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ISLAMIC MEDICAL EDUCATION RESOURCES 04

0010-ISLAMIZATION OF MEDICAL SCIENCES (PART I)

Lecture for 1st year medical students on 20th October 2000

0010-ISLAMIZATION OF MEDICAL SCIENCES

Lecture for 1st year medical students on 20th October 2000

 

OUTLINE

1.0 HISTORY OF MEDICINE, tarikh al tibb

A. PRE-ISLAMIC ROOTS

B. THE ISLAMIC ERA

C. LUMINARIES OF MEDICINE

D. MUSLIM CONTRIBUTIONS TO MEDICAL KNOWLEDGE

E. TRANSFER OF MEDICAL KNOWLEDGE TO EUROPE

 

2.0 PROPHETIC MEDICINE, tibb nabawi

A. BASIC CHARACTERISTICS OF TIBB NABAWI

B. SOURCES OF TIBB NABAWI

C. CLASSIFICATION OF TIBB NABAWI

D. APPLICATION OF TIBB NABAWI TODAY

E. CONCLUSIONS AND FUTURE CHALLENGES

 

3.0 ISLAMIC MEDICINE, tibb islami

A. CONFUSION BETWEEN ‘MUSLIM’ and ‘ISLAMIC’

B. CRITIQUE OF VARIOUS DEFINITIONS OF ISLAMIC MEDICINE

C. CRITIQUE OF VARIOUS MANIFESTATIONS OF ISLAMIC MEDICIN

D. ISLAMIC MDICINE AS EPARADIGMS, METHODOLOGY, and VALUES

E. NEED FOR REFORM IN MEDICINE

 

4.0 ISLAMIZATION OF KNOWLEDGE: CONCEPT and PRACTICE

A. THE CONCEPT OF ISLAMIZATION:

B. HISTORY OF ISLAMIZATION

C. REFORM OF DISCIPLINES:

D. MISUNDERSTANDING THE REFORM PROCESS

E. PRACTICAL STEPS / TASKS OF THE REFORM PROCESS:

 

5.0 CRITICAL THINKING and CREATIVITY

A. DECLINE and RENAISSANCE

SCIENTIFIC TARBIYAT IN THE QUR’AN

ISLAMIC INPUT CURRICULUM

RESEARCH and APPLICATION

THE CHALLENGE TO EXCEL

 

1.0 HISTORY OF MEDICINE, tarikh al tibb

A. PRE-ISLAMIC ROOTS

ANCIENT EGYPT:

The practice of embalming the dead gave Egyptians a lot of knowledge about anatomy. They also developed various medical and surgical modalities.

 

BABYLON:

The babylonians knew nasal tamponade for bleeding, cataract couching. They used blood-letting as a treatment. They knew circumcision and we learn from the sunnat that the great patriarch Ibrahim (PBUH) was circumcised.

 

CHINA

The saying ‘seek knowledge even if as far away as China’ is well known all over the Muslim world. Muslims learned a lot from the Chinese. Ancient Chinese medicine was well developed. The Chinese developed acupuncture and castration of males who became eunuchs. Chang Chon-Ching, who lived in the 2nd century CE,  was the most famous Chinese physician. He had famous medical writings and spread medical knowledge to Japan. In the 3rd century CE the Chinese surgeon Hua Chu wrote about physiology, anatomy, pathology, anesthetics. After him Huang wrote about acupuncture. Tao Hung Ching (454-536 CE) used acupuncture and had interests in internal medicine, anatomy, children and women diseases, obstetrics, dietetics, and drugs. Chao Yuan Fang (550-630 CE) wrote a medical encyclopedia. Sa’ad Ibn Abi Waqqaas the commander of the conquest of qadisiyyat (13 AH) and the founder of the city of Kufa (18 AH) was sent by Othman in a diplomatic mission to China 620-640 CE and is reported to have lived in the Chinese city of Canton. Thereafter contacts between Muslims and Chinese increased. A Chinese physician came to Al Razi (d. 313 AH/925 CE) and requested to study under him for 1 year. He learned Arabic and translated medical books into Chinese. Muslims were in contact with Chinese physicians who visited Central Asia such as Yuan Chwang 630-645 CE and I Tsung 675-685 CE.

 

INDIA

Surgical knowledge in India was very advanced. The following operations were carried out by Indian surgeons: tonsillectomy, amputation, tumor excision, hernia repair, repair of harelips, removal of bladder stones, couching cataracts, nose repair, ceserian section. They also developed surgical instruments. They knew the washing and bandaging of wounds. Hyoscamus (Henbane) and cannabis indica were used as anesthetics. In some cases hypnosis was used as anesthesia. The period 6-12th centuries CE witnessed development of Indian medicine especially in the field of toxicology. Indian medicine reached Baghdad both directly and indirectly, through Persia. Muslims entered Sindh in 15AH/637CE led by the omayyad military leader Muhammad Ibn al Qasim; a long period of contact with Indian medicine, trade and cultural exchange ensued. In the Abassid era the ruling Barmaki family were interested in indian culture especially its medicine. Yahya bin Khalid al Barmaki, vizier of Harun al Rashiid, sent missions to India to learn its medical knowledge. He also invited Indian physicians to Baghdad. Some Indian medical texts were translted into Arabic in Baghdad. The physician Abi al Hasan Ali Bin Sahal al Tabari in his book ‘Firdaus al Hikmat’ completed in 236 AH / 850 CE wrote about Indian medicine covering topics such as: importance of spiritual cures, treatment of metal disorders, importance of specialization, women diseases, obstetrics, internal medicine, dietary treatment, looking at the patient as one entity, diagnosis, preventive medicine, anatomy, surgery, surgical instruments, and medical training. The Indian physician Kankah treated Harun al Rashiid and translated a book on poisons. The Indian physician Salih bin Baghlat was famous at the Abassid court. Urnda, Siddhayogar, and Ibn Dahn al Hindi were Indian physicians who served the abassids and all worked at the Baghdad Hospital built in 187 AH/ 803 CE in the era of Harun al Rashid. Zantah was an Indian physician who wrote about poisons and their treatment. Ibn al Nadiim in his book ‘Al Fihrist’ mentioned Indian medical books that were translated into Arabic. Abubakr al Razi in his book ‘al Hawi’ depended a lot on Indian medical knowledge. Abi al Rayhan Muhammad bin Ahmad al Bairuni wrote about Indian medicine. He traveled in India and was very familiar with its people and culture.

 

SYRIAC

Syriacs translated Greek medical books into their language and subsequently into Arabic. Among the Syriac translators were: Sarjus al Ras’ani (d. 536 CE), Job of Edessa or Ayyub al Rahawi (d. 832 CE), and the famous Hunain Ibn Ishaq. In the Abassid era many translations were from Greek to Syriac and then to Arabic and not directly Greek to Arabic. The Syriacs not only translated but also wrote books making their own contributions for example Sarjus al Ras’ani wrote ‘ al isatisqau’ and Ayub al Rahawi wrote ‘Fahas al bawl’.

 

PERSIA

Persian interest in Greek medicine was demonstrated when the King of Persia invited the famous Greek physician Hippocrates (460-377 BC) to help deal with diseases and epidemics in Persia. Hippocrates did not agree. When Alexander of Macedonia defeated Persia, he spread hellenic civilization including its medicine. Greek knowledge was translated first into Persian then into Arabic. Hereafter many translations of medical works were made from Persian to Arabic especially at the time of the abassids. Persian influence was very strong at the abassid court in many areas including medicine.

 

ARABIAN PENINSULA

Medical knowledge in the Arabian peninsula before Islam was the folk medicine found in all human communities. We know a lot about the nature of this medicine from the many authentic hadiths on Tibb al nabawi. The prophet’s medicine was in most cases the medicine practised in Hejaz at that time. Pre-Islamic Arabs used cupping, hijamat; cautery, kayy, and branding with fire, wasm. They used a wide variety of herbal medicine. Among medical practitioners in the pre-Islamic era were: Ibn Huzeem, Nadr Ibn Harith, and Ramtha al Tamiimi. The harsh environment, isolation in the desert, the nomadic Bedouin life, and general illiteracy explain the low level of medical knowledge among Arabs before Islam. They sometimes confused medical practice with sorcery and magic.

 

GRECO-ROMAN

Greel medical knowledge was picked up by the Romans and was spread in West Asia by the Byzantines. The famous Roman physician Galen closely followed Hippocrates. He in turn had a major impact on Byzantine medicine. Muslims learned a lot from Galen but also had access to other Greek sources. Complete reliance on Galen eas not possible because Galen was selective in his copying from Hippocrates and other Greek physicians. Muslims played a big role in preserving early Greek medical knowledge, improving and enhancing it, and eventually passing it on to Europe during the renaissance. The Greek physician and father of European medicine, Hippocrates son of Heraclides (460-377 or 370 BC), introduced rational/scientific medicine. He introduced the theory of the 4 humors and the 4 elements of the body. The Hippocratic corpus consists of his writings and those of his students. Romans learned from the Greeks and developed advanced military hospitals called valetudinaria that were used to treat wounded soldiers on the battle-field. Three Roman physicians became famous: Celsus, Rofus, and Galen. Celsus described the cardinal signs of inflammation: rubor, tumor, calore, and dolore; provided  details of surgical procedures; and described ligation of blod vessels. He encouraged dissection. Rofus wrote 42 titles and made contributions to anatomy, surgery, and urinary tract disease. Claudius Galen (130-201 BC), a skilled Roman military surgeon, had great impact on Arab medicine. His writings were compiled by the Byzantines and were eventually translated into Arabic. The Greek-speaking multi-natonal Byzantine empire, with its capital at Constantinople in West Asia, lasted over 1000 years after the fall of Rome and acted as a bridge to transfer Greek knowledge to West Asia and North Africa. The Byzantines compiled Greek knowledge from Hellenic and Roman books. The University of Alexandria was the center of this activity. It continued functioning after the Muslim conquest of 642 CE and lasted until 719 CE. Johns Philoponus, the grammarian, was an Egyptian scholar in Alexandria who met Amre bin al Aas. He wrote commentaries on the books of Aristotle and Galen. Palladius and Asclepius wrote commentaries on Hippocrat’es writings in the 6th century CE. Paulinus, an expert in women diseases and obstetrics,  was another Byzantine physician in Alexandria.

 

B. THE ISLAMIC ERA

MEDICAL KNOWLEDGE IN THE EARLY ISLAMIC PERIOD (0 – 132 H)

Overview: The period under review covers the era of the Prophet (-13 – 10 H), the era of the 4 rightly-guided khulafa, khulafa al rashdiin (10-40 AH), the omayyad era (41-132 AH), and entry into Andalusia (starting 94 H). The prophet;s teachings gave a big impetus to medicine. He taught that there were two branches of knowledge: ‘ilm al abdaan & ilm al adyaan. He taught that the body had rights and had to be cared for. He also taught that the intestine was the abode of disease and prevention was the head of all medicine. He taught a lot about personal and environmental hygiene. He practiced medicine and urged his companions to seek cures for their diseases. The start of rapid medical advance was in the omayyad period. Translations of medical texts into Arabic started under the omayyads. Prince Khalid Ibn Yazid rewarded translators lavishly. A hospital was built for the lepers in Damascus.

 

Nurses: The followinh nurses became famous for their nursing work both in war and peace during the time of the prophet: Rufaidat bint Ka’ab al Aslamiyyat; Amiinat Bint Qays al Ghifariyyat; Umm ‘Atiyyah al Anasariyyat; Nusaibat Bint Ka’ab al Maziniyyat & her family; Zainab from the tribe of Bani Awd an expert in diseases and surgery of the eye. Rufaidah bint Sa'ad, is generally recognized as the first Muslim nurse. Rufaidat's full name was Rufaidat bint Sa'ad of the bani Aslam tribe of the Khazraj tribal confederation in Madinah. She was born in Yathrib before the migration of the Prophet Muhammad (PBUH). She was among the first people in Madina to accept Islam and was one of the Ansar women who welcomed the Prophet on arrival in Madina. Rufaidah's father was a physician. She learned medical care by working as his assistant. Her history illustrates all the attributes expected of a good nurse. She was kind and empathetic. She was a capable leader and organiser able to mobilise and get others to produce good work. She had clinical skills that she shared with the other nurses whom she trained and worked with. She did not confine her nursing to the clinical situation. She went out to the community and tried to solve the social problems that lead to disease. She was a public health nurse and a social worker. When the Islamic state was well established in Madina, Rufaidah devoted herself to nursing the Muslim sick. In peace time she set up a tent outside the Prophet's mosque in Madina where she nursed the sick. During war she led groups of volunteer nurses who went to the battle-field and treated the casualties. She participated in the battles of Badr, Uhud, Khandaq, Khaibar, and others. Rufaidah's field hospital tent became very famous during the battles. At the battle of the trench, ghazwat al khandaq, Rufaidah set up her hospital tent at the battle-field. The prophet Muhammad instructed that Sa'ad bin Ma'adh who had been injured in battle be moved to the tent. Rufaidah nursed him and carefully removed the arrow from his forearm and achieved hemostasis. The prophet visited Sa'ad in the hospital tent several times. Rufaidah had trained a group of women companions as nurses. When the Prophet's army was getting ready to go to the battle of Khaibar, Rufaidah and the group of volunteer nurses went to the Prophet Muhammad (PBUH). They asked him for permission "Oh messenger of Allah, we want to go out with you to the battle and treat the injured and help Muslims as much as we can". The Prophet gave them permission to go. The nurse volunteers did such a good job that the Prophet assigned a share of the booty to Rufaidah. Her share was equivalent to that of soldiers who had actually fought. Rufaidah's contribution was not confined only to nursing the injured. She was involved in social work in the community. She came to the assistance of every Muslim in need: the poor, the orphans, or the handicapped. She looked after the orphans, nursed them, and taught them. Rufaidah had a kind and empathetic personality that sothed the patients in addition to the medical care that she provided. History has recorded names of women who worked with Rufaidah: Umm Ammara, Aminah, Umm Ayman, Safiyat, Umm Sulaim, and Hind. Umm Ammara is also known as Nusaibat bint Ka'ab bin Amru bin 'Awf bin Mabdhool bin 'Amru bin Ghanam bin Mazin bin al Najjar al Ansariyat. She was the mother Abdullah and Habiib, the sons of Bani Zayd bin 'Asim. Nusaibat was assisted by her husband and her children in her nursing work. She participated in the convenants of 'Aqabat and Ridhwan. She was at the battle of Uhud with her husband and her son. She was also at the battle against Musailamah in Yamamah. She was injured 12 times in this battle, her hand was cut off, and she eventually died as a result of her wounds. She had gone to the battle of Uhud to nurse the fighters and provide them with water and when the battle turned against Muslims she took a sword and fought defending the Prophet. Amiinat bint Qays was reported to have helped in preapring Safiyat for her wedding to the Prophet (PBUH). Umm 'Atiyyah al Ansariyat al Khadfidhat treated women in Madina.

 

Physicians: Among the physians of this era were: al Harith Bin Kaldat,  Rufa’at bin Yathri,  Ibn Athaal,  Thiyadhuuq,  Abd al Malik Bin Sa’ied bin Hayyaan bin Abjar al Kinani , Abu al Hakam al Dimashqi,  Wahb bin Minyat (d. 112H /732 CE), and Ibn Juraih al Raahib (d. 130H). Abu Omar Bin Salal al Harith Bin Kaldat of the tribe of Thaqaf from Taif was praised by the prophet as the best Arab physician of his day. The prophet ordered Sa’ad bin Abi Waqqaas to consult al Harith. Al Harith studied medicine in Khuristan in Persia and became famous as a physician in Persia. He then returned to Taif and entered Islam and lived until the Omayyad era. He used to advise people to take preventive measures against disease. Rufa’at bin Yathri Abu Ramthat al Tamiimi lived at the time of the prophet and met him. Ibn Athaal, a Christian physician at the court of Mu’awiyah bin Abi Sufyan and an expert in medicines and poisons, was suspected in the death of many prominent people. Thiyadhuuq, said to have been a physician to omayyad governor Hajjaaj bin Yusuf, wrote a book with special interest on the relation between the patient and the physician and also wrote on dietary advice. Abd al Malik Bin Sa’ied bin Hayyaan bin Abjar al Kinani was a physician of the Khalifah Omar Ibn Abd al Aziiz (99-101 H) and had a famous saying: ‘leave the medicine alone as long as you can withstand the disease, d’i al dawaa ma ihtamala badanuka al ddaau’. Abu al Hakam al Dimashqi was a Christian physician with specialization in therapeutics and was physician to the second Omayyad khalifah, Yazid Ibn Abi Sufyan. ‘Aailat Ibn Hakam al Dimashqi was a Christian physician for the Omayyad rulers. His son Abu al Hasan ‘Isa bin Hakam bin Abi al Hakam was also a physician and authored a medical book.  Wahb bin Minyat (d. 112H /732 CE)  knew Greek physiology and believed that a person has 360 organs.

 

MEDICINE IN THE GOLDEN ERA OF THE ABASSID PERIOD (132 H – 656 H / 749 – 1258 CE )

Achievements: This era was a time of translation and advancement in medical knowledge and technology. This was made possible by the general conditions of peace that pax Islamica had established allowing movement of people and ideas across the expanse of a  large empire. The political leaders encouraged as well as patronized learning and science. They bought books and imported scientific brains. Al Ma amun established Bayt al Hikmat which undertook translations of Greek knowledge. Hunain Ibn Ishaaq (808-873 CE), one of the most famous translators,  translated from Syriac to Arabic assisted by his son Ishaaq and his daughter’s son, Hubaysh al A’am, and Isa bin Yahya. They were joined in the translation project by Istafan bin Basil, Qusta bin Luuqa, and Thabit bin Qurrat al Harraani. The translators gave priority to books of Galen over those of Hippocrates; however the ideas of the latter were included in he writings of the former. They translated other books in pharmacy and medicine by Greek and Byzantine authors. Unfortunately they also translated books on magic and sorcery which created confusion in Muslim medicine later. The age of translation was soon followed by the age of innovation; Muslims were no longer passive consumers of knowledge; they started adding to it and enriching it. The process of translation strengthened Arabic as a language of science. The translators had to arabise many technical terms, ta’ariib al mustalahaat. Greek tenets and ideas were islamized for example translators would use alternative words in the place of pig and alcohol. During the early abassid era, many measures of public health significance were undertaken. The abassid Minister Ali Ibn Isa asked the court physician Sinaan Ibn Thabit to organize regular visiting of prisons by medical officers. The first hospital was built by Harun al Rashiid in Baghdad. Khalifah al Mansur instructed his physician Isa bin Yusuf to examine all physicians to determine those who were competent; those who were successful were allowed to continue their work and the unqualified were expelled. Sinaan examined physicians in 319H.

 

Two families of physicians: Bakhtishu’u and Masawayh: The famly of Bakhtishu’u made many contributions to the early growrth of medicine. Jurjis bin Bakhtishu’u al Jandishapuri was a Syrian physician brought to treat the khalifah, al Mansur, in Baghdad. He cured the khalifah and returned to his hometown after 4 years. His place at the capital was taken by his son Bakhtyuush who later became a physician for Harun al Rashiid. Bakhtyuush was followed by his son Jibril bin Bakhtyuush who authored medical books. They were followed by others from the same family serving the rulers. The family served at the court for several generations and attained positions of influence, power, and wealth. Al Hakiim Yahya bin Bakhtyuush al Jandishapuri translated from Greek and Syriac to Arabic and died in Baghdad in 300H. Abu Sa’id Obaydullah bin Jibril from the family of bakhtyuush wrote several books: nawadir al masail, manaqib al attibba (completed in 423H), al taharat wa wujuubiha, tadhkirat al haadhir wa zaad al musaafir, and rawdhat tibbiyyat. The family of Masawayh made many contributions to medicine. Masawayh was a pharmacist who had two sons: Daud and Yahya. Daud became famous as a physician eloquent in Persian, Syriac, and a little Arabic. Abi Zakariyah Yohanna Ibn Masawayh (777-857 CE), a physician to several abassid rulers (Al Ma amun, al Mu’tasim, al Waathiq, al Mutawakkil) and teacher of Hunain Ibn Ishaaq, was commissioned together with his sons by Harun al al Rashid to translate ancient Greekn medical books. The Khalifah al Ma amuun made him head of the Bayt al Hikmat.  He was supervisor of the hospital in Baghdad and was the first person to establish a faculty of medicine. He wrote many books on fevers, nutrition, headache, and sterility in women that were translated in Europe. One of his famous publications was a book ‘kitaab al kamala wa tamaam’ that covered several diseases. He was so interested in dissection that he had a special room for that purpose and had apes brought to him from Nubia in Africa.

 

Other physicians: Abu al Hasan Ali Bin Sahl Rabn Al Tabari, a physician to two abassid khulafa, was born a Christian in Persia in 810 CE. He embraced Islam at the hands of al Mu ‘tasim and died in Baghdad after 227 H / 831 CE. He first lived in Tabarstan and moved to Baghdad in about 297H. He authored Firdaus al Hikmat, dedicated to al Mutawakkil and published in 850 CE, an encyclopedic work on medicine, philosophy, zoology, and astronomy greatly influenced by the writings of Hippocrates, Aristotle and Galen. The end of the book was a description of Indian medicine. Abu Yusuf Ya’aqub bin Ishaq bin Salih bin Ismail bin Muhammad bin al Ash’ath al Kindi the philosopher of the Arabs wrote a book on mental health titled ‘al Hiilat li Dafu’I al Ahzaan’ as well as other medical books. Qusta bin Luuqa al Ba’alabakki, born a Christian in 830 CE and died in 912 CE, was a contemporary of al Kindi. He translated many books into Arabic and wrote books on physiology and psychology. Mankah was an Indian who translated books into Arabic from Sanskrit including a treatise on poisons by the Indian physician Sanqah. Thabit bin Qurrat al Harraani translated many medical books. Hunain Ibn Ishaq al Ibaadi aka Johanitius (194-260 H / 810-873 CE) was a Christian who knew Syriac, Greek, and Arabic. He studied in Basra, Baghdad, Syria, and Byzantine. He translated Greek medical books including writings of Hippocrates and Galen. His work was continued after his death by his nephew Hubaish. He in addition wrote some books of his own the most famous being kitaab al aghdhiyat, al masail fi al tibb li al muta’alimiin, kitaab al madkhal fi al tibb, kitaab al maqqqlaat al asharat fi al saidalat. Ali Ibn Abbaas al Majuusi, a native of Ahwaaz from a Zoroastian family who died in 982 or 995 CE, authored a book on treatment of disease with single remedies, adwiyat mufradat, and another book on medicine called Kaamil al Sina’at al Tibiyyat that became famous after that as al Maliki and was translated into Latin and used as a reference in Europe. He was the first to explain that the fetus is expelled by the contractions of the uterus. Ibn Abi Usaybi’ah was born in Syria and practiced medicine in Cairo. His major contribution was writing bibliographies of all physicians before him. Ibn al Quffi, whose full name was Amin al Dawlah Ibn al Faraj Muwafiq al Ddiin Ya'qub Ibn Ishaq Ibn al Quffi al Malaki al Karki, was born in 630 AH/1233 CE and died in 685 AH/1286 CE. He wrote a surgical manual ' al 'umdat fi sina'at al jarahat'. Dhia Al Addin Abdullah Ahmad Bin Al Baitar was born towards the end of the 12th century and died in 1248 CE. He traveled widely. His most famous book was al Jamiu li Mufradaat al Adwiyat wa al Aghdhiyat. Abu Ibrahim Zain al Ddiin Ismail bin al Hassan bin Muhammad al Husayni al Alawi al Jarjaani (d. 531 H / 1137 CE) authored three books in the Persian language: al Tadhkirat al Ashrafiyat fi al Sina’at al Tibiyyat, al Ajwibat al Tibiyyat wa al Mabahith al ‘Alaniyat, and Zubdat al Tabiib. Muwafaq Al Adiin Abd Al Latiif Bin Yusuf Al Baghdadi (b. 1162 CE d. 1231 travelled to Cairo and Damascus. He started teaching medicine in Damascus in 1207 CE. Jurjus Bin Jibrail; Ibn Radhwan Al Masri; Alau al Ddiin Ali bin Abi al Hazm; Ali Bin Abbas Al Tusi.

 

MEDICINE IN THE LATER ABASSID ERA (659 – 923 H / 1261-1517 CE)

Following the Tatar invasion and destruction of the capital of the khilafat in Baghdad, the Muslim world went into a period of decline. Medicine and medical knowledge also declined.

 

ANDALUSIA:

Medical knowledge spread in Europe from Andalusia. The famous Andalusian physicians were: Urayb bin Salad al Katib, Abu Zakariyyah Yahya Ibn Ishaq, Abul al Qasim al Zahrawi, Ibn Abayya, Ibn Tufail, Ibn Rushd, Ibn Zuhr, Ibn Khatimah, Ibn al khatib. Abu Omran Musa bin Maimoon al Qurtubi al Andalusi aka Maimoinides (529-605 H / 1135-1209 CE) was a Jew born in Qurtuba in Andalusia in the year 1135 CE  who migrated to and settled in Egypt. He and his son, al Afdhal, after him became physicians to to Salah al Ddiin al Ayubi. He wrote the following books: dalaalat al hairiin, maqalat fi al sumuum, and al taharuz min al adwiyat al qattaalat. His most fampous book was al fusuul fi al tibb, aphorisms, that was extracted from writings of Galen.

 

THE MAGHREB:

Medical knowledge in the maghreb was an extension of the Andalusian medical knowledge.

 

THE OTTOMMAN STATE:

 

C. LUMINARIES OF MEDICINE,  a’alaam al tibb al muslimiin

AL RAZI

Abubakr Muhammad Bin Zakariyyah Al Razi (251-313H/865-923 CE), a Persian and a student of al Tabari, wrote more than 100 books the most famous being al Hawi al Kabir (in full ‘al Haawi fi Sina’at al Tibb) in 30 volumes) which was translated into Latin and reprinted many times in Europe. His other books were: al Mansuuri and Tibb al Ruuh. He was interested in chemistry and is said to have prepared absolute alcohol from fermented sugar. He invented a scale for measuring specific gravity. He described smallpox. He investigated women’s diseases, obstetrics, hereditary diseases, eye diseases, small pox, and measles. He was director of hospitals in Baghdad and his native land in Rayy.

 

IBN SINA

Al Shaikh al Rais Abu Ali Al Hussain Bin Abdillah Bin al Hassan Ibn Sina (370-428 H / 980 – 1037 CE) wrote many books the most famous being al Qanuun fi al Tibb, a 14-volume encyclopedia on disease classification and causes, therapeutics, simple and compound medicines, hygiene, and functions of the body. The book was translated into Latin and had a major impact on western medicine being taught until the 18th century CE. Ibn Sina recognized that TB was contagious and accurately described the symptoms of diabetes mellitus. Besides medicine, Ibn Sina made contributions to science, mathematics, chemistry, and philosophy.

 

AL ZAHRAWI

Abu Al Qasim Khalaf Bin Abbas Al Zahrawi (b. 912 CE, d. 404 AH/1013 CE) practiced medicine in Qurtuba in the reign of the omayyad Khalifat Abdurahman the Third who ruled 912-961 CE. His fields of interest were: surgery, pharmacology, and anatomy. He designed over 200 surgical instruments.His book Kitaab al tasriif liman 'Zajaza 'an Ta'liif  became a standard textbook of surgery. His other writings were Risala fi Tafdhil al ‘Asal ‘ala al Sukkar, Tadhkirat fi al Dawaa al Mushil [first medical encyclopedia in Andalusia], Maqala fi ‘ilal al Kula, Risalat fi al Baras, Kitaab al Iqtisad fi Islahi al Anfus wa al Jasad, Kitab al Aghdhiyat wa al Adwiyat, Kitaab al Jami fi al Ashribat wa ‘ilm al Ajinnat, Kitaab al Zina, Kitaab al Qaanuun al Muqtadab, Kitaab Mukhtasar Hilt al Bur li Jalinus.

 

IBN ZUHR

The family of Ibn Zuhr produced 6 consecutive generations of famous physicians the most famous being Abu Marwan Abdu Al Malik Ibn Zuhr (b. 1091 or 1094 CE d.487H / 1162 CE), a contemporary of Ibn Rushd, who lived in Andalusia and Morocco. His main book was al Taysir whose full title is Kitaab al Taysiir fi al Mudaawat wa al Tadbiir translated into Latin and used in Europe.

 

IBN RUSHD

Abu Al Waliid Muhammad Ibn Rushd (B. 1126 CE d.  595 H / 1198 CE) lived in Qurtuba in Andalusia. He was interested in philosophy and also practiced medicine medicine. He wrote a medical work called al Kulliyat translated in Europe. He made the observation that smallpox infected only once.

 

IBN AL NAFIIS

Alau Al Ddiin Abu Al Hasan Bin Abu Al Hazim Al Qurashi Al Dimashqi Ibn Al Nafees (d. 686H / 1288 CE) was born in Syria but practiced in Cairo. He described blood circulation before William Harvey but this was not noticed in Europe. He authored sharh tashriih al qanuun in which he explained pulmonary circulation.

 

D. MUSLIM CONTRIBUTIONS TO MEDICAL KNOWLEDGE

BASIC SCIENCES

Anatomy: Muslims largely dependec on the writings of Galen. They however made their own observations and corrected many mistakes made by Galen.

 

Physiology: Muslim physiological knowledge was influenced a lot by the Greek theories of the 4 elements, al asqaat: hot, cold, wet, and dry; the 4 humors, al alkhlaat: blood, phlegm, yellow bile, and black bile; the 9 temparaments, al mizaaj: 1 balanced and 8 out of balance; the pneumata, al arwaah: ruh tabi’I, ruh hayawaani, and ruh nafsaani. They also described the faculties, al quwaa: natural faculties, quwa tabi’iyat, animal faculties, quwa haiwaniyyat, psychic faculties, quwa nafsaniyyat; and procreative faculties, quwa al insaal. These Greek ideas had one very important and true concept, the idea of balance which is the forerunner of the modern physiological concept of homeostasis. Most of the details were however found by later research to be untrue and were discarded. The heart and circulation were described by Muslims as a mechanical pump. Ideas of food digestion were also known.

 

MEDICAL DISCIPLINES

Infectious diseases: Al Razi was aware of air-borne infection when he made an experiment to determine the site of a new hospital in Baghdad by putting meat in the air and waiting to see the site where it putrfied soonest. Al Razi in his book, Kitaab al judri wa al hisbat described the symptoms of smallpox and measles. The concept of contagion was known as early as the time of the prophet. Al Majuusi described contagious diseases like leprosy, elephantiasis, phrenitis, and trachoma. Ibn al Khatib and Ibn Khatimat described the symptoms of plague. Ibn Khatima had mentioned minute bodies causing disease in the 14th century CE.

 

Public health: the following wrote about public health: Qusta bin Luuqa, Ishaaq bin Omran, Ibn al Jazzaar, Ibn Sina, Fakhr al Ddiin al Razi, and Ibn al Quffi.

 

Blood circulation:  Ibn Nafees al Nafees described pulmonary circulation centuries before its ‘discovery’ by William Harvey.

 

Psychiatry: depression melancholia was related to organic factors. It was also realized that it could be caused solely by psychological factors. The symptoms of depression were described very well.

 

Metabolic/endocrine diseases: The symptoms of diabetes mellitus were described well. Urine examination was a very advanced art.

 

Allergy: Al Razi described rhinitis due to plant exposure centuries before similar descriptions by Europeans.

 

Dietetics: Muslims knew that diet is a method of treatment. The following wrote on diets: Hunain Ibn Ishaaq, Muhammad bin Zakariyyah al Razi, and Ibn Zuhr.

 

PHARMACEUTICALS

Muslims knew both simple and compound drugs. Among those who wrote about drugs were: Abu daud Sulaiman bin Hasan al Andalusi known as Ibn Juljul in the 4th century H / 10th century CE; Ibn al Jazzaar, Ibn al Raihan al Biruni, Abi Obaid al Bakri, Ibn Baja al Idrisi, and Abd al Latif al Baghdadi.

 

SURGICAL DISCIPLINES

Anatomy:  The main contributors were: Ibn Masawayh, Ibn Abi al Ash’th, al Majusi, Ibn Habal, Ali Ibn Abbas, Ibn Sina, Ibn al Quffi, Ibn al Nafiis, Ibn Ruhd, Abdul Lateef Baghdadi, Zakariyyah Ibn Muhammad Ibn Muhammad al Cazweeny d. 683 AH). Al Razi encouraged dissection and study of physiology. Al Zahrawi insisted on knowledge of anatomy before any surgery. 

 

Ophthalmology: (Ibn Hytham d. 1040 AD, Hunain Ibn Ishaq, Al Razi, Ibn Sina, Al Zahrawi, Ali Ibn Isa, Ibn al Rushd, Abu al Qasim Ammar). Ibm Hytham (965-1040 CE) in his book 'Kitaab al Manadhir' disproved the extromission theories of Euclid and Ptolmey and instead advocated an intromission view. He described the optic pathways and the point-to-point projection of the visual world into the  brain. He described how eye movements helpoed in visual perception. He also realised that several processes were involved in conscious visual experience. Jurjani (5th century AH) wrote about ophthalmology in his book 'Nur al ‘Uyuun'. Al Zahrawi described many extra-ocular operations. Al Zahrawi described the posterior displacement of the lens in cataracts. He also discovered many instruments such as: hooks, eye speculum, conjuctival scissors for removal of panus, pereforator and depressing needles for cataract surgery. Al Razi recommended tearing the capsule of the lens if it can not be displaced and Ibn Sina described various needles that can be used for this. Ali Ibn Isa was another ophthalmologist who wrote the book 'Tadhkirat al Kahaliin'. Both Al Razi and Ibn Sina described a procedure for operative decompression of glaucoma.

 

Anesthesiology: Al Zahrawi performed many of his operations under anesthesia: opium or mandragora.

 

Obstetrics: Al Baladi (circa 380 H) wrote a complete discourse on midwifery called ' Kitaab Tadbir al Habala'. Al Zahrawi described normal and abnormal presentations and described instruments for craniotomy to deliver a dead fetus in case of obstruction. He also developed a vaginal speculum.

 

General surgery: The main contributors were: Ibn Zuhr, al Shirazi, Ibn Dhahabi, and al Zahrawi. The book al Tasrif By Al Zahrawi took 30 years to compile in 30 volumes. The last volume deals with surgery and is one fifth of the whole book. The volume on surgery is divided into three sections: (a) cauterisation with 56 chapters (b) incisions, perforations, wounds & wound healing 93 chapters (c) bones setting and joints 36 chapters. The book contains anatomical details. It covered all branches of surgery. The book was used as a standard text in Europe and was translated into Latin in the 12th century CE. Al Zahrawi performed thyreidoctomy in 952 CE. Al Razi was the first to use gut sutures for intestinal repair. Al Zahrawi is also reported to have used catgut and cotton sutures. Al Zahrawi recognised pain as a symptom and not a disease. Among operations performed by Al Zahrawi and described in his writings were: tracheostomy as an elective procedure and bandaging techniques. Al Zahrawi has 11 inventions credited to his name such as use of the syringe for bladder irrigation, the vaginal speculum, and plaster for bone setting. Al Jurjani (d. 1136 CE) described the relation between goitre and exophthalmos

 

Traumatology & orthopedics: Al Zahrawi and al Quff described treatment of bone and joint trauma. Zahrawi wrote about osteomyelitis, amputations, and ostotomies for un-united fractures. He cautioned against above-knee and above-elbow amputations.

 

Wound treatment: The main contributors were: Ibn Sina, Al Zahrawi, Ibn Rushd, and Al Razi. Al Zahrawi taught the following methods of arresting hemorrhage: digital pressure, tourniquet, sponges, cauterisation, hypothermia, ligation of bleeding vessels by sutures of thread. He also advised against tight bandaging. Al Zahrawi emphasied the importance of cleanliness in would treatment. Ibn Sina mentioned dry dressing. Al Zahrawi wrote about the drainage of abscesses describing in detail the site and shape of the incision, packing of the wound, excision of the skin edges, use of slow decompression of large cavities, dependent and counter drainage.  

 

Urology: Al Zahrawi described bladder irrigation. He also developed original methods of lithotromy for impacted stones. He introduced a fine drill into the urethra and was rotated gently to break up the stone into small pieces that could be washed away by the urine.  He also wrote about using a bladder sound to locate bladder calculi, control of post-operative hemorrhage, and removal of clots from the bladder.

 

Gastro-enterology: Al Zahrawi used stomach tubes. He described paracentesis for ascites and intra-peritoneal abscesses. He mentioned use of trocar and cannula to drain liver abscesses. He also described the use a heated cautery to open liver abscesses. Ibn Zuhr (1113-1162 CE) was the first to describe in detail the distinction between gastric ulcer and gastric malignancy. Ibn Sina wrote about colitis and its management by diet, drugs, and enema. Abu Imran Musa bin Maymun (1135-1204 CE) wrote about hemorrhoids and the role of diet and surgery in their treatment. Mohammad bin Mahmood Al-Qusum (circa 1525 CE) in his book ' Zad al Masir fi 'Ilaj Bawasir' wrote about treatment of piles. Ibn al Quff wrote about complications of hemorrhoidectomy and post-operative anal stricture. Al Zahrawi originated cauterisation treatment of fistula-in-ano and was aware of the complications of this treatment.

 

Plastic surgery: Al Zahrawi described the cauterisation treatment of harelip. He wrote that the edges must be freshened first before cautery.

 

Ear , Nose, and Throat: Al Zahrawi discovered the guillotine method of tonsillectomy as well as the complications of the operation. He described the tunors of the tonsil. Among discoveries attributed to al Zahrawi are: use of special osteotomies for nasal operations and polypectomy, use of a marine sponge with an attached string for removal of foreign bodied from the throat, removal of foreign bodies from ears, treatment of nasopharyngeal tumors by repeated excision and cauterisation.

 

Dentistry: Ibn al Quff described making artificial teeth from bone. A Zahrawi described several dental operartions: wiring of loose teeth, extraction of roots of broken teeth and broken pieces of the mandible by use of special forceps.

 

Thermal and chemical cauterization for syphilitic lesions by Ibn Sina

 

Tumors: The main contributor was Abdul Malik Ibn Zuhr (d. 484 H). Al Zahrawi and Ibn Sina recommended wide excision including healthy tissue in removal of tumors. Use of cautery and drugs in treatment of tunors was also described. 

 

Neuro-surgery: Both al Zahrawi and Ibn Quff described in detail the various intra-cranial and extra-cranial hemorrahges due to arrow wounds and their respective treatments. Al Zahrawi described symptoms and signs of skull fracture. He also described the depressed fracture in children and recommended treatment by removal of a bone. In cranial operations, the drill may accidentally perforate the delicate intra-cranial structure; Al Zahrawi developed an instrument to prevent this accidental penetration. Al Zahrawi's craniotomy operations were remarkably like modern ones; using burr holes with a linking cut between them allowing to raise part of the cranial vault. Al Zahrawi described paralysis due to injury of the spinal cord. Ali Abbas described several types of fractures: simple, comminuted, displaced, and hairline. Ibn Sina classified fractures of the skull into two types: closed fractures and open fractures. He described treatment of skull wounds by relieving hematoma or removing pieces iof bone that culd hurt the brain. Al Baghdadi described the depression fracture found in children. He also described meningoceles that remained after skull surgery and appeared during coughing.  Samarkandi described treatment of brain edema following skull trauma and its relief using dehydration, venesection, and enema.

 

HOSPITALS & MEDICAL COLLEGES:

Hospitals were built in Baghdad, Cairo, Andalusia, and Dimashq. Bimaristan al Adudi al Kabir was opened in Baghdad in 982 CE. Bimaristan al Nuri al Kabir was established in Cairo in 160 CE. The Salahi and Mansuri hospitals in Cairo.

 

MAJOR WRITINGS by MUSLIM PHYSICIANS

Al Qanun Fi Al Tibb By Abu Abdullah Ali Al Hussein Bin Abdullah Ibn Siina

 

Al Hawi: By Muhammad Ibn Zaariyyah Al Razi

 

Kitaab Al Manadhir By Ibn Haytham

 

Al Tasrif By Al Zahrawi. The book al Tasrif that took 30 years to compile is in 30 volumes. The last volume deals with surgery and is one fifth of the whole book. The volume on surgery is divided into three sections: (a) cauterisation with 56 chapters (b)  incisions, perforations, wounds & wound healing 93 chapters (c) bones setting and joints 36 chapters. The book contains anatomical details. It covered all branches of surgery. The book was used as a standard text in Europe and was translated into Latin in the 12th century CE.

 

Al Kafi By Abu Nasr Ibn Al Ayn Zarbi

 

Al Umdat Fi Sinat Al Jarahat  By Abu Al Farag Ibn Al Kufi (1233-1286 CE). The book consists of 20 maqalas of which maqala 17 is devoted to traumatology while maqala 19 discusses surgical problems and their treatment from head to foot.

 

Al Jirahat Al Kaniya By Sharaf Al Dddiin Ali

 

Kamil Al Sinaet Al Tibiyyat By Ali Ibn Abbas

 

Kitaab Al Kulliyaat By Ibn Rushd

 

Kitaab Zad Al Musafir Wa Quut Al Hadhir By Abu Yafar Ahmad Ibn Ibrahim Ibn Abi Hadir Al Jazzan

 

The Ten Articles On The Eye  By Hasan Ibn Ishaq

 

A Manual For The Oculist By Ali Ibn Isa

 

Al Taysir Li Man Ajaza ‘An Taliif By Abu Al Qasim Al Zahrawi

 

Kitab Al Shamil By Ibn Nafiis

 

Kitaab al Dhakhiirat by Ismail al jarjani in Persian

 

E. TRANSFER OF MEDICAL KNOWLEDGE TO EUROPE

While Muslim medicine was flourishing in West Asia, Europe was in the ignorance and decline of its middle ages. There were three routes of knowledge transfer from the Muslim world to Europe: through Italy, through Andalusia, and by the crusaders. Constatine Africanus (d. 1087 CE) translated the most important medical books from Arabic into Latin. This gave new life to the Salerno (Italy) school of medicine. After him more books were translated. Many medical texts that had been lost in Europe were rediscovered thanks to the translations made by Muslims. Books by Hunain Ibn Ishaaq, al Razi, Al Zahrawi, Ibn Sina, and Ibn Zuhr were translated into Latin and were used in Europe as texts for many years. Europeans came to study at Muslim institutions in Andalusia and took back the knowledge to Europe. Crusaders in the Near East found themselves in a more advanced Muslim civilization and took back many ideas with them to Europe.

 

Go to Part II

Omar Hasan Kasule, Sr.  October 2000