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A Brief Overview of History of Medicine in Iran

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Title: A Brief Overview of History of Medicine in Iran


1
A Brief Overview of History of Medicine in Iran
  • Mehran Moghaddam, Ph.D.
  • Signal Pharmaceuticals, LLC
  • A wholly owned subsidiary of Celgene Corporation
  • March 7, 2007

2
  • If you dont know where youve been

Main sources of Information Medicine in Persia
by Cyril Elgood, M.D. (1892), and The Internet
Considering all the negative propaganda about
Iran and Iranians these days, it is critical to
know about our heritage and who we really are.
Of interest to this presentation is the role
Iranians have played in the development of
medical sciences.
3
IranAchamenid Dynasty (circa 500 B.C.)
Lets go back to the beginnings of Iran as a
unified multicultural country. The above map
shows that Iranian borders extended into three
continents of Africa, Europe and Central Asia, 25
centuries ago. Clearly, in an Empire that large
and as prosperous as Achaemenid (Hakhamaneshi)
Iran, there was a need for a healthcare system
during times of peace and war. This role was
originally entrusted to the Magi, the Zoroastrian
(Zarthushti) priests.
4
The Magi Zorastrian Priests(Etymology of the
word Magic)(Birth of Zoroasterianism to 622
A.D.)
  • The Magi were the priests practicing
    Zoroastrian. The best known
  • Magi to the Western world are the three Wise men
    from the East
  • Zoroastrian priests were in charge of
    religious, funerary,
  • and even medical needs of people of Media (Maad)
    and Persian empire
  • They became highly influential in Median society
    until the
  • unification of the Median and Persian Empires in
    550 BC by Cyrus the Great
  • The political power of the Magi was curtailed
    by Cyrus the Great and other emperors in
    Achamenid dynasty
  • The Magi served as royal physicians until they
    revolted against
  • the royal family
  • The Magi army, led by Smerdis, was defeated by
    Darius I
  • They were never trusted with the healthcare of
    the royalty, again. As a result, that
    responsibility was entrusted to the Greek
    physicians
  • Medical expertise of the Magi became largely
    ignored after that and
  • accurate and expanded accounts of their knowledge
    and expertise
  • disappeared with time and was replaced by those
    of the Greeks
  • Perhaps the only way to take a glimpse at the
    state of medicine as practiced by the Magi would
    be to study medical references in Avesta, the
    holy book of Zoroaster

5
Avesta The sacred book of Persia (Zoroastrianism)
  • Two main forces at work, the good and the evil
    (dualism)
  • Aryama (the good spirit) conquers all sickness
    and death, just as the evil spirit produces them.
    Rain from Heaven produces plants and trees,
    whose properties are to cure disease and prevent
    death. (Fargard xx.)

Diseases were thought to be caused by the evil
and the solution to that was provided by the
good spirit. The Magi had a knowledge of
medicinal properties of plants.
6
Practice of Medicine during Zoroastrian Iran(.-
642 AD)
  • If he shall ever treat with the knife any
    worshipper of Mazda and wound him with a knife,
    he shall pay for it the same penalty as is paid
    for willful murder. But if he can cure three
    infidels in succession, he is free to practice
    for ever (Fargard vii, 7.)
  • Fees varied according to the sex, age, and wealth
    of the patient
  • The abortifacient properties of certain drugs
    were well recognized and severe penalties were
    enacted for those procuring abortions
  • In case of abortion, father, daughter, and the
    operator were punished
  • The fatherless were to be supported in the
    society
  • It lies with the faithful to look in the same
    way after every pregnant female, either two
    footed or four-footed. Young dogs ought to be
    supported for six months, children for seven
    years. (Fargard xv.)
  • Medicine and religion were related

It appears that surgeries took place in ancient
Iran. Furthermore, there were rules and
regulations for practice of medicine. By
moving forward about 1000 years we can develop a
better understanding of pre-Islamic practice of
medicine in Iran.
7
IranSassanid Dynasty (circa 610 A.D.)
Jundi Shapur
Ctesiphon Iranian capital for 800 years.
Measuring about 30 square kilometers, it was
known as the largest city in the world from
570-637 A.D. (Wikipedia)
During the Sassanid (Sasanian) era, Iran had been
restored to its previous grandeur. By 610 A.D.,
Ctesiphon (Tisfun), around 20 miles south of
todays Baghdad had been the capital of Iran for
800 years and Jundi Shapur had develped into a
medical and industrial center.
8
Jundi Shapur Medical UniversitySassanid Era (226
A.D. 642 A.D.)
  • The city of Jundi (Gundi) Shapur, in Khuzistan
    (Southwest Iran), was rebuilt by Shapur I
    (depicted in the pictures) in 3rd century A.D.
    using mostly captured Roman soldiers
  • Jundi Shapur was a multicultural city
  • The oldest self-contained medical university and
    hospital in the world was established there in
    the 4th century A.D.
  • Staffed mainly with Zoroastrian, Christian,
    Jewish, Greek, Indian, and Persian professors and
    researchers
  • Jundi Shapur university was also a theological
    school (ie. Nestorian Christian theology was also
    thought in Jundi Shapur!)

9
Jundi ShapurAchievements and Downfall
  • Indian, Greek, Persian knowledge and science were
    followed and built upon Well known for eye
    surgery
  • Scientific methodology was used cases should
    be written down and general laws deduced
    therefrom.
  • The Persian emperors kept a close contact with
    Jundi shapur. Honored graduates met with the
    king. In 541 A.D. Khosru Anushirvan summoned a
    general medical council to discuss regulations
    for the advancement of medicine
  • Haris al-Saqafi, a Jundi Shapur honor student
    from Arabia, was tested by Khosru himself
  • Haris provided medical services to Prophet
    Mohammad after his return to Arabia
  • Jundi Shapur, in addition to being a medical
    center, became an industrial center famous for
    its perfumes and weaving
  • It fell into the hands of the conquering Muslim
    army in 638 A.D., but according to most
    historians was not disturbed. Then one might
    ask, what happened to the detailed records of
    scientific activities in Jundi Shapur???
  • After some 300 years from its inception, Jundi
    Shapur university began to decline due to
    establishment of medical colleges in Baghdad and
    Rey (todays Tehran). How many medical
    universities/hospitals do you know that are 300
    years old?

10
Ruins of Ctesiphon and Jundi Shapur
With demise of the Iranian Sassanid empire and
inception of Islamic era, the 800 year old
capital of Iran, once the largest city in the
world, fell to ruins (left). With gradual
destruction of Jundi Shapur (right), the center
of learning shifted to Baghdad and Rey.
11
Post-Islamic EraRise of Arabian Medicine (Al
Razi, Ibn Sina, Al Jurjani,)
A large percentage of the most prominent figures
responsible for the development of Arabian
Medicine were Persians. The fact that they
assumed Arabic names (probably a wise decision
considering Iranians were second class citizens
in their own country) and wrote in Arabic (or
else their writing would become obsolete and
remain largely unread in the Islamic Empire)
caused a confusion about the ethnicity of these
prominent physicians.
12
State of Medicine Under Caliphs
  • The high medical standards of Jundi Shapur was
    transferred to Baghdad and Rey
  • In tradition of Jundi Shapur, a Board of Medical
    Examiners was set up in Baghdad in the 900s A.D.
  • In 931 A.D., the Caliph demanded a more rigorous
    standard of examination and certification due to
    death of a patient
  • In that year, 860 physicians (excluding the royal
    physicians) applied for examination!
  • There are records indicating presence of female
    physicians
  • At one point, under the rule of Caliphs Baghdad
    had 15 functioning hospitals!
  • Eye surgeries were performed (Rhazes refused
    cataract surgery after examining the physician on
    eye anatomy.)
  • Monkeys were used for medical research! (in 836
    A.D. the ruler of Nubia was ordered to supply a
    particular species of apes, resembling man, for
    dissection)
  • Who were some of the best known physicians of
    that era?

I recommend that in order to remember these
names, you simplify them as follows Jabir Ibn
Hayyan Hayyan, Mohammad Ibn Zakarya Razi Razi
..
13
Jabir Ibn Hayyan(known to the West as
Geber)721-815 A.D.
  • Jabir was born in Tus, Khorasan, in Iran, but is
    believed by most to be of Yemeni descent
  • Extremely prolific as a chemist, pharmacist,
    astronomer, and philosopher
  • He is credited with the invention of many types
    of basic chemical laboratory equipment, and with
    the discovery and description of many commonplace
    chemical substances and processes such as the
    hydrochloric, citric, tartaric, and nitric acids,
    distillation, and crystallization
  • The Geber crater, located on the Moon, is named
    after him
  • He wrote in codes, so the word gibberish is
    sometimes theorized to be derived from his name

14
Ali Ibn Abbas Al-Majusi (Know in the West as
Holy Abbas, Ali Abbas, Masoudi)? 994 A.D.
  • Born in a Zoroastrian family in Ahwaz, but became
    a Muslim
  • Wrote a medical encyclopedia called The Complete
    book of Medical Arts or Liber Rigalis
  • The first 10 chapters are theory and the second
    10 chapters are practice of medicine
  • Some examples of topics covered are dietetics and
    materia medica, a rudimentary conception of the
    capillary system, interesting clinical
    observations, and proof of the motions of the
    womb during parturition (e.g. the child does not
    come out it is pushed out).

15
Rhazes (Razi) - 860 - 932 AD
  • Razi was born in Ray, Iran (modern day Tehran)
  • Wrote over 180 books in medicine and chemistry
  • Described distillation, sublimation, and
    calcination processes and established procedures
    for purification, separation, and the mixing of
    substances
  • For the first time generated pure alcohol from
    wine via distillation
  • Rhazes developed apparatus such as mortars and
    pestles, flasks, spatulas, beakers, phials, and
    glass vessels
  • He described a process for refining crude oil to
    obtain Naft
  • He was chief physician at the Baghdad and later
    at Ray hospital and trained many physicians
  • Known for his concentric teaching/diagnosing
    method in the hosptial
  • The first scientific description of Measles and
    its distinction from smallpox is attributed to
    Razi (Health-Disease.org)
  • The first in the medical field to use animal gut
    for sutures and plaster for casts
  • When he was not occupied with pupils or patients
    he was always writing and studying
  • Razi is also known for having discovered
    "allergic asthma," and was the first physician
    ever to write articles on allergy and immunology.
    In the Sense of Smelling he described the
    occurrence of rhinitis after smelling a rose
    during the Spring
  • Razi was the first to realize that fever is a
    natural defense mechanism, the body's way of
    fighting disease
  • Razi was a very generous man, with a humane
    behavior towards his patients, and acting
    charitable to the poor treatment without a
    charge

16
Ibn Sina (known to the West as Avicenna and
Often referred to as Persian Galen) - 980
1037 A.D.
  • Sina was born in a Persian family near Bukhara
    (todays Uzbekistan)
  • His education started in theology and mathematics
  • At age 16 started medical training and soon after
    that he became a physician to the royalty
  • By age 21 he had completed 2 book one was a
    synopsis of all the sciences of the day and
    another was a commentary on the Law
  • Due to his genius and reputation he was hired by
    the ruler of Khawrazm
  • Sultan Mahmud Ghaznavi (ancient Taliban) required
    Sinas presence in his court
  • Sina fled from one city to another to preserve
    his freedom
  • He loved socializing, practicing medicine,
    writing books on diverse subjects
  • At the end, women, wine, and hard work wore him
    out and he died at 57 years of age.
  • After his death, he was given the title of Chief
    of Chiefs (Rais Al Hokama)
  • He is best known for his book called Canon
    (Ghanoon), which was translated into Latin in the
    1500s
  • Canon in its Latin translation became the
    textbook for all the universities in Europe until
    19th century
  • Canon is believed to be a bridge between Galen
    and Hippocrates and Harvey and modern medicine

17
Sinas Contributions
  • Anatomy of eye muscles
  • it is not a ray that leaves the eye and meets
    an object that gives rise to vision, but rather
    that the form of the perceived object passes into
    the eye and is transmuted by its transparent
    body, the Lens.
  • Suggested that certain diseases were water-borne
    and caused by minute animals that lived in the
    water, too small to be viewed by human eye
    (microbial theory!?)
  • First to distinguish obstructive and hemolytic
    jaundice
  • Wrote extensively on nervous, cutaneous, and
    genitourinary diseases
  • He condemned astrology and made serious attempts
    to separate that from medicine

18
Sinas Contributions (continued)
  • He hypothesized that the veins and arteries were
    carriers of nourishment to organs, and they
    stayed as two separate compartments
  • Sina was not aware of circulation (through
    capillaries) and believed the blood in each
    compartment supplied nutrients by ebbing back and
    forth due to the heart
  • He suggested that veins and arteries were also
    principle organs of respiration. The purpose of
    respiration was to intake air into the blood and
    outpour of harmful vapors from body
  • Sina stated that inspiration of air took place
    into the skin and in the lungs through invisible
    pores, but that the latter played a major role
  • He claimed that the actual mechanics by which
    this took place was due to the heart expansion
    and contraction
  • William Harvey received credit for describing
    this in the 1600s

19
Sinas Contributions (Continued)
  • Disease might be caused by an obstruction to
    excretion of vapors, but it might also arise from
    the inspired air
  • At certain times the air becomes infected and
    anyone breathing the infected air falls sick (ie.
    plague) getting very close to the microbial
    theory
  • Sina was also a philosopher
  • Why should any one man suffer from any one
    disease rather than another? Why does disease
    exist at all?
  • Sina stated that in the make-up of most people
    there is somewhere a natural tendency to get out
    of order, some congenital weakness in one
    particular organ, tissue or system. He called
    this personal disposition
  • Sina put forward the view that each patient is to
    be looked upon as a distinct and separate case!
    (Personalized Medicine?! 1000 years ahead of his
    time)
  • His emphasis was on the patient, not on the
    disease, on treatment, not on diagnosis

20
Ismail Al-Jurjani(Gorgoni) Royal physician in
1100s A.D.
  • Gorgoni was born in Gorgon date unknown
  • The last of the Trinity of the great Persian
    physicians
  • The first one to write in Farsi (limited
    exposure?)
  • Gorgoni described all the Arabic medical
    terminology in Farsi and generated a medical
    dictionary for generations of Iranian physicians
    to come
  • Gorgoni is the first to connect goiter and
    swellings of the throat to exophthalmos, a sign
    rediscovered by Parry in 1825 (Graves-Basedow
    disease)

He was referred to as Jurjani because in the
Arabic alphabet there are no letter to sound like
?. Another example Nargess was called
Narjess.
21
From Mongol Invasion to Present
No more prominent names due to sparse Activity in
the medical field!
22
Thank you for your attention
I hope that once again we witness presence of
Iranians as the leaders in the fields of medicine
and pharmaceutical sciences in the near future
For more information on Iranian Scientist, please
look up http//en.wikipedia.org/wiki/List_of_Iran
ian_scientists_and_scholars
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