The health of Iranian leader Dr. Mohammad Mossadegh had a significant effect on his life and political career. At the height of his power as Prime Minister of Iran, Mossadegh was elderly, frail, and beleaguered by medical problems. Despite these obstacles, he worked tirelessly for the cause of independence and democracy for his country. In this article we will review the available medical information to gain a greater understanding of the effect this had on his life and work. 

PART ONE
The Early Years

Information about the general health of Dr. Mohammad Mossadegh for the first two decades of his life is scarce at best. Although he reportedly suffered from frequent colds as a youth, the earliest reference to any significant health problem appears about the time he was studying in Paris in the academic year of 1909. He was then 27 years old and married. Farhad Diba in his book Mossadegh, A Political Biography writes: "This period of study proved very difficult, owing to being in a totally new environment as well as the demands of studying in a foreign language. During the second year he fell ill with stomach ulcers and was forced to lie down on the benches during lectures. Eventually lack of sleep, a weak stomach and extreme nervous pressures took him to various doctors and specialists, ending up with a visit on 10 January 1910 to Professor Heim, a famous physiologist, who stated that he had seldom come across a patient with so many things wrong with him at the same time. He ordered a complete rest, forbidding any further academic studies for that year. This illness was to be with Mossadegh for the rest of his life, often restricting his movements and always exacting a very strict diet. His intake of food was not only controlled by his illness but was generally very small, which left him physically weak and liable to fainting spells." 

Homa Katouzian writes further about this period in his book Musaddiq and the Struggle for Power in Iran. "In Paris, he registered for a course in public finance. The psychological pressures facing a young married Iranian, with a classic Persian education, an important state office, and involvement in a revolutionary campaign, mixing in a completely alien culture with appreciably younger students in the same classroom must be left to imagination. But he was keen - perhaps too keen- to succeed, and this may have contributed to the onset of a nervous disease which he himself was always reluctant to mention in public by its real name. The tendency towards the illness must have existed already (it might even have been, at least partly, genetic), for it would not otherwise have reappeared in a severe form at difficult times throughout the rest of his life, resulting in fits and breakdowns in public on a few occasions. These incidents were unfairly used against him - when he was prime minister, and afterwards - by his Iranian and foreign detractors. In any events the illness caused him to give up his studies and rest in the care of a French nurse." 

Dr. Gholam-Hossein Mossadegh, who would come to serve as personal physician to his father, bore closer witness to the health issues effecting Mossadegh than any other individual. In an interview conducted in Farsi for the Iranian Oral History Project of Harvard University [Paris, July 1984], Gholam Hossein makes perhaps the only reference available to another serious medical condition afflicting his father. Gholam-Hossein states that during this period of studying in Paris, his father worked so hard that he developed tuberculosis, damaging one of his lungs and forcing him to return to Iran under the care of a nurse. In his book, In the Company of My Father, Gholam-Hossein says that while his father was a student in France he was anemic, had stomach ulcers [duodenal], and on several occasions suffered severe hemorrhages; conditions which would remain with him throughout his life. Gholam-Hossein adds that his father's blood pressure was always low, and at one point because of hard work, stress and the difficulties of political life and aging he literally developed "heart failure".  

Mohammad Mossadegh wrote in his memoirs that because of a nervous condition, weakness and lack of sleep, he saw two general practitioners while in Paris; a neurologist and Professor Heim who ordered him to bed for total rest. Mossadegh, however did not follow the advice and continued to attend his classes, even if he had to lie down from exhaustion during the lectures. His condition worsened to a point that he completely lost his ability to move around. This forced him to rest for a few months, including two months in a hospital outside of Paris, before deciding to return to Iran in the summer of 1911. Diba writes "He was so ill during his return trip that he was not able to walk even the few steps from the Austrian to the Russian train (he was carried in a wheelbarrow), nor from the boat in Enzelli [a port city in Caspian sea] to carriage (when a porter carried him piggy-back)." 

These accounts point to Mossadegh's precarious state of health at his relatively young age. There are several plausible explanations for his condition, such as the possibility of active tuberculosis, profound anemia secondary to bleeding ulcers, anxiety, exhaustion from intense study, inadequate rest and lack of proper nutrition.

Back in Iran with rest and improved diet, his condition improved under the care of his family and a nurse. Mossadegh wrote in his memoirs that when he arrived at home in Tehran, he began restricting his fluid intake as recommended by Professor Heim. Amid Tehran's hot late spring weather, he experienced dryness of the mouth so severe that he was eventually unable to talk. Finally, he gave in to his mother's admonishment to take better care of himself. Mossadegh obliged and after eating two cantaloupes that his mother brought him, he felt much better and was able to speak once again.

Several months later, Mossadegh left Iran with his family for Europe and settled in Neuchatel, Switzerland. He attended the school of law and received a doctorate degree in 1914, a first for an Iranian. While in Neuchatel Mossadegh's young son died of a childhood infection, which induced the unexpected agony of losing a child.

The next medical crisis happened in 1917 when he was diagnosed with appendicitis and traveled to Baku, Azerbaijan for an operation. Katouzian speculates that "..given the trouble his nerves had caused and were to cause him in the future, the diagnosis may have been wrong, and he could have been suffering from acute stomach cramps instead." Though such a theory has some merit, Mossadegh most likely did have appendicitis since his condition seemed to have improved following the surgery. In his memoirs Mossadegh wrote that after the surgery his doctor, "a famous surgeon," showed him his removed appendix in alcohol and told him that any more delay would have resulted in a poor outcome! 

Mossadegh was appointed as Minister of Finance in 1923 and while in Tabriz he became ill again, which he attributed to bad weather and the pressures of the job. Katouzian states that "...the recurrence of his nervous disease - which he himself put down to the bad climate as well as his frailty and frustration - this time manifested itself by bleeding through mouth. He had to move to a house in the country and talk as little as possible for a whole month". Adding to his stress during his stay in Tabriz, Mossadegh became the target of an assassination plot. Finally he resigned from his job and returned to Tehran. 

In 1928 Mossadegh found the political climate under the reign of Reza Shah unbearable- so much so that he actually feared for his life. He voluntarily withdrew from social and political activism and retreated to his village of Ahmad-Abad, located about 100 kilometers outside of Tehran. During this period when he occupied his time reading and farming, Mossadegh began to bleed from the mouth. The bleeding stopped when Professor Shams "burned" [cauterized] the site of the bleeding, reportedly in his throat. Later on the bleeding from his mouth reoccurred, but this time the source could not be determined. Mossadegh traveled to Berlin in 1936 and consulted a specialist and an internist about the problem of "expectorating blood." These physicians, Professors Eichen and Bergmann, did not make any specific recommendation. By this time the bleeding from his mouth had stopped, but according to Mossadegh himself it "changed direction" and he noticed blood in his urine. Following the toppling of his government in 1953, during his three year imprisonment he also experienced alot of blood in his urine, which alarmed him greatly. 

Mossadegh's problem with recurrent bleeding from the mouth and "expectorating  blood" and later presence of blood in his urine points to several possibilities: blood disorder, urinary tract problems, active tuberculosis and perhaps other undiagnosed ailments. 

     

PART TWO
An Unbearable Physical and Psychological Experience


Other than the episode of bleeding from the mouth, Mossadegh had a relatively uneventful life in self-imposed exile in Ahmad-Abad. His health was being overseen by Gholam-Hossein, who would examine him and check his blood pressure about every two or three days. 

The tranquility was shattered on July 26, 1940, when members of Reza Shah's police arrived to arrest Mossadegh. His house was searched and reportedly ransacked. No incriminating evidence against him was found, but nonetheless, he was taken to the central prison in Tehran. This was his first incarceration under the monarchy, but would not be the last.

Interrogated but never informed of the charges against him, Mossadegh was greatly disturbed by this turn of events. When he learned that he was to be taken to the infamous prison citadel in Birjand (a city in northeast Iran) he was distressed and feared for his life. Well aware of the fate of many others who dared to oppose Reza Shah’s arbitrary rule, he declared that he would no longer cooperate with the authorities of "this lawless state." He physically resisted his transfer to Birjand, but his captors bound him by rope and took him by brute force as he grasped the wheels of the car that awaited him. Diba  writes, "On the way, he attempted to commit suicide by swallowing the remainder of the contents of Dilodendril [a sedative / tranquilizer], but the quantity was insufficient to cause death." Mossadegh however became very ill as a result, vomited during the trip, and according to Katouzian he was "...in [a] coma when they pulled up at a local clinic in Shahrud and saved his life." 

Prison documents state that the prisoner, Mohammad Mossadegh, suffered from 'bimary-e gash' (fainting spells, fits or hysteria). Dr. Gholam-Hossein Mossadegh writes that the very small prison cell, bad food, lack of hygiene and preexisting poor health made his father severely ill and depressed. Believing that he would soon be killed, Mossadegh decided to abstain from drinking and eating. This was to be the first of five hunger strikes during his life. The Chief of police, fearing the demise of this important prisoner on his watch, came to the prison and swore on the Koran that they had no intention of putting him to death, and convinced him to resume eating by offering him milk and biscuits. Mossadegh broke his fast after 48 hours.

The harshest blow to Mossadegh resulting from his imprisonment was the effect it had on his 13 year old daughter, Khadijeh. The witnessing of her father's forced transfer to Birjand prison traumatized her for life - she spent the remainder of it in psychiatric hospitals. Mossadegh later commented that this tragedy was the cruelest punishment that could have ever been inflicted on him.  

Mossadegh was released from Birjand prison in November 1940 when, then Crown Prince Mohammad Reza Pahlavi secured his release by requesting it from his father, Reza Shah. Agreeing to his release, Reza Shah ordered that Mossadegh be transferred to Ahmad-Abad; "to live there, until he dies there". 

The background story is that Ernest Peron, a Swiss national and a very close friend of the crown prince, had been recently admitted to Najmieh Hospital (a charity hospital named after Mossadegh’s mother and directed by Gholam-Hossein), with diagnosis of kidney stones. The operation was performed by Professor Yahya Adl and Gholam-Hossein himself. Peron recovered nicely and wanted to show his appreciation. Gholam-Hossein solicited his help for the release of his father from prison, and Peron in turn requested it from Mohammad Reza, leading to the release of Mossadegh. 

Gholam-Hossein recounts that when he first saw his father after this ordeal he found him in a pitiful condition- feverish, lice infected and paralyzed from the waist down. It took about two months for Mossadegh to regain his strength and return to his usual condition. 

Mossadegh remained in Ahmad-Abad until the conclusion of his house arrest in September 1941, when he was informed that he was free to leave his residence. This was part of a general amnesty granted after Reza Shah's forced abdication by British and Russian governments and ascension of his son to the throne. 

Mossadegh left the compound and returned to his political activities. He was elected to represent Tehran to the 14th Majlis (Parliament) in 1944, receiving the highest votes of all other elected deputies from Tehran. 

PART THREE
Robust Spirit, Fragile Body


In May 1951 Mohammad Mossadegh agreed to assume the position of Prime Minister, and within just a few weeks succeeded in finalizing the nationalization of the Anglo-Iranian Oil Company. Gholam-Hossein Mossadegh remarks in his Iranian Oral History Project interview that at the time his father accepted the premiership, he was extremely weak and very fatigued. He questioned his father about the wisdom of accepting such a heavy responsibility in view of his frail condition. Mossadegh responded: "I've no choice, otherwise the nation's struggle and sacrifice for Nationalization of Oil would go to waste." 

Gholam-Hossein assumed the role of his father's physician from the time he received his diploma in 1934 [Persian calendar 1313], and saw his father at 6:00 a.m. daily during his premiership. He would check his pulse and blood pressure, and often gave him a B vitamin (Becozyme) injection for energy. In order to conserve energy, he advised his father to work from bed frequently. In this manner, Mossadegh worked an average of 14 hours daily during his entire 28 months as Prime Minister. He adds that his father never had a good night sleep and every night he would take 2 or 3 tranquilizers.

In October 1951, Premier Mohammad Mossadegh traveled to New York to personally defend Iran's right to nationalize its oil industry before the UN Security Council. When he arrived at the airport he was taken directly to what was then known as New York Hospital-Cornell Medical Center. He underwent a medical check up and then moved to a hotel. Farhad Diba writes, "..he stayed for a time in New York Hospital, not so much because he was ill but because he needed time to prepare the Iranian defense after consultations with his advisers." 

At the UN Security Council, Mossadegh gave a dramatic and successful presentation and then headed for Washington, DC where he met with President Harry S. Truman. Stephen Kinzer surmises in his book All The Shah's Men that Truman "...had arranged for Mossadegh to be installed at Walter Reed Hospital, where he could rest and be given a full battery of tests. To a man who had many ailments and believed he had many more, who felt comfortable in bed and never declined medical attention, this was an irresistible offer." Mossadegh and his son Gholam-Hossein both stayed in Walter Reed Hospital for three days. No official medical records from either hospital admission are believed to be available for review.

Gholam-Hossein understood that the medical evaluation found him to be weak but did not uncover any abnormality. Diba writes, "In fact, the question of doctors and the health of Iran's top leaders seemed to serve the Administration well. A few months previously, in June 1951, Dr. Claude E. Forkner had been sent to Iran. The stated purpose of his visit was to examine the Shah, but he was sent for political purposes, his medical services being a suitable cover. Curiously enough, this same Dr. Forkner examined Mossadegh at the New York Hospital when he first arrived in the United States, which leads one to wonder whether he reported to the State Department as he had done regarding the Shah. And in Washington, to comfort the British rather than Mossadegh, President Truman sent his personal physician, Dr. Wallace H. Graham, to check-up on Mossadegh's poor health." 

Dr. Wallace H. Graham was not only Truman's physician, he was a close family friend who also treated members of the White House staff and Secret Service during Truman's presidency. In a letter to his cousin Ethel Noland on December 12, 1951, President Harry Truman mentioned Mossadegh's condition: 

"Yes Dr. Graham took care of old man Mossadegh and that sent him home in a good humor. But it hasn't helped the Iranian Oil Situation much."

Truman's assistant Secretary of State George McGhee first met Mossadegh in New York Hospital, and writes in his book Envoy to the Middle World that while in Walter Reed Hospital at a later date, Mossadegh had a thorough examination and "Actually the doctors at Walter Reed could find nothing in particular wrong with Mossadeg apart from the natural debilities of his age." 

McGhee later wrote in his contribution to the compilation Musaddiq, Iranian Nationalism, and Oil that Mossadegh suffered from a disc condition in his back and frequently needed to lie down in bed. This reference to a disc condition is not noted by any other sources. However, in his memoirs, Mossadegh makes a reference to "leg pain" for which he made a trip from Tehran in 1921 to a "sulfuric hot spring." If indeed Mossadegh had a disc problem one can hypothesize that leg pain was possibly related to this condition.

There is a suspicious political dimension to Iranian leader Mossadegh being examined by physicians attached to the American government or admitted to a military institution such as Walter Reed Hospital. Though Mossadegh clearly had known medical problems, he was reportedly found to be generally healthy by two American hospitals and separately by two American physicians!



The most common ailment attributed to Mossadegh in numerous Western media sources is the habit of public fainting, yet substantiating these reports seems nearly impossible. There is no available eyewitness account to the alleged fainting spells of Mossadegh, nor are there any archived photographs or filmreels showing the scene of one of these fainting episodes. Even his long time close friend, compatriot, and later personal attorney, Mr. Nosrattolah Amini, who saw him frequently, had not been witness to any episode of fainting. Yet Mr. Amini tells us that as Prime Minister, Mossadegh would sometimes have coughing spells and bring up blood. [personal communication, August 2005]. Mossadegh himself explained it as the result of chest injury he sustained when he fell from a horse in Lavasan, a city in the outskirts of Tehran, years earlier. These episodes of coughing up blood, however, give more credence to the possibility of lung tuberculosis than the result of an old chest injury.

Dr. Gholam-Hossein Mossadegh was asked about this subject in his 1984 interview for the Iranian Oral History Project. In response to a question about the rumors that his father would faint at will for dramatic effect, he said that his father did indeed have a tendency to faint because of severe weakness and very low blood pressure. This would cause him to feel dizzy and quickly black out. In Homa Katouzian's contribution to the academic anthology Mohammad Mossadeq and the 1953 Coup in Iran, he writes of Mossadegh, "Throughout his life he suffered from a chronic nervous disease that in moments of high tension, led to his getting a lump in his throat and/or fainting".

Medically speaking, fainting (Syncope) is defined as a brief loss of consciousness. This condition is most commonly caused by limitation in blood flow to the brain usually due to decreased heart output. In the case of Mossadegh one can safely speculate that his faintings were of a much less serious nature; a condition called "Vasovagal Syncope". This form of fainting is usually precipitated by emotional or physical stimuli such as pain, fright or the sight of blood. 

Gholam-Hossein worried that his father would faint in front of reporters in New York who were anxious to snap his picture if that happened. He was particularly concerned on the day Mossadegh appeared at the UN, but "luckily he did not faint that day." 

One can deduce that fainting did occur, but the frequency of such episodes appears to have been greatly exaggerated. There is only one known account of Mossadegh fainting, and that incident was recorded by Mossadegh himself in his memoirs, and described in further detail to his son; who related the story to the Iranian Oral History Project:

In July 1952 [26 Tir 1331], Mossadegh had a meeting with Mohammad Reza Shah in the royal palace that lasted three hours. In this meeting Mossadegh requested that he be trusted with the control of the armed forces as Minister of Defense. The Shah refused to grant this request, and Mossadegh immediately offered his resignation as Prime Minister and then began exiting the room. The Shah moved swiftly and blocked the door to prevent his departure. Mossadegh recalled suddenly feeling sick. According to his son's account, the next thing Mossadegh remembered was finding himself on the ground as the Shah knelt next to him. His head was being cradled on the knee of General Yazdan Panah, who had entered the room after hearing the commotion inside. As the General began pouring sugar water down his throat, Mossadegh recalls hearing the Shah saying, "Don't die, don't die. If you die it will cause me lots of problems. I count on you. Whatever I have is from you!"

PART FOUR
The Final Years


On August 19, 1953 [28 Mordad 1332], Mossadegh's government fell victim to a coordinated covert operation by US and British governments and domestic enemies, code named TP-AJAX by the CIA. Mossadegh was arrested and hauled into court to be subjected to a grueling six week long military trial. During the subsequent appeal the public was forbidden from witnessing the proceedings, which were also not allowed to be published in the newspapers. To protest these actions Mossadegh went on a hunger strike, a form of non-violent dissent he was well experienced with from his past dealings with arbitrary rules.

Mossadegh was convicted as a traitor and sentenced, at age 71, to three years of solitary imprisonment. Upon completion of this prison time, he was taken to Ahmad-Abad and was kept under house arrest until his death. Mossadegh's company would be confined to a small circle of people for the remainder of his life - only close relatives and his personal lawyer Nosrattolah Amini were permitted visiting rights to his Ahmad-Abad estate. 

In Gholam-Hossein's book In the Company of My Father, he explains that during these years his father ate simply and in small portions. For breakfast, he would have bread and cheese with sweetened hot water; and for lunch he would eat rice and khoresh [various Persian sauces], ending with a light dinner. He liked fruit, particularly the Persian melon kharbozeh. 

Gholam-Hossein recalls that in this period his father was generally well and his mind was clear. His main complaint was living without companionship, which worsened when he lost his wife in 1965 (1344 Persian). In the winter of 1344 (1966-67) he developed pneumonia but recovered and did well until the following winter.

Gholam-Hossein describes that one Friday in the month of Aban 1345 (November-October 1966), he noticed redness and swelling on his father's left cheek. When he inquired about it, Mossadegh informed him about the presence of a painful blister on the roof of his mouth, for which he had applied Mercurchrome on his cheek to relieve the pain. Shortly afterward, Nosrattolah Amini brought in his close friend Dr. Esmail Yazdi, an oral surgeon (brother of Dr. Ebrahim Yazdi, who became Minister of Foreign Affairs in the early post Islamic revolution years and later an opposition leader) to examine Mossadegh. Dr. Yazdi recommended that Mossadegh be admitted to a hospital in Tehran for a more thorough evaluation. To secure permission from the Shah for this transfer, Gholam-Hossein asked professor Yahya Adl to intervene. A couple of days later the Shah granted this permission and Mossadegh was brought to Tehran and admitted to Najmieh hospital. He underwent a biopsy and was diagnosed with cancer in the roof of the mouth. While in the hospital no one was allowed to visit him, and he refused his children's offers to fly him to Europe for treatment or to bring physicians from abroad. 

Mossadegh was discharged from the hospital and began receiving cobalt radiation therapy in Mehr hospital while staying in his son's home, still under house arrest. Diba writes that cobalt therapy was "administered by Dr. Ahmad Farhad, one-time chancellor of Tehran University, and Dr. Sadr". According to Gholam-Hossein his father developed enlarged lymph glands in his neck and had tremendous pain, which was so severe that it caused him to scream in agony. He took a lot of analgesics which aggravated his stomach ulcer. Due to mouth and throat pain, Mossadegh lost his ability to eat and began vomiting blood and bled through his bowels. 

Mossadegh transferred back to the Najmieh Hospital and was transfused. His condition deteriorated rather rapidly and a few days later, he fell into a coma.

On the dawn of 14 Esfand 1346 (March 5, 1967) Mossadegh died at age 85. The Shah refused to allow his burial in the cemetery of martyrs as he had wished in his will and Mossadegh was buried in the ground of the dining room of his house in Ahmad-Abad. 

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