Major and Minor Criteria of Heart Mizaj (Temperament) Diagnosis from the Perspective of Persian Medicine: An Expert Panel Study

Background: Determining both general and organ-specific Mizaj is a crucial step in the diagnosis and treatment within Persian medicine (PM). Developing a standardized instrument for assessing the Mizaj of body organs, particularly the heart, is a research priority in PM. Objectives: The present study aims to extract major and minor indices of heart Mizaj based on PM literature and expert opinions as an initial step towards standard development. Methods: This qualitative study was designed using a hybrid model that includes both theoretical and experimental phases. Initially, heart Mizaj indices were extracted from ten written PM sources and categorized. Additionally, 23 PM experts were interviewed, and ten participated in expert panel sessions. Each expert scored the importance of each index on a scale of 0 - 3, and the practical method for determining each index was discussed. Final decisions on indices were based on average scores (< 1: Index removed, 1 - 2: Minor criterion; ≥ 2: Major criterion). Results: From the 30 primary heart Mizaj indices identified on the hotness axis, 15 were classified as major and 10 as minor. The wetness/dryness axis comprised 14 indices, with six categorized as major and five as minor. Across both axes, indices pertaining to mental and emotional states emerged as some of the most significant and frequently noted. Conclusions: The indices extracted in this preliminary study highlight their importance and provide methods for the practical diagnosis of heart Mizaj criteria. These findings can facilitate the development of a standardized tool for diagnosing heart Mizaj.