Hospitalization, Diagnosis, Treatment, and Surgery in Iran: The Lifecycle of Medical Sciences

By Ali Akbar Velayati

Hospitalization, Diagnosis, Treatment, and Surgery: The Lifecycle of Medical Sciences in Iran provides a complete understanding of the lifecycle of medicine in the underserved area of Iran. Coverage will elucidate the importance of communication between scientists in different countries for the further development of research to advance hospitalization infrastructure, diagnosis and treatment of diseases, and surgery techniques and availability.

Using a systematic timeline approach, coverage includes early medical sciences to present day of Iran. Each chapter highlights important research, techniques, and procedures throughout the lifecycle of medical sciences and includes topics from bloodletting and setting bones, to anesthesia and vaccines. The content in each chapter emphasizes standard protocols based on international recognition to help developing countries adopt newer technologies.

• Covers the lifecycle of medical sciences in Iran for a comprehensive introduction to the developments in hospitalization, diagnosis and treatment of diseases, and surgery
• Shows ways that modern technology can be utilized in underserved areas of the world
• Provides the unique perspective and insight into the diagnosis and treatment of infectious diseases like M. tuberculosis from a country that has seen the progression of the disease and its available treatments over many years

• Language: English
• Publisher: Academic Press
• Release date: Jan 14, 2023
• ISBN: 9780443153068

Ali Akbar Velayati

Dr. Velayati is the Director of National Research Institute of Tuberculosis and Lung Diseases (NRITLD) at the Shahid Beheshti University of Medical Sciences. He is a Full Professor of Pediatric Infectious Disease and he has guided more than 300 MD and PhD students. He is the Head of Mycobacteriology Research Center in NRITLD, where he directly monitors the basic and clinical trial on tuberculosis. Dr. Velayati is President of the Asian African Society of Mycobacteriology and Chief Editor of the International Journal of Mycobacteriology. He is also the Chief Editor of the Journal of Preventive, Diagnostic and Treatment Strategies in Medicine and the Biomedical and Biotechnology Research Journal.

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Chapter 1: Hospitalization, diagnosis, treatment, and surgery in Iran (Before Islam)

Abstract

The medical sciences has a long profile history which is date back to 4000 years ago. Iran has always been one of the important centers of various subjects especially pharmacy, cultivation of medicinal plants and medical knowledge. The historical literature highlight the word Pezeshk which means doctor; the same terminology even used in today era in Iran. Ancient Iran had three periods; Avesta era until the rise of the Sassanids, extinction of Sassanid Empire, Beginning of Islam to present era, which is referred as the golden age of Iranian. The first period start from pre-Avestan and Avesta (1500–1000 BCE) till the uprising of kingdoms of Medes that Inhibited mountainous region of northwestern Iran and the northeastern and eastern region of Mesopotamia located in the region of Hegmatan (Hamedan). The Medes have left no written source to reconstruct their history, which is known only from foreign sources such as the Assyrians, Babylonians, Armenians, and Greeks as well as a few Iranian archaeological sites which are believed to have been occupied by Medes. The documents relating to the Medes reported by Herodotus (484–425 BCE), have introduced the image of a powerful people, who would have formed an empire at the beginning 700–601 BCE, that lasted until the 550 BCE. Hippocrates 460–370 BCE, the father of Greek medicine, confessed in his writings that he had adapted some of his medical theoretical foundations from the Cina (cine) Moghani family in Hegmatan (Hamedan), the capital of the ancient Medo-Persian state. The global name of Medicine is taken from the first historical dynasty of Iran, maad or Medi in Greek. Basic medical sciences were shortly references in Avesta, some Pahlawi books and limited Greek sources. Although, Avestan texts cannot be dated accurately, nor can their language be located geographically. The earliest reference to the Avesta was found in Sasanian times in the inscriptions of Kirdēr (Kartēr). A Parsis merchant from Surat, hand over the first documentation of Avesta that named Vidēvdād sāda to the Bodleian Library in Oxford in the year 1723 CE; 1135 AH (18th century CE). After words, the west learned that Zoroaster's book was not lost. It had only to be collected and interpreted, which could be done only with the cooperation of the Parsi priesthood. Based on the available signs and writings, Iranian were familiar with the art of medicine; knew the properties of healing plants; they performed surgeries called medical knives and were aware of the effect of prayers on improving patients' well-being. The significance of ancient medical beliefs among Zoroastrians was mainly focused on personal hygiene, public health and prevention of contagious diseases. One of most important public duty was to keep the environment clean by especially taking care of the four elements, that is, water, fire, soil, and wind. They knew treatment and were even familiar with measures such as quarantine. In this chapter, the medicine in the Zend-Avestan tradition will be discussed.

Keywords

Borzouyeh; Gondēshāpūr University; Medical life sciences; Persia; Zoroastrians

Description

The medical Sciences during Zoroastrians.

SubChapter 1.1

Zend-Avesta medical administration; medicine by the knife (surgery), medicine by herbs, and medicine by divine words

Designation, as Zend means a commentary or explanation, and was applied only to explanatory texts, to the translations of the Avesta. Avesta (from the Old Persian âbastâ the law) is the proper name of the original texts (Boyce, 1984; Darmesteter & Mills, 1880a; Kellens & Cantera, 1987). The expression Avesta and Zend is often used in the Pahlavi commentary to designate the law with its traditional and revealed explanation. The Zend-Avesta is divided into two parts (Darmesteter, 2019; Darmesteter & Mills, 1880a; Rose, 1867). The first part, or the Avesta properly so-called, contains the Vendîdâd, the Vispêrad, and the Yasna. The Vendîdâd is a compilation of religious laws and of mythical tales which contains 22 Fargard. The second part, generally known as the Khorda Avesta or Small Avesta, is composed of short prayers which are recited not only by the priests, but by all the faithful, at certain moments of the day, month, or year (Darmesteter, 2019; Darmesteter and Mills, 1880b, 1887; James Darmesteter et al., 2018). The Fargard 20 is explain about "Thrita and the origin of medicine According to the Fargard 20 Thrita was the first who drove back death and disease, as Ahura Mazda had brought to him down from heaven 10000 healing plants that had been growing up around the tree of eternal life, the white Hôm or Gaokerena Thrita was originally the same as Thraêtaona or locally was called as Fereydun, the notable physician in that period. On the one hand, we see that in the Rig-veda, the great feat of Thraêtaona is ascribed to Trita as well as to Traitâna, and Trita Âptya, the son of the waters, was as well the celestial priest who pours Haoma into rain as the celestial hero who kills the snake in storms (Darmesteter and Mills, 1880b, 1887; Darmesteter, 2019; James Darmesteter et al., 2018). On the other hand, we see that Thraêtaona fulfilled the same functions as Thrita: according to Hamza, he was the inventor of medicine; the Tavids against sickness are inscribed with his name, and we find in the Avesta itself the Fravashi of Thraêtaona invoked against itch, hot fever, humourism, cold fever, vâvareshi against the plagues created by the serpent (Darmesteter and Mills, 1880b, 1887; Darmesteter, 2019; James Darmesteter et al., 2018)." We understand from this documents that disease was known as coming from the serpent; in other words, that it was considered a sort of poisoning. In various parts of Avesta, a significant number of disease names have been seen. For example: tafnu, sārama, and tanuš vīitareto paēso which means fever, diseases related to the head and leprosy, respectively, which refers to the familiarity of the ancient Iranians with these diseases and their treatment. Inquiries into the ancient medical Persia began long ago, the collected sources showed that oldest written knowledge on Iranian medicine are Avesta, Denkart, and Bundahishn (Britannica, 2011; Khaleghi-Motlagh, 1999).

The significance of ancient medical beliefs among Iranian was that they mainly divided doctors into five groups with different duties. They were known based on their treatment to people as following:

General doctor (ašō–baēšaza)

ašō doctor was supposed to be purity and truth characteristic (Oshidari, 2000; Farid, 2011). He have to consider the purity of body and environment, and for this reasons purity within ašō doctors soul and mind was mandatory (Oshidari, 2000; Farid, 2011). A doctor must have both purity (body and mind) to be able to treat others (Farid, 2011). ašō-Doctor could order and/or recommend keeping the living environment and the city clean and tidy, and take care of health matters. Like today Health and Welfare Organization, which is still teaching health and environmental care in the villages, cities and nursing (such as vaccinations, educational, first aid, etc.). They were keeping patients away from gathering and had permission to quarantining patients with dangerous diseases (Purdavud, 2002). Based on Old Iranian culture, there was four holy materials that named Akhshij that is, water, wind, earth, fire. The ašō-Doctor had responsibility to clear them from filth and uncleanness (Herodotus, 1965). Even cleaning the environment of dormitory was looked up by ašō-Doctor (Herodotus, 1965). Therefore, all the Iranian family had obligation to follow these rules and regulation. In this respect, old-Iranians learned to never contaminate the four Akhshij with impurities, so they did not wash themselves and avoided washing contaminated objects in running water. A great sin was spitting or urinating in water (Farid, 2011; Herodotus, 1965). Fire contamination with smoky and foul-smelling fuels was also prohibited. They always kept the place of the fire clean and did not contaminate the soil, earth with dirt and filth (Purdavud, 2002). They used to clean their house with frankincense and Pecan fragrant that could kill both insects and germs. These traditions and customs are still common among today-Iranians (Fig. 1.1.1).

Doctor of forensic medicine (dātō baēšaza)

The duties of these doctors were mostly worked on postmortem autopsy to diagnose the disease and find the treatment for the future causes (Oshidari, 2000). They were in charge of the deceased and issuing a permission for their burial. If the dead needed an autopsy, they performed it (Dostkhah, 1990). Also, the mummification of the dead was done by such doctors, which was more common in ancient Egypt (Farid, 2011) that was at time a part of Iranian empires (Fig. 1.1.2).

Figure 1.1.1  (A) Boswellia sacra (frankincense). (B) Peganum harmala (pecan) Esfand, seeds.

Figure 1.1.2  The Achaemenid empire, or Achaemenid Persian empire (550–330 BCE).

Doctor of knife (Karōt∂ baēšaza)

As the name suggests, the doctors used knife or surgery to treat the patients (Oshidari, 2000; Farid, 2011). In Vendîdâd Fargard VII, paragraph 39, it is stated about medical knives:" these doctors were to passed several test and examination, to be eligible to become a doctor of knives (Dostkhah, 1990; Farid, 2011). They had to study tools and equipment, and if the medicine and the plant did not produce results for the disease of joints and bones, the amputation was performed. In those times, for anesthesia induction, bang, which is an intoxicating substance and they extracted from cannabis were mixed with some kind of wine and were given to patients before operation (Purdavud, 2002).

Doctor of herbals (Urvarō baēšaza)

The history of plant medicine is associated with the beginning of agriculture and plant breeding in Iran. Herbal medicine is still popular in Iran and other parts of the world after thousands of years and is one of the most effective treatments (Oshidari, 2000; Farid, 2011). In ancient times, herbal medicine used in many countries like Iran, India, China, Mesopotamia, Egypt, etc., where it is still common in those countries, especially Pakistan and India (Dostkhah, 1990; Farid, 2011).

Regarding herbal medicine in Vendîdâd Fargard 20, paragraph four and seven states: "We praise and love all medicinal plants. to treat fever, chills, burns, smallpox, plague, headaches, burning; to fight the disease; To combat word disease; To deal with snake bites; To fight Duke disease; To deal with the disease of sari and to deal with the bad opinion, filth and filth that Ahrman (Evi–sprit) brought to the people" (Farid, 2011). The ancient method of treatment with herbs has been eating and rubbing (Farid, 2011).

Doctor of mantra (Mąθrō baēšaza)

The mantra means to calm and healed the person with using a pure and holy words (Dostkhah, 1990; Oshidari, 2000). In the Avestan tradition, the treatment of the best physicians (equivalent to the Avestan text: baēšazanąm baēšazyōt∂ma) is doctor of mantra Vendîdâd Fargard 20, paragraph 7–10 (Darmesteter and Mills, 1880b, 1887; Darmesteter, 2019; James Darmesteter et al., 2018). When the human psyche is disturbed, the doctor of mantra using the hopeful speech from Gatha Avesta poetry, or they ask the patients to listen to relaxation music (Farid, 2011). Doctor of mantra was more trusted and honored physicians by Iranians. Mentally ill people with fainting and weakness of the nerves are usually get treatment with whisper and hopeful sentences that soothe and heal their