Traditional Mediterranean medicine gets a modern makeover

The notion of the four humors—based on fire, air, water and earth—for use in health care might seem like a long-defunct remnant of the Dark Ages. But, in fact, it forms the basis of one of the most widely used herbal traditions in the world, and it is the inspiration behind new research and products that aim to find the most effective herbal synergies for therapeutic use today. Do your staff and shoppers know about traditional Greek-Arabic, or Unani, medicine?

A little history
“European herbalism until the 12th century was relatively primitive and nonprofessional,” says Stephen Fulder, Ph.D., author of The Handbook of Alternative and Complementary Medicine (William Heinemann, 1997). “Country people or priests would treat diseases using single herbs, with a strong Christian basis. Arabic medicine brought a large range of new herbs, a sophisticated and rational system and theory of medicine and the knowledge to build complex formulations of several herbs properly prepared for maximum therapeutic effect.”

Originally outlined by Hippocrates and developed further by the Roman physician Galen, the four-humor system of medicine was the dominant medical method in the Roman Empire, says Paul Bergner, C.N., a medical herbalist and director of the North American Institute of Medical Herbalism. As the Arab empire grew, its people adopted the Romans' medicinal tradition and expanded on it. The Arab scholar Avicenna scribed its five-volume canon, which Bergner explains was the authoritative medical text from Pakistan to Germany from 1000 to 1700. Greek-Arabic herbal knowledge, known as Unani—Arabic for “Greek”—was only partly imported to Europe, though, and much of its study and use has drastically declined, Fulder says. But it's still the go-to medicinal modality for hundreds of millions of people in India and the Middle East, Bergner says.

Humors and synergies
“Unani delves into the theory of four humors, which states that an individual's temperament is determined by a unique combination of humors. As long as these humors are in balance, the human system is healthy. It is the imbalance which can result in disease,” says Warren Niece, marketing director of Houston-based herbal company Himalaya USA, some of whose herbs are part of the Greek-Arabic, as well as Ayurvedic, tradition. “Although many herbs used in the Unani tradition are similar to those used in Ayurveda, there are a few herbs native to the Middle East and Greece such as Onosma bracteatum and Phoenix dactylifera, or dates, which are used widely in Unani medicine.”

Bergner describes practitioners in the Middle East who interview patients, take a pulse, look at the tongue and diagnose an herbal remedy according to the person's individual constitution. And though your shoppers are not likely to walk into your store with a prescription from a traditional therapist—a hakim—many of the herbs on your shelves likely gained credibility through the Greek-Arabic tradition.

Unani for a new world
Hundreds of manufacturers in India are developing products based on the Unani system of medicine, says Himalaya's Niece. But even though much of the herbal tradition of the Mediterranean and Middle East has never been translated for use in the U.S., one company is putting Unani-based research into products marketed for a modern Western world, and others are specializing in single-herb products backed by millennia of traditional use.

Sprunk-Jansen, a Danish company with offices in Santa Rosa, Calif., has made a point of investigating the synergies described in this ancient medicinal tradition and applying research in easy-to-use products for issues ranging from dry skin to blood-sugar problems. The company works with researchers at Israeli universities and university hospitals to explore potential remedies and combinations.

Because most Americans don't have a hakim on hand to make recommendations, Sprunk-Jansen took the four humors into account, but only insofar as to make sure to avoid extremes that might create reactions in one of the constitutional types, Fulder says. “In designing products for general sale, the products have to fit all types, be general and non-specific,” he says. “The constitutional typology is only relevant in a specific therapeutic relationship between an individual patient and a therapist.” For example, only people with certain constitutions might need a remedy for dry skin, but the company's Red Dry Skin product is formulated—with black cumin, arugula, Mediterranean sweet lemon and St. John's wort—to be safe for all constitutions.