Letter to editor
Avicenna (980-1037 AD), the foremost Iranian physician, introduced numerous herbs as diuretics in his renowned book of Canon of Medicine. He has recommended herbal diuretics for most ailments accompanied by fluid superabundance like lassitude, oedema, and ascites. (1)
He has classified diuretics as cold and hot ones according to their primary action and temperament (Table 1). Hot temperament diuretics have the power to dissolve or dilute viscous and congealed fluids from the pores of an organ and move them toward the urinary tract, while cold temperament diuretics act as a detergent and moistener to wash the residual matter from the body. (1)
Hot temperament diuretics are more potent than cold ones and can cause menorrhagia. They are contraindicated in the presence of irritative urinary symptoms whereas cold diuretics are advised for burning sensation secondary to urinary tract injuries and dryness. (1)
Today studies on the introduced herbal diuretics by Avicenna are scarce, though some have indicated their properties. For example Positive effects of cold temperament herbal diuretics like Pumpkin seeds in lower urinary tract symptoms of altered prostate health factors have been shown in clinical study (2) while hot diuretics like celery has been prohibited in the presence of symptomatic urinary tract infection due to its irritative volatile oil effect. (3)
The concept regarding potency of diuretic herbs, introduced by Avicenna is in line with the recent findings; hot temperament diuretics like parsley and celery are considered as strong diuretic herbs, (4) while cold ones like Malvaceae are used as mild diuretic. (5)
In recent investigation hot temperament diuretic herbs like anise, and fennel that are dissolvent were more efficient in decreasing weight of normal rats than cold ones such as cucumber, watermelon, and pumpkin; however, none of them did not increase the amount of urine output significantly. (6)
Overall, it seems that different medicinal indications could be considered for hot and cold temperament herbal diuretics, they do not act specifically in the nephrons, and they may play different therapeutic role in gastrointestinal and urogenital systems.
Table 1Different classes and actions of herbal diuretics in the Canon of Medicine. (1, 7)
| Common name | Scientific name | Name in Canon | Part used | family |
|---|---|---|---|---|
| Common hot temperament / strong diuretics | ||||
| Anise | Pimpinella anisum | Anisun | Fruit | Apiaceae |
| Black seed | Nigella sativa | Shuniz | Fruit | Ranunculaceae |
| Celery seed | Apium graveolens | Karafs | Fruit | Apiaceae |
| Carrot fruit | Daucus carota | Jazar | Fruit | Apiaceae |
| Cassia bark | Cinnamomum cassia | Salikhah | Bark | Lauraceae |
| Fennel | Foeniculum vulgare | Razianeh | Fruit | Apiaceae |
| Orris root | Iris germanica | Irsa | Rhizome | Iridaceae |
| Asparagus | Asparagus racemosus Willd | Hilyun | Root | Asparagaceae |
| Parsley | Petroselinum crispum (Mill) Fuss | Futrasaliyun | Whole plant | Apiaceae |
| Common cold temperament / mild diuretics | ||||
| Cucumber | Cucumis flexuosus | Qitha | Fruit | Cucurbitaceae |
| Pumpkin | Cucurbita pepo | Qar | Fruit | Cucurbitaceae |
| Common malva | Malva sylvestris | Khubbazi | Flower | malvaceae |
| Purslane | Portulaca oleracea | Baqla hamqa | Leaves and seeds | Portulacaceae |
| Small caltrops | Tribulus terrestris | Hasak | Fruit | Zygophyllaceae |
| Winter – cherry | Physalis Alkekengi | Kakenj | Fruit | solanaceae |
