Islamic Medicine History and Current Practice - International Society ...
Islamic Medicine History and Current Practice - International Society ... Islamic Medicine History and Current Practice - International Society ...
ISLAMIC MEDICINE HISTORY AND CURRENT PRACTICEHusain F. NAGAMIAcalled ‘Tasrif’. It comprised of thirty volumes. Theinitial volumes dealt with general principles, elementsand physiology of humors and the rest dealwith systematic treatment of diseases from head tofoot. The last volume is perhaps the most importantin that it deals with all aspects of Surgery. It was thefirst textbook of Surgery with illustration of instrumentsused in Surgery to be ever published. It gainedsuch great fame that it became the standard textbookof surgery in prestigious universities in the west andwas most widely read. He emphasized that knowledgeof Anatomy and physiology was essential priorto undertaking any surgery: ‘Before practicing surgeryone should gain knowledge of anatomy and thefunction of organs so that he will understand theirshape, connections and borders. He should becomethoroughly familiar with nerves muscles bones arteriesand veins. If one does not comprehend the anatomyand physiology one can commit a mistake whichwill result in the death of the patient. I have seensomeone incise into a swelling in the neck thinking itwas an abscess, when it was an aneurysm and thepatient dying on the spot.’Some operations describedby him are carried out even today in the manner hedescribed them almost 1000 years ago!. These wouldinclude operations on varicose veins, reduction ofskull fractures, dental extractions , forceps deliveryfor a dead fetus to mention just a few. Surgery wasraised to a high level of science by him, at a timewhen the Council of Tours in Europe declared in1163 AD:’Surgery is to be abandoned by all schoolsof medicine and by all decent physicians’However the greatest physician of the Islamic erawas Avicenna or Ibn Sina his full name being:‘AbuAli al-Husayn ibn Abdallah ibn Sina’. Some historiansof medicine acclaim him to be the greatest physicianthat has ever lived . That is because Ibn Sina wasnot only a physician par excellence but his knowledgeand wisdom extended to many other branches ofscience and culture including philosophy, metaphysics,logic, and religion. As a result of his greatwisdom, he has been awarded the titles: al-Shaykh al-Rais (The chief master) and al-Muallim al-Thani (thesecond philosopher after Aristotle)..Ibn Sina was indeed a prodigy. At the age of 10 hehad memorized the whole Quran.By age of 16 he hadmastered all extant sciences that appealed to himJISHIM 2003, 2including mathematics, geometry, Islamic law, logic,philosophy and metaphysics. By age 18 he taught himselfall that was to learn in medicine. Born in city ofBokhara in what is now central Asia in the year 370AH/980 AD he rapidly rose in ranks and became thevizier (prime minister) and court physician of theSamanid ruler of Bukhara Prince Nuh ibn-Mansur.TheRoyal Library was opened to him and this enlarged theknowledge of Avicenna to new dimensions. He beganwriting his first book at age 21. In all, in the short spanof 30 years of writing this man had written over a 100books of which 16 were on medicine. His magnumopus is one of the classics of medicine ever written.The Canon of medicine as it became known in thewest was written with the title of ‘Kitab al-Qanun fi al-Tibb’. This voluminous compendium of medicalknowledge revealed one written earlier by al-Razi andal-Majusi and indeed surpassed both of these in thecontent and originality. It was composed of five volumes:Volume I contained the general principlesVolume II Simple drugs Volume III Systematicdescription of diseases from head to foot Volume IVgeneral maladies viz fevers and Volume V Compounddrugs. The Canon was translated into Latin by Gerardof Cremora and Andrea Alpago and remained the standardtextbook of medicine in Louvain and Montpellieruntil the 17 th Century. A complete copy is in thearchives of National Library of Medicine in Bethesda,Maryland. The effects of the systematic collection ofhitherto unorganized Greco-Roman medicine andadding to it by personal observation and experimentationof these physician brought medicine to a new pinnaclesof practice.Writes Prof. Emile Savasge Smith, professor of historyat the Welcome Library of Medicine in a monographthat accompanied an exhibition of the oldestArabic manuscripts in collection at the NationalLibrary of Medicine: ‘The medicine of the day was sobrilliantly clarified by these compendia (especiallythose of Ibn Sina and al-Majusi) and such order andconsistency was brought to it that a sense of perfectionand hence stultifying authority resulted.’The Basic Sciences in Islamic MedicineContrary to popular belief, basic sciences werehighly developed in Islamic Sciences. For instanceOriental historians of Medicine have erroneously27
Husain F. NAGAMIAISLAMIC MEDICINE HISTORY AND CURRENT PRACTICEemphasized that science of anatomy, during theIslamic era was rudimentary ,and did not progressmuch further than the discoveries already made anddescribed by the Greeks or ‘the ancients’. It was popularlyheld that the Islamic physicians did not challengethe anatomic concepts of the ‘ancients’.Secondary to the religious proscription of dissectionand thus lacking in their own observations they reliedheavily on observations of Galen, Aristotle, Paul ofAgaeia and other Greek sources. However afterrecent discoveries of manuscripts by an EgyptianPhysician Mohiuddin al-Tatawi, that had been hethertounsrutinized, it has become evident that IslamicPhysicians not only possesed excellent knowledge ofanatomy but they added some challenging new conceptsthat were revolutionary to the then understandingof anatomical concepts laid down by the‘ancients’. The example that has now become wellknown is that of the discovery of the lesser or pulmonarycirculation by Ibn Nafis (d 687 AH/1288 AD)Until then the credit of the discovery of the lesser circulationwas given to Servetus and Colombo, whodescribed it in much similar terms as Ibn Nafis onlytwo hundred years later. The description given of thepulmonary circulation by Ibn Nafis challenged thefundamental concept held by Galen. In fact it suggestedthat there existed a pulmonary capillary bedwhere the blood was ‘purified ‘ before being broughtback to the heart by the pulmonary artery, thus predatingthe discovery of pulmonary capillaries longafterwards, following the discovery of the microscopeby Anthony Von Luwenheek.. It has to be notedthat it has been documented that Ibn Masawaih or‘Masseuse Senior’ his latinized name had with thespecial permission of the Caliph built a house on theirbanks of the river Tigris where he dissected apes, tolearn their anatomy and extrapolated the informationto human anatomy. That the knowledge of anatomywas pre-requisite for the surgeon has been emphasizedby Al-Zahrawi in the surgical section of hisbook ‘Tasrif’ where he writes in the introduction:‘Now this is the reason why there is no skilfuloperator in our day: the art of medicine is long andit is necessary for its exponent, before he exercises it,to be trained in anatomy as Galen has described it,so that he may be fully acquainted with the uses,forms, temperament of the limbs; also how they arejointed, and how they may be separated, that heshould understand fully also the bones, tendons andmuscles, their numbers and their attachments; andalso the blood vessels both the arteries and the veins,with their relations. And so Hippocrates said: ‘Though many are doctors in name, few in reality,particularly on the surgical side.’As regards the physiological concepts embodiedin the Islamic Medicine they were based on theHippocratic and Galenic concepts of elementsnatures and humors. The theory expounded beingthat harmony in the body prevails when all thehumors are in proper balance and it is their imbalancethat creates disease. Under this principle then, diseaseis a state of imbalance of humours and needs therestoration of balance, to bring the organism back toits normal healthy state. Under modern medicinesuch a concept would be unacceptable or at leastuntenable; because in modern medicine causation ofdisease is related to etiological agents or factors.However it was Claud Bernard’s concept of the‘milleu interior’ which can in modern terms be comparedto the Jabirean concept of innate harmony asexpanded by Islamic medicine. In order to furtherexemplify the factors affecting this balance the theoryof Islamic Medicine expounds the concept of elementsand temperaments. Basic elements are brokeninto: earth , fire, air and water and each of these isgiven a temperament: viz earth is dry and cold; wateris humid and cold; fire hot and dry heat, air is humidand hot. Even further each of the four essential bodyfluids like blood, phlegm, yellow bile and black bileare assigned a respective temperament. Each dietaryfood, medicine or climatic environment can thus thenmodify or temper the humors of the body and it is aninterplay of these that can restore health from sicknessor cause the sickness to worsen.Such a theory was understandably ill understoodand even laughed at and ridiculed by the scientists ofthe west. Yet the same scientists have now begun tolook at the human organism from different insights.To give an example: until recently the theoriticalbasis of Accupuncture would not have been acceptableto any physician trained by principles of westernor modern medicine and yet today this is beinglooked at with new insight and accepted because the28 JISHIM 2003, 2
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ISLAMIC MEDICINE HISTORY AND CURRENT PRACTICEHusain F. NAGAMIAcalled ‘Tasrif’. It comprised of thirty volumes. Theinitial volumes dealt with general principles, elements<strong>and</strong> physiology of humors <strong>and</strong> the rest dealwith systematic treatment of diseases from head tofoot. The last volume is perhaps the most importantin that it deals with all aspects of Surgery. It was thefirst textbook of Surgery with illustration of instrumentsused in Surgery to be ever published. It gainedsuch great fame that it became the st<strong>and</strong>ard textbookof surgery in prestigious universities in the west <strong>and</strong>was most widely read. He emphasized that knowledgeof Anatomy <strong>and</strong> physiology was essential priorto undertaking any surgery: ‘Before practicing surgeryone should gain knowledge of anatomy <strong>and</strong> thefunction of organs so that he will underst<strong>and</strong> theirshape, connections <strong>and</strong> borders. He should becomethoroughly familiar with nerves muscles bones arteries<strong>and</strong> veins. If one does not comprehend the anatomy<strong>and</strong> physiology one can commit a mistake whichwill result in the death of the patient. I have seensomeone incise into a swelling in the neck thinking itwas an abscess, when it was an aneurysm <strong>and</strong> thepatient dying on the spot.’Some operations describedby him are carried out even today in the manner hedescribed them almost 1000 years ago!. These wouldinclude operations on varicose veins, reduction ofskull fractures, dental extractions , forceps deliveryfor a dead fetus to mention just a few. Surgery wasraised to a high level of science by him, at a timewhen the Council of Tours in Europe declared in1163 AD:’Surgery is to be ab<strong>and</strong>oned by all schoolsof medicine <strong>and</strong> by all decent physicians’However the greatest physician of the <strong>Islamic</strong> erawas Avicenna or Ibn Sina his full name being:‘AbuAli al-Husayn ibn Abdallah ibn Sina’. Some historiansof medicine acclaim him to be the greatest physicianthat has ever lived . That is because Ibn Sina wasnot only a physician par excellence but his knowledge<strong>and</strong> wisdom extended to many other branches ofscience <strong>and</strong> culture including philosophy, metaphysics,logic, <strong>and</strong> religion. As a result of his greatwisdom, he has been awarded the titles: al-Shaykh al-Rais (The chief master) <strong>and</strong> al-Muallim al-Thani (thesecond philosopher after Aristotle)..Ibn Sina was indeed a prodigy. At the age of 10 hehad memorized the whole Quran.By age of 16 he hadmastered all extant sciences that appealed to himJISHIM 2003, 2including mathematics, geometry, <strong>Islamic</strong> law, logic,philosophy <strong>and</strong> metaphysics. By age 18 he taught himselfall that was to learn in medicine. Born in city ofBokhara in what is now central Asia in the year 370AH/980 AD he rapidly rose in ranks <strong>and</strong> became thevizier (prime minister) <strong>and</strong> court physician of theSamanid ruler of Bukhara Prince Nuh ibn-Mansur.TheRoyal Library was opened to him <strong>and</strong> this enlarged theknowledge of Avicenna to new dimensions. He beganwriting his first book at age 21. In all, in the short spanof 30 years of writing this man had written over a 100books of which 16 were on medicine. His magnumopus is one of the classics of medicine ever written.The Canon of medicine as it became known in thewest was written with the title of ‘Kitab al-Qanun fi al-Tibb’. This voluminous compendium of medicalknowledge revealed one written earlier by al-Razi <strong>and</strong>al-Majusi <strong>and</strong> indeed surpassed both of these in thecontent <strong>and</strong> originality. It was composed of five volumes:Volume I contained the general principlesVolume II Simple drugs Volume III Systematicdescription of diseases from head to foot Volume IVgeneral maladies viz fevers <strong>and</strong> Volume V Compounddrugs. The Canon was translated into Latin by Gerardof Cremora <strong>and</strong> Andrea Alpago <strong>and</strong> remained the st<strong>and</strong>ardtextbook of medicine in Louvain <strong>and</strong> Montpellieruntil the 17 th Century. A complete copy is in thearchives of National Library of <strong>Medicine</strong> in Bethesda,Maryl<strong>and</strong>. The effects of the systematic collection ofhitherto unorganized Greco-Roman medicine <strong>and</strong>adding to it by personal observation <strong>and</strong> experimentationof these physician brought medicine to a new pinnaclesof practice.Writes Prof. Emile Savasge Smith, professor of historyat the Welcome Library of <strong>Medicine</strong> in a monographthat accompanied an exhibition of the oldestArabic manuscripts in collection at the NationalLibrary of <strong>Medicine</strong>: ‘The medicine of the day was sobrilliantly clarified by these compendia (especiallythose of Ibn Sina <strong>and</strong> al-Majusi) <strong>and</strong> such order <strong>and</strong>consistency was brought to it that a sense of perfection<strong>and</strong> hence stultifying authority resulted.’The Basic Sciences in <strong>Islamic</strong> <strong>Medicine</strong>Contrary to popular belief, basic sciences werehighly developed in <strong>Islamic</strong> Sciences. For instanceOriental historians of <strong>Medicine</strong> have erroneously27
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