Qairooti (Cerate or Cera Beeswax Salve) in Traditional Iranian Pharmacy

BACKGROUND: Qairooti (Cerate), a medicinal salve or ointment, compounded of wax and oil, is a formulation used alone or as a basis for medicinal dosage forms. It is widely used from the ancient times to the present. Based on its structure, beeswax has unique characteristics. It builds stable emulsions and increases water absorbance of creams and ointments. The aim of this study was to gather all pharmaceutical information about preparing Qairooti products from traditional pharmacopoeaes, such as the various types of Qairooti and their preparation methods. METHODS: In this article, various types of Qairooti, their producing method and related indications have been discussed based on the main medical Persian manuscripts including Al-Canon fil tibb (Canon of Avicenna), Gharabadin-e-Kabir, Gharabadin-e-Salehi, Exir-e-Azam, Alhavi, Kamel-al-sanaat, Zakhireh-ye Khwarazm shahi, al-Shamel-fi-sanawat-al-tebie, Ekhtiarate badiee, Kholasat-al-tajarob, Tib-e-Akbari, Mofareh al-gholoob, Makhzan-ul-Adwiah, Hedayat-al-motealemin-fi-al-tibb, Altasrif-le-man-ajeza-an-talif, etc. RESULTS: About 500 different formulations from the above-mentioned manuscripts were found and their preparation method and other required information were collected. The amounts of oil and wax in Qairooti are not fixed and depend on different factors; providing the best consistency and appearance of the formulation, such as seasonal temperature. In order to prepare cerate, wax has to be melted by indirect heat and then mixed with the isothermal oil. Mixing process should be performed precisely to provide a homogenized product. If the multi-ingredient cerate is needed, other constituents have to be added to the warm mixture of oil and wax. CONCLUSION: There are many kinds of Qairooti in traditional Iranian pharmacopoeias recommended for different indications. Cerate was a common medication for injuries and wounds. Although it is still used in conventional medicine, some clinical applications in traditional Iranian medicine have been forgotten nowadays. It is recommended that we have a smarter approach to the traditional pharmacopoeias in order to use past experience and transcend existing knowledge of modern pharmacy.