Islamic Medicine History and Current Practice - International Society ...

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