Wednesday, March 2, 2011

Arab Medical Schools During The 12th And 13th Centuries

-I- The Status Of Medicine In The Islamic World
 
The Scientific movement in the early Islamic centuries has various aspects. One of them is the contribution of the early Arab Scientists, which took different forms, their role in scientific progress, the theories they have provided us with, and their methods and influence on the western world which started, as a result, viewing science in a new light during the middle ages.
In fact it is not easy to divide the whole unity of science, and claim that this science belongs completely to the Greeks or the Arabs or the West. It is not possible to divide science because it does not belong to one nation, nor to one race. It is the result of co-operation, and communication, among scientists and many other factors. This paper considers the case of medicine in the Arab Islamic World and investigates its nature and schools.

To understand the nature of Arab medical schools in the Arabic Islamic World, we have to deal with the status of medicine before the 12th century; the Bimaristans: their system and different purposes; medical educational assemblies: their role in configurating physicians' minds and the method that was followed and then conclude with the results. It is worth noticing that examples have been provided.

Medicine was the first science that the Muslims knew in their environment. The ancient Arabic sources mention Al-Harith Ibn Keladah (d. 634 A.D), the Arabian who travelled from the Arab peninsula to Persia to study medicine in Jundisabur where there was a well known Bimaristan (hospital). After he had finished his studies in Jundisabur, Al-Harith returned home to practise his science and to treat those who were in need of his knowledge.

The ancient sources inform us about Al-Harith especially Ibn Golgol , the most famous historian in the fourth century of Hijra (10th century), who said that Al-Harith «studied medicine in Persia and Yemen and was alive in the days of the Prophet(1). According to other sources (2) , the Prophet advised Saad Ibn Abi Waq'qas when he was sick to consult Al-Harith, the physician.

The power and authority of physicians began to increase during the rule of Mu'awiyah (660-680), who founded the Umayyad state. Mu'awiyah ordered his men to bring the best physicians from Jundisabur to care for his health, specially that he was afraid his enemies (3) might poison his food.

No doubt the successive physicians made great contributions and were the pioneers of medicine during the rule of Mu'awiyah and his sons. During the rule of Umayyad Caliph Marawan Ibn al-Hakam (d. 685), the Persian physician Masarjawayh played a vital and effective role, when he started, by order of Marawan, to translate the Medical Encyclopaedia of the Alexandrian priest Ahrun, from Syriac into Arabic. Masarjawyh's translation of Ahrun's book is considered to be the first translation of a medical book in Islam from a foreign language into Arabic (4) .

The Abbasids represent a very strong and important stage in the development of science, because they encouraged scientists, and tried to establish a solid scientific movement in the Islamic world, especially after they chose Baghdad to be the new capital, instead of Damascus. As we know the Abbasids were rationalistic. Most of the Caliphs were among the "Mutazilah scientists. The adoption of rationalism led to the flourishing of the sciences through the Islamic academy of science "Bayet al-Hikma" (5) (the House of Wisdom).

Practising medicine in Baghdad during the Abbasids rule was the responsibility of two families: (1) The family of Bukhtishu, and (2) the family of Masaway.

The Bukhtishu family came to Baghdad by the order of the Caliph Al-Mansour who was sick and suffering from pain in his stomach. He sent his men to bring Georges b. Jibril b. Bukhtishu to treat him in the year (148H. / 765). Georges was the chief physician (rais al atibba) in Jundisabur (6) .

When Georges left to Jundisabur after four years he ordered his son to stay in Baghdad to continue his mission. Both father and son wrote medical books in Syriac which were later translated into Arabic by Hunain b. Ishaq .

Hunain b. Ishaq (194-264 H.) who took the lead in the official movement of translation, was one of the most important figures both in translation and medicine. He translated the books of Hippocrates and Galen, and wrote down many medical books among which is his famous one about the eye (Al Ashr Maqalat fi al-'Ayn) The Ten Treatise on the Eye - Max Meyerhof verified and studied it critically (7) . The book of Hunain is considered the first scientific attempt towards Ophthalmology.

While the process of translation was going on, The Arabs began to organise Medicine as a profession, especially the bimaristans (hospitals) and practicing medicine among people.

Ancient Arabic sources - like al-Qifti (8) and Ibn Usaibi'ah (9) - mentioned that the real organisation of medicine took place by the order of al-Muqtadir who wrote to Sinan Ibn Thabit b. Qurrah to examine those who want to practice medicine and give them Ijaza (certificate). This was in the tenth century.

No doubt we have some good knowledge about the contribution of the Arab Muslim physicians who took part in the process of developing medicine (10) , such as al-Razi (Rhazes 850-923), Ibn Sina (Avicenna 980-1037), al-Zahrawi (Abulcasis 1013) and Ibn an-Nafis. let us look at the case of al-Razi and Ibn Sina, and their effect in medicine.

1- Al-Razi was one of the well known Muslim physicians in the West during the Middle Ages. Ibn al-Nadim enumerated the works of al-Razi among which are these major works: (1) Kitab al-Asrar The Book of Secrets, (2) Kitab al-Tib al-Mansuri Liber Almansouris, (3) Kitab al-Hawi (11) The Comprehensive Book, and (4) A Treatise on al-Judari wa al-Hasbah Small pox and measles.

Kitab al-Asrar was first translated into Latin by Gerard of Cremona (d. 1187), while Kitab al-Tib al-Mansouri appeared in the Latin translation in Milan in 1480, and so did the treatise on al-Judari wa al-Hasbah. As for al-Hawi (Continens) its translation had been made by Faraj Ibn Salim in 1279, and reprinted many times in Latin. This book had a great influence in Europe. Montgomery Watt, while dealing with al-Razi said "His greatest work is one translated into Latin as the Continens, The Comprehensive Book. It was an encyclopedia of all medical science up to that time, and had to be completed by his disciples after his death. For each disease he gave the views of Greek, Syrian, Indian, Persian and Arab authors, and then added notes on his clinical observations and expressed a final opinion." (12)

2- Ibn Sina was known as a philosopher and physician. His fame in these two fields was the cause of his influence in the West. Here we are dealing with his medical contribution that became so evident in his famous work Kitab al-Qanun fi al-Tib. The Organon in Medicine. This book was translated by Gerard of Cremona into Latin and published in Europe several times. The importance of al-Qanun came from two things:

a) Its well organized data, its method and scientific style. This is because Ibn Sina was a good philosopher and had an organized logical mind.

b) His description of some diseases such as mediastinitis and pleurisy. Also he mentioned the nature of phthisis and the spreading of diseases by water and soil, and gave the right diagnosis of ankylostomiasis (13) .

-II- Bimaristans in the Islamic World

Those who learn and study medicine and practice it as a profession must work in hospitals to get experience and practice the medical profession, so that they gain this experience from the cases they examine under the supervision of master scientists. Von Grunebaum says about the necessity of hospital visits for medical students "The medical student must always visit the hospitals and must be very careful of the conditions and situations of the persons found there, while he is accompanied by the most intelligent medical teachers, and must ask about patients' conditions, their symptoms, remembering what he read about changes and their significance whether good or bad. If he understands these things he will achieve a high rank in his profession (14) . So, it is evident that the medical - teaching in that time - had bases and rules and was practiced in the Bimaristans. To be acquainted with the rules of the process of medical teaching that dominated. The Islamic world, we have to study first the origin of the Bimaristans and their development in order to know their importance for medical teaching generally.

Ibn Abi Usaibia'h said: "Hippocrates cared greatly about his patients and their treatment. It is said that he was the first to invent and build the Bimaristan and the first to renew it, by allocating - near his house - part of his garden for the patients and assigned some servants to perform the treatments. He called this the «Akhssendokin», i.e. a patient complex. Also the word Bimaristan-which is of Persian origin-has the same meaning as (Bimar) in Persian means disease and (stan) is location or place, i.e. location or place of disease (15). This is the text we find in the «Uyun al-Anba» of Ibn Abi Usaibi'ah about the historical development of the Bimaristans or hospitals. But Max meyerhof (16) mentioned that the first hospital to be built in the Islamic world is that which was based in Baghdad by the order of Harun al-Rashed; then hospitals were built successively everywhere. Does Meyerhof's opinion present the absolute truth, or does this opinion contain some clear fallacies?

Ibn Qutayibah al-Dainuri was interested in his book Leadership and Politics (17) in throwing light on some important matters relating to Islamic history. He mentioned that the first Bimarastan or hospital was built for the Muslim army-after Abdallah Ibn al-Zoubair when he was blockaded in Mecca, built a tent on one side of the Mosque, so that when one of the Sahaba (Prophet's followers) was wounded he would be brought inside the tent to be treated and to be cared for by skilled persons. That is how the first type of Bimarastan (hospital) was built in Islam. This is the Arab Bimarastan (hospital).

Moreover we find other proofs in (Ibn al-Atheer) in al-Kamel (18) and al Maqrizi in Maqrizi Plans (19) which denote that al-Waleed ibn Abdel Malik was the first to build a Bimaristan it the real meaning of the word in Islam in 88 Hijri. Noushirawy (20) in his new book on Islamic Brimaristans in the Middle Ages seemed to adopt this opinion and he mentioned that the first Bimaristan built in Islam was in Damascus, by al-Waeed b. Abdel Malik (705-715 A.D) and built in 86 Hijri (706-707 A.D.). The aim of its building was treating patients and the care of affected chronic patients-as lepers and blind people... etc. The leprotics were imprisoned, treated freely and given money. In the Bimaristan there were more than one physician. It is obvious that Noushirawy adopted what was mentioned in (al-kamel) of Ibn AL-Atheer on this poing specifically. A person has great importance and consideration on this subject, is Ahmed Bey Issa (21) who was the first to write clearly about the development of the Bemaristan and its history in Islam, and he mentions that the Prophet Mohamed (may peace and prayer be upon him) was the first to order the establishment of mobile military Bimaristans. It is natural that this last opinion has its importance and consideration, because Muslims were rushed in many invasions in which they were attacked and injured. There was lots of chaos, and men were wounded or killed here and there. It was normal that there should be those who cared for these people and looked after their treatment, and hence complete care was provided for the fighters. This last opinion agrees with what Ibn Qutaiba al-Daynuri mentioned.

1- The Bimaristan system: The people who are interested in establishing any institution must set an administrative or technical system to be followed. Of course the physicians in the Islamic world put in mind to follow a precise system inside the hospitals so that it would be based upon academic graduation which fulfills two amis: First, the welfare of the patients to be dealt with their treatment according to the updated rules of medical treatment. Second, Bimaristans used for teaching medicine to the newly graduated physicians responsible to treat patients successfully. Therefore the Bimaristans in the Islamic world were followed all the technical rules that fulfilled the two purposes together.

Ibn Jubair (22) mentioned what he observed in the hospitals concerning work. Also Ahmed Bey Issa mentioned in his book (23) Bimaristans in Islam Amin Assaad Khayrallah (24) in his book Arab Medicine and Nushirawy (25) in his book Islamic Bimaristans in Middle Ages mentioned the administrative, technical and teaching organization existing in that period in the hospitals.

Concerning the technical choice of bimaristanic site they used to choose the best location with regard to the health conditions. They preferred to build the Bimaristans over hills or by rivers. Al Adoudi's bimaristan is a good example of this; it was built by Adoud al-Dawla b. Bawaih (26) in Baghdad by the River Deglah and the water of the river flowed through its courtyard and halls and returned to pour into Deglah.

Concerning organization, it was natural that the physicians comprehended the necessity of separating men and women, therefore they took into consideration as much as possible to divide the Bimaristan into two sections, one for men and the other for women. Each section was independent, each having large halls for the patients.

Concerning the administrative organization of the Bimaristan, it was as follows: each section contained a hall for each type of disease, while each hall had one physician or more and each group of doctors in a section had a chief doctor. The halls were specialized: a hall for internal diseases another for splinted patients, another for oculists, and another one for delivery a special hall for each type of disease including communicable diseases (27) .

Ibn Abi Usaibi'ah discribed in his book Uyun al-Anba (28) , the halls of internal medicine which frequently included a section for the patients affected by fever and another one for patients having mania. All sections of the Bimaristan were equipped with all the medical instruments and apparatuses necessary for the physician.

Ibn Abi Usaibi'ah tells us (29) that Adoud al Dawla set a test for a hundred physicians, when he decided to build the Adoudian Bimaristan on the Western side of Baghdad, and he chose twenty four physicians out of the hundred to work in the Bimaristan.

The chief of all physicians in the hospital was called (AI Saoor). The administrative and medical system in the hospital was based upon using boys who worked as employees or health workers, assistants or dressers; some of them were servants and they cleaned the Bimaristan and cared after the patients when necessary.

According to this order and system the Bimaristan was performing its medical job from a diagnostic point of view, disease definition and prescription of treatment. Moreover, they understood the necessity of adjoining a pharmacy to the Bimaristan to give out the drugs, which were given according to the physician's prescription, and the pharmacy was called «Al Sharabkhana» (30) .

And as it is the case today, they used to inspect the Bimaristan. This was the responsibility of an employee assigned by the minister or the Caliph and given the authority to enter the hospital to be acquainted with the patients' status and the care offered to them, the food given to them and whether the boys were serving them or not. Whether the physician is performing his duty perfectly or he neglecting it. This system assured the stay and continuity of the Bimaristan in a serious way that allowed it to work with a high competence technically, scientifically and administratively.

It is worth mentioning that each patient had his own card on which the physician recorded his observations while treating the patient. Also the phsician had his own special register to record his observations on the diseases he was treating. The physician performed his experiments and tests according to his observations. If the physician faced any problem in any matter of diagnosis, he went to the head of his division or the chief physician. Frequently the physicians held meetings to discuss cases. Undoubtedly these discussions and consultations were considered as a small scientific conference of physicians. We do the same today.

We notice that the historians of Arab medicine wrote special long pages on the medical personalities about whom discussions were held to set the work system in the hospital, or the Bimaristan between the physicians. There were shifts for the doctors, some worked in the morning and others at night, some worked a certain time in the morning and another period at night, so that they cared for the patient. At the same time they could get enough rest to allow them to continue working in the Bimaristan, supervise the treatment system and medical care of the patients.

Al-Maqrizi mentioned in his plans (31) that the patients were registered at the admission in the Bimaristan, their clothes were taken away and their money put in trust by the Bimaristan guardian. The patients received clean clothes instead of those taken from them, and they were given drugs and food under the supervision of the physicians freely till they were cured.

Ibn al-Okhowa described in his book (al-Hisba) the entrance of the patient to the outpatient clinic to see the physician. He said in a very important text «the physician asks the patient about the cause of his illness and the pain he feels. He prepares for the patient syrups and other drugs, then he writes a copy of the prescription to the parents attending with the patient. Next day he re-examines the patient and looks at the drugs and asks him if he feels better or not, and he advises the patient according to his condition. This procedure is repeated on the third day and the fourth... till the patient is either cured or dead. If the patient is cured, the physician is paid.

If the patient dies, his parents go to the chief doctor, they present the prescriptions written by the physician. If the chief doctor judges that the physician has performed his job perfectly without negligence, he tells the parents that death was natural; if he judges otherwise, he tells them: take the blood money of your relative from the physician; he killed him by his bad performance and negligence. In this honorable way they were sure that medicine is practiced by experienced well trained persons (32) .

2- Bimaristan Varieties according to different Purposes

In the early Islamic state, Muslims comprehended the different form and purposes that should be considered in Bimaristans. Normally, they should deal with this point seriously, precisely due to its importance to the patient and the physician as well as the desired degree of care for the patient. Certainly the Bimaristan established to serve the fighters in the battle field during the hustle of the battle must differ from that built for the patients affected by mental disease who do not have to hustle, but doctors might hustle away from them but this is different, or those built for a commercial caravan or the pilgrimage to Al-Kaaba.... and so on.

Each type of diseases might require a special Bimaristan for a group of patients. This can be noticed at least by specialization of Bimaristans for leprotics and mentally affected patients.

a) Mental Disease Bimaristan

Muslims realised the importance of the care for mentally affected patients. They frequently added to the big Bimaristans special places isolated by iron bars, specially for patients with mental diseases (33) , to avoid the aggression of these patients on the others.

Muslim physicians knew that psychiatric and mental diseases required a special type of care and that the physician must be acquainted with the etiology of the disease from which the patient is suffering.

It is worth mentioning that Ibn Abi Usaibi'ah (34) tells us in his book (Uyun al-Anba) about some cases of this type of disease and how the skilled doctor Waheed al-Zambian could treat them. One of the patients thought that he had a tun over his head that never leaves him; he was afraid that the tun might break while he was walking, therefore he walked carefully to avoid breaking it. Some doctors tried to treat him but they failed. Lastly he saw Waheed al-Zaman who realized that the man was suffering from illusions. He told his family: «bring him to the hospital. Waheed al-Zaman ordered one of his boys to bring a big stick and hit the head of the patient-while Waheed al-Zaman talks to him-as if he wants to break the tun that the patient pretends having on his head, in the same time he asked another boy to throw a tun- that he prepared for him-from the house top, the moment the first boy hits above the head of melancholic patient, to the ground. When the patient came, Waheed al-Zaman started to talk to him, disapproved he was carrying the tun, he gave the boy a signal and he started to hit over the head of the patient with the woody stick, in this moment the other boy threw the tun from the house top which caused a great noise and broke to many pieces. When the patient saw what happened to him and saw the broken tun he did not doubt that it was the tun he was carrying -in his imagination - this influenced him and he was cured from his illness.

b) Leprotic Bimaristan:

This was built specially for leprotics. At the start of our talk about Bimaristans we referred to what Nushirawy mentioned about al-Waleed b. Abd al-Malek saying that he was the first who was interested in establishing such types of Bimaristans.

According to Ibn al-Qifi (35) , the first who wrote a book on «Leprosy» was Yohan b. Masaway. The cause of interest in such a disease arises from the Muslim's idea of isolating the patients who had communicable diseases from the rest of the society. We find the same behaviour with the doctors of today towards such liseases.

c) Road Bimaristan:

Arabs knew this type of Bimaristans and they realized its importance, because the pilgrimage to Holy places or the commercial caravans that travailed for long distances required care for the travelers, such as treating wounded persons or saving a person asking for help.

Therefore, they equipped the caravans with medical missions where physicians worked and had boys to help them. Ibn al Qifti presented to us an important test while he was talking about «Al-Hakam b. Ali al-Hakam al-Damaski», he said «he was a doctor in the beginning of «Al Abbassid state», Mu'awiyah b. Abi Sofian sent him as a doctor with his son Yazeed to Mecca when he sent Yazeed as Emeer of the pilgrimage in that epoch. Al-Hakam said: He is the doctor my father sent with Yazeed when he went to Mecca and I was the doctor who went with Abd al Samad b. Ali b. Abd Alla b. Abbas to Mecca (36) .

Undoubtedly, Ibn al-Qifti's text we just mentioned kept the oldest idea about this type of Bimaristans. Ibn Katheer (37) pointed out in his book (The Beginning and the End) that road Bimaristans were conducted by a wise director who knew how to give treatment: The rich people, who had the ability to equip the caravans with medical missions supported those Bimaristans financially.

d) Prison Bimaristan:

The Muslims cared medically for the imprisoned the same way they did for people outside the prison. This is clear from the letter the minister, Issa b. Ali al-Garrah (38) Minister of al-Moktader, to Sanan b. Thabit al-Tabeib al-Natassi who was distinguished in Arab medicine and who embraced Islam at the hands of Al-Qaher. After Issa b. Ali had visited the prisons, he found it was necessary to treat the patients and preserve their humanity so, he sent his famous letter to Sanan in which he said: «I thought-May God prolong your life-of the imprisoned and they are exposed, due to their big number and their hard situation, to diseases; they are incapable to deal with their excretions or to meet doctors to seek their advice about diseases. You have - May God grant you honor - to assign physicians to visit them daily and they should carry with them drugs and syrups and all they need to treat the patients and cure illnesses with God's will. Sinan followed this advice» Also according to what Ibn al-Qifti mentioned al moktader asked Sinan b. Thabit to build a Bimaristan and give it his name. He ordered one at Bab Al-Sham and called it The Moktader Bimaristan and financed it with 200 Dinars monthly (39) This was in 306 Hijri and Sanan b. Thabit was assigned as chief doctor. When al-Moktader was told that one of his physicians had killed a man by mistake, he ordered Sinan to perform a test for the physicians. So, they were tested in Baghdad and their number became eight hundred physicians (40) .

It was Sinan b. Thabit who financially supported al-Sayeda Bimaristan, according to what Ibn al-Qifti said «On the first of Moharam 306 Hijri, Sinan b. Thabit inaugurated Bimaristan al-Sayeda in the Yahia Market and he stayed in it and he organized the work of physicians in it. Each month 600 Dinars were spent on the Bimaristan by Youssef b. Yahia al-Monajem because Sinan did not contribute to the expenditure of the bimaristan (41) .

e) The Mobile Bimaristan:

This type of Bimaristan visited villages, peripheries and cities caring for the health of people who lived away from the state capital and allowed the state services to reach anyone who needed treatment in the state.

Ali b. Issa al-Garrah - al Muqtadir's minister - ordered the first state physician Sinan b. Thabit, in a written letter, to let doctors travel to the peripheries of the state. He said in his letter «I thought of people who live in the peripheries and that among them are patients who do not receive any medical care because there are no doctors there. So, assign - May God prolong your life-some physicians to visit the peripheries; also a pharmacy containing drugs and syrups. They have to travel all through the peripheries and stay in each region enough time to perform treatment of patients, then they move to another one (42) .

It was the state's responsibility to care for the Bimaristans. The senior physicians were aware of establishing work rules and bases to teach the students who came to learn medicine from everywhere. Therefore, medicine schools were established in the Islamic world, in which teaching was performed by two methods:

1- The theoretical method in the medical schools, and 2- A practical method for training and practice where students gathered around the doctor in chier to see and examine the patients and the treatment he prescribed. When the students finished the studying period they applied for an exam, took an oath and got their certificates. When they started to practice medicine, they always worked under the state's supervision. This means of course that the Bimaristans were institutes for teaching medicine and to complete the study for junior doctors (43) . From a practical point of view, the professors prescribed the treatment for the patients, they examined them in the presence of the students who received their learning through professors, they writing their instructions. They performed these instructions in an organized way and they did a follow up to the patients and hence they acquired the necessary practical experience for a medical student. Muslim contribution in the field of medicine can be exposed throughout three main points which are, (1) the medical assemblies, (2) Al-bimaristan, and (3) the method that they followed.

-III- Medical Educational Assemblies

Educational assemblies spread throughout the Islamic world through a methodological system. They were sometimes sponsored by the state but most often by the scientists. This has always been their system. We know that a scientist is known by his assembly, his students, and followers, as well as by the influence he has on the following generations, as each of his pupils reflects him; therefore scientist are always careful to teach pupils in their assemblies in a special way different from other teachers.

The Arab Historian Ibn Abi Usaibi'ah, recognized and wrote down many things related to science and scientists in his book (Uyun al-Anba Fi Tabaqat al-Atibba) Sources of Information on the Classes of Physicians. He mentioned many characteristics concerning scientists assemblies. The medical assembly of Amin al-Dawla b. al-Thalmeed who knew many languages specially Syriac and Pahlavy as well as Arabic (44) , devoted himself to teach new generations, with the condition that they should master the Arabic language, and if any of his students committed grammar mistakes or if his Arabic seemed not good in construction he sent him to a grammarian to take care of and examine him after that. The assembly of Amin al-Dawla b. al-Thalmeed was probably the biggest assembly of science held at that time. Ibn Abi Usaibi'ah mentions a quotation by Mowafak al-Deen Abdel Latif b. Youssef to have said: «A man entered upon him bleeding in summer time so he asked his pupils who were approximately fifty and they did not know the illness» (45) .

Scientifc assemblies between physicians sometimes were held in the Bimaristans, we find Zahed al-Ulama who established al-Farki Bimaristan assembling his pupils there to answer their queries (46) .

Most educational assemblies acquired the form of a debate. Seif al-Deen al-Amidi's assembly adopted this form and eventually people praised «his eloquence in debating and research» (47) . So did the assembly of Shams al-Deen Ibn Al-Laboudi who «became strong in arguments, good at debating» (48) .

Sometimes during science assemblies, a physician wrote books for the students who had graduated under his teaching and who had become themselves teachers of science. The writing of books in this case was not meant for teaching or dictating but they were meant to urge the students to more studies and comprehension (49) .

Arab physicians' way of teaching had its characteristics and Abou Bakr al-Razi, maybe the physicians' leader and one of the best physicians of his time to preserve for us in their writings the essentials that a physician should know well, and that teachers should engrave in the pupils mind.

These teachings were not just theoretical, but they came out of experience and practice, Abou Bakr al-Razi was the best clinical physician, had no competitor in this field, beside being a good teacher of medicine and its writing. His book (The Guide or al-Fusul) is a good example. During his teaching sessions pupils crowded around him in circles according to the precedence of their joining these sessions. He used to present them patients and let them ask about the illness and try to diagnose it; if they failed he would intervene and give the final decision» (50) .

This quotation refers to many things in the field of medical education by these professors and their assemblies either in the Bimaristans or outside them. Al-Razi's educational assembly was of two kinds, one for theoretical teaching the other for the practical one (51) . Theoretical teaching took the form of debates between three groups of students; the group in the circle nearest to him were the more advance in learning and practice. Next came the second group of those with less experience and last came the third circle in which new students were grouped. He read to them, explained, argued and listened to their debates answering their queries. Whenever he detected an intelligent pupil he moved him to a circle nearer to him in which he had to spend three years. So he spent one year in each circle. During this period he was taught anatomy, physiology or organ properties and pathology.

As for the practical teachings, like during his theoretical ones, students placed themselves in circles around the patient's bed in the hospital. He explained to them rare cases one after the other. In this way al-Razi used the patient as a book to be read daily and continuously to be able to understand the symptoms of his illness (52) .

The most important thing in this matter, is that the teacher explained to his pupils in the assemblies each case he examined and noted his questions and his observations in a special page. He started by asking the patient, and the pupils around him, asking his name, age, country of origin, trips and his illness, the date it started, place of pain and symptoms. He assured that the patient was the best person to explain the extent of what he feels. He also asked the patient about his family and its members, and whether they felt the same symptoms.

To achieve all that, al-Razi examined his pupils and graduates. He asked first in the field of anatomy, and if the pupils failed to answer, he did not continue the clinical examination because their failure in this subject made them unworthy even if they passed the clinical exam (53) .

Mohazb al-Deen abd Al-Rahim b. Ali al-Dakhwar's assembly in the second half of the sixth century Hijri and the first quarter of the seventh century Hijri, was the same. Students used to gather around him in the Bimaristans while he examined patients. He taught them and explained the cases in front of them. One of his students, Ibn Abi Usaibi'ah, says: «I saw him once in the hall of the fevered; doctors felt the pulse of one patient and diagnosed weakness and prescribed chicken soup to give him strength, he said that his speech and the look of his eyes denoted weakness, then he felt the pulse of his right hand then of the other and said: Feel the pulse of his left hand, we found it strong, he then said: look at his right hand and how near his elbow the vein divides in two branches one remains and can be felt the other moves over the ulna towards the fingers, which we found true. He then said: this is a rare case but some people show this phenomena, and many physicians diagnose it wrong as weak pulse but it is just that they are feeling half the vein (54) . This is the scientific point of view of al-Dakhwar he had inherited from his medical ancestors who had laid the foundation of medical practice in the Islamic world. This is not strange, as al-Dakhwar studied al-Razi's writings and understood it well. He absorbed the instructions and descriptions of clinical cases that al-Razi mentioned in his book (Al-Hawi).

When al-Dakhwar finished in the Bimaristan he devoted his time first to transcription, studying and reading, then to his pupils. He asked them in «They came in and so did groups of doctors and practitioners, each read his lesson, discussed it with him explained it as much as he could then if there was need for further explanation or if there was a problem he would discuss it with the best of the attendants (55) . This was his system, and he explained the introduction of medicine in the same way, explaining its meanings and construction facilitating it to students.

Al-Dakhwar's system in theoretical teaching had a special character. He scrutinized the next he had, and tried as much as possible to bring out a text without mistakes, whenever someone read to him, "he would have a copy of the text in his hands, he looked at it, and compared it, if he found a mistake in the copy being read he would order its correction" (56) . Al-Dakhwar persisted in the accuracy and precision of the copy, Ibn Abi Usaibi'ah says: Sheikh Mohazab al-Deen's copies that were read to him were very accurate, most of them were in his hand writing. He surrounded himself with all he needed of medical books language books Abou Hanifa al-Danoury's botany book (57) . These are the tools that a scientist needs to perfect his research. After Al-Dakhwar's assembly was over and the attedants left, he returned to his private life ate something then spent the rest of the day studying and reading and stayed a good part of the night working (58) .

This was al-Dakwar's scientific assembly, where, he taught many pupils and physicians. He wanted scientists to remember him and commemorate him, therefore he transformed his home into a school for medicine, and it was considered one of the best known schools in Damascus, and was known in the history of Arab medicine as the Dakhwarian school the reputation of which in the seventeenth century Hijri spread all over the world. And from it graduated many well known doctors who spread all over the world presenting mankind their knowledge and studies.

Al Dakhwar succeeded in inspiring his students with the correct scientific doctrines which he himself had learned in his teacher, Tag al-Deen al-Kindi's assembly. This was very clear in his other interests besides medicine.

Actually, Ibn Abi Usaibi'ah preserved for us a great treasure in his book (Uyun al-Anba fi Tabaqat al-Atiba). In this book he deals with physicians not history, but at the same time he praises the interest in history, al-Dakhwar was not only a great figure in medicine during Ibn Usaibi'ah lifetime, nor was he only a Sheikh who taught this historian doctor, nor only did he establish a school well known in the Islamic world, and that became a true science institute attracting researches from all places, but he also wrote the history of medicine in consecutive periods, relating to his pupils among whom was Ibn Abi Usaibi'ah what he remembered, and what he heard from his elders about the science and views of his predecessors. This is not strange as al-Dakhwar the scientist and doctor was a descendant of Tag al-Deen al-Kanadi, who taught him how to look for the truth and seek its origin, this is the characteristic of a true scientist who ascribes sayings to their owners and not take the credit himself for science and learning and diminish others' abilities, as some ignorant people do nowadays pretending to know everything and deny the merit to others.

We have many examples of what Ibn Abi Usaibi'ah wrote, which show al-Dakhwar's views who connected good ideology to good morals and so spoke truthfully and honestly (59) .

-IV- The Fundamentals of Method

The method is considered to be the core idea that characterizes any science. Scientists who work without a method will never achieve a scientific discovery and will never get the chance for any scientific addition and hence will repeat opinions of others. Arab scientists and physicians realized the importance of concluding the ideas after following a clear method in their researches and following certain rules. Therefore they brought both sense and reason (intellect), they discussed intellectually and logically what sense exposed in the light of what previous scientists had recorded.

Though it is difficult to claim that Muslims had clearly written about method - as it is the case today - it is obvious from their writings that they followed a precise scientific method in studying and teaching when they talked about the topics they wrote and wanted people to learn.

Scientists and physicians in the period of the flourishing Islamic state achieved brilliant scientific results, which - for certain - were transmitted to the Western world, to Latin Europe, and European science benefited from them, during the Renaissance epoch. This made Ali Sami al-Nashar, when speaking about influence of the Islamic method on the West, assert while writing his introduction "I knew for sure that I am in front of the greatest discovery that the European world had ever known which is the discovery of experimental methods of the Islamic world in its most perfect form" (60) .

The talk about method could be divided into two parts:

A- The steps followed during research and study.

B- The characteristic and general features that characterized the method and allowed it to serve the purposes of scientific research and reflection upon the scientific works, the character and the nature of genuiness and seriousness, and hence allowed them to achive important scientific discoveries by which they went ahead of the European world for many centuries.

A- The steps followed in the research:

As previously mentioned, the method is the core of scientific research so that if you start the study of any topic without following a specific method to treat the topic through it, or without following a specific plan during your research, you will achieve nothing, i.e. you will not get any useful research result to be used theoretically and practically.

Though scientists in the capital of the Islamic state and in its peripheries did not have specialized clear writings - which we call method - the rules and regulations and the steps were clear in their minds and they used to draw the attention of the reader and the student to its importance from time to time.

We can conclude from their several writings, the general rules followed in the medical researches that led to the flourishing of that science in a way that astonished the Latin world.

1- Observation and Description

It is familiar to find some diseases that have similar symptoms to the extent that makes the distinction between them require a highly skilled physician. Muslim physicians have dealt frequently with such matters. We know this through several examples and observations found in the history of Arab Medicine. Here is al-Razi (61) who was known by his medical and scientific skills an intellect whom European medicine acknowledged before even Arabic medicine. He described in his study (Small Pox and Measles) the symptoms of small pox - which he saw himself - as follows: "the appearance of small pox is preceded by a continuous fever that causes back ache and itching in the nose and shivering during sleep".

Scientists have comprehended the steps of observation, description, comparison and detection of points of similarities and differences. They realized that there are qualitative observations that explain to us the different sides of what we are studying.

Example 1: Qualitative Observation Al-Bughdady was interested in the study of Diabetes Mellitus symptoms. He mentioned in two successive paragraphs "while examining the urine you must observe the amount whether a little or a lot, the colour of urine, its taste, and consistency i.e. whether it is thin or thick...". In another paragraph he said «while examining the urine we should examine three things: the colour, the consistency and weight, in addition we have to examine the odour, the temperature by putting your finger in it, as well as its sour taste» (62) .

Example 2: Comparative observation and the relation between sensation and intellect Al-Bughdady did not stop following his observation. He proved that Galen committed mistakes. Galen mentioned that the lower jaw in human beings consists of two parts attached together by a joint at the chin, but al-Bughdady could - through his precise observation - describe the real situation which is: the lower jaw in the mammalians consists of two parts which unite together sooner or later, the degree of union increases or decreases to form strong symphysis at the middle of the chin in different types of mammalians. In high mammalians and human beings the union of bone at the middle of the chin occurs strongly immediately after the delivery so that the lower jaw forms a single bone (63) .

Al-Bughdady was acquainted with the reasons of Galen's opinion on this point, but his observations contradicted what Galen assumed and hence he could, through concentrating his attention on what he observed, realise the point of similarities and differences of what he had in front of him, being provided with an ability of precise distinction and understanding.

Al-Bughdady found in a certain place near Cairo a Tomb full of human bones where he counted more than two thousands skulls. When he examined the shape of the bones and joints and the way of their articulation, he proved that the lower jaw is formed of one piece rather than two as Galen assumed in the sixth chapter of his book «The Children Bones» where he said that: «The lower jaw is formed of two parts which is proved by the fact that it can be cracked at its middle when it is crumbled».

But according to the precise observations of al-Bughdady «if the lower jaw was formed of two attached parts by a joint, we could see that joint at least in the brittle decayed bones, because the crumbling of bones starts firstly at the joints» (64) .

We can notice from all these examples, the importance of the step of precise scientific observation to the Arab scientists and the degree of correlation between the observation and the continuous description directly from reality, and the extent of their thinking to correlate between the parts of the observed subjects that they describe. This is proved by the example given by al-Bughdady which was just mentioned, that shows how just one empirical observation acquainted him with a wrong opinion that dominated for a long period and was adopted by the physicians since Galen. We will ascertain more precise observations while we review some important points.

But we are concerned mostly to demonstrate that al-Bughdady-and other scientists also-did not rely upon Galen and other persons sayings. This will become evident in case of Ibn al-Nafis. The sensational observations of those scientists were accompained with good works of mind in what the sense was exposed to. The sense might be wrong but the mind should correct this mistake.

2- Experimental and Testing:

Muslim physicans were concerned with referring to experiment because it is the best witness to the correctness of an opinion. That is why al-Razi mentioned in his book (The Characteristics of Things) many texts on experiment, "we add what we know by experiment and people know that we do not give our confidence to anything except after its test and experimentation" (65) .

Al-Razi believes also that the skilled physician must have two characteristics together "one, he should be skilled in the scientific art of medicine and the other, he must have at the same time a lot of experiences" (66) .

From this point of view, we find that al-Razi was committed always to experiment as it is considered the principal criterion in judging things. As long as experiment is the criterion that the physician always resorts to "to distinguish between the truth and the falsehood in what concerns these caracteristics that might be submitted to the denial of those who could not understand the aims of science" (67) .

Such texts and others reveal to what extent, the scientists of that epoch were concerned with the establishing of science upon correct scientific basis. It is impossible to use standards through which the science works today in the twentieth century as a basis to judge a science produced by the Islamic mind more than a thousand years ago approximately.

Muslims were skilled in the art of medicine and they achieved important achievements, they attributed in the way of distinction between one disease and another and the definition of many of communicable diseases which can be called epidemics. They did not only distinguish between communicable diseases, but they described each disease separately from the observations they made and the signs of disease occurrence and progress. There are many examples to demonstrate this fact. For example, al-Razi was the first to describe precisely and clearly small pox and measles (68) . Ibn Zahr was the first to describe mediastinal puncture, dry peritonitis and peritoneal effusion" (69) .

We can notice the precision of that description which al-Razi presented in the distinction between small pox and measles where he says "the appearance of small pox is preceded by a continuous fever which causes backache and itching in the nose and shivering during sleep. The important symptoms that denote its occurrence: backache with fever and burning pain all over the body, facial congestion and sometimes facial contractions, acute redness of the cheeks, eyes pressure sensation in the body which extends to the muscles, throat and chest pain accompanied with difficulty of breathing, cough and restlessness. Irritability, nausea, anxiety are more pronounced in measles than in small pox (70) . Al-Razi mentioned the cough of hereditary infections. The opinions presented by al-Razi were not only the results of his own efforts, but when he talked about many of the diseases, he gathered, first the opinions mentioned on the disease, by the Greeks, Syriac, Indians, Persians and Arabs, then he presented his own opinion and the experiment he performed and the observations he achieved after the process of diagnosis and treatment. In surgeries, he was a head of his contemporaries because he treated renal and bladder stones surgically. As Hitti descriped him in the field of surgery he was one of the first to use the seton.

Among other examples we find Avicenna who "distinguished between pneumonia and pleurisy, acute and secondary meningitis, intestinal and renal colics" (71) . Also, there were some important additions presented by Avicenna, where we find" the first description of anthrax which the Arabs called "The Persian Fire (72) . Avicenna mentioned that the infection occurs through water and dust. He described the life cycle of Ankylostomiasis (73) and he showed its effect on the body. Anatomically, Avicenna described all the organs, even the anatomy of teeth and jaw bones. When talking about the nerves and muscles he included the nerves of the face, forehead, eye globe, eye lids, cheeks, lils, tongue as well as the nerves of the marrow and chest. When he talked about "the nerves", he studied cases of paralysis. He described hemiplegia and distinguished between two main types: the first is the facial palsy resulting from a central cause in the brain and the second due to a local or peripheral cause (74) . It seems that the treatment of the causes of paralysis were familiar to the physicians of the Islamic world of that epoch. This was the result of their interest in treating skillfully mental diseases. They specified particular words in the Bimaristans - as for example they used one of three methods to treat such cases (we mean caes of paralysis and neurogenic diseases). In cases of paralysis they resorted to cooling drugs in contradiction with the familiar Greek method, which used the hot methods of treatment; or they resorted to methods similar to electricial shocks used in our days, as we have been told by some contemporary historians. Muslims were the first to use electricity to treat epilespy and neurogenic diseases by using a certain type of fish called Torpedo or cramp fish, which was put alive in water which was then connected to two straps of steel. When the patient held them, which he could not do but for a short time, he shivered and would throw them to the ground. After some days of this treatment he was cured from epilepsy (75) . The third method was based on psychiatric treatment and there are many examples for this. Harun al-Rashed had a slave maid attained by a certain type of hysterical paralysis. When she raised her hand upwards, the hand stayed hanging up. The physicians were perplexed in her treatment, therefore al-Rushed brought Gabriel Ibn Bachtishou to treat her. He asked for his safety while he performed the treatment in front of him and he said "if the Caliph will not be angry with me I have some tricks for her" al-Rashed said" and what are they?" the doctor said "the slave must come here in the presence of everyone till I do what I want and you must give me time and not be angry with me quickly. Al-Rashed ordered to bring her, when Gabriel saw her, he walked quickly towards her and bent her head and caught the tail of her dress as if he wanted to undress her in front of all the people; she was shocked and worried by this behaviour and her shyness obliged her to drop her hand downwards to hold her dress and to cover her body. At this moment, the physician turned towards the Caliph and said: "She is cured now" (76) .

These three examples reveal the intelligence of the physicians in the Islamic World and their insight about the cases presented to them and the way of giving successful treatment to such diseases after they examined them carefully and recognized its etiology and the facts and the way of its progress through scientific observations.

We find also that Muslims knew in detail other important diseases whose diagnosis was not known in the old medicine (77) . They were "the first to write about leprosy and the repair of the not known in the old medicine. They were " the first to write about leprosy and the repair of the teeth closure defects and tooth arches. They correlated piles with gastric contraction and recommended plant foods for its treatment". They were also "the first to draw attention to the shape of the nails of the tuberculous; they described treatment of jaundice and cholera, they used opium in certain doses to treat haemorrhage, and they treated shoulder disclocation by the surgical method known as sudden resistance reduction (78) . Moreover, al-Tabari was the first to discover the insect causing scabies.

Among the medical features of Muslims worth mentioning is Surgery. They were the first to use anaesthesia in surgical operations (79) . Abu al-Kaseem al-Zahrawi (Abulcasis) is considered "the greatest one to perform manual works skillfully in surgical operations and to use surgical instruments. His book presentation to those who failed to write consists of three parts: the first in medicine, the second in pharmacology and chemistry, and the third in surgery (80) . The previously mentioned reference of al-Zahrawi is considered to be one of the most important text books in the description of instruments used in performing surgical operations and the way to use them, kwith the detailed description of each instrument through illustrations and he acquired a great importance because he was the first in this subject (81) . Al-Zahrawi was the first to succeed in tying arteries to stop haemorrhage (82) . The Arabs knew in this epoch the anatomy of pulmonary arteries and veins. Not only this but Iban al-Nefis presented to us for the first time in history a complete description of the blood circulatory system.

The belief that predominated since the epoch of Galen till the time when Ibn al-Nafis first appeared was that blood originates in the liver from which it is transported to the right ventricle in the heart, then it flows in the veins to the different body organs to nourish them, some of the blood enters the left ventricle through pores in the diaphragm, where it is mixed with the air coming from the lungs. But, Ibn al-Nafis found that the process of blood purification occurs in the lungs due to its union with the air and hence it is purified, then it is transported to the left ventricle hence the small blood circulation discovered by Ibn al-Nafis. As the historians of science assert «Ibn al-Nafis, described precisely the blood circulation eight hundred years before the Portuguese Servit to which this discovery is attributed (83) . Muslims were skilled also in another medical branch which is Ophthalmology. The nature of hot environment of their countries encouraged them to study this branch of medical specialities and to contribute to it in an evident way which called for astonishment. The book of Salah Ibn Yousif al Kahhal on the eye might be the greatest reference that gathers all eye diseases. He wrote chapters on: eye description, sight description, eye diseases and their etiology, their symptoms, the care for the eye, eyelid diseases and diseases of the cornea and iris, and those diseases far from the senses, also eye treatments» (84) .

B- The Characteristics of the Methods

There were general characteristics ascribed to the method used by the different scientists and physicians, during the flourishing of Islamic development. These characteristics can be described as follows (85) :

1- Debating and not accepting ideas without proof.

2- Conscious and accurate analysis.

3- Scientific honesty. This feature characterised the books written by Arab scientists through the ages. Scientific honesty can be put in the following order:

a) Refer opinions to their owners.

b) Not to take credit for others' creativity.

c) Arab scientists used some statements that indicated complete uncertainty such as: «Some physicians told me» or «Aleppo citizens told me» or «I copied from some history books» or «I found in some books».

4- Freedom of opinion and stating observations without adhering to ancient theories.

5- Arab scientists were self confident and esteemed the bold scientific opinion, and their writings were characterized by fluent style and accuracy of presentation and being free of contracdictions and they sometimes depended on using equivocations.

Results

It cannot be said that the study of the history and development of Arab medicine has been completed, as we cannot also say that Arab physicians were just copiers from the Greek medicine heritage they had studied and understood. In reality they were aware of the details of medical theories specially those reached by Hippocrates and Galen. This did not stop them from having their own participation, and of correcting some mistakes in old theories.

Although many Orientalist studies deprived Arab and Islamic share in the medical heritage from its seriousness and originality in relation to theory and application, this opinion was mainly due to racism or misunderstanding.

This study we cannot be considered to have covered all aspects of the problem, or to have defined the development in a decisive manner. We cannot ascertain that. But this study gave us some important results, which if added to the results of other studies could help in better writting the history of the development of Arab medicine theoretically and from the view point of application.

The indications of this study could be stated in the following points.

1- Scientists throughout the Islamic world understood the Greek medical heritage, first they translated it magnificently by the care of Hunain b. Ishaq who travelled the nations in all directions searching for manuscripts and lost pieces (shreds of them. Ibn Al-Nadim, Ibn Golgol, Ibn al-Qifti, and Ibn AbiUsaibi'ah, confessed that Hunain's translations and his school played a great role in understanding this heritage. These writings also transferred to us some of Hunain's pupils translations, details of the translations and whether translated from Greek or Syriac. It is clear that there were medical assemblies, the most famous of which was that of «Yuhanna b. Massoyweh» Hunain b. Ishaq's teacher. These asemblies played a good role in increasing the growth of medical knowledge. Al Razi's assembly was a real school for teaching pupils. These assemblies of teaching medicine, were propagated between the fifth and the seventh century of the Hijri. After the translation era, started a period of flourishing and development as physicians had the opportunity to study from text books and to make clinical observations.

2- The period between the twelfth and thirteenth century was characterized by the propagation of medical assemblies. These assemblies were usually held in physician's homes. These can seen by the assemblies of Ibn al-Thalmeed and al-Dakhwar, students read with their professors important books and teachers explained the difficult parts.

3- The practical side of the study took place in the Bimaristan under the supervision of great physicians. In this light the bimaristans could be considered as true faculties for medicine paractical study.

4- In different periods of Islamic development, physicians encouraged Caliphs and men of influence and power to build hospitals which were called Bimaristans. From what we reviewed, we see that the building of Bimaristans started in an early stage of the history of the Islamic nation. They were built in all parts of the Islamic world. Physicians also understood, in those times, that medicine needed to be practiced in hospitals with precise organization both in management and treatment. New physicians were subject to pass an examination, and the profession itself was controlled by the government, through a man called Al-Mohtasib (Health Inspector). They had to pass examinations and get certificates. This proves the precision used in the practice of medicine in the Islamic world. The Bimaristans were of different types differing according to the type of disease treated in each, this shows us the precise understanding of the nature of diseases.

5- Study in the bimaristan meant the presence of clinical cases (the patient) in front of the student who osculated him and noted the course of the illness and observed any change in the symptoms. There were different kinds of bimaristans throughout the Islamic world, and these were under strict control.

6- Students attended physicians' teaching sessions in the bimaristans, after having completed the studies. They were examined theoretically and practically by the physician and were given certificates of graduation but had to practice medicine in the bimaristans under the professors' supervision.

7- Physicians taught in a scientific way, so, for the theoretical part of the study, there were certain books a student had to read and understand under the surpervision of his teacher, these books were those of Hippocrates, Galen, Hunain, al-Razi and Ibn Sina. The student also had to note the teacher's lectures, and that, led to the many versions for one writing. For the practical part, the students watched the teacher's way of diagnosis, and also attended the debates between the professors on some diseases.

8- Scientific method was systematically the most important pillar for medical practice and for understanding it in a scientific way. The different writings of physicians of that time show this clearly, as we find them following the trial rules of scientific method in its best form even before this method was discovered or created in the West. In this field the study points out that the many participations had special common characteristics that could be summarized as follows:

a) Medical study depended on observing and describing, as we found detailed descriptions of illnesses that physicians teated.

b) Physicians made comparisons between different illnesses specially that some of these had similar manifestations.

c) Cases were diagnosed after a meticulous clinical examination of the patient and after a proper understanding of the illness.

d) Physicians often turned to experiments, and we met many texts refereing to this fact.

e) Descriptive comparison of some studies showed mistakes made by the Greek physicians, specially Galen, and this drove Muslim physicians to correct them.

f) They used instruments and tools in the many surgeries they performed.

g) Physicians studied and criticized the Greek heritage.

h) We, often, find that physicians followed the meticulous analytic system in using the heritage they came about.

i) The studies that were done in the Islamic world were strictly scientifically honest. Never did any physician claim the merit for another's work, but always quoted other's ideas using precision in referring them to their owner, this gave them greater self confidence and a free courageous opinion.

9- The Arabic writings and inventions were transferred from the Arab world to Latin Europe. This genuine and diversified transferred heritage, led to the development of medicine in Latin Europe.

Footnotes

(1) Ibn Golgol, Tabaqat al-'atiba' wal-hukama' (The Generations of Physicians and Wise Men) ed. by Fu'ad Sayyid, Imprimerie de L'Institut Français d'Archéologie Orientale, Le Caire, 1955, P. 54.

(2) Ibn Golgol mentioned some stories about the advice of the Prophet to some men to visit physicians when they become ill. But Fu'ad Sayyid who edited the book of Ibn Golgol and verified it refuted-these stories, Ibid, P. 54.

(3) Some historians such as Ibn Abi Usaibi'ah used to say that Mu'awiyah used his physician Ibn Athal to get rid of his enemies. Ibn Abi Usaibi'ah Uyun al Anba, ed. by Nazar Reda, Dar Al-Hayat Publishing House, Beirut, 1965. P. 171.

(4) Max Meyerhof stated that "It was a Persian Jew, Massarjawaih, who translated Ahron's Pandects into Arabic and was responsible for what was probably the earliest scientific book in that language". Meyerhof, M., 'Science And Medicine', in The Legacy of Islam, ed. by Sir Thomas Arnold & Alfred Guillaume, Oxford University Press, 1952. P. 314 -5.
As Ibn Abi Usaibi'ah stated: Ahrun was an Alexandrian Physician and Christian priest. He devoted himself to medicine and wrote his main Encyclopedia of Medicine. Massarjawiayh translated the book of Ahrun from Syriac into Arabic, and after that Hunain b. Ishaq made corrections to the book. See: - Ibn Abi Usaibi'ah, "Uyun al-anba". P. 232.

(5) When al-Ma'mun established Bayt al-Hikma (The House of Wisdom) he stipulated that the rulers of the countries he conquered must submit the books instead of the Jiziah. The ancient sources mentioned that when al-Ma'mun achieved his great victory over the Rum (830 A.C.) he knew that they used to collect the Philosophy books in the cellars. Al-Ma'mun asked their king to give him these books instead of the Jiziah. Teofils (ÊíæÝíá) the king accepted and considered it a great gain for him, but al Ma'mun considered it a great blessing for him. see: Faroukh, O., The History of Arab Science, Dar al-Ilm Li-Al-Malayeen, Beirut, 1977, P. 113.

(6) Jundisabur was the famous centre of medical sciences before Islam. Its hospital (bimaristan) was founded to absorb the Graeco - Alexandrian medical sciences. Many physicians , especially the Syriac-speaking Christians, contributed in developing medicine in that hospital, also they took part in the early medical movement in Islam.
Maurice Gaudefroy - Demombynes while he was comminting and descriping the status of Arab physicians informed us that "like the theologians, they profit by the Greek heritage, but not by its teaching of the art of reasoning; they make use of the whole range of Greek learning, first through Syriac translations, and later, directly from the originals. The Monophysite medical centre at Gundeshapur was, from the 5th century, both a university and a school of medicine, to which the "Abbasid Caliphs turned for their physicians, and which gradually migrated altogether to Bagdad." P.204.
Maurice Gaudefroy - Demombynes, Muslim Insitutions, trans. from the French by John P. Macgregor, George Allen & Unwin LTD, London, 2nd impression, 1954.
Also we find Professor Max Meyerhof considers "The academy of Jundeshapur continued as the scientific centre of the new Islamic empire."
Meyerhof, M., "Science And Medicine". P. 314.

(7) Hunain b. Ishaq, Kitab al-Ashr Maqalat fi al-Ayn, The Ten Treatises on the Eye , Arabic-English edition by Max Mayerhof, Al-Maktaba al-Amiriyya, Cairo, 1928. This book influenced both the Arab and European medicine in the middle ages.

(8) Al-Qifti, Ta'rikh al-Hukama The History of Wise Men, Dar Al-Athar, Beirut, p.p. 132 -133.

(9) Ibn Abi Usaibi'ah, Uyun al Anba, ed. By Nazar Reda, the library of Dar al-Hayat, Beirut, 1965. Also, A.Muller edition, Cairo - Konisberg, 1882.

(10) Professor Hamarneh noted as a result of his investigation in the field of Arabic Medicine that "medicine and allied sciences, for example, were first imported but soon improved upon and greatly enriched by significant additions, investigations, and intelligent personal observation, experience, and experiments".
See: Hamarneh, S., "Arabic Histrography as related to the Health Professions in medieval Islam", P.23, in, SUDHOFFS ARCH IV, Band 50. Heet 1, Marz 1966.

(11) Max Mayerhof notes that "The greatest medical work of Rhazes, and perhaps the most extensive ever written by a medical man, is his al-Hawi, i.e. 'Comprehensive Book', which includes indeed Greek, Syriac, and early Arabic medical knowledge in their entirety".
Mayerhof, M., 'Science And Medicine', P. 324.
While Hitti mention that "true to its name al-Hawi was a veritable medical encyclopedia summing up what the Arabs knew of Greek, Syriac, Persian, and Hindi medicine and enriched by the addition of the author's experiments and experiences" P.116.
"The book was first translated into Latin (1279) under the auspices of Charles, king of Naples and Sicily by the Jewish physician Faraj ben Salim, translator of other Arabic medical works" P.116.
See: Hitti, P., Islam: Away of life, University of Minnesota Press, Minneapolis, 1970.

(12) Watt, W. M., The Majesty that was Islam, PP. 227-228.

(13) Professor Watt emphasized the effect of Ibn Sina (Avicenna) in the West by saying "His Vast Canon of Medicine was translated into Latin in the twelfth century and was used much more than the works of Galen and Hippocrates. It dominated the teaching of medicine in Europe until at least the end of the sixteenth century". Watt, W.M., The Majesty that was Islam, P 228.

(14) Von Grunebaum, G.E., The Civilization of Islam, Arabic Translation by A. Gaweid, P. 424.

(15) Ibn Abi Usaibi'ah, Uyun al Anba, P. 45.

(16) Max Mayerhof, "Science and Medicine", in The Legacy of Islam by T. Arnold, The Arabic translation by Gorgeis Fathallah, Dar al-Taleia, Beirut, 1972, P.423.

(17) Ibn Qutayibah, Al-Emama We'll-Seyasa, Leadership and Politics, Cairo, 1328 H., V.2, P 12.

(18) Ibn Al-Atheer, Al-Kamel Fi al-Tareikh, The perfect in History, Cairo, 1290 H. V. 4P. 219.

(19) Al Maqrizi, Kitab al-Mawa'ez wa al-Eitbar, The Book of Wisdom and Consideration - Maqrizi Plans, Dar Sader, Beirut, V. 2, P 405.

(20) Noshrawy, A.R., The Islamic Bimaristans in the Middle Ages, Arabic Translation by M. Kh. Badra, The Arab Legacy Bul. No. 21, P 202.

(21) Isa, A., The History of Bimaristans in Islam, Damascus, 1939, P. 9.

(22) Ibn Joubir, Rehlat Ibn Jouber, The Journey of Ibn Jouber, Cairo, 1358 H.

(23) Isa Bey, A., The History of the Bimaristans in Islam, PP. 20, 40.

(24) Khayrallah, A., Outline of Arabic Contributions to Medicine and Allied Sciences, Beirut, 1946, PP.63-68.

(25) Noushirawy, A.R., The Islamic Bimaristan, P. 201.

(26) Ibn Abi Usaibi'ah, Uyun al Anba, P. 415.

(27) Ibid, P 732.

(28) Ibid, PP. 732, 733.

(29) Ibn Abi Usaibi'ah, Uyun al Anba, PP. 415.

(30) Ibid.

(31) Al Maqrizi, Kitab, al-Mawa'es Wa al-Eitbar, V. 2, P. 405.

(32) Ibn al Okhwa, Ma'alem al-Qurba fi Talab al-Hisba, The Features of Relations in al-Hisba, Cambridge, 1937, P. 167.

(33) Noshrawy, A.R., The Islamic Bimaristans, P.202.

(34) Ibn Abi Usaibi'ah, Uyun al-Anba, P. 337.

(35) Al-Qifti, Tarikh al-Hukama, P. 249.

(36) Ibid, P. 123.

(37) Ibn Katheer, Al-Bidaya wa al-Nihaya, The beginning and the End, The Library of knowledge, Beirut, 1966, Vol. 12 P. 188.

(38) Al-Qifti, Tarikh al Hukama, P. 132.

(39) Ibid, P. 133.

(40) Ibid, P. 130.

(41) Ibid, P. 133.

(42) Ibid, P. 132.

(43) Marhaba, A. R., The Course in the History of Arab Science, The Lebanese Publishing House, Beirut, 1970, P. 50.

(44) Ibn Abi Usaibi'ah, Uyun al-Anba, P. 349.

(45) Ibn Abi Usaibi'ah, Uyun al-Anba, P. 353.
We can understand that Arabic was really a scientific language in studying medicine and other science. We also notice that characteristic in every other field of science.

(46) Ibid, P. 353.

(47) Ibid, P. 350.

(48) Ibid, P. 341.

(49) Al-Samarai, K., 'Who is Abou Bakr al-Razi', P. 15.
Ibn Abi Usaibi'ah who preserved for us Ibn Abi al-Ashaat on The Book of Single Medication he had written says: "Ahmed Ibn Mohamed al-Baladi asked me to write this book, and before him Mohamed b. Thawab, so in this book I wrote about them and their standings, and I started in the month of Rabii al-Awal of the year three hundred and fifty three, and they had reached a high rank in learning medicine, and became experts in its practice, to them and to my pupils and those interested in by writings, you should study, enlarge your knowledge and develop it".
See: Ibn Abi Usaibi'ah, Uyun al-Anba, P. 354.

(50) Nagi, K., "al-Razi the Pioneer of Clinical Medicine" P. 30, 35.

(51) Ibid, P. 25.

(52) Al-Samarai, K., "Who is Abou Bakr al-Razi?", P. 19.

(53) Ibn Abi Usaibi'ah, op.cit. P. 732.

(54) Ibid. P. 732.

(55) Ibn Abi Usaibi'ah, op.cit. P. 732.

(56) Ibid. P. 732.

(57) Ibid. P. 732, 733.

(58) Ibid. P. 733.

(59) When Ibn Abi Usaibi'ah was researching some sides of Amin al-Dawla Ibn al-Talmeed, he asked al-Dakhwar who repeated to him what he had heard of stories with their references. These were repeated by Ibn Abi Usaibi'ah as he heard it from his master he says: "Al Hakim Mohazab al-Deen b. Ali, he says: Sheikh Mowafak al-Deen b. Ilias b. al-Motran say: my father told me: Ismail Ibn Rashid said: Abou al-Farag b. Thoma and Abou al-Farag the Christian said: We were gathered in the presence of Amin al-Dawla b. al-Talmeed when a woman asked to enter with a young boy, he allowed her, when he saw the boy he told her that the son is suffering from burning while urinating and urinated sand. She said yes. He then prescribed medication and she left. We asked the symptoms on which he based his diagnosis, and that if the problem was in liver or the spleen his colour would be the same. He said: when he came in he was scratching himself and I found his fingers cracked and dry, I understood that the scratching was because of the sand and that the substance that made him scratch must have come in touch with his hands and caused their cracking and dryness, and my diagnosis was right". Al-Dkhwar was always very accurate in stating what he heard and from whom he heard it, to his pupil Ibn Abi Usaibi'ah, the authenticity of the story depends on the truth of its narrator Al-Dakhwar understood fully this point when he went to Tag al-Deen al-Kanadi's assembly to acquire knowledge and benefit and later to pass it along to his own students. We also find this virtue in Abi Usaibi'ah's book Uyun al-Anba'a.
See: Ibid. P.

(60) Al-Nashar, A. S., Methods of Research in Islam, Al-Nahda Al-Arabia Publishing House, Beirut, 1978, P.11.

(61) When Ibn Abi Usaibi'ah was researching some sides of Amin al-Dawla Ibn al-Talmed, he asked al-Dakhwar who repeated to him what he had heard of stories with their references. These were related by Ibn Abi Usaibi'ah as he heard it from his master he says: "Al Hakim Mohazab al-Deen Abdel Rahman b. Ali, he says: Sheikh Mowafak al-Deen b. Ilias b. al-Motran say: my father told me: Ismail Ibn Rashid said: Abou al-Farag b. Thoma and Abou al-Farag the Christian said: We were gathered in the presence of Amin al-Dawla b. al-Talmeed when a women asked to enter with a young boy, he allowed her, when he saw the boy he told her that the son is suffering from burning while urinating and urinated sand. She said yes. He then prescribed medication and she left. We asked the symptoms on which he based his diagnosis, and that if the problem was in liver or the spleen his colour would be the same. He said: when he came in he was scratching himself and I found his fingers cracked and dry, I understood that the scratching was because of the sand and that the substance that made him scratch must have come in touch with his hands and caused their cracking and dryness, and my diagnosis was right. "Al-Dakhwar was always very accurate in stating what he heard and from whom he heard it, to his pupil Ibn Abi Usaibi'ah, the authenticity of the story depends on the truth of its narrator Al-Dakhwar understood fully this point when he went to Tag al-Deen al-Kanadi's assembly to acquire knowledge and benefit and later to pass it along to his own students. We also find this virtue in Abi Usaibi'ah's book "Uyun al Anba'a".

(62) Al-Nashar, A.S., Methods of Research in Islam, Al-Nahda Al-Arabia Publishing House, Beirut, 1978, P.11.

(63) Olman, M., Islamic Medicine, Arabic Translation by Y. Al-Kilani, Kuwait, P.125.

(64) Ibid. P. 125.

(65) Ibid. P. 126.

(66) Ibid.

(67) Galal, M., The Arab Methodology of Scientific Research in Natural and Cosmological Sciences, The Lebanese Publishing House, Beirut, 1972, P. 128.

(68) Ibid. P. 187.

(69) Ibid. P. 182.

(70) Hitti, P., Islam: A way of life, P. 116.

(71) Ashour, S.A., Islamic Civilization and its influence upon Europe, The Arabic Renaissance House, Cairo, 1963, P. 154.

(72) Marhaba, A., The Concise History of Arab Sciences, P. 96.

(73) Ibid.

(74) Toukan, K. H., The History of Arab Sciences, P. 20.

(75) Ibn Al-Ibri, The Abridged History of the States, (Tarikh Moukhtasar al-Dowal), Beirut, P. 131.

(76) Marhaba, A., The Concise History of Arab Science, P. 96.

(77) Toukan, K. H., The Arab Sciences, P. 20.

(78) Ibid.

(79) Toukan, K. H., The Arab Sciences, P. 20.

(80) Ibid., P. 21.

(81) Ibid., P. 21.

(82) Ibid., P. 20.

(83) Toukan, K. H., The Arab Sciences, P. 24.

Concerning Ibn al-Nafis see:
a) Aly, M., Studies in Arab Medicine, Dar al-Maarifa al-Gameya, Alexandria, 1990.
b) Aly, M. An Introduction to the History of Arab Medicine, Dar al-Ulum al-Arabia, Beirut, 1987.
c) Aly, M. & Zaydan, J., Kitab Sharh Fusul Hippocrates Li Ibn Al-Nafis, Al-Dar al-Misrya al-Libnanya, Cairo, 1991.

(83) Ashour, S. A., Islamic Civilization, P. 158.

(84) Aly, M., The Muslim Contribution in Civilization. The House of University Knowledge, Alexandria, 1983, Pp. 113-114.

Edited by Prof. Maher Abd Al Kader M. Ali, Professor of History and Philosophy of Science,
Faculty of Arts, Alexandria University, Egypt
These pages are edited by Prof. Hamed Abdel-reheem Ead
Professor of Chemistry at Faculty of Science-University of Cairo Giza-Egypt and director of Science Heritage Center
Thanks to Alchemy Website

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