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| REVIEW ARTICLE |
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| Year : 2012 | Volume
: 31
| Issue : 4 | Page : 160-163 |
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Rhazes' concepts and manuscripts on nutrition in treatment and health care
Farzad Nikaein1, Arman Zargaran2, Alireza Mehdizadeh3
1 Research Office for the History of Persian Medicine; Department of Nutrition, Faculty of Health and Nutrition, Shiraz University of Medical Sciences, Shiraz, Iran
2 Student Research Committee; Department of Traditional Pharmacy, Faculty of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
3 Research Office for the History of Persian Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| Date of Web Publication | 18-Feb-2013 |
Correspondence Address:
Arman Zargaran
Student Research Committee, Neshat Street, Shiraz
Iran
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0257-7941.107357
The use of nutrition in medical practice has a long history dating back to 6000 years. The great Persian chemist, physician, and philosopher, Rhazes (865-925 AD), wrote over 200 books in different branches of science. Some of his work drew attention to the notion that nutrition is an important part of treating diseases and health care procedures. Rhazes formulated highly developed concepts of nutrition and wrote several special books about food and diet such as manfe' al aghzie va mazareha (Benefits of Food and its Harmfulness), teb al moluki (Medicine for Kings), and Ata'me al marza (Food for Patients). His writing included detailed guidance about eating fruit ma iaghdam men al favakeh va al aghzieh va ma yoakhar (Fruit Before or After Meal), and other food types keifiat al eghteza (Temperament and Quality of Foods) and al aghziat al mokhtasareh (Brief Facts about Food). Considering the time that these books were written, they have had a great influence on approaches to nutrition in the history of medicine, so Rhazes can be considered as a pioneer in the scientific field of nutrition. Keywords: History, nutrition, Rhazes
How to cite this article:
Nikaein F, Zargaran A, Mehdizadeh A. Rhazes' concepts and manuscripts on nutrition in treatment and health care. Ancient Sci Life 2012;31:160-3 |
| Introduction | |  |
The current concept of nutrition in medical science dates back to the end of the 18 th century AD following the chemical revolution in France. [1] Food was used to provide nutritional support for the body and to satisfy human beings' sensory tastes. There is recorded evidence dating back to the ancient Egyptians advocating the medicinal use of food to maintain a healthy body. [2] In China and India, the value of food and drink for health care was well known and dietary regimes were used from 2500 BC. [2] There have been dietary recommendations to combat obesity described by physicians in ancient Greek and later in Roman and Byzantine Empires such as Galen, Hippocrates, Dioscorides, and Soranus. [3] Claudius Aelian (170-235 AD) from ancient Greece described a surgical procedure to treat obesity. [4] Later, in the Islamic period, medieval Persian practitioners such as Rhazes and Avicenna wrote the first special treaties about nutrition, diet, and health regimes in the 10 th and 11 th centuries AD. [2] They transformed nutrition to a highly developed independent medical science. [5] Dietetics and diet were also important and used in al-Andalus (Spain) between 8 th and 15 th century AD and many nutritional concepts have been developed and formulated in this civilization. [6]
In the early Islamic era, Persian scientists such as Rhazes, Avicenna, and Haley Abbas developed medical sciences based on the knowledge of ancient civilizations, especially those of ancient Persia and Greece. [7] Rhazes (865-925 AD) is one of the greatest physicians to influence the development of medical sciences in human civilization. [8] His great achievements in medicine, such as the treatment of facial palsy, [9] hydrocephalus, [10] kidney diseases, [11] and many other diseases, are still being referred to today. He wrote several manuscripts and books about nutrition, but his work on the role of nutrition in medicine has not received widespread attention until now.
| Materials and Methods | | |
The traditional concepts on nutrition in health care and treatment of disease in the Persian medieval era investigated in this paper are based on Rhazes' special manuscripts about food and nutrition therapy such as Manfe' al Aghzie va Mazareha (Benefits of Food and its Harmfulness) and medical text books such as Al Hawi (Liber Continens). Some of Rhazes' manuscripts were available for research, others were inaccessible or non-existent. As a result, it is suffice to mention the name of non-existent manuscripts with brief information obtained from old and famous bibliographies. Eventually, the manuscripts that Rhazes wrote on nutrition, diet, and food are considered and explained separately.
| Results and Discussion | | |
Abu Bakr Muhammad ibn Zakaryya Razi (Rhazes)
Abu Bakr Muhammad ibn Zakaryya Razi, known in the west as Rhazes, was born in Rey (south Tehran, the capital city of Iran) in 865 AD. [12] He was first interested in music and then worked on alchemy and chemistry. He discovered many chemical substances such as ethanol and sulfuric acid. Over time, his experiments with chemical substances gradually damaged his eyes, so he stopped his experiments on chemicals. [7] He first started to take an interest in medicine and philosophy when he was older than 30. His great teacher was Ali ibn Sahl Rabban Tabbari, a famous Persian physician and author of one of the oldest encyclopedias on medicine named Firdous al-Hikmah. Rhazes established and managed a hospital in his hometown, Rey, during the reign of Mansur in the Samanid dynasty. When his fame reached Baghdad, the capital of the Islamic Empire, Caliph al Moktafi (from the Abbasid dynasty) asked him to build the largest ever hospital in Baghdad. Rhazes used a remarkable method to select the best location for building the hospital. He placed pieces of meat in different areas of Baghdad. He checked these pieces after a few days and selected the location where the piece of meat was least rotten as the site of the hospital. He believed that this location would be the cleanest place to build the hospital; this demonstrates the level of his concern about environmental health hazards. Caliph al Moktafi died in 907 AD, so he returned to Rey. In the last years of his prosperous life, Rhazes became blind from chemical-induced cataracts in both eyes and finally died in his hometown of Rey and was buried in this city in 925 AD. He had been committed to medical ethics and humanities. He was also a great scientist and had more than 200 treatise and books on medicine, chemistry, philosophy, and music. Al Hawi (Liber Continens) and al Mansuri fi at-Teb (Liber Medicinalis ad Almansorem) were his most well-known manuscripts. The first was the great encyclopedia of medical sciences and the second was a general teaching handbook of medical sciences. [7],[13]
Rhazes' manuscripts and books on nutrition
Rhazes usually dedicated whole chapters to food and nutrition therapy in his manuscripts, thus he included dietary recommendations and special foods to avoid, as well as medicaments and other approaches. He also wrote specific manuscripts and books about food and drink for health care and treatment of disease. Some of Rhazes' books on nutrition are mentioned below.
Manfe' al aghzie va mazareha (Benefits of food and its harmfulness)
This is a comprehensive encyclopedia of foods including the health benefits of certain foods as well as advice on how to avoid harmful effects of certain food. Rhazes wrote in the preface of this book: "I am going to compile a complete and comprehensive book and explain methods to prevent some harmfulness of foods in this book, which is more detailed and expressive than other discussions about this topic." This book contains 19 chapters in two main sections: 1) categorization of food and drink types and their properties and 2) general issues about food and drink. [14] He believed that different types of food should be eaten separately at different meals, because each one has a special process of digestion and they can be digested better when eaten separately. For example, he advocated that eating vegetables with meat could lead to incomplete digestion and absorption of the meat, which would cause weight loss. [14]
Teb al moluki
Rhazes wrote this book for Ali ibn Vahsouzan, the King of Tabarestan (north of Iran). It is a book for royalty about eating fruit, and drinking wine as an approach to manage common diseases such as headaches, poisoning, GI disorders, and other health care recommendations. He believed that drinking too much wine could lead to renal disease, as well as anorexia, tremor, or poor eyesight. In this book, Rhazes has denoted indications and contraindications of many types of beverage in different seasons for every temperament in this book.
Ata'me al marza (Food for patients)
Suitable food and drink for patients during the treatment period were discussed in this treatise.
Ma iaghdam men al favakeh va al aghzieh va ma yoakhar (Fruits before or after meal)
Rhazes believed that some fruits are suitable as a starter and others are more preferable for dessert. The manuscript presents this idea backed up with reasoning. He also denoted undesirable effects of fruits, particularly those that cause flatulence, such as some fresh fruit and sour fruit, when eaten with meals.
Keifiat al eghteza (Temperament and quality of foods)
Temperament, nutritional value, and quality of foods were classified by Rhazes in this book.
Al aghziat al mokhtasareh (Brief facts about foods)
Unfortunately, this treatise is not available. Its name is mentioned in old bibliographies. [15]
Rhazes' concepts on nutrition science
Rhazes attributed great importance to food in medical practice. He preferred to use appropriate foods instead of drugs to treat patients and recommended that physicians use food as the first line of treatment, and only then to administer simple medicines; the use of compound medicines should be reserved as the last line. [16] He also denoted that a physician who eases disease by food is successful and blissful. [15] He knew about the nutritional values of various foods and gave advice according to these values for the obese and the underweight. He administered dietary regimes for weight gain and weight loss. For example, pepper and vinegar were administered by Rhazes for weight loss and cumin and coriander seeds were applied to increase the appetite. [14] He believed that the pots and pans used for cooking had a special effect on nutrition and advocated the use of metal instruments made of iron or copper for cooking.
Rhazes believed that eating fresh fruit, especially sour fruit, had adverse effects on those patients suffering from alimentary tract malfunction, poor digestion, intestinal gas production, and flatulence. [17] According to newly developed understandings of nutrition, these fruits may contain significant amounts of fructose and alcoholic sugars like sorbitol, which should be reduced in functional GI disorders. [18] He also prescribed peppermint as a digestive herbal medicine. He recommended consumption of more prunes in diet as a food therapy for people who had constipation in warm weather, particularly in summer; [14] this practice is still widely recommended today in current medical nutrition therapy to control constipation. [18]
One of the most wonderful and debatable of Rhazes' concepts on nutrition is his method for weight gain and weight loss. He believed that when individuals eat only one group of foods at a meal, for example, legumes or meat or only bread, it is easier for the GI system to digest and absorb the food efficiently. So, the body can gain the maximum benefit from that meal; as a result, it attributes to weight gain. However, eating different kinds of food simultaneously at one meal, such as bread, meat, and vegetables mixed together, will lower the efficiency of the GI system in digestion and absorption because they have different digestive processes. Thus, digestibility of mixed foods would decrease and the body will not get all the energy from that food. Considering that new research has elucidated the role of dietary fiber and other food constituents such as phytate oxalate, mainly found in vegetables, which interact with other nutrients, especially dietary fats, by inhibiting or decreasing their absorption, Rhazes' theory is therefore justifiable. [19]
| Conclusion | | |
According to special nutritional concepts reflected in various manuscripts and books, 11 centuries ago, Rhazes knew much about nutrition and diet. In this regard, many of his highly developed concepts are accepted by today's achievements in nutritional science. It manifests Rhazes' great scientific personality in medical history and his role in the development of nutritional science as a part of treatment procedures in medicine; many of his concepts make suitable candidates for further studies in current medicine. A book with special title on nutrition and dietetic medicine introducing him as one of the pioneers in nutritional science remains to be published.
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