Farid Alakbarli. Medical Manuscripts of Azerbaijan. Page 12.


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§ 10. MEDICINES WITH COMPLEX COMPOSITION.


The term "complex medicines" (murakkabat) covers natural remedies with complex composition. As distinct from “simple medicines” (mufradat) prepared from one species of plant, one animal or one mineral, "complex medicines" contained dozens of various components. 866 types of medicines with complex composition have been identified while studying the medieval manuscripts. All these medicines are divided into more than 30 medical forms (ma'juns, juvarishs, tiryaks, iyarajs, etc.).

The classification of identified medicines according to medical forms is given in the Table 4 (medieval terms used in this table differ from modern classification systems).


Table 4. Classification of Medicines by Medical Forms.


Medical Forms
Number of Medicines
%
ma'juns
165
19.1
juvarishs
121
14.1
bandages
91
10.5
lozenges
86
9,9
pills
68
7,8
oils
49
5,6
powders
43
4,9
eye ointments
32
3,7
balsams
30
3,5
teeth medicines
26
3,0
licking pastes
23
2,6
iyarajs
21
2,4
eye drops
20
2,3
decoctions
18
2,1
eye powders
17
2,0
tonics
13
1,5
tiryaks
12
1,4
healing powders
9
1,0
mouthwashes
6
0,7
gargles
6
0,7
saturated decoctions
5
0,6
infusions
5
0,6
TOTAL
866
100,0

Some "healing dishes" (iskanjabins, sherbets, halva, sharabs, jams, syrup, etc.) also are mentioned in medieval pharmacopoeias. Three groups of medicines (majuns, juvarishs and iyarajs) are characterized as follows.

Ma'juns. As a result of the medieval manuscript's studying, 165 recipes of ma'juns have been identified. Ma'juns are complex medicines pre pared by careful grinding of components and mixing them in honey, sugar (or another) syrup. An example of the ma'jun described by Muhammad Yusif Shirvani (1712) is given below (to facilitate understanding of the recipe, the ancient weight units, such as dirkhams and miskals are converted into grams).

MA'JUN AGAINST COUGH. This mixture is good against both the acute and chronic cough and is repeatedly tested. Composition: jujube - 60 g, figs - 60 g, flax-seeds - 60 g, madder's root - 60 g, extract of liquorice - 20 g, saffron - 9 g. Application: Take these substances, carefully grind them, add components in honey, mix and take several times per day. [72]

Sometimes, the medieval scientists mentioned in their books names of authors of ma'juns. For example, they cited the following names: ma'jun of Abu Mahir, ma'jun of Abu Salim, ma'jun of Aga Shamsaddin, ma'jun of Aristomachus, ma'jun of Aristotle, etc. The list of authors includes the names of Muslim, Ancient Greek, Indian, Ancient Iranian scholars. We attempted to classify recipes according to regional schools of medcine (see Table 5.)

The names of Muslim scholars (including Christian and Jewish autors who worked inside boundaries of Islamic Medicine) are listed below: Muhammad Mu'min, Muhammad Bagir, Mas'ud bin Muhammad, Abu Mahir, Abu Salim, Aga Shamsaddin, al-Saymari, Ibn Sina, Yakub Hakim, Ibn Habal, Muhammad Zaman Tunkabuni, Samarkandi, Imadaddin Mahmud, Huneyn bin Ishak, Yuhanna bin Sarafiyun, Ruknaddin Mas'ud, Salim ibn Davud, Sanit, Davud Antaki, Ishak ibn Huneyn, Zakariya Razi, Zahiraddin. Thus, authorship of 47 recipes is ascribed to 27 Muslim scientists.


Table 5. Classification of Complex Medicines According to Schools of Medicine.



Authors
Number of Recipes
%
Muslim
47
28.8
Ancient Greek
17
10.3
Indian
7
4.2
Ancient Iranian
2
1,2
Unknown and mythical
92
55,8
TOTAL
165
100,0

Seventeenth recipes of ma'juns are attributed to ancient Greek scholars. Greek names of some from these medicines are distorted. For example: amrusiya, anacardiya, aristun. Muhammad Mu'min wrote about ma'juni-falasifa (ma'jun of philosophers): "...its author lived before Andromachus..." The names of Greek scholars, inventors of ma'juns are listed below: Aristotle, Hyppocrates, Galen, Socrates, Phylon, and Phylumen. Thus, the authorship of 17 recipes is ascribed to 7 Greek scholars. According to medieval authors, majority of these medicines /8/ were created by Galen. “Tibbname” (18th century) cited the recipe of medicines ascribed to Galen.

MA'JUN AGAINST POOR MEMORY. This medicine strengthens and stimulates the memory, puts the patient in good spirit and has a number of other useful properties. Composition: ginger - 100 g, gipsophyla - 100 g , sugar - 100 g.Application: Take these substances, carefully grind, mix them and take 10 g of it every morning. [72]

Seven recipes were compiled by the Indian schoilars. Medieval authors took most of them from the ancient Indian books on medicine such as "Charaka Samkhita" (6th century BC) and "Sushruta Ayurveda" (1st century AD). Medieval authors mentioned names of the following Indian scholars: Zamikhran, Kanaka, Sushruta and Charaka.

Table 6 presents classification of ma'juns according to their medical applications. As the same medicines were used to treat different diseases, they have been included in various medical groups. Therefore the sum of numbers in section titled "Number of recipes" is more than 725, and the sum of percentages is greater than 100%.


Table 6. Classification of Ma'juns According to Their Medical Applications.


Diseases
Number of recipes
%
Diseases of bowel and intestines
69
41.8
Neurologic disorders
45
27.3
Diseases of sexual organs
37
22.4
Diseases of liver and biliary tract
30
18,2
Urinary diseases
28
12,0
Diseases of respiratory organs
22
13,3
Aches and pains
15
9,1
Diseases of eyes, ears, mouth, nose
15
10,1
Diseases of spleen
13
7,9
Hemorrhoids
12
7,3
Cardiovascular diseases
12
7,3
Physical and psychical exhaustion
11
6,7
Lost of appetite
10
6,1
Infections of the skin
4
2,4
Asthma, bronchitis
3
1,8
Bad color of the face
3
1,8
Rheumatism
3
1,8
Weak eyesight
3
1,8
Gout
2
1,2
Snakebites
41
9,9
Bald spots
1
0,6
Bleeding
1
0,6
Vomiting
1
0,6

Juvarishs. The studies carried out on medieval sources have revealed the compositions of 57 juvarishs. The term juvarish was used for medicines made of various natural components mixed in honey. Unlike ma'juns, components of juvarishs weren't so carefully ground.

Numerous recipes of juvarishs are listed in books of such Azerbaijani authors as Haji Suleiman Qajar Iravani (18th century), Hasan bin Riza Shirvani (18th century), and others. Analysis of medieval manuscripts shows that juvarishs have been used in Azerbaijan and other oriental countries since antiquity - as far as 5th-6th centuries BC.

Lately, in the period of Hellenism juvarishs spread from Asia to ancient Greece and Rome. According to medieval Azeri authors, 3 recipes out of total 57 recipes of identified juvarishs were created by Dioscorides (1st century AD) and Galen (130-200 AD), the famous scientists of the ancient Rome. Along with it, some recipes of juvarishs are ascribed to Charaka (6th century BC), the ancient Indian author. Although juvarishs were used to treat a wide range of diseases, the majority of them are remedies improving the digestion. Description of a juvarish composed by Muhammad Yusif Shirvani is given below.

JUVARISH AGAINST INDIGESTION. It is good against intestinal colic and indigestion. It strengthens the stomach and facilitates digestion. It also treats fevers associated with surplus of black bile in organism. Take hot water with one pill of this remedy weighing approximately one nut. Composition. Take the cumin seeds, infuse in vinegar for a day, dry and roast. Then, take leaves of raute (Ruta graveolens) driedin shadow, pepper and ginger (each of them - 85 g), add 32 g of household soda. Ground these substances, mix with honey, store in a pot and use when necessary. [39]

Similar to other complex medicines, juvarishs consists of numerous components of the plant, animal and mineral origin mixed in honey or sugar syrup, sometimes with addition of vinegar or wine. Information on frequency of use of various components in juvarishs is given in the Table 7.


Table 7. Frequency of Use of Various Components in Juvarishs.


Components
Frequency of use
%
Plants
716
86.3
Animal products
26
3.1
Minerals
17
2.0
Honey
45
5,4
Sugar
11
1,5
Vinegar
8
0,9
Wine
7
0,8
TOTAL
830
100,0

Iyarajs. As a result of the studies carried out, the compositions of 21 types of ijarajs have been identified. The term iyaraj is derived from the Greek iera that means the holy (medicine).

According to medieval authors, iyarajs are purgatives. However, it should be taken into account that in the medieval Azerbaijan all medicines removing waste substances (urine, excrement, sweat, phlegm, pus) and four humors (blood, mucus, bile and black bile) from the organism were considered as purgatives.

Physicians of the Middle Ages believed that all diseases appear as a result of deficiency or surplus of these waste substances and "four humors". Therefore, many diseases were healed with the help of iyarajs which were used to remove these surplus substances from the organism. Ibn al-Beithar (13th century), Yusif bin Isma'il Khoyi known as Ibn Kabir(14th century), Muhammad Mu'min (17th century) considered that the first iyaraj was invented by Rufus who was the second (after Galen) greatest Greek physician and anatomist that lived in Rome during the reign of emperor Trajanus (83-117 AD).

Muhammad Mu'min wrote that in the ancient times, the term iyaraj was applied only to iyarajs of Rufus, but later on this name was spread upon other medicines as well. An example of iyarajs compiled by Haji Suleyman Iravani (18th century) is given below.

IYARAJ FOR IMPROVING OF EYESIGHT. This iyaraj strengthens eyesight, heals headaches, diseases of stomach, liver and spleen. Composition. Flesh of bitter cucumber (Citrullus colocynthis) - 32g; cinnamon and three kinds of pepper (black, white and cubeb), each of them - 6.4g; aloe, gumm myrrh, incense and saff ron, each of them - 3.2g; gum of scammony plant (Convolvulus scammonea) - 19.2 g; fresh juice of bitter wormwood - 6.4g; honey - sufficient amount. Take hot water with 12g of this remedy. [39]

Medieval physicians prescribed to take up to 18 g of iyaraj for one time. After preparation of iyarajs, pharmacists added to them some soda. The most popular iyaraj was called iyarajfikra that means "the bitter iyaraj". This name is considered to be derived from the Greek term iera pikra. The bitter taste was added by aloe contained in this medicine. Thus, before drinking, iyaraj was dissolved in honey water or dodder (convolvulus) decoction.

Numerous recipes of iyarajs are given in the books by such Azerbaijani authors as Mahmud bin Ilyas (13th century), Haji Suleyman Iravani (17th century), Hasan bin Riza Shirvani (17th century), and others. These authors mention names of following ancient scholars, authors of iyarajs: Andromachus, Archigenes, Paulus, Hippocrates, Phylagrius, Phylagorus, Rufus (transcription of the names is given according to medieval sources - author). The five anonymous recipes are varieties of the thiyadaritus. This word is derived from the Latin name theodaritus and means [the medicine] given by Good. The first original recipes of thiyadaritus were taken by medieval physicians from the ancient medical books.

Some recipes are ascribed to the following medieval Muslim scholars: Ibn Sarafiyun, Busit and Ibn Daud. Three recipes were compiled by Lugaziya, the ancient Hebrew physician who conbined in his works the rich heritage of Oriental and Greek medicine.

Iyarajs are the medical mixtures majority of which contain honey or sugar syrup. Major part of their components are plants. As compared to ma'juns and juvarishs, the iyarajs contain fewer components of mineral and animal origin. Information on frequency of use of various components in iyarajs is given in Table 8.


Table 8. Frequency of Use of Various Components in Iyarajs.


Components
Frequency of use
%
Plants
428
93.8
Honey and Sugar
19
4.1
Animal products
7
1.5
Minerals
2
0,4
Wine
1
0,2
TOTAL
457
100,0

IYARAJ AGAINST SPASMS. This iyaraj is good against spasms, headaches, migraine, diseases of stomach, liver and spleen. Composition. Flesh of bitter cucumber (Citrullus colocynthis) – 64 g; peppermint, agaric (Agaricus campestris), lavender, each of them - 32 g; birth-wort (Aristolochia longa), wild parsley, white pepper, opopanax (Opopanax chironium), sagapen-gummi (Ferula sagapenum.), each of them - 16 g; gum myrrh, sumbul, poly-germander (Teucrium polium), saffron, Chinese cinnamom (Cinnamomum cassia), each of them - 9.6 g.

The humid substances and honey should be dissolved and boiled on low heat. Then, thresh or grind dry substances, add them to the decoction, stir and use after six months. [6]

As it was mentioned above, iyarajs were considered as "purgatives" for removing all surplus substances which may cause various ailments. In the Table 9 iyarajs are divided into medical groups according to their medical applications.

As various iyarajs were used to treat different diseases, the sum of numbers in column titled "Number of recipes" is more than 21, and the sum of percentages is greater than 100%.


Table 9. Classification of Iyarajs According to Their Medical Applications.


Main medical Applications
Number of recipes
%
Headaches
19
47.7
Neurologic diseases
9
42.8
Diseases of stomach and bowels
2
9.5
Diseases of respiratory organs
24
19,0
Diseases of liver and gall bladder
4
19,0
Diseases of sexual organs
1
4,7
Traumatic diseases
1
4,7
Infectious diseases
5
23,8
Eye diseases
1
4,7
Rheumatism
1
4,7
Alopecia
1
4,7

As it is evident from the table, majority of iyarajs were applied to treating headaches and nervous diseases, and only two - to healing gastro-intestinal disorders. It is explained by the fact that in those times, the term “purgative” had the different meaning. It was considered that headaches and neurological diseases are associated with surplus of the black bile (savda) in an organism. Therefore, these diseases were treated with the help of special “purgatives” (including ijarajs) that remove the black bile from the organism.

Characteristics of other medical forms are the subject of another book dealing with the complex medicines of the medieval Azerbaijan.



CONCLUSIONS

Studying of medieval (10-18th centuries) manuscripts on medicine and pharmacy have revealed that there was the complete scientific-philosophic concept of health protection in the medieval Azerbaijan. The key issues of this concept are as follows:

1. Protection of environment (air, water, soil, plants and animals)

2. Correct planning of habitations and settlements to protect health of their residents.

3. Healthy mode of life (physical exercises, healthy nutrition, regime of labor and rest, regulations of emotions, regular purification of organism).

4. Treatment of diseases (medicine and pharmacology). Therefore, the concept of health protection existing in medieval Azerbaijan includes not only medicine and pharmacology, but also the culture of communication, mode of life, nutrition, work, rest, that is, the way of life on the whole. Consequently, it is the scientific-philosophic system offering rational lifestyle to protect the human's health.

Along with traditional treatment methods, Azerbaijanis of the Middle Ages widely used aromathotherapy, treatment by music, various sounds and color, healing with the help of suggestion, etc.,

The results of present study have opened access to the treasure of natural medicines used in our country since antiquity. For the first time, 724 species of medicinal plants, 150 species of animals and 115 species of minerals used in the medicine of the medieval Azerbaijan have been identified.

Most of the identified plants belong to indigenous species (422 species) widely spread in Azerbaijan. These plants were used to treat such diseases as infectious diseases of external tissues (150 species), urinary diseases (92), diseases of liver and biliary tract (73), pneumonia and pleurisy (71), cardiovascular diseases (63), etc. Out of these 422 indigenous plants, 256 are no longer used in modern phytotherapy.

It appears that there were 866 types of medicines with complex composition described in the medieval sources. For the first time, these medicines have been classified according to medical groups and their compositions have been established. A list of the identified medicines has been prepared as well.

The author believes that these "forgotten" medicinal plants (as well as minerals, animal products and complex medicines) might be broadly applied in modern medicine once they have been clinically and experimentally tested.



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86. William Dymock. Pharmacographia Indica. London, Bombay, Calcutta, 1893. Reprinted by "Hamdard", The Journal of the Institute of Health and Tibbi (Medical) Research, Pakistan, 1972, 643 P.

87. Yakut al-Hamawi. Mujam al-Buldan (Alphabetical List of Countries).Cairo, 1906 (in Arabic)

88. Yusif ibn Muhammad. Jam al-Favaid (Tibbi-Yusifi). Manuscript from the Collection of the Baku's Institute of Manuscripts.

89. Yusif ibn Ismail Khoyi. Jami al-Baghdadi. Manuscript from the Collection of the Baku's Institute of Manuscripts.

90. Yusif Balasagunlu. Kutadgu Bilik (Sacred Knowledge). Moscow, 1987

91. Ziyari, Keykavus. Gabusname. The manuscript from the collection of Baku's Institute of Manuscripts. No B 7865 (in Persian)



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