Iranian Journal of Medical Ethics and History of Medicine

Islamic culture has a bright and comprehensive history in human civilization. Based on Islamic teachings the spirit and body are in close relation with a mutual influence on humans’ health. The Holy Qur’an as well as the Prophet of Islam and his successors (peace be upon them) have paid deep attention to both spirit and body. Moreover, according to religious scholars’ decree (fatwa) cleanness and neatness has been mentioned as the main condition for worships to be accepted. The Prophet (PUH) said: “Neatness is half of the faith”. Therefore, efforts to keep the health of both spirit and body are important to Muslims.  Although, in ancient time, health and medicine were bined together, later they were divided into three sections including health, clinical diagnosis of disease and treatment. Based on Islamic teachings, Muslim scholars learned medicine and then began to translate some Greek, Seriani and Indian medical knowledge into to Arabic language, which has shaped the golden age of Islamic medicine spanning between the 8th and the 15th Centuries.
Among the Islamic countries Iran had a specific place in the field of medical sciences. Jondishapour was one of the most prominent medical educational centers back then. This article elaborates on the status of medicine based on historical evidence as well as Muslim physicians in the golden age of Islamic medicine.
 

Writing treatise on Islah al-Adwiat (Reducing the Side-Effects of Drugs) is one of the most important issues in Islamic medicine. During the first few centuries of Islamic civilization, four important treatises were written on this subject, which established the scientific tradition that formed the bases of the subsequent pharmacological formation. This paper addresses the tradition of writing books on reducing the side-effects of purgatives and it also critically edits and translates the books written by three prominent scholars – Hubaysh b. Atham of Damascus, Qusta b. Luqa of Balbak and Muhammad Zakaria Razi – relying on the surviving manuscripts. The research objective followed by this paper is examining and analyzing the purgatives as an important class in the pharmacological and medical books of the Islamic era.
Almost all books on medicine and pharmacology written in the old medical tradition have a section or a chapter devoted to the detailed introduction of purgatives and counteracting their side effects. Examining these bits, one may trace the main structure of the tradition, which continued for many centuries. Besides, comparing them may provide an appropriate perspective to look at the history of pharmacology. To this end, images of the material included in those books were obtained from libraries and museums, which have housed such books for almost a millennium. Then they were analyzed along with translating and editing.
It may be concluded that pharmacologists belonging to the old medical paradigm would use drugs to treat conditions of bad health caused by changes in the patient’s humors; the drugs, however, would cause some side-effects along with removing humors and residues, leading to a change in the main humor of the body. The pharmacologists; therefore, introduced the drugs, their harms, as well as the best type of the drug to be used and finally suggested some methods in detail to reduce their side effects

Gandhi Shapur was one of the largest medical centers in the late Sassanid and early Islamic schools in Baghdad. The doctors, who often had a field teaching at Gandhi Shapur, moved to the city during their transfer to Baghdad, and accordingly they gave a kind of scientific center to the capital of the new Islamic government. Among the doctors of this scientific center was the Bakhtiyad dynasty, which in this study we explored the role of this family in medicine. The study shows that Jundishapur University hosted a large number of Greek, Indian, Nestorian scholars and scholars working at the center, and the head of the Faculty of Medicine was led by the Bakhtiyad family. The desire of the Abbasid caliphs to boost the city of Baghdad such as the Sassanid Centers of Science and Technology, and their success in that area, were the factors that invited the scientists from Jindi Shapur and the caliphate support from them. The transfer of scientific activities of Ajar George Bin Bakhtih from Jindi Shapur to Baghdad was an introduction to the decline of the scientific star of this center and the influence of Iranian culture on Islam. Several factors such as the scientific need, attention and support of caliphs from scientists and conversion of the city of Baghdad to the center of the sciences were the causes for invitation of the Bakhtiyad family to Baghdad. In this study, we assess the activities of the Bakhtiyad family in  the government of Abbasid caliphs.
 

Reflecting on the Qara – Khitai of Kerman (from 619 to 704 A.H. / 1223 to 1305 A.D.), we can see that the rule of the dynasty, some women of Qara – Khitai, with expertise and competence into political, economic, scientific and cultural even reached into the kingdom of Kerman. Among these women the one that can be mentioned is -Qutlugh Terken (Terken Khatun), who was directly and indirectly involved in Kerman government for more than 40 years. So, the main question of this article is to assess measures of Qutlugh Terkan for promotion of Kerman's medical condition and further investigation of patients' rights. One of the findings of the present study was that Terken Khatun, build and equipped hospitals in Kerman with best facilities about eight hundred years ago, she also constructed an advanced school to train a new generation of intellectuals including physicians.

Waqf (donation) has a long history in human history and can have a high impact on economics, society, and culture. One of the most influential fields of the waqf is on human health. This study is a descriptive study. In this article, after reviewing the tradition of waqf and charity throughout history, and the experiences of charity in other countries, including the Pasteur Institute of Paris, the role of waqf in establishment and promotion of Pasteur Institute of Iran is reviewed and the benefactors of this institute are introduced. The headquarters of the Pasteur Institute of Iran in Tehran and its branches in Shemiran, Khalid Islambouli, Amol (north) and Hamadan (west) are donated by the charities for diagnosis, production of vaccines, and research in the field of contagious diseases’ control and prevention.  In Iran, most cases of waqf on health have been dedicated in the field of treatment, but Pasteur Institute of Iran is a successful example in the field of public health and specialized health services. One of the ways to expand waqf is to explain the effects of these endowments in society. Investigating the role and influence of Pasteur Institute of Iran in promoting public health can be a good explanation of the impact of these endowments in the field of health. It is suggested that Pasteur institute of Iran and its persistent effects be explained to the beneficent, so that some of the future endowments be extended to areas such as public health and diagnostic services.

The system of Iranian medicine in the Qajar era was the continuation of the system based on the humors view. Accordingly, the incidence of most diseases was attributed to whole view of the quadruple imbalance of blood, soda, bile, phlegm. Preventive and therapeutic approaches were also carried out in the same cognitive atmosphere. The example of Smallpox disease, indicates such a view in the Qajar era. According to the findings of this research, in Qajar medical literature, the bumps of pus in the skin of is described to be hard, single or non-separated with different colors and was called as Jodri or Smallpox. In terms of cognitive aspects, physicians of Qajar era following former physicians classified Smallpox disease in terms of humor among the hot and wet diseases and described boiling of blood in the body as the cause of this disease. Exposure to this disease was through the two pathways preventive and therapeutic measures. In order to prevent the disease, the necessary orders was recommended by the physicians by “sette zarurieh” and especially avoidance of several behaviuors. In terms of therapy, along with several types of diets, different kinds of medicines was used to relieve the symptoms and complications of the disease at different body parts. This study is a review, it has been attempted to examine the nature and purpose of the descriptive and analytical method and the therapeutic approach to treating Smallpox disease in medical system of Iranian Qajar era. Required information and data have been created in a desk research.

Adherence to professional ethics based on spiritual intelligence is conducive to patient welfare and satisfaction. The purpose of this study was to determine the relationship between professional ethics and spiritual intelligence of Kerman University of Medical Sciences' students. In this descriptive co relational study, 150 undergraduate medical students were enrolled in the census. The tools used were spiritual intelligence and professional ethics questionnaires. Data were analyzed by SPSS version 22 using independent t-test, one-way ANOVA, and Pearson correlation coefficient. The mean and standard deviation of professional ethics score was 57.72±6.2 and the spiritual intelligence of students was 73.97±12 12.3. The lowest score of professional ethics was in the area of ​​responsibility and the most in sympathy with others. There was also a significant positive relationship between professional ethics scores and students' spiritual intelligence (P = 0.001). This means that by educating and enhancing students 'spiritual intelligence during their studies, one can expect to increase students' professional ethics during clinical work and professional communication with the patient. To this end, teachers' emphasis on aspects of ethical applied education, especially during clinical education, as well as honoring spiritual patterns as the foundation of ethical education during college education seems necessary.

Ancient civilizations, proportionately to the extent and impact of their culture, used some methods in the field of personal sanitation to prevent infections and general diseases. Studying the indictors of personal sanitation, methods and the aims, in broad lands of Sasanians, would lead us to sanitary treatments of people in this empire. Considering the issue that personal sanitation in Sasanian period (651-224 A.D) was more influenced by the teachings of Zoroastrianism, the study of the Zoroastrian perspective is of the greatest importance in this regard. Personal sanitation in that period included washing with water, soil and gomiz, using special places for washing called Pādyāw, using napkins, using perfume and combing hair. There were also strict, detailed rules that made personal sanitation difficult and intolerable. Thus, some meges made efforts to change these rules. This paper aims to study indicators of personal sanitation and their applications for more than 400 years during Sasanian period with descriptive analytical method, on the base of literary evidence.

Smallpox was a dangerous disease that was considered one of the leading causes of mortality and disability in Iran up to Pahlavi II period. Therefore, combatting this disease was necessary. At the beginning of the second development plan (1955) and by founding Combatting Smallpox Service, the efforts for eradicating smallpox became more organized. This organization could overcome a lot of the different geographical and human obstacles and vaccinate a lot of the people every year. So, it could almost controlled smallpox up to the end of this period. In this paper, we investigated combatting smallpox from 1948 to 1967 and addressed its obstacles, approaches and achievements. Accordingly, we answered research questions  through content analysis and deductive reasoning. The major sources used were reports released by the state, particularly the reports of Planning Organization and Ministry of Health, as well as old medical magazines.

In the Qajar era, European countries deployed many doctors accompanied by their military, religious, and political groups to Iran consistent with their political goals and interests. Meanwhile, the role of France was more and more significant than the rest of European countries. This essay aims to introduce French physicians, to express the performance of French physicians in Iran during the Qajar period, to introduce the activities and extent of the influence of French physicians on the medicine of the Qajar period, and to examine the elements that advance the presence of French physicians in Iran during the Qajar era. This research was conducted using library resources and descriptive-analytical method. The findings indicate that the influence of French medicine on the developments of modern medicine in Iran was very significant, to the extent that the modern medicine was based on French physicians in Iran. Overall, the French effects on medicine in Iran can be found in two forms: establishment of the hospital and clinics and the formation of a health council. In addition, French physicians took important steps in the field of medical education such as ophthalmology, surgery, microbiology, vaccination, writing medical books, and quarantine to prevent communicable diseases. Therefore, French physicians, unlike other European countries, which only improved their health status, also evolved in the history of Iranian medicine. Finally it must be said the Qajar community was well-received by French medicine and physicians; Because both the Qajar court and the community were in need of medical care and the French government needed a comprehensive medical presence in Iran to achieve its political and economic goals.
 

Writing treatises and books on ethics and morality is one of the most important topics in medicine history. Teaching and learning medical knowledge and skills was a common one in the golden age of science in Islam, too. The scholars of that period considered the ethical points of view as an important fact in their medical profession. The present article reports the behavior and ethics of physicians based on the review on the first book in this field, "Adab al-Tabib". This book, which can be called the Encyclopedia of Medical Ethics, represents standpoints of the prominent Islamic scholar, Ishaq bin Ali Al-Ruhawi. In this paper, it was intended to summarize the main points of professional behavior and ethics among physicians. Due to the wide-ranging and comprehensive nature of the book, only a few pertinent topics were reviewed. Those topics include the necessity and concept of politeness; the behavior and commitment of physicians towards themselves, patients and society as well as the behavior of nurses, attendees and tips on how to train and examine medical and pharmacy students. Al-Ruhawi in this book, declares that the first necessity of medicine is the true faith and belief in God and the doctors are the guardians of the body and soul. Commitment to medical education, nurses and pharmacists’ role in the management process, physicians’ communication skills suggesting of learning other sciences such as philosophy and more important point, strong relationship of body and soul, are the strengths of Adab-al-Tabib that Ruhawi intended to improve quality of medical services by reviewing them.
 

It is a widely held belief that "health care" is an old concept. As one of the most important institutions dealing with this issue, the hospital has been treating human beings throughout human civilization. But historical studies show that, in the pre-modern era, the hospital was not for the treatment of patients. Its function was as a nursing home for the poor and patients. In this article, we attempt to examine the reasons for this in two ways. We first examine the socioeconomic conditions that led to this function for hospitals in the middle ages. We then show that the treatment of patients at that time was based on humorism and classification medicine, which was not only considered the hospital as a place of treatment but also considered it as a barrier to treatment. Therefore, the hospital served as a hospice for the elderly and disabled, and veterans.
 

Smallpox is one of the most dangerous and contagious diseases that have killed many people throughout history. Attempts to prevent and treat the disease have always been a concern of physicians and some government officials. In the Qajar era, attempts were made for a modern-style inoculation, but it failed because of its incompatibility with the culture and beliefs of the community and the fundamentals of traditional medicine. In the first Pahlavi period, despite the adoption of laws on free, public and compulsory inoculation, there were no desired results due to some problems. The present study seeks to study the obstacles and problems of inoculation in Iran during the first Pahlavi era and the government's actions with a focus on Isfahan city and its functions using descriptive-analytical method. It also seeks to answer the question of what caused failure of the government to cope with smallpox despite considerable efforts? The results of this study show that although the government's measures to enact free and compulsory public inoculation laws, employing inoculation doctors and threatening and penalizing offenders reduced the number of smallpox patients in Isfahan, however, there were problems such as the unawareness of the people and their refusal to inoculate, the lack of cooperation of several villages’ headman with the inoculation officers, the violation and negligence of some inoculation, and the lack of sufficient funds and health facilities. These problems made smallpox disease still prevalent and caused children’s mortality.

Jundishapur was built during the Sassanid Shapur era to house Roman prisoners, and a scientific school, especially in the field of medicine was established there. Jundishapur's urban and scientific identity are intertwined with three concepts of Medical knowledge, Syriac, and Christian Christianity. In this research, the establishment of the Nestorian dynasty in Jundishapur, as well as the distinguished position of these physicians in the flourishing of Islamic civilization, has been studied and recognized. Therefore, this issue will be explained and highlighted by analytical descriptive method and relying on library resources. After the rise of Islam and the conquest of Iran, the medical elites of Syriac and Nestorian Jundishapuri; in particular, the Bakhtishoo, Masouyeh, and Maserjuyeh families continued to incorporate the medical traditions of various nations and the translation of Greek medical texts into other languages at Jundishapur Hospital. With the employment of prominent people of these dynasties in the Abbasid Caliphate of Baghdad, human resources, academic, and clinical achievements and the results of centuries of experience of Jundishapur Hospital Medical Center in compiling and translating medical texts have transferred to Islamic civilization by them.

In the late 13th and early 14th centuries, Iran was involved with epidemics such as plague and cholera, affecting the population and economy of the country. The spread of these diseases, on the one hand, was the result of the government's inability to organize health centers and, on the other hand, the inability to prevent these diseases by the quarantine of the borders. The southern borders of the country were one of the most important ways of transmitting diseases. Iran was exposed to these diseases through the Persian Gulf. It was possible that the diseases with origin in Iran transmitted from this waterway to the neighboring countries as well. These diseases were transmitted in two ways. The merchant ships’ entering Iran's ports from India was one way, especially the cities of Calcutta and Mumbai. The other was via the Hajj caravans (pilgrimage) rout. The opening of the Suez Canal and subsequently increase in voyage of steamships, lead to expansion of trade in the southern ports of the country, and frequent and more convenient transportation of the Hajjis (pilgrims). Thus, this also increased the spread of the diseases in that era.

Muslims learned how to build a hospital using the experiences of physicians from other nations, especially Iranians, by modeling at Jundishapur Hospital, and this way set up many hospitals. In addition to building a variety of hospitals, Muslims created efficient structures and organized them based on bosses, deputies, stewards, supervisors, nurses, and the like, who served in different parts of hospitals. In Islamic hospitals, male and female physicians with various specialties treated patients regardless of religion or race. Using a descriptive-analytical approach based on library information, this research seeks to answer the question of how the structure and organization of hospitals in Islamic civilization have been. Findings of the present research verify that hospitals in Islamic civilization had a well-organized and efficient structure, and various medical departments. Findings also indicate that the structure and organization of Islamic hospitals have evolved over time.

The long-standing interaction of philosophy and medicine has assumed to be as follows: great physicians have been also philosophers, so there is a relationship between medicine and philosophy. In this paper, based on philosophical modeling, essentials of interaction for medicine and philosophy are presented. First, brief descriptions of two models of medicine-philosophy interaction are presented: Galen and Avicenna. Then, the distinct and innovative model of Fakhr Razi- that has been seriously neglected- will be descried. Galen believes “The best doctor is also a philosopher (logic and ethics)”. The logic helps physician to provide accurate diagnosis while the physician-patient relationship is regulated by ethics. Avicenna concerns more with the epistemological foundations of medicine, the position of medicine in the classification of knowledge and the importance of theory of medicine. He argues that philosophical debate on fundamental medical concepts is neither useful for medicine nor philosophy. Fakhr Razi's model can be described as Socratic Method, that is, understanding through dialogue based on questions and answers. His book called “Sharh Kulliyyat al-Qanun fi al-Tibb” (Commentary on Canon of Medicine) is philosophical reflection on basic concepts of medicine and It could be considered as of one of the first texts in medical philosophy. The main goal of his philosophical reflections seems to provide a deeper understanding of medical knowledge and its application in practice.

European tourists in their reports from Guilan in the Qajar era, also have addressed the issue of health and deadly diseases affecting lives of people, such as rice fever, malaria, cholera, and plague in addition to pointing out the numerous social tragedies. From these tourists’s point of view, the weather conditions, geographical location, livelihood and some living and social habits and behaviors of the people of this land were directly related to the prevalence and spread of these diseases. The epidemic of malaria, cholera, and plague has had a profound effect on the spread of poverty, public discontent, and demographic composition in the Qajar era. The authors seek to answer these questions; from the point of view of tourists and foreign visitors, what factors have caused the spread of epidemics in Guilan during the Qajar era? and what have been the consequences of the pervasive diseases on the human and economic situation of Guilan? The research findings show that the climate of Guilan, abundance of rivers, swamps, food culture, and some other natural factors caused some infectious diseases such as malaria and paddy fields in this province to be much higher than other parts of Iran. In addition to malaria, some epidemic diseases such as cholera and plague have played an important role in the economy and population of Guilan. According to the limited and scattered reports of tourists, in addition to the geographical factor in the spread of these diseases, people's lifestyles and the government's lack of attention to public health and welfare played an important role in the prevalence and spread of these diseases. Economic and social bankruptcy and the government's inability to support the people in Guilan's social movements, such as constitutionalism and the forest have made their mark. The research method in the present study is performed using historical method and descriptive-analytical studies.

Despite the peak of medical knowledge in the Abbasid period, the presence of famous medical families in the Abbasid court, translation and writing of medical works, attention to nutrition and health in the court of the Abbasid caliphs, the expectation of long life and quality was created for the Abbasid caliphs. However, all these possibilities were not used much by the caliphs, and if they had not been killed in the war, they would have died of disease, even at a young or middle age. This research is performed using library sources and descriptive-analytical method. According to the findings of this study, the urgent need of the Abbasid caliphs for "treatment" had caused physicians to be present in the court of the caliphs with great benefit of wealth and even power. Revelry, the unjustified lifestyle in having fun and spending a lot of time in the harem leads to the suffering from of some Abbasid caliphs in their age Young or untimely due to some incurable or incurable diseases that caused their premature death. Finally, among the 37 Abbasid caliphs, 30 of them were killed in internal or external wars and conflicts. The remaining number died of disease, despite the establishment of a coherent system of health and treatment and having all the medical facilities of their time. Therefore, despite the provision of medical facilities for the Abbasid caliphs, the wrong lifestyle and full of excesses in having fun has caused them to fall ill and eventually die.