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Islamic Medicine
History And Current Practice
Husain
F.Nagamia MD, FRCS (Eng & Edin)
Chairman
International Institute of Islamic Medicine
Introduction:
Considerable
confusion exists in literature regarding the definition of
'Islamic Medicine'. This is mainly because each author that
writes about 'Islamic Medicine' is actually writing about an
aspect of Islamic Medicine. Thus the definition can vary
depending upon the perspective. The context can be historical,
cultural, scientific, pharmacological, therapeutic, religious or
even a geo-political. In this monograph we shall be examining
this body of knowledge mainly from its historical, scientific,
therapeutic and application viewpoints.
The main source
of all inspirational knowledge in Islam is 'The Holy Quran' .
This book is considered by Muslims or followers of Islam to be
the word of Allah or God, revealed by Him to the Prophet of
Islam: Mohammed. A secondary source of a Muslims' inspiration is
the 'Hadith or Sunna', which are the recorded and authenticated
sayings and traditions of the Prophet of Islam: Mohammed.
As such not much
medicine is mentioned in the Quran except for beneficial effects
of some natural foods viz. honey and abstinence from intake of
alcohol or other intoxicants proscribed on every Muslim, yet the
Quran is the guiding spirit that every Muslim has to follow,
including the physicians in treating their patient and the
patients in handling their illness. However very early in the
Islamic era, the Hadith literature had accumulated a number of
sayings and traditions of the Prophet under a collection called
the 'Prophetic Medicine'.
These edicts
expounded on virtues of diet, natural remedies, and management
of simple ailments like headache, fever, sore throat,
conjunctivitis, etc. More importantly however injunctions were
prescribed against contact with persons having a contagious
disease for instance leprosy or entering or leaving an area of
an epidemic or plague, thus helping to limit the disease. In
addition a large number of traditions were collected under the
title of 'Spiritual Medicine'. These were a collection of the
verses of the Quran or prayers to the Almighty, which invoked
blessings and which had to be recited when affliction was to be
expurgated.
Prophetic
Medicine:
'Prophetic
Medicine' although popular amongst the masses of Muslims because
of its doctrinal and theological contents was considered by most
Muslim historians and physicians as distinct from scientific and
analytical Islamic Medicine. Ibn Khaldun (1332-1406 AD) a well
known medieval Muslim jurist, historian, statesman in his
'Muqaddimah' states:
'The Bedouins in
their culture, have a kind of medicine which they base primarily
on experience restricted to a few patients only, and which they
have inherited from their tribal leaders and old women. In some
cases it is correct, but it is not founded on natural laws, nor
is it tested against (scientific accounts) natural constitution
(of peoples). Now the Arabs had a great deal of this type of
Medicine before the advent of Islam and there were among them
well known doctors like al-Harith ibn Kalada and others.
Their Medicine
that has been transmitted in the Islamic religious works (as
opposed to those works which were considered scientific works)
belong to this genre. It is definitely no part of divine
revelation (to the Prophet: Mohammed) but was something
customarily practiced by the Arabs. This type of Medicine thus
is included in his biographies, just as are other multitudinous
of matters of sociological importance like the natural life and
customs of the Arabs, but forms no part of religion of Islam to
be practiced in the same way.'
Definition:
Islamic Medicine
in its true context, can thus be defined as a body of knowledge
of Medicine that was inherited by the Muslims in the early phase
of Islamic History (40-247 AH/661 -861 AD) from mostly Greek
sources, but to which became added medical knowledge from,
Persia, Syria, India and Byzantine. This knowledge was not only
to become translated into Arabic, the literary and scientific
lingua franca of the time, but was to be expounded, assimilated,
exhaustively added to and subsequently codified, and
'islamicized'.
The Physicians
of the times both Muslim and Non-muslim were then to add to
this, their own observations and experimentation and convert it
into a flourishing and practical science, thus helping in not
only in curing the ailments of the masses, but increasing their
standards of health. The effects of its domineering influence
extending not only in the vast stretches of the Islamic lands,
but also in all adjoining nations including Europe, Asia, China,
and the Far East. The span was measurable not only for few
centuries, but also perhaps for an entire millennium, 610 to
1610 AD.
During which
time, Europe and rest of the extant civilized nations of the
world were in grips of the 'dark ages'. It also to set the
standards of hygiene, and preventative medicine and thus was
responsible for the improvement of the general health of the
masses. It was to hold sway until decadence finally set in,
concomitant with the political decline of the Islamic nation.
With the advent of Renaissance in Europe, at the beginning of
the 17th Century AD, it was finally challenged by the new and
emerging science of modern medicine, which was to finally
replace it in most of the countries, including the countries of
its birth!
Historical
Background:
In order to
understand the milieu in which Islamic medicine was born, one
has to understand the salient events in the advent of Islam and
a few events just preceding the Islamic era. Arabia which was a
large area covered mostly by an arid desert that was roamed by
nomadic tribes of Bedouins. Certain communities had been
established where the trade routes intersected and water was
available. Mecca was along the Yaman- Damascus trade route. It
was considered a holy city and a sanctuary. The Kaaba or house
of worship was replete with idols of different gods each
representing a tribe or community.
These Bedouins
had their own tribal moral or ethical codes of conduct and
idolatry was in practice. Blood feuds were common and attacking
caravans along trade routes was a way of life. Sacrifices were
often offered to appease the gods and burying of live female
children was common practice. Family feuds were common and
settling scores in order to uphold tribal honor led to frequent
bloody encounters in which many people were killed.
Women and
children were treated as 'chattels' or private possessions and
became the property of the winner. This era of Arabia is
frequently referred by Muslims as 'Jahilliya' or age of
ignorance. Islam was not only to bring dramatic changes in the
religious practices of these warring nomadic tribes but also
unite them into an unprecedented social and cultural nation that
very quickly was to develop into a strong political entity, with
its own system of administration, justice, and military power,
all under one leadership.
The first leader
of the Islamic State was no doubt the Prophet of Islam, Mohammed
but then his four successors called the 'Pious Caliphs' were to
quickly consolidated and expand the nation. Within one hundred
years of coming into existence, the Islamic empire had spread
from Spain in the west, to China in the east, and encompassed in
its midst, the whole of northern Africa ,Egypt, Syria,
Palestine, Transjordan ,Central Asia and parts of western India.
Later it was to be even carried further by the Muslim merchants
to the shores of the far east including the Malaysian peninsula,
the islands of the East Indies and Indonesia.
In its early era
and for several centuries, the Islamic empire was centrally
governed by a leader or 'Caliph' and administered by provincial
governors. The first four Caliphs were elected democratically
but the later the Caliphate became dynastic. Later still a
western Caliphate was established in Spain. In later history the
Islamic Nation was to break up into various kingdoms, as the
provincial rulers become more autonomous and independent of the
center and was ultimately to be overrun by the Sejluk Turks who
were the forerunners of the Ottoman empire.
It was during
the early Caliphates of the 'Ummayads' and the 'Abbasids' that
the maximum development of Islamic Medicine took place. It was
also during this time and under the patronage of these Caliphs
that the great physicians both muslim and non-muslim thrived,
accumulated the wealth of medical knowledge and cultivated a
system of medicine that was to be later called 'Islamic
Medicine'.
The early era of
Islamic Medicine and the School of medicine at Jundishapur:
Jundishapur or
'Gondeshapur' was a city in Khuzistan founded by a Sasnid
emperor Shapur I (241-272 AD) before the advent of ISLAM.It was
to settle Greek prisoners, hence the name 'Wandew Shapur' or
'acquired by Shapur.' In present day western Persia the site is
marked by the ruins of Shahbad near the city of Ahwaz. The town
was taken by Muslims during the caliphate of Hadrat Umar, by Abu
Musa Al-Ashari in (17 AH/738 AD ). At this time it already had a
well established Hospital and Medical school.
Many Syrians
took refuge in the city when Antioch was captured by Shapur I.
In fact the latter nicknamed the city 'Vehaz-Andevi Shapur' or
'Shapur is better than Antioch.' The closing of the Nestorian
School of Edessa by Emperor Zeno in 489 AD led to the Nestorians
fleeing from there and seeking refuge in Jundishapur under
patronage of Shapur II, which got an academic boost as a result.
The Greek
influence was already predominant in Jundishapur when the
closing of the Athenian school in 529 AD by order of the
Byzantine emperor Justinian drove many learned Greek physicians
to this town. A University with a medical school and a hospital
were established by Khusraw Anushirwan the wise (531-579 AD)
where the Greeco-Syriac medicine blossomed. To this was added
medical knowledge from India brought by the physician vizier of
Anushirwan called 'Burzuyah.'
On his return
the latter brought back from India the famous 'Fables of
Bidpai', several Indian Physicians, details of Indian Medical
Texts and a Pahlavi translation of the 'Kalila and Dimma.'
Khusraw was even presented a translation of Aristotleian Logic
and philosophy. Thus at the time of the Islamic invasion the
school of Jundishapur was well established and had become
renowned as a medical center of Greek, Syriac and Indian
learning.
This knowledge
had intermingled to create a highly acclaimed and state of the
art Medical school and hospital. After the advent of Islamic
rule the University continued to thrive. In fact the first
recorded Muslim Physician Harith bin Kalada, who was a
contemporary of the Prophet acquired his medical knowledge at
medical school and hospital at Jundishapur.
It is likely
that the medical teaching at Jundishapur was modeled after the
teaching at Alexandria with some influence from Antioch but it
is important to note that 'the treatment was based entirely on
scientific analysis, in true Hippocratic tradition', rather than
a mix-up with superstition and rituals as was the case in Greek
'asclepieia' and Byzantine 'nosocomia'.
This hospital
and Medical Center was to become the model on which all later
Islamic Medical Scools and Hospitals were to be built .The
School none the less thrived during the Ummayid caliphate and
Sergius of Rasul'ayn translated medical and philosophical works
of both Hippocrates and Galen into Syriac.These were later to be
translated into Arabic casting an everlasting imprint onto all
the future of Islamic Medicine.
It was during
the Abbasid Caliphate that Caliph al-Mansur the founder of the
city of Baghdad invited the then head of the Jundishapur School
to treat him. This physician was Jirjis Bukhtyishu, a Christian
whose name meant 'Jesus has saved'. He treated the Caliph
successfully and got appointed to the court. He however did not
stay permanently in Baghdad returning to Jundishapur before his
death, but the migration to Baghdad had begun. Thus his son
Jibrail Bukhtishu established practice in the city and became a
prominent physician.
Another family
that migrated from Jundishapur to Baghdad was the family of
Masawayh who went at the invitation of Caliph Harun-ul-Rashid
and became a famous Ophthalmologist. Most famous amongst his
three sons who were physicians was Yuhanna ibn Masawayh (Mesue
Senior). He wrote prolifically and 42 works are attributed to
him. By this time second half of 2nd century after hijra (8th
century AD) the fame of Baghdad began to rise as also the
political power of the caliphate. Many hospitals and medical
centers were established and tremendous intellectual activity
was recorded. This culminated into the period of Islamic
Renaissance and the golden era of Islamic Medicine of which
description is given under a separate section.
The resources
for development of Islamic Medicine: The Bait-ul-Hikma or 'The
House of Wisdom':
'Bait-ul-Hikma'
or House of Wisdom was founded in 214 AH 830 AD by the Caliph
Al-Mamun an Abbasid Caliph. Ibn Al Nadim, who was the son of a
bookseller and whose famous catalogue of books 'Firhist of
Nadim' tells us of many of the Books of his time, relates this
story of the Caliph: Aristotle appeared in the dream of the
learned Caliph and told him that there was no conflict between
reason and revelation. The Caliph thus set about searching for
books and manuscripts of the ancient Greek philosophers and
scientists. He sent an emissary to the Byzantine Emperor to get
all the scientific manuscripts that were apparently stored in an
old and dilapidated building. After initially turning him down
the emperor granted him his request. Among the emissaries sent
to select the works was the first director of the house of
wisdom Salman, who was the one that led the delegation .
.Others in it
were al Hajjaj Ibn Matar, Ibn al Batrik.They brought back with
them many Greek scientific works and manuscripts. Translations
of all of these was immediately started.However the translation
of the medical works of the Greeks had started earlier during
the reign of Caliph Harun al Rashid, with the building of the
first hospital under the Caliph's patronage.
Ibn Nadim lists
57 Translators associated with he House of Wisdom. The one's who
formed the first delegation to the Byzantine King have already
been named. Other famous ones are as follows:
1. al Hajjaj ibn
Yusuf ibn Matar completed translation of Euclid's elements.
Other Greek authors including Aristotle, Archimedes, Pythogras,
Theodesius, Jerash, Apollonius, Theon and Menelaus all were
translated.
2. Muhammad ibn
Mujsa al-Khwarizimi born in Khiva systematically explored
arithmetic and al-gebra. The latter derived its name from his
discourse: 'Kitab al-Jabr wa al-Muqabla.' Algebra was derived
