Avicenna's Canon Of Medicine And Modern Urology. Part IV: Normal Voiding, Dysuria, And OliguriaBladder Pain Syndrome As Perceived A Millennium Ago

Main Category: Urology / Nephrology
Article Date: 30 Dec 2009 - 0:00 PDT

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UroToday.com - Abu Ali Sina, commonly referred to as Avicenna, was a Persian polymath and the foremost physician and philosopher of his time (980-1037). As noted in the Wikipedia and supported by numerous references (http://en.wikipedia.org/wiki/Avicenna) 40 of his surviving 150 treatises concentrated on medicine. His most famous works are The Book of Healing, a vast philosophical and scientific encyclopedia, and The Canon of Medicine, a standard medical text for over 600 years.

In a fascinating article, Seyed Mohammad Ali Madineh explored the writings of Avicenna with regard to what we might now call bladder pain syndrome. He compares the urological writings of the Canon of Medicine to what we "know" in modern urology.

As an example, he quotes book III, part 19, treatise 2, chapter 3

Dysuria is induced by the following situations:
1) urinary matter is pungent and borax due to abnormal temperament
2) there is a matter which is necessary for regulation and preparation of the urinary substance. When it is absent, the result is dysuria. …When this substance is removed, the urinary pathway is left without this sticky cover, and also, the lubricant material in urine is removed.

If dysuria is associated with pus and blood, its management is the same as the management of bladder ulcer. However, if it is not due to ulcer and there is no pus in the urine, its best management is cleansing the urine by herbs and that you make the urine to be drained. Avoid pungent, salty, and very sweet diets. The patient must not make himself tired and must not have sexual intercourse.

Ali Madineh goes on to discuss how the writings of Avicenna foretell some of the modern etiologic theories of BPS and prostatitis. In the canon, we can distinguish bases of the theory of infection and mucosal theory, along with abnormalities of urine, psychological factors, and abnormalities in prostatic secretions. Avicenna also indicates some differential diagnoses of and associated disorders with bladder pain syndrome. I highly recommend this article that appeared in an Iranian journal. It may stimulate you to learn more about Avicenna. Truly, there is nothing new under the sun!

Madineh SM
Urol J. 2009 Summer;6(3):228-33

Written by UroToday.com Contributing Editor Philip M. Hanno, MD, MPH

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