Introduction
The French physicians who had come to Iran with General Gaurden in 1807, established the first “medical clinic” in Tehran. During the reign of Nasir-al-Din Shahr Qajar, three years after Dr. Polak came to Iran, under the order of Shah (king) and the efforts of Dr. Polak, a special state hospital was established in form of an army hospital outside of Tehran in 1853. The hospital`s location was outside of Darvazeh Dolat St. Since its inception, this hospital was a place for training the students of Dar-ul-Funun and it was managed under the supervision of military head (Hakimbashi) [1].
In the subject of method of teaching medicine and health, which is the subject of this article, it is clear that before the establishment of Dar-ul-Funun, the teaching of professions and medicine was in form of apprentice. After passing the elementary course in the clinic of famous doctors, the trainees were taught medicine practically. With the establishment of the Dar-ul-Funun in 1849, medicine was one of the main field and was considered as a separate discipline. The first graduates of the medicine started working in 1856. The Dar-ul-Funun may be considered as the first school for higher education in Iran. At that time, the courses in medicine were divided into three distinct categories including Iranian medicine, European medicine, natural medicine and pharmacy. In this way the Iranian medicine were renewed. The state hospitals were stablished and students became familiar with the new medicine practically (Figure 1).

Figure 1) Image of Fakhr-al-Ateba, one of the physicians familiar with European medicine

A branch was established for the training of midwives and female physicians in the hospital. However, its initiation remained suspended for a while [2]. In the year 1918, the School of Medicine was separated from Dar-ul-Funun and became and independent school. It was assigned a separate head and place [3]. Before that, the most commonly used way to educate traditional physicians was in the clinic of the experienced doctors. The education of women was also was by a tutor and in the maktabkhaneh (traditional schools). At the time of Mozafar-al-Din Shah (1897-1906), the state of education changed, and somewhat changed from traditional to classical one, and schools established under the supervision of Ministry of Education. In addition to what was said, other factors contributed to the training of professionals in the field of medicine and women`s medicine in its traditional form. In this paper, the role of teaching and its impact on promotion of public health knowledge has been studied through 1) the scientific articles in the journals, 2) compilation and translation of strategic books, and 3) public education in old and modern schools.
 
Text Description

In the first step, to address the issues of journals that have been published in the domain of women`s health, it should be noted that, at the beginning, with the onset of the new era and the development of the publication of books, newspapers, and magazines, issues related to women`s health education were only being indirectly studied in the publications. If we look at written legacy of that era, we find that there is less topic focused on the subject of women. Only occasionally, topics discussed the condition of women. In this research, all the newspapers from the age of Naser-al-Din Shah was studied and we selected articles with the subject of women`s medicine and reproductive health. According to their content, the articles were separated. Three articles which had published in “Blossom” (Shekoufeh) Journal published after legislation period were also studied. Our references are as follows:

Women`s nutrition: Abolhassan Hakimbashi. Scientific Newspaper, Year 1, issue 38, January 28, 1878, p. 3
Newly born child: Abolhassan Hakimbashi. Scientific Newspaper, Year 1, issue 36, December 24, 1877, pp. 2-3. Human sperm and its form: Dr. Mirza Nostrat. Scientific Newspaper, Year 1, issue 22, July 9, 1877. pp. 1-2.
Uterus: Dr. Mirza Nosrat. Scientific Newspaper. Year 1, issue 29, September 23, 1877. P. 4.
Breast: Dr. Mirza Nosrat. Scientific Newspaper. Year 1, issue 30, October 30, 1877. pp. 1-2.
Syphilis: A bad disease, symptoms, types. Mirza Nasr Allah Hakimbashi, Scientific Newspaper. Year 2, No. 37, January 15, 1878. Pp. 2-3. Scientific Newspaper, Year 2, No. 38, January 28, 1878. pp. 1-3. /Scientific Newspaper. Year 2, No. 39, February 18, 1878. pp. 2-3. /Scientific Newspaper. Year 2, issue 40, February 25, 1878. P. 4. / Scientific Newspaper. Year 2, No. 43, June 4, 1878, p. 4.
Gonorrhea: Mirza Nasr Allah Hakimbashi. Scientific Newspaper. Year 2, No. 47, July 7, 1878, P.2. /Scientific Newspaper. Year 2, No. 48, July 14, 1878, P.2. /Scientific Newspaper. Year 2, No. 49, August 11, 1878, P.2. /Scientific Newspaper. Year 2, issue 50, September 7, 1878, P. 2. /Scientific Newspaper. No. 2, issue 51, October 30, 1878, p. 4.
Recovery and illness of children at the time of the thooth: “One of Tabriz`s doctors”. Naseri Newspaper, No. 21, January, 1895, pp. 172-173.
With the constitutional Revolution, women, the same as men, participated in the politics and social arena, and they were the source of many fundamental changes of which the development of women`s journalism can be mentioned. Between 1910 and 1925, eight women`s journals were published with the management of women all of which focused on the subject of “women and children’. Among these publications, was “Blossom” (Shekoufeh in Persian) Journal the articles of which were about women`s issues. Some topics have been selected form the journal and have presented here:
 

Women`s health protection
“The survival of the human species and the proliferation of human being, its social community and their comfort and affection depends on the existence of women because human beings cannot be proliferated except with sexual relationship and birth. Women are the main component for childbirth that they both have to be pregnant for nine months and breastfeed for two years. They have to raise children for seven years, and if in one of these issues, a problem occurs, the generation is deceased. Therefore, women need to maintain their health because of their duty in childbirth, lactation and raising children. There are many healthy women who do not pay attention to their health, and they are disturbed with diseases, and because their husbands do not pay attention to them, they and their children die. February 13, 1913” [4]; (Figure. 2).

Figure 2) A women in Qajar period

“I wish men knew how much bother and hurt women have during pregnancy. Alas! They are not aware of that. It is very shocking that some inconsiderate men have quarrel with their wives during their pregnancy and tell them bad words and make them upset. There are many cases that a man has injured his wife during the quarrel and this has caused the abortion. Women should be always considered and protected especially during pregnancy. In modern societies, pregnant women are exempt from many works and their health and comfort are accurately observed. Even a person who has quarrel with a pregnant women, is arrested. If we compare the man`s and women`s diseases, we notice that men`s diseases are one-third of women`s diseases including diseases of pregnancy, labor or after childbirth such as diseases of womb and the breast which may appear by an inexperienced midwife that will be mentioned later. Therefore, pregnant women should know that this creature in their womb is a person like them and it is considered as an organ of mother and is dependent on the health of mother. If mother gets disease, the fetus also get diseases. Pregnant women, of course, has experienced that whenever the get sick, the fetus moves less in their womb. The more the severity of diseases is, the less move of the fetus would be until that the fetus becomes aborted, and many diseases are transferred to fetus from mother. O` ladies, if you want your fetus to be healthy and have an easy childbirth, pay attention to your health. We need to write a brief note on women`s health to my beloved ladies that is very obligatory and necessary” [5].
“It was mentioned before that women`s diseases are two third higher than men`s diseases. Firstly, due to difference in the body form that women are more delicate. Their skeleton and their bones are thinner. Their muscles are small and their limbs are weak. They are more sensitive and they cannot tolerate difficulties like men. They become tired soon and they are affected by diseases that appear in both men and women much sooner than men. This is while, with their weak body, their boredom and trouble are much, and their worries are more. Particularly, women in the east that they are treated like an imprisoned person. Because of living in densely populated small dwellings, and due to lack of sanity and the dirty stagnant air, they become mournful and sick. If we pay attention to their finery and the points of their creation, it turns out that women are not created to exercise excessive labor that is beyond their natural state and opposes their creation. In this case they are destroyed and their bones are damaged. It is obvious that, like men, women need recreation as well. Some people may think that women should be kept at home. In modern society, women came out like men and their welfare, comfort and health are observed and they do not treat violently with women and restrain them from education. These are the things that are harmful to men themselves because when women become sick, men have to pay a lot to treat them and it is not clear whether she can be recovered. If a woman do not educate, she cannot educate the children and manage the home chores well” [6].

Medical and health articles by honorable Mr. Alam-al-Doleh
Pregnancy: among the signs that well signify pregnancy is the embryo movement that a pregnant woman feels that after month 4 or 4.5 of pregnancy. This movement is felt like a spider move on the skin and this results from the contacting of one or more of the fetus organs to the uterus membrane. When the hand is placed on the abdomen, these movements can be easily felt. The physician can notice the fetus by touching the abdomen and listening to the fetus heart beats. This sound is similar to the sound of a clock below a pillow. The heart beat rate is 110 to 160 per second. In the fifth month, this sound is heard near the navel and from then it is heard from the line drawn from the navel to the middle of the groin. If the heart beat is more than 140, it can often be assumed that the embryo is a girl and if it less than this is rate, the fetus, is probably a boy. The length of pregnancy vary from 260 to 290 days. During this period, women should try to be affected by getting cold and do not wear tight clothes and they should not wear tight shoes. Women who have given birth several times should wear a truss which is not to tight and keep themselves warm especially in the winter. They should eat nutritious food and avoid constipation. Pregnant women should not bother themselves. From the fourth month onward, they should repeatedly have urine test to be analyzed by laboratory so that the physician can predict some of the diseases during the pregnancy and give the special instruction on due time. In the France, according to statistics, it is estimated that from every 92 pregnancy, one is twin embryos and from every 8000 pregnancy, one is with three embryos and more than three embryos is really rare. … [7].
Also in the “Blossom”, there are other articles titled “protecting the health in pregnancy” in the issues 16, 17, 18, 20, and 21 in the fourth year. Another method of general education in that era, was complication, editing and translation of books among which some are introduced here briefly:

“Sewing a Tear” (Kherghe Bakhiyeh): This book is compiled in 1860 [8]. The name is taken from common expression in sewing. “Khergh Bakhiyeh” means sewing a tear in a cloth and this expression has been used ironically in this book.
Almost the entire book is about the sexual relationship, strengthening sexual power in men and women, and increasing infertility. In the final sections, however, it is about the method of abandon opium addiction and the urinary and anal diseases, as well as sexually transmitted diseases.

“Sexually Transmitted Diseases”: Since sexually transmitted diseases were common at that time, Mohammad Kermanshahi wrote the book “Sexually Transmitted Diseases” in the 18^th century. This book consists of three parts. The first part is about different types of sexually transmitted diseases. The second part is about complications in general and the third part consists of three speeches and an end. The first speech consists of 15 chapters; the second speech consists of 2 chapters, and the third speech consist of 3 chapters. The ending has two sections. The first section has two parts, and the second section has two parts: “different complications, genital wounds and their complications, and finally prescriptions for these complications”.

“Teaching Midwives”: At that time, Dr. Harutun Triakian wrote the book “Teaching Midwives” (midwifery education in the Qajar period) in French for teaching the primary education of caring mothers and infants [9]. Dr. Zebardastkhan, the author`s student, translated it into Persian. Eventually, this translation was published by the effort of Mohammad Ali-ben-Haj Shams al-ketab. This work is in three volumes: 1: The first book is on the subject of pregnancy. 2- The second book is on the subject of the midwifery, and 3-The third book is about natural healing. The book was published in 143 pages in total, with dimensions of 10x17 cm with a cardboard cover, and black and crimson color hard cover in 1903. A copy of this book numbering 6-5034 with the code 778996 and ranking code 15560-S-1. N5034 has been registered in the Treasury of Manuscript and Rare Books of the National Library and Archives of I. R. Iran.

“Strategies for Pregnant Women”: This book was written in 1894, the forty-seventh year of the reign of Naser-al-Din Shah, by Mohammad Salim, the son of Mohammad Safi Javanshir Gharebaghi. The book was written in the same year with the efforts of Ali Gholi Khan Mokhber-al-Doleh, Minister of education, Nosrat-al-saltaneh Amir Toman, Minister of economy, and Mohammad Ali Khan, and handwriting by Ali Akbar Taleghani and illustrating by Mistafa. The book was published in 59 pages with dimension 21x15 cm, in Nastaliq calligraphy, with a cardboard cover, and with brown cover. The book had the following headings: essential affairs for health, movement and rest, housing and air condition, clothes, foods, bathing, complications in pregnancy, longing of the pregnant women, salivation, hemorrhoids, varicose, puffiness (swelling), abortion, etc., and it was published in the clinic of Agha Mirza Habib Allah. As the name suggests, it has been written for pregnant women. In the introduction, the author writes: “Because of the lack of a female healer and the no publication of a book on pregnancy measures in Iran, women suffer from pregnancy complications from the time of fetus formation to the time of delivery. This sometimes happens because of the useless strategies suggested by inexperienced midwifes. Therefore, I write this book named “Strategies for Pregnant Women” “. A copy of this book, numbered 6-18365, and the national code 2660403 is available in The Treasury of the Manuscript and Rare Documents of National Library and Archives of the I.R. Iran.

Public education in traditional and modern schools
Teaching in traditional schools: the use of home teachers and the teachers of traditional school was the most common way of educating girls in the Qajar period. However, as deprived classes of societies could not afford the cost of home teachers, the teachers were mostly in service of royal girls and women. According to the available evidence, women in the king court, from Fathali shah to the late Qajar period, were educated by the home teachers. In this regard, a clergyman named Taleghani, has been mentioned as a teacher of Fathali Shah`s daughters [10].
Only few of girls had the chance of become literate by the literate members of their family such as their fathers or brothers. In this regard, Hinrich Brougesh, presents an interesting report on the literacy of the general public including the girls: “there were many private traditional schools in Tehran`s neighborhoods for the education of children and adolescents in which the clergy persons and their wives or sons were teaching girls” [11].

Teaching in modern schools: After the Constitution Revolution and from the beginning of the establishment of the national government to the disengagement of Mohammad Ali Shah, between the years 1905 and 1909, when the civil war began in Iran, and the autocratic government was at war with the freedom fighters, there was no useful step toward the development of culture [12, 13]. Only some schools such as “Religion”, “Zoroastrian” and “Wealth” were established in Tehran [14]. After the era of tyranny, people paid special attention to culture, and many national schools were published in Tehran and big cities by the public. According the law of the Ministry of Education, Endowment, and Fine Arts which included 3 chapters and 12 articles, which was approved by the National Assembly in September, 1910, Ministry of Education, Endowment and Fine Arts was appointed for dealing with education and school affairs throughout the country. The development of new schools in Iran began from these years. This growth was in up and down according to the political situations and conditions of each region, but generally speaking, this growth process could be seen everywhere. According to the law of September 20, 1911, the Ministry of Education was allowed to open nine primary schools. The articles of this law is as follows:
Article 1- nine primary schools, each of which was six classes, will be established in the center of Tehran, and the centers of four provinces as follows: 5 schools for Tehran, and one school for Shiraz, Tabriz, Mashhad, and Kerman. For each of the five schools in Tehran, 250 Tomans, Totally 1250 is allocated and for each of the schools in the center of provinces, 200 Tomans is allocated.
Article 2- In all the boy primary schools, considering the poor, half of the students are admitted freely and the other half have to pay a low fee according to the article 3.
Article 3: The fees for the primary school are as follows: annually 6 Tomans for the first and second grades, 9 Tomans for the second and fourth grades, and 12 Tomans for the fifth and sixth grades.
Article 4: The students of each class will not exceed 30 persons.
Article 5: the income of these primary schools is delivered to the Ministry of Finance, approved by the Supreme Council of Education and it will be used for completion and development of primary schools.
At the 9^th session, October 2, 1911, it was clear from the statutory provisions of article 1 that the monthly payment of 250 Tomans is made by the government” [15].
Also, with the approval of the Ministry of Education in October 31, 1911, according to article 3 primary school education is compulsory for all the Iranians.
Article 5: Everyone is obliged to bring his or her children from the age of seven to the primary school whether at home or at school.
Article 8: Traditional and modern schools are two kinds: formal and informal; formal schools are ones that are established by the government and informal schools have their own authorities” [16].
These approvals had a new evolution in the development of schools [12]. It was also stipulated that 30 young Iranian be sent to France and England each year for studying different fields [17]. Inland, since the year 1911, primary education became mandatory from the age of 7 years. With the introduction of this law, a movement began throughout Iran; new schools were established around the country, and for each school in Tehran and other cities the grant of 250 Tomans and 200 Tomans were allocated respectively and after that schools were established in other cities [15]. The School of Fine Arts was also established after these currents, beaded by Kamal-al-Molk (Mohammad Ghafari). Another important measure in those years was the enactment of law for sending students abroad and the formulation of secondary school curriculum [18].

Schools` budget: after the establishment of the constitution in 1909, the budget of the Ministry of Education was fixed at 1191540 Gheran; of this amount, 391650 Gheran, 113600 Gheran, 59580 Gheran, 122000 Gheran, 38350 Gheran and 2750 Gheran were allocated for Dar-ul-Funun, Military school, national schools, European schools, education of Iranian abroad, and Iranian schools abroad. In 1919, out of the whole of Iran, 76 boy primary schools and 47 girl primary schools were just for Tehran. The government did not run other schools that were in other provinces, and only helped them [19]. The Ministry of Education budget and the number of schools in Tehran were constantly increased and the government focused on expanding education.
Every day, people and country needed more education, and the ministers at that time took important steps in the development of education. With the rise of this movement, people began to establish school with their own personal budget.
However, the major advancement of Iranian schools began in 1918, and the basis of education was firmly established and several Teacher`s training schools and 40 free primary schools were established in Tehran. The budget of these schools in 1918 and 1919 reached 1344156 Gheran and 2600368 Gheran respectively. In this year, the number of secondary and primary schools reached 295 [17].
Therefore, girl`s schools were also partially expanded with the participation and activity of women of women in various political and social affairs and the foundation of associations after the first parliamentary term. The meetings of these association mostly focused on issues such as the need for women`s awareness, participation in charity and the establishment of girl`s schools. Much work was done on girls` education and establishment of schools. Several notices were being published in the “New Iran” Journal at the same time as the establishment of these schools [11].
In 1903, Hasan Roshdieh established a school for educating girls in his home with the management of Tooba Roshdieh and it was welcomed. On the fourth day of its foundation, there were 17 students, but the governmental servants took the billboard and dissolve the school with threat.
In 1908, Ms. Tooba Azmoodeh founded a school named “Namoos” in Shapoor St. near Hassanabad crossroad with the spiritual accompany of Roshdieh. The school was welcomed by everyone. In the school statuary it has been registered that the teacher of the school will always be chosen from the students in that school.
In 1910, a school named “Efaf” was established in Odlajan Avenue with the management of Alavieh Roshdieh. Also, in this year, a girls` school was established in “Charsoo Choobi” St. in “Darvazeh Qhazvin” neighborhood. Both of these schools were regarded as good schools of the city.
Different schools were established as follows: “Sham-al-Madares” with the management of Ms. Ataee in Ein-al-Doleh Street, “Hejab” with the management of Mirza Hasan Roshdieh`s sister in law in Moayer Pass in 1911, “Sadooghi” in Mostofi Pass, and “Kheirat-al-Hessan” with the management of Alavieh Roshdieh, the wife of Mirza Hassan Roshdieh.
The author of “Documents from girl`s schools from constitution to Pahlavi era” writes about the development of post-constitution schools:
“A large number of male and female high schools and supreme schools were established in the interior of the country and increased year by year, which was by no means comparable to the previous days. New equipment was purchased every day for schools. New and interesting school buildings were built all around the country and even for Iranians in other countries (Fig. 3).

Figure 3) Photograph of students and their teachers in the Iranian school area in Baku

Wise and expert teachers were recruited. Supreme schools such as schools of medicine, schools of law and schools for teachers` training, army school, school of agriculture, school of dentistry, school of medicine, school of midwifery, school of fine arts and music were become more complete each year and the number of teachers and students became increased (Figures 5 and 6). Business Branch was established in supreme school of law. The school of agriculture was opened with European teachers and a large number of Europeans teachers were recruited for high schools and supreme schools” [20].

Figure 4) students in one of female schools

Figure 5) Certificate for honorary teachers in women`s school

Female primary school curriculum: primary school curricula in the early years of constitutionalism included: Persian, Arabic, arithmetic and geometry, geography, religion, and art (carpet weaving, knitting, housekeeping) [21]. In 1919, during Ahmad Khan Nasir-al-Doleh, with his suggestion, there were studies on female primary school education and the female school curriculum (Fig. 4).
After the revision, it was decided in the Ministry of education that the curriculum be taught from the first to the sixth year, taking into account the various educational years, from October, 1918. The lessons of this course were Persian (including reading, writing, practice), religion (the customs of praying, obeying God and the prophet), ethics, Natural science (oral education, very simple information about the human body, names of week days, months, seasons, nutrition, cereals, and grains), Healthcare (orally, advice on cleanliness, harassment of eating and drinking too much), calligraphy (elementary), geography, and counting (addition and subtraction of single and double numbers, verbose numbers and write numbers) and ethics. In the third year lessons included drawing, painting, art (knitting and sewing), housekeeping, and healthcare. In the fourth year, cooking and in the fifth year, Persian, history and geometry were also added. The higher grades of the school had more lessons [11].

Figure 6) Photo of students in Mianeh City in 1938

In the following years, public health was added to the lessons in national and state schools. Therefore, in the 20^th session of the Supreme Council of the education on June 25, 1923 headed by Hakim-al-Doleh, Minister of education, Seyd Mohammad Tadayon, and Ali Akbar Dehkhoda, an agenda was concluded and signed. According to this decision, for the lesson “Natural Science and maintenance of Health” in the third grade of primary school, simple topics included human body, races of man and its civilization, and in the health section, sleep and awaking, motion and rest, air and water, four seasons, day and night hours and its division for life, drinking water and contaminated water, nutrition and healthy foods, housing and living condition were added [22].
In 1924, according to the instruction of female schools, the lesson of healthcare and child care were taught in two parts from the first grade to fifth grade of primary school in two parts of healthcare and childcare with the following headings:
Healthcare: in the first three years, the application of the rules of healthcare: 1. Diseases; germs and the means of preventing their effect, disinfection, 2-air, ventilation, danger of dust, 3-light and its importance for health, 4-drinking water conditions and harmful spices, 6. Avoiding too much eating 7. Body and home hygiene.
Childcare: 1. Caring a neonate, 2-cleaning clothes and cradle, 3-new infant feeding and breast feeding and its method, artificial milking, milk retention of corruption, feeding human and animal, baby sitter breastfeeding, 4- necessity care for the first year, taking care of baby feeding, developing a new infant, infant feeding after abandoning breastfeeding, primary education, primary teeth. In the fifth year, older students gave presentation in the health care lesson under the supervision of teacher according to the program.
Then, in 1919, Mirza Ahmad Khan Nasir-al-Doleh, the minister of education, turned the French female school, called Franco Pearson and established in 1905, to female teachers education center and he prescribed that 10 school students go to the maternity hospital three days a week and learn midwifery and women diseases. After obtaining a six-year primary school certificate, students could took part in the teacher education center which had a four year course. During the first three years, the lessons of high school were taught and in the fourth year, they were taught the principles of teaching. These trainings were the basis of the “School of Midwifery” which was later called the “Supreme School of Midwifery” which will be the subject of another article in the future issue of “Sarem Journal”.
Conclusion
Until the Constitutional Revolution, in Tehran and the center of the provinces of Iran, there were very few national and state schools for education of girls with the support of lovers of knowledge. However, the educated people in the field of health and especially the mother and childcare, considered the need of expanding knowledge as inevitable. Physicians started a new move to promote health knowledge and public awareness of women through the use of modern education through: 1. scientific articles in publications, 2. Compilation and translation of books, and 3. Public education in traditional and modern schools. These trainings were the beginning of the path leading up to the establishment of the Midwifery School and Supreme School of Midwifery.

Acknowledgements
The author appreciate the sincere cooperation of Ms. Ensieh Sheikh Rezaii (director of the Department of the Settlement and Processing of Visual and Audiovisual Documents) and Masoumeh Amari (expert of the mentioned department, for retrieval and selection of text photos) and Ms. Elham Hatami Bajgiran (for comparative analysis of text).
Ethical permissions
The case was not found by the authors.
Conflict of interests
The case was not found by the authors.
Contribution of authors
Ali Karimian (first author), all section of article has been carried out by him (100%).
Financial support
The case was not found by the authors.