Iranian traditional medicine

According to a definition given in one of the first Iranian Islamic medical textbooks called Hidayat al-Muta’allemin Fi al-Tibb [literally meaning ‘A Guide to Medical Learners’ containing articles about the elements, temperaments, humors, hygiene, anatomy, physiology, pathology, signs and symptoms of diseases and treatment of many diseases] written in Persian by Abu Bakr Rabee Ibn Ahmad Al-Akhawyni Bokhari in 10th century; medicine is a craft of scientifically and practically maintaining the health of human beings, and restoring it once it deteriorates.[1]

Therefore, it is important to recognise and ensure one's health and then in case of a disease nurse them back to full health, which is the most comprehensive definition of medicine provided today that underscores the primary mission of medical practices.

Consistently, Iranian traditional medicine focuses on prioritising health maintenance over treating diseases.

Iranian traditional medicine is a holistic medicine which has been based on individual differences, a determinant basic concept named as mizaj (temperament), a set of physical and mental characteristics defined by examining one's symptoms and signs in the past and in the present.[7][8] According to Iranian traditional medicine everybody has a definite mizaj which is determinant to construct all physical or mental characteristics.[9] Generally, mizaj represents the excess or lack of warmness and humidity in one's body and is classified into four categories - also called four qualities - of warmness, coldness, dryness and wetness. Mizaj is a spectrum, meaning that two persons might have warm mizaj but one's mizaj might be warmer than the other one. In fact, no two individuals have exactly the same mizaj, however they can resemble one another to some extent. Relatively speaking, mizaj and genetics are similar in that once an embryo starts to develop, its mizaj will be determined. Consistently the parents' mizaj can also be a deciding factor in the child's mizaj which is also referred to as the “inherent” or “main” mizaj with which one is born.[8]

While mizaj is forming, one or two of the four qualities of warmness, coldness, dryness, and wetness might become dominant and decide the main mizaj. Therefore, regarding which quality is more dominant, the tempers are classified into nine categories of warm, cold, wet, dry, warm and dry, warm and wet, cold and dry, cold and wet, and moderate (when none of the qualities are dominant).

There are no absolute good or bad temperaments, and as long as they are within their normal range - reflected in physical and mental health - they are in a balanced (normal or good) state. So, each individual should maintain their own balanced state during their life by choosing the kind of lifestyle which suits them best by corresponding to their own distinguishing mizaj. As each person's mizaj differs from another one's, peoples' lifestyles will necessarily be different; this is the main essence of the Iranian traditional medicine in maintaining health and treating illnesses.

By adopting the kind of lifestyle which fit each person's 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" (or s'ou-e-mizaj).[10]

Mizaj is not just confined to human beings but literally every object, situation, and state in the world has a defining mizaj which has an impact on human beings' health.

The tempers (amzajeh) are classified into nine categories: moderate, warm, cold, wet, dry, warm and dry,[11] warm and wet,[12] cold and dry,[13] cold and wet.[14]

Displaying some identifying behavioural and physical characteristics would describe one's temperament.[15]

• Being stout, sturdy, big-boned and prone to gain weight are signs of wetness, while not gaining weight and being thin are the distinguishing characteristics of dryness.[16]

• 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.[16]

• 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.[16]

• People with dry mizaj have coarse, curly and coiled hair; warmness causes the hair to grow faster and 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.[16]

• People with dry mizaj have dry skin, and people with wet mizaj have soft and squishy skin. Having naturally high body temperature once someone touches people with warm mizaj tells they are warm. People with cold mizaj feel cold and run colder than other people and once someone touches them can tell they are colder than normal.[16]

• Warmness brings about an increase in exuberance and energy levels, which boost speech and body movement and speed, while coldness causes quite the reverse symptoms, as people with cold mizaj don't have much energy and are generally slow, and take their time speaking and acting.[16]

• People with warm mizaj are normally and usually 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.[16]
• However, keep in mind that 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.[16]

• 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.[16]

• Sleeping too much or sleepiness is a sign of wetness and needing much less sleeping hours is a defining characteristic of dryness.[16]

• Waste matters (e.g. urine, sweat, and feces) in those with warm mizaj have strong colour and odour while in people with cold mizaj the waste matters don't have strong color or odor.[16]

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 proof of its warmness. Consuming too much food with warm Mizaj such as pepper and spices would give the person palpitations. Having a fixed shape and being stiff and firm are the signs of the heart dryness.[17]
• Brain: The brain, command centre for the human nervous system, is cold and wet. The brain is composed of water in addition to the squashy and 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 much dairy products such as yoghurt, water, and fruits and vegetables with high water content such as water melon, peach, or lettuce would increase coldness and humidity in the brain and result in sleepiness and impair its performance.[17]
• 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 fairly sweat food items which all have warm and wet Mizaj. However, overeating and consuming too much of the aforementioned food items would cause a build-up of waste materials in these organs which would manifest themselves by displaying symptoms of polycythemia, fatty liver disease, muscle stiffness and inflammation in muscles.[17]
• Bones, teeth, fingernails, and hair: They all have cold and dry Mizaj. They are firm and rigid and in order to protect and reinforce them and build strong bones and teeth one must consume food with cold and dry Mizaj such as essential minerals (magnesium, calcium, zinc, iron, etc.). Such minerals are normally found in Kashk (dairy product made from drained yogurt), wheat and rice bran, almond, and barley. Therefore, due to their Mizaj, these organs are sensitive to coldness and dryness. Coldness and dryness could bring about pain in bones in cold weather, toothache by having something cold, and brittle and dry hair and nails.[17]

Colors have temperament, meaning that they can reveal the real temperament of the objects or intensify the temperament of the individuals.[18]

The colour yellow is the symbol of warm and dry temperament and red represents warm and wet Mizaj. On the other hand, dark colours such as black, grey, and brown symbolise cold and dry Mizaj and bright colours such as white and blue are the symbols of cold and wet Mizaj[18].

Warm colours (red, orange, and yellow) are signs of warmness and can increase the temperature in a confined area. These colours are associated with danger, threat, warning, and movement and the way they affect the brain they increase metabolism and heat in the body and put it on alert which from Iranian traditional medicine point of view are a sign of excessive heat.[18]

Therefore, those with cold Mizaj who normally have slow metabolism, and feel sluggish had better use warm colour for their clothes and houses while for people with warm Mizaj the reverse is true. People with warm temperament who are normally vibrant, brisk, lively and stressed should avoid using such colours and use cool colours 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 colours do not suit people with cold temperament.[18]

Each season has a defining temperament and that's why they differ from one another dramatically. So individuals must 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 stuff and food items with warm Mizaj during spring. Instead they had better to eat light food with cold Mizaj.[18]
• Summer: Summer is warm and dry. Abstaining from foods with warm Mizaj and sun exposure, and using foods with cooling characteristics and taking enough rest particularly for people with warm and dry Mizaj is highly recommended during summer.[18]
• Autumn and winter: Autumn is cold and dry and winter is cold and wet. Those with cold Mizaj should take better care of themselves during these seasons. Cutting 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 such as spices, getting exercise and staying in warm places is of benefits to them.[18]

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, 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.[18]

Flavors have temperaments and accordingly would cause warmness, coldness, dryness and wetness in the body. One can simply decide the Mizaj of a food item or a drink by tasting them to a great extent.

Tasteless food items, also called watery, are cold and wet. Every insipid food item such as lettuce, dairy products such as yoghurt, or doogh (a yogurt-based beverage) and citrus fruits which are not too much sour or sweet are cold and wet.[19]

Sour flavour is cold and dry and cause dryness and coldness in the body as well. Vinegar and pickled vegetables and fruits preserved in vinegar, sour fruits or sour juices, verjuice, and Qarehqurut or black kashk (fabricated from the liquid yoghurt) are all cold and dry.[19]

Salty, bitter and spicy flavours which are usually used to give foods a special taste are warm and dry. Although spicy foods are warmer and dryer than bitter and salty foods respectively.[19]

Sweet flavour is warm and wet and most food items (including main dishes and high-calorie food) are classified in this group and that's why many people like sweet food and drinks.[19]

With that being said people with cold and dry Mizaj (melancholic temperament) who are normally thin and don't gain much weight with dark complexion and rough and dry skin, particularly in autumn (a cold and dry season) and in mountainous areas should avoid consuming sour foods and drinks or they are most likely to develop conditions such as dry skin, depression, and weakness.

The same goes for people with other temperaments, for instance, people with warm and wet Mizaj (sanguine temperament) should cut back on sweet foods, people with warm and dry Mizaj (choleric temperament) should avoid using much spices and salt, and people with cold and wet Mizaj (phlegmatic temperament) must use dairy products, water and citrus fruits cautiously.

Each climate has its own unique temperament. In general polar regions, mountainous areas with rocky landscapes and sandy grounds and north winds are cold and dry. Salt marshes and deserts are warm and dry. Coastal areas are cold and wet and the tropics are warm and wet.[19]

In Iran, southern, some eastern and mostly central areas which are getting the most sunlight and low humidity are warm and dry. Coastal areas in southern Iran and northern Iran (only during hot seasons) are warm and wet. Western and northwestern areas which are dominantly mountainous are cold and dry and coastal areas in northern Iran (except for warm seasons) are cold and wet.[19]

The house orientation, whether the house is south-facing or north-facing or built underground determines the house temperament. North-facing houses (in Iran) with less sun exposure, underground houses or houses built in damp and humid places are cold and wet or cold and dry. But south-facing houses which get enough sunlight and built in warm places are normally warm and dry.[19]

Even winds can develop a distinguishing temperament in an area. Winds blowing from northern and north western areas in Iran are cool and can cause a cold temperament while winds blowing from southern areas are warm and develop a warm and wet temperament in a place. Western and eastern winds are moderate and won't change the temperament much so it's better for the windows to be on the west and east sides of the house in Iran to get the eastern and western winds.[19]

The type of soil of an area also counts. Areas with loamy and clay soil which have great potential of retaining water are wet while areas with chalky or sandy soil composed of the large particles which prevent it from retaining water are warm and dry.[19]

Any changes in the psychiatric condition affect human’s temperament to some extent. The longer and deeper the conditions are the more dramatic and lasting the effects are. On the other hand, changes in one's temperament would influence psychiatric condition as well.[20]

By releasing the heat from inside the body to the surface and vice versa and by absorbing heat from the body's surface such psychiatric conditions would cause warmness or coldness in the body.

Anger and excitement increase warmness and dryness in the body and are the signs and also the cause of dry and warm Mizaj as someone with warm and dry Mizaj is more prone to get angry or excited. People who consume too much warm and dry food stuff might be affected by anger and excitement more often.

Therefore, all lifestyle tips for warm and dry Mizaj (temperament) would apply to anger and excitement as two psychiatric conditions. Eating spicy, sweat, salty, deep fried and roasted food stuff especially in warm seasons would trigger anger and excitement.

Pleasure and worry are warm and wet while fear, horror, and depression can be a result or sign of cold and dry or in some cases cold and wet Mizaj.[20]

Someone who is suffering from depression tends to sleep to evade the sad thoughts and this would cause wetness in the body. People who are preoccupied, cynical, pessimistic, skeptic, or experience mental or emotional instability must know that they might either have a cold temperament or consume too much food stuff with cold and wet or cold and dry Mizaj.[20]

These people should cut back on dairy products, watery and sour fruits and other food stuff of the kind. Instead they had better use food and hot drinks with warm temperament. Kebabs, spices, salty and spicy food, cinnamon tea, saffron tea, mint tea, or ginger tea suits such people as the fear and the sadness they feel caused by cold Mizaj of their brain or body would go away and they feel more courageous and fearless.

One should not necessarily experience the fear or anger, even imagining such psychiatric conditions would produce the same result.

In order to maintain mental health one can both practice self-control and seek professional help and consultations. But more importantly adopting a lifestyle that suits one's Mizaj by consuming foods and drinks in accordance with their temperament is very important in keeping mental health.

If someone with warm Mizaj keeps eating food stuff with warming characteristics particularly during warm seasons it is not very unlikely for them to lose their temper. So in order to remain healthy, both physically and mentally, one should firstly reconsider and reform his or her lifestyle and diet and then seek professional help or study more deeply about the situation.[20]

Moderate exercise would increase the heart rate and breathing (respiratory) rate, excrete sweat from the sweat glands which then evaporates off of the skin, more blood is able to near the surface of the skin making the skin feel warm and look red and finally make people often feel so at ease and cheerful. All these are symptoms of warm temperament which means taking exercise would lead to warmness in the body.[21]

But high-intensity exercise would drive the body to excessive coldness, weakness, getting blue face or lips after exercise; moreover after heavy exercise heart rate would take much longer to return to base which is not healthy.

Additionally, as getting exercise would increase heat in the body the humidity and other unwanted materials would excrete from the body through the bowels or the skin which result in dryness so taking exercise would do much good to people with warm and wet Mizaj (sanguine temperament) who are stout, sturdy, and burly with muscular body and also cold and wet Mizaj (phlegmatic temperament) who have coldness and wetness in their bodies. Although in general getting them is of benefit to everyone.[21]

On the contrary, lack of movement slow the metabolism and humidity and waste materials would accumulate in the body and drive the temperament to coldness and wetness which is accompanied by weakness, lethargy, obesity, and puffiness.

Certainly compared to light and mental exercises such as swimming and chess, vigorous and outdoor exercises such as football, and running have warmer and drier temperament.

In general, from Iranian traditional medicine point of view, anaerobic exercises which consist of short exertion and high-intensity movement would mostly increase the heat in the body and won't decrease the wetness much so they best suit people with cold Mizaj and don't help much in losing weight. On the other hand, exercises which are of light-to-moderate intensity and can be performed for extended periods of time would decrease the wetness and increase the heat in the body and therefore those with warm Mizaj who want to lose weight would benefit such exercise.

Sleep is a passive, dormant part of our daily lives while wakefulness is daily recurring brain state and state of consciousness. Sleep is physical and mental rest and wakefulness is the state of physical and mental activity.[21]

Therefore, the longer one stays up the drier and warmer their bodies get and the longer one sleeps the wetter the brain and the body gets and their temperament would drop lower. Actually while one is sleeping the body temperature drops meaning that the heat would move from the surface of the body and that's why one might need a blanket during night. During the day the heat would move to the surface of the body and the body temperature raise.[21]

In any cases that one is forced to get less sleep (having to study for an exam, being under mental pressure or having to finish a project) the brain and the body would get warmer and drier so in order to control the excessive warmness or dryness in the body one should cut back on warm and dry food stuff. Additionally taking a short nap during the day (20 minutes) especially in warm climates and seasons is highly recommended to them.[21]

Besides, those with cold and wet Mizaj should not sleep much as long sleep would increase wetness in the body. People with phlegmatic temperament should cut down on food items cold and wet temperament to sleep shorter and get up easily and not having trouble waking up. They had better wake up once or twice during the night so that wetness would not build up in their bodies.[21]

Although each person is born with a fixed and unique temperament, also called inherent or main Mizaj, with the passage of time the main Mizaj is subjected to fluctuation. For example, someone's Mizaj might get drier but this doesn't mean that they are suffering mal-temperament.[22]

Taking that into account, in addition to the main Mizaj, one must take heed of the temperament of the age as well and take necessary actions to stay healthy.

• Based on Iranian traditional medicine since one is born until the age 25 to 30 is called the “growth period” with the preponderance of warmness and wetness. To keep teenagers and children healthy they are recommended to consume food stuff with warm and wet Mizaj. Eating bread, meat, rice with bran, fruits especially apple and sometimes banana is good for them. However, one should be careful to avoid excessive warmness.[22]
• As one is growing up in this period they need to consume more food and increase their nutrient intake. Eating diverse types of foodstuffs and high quality food is of importance to this age group.

• From age 30 to 40 is called “youth” when the wetness will dwindle and the warmness and dryness will be more dominant. One should not use much food stuff with warm and dry Mizaj as it increases the yellow bile in the body.
• Many might break out in pimples, get irritable, and suffer sleep deprivation. Such people should abstain from spices, pepper, spicy food stuff, sweets, salty and deep fried food items. Instead they should use food stuff with cooling characteristics such as pomegranate, pomegranate juice, sour cherry, peach, lemon, lime juice, barberry juice, verjuice, lettuce, sekanjabin (Iranian drink made of honey, mint and vinegar), vegetable soups and dairy products such as yoghurt to moderate the warmness and dryness in the body. They can also use lifestyle tips for people with choleric temperament.
• During growth period and youth one has a strong digestive system and can easily digest heavy food such as meat.[22]

• Between the age 40 to 60, called “middle age”, warmness and wetness will plummet and instead, coldness and dryness will be predominant in the body. After the age 60, also called “old age”, abnormal wetness may occur in the body so the Mizaj will become cold and wet. And due to the excessive wetness for many old age is synonymous with puffy eyes and face, loose skin, drowsiness and loss of memory.[22]
• In some other cases coldness and dryness will be more predominant in the body. Therefore, the coldness and dryness affiliated with the old age would cause wrinkles, curvature of the spine, drop in body temperature, poor digestive system, and puffy eyes and face.
• Generally with the old age, comes decrease in warmness and wetness and the temperament of people aging over 60 will get colder and drier compared to their main Mizaj. That's why lifestyle tips for people with melancholic or phlegmatic temperament would also suit people age over 60.
• Due to their poor digestive system the elderly should abstain from fatty food, leftovers, deep fried foods, fast foods, tomato paste and sauces, and conserves and instead they should consume high calories and low volume foods. They should also cut back on water, dairy products, fruits with cooling characteristics, and sour food items.[22]
• They had better eat vegetables, celery, chives, fig, grape, raisin, walnut with fresh cheese, and almond porridge with honey or rock candy, fresh bread, lamb meat, meat extract, almond, pistachio, coconut and coconut extract, fruits such as sweet apple, grape, partridge and quail meat.
• Eating Abgoosht (Iranian stew made with lamb, chickpeas, white beans, onion, potatoes, and tomatoes, and dried lime) provided that it is not too fatty and is cooked well with cumin and apple is recommended to the elderly. Eating wheat Haleem (a stew made of wheat and meat) and drinking goat warm milk with honey also suit them. However, they should avoid drinking cold milk while they are hungry.
• In order to avoid constipation which is pretty normal at old age, eating plum or fig which are soaked together and drinking sweet almond oil or olive oil is of benefits.
• Applying moderate oils such as sweet almond oil or violet oil (for people with warm inherent Mizaj) on the body surface is also good for these people. Wet cupping therapy is not recommended to these people unless a physician order in a special condition.
• People over 40 must know that they had better follow lifestyle tips for old age and take them more seriously after age 60.

There are cases when the patient is diagnosed with excessive warmness in their bodies.[23] Here are reasons as to why someone might experience conditions caused by excessive warmness in their bodies:

• Heavy and fast exercise, intense activity, and getting too much high speed massage
• Great anger or happiness
• Being exposed to heat, either sun, or fire for a long time
• Consuming food stuff with warming characteristics or warm Mizaj such as date, pepper, etc.
• Clogged pores which reduce sweat
• Infection and infectious diseases which cause fever and excessive body heat
• Having a warm temperament, as people with warm Mizaj are more prone to be affected by warm Mizaj food stuff or warm environment than people with cold Mizaj

Fast heart rate, breaking out in pimple and mouth ulcers, and sleep deprivation are the side effects of excessive warmness.

Some actions or consuming some food stuff can contribute to excessive coldness in the body:[23]

• Lack of movement or not taking exercise
• Profound sadness and disturbing thoughts which lead to sleep deprivation and restlessness
• Intense mental or physical activity which will first increase the warmness but will ultimately result in nutrient deficiency and lack of warmness in the body
• Being in cold, dark and damp places
• eating, and drinking food stuff with cold Mizaj or rubbing cold ointments for long time
• Taking too many showers or baths which unclogs the pores, work up a sweat, and decrease the warmness in body
• Not eating much or going on starvation diet
• Overeating which slows digestion and decrease warmness in the stomach; poor digestive system would not efficiently convert food to energy, bad materials build up in body and the body would become cold

Unfortunately people with cold Mizaj can soon be affected by mal-temperament caused by excessive coldness by consuming food stuff with cold Mizaj.

Below is the list of reasons one might suffer conditions sparked by excessive dryness:[23]

• Factors contributing to increased warmness, such as being adjacent to fire, intense activities and heavy exercise which raise the warmness and correspondingly deplete the body of its natural humidity
• Being stressed out, overexcited, and feeling ecstasy as well as being preoccupied and sleep deprived
• Dry climate and seasons such as summer and autumn and residing in dry areas such as mountains and deserts
• Construction jobs and pottery and being in close contact with soil, stone and building materials
• Being in close contact with paint and solvents especially painters and those working in labs
• Consuming food stuff with dry Mizaj such as vinegar or salt, or applying volatile substances such as oil, gasoline, alcohol, ether, acetone, hair color and nail polish topically
• Not eating much (fasting for long time) as the body is unable to gain and maintain normal level of humidity

It is worth mentioning that thin people with dry and cold and dry and warm Mizaj are more likely to suffer from excessive dryness.

On the other hand, some actions and eating some foods and drinks can lead to excessive wetness in the body.[23]

• Lack of movement and not taking exercise which would cause excessive wetness built up in the body, getting swollen and puffy and not being able to rid of it
• Staying long in wet places such as bath or swimming pool
• Wet climate or seasons such as spring and winter or residing in coastal areas
• Being in close contact with water, for instance by working in paddy fields, teaching swimming, or being a lifeguard
• Consuming too much food and drinks with wet Mizaj such water, dairy products, vinegar, sour food, lettuce, peach, and nectarine as well as rubbing oils with wet Mizaj such as violet oil
• Overeating as the digestive system is not capable of converting the food into energy properly and that unwanted materials and humidity will build up in the body
• Decrease in the amount of body waste (sweat, menstrual fluid, urine, feces) discharged from the body which causes excessive wetness in the body

Again, overweight people with wet Mizaj are more prone to suffer excessive wetness.

• People with choleric temperament are usually tall and thin. They have a small frame, for instance, their fingers, lips, and other body parts are not much big and they are unlikely to get overweight.[24]
• They have a dry and warm skin colour with yellow and sometimes peachy undertone.
• They have rapid pulse, are exuberant, quickly finish what they are supposed to do – usually perfectly and carefully – and speak fast.
• People with warm and dry Mizaj mostly feel hot and have naturally high body temperature.
• Due to the dryness of their Mizaj they might suffer constipation and waste matter (urine, sweat, and feces) discharged from their bodies usually has strong odour and colour.
• Burning in the anus and urinary tract can be common among this group.
• Due to the warmness in their body they soon digest food and as they don't have adequate amount of nutrient supply to provide the energy needs of the body they soon get hungry and irritated if they don't get enough food timely.
• Normally their mouth gets dry soon.
• Due to the warmness in their body which moves upward to the head their hair grow faster. They have coarse thick black hair. Premature graying and hair loss is prevalent among these people.
• As they're able to think fast and act fast, they might lose concentration to some extent, in other words they may undertake multiple tasks at the same time and give up some of them halfway through them. Accordingly, they might be pegged as hyperactive.
• They have keen senses and can easily notice the smallest changes in smells, voices, taste, color, etc.
• They are overly sensitive and will be easily upset or offended by events or things that people say and must be treated delicately.
• They don't need much sleep and actually seem fine and ready for work with a little amount of sleep. They are not very sound sleepers and are prone to suffer stress, anxiety, and sleep deprivation.
• They are idealist and fond of efficiency. They are also in favour of punctuality as well. Once they make an appointment they are always worried not to get there on time.[24]

Here are some lifestyle tips for this group:

• People with warm and dry Mizaj are better not to consume deep fried food stuff specifically during hot seasons.
• Choleric people should not consume large amounts of food stuff such as pepper, garlic, cinnamon, and ginger as well as spicy and salty foods. They are better not to eat much sweets either.[25]
• They should also consume small amounts of red meat and abstain from eating other hot Mizaj meat with warming characteristics such as camel, quail and partridge meat as much as possible.
• Although honey is of great benefits, those with warm and dry Mizaj are not recommended to take too much of it particularly during hot seasons; however, eating honey in cold seasons is fine for them.[25]
• Tomato paste and sauces, specifically hot and chilly sauces, are pretty harmful for such people. They should use egg (especially yolk) the least possible during summer.
• Considering their Mizaj eating Abdoogh Khiar (a cold cucumber and yogurt soup) is highly recommended for these people during summer. Of course eating too much of it might cause flatulence.
• Additionally, eating vegetables such as lettuce and other summer fruits with cooling characteristics (cold Mizaj) is recommended as well. However, they have to be cautious about eating vegetable with warming characteristics (warm Mizaj) such as tarragon, leek, cress which also have strong tastes.
• In general people with warm and dry Mizaj can experience a healthier life by consuming food stuff with cooling characteristics such as sour or sweet-and-sour food items and drinks like barberry juice, raspberry juice, or pomegranate juice, liquid chicory extract (Kasni) and fumitory extract (Shahtareh), as well as flixweed.
• Such people should avoid direct sun exposure; warm colours such as yellow and red either of their clothes or their surrounding environment would stimulate and increase their internal heat.
• Watching thrillers and rock music are not recommended to these people.
• Placing drops of violet, zucchini or coriander oil in each nostril or rubbing the oils on the face is of benefits for this groups.
• Taking daily showers proved to be advantageous for people with choleric temperament as the wetness of the shower would help to balance the warm and dry Mizaj of these people.
• Accordingly, floating in water for example in a cold tub, swimming pool, or bath tub as well as using cool moisture humidifiers could be of benefits for these people. However, it is ill-advised to use a dry sauna.
• Staying up for long hours, engaging in intense activities, and being stressed out and anxious which will all increase the heat in the body should be avoided as much as possible particularly in hot seasons and warm climate.[25]

• People with sanguine temperament are normally gregarious, sociable and cheerful. They are usually in high spirits, beaming and funny, patient, and adaptable.[26]
• They have rosy and ruddy complexion and soft and smooth skin. They also have thick black hair, with thick density and more volume which can easily hold a curl or style.
• People with sanguine temperament are stout, sturdy, and burly with muscular body.
• These people have bigger veins which are prominent and easily seen through the skin in the arms and legs. They also have a more powerful and stronger pulse.
• They rarely get sick; however, they are more prone to develop diseases such as obesity, hypertension, blood clots, high cholesterol, and high uric acid.
• Drowsiness, particularly in spring, is pretty common among people with sanguine temperament.
• They are more likely to get abscess or pimple.
• They are good leaders and due to their wetness, they are patient and very well manage and cope with those inferior or superior to them.
• Their bodies feel squishy and warm.
• Those with warm and wet temperament have good appetite and have a craving for meat, bread, rice and in general wider selection of dishes.
• Waste matter (urine, sweat, and faeces) discharged from their bodies have usually strong colour and odour. As they consume food in large quantities they expel more body waste.[26]

Lifestyle tips for people with sanguine temperament are listed below.

• Similar to people with choleric temperament, those with sanguine temperament had better not consume large amounts of food with warming characteristics (warm Mizaj) especially in warm seasons and warm climate.[27]
• Consuming high calorie and heavy food items, such as red meat, camel meat, turkey, large amounts of bread and rice and liver especially during spring and summer (warm days) is not recommended to this group.
• In general, diet high in starchy foods such as pasta, potato, and egg is not very much to the benefit of sanguine people. People with warm and wet Mizaj should consume butter, cream, sweats, salty and spicy foods the least.
• Different kinds of ash (a thick soup or stew, which is usually served hot) such as rice ash, verjuice ash, sumac ash, pomegranate ash, Sekanjabin (one of the oldest Iranian drinks; a syrup made of boiled water, sugar and vinegar) ash, soups, broths and stews, light vegetarian cooked or steamed food, and Abdoogh Khiar (a cold cucumber and yogurt soup) are best for them.
• Heavy ash such as ash-e Reshteh (a thick soup with thin noodles, vegetables and beans, chickpea, lentil, etc.) or ash-e Shole Ghalamkar (another thick soup with beans, peas, lentils, leafy vegetables, rice, etc.) and Haleem (a stew which includes wheat or barley and meat as main ingredients) are not of much benefit for these people. Only light ash with small amounts of beans, fresh vegetables and slight sour taste are recommended to people with warm and wet Mizaj.
• Fasting and even in some cases skipping lunch (however cautiously) would be beneficial for these people. They should wait for hunger to hit them in order to eat.[27]
• They should consciously avoid being in warm and humid conditions such as sauna, steam room, or a bathroom filled with steam.
• As they have muscular body and a body composition of larger proportion of muscle tissue rather than fat they need to exercise and lack of movement would cause waste products and other toxins to build up in their bodies. Therefore, they are more prone to develop high uric acid and cholesterol levels.
• Consuming low-calorie food stuff which only fills one up without gaining weight such as light stews, celery, carrot, olive, lettuce, cabbage, broccoli, spinach, and zucchini are recommended to this group of people.
• People with warm and wet Mizaj are advised to donate blood and receive wet cupping therapy. As a general rule, enhancing body's natural ability to detox through main exit routes for toxins such as urine, feces, and perspiration is pretty good for this group.
• Drinking liquid chicory extract (Kasni), fumitory extract (Shahtareh), sour and sour-sweat Sekanjabin, pomegranate, lemon, or barberry syrups would also benefit them.
• Vegetables, salads and watermelon are also good provided they don't over eat. Consuming sour fruits and adding sour food items to stews and ash would be of advantage to them.[27]

• People with melancholic temperament are usually thin and have a small frame. They don't have much big body parts and they don't gain weight.
• They have a dark complexion and are likely to develop dark spots on their skin. Their skin is dry and rough and is prone to get wrinkles and show signs of premature skin ageing.[28]
• Their hair is coarse, curly and coiled. They also have excessive unwanted hair (hirsutism).
• From mental point of view people with melancholic temperament tend to be introspective and introvert. They act and speak unhurriedly and might need more time to accomplish a task but they do it perfectly.
• They might have negative thoughts. They can be perceived as cynical, skeptic, distrustful and suspicious and are more likely to develop mental disorders such as depression. They are also likely to have more nightmares than other people.
• They don't sleep much, have trouble falling asleep fast, they have a lower sleep efficiency which might cause disturbed sleep. They have a retentive memory.
• They are much more likely to suffer constipation and dry skin. Body waste discharged from their bodies (including urine, faeces, menstrual fluid or sweat) might become dark in colour. They are not in favour of change. For example, they try to wear the same clothes and perfumes as much as possible.
• They are sensitive to food stuff and drinks with cold and dry temperament and they have to cut down on pickled fruits and vegetables, food stuff with vinegar content, lentil, eggplant, leftovers, and fast food.[28]

Lifestyle tips fitting people with melancholic temperament are listed below.

• People with melancholic temperament should not stay in dark and dim places for long.[29]
• They should not take cold showers and stand in front of an air cooler. Living in warm and humid areas suit these people.
• Watching thrillers, tragedies and horror movies and reading tragedies might have some adverse effects on them.
• They had better to spend their lives by visiting family and friends, going to picnics, watching comedies and wearing colorful clothes and in general have fun.
• Wet cupping therapy is not recommended to this group as they usually suffer mild anaemia and weakness to some extent.
• They should abstain from fast food, vinegar, pickled food with vinegar content, eggplant, cabbage, and mushroom.
• Consuming meat with moderate Mizaj (not warm or cold) such as lamb, fresh wheat bread, sweat fruits, cardamom, cinnamon, and nuts especially pistachio and almond is advantageous to them.
• Taking regular but gentle and light exercise is of benefits for them, however exercising in a cold gym or under strong sun is not good for them.
• People with cold and dry temperament should not wear perfumes with cooling characteristics such as violet or lilac, but wearing rosewater perfume is agreeable to their temperament.
• To decorate their houses they can use colourful tableaus.[29]

• People with phlegmatic temperament usually feel cold and run colder than other people.[30]
• They are light, fair and smoothed-complexioned and relatively speaking they have fine, glowing, radiant, and flawless skin. They have silky, straight, smooth and thin hair. They don't have much unwanted hair.
• Their body parts are big. They are normally bulky and quickly gain weight with a body composition of larger proportion of fat rather than muscle tissue and they usually seem swollen. They take their time thinking, speaking and acting.
• They oversleep and as they get up they feel they haven't got enough sleep. They usually have trouble waking up and they wake up tired.
• These people are prone to wake up with swollen feet, hands and puffy face specially after sleeping in the evening.
• They feel dizzy and tired early morning particularly when it's cold or they have consumed food or drinks with wet Mizaj such as yoghurt, sour food stuff or Doogh (a savory yogurt-based beverage popular in Iran).[30]
• They usually are more sensitive to cold and humid weather. They are sensitive to dairy products, sour foods, large amounts of water, and high-water-content foods and should cut back on them.
• Due to the wetness of their bodies and brains, they tend to have a poorer and shorter memory compared to people of other temperaments, as wetness and coldness would result in decrease in transferring and storing data.
• People with cold and wet Mizaj are endlessly patient and calm and can put up with people with all sorts of belief.
• They expel fairly large amount of waste matter (urine, sweat, and faeces) but the waste matter don't have strong colour or odour unless waste materials have built up in their bodies.
• They don't have much strong pulse, neither do they have prominent veins. They also tend to suffer low blood pressure.[30]

Lifestyle tips that suit people with phlegmatic temperament are outlined below.

• Eating food stuff with cold and wet Mizaj is not recommended to people with phlegmatic temperament especially during cold seasons and in cold climate.
• In general they had better not to consume watery food such as soup or ash (kind of Iranian soup featuring noodle, beans, and vegetables) and stews. They should also try not to eat too much pasta, potato, and rice which would cause them to gain weight.[31]
• They should abstain from dairy products (cheese, yoghurt, or doogh - a savoury yogurt-based beverage), sauces, mayonnaise, sour paste or sour food items.
• Eating vegetables or fruits with cold Mizaj such as watermelon, cucumber, peach, plum, lettuce, and spinach is of no benefits to them, however, eating sweat fruits such as banana, apple, and quince would be advantageous to them.
• Consuming low-volume high calorie food such as salted or roasted almond, pistachio, raisin, and fig is good for them. Taking food stuff such as fig, melon seeds, radish, and thyme that trigger diarrhoea or urination which could lessen the wetness in their body and create a feeling of lightness and joy is recommended to this group.
• They should cut back on thick food such as barely soup, kalleh pacheh (a dish of boiled cow or sheep's feet and head) and tripe. Instead, eating high calorie and low-volume food such as Kabab Barg (a Persian style barbecued and marinated lamb dish), Kabab Chenjeh (pure meat and very similar to western steaks usually made from the meat of newly slaughtered sheep, when it's still soft and fresh) egg yolk, and quail.
• They had better have mint, chives, tarragon, or mountain vegetables such a thyme or other vegetables grow in local areas as well as onion and garlic with their meals which all have warm Mizaj, suit their temperament and help them fully and easily digest their food.[31]
• Adding salt and spices such as pepper, cinnamon, saffron, and ginger into their food is also of benefits to them.
• Being in cold and humid places such as bathtub, swimming pool, cold tub, and steam sauna is not good for them, while taking intense exercise such as jogging, running, cycling especially under low sun is recommended to them.
• While sleeping they had better use a hard mattress, use blanket, cover their head or sleep near to a heater with their head closer to it.
• Sleeping uninterruptedly for long hours would increase wetness in the body so people with phlegmatic temperament had better to get up during the night and then go back to sleep again.[31]
• Sleeping during the day especially in autumn and winter is not advised to these people. They should sleep in warmer places relatively stretching the body and soft sports after getting up is beneficial to them. Doing this in the morning would decreases the chances of dizziness, tiredness, puffiness, Post Nasal Discharge (PND) and memory loss.
• Wearing perfumes with warm and strong scents as well as wearing clothes with warm colours such as red, yellow and orange is advised to them.
• People with cold and wet Mizaj need warmness and blood (which is a very warm substance) in their bodies so they are ill-advised to undergo bloodletting therapies such as wet cupping therapy, phlebotomy and leech therapy. Cupping therapy without taking any blood is all right.
• Watching sad, horror and philosophical movies is not appropriate for these people while watching comedies and thrillers which increase the warmness in the body very well suit them.[31]

As mentioned previously everything around us in this world has Mizaj and Akhlat are no exception. Akhlat can be also examined according to their warmness and humidity :

• Yellow bile is warm and dry, in case it increases in the body the body will become warmer and drier
• Blood is warm and wet, excessive blood will surge warmness and humidity in the body
• Black bile is cold and dry, similarly with copious amounts of black bile the body will get drier and colder
• Phlegm is cold and wet, high amounts of phlegm in the body will rise coldness and humidity in the body

• Yellow bile is not as abundant as phlegm and blood in the body. It is the lightest of all humours. It resembles cooking foam. Yellow bile acts as a diluent and facilitates the transfer of blood and nutrients from capillaries to the remote body organs.[35]
• It is also in charge of metabolism of fats and lipids and ease digestion. Yellow bile is tasked with cleaning up the digestive system, vascular tissues, and genitalia. That's why people with excessive yellow bile might experience burning sensation with urination or defecation, frequent urination, frequent bowel movements, and heavy or prolonged menstrual bleeding.
• Thick or viscous blood cannot effectively flow into the small vessels and capillaries and provide the tissues with sufficient oxygen and nutrients, so it could cause lack of energy (fatigue) along with bruising or discolouration, cold feet, and cold hands. Yellow bile would stop such health conditions by improving blood circulation as its job is to accelerate the transfer of blood and nutrients in the body. Being hot and dry, yellow bile is accompanied with movement and motion rather than immobility.[35]

• Before describing the symptoms that might appear owing to the excessive yellow bile in the body it is worth mentioning that by having one of the symptoms one might not necessarily suffer excessive yellow bile but it doesn't mean that one must display all the symptoms at the same time to be diagnosed with excessive yellow bile either. Experiencing one or some of the symptoms might be the reasons for excessive black bile.[35]
• On the other hand, one might suffer excessive yellow bile along with other humours namely blood, black bile or phlegm and report symptoms which may occur due to the various humours excess that stem from today's unhealthy lifestyle. Therefore, one might exhibit symptoms for excess of one or more humours.
• Another point is that one might suffer some of the symptoms which seems to be relating to excess of humours but they might be actually experiencing another condition.
• Here are the symptoms that develop by excess of yellow bile in the body:
• Yellowing of the skin and eyes; feeling bitter taste in mouth; getting acne on the face or the scalp; having dry skin, eyes, mouth, nasal passages and bad breath; getting wrinkles; dark circles under the eyes; losing appetite; feeling nauseated, itching, burning, and irritation in genitalia or rectum; getting thin; feeling unquenchable thirst; troubled sleep; sleep deprivation; feeling stressed out; pins-and-needles sensation in fingers and/or toes and strong smelling waste materials (urine, sweat, menstrual blood) are some of the symptoms which appear by excessive yellow bile.[35]

• Food stuff with warming characteristics (warm Mizaj), spicy food, overly sweet or greasy food, foods that are easy to digest such as well-baked wheat bread and young birds’ meat specially in warm and dry season of summer can constitute to formation of fairly large amounts of yellow bile in the body.
• Those who are affected with excessive yellow bile should abstain from food stuff with warming or drying characteristics namely, spices, pepper, ginger, spicy vegetables such as garlic, onion, tarragon, and green cress, too much salt, sautéed or deep fried food, nuts such as walnut, hazelnut and peanut, sweet food stuff such as honey, red meat such as lamb, chicken, quail, partridge, or camel meat.[35]
• On the other hand, consuming sour food stuff such as sekanjabin (an Iranian traditional syrup made of honey or sugar and vinegar), verjuice, sour or sour-sweet tamarind, lettuce, cucumber, zucchini, spinach, coriander, sour fruits and fruits with high water content such as citrus fruit, greengage, black mulberry, sour apple, blackberry, sour cherry, tangerine, sour orange, water melon, white meat and food with barely or mung bean would benefit this group of people.
• Generally adapting the lifestyle suitable for people with choleric temperament would suit people with excessive yellow bile.[35]

“Blood” is the most abundant and accordingly the most important humour in the body which will be formed by eating main dishes. The humour of “Blood” is necessary for growth especially in children and teenager when growth spurt happens. So they will be needing larger amounts of “Blood” by consuming food stuff which will produce this humour in the body.[36]

A great deal of the bloodstream is made up of humour of “Blood” which is warm and wet. It is noteworthy that the body lives on “Blood” as it keeps the body warm and moist as warmth and humidity are indicatives of being alive.

• Similar to any other humour excessive amounts of “Blood” will cause discomfort or even serious illnesses. Dizziness, lightheadedness, frequent yawning, fatigue, red and bloodshot eyes, redness of the face and lips, blood filled pimples, abscess especially on the hips, genitalia or anus, bleeding of the gums while brushing your teeth, frequent nosebleeds, high blood pressure, losing mental acuity, a sweet taste in the mouth specially in the morning, heavier than normal or prolonged menstrual bleeding, itching, and hot and moist skin are of the symptoms of excessive “Blood”.[36]

• Consuming food stuff in accordance with one's Mizaj (temperament) would enable them to remain healthy.
• Though we might eat various food stuff the stable food which constitute to main dishes lead to the formation of “Blood” in the body. Wheat and wheat bread, rice, beans and chickpea, sweat fruits such as fig and grape, read meat specially lamb and beef, liver, kidney and heart meat, egg, fatty food stuff such as butter and cream, nuts like walnut and almond would produce “Blood” in the body. Consuming proportional amounts of such food items would normally produce “Blood” in the body and maintain the healthy state and growth.[36]

• As mentioned on multiple occasions Iranian traditional medicine highlights that abstaining and not consuming food and drinks which are not good for us depending on our main Mizaj are playing a major role in keeping healthy and in this case keeping baseline level of “Blood”.[36]
• Nowadays due to the lack of movement attributed to the modern life and consuming high amounts of food many suffer from excessive “Blood” and other Akhlat in their bodies and feel full all the time; in Iranian traditional medicine the feeling is called “Emtela” which means fullness in English.
• So, people especially those with warm and wet Mizaj (sanguine temperament), should not consume large amounts of food products with warm and wet Mizaj which produce excessive amounts of “Blood” in the body. Fasting and starving are of the treatments recommended to people suffering excessive “Blood”. Therefore, decreasing food intake drastically for a fortnight would benefit them.[36]
• Having a diet consisting of low calorie foods makes you feel full to help you ward off hunger. Food such as soups and stews with small amounts of rice, split peas, and fresh vegetables accompanied with natural laxative such as plum, tamarind, barberry juice, or sumac extract added half an hour before serving the food would help diminish excessive “Blood”.
• Such food is called ‘deceptive food’ in Iranian traditional medicine as they deceive the one who eats them by making them think they are eating something but they don't actually gain any weight. They can be helpful in weight loss diets as well.
• Vegetable, zucchini, or okra stews which taste sour by adding verjuice, lemon, barberry, plum, tamarind, as well as salads and dairy products, drinking sour juices namely sour cherry and barberry, and homemade pickles provided they are not very spicy would benefit people experiencing excessive “Blood”.
• Also wet cupping or bloodletting and donating blood prescribed or recommended by a skilled traditional medicine specialist proved to be effective in decreasing excessive “Blood” in the body.[36]

• Black bile is cold and dry. It is sparse in the body but it sure is pretty essential for the body. The right amounts of black bile keep bones healthy and strong and that's why bones, teeth and tendons primarily live off black bile.[37]
• Normal amounts of black bile also supports hair and nails, in fact black bile strengthen body parts, therefor, lack of black bile in the body will compromise bone's strength and the tendons function. In worst-case scenario it can lead to osteoporosis. Its shortage would also cause tooth decay and hair falling. Black bile also it stimulates appetite when the stomach is empty.

• Darkening of the skin, developing brown skin patches, wrinkles, having dull skin, developing dark circles under your eyes, suffering muscle cramps (specially muscles of the posterior leg and toes during sleep), more painful menstrual cramps, irregular menstrual cycle, having depressing and negative thoughts, poor sleep, having nightmares, darker waste materials (sweat, urine), constipation, fake hunger, thicker and darker blood, having excessive unwanted hair, getting thinner, developing mental disorder such as depression, obsession, isolation, skepticism, and cynicism are symptoms of built up excessive or abnormal black bile in the body.[37]

• All canned foodstuff, leftovers, fast foods containing sausages and deli meat (in general pre-cooked and processed meats), frozen meat which are kept for a long time in the freezer, meet of old animals, salted or smoked fish can produce black bile in the body. Generally the older a food stuff is the more black bile and waste material it produces in the body and the harder it will be to digest.
• Fast foods, all kinds of sauces, and pickled fruits and vegetables are not good for people with excessive black bile and increase it in the body.
• Additionally, all kinds of sauces, food with additives, junk food such as chips, gumdrops, too much coffee, black and strong tea, vegetables such as eggplant, cabbage, cauliflower, tomato, green pea, corn, lentil, sour fruits, pickled vegetables and fruits, vinegar, too much cold water and ice, too much yogurt, sour doogh (a savory yogurt-based beverage popular in Iran), kashk (fabricated from the liquid yoghurt), and old sour cheese would result in production of black bile in the body.
• It is worth mentioning that black bile production in cold seasons, especially autumn, and cold climates such as mountainous regions normally increases.[37]

• Clearly people suffering excessive black bile should avoid consuming food stuff which increase the aforesaid humour in the body.
• In case they are used to consume such food stuff they should try to modify their bad eating habits step by step in order to become healthy.
• People with melancholic temperament or those who suffer excessive black bile should eat foods with warm and wet temperament more and consider such food items in their food choices. Abgoosht (Iranian stew made with lamb, chickpeas, white beans, onion, potatoes, and tomatoes, and dried lime), lamb kebab, quail, partridge, chicken or sheep heart (one should not consume too much liver or kidney because of their bad effects on the body tissues), soft-boiled or sometimes fried egg, wheat and wheat bread, haleem (a stew including wheat or barley and meat), ash (a traditional slow-cooked, thick soup made with chickpeas, beans, noodles, and fresh herbs), chick pea and beans and food containing them, sangak bread (bread made from whole-wheat flour) with some butter or animal fat or oil, sweet food stuff such as date or grape syrup, rock candy, homemade jams, sweet fruits, raisin, grape, quince, apple, melon, fresh fig, fresh or dried berries, vegetables such as basil and tarragon, nuts like almond, peanut, and hazelnut, almond porridge made with or without milk, spices used to give cardamom, cinnamon, and ginger would increase warmness and humidity in the body and help get rid of the built up black bile.[37]
• Eating food stuff with warming characteristics which also increase the humidity in the body such as raisin, soft-boiled egg, and ginger can help people suffering excessive black bile.
• Eating natural laxatives such as olive oil or fig soaked in rosewater in order to rid the body of the waste material would also help ease excessive black bile symptoms. Rubbing sweet almond oil on the body especially in the shower or placing it in nostrils would greatly help treat dry skin and membranes. It would also ease the nerves and improve sleep quality.[37]

• After the humour of blood, phlegm is the second most abundant humour in the body which has a cold and wet Mizaj.[38]
• Phlegm is a slimy liquid very much like water (colourless, odourless and tasteless) and it can be found in body parts such as dermis, adipose tissue (body fat), synovial fluid, and the mucus lining the lungs, throat, mouth, nose, etc. which require humidity and flexibility to function properly.
• The cerebrospinal fluid which is the clear, colourless body fluid found in the brain and spinal cord is also made up of phlegm.
• One of the advantages of the phlegm is that by the temperature rise in each body part it can turn into the humour of blood and can feed that specific organ, so phlegm can be considered as a kind of food supply for the body.
• Maintaining or improving flexibility is owed to the humour of phlegm, so very much like other humours phlegm is of great benefits to the body.[38]

• Feeling heavy specially the eyelids and the head, getting puffy and swollen, feeling cold (in contrast with people with sanguine temperament), breaking into cold sweat, getting sweaty palms, getting pale, not feeling thirsty or feeling false thirst, increased mucus production (getting runny nose or watery eyes), stringy or thick saliva, weakness, weakened muscle, sagging of skin, sleepiness, having trouble waking up especially in dam places or northern cities with high humidity and during cold seasons, memory loss, dizziness, difficulty learning or remembering something, having difficulty digesting food, bloating, frequent urination, sour burp, and diarrhoea are the symptoms of excessive phlegm in the body.[38]
• On the other hand, joint making cracking sounds can be a symptom of lack of phlegm. Joints, respiratory and digestive tract would function healthily with sufficient amounts of phlegm.

• Food that look like water or have similar characteristics as water by being odourless, tasteless, colourless, and food that are watery and slimy such as soups, broths, and sour stews containing vegetables, water from boiled Kaleh pache (dish of boiled cow or sheep's feet and/or head) or tripe (edible lining from the stomachs of sheep), frozen food, raw food, or cooked food served cold, consuming too much rice without bran, potato, tomato, sauces particularly mayonnaise, salads, dairy products, water, fruits and vegetables with cold Mizaj (cooling characteristics) such as lettuce, cucumber, citrus and sour fruits could form or increase phlegm in the body.[38]

• People with excessive phlegm should avoid consuming food that could increase phlegm in the body. Fasting, being hungry and thirsty would benefit such people in that it let them get rid of the excessive phlegm build up in their bodies and become warmer and drier.
• People suffering excessive phlegm should eat low volume, high calorie food stuff such as kebab with small portions of rice and bread, roasted chicken heart for a week, bird meat like quail and partridge, toasted nuts (in general toasting, stir frying, and sautéing food stuff is good for such people), dried fig, raisin, dried berries, rock candy, honey, natural sweets, one tea spoon of date and grape syrup a day, sweet homemade jams, fairly salty food with spices such as pepper, cinnamon, cardamom, vegetables such as mint, leek, tarragon, parsley and savoury as well as fruits like ripen and sweet apple, mango, banana, and pear.[38]