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Objectives: The semiology of liver dystemperament can help in predicting susceptibility to some diseases and improving the treatment process of the liver or general disease such as non-alcoholic fatty liver disease (NAFLD). Therefore, the aim of this study was to explain the wet liver dystemperament concept in Iranian traditional medicine (ITM) based on a hybrid concept analysis. Materials and Methods: The literature review of this qualitative study focused on evaluating 11 major academic textbooks from the 3rd to 19th century and some databases. In-depth, semi-structured, and face-to-face interviews were conducted with 16 ITM experts with a minimum of five years of clinical experience and maximum variations in terms of gender, age, and clinical experiences for empirical data gathering. Data were analyzed with MAXQAD10 and conventional content analysis. Results: In this study, wet liver dystemperament was classified into three main themes of systemic, local, and Para-clinical symptoms and 10 categories. Conclusions: This manuscript explains wet liver dystemperament as a disorder in general temperament and determines more important diagnostic criteria. [ABSTRACT FROM AUTHOR]

Objectives: According to Persian medicine (PM), the uterus is an important organ in women, responsible for purifying the blood and nourishing the fetus. Each organ has a specific temperament distinct from the whole-body temperament based on PM. Dystemperament occurs when body or organ Mizaj (Persian word for temperament) deviates from what is considered normal, resulting in malfunction. Many gynecological disorders described in PM and conventional medicine, including infertility, recurrent miscarriage, oligomenorrhea/amenorrhea, hypermenorrhea, vaginitis, cervicitis, urinary incontinence, and pelvic pain, are considered to be associated with uterine dystemperaments. Hence, proper management of such disorders requires precise diagnosis and treatment of uterine dystemperaments. Accordingly, this review study aimed to collect and categorize these symptoms from PM texts and other relevant articles. Methods: In this study, we reviewed 10 well-known PM references, including Canon in Medicine (Al-Qanun Fi al-Teb), the Great Panacea (Exir-e A'zam), the Treasure of Kharazmshah (Zakhireh Kharazmshahi), the Perfect Book of the Art of Medicine (Kamel al-Sana'a al-Tebbiya), Akbari's Medicine (Tebb-E-Akbari), Gharshi's Commentary on Canon of Medicine (Sharh-e Qarshi bar Qanun), Commentary on Hippocrates' Aphorisms (Sharh-e Fosul-e Boqraat), Summary of Experiences (Kholasa-tut Tajarob), Description of Signs and Symptoms (Sharh-e Asbab va Alamat), and Aghili's Treatments (Mo'alejat-e Aghili). Moreover, Scopus, PubMed, Web of Science, SienceDirect, and Google Scholar databases were queried with the keywords 'mizaj', 'temperament', 'uterus', 'uterine', 'cold/hot or warm', and 'dry/wet', while Persian databases of Magiran, Iran Medex, and SID were searched using keywords 'mizaj', 'rahem', 'garm', 'sard', 'tar', and 'khoshk' to extract signs and symptoms associated with uterine temperament and dystemperament. Results: Five indicators were specified in the articles and PM sources for determining the temperament and dystemperament of the uterus as follows: 1) Menstrual blood characteristics (including amount, temperature, color, odor, flow rate, and consistency); 2) Uterine discharge characteristics (including amount, consistency, color, odor, and accompanied symptoms, especially burning and itching); 3) Fertility and pregnancy status (including infertility, abortion, etc.); 4. Other characteristics of the female reproductive system (including pubic hair, menarche age, sexual desire and quality of intercourse, and vaginal and cervical condition on vaginal examination); and 5) General symptoms (including the ten PM indicators of whole-body Mizaj). Conclusions: PM sources have described the characteristics of uterine temperament and dystemperament in detail. These indices can be used for more effective diagnosis, treatment, and even prevention of gynecological diseases, as well as designing and validation of standard tools for determining uterine temperament and dystemperament. [ABSTRACT FROM AUTHOR]

The avascular necrosis (AVN) of the femur head due to the death of the osteocytes of the bone marrow occurs because the organ is not supplied with sufficient blood. The prevalence of the problem is 10%-50% in adults. The etiology of the disease includes various factors such as trauma, cigarette smoking, drinking spirits, taking corticosteroids, genetics, metabolic disorders, human immunodeficiency virus, pregnancy, and the like. The treatment of necrosis can be conducted regarding the degree of the problem. In the present paper, a case was reported whose femur head necrosis was treated by applying Iranian Medicine without using common drugs in modem Medicine. The patient was a 46-year-old man who had felt severe pain in his left hip since a month before referring. The pain had gradually increased and the AVN of the femur head was diagnosed after magnetic resonance imaging. Finally, the surgery and arthroplasty of the femur head were recommended in this regard. In general, surgery and arthroplasty were recommended regarding the hard medicinal and complicated treatment of the AVN of the femur head. However, it is noteworthy that applying Iranian medicine capacities is possible for curing the disease. [ABSTRACT FROM AUTHOR]

Objectives: Cardiovascular disorders are the most common causes of mortality and morbidity worldwide. Complementary medicine reduces the complications related to cardiovascular disorders while improving the quality of life of patients. The aim of this study was to review the effects of aromatherapy on cardiovascular disorders from the perspectives of Persian and modern medicine. Methods: In this review article, information related to Persian medicine was collected by searching through "Comprehensive Library of Traditional and Islamic Medicine" software (Noor Digital Library) using keywords such as "smelling", "sham", "lakhlakheh", "bakhoor", "heart", and "dill". Additionally, to find clinical trials (1994-2019) related to the effect of aromatherapy on cardiovascular disorders, electronic databases such as ISI, Scopus, PubMed, ScienceDirect, and Google Scholar were searched using several keywords including "cardiovascular disorder", "heart," "coronary", "cardiovascular disease", "cardiac", "aroma", and "aromatherapy". Results: According to Persian medicine references, the heart is the most important organ and gives life to the whole body. Aromatherapy using odorous herbs such as rose, apple, quince, and saffron helps balance the heart temperament and improve cardiovascular disorders through their cardiotonic, anti-syncope, anti-depressant, and anti-arrhythmic properties. Conclusions: Based on Persian medicine references and recent findings in modern medicine, aromatherapy is an effective approach for relieving cardiovascular disorders. Considering these findings, it is suggested to include aromatherapy as a palliative measure for cardiovascular patients. It is also recommended that more clinical trials derived from Persian medicine references be conducted to value the effectiveness of aromatherapy for treating various cardiovascular ailments. [ABSTRACT FROM AUTHOR]

Objectives: Atherosclerosis is the basic pathology of most cardiovascular diseases which are the most common non-communicable diseases in the world. Recently, inflammation in the arterial wall has been proposed for the initiation of atherosclerosis although there is no specific anti-inflammatory treatment for atherosclerosis. Persian medicine (PM) with at least 7000 years of practice background may help in atherosclerosis management. The aim of this study was to describe atherosclerosis according to the teachings of PM to find better methods for its management. Materials and Methods: To this end, several data were searched, including current medical literature and published articles on PM, as well as Avicenna's main medical textbook, the Canon of medicine for creating the hypothesis of the mechanism of atherosclerosis in PM. Results: Avicenna has implied Waram in the arterial wall. The features of Waram in PM accommodate inflammation, and Waram in the artery is compatible with atherosclerosis. The natural history of atherosclerosis is highly similar to humoral evolutions in Waram. PM has a wide range of therapeutic drugs and treatment plans for warm, and many of the applied drugs in this regard have documented anti-inflammatory effects in the current medicine. New risk factors for prevention and new treatment modalities are recommended based on this hypothesis. Conclusions: The new hypothesis that emerged from PM for atherosclerosis is compatible with the newest hypothesis of the mechanism of atherosclerosis in current medicine. Moreover, PM introduces new preventive and treatment modalities for atherosclerosis which is unknown in current medicine and their application may reduce disease burden and mortality of atherosclerosis-related diseases. [ABSTRACT FROM AUTHOR]

Objectives: Mizaj (temperament) refers to a concept in Persian medicine and is the basis for defining health and disease. Brain, as the most important organ of the body (Aza-e-raeiseh), controls vital functions. So far, no standardized questionnaire has been designed for distinguishing temperament in Persian medicine. Therefore, the aim of this study was to provide a reliable objective self-report questionnaire and a standardized diagnostic checklist for Mizaj identification via determining their reliability and validity in Persian medicine. Materials and Methods: This was an exploratory sequential study in which we designed a 121-item questionnaire, and a 20-item checklist as an item pool using Mizaj-related indices searched in Persian medicine references. The number of items for questionnaire and checklist finally reached 35 and 12 after qualitative and quantitative assessments (e.g., content and face validities). The test-retest reliability of each question of the questionnaire and checklist and their consistency were evaluated by participation based on the weighted and Fleiss' kappa statistics, and intraclass correlation coefficient (ICC). The final version of the questionnaire and checklist were divided into two subscales (i.e., warm/cold and wet/dry), and the minimum and maximum scores were determined. Results: Significant findings of our data showed that the weighted and Fleiss' kappa coefficients of the 35-item questionnaire (between 0.4 and 0.9) and 12-item checklist (between 0.4 and 0.8) were found in the study based on their reliability. The degree of reliability in the self-report questionnaire was assessed using weighted kappa (WK), where 6 items of the questionnaire were omitted due to a WK less than 0.6 and the number of items reached 35. While 2 items of the checklist with Fleiss' kappa (FK) <0.2 were omitted and the number of items reached 12 items. WK coefficients of the 35-item questionnaire (between 0.4 and 0.9) and 12-item checklist (between 0.4 and 0.8) were found in the study, suggesting their reliability. The highest WK was found to be linked to sleep, and psychic and physical functions, suggesting the appropriateness of questions/items and design. The calculated ICC of the two stages for the warm/cold and wet/dry subscales of 35-item questionnaire was determined as 0.92 and 0.91, respectively, showing the stability of total score. ICC of the final score for the warm/cold subscale of the 35-item questionnaire was 0.88 (0.86 to 0.96), while this value was 0.91 for the wet/dry subscale (0.83 to 0.95). Conclusions: The present questionnaire and checklist were validated in terms of the design, reliability, and validity of a standard Mizaj determination questionnaire and checklist. The final questionnaire and checklist may be capable of distinguishing Mizaj of brain at the clinical and research levels for Persian medicine practitioners. [ABSTRACT FROM AUTHOR]

Objectives: Hemorrhoid disease has been a common medical problem since ancient times. About 5%-10% of patients do not respond to conservative treatment, and surgical procedures have a 20%-25% complication rate including pain, stenosis, infection, incontinence, and the like. Thus, most patients and physicians seek alternative and complementary medicines. Persian medicine (PM) is one of the oldest traditional medicines that present different treatment methods for managing hemorrhoid complications. Accordingly, the present study reviewed these methods and their applications. Methods: This historical review surveyed the principle of management and different medicinal and non-medicinal treatments for each complication of hemorrhoid based on the main textbooks of disease-treatment and famous pharmacopoeias of PM from 10th to 18th century AD. Recent findings about their pharmaceutical properties and mechanisms of action were searched in Google Scholar, Science Direct, and PubMed databases. Results: In PM, it is believed that hemorrhoid disease is because of melancholic or sanguineous distemperament. Cleansing the body and then strengthening the gastrointestinal and the liver for more effective treatment and prevention of relapse are the first therapeutic approaches in this regard. They use herbal and non-herbal medicines with anti-oxidant and anti-inflammatory, analgesic, and phlebotonic properties. In addition, different methods of bloodletting are used for body cleansing, reducing pain, and treating bleeding or thrombotic hemorrhoids. Conclusions: In general, the proposed herbal and non-herbal medicines could be formulated for generating different pharmaceutical products. Finally, non-pharmaceutical methods could be used for postponing the need for surgical interventions. [ABSTRACT FROM AUTHOR]

Objectives: Excessive belching is a common complaint that may be observed alone or with other diseases such as indigestion and reflux. In addition, it has adverse effects on patients' social life. Due to the insufficient evidence regarding the successful treatment of this disorder, the present study reviewed the medical views of Avicenna in order to find a better solution in this regard. Methods: This literature review was done by searching for "belching" and its MeSH heading term, namely, "eructation" in databases such as Google scholar and Pub Med and their synonyms in Iranian traditional medicine "Josha" in Avicenna's "Canon of Medicine". Results: The definition of belching in modern medicine was the same as "Josha" but its classifications and treatments were different. Modern scientists have divided excessive belching into gastric and supragastric based on its source although Avicenna classified it into three kinds based on its smell. In recent studies, specialists have come to a link between the brain and the stomach due to the inadequacy of their therapies while Avicenna has along pointed out the relationship between belching and certain organs. He further recommended three main approaches for its treatment, including lifestyle modification, herbal medicines, and physical manipulations. Conclusions: In general, considering the lack of effective treatment for excessive belching, it is important to present a better classification and management. This might be possible with regard to Avicenna's "Canon of Medicine". Thus, clinical trials are suggested to assess the efficacy of Avicenna's recommendations as a complementary method. [ABSTRACT FROM AUTHOR]

Objectives: Regarding the increasing prevalence of hypertension and its associated disabilities, it is beneficial for physicians to build on the potential of other medical schools like Persian medicine (PM) as it can provide useful knowledge of the factors leading to hypertension by identifying its pathogenesis in another medical attitude. Thus, the present study aimed at applying a strategy to prevent and treat hypertension. Materials and Methods: The current qualitative brief report was initiated by reviewing valid databases. Subsequently, the risk factors of hypertension were extracted using keywords such as "hypertension", "high blood pressure", "prevalence", "epidemiology", and "predisposing and risk factors". Then, each of these factors was conceptually matched to the fundamentals (4 qualities or Mizaj) of PM by Avicenna in his book named "The Canon of Medicine. Results: The known risk factors of hypertension were prone to occur in an individual before the onset of clinical hypertension due to his/her increased coldness (six items) and increased dryness (seven items). Given a few reports taking hypertension more associated with the warmth quality, it is probable that the patients with hypertension have a basically warm temperament, but they experience hypertension upon encountering with factors that result in increased coldness and dryness. Conclusions: Overall, the etiology and pathogenesis of hypertension can be better understood according to four qualities in PM. Therefore, hypertension is preventable in risky people by making modifications in lifestyle, and hence, changes in body qualities and orientation toward a relatively balanced state. [ABSTRACT FROM AUTHOR]

Objectives: Uterus is one of the most important organs of a woman which purifies the blood and carries a fetus and its function is related to the main organs like the brain, heart, liver, kidneys, and stomach. Uterine distemperaments are among the most important diseases of this organ and various symptoms are mentioned for them in Persian medicine (PM). Accordingly, the evaluation of these symptoms will help the diagnosis and treatment of different types of disorders related to the female reproductive system. Materials and Methods: This concept analysis qualitative study was conducted to collect and classify the symptoms of uterine distemperaments using a hybrid method and included theoretical, fieldwork, and analysis phases. In the theoretical phase, the resources of PM were reviewed, followed by interviewing the experts of PM and patients with uterine distemperament in the fieldwork phase. Finally, the guidelines were provided for diagnosing uterine warm and cold distemperaments. Results: The signs and symptoms of uterine distemperaments were classified into 5 general categories including menstrual blood characteristics (i.e., volume, consistency, color, smell, temperature, and outgoing speed), uterine discharges, pubic hair characteristics, other characteristics related to the female reproductive system, and the general symptoms. Eventually, the most important concepts were converted to a guideline of "Major and Minor Diagnostic Criteria for Uterine distemperaments". Conclusions: In general, the recognition of the symptoms of uterine distemperaments facilitates the prevention, diagnosis, and treatment of different types of gynecologic disorders. The results of the current study can be an appropriate basis for designing and standardizing diagnostic tools for uterine distemperaments and related diseases. [ABSTRACT FROM AUTHOR]