The history of Unani medicine can be characterized by the work of its practitioners, or hakims, who relied on natural healing based on principles of harmony and balance, uniting the physical, mental, and spiritual realms.

Al-Umoor al-tabiyah: basic physiological principles

According to practitioners of Unani medicine, the health of the human body is maintained by the harmonious arrangement of al-umoor al-tabiyah, the seven basic physiological principles of the Unani doctrine. These principles include (1) arkan, or elements, (2) mizaj, or temperament, (3) akhlat, or bodily humours, (4) aaza, or organs and systems, (5) arwah, or vital spirit, (6) quwa, or faculties or powers, and (7) afaal, or functions. Interacting with each other, these seven natural components maintain the balance in the natural constitution of the human body.

Arkan and mizaj: elements and temperament

As four simple, indivisible entities—arz (earth), maa (water), nar (fire), and hawa (air)—arkan not only constitutes the primary components of the human body but also makes up all other creations in the universe. There are predictable consequences to the actions and interactions (imtizaj) of the four arkan. As these elements act upon and react with each other, they continually undergo change into various states of “genesis and lysis” (generation and deterioration), due to ulfat-e-keemiyah(acceptance of a medicine by the body) and nafarat-e-keemiyah (rejection of a medicine). Skilled hakims claim that they can perceive, recognize, and observe such states.

Doctrine of akhlat

Hippocrates propounded the doctrine of fluids, or humours, of the body, and he categorized the humours into four groups based on their colour. These groups were refined by Galen and later by Avicenna. They appear in Unani practice as dam (blood), balgham (phlegm), safra (yellow bile), and sauda (black bile). The human dispositions corresponding to these humours are, respectively, sanguine, phlegmatic, choleric, and melancholic. Each person is considered to have a specific humoral makeup, determined by the predominance of a given humour in his or her constitution. The quality and quantity of the humours in an individual—a person’s unique, proper, and proportionate humoral makeup—is said to guarantee health. Conditions other than this balance signal ailment or disease.

Relationship between tabiyat and asbab-e-sittah-zarooriah

In the Unani system of medicine, tabiyat is an individual’s internal power or capacity to withstand or combat disease and to perform normal physiological functions. Believing that it is only tabiyat that is engaged in actually curing a disease, Unani hakims hold that they only assist from “outside” by prescribing therapeutic relief. If not adversely affected, tabiyat can eradicate most infections without medical treatment, using what may be thought of as the natural defense system of the mind and body.

Unani medicine recognizes six physical, or external, factors, called asbab-e-sittah-zarooriah, which are essential in establishing a synchronized biological rhythm and thus living a balanced existence. The six asbab-e-sittah-zarooriah are:

  • Hawa (air), in which the quality of the air a person breathes is thought to have a direct effect on his or her temperament and, thus, health.

  • Makool-wo-mashroob (food and drink), in which the nutritional value and the quality and quantity of one’s food and drink are believed to ensure physical fitness by strengthening tabiyat.

  • Harkat-wo-sakoon-e-jismiah (bodily exercise and repose), which emphasizes the positive effects of balanced physical exercise on an individual’s internal resistance and tabiyat.

  • Harkat-o-sakoon nafsaniah (mental work and rest), which emphasizes the simultaneous engagement of the human mind in numerous emotional and intellectual activities. Just as the body needs systematic and planned exercise and rest, Unani medicine holds that the human mind and brain need adequate stimulation and proper relaxation as well.

  • Naum-o-yaqzah (sleep and wakefulness), in which an individual’s health and alertness are understood as being dependent on a specific amount of sound sleep in the course of a 24-hour (circadian) cycle.

  • Ihtebas and istifragh (retention and excretion), which considers the metabolism of food and liquid as both affecting and being regulated by tabiyat. According to Unani medicine, the assimilation of food and liquid facilitates the elimination from the body of excessive and noxious substances. Therefore, to maintain a harmonic and synchronized tabiyat, certain beneficial end-products of kaun-o-fasad (genesis and lysis) are retained in the body while harmful ones are expelled.