WORLD JOURNAL OF PHARMACY AND PHARMACEUTICAL SCIENCES

Naaz et al. World Journal of Pharmacy and Pharmaceutical Sciences

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Volume 5, Issue 9, 1547-1556 Research Article ISSN 2278 – 4357

CLINICAL EVALUATION OF MIZAJ (TEMPERAMENT) OF THE

PATIENTS OF QILLAT-E-HUWAIN-E-MANVIA
(OLIGOZOOSPERMIA)

Mohd. Abid*, Farah Naaz*# and Noman Khan*

*Research Associate, Central Council for Research in Unani Medicine, Ministry of AYUSH,
Government of India.

ABSTRACT
Article Received on
01 July 2016, The theory of Mizaj (Temperament) is exclusive to Unani system of
Revised on 22 July 2016, Medicine and the entire system relies upon the basic philosophy of
Accepted on 11 Aug 2016,
DOI: 10.20959/wjpps20169-7577 Mizaj. Hippocrates (460-370BC), the father of Medicine and the
pioneer of Unani system of Medicine was the first to put forward the
ideology of Mizaj (temperament). The theory of Mizaj suggests that
*Corresponding Author
the every individual has a specific temperament (Mizaj) which is fixed
Dr. Farah Naaz
Research Associate, and cannot be changed. Each individual may have their unique likes,
Central Council for dislikes, interests and skills. These all characteristics make up the elite
Research in Unani disposition or temperament (Mizaj) of an individual. A person‟s
Medicine, Ministry of
temperament (Mizaj) has a direct influence on the state of health and
AYUSH, Government of
inclination towards illnesses. Unani physicians have classified the
India.
mizaj (temperament) of an individual into four types namely Damvi
(sanguine), Balghami (phlegmatic), Safravi (bilious) and Saudavi (melancholic). Thus,
knowledge of temperament can help in planning a diet that is optimum for an individual, and
physical activities that promote a happy, healthy and productive lifestyle enabling people to
live in harmony with self and world around them. Oligozoospermia refers to semen with a
low concentration of sperm and it is one of the leading causes of male factor infertility,
perhaps also the most important treatable cause. Male sterility due to oligospermia can be
defined as a failure to conceive following one year of marital life with uninterrupted coitus
due to low sperm count and motility. The objective of the study was to assess and establish
the temperament (Mizaj) of patients of Qillat-e-Huwain-e-Manvia (Oligozoospermia). The
consideration of this study had the potential to prevent and treat Oligozoospermia based on
classical theory of temperament (Mizaj). The study was carried out at A& U Tibbia College,

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Naaz et al. World Journal of Pharmacy and Pharmaceutical Sciences

Karol Bagh, New Delhi-05. 60 subjects with confirmed clinical diagnosis of

Oligozoospermia complying inclusion and exclusion criteria‟s were included in the study.
Mizaj (temperament) of the subjects was assessed by a standard questionnaire of
temperament. In present observational study, the higher incidence of patients was observed
from Damvi (Sanguine) and Safravi (Bilious) mizaj. This study is in consonance with
classical Unani literature, so the temperament of a patient may be considered as an important
factor in the pathogenesis of Oligozoospermia.

KEYWORDS: Oligozoospermia, mizaj, temperament, damvi, balghami, safravi and saudavi

mizaj.

1. INTRODUCTION
Mizaj (Temperament) has been an important point of discussion among both ancient and
modern researchers. The concept of Mizaj (Temperament) is exclusive to Unani system of
Medicine and the whole system is based on the philosophy of Mizaj. The Hippocrates (460-
370BC) gave the fundamental theory of Mizaj which suggests that the every individual has a
specific temperament (Mizaj) which is fixed and cannot be changed. Each individual may
have their unique likes, dislikes, interests and skills. These all characteristics make up the
elite disposition or temperament (Mizaj) of an individual. There are four biological fluids or
Akhlat (Humors) viz. Blood (Dam), Phlegm (Balgham), Bile (Safra) and Black bile (Sauda);
a right proportion, according to quality and quantity constitutes health and upright proportion
and irregular distribution, according to their quantity and quality constitutes disease. Excess
of any of the four basic humours (akhlat) of body obviously exerts its influence on the mizaj
(temperament) of the person and treatment is based upon the correction of that particular
humor (khilt). Hence mizaj (temperament) plays an important role in assigning specific
treatment of any disease. The four basic mizaj include Damvi (sanguine), Balghami
(phlegmatic), Safravi (Bilious), Saudavi (melancholic).

Diminished quantity of Huwain-e-manvia (spermatozoa) in mani (seminal fluid) is called

qillat-e-huwain-e-manvia (Oligozoospermia). Male sterility due to, oligospermia can be
defined as a failure to conceive following one year of marital life with uninterrupted coitus
due to low sperm count and motility. Data accumulated over the past four decades reveals
that in approximately 33% of all couples evaluated for infertility, significant pathology is
found only in male partners. In another 20% both male and female partners are found to be

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Naaz et al. World Journal of Pharmacy and Pharmaceutical Sciences

abnormal. Thus in approximately 50% of infertile couples, male factor is at least partly
responsible for the failure to conceive.[1]

In the classical Unani literature the semen deformities are mentioned under the caption
“Qillat-e-mani and Riqqat-e-mani”.[13-14] The term Qillat means deficiency, Mani means
Semen and Riqqat means Fluidity.[13-16] Both this Qillat and Riqqat-e-mani is mainly
responsible for sexual disorders like Zofe Bah, Surat e anzal, Ehetlam, Uqar, Jiryan etc.[1-5]

Qillat and Riqqat disorders are final outcome of Su-e-mizaj (morbid temperament) of body.
In Unani system of medicine the general term of Muqawwi e Bah is used commonly in the
management of semen and semen related problems.[6-9] The medicines or foods which
improve the quality and quantity of semen are termed as Mawallid-e-Mani. All Mawallid-e-
Mani agents are also Muqawwi-e-Bah.[2-7]

There are many causes of oligozoospermia, Mizaj of a person and temperature of testes play a
very important role in regulation and formation of semen.[2-4,17] Bringing back or maintaining
the normal mizaj of testes and the whole body is fundamental line of treatment in Unani
system of medicine.[18] The sterility and sexual disorders continues to cause lot of mental
agony to innumerable couples. Hence, the collective efforts of scientists, doctors and hakims
in the treatment of qillat and riqqat e mani can improve the quality of life of present
generation and also to the next generations. Keeping in view, the above objectives, an attempt
has been made in this study to find out the mizaj (temperament) of the patients of
Oligozoospermia, so that effective treatment may be administered to the patients of
oligozoospermia based on the principles of Unani medicine, which is cost-effective and least
toxic.

2. Objectives of the study

This study aimed to assess and establish the temperament (Mizaj) of patients of
Oligozoospermia. The consideration of this study had the potential to prevent and treat
oligozoospermia based on classical theory of temperament (Mizaj). An early and accurate
diagnosis of is of paramount importance for the effective management and for the prevention
of long-term sequelae.

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3. MATERIAL AND METHODS

It is an observational study, carried out at Ayuryedic & Unani Tibbia College, Karol Bagh,
New Delhi-05 during 2012-2014. A comprehensive protocol was framed and approved prior
to the commencement of the study. 60 subjects with sign and symptoms of oligozoospermia
as per screening criteria were enrolled for the study. All the screened subjects were then
confirmed for the clinical diagnosis. During the enrollment procedure, complete history
including general physical and systemic examination was carried out and recorded on a case
report proforma. Mizaj of the patients was evaluated on standard parameters (Alamat-e-
Ajnas-e-Ashra) as described in the classical unani text (Table No.1 & Annexure-I).

Table 1 shows ten characteristics of different temperament (Ajnas-e- Ashra)

Damvi Balghami Saudavi
Parameters Safravi (Bilious)
(Sanguine) (phlegmatic) (melancholic)
(1) MALMAS (Touch)
i) Touch Moderately Soft Dry Soft Dry
ii) Temperature Warm Warm Cold Cold
(2) LAHM-WA-SHAHM (Muscles and Fat)
Muscular Moderately muscular Lack of fat &
Fatty less
Muscles are & less Fatty Muscles muscle Muscles
Body Built muscular joint
fully developed are moderately are under
well covered
& strong developed/ large joint developed
(3) SHAIR (Hairs)
(i)Texture Thick & lusty Thick & curly Thin & straight Coarse
(ii)Growth &
Rapid average Rapid profuse Slow scanty Rapid excessive
Distribution
(iii)Colour Blackish brownish Black white
(4) LON-E-BADAN (Body Complexion)
Complexion Reddish Yellowish Whitish Blackish
(5) HAYAT-E-AZA (Physique)
(i) Built Muscular & firm Slim & firm Fatty & flabby thin
(ii) Chest Broad Wide Flat Narrow
(iii) Height Tall Medium Short Short
(iv) Blood vessels Mild prominent More prominent Not prominent Narrow
(6) KAIFIAT-E-INF’AL (Responsiveness of organs)
(i)Tolerate well Dryness Cold Heat Dampness
(ii)Remains well in Spring Winter Summer Autumn
(7) AFAL-E-AZA (Functions of the body organs)
(i) Digestion Average Strong Poor Irregular
(ii) Appetite Normal Increased Less Feeble
(iii) Taste Sweet Bitter Normal Sour/normal
(iv) Thirst Normal Increased Decreased Low
(v) Salivation Moderate Decreased Increased low
(vi) Voice High Medium Slow Slow
(vii)Respiratory rate Easily/rapid Rapid/increased Regular slow slow

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(viii)Physical activity Average Hyperactive Not active Decreased

(ix) Speech Average Quick Slow Slow
(x) Pulse Azeem wa qawi Sari wa mutawatir Saghir wa bati Bati wa sulb
(xi) Nausea Sometimes Very rare Frequent Frequent
(xii)Favourable diet Cold & dry Cold &moist Hot & dry Hot & moist
(xiii) Dislikes Hot & moist Hot &dry Cold &moist Cold & dry
(8) FUZLAT-E-BADAN (Excreta of the body)
(i)Urine colour Normal/reddish Yellowish whitish Darkish/blackish
(ii) Urine quantity Moderate Less More Less
(iii) Urine conc. Concentrated Dilute Turbid Turbid
(iv)Stool Consistency Semi Solid Loose Loose Constipated
(v) Stool quantity Voluminous Less amount Voluminous Less amount
Average bad
(vi) Stool odour Odour full Odour full less
odour
(vii) Stool colour Brownish yellowish Whitish Blackish
Average bad
(viii) Sweat Odour full More odour full Less
odour
(9) NOM-WA-YAQZA (Sleep and Wakefulness)
Less &
Sleep Average Less Excessive
Disrupted
(10) INFALAT-E-NAFSANIA (Psychic reactions)
(i)Response Aggressive Brave Weak Coward
Easily come, Frequent, severe & Comes hardly, Infrequent but
(ii) Anger/Joy
easily lost persist for long time easily lost persists
Enthusiastic
(iii)Mental Alertness Reactive provoked Dull sluggish Deep thinking
prepared
Not good Not good but
Excellent, Long Good, Short term,
(iv) Memory Cannot retain excellent
term, retenti retention
for long time retention
Angry/loose temper Depressed,
(v)Behavior Cheerful Calm, quick
easily nervous
(vi) Decision Take bold Quick Hesitate afraid
Blood, red Fire, red or yellow White, cold Fearful, black
(vii) Dreams
object object object object

4. RESULTS
During the course of the study, subjects were divided into different age groups of five year
interval from 21-60 years of age. The highest number of subjects i.e., 30 (50%) subjects were
reported in age group of 26-30 yrs followed in decreasing frequency by 31-35 yrs age group
i.e., 15 (25%) subjects, 21-25 yrs age group i.e., 13 (21.6%) subjects and 36-40 yrs age group
i.e., 2 (3.3%) subjects, no patient reported in age groups 41-45, 46-50, 51-55, 56-60.
[Table.No.2].

Patients were also divided into three groups according to the number duration of illness of
infertility, most of the patients presented within 1-4 years group i.e., 37 (61.6%) followed by

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5-8 years i.e., 22 (36.7%). Only 1 (1.7%) patient presented within 9-12 years group [Table
No.3].

Highest number of subjects was of damvi and safravi mizaj (sanguine and bilious
temperament) 21 in each (50%) followed by balghami (phlegmatic temperament) 12 (20%).
10 (16.7%) patient of damvi (sanguine temperament) and 6 (10%) patients of saudavi
(melancholic temperament) was found [Table.No.4].

Table: 2 Distribution of Patients according to age group

Age group No. of %
(years) patients Percent
21-25 13 21.6
26-30 30 50
31-35 15 25
36-40 2 3.4
41-45 0 0
46-50 0 0
51-55 0 0
55-60 0 0

Table 3 Distribution of Patients according to Duration of illness

Duration of illness No. of Patients in test No. of Patients in %
Total
(in years) group Placebo group Percent
1-4 17 20 37 61.66%
5-8 13 9 22 36.66%
9-12 0 1 1 1.66%
Total 30 30 60 100%

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Table 4 Distribution of Patients according to Mizaj (Temperament)

No of Patients No of Patients in %
Mizaj Total
in test group placebo Group Percent
Damvi 12 9 21 35%
Balghami 3 9 12 20%
Safravi 11 10 21 35%
Saudavi 4 2 6 10%
Total 30 30 60 100%

5. DISCUSSION
The results were analyzed according to age of the study subjects, duration of illness and mizaj
(temperament) of the subjects. Analysis of the results of 60 cases of oligozoospermia
revealed following facts which are discussed below:
 Infertility affects about 15% of couples attempting pregnancy with male factor infertility
identified in approximately 50% of the cases.[18] More than 90% of male factor infertility
is characterized either by low no of sperm in semen or by production of poor quality
sperm.[19] The higher incidence of oligozoospermia in this study was observed in the age

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group of 26-30 years (50%). A recent study has indicated that there is a decrease in sperm
density over a period of past fifty years.[20]
 In this study most of the patients presented between 1-4 years of duration of infertility.
This finding may be attributed to the fact that most of the patients become serious if they
fail to conceive within few years of marriage and also the cumulative pregnancy rate is
27% in infertile couples with 2 years of follow-up with oligozoospermia as the primary
cause of infertility.[21]
 Mizaj of a person and temperature of testes play a very important role in regulation and
formation of semen.[5,9] In this study higher incidence of patients from Damvi and Safravi
group (35% each) was reported. It means that total of 70% patients were from Damwi and
Safrawi group.

These findings suggested that oligozoospermia is likely to be predisposed by damvi

(sanguine) and safravi (bilious) constitution, both of these temperaments have hot quality.
The findings may be related to the fact that the temperature of the scrotum is 3°C lower than
the core body temperature and this is an important prerequisite for optimal spermatogenesis.
The germ cells and sertoli cells are highly sensitive to elevated temperature which causes
partial or complete spermatogenic arrest.[22] Wang et al. (1997) reported that elevation of
testicular temperature 1°C above the baseline depressess spermatogenesis by 14% and thus
decreases sperm output. They postulated that heating the testes induced a depression not only
in the amount but also in the quality of sperm output.[23]

6. CONCLUSION
In light of this study, it can be concluded that patients with damvi (sanguine) and safravi
(bilious) mizaj are prone to develop oligozoospermia and suffer from infertility. So the
temperament of a patient may be considered as an important factor in the pathogenesis of
oligozoospermia. Since oligozoospermia is one of the causes of male infertility, an early
screening could provide opportunity to target the group for promoting healthy lifestyles and
early intervention to prevent future morbidity.

7. ACKNOWLEDGMENTS
The Authors are thankful to Prof. Rais-ur-Rahman, Director General (In-Charge), Central
Council for Research in Unani Medicine, Advisor (Unani) to Govt. of India, Ministry of
AYUSH, HOD-Department of Maolijat, A & U Tibbia College, Karol Bagh, New Delhi for

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his perpetual guidance and support. We are also thankful to the administration of A & U
Tibbia College, karol Bagh, New Delhi as the piece of work presented is part of the research
programme conducted during 2012-2014 at Tibbia College, Karol Bagh, New Delhi.

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