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NATE121
www.endeavour.edu.au
Session 8
Middle Eastern Medicine
Department of Social
Sciences
Dr Melisa Ryan Rangitakatu
© Endeavour College of Natural Health www.endeavour.edu.au 2
Session Objectives
o Describe the history, philosophy, worldview and cultural
context of Middle Eastern Medicine
o Identify the principles of Middle Eastern Medicine
o Identify Middle Eastern Medical Practices
o Describe Unani-tibb
o Describe the role of Avicenna in Middle Eastern
Medicine
© Endeavour College of Natural Health www.endeavour.edu.au 3
The Ancient Middle East
© Endeavour College of Natural Health www.endeavour.edu.au 4
Mesopotamia
© Endeavour College of Natural Health www.endeavour.edu.au 5
Babylon
o Most famous city from ancient Mesopotamia
o 2000 BCE – controlled the “Fertile Cresent”
o Under rule of Hammurabi (1792-1750 BCE) became the
most powerful and influential city in Mesopotamia
© Endeavour College of Natural Health www.endeavour.edu.au 6
Code of Hammurabi
o One of the oldest codes of Law
o Includes laws related to the practice of medicine
o Reflects culture and ethical philosophy of the time
(Encyclopaedia Britannica, 2015)
© Endeavour College of Natural Health www.endeavour.edu.au 7
Mesopotamian Disease
Concepts
o Disease often blamed on pre-existing spirits: gods,
ghosts, etc.
o Gods could be blamed at a higher level for causing
diseases/ organ malfunction
o Plants were generally used to treat symptoms of disease
o Offerings were made to a god or spirit
(Indiana.edu, nd)
© Endeavour College of Natural Health www.endeavour.edu.au 8
Mesopotamian Practitioners
Two types:
o Ashipu - the "sorcerer”
• Diagnosis: Depended on the divine entity responsible for illness
• Treatment: charms and spells
o Asu - the “physician”
• Diagnosis was of empirical application
• Treatment: empirical application of medicines. Wounds were
treated by washing, bandaging, and making plasters
(Indiana.edu, nd)
© Endeavour College of Natural Health www.endeavour.edu.au 9
The Temple of Gula
o Possibly sites for the diagnosis of illness
o Gula was consulted as to which god was responsible for
a given illness
o Temples doubled as libraries for medical texts
o No evidence that the sick were housed at the Temples
(Indiana.edu, nd)
© Endeavour College of Natural Health www.endeavour.edu.au 10
Medicine Post Roman Empire
o The Arabic world was the centre for science and
medicine after the fall of the Roman Empire
o Greek theories were refined and developed by Islamic
physicians
o The first models of professional pharmacology began in
the Arab population
(Azaizeh, Saad, Khalil & Said, 2006)
© Endeavour College of Natural Health www.endeavour.edu.au 11
Israel
o Israel – Small country with Jewish majority
o Surrounded by Arab Middle Eastern states
o Indigenous minority – Arabs ~ 20% population
o Traditional Arab healers – sheikh, darvish, moalj bel
Qur’an
(Keshet & Popper-Giveon, 2013)
© Endeavour College of Natural Health www.endeavour.edu.au 12
Medicine in Israel
o Medicine and religion were closely linked in ancient
times
o Illness was considered divine retribution
o Jewish physicians view their work as being spiritually
endowed
o Up until the 1960s, over 20% of all Nobel Prize winners
for medicine were Jewish
(Encyclopedia Judaica, 2008)
© Endeavour College of Natural Health www.endeavour.edu.au 13
TM in Israel
o Healers diagnose patients using the Qur’an or by an
object belonging to the patient
o Cause of patient’s problem often attributed to
possession, the “evil eye” or witchcraft
o Treatment – use of Qur’an or astrological and
numerology based on patient’s name and the name of
his/her mother, amulets and medicinal plants
(Keshet & Popper-Giveon, 2013)
© Endeavour College of Natural Health www.endeavour.edu.au 14
Present-Day CM in Israel
o 65% patients use CM in Israel
o Physicians are typically dually trained
o Treatments include reflexology, Chinese medicine and
acupuncture, massage, Shiatsu, tui na, homeopathy and
naturopathy
(Keshet & Popper-Giveon, 2013)
© Endeavour College of Natural Health www.endeavour.edu.au 15
Talismans and Amulets
o Objects believed to have magical or spiritual powers
o In medieval Islam, magic number squares were widely
used as talismans
o Holy books can have talismanic qualities
o Many Middle Eastern households display necklaces to
ward off the ‘evil eye’, which is commonly thought to
bring misfortune and disease
(Science Museum, nd)
© Endeavour College of Natural Health www.endeavour.edu.au 16
Traditional Arab Herbal Medicine
Bilad el-Sham region
o Over 2, 600 plant species (700 with noted medicinal or
natural pesticide indications)
o Most natural medicines were derived from plants or
animals
o Rich inventory of natural medicinal herbs in the Middle
East
o Traditional knowledge is partially lost with each
generation(Azaizeh, Saad, Khalil & Said, 2006)
© Endeavour College of Natural Health www.endeavour.edu.au 17
Traditional Arab Herbal Medicine
Plant Species Preparation Indications
Astragalus macrocarpus
DC
Leaf decoction Heart diseases
Ceratonia siliqua L. Leaf decoction Herpes & lip sores
Cichorium pumilum
Jacq.
Foliage decoction Bacterial infection,
poisoning, rheumatism
Cupressus sempervirens
L.
Fruit decoction Antiseptic, nervous
system
Mercurialis annua L. Leaf decoction Cancer, skin diseases
Quercus calliprinos
Decne
Fruit and bark decoction Cancer, bed wetting,
ulcer
Teucrium polium L. Foliage decoction
© Endeavour College of Natural Health www.endeavour.edu.au 18
Abū ʿAlī al-Ḥusayn ibn ʿAbd
Allāh ibn Sīnā
o Arabic – Ibn Sīnā (Avicenna)
o Bukhara Iran (present day Uzbekistan), 980-1037
o Wrote over 240 works
• Book of the Cure
• The Book on Psyche
• The Canon of Medicine ( الطبفيالقانون al-Qānūn fī al-Ṭibb)
© Endeavour College of Natural Health www.endeavour.edu.au 19
Ibn Sīnā (Avicenna)
o Disease starts as a ‘dystemperament’ to a new
temperament that is outside normal range
o Prolonged dystemperament imbalanced the humours
(~body fluids) in quality and quantity
© Endeavour College of Natural Health www.endeavour.edu.au 20
© Endeavour College of Natural Health www.endeavour.edu.au 21
The Canon of Medicine
الطبفيالقانون al-Qānūn fī al-Ṭibb
5 Books
• Book I: General Matters of Medicinal Science
• Book II: Single Drugs
• Book III: Diseases Specific to Organs
• Book IV: Diseases Not Specific a Single Organ; The Cosmetic
Art
• Book V: The Formulary and Aqrabadhin
© Endeavour College of Natural Health www.endeavour.edu.au 22
The Canon of Medicine
© Endeavour College of Natural Health www.endeavour.edu.au 23
Unani “Tibb” Medicine
o Also called “Unani tibb”, “Arabian medicine”, “Islamic
medicine”
o Traditional system of healing and health maintenance
o Origins are found in Egyptian doctrines, later Greek
• Developed and refined by the Arabs
o Based on principles of harmony and balance
o Hakim (practitioner)
© Endeavour College of Natural Health www.endeavour.edu.au 24
Principles of Unani Medicine
Comprehensive Medical System – 7 sets of hierarchical
concepts - “The Naturals”
• Elements - arkan
• Temperament - mizaj
• Humours – akhlat
• Organs – a’dha’
• Spirits/breath – arwah
• Faculties/Powers – quwa
• Functions – af’al
(Abu-Asab, Amri and Micozzi, 2013)
© Endeavour College of Natural Health www.endeavour.edu.au 25
The Balance of Principles
o Human health is maintained by a harmonious balance of
al-umoor al-tabiyah
o The 7 natural components interact with each other to
maintain balance
o Tabiyat – The self-regulating capacity of each individuals’
constitution
(Britannica Online Encyclopedia, 2015)
© Endeavour College of Natural Health www.endeavour.edu.au 26
Elements - arkan
Arkan - Constitutes the primary components of the human
body and all other creations in the Universe
• Araz (earth)
• Maa (water)
• Nar (fire)
• Hawa (air)
(Britannica Online Encyclopedia, 2015)
© Endeavour College of Natural Health www.endeavour.edu.au 27
Temperaments - mizaj
Mizaj – Four essential temperaments.
Deviation of the body or any of its organs is compared to
the patient’s population, gender and ethnicity
Hot
Cold
Moist
Dry
(Abu-Asab, Amri and Micozzi, 2013)
© Endeavour College of Natural Health www.endeavour.edu.au 28
Avicenna on Temperaments
o Avicenna’s concept of the Temperaments draws from the
Chinese 5-phases
o Life is sustained by heat
o Life grows by moisture
o Moisture supports and feeds heat
(Abu-Asab, Amri and Micozzi, 2013)
© Endeavour College of Natural Health www.endeavour.edu.au 29
The Humours - akhlat
o Soluble substances produced from food and drink
o Arabic translation “mixtures”
o Characteristics are associated with one of the physical
elements
o Humours determine physiological health
(Abu-Asab, Amri and Micozzi, 2013)
© Endeavour College of Natural Health www.endeavour.edu.au 30
The Humours - akhlat
Four major humours:
o Blood (dām) - sanguine
o Phlegm (bālghām) - phlegmatic
o Yellow bile (sāfrā’) - choleric
o Black bile (sāudā’) - melancholic
© Endeavour College of Natural Health www.endeavour.edu.au 31
Tabiyat and asbab-e-sittah-
zarooriah
o Tabiyat – an individual’s internal power to withstand
disease and perform normal physiological functions
o Asbab-e-sittah-zarooriah – 6 External factors essential in
establishing biological rhythms and a balanced existence
(Britannica Online Encyclopedia, 2015)
© Endeavour College of Natural Health www.endeavour.edu.au 32
The Six asbab-e-sittah-zarooriah
Directly affect harmony of the body and mind:
o Hawa ( Fresh Clean Air)
o Makool-wo-mashroob (Food and Drink)
o Karkat-wo-sakoon-e-jismiah (Movement and Rest)
o Markat-o-sakoon nafsaniah (Mental Work and
Rest/Mental Health)
o Naum-o-yaqzah (Sleep and Wakefulness)
o Ihtebas and istifragh (Retention and Excretion)
(Britannica Online Encyclopedia, 2015)
© Endeavour College of Natural Health www.endeavour.edu.au 33
Unani Treatment
Focused on normalising and balancing external factors
o Ilaj-bi-ghiza – Dietotherapy
o Ilaj-bi-misla – Organotherapy
o Ilaj-bi-dawa - Pharmacotherapy
o Tadabeer – Regimental Therapy
(Britannica Online Encyclopedia, 2015)
© Endeavour College of Natural Health www.endeavour.edu.au 34
? Review Questions ?
o What is Unani tibb?
o Describe the role of Avicenna in Middle Eastern
Medicine.
o What are amulets and talismans used for?
o Describe the principles of Unani medicine.
© Endeavour College of Natural Health www.endeavour.edu.au 35
References
Abu-Asab, M., Amri, H., & Mivozzi, M. S., (2013). Avicenna’s Medicine, A New Translation of the 11th
Century Canon with Practical Applications for Integrative Care. Healing Arts Press:
Rochester, VA
Azaizeh, Saad, Khalil & Said (2006). The State of the Art of Traditional Arab Herbal Medicine in the
Eastern Region of the Mediterranean: A Review. National Institutes of Health eCAM; 3(2)
229-235, doi: 10.1093/ecamnel034
Brittanica Online Encyclopedia (2015). Avicenna. Retrieved from http://www.Britannica.com
Britannica Online Encyclopedia, (2015). Unani medicine. Retrieved from http://Britannica.com
Encyclopedia Britannica (2015). History of Medicine: The ancient Middle East and Egypt. Retrieved
from http://www.britannica.com/EBchecked/topic/372460/history-of-medicine
Encyclopedia Judaica (2008). Medicine. Retrieved from:
https://www.jewishvirtuallibrary.org/jsource/judaica/ejud_0002_0013_0_13493.html
Indiana.edu (nd). Medicine in Ancient Mesopotamia. Retrieved from
http://www.indiana.edu/~ancmed/meso.HTM
Keshet, Y.,& Popper-Giveon, A., (2013). Integrative Health Care in Israel and Traditional Arab Herbal
Medicine: When Health Care Interfaces with Culture and Politics. Medical Anthropology
Quarterly, 27 (3), 368-384