Physis maintains harmony between the individual and the environment – both internally and externally. It ensures that an ideal balance exists within the entire body starting from a cellular level, to the tissues and between the many internal organs. Physis is also involved in our interaction with the outside environment. This applies to the air we breathe, our food and drink, exercise, our emotional state, sleep, and the many toxins threatening us from the environment.
Physis is not confined to humans – it pervades all living tissues. It is part of the biochemical unity of life. It follows the laws of nature, as we understand them, and works in a predetermined, instinctive manner.
Once we are aware that Physis (our internal doctor) exists, we can begin to listen to it. Behind every natural action of the body is an inherent wisdom. No medicine we take can heal the body without the body’s help. Tibb recognizes the body’s own ability to heal and works in accordance with this ability.
The word ‘physician’ derives from Physis and we see the true role of the physician as aiding Physis in the healing process, understanding the factors that govern Physis, and planning and executing treatment accordingly.
To give an example of how Physis works we look at what happens after someone has eaten something that disagrees with them. They might react by vomiting or getting Diarrhoea. Neither of these reactions should be suppressed but should rather be managed as they serve the purpose of purging the body of certain toxins. This is the wisdom affected by Physis to cure the body. In the Western world, symptoms of discomfort are dealt with by reaching for a ‘quick-fix’ solution, perhaps a pill to stop the symptoms. By doing this we may interrupt and obstruct the work our bodies are doing. Illness should therefore be looked at in the context of Physis. Remember that treatment comes from outside, healing from within.
Temperaments in Tibb
One of the unrivalled features of Tibb is recognition of each person’s uniqueness known in Tibb as Temperament. It describes a person’s physical characteristics (the constitution) plus his or her psychological, emotional, and spiritual attributes. It assesses personality strengths and weaknesses, and includes the predisposition (risk factors) for particular disorders.
Although each person’s temperament is as unique as his/her fingerprint, Tibb divides people into a combination of four broad categories, Sanguinous, Phlegmatic, Melancholic and Bilious, with a dominant and a sub-dominant temperament. Each temperament has qualities of heat, coldness, moistness and dryness with every combination having an overall quality as indicated in the picture below where a person with a Sanguinous/Phlegmatic temperamental combination will have an overall quality of moistness.
Knowing one’s Temperament as well as the dominant quality associated with the temperament allows individuals to make positive choices in lifestyle that will benefit health and improve their quality of life. The practice of Tibb revolves around the art and skill of identifying a person’s individual authentic temperament, combined with the science and practice of serving his or her Physis to reach and maintain their particular ideal state of health.
The importance of knowing a person’s temperament was highlighted by Hippocrates who said:
“It is more important to know what sort of a person has a disease, than to know what sort of disease a person has”
An individual’s temperament and their ideal qualities is maintained by the body fluids or humours of the body. These humours also have qualities of heat, coldness, moistness and dryness associated which exists both at a physical and a metaphysical level, each one reflecting a fluid or flow of a biological force or energy in the body. Humours are manufactured by the digestion of food and drink that is processed and transformed in the liver. There are four humours, each of which has specific qualities of its own.
Just as each individual has a unique temperament with associated qualities, each person also has a unique ratio of humours and qualities to match the ideal temperament of the individual. For example, a person who is dominant sanguinous will have slightly more of the sanguinous humour to maintain the ideal heat and moisture associated with that temperament. Similarly, this is the case with the other temperamental types.
Health will only be maintained as long as the overall quality of the humours is in harmony with the overall quality of the temperament of the individual. Changes to this ideal humoral balance occur as a result of the interaction between the individual and the environment. Tibb philosophy describes this environment as the governing or lifestyle factors.
According to Tibb, our health reflects a state of harmony with our personal environment. Their harmony is affected by the normal human activities of breathing, eating and drinking, sleeping, bodily evacuation, movement and rest. The emotional state and age of the person, together with the season of the year will also exert an effect – our lifestyle. Management of lifestyle determines the outcome of health or disease. If well managed, good health will be maintained; if poorly managed, disease will result.
However because each of us as a unique temperament our requirements of lifestyle has to be tailored to suit our individual needs. Whilst strenuous exercise maybe good for a one temperament it can be harmful to other temperaments. Lifestyle plan has to take into account the unique temperament and more particularly the dominant qualities associated with the individual.
Lifestyle factors influence our health by the qualities they exert, for example certain foods such as ginger have heating properties and would therefore increase heat within the body; exercise too, would increase heat; sleep has a cooling effect and emotions such as grief are associated with cold and dryness. These changes in qualities affect the ideal qualitative state of our temperament.
Physis is responsible for controlling these changes so that the body remains in a state of balance. However, when there is too much of a certain quality it becomes difficult. This is easier explained through the following scenario. If a person has a Bilious Temperament, the qualities of his overall constitution are hot and dry. If he then eats a diet that has heating foods in excess, does too much strenuous exercise (which also increases heat), does not check his emotions – as Bilious personalities tend to get angry easily, and anger is associated with heat as well. Then all of this may cumulatively have a negative effect on him.
Principles in Tibb
The principles in Tibb are an assimilation of the philosophies of Hippocrates, Galen and Ibn Sina. These concepts not only allow for a comprehensive understanding of health promotion, but also provide valuable insights into the causes, pathological processes and the management and treatment of illness conditions.
Tibb Principle: Qualities
As previously mentioned in the Tibb principle of “Creation” – everything in the universe is made-up from elements, with corresponding qualities: Earth (Cold & Dry), Water (Cold & Moist), Air (Hot & Moist) and Fire (Hot & Dry). The effect of qualities on human beings, as well as on all living organisms, is an important consideration in the philosophy of Tibb.
According to Tibb philosophy the qualities of heat and coldness are active qualities whereas moistness and dryness have passive qualities. To understand the influence that these qualities have on us it is necessary to understand the interaction of qualities in nature.
Their interaction in nature is shown below, where the quality of heat is opposite to the quality of coldness and moistness opposite to the quality of dryness:
Opposing qualities cannot exist simultaneously. Nothing can be Hot & Cold at the same time, nor Moist & Dry at the same time.
There is always a gradual transition between opposing qualities – there is no rapid change from one extreme to another. For example, the cold of winter is never followed by the heat of summer. Nature ensures a gradual transition between opposite qualities, so minimising the negative effects of sudden change to plants, animal and man.
This results in intermediate states of Hot & Moist, Cold & Moist, Cold & Dry, Hot & Dry.
Without the technology of today Tibb philosophers devised imaginative ways of interpreting information in a rationale, logical and systematic way. As qualities is used to describe the Tibb principles of Creation/Temperament, Humours, Lifestyle Factors and Illness Conditions, qualities enabled Tibb philosophers to understand and interpret health and disease in a simple and effective manner for thousands of years. In Tibb philosophy qualities form the basis of interpreting aetiology, pathology, diagnosis and treatment.
This is elaborated on in the Tibb principles of Temperament, Humours, Lifestyle Factors and Illness Conditions.