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Iran has a long history of almost 3,000 years, in which medicine was very important. The history of medicine in Iran is as old as Iranian civilization and goes far back to pre-Islamic times.
History of Iranian medicine
Before the establishment of the two famous medical schools in ancient Greece during the sixth century BC, in Cnidos in Asia Minor and on the Aegean island of Cos, medical healing arts spread to a high level in Mesopotamia, India and Iran. The oldest written sources that we know about Iranian medicine are the Avesta and other Zoroaster religious texts, including Denkart and Bundahishn. They show the importance of old medical beliefs that focused on personal hygiene, public health and the prevention of infectious diseases.
The ancient Persians lived in a wild territory with a great variety of climate and vegetation; this made them familiar with various medicinal plants. Various medicinal plants such as basil, chicory and peppermint are mentioned in the Avesta, and the Bundahishn cites 30 medicinal plants.
Persia was a center of academic knowledge in ancient times. Persian scientists led in astronomy, medicine, mathematics, literature and philosophy. Under Cyrus II, the Persian Empire became the first world empire in history; it stretched from the Danube to Pakistan and from Egypt to the Caucasus. The knowledge of Greece, Egypt, Babylon, India and even China flowed into Persian medicine and developed over 4,000 years.
Millennia of conquests and foreign rule could not destroy this knowledge. The Persian scientists continued to work under their new masters, among Arabs as well as among Mongols - and the rulers were dependent on this knowledge. Even in the Middle Ages, which was a major step back in medicine in Europe, Persia produced the best teachers in various sciences. Persian doctors were a role model in Europe, and Persian medicine flowed into European healing practice in the 13th century.
Iranian universities like that of Jundsihapur in the third century were breeding grounds for collaboration between scientists from different civilizations. These centers successfully followed the teachings of their predecessors and continued to develop their scientific research in history. Iranian science teachers have played a major role in the preservation, consolidation, coordination and development of ideas and knowledge of ancient civilizations.
Some Iranian Hakim (general practitioners) such as Abu Bakr Mohammad Zakariya Al-Razi, known in the West as Yazes and Abu Ali-Hussain ibn Abdullah Ebn-e Sina, better known as Avicenna, were not only responsible for the existing information of the time Spread medicine, but also developed knowledge through their own observations, experiments and skills. "Qanoon fel teb" by Avicenna (the canon) and "kitab al-hawi" by Razi were among the elementary texts in Western medicine from the 13th to the 18th century.
The medical sciences in the Avesta
According to the ancient texts, Jamshid, the fourth Pishdadi king, established the requirement to bathe with cold and hot water. The chroniclers praised him that under his rule no plant withered and no living being died. This could mean that during Jamshid's reign, the medical sciences developed to such a level that plants and animals could live without disease for a long time.
The medicinal properties of many plants were known to the peoples of ancient Iran, as evidenced by the texts of the Avesta. The Avesta notes that Ahura Mazda Zarathustra gave 10,000 healing plants: "And I, Ahura Mazda, send him herbs that grow by the hundreds and thousands and tens of thousands around Gaokerena" (Gaokerene or white Hom was the king of medicinal plants).
The Avesta names Faridun the first wise healer to "send disease back to disease and death back to death, pushing the tip of the sword away as the fever of fire from the bodies of mortals."
We also read in these sources that some of the plants mentioned were common; the Avesta imposes severe penalties for those who use henbane for abortion. With the help of Soma, a narcotic plant, Ardaviraf traveled to the world of the dead and came back to earth after visiting the under and upper world to write about his experience in Ardaviraf nameh.
In Garshab nameh, Garshab tells how a whale is killed and its brain used for medical purposes. He describes different islands and names plants that grow there with a medicinal value, for example by making the old ones young, or flowers whose scent evokes laughter.
The foundations of anatomy were described figuratively in Bondahishn, a Pahlavi text that deals primarily with the origin of creation. The human body is treated as an image of the world: the bones are the mountains, the stomach the ocean, the skin the sky, the flesh the earth, the veins the rivers, the bloodstream the water of the rivers, and the hair the forests. In Bondahishn, a tree is called the "tree of many seeds" and it is said to carry the seeds of all beneficial and medicinal plants.
In the Zoroastrian religion it was forbidden to contaminate water, earth, fire and plants. The Zoroasters did not bathe in running water or wash dirty objects in them; Urinating or spitting in the water was considered a great sin. Strong smelling things were never thrown into the fire.
Corpses were considered completely unclean and no one was allowed to touch them. Cleanliness in the house and the living quarters was considered a religious duty and at least once a year the spring cleaning was a public duty before the New Year. Wild herbs were always burned in the house to kill insects - a tradition that continues to this day.
The pre-Islamic period
In a passage in the Vendidad, one of the surviving texts of the Zandavesta, three types of medicine are distinguished: medicine of the knife (surgery), medicine with plants and medicine with holy words; medicine with holy words was considered the best medicine. As in Vedic India, mantric medicine was the most important, and disease was the result of an act of supernatural powers, especially demons. This is the reason for the ten thousand medicinal plants that Ohrmazd created to ward off the ten thousand diseases that the evil god Ahriman had created.
The second epoch falls in the era known as Pahlavi literature. During this time, the entire field of medicine was systematically treated in Dinkart's encyclopedic work, which discusses 4,333 diseases.
The third era began with the Achaemenid dynasty and spanned Darius I, whose interest in medicine was said to be so great that he rebuilt the medical school in Sais, Egypt, which had previously been destroyed.
The first teaching hospital, where students were methodically trained on patients under the supervision of doctors, was the Academy of Gundishapur in the Persian Empire. Some experts even say that a large part of the entire hospital system goes back to Persia.
According to the Vendidad, doctors had to cure three patients to prove their professionalism, and if they failed, they were not allowed to use medicine. At first glance, this sounds discriminatory and based on human experiments. But some authors note that from the beginning, doctors tore down mental barriers and treated enemies as well as friends. The payment for the doctor's services was based on the patient's income.
Long before Islam, Persian science influenced Greek philosophy. The first pre-Socratic thinkers lived in Asia Minor under Persian rule. Thales of Miletus and Heraclitus of Ephesus introduced Persian science to a liberal Greek society that readily accepted the new influences.
The period of the cultural prosperity of Greece is not only a local achievement, but was also supported by a long tradition of science transfer from Persia to Greece from 600 to 300 BC.
The University of Gundishapur
The exact date when the Gundishapur School was founded is unknown, but most researchers suspect that it was founded at the time of Shapur II (309-379 AD). The ninth king of the Sassanids, Shapur II, chose the city as his capital and had the oldest known medical center in the world built, which also contained a university and a library with 400,000 books.
Gundishapur was probably the first teaching hospital in the world. According to the Christian chronicler Georgy Zeidan, Khosrow Anushiravan established an institution where doctors looked after the sick methodically and where students learned under the guidance of teachers from Greece and India.
The school was an important center of medicine and became known as the "City of Hippocrates" (Cuitus Hippcratica). At this medical institution, the Hippocratic (460-377 BC) and Galenic traditions (130-199 AD) were taught - combined with developed as well as the rich Persian and Indian heritage, it took over the Islamic world.
The medical students learned that in practical medicine they had to take the optimal expert advice seriously in order to understand the patient in his suffering, that they had to take the time to listen and then apply their knowledge of medical science to individual illness problems and the health situation . They learned to diagnose the disease with their patients and to make decisions about successful therapies.
The university was also a center for outlawed scientists from other parts of the world. Philosophers from the School of Athens, who were persecuted in their homeland, found their refuge here and occupied demanding positions. They were allowed to teach Greek philosophy - as guest lecturers.
A medical congress took place at Gundishapur University in 261 AD. In addition to Iranian doctors, numerous doctors from Greece, Rome and India also participated; Jewish scholars also enriched the discussion about diagnoses and treatments of diseases. The results of the discussions were recorded in writing, so that after the congress a congress book could be published which contained all essential points.
The Islamic period
Iranian science suffered a slump as a result of the invasion of the Arabs 630 AD. The conquerors destroyed schools, universities and libraries, burned books and killed teachers. Nevertheless, the Iranian scientists continued and the science of Persia came to the fore again in the Islamic period. To protect the books from destruction by the Arabs, many of them were translated into Arabic from the Pahlavi period, and during the Islamic period, Iran produced doctors and scientists such as Avicenna and Rhazi.
The first direct communication between the University of Gundishapur and the Islamic Baghdad began during the time of the second Abassid caliph, Abu Jaafar Mansour (755-774 AD). Al-Mansour used Baghdad as the capital. He was the first caliph to take astronomers to his court and use them as advisors in all matters - and for this he relied on the knowledge of the Iranians.
The director of the university, Jirjis, was also involved to advise the caliph, many doctors from Gundishapur played important roles in the development of Islamic medicine and pharmaceutical science. Many of the medicinal plants mentioned in Islamic medical books bear the names with which they were referred in Gundishapur.
In 810 AD, Caliph Harun el Rashid had a hospital built in Baghdad to compete with the famous Gundishapur hospital, and doctors from the old center were brought to the new hospital. After the lecturers, philosophers and teachers from Gundishapur had gathered in Baghdad, the Abbasid Court in Baghdad was based on an efficient infrastructure.
Many hospitals were founded in the early Islamic period. The old Persian word Bimaristan means hospital. Medieval Islam adopted the term, referring to official hospitals with professional staff.
The first Islamic hospital was founded in Damascus in 707 with the help of Christians. The main medical facility, however, originated in Baghdad; it opened during the reign of Harun al-Rashid in the eighth century. He had it built according to the Persian model and called it Bimaristan. A bayt al-hikmah (House of Wisdom) was connected, in which professors and graduates from Gundishapur taught. The first director was the Christian doctor Jibrael ibn Bukhtishu from Gundishapur; later leaders were Muslims.
Islamic hospitals were the first to write reports about patients and the course of medical treatment. Students were responsible for keeping these reports; then doctors checked them and referred to them in future treatments.
Abu Bakr Mohammad Ibn Zakariya al-Razi (Rhazes)
Abu Bakr Mohammad Ibn Zakariya al-Razi, known to the scholars of Europe in the Middle Ages as Rhazes, Razi or Rasis (865-925), was a Persian alchemist, chemist, doctor, philosopher and teacher. He is known as a universal scholar and is said to be the greatest and most original of all doctors of the Islamic period and one of the most distinguished authors.
Abu Bakr Muhammad ibn Zakariya al-Razi was born in Ray, a city near what is now Tehran in northeastern Iran. It is believed that he spent his early years studying medicine and philosophy.
Razi gathered fundamental knowledge in the fields of medicine, alchemy, music and philosophy, which he published in more than 184 books and articles. He was well versed in the medical knowledge of the Persians, Greeks and Indians and made various advances in medicine possible through his own observations and discoveries. Much more: In his first works he dealt with the interplay between mental and physical illnesses and introduced psychosomatic medicine to academic medicine.
But he was anything but a "soul doctor". He valued the written knowledge and disapproved conclusions that ignored the traditional experiences. He systematically built his own knowledge on the traditions. So he studied Galen's extensive work and built up a curriculum for medical studies that was to remain valid for centuries. He tried out his own hypotheses until they made clear statements possible - in other words, he laid the foundations for the empirical method of modern times.
He maintained this sharp analysis even on philosophical questions and negated the inviolability of religious texts when their information was insufficient. He criticized the Koran in a way that would at least put him in prison under today's mullah regime: “They claim that the obvious miracle in the form of the Koran is accessible to everyone. They say ‘whoever denies this should reproduce something comparable’. In fact, we could reproduce a thousand similar products from the works of rhetoricians, eloquent speakers, and brave poets, the formulations of which are more appropriate and shorter. They can communicate their intentions better and their rhyming prose also has a better rhythm. God, what you tell us amazes us! You are talking about a book that enumerates old myths and at the same time is full of contradictions and contains no valuable information or explanations. Then say ‘Produce something comparable!’ ”
He was a pioneer in ophthalmology and was the first to distinguish measles and smallpox as different diseases. As an alchemist, Razi is known for his studies on sulfuric acid and the discovery of alcohol; he was an excellent surgeon using opium as a narcotic. Al-Razi discussed a method of preserving corpses. The intestines were removed, the body cavities were washed out with vinegar and wine spirit, and then the body was filled with salt. This method was practiced until modern times.
Razi became the chief doctor of the hospitals in Baghdad and Rey. He placed special emphasis on healing and prevention through healthy eating, which in turn influenced his mental state.
Avicenna (Ibn Sina)
Abu Ali al-Husayn ibn Sina is known in Europe under its Latinized name Avicenna. He was born in 980 AD in Afshaneh near Bukhara. Avicenna wrote approximately 450 works, from physics and philosophy to astronomy, mathematics, logic, poetry and medicine, including the "Canon of Medicine", an encyclopedia that changed our understanding of the human body and its inner processes forever. This masterpiece of science and philosophy - or metaphysics - remained the standard work in medical studies for six hundred years.
His canon of medicine is an immense study of over a million words. It outlines the causes of diseases as well as the causes of good cures. The canon contains a large number of contributions that were unique at the time, for example on the contagious nature of diseases such as tuberculosis. That seems self-evident today; However, European medicine did not yet know that epidemics were transmitted from person to person even during the plague wave 300 years after Avicenna's death. Avicenna continues to discuss how diseases spread through water and earth. Other chapters of the canon are devoted to drug treatment, anatomy, psychology and surgery, for example.
In addition to philosophy and medicine, the work includes texts on astronomy, alchemy, geography and geology, Islamic theology, logic, mathematics, physics and poetry.
Avicenna is considered the father of modern medicine because he made valuable efforts to introduce clinical trials and test drugs experimentally. He also designed a practical textbook for practical experiments to discover and test the effectiveness of natural medicinal substances. He summarized the four temperaments: two of the elementary qualities, hot and cold, were active, two were passive, namely dry and moist. Health means that the strength of all temperaments is in balance. On this basis, the doctors of his time developed various methods of curing illnesses.
Avicenna not only discovered blood circulation; it also precisely reproduced the internal organs - for example the uterus. According to the Koran, it was a mortal sin to open the human body, because it would equate man with the Creator. Avicenna, in all likelihood, overruled the ban and secretly dissected corpses.
There are thousands of plants growing in Iran, and many of them are endemic. Avicenna knew many of them: Iranian lavender helped against gastrointestinal diseases; the arum cured pneumonia and gout; the resin of the Astágalus tree helped against colds; the Persian onion has an antibacterial effect. Avicenna used the bitter almond against kidney stones.
Avicenna's work, translated into Latin, got the market for Iranian medicinal herbs going in Europe. They reached Venice via Syria and from there to Central Europe. Once here, they were more valuable than gold.
Stagnation among the Safavids
Iranian medicine was superior to European medicine in the Middle Ages and was considered a role model. It had survived the political upheavals and even developed further. The prominent role of Persian medicine (and science) since antiquity had two main reasons: Zoroastrianism and the infrastructure of the Persian empire. The Zoroastres had raised meaningful hygiene and scientific research to the rank of religion; the Persian Empire had unique access to Old World knowledge centers: Egypt, Mesopotamia and India - with contacts to China and Greece.
The Arab conquerors introduced Islam and their Islamic rule began to suppress the Persian tradition. However, after initially persecuting the Zoroaster rituals and destroying libraries, once they established their rule, they made use of Persian science - under the Islamic seal and in Arabic.
The Persian tradition of knowledge turned out to be extremely tough. It had seen the violent change of various dynasties, and the caliphs were as dependent on Persian scholars as their ancient predecessors. Thus, under Islamic rule, the Persian tradition was preserved and with it the knowledge of ancient Greece, Mesopotamia and even Egypt, which were lost in Europe in the turmoil of the peoples' migration and under the Catholic dogma. It was no different under the rule of the Mongols; the new rulers from the steppes of the east were merciless when they entered the Islamic world; They committed what was probably the greatest genocide in history at the time - but they were tolerant in cultural matters, and the Persian scholars soon put the intellectual underpinnings back.
However, Persian medicine stagnated in the early modern period. The Safavids came to power in the 16th century and belonged to the Shiites. In order to differentiate themselves from their Ottoman enemies, they made the Twelve Schia the state religion. Early Islam had already fought against the Zoroastrian tradition and with it the traditional medicine that was inextricably linked. But she was able to build herself up again under the new omens.
Now, however, not only did Muslims refer the Zoroastres (as well as Jews and Christians) to their subordinate positions, but one Islamic school, the Shia, oppressed the other, the Sunnis. Iranian Sunnis therefore emigrated in large numbers, especially scholars and many medical professionals. From then on, they worked for the Grand Mogul of India, who was liberal compared to the Shiite legal scholars. During the Safavid period, Hakim continued to work in Iran, as the Iman Reza Hospital flourished, and their doctors described the effects of countless medications.
The geographical location no longer offered the advantage of being an interface between the high cultures as in antiquity and the Middle Ages: the Shiites were also a minority in Islam, and the focus on Shia politically isolated Iran and dried up the transfer of knowledge. While Avicenna and Razi represented Enlightenment views, behind which Europe at that time lagged far behind, the 18th century Enlightenment came from Europe and only seeped into Iran at certain points.
Iran remained sovereign in the 19th century imperialism, but was isolated at the same time. The British ruled India and the Persian Gulf coast; the Russian Empire stood in the north, and Iran was cut off from modernization. Iranians now traveled to Europe and compared the industrial companies there with "backward" Iran.
Modern medicine in Dar al-Fonun
The fourth Quajar king, Naser-ad Din Shah, ruled from 1848 to 1896. He wanted to modernize Iran and his minister Amir Kabir should take the necessary measures. Amir Kabir founded in 1851 the first modern institute for higher education, the so-called "Dar al-Fonun", the House of Technology.
One of the subjects was medicine; Today, the then established course of study is the main step towards introducing modern medicine in Iran. Initially, the students at Dar al-Fonun were mainly trained by Austrians with the help of local interpreters. Already in 1860 the lecturers of the medical faculty were multinational. So European doctors taught at the Haus der Technik, and so Iranian doctors learned western medicine and wrote books about modern medicine, which was then practiced in the west.
Among the doctors in Dar al-Fonun was Dr. Johan Louis Schlimmer, a Dutch doctor. Born in 1819, he graduated from Leiden Medical School. In 1849 he came to Iran and was sent to Talesh. Then he worked in Rashat, in the Guila province in northern Iran, where he spent several years treating lepers. In 1855 he became the deputy of Dr. Jacob Eduard Polak (1818-1891) in Dar al-Fonun; the Austrian worked there as a medical lecturer.
Schlimmer worked at the university until 1864, first in French, later learning Persian and teaching the students in their mother tongue. He researched diseases such as leprosy and cholera and was responsible for the clinical education of medical students at the state hospital, which was established in 1852.
The Iranian Mirza Reza Mohandes planned the institute, and the architect Taqi Khan Memar-Bashi built it under the supervision of Quajari prince Bahram Mirza. These included a theater, a library, a cafeteria and a publishing house. But in 1930 Mirza Yahya Khan Qaragozlu had it destroyed and rebuilt - in a Russian design.
Today's medicine in Iran
In 1849, when Dar-al-funun was founded, a new era in Iranian medicine began. Until Tehran University was established, Dar-al-funun was the only modern medical center in the country. In 1925, 650 Hakim trained there practiced in Iran. The Tehran University School of Medicine was founded in 1938 and Iranian graduates returned from European medical schools. Iran thus found a link to modern specializations and practice that was already based on “apparatus”. The Pahlavi Hospital (now Iman Khomeini Hospital) built rooms for endocrinology and metabolism.
In the decades after the Islamic Revolution in 1979, the population of Iran doubled, while the number of universities and students increased tenfold. All foreign doctors in the clinics have been replaced by young Iranian graduates. Despite the difficult circumstances, an eight-year war with Iraq, political brainwashing, the exclusion of Iranian scientists from international journals, and the sanctions of the Western world, which caused necessary technical equipment to be missing, medical science developed in Iran.
In today's Iran, a doctor is a highly recognized profession. This is partly due to the historical size of Persian medicine and partly due to the massive social problems compared to Western Europe. To be a doctor means the security of having a well-paid job and at the same time belonging to the educational elite. Only the best are admitted to study medicine, and anyone who settles down as a doctor has also undergone extensive training. The level at universities in Iran is high and many Iranians study abroad.
The number of doctors among citizens with an Iranian migration background is very large: in Austria, for example, every 13th Austroiran is a graduate in medicine.
Many internationally known doctors come from Iran, for example Professor Samii in Hanover, who attached microchips to nerve cells and thus made it possible for deaf people to hear. Now he is researching methods that are supposed to cure paraplegics. Dr. also work in Hanover Azmi and Dr. Rahimi, who developed new surgical methods that can prevent amputations. The Iranian doctors founded the "Association of Iranian Doctors and Dentists in the Federal Republic of Germany" (VIA) in 1961.
Book review "Paths of Knowledge as Cultural Bridges"
"Paths of Knowledge as Cultural Bridges" illuminates how science flourished in the Middle East, while Central Europe fell behind in the Middle Ages. As the authors prove, this ranged from critical historical research to state theories to advanced medical methods. For example, Islamic doctors did not primarily practice faith-based medicine, but referred to the ancient Greek approaches that were rational at the time.
Johannes Gottfried Meyer shows that Ibn Sina's merit was to have represented all medicine in a logical system. Apart from the Persian type, the centers of medical science of Islam would have been located in Al Andalus, Spain, and particularly in Cordoba. The writings there, like that of Ibn Rushd, who died in Marrakech in 1198, were quickly translated into Latin in Toledo.
Islamic writings on health prevention, such as the Taqwim as-sihha by Ibn Butlan, which tabulated its sources, also became important. He classified food in warm, cold, moist or dry, showed its optimal condition as fresh, baked, dried or raw, mentioned the respective health effects of a dish and its negative effects, as well as antidotes and special effects.
Auch Mayer betont: „So wurde die Arzneimittellehre – also die Pharmazie – des europäischen Mittelalters zu einem guten Teil durch Übersetzungen aus arabischen Werken wie dem Aggregator, aber auch durch das zweite Buch des Canon medicae geprägt. Die Gesundheitsregime fußten derweil nahezu ausschließlich auf arabischen Vorbildern.”
Detlev Quintern zeigt im Kapitel „Seelen leiden, Seelen heilen – Psychologie als Prävention”, dass der arabische Arzt ar-Razi in seinem Werk Spirituelle Medizin (At-Tibb ar-ruhani) sogar Methoden entwarf, die wir heute als Psychotherapie bezeichnen. Ar-Razi entwickelte die Lehre, dass eine seelisch ausgeglichene Lebensführung Krankheiten vorbeugen sollte und bezog sich dabei auf die Seelenlehre von Platon und Galen. So gewährleiste das Eindämmen und Zurückdrängen von Begierden eine ausgeglichene Persönlichkeit. Spirituelle Medizin bedeutete für ar-Razi auch eine ethische Methode, um seelischen Entgleisungen vorzubeugen.
Abu Zaid al-Balhi (850-934) schließlich wurde ein Pionier der Psychosomatik und erkannte, dass seelische Leiden körperliche Krankheiten verursachen. Er beschrieb Phänomene wie Phobien, Depression und Panik. Eine klinische Therapie war Musik.
„Wissenswege als Kulturbrücken“ zeigt den elementaren Beitrag, den Wissenschaftler des Orients zum Fortschreiten der menschlichen Erkenntnis leisteten. Es ist dabei für ein wissenschaftliches Werk einfach zu lesen, gut strukturiert und nicht allzu umfangreich. Besondere Empfehlung!
Fansa, Mamoun, Quintern, Detlev (Hg.): Wissenswege als Kulturbrücken. Wissenschaften im Islam (8. – 16. Jahrhundert); Nümerich Asmus Verlag, Mainz, 2017. (ua)
Author and source information
This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
Dr. phil. Utz Anhalt, Barbara Schindewolf-Lensch
- Fansa, Mamoun, Quintern, Detlev (Hg.): Wissenswege als Kulturbrücken. - 16. Jahrhundert); Nümerich Asmus Verlag, Mainz, 2017
- Abdollahi, Manizheh & Pourgiv, Farideh: A Historical-Literary Survey of Medicine in Ancient Iran; in: Research on History of Medicine, Vol. 1, Issue 3, Seite 97-101, 2012, Scientific Information Database
- Academy of Gundishapur. www.iranreview.org (abgerufen am 09.10.2019), Iran Review
- Iranian Science: Gondi-Shapur History & Medical School. www.cais-soas.com (abgerufen am 09.10.2019), Circle of Ancient Iranian Studies