History of epilepsy in Medieval Iranian medicine

Abstract

The history of epilepsy in Medieval Persian medicine is not well-known in the Western world. This article presents the clinical approaches according to which Medieval Iranian practitioners viewed epilepsy and dealt with its problems. The clinical viewpoints of epilepsy are collected from Medieval Persian scientific references. These describe clinical manifestations, basic mechanisms, etiologies, treatment and prognosis. Medieval Iranian practitioners provide detailed clinical information on epilepsy. They mention various forms and symptoms of epilepsy and its apparent causes and offer dietary and hygienic rules, as well as a long list of pharmacologic compounds for treating it. Their findings about epilepsy are very accurate and vivid and many of them are accepted even today.

Introduction

The ancient Iranian medicine was combined by different medical traditions from Greece, Egypt, India and China for more than 4000 years and merged to form what became the nucleus and foundation of medical practice in the European countries in the 13th century. The Iranian academic centers like Jundishapur University (3rd century AD) were a breeding ground for the union among great scientists from different civilizations [1], [2]. These centers successfully followed their predecessors’ theories and greatly extended their scientific research through history. One of the main roles played by Medieval Iranian scholars in the scientific field was the conservation, consolidation, coordination and development of ideas and knowledge in ancient civilizations. Some Iranian Hakim (practitioners) such as Abu Bakr Muhammad ibn Zakariya Al-Râzi known to the West as Rhazes (b: 860 AD, Ray near modern Tehran—d: Ray, 940 AD) and Abu Ali Al-Hussain ibn Abdullah Ebn-e Sinâ better known as Avicenna (b: 980 AD, Afshana near Bukhara—d: Hamadan, 1037 AD) were not only responsible for accumulating all the existing information on medicine of the time, but adding to this knowledge by their own astute observations, experimentation and skills [3], [4]. ‘Qanoon fel teb of Avicenna’ (‘The Canon’) and ‘Kitab al-hawi of Râzi’ (‘Continens’) were among the central texts in Western medical education from the 13th to the 18th centuries [5], [6].

Many studies concerning the history of epilepsy have been performed [7], [8], [9], [10], [11]. In spite of these, the history of epilepsy in Iranian medicine has received scant attention from modern medical historians. The Iranian neuroscience history can be traced to the 3rd century BC, when the first cranial surgery was performed in the Shahr-e-Sukhteh (Burnt City) in south-eastern Iran. The archaeological studies on the skull of a 13-year-old girl suffering from hydrocephaly indicated that she had undergone cranial surgery to take a part of her skull bone and the girl lived for at least about 6 months after the surgery [12]. Epilepsy is an important issue in the field of traditional Persian ‘neuroscience’. Although some studies have been performed on the history of Medieval Persian medicine [13], [14], [15], only Vanzan and Paladin reviewed the historical concepts of epilepsy in Persian culture [16]. Here we put special emphasis on the review of clinical aspects of epilepsy throughout Iranian medical history in the Middle Ages. Our main goal and intention in this study is: firstly, to isolate and analyze all of the clinical aspects of epilepsy in order to clarify the manner in which Medieval Iranian practitioners viewed and dealt with this problem. Secondly, to provide appropriate clinical data from centuries of experience in the field of epilepsy which may be helpful for testing their probable benefits for epileptic patients. In recent years, some experimental studies have indeed evaluated Medieval Iranian medical remedies using modern scientific methods. These studies raised the possibility of revival of traditional treatments on the basis of evidence-based medicine. Although the efficacy of some traditional antiepileptic drugs, as well as a common basic mechanism of action, was confirmed in different in vivo and in vitro epilepsy models [17], [18], [19], [20], [21], [22], most ideas remain largely unexamined. Thus, it seems desirable that Western medicine takes some cognisance of the Medieval Persian medicine and its seemingly outdated beliefs in epilepsy.