Contribution of Islam to Medicine [Electronic resources] نسخه متنی

Arab chemist Jabir Ibn- Hayan discovered sulphuric and nitric acids.
According to Webster Dictionary, the words sugar, alcohol, alkali,
syrup, coffee, cotton, all are Arabic words. Fielding H. Garrison,
the author of the well-known work on the "History of Medicine" said:
"...The Saracens themselves were the originators not only of
algebra, chemistry, and geology, but of many of the so- called
improvements or refinements of civilization, such as street lamps,
window-panes, firework, stringed instruments, cultivated fruits,
perfumes, spices, etc... "

2. High prestige of
physicians: The physicians in this era earned a high prestige.
Although anyone, irrespective of his social status, can study
medicine, yet the route was long and tedious. He had to finish
Islamic studies, philosophy, astronomy, art, chemistry, etc. before
being accepted as a medical student. Therefore, the physician was a
cultured person who had wisdom and knowledge. In fact, the Arabic
translation of a physician is "Hakim" which means sage. In the 9th
and 10th century, the Court- Physician was in the protocol ahead of
the Chief-Justice. Many eminent physicians, as we will discuss
later, showed enough talent, social knowledge, political
capabilities, and wisdom to be appointed by the Caliphs as prime
ministers (Visiers). Owing to the high prestige and connections of
physicians, generous funds for hospitals were easily
obtained.

3. Rulers'
involvement in public services: The Caliphs of the Islamic empire
built magnificent hospitals for one or more of the following
reasons:

a. Religion: Their
religion stated that money spent on charity is a good investment for
Judgment Day.

b. Eternity: The
Pharoahs of Ancient Egypt sought eternity by building pyramids, the
rulers of Islam sought the same thing by building mosques,
hospitals, and schools carrying their names.

c. Politics: To
show their people that they cared, and were interested in them, the
rulers built hospitals.

Whatever the motive
of the ruler, the population benefited and good hospitals were
erected.

4. Adequate
financing to run the hospitals:The rulers set aside generous funds
to run these hospitals. Also the philanthropists gave generously,
thus following their religious beliefs and imitating their rulers.
In Islam, there is a special system called Al-Waqf. A person can
donate part or all of this wealth to charity. The government takes
care of such a donation, and its revenues help to maintain and build
mosques, hospitals, and schools. Another source of funds and an
important pillar of Islam is alms-giving (2 1/2% of property value).
Collected alms goes to the state treasury which takes care of
charitable organizations. Very few hospitals in the Islamic era were
private. Thus, patients fees constituted an unimportant source of
funding.

Specific Hospitals

The capital of the
Islamic empire kept changing from one dynasty to the other. In each
capital, an important medical center developed. Thus, by the end of
the 13th century, there were many medical centers spread throughout
the Arab world. Space does not allow the description of all the
hospitals built throughout these centuries. We, therefore, chose
some of the important ones which will be described according to the
region where they were developed.

1. In
El-Sham

El-Sham at that
time included what is known now as Syria, Lebanon, Jordan, and
Palestine, Damascus and Jerusalem were the important cities.

a. In Damascus: The
first known hospital in Islam was built in Damascus in 706 A.D. by
the Umayyad Caliph, Al-Walid (Hamarneh 1962). The most important
hospital built in Damascus in the middle ages was named Al-Nuri
Hospital, after King Nur Al-Din Zinki, in 1 156. This hospital was
built during the Crusade Wars to fulfill a need for a well-equipped
and well-staffed hospital. It turned out to be not only a first
class hospital, but also a first class medical school.

The king donated to
the hospital a whole library rich in medical books. It is important
to understand why books were expensive and limited in number in the
middle ages. This was because they were hand-written as printing was
not used until the middle of the fifteenth century. The hospital
adopted medical records, probably the first first in history. From
its medical school, many eminent physicians graduated, an example is
Ibn Al-Nafis, the scholar who discovered the pulmonary circulation
as will be discussed. The hospital served the people for seven
centuries and parts of it still exist.

b. In Jerusalem: In
1055 A.D., the Crusaders built Saint John Hospital. By the end of
the eleventh century, it grew to such an extent to include a
hospital, a palace for knights, and a convent for the nursing
sisters. The medical activities of the hospital were tremendous
because of the large number of daily admissions of patients,
pilgrims, and wounded soldiers. After the liberation of Jerusalem by
Salah Al-Din in 1187 A.D., the hospital name was changed into
Al-Salahani Hopital. He expanded the hospital which continued to
serve the people until its destruction by an earthquake in 1458
A.D.

2. In Iraq and
Persia: In 750 A.D., Baghdad was built to be the capital of the
Abbasid dynasty by the Calip Abu-Gaifar Al- Mansur. In 766 A.D., he
assigned the dean of the medical school of Jindi Shapur, Judis
Ibn-Babtishu', to be the Court- Physician and to establish hospitals
proportionate to the glory and prosperity of Baghdad.

When Harun
Al-Rashid followed (786-809 A.D.), he ordered the grandson of
Ibn-Bahtishu and his Court-Physician, Jibril, to build a special
hospital named Baghdad Hospital. This hospital developed into an
important medic center. One of its chiefs was Al-Razi, the eminent
Internist.

In 918 A.D., the
Caliph Al-Mugtadir built two hospitals in Baghdad. One was on the
east side of the city which he named Al-Sayyidah Hospital, after his
mother. The other was on the west side which he named, Al- Mugtadiri
Hospital, after himself.

Another important
hospital was named Al-Adudi Hospital. It was built in 981 A.D. after
King Adud Al-Dawlah. It was the most magnificent hospital built in
Baghdad before modern time. The Caliph wanted to outdo his
predecessors. It was furnished with the best equipment and supplies
known at the time. It had interns, residents, and 24 consultants
attending its professional activities. Haly Abbas, who wrote the
famous book "Liber Regius (Al-Malaki)", was one of the staff. It was
destroyed in 1258 when the Mongols, led by Holagu the grandson of
Ghingiz Khan, invaded Baghdad.

3. In Egypt:

In 872 A.D., Ahmed
Ibn-Tulun built a hospital called Al-Fusta Hospital in the City
Al-Fustat which is now in old Cairo. It served the growing Cairo
population for six centuries. It was divided into separate wards. On
admission, the patients were given special apparel while their
clothes, money, and valuables were stored until the time of their
discharge.

In 1284 A.D., King
Al-Mansur Qalawun built an important hospital named
Al-MansuriHospital . The story behind its construction is
interesting. King Al-Mansur Qalawun was an officer in the Arabian
army fighting the Crusaders. While in the Holy Land, he fell sick
and was admitted to Al- Nuri Hospital. On recovery, he vowed that if
he ever became the ruler of Egypt, he would build a great hospital
in Cairo even more magnificent than Al-Nuri Hospital for, the sick.
poor, and rich alike. At the dedication ceremony, he asked for a cup
of wine from the pharmacy. After drinking it he declared that by
taking that portion as a medication, he was signifying that the
hospital was serving all people. from the king to the least of his
subjects (Hamarneh 1962).

e. It was the best
hospital built then as reported by the contemporary historians such
as Ibn-Battota and El-Kalkashandi. It had different sections for
different diseases. Music therapy was used as a line of treatment
for psychiatric patients. It served 4,000 patients daily. The
patient's stay in the hospital was free moreover on his discharge,
the patient was given food and money for compensation for being out
of work during his hospital stay. Al-Mansuri Hospital has served
Cairo for seven centuries since it has been built. It is now used
for ophthalmology and called Mustashfa Qalawun. Its ancient door is
preserved in the Islamic Museum of Cairo.

4. In North Africa
(Al-Maghrib Al-Arabi):

a. Tunisia: In 830
A.D., Prince Ziyadat Allah I, built Al-Qayrawan Hospital in a
district of the Qayrawan city called Al-Dimnah. Subsequently all
hospitals in Tunisia were called Dimnah instead of Bimaristan as
they were called in the East, which is a Persian word meaning a
hospital. The Qayrawan Hospital was characterized by spacious
separate wards waiting rooms for visitors and patients, and female
nurses from Sudan, an event representing the first use of nursing in
Arabic history. The hospital also included a chapel for
prayers.

b. Morocco: In 1190
A.D., the king Al-Mansur Ya'qub Ibn-Yusuf, built a hospital in the
capital city, Marakesh, named it the Marakesh Hospital. It was a
huge hospital beautifully landscaped with fruit trees and flowers.
Water was brought by aqueducts to all sections. Patients were
provided with special apparel: one for winter and another for
summer. The pharmacy was taken care of by specialists called the
Sayadlah. There was an expensive private section where a patient was
charged what is equivalent to $ 1501 day. One thousand years ago,
this fee was quite expensive.

5. Al-Andalus
(Spain):

In 1366 A.D.,
Prince Muhammed Ibn-Yusuf Ibn Nasr, built the Granada Hospital in
the city of Granada which had expanded to half a million population.
The hospital represented the beauty of the Arabic architecture in
Spain and served the people until the fall of Granada in 1492
A.D.

Method of Therapy in Islamic Medicine

The patients were
treated through a scheme starting with physiotherapy and diet; if
this failed, drugs were used, and at last, surgery would be resorted
to. The physiotherapy included exercises and water baths. The Arabs
had an elaborate system of dieting and were aware of food
deficiencies. Proper nutrition was an important item of
treatment.

Drugs were divided
into two groups: simple and compound drugs. They were aware of the
interaction between drugs; thus, they used simple drugs first. If
these failed, compound drugs were used which are made from two or
more compounds. If these conservative measures failed, surgery was
undertaken.

Medical Ethics in Islam

The medical
profession was a well respected specialty and its Ieaders kept it
this way by laying down proper ethics. Al-Tabari, the chief
physician in 970 A.D., described the Islamic code of ethics as
follows (Hamamch 1971, Levy 1967):

I. Personal
characters of the physician:

The Physician ought
to be modest, virtuous, merciful, and un addicted to liquor. He
should wear clean clothes, be dignified, and have well- groomed hair
and beard. He should not join the ungodly and scaffers, nor sit at
their table. He should select his company to be persons of good
reputation. He should be careful of what he says and should not
hesitate to ask forgiveness if he has made an error. He should be
forgiving and never seek revenge. He should be friendly and
peacemaker. He should not make jokes or laugh at the improper time
or place.

II. His obligation
towards patients:

He should avoid
predicting whether a patient will live or die, only God (Allah)
knows. He ought not loose his temper when his patient keeps asking
questions, but should answer gently and compassionately. He should
treat alike the rich and the poor, the master and the servant, the
powerful and the powerless, the elite and the illiterate. God will
reward him if he helps the needy. The physician should not be late
for his rounds or his house calls. He should be punctual and
reliable. He should not wrangle about his fees. If the patient is
very ill or in an emergency, he should be thankful, no matter how
much he is paid. He should not give drugs to a pregnant woman for an
abortion unless necessary for the mother's health. If the physician
prescribes a drug orally, he should make sure that the patient
understands the name correctly, in case he would ask for the wrong
drug and get worse instead of better. He should be decent towards
women and should not divulge the secrets of his
patients.

III. His obligation
towards the community:

The physician
should speak no evil of reputable men of the community or be
critical of any one's religious belief.

IV. His obligations
towards his colleagues:

The physician
should speak well of his acquaintances and colleagues. He should not
honor himself by shaming others. If another physician has been
called to treat his patient, the family doctor should not criticize
his colleague even if the diagnosis and the recommendations of the
latter differ from his own. However, be has the obligation to
explain what each point of view may lead to since his duty is to
counsel the patient as best as he can. He must warn him that
combining different types of therapy may be dangerous because the
actions of different drugs may be incompatible and
injurious.

V. His obligations
towards his assistants:

If his subordinate
does wrong, the physician should not rebuke him in front of others,
but privately and cordially.

ISLAMIC PHYSICIANS

Medicine in Islam
passed through three stages:

I. The first stage
is the stage of translation of foreign sources into Arabic. It
extended mainly during the seventh and eighth
centuries.

II. The second
stage is the stage of excellence and genuine contribution in which
the Islamic physicians were the leaders and the source of new
chapters to medicine. This stage extended during the ninth through
the thirteenth centuries.

III. The third
stage is the stage of decline where medicine, as well as other
branches of science, became stagnant and deteriorated. The stage
started mainly after the thirteenth century.

During the first
stage, Syrian and Persian scholars did a marvelous job by
translating honestly the ancient literature from Greek and Syriac in
Arabic. Thcy translated different branches of science including
philosophy astrology, and medicine. The works of Hippocratcs
(460-370 BC), Aristototle (384-322 BC), and Galen (131-210 A.D.)
were among those translated From Arabic, the classic Greek
literature was translated into Latin, then into Greek because most
of the original scripts were lost and the only source was the Arabic
translation.

If the Arabs did
only one thing, namely, preserving the ancient literature and
handing it honestly to Europe, that would have been a sufficient
contribution in itself. The Moslem rulers encouraged translation,
e.g. Khalif Al-Mamun Al-Abbassi paid the translator the weight of
his translation in gold (Haddad 1942). Among the eminent physicians
who took part in the first stage were Jurjis lbn-Bakhtisliu, his
grandson Jibril, Yuhanna Ibn-Masawaya, and Hunain Ibn-Ishak; most of
them were Christians, yet they were respected and well treated by
the Moslem rulers.