No Abstract

Persian Medicine (PM) is a holistic school of medicine with a unique philosophy and terminology. “Masam” (pores) is a widely used concept in PM literature, both in physiologic and pathologic conditions, defined as natural openings on the skin surface and also other organs. Penetration of substances topical medications, expulsion of substances including hair, excretion of waste products such as sebum and sweat, and substance transport in various organs, including the placenta, uterus, synovial membrane, stomach, muscle, lung vessels etc. are facilitated through these macroscopic, microscopic and nanoscopic pores. “Masam” are subject to various alterations, including collapse and occlusion, which may lead to bad deposition of material in the body and prevention of the Haar -innate heat- from reaching the organs, leading to dysfunction and dystemperament. Changing rheological characteristics of such material by “Nozj” may help their removal and therefore open “Masam” to yield the return of normal organ temperaments and functions.

Vitiligo is an acquired chronic skin disorder characterized by progressive loss of melanocytes from epidermis resulting in depigmented areas. Although various therapies for vitiligo, including topical and systemic corticosteroids, topical immunomodulators, phototherapy plus chemotherapy, tissue grafting techniques and depigmentation of normally pigmented skin are practiced, these modern methods are not always satisfactory. Vitiligo has been introduced in medieval manuscripts of Persia under two categories of Bahaq and Baras. Besides the diagnostic differences between these two disorders, a variety of formulations have been suggested by Iranian scholars for treatment or covering white patches. Extracting the ideas of our ancestors could both revive forgotten medicinal knowledge and also depict the contribution of one nation in progress of medicine and pharmacy.

Traditional medicine is used for treating diseases in different countries and it is a way for promoting public health especially in under developing countries. Persian medicine has a long history and has been an inseparable part of the Iranian people's life and culture. There are many herbal formulations in Iran that prepared following Persian medicine methods and prescribed for different diseases. Majoon-e-Dabeed-ul-Ward is one of these products and to the best of our knowledge there is no documented study about the formulation used in Iran. In this study, Persian medicine manuscripts were explored for main ingredients of Majoon-e-Dabeed-ul-Ward as well as serious diseases in which this medication has been considered as a potential treatment. Additionally, the antioxidant effect of the commonly used formula in Iran was studied using DPPH method. There were different formulations with 16 or more constituents under the name of Dabeed-ul-Ward in Persian manuscripts; Rosa damascena was the main constituent of this herbal mixture.  Majoon-e-Dabeed-ul-Ward has been prescribed for different purposes like liver disorders, pelvic inflammation, eczema, psoriasis, headache and vertigo. Commonly used Majoon-e-Dabeed-ul-Ward in Iran contains 16 plants in addition to sugar. Majoon-e-Dabeed-ul-Ward hydro- alcoholic extract possessed radical scavenging activity with IC50 value of 174 μg/mL.

In middle and west Asia, Europe and north of Africa in ancient and medieval time the main paradigm  and doctrine of medicine was based on humoral theory. This theory of medicine was based on four temperaments (mizaj). Regarding, it was a terminology called Tabiat (Nature) in the humoral medicine which plays a key role in the paradigm as a wisdom force in the body to keep body healthy and back body to healthy condition in diseases. There were four principles of nature: Wisdom (Hikma), Cosmos, Attorney, and Treatment.  Based on the Persian medicine principles, physician is the servant of the nature. He/she should try to help the nature of the patient to restore health.  

Seyyed Esmail Jorjani (1042-1137 AD) is a well-known Iranian wise scientist. This highly valued wise man wrote many valuable works such as the Treasure of the Khwarazm Shah (Zakhireye Khwarazmshahi), medical objectives (Al - Aghraz al Tibbia val Mabahess al – Alaiia), Alaii’s secret (Khofi-e-alaii) and Keepsake (Yadegar). The works of this wise man were written in such a way that in the present time, it has maintained its effectiveness despite all the advances in medicine. This high-level scientist in his works has set up duties for the physician which are essential when attending the patient's bedside. He also believes that, after learning medicine well, the doctor should observe some points when attending the patient's bedside, referred to as "the wills the physician should listen to". Hakim Jorjani considers the first requirement for a physician in attending a patient's bedside is to respect religious trust and that the physician should keep his organs out of all unpleasantness. In fact, after completing this moral virtue, the doctor can serve his professional career. Jorjani refers to the subtleties that some of them will be mentioned in this article.

Sinafaravar  pharmaceutical Company  has produced Curcuma-sina that helps people have healthier lives. Curcuma-Sina shows strong anti-oxidation, anti-inflammatory and anti-tumor properties. This product is including Curcuma longa and Piper nigrum. Anti-inflammatory products are being used to remedy chronic inflammatory disorders and cancers. Thus, there is an urgent need to develop safe and effective medicines for the long-term use. Researchers have studied small molecules derived from natural sources with the aim of developing new treatments for clinical features. Curcuma longa and Piper nigrum, are well known to have beneficial clinical effects. Curcuma longa  has various therapeutic effects on different diseases. However, it has limited tissue distribution, low serum levels and apparent rapid metabolism in human. To increase Curcuma longa  bioavailability, Piper nigrum, known as a natural adjuvant increases the bioavailability of Curcuma longa.

Oral mucositis is one of the severe complications of chemoradiotherapy in patients with cancer. Current treatments such as artificial saliva, antimicrobial agents, and local analgesics could not fully satisfy patients and thus, further investigations are essential. Medicinal plants, containing a wide variety of phytochemicals may be suitable suggestions to be investigated for the management of this complication in cancer patients. To review current literature regarding the effectiveness of herbal preparations in chemoradiotherapy-induced oral mucositis, electronic databases including PubMed, Scopus, and Cochrane library were searched using "mucositis" or "xerostomia" or "dry mouth" in the title/abstract, and "plant" or "extract" or "herb" or "phytochemical" keywords in the whole text up to August 2017. A total of 14 clinical trials were finally included. Aloe vera (aloe), Matricaria chamomilla (German chamomile), Malva sylvestris (high mallow), and Alcea digitata (hollyhock) are the most evident medicinal plants useful for the management of oral mucositis and xerpstomia. Mucilage, flavonoids, flavonolignans and terpenoids are the active ingredients which show soothing effect on the lesions of oral cavity. Herbal preparations could reduce the duration of ulceration, ulcer severity, pain and use of analgesics, as well as dysphagia and the need for total parenteral nutrition. In conclusion, medicinal plants are capable of improving chemoradiotherapy-induced oral mucositis and xerostomia in patients with cancer. Future well-designed clinical trials are required for further confirmation of the safety and efficacy of medicinal plants for the management of oral mucositis.