Farid Alakbarli. Medical Manuscripts of Azerbaijan. Page 8
CHAPTER 4. FOLK MEDICINE OF MEDIEVAL AZERBAIJAN
§ 1. PROFESSIONAL AND FOLK MEDICINE
It's very important to make the distinction between Folk Medicine and ancient professional medicine. Folk medicine is treatment that is carried out by folk practitioners, not doctors or professional healers. Secrets of folk medicine are passed down from generation to generation, from parents to children and then to their grandchildren. Folk healers have their own special knowledge and skills in treating disease; they aren't graduates from universities and they don't rely on textbooks or other written sources.
Professional doctors in those times were educated and wealthy. They usually lived in cities. Some became famous as court physicians in palaces of kings and governors. In contrast, common people of the Middle East, especially illiterate peasants in villages, had no idea about Avicenna and Hippocrates. Despite the fact that there were major hospitals in Tabriz, Ganja, Shamakhi and other medieval cities of Azerbaijan, professional medical care was not available in villages. Therefore, people tried to benefit from the knowledge of folk medicine, which was both widespread and inexpensive. Folk medicine treatment in Azerbaijan was called Turkahara
This procedure was well known among Turkic tribes living in the region of Azerbaijan. It consisted of various methods including magic, medicinal plants, folk surgery and massage. Evidence for Turkachara treatment in medieval Azerbaijani folklore exists in various sources such as Kitabi Dada Gorgud (Book of My Grandfather Gorgud). This oral epic predates its written form of the 11th century and preserves traces of ancient Turkic folk medicine.
§ 2. HERBS IN FOLK MEDICINE
The Azerbaijan folk poetry genre known as "bayatı" describes medicinal herbs that were used by people in their daily lives. One of the poems mentions a person who can't find "yarpız" (pennyroyal, water mint). This leads us to conclude that in earlier times this species of mint was used in folk medicine to treat wounds. Modern field research also confirms that villagers still use yarpiz as an analgesic, anti-inflammatory and antiseptic remedy. In addition, this herb promotes digestion and is good for the stomach. It also has the ability to draw pus from wounds.
Indeed, yarp_z was one of the most famous herbs of Azerbaijani folk medicine. Mirza Fatali Akhundov, founder of Azerbaijani drama (19th century), refers to yarpiz in his famous play, “The Story of Monsieur Jordan, a Doctor, and Darvish Mastali-Shah, a Famous Magician”. One of the characters, the French botanist Monsieur Jordan visits the Karabakh region to study local flora. He discovers that yarpiz is very popular among the local population. The Azerbaijan Film Studio produced a film based on this play, "Darvish Explodes Paris" (Dərviş Parisi Dağıdır) where the famous Russian actor Sergey Yursky played Jordan.
Today, pennyroyal is used both in folk medicine, as well as in cuisine. "Dovga", made from yogurt and greens such as pennyroyal, is considered to be good for digestion and for alleviating intestinal colic. Similar to peppermint, it is also eaten as a fresh table green. Of course, not only is pennyroyal used in Azerbaijani folk medicine, modern field research shows that at least 800 species of herbs were used in folk medicine. 
The most commonly used herb is thyme. The entire upper part of this plant (stem, flowers and leaves) is widely used in both folk medicine and cuisine. Dried thyme is sold in bazaars, markets and pharmacy shops. People add it to their tea to treat intestinal colic or indigestion. One tablespoon is infused in a glass of hot water. People drink it three times a day prior to meals to cure infectious diseases of stomach and intestines and to stimulate the appetite.
Thyme is used to flavor meat as well, especially kababs. It adds aroma and aids digestion. It is also used in the preparation of sherbets (fruit and herbal non-alcoholic refreshing drink), which are good for digestion and to promote secretion of gastric juices. Since ancient times people have used the alcoholic extraction of peppermint for external application. This extraction is called cövhərnanə (sometimes, nanəcövhər as well) (peppermint essence). Jovharnana is used to massage the belly when someone is experiencing intestinal colic. After the massage, the person covers up with blankets. This remedy is applied to treat neuralgia. It is used to ease breathing of those with colds and influenza. People pour jovharnana into a spoon and heat it and inhale the extract as it evaporates. It clears out stuffed noses and eases breathing.
People frequently use the peel of pomegranates for dyspepsia and indigestion. It is a very strong remedy. The skin - either fresh or dried - can be boiled in water and sipped throughout the day. The taste is quite bitter so some people add sugar. Unlike antibiotics, pomegranate skin has no side effects and may be used in the treatment of little children.
Other frequently used herbs include chamomile (çobanyastığı), which is used for infectious diseases, peppermint (nanə) used for abdominal colic and colds, and juniper cones (ardıc qozaları) for urinary infections.
§ 3. FOLK SURGERY
Folk doctors called sınıqçı (fracture doctors) specialized in the treatment of dislocations and fractures. To alleviate severe pain in the extremities, compresses made of the fat of sheep's tail were placed on the injured part. Usually, these compresses were kept on throughout the night and removed the next morning. As a result, pain and inflammation decreased and the diseased joint had more flexibility.
Another group of folk healers was called çöpçü. They were skillful in removing any bones that got lodged in the throat.
§4. CHILDAGH - FOLK REFLEXOTHERAPY
On the Absheron peninsula, there are still folk healers named childagchi (spot burners) who treat nervous diseases and remove tiredness by applying heat to certain spots on the forehead, arms and legs. Childagh is still practiced in Mashtagha, one of the villages in the suburbs of Baku. Many people still seek out this treatment. 
The art of Childagh is quite unique although it has not been thoroughly investigated. It is not known when Childagh was introduced into this region or from where it originated. It seems to be a modified form of Chinese reflexology replacing needles with cauterization (burning).
Perhaps this art came to Azerbaijan from China during the Mongolian invasion of the 13th century when many features of Chinese culture and medicine were brought to Azerbaijan. The Mongolian rulers of the Elkhanid Dynasty who ruled in Azerbaijan favored such Chinese traditions.
Childagh has not been found to be documented in the ancient medical manuscripts of Azerbaijan or surrounding Muslim regions. However, Ibn Sina does mention in his Canon that some nervous diseases were treated by burning three points on the forehead. Sharafaddin Hakim, a Turkish physician of the 15th century, also describes this treatment in his book of surgery, which is now preserved in the Topkapi Museum in Istanbul. This book provides color miniatures showing this treatment. We see a physician burning the points on a patient's forehead with a metallic stick - like implement. Some Azeri Turkic verses by Muhammad Fuzuli (1494-1562) also provide information about early cauterization practice. In Childagh as practiced in Azerbaijan today, the healer uses a cigar made of wormwood or plain cotton wool. Chinese also use this same type of cigarette.
§ 5. FOLK MEDICINE AND MAGIC
Healing by magic was also an essential part of folk medicine in Azerbaijan. Beginning in ancient times, shamans (qam in ancient Turkic) from Oguz tribes who inhabited Azerbaijan used various magical songs, music and verbal formulas to stave off evil spirits. They used various parts of animals in this process. Vestiges of these practices are evident in Azerbaijan even today, even though Islam severely criticizes such beliefs and considers them to be superstitious. 
For example, some people believe that if a childless woman eats fried rooster genitals, she will become pregnant. According to another folk belief, the eyes of an owl work well for both inability to sleep, as well as an excessive desire to sleep. This folk idea is described in the medieval book, Tibbname (Book of Medicine) of 1712: "It is necessary to remove both eyes of an owl and put them in a bowl with water. A heavy eye will sink, a light eye will float on the water's surface. If a person suffering from insomnia swallows the heavy eye, he will fall into a sound sleep. However, if he consumes the lighter eye, he will not sleep all night". 
Some healing practices are related to Islam as well as folk magic. For example, according to the Tibbname, if one reads the Sura of Fatiha from the Koran every morning and then trims his eyebrows with a comb, he never will die of plague. Another belief advises that bad memory can be treated by writing down the Fatiha on a big piece of sugar and then eating it on an empty stomach. All such recommendations are held in disdain by Islam and have nothing to do neither with religion nor with traditional medicine of medieval Azerbaijan. However, such beliefs continue to persist.
Rhinoceros Horn and Lion's Heart
It is believed that if one eats the heart of a lion that he will be brave and recover from such conditions such as depression, bad mood and nervousness. Even today, Azerbaijanis have an expression to describe such a courageous person. They say: "Did you eat a lion's heart?" (şir ürəyini yemisən?). It's impossible to find any lions' hearts in Azerbaijan today because they all became extinct in the 16th century.
However, there have been occasions when people have gone to the Baku Zoo and tried to persuade personnel to sell various animal parts: snake skins, wolf paws, camel fur, rhinoceros excrement, and even elephant urine. Such a situation is described in Magsud Ibrahimbeyov's short story, "The Horn of Rhinoceros". The protagonist of the story, an elderly person decides to marry a young girl. He discovers an ancient book with a folk recipe describing how to make himself appear younger and healthier. One of magical ingredients was powder from the horn of rhinoceros. So he goes to the zoo at night with the intention to saw off a horn of a rhinoceros. However, he is suddenly attacked by a small kiwi bird, which made such a noisy racket that the perpetrator gets arrested by the police.
Hedgehogsand Wolf Claws
Hedgehogs are extremely popular in Azerbaijani folk medicine. It is believed that the fried meat of hedgehog cures female infertility. So many hedgehogs have become victims of this superstition. The wolf is considered a sacred ancestor or totem of Turkic tribes. Many beliefs are associated with this animal. All of them date to Pre-Islamic times though they still live on in folk belief today despite the negative attitude of Islam towards such "pagan ideas".
All parts of the wolf are believed to produce positive medical effects. For example, the wolf's claws are considered the best medicine against male impotence. It was recommended to carry claws to increase potency. Another belief advised soaking the claws in oil for a long time and then using this oil as an ointment.
Extrasensors and Fortune Tellers
Azerbaijan has its share of extrasensors who are convinced that they have the ability to treat others with the help of words, suggestions or bioenergy. Many extrasensors are folk healers and have no medical diploma. Sometimes they mix their practice with Islam and magic, meaning that they make a diagnosis based randomly selecting texts in the Koran along with amulets and magical formulas. One of Azeraijan's most famous extrasensors Tofig Dadashov claims to be able to treat diseases by drawing upon his telepathic skills. There are also fortunetellers and magicians who claim to have the ability to remove evil eye with the help of black and white magic.
Therapy with massage and chiropractics is less widespread now in comparison to a few decades ago, but they continue to be practiced. Throughout Azerbaijan there are centers where Tibetan, Indian and Chinese folk medicine is used to treat those in need of medical assistance and cures.
CHAPTER 5. PROFESSIONAL MEDICINE IN MEDIEVAL AZERBAIJAN
§ 1. MEDICAL THEORY
The professional medicine of medieval Azerbaijan was a scholarly system that was studied in medieval universities (madrasa) and based upon treatises by such erudite physicians as Avicenna (Ibn Sina, 980-1037) and other prominent medieval doctors of the Muslim World. Their ideas were rooted in scientific observations based on ancient Greek medicine set forth by Hippocrates and Galen.
Medicine of medieval Azerbaijan was similar to the Greek-Arabic or Islamic medicine. The basic theoretical conceptions of the medieval Azerbaijan medicine are as follows: teachings about four elements of Nature (fire, earth, water and air), four qualities of these elements (humidity, dryness, warmth and coldness), four basic humours of organism (blood, bile, black bile and mucus) and four temperaments (sanguine, phlegmatic, choleric and melancholic). The teaching about Four Holy elements was created by Zoroastrians in ancient Azerbaijan, Persia and the Central Asia.
It made a great influence on the development of science in ancient Greece. In the 6th-5th centuries BC, these scientific doctrines were developed by such Greek scientists as Empedocles, Heraclites and Hippocrates. As evident from medieval sources, during the Middle Ages these theories deeply influenced the traditional medicine in the Muslim East including Azerbaijan.
According to scholars of those times, all substances consist of four elements of Nature. Each element has two of the existing four properties (humidity, dryness, warmth, coldness). Ancient scholars considered that each living being was made of four humours (blood, bile, black bile and mucus). Physicians of those times believed that a deficiency or surplus of any of these substances would cause disease.
Every medicine also has its own nature - cold or hot, dry or humid. For example, if you suffer excess cold in the organism, you must take hot medicine, while a patient with hot nature must balance it with a cold medicine. Foods also were considered to be cold, hot, dry or humid. For example, pepper is hot, while potato is cold. It was recommended to eat cold when an organism is hot, and eat hot when it is cold.
The medieval Azeri authors emphasized that each season was associated with a relevant humour. For example, in summer, the total amount of bile in the organism increases, while the amount of mucus increases in winter. The anonymous author of "Risala-i Tibb" (17th century) writes: "First comes spring which consists of three months. Its nature is hot and humid. During these days, the total amount of blood rises in the organism. The patient should be treated in line with the nature of this season." 
"The second season is summer which is hot and dry by nature increasing the amount of bile in organism. The third season is autumn, with its cold and humid nature increasing the mucus amount. The fourth season is winter with its cold and dry nature increasing the amount of black bile." 
Of course, this is only a brief survey of the ancient medical ideas spread in Azerbaijan and other Muslim countries during that time
Table1. Principal Humours and Temperaments (According to medieval medical sources)
§ 2. COMPLEX TREATMENT
Physicians of medieval Middle East including Azerbaijan believed that it is necessary to treat not a separate organ, but the human as a whole, applying a set of various methods of treatment influencing on his physical and emotional state. Thus, various kinds of therapy mutually support the positive effects of each other.
The great Turkic scientist Abu Nasr al-Farabi (873-950 AD) wrote: «... The physician treats each organ only correlating him with all body and the organs adjoining and connected to him. From such treatment all body gets benefit... Sometimes, doctor does not keep it. Aspiring to ensure health to this or that organ, he treats him not considering a state of other organs adjoining to him. Therefore, he cures one organ causing harms to all others. In this case, the organism does not get any benefit from the treatment. The diseased organ and the parts of an organism linked to him gradually weaken and the harm from them is transferred to other organs affecting all body» 
Thus, the physicians of medieval times tried to treat the patient by influence not on only one diseased organ, but on many parts of an organism. They successively applied several kinds of medical procedures. These ways of treatment are listed below.
1. Taking drugs from medicinal plants and other natural medical agents.
2. Taking baths with decoctions of medicinal plants.
3. Healing massage (preventive and medical with use of curative aromatic oils).
4. Rubbing in medicinal ointments, use of powders and compresses from natural agents.
5. Medical exsanguinations
6. Treatment by odors (aromatherapy).
7. Psychotherapy (treatment by music, color, mental exercises, etc.)
8. Surgical intervention.
Often, these methods of treatment were carry out not separately, but together that even more strengthened their effect. For example, "Tibbname" (1712) writes:
PARALYSIS. «To help the patient with a paralysis, the physician should collect a little amount of the Greek lavender, celery seeds, anise, fennel, licorice root, mix them with each other, boil, filter, and add a few petals of rose and honey. It is necessary to give it to the patient each morning.
Then, it is recommended after each three days to visit bath and (after hydrotherapeutic procedures) dub a body with the oil from euphorbia juice, either with the chamomile oil, or herb of Nigella sativa, or other herbs similar to them." 
The similar ideas can be found in the work "Canon of Mediciine" by Abu Ali Ibn Sina (980-1037 AD):
FATIGUE. "For elimination of fatigue from a physical work, it is necessary two - three times per day to take a bath and rub the body with special unguents."  Let's pay attention to the word special. Ibn Sina did not mean usual baths and ointments. To treat diseases, the special herbal mixtures for baths and massage balms were applied.
STONES IN URINARY BLADDER. "In the presence of stones in urinary bladder, it is necessary to take a bath with decoction of the following plants: leaves of Judas tree, maiden-hair, mugwort, rose, and also with plants having astringency (cortex of oak, pomegranate skin, etc.).
Immediately after taking a bath, the patient is dubbed with the special fragrant ointments. These unguents necessarily should contain the pine pitch and euphorbia juice.” 
As it was already stated above, for treatment of series of diseases alongside with baths and massage it was recommended to drink decoctions and infusions of medicinal plants. For example, Muhammad Mu'min, the court physician of Shah Suleyman Safavi, wrote in his work «Tuhfat al-Mu'minin» (1669 AD):
INFLAMMATION OF URETER. «In the presence of inflammation of the genitourinary organs, it is necessary to drink the chamomile decoction, take a bath in decoction of elder, and dubb the body with special unguents containing mint, pepper, etc.» 
About same writes Ibn Sina (980-1037 AD) in his "Canon of Medicine":
JAUNDICE. «The patient suffering from jaundice should take a bath in the decoction of maiden-hair, and, at the same time, drink the turnip juice.» 
Therefore, the medieval scientists were advocates of the complex treatment of many diseases. The base parts of this complex are as follow: taking of natural medicinal preparations, herbal baths and massage with medical oils of natural origin, curative exsanguinations, treatment by
breathing of odors of herbs and flowers, application of healing and analgesic unguents, suitable diet and mode of life, treatment by music and colors, if necessary – surgical intervention, etc.
ADVANTAGE Of COMPLEX TREATMENT. The importance of complex treatment is that each of his subsequent stages strengthens the advantages of previous procedures. For example, the combination of herbal baths with medical massage improves circulation of blood in the organism, contributes in supply of internal organs with blood and nutritious substances. Dissolved in water herbal substances through the skin get in an organism of the human and render the medical effect. The subsequent massage with application of herbal, mineral and animal oils improves a blood supply of tissues, calms the nervous system, and selectively influences function of many internals. During treatment, the patient drinks decoctions of medicinal plants that even more supports the curative effect of herbal baths and massage. Now, we will characterize each of the mentioned above stages separately.
§3. TREATMENT METHODS
Herbs and aromatherapy were considered to be an important part of staying healthy. Unfortunately, much of the knowledge found in these texts has been lost or forgotten. For instance, out of the 726 medicinal herbs mentioned in medieval sources, only 466 are known to grow in Azerbaijan today. Of these, 252 are not being used for any modern medicinal purpose. Medieval physicians used 115 kinds of minerals and 150 species of animals. 
Not only were diseases treated by natural remedies (herbs, animals and minerals), but they were also treated by such methods as medical bloodletting (exsanguinations), leeches and massage. Bloodletting or "hajamat" (həcəmət) was carried out to let out "the bad blood", stimulate the formation of new blood and lower blood pressure. However, it was forbidden to carry out bloodletting on small children or any person who had no appetite or who was physically exhausted. Spring was considered the best time for bloodletting. The practice was only rarely performed in summer under dire, emergency situations.
Even today, when Azerbaijanis are in a bad mood, they often say: mənim qanım qaradır (my lood is black). In old days, black blood was considered the reason why people experienced bad moods (melancholy). Specialists identified scores of veins, each of which they thought was responsible for specific diseases.
In addition to doctors, barbers were also involved in medical practices. Not only did they cut and shave hair, but they performed medical practices such as bloodletting, extracting of teeth and use of leeches.
Early physicians were also familiar with aromatherapy, which is becoming more and more popular in the West today. The smell of quince, for example, was believed to strengthen the natural energy of the body. Citron was used to tone the nervous system, and apples, to stimulate the brain.
Music was also recognized as another form of therapy because of its ability to affect emotions. Positive effects were observed when people listened to music or to birds singing, especially the nightingale. Even listening to someone recite poetry was viewed as curative.
Even color entered into the treatment of some physicians. The 18th century text "Tibbname" suggests that one's place of rest be decorated in flowers and painted in pale blue, green or white tones.
§4. SURGICAL TREATMENT
Physicians of Azerbaijan started to use surgical treatment many thousand years ago. Archaeologists have found on the territory of our Republic a human skull with traces of trepanning. This skull dates back to 4.000 years BC. Some medieval manuscripts devoted to surgery are kept in the Institute of Manuscripts. Among them we should point out such books as "The Treatise about Surgery and Surgical Instruments" by Abu al-Kasim al-Zahrawi (13th century).
This manuscript contains descriptions and drawings of many surgical instruments including diff e rent knives, scalpels, scissors, etc., used especially for surgical operations on human face (eyes, nose, lips etc.). Most of other medieval manuscripts in the field of medicine contain special chapters devoted to surgery. Thus, Mahmud bin Ilyas (14th century) describes the following types of surgical operations: treatment of walleye, furuncles, warts, burns, stub-wounds, and various tumors; extraction of teeth; amputation of extremities; blood-letting; etc.
According to Muhammad Yusif Shirvani (18th century), medieval physicians had special threads to sow wounds and surgical sections, as well as herbal antiseptics for treatment of external and internal tissues. 
REMOVING OF SPLINTERS. To remove splinter fro m wound, one should take the dried birth-wort, thresh it and pour on a wounded surface. This medicine will extract the splinter from wound. Besides, it is required to take haricot root and some pieces of wild onion and apply on the wound. If to mix some manure with fat of cattle and apply on wounded surface, splinter will be extracted.
TREATMENT OF BURNS. Take some mallow leaves, carefully thresh, add some olive oil and massage on the burned surface. Also, it is recommended to heat some hairs with graphite, then add some rose oil and apply on burns. It is good to treat burns by white of eggs. To avert bump evolving, it is recommended to apply salt and olive oil mixture on the wounds.
TREATMENT OF STUB-WOUNDS. If an irony subject goes into the bone, try to remove it and fill the wound with mixture of salt with sugar. When soft tissues are cut, it is necessary to apply a basil and onion ointment on the wound while extracting the subject. Then, you should bandage and wait for three days. If there is no abscess, treatment may be finished by healing unguents. To prevent abscess, it is good to burn a wound with a very hot iron instrument and apply antiseptic ointments once again. If a stomach is cut by saber of knife, it is necessary to sow the cut by special threads, but leave a little hole to allow pus, water and grease to flow outside.
TREATMENT OF FESTERING WOUNDS. Muhammad Yusif Shirvani wrote: "Surface of an old wound should be treated by honey and decoction of hyssop (Hyssopus officialis) until the wound has closed. Further it should be treated by the ointment pre p a red from caraway-seeds or by Egyptian ointment..." 
TREATMENT OF FURUNCLES. Muhammad Yusif Shirvani wrote: "It is necessary to let blood from the vein named basilica. Then, a furuncle should be dubbed by rancid butter. Take some sour dough, pigeon's droppings, sparrow droppings, borax, acorn flour, pound them, add some honey and melted butter and mix them to prepare an ointment. Further, dub this ointment on furuncle surface and left it for a night and furuncle will break." 
Physiotherapy including massage was considered as one of surgical methods. The medieval Azeri authors recommended different types of massages with healing ointments. For example, a medieval physician wrote:
MASSAGE AGAINST DYSPEPSIA. It is required to massage regularly the body of patient with dyspepsia before and after meal. If his body becomes weak due to illness, it is necessary to execute a strong massage of stomach and back by rough rag. Sometimes, it is necessary to apply on his body zift (gum of pine) and other remedies which may cause redness of the skin.
MASSAGE AGAINST COLIC. This type of massage is recommended against coils resulting from accumulation of wind in bowels. Slightly massage the patient stomach and rub such liniments as heated jasmine and peppermint oils. Besides, you can make poultices with hot millet and salt. Azerbaijani physicians were capable of executing very difficult surgical treatments, including trepanning, eye, nose and joint's surgery, and treating dislocations, fractures, injury, etc. Medieval physicians had special surgical instruments. In order to treat some diseases, ancient healers recommended letting blood from different blood vessels in order to clean organism and stimulate functioning of internal organs.
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