Islam had a major impact on the culture
of Iranians. After their conversion to Islam, scholars in Jondishapur
began to form strong working relationships with their colleagues in
Baghdad. In so doing, a large number of Iranian physicians contributed
to the building of medicine within Islam. Great names such as Tabari,
Razi, Ahwazi, Ibn Sina, and Jorjani are amongst these physicians.
Seyed Ismael Jorjani (known simply as Hakim Jorjani) was born in 1042 A.D. in Jorjan, located in northeast Iran near the shores of the Caspian Sea. Jorjan was an important city till the 4th century, when it was destroyed in the Mongal attacks. A new city was built near the destroyed city many years later, and today it is called Gorgan. After Islam and until the time of Jorjani, almost all scientific books that were written in Iran were in Arabic. Jorjani was the first who wrote his great book in Farsi. He was living in the kingdom of “kharazmshahian” and so named his book as Zakhireh kharazmshahi.
This book was the first book in Post-Islam Iran written in the Farsi language and became a primary resource for Iranian physicians for centuries to come. Indeed, after some years, by writing a medical book in fluent Farsi, Jorjani made a noticeable impact on Iranian medicine. Soon after, Zakhireh became one of the main references for Iranians and was also translated into Hebrew, Urdu and Turkish languages. Angelus, a French priest, comments in his book Pharmacopae Persica that Zakhireh was the most current medical text book in the Safavid dynasty of the 17th century, more than six hundred years after its writing.
Zakhireh is indeed a medical encyclopedia, written in ten tomes. In a lengthy preface, Jorjani describes in great detail the climate, geography and common diseases of where he lives. After presenting this background, he explains the necessity of writing a medical textbook in his native language.
The arrangement of the ten tomes of Zakhireh is very similar to Avicenna’s Cannon. In current medical terminology, each tome discusses the following:
- First tome: Anatomy, physiology and knowing temperaments, humors and elements.
- Second tome: General pathophysiology. A chapter on the description of the kinds of pulses and a chapter on causes of death are also part of this tome.
- Third tome: Hygiene and nutrition. Separate chapters on diseases of childhood, ages and especially diseases in travels are amongst the contents.
- Fourth tome: Differential diagnoses of diseases
- Fifth tome: Fever and its classification
- Sixth tome: Treatments. This volume was the most sought after for physicians at that time.
- Seventh tome: Infectious diseases.
- Eighth tome: How to adorn the appearance (aesthetics).
- Ninth tome: Toxicology
- Tenth tome: Pharmacology
Discussion of the four elements was a cardinal part of every medical textbook in ancient Iran and Zakhireh is no exception. The physicians in old Iran considered the four elements to be the main foundations of the world: fire, air (wind), water and soil (earth). According to them, there were nine different temperaments: four simple, four mixed (sanguine, bilious, melancholic and phlegmatic) and one ideal moderate. These temperaments differed with age and even climate and were also in relation with four seasons and four geographic directions (Figure 1). The eight Trigrams of Chinese medicine, invented by Fu Xi (Taihao Feng), has a more or less similar base, although it is more complicated and more related to mathematics.
As mentioned previous, Jorjani dedicated several chapters of Zakhireh to skin diseases. In the seventh volume, he presents in great detail a variety of skin infections and proposed a classification of ulcers. He also prepared a separate volume discussing beauty and gives notes on maintaining healthy skin.
In a wonderful discussion about tumors, Jorjani divided these lesions into soft and hard and called them “Saghirus” and “Saratan” (= Crab / Cancer) respectively. He believed that cancers are more common in females, and stated correctly that ”the diagnosis of cancer in early stages is not simple and by the time you can diagnose a cancer, it is usually when you cannot treat it.” He then adds that if a cancer is far from the vital organs, you should excise it completely with all of its roots and he explained in detail how he resected the breast of a woman with breast cancer.
Other texts written by Jorjani included Khof Alaei, Aghraz Tebieh, Mabahes Alaei, and Yadgar.
Khof Alaei (“high ranks’ boot”) is amongst the first manuals in medical history. It is an abstract of Zakhireh written in short papers so that physicians and commanders could keep it always in their boots during journeys and battles.
Hakim Jorjani died in Marv in 1136 AD. His role in the revival of Iranian medicine is indisputable, and Iranian physicians should not forget his great name.
- Elgood CL. A medical history of Persia and the Eastern Caliphat. Translated by Dr. Baher Forghani. Amir Kabir Publication, Tehran 1982
- Elgood CL. Safavid medical practice. Translated by M. Javidan. Tehran University Publications, Tehran 1978
- Najmabadi M. Medical history in Iran after Islam. Tehran University Publications, Tehran 1996
- Jingfeng B. Episodes in tradional Chinese medicine. Panda books, Beijing 1998
- Zitouna M, Mouaffak F, Mansour A, Labbene R, et al. Ulcerations and their classification by Ismael Jorjani. Tunis Med. 2003 Jun; 81(6):437-9.