Islamic Medicine [Electronic resources] نسخه متنی

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Islamic Medicine [Electronic resources] - نسخه متنی

Husain F.Nagamia

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published and some survive to this day al-Razi devoted a lot of
his time to teaching, bedside medicine and attending to the
royalty and court.The impact of these publications on Islamic
Medicine was tremendous. His books became an invaluable additon
to the armamentarium of a medical student of the time and
remained standard texts until the appearance much later of texts
by al-Majusi (see below) and by ibn Sina :'Qanun fil Tibb''The
Canon of Medicine' of which description will be given later.

In the 4th
century of Hijra, 10th century AD another Islamic physician
gained prominence in Baghdad. His name al-Majusi or Haly Abbas
to the west (d 384 AH/994 AD). He became the director of the
Adud-dawlah Hospital .It was to its founder that al-Majusi
dedicated his medical work entitled Kitab Kamil al Sina
al-Tibbiyah' or ' The complete book of the Medical Art ' also
called 'al-Kitab al-Maliki' or 'The Royal Book'. This book (of
which again a copy is preserved in the NLM at Bathesda) is very
well systematized and organized. Divided into two basic volumes
one covers theory and the other practical aspects. Each of these
has 10 Chapters.

The first volume
deals with historical sources,anatomy, faculties,six primeval
functions, classification and causation of disease, symptoms and
diagnosis, urine, sputum, saliva and pulse as an aid to
diagnosis, external or visible manifesttions of disease and
internal diseases like fever, headache epilepsy and warning
signs of death or recovery. The second volume deals with hygine,
dietics, cosmetics. Therapy with simple drugs. Therapy for
fevers and diseases of organs viz of respiration, digestion,
reproduction etc. There is a chapter on surgery, orthopedics,
and finally treatment by compound medicaments.

About the 2nd
century AH/ 8th century AD a great center of knowledge learning
and culture had been developing in the western part of the
Islamic empire. This was in Spain or 'Andalusia'as it was called
by the Arabs.Spain had been invaded and conquered by the Muslims
in 93 AH/714 AD. When the Ummayad dynasty ended in Baghdad the
last of Ummayad princes had escaped to Spain where they
established a greart dynasty called the Western Caliphate. The
rulers of this dynasty laid the foundation of the muslim rule of
Spain that was to last for seven centuries. The epoch of this
period was to come during the reign of Amir Abdar-Rahman
Al-Dakhil in 138 AH/756 AD.

During his reign
Cardoba also called 'Qurtuba' became a great center of
International learning. A great library containing more than a
million volumes was estasblished. Sciences flourished and great
men of learning and physicians worked under the Royal patronage.
Later this center was to shift to Granada, under the patronage
of the great Ummayad ruler Abd al-Rahman III al-Nasir (300-350
AH/912-961 AD). Perhaps the most famous physician and surgeon of
the era was 'Abu al-Qasim Khalaf ibn al-Abbas Al-Zahrawi' known
to the west as Albucasis (318 AH/930 AD to 403 AH/1013 AD). He
gained great fame as a physician. He wrote a major compendium of
extant medical knowledge called 'Tasrif'.

It comprised of
thirty volumes.The initial volumes dealt with general
principles, elements and physiology of humors and the rest deal
with systematic treatment of diseases from head to foot. The
last volume is perhaps the most important in that it deals with
all aspects of Surgery. It was the first textbook of Surgery
with illustration of instruments used in Surgery to be ever
published. It gained such greart fame that it became the
standard testbook of surgery in prestigious universities in the
west and was most widely read.He emphasised that knowledge of
Anatomy and physiology was essential prior to undertaking any
surgery: '

Before
practicing surgery one should gain knowledge of anatomy and the
function of organs so that he will understand their shape,
connections and borders.He should become thoroughly familiar
with nerves muscles bones arteries and veins.If one does not
comprehend the anatomy and physiology one can commit a mistake
which will result in the death of the patient. I have seen
someone incise into a swelling in the neck thinking it was an
abscess, when it was an aneurysm and the patient dying on the
spot.'

Some operations
described by him are carried out even today in the manner he
described them almost 1000 years ago!.These would include
operations on varicose veins, reduction of skull
fractures,dental extractions , forceps delivery for a dead fetus
to mention just a few. Surgery was raised to a high level of
science by him, at a time when the Council of Tours in Europe
declared in 1163 AD:'Surgery is to be abondoned by all schools
of medicine and by all decent physicians'

However the
greatest physician of the Islamic era was Avicenna or Ibn Sina
his full name being:'Abu Ali al-Husayn ibn Abdallah ibn Sina'.
Some historians of medicine acclaim him to be the greatest
physcian that has ever lived . That is because ibn Sina was not
only a physician par excellence but his knowledge and wisdom
extended to many other branches of science and culture including
philosophy, metaphysics, logic, and religion.As a result of his
great wisdom, he has been awarded the titles: al-Shaykh al-Rais
(The chief master) and al-Muallim al-Thani (the second
philosopher after Aristotle)..

Ibn Sina was
indeed a prodigy. At the age of 10 he had memorized the whole
Quran.By age of 16 he had mastered all extant sciences that
appealed to him including mathematics, geometry, islamic
law,logic, philosophy and metaphysicis. By age 18 he taught
himself all that was to learn in medicine. Born in city of
Bokhara in what is now central Asia in the year 370 AH/980 AD he
rapidly rose in ranks and became the vizier (prime minister) and
court physician of the Samanid ruler of BukharaPrince Nuh
ibn-Mansur.The Royal Library was opened to him and this enlarged
the knowledge of Avicenna to new dimensions.

He began writing
his first book at age 21. In all, in the short span of 30 years
of wrting this man had written over a 100 books of which 16 were
on medicine. His magnum opus is one of the classics of medicine
ever written.The Canon of medicine as it became known in the
west was written with the title of 'Kitab al-Qanun fi al-Tibb'.
This voluminous compendium of medical knowledge rivalled one
written earlier by al-Razi and al-Majusi and indeed surpassed
both of these in the content and originality.It was composed of
five volumes: Volume I contained the general principles Volume
II Simple drugs Volume III Sytematic description of diseses from
head to foot Volume IV general maladies viz fevers and Volume V
Compound drugs.

The Canon was
translated into Latin by Gerard of Cremora and Andrea Alpago and
remained the standard textbook of medicine in Louvain and
Montpellier until the 17th Century. A complete copy is in the
archives of National Library of Medicine in Bethesda, Maryland..
The effects of the systematic collection of hitherto unorganized
Greco-Roman medicine and adding to it by personal observation
and experimentation of these physician brought medicine to a new
pinnacles of practice.

Writes Prof
Emile Savasge Smith, professor of history at the Welcome Library
of Meidicine in a monograph that accompanied an exhibition of
the oldest Arabic manuscripts in collection at the National
Library of Meidicne:

'The medicine of
the day was so brilliantly clarified by these compendia
(especially those of Ibn sina and al-Majusi) and such order and
consistency weas brought to it that a sense of perfectioin and
hence stultifying authority resulted.'

The Basic
Sciences in Islamic Medicine:

Contarary to
popular belief, basic Sciences were were highly developed in
Islamic Sciences. For instance Oriental historians of Medicine
have erroneously emphasised that science of anatomy, during the
Islamic era was rudimentary ,and did not progress much further
than the discoveries already made and desribed by the Greeks or
'the ancients'. It was popularly held that the Islamic
physicians did not challenge the anatomic concepts of the
'ancients'. Secondary to the religious proscription of
dissection and thus lacking in their own observations they
relied heavily on observations of Galen, Aristotle, Paul of
Agaeia and other Greek sources.

However after
recent discoveries of manuscripts by an Egyptian Physician
Mohiuddin al-Tatawi, that had been hetherto unsrutinized, it has
become evident that Islamic Physicians not only possesed
excellent knowlege of anatomy but they added some challenging
new concepts that were revolutionary to the then understanding
of anatomical concepts laid down by the 'ancients'.

The example that
has now become well known is that of the discovery of the lesser
or pulmanary circulation by Ibn Nafis( d 687 AH/1288 AD) Until
then the credit of the discovery of the lesser circulation was
given to Servetus and Colombo, who discribed it in much similar
terms as Ibn Nafis only two hundred years later. The description
given of the pulmonary circulation by Ibn Nafis challenged the
fundamental concept held by Galen.

In fact it
suggested that there existed a pulmonary capillary bed where the
blood was 'purified ' before being brought back to the heart by
the pulmonary artery, thus predating the discovery of pulmonary
capillaries long afterwards, following the discovery of the
microscope by Anthony Von Luwenheek.. It has to be noted that it
has been documented that Ibn Masawaih or 'Masseuse Senior' his
latinized name had with the special permission of the Caliph
built a house on ther banks of the river Tigris where he
dissected apes, to learn their anatomy and extrapolated the
information to human anatomy.

That the
knowlege of anatomy was pre-requisite for the surgeon has been
emphasized by Al-Zahrawi in the surgical section of his book
'Tasrif' where he writes in the introduction:

'Now this is the
reason why there is no skilful operator in our day: the art of
medicine is long and it 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,
temparament of the limbs; also how they are jointed, and how
they may be seperated, that he should understand fully also the
bones, tendons and muscles, their numbers and their attachments;
and also the blood vessels both the arteries and the veins, with
their relations. And so Hippocrates said: ' Though many are
docotors in name, few in reality, particularly on the surgical
side.'

As regards the
physiological concepts embodied in the Islamic Medicine they
were based on the Hippocratic and Galenic concepts of elements
natrures and humors. The theory expounded being that harmony in
the body prevails when all the humors are in proper balance and
it is their imbalance that creates disease.

Under this
principle then, disease is a state of imbalance of humours and
needs the restoraion of balance, to bring the organism back to
its normal healthy state. Under modern medicine such a concept
would be unacceptable or at least untenable; because in modern
medicine causation of disease is related to etilogical agents or
factors. However it was Claud Bernard's concept of the 'milleu
interior' which can in modern terms be compared to the Jabirean
concept of innate harmony as exponded by Islamic medicine.

In order to
further exemplify the factors affecting this balance the theory
of Islamic Medicine expounds the concept of elements and
temperaments. Basic elements are broken into: earth , fire, air
and water and each of these is given a temperament: viz earth is
dry and cold; water is humid and cold; fire hot and dry heat,
air is humid and hot. Even further each of the four essential
body fluids like blood, phlegm, yellow bile and black bile are
assigned a respective temperament. Each dietary food, medicine
or climatic environment can thus then modify or temper the
humors of the body and it is an interplay of these that can
restore health from sickness or cause the sickness to worsen.

Such a theory
was understandably ill undeerstood and even laughed at and
ridiculed by the scietists of the west. Yet the same scientists
have now begun to look at the human organism from different
insights. To give an example: until recently the theoritical
basis of Accupuncture would not have been acceptable to any
physician trained by principles of western or modern medicine
and yet today this is being looked at with new insight and
accepted because the application have shown practical results
which would otherwise be unexplainable by modern principles of
anatomy and physiology.For a further exposition of the theories
of Islamic Medicine the reader is directed to read an exposition
by O.C. Gruner and a desertation on the subject by Hakim
Mohammed Said.

More importantly
however it was the fundamental belief of a Muslim Physician that
the organic body alone cannot manifest life being innate and
devoid of a life force. That it was the instillation of this
life force or 'Ruh' which give its vibrance and vitality of
spirit.Thus without the 'ruh' no function of the body is
possible. It is the 'Ruh' which descends from the Almighty to
mix with the anatomic and physioogic body to make a complete
human being.It is thus essential when treating a diseased state
to take into consideratioin the 'Ruh' or the Soul, a concept
totoally alien to the followers of Modern Medicine.

Pharmacy,
Pharmacognosy, Materia Medica and Therapeutics:

One of the
greatest sciences that had a great impetus on Islamic medicine
was the development of pharmacy and phamacognosy. Chemistry or
'Alchemia' had been studied by most Islamic Physicians and
scholars. This study was furthered by concomitant development of
techniques to refine drugs, medications and extracts by process
of distillation, sublimation, crystallization. Druggists or
Attarin became commonplace in Islamic lands and their
proliferation ultimately required the institution of licensing
of pharmacists and druggists.

Pharmacological
drugs were classified into simple and compound drugs, 'the
mufraddat and the murakkabat'. The effects of these were
detailed and documented. The earliest Islamic works on
pharmacognosy were written before translation of the Greek works
of Dioscorides. Titles such as 'Treatise on the power of drugs
their beneficial and their ill effects' and then again The Power
of simple drugs' were written in the third and fourth century
AH/ ninth century AD. Most medical texts contained chapters on
the use of both these types of remedies, thus Razi's al-Hawi
mentions 829 drugs.

Materia Medica
and texts containing compendia of drugs their effects appears
frequently during the era of Islamic Medicine. Notable amongst
these is the contribution of Abu Bakr ibn Samghun of Cardoba on
'The Comprehensive book on views of the Ancients as well as the
Moderns on Simple Drugs' Ibn Juljul made a commentary of drugs
and plants described by Dioscordes and added a number of newer
ones. Al-Zahrawi's Tasrif mentioned earlier in reference to its
surgical volume also had a section on plants and drugs.

The second book
of the Canon is devoted to the discussion of simple drugs and
the powers and qualities being listed in charts. One of the most
authoritative book on drugs was written by famous scholar and
philosopher al-Biruni entitled 'The Book on drugs' which
contains a huge compendium of drugs, their actions and their
equivalent names in several languages.

Even today
perhaps the most extensive pharmacotherapy especially as related
to plant medicinal and herbal preparations can be attributed to
modern day Islamic or Tibbi Medicine and finds great favor in
the Indian subcontinent often being as popular as western or
synthetic medicine.

In fact western
pharmaceutical companies have often 'invaded' into this domain,
the classical example being of the extract of 'Ruwalfia
Serpentina' a root that yielded a potent anti-hypertensive which
was a very popular remedy for hypertension in the sixties and

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