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226 Saeideh Momtaz etal.
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6 Herbal Medicine for Cardiovascular
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Disease in View of Avicenna
1
Zahra Taghipour1* and Mamak Hashemi Habib Abadi
Department of Traditional Pharmacy, School of Persian Medicine,Tehran University
2
of Medical Sciences,Tehran, Iran; 2Department of Persian Medicine, School of
Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
Abstract
Cardiovascular disease (CVD) is a spectrum of diseases aecting the heart and blood vessels and is the
rst cause of death worldwide. e epidemiology of CVD demonstrates a transition, driven by industri
alization, urbanization, and associated lifestyle changes, and is taking place in every part of the world
among all races, ethnic groups, and cultures. In the present stage, coronary heart disease (CHD), stroke,
congestive heart failure, and peripheral vascular disease are the most common CVDs. However, CVDs
have historically occurred in the form of rheumatic heart disease and cardiomyopathies due to infection
and malnutrition. Avicenna made a great contribution to the eld of cardiology and many of the current
well-known concepts can be traced back to his views. He was the rst scientist who established cardiology in the early Middle Ages, thus initiating the enormous progress of cardiological sciences up to the
present day. Besides nutritional recommendations and specic manipulations (e.g., venesection, hijmat,
laxation) to prevent and manage heart diseases, a lot of cardioactive drugs of herbal, animal, and min
eral origins are explained by Avicenna to treat dierent heart diseases. In addition, he specically mentioned 83 simple cardioactive drugs of which 50 are medicinal herbs. In this chapter the medicinal
plants used by Avicenna to treat CVDs and new related research studies are presented.
-
-
Cardiovascular disease (CVD) is a spectrum
of diseases involving the heart and blood
vessels and is the first cause of death globally (Mendis et al., 2015). In 2015, CVDs
accounted for ~17.9 million deaths worldwide (32% of total). The epidemiology of
CVD demonstrates a transition, driven by
industrialization, urbanization, and associated lifestyle changes, and is taking place in
every part of the world among all races,
*Email: z_taghipour@ymail.com
230
Introduction
ethnic groups, and cultures. In the present
stage, coronary heart disease (CHD), stroke,
congestive heart failure, and peripheral vas
cular disease are the most common CVDs.
However, CVDs have historically occurred in
the form of rheumatic heart disease and cardiomyopathies due to infection and malnutrition (Kasper etal., 2018).
Avicenna made a great contribution to
the field of cardiology and many of the current well-known concepts can be traced back
to his views. He was the first scientist who
© CAB International 2023. Medicinal Plants Used in Traditional Persian Medicine
(eds. H. Schulz, Seyed Ahmad Emami and Farsad Nadjafi)
DOI: 10.1079/9781800621671.0006
-
Herbal Medicine for Cardiovascular Disease 231
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founded cardiology in the Early Middle Ages,
thus initiating the enormous progress of
cardiological sciences up to the present day
(Zarshenas and Zargaran, 2015). He discussed various heart problems in the third
book of his comprehensive textbook entitled
The Canon of Medicine (Al-Qanun fi’l-Tibb)
(Ibn Sinā, 2002; Sobhani et al., 2017) as well
as in another specific book named The Trea-
tise on Cardiac Drugs (Al-Adwiyah al-Qalbiyah)
(Ibn Sinā, 2009). According to the era when
Avicenna wrote his books, CHD was not the
most common CVD, so as we see, he reported heart diseases similar to myocarditis
and some disorders of rhythm and myocardial infarction.
Besides nutritional recommendations
and specific manipulations (e.g., venesection,
hijmat, laxation) to prevent and manage
heart diseases, a lot of cardioactive drugs
of herbal, animal, and mineral origins are
explained by Avicenna to treat different
heart diseases. In addition, he specifically
mentioned 83 simple cardioactive drugs of
which 50 are medicinal herbs (Sobhani
etal., 2017).
Cardiovascular Diseases
and Treatments in View of Avicenna
• cold cardiac dystemperament is treated
with warm-temperament foods, moderate exercise, wine, oral complex drugs
(maʿajoon), and topical warming liquid
and semiliquid drugs on the chest;
• dry cardiac dystemperament is treated
by drinking cool water, decreasing activity, taking a bath afterward eating,
therapeutic sitz baths, and moisturizing
foods and drugs; and
• wet cardiac dystemperament is treated
with frequent exercises, taking a bath
before eating, and administering laxative and diuretics.
It seems that heart dystemperaments are
some kinds of myocarditis from the conventional medicine point of view.
Heart warm inflammation (waram har )
This can be a fatal disease that manifests
with severe palpitation (khafaqān) plus
symptoms of heat and inflammation in the
heart. In most cases venesection is necessary
and lifesaving, then local administration of
herbal lotions and continued drinking of
cool liquid drugs. This condition resembles
acute infectious myocarditis.
According to the concepts of Traditional Persian Medicine (TPM), the heart is the origin
of the “innate body heat” and so the factors
affecting “innate body heat” may lead to cardiac weakness and diseases. Excess in exercise and sexual activity, emotional stress,
and insomnia are the most important mentioned factors.
Heart dystemperaments
In accordance with humoral medicine, treatments for cardiac disorders that can lead to
various clinical symptoms are divided into
the following four types:
• warm cardiac dystemperament is treat-
ed with specic fruit sauces like apple
and quince and topical cooling liquid
and semiliquid drugs on the chest;
Syncope (al-ghashi)
Syncope may be caused by suppression of
body motor functions due to heart weakness.
Weakness in other headship organs like the
brain and liver, or in related organs such as the
stomach, can also lead to heart weakness and
finally cause fainting (al-ghashi). Multiple factors are listed as its etiology such as obstruction, inflammations, enormous discharges,
severe pains, and emotional disasters.
Sudden force decrease
(soqut-al-qowah)
This condition is similar to al-ghashi but different in etiology and intensity. In this condition patients do not drop and can move even
with excessive effort. Hence soqūt-al-qowah
232 Zahra Taghipour and Mamak Hashemi Habib Abadi
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may lead to al-ghashi (syncope) if it intensifies. The cause is excessive dense humors.
Palpitation (khafaqan)
Palpitation (khafaqān) is considered fasciculation (abnormal movement) triggered in the
heart. Its etiology is any factor that disturbs
the heart or pericardium, either a somatic factor or a psychological one, such as severe anxiety. It is an irregular pulse, characterized by
changeable intensity, frequency, and speed.
Myocardial infarction (mawt e faj’ah)
The increase in blood viscosity and appearance of clots may lead to arterial obstruction
in the heart and cause myocardial infarction
(mawt e fajʼah). Regarding the basics of TPM,
Avicenna explained that yellow bile is needed
to restore permeability in the capillaries and
arteries. In the case of a decrease in yellow
bile, he emphasized, blood viscosity could
lead to arterial obstruction and myocardial
infarction.
automaticity, and triggered activity are proposed mechanism for arrhythmia (Lévy and
Olshansky, 2021).
Treatment
Some rhythm disturbances, such as rapid
rates in atrial fibrillation, or sustained ventricular tachycardia, require urgent attention. Others, such as ectopic atrial and ventricular beats, may cause concern but do not
need immediate management. Depending
on the individual patient’s situation, antiarrhythmic drugs, pacemakers, implantable
cardioverter-defibrillators (ICDs), and biventricular devices may be prescribed (Lévy and
Olshansky, 2021).
Shock
Shock is defined as a state of cellular and tissue hypoxia that can be due to intracardiac
causes of cardiac pump failure that result in
reduced cardiac output (CO). Myocardial infarction, atrial and ventricular tachyarrhythmias, and bradyarrhythmias as well as
mechanical disturbance can lead to shock
(Gaieski and Mikkelsen, 2021).
Brief Review on Some Types of
Cardiovascular Diseases and Their
Treatments in Modern Medicine
An arrhythmia is any rhythm that is not a
normal sinus rhythm with normal atrioventricular (AV) conduction, of which palpitation is its most common presentation. This
disorder can occur as bradycardias, ventricular tachycardia, atrial fibrillation, AV block,
etc. Palpitation, which is defined as an unpleasant awareness of the forceful, rapid, or
irregular beating of the heart, is one of the
disorders induced by arrhythmia. Abnormal
impulse formation can arise from abnormal
automaticity or triggered activity originating
from the sinoatrial (SA) node or other sites.
Hypoxia, ischemia, or excess catecholamine
activity could lead to abnormal automaticity. Ion channels and currents, enhanced
Arrhythmia
Treatment
Ventilatory support followed by hemodynamic support with/without norepinephrine, dopamine, and nitroglycerin, etc. can
be prescribed depending on the patient’s
condition (Gaieski and Mikkelsen, 2021).
Scientifc Evaluation of Medicinal
Plants Mentioned for the Management
of Cardiovascular Diseases
in Avicenna’s Canon
The medicinal herbs mentioned in the Canon
of Medicine for the management of CVDs
and some scientific evidence supporting
their efficacy are described individually in
this section. In addition, the traditional application of some plants is also reported. All
collected results are presented in Tables 6.1,
6.2, 6.3, and 6.4.
Table 6.1. Medicinal plants mentioned in Canon of Medicine for treatment of CVD.
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Common English
No. Scientific name(s) Synonym(s) Arabic name(s)
1 Anchusa azurea Mill.
Echium amoenum Fisch. & C.A. Mey.
2 Doronicum grandiflorum Lam. Doronicum scorpioides Lam. Dorunaj – Asteraceae
3 Zingiber zerumbet (L.) Sm. Amomum zerumbet L. Zurunbad Bitter ginger Zingiberaceae
4 Crocus sativus L. Crocus officinalis (L.) Honck. Zaʿ afaran Saffron Iridaceae
5 Curcuma zedoaria (Christm.) Roscoe Costus nigricans Blanco Jadwar White turmeric Zingiberaceae
6 Centaurea behen L. Centaurea alata Lam. Bahman abyad White behen Asteraceae
7 Limonium vulgare Mill. Statice limonium L. Bahman ahmar Sea lavender Plumbaginaceae
8 Syzygium aromaticum (L.) Merr. & L.M.
Perry
9 Melissa officinalis L. Melissa hirsuta Hornem. Badranjbuyah,
10 Ocimum basilicum L. Ocimum album L. Badruj Basil Lamiaceae (Labiatae)
11 Tanacetum balsamita L. Balsamita major Desf. Shahesfaram Balsam weed Asteraceae
12 Amomum subulatum Roxb. Cardamomum subulatum (Roxb.) Kuntze Qaqolah, Hil aswad Black cardamom Zingiberaceae
13 Piper cubeba L. Cubeba officinalis Rafin. Kababah Cubeb Piperaceae
14 Clinopodium acinos (L.) Kuntze Calamintha acinos (L.) Clairv. Falanjmeshk Basil thyme Lamiaceae (Labiatae)
15 Citrus medica L. Citrus × aurantium var. medica (L.)
16 Cinnamomum citriodorum Thwaites Camphora citriodora (Thwaites) Lukman. Sadaj hendi Malabar cinnamon Lauraceae
17 Inula helenium L. Aster helenium Scop. Rasan Elecampane Asteraceae
18 Cinnamomum camphora (L.) J. Presl. Camphora camphora (L.) H. Karst. Kafur Camphor Lauraceae
19 Pterocarpus santalinus L. Lingoum santalinum (L.f.) Kuntze Sandal ahmar Red sandalwood Fabaceae (Leguminosae)
20 Santalum album L. Sirium myrtifolium L. Sandal abyad White sandalwood Fabaceae (Leguminosae)
21 Rosa × damascena Mill. Rosa belgica Mill. Ward juri Damask rose Rosaceae
22 Bambusa bambos (L.) Voss B
23 Malus domestica Borkh. Pyrus malus L. To f fa h Apple Rosaceae
24 Coriandrum sativum L. Coriandrum majus Gouan Kozbarah Coriander Apiaceae (Umbelliferae)
25 Raphanus sativus L. Raphanus candidus Vorosch. Fojl Radish Brassicaceae (Cruciferae)
26 Citrullus colocynthis (L.) Schrad. Cucumis colocynthis L. H anzal Bitter apple Cucurbitaceae
Echium orientale C.A. Mey.
Anchusa italica Retz.
Caryophyllus aromaticus L. Qaranful Clove Myrtaceae
Wight & Arn.
ambusa arundinacea (Retz.) Willde.
Gavzaban Bugloss
Toranjan
Otroj Citron Rutaceae
Kheizaran, Tabashir Giant thorny
name Family
Boraginaceae
Sea bugloss
Lemon balm Lamiaceae (Labiatae)
Poaceae (Gramineae)
bamboo
Continued
Herbal Medicine for Cardiovascular Disease 233
Common English
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No. Scientific name(s) Synonym(s) Arabic name(s) name Family
27 Laricifomes officinalis (Vill.)
Kotl. & Pouzar
28 Cuscuta epithymum Murray Cuscuta acutiflora Rota Aftimoon Dodder Convolvulaceae
29 Cydonia oblonga Mill. – Safarjal Quince Rosaceae
30 Pyrus communis L. – Komathara Common pear Rosaceae
31 Origanum majorana L. Majorana hortensis Moench Marzanjosh Sweet marjoram Lamiaceae (Labiatae)
32 Moringa oleifera Lam. Hyperanthera moringa (L.) Vahl . Ban Ben Moringaceae
33 Hordeum vulgare L. Hordeum sativum Pers. Shaʿir Common barley Poaceae (Gramineae)
34 Punica granatum L. Punica nana L. Romman (jolnar) Pomegranate Lythraceae
35 Amaranthus blitum L. Amaranthus alius K. Krause Baqlah yamaniah Blite Amaranthaceae
36 Salix sp. – Khalaf Willow Salicaceae
37 Citrus limon (L.) Burm.f. – Laymun Lemon Rutaceae
38 Rheum palmatum L. Rheum potaninii Losinsk. Rawand Rhubarb Polygonaceae
39 Lens culinaris Medik. Ervum lens Wall. Aʿdas Lentil Fabaceae (Leguminosae)
40 Aquilaria agallocha Roxb. – Uʿd Eaglewood Thymelaeaceae
41 Alhagi maurorum Medik. Alhagi camelorum Fisch. Taranjebin, Aʿqul Manna of
42 Lactuca sativa L. Lactuca palmata Willd. Khas Lettuce Asteraceae
43 Cichorium intybus L.
Cichorium endivia L.
44 Portulaca oleracea L. Portulaca fosbergii Poelln. Baqlat al hamqa Common purslane Portulacaceae
45 Atropa belladonna L. Atropa lethalis Salisb. Lifah Belladonna Solanaceae
46 Papaver somniferum L. – Al’afiun Opium poppy Papaveraceae
47 Operculina turpethum (L.) Silva Manso Ipomoea turpethum (L.) R. Br. Torbod Turbith Convolvulaceae
48 Commiphora mukul (Hook. ex Stocks)
Engl.
49 Terminalia chebula Willd. ex Flem. Terminalia gangetica Roxb. Ihlilaj kabuli Chebulic
50 Cicer arietinum L. Cicer album Hort. H immas Chickpea Fabaceae (Leguminosae)
51 Cucumis sativus L. Cucumis esculentus Salisb. Khiar Cucumber Cucurbitaceae
52 Boswellia sacra Flueck. Boswellia carteri Birdw. Kondor Frankincense Burseraceae
53 Myrtus communis L. Myrtus acuta Mill. As Myrtle Myrtaceae
Fomitopsis officinalis (Vill.) Fr.
Bond. & Sing.
Cichorium commune Pall.
Cichorium ambiguum Schult.
Balsamodendrum mukul Hook.
ex Stocks
Gharighun Ghariqun Fomitopsidaceae
Fabaceae (Leguminosae)
hedysarum
Hindiba’ Chicory Asteraceae
Endive
Muqil Guggul Burseraceae
Combretaceae
myrobalan
234 Zahra Taghipour and Mamak Hashemi Habib Abadi
54 Paeonia officinalis L. Moutan officinalis (L.) Lindl. & Paxton Fawania Common peony Paeoniaceae
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55 Hyssopus officinalis L. Thymus hyssopus E.H.L. Krause Zufa Hyssop Lamiaceae (Labiatae)
56 Nardostachys jatamansi (D. Don) DC. Nardostachys grandiflora DC. Naridin, Sonbol
Hindi
57 Sinapis alba L. Brassica hirta Moench Khardal abyad White mustard Brassicaceae
58 Brassica nigra (L.) K. Koch Sinapis nigra L. Khardal aswad Black mustard Brassicaceae
59 Anacyclus pyrethrum (L.) Lag. Anthemis pyrethrum L. Aʿqraqarha Pellitory Asteraceae
60 Pistacia lentiscus L. Lentiscus vulgaris Fourr. Mistakiu Mastic Anacardiaceae
61 Lilium candidum L. Lilium album Houtt. Susan azad Madonna lily Liliaceae
62 Commiphora myrrha (Nees) Engl. Balsamodendrum myrrha T. Nees Mor Myrrh Burseraceae
Commiphora habessinica
(O. Berg) Engl.
Commiphora schimperi
(O. Bergman) Engl.
63 Convolvulus scammonia L. – Saqmunia Scammony Convolvulaceae
64 Olea europaea subsp. cuspidata
(Wall. & G. Don) Cif.
Olea europaea L. Olea pallida Salisb.
65 Prunus amygdalus Stokes – Lawz Almond Rosaceae
Commiphora abyssinica (Engl.) Engl.
Balsamea schimperi Engl.
Olea africana Mill. Zaytun Olive Oleaceae
Nard Caprifoliaceae
Herbal Medicine for Cardiovascular Disease 235
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