Avicenna's Canon of Medicine: a review of analgesics and anti-inflammatory substances

Document Type : Review Article


1 Epilepsy Research Center, Universitätsklinikum Münster, Münster, Germany

2 Department of Neurosurgery, Universitätsklinikum Münster, Münster, Germany

3 Institut für Physiologie I, Klinik und Poliklinik für Neurochirurgie, Department of Neurology, Epilepsy Research Center, Westfälische Wilhelms-Universität Münster, Germany


Naturally occurring substances mentioned in medieval medical literatures currently have, and will continue to have, a crucial place in drug discovery. Avicenna was a Persian physician who is known as the most influential medical writers in the Middle ages. Avicenna`s Canon of Medicine, the most famous books in the history of medicine, presents a clear and organized summary of all the medical knowledge of the time, including a long list of drugs. Several hundred substances and receipts from different sources are mentioned for treatment of different illnesses in this book. The aim of the present study was to provide a descriptive review of all anti-inflammatory and analgesic drugs presented in this comprehensive encyclopedia of medicine. Data for this review were provided by searches of different sections of this book. Long lists of anti-inflammatory and analgesic substances used in the treatment of various diseases are provided. The efficacy of some of these drugs, such as opium, willow oil, curcuma, and garlic, was investigated by modern medicine; pointed to their potent anti-inflammatory and analgesic properties. This review will help further research into the clinical benefits of new drugs for treatment of inflammatory diseases and pain.


Main Subjects

Abdel-Tawab M, Werz O, Schubert-Zsilavecz M. 2011. Boswellia serrata: an overall assessment of in vitro, preclinical, pharmacokinetic and clinical data. Clin Pharmacokinet, 50: 349-369.
Allan GM, Arroll B. 2014. Prevention and treatment of the common cold: making sense of the evidence. CMAJ, 186: 190-199.
Amann R, Peskar BA. 2002. Anti-inflammatory effects of aspirin and sodium salicylate. Eur J Pharmacol, 447: 1–9.
Amin B, Hosseinzadeh H. 2012. Evaluation of aqueous and ethanolic extracts of saffron, Crocus sativus L., and its constituents, safranal and crocin in allodynia and hyperalgesia induced by chronic constriction injury model of neuropathic pain in rats. Fitoterapia, 83: 888-895.
Arshami J, Pilevar M, Aami Azghadi M, Raji AR. 2013. Hypolipidemic and antioxidative effects of curcumin on blood parameters, humoral immunity, and jejunum histology in Hy-line hens. Avicenna J Phytomed, 3: 178-185.
Avicenna. 1988. Qanoon dar Teb, Translated to Persian by Abdorahman Sharafkandi, Soroosh Press, Tehran, 1988.
Bayan L, Modarres Mousavi SM, Gorji A. 2013. History of Neurological Disorders in Persian Medicine, J Res Hist Med, 2:115–127.
Bayan L, Koulivand PH, Gorji A. 2014. Garlic: a review of potential therapeutic effects. Avicenna J Phytomed, 4: 1-14.
Behrend SW. 2013. Cannabinoids may be therapeutic in breast cancer. Oncol Nurs Forum, 40: 191-192.
Berrios I, Castro C, Kuffler DP. 2008. Morphine: axon regeneration, neuroprotection, neurotoxicity, tolerance, and neuropathic pain. P R Health Sci J, 27: 119-128.
Brentjes S. 1980. Spuren des Einflusses wissenschaftlicher Schriften aus der islamischen Welt auf den Lehrbetrieb an der Universitat Leipzig im 15. und 16. Jahrhundert. Schriftenreihe für Geschichte der Naturwissenschaften, Technik und Medizin.
Charousaei F, Dabirian A, Mojab F. 2011. Using chamomile solution or a 1% topical hydrocortisone ointment in the management of peristomal skin lesions in colostomy patients: results of a controlled clinical study. Ostomy Wound Manage, 57: 28-36.
Danielle J. 2008. Islamic Pharmacology in the Middle Ages: Theories and Substances. Eur Rev, 16: 219–227.
Espley RV, Butts CA, Laing WA, Martell S, Smith H, McGhie TK, Zhang J, Paturi G, Hedderley D, Bovy A, Schouten HJ, Putterill J, Allan AC, Hellens RP. 2014. Dietary flavonoids from modified apple reduce inflammation markers and modulate gut microbiota in mice. J Nutr, 144: 146-154.
Farideh ZZ, Bagher M, Ashraf A, Akram A, Kazem M. 2010. Effects of chamomile extract on biochemical and clinical parameters in a rat model of polycystic ovary syndrome. J Reprod Infertil, 11: 169-174.
Francini A, Sebastiani L. 2013. Phenolic Compounds in Apple (Malus x domestica Borkh.): Compounds Characterization and Stability during Postharvest and after Processing. Antioxidants, 2: 181-193.
Ghosh N, Ghosh R, Bhat ZA, Mandal V, Bachar SC, Nima ND, Sunday OO, Mandal SC. 2014. Advances in herbal medicine for treatment of ischemic brain injury. Nat Prod Commun, 9:1045-1055.
Gorji A, Khaleghi Ghadiri M. 2001. History of epilepsy in Medieval Iranian medicine. Neurosci Biobehav Rev, 25: 455-461.
Gorji A, Khaleghi Ghadiri M. 2002. History of headache in medieval Persian medicine. Lancet Neurol, 1: 510-515.
Gorji A. 2003. Pharmacological treatment of headache using traditional Persian medicine. Trends Pharmacol Sci, 24: 331-334.
Gupta SC, Patchva S, Aggarwal BB. 2013. Therapeutic roles of curcumin: lessons learned from clinical trials. AAPS J, 15: 195-218.
Hakim Syed Zillur Rahman. 2004. Qanun Ibn Sina and its Translation and Commentators (Persian Translation). Society for the Appreciation of Cultural Works and Dignitaries, Tehran, Iran.
Hamilton GR, Baskett TF. 2000. In the arms of Morpheus the development of morphine for postoperative pain relief. Can J Anaesth, 47: 367-374.
Hamilton GR, Baskett TF. 2000. In the arms of Morpheus the development of morphine for postoperative pain relief. Can J Anaesth, 47:367-374.
Jelodarian S, Haghir Ebrahimabadi A, Khalighi A, Batooli H. 2012. Evaluation of antioxidant activity of Malus domestica fruit extract from Kashan area. Avicenna J Phytomed, 2: 139-145.
Jepson RG, Kleijnen J, Leng GC. 2013. Garlic for peripheral arterial occlusive disease. Cochrane Database Syst Rev, 4: CD000095.
Kazemi H, Rahgozar M, Speckmann EJ, Gorji A. 2012. Effect of cannabinoid receptor activation on spreading depression. Iran J Basic Med Sci. 15: 926-936.
Khaleghi Ghadiri M, Gorji A. 2004. Natural remedies for impotence in medieval Persia. Int J Impot Res, 16: 80-83.
Koulivand PH, Khaleghi Ghadiri M, Gorji A. 2013. Lavender and the nervous system. Evid Based Complement Alternat Med, 2013: 681304.
Lipman AG. 1990. Clinically relevant differences among the opioid analgesics. Am J Hosp Pharm, 47: S7-13.
Maliakal PP, Wanwimolruk S. 2001. Effect of herbal teas on hepatic drug metabolizing enzymes in rats. J Pharm Pharmacol, 53: 1323-1329.
Marschollek C, Karimzadeh F, Jafarian M, Ahmadi M, Mohajeri SM, Rahimi S, Speckmann EJ, Gorji A. 2014. Effects of garlic extract on spreading depression: In vitro and in vivo investigations. Nutr Neurosci, [Epub ahead of print].
Miller T, Wittstock U, Lindequist U, Teuscher E. 1996. Effects of some components of the essential oil of chamomile, Chamomilla recutita, on histamine release from rat mast cells. Planta Med, 62: 60-61.
Mladenka P, Zatloukalová L, Filipský T, Hrdina R. 2010. Cardiovascular effects of flavonoids are not caused only by direct antioxidant activity. Free Radic Biol Med, 49:963-975.
Moosavi J. 2009. The place of avicenna in the history of medicine. Avicenna J Med Biotechnol, 1: 3-8.
Moqrich A, Hwang SW, Earley TJ, Petrus MJ, Murray AN, Spencer KS, Andahazy M, Story GM, Patapoutian A. 2005. Impaired thermosensation in mice lacking TRPV3, a heat and camphor sensor in the skin. Science. 307: 1468-1472.
Nauck F, Ostgathe C, Klaschik E, Bausewein C, Fuchs M, Lindena G, Neuwöhner K, Schulenberg D, Radbruch L; Working Group on the Core Documentation for Palliative Care Units in Germany. 2004. Drugs in palliative care: results from a representative survey in Germany. Palliat Med. 18: 100-107.
Omidi A, Riahinia N, Montazer Torbati MB, Behdani MA. 2014.  Hepatoprotective effect of Crocus sativus (saffron) petals extract against acetaminophen toxicity in male Wistar rats. Avicenna J Phytomed, 4:330-336.
Osler W. 1972. Evolution of modern medicine: a series of lectures delivered at Yale University on the Silliman Foundation in April, 1913. Ayer Company Publishers, Manchester.
Pendergrass PB, Scott JN, Ream LJ, Agna MA. 1985. Effect of small doses of aspirin and acetaminophen on total menstrual loss and pain of cramps and headache. Gynecol Obstet Invest, 19:32-37.
Ramos-e-Silva M, Ferreira AF, Bibas R, Carneiro S. 2006. Clinical evaluation of fluid extract of Chamomilla recutita for oral aphthae. J Drugs Dermatol. 5: 612-617.
Roussos AP, Hirsch AR. 2014. Alliaceous migraines. Headache, 54: 378-82.
Safayhi H, Sabieraj J, Sailer ER, Ammon HP. 1994. Chamazulene: an antioxidant-type inhibitor of leukotriene B4 formation. Planta Med, 60: 410-413.
Sanchez AM, Vigano P, Mugione A, Panina-Bordignon P, Candiani M. 2012. The molecular connections between the cannabinoid system and endometriosis. Mol Hum Reprod, 18: 563-571.
Sasannejad P, Saeedi M, Shoeibi A, Gorji A, Abbasi M, Foroughipour M. 2012. Lavender essential oil in the treatment of migraine headache: a placebo-controlled clinical trial. Eur Neurol, 67: 288-291.
Scalbert A, Johnson IT, Saltmarsh M. 2005. Polyphenols: antioxidants and beyond. Am J Clin Nutr, 81: 215S-217S.
Sekhon-Loodu S, Catalli A, Kulka M, Wang Y, Shahidi F, Rupasinghe HP. 2014. Apple flavonols and n-3 polyunsaturated fatty acid-rich fish oil lowers blood C-reactive protein in rats with hypercholesterolemia and acute inflammation. Nutr Res, 34:535-543.
Sengupta K, Kolla JN, Krishnaraju AV, Yalamanchili N, Rao CV, Golakoti T, Raychaudhuri S, Raychaudhuri SP. 2011. Cellular and molecular mechanisms of anti-inflammatory effect of Aflapin: a novel Boswellia serrata extract. Mol Cell Biochem, 354: 189-197.
Shen H, Shahzad G, Jawairia M, Bostick RM, Mustacchia P. 2014. Association between aspirin use and the prevalence of nonalcoholic fatty liver disease: a cross-sectional study from the Third National Health and Nutrition Examination Survey. Aliment Pharmacol Ther, 40:1066-73.
Shen T, Li GH, Wang XN, Lou HX. 2012. The genus Commiphora: a review of its traditional uses, phytochemistry and pharmacology. J Ethnopharmacol, 142: 319-330.
Shin IS, Hong J, Jeon CM, Shin NR, Kwon OK, Kim HS, Kim JC, Oh SR, Ahn KS. 2013. Diallyl-disulfide, an organosulfur compound of garlic, attenuates airway inflammation via activation of the Nrf-2/HO-1 pathway and NF-kappaB suppression. Food Chem Toxicol, 62: 506-513.
Siddiqui MZ. 2011. Boswellia serrata, a potential antiinflammatory agent: an overview. Indian J Pharm Sci. 73:255-261.
Silveira JW, Issy AC, Castania VA, Salmon CE, Nogueira-Barbosa MH, Guimarães FS, Defino HL, Bel ED. 2014. Protective effects of cannabidiol on lesion-induced intervertebral disc degeneration. PLoS One, 9: e113161.
Srivastava JK, Shankar E, Gupta S. 2010. Chamomile: A herbal medicine of the past with bright future. Mol Med Rep, 3: 895-901.
Tamaddonfard E. 2013. Turmeric active substance, curcumin, enhanced apomorphine-induced yawning in rats. Avicenna J Phytomed, 3: 231–237.
Tomić M, Popović V, Petrović S, Stepanović-Petrović R, Micov A, Pavlović-Drobac M, Couladis M. 2014. Antihyperalgesic and antiedematous activities of bisabolol-oxides-rich matricaria oil in a rat model of inflammation. Phytother Res, 28: 759-766.
Umar S, Umar K, Sarwar AH, Khan A, Ahmad N, Ahmad S, Katiyar CK, Husain SA, Khan HA. 2014. Boswellia serrata extract attenuates inflammatory mediators and oxidative stress in collagen induced arthritis. Phytomedicine, 21: 847-856.
Vakili N, Gorji A. 2006. Psychiatry and psychology in medieval Persia. J Clin Psychiatry, 67: 1862-1869.
Vallejo R, Barkin RL, Wang VC. 2011. Pharmacology of opioids in the treatment of chronic pain syndromes. Pain Physician, 14: E343-360.
Weisser , U. 2011. AVICENNA xiii. The Influence of Avicenna on Medical Studies in the West. In: Encyclopædia Iranica, Vol. III, Fasc. 1, pp. 107-110.
Wilson RI, Nicoll RA. 2002. Endocannabinoid signaling in the brain. Science, 296: 678–682.
Xu H, Blair NT, Clapham DE. 2005. Camphor activates and strongly desensitizes the transient receptor potential vanilloid subtype 1 channel in a vanilloid-independent mechanism. J Neurosci, 25: 8924-8937.
Yaksh TL, Wallace MS.  2011. Opioids, Analgesia, and Pain Management. In: Goodman & Gilman's The Pharmacological Basis of Therapeutics, 12e, Chapter 18, The McGraw-Hill Companies, Inc.
Zargaran A, Borhani-Haghighi A, Faridi P, Daneshamouz S, Kordafshari G, Mohagheghzadeh A. 2014. Potential effect and mechanism of action of topical chamomile (Matricaria chammomila L.) oil on migraine headache: A medical hypothesis. Med Hypotheses, 83: 566-569.
Zhang D, Mi M, Jiang F, Sun Y, Li Y, Yang L, Fan L, Li Q, Meng J, Yue Z, Liu L, Mei Q. 2015. Apple polysaccharide reduces NF-kb mediated colitis-associated colon carcinogenesis. Nutr Cancer, 67: 177-190.