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Postprandial hyperglycemia indicates the abnormality in glucose turnover leading to the onset of type 2 diabetes. Therefore, correction of postprandial hyperglycemia is crucial in the early stage of diabetes therapy. One of the most effective strategies to control postprandial hyperglycemia is medication combined with intake restriction and an exercise program. However, along with the prevalence of chronic diseases with multi-pathogenic factor, drugs with single chemical composition are usually not effective. In this view, phytotherapy has a promising future in the management of diabetes, considered to have less side effects as compared to synthetic drugs.
The World Health Organization estimates that in developing countries about 80% of the population now still depend on herbal treatment. Olive (Olea europea) (OE) has been used in traditional remedies in Europe and Mediterranean countries as a food and medicine for over 5,000 years especially for the prevention and treatment of chronic diseases such as hypertension, atherosclerosis , cancer and diabetes. In addition, olive is considered as the most important component of the Mediterranean diet with many health benefits.
Several experimental studies have demonstrated the beneficial effect of OE on diabetes. This effect has been demonstrated in the animal models such as streptozotocin-induced diabetic rats, alloxaninduced diabetic rats and obese diabetic sand rats fed a hypercaloric diet. In these models olive extracts have been shown to exhibit a significant reduction on both blood glucose and insulin levels. Few randomized clinical trials have demonstrated the beneficial effect of olive and one study has shown that the subjects treated with olive leaf extract exhibited significantly lower Glycated hemoglobin (HbA1c) and fasting plasma insulin levels.
Another study performed in recent onset type 2 diabetic patients has revealed that OE leaves exhibited antidiabetic activity when it added as a mixture of extract of leaves of Juglans regia, Urtica dioica and Atriplex halimus. The underlying mechanism seems to be the improvement of glucose uptake and no side effect was reported while extracts from OE have been found to exhibit cytotoxic effects only at concentrations higher than 500 μg/ mL in cells from the liver hepatocellular carcinoma cell line (HepG2) and cells from the rat L6 muscle cell line. As far as the phytochemical analysis is concerned, it is now well-established that major fatty acid constituents and minor phenolic components in olives and olive oil exert important health benefits particularly for cardiovascular diseases, metabolic syndrome and inflammatory conditions.
Hydroxytyrosol and oleuropein are considered as major polyphenolic compounds in olive leaf. Oleuropeoside, a phenylethanoid isolated from OE demonstrated a significant hypoglycemic activity in alloxan-induced diabetes and the hypoglycemic activity of this compound may result from both the increased peripheral uptake of glucose and potentiation of glucose-induced insulin secretion. In addition, Maslinic acid (MA), a natural triterpene from OE with hypoglycemic activity is a wellknown inhibitor of glycogen phosphorylase in diabetic rats without affecting hematological, histopathologic and biochemical variables, thus suggesting a sufficient margin of safety for its putative use as a nutraceutical. More recently a study has showed that MA exerts antidiabetic effects by increasing glycogen content and inhibiting glycogen phosphorylase activity in HepG2 cells.
Furthermore, MA was shown to induce the phosphorylation level of insulin-receptor β-subunit, protein kinase B (Akt) and glycogen synthase kinase-3β. MA treatment of mice fed with a high-fat diet reduced the model-associated adiposity, mRNA expression of proinflammatory cytokines and then insulin resistance, and increased the accumulated hepatic glycogen.
Finally, a recent clinical study has revealed that supplementation with olive leaf polyphenols significantly improved insulin sensitivity and pancreatic β-cell secretory capacity in overweight middle-aged men at risk of developing the metabolic syndrome. In conclusion, OE has been and continue to represent a natural source of phytocompounds eliciting a beneficial effect in human health especially in the management of hyperglycemia [1–15].
- Bennani-Kabchi N Fdhil H,Cherrah Y,El Bouayadi F,Kehel L,et al.(2000) Therapeutic effect ofOleaeuropeavar. oleaster leaves on carbohydrate and lipid metabolism in obese and prediabetic sand rats (Psammomysobesus).Ann Pharm Fr 58: 271-7.
- Said O,Fulder S, Khalil K,Azaizeh H, Kassis E, et al. (2008) Maintaining a physiological blood glucose level with ‘glucolevel’, a combination of four anti-diabetesplants used in the traditional arab herbal medicine. Evid Based Complement Alternat Med 5:421-8.
- Bouallagui Z,Han J,Isoda H,Sayadi S. Hydroxytyrosol rich extract from olive leaves modulates cell cycle progression in MCF-7 human breast cancer cells (2011) Food ChemToxicol 49:179-84.
- Nan JN,Ververis K ,Bollu S,Rodd AL,Swarup O,et al. (2014) Biological effects of the olive polyphenol, hydroxytyrosol: An extra view from genome-wide transcriptome analysis.Hell J Nucl Med 17: 62-9.
- Guan T, Qian Y, Tang X, Huang M, Huang L, et al. (2011) Maslinic acid, a natural inhibitor of glycogen phosphorylase, reduces cerebral ischemic injury in hyperglycemic rats by GLT-1 up-regulation. Neurosci Res 89: 1829-39.
- Sánchez-González M, Lozano-Mena G, Juan ME, García-Granados A, Planas JM (2013)Assessment of thesafetyof maslinic acid, a bioactive compound from Oleaeuropaea L.Mol Nutr Food Res 57:339-46.
- Liu J, Wang X, Chen YP, Mao LF, Shang J, et al. (2014) Maslinic acidmodulates glycogen metabolism by enhancing the insulin signaling pathway and inhibiting glycogen phosphorylase.Chin J Nat Med 12: 259-65.
- de Bock M, Derraik JG, Brennan CM, Biggs JB, Morgan PE,(2013) Olive(Oleaeuropaea L.) leaf polyphenols improve insulin sensitivity in middle-aged overweight men: a randomized, placebo-controlled, crossover trial.
Prof. Mohamed Eddouks
Dean, Polydisciplinary Faculty of Errachidia
Moulay Ismail University, Morocco
Oct 1995–present, ProfessorUniversité Moulay Ismail · Department of Biology · Physiology and endcorine PharmacologyMorocco · Errachidia, Meknès-Tafilalet-Professor (2001 until now) -Vice Dean of Scientific Research and Cooperation Faculty of Sciences and Techniques Errachidia (2005-2008 -Dean Polydisciplinary faculty of Errachidia (2008-2012)
- Eddouks M, Chattopadhyay D, Zeggwagh NA.Animal models as tools to investigate antidiabetic and anti-inflammatory plants.Evid Based Complement Alternat Med. 2012;2012:142087.
- Zeggwagh NA, Michel JB, Eddouks M.Vascular Effects of Aqueous Extract of Chamaemelum nobile: In Vitro Pharmacological Studies in Rats.Clin Exp Hypertens. 2012.
- Oufni L, Taj S, Manaut B, Eddouks M. 2011.Transfer of uranium and thorium from soil to different parts of medicinal plants using SSNTD. Journal of Radioanalytical and Nuclear Chemistry, 287; 403-411.
- Zeggwagh NA, Moufid A, Michel JB, Eddouks M. Hypotensive effect of Chamaemelum nobile aqueous extract in spontaneously hypertensive rats.Clin Exp Hypertens. 2009.31(5):440-50.
- Zeggwagh NA, Farid O, Michel JB, Eddouks M. Cardiovascular effect of Artemisia herba alba aqueous extract in spontaneously hypertensive rats.Methods Find Exp Clin Pharmacol. 2008. 30(5):375-81.
- Eddouks M, Maghrani M, Louedec L, Haloui M, Michel JB.Antihypertensive activity of the aqueous extract of Retama raetam Forssk. leaves in spontaneously hypertensive rats.J Herb Pharmacother. 2007;7(2):65-77.
- Zeggwagh, N-A., Eddouks, M . Anti-hyperglycaemic and hypolipidemic effects of Ocimum basilicum aqueous extract in diabetic rats. American Journal of Pharmacology and Toxicology. 2(3): 123-129, 2007.
- Lemhadri, A., Burcelin, R., Eddouks, M. Chamaemelum nobile L. aqueous extract represses endogenous glucose production and improves insulin sensitivity in streptozotocin-induced diabetic mice. American Journal of Pharmacology and Toxicology. 2(3): 116-122, 2007.
- Lemhadri, A., Eddouks, M., Burcelin, R. Anti-hyperglycaemic and anti-obesity effects of Capparis spinosa and Chamaemelum nobile aqueous extracts in HFD mice. American Journal of Pharmacology and Toxicology. 2(3): 106-110, 2007.
- Zeggwagh, N.A., Michel, J.B, and Eddouks, M. Acute Hypotensive and Diuretic Activities of Chamaemelum nobile Aqueous Extract in Normal Rats. American Journal of Pharmacology and Toxicology. 2(3): 140-145, 2007.
- Zeggwagh, N-A., Michel, JB., Eddouks, M . Cardiovascular effect of Capapris spinosa aqueous extract in rats Part II: Furosemide-like effect of Capparis spinosa aqueous extract in normal rats. 2(3): 130-134, 2007.
- Zeggwagh, N-A., Michel, JB., Eddouks, M . Cardiovascular effect of Capparis spinosa aqueous extract. Part III: Antihypertensive effect in spontaneously hypertensive rats. American Journal of Pharmacology and Toxicology. 2(3): 111-115, 2007.
- Zeggwagh, N-A., Eddouks, M .Michel, JB. Cardiovascular effect of Capparis spinosa aqueous extract. Part VI: in vitro vasorelaxant effect.American Journal of Pharmacology and Toxicology. 2(3): 135-139, 2007.
- Eddouks, M., Ouahidi, M.L., Farid, O., Moufid, A., Lemhadri, A. The use of medicinal plants in the treatment of diabetes in Morocco. Phytothérapie. 2007, 5, no4, pp.194-203.
- Eddouks M; Khalidi A; Zeggwagh N.-A; Pharmacological approach of plants traditionally used in treating hypertension in Morocco. Phytothérapie. 2009, 7, no2, pp. 122-127.
- Zeggwagh NA, Ouahidi ML, Lemhadri A, Eddouks M. 2006. Study of hypoglycaemic and hypolipidemic effects of Inula viscosa L. aqueous extract in normal and diabetic rats. Journal ofEthnopharmacology. 24; 108(2): 223-7.
- Lemhadri A, Hajji L, Michel JB, Eddouks M. Cholesterol and triglycerides lowering activities of caraway fruits in normal and streptozotocin diabetic rats. Journal ofEthnopharmacology 2006 19; 106(3):321-6.
- Eddouks, M., Maghrani, M, Michel, J-B.Antihypertensive action of Lepidium sativum in SHR rats. In Press. Journal of Herbal Pharmacotherapy.Eddouks, M., Michel, J-B., Mghrani, M. Effect of Lepidium sativum L. On renal glucose reabsorption and urinary TGF B levels in diabetic rats. Phytotherapy Research. 2008 ;22(1):1-5.
- Eddouks M, Maghrani M, Michel JB.2005.Hypoglycaemic effect of Triticum repens P. Beauv. in normal and diabetic rats. Journal of Ethnopharmacology. 2005 ; 102(2):228-32.
- Eddouks, M. 2005. Les plantes anti-diabétiques. Phytothérapie Européenne. 28, 8-12.
- Zhang J, Onakpoya IJ, Posadzki P, Eddouks M. The safety of herbal medicine: from prejudice to evidence. Evid Based Complement Alternat Med. 2015;2015:316706.
- Yakubu MT, Sunmonu TO, Lewu FB, Ashafa AO, Olorunniji FJ, Eddouks M. Efficacy and safety of medicinal plants used in the management of diabetes mellitus. Evid Based Complement Alternat Med. 2014; 2014: 793035.
- Eddouks M, Chattopadhyay D, De Feo V, Cho WC. Medicinal plants in the prevention and treatment of chronic diseases 2013. Evid Based Complement Alternat Med. 2014;2014:180981.
- Eddouks M, Bidi A, El Bouhali B, Hajji L, Zeggwagh NA. Antidiabetic plants improving insulin sensitivity. J Pharm Pharmacol. 2014 Sep;66(9):1197-214.
Efficacy and Safety of Olive in the Management of Hyperglycemia
Faculty of Sciences and Techniques Errachidia, Moulay Ismail university, BP 21, Errachidia, 52000, Morocco
Faculty of Sciences and Techniques Errachidia
Moulay Ismail University
Dr. Mohamed Eddouks is currently working as a professor at Moulay ismail university, morocco. He worked as assistant professor at faculty of sciences and techniques errachidia (1995) and as head of the department of biology at faculty of sciences and techniques errachidia (2003). He completed his PhD degree in Physiology and Pharmacology from University of Liege, Belgium and Sidi Mohammed Ben Abdellah University. He published many articles in international journals.
Citation: Eddouks M (2015) Efficacy and Safety of Olive in the Management of Hyperglycemia. Pharmaceut Reg Affairs 4:e145. doi:10.4172/2167-7689.1000e145
Er Rachidi; Errachidia
Asparagusic acid is the organosulfur with the formula S2(CH2)2CHCO2H. The molecule contains both carboxylic acid and disulfide functional groups. It is present in the vegetable asparagus and may be the metabolic precursor to other odorous thiol compounds.
Biosynthetic studies revealed that asparagusic acid is derived from isobutyric acid. This colorless solid has a melting point (m.p.) of 75.7–76.5 °C. The corresponding dithiol (m.p. 59.5–60.5 °C) is also known; it is called dihydroasparagusic acid or dimercaptoisobutyric acid.
Over the past forty years several papers have been published on the subject, and several studies undertaken, to try and determine the chemical compounds responsible, and though there is still no definitive verdict as to the manner in which these compounds are formed, it has been suggested that they all form from asparagusic acid.
Asparagusic acid is, unsurprisingly considering the name, a chemical found exclusively in asparagus, and absent in other related vegetables.
The asparagus-pee molecules that you smell come mostly from the breakdown of a molecule known as asparagusic acid, which is present naturally in asparagus. When your body breaks down asparagusic acid it forms a wide variety of chemicals, all of which contain sulfur!
This has made it an obvious candidate for being the origin of the peculiar effect that asparagus has on urine. It has been suggested by recent studies that it could be metabolised in the body to produce the volatile compounds found in the urine after consuming the vegetable.
Steamed asparagus prepared with roasted pine nuts
Many chemicals that contain sulfur atoms smell horrible in similar ways, and I have no idea why this is. This is one chemical/biological mystery that, much to my chagrin, remains unsolved in my head (internet people, if the reason is known, please help!).
Aside from sulfur, the thing that all these smelly asparagus-pee chemicals have in common is that they are “light” enough (a.k.a. they are “volatile”, which means they have a relatively low boiling point) that they can float up into the air and into your nose. That is partly why asparagus doesn’t smell like asparagus-pee, because asparagusic acid is not volatile (remember that word). In fact, asparagusic acid boils above 300 °C (>600 °F), so there is no way any of it gets into your nose!
Asparagus has been used as a vegetable and medicine, owing to its delicate flavour, diuretic properties, and more. It is pictured as an offering on an Egyptian frieze dating to 3000 BC. Still in ancient times, it was known in Syria and in Spain. Greeks and Romans ate it fresh when in season and dried the vegetable for use in winter; Romans would even freeze it high in the Alps, for the Feast of Epicurus. Emperor Augustus tossed off the “Asparagus Fleet” for hauling the vegetable, and coined the expression “faster than cooking asparagus” for quick action. A recipefor cooking asparagus is in the oldest surviving book of recipes, Apicius’s third-century AD De re coquinaria, Book III.
The ancient Greek physician Galen (prominent among the Romans) mentioned asparagus as a beneficial herb during the second century AD, but after the Roman empire ended, asparagus drew little medieval attention. until al-Nafzawi‘s The Perfumed Garden. That piece of writing celebrates its (scientifically unconfirmed) aphrodisiacal power, a supposed virtue that the IndianAnanga Ranga attributes to “special phosphorus elements” that also counteract fatigue. By 1469, asparagus was cultivated in French monasteries. Asparagus appears to have been hardly noticed in England until 1538, and in Germany until 1542.
The finest texture and the strongest and yet most delicate taste is in the tips. The points d’amour (“love tips”) were served as a delicacy to Madame de Pompadour. Asparagus became available to the New World around 1850, in the United States.
Some of the volatile organic compounds responsible for the smell are:
- dimethyl sulfide
- dimethyl disulfide
- dimethyl sulfoxide
- dimethyl sulfone
Subjectively, the first two are the most pungent, while the last two (sulfur-oxidized) give a sweet aroma. A mixture of these compounds form a “reconstituted asparagus urine” odor. This was first investigated in 1891 by Marceli Nencki, who attributed the smell to methanethiol. These compounds originate in the asparagus as asparagusic acid and its derivatives, as these are the only sulfur-containing compounds unique to asparagus. As these are more present in young asparagus, this accords with the observation that the smell is more pronounced after eating young asparagus. The biological mechanism for the production of these compounds is less clear.
Gas chromatography-mass spectrometry was used to analyse the ‘headspace’ of urine produced after consumption of asparagus. The headspace is the gas space immediately above the liquid surface, which is occupied by light, volatile compounds in the liquid, and analysis of this is useful in identifying odour-causing compounds. The analysis of the post-asparagus urine showed the presence of several compounds that were not present, or present in negligible amounts, in normal urine. The primary compounds present, in quantities a thousand times greater than in normal urine, were methanethiol and dimethyl sulfide. The compounds dimethyl sulfide and dimethyl sulfone were also present and it was suggested that they modify the aroma to give it a ‘sweet’ edge.
|Nutritional value per 100 g (3.5 oz)|
|Energy||85 kJ (20 kcal)|
|– Sugars||1.88 g|
|– Dietary fibre||2.1 g|
|Vitamin A equiv.||38 μg (5%)|
|– beta-carotene||449 μg (4%)|
|– lutein and zeaxanthin||710 μg|
|Thiamine (vit. B1)||0.143 mg (12%)|
|Riboflavin (vit. B2)||0.141 mg (12%)|
|Niacin (vit. B3)||0.978 mg (7%)|
|Pantothenic acid (B5)||0.274 mg (5%)|
|Vitamin B6||0.091 mg (7%)|
|Folate (vit. B9)||52 μg (13%)|
|Choline||16 mg (3%)|
|Vitamin C||5.6 mg (7%)|
|Vitamin E||1.1 mg (7%)|
|Vitamin K||41.6 μg (40%)|
|Calcium||24 mg (2%)|
|Iron||2.14 mg (16%)|
|Magnesium||14 mg (4%)|
|Manganese||0.158 mg (8%)|
|Phosphorus||52 mg (7%)|
|Potassium||202 mg (4%)|
|Sodium||2 mg (0%)|
|Zinc||0.54 mg (6%)|
Khat (Catha edulis) is a flowering plant native to the Horn of Africa and the Arabian Peninsula. Among communities from these areas, khat chewing has a long history as a social custom dating back thousands of years.
Khat contains a monoamine alkaloid called cathinone, an amphetamine-like stimulant, which is said to cause excitement, loss of appetite and euphoria. In 1980, the World Health Organization (WHO) classified it as a drug of abuse that can produce mild to moderatepsychological dependence (less than tobacco or alcohol), although the WHO does not consider khat to be seriously addictive. The plant has been targeted by anti-drug organizations such as the DEA.It is a controlled substance in some countries, such as the United States, Canada and Germany, while its production, sale and consumption are legal in other nations, including Djibouti, Ethiopia, Somalia and Yemen.
Man chewing khat in Sana’a, Yemen, January 2009
Allegedly according to some sources, but disputed by others, khat’s exact place of origin is uncertain.One argument is that it was first grown in Ethiopia,with the explorer Sir Richard Burton suggesting that the plant was later introduced to Yemen from Ethiopia in the 15th century. He specifically mentions the eastern city of Harar as the birthplace of the plant.
However, amongst communities in the Horn of Africa (Djibouti, Eritrea, Ethiopia, Somalia) and the Arabian Peninsula, khat chewing has a long history as a social custom dating back thousands of years.
The Ancient Egyptians considered the khat plant a divine food, which was capable of releasing humanity’s divinity. The Egyptians used the plant for more than its stimulating effects; they used it for transcending into “apotheosis”, with the intent of making the user god-like.
The earliest known documented description of khat is found in the Kitab al-Saidala fi al-Tibb كتاب الصيدلة في الطب, an 11th century work onpharmacy and materia medica written by Abū Rayhān al-Bīrūnī, a Persian scientist and biologist. Unaware of its origins, al-Bīrūnī wrote that khat is:
a commodity from Turkestan. It is sour to taste and slenderly made in the manner of batan-alu. But khat is reddish with a slight blackish tinge. It is believed that batan-alu is red, coolant, relieves biliousness, and is a refrigerant for the stomach and the liver.
In 1854, Malay writer Abdullah bin Abdul Kadir noted that the custom of chewing khat was prevalent in Al Hudaydah in Yemen
You observed a new peculiarity in this city – everyone chewed leaves as goats chew the cud. There is a type of leaf, rather wide and about two fingers in length, which is widely sold, as people would consume these leaves just as they are; unlike betel leaves, which need certain condiments to go with them, these leaves were just stuffed fully into the mouth and munched. Thus when people gathered around, the remnants from these leaves would pile up in front of them. When they spat, their saliva was green. I then queried them on this matter: ‘What benefits are there to be gained from eating these leaves?’ To which they replied, ‘None whatsoever, it’s just another expense for us as we’ve grown accustomed to it’. Those who consume these leaves have to eat lots of ghee and honey, for they would fall ill otherwise. The leaves are known as Kad.”
khat contains Cathinone ,
or benzoylethanamine (marketed as hagigat in Israel), is amonoamine alkaloid found in the shrub Catha edulis (khat) and is chemically similar toephedrine, cathine and other amphetamines. Cathinone induces the release of dopaminefrom striatal preparations that are prelabelled either with dopamine or its precursors. It is probably the main contributor to the stimulant effect of Catha edulis. Cathinone differs from many other amphetamines in that it has a ketone functional group. Other amphetamines that share this structure include the antidepressant bupropion and the stimulantmethcathinone, among others.
Internationally, cathinone is a Schedule I drug under the Convention on Psychotropic Substances. Circa 1993, the DEA added cathinone to the Controlled Substances Act’s Schedule I.
The sale of khat is legal in some jurisdictions, but illegal in others — see Khat (Regulation). Synthetic cathinone is also often used as the key ingredient of recreational drug mixes commonly known as ‘bath salts’ in the United States.
Cathinone is structurally related tomethcathinone, in much the same way asamphetamine is related to methamphetamine. Cathinone differs from amphetamine by possessing a ketone oxygen atom (C=O) on the β (beta) position of the side chain. The corresponding alcohol compound cathine is a less powerful stimulant. The biophysiological conversion from cathinone to cathine is to blame for the depotentiation of khat leaves over time. Fresh leaves have a greater ratio of cathinone to cathine than dried ones, therefore having more psychoactive effects.
Cathinone can be extracted from Catha edulis, or synthesized from α-bromopropiophenone(which is easily made from propiophenone).
Tree Germander (Teucrium fruticans)
This plant is used in folk medicine for treating diarrhea, cough, jaundice and abdominal pain
Medicinal plants are used for the treatment of different diseases in almost all cultures. Teucrium species grow wildly at different geographical locations around the world. Teucrium stocksianum is used in folk medicine for the treatment of diarrhea, cough, jaundice and abdominal pain. Scientific study on Teucrium stocksianum shows that it possesses anthelmintic, cytotoxic and antispasmodic activity. The aim of our present study is to identify the chemical composition and antinociceptive potential of the essential oil extracted from Teucrium stocksianum bioss.
Teucrium is a genus of perennial plants in the family Lamiaceae. The name is believed to refer to King Teucer of Troy. Members of the genus are commonly known as germanders. These species are herbs, shrubs or subshrubs. They are most common in Mediterranean climates.
An unusual feature of this genus compared with other members of Lamiaceae is that the flowers completely lack the upper lip of the corolla, although it is somewhat reduced also in other genera (Ajuga among them).
Several species are used as food plants by the larvae of some Lepidoptera species including the Coleophora case-bearers Coleophora auricella and Coleophora chamaedriella. The latter is only known from Wall Germander (T. chamaedrys).
Teucrium species are rich in essential oils. They are valued as ornamental plants and a pollen source, and some species have culinary and/or medical value.
In the history of medicine, Islamic medicine, Arabic medicine, Greco-Arabic and Greco-Islamic refer to medicine developed in the Islamic Golden Age, and written in Arabic, the lingua franca of Islamic civilization. The emergence of Islamic medicine came about through the interactions of the indigenous Arab tradition with foreign influences.Translation of earlier texts was a fundamental building block in the formation of Islamic medicine and the tradition that has been passed down.
Latin translations of Arabic medical works had a significant influence on the development of medicine in the high Middle Ages and early Renaissance, as did Arabic texts which translated the medical works of earlier cultures.
In the early Islamic and Mack’s period (661–750 AD), Muslims believed that Allah provided a treatment for every illness.Around the ninth century, the Islamic medical community began to develop and utilize a system of medicine based on scientific analysis. The importance of the health sciences to society was emphasized, and the early Muslim medical community strived to find ways to care for the health of the human body. Medieval Islam developed hospitals, expanded the practice of surgery.
Important medical thinkers and physicians of Islam were Al-Razi and Ibn Sina. Their knowledge on medicine was recorded in books that were influential in medical schools throughout Muslim history, and Ibn Sina in particular (under his Latinized name Avicenna) was also influential on the physicians of later medieval Europe. Throughout the medieval Islamic world, medicine was included under the umbrella of natural philosophy, due to the continued influence of the Hippocratic Corpus and the ideas of Aristotle and Galen. The Hippocratic Corpus was a collection of medical treatises attributed to the famous Greek physician Hippocrates of Cos (although it was actually composed by different generations of authors). The Corpus included a number of treatises which greatly influenced medieval Islamic medical literature
The first encyclopedia of medicine in Arabic language] was Persian scientist Ali ibn Sahl Rabban al-Tabari‘s Firdous al-Hikmah (“Paradise of Wisdom”), written in seven parts, c. 860. Al-Tabari, a pioneer in the field of child development, emphasized strong ties between psychology and medicine, and the need for psychotherapy and counseling in the therapeutic treatment of patients. His encyclopedia also discussed the influence of Sushruta and Chanakya on medicine, including psychotherapy
Medical contributions made by Medieval Islam not only involved the development and expansion of the human anatomy, but also included the use of plants as a type of remedy or medicine. Medieval Islamic physicians used natural substances as a source of medicinal drugs—including Papaver somniferum Linnaeus, poppy, and Cannabis sativa Linnaeus, hemp. In pre-Islamic Arabia, neither poppy nor hemp was known. Hemp was introduced into the Islamic countries in the ninth century from India through Persia and Greek culture and medical literature. Dioscorides, who according to the Arabs is the greatest botanist of antiquity, recommended hemp’s seeds to “quench geniture” and its juice for earaches. Beginning in 800 and lasting for over two centuries, poppy use was restricted to the therapeutic realm. However, the dosages often exceeded medical need and was used repeatedly despite what was originally recommended. Poppy was prescribed by Yuhanna b. Masawayh to relieve pain from attacks of gallbladder stones, for fevers, indigestion, eye, head and tooth aches, pleurisy, and to induce sleep. Although poppy had medicinal benefits, Ali al-Tabari explained that the extract of poppy leaves was lethal, and that the extracts and opium should be considered poisons
The way early Arab medicine developed should be contrasted to how medicine evolved in Christianity up until the Renaissance. While Christian Rome and Byzantium inherited the rich Graeco-Roman medical legacy of thinkers like Hippocrates and Galen, after the fall of Rome in 476, Dark Age Europe increasingly tended towards a fatalistic view of suffering and disease, further tempered by superstition about curses and God’s punishment for man’s sins sent down in the form of disease and affliction.
Many historians point to the explicit tradition of fact-based, scientific medicine as articulated by the Prophet himself (pbuh). First, the concept of ‘sinful’ mankind seems not as strong in Islam as in early Christianity. Disease was seen by Arabs and other Muslims as one more problem to be solved, not a curse from God or a trial to be endured so one would be assured of entering Paradise.
Consider these statements on health and medicine attributed to the Prophet (pbuh):
“There is no disease that Allah has created, except that He also has created its treatment.”
“Make use of medical treatment, for Allah has not made a disease without appointing a remedy for it, with the exception of one disease, namely old age.”
The Prophet (pbuh) was also credited with articulating several specific medical treatments, including the use of honey, cupping, and cauterisation. He spoke about the contagious nature of leprosy, sexually transmitted disease, and the animal disease known as the mange. But most importantly, whereas other societies usually stigmatised and feared the sick and afflicted, at best isolating them and at worst leaving them somewhere to die, the Prophet (pbuh) and early Islam had a very compassionate and forgiving view of the sick.
As in other fields, the earliest Arab-Muslim medical efforts were devoted to translating the medical wisdom of older civilisations, beginning in the late 700s in Baghdad with the works of the Roman physician Galen as well as advanced medical writings from Persia, including the great pre-Islamic medical centre at Gundishapur.
Gundishapur is credited with having developed the first truly modern hospital, where patients actually went to be healed and cured, rather than prayed over as they suffered a slow and inevitable death as in Dark Age Europe.
The first major Arab-Muslim healer was the chemist Al Razi, who turned to medicine at about age 30, perhaps to find cures for his injuries suffered during alchemical experiments, especially eye ailments. His first inspiration was the Roman physician Galen.
Galen had pushed Roman medical knowledge as far as it could go in that time, undertaking innumerable vivisections of live animals to see how their organs functioned, as well as dissections of human cadavers.
Al Razi was especially troubled by Galen’s theory of the humours, which just didn’t hold up to examination. There seemed a lot more going on inside the human body than those four humours. And so he would write around 865:
“I prayed to God to direct and lead me to the truth in writing this book. It grieves me to oppose and criticise the man Galen from whose sea of knowledge I have drawn much. Indeed, he is the Master and I am the disciple. Although this reverence and appreciation will and should not prevent me from doubting, as I did, what is erroneous in his theories. I imagine and feel deeply in my heart that Galen has chosen me to undertake this task, and if he were alive, he would have congratulated me on what I am doing. I say this because Galen’s aim was to seek and find the truth and bring light out of darkness. I wish indeed he were alive to read what I have published.”
Al Razi would write as many as 184 papers and articles on subjects ranging from his doubts about Galen to the first known distinction between smallpox and measles, the discovery of allergic asthma, the discovery of fever as the body’s defence mechanism, medical ethics, using opium as a treatment for depression, the first medical handbook for common people, and paediatrics.
Al Razi would also theorise about the connection of the soul and state of mind to the physical health of the body, suggesting that someone with mental and emotional disturbances would be more vulnerable to infection and chronic ailments.
Al Razi’s medical insights would be translated into Latin several centuries after his death. By the late 1200s, mediaeval Europeans were beginning to stir out of their long Dark Age sleep and for a century were captivated by the writings of Al Razi – who by then had been given the Latin name Rhazes.
About eight decades after Al Razi, a brilliant healer named Al Zahrawi laid the foundation of modern surgery while working in the Umayyad imperial compound outside Cordoba.
Because all records were destroyed in the civil wars that marked the end of the Umayyad reign in Spain, hardly any facts about Al Zahrawi’s personal life remain. What does survive is his 30-chapter Kitab al Tasrif, a compendium of this man’s medical knowledge and genius. A century and a half after his death, it would be translated into Latin and have even more impact than the work of Rhazes. Al Zahrawi’s Latin name was Albucasis.
His discoveries would continue to resonate into the 21st century, first for his invention of about 200 medical instruments, many of which are still in use – such as the obstetrical forceps, scalpel, surgical needle, surgical retractor, specula, and the use of catgut for internal suturing. But he was also exceptional for innovating surgical procedures like mastectomies, orthodontia, repairing fractures, and using ligature for suturing arteries instead of cauterising them.
Another Muslim healer would follow in the Arabic tradition and even eclipse the great Al Zahrawi, this one a Persian working exclusively in Persia. This man was Ibn Sina. Europe and the Arab world would come to know him as Avicenna, the Prince of Medicine, and the single most important influence on Islamic and Western medicine for about 500 years.
Ibn Sina was consummately gifted. He is reputed to have memorised the Qur’an by age 10, Aristotle’s Metaphysics several years later (he claimed to have read it 40 times), and had become a practising physician by age 16.
Ibn Sina’s greatest motivation was his burning intellectual curiosity for the world, and the world beyond, not social status or financial security. By the age of 20, he had turned down his ruler’s offer to become court physician, preferring only the right to study as much as he wanted in the ruler’s royal library.
A political upheaval overthrew the ruler and Ibn Sina began a long life of wandering Persia in search of a secure patron who would allow him to indulge in his medical and scientific research. Unfortunately, political instability and Ibn Sina’s harshly arrogant manner meant he was constantly changing jobs.
But despite his unending struggle, he was able to gradually systemise Islamic understanding of the medical sciences in such a way that not only was the Arab and Islamic world forever indebted, so also was Europe and the West.
Although Ibn Sina is credited with writing as many as 450 papers and books in a dozen fields, the work that continued to resonate most powerfully was his Canon of Medicine written around 1025, a 14-volume work that was for 500 years Europe’s most influential medical source book. The Canon was a combination both of the collected medical wisdom of other writers as well as his own observations and research. Although it provided a window into forgotten Greek medicine, its greatest value was in the modernistic approach it took to a field riddled with false theory and ignorance.
It could be argued that Ibn Sina was the first to formally explain the experimental method in medicine, the spread of contagious diseases, the use of quarantine, clinical trials, psychiatry, and psychotherapy. He also seems to be the first to show that tuberculosis was a contagious disease, as well as to identify diabetes.
According to some sources, the Canon was the first documented explanation of modern medical methods like the randomised clinical trial, and the first modern set of comprehensive rules for testing new drugs.
His deeper research into the mind-body connection, and the mental or spiritual source of physical ailments, was built on the first intuitive work of men like Al Razi. But Ibn Sina went further, beginning the first documented forays into what we today would call psychotherapy, 900 years before Sigmund Freud.
One account says that a young man had come to him with a condition that looked very much like consumption. He was literally wasting away. But Ibn Sina could find no signs of a cancer or other disease that would indicate some physical explanation.
He conducted a series of interviews or conversations with the young man. As Ibn Sina spoke certain key words and phrases, he was also checking the man’s pulse and found it became elevated around certain terms. Thus it gradually emerged that the patient was in love with a woman back in his home village. For whatever reason he had never expressed this to her, and the unfulfilled desire was sapping him of his energy.
Ibn Sina gradually concluded that the source of the young man’s physical condition was his unexpressed love. He suggested that the patient go to the object of his affections and profess his love to her. The young man did this, the girl agreed to marry him, and the patient swiftly recovered his vitality.
As far as we know this was the earliest documented account of the use of word association in psychoanalysis, which modern medicine credits to Carl Jung 900 years later.
While medical thinkers like Al Razi, Al Zahrawi and Ibn Sina are closely tied to their innovations through their writings, many of the great breakthroughs of Arab medicine were collective undertakings and are difficult to identify with any single author or inventor.
This is particularly true with key Arab-Muslim institutions like the modern insane asylum, the public hospital, free medical care, and the pharmacy. The modern hospital itself was not an Arab invention, but Arabs and their partners made it a public institution and spread it around the world.
Isolated healing temples and places for the sick had existed in many older cultures including around the Mediterranean and across Asia. But with few exceptions they were unable to offer real cures in the modern sense. Often their method was a mixture of magic or religion with means of making one feel better, if only briefly.
But in 6th century pre-Islamic Persia, a true hospital called a bimaristan or ‘sick place’ was built in the city of Gundishapur, complete with surgery, pharmacy, and outpatient treatments. This came to the attention of the Arabs, in particular Caliphs Harun Al Rashid and his half-Persian son Al Mamun, and they set about replicating these institutions across their realm.
Harun invited a doctor from the bimaristan in Gundishapur to open the first bimaristan in Baghdad. Al Razi was later commissioned with overseeing the Audidi Hospital in Baghdad, in the mid 800s. He applied his evolving understanding of sanitation and infection to find the best location possible. He hung raw meat in various parts of the city to see comparative rates of decay, and where the meat lasted longest, there he put the hospital.
Audidi had more than two dozen doctors including surgeons, eye specialists, and physiologists.
By the year 1000, Baghdad alone would number five public hospitals when there were none in all of Europe. Hospitals would also be found in Cairo, Damascus, Aleppo, North Africa, and Al Andalus. These centres would offer surgery, outpatient clinics, mental wards, convalescent centres, and even nursing homes.
One of the greatest hospitals would be Al Mansuri in Cairo, which was reported to have as many as 8,000 beds and annual revenues of one million dirhams. Al Mansuri was a true public hospital because it was charged with offering treatment to anyone, rich or poor, including the indigent who could not pay at all.
The Arab establishment of humane mental wards and insane asylums was especially futuristic and important. The Arab world, in line with the teachings of the Prophet (pbuh) and others, never stigmatised the mentally afflicted, seeing mental illness as one more disease that might be cured. Europe and the West did not develop a modern non-judgmental view of mental illness until the 19th and 20th centuries.
Arab pharmacies were another important invention. Although other cultures offered various potions and herbs for sale, it was rare to find cures that really worked. People were just as inclined to faith healing and magic as to ‘healing’ substances, because they were all equally ineffective. But the evolution of modern evidence-based pharmacology under thinkers like Al Razi, Al Kindi and Ibn Sina created a new class of substances that really worked.
Arab pharmacies were known as saydala, and the first one seems to have been at Harun al Rashid’s hospital in Baghdad built in the late 700s. Within half a century saydala were spreading throughout the caliphate. These remedies were often fabricated right on the spot at in-house laboratories. More importantly, they were overseen by government inspectors to make sure they were pure, not out of date, measured in verified scales, and correctly identified.
Al Razi would even introduce the concept of generic drugs for the poor, while Al Kindi would also seek to identify cheaper alternative treatments for those who could not afford expensive drugs.
The same kind of modern pharmacies selling remedies that really worked would only begin to appear in Italy in about the 12th century, fuelled largely by the growing trade between Arabs and Europeans.
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Kamal, Hassan. Encyclopedia of Islamic Medicine. Cairo: General Egyptian Book Organization, 1975.
Levey, Martin. Early Arabic Pharmacology. Leiden, Netherlands: E. J. Brill, 1973.
Savage-Smith, Emilie. Islamic Culture and the Medical Arts. Bethesda, Md.: National Library of Medicine, 1994.
Siddiqi, Muhammad Zubayr. Studies in Arabic and Persian Medical Literature. Calcutta: Calcutta University Press, 1959.
Usama, Ibn Shuraik. Sunna Abu-Dawud, Book 28, No. 3846 (part of the hadith, a narrative record of the sayings of Mohammed and his companions).