iranian traditional medicine iranian traditional medicine iranian traditional medicine (itm) (persian: طب سنتی‌ ایرانی, romanized: tebbe sonnati-e irāni), also known as persian traditional medicine, is one of the most ancient forms of traditional medicine. 13th century depiction of rhazes browsing urine samples of patients, in gerard of cremona itm is grounded in the concept of four humors: phlegm (balgham), blood (dam), yellow bile (ṣafrā') and black bile (saudā'). the four humors concept is based on the teachings of rhazes and avicenna into an elaborate medical system. some scholars believe that efforts for revitalizing itm in recent years have shaped two main attitudes: evidence-based medicine, and quackery. while many academics use evidence-based scientific measurements (for example, various studies have been conducted and reported on the effect of traditional persian medicine formulas on the sars-cov-2 and these treatments have been studied in various clinical trials in iran), there is also a pseudoscientific stream in the modern academia. history globally, this medicine reached its peak in iran, concurrent with polymaths such as muhammad ibn zachariah al-razi, ibn sina and esmaeil jorjani. ancient iranian medicine, the basic knowledge of four humors as a healing system, was developed by hakim ibn sina in his medical encyclopedia the canon of medicine. health maintenance according to a definition given in one of the first iranian medical textbooks called hidayat al-muta'allemin fi al-tibb (translated as 'a guide to medical learners'), written by al-akhawyni bokhari in the 10th century, medicine is a technique of scientifically maintaining the health of human beings, and restoring it when it deteriorates. itm strongly focuses on prioritizing health maintenance and disease prevention over treatment. attari herbs, spices and plant extracts for traditional persian medicine are often sold in a kind of specialized shop called an attari. operation of such a drug store is regulated by the government. principles the lifestyle rules in itm are focused on six core principles, known as setah zaroriah in persian. nutrition, environment, physical activity, sleeping patterns, emotions, and ridding the body from waste materials, are the six fundamental and guiding principles behind the itm lifestyle. it is believed that health is found in recognizing one's temperament, or physical and mental characteristics, and using this information to guide your lifestyle. temperament mizaj (temperament) itm is a holistic medicine based on individual differences, a concept known as "mizaj", or temperament. it is a set of physical and mental characteristics, defined by certain symptoms in the body and mind. according to itm, everybody has a definite mizaj which determines all physical or mental characteristics. generally, mizaj represents the excess or lack of warmness and humidity in one's body, and is classified into four qualities: warmness (persian: گرمی , transliteration: garmī), coldness (persian: سردی , transliteration: sardī), dryness, and wetness. mizaj is a spectrum, and some have warmer mizaj than others. no two individuals have exactly the same mizaj, but they can resemble one another to some extent. it is believed that mizaj is determined in the embryo. consistently, the parents' mizaj can also be a determining factor in the child's mizaj. while the mizaj is forming, one or two of the four qualities can become dominant and determine the main mizaj. therefore, the tempers are classified into nine categories: warm, cold, wet, dry, warm and dry, warm and wet, cold and dry, cold and wet, and moderate—where none of the qualities are dominant. there are no absolute good or bad temperaments, and as long as they are within their normal ranges—reflected in physical and mental health—they are in a balanced, or normal, state. as each person's mizaj differs from others, peoples' lifestyles will be different; this is the main essence of itm in maintaining health and treating illnesses. by adopting the kind of lifestyle that fits their mizaj, one should try to keep the inherent warmness and humidity of their body in certain range, as per their main mizaj, and avoid possible "mal-temperament". mizaj is not just confined to human beings. every object, situation, and state in the world has a special and defined mizaj. determining temperament the tempers, or amzajeh, are classified into nine categories: moderate, warm, cold, wet, dry, warm and dry, warm and wet, cold and dry, cold and wet. some identifying behavioral and physical characteristics help to determine one's temperament. frame being stout, sturdy, big-boned and prone to gain weight are signs of wetness, while not gaining weight and being thin are characteristics of dryness. body parts bigger faces, fingers, lips, noses, organs, and body parts are defining characteristics of people with wet mizaj, whereas people with dry mizaj have smaller body parts. complexion a rosy and ruddy complexion is a sign of warmness and wetness, while having a yellow cast is sign of warmness and dryness; on the other hand, a light and fair complexion is a distinctive characteristic of people with wet and cold mizaj. people with a dark complexion have a cold and dry mizaj. hair people with dry mizaj have coarse, curly and coiled hair; warmness causes the hair to grow faster. people with warm mizaj have thick black hair, with thick density and more volume. silky, straight, smooth, thin and fair hair which grows slower is a distinctive characteristic of people with cold mizaj. wetness would cause the hair to easily hold a curl or style. skin people with dry mizaj have dry skin, and people with wet mizaj have soft and squishy skin. people with cold mizaj feel cold and run colder than other people, and the reverse is true for those with warm mizaj. activity warmness brings about an increase in exuberance and energy levels, which boost speech and body movement, while coldness causes the reverse symptoms, as people with cold mizaj do not have much energy and are generally slow, and do not spend their time speaking and acting as much as people with warm mizaj. mental traits people with warm mizaj are normally more extroverted, sociable, and less patient, while people with cold mizaj are more introverted, calmer, and more patient. people with warm mizaj are more inclined to suffer stress and restlessness; however, people with cold mizaj have a tendency to experience depression and melancholic thoughts and may have hallucinations or sometimes delusions. however, one's personality traits may be modified or changed due to various factors such as upbringing, religion, spirituality, and one's striving to change their attitude. therefore, one's personality may not necessarily match their temperament. sensitivity people with warm mizaj are more sensitive to warmness (surrounding environment, foods and drinks); those with cold mizaj are more sensitive to coldness; those who have dry mizaj are more sensitive to dryness and those with wet mizaj are more sensitive to humidity. sleep sleeping too much or sleepiness is a sign of wetness and needing less sleep is a defining characteristic of dryness. waste waste (e.g. urine, sweat, and feces) in those with warm mizaj have strong color and odor while in people with cold mizaj the waste matters do not have a strong color or odor. organs's temperament all organs and body tissues have a specific mizaj. heart: the heart has a warm and dry temperament. the constant movement of the heart throughout one's life is determinant of its warmness. consuming too much food with warm mizaj such as pepper and spices results in palpitations. having a fixed shape and being stiff and firm are signs of the heart's dryness. brain: the brain, command center for the human nervous system, is cold and wet. the brain is composed of water in addition to the soft grey and white matter. the brain is capable of transmitting a great number of signals without failing. the way the brain is operating and its shape all are defining its cold and wet mizaj. consuming too many dairy products such as yogurt, water, or fruits and vegetables with high water content increase the coldness and humidity in the brain, which results in sleepiness and performance impairment. blood, liver, muscles: these organs are warm and wet. they are pretty warm and flexible and in order to protect them, stay healthy, and keep on living one must consume meat, bread and sweet food items which all have a warm and wet mizaj. however, overeating and consuming too much of these foods can cause a build-up of waste materials in these organs, which could manifest themselves with symptoms of polycythemia, fatty liver disease, muscle stiffness or inflammation in the muscles. bones, teeth, fingernails, and hair: these all have cold and dry mizaj. they are firm and rigid and in order to protect them and build strong bones, one must consume food with a cold and dry mizaj, like essential minerals such as magnesium, calcium, zinc, or iron. such minerals are found in kashk, wheat and rice bran, almond, and barley. due to their mizaj, these organs are sensitive to coldness and dryness, and an overabundance of these could cause pain in cold weather, toothaches, and brittle hair and nails. colors temperament colors have temperament, meaning that they can reveal an object's temperament, or intensify the temperament of an individual. the color yellow is the symbol of a warm and dry temperament, and red represents warm and wet mizaj. on the other hand, dark colors such as black, grey, and brown symbolize cold and dry mizaj, and bright colors such as white and blue are the symbols of cold and wet mizaj. warm colors are signs of warmness and can increase the temperature in a confined area. these colors are associated with danger, threat, warning, and movement. they can increase the metabolism in the body and put it on alert. therefore, those with cold mizaj who normally have a slow metabolism and feel sluggish should use warm colors for their clothes and houses, while people with warm mizaj should do the reverse. people with a warm temperament who are normally vibrant, brisk, lively and stressed should avoid using warm colors, and use cool colors such as white, blue, and light green. such cool hues can bring about a more passive reaction in the brain and can make a person feel pleased and relaxed. accordingly, cool colors are not ideal to people with a cold temperament. seasons temperament each season has a defining temperament, so individuals should take special measures depending on the seasons. spring: spring is warm and wet. individuals, especially those with warm and wet mizaj, should avoid consuming sweets, fatty, greasy, and heavy food items with warm mizaj during the spring. summer: summer is warm and dry. abstaining from foods with warm mizaj and sun exposure, using foods with cooling characteristics, and getting enough rest, particularly for people with warm and dry mizaj, is highly recommended during summer. autumn and winter: autumn is cold and dry, and winter is cold and wet. those with cold mizaj should cut back on foods with cold mizaj such as sour foods, dairy products and citrus fruits, and staying away from cold places is recommended to people with cold mizaj. on the other hand, consuming sweets and foods with warming characteristics, getting exercise, and staying in warm places is of benefit to them. day and night hours the amount of warmness and humidity fluctuate over days and nights, therefore different temperaments form: morning is cold and wet, before noon is warm and wet, the afternoon is warm and dry, and evening and night are cold and dry. the various mizaj of the day and night are the reasons behind mood swings and pain or discomfort varying during the day and night. flavors flavors have temperaments and accordingly would cause warmness, coldness, dryness and wetness in the body. one can determine the mizaj of a food item or a drink by taste alone. tasteless food items, also called watery, are cold and wet. every insipid food item such as lettuce, dairy products such as yogurt, and citrus fruits, which are not very sour or sweet are cold and wet. sourness is cold and dry and causes dryness and coldness in the body as well. vinegar and pickled vegetables, sour fruits or sour juices, and kashk are all cold and dry. salty, bitter and spicy flavors which are usually used to give foods a special taste are warm and dry, although spicy foods are warmer and dryer than bitter