Crisis is one of the sophisticated yet important and practical concepts of Persian medicine which have been discussed and pointed out throughout traditional medical literature starting from Hippocrates, Galen, Avicenna and others or discussed independently in their related treatises. Being so important, it was used to classify the days of illnesses according to days devoted to it (critical days) or the days forecasting it (warning days) and the days in between. Crisis was known to be an important change in the process of disease which afterwards the destiny of the patient was predicted. It was categorized by its completeness/incompleteness and its good/bad prognosis, timing and direction of the pathogenic substance displacement or excretion. Many factors have been known to affect the onset and type of crisis including type of illness, the temperament of the patient, the season of disease occurrence, and even the effect of heavenly bodies especially the tidal force of the moon and the sun. Therefore many branches of science like chronobiology, physics, nanomechanics, astrophysics and rheology are needed to understand and demystify the narrated information derived from centuries of clinical observation. This understanding may lead to the decoding of unknown causes of exacerbation and remission of chronic diseases like multiple sclerosis and so on. As mentioned in previous articles, we have also designed a set of treatments named SINA therapy to simulate good crisis artificially in order to hasten the coction period and facilitate the curing of the daily increasing material diseases.

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In Persian Medicine (PM) literature, a crisis is the culmination of the body’s response to illness, which necessitates fundamental dietary modification to improve prognosis. In this narrative review, authentic PM textbooks as well as articles on diets for critically-ill patients (CIPs) obtained from PubMed and Google Scholar databases, were reviewed, and after gathering data, they were classified, coded, analyzed, and compared. In the acute phase, both PM and conventional medicine agree on relative food restriction, but PM lays a special focus on the use of meat in cases of weakness. There are both similarities and differences between PM and conventional medicine regarding nutritional recommendations in critical illness. For example, recommendations for food restriction and protein intake are similar in both schools, but recommendations for carbohydrate intake are different. The variables addressed and emphasized in PM require further evaluation in clinical trials.

The term “crisis” in medical context is an important turning point or stage which occurs in some diseases and if not managed correctly, can become life threatening. Despite the use of the term in modern medicine, it was a much wider and sophisticated traditional medical concept. The first usage has been seen in the Greek writings of Hippocrates. In the Islamic Golden Age, this concept entered Persian Medicine by translation of Greek medical treatises. Great Persian Medicine scholars have paid particular attention to the concept and have written exclusive chapters about it. One of such scholars, Hakim Mohammad Azam Khan Chishti (1814-1902), an Indo-Persian physician and medical writer, wrote several comprehensive encyclopedic books - in Persian language - about various aspects of PM including crises. In this historical review we discuss his biography and his books, especially his important book Rokn-e-Azam, which is a comprehensive work on the concept of crisis in which he collected and discussed opinions of great medical scholars from ancient times to the 19th century. Despite his fidelity, unfortunately he rarely criticized the previous literature and thus did not add an additional value to the subject else than his comprehensive review. In the recent worldwide accepted roadmap towards Integrative Medicine, studying such inclusive traditional manuscripts may give better insight and understanding of the behavior of acute and chronic diseases and their appearance, exacerbations and remissions.