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History of Ancient Medicine in Mesopotamia & Iran
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Last Updated: October, 2009
Partition

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At one point Darius orders a representative to return to Egypt in order to restore the department of the ruined house of life dealing with medicine: " While his majesty was in Elam he ordered me (Udjahorresne) to return to Egypt. I gave them every useful thing and all their instruments indicated by the writings, as they had been before. His majesty did this because he knew the virtue of this art to make every sick man recover". The subsequent Seleucid and Parthian dynasties followed the same trends with more Greek influence in science and art due to massive presence of Greeks in the area. However, the flourishing of the science and technology happened in the Sasanian period with major centers of learning and the famous university Jundaishapur.

The Sasanian king Khosrow Anoshirvan is mentioned by many historians and biographers to have been a major promoter of all sciences, including philosophy and medicine. In a Pahlavi text (Karnamag) he is quoted as saying the following:

"We have made inquiries about the rules of the inhabitants of the Roman Empire and the Indian states. We have never rejected anybody because of their different religion or origin. We have not jealously kept away from them what we affirm. And at the same time we have not disdained to learn what they stand for. For it is a fact that to have knowledge of the truth and of sciences and to study them is the highest thing with which a king can adorn himself. And the most disgraceful thing for kings is to disdain learning and be ashamed of exploring the sciences. He who does not learn is not wise".

Greek Philosophers, Syriac speaking Christians and Nestorian Christians fleeing persecution by the Byzantine rulers were received by Anoshirvan and were commissioned to translate Greek and Syriac texts into Pahlavi. Paul the Persian dedicated Works of logic to the king. The Greek philosopher Priscianus Lydus wrote a book in response to the king’s questions on a number of subjects in Aristotelian physics, theory of the soul, meteorology and biology. The Sasanian religious text Dinkard shows familiarity with all these topics, especially Aristotelian physics. It is apparent from the text that Aristotle’s famous article ‘On Coming to be and Passing away’ was well known by the compilers of Dinkard. Becoming, decay and transformation the three fundamental concepts in the article are mentioned and discussed. Pahlavi texts also indicate that the doctors were paid according to the rank of the patient. Books in medicine, astronomy, Almagest (by Ptolemy), Aristotle’s Organon and a number of texts in crafts and skills were translated from Greek. Syrian Christians in particular played a significant part in communicating Greek sciences and knowledge to the Persians.

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The famous university and the hospital at Jundaishapur built earlier reached its peak at Anshirvan’s time. The Muslim historian Qifiti (12/13th century AD) in his book ‘History of Learned Men’ quotes the following; "In the twentieth year of the reign of Khosrow II (Anoshirvan) the physicians of Jundaishapur assembled for a scientific symposium by order of the king. Their debates were recorded. This memorable session took place under the presidency of Jibril Durustabad, the physician in ordinary to Khosrow, in the presence of Sufista’i and his colleagues, together with Yuhanna and a large number of other medical men".

It is very likely that the medical teaching resembled those at Alexandria with some influence from Antioch. The Jundaishapur hospital and the medical center were to become the model upon which all future Islamic Medical Schools and hospitals were to be built. Earlier Muslim historians such as Maqdisi (10th century) mention the medical school in Khuzistan and name its famous associates and practitioners. The famous writer and translator Burzoy, who translated the Indian book of fables the Panchatantra (later, Kalila wa-Dimna) for Anoshirvan, was also a well-known physician from Nishapur. The first recorded Muslim Physician Harith bin Kalada had studied at Jundaishapur Medical School.

In Jundaishapur Greek, Indian and Persian scientific traditions were assimilated. Indian scientific material in astronomy, astrology, mathematics and medicine were also translated into Pahlavi along with Chinese Herbal medicine and religion. The books were kept at the university and the royal libraries and Greek medicine based on works by Hippocrates and Galen dominated the discipline.

The later Muslim historians refer to the Sasanian Imperial library as the House of Knowledge (Bayt al Hikmat). The library functioned as both a place where accounts of Iranian history and literature were transcribed and preserved. At the same time it was a place where qualified hired translators, bookbinders and others worked to preserve, purchase, copy, illustrate, write and translate books. It was such texts that made their way into the Islamic period. Many books in sciences and philosophy were translated by the Persians, Greeks, and Syriac and Aramaic-speaking scholars into Arabic and eventually made their way into Muslim Spain and Western Europe. Persia and Byzantium dominated the area before Islam. The latter was a continuation of the Eastern Roman Empire and the seat of Greco-Roman art, culture and civilization. Alexandria and Constantinople were major centers of intellectual activities with theaters, libraries and universities. In addition to Major cities like Alexandria Constantinople and Jerusalem, intellectuals and scientists moved and carried ideas from Edessa in the west, through Nisbis and Mosul (Iraq) to Marv and Jundaishapur in Western Persia.

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The conquest of Islam in the 7th century united east and west, improved trade and boasted book publishing by introducing advanced paper making techniques from China. However, major cities and libraries were destroyed, Arabic eventually became the universal language of the empire, and forced conversions into Islam threatened national identities and local cultures. The Imperial library at Ctesiphon was lost; the whole city was totally destroyed and never rose again. The destruction of such major libraries with the rise of Arabic language made it clear to the scholars and intellectuals that all pre-Islamic knowledge and national identities were in danger of total destruction and that they must be preserved. Massive and heroic efforts were made and the result was the formation of a dynamic and significant translation movement for almost two hundred years until the 10th century. The movement started in Damascus in Umayyad times and flourished in Abbasid Baghdad (754 AD). All major surviving Greek, Syriac, Persian and Indian texts were translated into Arabic and Neo-Persian. Pre-Abbasid translations from Pahlavi included major religious, literary, scientific and historical texts.

Nawbakht the court astrologer and his son Abu Sahl and other colleagues Farazi and Tabari and many others sponsored by the Barmakid family (the chief ministers to the early Abbasids who were later murdered) promoted and translated Pahlavi texts into Arabic and Neo-Persian. They were all Iranians and aimed to incorporate Sasanian culture into Abbasid ideology and guarantee the continuity of the Iranian heritage. Christian and Jewish learned families of Sasanian Persia such as Bukhtishu and Hunyan families were also great translators of Syriac, Greek Pahlavi and other texts into Arabic. Both families had served at Jundaishapur University for generations and were instrumental in founding the Adudi Hospital and Medical School in Baghdad.

The Nestorian physician Jabrail Ibn Bakhtishu was the head of the Jundaishapur University when he was called to Baghdad in 148 AD as the court physician to Caliph al-Mansur. He was later charged with building the first hospital (Bimarestan or Maristan) in the city based on the Syro-Persian model already established at Jundaishapur. He went back to Iran, but many members of his family served the Abbasids for a long time.

Baghdad, a suburb of Ctesiphon was built in 762 by al-Mansur. The Royal library at Baghdad was based on the Sassanian model and was also called the house of knowledge (Bayt al-Hikmat) and like the Persian royal library became a center of learning and attracted scientists and intellectuals alike and many of it’s directors were either Iranian or of Iranian descent. Baghdad itself became hire to the Alexandrian and Persian scientific traditions and thought. The ‘Adudi’ hospital was built under the instructions of the great Iranian Physician Razi (Latin Rhazes—he was from Ray) and resembled the great hospital in Jundaishapur. It is said that in order to select the best site for the hospital he had pieces of meat hung in various quarters of the city and watched their putrefaction and chose the site where the putrefaction was the slowest and the least. At its inception, it had 24 physicians on staff including specialists categorized as physiologists, oculists, surgeons and bonesetters. Various historians have mentioned that the hospital was ‘like a great castle’ with water supply from the Tigris and all appurtenances of Royal Palaces.

Medicine remained dominated by the Greek tradition, the first to rid the science of supernatural powers and spirits. Around 450 BC, the Italian-born Greek natural philosopher and physician Alcmaeon began forwarding the new theory that disease was caused by a fundamental imbalance in the body between certain opposed qualities, such as heat and coldness (sardi/garmi), or wetness and dryness (tari/khoshki). This theory was picked up and elaborated by Hippocrates (460-377BC) who completely disregarded the presumption of the spiritual causes of disease. He proposed that health resulted from the equal influence of four bodily "humours" that was analogous to the four elements of Greek physics (earth, water, air and fire). Blood, phlegm, and two kinds of bile were associated with four major organs: heart, brain, liver and spleen – and with the four seasons and the four ages of man: childhood, youth, maturity and old age. Deviations from perfect balance among the four produced diseases. Therapies consisted of attempting to restrain the overactive mood while encouraging the others.

Five centuries later, the great Greek physician, Galen (130-200AD) concluded that blood was manufactured in the liver from material provided by the stomach. He also posited two other systems of essential fluid. One originated in the heart and was carried by the arteries. The other ‘anima’ (soul or the life principle) proceeded from the brain by way of the nerve tracts. Although none are correct, nevertheless Galen’s meticulous anatomical studies and logical method provided a point of departure for the development of modern medicine. Once this Greek heritage and knowledge was translated into Arabic it became universal and replaced most of the older traditions and schools. Greek, Persian, Arab and Indian scholars refined the assimilated ideas and by the 12th century advances were made toward understanding the organic cause of disease. Most of the physicians of the golden Age of Islam came from Iran, Egypt, Syria and Lebanon. The brilliant Iranian scientist Razi (845-925 AD) distilled alcohol and clearly distinguished smallpox from measles.

The celebrated Iranian physician and philosopher Avicenna (Ibn Sina, 965-1040) wrote 100 books on many subjects including his most famous compendium, Canon of Medicine. His magnum opus is one of the classics of medicine. He extensively studied herbal medicine from China, India and Persia. Avicenna, like his predecessor Farabi (another well-known Iranian), was an outspoken empiricist and insisted that all theories must be confirmed by experience. He argued against the blind acceptance of any authority and improved distillation techniques.

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