Journal - International Society for the History of Islamic Medicine

Plinio PRIORESCHI MEDICAL ETHICS IN MEDÝEVAL ISLAM
Hippocrates in regard to his oaths to carry out his
word. You must adhere to his oaths and go along with
his beliefs from which the oaths are derived since
these belong to the art of medicine. These must be
observed under all conditions (7).
And this about quacks:
Since medicine is the greatest in value of the arts
for the benefit of man, its legitimate practitioners are
of a noble and high rank, respected by the people.
Further, this art is confined to a private group; it is not
possible for everyone who seeks it to enter it. People,
by their nature, like to be in the upper class and to be
applauded; in this, there is no art above that of medicine.
It attracts the jealousy of those who have succeeded
into the high rank by the unsuccessful ones
who have evil complexions and error in their inborn
dispositions. Thus, they return to [the use of] cunning
against the people with many kinds of deceit.
You may see them in dress and garb like legitimate
physicians; the same is true for the way they
speak and in most of their affairs. They embellish
their offices and exhibit their instruments to hunt for
people as in setting a trap or a net for beasts. Because
of this calamity which intrudes in this art among its
practitioners, there arises doubt of some of them. As
a result, they are exposed to evil opinion by many
people. Galen, in his book, On Wonders in the
Superiority of Knowledge said, “As to what many
physicians see, O Efihanes, it is impossible for one to
proceed to warn about what happens to the ill, one by
one. This is because, the busier a physician is, the further
his conjecture is from the truth. This is a fact not
only in medicine but in other arts.” (6).
There are people who set out to become famous.
They learn to speak well, act well, incline toward
pleasure, blandishment, and permission with bowing
and submission every day to the wealthy and the city
authorities; they escort them from region to region,
go out to meet them when they come to the country,
and use cunning and laughter in groups. Some of
these people are not content with these things but
they also attempt to convince the public that they
deserve expensive dress, beautiful rings, many companions,
and silver vessels… Their purpose in general
is to conduct themselves like legitimate physicians
both in action and appearance so that people will be
convinced… There is no honesty in their treatment of
the ill or in the maintenance of [the health of] well
people; on the contrary, their activities cause illness
of healthy ones. As was stated previously, some of
them practice splitting, cauterization, etc., forcibly
handling organs when it is unnecessary. They cause
illness in the healthy so that treatment and curing are
necessary for a long time - even to the point of
death.This is not among Galen’s known works and
the name Efihanes is not found in Galenic literature.
Concerning remuneration, al-Ruhawi suggests
that the rich should be charged enough for medical
treatment to allow the poor to be treated for a small
fee or none at all (6).
It is of interest to quote al-Ruhawi’s interpretation
of the passage of the Hippocratic Oath about surgery
(6,7):
It is necessary that you obtain the advice of
Hippocrates who gave this admonition, “I do not visit
one who has a calculus in his urinary bladder; on the
contrary I leave him to one whose area is this specialty.”
It is not necessary for you to do this except in a case
of calculus distress. In similar ailments as that of the
eye [this is also true]. There are people who specialize
in these occupations so that you need not practice what
is not in your field; this would only harm the ill (1).
It is evident that al-Ruhawi, like Usaybia, clearly
realized that the Oath’s prohibition about surgery
referred only to the cutting of the stone and not to
surgery in general (6). In addition, it is worth noting
that the prohibition against the cutting of the stone is
interpreted by al-Ruhawi as an exhortation for the
physician to seek the help of the more skilled unless
the patient is in acute distress.
Very often, the ethical rules for the physician were
associated with the ideal physical characteristics that
the physician was supposed to possess. Ibn Hubal
(1117-1213), (1) in his Kitab al-Mukh tarat fi l-tibb
(“Book of What is Best in Medicine,” also referred to
as “Anthology of Medicine”), described the desirable
physical characteristics of a doctor:
Regarding what should be desired in a student of
this profession, he should be of attractive appearance
46 JISHIM 2004, 3