What is Acne? 
Acne is a skin condition that occurs when the hair follicles become plugged with oil and dead skin cells. Acne most commonly appears on the face, neck, chest, back and shoulders.

Signs & Symptoms 
Blackheads, pimples, whiteheads and pus-filled cysts form on the face, shoulders, upper back and chest, which becomes sore andinflamed. The affected skin is greasy or oily.

Complications
Scarring is a common complication of acne.

What Causes Acne?
During puberty, a natural increase in hormone production occurs, which stimulates the over- production of sebum (an oily substance which protects the skin). This in turn leads to clogged pores. People with an oily skin, or who consume junk food like chocolates and deep fried foods, are prone to acne. Stress can aggravate acne, but does not usually cause it.

The Tibb View on Acne

According to Tibb, acne results from excessive heat in the body. During adolescence a lot of heat is produced in the body, as this is a period of increased growth. This growth also leads to the increased production of hormones which causes more oil to be produced by the skin and can cause acne. A lifestyle that increases heat, from poor diet and increase stress, will further contribute to the development of acne. While most teenagers may suffer from mild to moderate acne individuals with a dominant/sub-dominant sanguinous temperament will be more at risk.

Treatment and Management of Acne 
Treatment and management is aimed at reducing the excess heat associated with acne, by implementing Tibb Lifestyle Factors that increases the quality of coldness. This assists Physis in addressing both the symptoms, and the causes of acne.

Tibb Lifestyle Factors
Food and Drink

• Eat mostly Cold & Moist – such as carrots, cucumber, lettuce, and rice, followed by Cold & Dry  – like citrus fruit, yogurt, fish and
• Eat less of Hot & Dry – such as eggs, chickpeas, onion and chili, and the least amount of Hot & Moist – like sugar, white flour products, cheese, and
• Avoid heavily spiced foods, alcohol, fried
• Limit the intake of sugary foods and drinks, as this serves to feed the causative bacteria as well as lowering the immune Stabilizing your blood sugar is important because spikes produce more androgens.
• Steamed fish should be preferred over red meat, as a high intake of saturated or hydrogenated fats contributed to acne formation; Adopt a low glycaemic diet which is rich in raw/steamed vegetables and fruits, and low in refined and processed
• Nutritional deficiencies are a contributing factor to acne formation and high fibre helps to keep the colon Add carrots, cucumber and lettuce to salads, as this will reduce the heat that causes acne; Add plain yogurt to salads to increase probiotic intake.
• Follow a fasting programme to allow Physis to restore healing by eliminating

 Other Lifestyle Advice

• • Take up a regular aerobic exercise programme, like walking, jogging or swimming.

• Carry out regular breathing exercises, preferably in the morning.
• Squeezing pimples aggravates acne. Avoid washing with hot water, as this can worsen your acne.
• Acute acne flare-ups can be relieved by dabbing with a clean sponge soaked in cold, milk-free rooibos tea.

Herbal Remedy

• Take a handful of washed coriander leaves and place them in a blender. Place the paste on a sieve to extract the juice. Add a pinch of turmeric powder and mix well. Apply this to the face every night.

What is Ammenorrhoea? 
Amenorrhoea is the absence of menstruation for more than 3 menstrual periods, or menstruation that has not yet begun in girls older than 16 years.

 What causes ammenorrhoea? 
There are numerous causes of amenorrhoea. Natural causes include pregnancy, breastfeeding and menopause. Women taking the contraceptive pill may also experience amenorrhoea. Certain medications, such as antipsychotics, antidepressants, chemotherapy and blood pressure lowering medication may cause amenorrhoea as a side effect. Lifestyle factors include high stress levels and excessive exercise. Hormonal imbalances from polycystic ovaries, premature menopause, tumours and thyroid disease can also lead to amenorrhoea. Structural abnormalities may prevent menstrual bleeding.  These include uterine scarring, which may block the production of uterine lining, absent / underdeveloped reproductive organs, an obstruction of the vagina.

 The Tibb View of Amenorrhoea
According to Tibb, these conditions are associated with excessive qualities of coldness generally throughout the body, specifically affecting the brain, pituitary gland, ovaries, uterus and thyroid gland. Amenorrhoea may either be linked to qualities of coldness with moistness which arises due to excessive intake of cold and moist foods, dairy and refined sugar products and a sedentary lifestyle. Amenorrhoea linked to coldness with dryness can result from excessive dieting, excessive weight loss and over-exercising. Phlegmatic/Melancholic temperamental combinations are most predisposed to developing ammenorrhoea due to their innate coldness.

Treatment and Management of menstrual disorders
Treatment and management is aimed at reducing the excess coldness associated with amenorrhoea, by implementing Tibb Lifestyle Factors that will increase the quality of heat.This will assists Physis in addressing both the symptoms and the causes of amenorrhoea.

Tibb Lifestyle Factors 
Food and Drink

• Eat mostly Hot & Dry – such as chicken, oily fish, garlic and celery, followed by Hot & Moist – such as ginger, turmeric, spinach and black pepper.
• Eat less of Cold & Dry – like naartjies, oranges, beans and yogurt, and the least amount of Cold & Moist – such as milk, cucumber, broccoli, and rice.
• Avoid dairy products, carbonated beverages, refined sugar, white flour and chocolates.
• Eat one or two handfuls of roasted chickpeas for breakfast and 20 grams of walnuts or hazelnuts daily.
• Do not eat or drink foods that are cold. Allow them to reach room temperature before consumption.

 Other Lifestyle Advice

• Exercise regularly. Partake in mild physical activities such as walking. Exercise increases heat in the body.
• Keep warm in cold conditions. Avoid the use of air conditioners.

Herbal Remedies

• Make a tea using 1gram of cinnamon and 1 gram of cloves. Add 1 tsp of honey and drink daily.
• Mix together 25 grams each of the following – cinnamon, cloves, celery seeds and carrots seeds. Grind together to form a powder. Take 1tsp of this powder 3 times daily 30 minutes before meals.

What is Asthma?
Asthma is a condition of the lungs that causes the bronchi (airways) to narrow. The airways are tubes that carry air into and out of the lungs. When the airways narrow, less air can flow into the lungs. This results when the airways are obstructed with phlegm, inflamed with heat or become hard and brittle with coldness with dryness. For the lungs to function well, a balance of heat, moistness and dryness needs to be maintained. If not breathing difficulties arise. Asthma may affect all age groups, except newborn babies, and typically develops during early childhood. An asthma attack can be fatal if not treated appropriately. One long term complications of asthma is permanent narrowing of the airways.

 Types of Asthma
Tibb has identified 3 main types of asthma:

• Allergic asthma: due to excess of heat.
• Phlegmatic asthma: due to an excess of coldness with moistness causing an increased phlegm production.
• Melancholic asthma: due to an excess of coldness with dryness causing hardened, fibrosed airways.

Allergic Asthma 

Signs and Symptoms
Breathing difficulties; itchy and red watery eyes; allergic rhinitis with post-nasal drip.

What Causes Allergic Asthma?
Allergic asthma is caused by an irritation of the mucous membrane by airborne toxins.

The Tibb View on Allergic Asthma
According to Tibb, this condition is linked to excessive heatwith either moistness or dryness. This excessive heat results in the hyper-sensitization of the immune system which causes inflammation of the mucous membrane when exposed to certain airborne stimuli. Individuals with a bilious/sanguinous temperament are more inclined to develop allergic asthma, due to the dominance of heat associated with this temperamental combination.

Treatment and Management of Allergic Asthma 
Treatment and management is aimed at reducing the excess heat associated with allergic asthma by implementing Tibb Lifestyle Factors that will increase the qualities of coldness. This will assist Physis in addressing both the symptoms and the causes of allergic asthma.

Tibb Lifestyle Factors 
Food and Drink

• Eat mostly Cold & Moist – such as carrots, cucumber, rice and pumpkin, followed by Hot & Dry  – like yogurt, potatoes, apples and mielies.
• Eat less of Cold & Dry – such as white flour products, sugar, and cheese, and the least amount of Hot & Dry  – like garlic, chicken, eggs and onions.
• Cut out hyper-allergenic foods from the diet, such as eggs, dairy, nuts and wheat products.
• Avoid any known triggers. Avoid heavily spiced, fried or grilled foods, as well as sugary and refined foods;
• Eat foods with low allergenic properties, such as apples, apricots, barley, beets, carrots, lettuce, millet, plums, rice, sweet potatoes and tapioca.

Herbal Remedies

• Make an infusion using 1tsp Marshmallow (flower, root or leaves) in one cup of boiling water. (This can also be used for bronchitis and dry coughs). This is high in mucilages which soothes the mucous membrane.
• Add ½ tsp liquorice root powder (not suitable for people with hight blood pressure) to some water and stir. This is good when the mucous membrane inflammation.
• If the cause of allergic asthma is related to the upper respiratory system, infuse 1tsp lavender leaves in 1 cup of water.  Strain and drink.

Note: do not discontinue the use of conventional medication, without consulting your practitioner. 

Phlegmatic Asthma 

Signs and Symptoms
Coughing; wheezing; a feeling of tightness in the chest; difficulty in breathing.

What Causes Phlegmatic Asthma?
Risk factors for the development of phlegmatic asthma includes genetic factors or a phlegmatic dominant or sub-dominant temperament, having a low birth weight, respiratory infections, and exposure to cold air.

The Tibb View on Phlegmatic Asthma
According to Tibb, phlegmatic asthma is associated with excessive coldness with moistness resulting from an accumulation of phlegm that may be thick and/or sweet. Symptoms often worsen in cold conditions. Children are more likely to develop phlegmatic asthma as well as people with phlegmatic dominant or sub-dominant temperaments due to the innate coldness and moistness linked to these individuals.

Treatment and Management of Phlegmatic Asthma
Treatment and management is aimed at reducing the excess coldness with moistness associated with phlegmatic asthma by implementing Tibb Lifestyle Factors that will increase the qualities of heat and dryness. This will assist Physis in addressing both the symptoms and the causes of phlegmatic asthma.

Tibb Lifestyle Factors 
Food and Drink

• Eat mostly Hot & Dry  – such as chicken, oily fish, celery and garlic, followed by Hot & Moist – like olive oil, ginger, turmeric and spinach.
• Eat less of Cold & Dry  – such as citrus fruit, yogurt and beans, and the least amount of Cold & Moist  – like milk, cucumber, broccoli and sprouts.
• Soak fruits in hot water for a few minutes before eating.
• Include garlic and onions in the diet.
• Eat plenty of raw fruits and steamed vegetables.
• Avoid simple sugars and white flour products. Avoid dairy products, as these increase the coldness and moistness in the body.
• Avoid cold foods and drinks and eating or drinking foods straight from the refrigerator.  Allow it to reach room temperature before consumption.

Other Lifestyle Factors

• Keep warm at all times as the cold can cause broncho-constriction.
• Partake in regular moderate exercise during the day.

Herbal Remedy

• Take one cup of very hot water and add one teaspoon of powdered fenugreek seeds, cover for 20 minutes. Strain and mix with two teaspoons honey. Drink 3 times a day and also during an attack.
•  Blackseed (Nigella Sativa) is excellent for respiratory conditions. Make tea by pouring one cup of boiling water over 1 tbsp of blackseed letting the mixture steep for about 10 minutes. Keep the tea covered until you are ready to drink so as not to lose the aroma.

Note: do not discontinue the use of conventional medication, without consulting your practitioner.

Melancholic Asthma 

Signs and Symptoms
Marked breathing difficulty; mucus or phlegm expectorant is absent; coughing is rare.

What Causes Melancholic Asthma?
Genetic factors; or a melancholic dominant/sub-dominant temperament; certain medication; smoking and exposure to cold air.

The Tibb View on Melancholic Asthma
According to Tibb, melancholic asthma occurs from excessivecoldness with dryness causing the bronchi to become thick and hard. Melancholic asthma may result from chronic phlegmatic asthma or as a result of the use of certain medications and smoking, both of which causes phlegm to harden. A person with a dominant/sub-dominant melancholic temperament is more inclined to develop melancholic asthma.

Treatment and Management of Melancholic Asthma
Treatment and management is aimed at reducing the excess coldness with dryness associated with melancholic asthma by implementing Tibb Lifestyle Factors that will increase the qualities of heat and moistness. This will assist Physis in addressing both the symptoms and the causes of melancholic asthma.

Tibb Lifestyle Factors 
Food and Drink

• Eat mostly Hot & Moist  – such as ginger, turmeric, spinach and olive oil, followed by Hot & Dry  -like chicken, oily fish, celery and garlic.
• Eat less of Cold & Moist  – such as milk, cucumber, broccoli and sprouts, and the least of Cold & Dry – like yogurt, citrus fruit, and beans.
• Soak fruits in hot water for a few minutes before eating.
• Include garlic and onions in the diet.
• Eat plenty of raw fruits and steamed vegetables.
• Avoid simple sugars and white flour products.
• Avoid cold foods and drinks and eating, or consuming foods straight from the refrigerator.  Allow it to reach room temperature before consumption.
• Avoid gas-producing foods such as the brassicas (broccoli, cauliflower and cabbage) and large amounts of bran. Gas can irritate an asthmatic condition by putting pressure on the diaphragm.

Other Lifestyle Factors

• Keep warm at all times as cold surroundings can trigger broncho-constriction.
• Quit smoking, as this increases dryness
• Partake in regular moderate exercise.
• Avoid exposure to cold & dry conditions.

Herbal Remedy

• Take one cup of very hot water and add one teaspoon of powdered fenugreek seeds, cover for 20 minutes. Strain and mix with two teaspoons honey. Drink 3 times a day, and also during an attack.

Note: do not discontinue the use of conventional medication, without consulting your practitioner.

What is backache? 
Back pain is a common problem that affects most people at some point in their life. Backache describes pain experienced in the lower back or lumber region that can feel like an ache, tension or stiffness. Pain in the lower back is referred to as lumbago. The pain can be acute, occurring suddenly and of severe intensity, or chronic (lasts for more than 3 months).

Signs and Symptoms
Muscle pain in the lower back, which can radiate into the backside and back of the legs; shooting or stabbing pain; muscle tension in the lower back, resulting in the feeling of stiffness; limited flexibility and range of motion of the back especially when leaning forward and bending back; pain is worse on movement; severe backache may cause the back to tilt to one side, causing a limp or a change in posture.

Causes and Risk Factors 
There are multiple causes of backache including: muscle or ligament strain which results from incorrect lifting of heavy objects; from arthritis which causes the joint spaces to narrow; from osteoporosis, which results in brittle and porous bones; and also direct exposure to cold.  Historically, people wore vests to keep the back warm and dry. In today’s times the lower back area is very often exposed. When we perspire, the evaporation of the sweat brings about coldness which reduces the blood flow to the lower back, so leading to backache.

The Tibb View of Backache
According to Tibb, backache is associated with qualities of coldness with dryness. The reduced heat and decreased blood supply can lead to chronic inflammation and chronic backache.  Although persons with a melancholic dominant/sub-dominant temperament are predisposed to backache, other temperamental types are also at risk from lack of exercise and being overweight.

Treatment and Management of backache
Treatment and management is aimed at reducing excess coldness associated with backache, by implementing Tibb Lifestyle Factors that increase the qualities of heat. This will assist Physis in addressing both the symptoms and causes of backache.

Tibb Lifestyle Factors 
Food and Drink

• Eat mostly Hot & Moist  – such as banana, mutton, ginger, olive oil, turmeric, and honey, followed by  Hot & Dry  – like egg, garlic, chicken and mustard.
• Eat less of Cold & Moist  – such as rice, broccoli, milk and cucumber and the least amount of  Cold & Dry – like citrus fruit, yogurt and beef should be eaten.
• Drink lukewarm water until symptoms subside. Consume plenty of fruit and vegetables.
• Avoid red meat. It is acidic, so contributes towards pain and inflammation.
• Avoid dehydrating drinks (coffee, tea, alcoholic drinks), and sugar-rich fizzy drinks.
• Follow a detox programme, consisting only of vegetables and fruit, herbal teas and water.

Other Lifestyle Advice

• Practice light exercise, like walking daily. However, if this aggravates the pain, stop walking until there is better resolution of the symptoms.
• Exercises to strengthen the core back muscles are advised. Pilates should be considered to strengthen abdominal and muscles.
• Apply a heat pack over the affected area.
• Keep the area warm by wearing a vest or other appropriate clothing which covers the lower back area.
• At night, sleep with a pillow between your knees.
• Avoid lifting heavy objects. When the condition resolves practice proper bending and lifting techniques. Bend with the knees keeping the object as close to the body as possible before lifting.

Herbal remedies

• Add ¼ – ½ tsp turmeric to 1 cup of hot milk. Add a pinch of black pepper and honey to taste. Drink twice daily.
• Detox – Add Epsom salts to bathwater to soothe inflamed muscles.

What are Boils?

Boils, or furuncles, are painful pus-filled bumps that form under the skin when bacteria infect and inflame one or more of the hair follicles.

Signs & Symptoms

A small hard swelling (abscess) containing pus forms on the face, neck, scalp, armpit or buttock. The swelling becomes itchy, painful to the touch, and inflamed. Swellings become visible on the lymph nodes on the neck, or in the armpit or groin.

Complications

The main complication associated with boils is tissue scarring. However, if they are not treated properly the infection can spread to other areas of the skin, as well as into the blood stream. In this case there may be serious consequences.

What Causes Boils?

Boils are caused by blockage of the skin pores or deep in the hair follicles, usually due to poor hygienic habits. This provides a welcomed environment for bacteria, Staphylococcus aureus, to thrive, invade tissues and cause infections. Risk factors for the development of boils include chronic illness conditions and compromised immunity as in diabetes. This makes it more difficult for the body to fight infection, making it susceptible to developing boils.

Stress – increases heat in the body and this can increase the risk of developing boils.

The Tibb View on Boils 
According to Tibb, boils are associated with qualities of excessive heat which makes the skin susceptible to infection and results in painful inflammation. Boils are more common in individuals with a sanguinous/bilious temperamental combination, where the quality of heat is dominant.

Treatment and Management of Boils
Treatment and management is aimed at reducing the excess heat associated with boils, by implementing Tibb Lifestyle Factors that increase the quality of coldness.  This assists Physis in addressing both the symptoms and the causes of boils.

Tibb Lifestyle Factors 
Food and Drink 

• Eat mostly Cold & Moist  -such as carrots, cucumber, lettuce, and rice, followed by  Cold & Dry  – like citrus fruit, yogurt, fish and beans.
• Eat less of  Hot & Dry – such as eggs, chickpeas, onion and chili, and the least amount of Hot & Moist  – like sugar, white flour products, cheese, and mutton.
• Drink at least two litres of water daily.
• Select a high fibre diet of fruit and vegetables to encourage regular bowel movements.
• Eat plenty of raw/steamed vegetables and fruits.
• Avoid heavily spiced, fried foods, as well as sugary and refined foods.
• Avoid cashew nuts, pecan nuts, peanuts, eggs, cheese, pickles, processed meats and chocolates.
• Partake in a cleansing fast monthly to rid the body of accumulated toxins.
• Drink rooibos tea with lemon juice, instead of milky tea and coffee.

Other Lifestyle Advice

• Clean the skin around the boils with hydrogen peroxide (10 vols).
• Repeated attacks of boils can be prevented by cleansing the skin area regularly with antiseptic liquid.
• After the boil has drained, apply a mixture of blackseed honey to prevent further infection and promote healing.
• Shower instead of bathing. This reduces the chance of the boils spreading to other parts of the body.
• When dealing with boils, keep the hands scrupulously clean.
• Adhere to strict hygienic measures if you are involved in food handling and preparation.
• Reduce stress by performing slow and deep breathing exercises daily.

 
Herbal Remedies

• Apply a hot compress to the affected area. This will encourage a head to form on the boil, and help it to drain.
• Cover the boil with a thin cloth envelope containing a slice of onion or tomato, or a crushed garlic clove, or a used cold teabag.

What is BPH? 
BPH, also known as an enlarged prostate, is a common complaint amongst men over fifty. The middle section of the gland enlarges, partially blocking the flow of urine through the urethra.

Signs and Symptoms 
Increased frequency of urination, usually first noted at night (nocturia); difficulty in urination; dribble or overflow incontinence; inflammation of the urethra and bladder due to stagnant urine; aching and burning feeling on urination and complications such as malaise and even mental disorders.

What Causes BPH? 
In most men, the prostate continues to grow throughout life. The exact cause of this is unknown; however it may be due to changes in the balance of sex hormones.

The Tibb View of BPH
According to Tibb, BPH is due to excessive moistness with cold. This excessive moistness results from an improper diet which is rich in carbohydrates, refined sugar and cold and moist foods. With age, the metabolism slows down resulting in insufficient heat to process moist foods. Although sanguinous/phlegmatic temperamental types are more at risk other temperaments can also be affected from poor lifestyle.

Management of BPH
Treatment and management is aimed at reducing excess moistness with coldness, associated with BPH, by implementing Tibb Lifestyle Factors that will increase the qualities of heat and dryness.  This will assist Physis in addressing both the symptoms and the causes of benign BPH.

Tibb Lifestyle Factors 
Food and Drink 

• Eat mostly Hot & Dry – such as bittergourd, chickpeas, avocado, and cinnamon, followed by Cold & Dry  – like beef, cabbage, lemon and peanuts.
• Eat less of  Hot & Moist  – such as mutton, banana, fennel and sweet potato, and the least amount of Cold & Moist – like rice, butternut and cucumber.
• Avoid alcohol, as it decreases the body’s ability to produce testosterone.
• Avoid dairy products, white flour products, carbonated beverages, chocolate, refined sugar and products containing artificial food colouring.
• Follow a diet which includes plenty of fruit, vegetables, nuts, and whole grains.
• Eat 20g of pumpkin seeds daily. Pumpkin seeds are helpful for almost all kinds of prostate troubles, because they are rich in zinc.
• Eliminate from your lifestyle such items as alcoholic beverages (especially beer and wine), caffeine, fluoridated water and spicy and junk food.
• Have one bitter gourd in the morning.

Other Lifestyle Advice

• Get regular exercise. However, cycling should be done with a special seat so as not to put added pressure on the prostate gland. Walking is a preferred exercise.
• Quit smoking.
• Avoid constipation – regular bowel movements will relief symptoms of BHP as constipation can put pressure on the prostate gland.

Herbal Remedy

• Add 1tsp Parsley, 1tsp celery seeds, 1tsp fennel seeds, 1tsp aniseed, 3 crushed black pepper corns and 1tsp saw palmetto. Add to 1 cup of boiling water. Allow to stand for 3 minutes, strain and drink.

What is bronchitis? 
Bronchitis is inflammation of the lining of the bronchial tubes or airways, which carry air to and from the lungs. Bronchitis may be either acute or chronic.

Signs and Symptoms 
Painful coughing and wheezing; throat and chest pains; feeling feverish and generally unwell; poor concentration; excessive production of thick, sticky and/or pus-containing sputum; difficulty in breathing or breathlessness which interferes with daily activities.
Although a single episode of bronchitis usually isn’t cause for concern, it can lead to pneumonia in some people.

What Causes Bronchitis? 
Inflammation due to infection or irritation of the airways is the underlying cause. Risk factors include: cigarette smoking which dries and irritates the airways; exposure to air pollution, such as dust; and sudden changes in temperature such as moving from a hot environment to a cold one.

The Tibb View on Bronchitis
According to Tibb, bronchitis is associated with qualities of dryness, either with heat or coldness. This results in painful inflammation and constriction of the airways. Individuals with a bilious/melancholic temperamental combination are more susceptible to developing bronchitis, due to their dominance of dryness.

Management of Bronchitis
Treatment and management is aimed at reducing the excess dryness associated with bronchitis, by implementing Tibb Lifestyle Factors that will increase the qualities of moistness. Treatment and management for bronchitis includes getting adequate rest, breathing in moist air and keeping hydrated. This assists Physis in addressing both the symptoms and the causes of bronchitis.

Tibb Lifestyle Factors 
Food and Drink

• Eat mostly Hot & Moist – such as sweet potato, ginger, turmeric and brown bread followed by Cold & Moist  – like carrots, cucumber, rice and pumpkin.
• Eat less of Hot & Dry – such as egg, garlic, chili and onion and the least amount of Cold & Dry  – like beef, tomato, cabbage, and peanuts,
• Drink plenty of water either warm or at room temperature, or decaffeinated tea if preferred.

Other Lifestyle Advice

• Get plenty of bed rest, preferably with a humidifier in the room.
• For those who smoke, now is a good time to stop.
• Steam inhalation which are warm and moist, helps to cough up obstinate mucus.
• Do light exercises like stretching if fever is absent. Avoid exercising if fever present.
• Avoid inhaling passive smoking in social environments.

Herbal Remedy

• Use a vapour rub containing camphor, eucalyptus, menthol, nutmeg oil, or turpentine oil Apply frequently during the day, and especially before sleep.

What is Chronic Fatigue? 
This is a common, almost constant state of weariness that develops over time. It diminishes energy levels and mental capacity. Chronic fatigue has a major impact on a person’s emotional and psychological well-being.

Signs and Symptoms 
Unusual physical or mental tiredness following intense activity; deep tiredness lasting through the day; difficulty in concentrating. This form of fatigue can last anything from a few days to several weeks.

What Causes Chronic Fatigue?
Fatigue is attributed to a number of causes, including lifestyle factors, medical and psychological conditions.
Risk factors include over-exerting the skeletal muscles and the consumption of inadequate or poor quality food. It is also a common side effect of a weight-reduction diet, from too-frequent skipping of meals, or from eating regularly ‘on the hoof’; Certain medical conditions such as thyroid problems, anaemia, cancer, heart disease, depression, obesity and asthma often include fatigue as a symptom.

The Tibb View on Chronic Fatigue
According to Tibb, fatigue is associated with qualities of cold and moistness, which slows bodily processes by dampening the heat of metabolism. This leaves the person affected feeling tired and sluggish. Fatigue is aggravated by a lifestyle that increases qualities of cold and moistness in the body.
As there are numerous causes of chronic fatigue, both mental and emotional, all temperamental types are at risk of chronic fatigue.

Treatment and Management of Chronic Fatigue
Treatment and management is aimed at reducing the excess cold/moistness associated with fatigue, by implementing Tibb Lifestyle Factors that increase the qualities of heat and dryness.  Treatment and management of fatigue often includes rectifying the underlying condition or faulty Lifestyle Factor. A balanced diet and regular exercise is also recommended. This assists Physis, in addressing both the symptoms and the causes of chronic fatigue.

Tibb Lifestyle Factors
Food and Drink

• Eat mostly Hot & Dry  – such as oily fish, chicken, celery, and garlic, followed by  Hot & Moist – like olive oil, ginger, turmeric and spinach.
• Eat less of  Cold & Dry  – such as citrus fruit, yogurt and beans, and the least amount of  Cold & Moist  – like milk, cucumber, broccoli, and sprouts.
• Start the day with a good high-fibre breakfast. Eat plenty of fresh fruits and vegetables and whole grain foods.
• Avoid fried foods; junk foods; processed foods; stimulants such as coffee; tea and soft drinks; sugar; products containing yeast and/or white flour such as bread or pasta; chocolate.

Other Lifestyle Advice

• Breathing – Practice deep breathing exercises, as they help to energise and relax.
• Exercise – Regular, mild or moderate physical exercise, followed by plenty of restoring rest, is known to help. Exercises such as yoga and Pilates should be practiced as they encourage deep breathing. This promotes increased oxygen supply to the brain and muscles.
• Sleep – Try to develop beneficial, regular and long-term sleeping habits, by practicing good sleep hygiene.
• Meditation – Allow time for meditation and breathing exercises, early in the morning and the evening.
• As stress often goes with fatigue, take up stress-reducing techniques (deep breathing, yoga, meditation).
• Get into positive leisure activity – not watching TV or the computer, but reading, DIY, knitting or a similar hobby.
• Do not overdo things. Be realistic about what can be achieve, and when.
• In the morning, plan your day, and prioritise the activities. Start with the worst, heaviest chores.
• Try to shake the smoking habit if applicable, as it reduces the amount of available oxygen for energy production.
• If possible, reduce your workload. Learn to say: “No thank you”.
• If overweight, taking measures to reduce body mass. This will help reduce periods of fatigue.

 
Herbal Remedies

• Licorice or gingko biloba powder (500mg) sprinkled on food.
• Take 2 teaspoons each of Poppy seeds and honey plus 10 almonds and liquidised in 200ml of milk. Drink first thing in the morning.

What is a cold? 
Common Cold (Coryza) is an acute condition that affects only the upper respiratory tract (mainly the nose).  It is the most common respiratory disorder in many parts of the world.

Signs and Symptoms of a Cold
Runny nose (with clear mucus); blocked nose; sneezing; sore throat; watery eyes; coughing; headache (sometimes); and slight fever (sometimes).

What is the Flu?
Flu (Influenza) is also an acute and contagious condition that affects the respiratory system. It is often confused with the common cold, but flu is much more severe.  Flu usually lasts for four to five days, but the complications can be longer lasting and more serious, especially with lung infections such as bronchitis and pneumonia.

Signs and Symptoms of Flu
Fever and extreme coldness (chills/shivering/shaking); body aches (especially joints and throat); nasal congestion (with yellow – green mucus); runny nose; coughing; headaches; fatigue; irritated, watery eyes; and diarrhea (usually in children).

What Causes Colds and Flu?
The common cold and flu are due to infection from certain viruses.
Risk factors include exposure to cold and rainy weather, and an immature immune system, especially in children.

The Tibb View on Colds and Flu
According to Tibb, colds and flu are associated with coldness with moistness as they typically develop in cold months of the year. Symptomatically colds and flu presents with excessive mucous production such as a runny or congested nose, and productive coughing. Due to the weakened immune system, Physis is unable to prevent the virus infection, but actively fights it in order to restore the body back to health within 4 days (for a cold) or 21 days (for the flu).  Although all temperamental types can be affected with colds and flu, people with a phlegmatic dominant/sub-dominant temperament are more at risk due to their innate qualities of coldness and moistness.

Treatment and Management of Colds and Flu
Treatment and management is aimed at reducing the excess coldness with moistness associated with colds and flu, by implementing Tibb Lifestyle Factors that will increase the qualities of heat and dryness.  This assists Physis in addressing both the symptoms and the causes of colds and flu.

Tibb Lifestyle Factors 
Food and Drink

• Eat mostly Hot & Dry  – such as chicken, oily fish, garlic and onion, followed by Hot & Moist  – like flavoured with spices like ginger, turmeric and black pepper.
• Eat less of Cold & Dry  – such as lemon, oranges and yogurt and the least amount of Cold & Moist  – like milk, cucumber and rice.
• Avoid dairy products, margarine, fried foods and all sugars;
• Avoid solid foods for three days.
• Sip hot chicken, beef or mutton soup spiced with garlic, ginger, black pepper and salt for three days.
• Drink at least 2 litres of warm water per day.

Other Lifestyle Advice

• Remain as active as possible unless you have a fever in which case bed rest is strongly advised.
• Mix a solution of 1 cup warm distilled water, ½tsp of sea salt and a pinch of bicarbonate of soda. Use a squeeze spray bottle to instil the solution in the nostrils, one side at a time. Repeat this procedure 3-4 times a day as necessary for relief from stuffiness.
• Avoid exposure to cold and wet weather.
• Use steam inhalations to promote drainage and ease pressure. Use a pot of hot water and add a few drops of eucalyptus or rosemary oil. Put your face over the pot and cover with a towel. Breathe in deeply. Do this several times a day for 5-10 minutes.
• Massaging the chest and throat with a heating ointment (such as Blackseed Rub) will ease congestion and help eliminate phlegm.

Herbal Remedies 

• 2 grams fenugreek seeds, 1 gram cinnamon, 1 gram cloves, 2 grams fresh ginger. Boil in 2 cups of water until 1 cup remains. Strain and mix in 2 tsp of honey and drink. Repeat the same 3 times a day.
• Ginger and honey tea: Grate 2 cm piece of ginger to a pot of 2 cups of water. Bring to the boil, then add 1tbsp of honey. Drink it whilst hot.

What is constipation? 
Constipation is infrequent bowel movements or difficult passage of stools that persists for several weeks or longer.

Signs and Symptoms 
Bowel movements are less frequent than usual (fewer than three times a week); passing the stool is difficult, painful, takes a long time, and feels incomplete; the faeces are like pellets – small, dry and hard, and often very dark brown in colour; the abdomen may feel swollen and uncomfortable; if constipation has been present for some time, there may be bleeding during defaecation. Constipation can result in the development of piles (haemorrhoids) or tears in the anus (anal fissures).

What Causes Constipation?
Constipation most commonly occurs when waste or stool moves too slowly through the digestive tract. This is due to a lack of heat and moistness, causing the waste to become hard and dry.
Risk factors includes poor eating habits, especially where there is not enough fibre (roughage) which is present in vegetables and fruit; and not drinking enough water. A lack of exercise may make constipation worse. Bad bowel habits, such as ignoring the call of nature can lead to constipation. The repeated use of certain medications like some painkillers, antacids, anti-allergy drugs can also lead to constipation.

The Tibb View on Constipation
According to Tibb, constipation is associated with qualities ofcoldness with dryness due to an improper lifestyle. Included in this is an excessive intake of cold and dry foods which results in stool moving slowly through the digestive tract, causing dry and hard stools. Although people with a melancholic dominant/sub-dominant temperament are mostly likely to develop constipation due to their innate qualities of coldness and dryness, other temperamental types can also suffer from constipation from a faulty diet and other lifestyle factors.

Management of Constipation
Treatment and management is aimed at reducing excess coldness with dryness associated with constipation, by implementing Tibb Lifestyle Factors that will increase the qualities of heat and moistness. This will assist Physis in addressing both the symptoms and the causes of constipation.

Tibb Lifestyle Factors
Food and Drink

• Eat mostly Hot & Moist  – such as dates, mangoes, honey and brown bread, followed by Hot & Dry  – like celery, red pepper, onion and oily fish.
• Eat less of Cold & Moist  – such as litchis, watermelon, cucumber and broccoli, and the least amount of Cold & Dry  – like beans, beef, citrus fruit and yogurt.
• Avoid sour foods and drinks, fried foods, spicy foods, soft drinks, meat, processed foods, white flour products, salt, coffee, alcohol and sugar. These foods are difficult to digest and contain little or no fibre.
• Maintain a high-fibre diet of fresh fruits, raw green leafy vegetables, brown rice, oatmeal, sprouts, carrots, and whole-grains. Eat fruits that contain soluble fibre such as apricots, bananas, blackberries, blueberries, cranberries, figs, grapes, peaches and dried prunes.
• Drink at least 8-10 glasses of warm water daily.
• Drink a cup of warm water with 1 tbsp honey and 1 tbsp olive oil 30 minutes before meals.

Other Lifestyle Advice

• Try to exercise more. Regular exercise increases rhythmic bowel movement (peristalsis). A brisk 20 to 30 minute walk daily is often effective in relieving the problem, especially for pregnant women.
• Practice daily breathing exercises to help sort out any emotional problems like stress.
• Go to the toilet at the same time every day even if the urge doesn’t exist. Try to relax as stress tightens the muscles and can cause constipation. Many people find reading a helpful way to relax.
• Never repress the urge to defecate.
• Take a natural laxative as and when necessary.

 
Herbal Remedies

• Grind 2 parts of psyllium seeds, and 1 part each of flaxseed and oat bran and mix with some water to make a paste. Take 1 teaspoon in water before bedtime.
• Take 2 tablespoons of aloe vera juice every morning. Alternatively make it by boiling 3 or 4 aloe vera leaves in 1 litre of water for 30 minutes. This softens the faeces, and heals and cleans the digestive tract.
• Drink a glass of warm water with 1tsp of honey and 1tsp of olive oil 30 minutes before meals.

What is the reason for coughing?
Coughing protects the airways from irritants which can cause inflammation. However, too much coughing can damage the breathing passages, and make sleep and daily activities difficult.

Types of Coughing 
There are two main types of coughing:

• Wet coughs, which usually occur with colds or respiratory infections.
• Dry coughs, which are usually due to chemical irritants, pollutants, fumes or dust.

What Causes Coughing?
Coughing is the body’s way of removing foreign material or excess mucus from the lungs and upper airway passages. This occurs due to sudden exposure to a cold environment resulting in irritation and inflammation of the airways, or of reacting to an irritated airway.
Excessive intake of cold foods and drinks (like refrigerated milk and beverages) can trigger coughing.
Risk factors for coughing include: irritants in the breathing passages; air pollutants like smoke from cigarette and wood-burning stoves; lung infection due to microbes. Diseases like tuberculosis and cold typically produce coughing.
Several breathing disorders result in coughing, such as asthma, bronchitis, and post-nasal drip.
Other disorders like anxiety, heartburn, ear problems and early heart failure feature coughing as a symptom.
Certain conventional drugs, like ACE inhibitors for hypertension often have coughing as a side effect.

The Tibb View on Coughing
According to Tibb, wet coughing is associated with qualities ofcoldness with moistness as phlegm is present. On the other hand, dry coughing is associated with qualities of coldness with dryness, where phlegm is notably absent. People with a phlegmatic dominant/sub-dominant temperament are more likely to develop a wet cough, whereas those with a melancholic dominant/sub-dominant temperament are more likely to develop a dry cough.
Treatment and Management of Coughs
Treatment and management is aimed at reducing the excess coldness either associated with moistnessin the management of a wet cough or dryness in the management of a dry cough, by implementing Tibb Lifestyle Factors that will increase the qualities of heat and dryness or heat and moistness respectively.   This assists Physis in addressing both the symptoms and causes of coughing.

Tibb Lifestyle Factors
Coughing Associated with Qualities of Coldness with Moistness (Wet Cough):
Food and Drink

• Eat mostly Hot & Dry – such as  eggs, chicken, garlic and mustard, followed by Hot & Moist  like  ginger, black pepper, turmeric and honey.
• Eat less Cold & Dry – such as yogurt, citrus fruit and mealie meal, and the least amount of Cold & Moist  – like rice, milk, cucumber, and watermelon.
• Drink lots of water. Try for at least 8 glasses of warm water daily, to replace fluid lost from coughing.

Coughing Associated with Qualities of Coldness with Dryness (Dry Cough):
Food and Drink

• Eat mostly Hot & Moist  – such as ginger, black pepper, lamb, and spinach, followed by  Hot & Dry  – like egg, chicken, garlic, and turmeric.
• Eat less of  Cold & Moist  – such as rice, milk, butter, and watermelon, and the least amount of Cold & Dry  – like beef, yogurt, cabbage, and beans.
• Hot beverages, like tea with honey, and broths work well to soothe the throat affected by a dry cough.

Other lifestyle factors 

• Pour hot water into a basin or bowl. You may add blackseed winter oil or any other ointment that contains menthol or eucalyptus. Throw a towel over your head and inhale the vapour. (Take caution when doing this).
• Take slow and deep breaths in and out through the nose for five minutes, several times daily.

Herbal Remedies 

• Steep several slices of fresh ginger root in boiling water, add honey to taste.
• Echinacea (10 to 12 drops tincture, four times daily) can lessen the severity of a troublesome cough.
• Consuming raw garlic can help improve a cough.

What is depression? 
Depression is a mood disorder which causes a constant feeling of sadness and a loss of interest in life. Depression affects the way one feels, think and behave and can make carrying out daily activities difficult.

Signs and Symptoms 
Feeling of constant sadness or unhappiness; loss of interest in daily activities; an inability to feel pleasure; sleeping too much (hypersomnia) or lack of sleep (insomnia); loss of appetite or excessive eating; slow thinking, speaking or body movements; loss of concentration and memory; frequent onset of physical symptoms, such as backache and headaches; and thoughts of death and suicide.

Causes and Risk Factors 
There are a number of possible factors that contributes towards the development of depression.
Depression is more prevalent in women, linked probably to an imbalance of brain chemicals or hormones.
Depression is considered an inherited or temperamental condition, as it is more common in people whose biological relatives also have it. Traumatic events such as death of a loved one, divorce or financial problems can trigger depression.
Poor weather, especially in winter, can lead to a form of depression called Seasonal Affective Disorder.

The Tibb View on Depression
According to Tibb, depression is associated with qualities of coldness, with either moistness or dryness. Phlegmatic depression includes feelings of general unexplained sadness, withdrawal from society, excessive sleep and eating, and is more prevalent in people with phlegmatic temperaments.
Melancholy common to people with a melancholic temperament includes a loss of pleasure in almost all activities, insomnia and a loss of appetite. Phlegmatic depression increases qualities of coldness with moistness and can be detrimental to the brain and the digestive system, as it results in sluggishness and mental dullness. Melancholy is harmful to the brain and heart as it causes excessive coldness with dryness which increases the risk of strokes and heart attacks.

Treatment and Management of Depression
Treatment and management is aimed at reducing the excess coldness either associated with moistness in the management of phlegmatic depression or dryness in the management of the melancholic form, by implementing Tibb Lifestyle Factors that will increase the qualities of heat and dryness or heat and moistness respectively.   This will assist Physis in addressing both the symptoms and causes of depression.

Tibb Lifestyle Factors
Phlegmatic Depression Associated with Qualities of Coldness with Moistness:
Food and Drink

• Eat mostly Hot & Dry – such as eggs, chicken, oily fish, garlic and mustard, followed by  Hot & Moist – like ginger, black pepper, turmeric, lamb and dates.
• Eat less of  Cold & Dry – such as yogurt, citrus fruit, and beans, and the least amount of  Cold & Moist – like milk, cucumber, rice and watermelon.
• Eat complex carbohydrates. This helps stimulate serotonin, a mood enhancer.
• Avoid sugar and foods and drinks that contain high amounts of sugars like cool drinks, cakes and chocolates etc. These foods cause quick mood highs but results in feeling sluggish and depressed thereafter.

Other Lifestyle Factors 

• Exercise regularly by partaking in exercises like walking, swimming or any other exercise that you might enjoy.
• Practice mind-body exercise such as meditation to counter stressful situations.

Herbal Remedies 

• Add a pinch of saffron to meals daily.

Melancholy Associated with Qualities of Coldness with Dryness:
Food and Drink

• Eat mostly Hot & Moist – such as ginger, black pepper, turmeric, lamb and dates, followed by Hot & Dry  – like eggs, chicken, oily fish, garlic and mustard.
• Eat less of Cold & Moist – such as milk, cucumber, rice and watermelon, and the least amount of  Cold & Dry – like yogurt, citrus fruit, and beans.
• Eat of complex carbohydrates. This helps stimulate serotonin, a mood enhancer.
• Avoid refined sugar, and foods and drinks that contain high amounts of sugar like cold drinks, cakes and chocolates. These foods cause quick highs but leave you feeling down, sluggish and depressed thereafter.

Other Lifestyle Factors 

• Exercise regularly by partaking in exercises like walking, swimming or any other exercise that you might enjoy.
• Practice mind body exercise such as meditation to counter stressful situations.

Herbal Remedies

• Take 1 tsp of cashew nut powder (crushed cashew nuts) in 1 glass of milk daily.

What is Diabetes?
Diabetes is a chronic condition that occurs when the body cannot produce enough insulin, or use it effectively. Insulin is a hormone produced by the pancreas that allows glucose from food to enter the body’s cells, where it is converted into energy which is needed by muscles and tissues to function. As a result, a person with diabetes does not absorb glucose properly, and glucose stays circulating in the blood and reaches high concentrations (hyperglycaemia), and this damages tissues and organs over time, even leading to life-threatening health complications.

Types of Diabetes 
There are two main types of diabetes:
Type 1 diabetes – Insulin dependent diabetes
Type 2 diabetes – Non-insulin dependent diabetes

Type I Diabetes 
Type 1 diabetes occurs when the insulin cells in the pancreas are destroyed. As a result the body can no longer produce the insulin it needs. It is still unclear why this happens. The onset of type 1 diabetes usually develops in children and young adults. People with this form of diabetes are dependent on the use of daily insulin injections to control their blood glucose levels. Without insulin, serious complications and death will result.

Type 2 Diabetes 
Type 2 diabetes is the most common type of diabetes. It usually occurs in adults, but is increasingly seen in children and adolescents. In type 2 diabetes, the body is able to produce insulin, but it is either not sufficient or the body is not responding to its effects. This leads to a build-up of glucose in the blood.

Signs and Symptoms of Diabetes 
Abnormal thirst and dry mouth; frequent urination; extreme tiredness/lack of energy; constant hunger; sudden weight loss; slow-healing wounds; recurrent infections; blurred vision.

Complications of Diabetes 
Deteriorating vision; foot ulcers; sexual impotence; skin infections; increased risk of heart attacks and strokes.

Prolonged Complications
Kidney damage (nephropathy); nerve damage (neuropathy); blindness (retinopathy); amputations.

What Causes Type 2 Diabetes?
Risk factors for developing type 2 diabetes include being overweight or obese; a lack of regular physical activity; unwisely food choices (eating too much carbohydrate rich foods, for example); and a genetic predisposition. These risk factors increase moistness in the body.

The Tibb View on Type 2 Diabetes
Diabetes is linked to qualities of moistness. Heat is needed for the pancreas to function well. Excessive moistness dampens heat and results in insufficient production of insulin. Excessive moistness may also affect the tissue cells’ sensitivity to insulin, resulting in increased levels of glucose circulating in the blood stream.
Individuals with a sanguinous dominant/sub-dominant temperament are most likely to develop diabetes. This is due to the innate qualities of moistness associated with this temperamental type and their predisposition to overeating. A person with a sanguinous/phlegmatic temperament is at even greater risk of developing diabetes, due to the dominance of moistness in this combination type.

Treatment and Management of Type 2 Diabetes 
Treatment and management is aimed at reducing the excess moistness associated with diabetes, by implementing Tibb Lifestyle Factors that will increase the qualities of heat and dryness. Lifestyle advice includes decreasing the intake of carbohydrate-rich foods and increasing levels of physical activity. This will decrease the level of moistness produced in the body and increase heat, which is needed for the proper functioning of the pancreas.  This assists Physis in addressing both the symptoms and the causes of type 2 diabetes.

Tibb Lifestyle Factors
Food and Drink 

• Eat mostly Hot & Dry – such as bittergourd, avocado, chickpeas, fenugreek and cinnamon, followed by Cold & Dry – like beef, fish, cauliflower and mushrooms.
• Eat less of Cold & Moist – such as carrots, pumpkin, rice and butternut, and the least amount of Hot & Moist – like bread, pasta, bananas and wheat cereals.
• Avoid hydrogenated fats, high-glycaemic, refined, processed or refrigerated foods.
• Avoid alcohol and tobacco.
• Avoid salty and sweet foods and drinks.
• Avoid fried, sugary and oily foods.
• Avoid refined sugar and fizzy drinks.
• Avoid icy and cold foods.
• Avoid high-glycaemic foods such as white rice, white flour products, starchy vegetables and many processed foods.
• Avoid eating carbohydrates like rice, bread or pasta, especially late in the date. Vegetables are acceptable.
• Eat 5 small meals per day instead of a few larger meals, especially supper. This should consist of three main meals and two snacks in between.
• Boiled/steamed/grilled steak, chicken or fish should be preferred;
• Increasing the intake of dietary fibre helps to reduce surges in blood sugar levels.
• For snacks eat fruit, vegetables or yogurt. Biltong and popcorn are also acceptable, but portion sizes should be small.
• Low carbohydrate foods such as cabbage, green beans, cauliflower leafy greens, beans, mushrooms and oranges should be included in the diet.
• Foods such as berries, eggs, fish, garlic, kelp, and most vegetables help stabilize the blood glucose levels.
• Vegetarian food should replace meats once weekly with vegetable sources of proteins such as legumes. Nuts and seeds (sesame flax and sunflower) in the diet should be increased.
• Minimize liquid intake during a meal.  Drink water (preferably warm) 30 minutes before and 30 minutes after eating.
• Drink fresh vegetable juice instead of fruit juices.

Other lifestyle advice

• Exercise has an insulin-like effect on the body.  Start with 10 minutes per day of cardiovascular exercises such as walking, running, cycling, or swimming.  Gradually build up to 45-60 minutes at least three times a week;
• Foot hygiene: to avoid foot ulcers keep feet dry, and massage regularly with heating oils;
• Avoid emotional stress through breathing exercises, counseling and other appropriate measures.

Herbal Remedies 

• Regular use of cinnamon (1 tsp daily added to food), cloves, and turmeric helps the body use insulin more effectively.
• Add a handful of stinging nettle to a litre of boiling water. Cover overnight. Strain and drink throughout the day.
• 100 grams each: ajmo/carrom seeds, fenugreek seeds, dried bitter gourd and 250ml bitter gourd juice. Mix the juice with the powder and pour it into a tray. Place the tray in a warm, dry and well ventilated place until completely dry. Use 500-1000mg 3 times a day of the powder. For children, reduce the dose by half.

Note: do not discontinue the use of conventional medication, without consulting your practitioner.

What is diarrhoea? 
Diarrhea is the condition of having three (3) or more loose or liquid bowel movements per day – may also be accompanied with gastro-enteritis. Diarrhoea is not a disease itself, but a symptom of several underlying diseases.

There are 3 types of diarrhoea

• Acute watery diarrhoea – lasts several hours or days
• Acute bloody diarrhoea – also called dysentery
• Persistent diarrhoea – lasts 14 days or longer

Signs and Symptoms 
Frequent, loose and watery stools, often accompanied by vomiting, stomach cramps, thirst, abdominal pain; and moderate fever.

Complications
Dehydration; malnutrition; and death.

What Causes Diarrhoea?
Diarrhoea is caused when there is inflammation of the intestines which does not allow for the absorption of nutrients and liquid. Some of the causes include:
Infection: resulting from contaminated water, poor sanitation and improper hygiene.
Food intolerance: from milk and dairy products, over eating, and consuming too many different foods. Medication: side effects from conventional medication.
From chronic illnesses: these include Irritable Bowel Syndrome, Inflammatory Bowel Disease including Crohn’s disease and Ulcerative Colitis, chronic pancreatitis, celiac disease, colon cancers and certain tumours of the small intestines.
Incomplete digestion of food: eating meal upon meal can result in undigested food remaining in the gastrointestinal tract.

The Tibb View of Diarrhoea
According to Tibb, diarrhoea is a physis response to eliminate the contents of the colon from food that is undigested, spoilt or contaminated.  Diarrhoea is in most cases associated with qualities of excessive moistness either with coldness or heat as the body eliminates toxic fluid. Excessive moistness with coldness results from too much cold & moist and Hot & Moist foods such as dairy products. This type of diarrhoea is common in children because of the innate quality of moistness.  Diarrhoea with qualities of moistness with heatresult from infections as well as from certain chronic diseases that increases heat, resulting in increased gastric motility. As there are numerous causes that can lead to diarrhoea, all temperamental types can be affected.

Treatment and Management of Diarrhoea
Treatment and management is aimed at reducing the excess qualities associated with diarrhoea, by implementing Tibb Lifestyle Factors that will increase the qualities of dryness and heat in patients with symptoms of excess moistness with cold, and dryness and cold in patients with excess moistness with heat. This will assist Physis in addressing both the symptoms, and the causes of diarrhoea.

Tibb Lifestyle Factors
Diarrhoea Associated with Qualities of Moistness with Cold:
Food and Drink

• Eat mostly Hot & Dry  – such as avocado, chickpeas, cinnamon and cloves, followed by  Cold & Dry  – like yogurt, potatoes, and mealie meal.
• Eat less of Hot & Moist  – such as bread, pasta, almonds, and spinach and the least amount of Cold & Moist  – like milk, margarine, rice, and squash.
• Avoid high fibre foods, which may stress the digestive system. Also fried, junk and processed foods.

Diarrhoea Associated with Qualities of Moistness with Heat:
Food and Drink 

• Eat mostly Cold & Dry  – such as yogurt, potatoes, and mealie meal followed by  Hot & Dry – like avocado, chickpeas, cinnamon and cloves.
• Eat less of Cold & Moist  – such as cumin, cardamom, rice, and squash and the least amount of Hot & Moist  – like bread, pasta, almonds, and spinach.
• Drink 3 cups of rice water daily. To make rice water, boil ½ cup of brown rice in 3 cups of water for forty five minutes. Strain out the rice and drink the water.

Other Lifestyle Advice

• Avoid solid food for a few hours until you feel better;
• Avoid dehydration. Drink water or a rehydration drink regularly, or liquids such as clear broth, weak tea, and clear fruit juices. Avoid very hot or cold liquids;
• Do not exercise strenuously until free of symptoms.

 
Herbal Remedies for diarrhoea associated

• Mix cinnamon powder, cumin powder, ginger powder (1 part) and honey (3 parts) in hot water.  Use 1tsp three times a day in adults and ½ tsp in children.
• If the diarrhoea does not have an offensive odour, or is the result of intake of antibiotics, then 1tbsp psyllium husk added to 5 tbsp Greek style yogurt and 2 tsp brown sugar. Mix thoroughly and eat. The yogurt will increase the probiotics in the digestive tract.

What is Dry Skin?
Although dry skin is not generally a serious condition, it may be uncomfortable, leaving the skin looking unsightly. When the condition is serious or severe, it is called ichthyosis.

Signs and Symptoms 
Dull looking, scaly and flaky skin, with fine lines and wrinkles; the skin feels unusually tight and uncomfortable, especially after washing; itchiness; a grey, ashen skin is evident in people with a dark complexion. Exposed areas of skin, like hands and face, are mostly affected. Chapped and cracked skin are signs of severely dehydrated skin.

What Causes Dry Skin?
There are many factors that may contribute towards dry skin:
Environment: long-term exposure to extremes of high and low temperatures.
Air-conditioners and heaters: these reduce the moisture present in the air, and contribute towards skin dryness.
Hot baths and showers: taking baths and showers in very hot water for long periods of time causes skin dehydration.
Harsh soaps and detergents: these strip natural oils from the skin.
Medications: dry skin may result from side effects of certain medications.

The Tibb View of Dry Skin
According to Tibb, dry skin is associated with dryness with coldness, as the skin lacks moisture. Most peoples’ skin becomes thinner and drier with age because of a natural increase in cold and dryness qualities. Dry skin is more prevalent in people with a melancholic dominant/sub-dominant temperament, with people with a melancholic/bilious temperament being at greatest risk due to their inherent qualities of dryness.

Treatment and Management of dry skin
Treatment and management is aimed at reducing the excess dryness with coldness associated with dry skin, by implementing Tibb Lifestyle Factors that increase the qualities of heat and moistness.  This assists Physis in addressing both the symptom and the causes of dry skin.

Tibb Lifestyle Factors 
Food and Drink

• Eat mostly Hot & Moist – such as sweet potato, banana, almonds and brown bread, followed by Cold & Moist – like butternut, carrots, pumpkin seeds and rice.
• Eat less of Hot & Dry – such as bittergourd, grapes, chickpeas and cinnamon, and the least amount of Cold & Dry – like beef, tomatoes, lemon, peanuts and beans.
• Eat a balanced diet that includes vegetables, fruits, grains, seeds, and nuts – raw wherever possible.
• Consume plenty of yellow and orange vegetables. (These are high in beta-carotene, a precursor of the skin-improving vitamin A).
• Drink at least two litres of water every day to keep the skin well hydrated.
• Do not drink soft drinks or eat sugar, chocolate, potato chips, or other junk foods.
• Avoid regular or excessive alcohol and caffeine intake.

Other Lifestyle Factors 

• Always moisturise the skin after cleansing. Apply pure olive or almond oil liberally to the skin.
• Avoid cigarette smoking, and exposure to second-hand smoke.
• Avoid harsh soaps, cold creams, or cleansing lotions.

Herbal Remedies 

• Mash two ripe bananas. Add two tbsp of honey. Mix well. Apply on dry skin. Leave it for 20 min. Wash off with warm water.
• Take one tablespoon of aloe juice in a glass of water daily.

What is Eczema?
Eczema is an itchy inflammation of the skin. It is a chronic disorder which may be associated with asthma or hay fever.

Signs and Symptoms
Red to brownish-gray colored patches form on the skin, most commonly in the skin folds; thick, cracked or scaly skin; severe itching, especially at night; small, raised fluid filled bumps appear when the skin is scratched.

Complications
Scratching frequently results in the skin becoming hard, leathery, raw, darker than normal, and permanently scarred; infections can appear on the skin. Scratching can also result in open sores developing, which are sensitive to the touch, and susceptible to infection. Eczema may affect the eyes, resulting in itching in and around the eyelids. This may lead to permanent eye damage.

What Causes Eczema?
The exact cause of eczema is unknown, but its predisposition is thought to have a hereditary or temperament component. Stress and other emotional disorders may worsen eczema. Eczema is more common in children.

The Tibb View of Eczema 
Eczema is linked to qualities of heat with either dryness or moistness as it is an inflammatory skin condition which present with itchy skin either associated with dry, scaly skin, or the presentation of discharge through damaged skin. Eczema may affect children of any temperament. The presentation of the eczema often differs according to the temperament. Melancholic children present with dry flaky skin, phlegmatic/sanguinous temperamental combination are more likely to develop “wet” eczema, and bilious children present with red, raw and highly inflamed skin.

Treatment and Management of eczema 
Treatment and management is aimed at reducing the excess qualities associated with eczema, by implementing Tibb Lifestyle Factors that will either increase the qualities of cold and moistness in patients with symptoms of excess heat and dryness, and cold and dryness in patients with excess heat with moistness. This assists Physis in addressing both the symptoms and the causes of eczema.

Tibb Lifestyle Factors 
In Eczema associated with qualities of heat with dryness:
Food and Drink 

• Eat mostly Cold & Moist – such as cucumber, watermelon, carrots and broccoli, followed by Cold & Dry – like yogurt, citrus fruit and coconut oil.
• Eat less Hot & Moist – such as ginger, white flour products, cheese and sugar, and the least amount of Hot & Dry – like eggs, fish, walnuts and garlic.

In Eczema associated with qualities of heat with moistness:
Food and Drink 

• Eat mostly Cold & Dry – like yogurt, citrus fruit and coconut oil, followed by  Cold & Moist – such as cucumber, watermelon, carrots and broccoli,
• Eat less Hot & Dry – like eggs, fish, walnuts and garlic and the least amount of Hot & Moist – such as ginger, white flour products, cheese and sugar.

Additional dietary Advice for Eczema associated with both heat with dryness and heat with moistness

• Avoid cashew nuts, pecan nuts, peanuts, cheese and other dairy products, pickles, processed meats, chocolate, wheat, strawberries, fats and fried foods.
• Try a gluten free diet for six weeks. Slowly reintroduce gluten foods one at a time back into your diet, and note any changes.
• Drink Rooibos tea (without milk and sugar). This has cooling properties and is rich in antioxidants.
• Avoid simple sugars and white flour products. Opt instead for brown variants and use honey, xylitol or Stevia to replace sugar.
• Camomile can be taken internally, as it strengthens and calms nerves. It can be used as well as on the skin to reduce skin inflammation.

Other Lifestyle Factors 

• Use non-perfumed moisturising lotions for bathing, such as aqueous creams or Episone-E. Add a half cup of boiling water to five Rooibos teabags, add to Episone-E lotion, and apply to the affected skin as a moisturiser. This helps reduce itchiness and inflammation. A tablespoon of honey can be added.
• Keeping the home humidified helps relieve symptoms of eczema linked to heat with dryness.
• Taking fewer showers and baths reduces the loss of the natural skin protective oils.
• Take measures to keep the colon clean. Use regular enemas to help rid the body of toxins.

Herbal Remedy 

• Drink two to three tablespoons twice daily of pure Aloe Vera juice. This can also be applied directly over the skin.

What is Flatulence? 
Flatulence is the result of excess intestinal gas being passed through the anus from the lower intestine.

Signs and Symptoms 
Excessive or unwelcome passage of gas from the anus; embarrassing wind breaking during coughing, sneezing or laughing, or during exertion; disagreeable and uncomfortable bloating of the abdomen due to gas accumulation; a feeling of urgency similar to the one signaling the need to defaecate; and the most serious (embarrassing) complication is breaking out in public.

What Causes Flatulence?
Flatulence is a by-product from the normal intestinal flora’s (bacteria) action of hard to digest foods that passes into the colon such as beans. Food sensitivities or intolerance, as with ingesting foods containing gluten or lactose can also cause excessive buildup of intestinal gas, which is sometimes painful. Ailments such as IBS often feature excessive flatulence as a symptom.

The Tibb View of Flatulence
According to Tibb, the qualities associated with flatulence are dependent on the underlying cause. Eating gas-forming, cold and dry foods like beans, produces flatulence linked to qualities of dryness with cold. Although people with a melancholic dominant/sub-dominant temperament are most inclined to suffer with flatulence, other temperamental types can also suffer from it, due to a faulty diet or a poor lifestyle.

Treatment and Management of Flatulence
Treatment and management is aimed at reducing the excess dryness with cold associated with flatulence, by implementing Tibb Lifestyle Factors that will increase the qualities of heat and moistness.  Treating the underlying condition and avoiding certain foods should also be adopted. This assists Physis in addressing both the symptoms and the causes of flatulence.

Tibb Lifestyle Factors 
Food and Drink 

• Eat mostly Hot & Moist  – such as banana, sweet potato, and brown bread, followed by Cold & Moist  – like butternut, carrots, pumpkin and pears.
• Eat less of Hot & Dry  – such as avocado, garlic, onion and chickpeas, and the least amount of Cold & Dry  – like beef, tomato, beans and mealie meal.
• Try to eat more fresh vegetables, fruit and whole meal bread, as these will increase roughage in the diet.
• Drink at least 6-8 glasses of warm water per day.
• Drink at least 2 liters of warm water daily.
• Use rice instead of potatoes, corn or noodles wherever possible.
• Avoid gas-promoting foods, especially apricots, beans, cabbage, brussels sprouts, broccoli, cauliflower, lentils, onions and radishes.
• Avoid food combinations that upset your stomach, such as consuming fruit with a heavy meal or milk with fermented products.

Herbal Remedies 

• Add 1 teaspoon of fennel seeds to 1 cup of boiling water. Drink after cooling and straining.
• Adding the spices cumin, coriander, caraway and turmeric when preparing meals counteracts intestinal gas production.

What are Gallstones?
Gallstones are hardened deposits of bile and other material that forms in the gallbladder. Gallstones can range in size from a grain of sand to that of a golf ball.

Signs and Symptoms
Gallstones may present with no signs and symptoms, depending on the size; a colicky pain in the upper right side of the abdomen that may radiate to the right shoulder; intensifying pain in the abdomen just below the breast bone; and pain between the shoulder blades.

Complications
Inflammation of the Gallbladder: Inflammation may result when a gallstone becomes lodged in the neck of the gallbladder.
Blockage of the Bile Duct: Gallstones may lodge in the common bile duct, resulting in jaundice or an infection of the bile duct.
Blockage of the Pancreatic Duct: A gallstone may lodge in the pancreatic duct, increasing the risk of developing inflammation of the pancreas.

What Causes Gallstones? 
Bile is responsible for dissolving cholesterol. If the liver secretes too much cholesterol for the bile to dissolve, the cholesterol hardens and form stones. Gallstones may also form if too much of the chemical bilirubin is produced. Bilirubin is responsible for breaking down red blood cells. Too much of it is produced in certain illness conditions, especially liver cirrhosis.
If the gallbladder fails to empty completely or often enough, bile may become very concentrated, and this contributes to the formation of gallstones.
Risk factors include being female; being obese or overweight; being over the age of 60; eating a rich, high fat, low fibre diet; rapid weight loss; and diabetes.
Certain medications such as cholesterol-lowering medication and hormone therapy also increase the risk of developing gallstones.

The Tibb View on Gallstones
Gallstones are linked to qualities of coldness with dryness as digestive fluid solidifies to form stones. Individuals, especially women, as their predominantly phlegmatic temperament are more likely to develop gallstones, due to their innate quality of coldness. Irregular eating patterns and skipping meals, which are associated features of the phlegmatic temperament, result in an imbalance of chemicals in the gallbladder. This frequently goes on to form gallstones.

Treatment and Management of Gallstones
Treatment and management is aimed at reducing the excess coldness with dryness associated with gallstones, by implementing Tibb Lifestyle Factors that increase the qualities of heat and moistness. Lifestyle changes such as exercising and eating a healthy diet are strongly advised.

Tibb Lifestyle Factors 
Food and Drink

• Eat mostly  Hot & Moist – such as olive oil, turmeric, dates and mutton, followed by  Hot & Dry – like oily fish, garlic, chicken and mustard seeds.
• Eat less of  Cold & Moist – such as litchis, watermelon, cucumber, milk and broccoli, and the least amount of  Cold & Dry – like beef, tomato, yogurt and citrus fruits.
• Avoid sour foods and drinks.
• Avoid animal products, especially pork.
• Avoid fried fatty, sugary or refined foods.
• Avoid all hydrogenated and hardened fats, and oils such as margarine, lard and butter.
• Drink juices such as pear, beet, and apple for 3 days.
• Boiled/steamed chicken and fish should be preferred over red meat.
• Avoid cold and icy foods and drinks.
• Drink at least two to three litres of warm water a day.

Other Lifestyle Factors

• Colonic cleansing or irrigation is recommended to assist in eliminating waste from the body.
• Daily moderate exercise such as moderate walking is advised.

Herbal Remedies

• Take 3 tablespoons of olive oil with the juice of a lemon (3 tablespoons) before bed and upon wakening. Stones are often passed in the stools with this technique. Substitute lemon with grapefruit if desired.

Detox Programme 

2. During treatment, eat normally, but avoid red meats, dairy and fried foods completely.
3. On Day 1, take 1 tablespoon olive oil plus 1 tablespoon of lemon juice at bedtime.
4. On Day 2, carry on with the apple juice. Take 2 tablespoons olive oil plus the same amount of lemon juice at bedtime.
5. On Day 3, carry on with the apple juice. Take 3 tablespoons olive oil plus the same amount of lemon juice at bedtime.
6. On Day 4, carry on with the apple juice. Take 3 tablespoons olive oil plus the same amount of lemon juice at bedtime.
7. On Day 5, carry on with the apple juice. Take 4 tablespoons olive oil plus the same amount of lemon juice at bedtime.
8. On Day 6, carry on with the apple juice. Take 5 tablespoons olive oil plus the same amount of lemon juice at bedtime.
9. On Day 7, carry on with the apple juice till midday, then take a light lunch. At 6 pm, take a teaspoon of Epsom Salts (magnesium sulphate) with a glass of warm water.
At 8 pm, repeat the same. Epsom Salts open the gallbladder ducts.  
At 10 pm, take a half-cup olive oil with same amount of lemon juice. Mix it well and drink it.
After this, sleep or at least lie down on the right side and rest. Do not engage in physical activity.  
To avoid nausea and vomiting suck grapefruit with salt or chew mint leaves.
The next morning, you will pass a loose stool.
Check the stool for toxins, worms, and green coloured gallstones. 

What is Gastritis?
Gastritis is a group of symptoms that arise from inflammation of the stomach lining.

Signs and Symptoms 
A gnawing or burning ache or pain in the upper abdomen; it may become better or worse with eating; nausea; vomiting; a feeling of fullness in the upper abdomen after eating.

Complications
Stomach ulcers; internal bleeding; an increased risk of developing stomach cancer.

What Causes Gastritis?
The stomach is lined with a mucous barrier which protects it from the acid secreted to digest food. It develops when the stomach lining becomes weak or damaged. Weakness in this mucous barrier results in acid attacking the lining of the stomach. A number of ailments make the protective layer susceptible to damage, and so increase the risk of developing gastritis.

The Tibb View of Gastritis
According to Tibb, gastritis is linked to qualities of heat with dryness. These lead to the burning abdominal pain experienced. A lifestyle that promotes this heat and dryness, such as the excessive intake of heavily spiced foods, poorly managed stress and alcohol abuse, increases the risk of developing gastritis. People with a bilious dominant/sub-dominant temperament are most likely to develop gastritis, due to their inherent qualities of heat/dryness.

Treatment and Management of Gastritis 
Treatment and management is aimed at reducing the excess heat with dryness associated with gastritis, by implementing Tibb Lifestyle Factors that increase the qualities of coldness and moistness. This assists Physis in addressing both the symptoms and causes of gastritis.

Tibb Lifestyle Factors
Food and Drink

• Eat mostly Cold & Moist – such as rice, cucumber, watermelon and milk, followed by Cold & Dry – like yogurt, potato, citrus fruit and coconut oil.
• Eat less of Hot & Moist  – such as mutton, ginger, spinach and sugar, and the least amount of Hot & Dry – like chicken, eggs, garlic and onions.
• Drink a large glass of water rapidly to relieve pain. This dilutes excess stomach acid, flushing it into the duodenum, where it is neutralised;
• Eat frequent small meals, including well cooked white rice, yoghurt and cottage cheese.
• Eat vegetables such as carrots and broccoli occasionally.
• Allow hot beverages, such as rooibos tea, to cool before drinking. This avoids triggering gastric discomfort.
• Avoid fried foods, tea, coffee, alcohol, chocolate, strong spices, animal fats and carbonated drinks.

Other Lifestyle Advice

• Avoid non-steroidal anti-inflammatory drugs, especially aspirin.
• Quit smoking.
• Practice slow and deep breathing exercises twice daily.
• Keep the colon clean by consuming a high-fibre diet. The use of a gentle and natural laxative monthly is recommended.

Herbal Remedies

• Drink 25ml of Aloe Vera juice two to three times per day.
• 1tsp of licorice root powder mixed in 100ml of warm water and taken three to four times per day on an empty stomach promotes the healing of the mucous barrier.
• Take 1teaspoon of psyllium husk with warm water before retiring at night.

What is GORD? 
Gord is a chronic disease where stomach acid occasionally flows back into the oesophagus. The acid irritates the lining of the oesophagus and causes the signs and symptoms of GORD.

Signs and Symptoms 
A burning sensation behind the breastbone; a sour taste in the mouth; regurgitation of food or acid/bile; chest pain; difficulty swallowing; dry cough; and a sensation of a lump in the throat.

Complications
Narrowing of the oesophagus. This is due to damage by the acid reflux. Scar tissue might form, causing the oesophageal space to narrow.
Oesophageal Ulcers. The stomach acid erodes the mucous barrier in the oesophagus. This causes an open sore to form.
Barrett’s Oesophagus. Damage caused by the acid reflux may result in abnormal/precancerous cells developing.

What Cause GORD?
GORD results from frequent episodes of heartburn or acid reflux, due to stomach acid moving into the oesophagus. During digestion the muscles above the stomach relaxes to allow food in and then closes again. With GORD, the frequent muscle relaxation allows stomach acid back up into the oesophagus, causing heartburn.

The Tibb View on GORD
According to Tibb philosophy, GORD can either result from an excess of heat with dryness which produces an excess amount of stomach acid, or from an excess of moistness, which causes the muscle to relax abnormally. The form of GORD linked to heat with dryness is more prevalent in people with a bilious dominant/sub-dominant temperament, due to their innate qualities of heat and dryness. The form of GORD linked to moistness is more commonly found in people with a phlegmatic/sanguinous temperament, due to the inherent dominance of moistness.

Treatment and Management of Heartburn
Treatment and management is aimed at reducing the excess qualities associated with GORD, by implementing Tibb Lifestyle Factors that will increase the qualities of coldness with moistness in patients with symptoms of excess heat with dryness and by increasing the quality of dryness in patients with symptoms of excess moistness. This assists Physis in addressing both the symptoms and causes of GORD.

Tibb Lifestyle Factors
GORD associated with Qualities of Heat with Dryness:
Food and Drink

• Eat mostly Cold & Moist – such as rice, cucumber, watermelon and milk, followed by  Cold & Dry – like yogurt, potato, citrus fruit and coconut oil.
• Eat less of Hot & Moist  – such as mutton, ginger, spinach and sugar, and the least amount of Hot & Dry  – like chicken, eggs, garlic and onions.
• Drink a large glass of water rapidly to relieve pain. This dilutes excess stomach acid, flushing it into the duodenum where it is neutralised;
• Eat frequent small meals, including well-cooked white rice, yoghurt and cottage cheese.
• Occasionally eat vegetables such as carrots and broccoli.
• Allow hot beverages, like rooibos tea, to cool before drinking, to avoid triggering gastric discomfort.
• Avoid fried foods, tea, coffee, alcohol, chocolate, strong spices, animal fats, and carbonated drinks.
• Avoid eating and drinking at the same time. Fluids should be taken 30 minutes before or after a meal.

Other Lifestyle Advice

• Avoid lying down immediately after a meal.
• Wear loose, comfortable clothing.
• Avoid non-steroidal anti-inflammatory drugs, especially aspirin.
• Quit smoking.
• Practice slow and deep breathing exercises twice daily.
• Keep the colon clean by following a high-fibre diet. The use of a gentle and natural laxative is recommended monthly.
• Drink a glass of chilled milk to reduce discomfort caused by stomach acid.

Herbal Remedy

• Grind 2 cardamom pods, add 250ml of water boil for 15minutes, strain, and drink three times daily.

Tibb Lifestyle Factors
GORD (Associated with the Quality of Moistness):
Food and Drink

• Eat mostly Hot & Dry – such as chicken, avocado, bittergourd and chickpeas, followed by Cold & Dry – like beef, potato, and yogurt.
• Eat the less of Hot & Moist – such as bread, pasta, sugar and bananas, and the least amount of Cold & Moist  – like squash, butter, cucumber and pears
• Avoid triggers such as fatty or fried foods, tomato sauce, alcohol, chocolate, mint, garlic, onion and caffeine. These often make heartburn worse.
• Eat smaller meals.

Other Lifestyle Advice 

• Avoid lying down immediately after a meal.
• Wear loose, comfortable clothing.
• Lose weight if overweight.
• Quit smoking.

Herbal Remedies

• Chew five to six basil leaves after meals.
• Chew a clove of garlic to lessen discomfort.

What is Gout? 
Gout is a recurrent acute, painful inflammatory disease that affects the person’s joints, especially in the big toes. It is a metabolic disorder resulting from the accumulation of uric acid in the blood and other body fluids.  The uric acid forms crystals in the joints, which trigger an acute inflammatory response. It can also develop into a chronic or recurring condition.

Signs and Symptoms
Severe, throbbing, excruciating pain in a joint, particularly in the big toe (50% of cases), ankle or knee. The affected joint is inflamed – red, swollen, hot and very tender to the touch. Flu-like symptoms may appear, such as muscle aches and fever; hard nodules form on the joint surface; and physical movement is painful and difficult. Gout can also affect the ankles, knees, wrists, tendons and surrounding tissues.

Complications 
Untreated gout may cause urate crystals nodules (tophi) to form under the skin. Tophi can develop in several areas such as the fingers, hands, feet, elbows or Achilles tendons along the back of the ankle. Tophi themselves are not usually painful, but they can become swollen and tender during gout attacks. Another complication that may occur is the development of kidney stones due to urate crystals forming in the urinary tract.

What Causes Gout?
Gout occurs when urate crystals accumulate in joints, causing the inflammation and intense pain typical of a gout attack. The uric acid is a normal waste product of the body’s metabolism, but is not excreted properly in gout.
Gout often results from long-term consumption of rich, high-protein food, especially cold and dry foods like beef. Other risk factors include: side effects of certain medications such as diuretics, and a genetic or temperamental predisposition.

The Tibb View on Gout
According to Tibb, gout is linked to coldness with dryness. It develops in the peripheral areas of the body which do not receive as much heat as the core organs and tissues. Physis is unable to regulate the high uric acid levels circulating in the blood, resulting in these crystals depositing and “freezing” in the joint spaces. The body’s reaction to this is the origin of the signs and symptoms of gout. Although individuals with a melancholic dominant/sub-dominant temperament are predisposed to gout, people with dominant/sub-dominant sanguinous temperaments are also at risk. This is the result of the oxidation of the sanguinous humour into abnormal melancholic humour.

Management of Gout 
Treatment and management is aimed at reducing the excess coldness with dryness associated with gout, by implementing Lifestyle Factors that will increase the qualities of heat with moistness. This assists Physis in addressing both the symptoms and causes of gout.

Tibb Lifestyle Factors 
Food and Drink

• Ideally eat only fruit and vegetables (juiced), and avoid nuts, eggs, meats and fried foods for several days during an acute attack;
• Eat mostly Hot & Moist – such as spinach, dates, mango, and turmeric, followed by Hot & Dry – like oily celery, green or red peppers, avocados and parsley.
• Eat less of Cold & Moist – such as milk, pineapples, and broccoli, and the least amount of Cold & Dry – like beef, tomatoes, sour milk, and beans.
• Cut down on tea and coffee, and restrict alcohol consumption, especially beer.
• Do not eat purine-rich foods, which include brains, herring, anchovies, liver, kidneys, sardines and pilchards.
• Drink at least three litres of warm water daily to dissolve and flush out uric acid deposits.
• Drink caffeine-free herbal teas to increase fluid intake; peppermint, rose hip and yarrow, for example.
• Avoid frequent sugary soft drinks, as they contain much fructose, which can increases recurrence.
• Avoid eating protein-rich foods
• A light fast for a couple of days is often beneficial.

Other Lifestyle Factors
Try steam bathing or sauna (for short sessions) daily. Heat helps to soften the uric acid crystals.

Herbal Remedy

• Infuse in 1 cup of boiling water with ½ tsp cinnamon powder, ½ tsp fenugreek powder, and a ¼ tsp celery seeds powder. Add honey to taste.

What are Haemorrhoids/Piles? 
Hemorrhoids are swollen and inflamed veins located in the region of the anus and lower rectum.

Signs and Symptoms
Itching, pain and burning feeling around the anus; heavy feeling within the rectum; soft swelling or a lump protruding from the anus; and bleeding of bright red blood from the anus during defaecation.

Complications
Haemorrhoids which bleed can lead to chronic anaemia due to excessive blood loss. Strangulation of the blood supply to an internal haemorrhoid may be cut off, causing severe pain and tissue death (gangrene).

What Causes Piles?
The veins around the anus tend to stretch under pressure, and may bulge or swell. Swollen veins (haemorrhoids) develop from an increase in pressure in the lower rectum. There are a number of risk factors that may contribute to this by reducing blood circulation.
Physical factors, such as chronic constipation, pregnancy, lifting heavy weights, obesity, enlarged prostate (in men); poor diet, especially from  low fibre foodstuffs, cold and dry food items;, food allergies; faulty habits, especially lack of physical exercise, frequent use of chemical laxatives, sitting or standing still for long periods of time, so encouraging poor blood circulation.

The Tibb View on Piles
According to Tibb, haemorrhoids are associated with qualities of dryness with cold as it is often results as a complication of constipation. Bleeding piles are associated with dryness with heat. People with a melancholic dominant/sub-dominant temperament are more predisposed to developing piles due to their dominance of dryness and cold.

Management of Piles
Treatment and management is aimed at reducing the excess quality of dryness associated with haemorrhoids, by implementing Tibb Lifestyle Factors that either increase the qualities of heat and moistness in haemorrhoids which are linked to excess dryness with cold, or increase the qualities of coldness and moistness in haemorrhoids which are linked to excess dryness with heat. This assists Physis in addressing both the symptoms and causes of piles.
Lifestyle modification is often a simple and effective approach to treating haemorrhoids. It includes drinking more water, adding more fibre to the diet, and increasing the level of physical activity.

Tibb Lifestyle Factors 
Haemorrhoids Associated with Qualities of dryness with coldness: 
Food and Drink

• Eat mostly Hot & Moist – such as banana, sweet potato, and brown bread, followed by  Cold & Moist – like butternut, carrots, pumpkin and pears.
• Eat less of Hot & Dry  – such as avocado, garlic, onion and chickpeas, and the least amount of Cold & Dry  – like beef, tomato, beans and mealie meal.
• Slowly build up to eating more fresh fruit, vegetables and high-fibre foods, and drink plenty of warm water.

Haemorrhoids Associated with Qualities of dryness with heat: 
Food and Drink

• Eat mostly Cold & Moist – such butternut, carrots, pumpkin and pears followed by  Hot & Moist – like banana, sweet potato, and brown bread.
• Eat less of Cold & Dry  – such as beef, tomato, beans and mealie meal and the least amount of Hot & Dry  – like avocado, garlic, onion and chickpeas.
• Slowly build up to eating more fresh fruit, vegetables and high-fibre foods, and drink plenty of warm water.

Other Lifestyle Factors for haemorrhoids linked to both dryness with coldness and dryness with heat

• Exercise: Regular light/moderate exercise (brisk walking 20-30 min daily). Avoid standing/sitting for long periods.
• Detox: A 15min sitz bath in hot water will bring relief.
• Hygiene: Keep the anal area clean by regular use of a plain warm water enema. Apply warm water washing of the anal area after defaecation.
• Others: Lubricate the anus with Vaseline or olive oil to help with constipation.
• Avoid lifting heavy weights, or learn to apply proper lifting techniques.

Herbal Remedies 

• Herbal – consume more dark coloured berries. These contain natural flavonoids, which strengthen the walls of veins around the anus
• Avoid constipation by using a mild laxative regularly like aloe vera or prune juice. Avoid strong or harsh chemical laxatives. Eat two to three dried figs, previously soaked in water, daily
• Take one or two tablespoons of flaxseed daily to help soften the stool. Flaxseed is rich in omega-3 fats which have useful anti-inflammatory activity.

What is Hayfever?
Hay fever, also called allergic rhinitis, is the result of an allergic response to outdoor or indoor allergens, such as pollen, dust mites or pet dander.

Signs and Symptoms
Itchy eyes, nose and palate; watery discharge from nose and eyes; sneezing; nasal congestion; sinus pressure and facial pain; discoloured bluish-black skin under the eyes; and a decreased sense of taste or smell.

Complications
Ear infections in children; infection or inflammation of the sinuses; increasing asthma attacks; disturbed sleep.

What Causes Hayfever?
Hay fever occurs when the immune system becomes hyper-sensitive. This triggers the release of antibodies towards these harmless substances. Later, when there is further exposure to these substances, the immune system releases chemicals like histamine which leads to the signs and symptoms typically associated with hay fever.

The Tibb View on Hayfever
Hay fever results from an excess of the quality of heat, with either moistness or dryness. This leads to irritation and inflammation of the epithelial membranes lining the nose and throat. Bilious/Sanguinous temperamental combinations are most susceptible to developing hayfever due to their innate qualities of heat.

Management of Hayfever
Treatment and management is aimed at reducing the excess qualities associated with hayfever, by implementing Tibb Lifestyle Factors that will increase the qualities of coldness with dryness in patients with symptoms of excess of heat with moistness and by increasing the qualities of cold with moistness in patients with symptoms of excess heat with dryness. This assists Physis in addressing both the symptoms and causes of hayfever.

Tibb Lifestyle Factors 
Hayfever associated with Qualities of Heat with Moistness:
Food and Drink

• Eat mostly Cold & Dry – such as beef, fish, cauliflower and mushrooms, followed by Cold & Moist – such as carrots, pumpkin, rice, and milk. Eat less of Hot & Dry – like bittergourd, avocado, chickpeas and garlic and the least amount of Hot & Moist – like bread, pasta, bananas, and wheat cereals.
• Increase the consumption of fruits, vegetables, grains, raw nuts, and seeds.
• Eat yogurt and soured or fermented products three times a week. This significantly reduces the incidence of hay fever attacks, especially in people with a dominant or sub-dominant bilious temperament.
• Foods which are rich in magnesium, such as kidney beans, soya beans, brown rice and peas are very beneficial and protective during the allergy season.
• Avoid cake, chocolate, coffee, dairy products (except yogurt), processed foods, pies, fizzy drinks, sugar, tobacco, white flour products, junk foods and synthetic juices.

Hayfever associated with Qualities of Heat with Dryness:
Food and Drink  
Eat mostly Cold & Moist  – such as carrots, pumpkin, rice and milk followed by  Cold & Dry – like beef, fish, cauliflower and mushrooms and  Hot & Moist  – such as bread, pasta, bananas and wheat cereals and the least amount of Hot & Dry  – like chicken, oily fish, green pepper, eggs and garlic.

Herbal Remedies 

• Take 1gram of licorice root powder three times a day for seven days. However, avoid this if you have high blood pressure.
• Soak 1tbsp of poppy seeds and about seven almonds in 200ml of water overnight. In the morning, liquidise and drink.

The Tibb View on Headaches
According to Tibb, headaches are a sign of an underlying imbalance in the body. There are four main types of headaches linked to the four different temperaments – Bilious Headache, Sanguinous headache, Phlegmatic headache and Melancholic headaches. Each of these headaches result from qualitative imbalances that present with specific signs and symptoms.

Bilious Headache/Migraine
This headache starts from the left half of the cranium and left eye spreading throughout the head. This headache normally starts at sunrise and gradually increases in intensity by midday. The headache is accompanied by nausea and sometimes vomiting. There is also intolerance to noise and light. In the later part of the afternoon, some relief from the intensity of pain may be experienced.

What Causes Bilious Headaches? 
There are many factors that can contribute towards the development of a bilious headache. This includes: a hot environment or hot weather; inadequate sleep; excessive wakefulness; excessive intake of hot and spicy foods; and emotions such as stress, anger and irritability.

The Tibb View on Bilious Headaches
Bilious headaches are due to excess qualities of heat with dryness. People with a dominant/sub-dominant bilious temperament are most likely to suffer with chronic bilious headaches/migraines due to their innate qualities of heat and dryness.

Management of Bilious Headaches
Treatment and management is aimed at reducing the excess heat with dryness associated with bilious headaches, by implementing Tibb Lifestyle Factors that increase the qualities of coldness and moistness. Treating the underlying source of the headache, and avoiding certain food-triggers and gas producing foods in the diet should also be adopted. This assists Physis in addressing both the symptoms and causes of bilious headaches.

Tibb Lifestyle Factors 
Food and Drink

• Eat mostly Cold & Moist – such as carrots, cucumber, lettuce, watermelon and rice, followed by Cold & Dry – like yogurt, fish and citrus fruit and  Hot & Moist – such as bread, pasta, sugar and cheese, and the least amount of Hot & Dry like – chicken, egg, garlic and onion.

Other Lifestyle Advice 

• Practice good sleep hygiene to ensure adequate rest and sleep at night.
• A high- fibre diet should be adopted to promote regular bowel movements. The use of a gentle laxative may be used every two weeks.
• Avoid strenuous exercise. Partake in light exercises like yoga and Pilates. Swimming is also an acceptable form of exercise.

Herbal Remedy

• Soak one tsp of lavender, two pinches of black pepper, ½ tsp coriander powder and about seven almonds in 150ml of hot water for 30 minutes. Liquidise and strain. Add 1tsp of honey and drink two to three times a day.

Sanguinous Headaches 
A sanguinous headache is the result from an increase in blood volume. The accumulation of this excess blood in the region of the head results in a sanguinous headache. Signs and symptoms include throbbing pain in the temple region; elevated blood pressure; dizziness; and heaviness behind the eyes.

What Causes Sanguinous Headaches?
Hot and humid weather, improper diet and the excessive intake of Hot & Moist such as white flour products, sugar and salt, stress, and certain medications, such as oral contraceptives.

The Tibb View of Sanguinous Headaches
Sanguinous headaches are due to an excess of heat and moistness resulting from an increase in blood volume that is common with sanguinous temperamental types. Sanguinous types are most likely to develop sanguinous headaches due to their inherent qualities of heat and moistness.

Management of Sanguinous Headaches
Treatment and management is aimed at reducing the excess qualities associated with sanguinous headaches, by implementing Tibb Lifestyle Factors that increase the qualities of coldness and dryness. Treating the underlying source of the headache, and avoiding certain food-triggers and gas producing foods in the diet should also be adopted. This assists Physis in addressing both the symptoms and causes of sanguinous headaches.

Tibb Lifestyle Factors 
Food and Drink

• Eat mostly Cold & Dry  – such as beef, potato, yogurt and citrus fruit, followed by Hot & Dry  – like eggs, garlic, chicken and onion, and  Cold & Moist  – such as cucumber, carrots, pears and rice, and the least amount of  Hot & Moist – like mutton, salt, sugar, bread and pasta.
• Eat mostly broccoli, garlic, green leafy vegetables, melons and squash. Eat grains like brown rice.
• Drink two litres of lukewarm water daily.
• Avoid all animal fats, bacon, beef, liver, corned beef, dairy products, pork, sausages and smoked or processed meats.
• Skinless chicken and mutton should be consumed in moderation only.
• Avoid foods such as avocado, chocolate, beans, pickled herring and sour cream.
• Avoid fried foods, coffee, black tea, fizzy drinks, alcohol and tobacco.

Herbal Remedy

• Mix together 20g of lavender powder, 50g of cardamom powder, 20g of coriander powder and 10g of fine black pepper. Take 1g of this powder 3-4 times a day. During an attack, take 0.5g every 15 minutes for 4-6 doses.

Phlegmatic Headache/Migraine
This headache starts above the eyebrows, moving horizontally all the way around to the back of the head like a band, and then spreads throughout the head. It starts in the late afternoon or early evening and worsens during the night. The intensity lessens after sunrise and during the day.

What Causes Phlegmatic Headaches? 
Causes may include a cold and rainy environment, winter seasons, excessive intake of Cold & Moist such as dairy products, and the use of air conditioning.

The Tibb View on Phlegmatic Headaches
Phlegmatic headaches are associated with the qualities of moistness with coldness. People with a phlegmatic dominant/sub-dominant temperament are most susceptible to the development of phlegmatic headaches due to their innate qualities of coldness and moistness.

Management of Phlegmatic Headache/Migraines 
Treatment and management is aimed at reducing the excess moistness with coldness associated with phlegmatic headaches, by implementing certain Tibb Lifestyle Factors that increase the qualities of heat and dryness.   Treating the underlying source of the headache, and avoiding certain food-triggers and gas producing foods in the diet should also be adopted. This assists Physis in addressing both the symptoms and causes of phlegmatic headache.

Tibb Lifestyle Factors 
Food and Drink 

• Eat mostly Hot & Dry – such as chicken, chickpeas, avocado, and cinnamon, followed by Cold & Dry  – like beef, tomato, potato and citrus fruit and  Hot & Moist  – such as white flour products, sugar, bananas and cheese, and the least amount of Cold & Moist – like milk, cucumber, rice and pears.
• Drink plenty of fresh warm water; Consume hot liquids like soups and herbal teas, which promote the elimination of phlegm.
• Eat plenty of fruit and vegetables.
• Eat food which is rich in garlic and horseradish. Also pepper-rich dishes, which contain capsaicin or cayenne. Eat plenty of protein, especially chicken, fish and meat.
• Avoid wheat, sugar-rich and salty foods, and ice-cold drinks.
• Restrict dairy or milky foods, except yoghurt.

Other Lifestyle Advice

• Avoid exposure to cold environments and rainy weather.
• Avoid day time napping.

Herbal Remedy

Boil 2tsp of lavender, ¼ tsp of fenugreek seeds, ¼ tsp of cinnamon, 2 crushed cloves in 2 cups of water. Boil down until one cup remains. Strain and add 1tsp of honey and drink while still warm. Repeat this two to three times a day, especially at the onset of an attack.

Melancholic Headache
Melancholic headaches present with the following symptoms: pain  at the back of the skull, with a pulling of the neck muscles; a dull feeling in the head; flatulence and stomach wind; indigestion; hiccoughs; constipation; or irregular liquid bowel movements.

What Causes Melancholic Headaches? 
These headaches are caused by an excessive intake of Cold & Dry like sour products, cold and dry weather, excess tea, coffee and alcohol. Fermentation of food in the gut produces gas due to insufficient heat in the body.

The Tibb View on Melancholic Headaches
Melancholic headache is due to an excess of the qualities dryness with cold. People with a dominant/sub-dominant melancholic temperament are predisposed to developing this type of headache due to their innate coldness and dryness.

Management of Melancholic Headaches
Treatment and management is aimed at reducing the excess dryness with cold associated with melancholic headache, by implementing certain Tibb Lifestyle Factors that increase the qualities of heat and moistness.  Treating the underlying source of the headache, and avoiding certain food-triggers and gas producing foods in the diet should also be adopted. This assists Physis in addressing both the symptoms and causes of melancholic headaches.

Tibb Lifestyle Factors 
Food and Drink 

• Eat mostly Hot & Moist – such as banana, brown bread, sweet potato and mutton, followed by Cold & Moist – like carrots, butternut, rice and milk, and  Hot & Dry – such as egg, bittergourd, avocado and garlic, and the least amount of Cold & Dry – like yogurt, beans, beef and lemon.
• Avoid the excessive intake of coffee, tea, smoking and alcohol.

Other Lifestyle Advice 

• A cleansing enema should be used on a monthly basis, especially in cases of headache where constipation and indigestion occur as well.

Herbal Remedy

• Add 1 teaspoon of fennel seeds with one cup of boiling water. Drink after cooling and straining.

What is Heartburn? 
Heartburn is a burning sensation just behind the breastbone. It is often worse when lying down.

Signs and Symptoms
A burning sensation behind the breastbone or a burning feeling in the throat; it usually occurs after eating; it is usually worse at night.; it may be accompanied by a sour or bitter taste in the mouth or the sensation of food being stuck at the back of the throat.

What Causes Heartburn?
Heartburn is caused by stomach acid moving back up into the oesophagus. When we eat, the muscle above the stomach relaxes to allow food in and then closes again. With heartburn, the muscle relaxes abnormally or is weakened, and this allows stomach acid back up into the oesophagus.

The Tibb View on Heartburn 
According to Tibb philosophy, heartburn either results from an excess of heat with dryness, caused by increase production of stomach acid; or it results from an excess of moistness which causes the muscle to relax abnormally.
Heartburn linked to heat with dryness is more prevalent in people with a dominant/sub-dominant bilious temperament, because of their innate qualities of heat and dryness. However, heartburn linked to moistness is more commonly found in people with a phlegmatic/sanguinous temperament, because of their inherent dominance of moistness.

Management of Heartburn
Treatment and management is aimed at reducing the excess qualities associated with heartburn by implementing Tibb Lifestyle Factors that will increase the qualities of coldness and moistness in cases of heartburn linked to excess heat with dryness; or increase dryness in cases of heartburn linked to excess moistness. This assists Physis in addressing both the symptoms and causes of heartburn.

Tibb Lifestyle Factors
Heartburn Associated with Qualities of Heat with Dryness:
Food and Drink

• Eat mostly Cold & Moist – such as rice, cucumber, watermelon and milk, followed by  Cold & Dry – like yogurt, potato, citrus fruit and coconut oil.
• Eat less of  Hot & Moist – such as mutton, ginger, spinach and sugar, and the least amount of  Hot & Dry – like chicken, eggs, garlic and onions.
• Drink a large glass of water rapidly for pain relief. This dilutes the stomach acid, flushing it into the duodenum, where it is neutralised;
• Eat frequent small meals, including well cooked white rice, yoghurt and cottage cheese.
• Eat vegetables such as carrots and broccoli occasionally.
• Allow hot beverages, like rooibos tea, to cool before drinking, to avoid triggering gastric discomfort.
• Avoid fried foods, tea, coffee, alcohol, chocolate, strong spices, animal fats, and carbonated drinks.
• Avoid eating and drinking at the same time. Take in fluids 30 minutes before or after a meal.

Other Lifestyle Advice

• Avoid lying down immediately after a meal.
• Wear loose, comfortable clothing.
• Avoid non-steroidal anti-inflammatory drugs (especially aspirin).
• Quit smoking.
• Practice slow and deep breathing exercises twice daily.
• Keep the colon clean by adopting a high-fibre diet. The use of a gentle and natural laxative is recommended monthly.
• Drink a glass of chilled milk to reduce discomfort caused by stomach acid.

Herbal Remedy

• Grind up two cardamom pods. Add 250ml of water. Boil for 15 minutes. Strain and drink three times daily.

Tibb Lifestyle Factors
Heartburn Associated with Qualities of Moistness:
Food and Drink

• Eat mostly Hot & Dry , such as chicken, avocado, bittergourd and chickpeas, and Cold & Dry like beef, potato, and yogurt.
• Eat the least amount of Hot & Moist , such as bread, pasta, sugar and bananas, and Cold & Moist  like squash, butter, cucumber and pears.
• Avoid triggers such as fatty or fried foods, tomato sauce, alcohol, chocolate, mint, garlic, onion, and caffeine, as these may make heartburn worse.
• Eat smaller meals.

Other Lifestyle Advice

• Avoid lying down immediately after a meal.
• Wear loose, comfortable clothing.
• Lose weight if overweight.
• Quit smoking.

Herbal Remedies

• Chew 5-6 basil leaves after meals.
• Chew a clove of garlic to lessen stomach discomfort.

What is High Cholesterol (Hypercholesterolaemia)? 
Hypercholesterolaemia is the presence of abnormally high levels in the blood of cholesterol and triglycerides (a type of fat in the blood used for energy) that can lead to obstruction of blood flow in the arteries. This inhibits blood flow to the brain, kidneys, genitals, heart and other areas of the body.  Cholesterol is considered high if it is greater than 5mmol/l.

Signs and Symptoms
High cholesterol has no symptoms. A blood test is the only way to detect whether you have it or not.

Complications 
Angina pectoris, transient Ishcaemic attacks (mini-strokes), deteriorating kidney function, low exercise tolerance, atherosclerosis and heart attack.

What Causes High Cholesterol?
Poor lifestyle behaviours such as physical inactivity and unhealthy diet are responsible for increasing LDL (“bad”) cholesterol and decreasing HDL (“good”) cholesterol levels in the blood. However, other factors such as genetic/ temperament may prevent the removal of LDL cholesterol from the blood, so causing the liver to produce too much cholesterol.
Risk factors include:

• Diet – An excessively cold diet, hydrogenated fats like margarine, processed and refined foods.
• Poor liver function.
• Low production of bile (in the gall bladder) which is produced by the liver to aid digestion of fats.
• Lack of Exercise – Regular physical exercise increases HDL levels, so assisting the removal of LDL.

The Tibb View on High Cholesterol
According to Tibb, high cholesterol results due to excessive coldness. This lack of heat impairs blood circulation and allows saturated fats to gather in the blood vessels. This results in fatty plaques being deposited inside the vessel walls. The arterial bore or lumen narrows, and this reduces blood circulation even further. The reduced blood circulation increases the risk of heart attacks and strokes.
Individuals with a melancholic dominant/sub-dominant temperament are innately more susceptible to developing high cholesterol due to their inherent cold and dry nature. However, due to a faulty diet and improper lifestyle, other temperaments can also develop high cholesterol. People with sanguinous temperaments, who indulge in over-eating and lead a sedentary lifestyle, may also develop high cholesterol. Phlegmatic individuals are also at risk, as they have innate qualities of coldness and sluggish metabolism linked to their temperament.

Management of High Cholesterol
Treatment and management is aimed at reducing the excess coldness with dryness associated with high cholesterol, by implementing Tibb Lifestyle Factors that will increase the quality of heat. This assists Physis in addressing both the symptoms, and the causes of high cholesterol.

Tibb Lifestyle Factors 
Food and Drink

• Eat mostly Hot & Moist  – such as olive oil, ginger, turmeric and spinach followed by  Hot & Dry  – like oily fish, chicken, celery and garlic.
• Eat less of  Cold & Moist  – such as cucumber, broccoli, milk, and sprouts and the least amount of  Cold & Dry  – like citrus fruit, yogurt and beef.
• Add fresh garlic to meals where appropriate. Garlic is commonly used in the management of conditions of the heart and circulatory system and is indicated for hypertension and high cholesterol. Other heating herbs and spices like chilli, turmeric and ginger should be added to meals. These help in lowering blood cholesterol and promoting better blood circulation.
• Avoid eating and drinking refrigerated foods and drinks. Allow the food to reach room temperature before consumption.
• Reduce the intake of red meat like beef. Chicken and oily fish like tuna and salmon are preferred.
• Include the following cholesterol lowering foods in your diet: almonds, bananas, garlic, oats, olive oil, salmon, and walnuts.
• Water soluble dietary fibre is important for reducing serum cholesterol. It is present in barley, brown rice, fruits, and oats.
• Use vegetable oils which are liquids at room temperature such as olive and flaxseed oil. Boiled/steamed/grilled chicken and fish should be preferred.
• Eat only raw unsalted nuts, especially pecan, almonds and walnuts. Almonds are rich in the amino acid arginine which has cholesterol-lowering properties.
• Reduce the amount of saturated fats and cholesterol-containing foods in your diet.  Saturated fats include coconut and palm oil. Eliminate hydrogenated fats and hardened fats such as margarine and butter.
• Avoid pork or pork-containing products, fried and fatty foods.
• Do not consume alcohol, cakes, candy, carbonated drinks, coffee, gravies, pies, processed or refined foods, refined carbohydrates, tea, tobacco or white bread.
• Drink at least 2 litres of warm water a day.

Other Lifestyle Advice

• Regular physical exercise such as brisk walking should be carried out several times weekly.
• Quit smoking as this contributes to the hardening of the arteries.

Herbal Remedies

• Turmeric – Add ¼ to ½ tsp to rice or couscous.
• Mix ¼ teaspoon red chillies, ½ teaspoon ginger root, 3 black pepper and 4 garlic cloves as chutney.

Take this with meals 3 times a day.

• Take 1tbsp psyllium husk/whole seeds mixed in 1 cup of water.
• Make an infusion using 2tsp fennel seed with 20 mint leaves in 1 cup of boiling water.

What is the Human Immunodeficiency Virus (HIV)? 
The HI Virus weakens the immune system by targeting CD4 Lymphocytes (White Blood Cells) also called T-Helper Cells.  This will result in antibodies to the virus being present in the blood of persons who are identified as being HIV + (positive).  This virus may take many years to damage the immune system resulting in AIDS.
Types of HIV
There are 2 types transmitted in exactly the same way:

• HIV-1 – This is the worldwide predominant type
• HIV-2 – Found mainly in West Africa; less easily transmitted and the period between initial infection and illness is longer.

What is Acquired Immune Deficiency Syndrome (AIDS)
AIDS is a term used for a group of diseases that results from a weakened immune system.  A person is identified as having Aids when their CD4 count is less than 200/ml blood.

How is HIV spread? 
Risk factors for the transmission of HIV includes having unprotected sex with multiple partners; Sharing needles and syringes with drug users may also expose individuals to the blood of other infected people; A pre-existing STI – may cause open wounds and sore on the genital region which may act as an entryway for HIV.

Signs and Symptoms 
Sore throat (coldness with moistness); mouth ulcers (moistness); diarrhea (moistness); thrush (moistness); weight loss (coldness with dryness); fever and night sweats (hot & dry); dry cough (dryness); shortness of breath (dryness); swollen glands (TB – heat; weight loss (heat towards dryness); infections due to weak immunity; recurrent herpes infections; recurrent bacterial infections; and genital ulcers.

The Tibb View on HIV & AIDS
Tibb recognizes that an immune system compromised with the HI Virus, will result in signs and symptoms related to the HI Virus and/or AIDS.  Tibb does not attempt to eliminate the HI Virus, but rather to boost the person’s immune system and thereby assist the body in staying healthy and delaying the symptoms of HIV and AIDS.  According to Tibb the temperament of a person influences what symptoms the HIV positive person will most likely be affected with.  For example a person with a dominant/sub-dominant bilious temperament, will most likely suffer with symptoms associated with qualities of heat and dryness, including a dry cough, swollen glands, night sweats, and tuberculosis.  Similarly persons with a dominant/sub-dominant phlegmatic temperament will be inclined to symptoms of vomiting, diarrhea, weight loss and thrush as these symptoms are associated with qualities of moistness (and or cold).
Because of the increase moistness associated with the phlegmatic temperamental combination, these individuals are more likely to develop AIDS related infections as their moist temperament increases the risk of infections.
As Tibb takes into account the influence of a person’s temperament in HIV & AIDS, treatment cannot be the same for all HIV & AIDS patients.

Management of HIV & AIDS
Treatment and management is aimed at reducing the excess qualities associated with HIV & AIDS, by implementing Tibb Lifestyle Factors that will either increase the qualities of heat and dryness in patients with symptoms of excess moistness with coldness, and coldness and moistness in patients with symptoms of excess heat with dryness. This will assist Physis in addressing both the symptoms, and the causes of HIV & AIDS.  Tibb Lifestyle Factors will also benefit people who are on ARV medication.

Tibb Lifestyle Factors 
HIV associated with Qualities of Moistness with Coldness:
Food and Drink

• Eat mostly Hot & Dry – such as egg, chicken, garlic and cinnamon, followed by  Cold & Dry – like beef, tripe, cabbage, potatoes, beans and mealie meal.
• Eat less of Hot & Moist – such as white flour products, sugar, banana and cheese, and the least amount of  Cold & Moist – rice, squash, butter and milk.
• Sip hot chicken, beef or mutton soup with added garlic, ginger, black pepper and salt for three days;
• Avoid dairy products, margarine, fried foods and all sugars;
• Drink at least 2 litres of room temperature or warm water per day
• Eat plenty of in season fruit and vegetables per day
• Avoid refined carbohydrates such as sugar and white bread. Choose whole wheat options instead.

Other Lifestyle Advice 

• Remain as active as possible. A brisk walk or any type of moderate exercise should be done on a daily basis.
• Wash your hands often. Viruses can survive for several hours on your hands, tissues or hard surfaces.

Herbal Remedy

• 2 grams fenugreek seeds, 1 gram cinnamon, 1 gram cloves, 2 grams fresh ginger. Boil in 2 cups of water until 1 cup remains. Strain and mix 2 tsp of honey and drink. Drink daily

HIV associated with Qualities of Heat with Dryness:
Food and Drink

• Eat mostly Cold & Moist – such as rice, cucumber, lettuce and carrots, followed by Cold & Dry – like yogurt, citrus fruit, beans and potato.
• Eat less of Hot & Moist – such as white flour products, sugar, cheese and salt, and the least amount of Hot & Dry – like eggs, garlic alcohol and onions.
• Avoid heavily spiced, fried or grilled foods;
• Avoid sugary and refined foods;
• Drink plenty of fluids. Herbal teas and soups are good choices.
• Avoid mucous forming foods such as dairy products, processed foods, sugar, sweet fruits, and white flour;

Other Lifestyle Advice 

• Do not smoke and avoid second hand smoke. Cigarette smoke is very harmful.
• Add moisture to the air by using a humidifier or vapourizer.
• Avoid strenuous exercise until recovery.
• Rest in bed in the early stages, when the fever is present. Once the fever subsides and you are feeling better, alternative periods of rest with periods of moderate activity to prevent secretions settling in the lungs.
• Do not swallow mucous.

 
Herbal Remedy

• Make an infusion with 1 tsp of Sage and 3tsp of Chamomile tea in 1 cup of boiling water.

What is Hypertension?
Hypertension, commonly known as high blood pressure is the force needed by the heart to pumps blood through the blood vessels in order to deliver essential nutrients to all parts of the body.
The factors that influence blood pressure include: the volume of the blood in circulation; resistance to blood flow by the walls of the blood vessels; and the strength of the heart.
Normal Blood Pressure is 120/80 mmHg, systolic/diastolic. These figures vary according to age and gender, and fluctuate markedly throughout the day.

What is High Blood Pressure? 
High blood pressure, or hypertension, results if the blood pressure rises above the range which is normal for the person, and stays there for some time. This can cause severe, even deadly, damage to several body organs if it not reduced.
Hypertension can be classified in different levels:

Types of High Blood Pressure

• Primary Hypertension 
• Resistance Hypertension 

Primary Hypertension 
Signs and Symptoms 
Constant headache mostly in the temple region: redness and heaviness in the eyes; dizziness; and bleeding from the nose and gums.

Resistance Hypertension 
Signs and Symptoms 
Constant headache at the back of the head; tightness in the neck muscles; muscle cramps in the legs; and shortness of breath.

Complications of High Blood Pressure
Creates strain on the heart; weakens the walls of the arteries; increased risk of heart attack or stroke; and kidney failure.

What causes Hypertension?  
As a person grows older, a poor diet, lack of exercise and being overweight lead to an increase in the volume of blood in circulation (blood volume). This results in the more common type of hypertension known as Primary or Essential Hypertension.
Another form of hypertension arises from increased resistance developing in the blood vessels, due to a hardening and narrowing of the arteries due to fibrous and fatty deposits, or arteriosclerosis. This form is known as Resistance Hypertension.
Hypertension can also result from other causes, such as kidney disease, a number of tumours, and certain conventional medications.

The Tibb view of Hypertension 
Tibb medicine clearly identifies the two different types of hypertension from the causes and also the symptoms associated with each type.
Primary hypertension results from an increase in blood volume either from an excess of moistness and/or heat, caused from poor lifestyle, especially being overweight and lack of exercise.  This hypertension is more prevalent in persons with a dominant/sub-dominant sanguinous temperament as they have qualities of heat/moistness.
Resistance hypertension also results from poor lifestyle especially from an excess of cold and dry foods such as beef and fish, which leads to a buildup of plaque in the arteries.  Persons with a dominant/sub-dominant melancholic temperament will be more predisposed to this type of hypertension as their temperament has qualities of coldness/dryness

Management of Hypertension
Treatment and management is aimed at reducing the excess qualities associated with high blood pressure, by implementing Tibb Lifestyle Factors that will increase the qualities of coldness and dryness in people with primary hypertension, and increase the qualities of heat and moistness in people with resistance hypertension.
This assists Physis in addressing both the symptoms, and the causes of both forms of hypertension.

Tibb Lifestyle Factors
Primary Hypertension Associated with Qualities of Heat and Moistness:
Food and Drink

• Eat mostly Cold & Dry – such as beef, fish, cauliflower and mushrooms, followed by Hot & Dry – like bittergourd, avocado, chickpeas and garlic.
• Eat less of Cold & Moist – such as carrots, pumpkin, rice and coriander, and the least of Hot & Moist  – like bread, pasta, bananas, salt and wheat cereals.
• Good advice is to eat more skinless chicken, fish and vegetable proteins such as legumes. Also generally more fruits and vegetables, such as apples, cabbage, eggplant, garlic, grapefruit, green leafy vegetables, peas, prunes, raisons, and sweet potato.
• Avoid salty and sweet foods and drinks, and limit overall salt intake. Reduce consumption of animal fats such as bacon, beef, chicken liver, corned beef, dairy products, pork, sausages and smoked and processed meats. Avoid hydrogenated and hardened fats such as margarine and lard. Cut down on alcoholic drinks, cakes, candy, fizzy drinks, coffee, pies, processed or refined foods, tea, tobacco, coffee or white bread.
• Drink fresh “live” juices, especially those containing celery, citrus fruits and parsley.
• Add two tbsp of flaxseed oil to meals daily.

 Other Lifestyle Advice

• Commit to exercising regularly, and becoming more physically active generally. Brisk walking, cycling, jogging are usually effective.
• Give up or cut down smoking.

Herbal Remedies

• Add two tbsp of flaxseed oil to meals daily.
• Sprinkle freshly chopped garlic over foods and salads.  Try to eat two to three cloves per day.

Note: do not discontinue the use of conventional medication, without consulting your practitioner. 

Tibb Lifestyle Factors
Resistance Hypertension Associated with Qualities of Coldness and Dryness:
Food and Drink

• Eat mostly Hot & Moist – such as banana, sweet potato, and brown bread, followed by Cold & Moist – like butternut, carrots, pumpkin and pears.
• Eat less of Hot & Dry  – such as avocado, garlic, onion and chickpeas and the least amount of Cold & Dry  – like beef, tomato, beans and mealie meal.
• Reduce the intake of red meat like beef and lamb. Chicken and oily fish like salmon should be preferred instead.
• Add fresh garlic to meals. Garlic is commonly used in the management of conditions of the heart and circulatory system and is effective in reducing high blood pressure and raised cholesterol levels.
• Include heating spices like chilli, turmeric and ginger in meals. These herbs help to lower blood cholesterol and promote better blood circulation.
• Avoid eating and drinking refrigerated foods and drinks. Consume food at room temperature or above.

Other Lifestyle Advice

• Give up or cut down smoking. Counseling, nicotine patches and e-cigarettes are effective ways of doing so. Practice deep breathing exercises daily. This usually helps to reduce stress and so lower blood pressure.

Herbal Remedies

• Green Tea helps to reduce raised blood pressure. Also an infusion with 1tsp yarrow, and 1tsp Green Tea in a cup of boiling water, strained and drunk hot.
• Sprinkle freshly chopped garlic over foods and salads.  Try to take in two or three cloves a day.
• Mix ¼ teaspoon red chilies, ½ teaspoon ginger root, 3 black pepper and 4 garlic cloves as chutney. This should be taken with meals three times a day.

Note: do not discontinue the use of conventional medication, without consulting your practitioner.