The Sources of Medical Knowledge for the Arabs:
The Arabian peninsula was bounded by several states which had ancient civilizations,
such as Egypt and the Byzantine and Persian empires:
Physicians among the ancient Egyptians had
certain specialties: ophthalmology, gynecology, surgery and internal medicine.
There were also medical schools attached to ancient Egyptian temples, and
the physicians used to combine medicine with the priesthood. Medical knowledge
was not all written down, and there were parts of it which were considered
secret, not permitted to be revealed, and each generation used to inherit
this secret knowledge. In museums and in the drawings on tombs and in papyri,
much has been discovered of what the ancient Egyptians knew about the practice
of medicine. Physi-cians used to be attached to temples and used to examine
and treat ordinary people without fee, and the state rewarded the physician
for his services. The pharaohs had physicians attached to their courts. Medical
knowledge flourished in ancient Egypt, and some of the drugs which were used
then are still used now. There are in the medical papyri accurate descriptions
of some of the drugs which were used then are still used now. There are in
the medical papyri accurate descriptions of some diseases, their progress
and method of treatment.
Among the ancient Greeks the first physician of prominence was Hippo crates,
he considered to be the father of medicine; his descriptions of disease and
his clinical talents earned him that title. Hippo crates was held to be the
model physician, and the ethics practiced by him are reflected in the so-called
"Hippocratic Oath" that doctors swear on starting their medical
careers.
Egypt was the center of medical learning once again from the year 271 BC when
the School of Alexandria was set up. Here Herophilus and Erasistratus taught,
dissected, and investigated the functions of organs; they were particularly
interested in the central nervous system, and they were able to distinguish
the sensory from the motor nerves.
Greek medicine did not make its appearance in Italy until 124 BC, and this
was largely due to Asclepiades, who became famous for his interest in mental
diseases. Galen (AD131 to 201) is considered to be, without exception, the
greatest of the Greek physicians after Hippo crates. It is said of him that
he was the initiator of experimental physiology, and he was known to be widely
traveled. He became the chief physician in Rome in AD164 and was renowned
as a skilled physician and as a scholar. He built a medical system which allowed
him to suggest an answer to every question and an explanation for every phenomenon.
The comprehensiveness of this system, and possibly also of Galen's teleology,
were very appealing to the generations who succeeded him. As a result, there
was a tendency for later physicians to neglect original investigation and
to rely solely an the authority of Galen instead. For instance, Galen taught
that blood passed from the right to the left ventricle of the heart through
invisible pores, and was unaware. of the pulmonary circulation; this, Ibn
al-Nafis was to describe much later.
The Nestorian sect, founded in AD428 by Nestorius, the Patriarch of Constantinople,
was an heretical sect. The Nestorians were persecuted and so they emigrated
to the Syrian city of Al-Ruha (Edessa), where they founded their medical school.
But persecution followed them, and the Byzantine Emperor expelled them in
AD489. So they emigrated to Persia, where they were welcomed and treated well
by the emperor, and they settled there and penetrated eastwards until they
reached Jundi-Shapur. And so it was that the Nestorian center of learning
moved from Syria to Jundi-Shapur in Persia, and there the Nistorians established
a large hospital. Jundi-Shapur became the most prominent cultural center at
the time of the Persian Emperor Kisra Anushirawan, who attracted to the city
the most famous Indian, Jewish, Syrian and Persian physicians. Kisra used
to send his physicians to India to look for medical books to translate from
Sanskrit to Persian and Syriac, also the Greek books were translated; and
so Jundi-Shapur acquired a large scientific library.
This is merely a brief sketch of the development of ancient times and of how
medical knowledge was transferred to the lands bording on the Peninsula, from
which the Arabs were to draw their Medical knowledge when Islam appeared.
Development of Medicine in Islam:
Islam spread and the Muslims were keen to collect
all that was available to them of manuscripts and books of the ancients; such
things were frequently the only booty they prized as conquerors.
When the phase of active conquest was over, the Arabs directed their energies
to various branches of learning with great eagerness, and they translated
all that they acquired of Greek, Persian and Indian manuscripts. The Christians,
Jews, and Nestorians played a large part in this work.
Within one and a half centuries of the appearance of Islam, Baghdad came under
the rule of the Abbassids and Cordova under the Umayyads, and these became
world centers for learning and particularly for medicine. Among the famous
physicians of Ummayyad times were Ibn Uthal and Abu al-Hakam al-Dimashqi.
Ibn Uthal was a Christian, and physician to the first Umayyad caliph, Mu'awiyah.
He was skilled in the science of poisons, and during the reign of Mu'awiyah
many prominent men and princes died mysteriously. Ibn Uthal was later killed
in revenge. Abu al-Hakam al-Dimashqi was a Christian physician skilled in
therapeutics. He was the physician to the second Umayyad caliph, Yazid.
Translation into Arabic began under the rule of the Umayyads in the time of
Prince Khalid ibn Yazid. Prince Khalid was interested in alchemy, and so he
employed the services of Greek philosophers who were living in Egypt. He rewarded
them lavishly, and they translated Greek and Egyptian books on chemistry,
medicine and the stars.
A contemporary of prince Khalid was the great Arab chemist Jabir Ibn Hayan
(Geber), who was born in AD705 and died sixty-four years later. He became
expert in chemical and al-chemical procedures, and was the first to discover
mercury.
Another medical achievement during the rule of the Umayyads was the hospital
for lepers which was built in Damascus. This was the first of its kind and
enjoyed many endowments. This should be contrasted with European practice
which, even six centuries later, condemned lepers to be burnt to death by
royal decree.
The Umayyad Caliphate lasted for about ninety years, and during that time
Islam spread from China in the east to Spain in the west. Translation of scientific
books into Arabic had already begun, but under the Abbassids, who succeeded
the Umayyads, it was greatly accelerated. An important factor which facilitated
the work of translation was the flexibility of the Arabic language, the richness
of its terminology, and its capacity for expression.
The center of the world in all the arts and sciences became Baghdad, which
the first Abbassid Caliph, Al-Mansur, took for his capital. The age of Haroun
al-Rashid, the ninth-century Caliph renowned in the Arabian Nights, was among
the most golden of historical ages. He surrounded himself with the fore-most
physicians of the age, who had studied Persian, Greek and Indian medicine.
It is said that the Caliph Al-Abbas asked his physician Isa ibn Yusuf to prepare
an examination of medical competence. Those doctors who did not pass the examination
were debarred from medical practice. Some 860 men were successful, and hundreds
of charlatans were thus expelled from the profession.
The Caliph Al-Mansur invited Jurjis ibn Jibrail, a Syrian physician and the
head of the hospital in Jundi-Shapur, to attend him. This man was a member
of the family of Bakhtyishu which produced many famous physicians through
several generations. They served at the Abbassid court for about three centuries,
where they attained great wealth and positions which were sometimes higher
than those of princes or ministers. Some of them were translators of scientific
texts and authors of a number of books on medicine.
Yuhannah ibn Masawayh was a physician at the time of Haroun al-Rashid. At
the Caliph's request, he translated Greek medical books purchased in Byzantium
and was himself the author of books on fevers, nutrition, headache, and sterility
in women. Al-Mu'tasim the successor to Harnoun al-Rashid, was so interested
in Yuhannah's work on dissection that he made a special dissection room available
for his use, and he used to have apes specially brought for hirn from Nubia
in Africa.
Hunain ibn Ishaq (Johanitius), was probably the greatest translator in Arab
history. He had a superlative knowledge of Syriac, Greek, and Arabic, and
carried out a large number of translations from Greek scientific and philosophical
manu-scripts into Arabic. These included most of the works of Hippo crates
and Galen. After his death, much of this work was continued by his pupils
and by his nephew Hubaish. This man Hubaish also wrote books on medicine,
among which was a treatise on nutrition.
There are many other translators who were prominent writers and philosophers.
Thabit ibn Qurrah, who wrote many books on a variety of medical topics as
well as on philosophy and astronomy; Qusta ibn Luqa, a contemporary of AI-Kindi,
who translated many books into Arabic. There was also Mankah the Indian, who
translated from Sanskrit into Arabic, and translated a treatise on poisons
written by the Indian physician Shanaq.
The Abbassid Caliphs were not only concerned with translation. They were also
interested in public health, and it was an Abbassid minister, Ali ibn Isa,
who requested the court physician, Sinan ibn Thabit, to organize regular visiting
of prisons by medical officers. The first hospital in the Muslim empire was
built in the ninth century in Baghdad, by the Abbassid Caliph Haroun al-Rashid;
after that many other hospitals were built in the Muslim world. The first
hospital to be built in Cairo was at the time of the governor of Egypt, Ibn
Tulun, in AD872. These hospitals were remarkably advanced in design, for they
contained pharmacies, libraries, lecture-rooms for medical students, and separate
wards for men and women.
The age of translation paved the way for the age of composition and innovation.
The latter half of the ninth and the tenth centuries form the most creative
period in the history of Muslim science and learning.
Al-Tabari was a native of Tabaristan who was physician to two of the Abbassid
Caliphs. He wrote an encyclopedic work on medicine, philosophy, zoology, and
Astronomy, and was greatly influenced by the writings of Aristotle and Galen.
Ai-kazi (Rhazes), AD865 to 925, was a Persian and the pupil of Al-Tabari.
He was one of the greatest of Muslim physicians and a most prolific writer.
He took a great interest in chemistry and is said to have prepared absolute
alcohol from fermented sugars, and to have invented a scale for measuring
the specific gravity of fluids. But his great farme rests on his supreme abilities
as a clinician, and his descriptions of the clinical signs of many illnesses
were unsurpassed. He investigated women's diseases and midwifery, hereditary
diseases, and eye diseases. He wrote an account of smallpox and measles, and
books on chemistry and pharmacy, but the most famous of his bnoks is Al-Hawi,
"the Continence", aq large encycopaedia on medicine in 24 volumes.
It was translated into Latin by Sicilian Jewish, it made a great mark on the
European thinking in medicine.
Al-Majusi was also born in Persia. He wrote a medical book called Al-Maliki,
known as Liber Regius in Latin translation. It was widely used as a reference
work in the Middle Ages. Al-Majusi was the first physician to explain that
the foetus does not leave the uterus by its own efforts, but rather that it
is extruded by the contractions of the uterus.
Ibn Sina (Avicenna) was born in 980 and died aged fifty-three. He wrote copiously
and on many subjects, but the most famous of his books was The Canon of Medicine.
This is an encyclopedic work in fourteen volumes, and embodies the combination
of Greek and Arabic medical systems, with the addition of Ibn Sina's personal
experience. It deals with diseases, their classification, description, and
causes; with therapeutics and the classification of simple and compound medicines;
with hygiene, the functions of parts of the body, and with many other topics.
In particular, Ibn Sina noted the fact that pulmonary tuberculosis was contagious,
and he thought that it spread through soil and water. He also described accurately
the symptoms of diabetes mellitus and some of its complications. He was very
interested in the effect of the mind on the body, and wrote a great deal on
psychological disturbance. The Canon was translated into Latin and published
many times. It had the most fundamental influence in Europe during the Middle
Ages, and was a standard reference book in universities right up until the
seventeenth century.
The other major cultural center of the Muslim world was Cordova in Spain.
The library was reputed to have over 600,000 books. Among the greatest men
whom Spain produced was Abu al-Qasim al-Zahrawi (Albucasis), who was born
in Al-Zahra in AD936. He is regarded as the most famous of the Arab surgeons,
but he was also skilled in the use of simple and compound remedies, and was
thus sometimes described as "the pharmacist surgeon". He wrote the
famous manual on surgery, called Al-Tasrif, although it also includes sections
on the preparation and dosage of drugs, nutrition, public health, and anatomical
dissection. The celebrated sections on surgery are illustrated with drawings
of about one hundred surgical instruments. There are descriptions of techniques
for operating to relieve various conditions, including the amputation of limbs,
the removal of foreign bodies, and the crushing of bladder stones. He invented
many of the instruments in his book, and in particular ge devised a pair of
forceps for use in midwifery. Al-Zahrawi was no mean dentist either; it is
said that he per-formed cosmetic operations to correct dental irregularities.
His book became famous in the universities of Europe in the Middle Ages. It
was translated into Latin by Gerard of Cremona in 1187, and it was the chief
reference work for surgery in the universities of Italy and France.
Ibn Rushd (Averroes) was a twelfth-century physician, philosopher, and astronomer
of Cordova. He was primarily concerned with philosophy and wrote an extensive
commentary on the philosophical works of Aristotle. But he also practiced
medicine and wrote a medical work entitled Al-Kulliyat, which became known
in the Latin West as Colliget. Among his many original contributions was the
observation that smallpox can only infect once.
The family of Ibn Zuhr produced through six consecutive generations a number
of famous physicians, men and warnen. The most celebrated of them was Ibn
Marwan ibn Zuhr (Aven-zoar). He was a contemporary of Ibn Rushd and an extremely
able clinician. His book Al-Teisir was among those which were translated early
on into Latin and thus passed into Europe.
Two other physicians who belonged neither to Baghdad nor to Cordova are worthy
of note in this survey. Ibn Abi Usaybi'ah was born in Syria and practiced
medicine for a while in Cairo. His major contribution to medicine was his
large biographical work on the physicians who had preceded him. The second
physician of note is Ibn al-Nafis, also born in Syria; he too practiced medicine
in Cairo. He refuted what Galen had said about the passage of blood through
invisible pores in the septum which separates the right and left ventricles
of the heart. He described the lesser (pulmonary) circulation for the first
time in history before the English Harvy. It is a regrettable fact that this
signal achievement of Ibn al-Nafis received very little notice through the
ages and his views were ignored for centuries.
This has been a brief survey of the medical contributions made by some of
the most prominent people in Arabic Muslim cultural history.