Introduction
Modern medicine was established in Iran during the Qajar period, and with the advent of Mirza Taghi Khan Amir Kabir and the establishment of the Dar ul-Funun. The Graduate School of Dar ul-Funun was first established in 1852, with the various disciplines of medicine and pharmacy, mathematics, literature, fine arts, military education and political economy. In 1858, the school was a major contributor to the development and training of modern medicine by recruiting foreign teachers and sending students abroad (or, as Mojtaba Minavi says Caravan of knowledge). Prior to the establishment of the Dar-ul-funun, the practice of teaching professions was as an apprenticeship and in form of teacher and student and medical practitioners after finishing the pre-primary course, were practically learnt the medicine [1].
In the year 1849, with the establishment of the Dar ul-funun, medicine alone was one of the branches of the Academy of Sciences and as a separate discipline, it was considered as one of the main lessons of education. The first graduated students in medicine began to work in 1856 .The Dar-ul-funun School of Medicine may be considered as the first supreme school in Iran. At that time, the courses in medicine were divided into 3 distinct categories, including Iranian medicine, European medicine, natural medicine, and pharmacy. Thus, the natural sciences of Iran were vital, state clinics were established, and the students were practically familiar with the new medicine. A Branch was established in the clinic for the training of midwives and female doctors, but its initiation remained suspended for a while [2]. In 1918, the Department of Medicine was separated from the Dar-ul-Funun and became an independent school and a separate head and place were allocated for it [1]. During the reign of Naser-al-Dinshah Qajar in 1853, three years after Dr Polak came to Iran, under the orders of the Shah (king) and the efforts of Dr. Pollak, a state-owned military clinic was established for military aids for the troops outside Tehran. The hospital's location was outside the Darvazeh Dolat Avenue. Since its inception, this clinic was a place for the education of students at the Dar ul-Funun Branch and was under the control of military managers for many years [3]. Madame Carla Serena, native of France, arrived in Iran in November 1877, along with the thirtieth year of the reign of Nase-al-Din Shah, through the Mazandaran Sea. She writes about the military clinic:
"The military clinic, built several years ago by the order of Naser al-Din Shah in Tehran, has been known as the" Living Cemetery ", it consists of several rooms in which there are 20 beds waiting for the patient and no one is crazy about sleeping in this hospital. Everyone knows that there is sufficient budget for the maintenance of the patient and this budget is regularly paid. However, there is no guardian, nurse, doctor and drug. The hospital is based on the good intentions and that the students of the medical school of Dar-ul-Funun can learn good lessons in practice, but with the death of a European professor, who was teaching one of the courses, its activity has been completely stopped [4]. "
In the year 1873, Nasseraddin Shah, who was strongly influenced by the advances in industrial and medical care in Europe, after returning from France, ordered the establishment of clinic with the style of hospitals in the countries of Europe. For this purpose, he appointed Moshir al-Doleh, Chancellor and Ali Gholi Mirza Etezad al-Saltanah, Minister of Science to do that. After establishing the provisions for the construction of this clinic and its partial equipping, they established a clinic in 1876 which later became known as the” State Hospital”, and after being established for 5 years, Dr. Ali Akbar Khan Nafisi (Nazem-alateba) was the head of the department. In 1881, Mokhber-al-Doleh was appointed as the head of the clinic [5]. However, before the introduction of high and supreme education in the field of midwifery, the task of helping in labor, and protection of mother and baby was on behalf of the experienced midwives who had learnt this practically, and perhaps even when the delivery was unusual, they did not do anything about them, and in such circumstances, it resulted in death of infant or mother or both of them [6]. Such events have been less widely studied in the written heritage, and today with the help of the documents, books and publications that have passed from the past, we have been able to provide the history of Women's Hospital. It is hoped that this attempt be an introduction for future research.
 
Text description
In the year 1907, Dr. Amir Alam, head of the Department of Health (Figure 1), went to visit the holy shrine in Mashhad and visit the health and medical institutions. In visiting medical centers, He found the Dar ul-Shafa in displeased condition, and in a part of his notes, while comprehensively reviewing the Dar ul-Shafa, he depicted the status of the treatment of women.

Figure 1) Dr. Amir Alam, Head of Department of National Health, Qajar period
 

After that trip, Dr. Amir Alam sought to establish a separate women's specialized clinic and train women's medical staff. In this regard, in his writings, he states:
"For the women's branch, I am thinking of seeking female doctor and surgeon and midwife, which, in terms of therapies, should be separated from the male branch, and perhaps we could train female doctors or at least highly trained midwives, and prevent the terrible casualties of women, and infants as much as possible. We know that in our country, about 30-50 out of 100 pregnant women die during delivery, and most of their infants die as well. This shows how important is our concern [7]. "
Dr. Amir Alam, in addition to the aforementioned issues, wrote articles on the issue of women and children. For example, in Blossom (Shekoufeh) Jounral, which was published in Persian by heading Mariam Amid Semnani (Mozayan-al-Saltaneh) in Tehran, with lithography, Nestaliq's line, in the cut-off and every issue in 4 pages, the following is inserted: "This writing is from honorable Dr. Amir Alam, who adorn the “Blossom” with his writing"; as follows:
"Of course, there is no need to say that in a big city like Tehran with a population of almost 4,000 people,  lack of a special clinic for women and children, is a shame. Perhaps, if such clinic had been establish, Many poor women and poor children who could not afford medicine and food would had been treated and we would not had been lost people. It is evident that one of the reasons for the lack of population growth in Iran is the lack of women's clinic. In order to achieve this legitimate purpose, this servant, has been sent to help and assist to establish a special clinic for women and children. Since this is about the public interest and the press always believes and advocates public interest as its duty and slogan, it is expected to promotethis despicable intention and inform the public, For the sake of this honorabl jouranal, a copy of related  bill is presented in attachment"[8].
“Blossom Journal”:
“Yes, the Lord says: "So fast up the good". The clever people, but those who are fortunate and happy, are those who overcome and advance in the charity, which is the convenience and comfort of the public, that man himself goes and names himself in history. His goodness is always described among the people that this school or clinic, charity or qanat, has been built by that person. It is a custom in abroad that the statue of people who have acted in great deeds is built and placed in the exhibitions, for the purpose of watching and reminding. This action from you, honorable Dr. Amir Alam, is a symbol of philanthropy and you have considered the comfort of human beings, and you have been winner in the race for philanthropy. Firstly, in the case of Injection of smallpox vaccine in the center and other provinces, as well as rural areas, you served so much in humanity and health service that no one can appreciate you as you deserve. So many child used to die because of lack of smallpox vaccination. Also, in case of construction of Ahmadieh Clinic, you provided the health and comfort of patients, and it is administered in good faith. The members of board of this clinic and the physicians and the surgeons, are all noble and righteous people, and serve with ultimately kindness and compassion. The way that these members serve, is not found in any clinic in Tehran, and thank god, all the patients are well treated. Regarding your new decision about construction of the hospital for the women and children, it is a sacred purpose that no better than that can be imagined; if the authorities help in this issue, not only we can increase women's health and safety but it would be our proud as well. Why do not have any special hospital for women in our city? Every country and every city that has more civilization and knowledge, has more clinics. The city that does not have a clinic indicates the lack of knowledge among the authorities. While there are a lot of clinics abroad, we do not have any clinic. It's not mistaken. Most of their clinics are national which are built by endowments from the benevolent people. A lot of people testate in their will that specific amount of their properties be spent on the clinic. Some donate their money for this benevolent affair. Even, rural areas have clinic. Alas to Iran and Iranian; Men and women have all sorts of expenditures that are futile and do not spend money to form a woman's and children's clinic, and they do not donate to build such hospital. People are too indifferent that they walk through the street, and they see the crazy women. Men and women just stop and watch them and walk over them. They sleep in the streets at night, and it is possible that they do a lot of offensives. They are not ashamed of God, nor are they embarrassed at the expense of the foreign states. If we had a hospital for woman or at least a clinic for crazy people. , We could collect them. Also, all people know that female patients are embarrassed to explain their disease and doctors cannot diagnose their disease and most of women`s diseases cannot be diagnosed and so many women die every year. If we had a clinic, female doctors, nurses and midwives can be appointed and the diseases can be treated. Therefore, Dr. Amir Alam should be appreciated for this action and he should be helped in this benevolent work by   both authorities and respectful and authorized women. Donation also should be collected to do this work as soon as possible. If anyone dedicate one-third of his property for this purpose, he will gets a lot of reward from God. “Blossom Journal” appreciate and congratulate Dr. Amir Alam from all countrymen for this his action [8].”  
Establishment of Women's Hospital
As it was said, Dr. Amir Alam sought to establish a special hospital for women, because before that, there was no hospital that could easily accept women and children [9]. In this situation, Dr. Amir Alam pointed to the need for the establishment of a women`s hospital to the Ministry of Education and the Endowment and Fine Arts in May 3, 1916. Morteza Khan Momtaz al-Molk, the Minister of Education, made a proposal to the state board and requested that a building be made available [10]. With the approval of the Board of Governors and the efforts of the Amir Alam, a building and a land plots that were the properties of Arbab Jamshid in the previous years and were given to government for his debt, and they were in rent for a period, were allocated for the hospital (Figure 2).

 Figure 2) The women`s hospital donation document
 

During the time of the cabinet of Tonekaboni and the Ministry of Momtaz-al-Molk, from the Ministry of Education, request for transferring of the mansion to the hospital was provided and was allocated to the Women`s Hospital under the ownership certificate No. 1264, in which the property was previously owned by the state [11]. One part of the hospital was operated as a central part and the other parts were clinics and pharmacies [10]. The location of the mansion, in terms of geographical location, was near the Darvazeh Dolat avenue [12]. After providing the equipment and facilities in in 1917, Dr. Amir Alam provided the basis for the establishment of the Women`s Hospital. Deceased Adib-al-mamalek Farahani, on the occasion of the opening of the Women`s Hospital, wrote this piece:
"It is on the honor that at the era of this king, this glorious place was constructed by the order of Ministry of education with the mediation of the Amir Alam, as his art is clear from his action. This is place for the comfort of women and children and in this glorious palace, the treatment is free. Its name and date is Women`s Hospital”.
“it is Women`s Hospital” based on special alphabet (Abjad) which means number and alphabet and terms, shows the year of establishment of Women`s Hospital i.e. 1335 lunar year or 1917. It is calculated in this way:
Based on this special alphabetic order, the initial six letters of the word hospital (in Persian Bimares) get numbers 2, 10, 40, 1, 200 and 60 respectively
The three last letter of the word hospital (in Persian tan) get numbers 400, 1 and 50 respectively.
The letters of the word women (Banovan in Persian) received the numbers 1, 2, 50, 6, 1, 50 respectively.
The letters of the word is (Ast in Persian) gets the number 1, 60, and 400 respectively.
The sum of these numbers becomes 1335 that indicates the lunar year 1335.
The Women`s Hospital was run under the supervision of Dr. Alireza Mohazab-al-Saltanah (cousin of Dr. Hossein  Ehya-al-Saltanah, the Head of Ministry of National Health). He studied in Tehran and Paris, and in addition to the management of Women`s Hospital, he was heading the optometry and medical section of the hospital as well. At this time, Madame Fraskina, daughter of Markar, a graduate of Geneva, who was appointed by the government in 1917, and Dayeh Khanum and Ms. Masoumeh who was a nurse were in the hospital and with the sincerity of these four persons, the hospital was managed very well. [13] Mirza Ahmad Khan Nasir al-Doleh was the Forty-third Minister of Education, Endowment and Fine Arts from Wednesday, July 17, 1918 to Friday, June 25, 1920. Nasir al-Dolah established a supreme school for female teachers` Education which was called Dar-ul-Moalemat in the late 1880 or the early 1881. The first place was at the corner of the Shah (Naderi) Street and Nobahar Alley. The school had only 2 classes: one elementary class and one high school class. The elementary class was the class for training elementary school teachers and the high school class was for training teachers for high school. Then the school was moved to the Mansion of Farhang Co. located in Takht-e-Zomorod Avenue, Sahm-al-Molk Alley. This school was established based on the Franco-Girls School Organization and its head was Abolhasan Forooghi and the principal was Esmail Marat. Forooghi headed the school for ten years from 1919 to 1928 [14].This school had been founded by Moadab-al-Molk and in addition to the complete elementary school, had three secondary classes. Good students could continue their education in the secondary school after graduation from the elementary school. Minister of Education Nasir al-Doleh, in order to train and educate female teachers, converted the school to the Dar-ul-Moalemat and ordered to two students to attend Women`s Hospital three days a week to learn lessons on women's diseases and midwifery [13]. At that time, male physicians were prohibited from examining women although in this case Zahra Sheidani and Dr. Rafieh (Amin) were also at the hospital [15]. For this reason, Dr. Amir Alam hired some well-known female specialist, such as Madame Fraskina, and later Madame Dormpas who was French. Dr. Matild Dormpas was a doctor and former student at the Eastern Languages ​​School. She writes about her work in Iran: "When I arrived in Iran, the Vosoogh-al-Doleh Cabinet was in power and was more interested in hiring foreign staff than nationalist governments who later took the control of affairs [15].”
Dr. Penn and Dr. Sarkisian, who were specialized in gynecology and midwifery, were invited to Iran and were recruited in Women`s Hospital [13]. In this way, Women`s hospital was founded (Fig. 3).

Figure 3) Opening Ceremony of Women's Hospital, Qajar Period
 

Since the establishment of the Women's Hospital, for Inspection of condition of patients and hospital, an inspectors from the Ministry of Education was responsible to write a report about the hospital until January 1921 when the Hospital was closed and it was reopened again with the efforts of Head of the Ministers (Figure 4). The inspectors came to the hospital twice a month to prepare a report from the hospital. They were completing the form content containing the row, the patient's name, the patient's father, the diagnosed disease, and the bed no., the date of entry, and the date of discharge, and the forms were sent to Ministry of Education for inspection. It seems that the Ministry of Education had 3 observers at that time, and all of these reports were provided by Mehrbanoo Danbali Sepahi, Ozra Agh Oli and Fakhr al-Ashraf, and usually with the help of the Alam-al-Molook, the secretary. In the summary of the reports of Mehrbanoo Dambely in August 28, 1921, the number of patients has been reported to be 46.

Figure 4) Women`s Hospital, 1921
 

Also in this report, it is written in protest to the behavior of Mademoiselle Dormpas:
"The doctor of hospital, Mademoiselle Dormpas, was not available at the hospital. She came half an hour before the noon. She came to the office to change the clothes, and asked who I was. Alam-al-Molook introduced me. She smirked and went outside. She went to the patient room and started shutting at the patients. I could not tolerate anymore and left the hospital." In the report of Ozra Agh Oli the number of patients were 6 and 8 on Monday, September 26, and on Thursday, November 6 respectively who had complaint about the food and kitchen and the number of patients was 10 in November 12. According to Agh Oli report, " Two o'clock in the afternoon, I entered the hospital. Mr. Mohazab-al-Saltaneh was present at the patient's eye clinic. At 3 o'clock in the afternoon, he started dealing with hospital affairs because there was no patient. I evaluated the 6 beds and the patients were in the beds according to the list, and he left there at quarter past three”. In the report of Mehrbanoo Danbali, the hospital has been inspected on November 27. At the time of inspection, there were 6 patients in the hospital. In her report on this day, she stated: "Due to the lack of heater, patients suffer from coldness and still coals have not been supplied for the hospital [16].”
In the report of the Fakhr al-ashraf, which has been prepared during November, 1921, 14 patients has been discharged from the hospital [17]. According to the report in December 30, 1921, there were three patients in the hospital and in this month, also, 5 patients had been discharged [16]. At that time, the number of pregnant women who were referred to the hospital for delivery was very small and only occasionally in the cases of abnormal childbirth, they were brought to the hospital for delivery. Therefore, every 15 to 20 days, only one delivery was performed [10].
Equipping Women's Hospital
In order to equip and supply the required medicines, the Board of Governors approved in a session in July 29, 1924 that some tools and equipment belonged to Women`s Hospital which were brought by Dr. Dormpas in her return from Paris through Beyroot and Baghdad, in addition to her clothes be exempted from the custom fare [18]. The budget for the hospital in 1918 was 14232 Gheran and 550 Dinar which was spent for the salary of staff and some construction expenses (Figure 5).

Figure 5) Document for the financing of the Women`s Hospital by Vosoogh-al-Doleh (Head of Ministers)

Thus, for 5 months: Hassan Khan Khajeh was paid 425 Gheran; gardener received 842 Gheran ; nurse received 516 Gheran. Madame Fraskina received 560 Gheran for 5 months. The water charge was 500 Gheran; the 4 month salary of Mirza Ali Khan Nazer was 400 Gheran. The building cost of the hospital was 2830 Gheran. The price of medicine was 32 Gheran. The price of equipment was 72 Gheran and 5 Dinar. The 5 month salary of Dr. Mohazab-al-Saltaneh was 1000 Gheran. Cleaning and washing warehouse was 40 Gheran. The price of gypsum, brick and lime was 92 Gheran. The price of purchased item was 1324 Gheran and 50 Dinar [18].
The hospital was sometimes found to be in dire straits due to lack of funding and payment of employees' salaries, so that in the year 1922, the Cabinet of Ministers approved the monthly budget of the three state hospitals, ministry hospital and Women`s Hospital and from the following month on customs revenues [19]. In this situation, although hospital budget funding problem was solved to some extent, it was not still enough. Therefore, in the following years, night feast were held to collect money for the sake of Women`s Hospital [20]. The following two documents are noteworthy for more information on the low cost and the availability of medical and medical staff:
“Date: January 22, 1917.
The amount of 3375 Toman was allocated for the salary of a foreign female doctor and teacher in the budget of this year and approved by this honorable ministry. Half of this amount equal to one thousand three hundred three hundred and seven Toman and five is allocated for a midwife and four nurses. On August 2, a request for payment of the amount was issued and sent to the commission for the Affairs of Remittances. The commission acknowledge the amount of eight hundred and forty three Tomans and eight thousand and fifty dinars, which was for the first six months and it acknowledges the remained amount of 843 Toman at the end of the year. Since only two more months have been left until the end of the year and as the commission has declared that the remained amount would be at the end of the year, kindly please order that the remained amount be transferred and until the end of the year, the request paper be sent to commission for confirmation.
[Margin] it is not specified here that whether the first six month salary has been paid or not and how much would be the amount to be paid by the end of the year. [Signature] January 24, 1917
-The salary of a midwifery and four nurses for this year has been 1687.5 Toman which has been requested from the Ministry of Education. The first six month has been confirmed the amount of which is 843. 75. Kindly please order for transmission of this amount. The salary of the second six month will be paid after permission.
-Please transfer the salary of the first six months.
Ministry of Education and Endowment, Department of computing, Department of Correspondence, no. 6734 [21]”.
“Date: July 12, 1917.
The honorable Ministry of Finance, according to the approved budget of Ministry of Education, the salary of a foreign medical teacher the amount of which is 3375 Toman has been allocated for two midwives. The Ministry of Education, based on the suggestion of Mr. Amir Alam has allocated the half of this amount for a midwife and four nurses. The request has been sent with no. 65 date August 2. Unfortunately, this amount has not be transferred. Now, we would like to ask the honorable Head of Ministers to write a letter to that ministry and ask them to transfer this amount as soon as possible to pay the expenses of the hospital [Signature] Morteza Momtaz-al-Molk.
Ministry of Education, Endowment, and Fine Art, Head of Ministry, No. 3733, Date January 3, 1917
Honorable Ministry of Finance, please order to transfer the salary of the female doctor and nurses working in Women`s Hospital according to the approved law and provide their comfort.
[Stamp] Head of Ministry
[Signature] Hassan Vosoogh-al-Doleh
[Margin] Department of finance, please note your information [21]” (Figure 5).
Study of the status of women`s Hospital in Gilmour report
Dr. John Gilmour traveled to Iran in the year 1924 from the UNHCR and at the request of the Iran for a health report. The purpose of the mission was to investigate the prevalence of malaria and the spread of epidemic diseases. These surveys lasted from September to June 1924. Dr. Gilmour, with many efforts, was able to compile and formulate an interesting report on the health of the years 1922 and 1923, and he presented this report to the United Nations in 1925.
Dr. Gilmour writes about women's Hospital:
"It is a small hospital with 20 beds, which is located on a large land in the north of Tehran (the Cabinet of Ministers approved a meeting of November 10, 1924, to allocate the 327 square meter for building Women`s Hospital which is belonged to the government for free of charge [22]. "
"This hospital was established three years ago and is also used as a school of women's medicine. Most of the patients have sexually transmitted and women diseases (apart from women's illnesses, there were also other sections, that it has been approved in one of the documents that 300 Rials from Government grants be given to Dr. Hassan Riaz, a dentist in Women`s Hospital [23].) The outpatient department is also crowded, and the number of patients admitted to this area from April 1923 to April 1924 was 107 that 20 of them had malaria. From April 1922 to April 1923 the number of death child and abortion has been 215. The number of death in women because of syphilis has been 50. The causality of women during labor has been 3. 9 have been died because of fever of labor and one has been died because of sexually transmitted disease. From April 1923 to 1924, the number of causalities because of abortion, syphilis, labor and labor fever has been 234, 41, 32, and 7 respectively [24]”.
The head of the hospital was Alireza Bahrami (Mahazab-al-Saltaneh) from the very beginning until the year 1926, and gradually the medical, surgical, midwifery, optometry, and general medical departments were added [10]. Later, according to existing records from September 9, a section for pediatric diseases was also established and the hospital was officially titled "Women`s and Children`s Hospital" [16]. The surgical part of the hospital, which included the surgery of abnormal delivery, was managed by Dr. Loghman-al-molk. The midwifery department was managed by Mademoiselle Dormpas and the optometry section was managed by Dr.Mohazab-al-Saltaneh that this section was disbanded after Dr. Mohazab-al-Saltaneh left there. For a while Dr. Abolghasem Bahrami was the sponsor of the hospital and Dr. Alim-al-Molk Farahmandi was the head of the Technical Department of the hospital. Later, Dr. Moaven and Dr. Bakhtiar took over this position [10].
From one person`s complain named Rajab Ali Nokhandi, dated March 30, 1931, from the function of Dr. Moaven, a writing has been left and after that date, the response of Dr. Mohammad Motamen has been written:
“This person came to Cabinet of Health and stated that Dr. Moaven is not a good doctor. He has referred my wife to different places. It is necessary to refer my wife to Ms. Daneshvar (Zinat Daneshvar was one of the distinguished students of the Midwifery School and in January 14, 1925, by the request of Dr. Amir Alam a second grade medal was requested for her and the same medal was requested from Dr. Dormpas for Ms. Rana intern in the Women`s Hospital [25]). From the point of view of being a doctor, I advised him to work in the hospital since he is graduated from Europe and is specialized in the women`s diseases and the Department of Health appointed him for this position. He works with sincerity. It is better for you to refer to himself to diagnose the disease of your wife and treat it as soon as possible. You stated that since he is a man, he does not work well. Please notice that educated people do not pay attention to this issue. However, since you had asked that your wife be referred to Ms. Daneshvar, We arranged your patient to be visited by Ms. Daneshvar [26].
The status of the Women`s Hospital, diseases, child mortality, pharmacy and midwifery, nurses, etc.
Dr. General Clonieh, Head of Department of National Health, in 1933 and 1934 was charged to propose a 3-year-plan for country health reform. He provide a very comprehensive and detailed report in 14 sections that this article which is only about the field of sexually transmitted diseases, women, children, or related issues to Women`s Hospital is rewritten and presented. The whole content of the year report will be written in another time. In relation to what has been said, Dr. Colonieh writes:
“Sexually transmitted diseases: all physicians in Tehran and other provinces acknowledges that these diseases are prevalent. The ways to prevent these diseases include: 1- individual disinfection measures, 2-social measures such as the establishment of treatment centers, regulation of prostitution, the intermittent examination of some young people, 3- Education and awareness of the public, 4. Therefore, the measures that has been proposed by the commission recently, should be first implemented in Tehran and then other provinces. The summary of the suggestions is as follows: the regulation of prostitution, examination of courtesan, treatment of sick courtesans in the hospital until the removal of their disease, intermittent examination of some young people, providing facilities for referring to doctors and treating sexually transmitted diseases, giving health advice to people.
Child mortality: the proportion of casualties cannot be determined by providing sufficient statistics. The cause of the death of children, also, as I have seen during my inspections, are not well known. The cause of the death of children differ from one place to another, and it depends on the ignorance and poverty of mothers, the lack of nutrition of mothers due to poverty, indigenous and local (malaria) diseases, the development of social diseases (tuberculosis and syphilis). Child deaths are more commonly attributed to childhood diarrhea. The fight against child mortality which has been satisfactorily begun by the admirable Red Cross must be sustained by the protection of women during pregnancy and postnatal birth and the establishment of a special clinic for referring of pregnant women before labor, and the examination and treatment of neonates in the state or private health institutions.
Pharmacist and midwife: pharmacists and midwifes in Tehran, are not willing the leave the capital and go to other provinces while no pharmacist or midwife is found there. Therefore, provinces do not care much about providing prescriptions and women`s labor is done with inexperienced midwifes who do not know the rules of cleaning and disinfection, and so labor causalities and complication are seen a lot. They have not learnt the basics of cleaning and apparently their training has been useless. Therefore, at present a lot of midwives who have diploma should be sent to the provinces. Women who have the experience of midwifery should be educated and should do midwifery only with the permission. They should attend state or private women`s hospitals for two years to learn midwifery practically and they are given a certificate if they could pass the related exams. These authorized midwives will have the right to work in the province that they have trained.
Male and female nurse: male and female nurses do not have sufficient experience and information, and it is no wonder because they lack the necessary information. With the establishment of a new hospital which has enough equipment and systematic organization, teaching of nurses would be satisfactory.
Home nurses: if five or six girls from eligible families with sufficient knowledge go to Europe, they will be helpful to serve in the homes of people who have important social and health responsibilities. When these girls return to Iran, they will be the teachers of other nurses.
Health centers, Tehran hospitals: Except from the army hospital with 200 beds, there are three state hospitals in Tehran that totally they have 125 beds, and there are municipality hospital with 50 beds and three military hospitals with 50 beds. The mentioned hospitals also have free public health clinics. In addition, there are American hospitals with 50 beds and a Russian hospital with 40 beds that are free and they have free clinics or clinics which have visiting fees. Finally, there are three private hospitals which are not free and headed by Iranian doctors that totally have 50 beds. The number of available beds in Tehran, whether in state or non-state hospitals and small private clinic is not sufficient for people of Tehran. Also, some people come to Tehran from other provinces and the number of patients is added in Tehran. Since here is just the talk of state hospitals, it should be noted that the cost of administrating the hospitals is high and the benefit is low because many peoples get salary in the mentioned centers that has a low revenue. Therefore, I would like to emphasize again about the necessity and urgency of building a regular and well-organized hospital in Tehran with complete equipment and facilities and according to the new principles. The hospital should be such as to provide the needs for the patients in the city and patients come from other cities and teaching of physicians, pharmacists, midwifes, and female and male nurses. This hospital should have different sections and departments for medical and surgical clinics as well as specialized branches. Here, I review my suggestions on March 25, 1932:
The first proposal: a building for 1000-bed hospital according to Professor Tolmer`s proposal of 1928.
The second proposal: the building of the same 1000-bed hospital which is completed gradually during six years, that is 2 years for the first phase, and four years for the second phase
The third proposal: The building of the 350 to 375 bed hospital in two years that I previously mentioned.
I prefer the last proposal. The mentioned hospital, in addition to general clinics will have medical and surgical departments, and the specialized fields will have departments in the center, and there will be separate departments for laboring and infectious diseases in the two sides. In addition, the hospital will have all facilities and equipment.
Children`s Hospital: At present, Tehran has a charity for young children with 40 beds. Therefore, especial hospital should be predicted for children according to new principles. This hospital should have special organization due to vast infectious diseases among the children.
The Red Cross has the purpose to establish an institute near the capital. If this is to be done, another building will be extra.
A hospital for sexually transmitted diseases: it is good that patients with sexually transmitted diseases that their illness force them to be in the hospital, to be treated in hospital with more detailed and more stringent regulations. The necessity for a separate department in hospitals for patients with sexually transmitted diseases was mentioned. However, development of syphilis and other sexually transmitted diseases in Iran requires the establishment of a special institution to prevent sexually transmitted diseases through the implementation of instructions for treating syphilis presented by Dr. Vern. The basis of Dr. Vern`s way is on a fluid reaction which is very easy to do with a simple gadget. The severity and weakness of the serum of blood or spinal fluid which is determined with special scale, is a means for diagnosis of the condition and the method of treatment and treatment guide. This method contains the necessary conditions for the treatment of syphilis by preventing syphilis and provides significant results. This method contains the necessary conditions for the treatment of syphilis by preventing syphilis and provides significant results. The institute for the prevention of sexually transmitted diseases, administered in Paris under the supervision of Dr. Vern has been officially recognized in France in 1916 and many branches has been established throughout the world. The Institute for the Prevention of Sexually Transmitted Diseases should be established in Tehran and it will practice the treatment of syphilis and other sexually transmitted diseases. The institute may be chaired by one of the young Iranian doctors who is studying in France, provided that the mentioned doctor obtain specialty in sexually transmitted diseases and acquire enough skill in the implementation of Dr. Vern`s method.
Maternity hospital: Beds which have been allocated in the state hospitals for maternity ward do not exceed 30 beds. Therefore, in a new hospital, a maternity part has been predicted [27].”
Dr. Kolonieh provided another detailed report in February 24, 1934 of the status of country`s health and presented to the prime minister. In this report, he writes about the Women`s Hospital:
“ In the Women`s Hospital, whose capacity in 1934 reaches 30 beds, have a new waitress and four midwifery students and for the repairing of the building, the east garden wall is destroyed from the municipality and 15000 Rial has been predicted for other repairing and 22000 Rials has been asked for a new building. “
The total health budget of whole country in the year 1933 and 1934 was 6954880 and 16391140 Rials respectively [28]. The proposed budget surplus for the year 1934 compared to the last year was 9436260 Rials (National Library and Archives of the Islamic Republic of Iran, No. 103004, envelope 6443). Until 1935, the scientific and administrative technical affairs of higher education institutions were under the supervision of the Ministry of Education. However, by setting up the policy of centralization of higher education institutions, the National Assembly approved the constitution of the establishment of the University of Tehran and practically University of Tehran was established with six colleges (medicine, law, political science, literature, technical and sensible) [1]. After recruiting the new head of the college and hospitals, and examining the defects of works and observing the country`s requirements, actions were done for reorganization of the medical education organization, some of which including joining the hospitals of Tehran to medical college. For this purpose, the corrective law of the establishment of the University of the Medical Sciences was approved, and it was implemented from October, 1940. According to this law, from the April 1940, the hospitals of Tehran were added to the Medical University [29]. Women`s Hospital, also, which was under the supervision of Department of Health and then Ministry of Education until 1940, was moved to the Medical University and was called “Women`s Hospital” [12, 30]. In 1943, the women`s clinic of Women`s Hospital was transferred to the current location of Enghelab Street and in 1944, when Professor Oberlin, a French, was the head of College of Medicine in the University of Tehran, with the approved of the Council of the University and for his valuable health and cultural services of its founder, it was called Amir Alam Hospital [13].
After the establishment of Women`s Hospital and the experience of its development in terms of medical treatment and teaching medicine, and midwifery, other hospitals were run. Also, with the establishment of Tehran University in 1934, various medical courses began. From 1949, the hospitals of Tehran joined the medical school. Jahanshah Saleh returned to Iran after graduating from Syracuse University around 1934 [31]. Dr. Abolghasem Bakhtiar, the most famous female doctor in Tehran who had a clinic in Kaj Street (The current Palestine St.) was partnered with Dr. Saleh and these two doctors started working with each other. Shortly afterward, Dr. Saleh was considered by the patients, and this caused hostility between them. Dr. Abolghasem Bakhtial due to his origin and his age, fell out with the Medical University and went to Abadan. As a result, Dr. Saleh achieved a high position in the new organization of the Medical University [32]. Dr. Saleh, with a degree in associate professorship at the Faculty of Medicine, relied on the professorship of gynecology, particularly embryology, and for some time was in charge of Vaziri Hospital, the heading of Surgery Department of Women, and the heading of Midwifery School. In 1938, Dr. Gholam Hossein Mosadegh became the head of Midwifery School [33]. Then, due to the activities of Dr. Jahanshah Saleh in the Women`s Hospital, he was expected to be honored with his service, and the Women`s Hospital was called “Jahanshah Saleh Hospital” [31]. The hospital, which was previously in the Pich Shemiran Avenue changed its name and place and moved to the former “Soviet Hospital’. Eventually, after the victory of Islamic Revolution, the hospital, called Mirza Koochak Khan” and served as a specialized maternity care center [9]. In addition to this hospital, other hospitals were gradually equipped with small department for women and maternity such as Shah Reza Hospital (Imam Reza Hospital in Mashhad), Arya Hospital in 1969, Alavi Ardebili Hospital from 1975 and then gradually famous hospitals were equipped with the maternity ward.

Conclusion
No women`s health center was established in Iran until about 1916 before the establishments of “Women`s Hospital” in Tehran. At that time, due to the increasing incidence of women`s mortality especially during childbirth, Dr. Amir Alam proposed the importance of establishing a specialized hospital for women to the government of the time (cabinet of Sepahsalar Tonekaboni and ministry of Morteza Gholi Khan Momtaz-al-Molk). With the approval of government, a mansion and land was donated to the hospital and by funding, equipment and recruiting medical personnel among educated women i.e. Dr. Madame Fraskina, Dr. Matild Dormpas, Dr. Penn, Zinat Daneshvar, and Dr. Sarkisian, it started its work. This hospital is the first female specialized hospital in Tehran, and so far there has not been a book or an independent article about its history. This is the first article for the first women`s hospital which was compiled using archival documents and Qajar period periodicals.

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Ali Karimian (first author), all sections of the article is carried out by the author (100%).
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