May Inspiration from the Past Solve the Problems of the Present?

Dear Editor-in-Chief

Tuberculosis (TB), after HIV, is the second leading cause of death from infectious disease in the world (1). Currently, the treatment process for TB takes a minimum of six months. The World Health Organization recommends a drug treatment regimen in this time frame and prescribes four drugs (a combination of rifampicin, isoniazid, ethambutol and pyrazinamide for two months, followed by a four-month continuation phase of rifampicin and isoniazid) (2).

Although strong efforts are made to cure patients with this disease, physiological, psychological and financial costs on one hand and drug-resistance (3–5) on the other hand make a viable cure extremely difficult. Therefore, the effective treatment process of TB is still a major challenge that scientists face. The general goal is to invent a new drug or find a new drug treatment that minimizes side effects and shortens the time needed for treatment. While it is important to look for new insights on treating this disease, it would be highly beneficial to gain inspiration from traditional sources of medicine.

Over the past centuries, in Iran, traditional disease treatment has long focused on organic elements. Plants and animals found in the natural habitat of Iran have thus played an important role in ancient Iranian medical texts. One main method of treatment for TB thus, found in these texts, has been based on the use of freshwater crab. Abu Mansur Ali ibn Movafag-e Heravi (10^th – 11^th century AD), famous Iranian physician, wrote in his book (6) that freshwater crab, Hollyhocks, Arabic gum, Tragacanth gum, and root of glycyrrhizaglabra (Liquorice) should be blended together and consumed by the TB patient for 40 days.

Ali ibn Hossein Ansari Shirazi, another well-known Iranian Medic (14^th – 15^th century AD), reports in his book Ekhtiyarat-e Badi i (7) that sweet water crabs and fresh donkey’s milk should be made into a paste to be consumed by the TB patient. Physician Seyyed Mohammad Hossein Aghili-e Khorasani (17^th – 18^th century AD), in his book Makhzan-ol-Advieh (Storehouse of Medicaments) (8) writes after cutting off the limbs of a freshwater female crab, the abdomen needs to be emptied, washed with water. Finally, with natural olive oil cooked in barley porridge, to be consumed by people who suffer from TB. All of these ancient medical recounts all recommend freshwater crab as a common element in their methods of therapy. Hence, further research needs to be done on the possible anti-mycobacteria effects of crab meat.