Ancient Persia

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Avicenna: Full name: Abu Ali al-Husayn ibn Abd Allah ibn Sina
Born: 980CE in Afshana (in present-day Uzbekistan)

 

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Each part of the Fravahar signifies an idea or a philosophy

 

Some of the earliest records of history of Ancient Iranian medicine can be found in Avesta, the primary collection of sacred texts of Zoroastrianism. Two streamers, above, which extend outward from the central disc illustrate Zoroastrian ethics. They symbolize the two choices humans have between good or evil, or that one should proceed toward good and turn away from bad. The three-layered wings, above, symbolize “good thoughts, good words, and good deeds”, the Threefold Path of Zoroastrianism.

 

The practice and study of medicine in Persia has a long and prolific history. The Iranian academic centers like Jundishapur University (3rd century CE) were a breeding ground for the union among great scientists from different civilizations. These centers successfully followed their predecessors’ theories and greatly extended their scientific research through history.

 

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The painting above depicts Persian-born physician Rhazes (circa 865-925 CE) at the bedside of a young patient afflicted with measles. First to describe measles and smallpox with clinical accuracy, and first to observe and report pupillary reaction to light, Rhazes wrote the earliest known book on pediatric care. His accomplishments, more than a thousand years ago, represent Persian medicine at its best.

 

King Darius I (550-486 BCE), third King of Persia , had an interest in medicine, so great that he re-established the school of medicine in Sais, Egypt, which previously had been destroyed, restoring its books and equipment. The first teaching hospital where medical students methodically practiced on patients under the supervision of physicians was the Academy of Gundishapur in the Persian Empire. Some experts go so far as to claim that: “to a very large extent, the credit for the whole hospital system must be given to Persia”.

 

Persian physicians, for proof of proficiency, had to cure three patients and if they failed they could not practice medicine. Physicians were taught to remove any mental barriers and to treat adversaries as well as friends. A physician’s fee for service was based on the patient’s income.

 

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A 500 year old Latin translation of the Canon of Medicine by Avicenna

 

Iranian science was interrupted by the Arab invasion of 630 CE. Many schools, universities and libraries were destroyed, books were burned and scholars killed. Nevertheless, the Iranian scientists carried on and the science of Persia resurfaced during the Islamic period. To save the books from the Arab carnage, many Pahlavi scripts were translated into the Arabic, and Iran produced physicians and scientists as Abu Ali al-Ḥusayn ibn Abd Allah ibn Sina, Muhammad ibn Zakariya al-Razi and mathematicians as Kharazmi and Omar Khayyam. They collected and systematically expanded the Greek, Indian, and Persian ancient medical heritage and made further discoveries.

 

The Islamic Golden Age is an Abbasid historical period lasting until the Mongol conquest of Baghdad in 1258. The Islamic Golden Age was inaugurated by the middle of the 8th century by the ascension of the Abbasid Caliphate and the transfer of the capital from Damascus to Baghdad. In the 14th century, the Persian language medical work Tashrih al-badan (Anatomy of the body), by Mansur ibn Ilyas (c. 1390), contained comprehensive diagrams of the body’s structural, nervous and circulatory systems.

 

Evidence of surgery dates to the 3rd century BCE, when the first cranial surgery was performed in the Shahr-e-Sukhteh (Burnt City) in south-eastern Iran. The archaeological studies on the skull of a 13-year-old girl suffering from hydrocephaly indicated that she had undergone cranial surgery to take a part of her skull bone and the girl lived for at least about 6 months after the surgery.

 

Several documents still exist from which the definitions and treatments of the headache in medieval Persia can be ascertained. These documents give detailed and precise clinical information on the different types of headaches. Antiepileptic drug therapy plan in Medieval Iranian medicine is individualized, given different single and combined drug-therapy with a dosing schedule for each of those. Physicians stress the importance of dose, and route of administration and define a schedule for drug administration. Recent animal experiments confirm the anticonvulsant potency of some of the compounds which are recommended by Medieval Iranian practitioners in epilepsy treatment.

One of the main roles played by medieval Iranian scholars in the scientific field was the conservation, consolidation, coordination and development of ideas and knowledge in ancient civilizations. Some Iranian Hakim (practitioners) such as Fakhr al-Din al-Razi, Muhammad ibn Zakariya ar-Razi, known to the West as Rhazes, and Ibn Sina, better known as Avicenna, were not only responsible for accumulating all the existing information on medicine of the time, but adding to this knowledge by their own astute observations, experimentation and skills. “Qanoon fel teb of Avicenna” (“The Canon”) and “Kitab al-hawi of Razi” (“Continens”) were among the central texts in Western medical education from the 13th to the 18th centuries.

 

The most famous works of Avicenna are The Book of Healing, a vast philosophical and scientific encyclopedia, and The Canon of Medicine, which was a standard medical text at many medieval universities. The Canon of Medicine was used as a text-book in the universities of Montpellier and Leuven as late as 1650. Avicenna’s Canon of Medicine provides a complete system of medicine according to the principles of Galen (and Hippocrates).

 

The Canon of Medicine agrees with Aristotle (and disagrees with Hippocrates) that tuberculosis was contagious, a fact which was not universally accepted in Europe until centuries later. It also describes the symptoms and complications of diabetes. Both forms of facial paralysis were described in-depth.

 

The Canon of Medicine discussed how to effectively test new medicines:

 

  1. The drug must be free from any extraneous accidental quality.
  2. It must be used on a simple, not a composite, disease.
  3. The drug must be tested with two contrary types of diseases, because sometimes a drug cures one disease by its essential qualities and another by its accidental ones.
  4. The quality of the drug must correspond to the strength of the disease. For example, there are some drugs whose heat is less than the coldness of certain diseases, so that they would have no effect on them.
  5. The time of action must be observed, so that essence and accident are not confused.
  6. The effect of the drug must be seen to occur constantly or in many cases, for if this did not happen, it was an accidental effect.
  7. The experimentation must be done with the human body, for testing a drug on a lion or a horse might not prove anything about its effect on man.

 

Avicenna created an extensive corpus of works during what is commonly known as Islam’s Golden Age, in which the translations of Greco-Roman, Persian, and Indian texts were studied extensively. Greco-Roman (Mid- and Neo-Platonic, and Aristotelian) texts by the Kindi school were commented, redacted and developed substantially by Islamic intellectuals, who also built upon Persian and Indian mathematical systems, astronomy, algebra, trigonometry and medicine. The Samanid dynasty in the eastern part of Persia, Greater Khorasan and Central Asia as well as the Buyid dynasty in the western part of Persia and Iraq provided a thriving atmosphere for scholarly and cultural development. Under the Samanids, Bukhara (ancient birthplace of Avicenna) rivaled Baghdad as a cultural capital of the Islamic world.

 

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A drawing of Avicenna from 1271

 

 

Avicenna’s first appointment was that of physician to the emir, who owed him his recovery from a dangerous illness in 997. Avicenna’s chief reward for this service was access to the royal library of the Samanids, well-known patrons of scholarship and scholars. When the library was destroyed by fire not long after, the enemies of Avicenna accused him of burning it, in order for ever to conceal the sources of his knowledge. After the death of his father, Avicenna proceeded westwards to Urgench in modern Turkmenistan, where, as a scholar, he was able to receive a small monthly stipend. However, he continued wandering from place to place seeking an opening for his talents. Avicenna was stricken by a severe illness in 1012. Finally, near the Caspian Sea, Avicenna met with a friend and patron, who encouraged Avicenna to give lectures and to spend time writing. Several of Avicenna’s treatises were written for this patron; and the commencement of his Canon of Medicine started at this time.

 

An Arabic edition of the Canon appeared at Rome in 1593, and a Hebrew version at Naples in 1491. Of the Latin version there were about thirty editions, founded on the original translation by Gerard de Sabloneta. In the 15th century a commentary on the text of the Canon was composed. Other medical works translated into Latin are the Medicamenta Cordialia, Canticum de Medicina, and the Tractatus de Syrupo Acetoso.

 

The remaining ten or twelve years of Ibn Sins’s life were spent in the service of Abu Ja’far ‘Ala Addaula, the well known prefect of the dynamic city of Isfahan, whom he accompanied as physician and general literary and scientific adviser, even in his numerous war and/or political campaigns. A severe colic, seized him during an army march against Hamadan. Avicenna took remedies but the illness was so violent that Avicenna could scarcely stand. He eventually recovered but during another war situation, the disease returned, stronger than before. His friends advised him to slow down and take life moderately. He refused, stating that: “I prefer a short life with width to a narrow one with length.” On his deathbed he bestowed his goods on the poor, restored unjust gains, freed his slaves. He died in June 1037, in his fifty-eighth year, and was buried in Hamadan, Iran.

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