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Rhazes’ concepts and manuscripts on nutrition in treatment and health care

Article  in  Ancient Science of Life · April 2012

DOI: 10.4103/0257-7941.107357 · Source: PubMed

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Rhazes’ concepts and manuscripts on
nutrition in treatment and health care
Farzad Nikaein1,2, Arman Zargaran3,4, Alireza Mehdizadeh1
Research Office for the History of Persian Medicine, 2Department of Nutrition, Faculty of Health and Nutrition, 3Student Research
1
Committee, 4Department of Traditional Pharmacy, Faculty of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
ABSTRACT:
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.
KEY WORDS: History, nutrition, Rhazes
INTRODUCTION
T he current concept of nutrition in medical science dates
back to the end of the 18th 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
190 Ancient Science of Life / Apr-Jun 2012 / Vol 31 / Issue 4
Original Article
in the 10th and 11th 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 8th and 15th 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
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DOI:
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Nikaein, et al.: Rhazes concepts and manuscripts on nutrition
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
Ancient Science of Life / Apr-Jun 2012 / Vol 31 / Issue 4
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.
191
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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,
192 Ancient Science of Life / Apr-Jun 2012 / Vol 31 / Issue 4
Nikaein, et al.: Rhazes concepts and manuscripts on nutrition
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.
REFERENCES
1. Carpenter KJ. A short history of nutritional science: Part 1 (1785–1885).
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2. Cannon G. The rise and fall of dietetics and of nutrition science, 4000
BCE–2000 CE. Public Health Nutr 2005;8:701‑5.
3. Papavramidou N, Christopoulou‑Aletra H. Greco‑Roman and
Byzantine views on obesity. Obes Surg 2007;17:112‑6.
4. Bevegni C, Adami GF. Obesity and obesity surgery in ancient Greece.
Obes Surg 2003;13:808‑9.
5. Abdel‑Halim RE. Obesity: 1000 years ago. Lancet 2005;366:204.
6. Salas‑Salvado J, Huetos‑Solano MD, García ‑Lorda P, Bulló M. Diet and
dietetics in al‑Andalus. Br J Nutr 2006;96:S100‑4.
7. Modanlou HD. Tribute to Zakariya Razi (865–925 AD), an Iranian
pioneer scholar. Arch Iran Med 2008;11:673‑7.
8. El Gammal SY. Rhazes contribution to the development and
progress of medical sciences. Bull Indian Inst Hist Med Hyderabad
1995;25:135‑49.
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Rhazes (865–925 AD). J Neurol 2012;259:1001‑2.
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2007;27:305‑7.
14. Rhazes. Manfe’ al Aghzie va Mazareha (Benefits of Food and its
Harmfulness). Tehran, Iran: Taban Press; 1964.
15. Najmabadi M. Moalefat va Mosanefat e Abubakr Mohammad ibn
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Nikaein, et al.: Rhazes concepts and manuscripts on nutrition

Zakaryya Razi (Books and manuscripts of Rhazes). Tehran: Tehran Address for correspondence:
University Publications; 1992.
Dr. Arman Zargaran,
16. Rhazes. The book of the collector of medicine  (Liber Continens).
Hyderabad: Osmania Oriental Publications, Osmania University; 1961. Student Research Committee, Neshat Street, Shiraz, Iran.
17. Rhazes. Man la Yahzar ol Tabib (for one without a Doctor). Tehran: E‑mail: zargarana@sums.ac.ir
Jahad Daneshgahi Press; 1984. (Translated by Pazargadi A, Nafisi A.,
in Persian).
How to cite this article: Nikaein F, Zargaran A, Mehdizadeh A. Rhazes'
18. Mahan  LK. Escott‑Stump  S. Krause’s Food and the Nutrition Care
concepts and manuscripts on nutrition in treatment and health care.
Process. Philadelphia: Saunders Company; 2012. Ancient Sci Life 2012;31:190-3.
19. Lattimer JM, Haub MD. Effects of dietary fiber and its components on
metabolic health. Nutrients 2010;2:1266‑89. Source of Support: Nil. Conflict of Interest: None declared.

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