Cardiac Infertility in Persian Medicine: Avicennaâ€™s View
Authors: Daneshfard Babak , Jaladat Amir-Mohammad Jaladat , Sanaye Mohammad Reza Sanaye , Dalfardi Behnam 
Published: January 2022

Dear Editor
Sexual activity makes up a significant portion of anybodyâ€™s life: it plays a crucial role when it comes to having full physical, mental, and psychological health.Â This part of life-style has been emphasized as an essential need in Persian Medicine (PM) literature [1]. PM sages â€“such as Rhazes (865-925 AD)â€“ have discussed different types of sexual disorders in their books, offering their own therapeutic methods [2]. Nevertheless, the recent increasing trend of sexual disorders and related complications e.g., infertility, has posed a serious challenge to the physicians and a growing burden to health care systems.
Putting emphasis on having a healthy sex life, PM underlines proper regimen and normal digestive system without which negative consequences on both potency and fertility may occur [3]. Moreover, accomplishment of sexual desire and normal sexual function is conditioned upon the well-being of vital organs i.e., heart, brain, liver, and genital system. Not only in traditional literature but also in current studies the relation between cardiovascular diseases and sexual disorders has been mentioned [4].
Avicenna (980-1037 AD) (Figure 1), the great Persian scholar of the Islamic Golden Age, is known as one of the pioneers of modern science of cardiology. He has discussed sexual disorders in the third volume of his masterpiece, Canon of Medicine.
In the chapter on â€œnoghsan-e-bahâ€ (sexuality weakness), Avicenna discusses different sexual disorders and their proper remedies. For instance, he goes on to cover erectile dysfunction, mentioning its cardiovascular origin [5]. Avicenna precisely describes the clinical features of impotence/infertility with cardiovascular origin: â€œâ€¦If the decrease in the stamina of intercourse is from a cardiac origin, erection would happen less, and ejaculation may occur in a non-erectile state. The pulse would be soft and weak â€“body temperature drops under the normal degreeâ€¦â€ [6].
Avoidance of grief and improving body weakness using meat juice are the basic treating approaches in this case. As for the pharmacotherapy, application of fragrant herbs such as sandalwood, rose, and musk has been emphasized. Apple, lemon balm, and borage drinks are repeated prescriptions of Iranian physicians in this regard. In addition, pearls, amber, coral, silk, cloves, white behen, mastic, valerian, and cinnamon are the most common components that are used in combination forms for treating cardiogenic infertility/impotency [7].
Establishing such a link in between cardiac diseases and infertility in PM is not far from the current evidence. For instance, it has been revealed that serum testosterone level is significantly decreased in men with chronic heart failure [8]; this could inevitably pose negative effects on fertility. On the other hand, some clinical evidences have shown that using a formulation (Loboob) which increases the cardiac [and other vital organsâ€™] stamina is effective in treatment of infertility [9]. In addition, at least some â€“if not allâ€“ of the medicinal plants used for managing sperm abnormalities in PM have cardiotonic properties [10]. With this regard, we suggest more rigorous investigations to well understand the concept of cardiac infertility and its underlying mechanisms.