Are the four humours of Unani medicine the key to better health?

Here’s how understanding the four humours can transform your health, bringing balance to your life with the ancient principles of Unani medicine.

In a conversation with Dr Safina Anees, a respected Unani practitioner,  I was introduced to the key role that this ancient system of medicine plays in keeping both the body and mind healthy. Central to Unani medicine is the concept of the four humours; blood, phlegm, yellow bile, and black bile, and each humour contributes significantly to our well-being.

The Comprehensive nature of Unani medicine

Unani medicine, rooted in Greco-Arabic traditions, has been practised for over 2,500 years. Like Ayurveda, it focuses on the idea that health is about maintaining balance. This balance revolves around the four humours, and if any one of them falls out of harmony, it can lead to illness. Dr Anees explains, “Each humour is linked to a natural element: blood to air, phlegm to water, yellow bile to fire, and black bile to earth. Keeping these humours balanced is the key to staying healthy.”

Understanding the four humours

The four humours (blood, phlegm, yellow bile, and black bile) influence both the body’s health and temperament. When they’re in balance, they help us stay energetic and resilient. Here’s a brief overview of each:

• Blood (Dam): Warm and moist, this humour represents energy and vitality. Too much blood can cause inflammation or high blood pressure, while too little can lead to fatigue or depression.
• Phlegm (Balgham): Cold and moist, phlegm helps cool the body and manage hydration. If it’s out of balance, it can cause respiratory problems or sluggishness.
• Yellow Bile (Safra): Warm and dry, it controls digestion and metabolism. An excess can cause acidity, hyperactivity, or heartburn.
• Black Bile (Sauda): Cold and dry, this humour is tied to digestion and mental health. If unbalanced, it can result in constipation or melancholy.

Dr Sumaiya Petiwala, a registered dietitian and general physician, adds, “Health in Unani is all about keeping the four humours balanced. If they become unbalanced, it can lead to both physical and mental issues, like fatigue or irritability.”

The Humours-Gut Connection

Much like modern medicine’s focus on gut health, Unani medicine also highlights the importance of digestion for overall well-being. In Unani, the digestive system is often referred to as the body’s ‘factory,’ as it processes and distributes nutrients throughout the body. When the digestive system functions well, it helps keep the body and mind in balance. A 2023 study published in Frontiers in Physiology backs this up, showing that the balance of bodily fluids, especially bile, plays a big role in regulating metabolism and maintaining health.

Unani dietary guidance for balancing the four humours.

Keeping the humours balanced is key to staying healthy and preventing illness. Unani medicine offers natural ways to restore balance, including diet advice, herbal treatments, and therapies like cupping (Hijama). These methods have been refined over centuries and are still effective today, especially for managing long-term conditions like digestive disorders, diabetes, and liver diseases. One of the most effective ways to improve overall health and wellness has always been through changes in our diet. Dr Petiwala says, “Dietary recommendations not only balance the humours but also improve overall health by addressing underlying metabolic and digestive functions.”

Here are some dietary tips to help balance each humour:

• For blood (Dam): Eat cooling foods like cucumbers, leafy greens, and pomegranates. If you’re experiencing heat or inflammation, avoid spicy and fried foods.
• For phlegm (Balgham): Warming spices like ginger, cinnamon, and black pepper can help with sluggish digestion and respiratory issues.
• For yellow bile (Safra): Eat hydrating and cooling foods like yoghurt and melons to reduce acidity and digestive heat.
• For black bile (Sauda): Warm, moist foods like honey, root vegetables, and oats can ease feelings of melancholy and help digestion.

Mental Health and the Four Humours

Unani medicine also recognises the link between physical and mental health, especially how imbalances in the humours can affect mood. Dr Sumaiya Petiwala explains, “An imbalance in black bile, for instance, is often tied to feelings of melancholy or depression. Balancing this humour can improve both digestion and mental well-being.”

An article in Psychiatric Times published in 2020 discussed how Avicenna recognised melancholia and linked it to an excess of black bile in the brain, emphasising the need to maintain a balance.

Prevention is key.

Unani medicine isn’t just about treating illness; it also focuses on prevention. Dr Safina highlights that “by following a good diet, getting regular exercise, and managing stress, you can keep your humours in balance and avoid illness.”

Practices like Dinacharya (daily routine) and Panchakarma (detox) are important in Unani medicine for long-term health. Regular detoxes help remove toxins that can cause imbalances, keeping both the body and mind in harmony.

Unani’s growing popularity

As more people look for natural alternatives to modern medicine, Unani has gained popularity for its focus on natural remedies and personalised care. A chapter in the 2024 book Preserving Health, Preserving Earth also explores how Unani’s personalised dietary interventions and focus on ecological conservation align with current health and environmental concerns.

Dr Safina concludes, “Unani’s strength lies in its ability to address chronic lifestyle diseases by focusing on restoring balance naturally, without the side effects of modern medicine.”

As we continue to face health challenges today, the ancient wisdom of Unani medicine is more relevant than ever. By understanding our body’s needs, balancing the four humours, and making simple lifestyle changes, we can find vitality and inner harmony.