stressors.
• Meditation: Tibb meditation exercises should be practiced for at least five minutes early morning daily, and at bedtime.
• Detox: A short monthly fruit or vegetable fast is advised.

Herbal Remedy

Vaginal Dryness lotion: Mix 30ml of almond oil, two drops of geranium essential oil, one capsule (1,000 IU) of Vitamin E. Apply inside and outside the vagina twice a day.

What is Menorrhagia? 
Menorrhagia describes abnormally heavy menstrual bleeding which requires you to change you sanitary pad at least once every hour.

What is Polymenorrhoea? 
Polymenorrhoea refers to an abnormally long menstrual period. Intervals between periods are less than 23 days. The intensity of menstrual bleeding is often normal.

Signs and Symptoms 
Bleeding through one or more sanitary pads or tampons every hour for several consecutive hours; the use of double sanitary pads to avoid bleeding through; getting up at night to change sanitary pads; passing large blood clots with menstrual flow; restricting daily activities due to heavy menstrual flow; symptoms of anemia, such as tiredness, fatigue or shortness of breath; and bleeding that last for more than a week.

Causes and Risk Factors 
Menorrhagia may arise either from a disturbance of the normal hormonal pattern, or from a physical abnormality of the uterus, such as a congenital defect or from the presence of fibroids (fibromyomata) or polyps. Fibroids are benign tumours composed of fibrous tissue and smooth muscle which develop in the wall of the uterus, usually close to the inner cavity. Polyps are groups of cells that form the endometrium, which are normally flushed out during a period. These bundles of cells remain in the uterus, develop a stalk, and attach to the inner uterine cavity.
Menorrhagia may occur from the use of an intrauterine device, or as a side effect of drugs which inhibit blood clotting. Teenage girls who have recently started menstruating and older women approaching menopause are most likely to develop heavy or prolonged bleeding.

The Tibb View of Menorrhagia and Polymenorrhoea
According to Tibb, these menstrual disorders are associated mostly with excessive heat and is aggravated by a lifestyle that promotes heat like stress, anger, hot and spicy foods and a hot environment. People with a Bilious dominant or subdominant temperament are more predisposed to develop menstrual disorders due to an excess of heat.

Management of  Menorrhagia and Polymenorrhoea

Management is aimed at either reducing the excess heat associated with menorrhagia and polymenorrhoea, by implementing Tibb Lifestyle Factors that will increase the qualities of coldness. This assists Physis in addressing both the symptoms and the causes of menorrhagia and polymenorrhoea.

Tibb Lifestyle Factors
Food and Drink

• Eat mostly Cold & Moist – such as rice, cucumber, lettuce and carrots, followed by  Cold & Dry  – like yogurt, citrus fruit, beans and beef.
• Eat less of  Hot & Moist – such as white flour products, sugar, cheese and salt, and the least amount of Hot & Dry – like eggs, chicken, garlic and alcohol.
• Eat a well balanced diet consisting of 50% raw fruits and vegetables, whole grains, raw nuts and seeds, and fish.
• Eat apricots, prunes, papaya, asparagus, avocado, banana, and broccoli.
• Consume soured products like sour milk, yogurt and cottage cheese.
• Avoid coffee, tea and carbonated beverages.
• Drink two to three litres of water daily.
• Avoid heavily spiced foods and alcohol.

Other Lifestyle Advice

• Ensure you get an adequate nights rest by practicing good sleep habits.
• Do light to moderate exercise daily like walking and swimming. Do not partake in excessive/strenuous activities.
• Practice slow and deep breathing exercises in the morning and before retiring to bed at night.

Herbal Remedy

• Take 4 tbsp of flax seeds. Soak them in 1 cup of water overnight. Strain and drink this water the next morning.

What are Muscle Pains and Cramps?
Almost everybody suffers with muscles pains and cramps, but these usually resolve within a few days. However, sometimes they can last for much longer. Muscle pain (myalgia) ranges from mild to severe, and can affect any part of the body, especially the legs, back, arms and neck.

Signs and Symptoms 
Sudden muscle cramp, especially of the legs during sleep; muscle pain or soreness, especially after exercise; and a muscle strain which may last several days.

What Causes Muscle Pains and Cramps
The most common causes of muscle pain are tension, stress, overuse, and minor injuries. Muscle cramps may occur because of disharmony in the skeletal muscles, often due to deficiency of mineral like calcium. People taking the conventional drugs statins to reduce high cholesterol often complain about muscle pain. Lactic acid build-up from over-exercising can also result in muscle pain.

The Tibb View of Muscle Pains and Cramps
According to Tibb, muscle pain and cramp is associated with qualities of dryness with cold. Chronic muscle pain may result when the person’s skeletal muscle is overused. This overuse increases the quality of heat, which over time increases dryness and eventually cold. Insufficient heat due to decreased blood supply to the muscles can result in chronic inflammation of the muscles. When blood flow to the skeletal muscle is impaired, pain usually results. Although all temperamental types can be affected with muscle pain and cramps, people with a melancholic dominant/sub-dominant temperament are more at risk due to their innate qualities of coldness and dryness.

Management of Muscle Pain and Cramps
Management is aimed at reducing the excess dryness with cold qualities associated with muscle pain and cramp, by implementing Tibb Lifestyle Factors that will increase the qualities of heat and moistness. This assists Physis in addressing both the symptoms and the causes of muscle pains and cramps.

Tibb Lifestyle Factors 
Food and Drink

• Eat mostly Hot & Moist , such as banana, sweet potato, and brown bread, followed by Cold & Moist  like butternut, carrots, pumpkin and pears.
• Eat less of Hot & Dry  such as avocado, garlic, onion and chickpeas, and the least amount of Cold & Dry  – like beef, tomato, beans and mealie meal.
• Drink lukewarm water, which often helps to relieve symptoms, especially pain and soreness.
• Consume plenty of fruit and vegetables to increase moistness.
• Avoid dehydrating drinks (such as coffee, tea and alcoholic drinks), and sugar-rich fizzy drinks.

Other Lifestyle Advice

• Breathing:  Early morning breathing exercises will help relax the affected muscles.
• Exercise: Rest the affected limb horizontally to allow inner healing to take place. Carry out gentle stretching exercises of the affected limb when warmed up. Do not return to physical activity until cramps have gone.
• Resting: Cut down physical activity by resting the muscles of the affected limbs horizontally.
• Meditation: Short meditation session will help deal with lasting symptoms, especially pain
• Elimination: Boost regular bowel movements by eating high-fibre grains (e.g. brown rice, whole-wheat, oats)
• General: Keep warm generally, using heating pads if necessary, especially at night.

Herbal Remedies 

• Herbal – Add ¼ – ½ teaspoon of turmeric to 1 cup of hot milk. Add a pinch of black pepper and honey to taste. Drink this twice daily.
• Detox – Add Epsom salts to bathwater to help remove toxins and soothe inflamed muscles.

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What is Nausea and Vomiting?
Nausea is a sensation of discomfort in the upper abdomen, accompanied by an urge to vomit.
Vomiting describes the forceful expulsion of the contents of the stomach via the mouth or sometimes the nose. Nausea and vomiting are involuntary actions which protect the person from noxious substances when taken by mouth. They are caused by numerous factors, such as unsuitable food, toxins and certain illnesses.

Signs and Symptoms
Faintness; physical weakness; vertigo; headache; profuse sweating; indigestion; retching; difficulty keeping food down; dehydration is a major concern with vomiting excessively.

Complications 
Recurrent and persistent vomiting may result in: dehydration, electrolyte disturbances, inflammation of the oesophagus (oesophagitis) or stomach (gastritis).

What Causes Nausea and Vomiting?
Nausea and vomiting are important mechanisms which serve to protect the person’s body. Their action helps to remove ingested toxins quickly before damage ensues. Risk factors include:
Emotional factors, such as anxiety, stress and irritability.
Environmental factors, such as irregular body motions, cooking smells, and cigarette smoke.
Chemicals, drugs and toxins, such as anti-cancer drugs (chemotherapy), excess alcohol intake, unpleasant odours, and toxins in food.
Clinical disorders, such as anorexia, bulimia, onset of a heart attack, and several gastro-intestinal disorders.
Food, such as excessive intake of cold and moist food, and undigested food.

The Tibb View of Nausea and Vomiting
According to Tibb, there are two distinct causes of nausea and vomiting. One is related to excessive or undigested food. This type of nausea and vomiting is associated with qualities of moistness with cold. The other is linked to excessive production of bile due to stress and excessive heat which is associated with qualities of heat with dryness. As there are numerous causes all temperamental types can be affected.

Management of Nausea and Vomiting
Management is aimed at reducing the excess qualities associated with nausea and vomiting, by implementing Tibb Lifestyle Factors that will increase the qualities of dryness and heat in patients with excess moistness with cold, and increase qualities of moistness and cold in patients with excess heat and dryness.  This assists Physis in addressing both the symptoms and the causes of nausea and vomiting.

Tibb Lifestyle Factors
Nausea and Vomiting Associated with Qualities of Moistness with Cold:
Food and Drink

• Eat mostly Hot & Dry – such as chicken, chickpeas, avocado, and cinnamon, followed by Cold & Dry  – like beef, tomato, potato and citrus fruit.
• Eat less of Hot & Moist  – such as white flour products, sugar, bananas and cheese, and the least amount of Cold & Moist – like milk, cucumber, rice and pears.

Nausea and Vomiting Associated with Qualities of Heat with Dryness:
Food and Drink

• Eat mostly Cold & Moist – such as rice, cucumber, watermelon and milk, followed by  Cold & Dry – like yogurt, potato, citrus fruit and coconut oil.
• Eat less of Hot & Moist  – such as mutton, ginger, spinach and sugar, and the least amount of Hot & Dry  – like chicken, eggs, garlic and onions.

Other Lifestyle Advice for Vomiting associated with both Moistness with Cold and Heat with Dryness

• Avoid high-fibre, fried, junk and processed foods, as these may stress the digestive system.
• If infection is the source of nausea and vomiting, follow the BRAT diet for the duration of vomiting (Banana, Rice, Apple sauce and Toast)
• Once the nausea and vomiting subsides follow a high- fibre diet, containing grains and vegetables.
• Confront and resolve any persistent worries or anxieties with Tibb Deep Breathing exercises or Tibb meditation
• Drink clear fruit juices, water and black tea
• Eat small, frequent meals as this is better tolerated

Herbal Remedies

• Replace body fluid lost from repeated vomiting by increasing fluid intake. Make a rehydration solution using five cups of boiled water with eight tsp of sugar and one teaspoon of salt (or ½ teaspoon of salt for children).
• Drink a glass of warm, flat coke several times a day.
• Add 10 grams each of tamarind and prunes to a glass of water. Soak for 60 min, strain, add salt to taste. Drink the water.
• Mint leaves (one cupful) soaked in boiling water for several minutes. Drink when cooled down.

What is Osteoarthritis? 
Osteoarthritis is inflammation of one or more joints, usually as a result of wear and tear.

Signs & Symptoms
Joint pain; joint swelling; joint stiffness, especially in the early morning; grating sensation in the joint on movement.

Complications
Joint pain and stiffness may become severe enough to make daily tasks difficult. Some people are no longer able to work as a result of the pain and stiffness. In some cases, joints may become twisted and deformed.

What Causes Osteoarthritis?
Osteoarthritis results from the natural deterioration of body joints, usually starting in the late 40’s, due to general wear-and-tear. The cushions (cartilages) between the joints’ bones begin to break up, so bone-on-bone contact develops. Osteoarthritis is aggravated by being overweight, excessive weight carrying, and some hormonal changes. Osteoarthritis can start earlier in athletes and in people performing high-impact exercises over the long term.

The Tibb View of Osteoarthritis
According to Tibb, osteoarthritis is associated with qualities of coldness with dryness, as it is generally worse during the colder seasons or colder times of the day.
Arthritic stiffness often worsens during periods of inactivity which exert a cooling effect on the body. With increased age, or over-use, the excessive heat created in the joint space due to movement can result in dryness. Increasing age also results in a slowing down of the body’s metabolism, causing less blood to flow to the peripheral areas of the body. Blood brings about a balance of heat and moistness to the joints.
Individuals with a melancholic dominant/sub-dominant temperament are more predisposed to developing osteoarthritis. However, due to an improper diet and lifestyle, any temperament may develop arthritis.
People with a bilious temperament may develop osteoarthritis due to over-use, as these individuals are highly competitive and often unaware of, or ignore, their limits. Those with a sanguinous temperament, who are prone to over-eating and sedentary lifestyles, may also develop arthritis due to a build-up of metabolic wastes.

Management of Osteoarthritis 
Management is aimed at reducing the excess coldness with dryness, by implementing Tibb Lifestyle Factors that will increase the qualities of heat and moistness. This assists Physis in addressing both the symptoms and causes of osteoarthritis.

Tibb Lifestyle Factors
Food and Drink

• Eat mostly Hot & Moist – such as dates, olive oil honey, turmeric and brown bread, followed by Hot & Dry – like celery, red pepper, garlic and oily fish.
• Eat less of Cold & Moist – such as rice, watermelon, cucumber and broccoli, and the least amount of Cold & Dry – like beans, beef, citrus fruit and yogurt.
• Increase body moisture by eating plenty of fruit and vegetables.
• Drink two to three litres lukewarm water a day.
• Avoid dehydrating drinks (such as coffee, tea and alcoholic drinks), and sugar-rich fizzy drinks.

Other Lifestyle Advice

• Breathing: Early morning breathing exercises will help relax the joint-supporting muscles
• Exercise:  Light to moderate aerobic or stretching exercises, such as a daily walk in the mornings and evenings. Cut down on strenuous exercise, as this damages the joint cartilage
• Sleep:  Try for good quality sleep as this supports Physis. Listen to your body, and take adequate rest.
• Meditation:  A Short meditation session will help deal with symptoms, especially pain
• Elimination:  Boost regular bowel movements by eating high-fibre grains, such as brown rice, whole-wheat and oats.
• Massaging the affected joints also helps to increase the heat in that area, and so bring about increased blood circulation.

Herbal Remedies

• Herbal: Infuse a few slices of fresh ginger root in a cup of boiling water. Allow it to stand with the top covered for 30 minutes before drinking.
• Detox: Add Epsom salts to bathwater to help remove toxins and soothe inflamed joints.

What is Osteoporosis? 
Osteoporosis is excessive thinning of the bones, causing them to become weak and brittle, increasing the risk of fracture.   Osteoporosis-related fractures most commonly occur in the hip, wrist or spine.

Signs and Symptoms
Back pain; loss of height over time; a hunched posture; and bone fractures.

What Causes Osteoporosis?
Bone is a living tissue which constantly needs to renew itself. New bone for the skeleton is synthesised constantly, and old bone is broken down. When young, the rate at which new bone gets made is faster than the rate of old bones breaking down. This results in greater bone mass and stronger bones. However, with age, bone mass is lost faster than it is created, so the remaining bone becomes weaker, and prone to fracture. The likelihood of developing osteoporosis depends on how much bone mass was acquired during youth and the rate of creation of new bone versus loss of bone.

The Tibb View on Osteoporosis 
According to Tibb, osteoporosis is associated with qualities of dryness with coldness, as bones become brittle and porous. This makes them more susceptible to breaks and fractures. People with melancholic dominant or subdominant temperaments are at risk of developing osteoporosis. Those with melancholic/bilious temperamental combination are at an even greater risk, due to their innate dominance of dryness.

Management of Osteoporosis
Management is aimed at reducing the excess dryness with cold associated with osteoporosis, by implementing Tibb Lifestyle Factors that will increase the qualities of heat and moistness.  This assists Physis in addressing both the symptoms and the causes of osteoporosis.

Tibb Lifestyle Factors
Food and Drink

• Eat mostly Hot & Moist – such as banana, turmeric, sweet potato, and brown bread, followed by Cold & Moist – like butternut, carrots, pumpkin and pears.
• Eat less of Hot & Dry  – such as avocado, garlic, onion and chickpeas, and the least amount of Cold & Dry  – like beef, tomato, beans and mealie meal.
• Eat whole-grain cereals and calcium containing foods on a regular basis. This will help to increase calcium absorption into the body, and so strengthen existing bones.
• Menopausal and post-menopausal women should include soy products in their diet.
• Avoid soft drinks, sugar, yeast and salty foods.

Other Lifestyle Advice 

• Keep as active as possible. Partake in exercises such as walking, dancing, climbing up stairs etc. Also do weight baring exercises as this will prevent bone mass loss.
• Quit smoking, and avoid second hand smoke.

Herbal Remedy 

• Soak about 11 almonds overnight in some water.  Peel and blend with a cup of warm milk. Drink daily.

What is PUD? 
Peptic ulcers are open sores that develop on the inside lining of the lower oesophagus, stomach and the upper part of the small intestine.

Types of PUD

• Oesophageal Ulcers: Occur in the oesophagus.
• Gastric Ulcers: Occur in the stomach.
• Duodenal Ulcers: Occur in the upper part of the small intestine.

Signs and Symptoms 
An intense, burning and gnawing pain in the stomach and abdominal region; usually worse when hungry;  the pain may be relieved for a while by certain foods; the pain is sometimes worse after eating; pain flare-ups commonly occur at night.

Complications
Internal Bleeding: This may result in anaemia if not treated in time.
Infection: Peptic ulcers may perforate the inside lining of the stomach or small intestine, so increasing the risk of infections such as peritonitis.
Scar Tissue: Peptic ulcers may produce scar tissue, which blocks the passage of food along the digestive tract.

What Causes PUD? 
The condition develops when the production of protective mucus by the stomach lining is reduced, or the production of stomach acids is increased excessively, or both. Peptic ulcers occur when acid in the digestive tract eats away at the inner surface of the oesophagus, stomach or small intestine. The overuse of certain medications, like non-steroidal anti-inflammatory drugs and corticosteroids, or high-dose Vitamin C, may cause peptic ulcers.
Risk factors include: low intake of water, excessive eating of meat or fried and heavily spiced foods, and constant unresolved stress and anxiety. These factors bring about excessive secretion of digestive acid in the stomach.

The Tibb View on PUD
According to Tibb, peptic ulcers are linked to the qualities of heat with dryness. The result is often burning gastric or abdominal pain. If a person’s lifestyle promotes abnormal build-up of the qualities of heat and dryness, the risk of developing peptic ulcers increases markedly. Often responsible are consuming heavily spiced foods and alcoholic drinks excessively, and failing to manage stress appropriately, The excessive heat also makes the person more susceptible to inflammation caused by H. pylori bacteria. People with a dominant or sub-dominant bilious temperament are most likely to develop peptic ulcers due to their inherent qualities of heat and dryness.

Management of PUD
Management is aimed at reducing the excess heat with dryness associated with peptic ulcers, by implementing Tibb Lifestyle Factors that will increase the qualities of coldness and moistness. This assists Physis in addressing both the symptoms and the causes of peptic ulcers.

Tibb Lifestyle Factors
Food and Drink

• Eat mostly Cold & Moist – such as rice, cucumber, watermelon and milk, followed by  Cold & Dry – like yogurt, potato, apples and coconut oil.
• Eat less of Hot and Moist foods – such as mutton, ginger, spinach and sugar, and the least amount of Hot & Dry  – like chicken, eggs, garlic and onions.
• Eat frequent small meals, consisting in part of well-cooked white rice, yoghurt and cottage cheese.
• Eat more vegetables and fruit such as carrots, broccoli and sweet apples.
• Allow hot beverages, like rooibos tea, to cool down before drinking, to avoid triggering gastric discomfort.
• Avoid fried foods, tea, coffee, alcohol, chocolate, strong spices, animal fats, and carbonated drinks.

Other Lifestyle Advice

• Practice slow and deep breathing exercises twice daily
• Drink plenty of water. A glass of water drunk rapidly often relieves gastric pain. The water dilutes stomach acid, flushing it into the duodenum where it is neutralised.
• Avoid non-steroidal anti-inflammatory drugs, especially aspirin.
• Consider quitting smoking, as nicotine irritates the stomach lining.
• Keep the colon clean by selecting a high fibre diet. The use of a gentle and natural laxative is recommended monthly.

Herbal Remedies 

• Drink 25ml of Aloe vera juice two to three times daily.
• 1tsp of licorice root powder mixed in 100ml warm water taken three to four times per day on an empty stomach promotes the healing of the peptic ulcer.
• Take 1tsp of psyllium husk with warm water before retiring at night.

What is the Premenstrual Syndrome?
The premenstrual syndrome is a complex of symptoms, both physical and emotional, which occurs a few days before the onset of menstruation.

Signs and Symptoms
The most common ones are:
Physical symptoms: Headache, feeling bloated, swollen ankles, weight gain, and fatigue.
Emotional symptoms: Irritability, insomnia, decreased sex drive, tearfulness, poor concentration, irrational food cravings, mood swings, depressed feelings.
PMS where symptoms are particularly severe is called Premenstrual Dysmorphic Disorder.

What Causes PMS? 
The exact cause of premenstrual syndrome is unknown, but several factors may contribute to it. Internal disharmony brought about by changes in the balance of the woman’s hormones lead to a number of the symptoms. There is a rise in the female hormone estrogen, and a fall in progesterone levels. The result is a build-up of salt and water in the body, which leads to several other symptoms.
Risk factors include an improper diet, over-rich in foods which are hot and moist or cold and moist foods, such as salty and sweet foods.

The Tibb View of PMS
As many symptoms such as water retention, tissue swelling, mood swings, and cravings may have several causes, the qualities associated with PMS should be assessed for each woman and can affect all temperaments.

Management of PMS
Management is aimed at reducing the qualities associated with the person’s dominant temperament, with the appropriate Tibb Lifestyle Factors. Special attention should be given to foods with high nutritious value. This assists Physis in addressing both the symptoms and the causes of PMS.

Tibb Lifestyle Factors 
Food and Drink

• Phlegmatic temperament – eat mostly Hot & Dry  – such as garlic, onion, fenugreek and mustard, followed by Hot & Moist – like mutton, ginger, turmeric and black pepper, and Cold & Dry – such as  citrus fruit, basil, yogurt and mealie meal and the least amount of Cold & Moist  – like milk, rice, cucumber and watermelon.
• Sanguinous Temperament – eat mostly Cold & Dry  – such as yogurt, citrus fruit, beef and basil followed by Cold & Moist – like coriander, rice, beetroot and broccoli, and Hot & Dry – such as garlic, onion, chicken and eggs,  and the least amount of Hot & Moist  – like white flour products, sugar, cheese and bananas.

• Melancholic Temperament – eat mostly Hot & Moist  – such as ginger, olive oil, turmeric and honey, followed by Hot & Dry – like garlic, onion, chicken and eggs,   and Cold & Moist – such as coriander, rice, beetroot and broccoli and the least amount of Cold & Dry  – like yogurt, citrus fruit, legumes and tomatoes.
• Bilious Temperament – eat mostly Cold & Moist  – such as rice, coriander, cucumber and beetroot, followed by Cold & Dry – like citrus fruit, basil, yogurt and mealie meal, and Hot & Moist – such as ginger, olive oil, turmeric and honey, and the least amount of Hot & Dry  – like onion, eggs, alcohol and garlic.

Dietary advice to be followed by all temperamental types

• Consume more fresh vegetables, fruit, and yogurt. Consume foods that are rich in calcium such as sesame seeds, celery and oranges.
• Avoid red meats; eat fish and chicken instead.
• Cut down on white flour products (like bread and pasta) and sugar.
• Avoid adding salt to meals, and drinking caffeine and alcoholic beverages a week before a menstrual period is expected.

Other Lifestyle Advice

• Breathing exercises: Tibb deep breathing exercises lowers irritability and anxiety, and dampen mood swings.
• Physical exercise: Any form will do, lasting 30 minutes/day at least 3 days/week. This boosts mood and reduces emotional stress. It also helps control appetite and regulates blood sugar levels.
• Sleep: Increasing sleep time for a few days before expected premenstrual symptoms helps to reduce the intensity of symptoms.
• Relaxation: Taking a hot bath with salt added (1 cup each of baking soda and sea salt per bath) helps. Regular massage reduces stress and anxiety.
• Meditation: Tibb meditation exercises 15min early morning and at bedtime is recommended.

Herbal Remedies

• Rosemary tea: Before a period, steep dried leaves (1tsp) in a cup of boiling water. Drink warm.
• Evening primrose oil: Helps reduce cramping and dampen mood swings.
• Poppy seeds (2tsp), almonds (10), liquidised in milk (1 glass), sweetened with honey to taste, drink at breakfast.
• Fennel seed (1tsp), cumin (½tsp), cardamom (2 crushed) in skim milk or water (1cup), boil down to 100ml. Strain and drink 3-4 times daily.

What is Sciatica? 
Sciatica is pain due to shock or damage to the major leg nerve, the sciatic nerve. This is located in the back and outer side of both legs. However, sciatica generally affects only one side of the body.

Signs and Symptoms 
Pain radiating from the lower back, through the back of the thigh, and down through the leg. Depending on where the sciatic nerve is damaged, the pain may also radiate to the foot and even the toes. Other symptoms are: stiffness in the back, leg and foot;  decreased sensation or numbness affecting the back of the calf or sole of the foot; tingling, burning or abnormal sensations; weakness of the knee or foot; difficulty in walking; inability to move the foot and bend the knee (in severe cases).

Causes and Risk Factors 
Sciatica may develop due to several causes: a slipped disc; local pressure due to a poorly administered intra-muscular injection; prolonged pressure on or entrapment of the nerve; direct trauma due to fracture of the pelvis and gunshot wounds. Risk factors include improper lifting of heavy objects; poor posture; exposure of the lower back to cold weather or low temperatures, and excessive intake of Cold & Dry .

The Tibb View of Sciatica
According to Tibb, sciatica is associated with the qualities of coldness with dryness, which are aggravated by the exposure of the lower back to coldness. Overuse and improper bending and lifting techniques create excessive heat which eventually leads to dryness and then cold. Insufficient heat due to decreased blood supply to the lower back can result in chronic inflammation which causes nerve entrapment.  All temperamental types can be affected.

Management of Sciatica 
Management is aimed at reducing the excess coldness with dryness associated with sciatica, by implementing Tibb Lifestyle Factors that will increase the qualities of heat and moistness. This assists Physis in addressing both the symptoms and causes of sciatica.

Tibb Lifestyle Factors 
Food and Drink

• Eat mostly Hot & Moist – such as spinach, dates, mango, and tumeric, followed by Hot & Dry – like oily celery, green or red peppers, avocados and parsley.
• Eat less of Cold & Moist – such as milk, pineapples, and broccoli, and the least amount of Cold & Dry – like beef, tomatoes, sour milk, and beans.
• Eat mostly fruit and vegetables during an acute attack.
• Drink 2-3 litres of warm water daily.
• Limit the intake of tea, coffee, cauliflower, dried beans, lentils, fish, eggs and peas.
• Avoid all red meat for at least 15 days.
• Avoid all fried foods and roasted nuts.

Other Lifestyle Advice 

• Rest in order to take the weight off the affected area until the symptoms subside.
• Once the acute attack has subsided, practice stretching exercises like yoga as this may help relieve nerve compression.
• Two to three days after the onset of the acute attack, apply a hot pack to relieve pain in the affected area.
• Avoid lifting heavy objects. When the condition resolves, practice proper bending and lifting techniques. For example, before lifting, bend down at the knees, and keep the load as close to the body as possible.

Herbal Remedies 

• Add ¼ – ½ teaspoon of turmeric to 1 cup of hot milk. Add a pinch of black pepper and honey to taste. Drink twice daily.
• Detox – Add Epsom salts to bathwater to help remove toxins and soothe inflamed muscles.

What is Sinusitis? 
In sinusitis, the cavities (sinuses) around the nasal passages become inflamed, painful and swollen. Acute sinusitis often results from a cold or flu, and should resolve spontaneously. Sinusitis becomes chronic if the sinuses remain inflamed for at least eight weeks despite repeated attempts at treatment.

Signs and Symptoms
The main symptoms are: headache; a blocked nose; feelings of pain, pressure and heaviness around the head, especially in the jaws, eyes and face; a discharge of thick mucous from the nose; loss of the sense of smell; post-nasal drip, which disturbs sleep; a sore throat; a mild fever; and bad breath.
Sinusitis often triggers coughing spasms, in an attempt to remove built-up mucous.

Complications
The following complications are associated with untreated sinusitis: bacterial infection of the sinuses and their surrounding bone tissues, and even the brain, as meningitis.
Also possible are: asthma flare-ups; visual problems; nasal polyps; and ear infections.

What Causes Sinusitis? 
Sinusitis is caused when the mucous membrane of the nose, sinuses and throat becomes inflamed. Swelling obstructs the sinus openings and prevents mucous from draining normally. This results from a number of underlying conditions: upper respiratory tract infection linked to qualities of coldness with moistness, such as tonsillitis or a cold; improper diet, featuring excessive intake of cold and moist and hot and moist foods like dairy products and refined foods.
Long lasting sinusitis can be brought on by an allergy to pollen, various fungi animal dander; and dust.

The Tibb View of Sinusitis
According to Tibb, sinusitis is linked to qualities of moistness either with heat or with coldness. Sinusitis that worsens during the colder seasons is linked to moistness with cold and presents with thick mucous. Sinusitis which worsens during spring is linked to moistness with heat and may present with thin, runny mucous. As both heat and coldness are associated with sinusitis, people who have a phlegmatic, sanguinous or bilious temperament are mostly affected.

Management of Sinusitis 
Management is aimed at reducing the excess qualities associated with sinusitis, by implementing Tibb Lifestyle Factors that will increase the qualities of dryness with cold in patients with symptoms of excess of moistness with heat and by increasing the qualities of dryness with heat in patients with symptoms of excess moistness with cold. This assists Physis in addressing both the symptoms and causes of sinusitis.

Tibb Lifestyle Factors 
Sinusitis Associated with Qualities of Moistness with Heat:
Food and Drink

• Eat mostly Cold & Dry – such as beef, fish, cauliflower and mushrooms, followed by Hot & Dry – like bittergourd, avocado, chickpeas and garlic and  Cold & Moist – such as carrots, pumpkin, rice and milk, and the least amount of Hot & Moist – like bread, pasta, bananas and wheat cereals.
• Plenty of pure warm water should be drunk to facilitate the elimination of mucous.
• Eat plenty of fruit and vegetables, and protein-rich foods like beef and fish.
• Eat pepper-rich dishes, which contain capsaicin or cayenne.
• Avoid wheat, sugary and salty foods and ice-cold drinks, and restrict consumption of dairy products, but not yoghurt.

Sinusitis Associated with Qualities of Moistness with Cold:
Food and Drink

• Eat mostly Hot & Dry – such as chicken, oily fish, green pepper, eggs and garlic, followed by Cold & Dry – like beef, fish, cauliflower and mushrooms.
• Eat less of Hot & Moist – such as bread, pasta, bananas and wheat cereals and the least amount Cold & Moist – like carrots, pumpkin, rice and milk.
• Consume hot liquids like soups and herbal teas regularly, as they increase mucous flow.
• Eat food which is rich in garlic and horse radish.
• Avoid wheat, sugary and salty foods and ice-cold drinks, and restrict consumption of dairy products, but not yoghurt.

Other Lifestyle Advice

• Irrigate the nasal passages regularly with saline drops or spray
• Install a steam humidifier in the bedroom, and put eucalyptus oil in the water.
• Apply moist heat pads for several minutes to the tender parts of the face.
• If the sinus areas of the face are sore, rub them gently. Press thumbs firmly on sides of nose for about 30 seconds.

Herbal remedies

• Take ¼ teaspoons each of aniseed, thyme, fenugreek, echinacea, and boil in one to two cups of water, until one cup remains. Strain, mix with two teaspoons of honey, and drink three times a day.
• Crush fresh ginger root and apply as a hot poultice to the forehead and nose areas. This stimulates circulation and mucous drainage.
• Place two drops of menthol or eucalyptus oil into a bowl of boiling hot water and inhale the steam several times daily.
• Nasal Irrigation – Mix a solution of one cup of warm preferably distilled water, ¼ teaspoon each of sea salt and bicarbonate of soda. Use a squeeze spray bottle to instill the solution into the nostrils, one side at a time. Repeat this procedure three to four times daily, for relief from stuffiness.

What is a Sore Throat? 
A sore throat (pharyngitis) is characterized by pain, scratchiness and irritation of the throat due to inflammation. It is worse when swallowing.

What is Tonsillitis? 
Tonsillitis is inflammation of the tonsils, which are located on either side of the back of the throat. In most cases it is due to a bacterial or viral infection.

Signs and Symptoms
Sore throat; difficulty or painful swallowing; swollen neck glands; fever; swollen, red tonsils; white patches on the surface.

Complications
Recurrent tonsillitis may lead to chronic tonsillitis. This can cause breathing difficulties, sleep apnea, and abscesses on the tonsils…

What Causes Sore Throats and Tonsillitis? 
Sore throat is most commonly caused by the same viruses that bring on the common cold and flu. Less commonly it is caused by bacteria. Other causes include allergies; dry weather or dry climate; tobacco smoke or other chemical irritants; muscle strain which results from screaming or shouting.  Acid reflux (GORD) from the stomach can result in a sore and scratchy throat.
Tonsillitis is most often brought on by respiratory viruses, but sometimes bacterial infections are the cause. The tonsils are the immune system’s first line of defense against bacteria and viruses that enter the mouth. This function makes the tonsils particularly vulnerable to infection and inflammation.
The Tibb View on Sore Throat and Tonsillitis 
According to Tibb, sore throat and tonsillitis are linked to qualities of moistness either with heat or with coldness.
Due to the affected person’s weakened immune system, Physis is unable to prevent an infection by the viruses or bacteria, but actively fights it in order to restore good health. People with phlegmatic or sanguinous temperaments are most are risk of developing sore throats and tonsillitis. Children are particularly vulnerable for developing tonsillitis, due to their innate moistness.

Management of Sore Throat and Tonsillitis 
Management is aimed at reducing the excess qualities associated with sore throat and tonsillitis, by implementing Tibb Lifestyle Factors that will increase the qualities of dryness and heat in patients with symptoms of excess moistness and coldness and by increasing the qualities of dryness with cold in patients with symptoms of excess moistness with heat. This assists Physis in addressing both the symptoms and the causes of sore throat and tonsillitis.

Tibb Lifestyle Factors 
Sore Throat and Tonsillitis Associated with Qualities of Moistness with Coldness:
Food and Drink 

• Eat mostly Hot & Dry – such as chicken, avocado, bittergourd and chickpeas, followed by Cold & Dry – like beef, potato, and yogurt.
• Eat less of Hot & Moist – such as bread, pasta, sugar and bananas, and the least amount of Cold & Moist  – like squash, butter, cucumber and pears.

Sore Throat and Tonsillitis Associated with Qualities of Moistness with Heat:
Food and Drink

• Eat mostly Cold & Dry – like beef, potato, and yogurt, followed by Hot & Dry – such as chicken, avocado, bittergourd and chickpeas.
• Eat less of Cold & Moist  – like squash, butter, cucumber and pears, and the least amount of Hot & Moist – such as bread, pasta, sugar and bananas.

Dietary Advice for Sore Throat and Tonsillitis linked to both Moistness with Coldness and Moistness with Heat

• Avoid heavily spiced, fried or grilled foods, as well as sugary and refined foods.
• Steamed vegetables and proteins should be preferred as a diet.
• Avoid cold water and cold foods like dairy products;
• Drink at least two litres of pure warm water a day.

Other Lifestyle Advice 

• Gargle frequently with warm salty water. Dissolve ½ tsp of salt in one cup of warm water, and gargle with it three times daily to help reduce swelling, relieve pain and remove mucus.
• Apply a hot compress to the throat area.
• Use a humidifier at home. Moist air stimulates blood flow to the mucous membranes, promoting healing.
• Take advantage of the sore throat to give up smoking.

Herbal Remedies

• For relief of pain inhale essential oils of bergamot, lavender, tea tree, thyme, benzoin and lemon.
• Take two grams each of chamomile, Echinacea and golden seal. Boil in 1 ½ cups of water until 1 cup remains. Strain and add 1tsp of honey. Drink warm three to four times a day.
• Apply a paste of honey and turmeric powder to the tonsils if possible. Repeat four to five times a day.
• Gargle with 1tsp Himalayan salt in a glass of warm water.

What is Sexually transmitted Diseases? 
Sexually transmitted Diseases include gonorrhoea, chlamydia, genital warts and pubic lice.  They arise from infections, or infestation in the case of lice. Both males and females are affected.

What is Gonorrhoea/Chlamydia/Genital Warts/Pubic Lice?
Gonorrhoea/Chlamydia/Genital Warts/Pubic Lice are sexually transmitted infections or infestations (in the case of Pubic Lice) that can infect both males and females.

Signs and Symptoms of Gonorrhoea/Chlamydia/Genital Warts and Pubic Lice 
Gonorrhoea and chlamydia are often present without symptoms.
However, some of the symptoms may include: painful passage of cloudy, yellow-green, pus-laden urine, especially in men; pus-like discharge from the penis; pain or swelling in one testicle; yellow-green vaginal discharge; vaginal bleeding, especially after sexual intercourse; abdominal pain;  red, painful, itchy sores with discharge in the anus; genital warts, with small, flat cauliflower-like bumps or lesions in the genital or anal area; and intense itching in the pubic area as a result of pubic lice infestation of lower body hair.

Complications 
If gonorrhoea and chlamydia are not treated promptly, and necessary precautions not taken, infertility in both men and women may develop. STDs increase the risk of becoming infected with the Aids virus. The infection may spread via the blood stream and infect other areas of the body, including the joints. The virus responsible for genital warts may contribute towards the onset of cervical and other types of cancer.

What causes these STD’s? 
Gonorrhoea and chlamydia result from infections by bacteria, and genital warts from infections by viruses. These micro-organisms are transmitted during unprotected sexual activity, and may be passed on from mother to child during delivery. Pubic lice are carried from one person to another by direct physical contact, and by shared clothing and bedding.

The Tibb View of STD’s
These STDs are linked to qualities of heat with moistness, as the micro-organisms thrive in an environment of heat and moistness usually existing in the genital and anal areas. Symptoms of inflammation, especially pain, redness and swelling, and the presence of discharge in both men and women are associated with these qualities.  As STDs are caused by infections, all temperamental types can be affected.

Management of STD’s
Management is aimed at reducing the excess qualities of heat with moistnessassociated with these STDs, by implementing Lifestyle Factors that will increase the qualities of coldness and dryness. This assists Physis in addressing both the symptoms and causes of STDs.

Tibb Lifestyle Factors
Food and Drink 

• Eat mostly Cold & Dry – such as beef, tripe, broccoli and yogurt, followed by Cold & Moist  – like rice, cucumber, lettuce and carrots.
• Eat less of Hot & Dry – such as onions, egg, peppers and alcohol, and the least amount of Hot & Moist – such as mutton, cheese and sugar.
• Reduce consumption of coffee, tea, alcohol, smoking and fizzy drinks; and processed foods.
• Drink a glassful of pure water hourly.

Other Lifestyle Advice 

• Detox: Take a 20 minute hot Sitz bath to which 20g of alum powder or a cupful of apple cider vinegar has been added. Woman should sit with her knees up and apart so that the water can enter the vagina.
• For those affected with pubic lice, Vaseline is safe to apply to the eyelashes and eyebrows. Tea tree oil may be diluted with olive or almond oil and massaged onto the areas suspected to be infested by lice.
• A paste of castor oil and baking soda, applied onto genital warts three times daily is advised.

Prevention

• Both partners should be tested for infection before engaging in sexual activity.
• Both sexual partners should seek professional advice. .
• Practice safe sex by always using a condom. Abstinence is the only sure way to prevent infection by gonorrhoea and chlamydia.
• Having a monogamous relationship reduces the risk of contracting an STD. Having multiple sex partners increases the risk.
• A douche in the vagina should not be used, as this increases susceptibility to contracting an STD.
• If pubic lice infestation is suspected, all contaminated sheets, clothing, towels and blankets should be thoroughly washed to prevent spreading.
• Regularly removing off the pubic hair is advised to remove lice.

What is Stress/Anxiety?
Stress can develop from any event or thought that leads to frustration, anger or nervousness. It emerges from a fear that personal resources are not adequate to cope with life events. Anxiety is a feeling of fear, unease and worry. The source of many of the symptoms linked to these disorders is not known.

Signs and Symptoms
A feeling of  anxiety or nervousness much of the time; sleep difficulties; dry mouth; grinding teeth; lip quivering and jaw clenching; frequent headaches; neck ache; tightness in the chest; buzzing or ringing in the ears; stuttering; blushing; cold, clammy hands and feet; sweaty palms; hand tremors; back pain or muscle spasms; and irregular bowel habits, such as constipation or diarrhoea.

Complications
Poorly managed stress is a risk factor for the onset of many chronic diseases. As stress lowers immunity, the body is more susceptible to developing or aggravating several illnesses.

What Causes Stress and Anxiety?
A number of physical, emotional and social causes are linked to stress and anxiety. They include: divorce; bereavement; money problems; job loss or change; loneliness; insomnia and sleep deprivation. Stress may be aggravated by nutritional deficiencies, poor eating habits, like ‘eating on the run’, excessive alcohol or drug intake, constant physical over-exertion, and career challenges. Chronic illnesses such as thyroid disease, diabetes and asthma may trigger the onset of stress and anxiety.

The Tibb View of Stress and Anxiety
According to Tibb, anxiety and stress are associated with the qualities of heat with dryness. This leads to an increase in heart and breathing rates, and symptoms like diarrhoea. Although people with all temperaments are faced with different stressors each day, people with a dominant/sub-dominant bilious temperament are most susceptible to developing stress and anxiety. This is due to their inherent dominance of heat.

Management of Stress and Anxiety 
Management is aimed at reducing excess heat with dryness associated with stress and anxiety, by implementing Tibb Lifestyle Factors that will increase the qualities of coldness and moistness. This assists Physis in addressing both the symptoms and the causes of stress and anxiety.

Tibb Lifestyle Factors 
Food and Drink 

• Eat mostly Cold & Moist – such as rice, cucumber, watermelon and milk, followed by  Cold & Dry – like yogurt, potato, citrus fruit and coconut oil.
• Eat less of Hot and Moist foods – such as mutton, ginger, spinach and sugar, and the least amount of Hot & Dry  – like chicken, eggs, garlic and onions.
• Try to eat more high fibre fruit and vegetables.
• Eat plenty of raw nuts and seeds particularly almonds and pumpkin seeds.
• Eat foods like avocados, apricots, asparagus and broccoli.
• Cut down eating simple sugars found in white bread, pasta, cakes, sweets and biscuits.

Other Lifestyle Factors 

Lifestyle:
(a) Try for better quality sleep.
(b) Take periodic rests, with meditation.

(c) Take up regular physical exercise.
(d) Take deep breaths, and practice breathing exercises.
(e) Adopt regular eating habits.

Psychological: There are several mind-body techniques which effectively reduce stress, like meditation, breathing exercises, yoga, tai-chi, and self-hypnosis. These should be evaluated to see which best suits the anxious or stressed person.

(a) Develop a positive attitude, and try turning stress to advantage.

(b) Take a short holiday.
(c)  At work, practice better time management and decision-making skills.
(d) Talk problems through with friends.

Acupressure:
(a) Pressing and rub temples.
(b) Drop the jaw and move it around.

Aromatherapy: 
Adding plant essential oils (geranium, jasmine and lavender) to a hot bath is valuable for stress-prone people.

Massage therapy: 
With or without these essential oils, massage is well worth considering
Others: Listen to soothing music, and smell the flowers.

Herbal Remedies

• Liquidise 11 almonds, 2tsps poppy seeds, 2tsps honey and 200ml milk. Drink daily at breakfast.
• Brew and drink chamomile tea at least three times daily.

What is TB?
TB is an infectious disease caused by a bacteria, Mycobacterium tuberculosis. It affects many areas of the body, especially the lungs, but also the lymphatic glands, bones, bladder, and spine.

Signs and Symptoms 
Cough; fever; night sweats; loss of appetite; loss of weight; and weakness.

Complications 
TB is often fatal without the proper treatment. Untreated TB of the lungs may spread through the blood stream to infect other areas of the body.

What Causes TB?
TB is commonly spread from person to person through the air. When an infected person coughs, sneezes or spits, germs are propelled far into the air. If another person inhales these germs they will most likely become infected with TB also. TB bacteria are present in about one third of the world’s population, but not all show symptoms of the disease. People who have a weak immune system, such as those who are malnourished, diabetic or chronic smokers, or who are affected by HIV, are at a greater risk of becoming ill with this disease.

Tibb Perspective of TB
TB is associated with qualities of heat with dryness. The symptoms of TB, such as night sweats, high fever and loss of weight are linked to heat. TB is most frequently associated with inflammation of the lung tissue, resulting in the airways of the lungs becoming dry and hard from fibrosis. People with a dominant or sub-dominant bilious temperament are more predisposed to developing TB due to their innate qualities of heat and dryness.

Management of TB         
Management is aimed at reducing excess heat with dryness associated with TB, by implementing Tibb Lifestyle Factors that will increase the qualities of moistness. This assists Physis in addressing both the symptoms and causes of TB.  The Tibb approach, together with TB medication, helps in the recovery of the TB patient.

Tibb Lifestyle Factors 
Food and Drink

• Eat mostly Cold & Moist – such as rice, cucumber, watermelon and pears, followed by  Cold & Dry – like yogurt, potato, citrus fruit and coconut oil.
• Eat less of Hot & Moist  – such as mutton, ginger, spinach and sugar, and the least amount of Hot & Dry  – like chicken, eggs, garlic and onions.
• Avoid heavily spiced, fried or grilled foods.
• Avoid sugary and refined foods.
• Drink plenty of fluids, such as herbal teas and soups.
• Avoid mucous forming foods, such as dairy products, processed foods, sugar, sweet fruits and white flour.

Other Lifestyle Advice

• Do not smoke, and avoid second hand smoke. Cigarette smoke is very harmful;
• Increase the moisture in the air by using a humidifier or vapourizer.
• Clean everything frequently to prevent bacterial overgrowth.
• Avoid strenuous physical exercise until recovery;
• Rest in bed in the early stages, when the fever is present. Once the fever subsides and the condition improves, take alternate periods of rest with periods of moderate activity to prevent mucous secretions settling in the airways.
• Do not swallow mucous; rather spit it out into a disposable receptacle.

Herbal Remedy

• Make an infusion with 1 tsp of sage and 3tsp of chamomile tea in a cup of boiling water. Drink this daily.

What is a UTI? 
A  UTI is an infection in any part of the urinary system: kidneys, the ureters, bladder and urethra. Most infections involve the lower part of the urinary tract; that is, the bladder and the urethra.

Types of UTI’s and Signs & Symptoms:
Each type of UTI shows specific signs and symptoms, depending on which part of the urinary tract is infected.

Kidneys (acute pyelonephritis)
Pain in the upper back and side; high fever; tremor and chills; nausea and vomiting.

Bladder (cystitis)
Lower abdomen discomfort; pelvic pressure; frequent, painful urination; blood in urine.

Urethra (urethritis)
Urination with burning sensation.

Complications 
Recurrent infections; permanent kidney damage; pregnant women may deliver low birth weight babies.

What Causes UTI’s?
The usual cause of a UTI is infection from bacteria migrating from outside into the urethra, which then begin to multiply in the bladder. Most UTIs mainly affect the bladder and urethra of women, due to having a shorter urethra, which allows  easier access.

The Tibb View of UTI’s
Bladder infections are associated with qualities of moistnesswith heat as they more commonly result in women, who are innately more moist than men. The pubic area also has qualities of moistness with heat and when these qualities are out of balance it provides an ideal environment for bacteria to grow. Women with a dominant or sub-dominant sanguinous temperament are more susceptible to developing UTIs due to their innate dominance of heat and moistness.

Management of UTI
Management is aimed at reducing the excess moistness with heat associated with UTIs, by implementing Tibb Lifestyle Factors that will increase the qualities of cold and dryness.  This assists Physis in addressing both the symptoms and the causes of UTIs.

Tibb Lifestyle Factors 
Food and Drink 

• Eat mostly Cold & Dry – like beef, fish, cauliflower and mushrooms, followed by Hot & Dry – such as bittergourd, avocado, chickpeas and garlic.
• Eat less of Cold & Moist – such as carrots, pumpkin, rice and butternut, and the least amount of Hot & Moist – like bread, pasta, bananas and wheat cereals.
• Avoid coffee, tea, alcohol, smoking, tea and fizzy drinks, and additive-rich processed foods.
• Drink 200ml pure, fresh water every hour.

Other Lifestyle Advice

• Exercise: Swimming is recommended. Dry the intimate areas thoroughly afterwards, and dress in dry cotton underwear.
• Detox: Take a 20 minute hot Sitz bath with 20g alum powder or a cup of apple cider vinegar added. Women should sit with her knees up and apart so that the water can enter the vagina. You can alternate this with a bath made with two cloves of crushed garlic added.
• Elimination: Emptying the bladder regularly, at least every two to three hours during the day. Keep the genital and anal areas clean and dry. Women should wipe from front to back after urination or bowel movement.
• Habits: Urination should be carried before and after exercise and sexual intercourse, and appropriate cleansing carried out.
• Hygiene: White cotton, not artificial fibre, underwear is advised. Packaged douches, bubble baths, tampons, sanitary towels or toilet paper containing fragrance should be avoided, as they can be irritating and cause inflammation. Sanitary towels instead of tampons should be used if urinary tract infections occur frequently.

Herbal Remedies

• Cranberry juice. This prevents offending bacteria from sticking to the bladder wall.
• Alkaline drink. Add ¼tsp of baking soda to a glass of water, and drink once a day when symptoms appear.

What are Varicose Veins? 
Varicose veins are twisted, enlarged veins. Any vein may become varicose, but the veins most commonly affected by far are those in the lower legs and feet.

Signs and Symptoms
The leg veins appear large and prominent; the feet and ankles swell; the legs ache and become uncomfortable, especially after standing still for long periods; cramp-like pains; feet and ankles feel tired; and leg ulcers or rashes develop.

Complications
Varicose veins, if not treated, often develop painful venous ulcers; and blood clots form within the deep veins.

What Causes Varicose Veins
Varicose veins may form in the following situations: Being overweight; pregnant, especially in the later stages; prolonged periods of standing; inflammation of the inner vein lining due to a blood clot forming, or in certain persons with an inherited tendency to the ailment.

The Tibb View of Varicose Veins
According to Tibb, varicose veins are associated with qualities of moistness with heat. Persons with a dominant/sub-dominant sanguinous temperament are particularly predisposed to developing varicose veins, as they possess the qualities of heat & moisture.

Management of Varicose Veins
Management is aimed at reducing the excess moistness associated with varicose veins, by implementing Tibb Lifestyle Factors that will increase the qualities of dryness. This assists Physis in addressing both the symptoms and causes of varicose veins.

Tibb Lifestyle Factors
Food and Drink

• Eat mostly Hot & Dry – such as chicken, avocado, bittergourd and chickpeas, followed by Cold & Dry – like beef, potato, and yogurt.
• Eat less of Hot & Moist – such as bread, pasta, sugar and bananas, and the least amount of Cold & Moist  – like squash, butter, cucumber and pears.
• Eat small, frequent meals as this will assist in weight loss.

Other Lifestyle Advice

• Breathing: Smokers should stop or cut down the habit, as it badly affects blood circulation in the lower limbs.
• Physical exercise: Regular walking, cycling and jogging help improve circulation in the legs, so preventing blood pooling. People in sedentary occupations should move around frequently to avoid blood pooling.
• Sleeping: Keeping a pillow under the lower legs while sleeping helps prevents blood pooling.
• Elimination: Varicose veins are made worse in surrounding which are too warm or hot, so avoiding over-heating is important. Likewise, avoiding hot baths and showers is advised.

Herbal Remedy

• Soak two dried figs in a cup of boiling water at night. Eat the figs and drink the warm liquor before sleep.