The Circle of Ancient Iranian Studies
.IRANIAN MEDICAL SCIENCE
By: Sâdeq Sadjâdi
(Pers. dârû, Pers-Ar. dawâ, pl. adwîa) Information on drugs in the pre-Islamic period is very scarce and, apart from clues in sources from after the Islamic conquest, limited to a few mentions in the Avesta (q.v.) and other ancient texts. They indicate that ancient Iranians were aware of the therapeutic properties of various substances and made deliberate use of them. In a travel narrative sometimes ascribed to Pythagoras (Pseudo Pythagoras, tr., p. 54) unspecified herbal drugs are mentioned, including a sleeping draft said to have been used by Zoroaster. Herbal treatment is also mentioned in the Avesta (Yt. 3.3), where frequent reference is made to the plant haoma (Mid. Pers. hôm, identified by Flattery and Schwartz as harmal), which "gives good cures," "keeps death away," and "implants strength" (Y. 9-11, 20; Yt. 10.23). Mazdeans believed that Ohrmazd had created at least one herb to cure each disease (Christensen, Iran Sass., p. 419). The most cogent evidence for ancient Iranian interest in pharmacy is the Iranian origin of many drug names in medieval medical and pharmacological treatises (Browne, p. 22). The first writers in the Persian empire to discuss drugs and their properties were mainly physicians from the college at Gondêšâpûr in Khûzestân or their pupils; their works were the sources on which later writers relied (cf. al-Khûz, a source for Bîrûnî, 1992, pp. 530, 611; and Râzî, 1955-71, XXI, pp. 45, 70, which seems a reference to the physicians at Gondêšâpûr; Konnâš al-khûz, mentioned by Bîrûnî, 1888, p. 205, seems to be the title of a book on pharmacology composed there).
The Post Sasanian until the rise of the Buyids
The medical college at Gondêšâpûr remained active under the Omayyads, but very little is known about the work of Persian physicians and pharmacologists there. In keeping with the ancient theory of humors, drugs were classified as cold, hot, moist, or dry (e.g., Tabarî, p. 400). The essential function of a drug, according to this theory, is to help the body keep or recover a stable balance among the humors and temperaments. Contrary to the modern medical assumption that patients normally react to a drug in the same way, medieval physicians thought that reactions varied with the temperament of the patient, as well as the nature of the drug. Drugs were classified as "simple" (mofrad, ´aqqâr, pl. ´aqâqîr) and "compound" (morakkab, qarâbâdhîn, aqrâbâdhîn < Gk. graphidion, lit., "small treatise"). Compounds were designed to achieve a balance among the component simple drugs (see, e.g., Ebn Sînâ, II, p. 222).
One of the first known Persian pharmacologists was Mâsarjûya (Pers. Mâsargôya), a prominent Jewish physician from Basra who lived in the early ´Abbasid period and was said to have written books about drugs, including Qowâ al-´aqâqîr wa manâfe´ehâ wa mazârrehâ (Ebn al-QeftÂî, pp. 324-25); his treatise on substitute drugs still survives. It was, however, the arrival of Jorjîs b. Bokhtîšû´ (see BOKhTIÚŠUÚ´) from Gondêšâpûr at the court of the caliph al-Mansûr (136-58/754-75) that marked the beginning of the transmission of Persian pharmacological knowledge in the ´Abbasid capital, whence it was diffused throughout the Muslim world. Jorjîs himself was said to have written al-Konnâš, a collection of essays on medical and pharmacological subjects. His pupil at Gondêšâpûr ´Isâ b. Sahârbokht (Chahârbokht) Jondîsâbûrî wrote Qowâ al-adwîa al-mofrada (Ebn al-Nadîm, p. 356; cf. Sezgin, GAS III, p. 243) on simple drugs. Another noted contemporary was Mâsûya, who practiced pharmacology at Gondêšâpûr for forty years (Ebn al-QeftÂî, pp. 383-84; cf. Sezgin, GAS III, p. 229). His son Yûhannâ (d. 243/857) wrote essays on the subject, including al-Adwîa al-moshela and Eslâh al-adwîa al-moshela on aperient drugs, which were cited several times by Râzî (1955-71, XV, p. 234, VI, p. 109, XX, pp. 105, 133, XXI, p. 653; cf. Sezgin, GAS III, pp. 231-36). From remarks by Ebn Abî Osaybe´a (I, p. 157) about the experiences of pharmacists in the camp of Afšîn during the war against Bâbak the Khorramî (qq.v.) in the early 9th century, it appears that early pharmacists constituted a professional or occupational class, including untrained quacks.
One of the most widely used pharmacological books written in the 9th century was a treatise on compound drugs, Aqrâbâdhîn, by Sâbûr (Šâpûr) b. Sahl Jondîsâbûrî (d. 355/869; Ebn al-Nadîm, p. 355); it included formulas for pills, ointments, poultices, and other drugs (Bâbâ, 1976, p. 579). At about the same time Bokhtîšû´ b. Jebrâ`îl (d. 256/870) wrote Nasâ`eh al-rohbân fi'l-adwîa al-morakkaba, of which a manuscript survives in the Taymûrîya library in the Dâr al-kotob, Cairo (Sezgin, GAS III, p. 243; Sâmarrâ`î, I, p. 391; cf. Ebn al-QeftÂî, p. 103).
The outstanding physician of the ´Abbasid period was, however, Honayn b. Eshâq (192-260/816-73), who wrote and translated many works, including a book about drugs, Ekhtîâr al-adwîa al-mojarraba, and another about antidotes, al-Teryâq (Ebn al-Nadîm, p. 353; Ebn al-QeftÂî, pp. 173-74). One of his translations, al-Adwîa al-mofrada, was a pharma-copoeia attributed to Galen, and the seventh discourse (pp. 147-58) of his ´Ašar maqâlât is about simple drugs in general. Honayn followed the old classification of drugs according to humors and further subdivided them by the degree of change induced in the human organism (pp. 152-53). He also revised EstÂefân b. Basîl's Arabic translation of a portion of the Greek De Materia Medica by Dioscorides (Dîosqoredîs) under the title Hayûlâ'l-tÂebb fi'l-hašâ`eš wa'l-somûm. This work had a strong influence on pharmacology in Honayn's lifetime and subsequently (Sezgin, GAS III, p. 59), but its importance was more theoretical than practical because many of the cited drugs were unobtainable in the eastern part of the caliphate and could not be tested or prescribed; local pharmacists relied on Persian and Indian drugs instead (Bâbâ, 1977, pp. 188-89).
The medical treatise Ferdaws al-hekma by the Persian physician ´Alî b. Rabban Tabarî (d. ca. 250/864) also deserves mention. It includes chapters on simple and compound drugs; uses of drugs made from the bodies of animals (pp. 420-23); oils, juices, seeds (pp. 374-99), and antidotes (p. 449-66); and various antitoxic and anticholeric pills and remedies (pp. 467-72). Tabarî wrote another treatise, on the medical uses of different foods, drinks, and simple drugs, Manâfe´ al-atÂ´ema wa'l-ašreba wa'l-´aqâqîr (Ebn al-Nadîm, p. 354; for a different title, see Sezgin, III, p. 240), an abridged version of which, by Mûsâ Motatabbeb Yamânî (ca. 1250/1834), survives in a private library at Aleppo (Sezgin, GAS, pp. 236-40; Sâmarrâ`î, I, p. 471).
Pharmacology was often linked in the early sources with the study of botany, alchemy, mineralogy, and even zoology. In fact, these studies were often motivated by the desire for pharmacological knowledge (Seddîqî, p. 448; Nasr, p. 459), and any general medical treatise usually included a chapter on simple and compound drugs. Abû Bakr Mohammad b. Zakarîyâ` Râzî (d. early 10th century) devoted three volumes of his great medical encyclopaedia al-Hâwî fi'l-tÂebb to pharmacology. His precise and highly technical studies of drugs and compounding were positively influenced by his knowledge of alchemy. The various drugs are discussed in alphabetical order; for each entry the theories of earlier pharmacologists are given first, then varieties and properties. Sometimes the Greek or Syriac name is also given. Râzî's main achievement in this field, however, was to bring the practice of pharmacy under scientific scrutiny. In a preliminary essay he pointed out that pharmacology is not a branch of medicine but a tool in its service; the best physicians were also qualified pharmacists, and one who knew only about the characteristics of drugs was not a physician (1955-71, XXII, pp. 2, 4; idem, 1977, pp. 2, 3, 13; cf. Elgood, 1951, p. 272). He also emphasized the importance of freshly gathered herbs and mentioned the sources of supply for many. He even noted the volumes and weights to be used in mixing drugs and measuring doses and provided tables highlighting different names (1955-71, XXII, pp. 2-66). Râzî wrote several other books on pharmacology, including al-Aqarâbâdhîn al-kabîr, al-Qarâbâdhîn al-saghîr, al-Adwîa al-mawjûda be-koll makân, and Abdâl al-adwîa (Ebn al-QeftÂî, p. 274; Sezgin, GAS III, pp. 274-94).
The Samanids and Buyids
In Samanid Bukhara Abû Bakr Akhawaynî (q.v.) wrote a medical textbook, Hedâyat al-mota´allemîn. Although it is not primarily concerned with pharmacology, it includes descriptions of about 3,000 simple and compound drugs, many with Persian names, in connection with relevant diseases. The author apparently intended to write a separate book on drugs (p. viii). Akhawaynî claimed to have personally tested most of the drugs mentioned in his book (pp. 407, 455, 589) and did not hesitate to criticize earlier physicians for misusing them (pp. 457, 560, 580). He also classified them as foods, drugs, medicinal foods, and poisons (p. 3). Whenever possible, he gave the Persian, Arabic, Syriac, and Greek names of each drug. From the same period is preserved the oldest surviving pharmacological work in Persian, Ketâb al-abnîa, by Abû MansÂûr Mowaffaq Heravî (q.v.), in which 584 drugs are described (Meyerhof, pp. xvi-xvii). Ahmad b. Abi'l Aš´ath (d. 360/970), a Persian physician living in Mosul and author of many medical books, wrote a manual of simple drugs, Ketâb al-adwîa al-mofrada, and a book on compound drugs, Tarkîb al-adwîa (Ebn Abî Osaybe´a, I, pp. 246-47; Sezgin, GAS III, pp. 301-02).
The great Avicenna (q.v.; Ebn Sînâ) completed his major work, al-Qânûn fi'l-tÂebb, in the early 11th century. Books 2 and 5 are devoted to simple and compound drugs respectively. Avicenna, who had personally prepared and tested many drugs, recommended balanced remedies blending the four basic humors (II, p. 224); the properties of such remedies could be ascertained by experimentation and inference (II, p. 223 ff.). Whenever a simple drug failed to cure a given sickness, proved harmful to another part of the body, or was found to be excessively hot, cold, dry, or moist, it was to be mixed with other simple drugs in order to strengthen its curative properties, counteract its harmful effects, and balance the nature of the drug (III, p. 309 ff.). Avicenna provided the earliest descriptions of a number of remedies, including opium (al-teryâq al-kabîr) for stomach and liver disorders (III, p. 321). According to Ebn al-QeftÂî (p. 418), he also wrote a monograph on cardiac drugs, al-Adwîa al-qalbîya.
The Ghaznavids and Saljuqs
The outstanding pharmacological work of the later 11th century is Ketâb al-saydana (comp. 442/1050) by Abû Rayhân Bîrûnî (q.v.). It begins with definitions of the terms "pharmacy" (saydana) and "simple drug," a substance intermediate between a food and a poison that can neutralize either; like his predecessors Bîrûnî emphasized that drugs can be evaluated only by expert physicians (pp. 9-10). He distiguished two kinds of substitute for scarce or unobtainable drugs: an inferior variety or a different drug (pp. 12-13) with similar curative properties. He also observed that a given drug may have different effects, depending on whether it is administered as a potion, a poultice, or an ointment (p. 13). He then described individual drugs in alphabetical order, with Arabic, Persian, Greek, Indian, and Syriac names as appropriate. One of his sources was probably the Syriac Poššâq šmâhê (Explanation of the names), which some Christians had permitted him to see; it was also known as Ch (Four names) because it included the Persian, Syriac, Greek, and Arabic names of drugs (Bîrûnî, Saydana, pp. 16-17; cf. Ebn Abî Osaybe´a, I, p. 318; Ullmann, pp. 335-36). In the medieval Persian translation of the Saydana 819 drugs are mentioned; the chapter on properties of drugs, including only 799 entries, is a later addition (1992, p. xxvii).
The leading author in the 12th century was Sayyed Esmâ´îl Jorjânî (d. ca. 531/1136), who devoted book 10 of his lengthy medical encyclopedia Dhakhîra-ye khúârazmšâhî to pharmacology (pp. 651-745). In the first discourse he described drugs in thirty-eight categories according to their effects on various ailments. The second discourse begins with a discussion of experimentation and analogy as methods for determining the curative properties of drugs (p. 686). His view of circumstances calling for compound drugs was broadly similar to those of Avicenna and Bîrûnî. Book 9 comprises four discourses on poisons, antidotes, and harmful herbal, mineral, and animal drugs (pp. 626-51). At the end of the Saljuq period Najîb-al-Dîn Mohammad b. ´Alî Samarqandî (d. 619/1222) wrote the lengthy treatise Qarâbâdhîn on compound drugs, classified by the diseases they helped relieve, and a work on simple drugs, both preserved in manuscript (al-Dharî´a XVII, p. 60).
The Ilkhanids and Timurids
The Tansûkh-nâma-ye îl-khânî, a treatise on precious stones and rare minerals ascribed to Nasîr-al-Dîn Tûsî, includes discussion of medical uses, for example, powdered pearls for certain eye diseases, headaches, and bleeding in the throat (p. 105) and lapis lazuli for bilious dysentery and melancholia (pp. 116-17). Similarly ´Abd-Allâh Kâšânî, in his book on precious stones and perfumes, mentioned medical properties attributed to such substances as diamonds, rubies, mercury, and camphor (q.v.; pp. 36, 82, 212, 262), which are known to have actually been used as remedies for several diseases in later centuries (see, e.g., Chardin, V, p. 187). Zakarîyâ` Qazvînî (d. 682/1283) attributed medical properties to the hair, skull, blood, and other parts of the human body, as well as to parts of the bodies of asses, camels, giraffes, hares, and so on (pp. 253-55, 264-340).
Large hospitals (see BÎMÂRESTÂN) had specialized pharmacists and pharmaceutical laboratories (š, bayt al-adwîa, dârû-khâna) headed by officials called mehtar-e šarâb-khâna or khâzen (Rašîd-al-Dîn, 1977, pp. 42, 146, 148; Qalqašandî, III, p. 472, X, p. 4, V, pp. 469-70). The Il-khanid vizier Rašîd-al-DÚîn Fazl-Allâh founded a hospital and dispensary in the Rab´-e Rašîdî at Tabrîz, where drugs were dispensed to patients every Monday and Thursday. They had to be prescribed by a physician and were administered under his direct supervision or in the presence of the pharmacist (š) and the manager of the pharmacy (khâzen; 1977, pp. 146-47). Rašîd-al-Dîn ordered that drugs be obtained from every city and declared that one of his reasons for traveling to India was to arrange for medical supplies (1945, pp. 16, 53-54).
On the other hand, concoction and sale of drugs by unqualified pharmacists and itinerant vendors became so widespread that in every city special regulations were adopted; they were enforced by the mohtaseb (market supervisor), who was empowered to enter the premises of any apothecary, even at night, without the owner's permission, in order to inspect substances and equipment and to ensure conformity with the official formulary, in principle that of Ebn Abi'l-Bayyân (d. 640/1242) or that of Ebn al-Telmîdh (d. 560/1165); the latter survives in manuscript but has not been published. Druggists were forbidden, for example, to dilute simple drugs like essence of violets with such substances as lemon juice. Violations were punishable under Islamic law (Ebn al-Okhûwwa, pp. 115-25).
The great influence of Jâme´ al-mofradât by Ebn al-Baytâr (d. 646/1248), a work on pharmacology, throughout the Muslim world can be seen in Nasîr-al-Dîn Jovaynî's Mâ lâ yasa´o'l-tabîba jahloho (comp. mid-14th century), in two parts on simple and compound drugs respectively. Jovaynî claimed (fol. 4a) that his book replicates Jâme´ al-mofradât but is an independent work, insofar as Persian names of many drugs are given; he attempted to find Persian equivalents for many Syriac, Greek, Indian, and Arabic drug names. Some of these drugs cannot yet be identified, for example arand sorand, a bulb (fol. 12a); oštorghân, called tâkhak in Tabarestân (fol. 13a); khoškanjabîn (fol. 83b); bâdâmak; and bârzad (fol. 31b). In one respect his book is superior to that of Ebn al-Baytâr: More attention is given to appraising the properties of drugs and specifying quantities to be used in compounds. Jovaynî also noted undesirable side effects of certain drugs and discussed appropriate countermeasures (fols. 3b-4a).
Among authors of the Timurid period the most distinguished were Najîb-al-Dîn Samarqandî, whose works survive in manuscript (e.g., Osûl-e tarkîb-e adwîa and Tarkîb al-adwîa al-qalbîya, Ketâb-khâna ye Majles-e Senâ, Tehran, ms. nos. 536-37) and Borhân-al-Dîn Nafîs.
The Safavids, Afsharids, and Zands
In the 16th-18th centuries few physicians and pharmacists presented new ideas or original research. ´Alî Afzal QâtÂe´, apparently a hospital administrator at Qazvîn in the Safavid period (ca. 1051/1641), characterized his Manâfe´-e afzalîya as a selection of excerpts from the works of earlier authorities (fol. 1b); after classifying diseases and drugs according to the four humors (fols. 8a-20b), he discussed aperients, sedatives, and drugs for stomach and liver disorders (fols. 20b-finis). Many pharmacological books of the Safavid period include the word qarâbâdhîn in the title, for example, Qarâbâdhîn-e Šefâ`î by Mozaffar b. Mohammad Hosaynî Šefâ`î (d. 963/1556), a work preserved in numerous manuscripts (al-Dharî´a XVII, p. 61; Monzawî, Noskhahâ I, p. 580), the main source for the Pharmacopoeia Persica of Father Angelus, published in France in 1681 (Elgood, 1970, p. 34). A large number of medical and pharmacological treatises were written in India in the Persian language, often with Sanskrit or Urdu, as well as Persian, drug names, for example, Ekhtîârât-e qotÂbšâhî (on simple and compound drugs; ca. 972/1563) by Mîr Majd-al-Dîn Mohammad Hosaynî Kâšânî, Ganj-e bâdâvard (1035/1624) by Amân-Allâh Khan b. Mahâbat Khan, Alfâz al-adwîa (1038/1627) by Nûr-al-Dîn ´Abd-Allâh Šîrâzî, Qarâbâdhîn by Mohammad-Hâšem ´Alawî Khan (d. 1162/1749), Qarâbâdhîn-e jalâlî by Jalâl al-Dîn Amrûdahî, and Majmû´a-ye Hakîm-al-Molk by Hakîm-al-Molk Gîlânî (WâsetÂî, pp. 51, 91, 115-16; Šahmardân, p. 684).
In contrast to the practice in earlier periods, in the 17th century it was customary for apothecaries (´atÂtâr) to examine sick customers in their shops and to prescribe drugs (Elgood, 1970, p. 31). Sometimes (Chardin, V, p. 176) a physician and a druggist might consult on the diagnosis and prescription. The English traveler Thomas Herbert (in Persia 1627-28) praised Persian physicians and remarked on their preference for vegetable, rather than mineral, drugs (Elgood, 1951, pp. 406-07), but his countryman John Fryer (in Persia 1676-78) criticized their ignorance of the medicinal properties of juices and extracts from plants and roots; nevertheless, Fryer found the apothecary shops unequaled in the world for the variety of drugs and medicinal herbs on offer (Elgood, 1951, pp. 392-406). Jean Chardin noted that physicians kept collections of medicinal herbs for use in training apprentices (V, p. 175). Among the drugs then in common use in Persia were š and gazangabîn (two kinds of manna), morr-e makkî (Meccan myrrh), folûs (cassia), senâ (senna), rîvand (rhubarb), š (licorice), nošâder (sal ammoniac), saqmûnîâ (scammony), and chûb-e chînî (China root; Chardin, V, pp. 187-88).
The most eminent physician of Safavid Persia was Hosayn Nûrbakhš, who drew on both experience and precedent in his medical treatise Kholâsat al-tajâreb (957/1550), several chapters of which were devoted to pharmacology and the pharmacopoeia. In chapter 26 he defined poisons and antidotes, distinguishing toxic substances from drugs with harmful side effects, then named and described various poisons (fols. 308b-10a); vegetable antidotes included jadvâr or mâhparvîn (zedoary), zarâvand (birthwort), zoronbâd (broad-leaved ginger), and mûrd (true myrtle), and among mineral and animal antidotes he mentioned Armenian bole, black and white naphtha, and rhinoceros horn (fols. 320a-25b). In chapter 27 he described compound drugs of his own invention, including habb al-šefâ (cure pills), hâfez al-sehha (health preserver), teryâq-e jadîd (new theriaca), and teryâq al-tÂîn-e jadîd (new mud theriaca; fols. 335a-34b), several aperients, and such potions as chahâr-šarbat (four syrups, fol. 337b) and pâlûda-ye tÂebbî (medicinal pâlûda, a sort of jelly, fol. 338a-b). Chapter 28 is about technical terms and weights and measures used in compound drugs (fols. 340b-41a).
The most widely used pharmacological manual in the Safavid period was Tohfat al-mo`menîn by Mohammad-Zamân Tonakâbon, personal physician to Shah Esmâ´îl I (907-30/1501-24), and his son Mohammad-Mo`men. It consists of two parts, the first with names and descriptions of drugs, the second explaining preparations. The authors noted the regions and seasons in which the plants grow (pp. 6-9) and their corresponding effectiveness. There is also a chapter on poisons and treatment of poisoning (pp. 883 ff.).
No information about pharmacology survives from the Afsharid period, apart from some references by personal physicians of Nâder Shah (1148-60/1736-47) to drugs that they themselves prepared (Bazin, tr., pp. 31-32). A report by Antony Forbes in 1726 shows that drugs in use at the hospital of the English East India Company (q.v.) at Gombroon (Bandar-e ´Abbâs, q.v.) included pills, pastes, salts, juices, seeds, and roots, all apparently imported from India (Elgood, 1951, p. 409).
An important pharmacopoeia, Makhzen al-adwîa, was compiled in the reign of Karîm Khan Zand (1163-93/1750-79) by Mohammad-Hosayn ´Aqîlî Khorâsânî. The author drew his material from pre-Safavid works, listing simple and compound drugs in respective sections, each organized alphabetically. In ´Aqîlî's opinion the effects of drugs depended on their properties and generic types (p. 4). On the assumptions that every drug is a substance from one of the three "kingdoms" (mineral, vegetable, animal) or a compound of such substances and that, as the ancients believed, these kingdoms are subject to influences from the seven planets, he argued that the medical properties of drugs depend on the "temperaments" of the planets. He therefore included in his book several diagrams of these influences and linkages (pp. 59, 66-79). As a consequence of these relations, drugs of demonstrated medicinal value in one region would not necessarily be as effective in others (p. 23). ´Aqîlî also discussed in detail how long drugs remain usable and proper storage (pp. 36-37).
(For cited references not found in this bibliography and for abbreviations found here, see "Short References.")
Copyright © 1998-2015 The Circle of Ancient Iranian Studies (CAIS)