Child Health as Viewed by Ibn-Sina - International Society for the ...

Child Health as Viewed by Ibn-SinaAbdul Nasser KAADAN, MD, PhD** Head of History of Medicine Department, Institute for the History of Arabic Science, Aleppo University, Aleppo - SyriaThe Secretary General of ISHIM (www.ishim.net).P.O. Box: 7581, Aleppo, SyriaE-mail: a.kaadan@scs-net.orgSummaryIbn-Sina, or Avicenna as known in the west, was born in the year 980 A. D. in Afshana near Bukhara in Turkistan, which is nowcalled Uzbekistan. He left Bukhara when he was 21 years of age, and spent the rest of his life in various towns in Persia. He composed276 works; all of them written in Arabic except very few small books written in his mother tongue Persian. Al-Qanun Fit-tib(or Code of Laws in Medicine) represents the most important work of Ibn-Sina, and as Osler described it, the most famous medicaltextbook ever written. In the first book Ibn-Sina devoted a special part for talking about children bringing up and their diseases, andhe called it (The first education in bringing up). This part consists of four chapters: The first chapter is for the management of thenewborn until the walking age. In the second chapter he talks about milk feeding, the characters of the good wet nurse and weakling.In the third chapter he talked about pediatric diseases and their treatments. The fourth chapter was devoted to children managementuntil adulthood.In al-Orjozah fi-ttib, Ibn-Sina devoted fifty-six verses for talking briefly about prenatal and postnatal care, delivery, newborn babycare and how to choose the suitable wet nurse.The aim of this study is to highlight child health as viewed by Ibn-Sina, and to present his contribution in this field of medicine.Ibn SinaIbn-Sina, or Avicenna as known in the west, wasborn in the year 980 A. D. in Afshana near Bukharain Turkistan, which is now called Uzbekistan. He leftBukhara when he was 21 years of age, and spent therest of his life in various towns in Persia. When hedied in the year 1037 he was known as one of thegreatest philosopher in Islam, and in Medicine hewas highly regarded that he was compared to Galen,so he was known as the Galen of Islam. Because ofhis great celebrity, many nations disputed and competedto celebrate his anniversary. Turkish were thefirst who revive his anniversary in 1937, when theyheld a great meeting for the occasion of nine hundredyears since his death. Then Arabs and Iranians followedthem by holding two festivals in Baghdad in1952, then in Tehran in 1954. To appreciate his contributionin developing the philosophical and medicalsciences, in 1978 UNESCO invited all its members tocelebrate the anniversary of one thousand years sincehis birth. All the members participated in the celebration,which was held in 1980.Ibn-Sina composed 276 works; all of them writtenin Arabic except very few small books written inhis mother tongue Persian. Unfortunately, most ofthese works were lost, but there are still 68 books ortreatises available in the eastern and westernlibraries. He composed in all branches of science, buthe was more interested in philosophy and medicine.Some recent historians consider him as a philosophermore than a physician, but others consider him as aprince of the physicians during the Middle Ages.The classification of Ibn-Sina works according totheir content is as follow:43 works in medicine, 24 in philosophy, 26 inphysics, 31 in theology, 23 in psychology, 15 inmathematics, 22 in logic, 5 in the Holy Koran interpretation.In addition, many treatises in asceticism,love, music and some stories.Al-Qanun Fit-tib: (or Code of Laws in Medicine)represents the most important work of Ibn-Sina,which is written in Arabic, and as William Oslerdescribed it, the most famous medical textbook everJISHIM 2003, 237

Abdul Nasser KAADANCHILD HEALTH AS VIEWED BY IBN-SINAwritten. This book is considered a unique reference ordocument containing all medical knowledge, as itaccumulated through many civilizations until thetime of Ibn-Sina himself.In his way of explanation Ibn-Sina was very closeto the way which modern medical textbooks followregarding classification, causes of diseases, epidemiology,symptoms and signs, treatment and prognosis.In this respect we can say that the excellence in itsarrangement and comprehensiveness made al-Qanunbook the most widespread in the Islamic andEuropean countries. Al-Qanun book was known tothe Europeans through the Latin translations ofGerard of Cremona in the 15 th century, and remainedin use in medical schools at Louvain and Montpellieruntil the 17 th century, and according to the Journal ofUNESCO, October issue, 1980, the Qanun bookremained in use in Brussels University until 1909.By the 12 th century awareness set in that thesecompendia were too large to be really useful forready reference. Consequently, epitomes of theQanun were produced to make the ideas more quicklyaccessible, and commentaries were written to clarifythe contents. The most popular of all the epitomeof the Qanun was that called Kitab al-Mujiz fil Tibbor the Concise Book in Medicine. It was written inSyria by Ibn-al-Nafis, who died in 1288.Ibn-Sina begins his book al-Qanun by definitionmedicine by saying: Medicine is a science, fromwhich one learns the states of the human body, withrespect to what is healthy and what is not, in order topreserve good health when it exists, and restore itwhen it is lacking.Al-Qanun book consists of five books, the firstconcerned with general medical principles. The secondwith materia medica. The third with diseasesoccurring in a particular part of the body. The fourthon diseases not specific to one bodily part (such asfevers), in addition, to traumatic injuries such as fracturesand dislocations of bones and joints. With thefinal book containing a formula giving recipes forcompound remedies.In the first book Ibn-Sina devoted a special partfor talking about children bringing up and their diseases,and he called it (The first education in bringingup). This part consists of four chapters:The first chapter is for the management of thenewborn until the walking age. In this chapter we canfind the concepts of Ibn-Sina and all other physiciansbefore him regarding issues, which are necessary tobe carried out for every newborn baby. He says thatafter delivery the umbilical cord should be cut for adistance of four fingers breadth, and ligated by usinga wool string, then a bandage dipped by oil appliedon. All of his body should be washed, with a necessityof dropping inside his eyes, and the nose orificesshould be cleaned. Then Ibn-Sina talked about thenewborn bathing, dressing and sleeping.In the second chapter he talks about milk feeding,the characters of the good wet nurse and weakling. Inthis regard Ibn-Sina stresses on the necessity of doingall efforts to keep the newborn on his mother milkfeedingas possible, because it is in its essence likehis feeding during the embryonic stage. Regardingweakling Ibn-Sina says that it should be gradually,and should be given first light foot such as light meetwith soup. Then he stressed on the necessity of notenforcing the baby to sit or stand before he could performthat by him self.In the third chapter he talked about pediatric diseasesand their treatments. Among these diseases are:gum tumors, aphtha, xophthalmous, thrush, ear painand discharge, difficult breathing, cough, commoncold, throat tumors, diarrhea, vomiting, hiccup,abdominal cramp, rectal prolapse, tenismus, worms,crying, sleeping disorders, bad dreams.The fourth chapter was devoted to children managementuntil adulthood. In this chapter Ibn-Sinatalks about the moral and emotional education of thechildren, revealing his opinions in this regard.In the other chapters of al-Qanun book we canfind some remarks related to pediatric diseases suchas: bed wetting, convulsions, measles, smallpox andsome congenital deformities.When he talked about traumatic dislocation of thehip, Ibn-Sina says that this dislocation may developbefore or just after delivery, mentioning to what isknown now congenital dislocation of the hip.Al-orjozah fi-ttib (Medicine in a poem)This is considered the second most importantmedical works of Ibn-Sina after al-Qanun. Ibn-Sina38 JISHIM 2003, 2

CHILD HEALTH AS VIEWED BY IBN-SINAAbdul Nasser KAADANcomposed a popular poem included all branches ofmedicine in a very interesting and easy way. This iscalled Orjozah (taken from the name of the poemmeter or measure, which is called al-Rajaz). Indeed,many Orjozah are attributed to Ibn-Sina, but the mostfamous one is the long poem and consists of 1337verses. The next famous Orjozah consists of 146verses in which Ibn-Sina talked about health managementin the four seasons.The long Orjozah is considered as a revision of al-Qanun book, and Ibn-Sina intended to make it as aquick reference for the medical students, in additionto be easily memorized.Ibn-Sina divided this poem into two parts, the firstone is theoretical, while the second is practical exactlyas he did in his book al-Qanun.Many medical students in the middle ages benefitedbecause of this Orjozah. Ibn-Zuhr praised it andsaid it contained the most important medical principles,so it is possible to dispense with so many othermedical textbooks.The Orjozah explanations: Ibn-Sina Orjozahcontains some clear verses and easily to be understood,while some others contains difficult meaningsfor many medical students. The first who composedan explanation for it was Ibn-Rushd who died in1198. After that some explanations were appeared,but the most famous are:1. Al-Sharif al-Sakalli explanation, who died in 1434.2. Musa Ibn-Ibrahim explanation, who died in 1465.3. Muhammad Ibn-Ismail, who died in 1575.4. Muhammad al-Jabali, who died in 18655. Dr. Shebli al-Shameel, who died in 1887.Translation of the Orjozah into Latin and Hebraic:Gerard of Cremona translated this Orjozah intoLatin in the year 1180. The first translation intoHebraic was carried out in the year 1265 by SulimanIbn-Yousef al-Garnati, a copy of this translation iskept in the National Library of Paris under the number1135. Another translation into Hebraic wasaccomplished by Musa Ibn-Tabbon; a copy is kept inthe British Museum under the number 893.Ibn-Sina begins the long Orjozah:While he begins the second Orjozah which is devoted for talking about health preserve during the four seasons:Ibn-Sina devoted fifty-six verses for talking briefly about prenatal and postnatal care, delivery, newbornbaby care and how to choose the suitable wet nurse.Regarding prenatal care he says:JISHIM 2003, 239

Abdul Nasser KAADANCHILD HEALTH AS VIEWED BY IBN-SINADuring labor:In choosing the wet nurse:40JISHIM 2003, 2

CHILD HEALTH AS VIEWED BY IBN-SINAAbdul Nasser KAADANIn the management of the child during the nursing period:At the end, I would like to conclude my presentationby a word of truth, written by the European doctorDe Poure who declared: Medicine was absent tillHypocrites created it, dead till Galen revived it, dispersedtill Rhazes collected it, deficient till Avicennacompleted it. Also, in the west it has been said: anyone who wants to be a good doctor must beAvicennist.REFERENCES1 Al-Baba MZ: Some of Medical Books Edited by Ibn Sina.Institute for History of Arabic Science-Aleppo University,Aleppo-Syria, 1984.2. Al-Baba MZ: History and Legislation of Pharmacy, p. 344,Damascus University, Damascus-Syria, 1986.3. El- Shatti Shevket, History of Medicine, University ofDamascus, 1960.4. Ibn-Sina: Al-Qanun fit-Tibb. Vol. 3, P. 197, Dar Sader,Lebanon, 1980.JISHIM 2003, 2 41