Categorization of Cathartic (Purgative) Medicines Mentioned in TPM Resources According to Their Specific Function

BACKGROUND: According to traditional Persian medicine (TPM) resources, the human digestive system includes four steps. In the first step, gastric digestion, the ingested food pours into the stomach and changes into the leachate called chylous due to the heat produced in the stomach. In the second step, hepatic digestion, the chylous enters in the liver through mesenteric vessels and transforms into the quadruple humors, sanguine, phlegm, bile and black bile due to the liver heat. In the case of humor predominance, using moshel or cathartic medicines is considered as a strategic medical plan. In this study, we introduce cathartic (purgative) medicines mentioned in TPM resources according to their specific function. METHODS: Literature review of TPM resources, including Canon of Medicine and Aghili’s Makhzan-ul-Adwiah was performed in order to find cathartics cited in the aforementioned books, prescribed specifically for different humor’s predominance in the body. RESULTS: The survey found that the cathartics are categorized into eight groups: 1. Cathartic of “balgham” such as “Citrullus colocynthis and Colchicum autumnale”. 2. Cathartic of bile such as “Prunus domestica and Alhagi Camelorum A. maurorum”. 3. Cathartic of “sovda” such as “lajward stone and Armenian stone”. 4. Cathartic of “Ma’a-e-asfar” such as “Marrubium vulgarre and Rivand extract”. 5. Cathartic of melancholy and phlegm such as “Cuscuta epithymum and Adiantum capillus veneris. 6. Cathartic of bile and phlegm such as “Nepeta menthoides and Fumaria parviflora”. 7. Cathartic of “Ma’a-e-asfar and phlegm such as Urtica dioica and Qsa’alhmar. 8. Cathartic of all mucus such as “Cassia acutifolia” and “kharbaghe Aswad”. CONCLUSION: Medical students of traditional Persian medicine should be familiar with cathartics and purgatives specific for each humor. In this study, cathartics has classified into main cathartics of phlegm, bile, black bile, Ma’a-e-asfar, black bile and phlegm, Ma’a-e-asfar and phlegm, as well as cathartic of all triple humors for a better memorization and feasibility of prescribing in practice.