Abstract

Background & objective: Every person is supposed to have a unique humoral constitution that creates an equilibrium status which represents the temperament of the body. This includes his physical characteristics and physiological, psychological as well as an emotional state. The humoral compositions play an important role in the formation of the temperament. The objective of this study is to assess the maximum length (cranio-caudal) of liver in choleric (Billious) and phlegmatic temperament through ultrasonography, because liver is an important organ for formation of temperament as it is said to be the seat of the production of akhlat (humors). In Unani medicine it is believed that humours play an important and deciding role in the creation of human temperament. Thus liver being an important metabolic organ plays an important role in the formation of temperament.
Research hypothesis: Maximum (cranio-caudal) length would be relatively higher in Bilious (Safravi) than phlegmatic temperaments because as per Unani literature, the Bilious (Safravi) individuals are energetic and hyperactive than phlegmatic individuals. They have excellent metabolism; hence they have physiologically greater size of liver because liver plays an important role in metabolism. The metabolic rate of Safravi (billious) individuals are rapid than Balghami (phlegmatic), therefore the size (length) should be greater in billious than phlegmatic individuals. In comparison to billious, phlegmatic individuals have flaccid and obese body structure with soft and flabby muscles and possess more fat in their body. Fat always denotes coldness. But billious individuals are lean and thin and possess very little fat which is suggestive of the temperament being hot and dry.
Methods: This study was carried out on 100 healthy Females volunteers during the period from 2014-2017 in the age group of 18-35 years, having Choleric (Safravi) and Phlegmatic (Balghami) temperament. The reason for selecting this age group is that the volunteers in this age group are mostly healthy and disease free. The volunteer suffering from Malnutrition, Diabetes Mellitus, Hyperthyroidism, Hypothyroidism, Tuberculosis or any disease that influence liver size were excluded from the study. The temperament of the volunteers was assessed using a Performa prepared on the basis of Ajnas-e-Ashra (Ten determinants of temperament), mentioned in classical Unani literature. After the assessment and categorization of temperament, the volunteers were randomly called for ultrasound of liver for the assessments of maximum (cranio-caudal) length of liver.
Result: The mean and standard deviation of maximum length (cranio-caudal) of bilious and phlegmatic subjects were measured. It was revealed after this study that the maximum length of liver of bilious subjects was 13.422 with standard deviation 1.182 and 11.694 with standard deviation 1.402 in phlegmatic subjects. In this way it can be said that the average maximum length of liver of healthy bilious subjects is greater than that of phlegmatic subjects. The unpaired T-test was applied to test the significance of the results and it was found that the difference of maximum length of liver of bilious (Safravi) and Phlegmatic (Balghami) subjects was extremely significant (p<0.0001).
Conclusion: With the limitation of resources and time, the study sample could not be large enough, however the results show that there exists a relationship between size (length) of the liver and the temperament of an individual. The need of the hour is to understand the concept & importance of temperament (Mizaj) and its application in Unani as well as other health care.

Keywords:Temperament (Mizaj); Humor; Bilious (Safravi); Phlegmatic (Balghami); Liver