When one tries to arrive at a simple explanation of what is health, almost everyone is at a loss for a definitive answer. The general reply seems to be that health is simply not being sick. But definitions of disease do abound.

    Primitive cultures believed that disease was due to the evil influences of malignant ghosts, devils, magic, and spells. Many religions have taught that diseases are punishment for sins. The ancient tribes of Australia traced disease to "bone pointing." The Pythagoreans connected the origin of disease with mathematics and saw diseases as being related to odd numbers!

    Paracelsus (1490-1541) stated that all disease was the result of maladjustment of three elements: sulfur, mercury, and salt. According to the doctrine of Goto (1659-1733), the universal spirits of cold, air, heat, and humidity circulated in the body and caused illness. Samuel Hahnemann (1755-1843) explained that disease was the result of weakness of the vital force of a pathogenic matter called "psora." Others have advanced theories that disease is the result of imbalance of colors, cellular salts, psychological factors, and many other sources.

    Our modern notions of disease were a distinct development of the nineteenth century. Bacteria were unmasked and claimed as the definitive causes of such diseases as typhoid, cholera, tuberculosis, and others. Stedman's Medical Dictionary currently describes diseases thus: "Morbus, illness, sickness. An interruption or perversion of functions of any of the organs, a morbid change in any of the tissue or an abnormal state of the body as a whole, continuing for a longer or shorter period of time.

    Also interesting is that among the history of definitions of health or disease, a very long list of physicians and scientists have held to the view of the humoral basis of health and have stated that improper metabolism of foods leads to disease. Those holding to the humoral concepts include some of the most glittering names in medical history: Thales (sixth century BC), Hippocrates of Cos (460 BC), Aristotle (384-322 BC), Asclepaides (first century BC; he was the first to hint at the atomic variation in hot and cold foods), Galen (c. A.D. 131-200), Avicenna, Ishin Ho (Buddhist school), Theophilus Lobb (author of Medical Principles and Causations, 1751), Abernathy (1764-1831), Broussais (1772-1838), Samuel Thomson (1769-1830), and many others.

    By the time of the early eighteenth century, the Unani system was the basis of virtually all medicine in the civilized world, having been translated and formed as the basis of the work of such men as Father Sebastian Kneipp (1821-1897) and Samuel Hahnemann (1755-1843), the founder of homeopathy, who is reputed to have known Arabic and read Avicenna's works.

    In the mid-1800s, there occurred a cross-pollination of medicine between Europe and the United States. Individuals such as William Kellog learned these systems of natural therapeutics, mainly from the European clergy, and spread them among the general population.

    All of the modalities of natural therapeutics thrived in Europe and the United States until the beginning of the twentieth century, when chemical medicine began to predominate. This evolution of disease concepts and treatments is important enough to warrant a few words of reflection.

    The historical concept of "disease" has changed from the time of the ancient Greeks to modern times. The pre-Hippocratic physicians based their practice only on the study of the diseased individual. But because the variety of signs in disease is so great, it was quickly realized that some system of classification was necessary. Thus the Cnidian physicians introduced nosographical classification. This system required that all symptoms be listed in numerical order and then be evaluated to see which of the symptoms occurred with greatest regularity and frequency. These regularly occurring symptoms received arbitrary names as "diseases;' mainly a reflection to the symptoms they represented (e.g., bursitis, meaning "inflammation of the bursa," which reveals nothing about the cause). All medicine, from the time of the Cnidians until the beginning of the nineteenth century, was based upon this symptom-complex form of classification.

    The dawn of the nineteenth century witnessed the construction of a new class of fictional diseases, based upon the French, British, and Viennese schools of anatomy and clinical studies. The symptomatology of the past was discarded in favor of the series of signs that occurred with regularity in combination and were considered to represent a set of symptoms corresponding to a specific lesion or a disturbance in the function of an organ. Thus, the adherents of these anatomical-clinical schools succeeded in switching the basic concept of disease from symptom complexes to lesion-anatomical syndromes.

    During the third quarter of the nineteenth century (1860-1890), the basic conceptions of disease were again altered by the advent of the bacteriological school, which introduced what was primarily called the etiological (meaning bacteriological) origin of disease. In the past, physicians believed that disease symptoms revealed some organic malfunction. But with the bacteriological school, this idea was abandoned in favor of the notion that there was a "special cause"--usually a microbe or virus--responsible for the symptom.

    The Unani system follows the traditional mode of evaluation of symptom groups and disregards the idea of germs or viruses as the primary cause of disease. The key concept-word in Unani is temperament (mizaj). This word expresses the various reactional tendencies of the individual, which is an important consideration for physicians from a clinical point of view, especially those endeavoring to defend microbial theories of medicine. For example, it is well known that most physicians attribute the occurrence of influenza to one or more viruses. However, if a particular virus caused a particular flu (or cold or any other disease), then one would assume that everyone coming into contact with that causative virus would fall ill. Obviously, such is not the case. Even though many children in one school may get the same flu symptoms, not every child falls ill. Physicians use this notion of temperament to "explain" that some people are "disposed" to get the disease. (The term used is "predisposing factor.") Indeed, this being the case, one wonders how anyone has accepted the microbial theories of disease, since to explain vital theory, some intemperament is clearly accepted as the initial cause of disease.

    In fact, if the vital/bacterial theories were accurate (or complete) then one would assume that no nurse or physician on earth would survive, as such people are constantly exposed to every conceivable form of virulent microbe, yet seldom fall ill. Even though many children for the first several years of life suffer dozens of colds, flus, and infections, the mother virtually never "catches" any of them.

    Why do none of these people who are exposed and overexposed to diseases claimed to be caused by serious viruses never fall ill? The answer that Unani has--and upon which its entire system is built--is the notion of the temperament, or humor. While admitting the existence of microbes, the Unani system claims that it is the original imbalance of temperament that provides an altered biotic environment in which these viruses and bacteria can thrive. And the causes of the initial imbalance of temperament are often to be found in more subtle elements of life, such as rest and activity patterns, work stresses, and interpersonal relations (anger, for example, can dispel moisture in the humor regulating the heart). Treatments of bacterial populations present in disease conditions may kill off all bacteria and provide a temporary "cure," but without restoring the humor to its proper balance, the disease will recur (as happens, for example, with recurring vaginal infections, upper respiratory problems, flus). Today, the knowledge of temperament constitutes for the clinician, from the point of view of physiology as well as of psychology and therapeutics, a notion of primary importance.