Mansur ibn Ilyas Shirazi (1380-1422 AD), a pioneer of neuroanatomy.

History of anatomy is as long as the history of medicine itself. Development of this basic science was not possible without the dedicative effort of those physicians and scholars who were committed to discover the mysteries of human anatomy. In this regard, Iranian scholars played an important role in the development of the anatomical sciences despite the religious limitations in their societies. Mansur ibn Ilyas Shirazi is an Iranian physician of fourteenth century who wrote the first color illustrated anatomical book, Mansur's Anatomy. A considerable portion of the book has been dedicated to the central and peripheral nervous system so that he could be considered as one of the pioneers of neuroanatomy.

Early description of amniotomy in medieval Persia.

AIM: Artificial rupture of the amniotic membranes during the labor, which is called amniotomy, is a common procedure in modern obstetric and midwifery protocols. There is no definite agreement regarding the timing of amniotomy in a delayed labor. In this study, we have discussed the history of amniotomy in medieval Persia mentioning the Persian medicine recommendations in this regard. METHODS: We studied main Persian medicine textbooks such as Canon of Medicine by Avicenna to investigate the history of labor management and amniotomy indications. In addition, amniotomy in current literature was studied using PubMed and Google Scholar databases. RESULTS: Persian medicine has recommended artificial rupture of membranes for labor augmentation based on its own theories. Methods for facilitation of the labor have been divided into two groups: one group before and the other during the labor. Avicenna has carefully explained the indication of amniotomy. He has recommended artificial rupture of membranes in cases of intact membranes with cervical dilatation and fetal descent. A needle or a kind of surgical knife called Mabzaa had been introduced for this procedure. CONCLUSIONS: It seems that Iranian physicians are the first scholars who have introduced the amniotomy for labor management in the 11th century. Persian medicine recommendations for labor facilitation should be considered in future studies.

Effect of topical marshmallow (Althaea officinalis) on atopic dermatitis in children: A pilot double-blind active-controlled clinical trial of an in-silico-analyzed phytomedicine.

Atopic dermatitis (AD) is a chronic relapsing eczematous skin disease, which primarily affects infants and young children. Due to the side effects of commonly used drugs for its treatment, the development of safer therapeutic strategies is needed. There are many reports on the topical use of marshmallow (Althaea officinalis) for a range of skin diseases in Persian medicine. The main aim of the present investigation was evaluating the efficacy of marshmallow in children with mild-to-moderate atopic dermatitis. Another aim of the study was screening the anti-allergic and anti-inflammatory potential of phytocomponents against target proteins, including TNF-alpha, IL6, and PDEs A, B, and D enzymes with PDB IDs: 2AZ5, 1P9M, 3I8V, 4KP6, and 1Y2K, respectively, along with their respective standard ligands using computational docking analysis. A pilot clinical trial was designed to investigate the safety and efficacy of Althaea officinalis in children with AD. The diagnosis of AD was made according to the criteria of Hanifin and Rajka. Children between 3 months and 12 years old were participated in this trial and randomly allocated into two parallel intervention and control groups. The intervention group used Althaea officinalis 1% ointment while the positive control group used Hydrocortisone 1% ointment twice a day for a week and after that, three times per week for a period of 3 weeks. The severity of AD was measured using the SCORAD score at the end of each assessment visits. A total number of 22 patients completed the study. A significant decrease of the SCORAD score was observed in both groups. At the end of the study, this score change, which indicates the improvement of the patients was significantly higher in the intervention group in comparison to the baseline (p-value = .015) and week 1 (p-value = .018). In the docking analysis of the study, 33 phytochemical compounds were identified, which were docked into the active site of IL6, TNF-alpha, and human PDE4 isoenzymes. Affinity toward the selected enzymes was significantly higher in glycosylated compounds. The results of this pilot study showed that the efficacy of Althaea officinalis 1% ointment in a decrease of disease severity is more than Hydrocortisone 1% in children with AD. However, further studies are needed to confirm this finding. Moreover, the docking analysis revealed that the inhibitory activity of compounds with free hydroxyl groups such as glycosylated compounds was better than others, probably due to the hydrogen bond interaction of hydroxyl groups of the ligands with the enzymes.

Prolegomena to a True Integrative Medical Paradigm.

When a paradigm starts to show signs of failure to cope with significant questions in any basic/applied branch of human knowledge, there come on the scene those who have perused the related literature enough to either answer those major questions according to the established paradigm or proffer a (wholly) new way of looking at things. In the latter case, the history of science tells us, a paradigm shift takes place. Modern medicine cannot be proven to be totally disconnected from its traditional roots. Where traditional medicine came to give its place to present-day conventional medicine, a number of humanistic aspects of healing, in addition to some axioms of old wisdom, were actually lost. Employing a personalized strategy by considering the patient's specific conditions, integrative medicine endeavors to apply all appropriate interventions from a whole set of science branches to bring back health. However, this does not remain fully without its own challenges from almost all sides. Complementary and alternative medicine, on the one hand, and evidence-based medicine, on the other, have their own rightful say in the affair. Delving deep into the details of medical history's ups and downs, and examining-from the philosophy of medicine's and philosophy of science's standpoints-the pros and cons of integrative medicine, this present treatise makes a systemic, interdisciplinary effort to put forward the best possible paradigmatology in a methodical way as far as the demands of society are concerned.

Early Description of Diet-Induced Blistering Skin Diseases in Medieval Persia: Avicenna's Point of View.

Pemphigus is an autoimmune blistering skin disease that is strongly associated with different environmental factors. Among these, nutritional factors are considered to trigger pemphigus; however, their role may be underestimated. Investigated more recently in conventional medicine, this causative bond between dietary factors and blistering skin diseases was mentioned by Persian scholars such as Avicenna a thousand years ago. Avicenna, a well-known Persian physician and philosopher, who could be considered a pioneer in dermatology, discussed skin diseases in a chapter in The Canon of Medicine. He accounted for some nutritional triggers for skin blisters (mentioned as "hot swellings"), such as onion, garlic, leek, pepper, and wine. His precise description of causative factors based on principles of traditional Persian medicine (TPM) is appreciable and might well lead us to find more efficient ways for the prevention and treatment of blistering skin diseases.

Avicenna's View on Optimal Daily Water Intake.

BACKGROUND: Fluid intake is an essential factor in having a normal homeostasis. However, proper amount of daily water intake in a healthy individual is controversial. There is a prevalent thought that we all have to drink eight glasses of water daily, however, it lacks enough supportive evidence at least for healthy individuals. Here, we try to clarify this topic from the perspective of Avicenna and traditional Persian medicine (TPM). METHODS: The most important traditional Persian medical encyclopedia, Al-Qanun fil-Tibb (Canon of Medicine), was reviewed. Furthermore, Medline, EMBASE, Scopus, IranMedex, and Science Iranian Database (SID) focusing on the keywords "traditional medicine", "water intake", "fluid'', and "complementary and alternative medicine" were reviewed to find relevant information. RESULTS: Avicenna believed that the demand for daily water is not the same in different individuals. The determinant variables mentioned in his book, The Canon of Medicine, comprises mizaj (temperament), health status, age, sex, season, place, habits, occupation, etc. He believed that water in extra amount quenches the hararat-e-ghariezi, which is the basal internal heat to convey normal homeostasis and metabolism in the body. CONCLUSION: Several factors determine the actual need of any person to drink water. Consequently, recommending a specific amount of daily water intake for all is illogical. Moreover, important recommendations of TPM sages on an appropriate amount of water intake should be considered to prevent associated disorders.

Porosity and Health: Perspective of Traditional Persian Medicine.

BACKGROUND: The authors of this manuscript aimed to show the importance of porosity and condensation in health according to traditional Persian medicine (TPM) with consideration of new evidence in conventional medicine. METHODS: Cardinal traditional medical and pharmacological texts were searched for the traditional terms of takhalkhol (porosity) and takassof (condensity) focused on preventive methods. The findings were classified and compared with new medical findings. RESULTS: According to traditional Persian medicine, porosity and condensity are the two crucial items that contribute to human health. Somatotype is a taxonomy based on embryonic development, which may be considered in parallel with porosity and condensation. However, these terms are not completely the same. There are many causes for acquired porosity comprising hot weather, too much intercourse, rage, starvation, and heavy exercises. In general, porosity increases the risk of diseases as it makes the body organs vulnerable to external hot and cold weather. On the other hand, the porose organs are more susceptible to accumulation of morbid matters because the cellular wastes cannot be evacuated in the normal way. There are some common points between traditional and conventional medicine in the context of porosity and condensity. The relation between diet and somatotype is an example. CONCLUSION: Condensity and porosity are the two basic items cited in the TPM resources and contribute to health maintenance and disease prevention of body organs. Creating a balance between these two states in different body organs, strongly contributes to disease prevention, treatment and diminishing chronic diseases period. Choosing proper modality including diet, drug therapy, and manual therapy depends on the amount porosity and stiffness of the considered organ and the preferred porosity of the affected organ keeping in a normal healthy state.

Spinacia Oleracea: Exploring the Therapeutic Potential in Persian Medicine and Modern Pharmacology.

BACKGROUND: Spinach is a widely cultivated dark leafy vegetable highly regarded for its medicinal properties in traditional Persian medicine. It is rich in vitamins, minerals, flavonoids, carotenoids, and other bioactive compounds, and this review aims to explore the historical applications of spinach in Persian medicine and juxtapose them with current scientific evidence. Despite its historical significance, there remains a need to comprehensively evaluate and integrate traditional knowledge with modern research on the therapeutic benefits of spinach. METHODS: To achieve this, a comprehensive search was conducted in Persian medicine references and scientific databases to gather information on the traditional uses, chemical composition, and pharmacological effects of spinach. Studies that met the inclusion criteria were meticulously categorized, and relevant data were analyzed to draw insightful comparisons. RESULTS: Persian medicine describes spinach as a nutrient-rich, laxative, and fast-digesting agent with therapeutic effects on inflammation, lung diseases, back pain, sore throats, jaundice, urinary disorders, joint pain, eye inflammation, insomnia, dementia, and more. Modern studies have substantially corroborated these traditional uses, revealing that spinach possesses antioxidant, anti-inflammatory, anti-cancer, blood sugar-lowering, lipid-lowering, anti-obesity, neurological, ocular, and musculoskeletal effects. CONCLUSION: Spinach exhibits a wide range of beneficial effects on various health conditions. Its widespread availability, low cost, and exceptional nutritional richness position it as a promising candidate for further investigation. Future studies should explore the clinical effectiveness of spinach in various diseases, while taking into consideration the principles emphasized in Persian medicine to guide research and inform therapeutic strategies.

Effect of Dill (Anethum graveolens) Oil on Pruritus and Quality of Life of Hemodialysis Patients: A Randomized Double-Blind Three-Arm Controlled Trial.

Introduction: Anethum graveolens (AG), commonly known as dill, is a plant from the Apiaceae family that has been traditionally used as a skin softener and purifying agent in Persian medicine. In a previous study conducted on male rats, dill was found to have anti-inflammatory effects. The current study aimed to examine the efficacy of topical application of Anethum graveolens oil on pruritus severity, skin dryness, sleep quality, and quality of life in patients undergoing hemodialysis. Methods: In the current clinical trial, the participants were randomly assigned to one of these groups: topical AG preparation, sesame oil, or a control group receiving no treatment. The study was double-blind and placebo-controlled. The topical treatment was applied twice a day for one month to areas of the skin affected by pruritus. The outcome measures included the severity of skin dryness, the Pittsburgh Sleep Quality Index, Duo's Uremic Pruritus Severity Scale, and the Itchy QoL questionnaire. Results: This study involved 106 hemodialysis patients, and after intervention for one month, the medication group had a significantly lower mean score of sleep quality (3.24 ± 2.41) than the placebo (4.54 ± 3.11) and control (5.05 ± 3.21) groups (P=0.032). The mean change in pruritus severity was significantly greater in the medication group (-17.28 ± 8.938) than the placebo (-5.91 ± 5.398) and control (-3.43 ± 3.228) groups (P < 0.001). Moreover, a significant difference was observed in the mean changes in quality of life between the medication, placebo, and control groups, with values of -14.88 ± 7.89, -5.34 ± 4.50, and -1.92 ± 2.86, respectively (P < 0.001). Furthermore, both the medication and placebo groups showed improvement in skin dryness compared to the control group having the values of -1.65 ± 0.91, -1.11 ± 0.79, and -0.38 ± 0.54, respectively (P < 0.001). Conclusion: Topical Anethum graveolens preparation significantly improved the sleep quality and quality of life and reduced skin pruritus and dryness in hemodialysis patients. It could be considered as a simple therapeutic modality to control pruritus in hemodialysis patients. This trial is registered with IRCT2017022032671N1.

Effects of Pistacia genus on gastrointestinal tract disorders: A systematic and comprehensive review.

Gastrointestinal (GI) disorders characterized by persistent and recurrence gastrointestinal symptoms are prevalent. The genus Pistacia is widely emphasized as the relief of gastrointestinal diseases in traditional medicine. This review aimed to investigate the latest evidence on the effect of the Pistacia genus on GI tract disorders. The systematic search was performed following to PRISMA guidelines. The databases PubMed and Scopus were searched from 1980 to 2022 with restrictions to the original studies. Electronic databases were searched in title/abstract, using the keywords relevant to GI tract disorders. Forty-eight studies were included in this review following the inclusion criteria. Fifteen and 22 studies were clinical and animal studies, respectively, of which 6 clinical and 13 animal studies were on Inflammatory Bowel diseases. Seven clinical studies were on functional GI disorders. The most pieces of evidence from animal and clinical studies were on the intestinal inflammation and peptic ulcer affecting the inflammation as well as oxidative stress through different mechanistic pathways. The most referred active phytochemicals seem to be terpenoid compounds. Various in vitro studies have also shown the inhibitory activity of the different plant parts of Pistacia herbs on several GI tract cancer cells. Available scientific evidence supports the effects of various components of Pistacia genus plants in the field of GI tract diseases, especially digestive inflammations. Further studies are required to systematically evaluate the natural products of the genus Pistacia, particularly in the context of digestive disorders.

Herbal Treatment of COPD and Asthma According to Persian Medicine: a Review of Current Evidence.

Background: Chronic obstructive pulmonary disease (COPD) is one of the most common pulmonary diseases. The current therapeutic outcomes are not satisfactory and may cause adverse events such as cardiovascular complications. In this study, we aimed to discuss some effective medicinal herbs for the management of COPD. Materials and Methods: In this review, we looked for effective medicinal herbs for productive cough with thick and sticky mucus in Persian medicine sources such as Qanoon fi al-Teb, Exir Azam, and Zakhire Kharazmshahi. Then, to find relevant evidence about them, the data sources (PubMed and Google Scholar) were searched in the English language without time restriction from inception up to March 2022. Results: We found that Zataria multiflora, Thymus vulgaris L, Glycyrrhiza glabra L., Crocus sativus L., Nepeta bracteata Benth., and Hyssopus officinalis have beneficial effects on COPD due to their properties including anti-inflammatory and antioxidant activity. In addition, considering asthma COPD overlap (ACO), medicinal herbs including Cordia myxa, Adiantum capillus-veneris, Cinnamomum verum, Viola odorata, Borago officinalis, Linum usitatissimum and Vitis viniferia L. were found to have useful effects on asthma. Conclusion: Considering the mentioned beneficial mechanisms of action of these medicinal herbs, they could be used as a complementary therapy in COPD and asthma. However, more experimental and clinical research should be done to confirm their clinical effects.

Effect of MS14® on physical activity of multiple sclerosis patients: A randomized triple-blind placebo-controlled clinical trial.

INTRODUCTION: Multiple Sclerosis (MS) is a neurological disorder with an increasing global prevalence and severe complications. MS14® is a Persian-medicine-derived natural product with herbal and marine origin which has shown beneficial effects in the management of MS complications. In this study, its effect on physical activity of MS patients was investigated. METHODS: A triple-blind placebo-controlled clinical trial was conducted. Participants used either MS14 capsule or placebo 3 times a day for 3 weeks. At baseline and end of the study, physical activity indices were assessed using international physical activity questionnaire (IPAQ). Secondary outcome measures were Fatigue Severity Scale (FSS), timed 10 m walk, Ashworth scale, and Timed Get up and Go. RESULTS: A total number of 80 MS patients completed the study. At the end of study, improvement of general physical activity (p-value=0.047) and Timed 10 m walk index (p-value=0.003) in the MS14 group was significant when compared to placebo. No serious adverse effects were observed in this study. CONCLUSION: Considering the improvement of some physical activity indices, MS14® is seems to be a safe natural product which could be considered as a supplementary treatment in MS patients. Future larger trials are suggested to further evaluate its efficacy.

Medical education in the first university of the world, the Jundishapur Academy.

The Academy of Jundishapur was the world's first university established during the Sassanid Empire in old Persia. Some of the important features of this scientific center of the ancient world include a policy of tolerance, conducting annual international congresses, compiling the first comprehensive medical textbook, doing the hospital rounds, physician licensure exam, special attention to the ethics, and using an educational curriculum. Moreover, its unique style of education made Jundishapur a brilliant school in the history of science. This outstanding academy maintained its impact on the scientific movement of that era for four centuries. It finally declined after transmission to Baghdad medical school. In this study, we have discussed the features of the Jundishapur school which made it a successful model for medical education.

Effect of chamomile on chemotherapy-induced neutropenia in pediatric leukemia patients: A randomized triple-blind placebo-controlled clinical trial.

OBJECTIVE: Chemotherapy-induced neutropenia is one of the main side effects of acute lymphoblastic leukemia (ALL) treatment. In this trial, we evaluated the efficacy of chamomile in management of neutropenia. MATERIALS AND METHODS: This randomized triple-blind placebo-controlled clinical trial was carried out in 2-18-year-old children with ALL. Participants in each group daily received 2.5 ml of either chamomile syrup or placebo syrup for a period of 30 days. Participants' white blood cell (WBC), and absolute neutrophil count (ANC), as well as their quality of life were evaluated. RESULTS: The study was completed with a total of 40 patients. An increasing trend of ANC was observed in the treatment group despite the decreasing trend in placebo group, which was statistically significant between the two groups (P Interaction=0.019, 95% confidence intervals=15.076-171.324). No serious side effects were reported. CONCLUSION: Using chamomile syrup as a complementary therapy in children with leukemia could improve their immunity (as it increased WBC) by minimizing chemotherapy-induced neutropenia.

Ibn Mandevaih Isfahani (949-983(?) AD), a physician from Isfahan's medical school.

There have arisen a number of prominent Iranian-Islamic physicians throughout the history of the fertile medicine landscape of Iran, some of whom are not very well known. Abu Ali Ahmad ibn Abd al-Rahman Mandevaih Isfahani (949-983(?) AD) was a great medical figure with scientific activities in the Hospital of Isfahan and al-Adudi Hospital of Baghdad in the golden age of Iranian-Islamic history, culture, and civilization during the reign of the Buyid dynasty and Abbasid Caliphate. He was also a prominent physician during the reign of Adud al-Dawla Deylami (949-983 AD). This present research has as its objectives the studying of the scientific life of ibn Mandevaih Isfahani and his works in this field. The works of this scientist and scholar reflect his skill and expertise in literature, philosophy, medicine, and medicine-related fields including ophthalmology and pharmacology.

Insomnia in Traditional Persian Medicine

Insomnia is a common complaint in outpatient clinics. It usually affects quality of life neg-atively, especially in severe cases. Nowadays, routine medical interventions comprise pharmacological approaches and cognitive behavioral therapy. Common medications used by afflicted patients are not competent enough in addition to their annoying side effects. It would naturally denote the need for considering novel strategies for treating insomniac patients. Approach to insomnia in traditional Persian medicine (TPM) has been cited in a scrutinized manner focusing on its main causes. Accordingly, its treatment is tailored based on the constitution of the patient, intensity of the disease, and type of the cause. In this paper we have discussed the causes of insomnia, diagnostic approach, and various medical interventions proposed in valid sources of TPM.