Arabic (Or Islamic) Influence On The Historical Development Of Medicine

Definition:
Arabic, or what  we may be called Islamic, science in terms of location in space and time  denotes the scientific activities of individuals who lived in a region that might extended chronologically from the eighth century A.D. to the beginning of the modern era, and geographically from the Iberian Peninsula and north Africa to the  Indus valley and from the Southern Arabia to the Casian Sea that is, the region covered for most of that period by what we call Islamic Civilization, and in which the results of the activities referred to were for the most part expressed in the  Arabic Language. [A. I. Sabra, Isis, 1996, 87:654-670]
 
Introduction:
The west has not done justice to the the influence of the Muslim on the historical development of medicine. Western writers have given little prominence to Islamic' Scientific and  intellectual contributions to this field. But the fact is that the Muslims carried the torch of science and thought in an age when no other civilization was cabbala of doing so.  At one time, learning was regarded as heresy, and the Eastern Christian Church persecuted all scientists. They fleeing from persecution, found no refuge but the Islamic empire, which look them in and acquired from them the scientific heritage of the time. They were given a great deal of veneration and respect by the Muslims, who endeavored to ensure for them a congenial atmosphere in which to work and to develop learning. That was the beginning of a universal cultural revolution which enlightened the ancient world, and which the West later embraced, inheriting from the  Muslims their scientific and intellectual achievements.

Medical Knowledge Pre Islamic Times:
The medical knowledge in the pre Islamic times was negligible, due to the unsettled, nomadic, desert environment the Arabs lived in. It is understandable that the only the only settlement was in  towns such as Mecca, Medina and Al-Ta' if, in the vicinity of oases. The only contact of Arabs with the civilization of other countries came by the way of the trade caravans which made bi-annual trips from Mecca, traveling to Syria in the north and to Yamen in the south.
There were some medical practitioners in pre-Isalmic times, such as Ibn Huzeem, Harith Ibn Kalda al-Thaqafi, Ndr ibn Harith and others.
The only drugs the Arabs knew at that time came from plants and the leaves of trees, certain pods, animal bones, and spice and incense. By and large, they tended to live frugally, and to eat a simple diet, and this may well have protected them against many diseases. It is happened that in the first days of Islam, the ruler of the Copts in Egypt once sent presents, including an Egyptian doctor, to the Prophet Mohammed. The Prophet kept the presents but sent the doctor back, with this message: "We have no need of doctors, for we are people who eat only when we are hungry, and when we eat it is never to excess".

The Sources of Medical Knowledge for the Arabs:
The Arabian peninsula was bounded by several states which had ancient civilizations, such as Egypt and the Byzantine and Persian empires:

• Physicians among the ancient Egyptians had certain specialties: ophthalmology, gynecology, surgery and internal medicine. There were also medical schools attached to ancient Egyptian temples, and the physicians used to combine medicine with the priesthood. Medical knowledge was not all written down, and there were parts of it which were considered secret, not permitted to be revealed, and each generation used to inherit this secret knowledge. In museums and in the drawings on tombs and in papyri, much has been discovered of what the ancient Egyptians knew about the practice of medicine. Physi-cians used to be attached to temples and used to examine and treat ordinary people without fee, and the state rewarded the physician for his services. The pharaohs had physicians attached to their courts. Medical knowledge flourished in ancient Egypt, and some of the drugs which were used then are still used now. There are in the medical papyri accurate descriptions of some of the drugs which were used then are still used now. There are in the medical papyri accurate descriptions of some diseases, their progress and method of treatment.
• Among the ancient Greeks the first physician of prominence was Hippo crates, he considered to be the father of medicine; his descriptions of disease and his clinical talents earned him that title. Hippo crates was held to be the model physician, and the ethics practiced by him are reflected in the so-called "Hippocratic Oath" that doctors swear on starting their medical careers.
• Egypt was the center of medical learning once again from the year 271 BC when the School of Alexandria was set up. Here Herophilus and Erasistratus taught, dissected, and investigated the functions of organs; they were particularly interested in the central nervous system, and they were able to distinguish the sensory from the motor nerves.
• Greek medicine did not make its appearance in Italy until 124 BC, and this was largely due to Asclepiades, who became famous for his interest in mental diseases. Galen (AD131 to 201) is considered to be, without exception, the greatest of the Greek physicians after Hippo crates. It is said of him that he was the initiator of experimental physiology, and he was known to be widely traveled. He became the chief physician in Rome in AD164 and was renowned as a skilled physician and as a scholar. He built a medical system which allowed him to suggest an answer to every question and an explanation for every phenomenon. The comprehensiveness of this system, and possibly also of Galen's teleology, were very appealing to the generations who succeeded him. As a result, there was a tendency for later physicians to neglect original investigation and to rely solely an the authority of Galen instead. For instance, Galen taught that blood passed from the right to the left ventricle of the heart through invisible pores, and was unaware. of the pulmonary circulation; this, Ibn al-Nafis was to describe much later.
• The Nestorian sect, founded in AD428 by Nestorius, the Patriarch of Constantinople, was an heretical sect. The Nestorians were persecuted and so they emigrated to the Syrian city of Al-Ruha (Edessa), where they founded their medical school. But persecution followed them, and the Byzantine Emperor expelled them in AD489. So they emigrated to Persia, where they were welcomed and treated well by the emperor, and they settled there and penetrated eastwards until they reached Jundi-Shapur. And so it was that the Nestorian center of learning moved from Syria to Jundi-Shapur in Persia, and there the Nistorians established a large hospital. Jundi-Shapur became the most prominent cultural center at the time of the Persian Emperor Kisra Anushirawan, who attracted to the city the most famous Indian, Jewish, Syrian and Persian physicians. Kisra used to send his physicians to India to look for medical books to translate from Sanskrit to Persian and Syriac, also the Greek books were translated; and so Jundi-Shapur acquired a large scientific library.

This is merely a brief sketch of the development of ancient times and of how medical knowledge was transferred to the lands bording on the Peninsula, from which the Arabs were to draw their  Medical knowledge when Islam appeared.

Development of Medicine in Islam:

• Islam spread and the Muslims were keen to collect all that was available to them of manuscripts and books of the ancients; such things were frequently the only booty they prized as conquerors.
• When the phase of active conquest was over, the Arabs directed their energies to various branches of learning with great eagerness, and they translated all that they acquired of Greek, Persian and Indian manuscripts. The Christians, Jews, and Nestorians played a large part in this work.
• Within one and a half centuries of the appearance of Islam, Baghdad came under the rule of the Abbassids and Cordova under the Umayyads, and these became world centers for learning and particularly for medicine. Among the famous physicians of Ummayyad times were Ibn Uthal and Abu al-Hakam al-Dimashqi. Ibn Uthal was a Christian, and physician to the first Umayyad caliph, Mu'awiyah. He was skilled in the science of poisons, and during the reign of Mu'awiyah many prominent men and princes died mysteriously. Ibn Uthal was later killed in revenge. Abu al-Hakam al-Dimashqi was a Christian physician skilled in therapeutics. He was the physician to the second Umayyad caliph, Yazid.
• Translation into Arabic began under the rule of the Umayyads in the time of Prince Khalid ibn Yazid. Prince Khalid was interested in alchemy, and so he employed the services of Greek philosophers who were living in Egypt. He rewarded them lavishly, and they translated Greek and Egyptian books on chemistry, medicine and the stars.
• A contemporary of prince Khalid was the great Arab chemist Jabir Ibn Hayan (Geber), who was born in AD705 and died sixty-four years later. He became expert in chemical and al-chemical procedures, and was the first to discover mercury.
• Another medical achievement during the rule of the Umayyads was the hospital for lepers which was built in Damascus. This was the first of its kind and enjoyed many endowments. This should be contrasted with European practice which, even six centuries later, condemned lepers to be burnt to death by royal decree.
• The Umayyad Caliphate lasted for about ninety years, and during that time Islam spread from China in the east to Spain in the west. Translation of scientific books into Arabic had already begun, but under the Abbassids, who succeeded the Umayyads, it was greatly accelerated. An important factor which facilitated the work of translation was the flexibility of the Arabic language, the richness of its terminology, and its capacity for expression.
• The center of the world in all the arts and sciences became Baghdad, which the first Abbassid Caliph, Al-Mansur, took for his capital. The age of Haroun al-Rashid, the ninth-century Caliph renowned in the Arabian Nights, was among the most golden of historical ages. He surrounded himself with the fore-most physicians of the age, who had studied Persian, Greek and Indian medicine.
• It is said that the Caliph Al-Abbas asked his physician Isa ibn Yusuf to prepare an examination of medical competence. Those doctors who did not pass the examination were debarred from medical practice. Some 860 men were successful, and hundreds of charlatans were thus expelled from the profession.
• The Caliph Al-Mansur invited Jurjis ibn Jibrail, a Syrian physician and the head of the hospital in Jundi-Shapur, to attend him. This man was a member of the family of Bakhtyishu which produced many famous physicians through several generations. They served at the Abbassid court for about three centuries, where they attained great wealth and positions which were sometimes higher than those of princes or ministers. Some of them were translators of scientific texts and authors of a number of books on medicine.
• Yuhannah ibn Masawayh was a physician at the time of Haroun al-Rashid. At the Caliph's request, he translated Greek medical books purchased in Byzantium and was himself the author of books on fevers, nutrition, headache, and sterility in women. Al-Mu'tasim the successor to Harnoun al-Rashid, was so interested in Yuhannah's work on dissection that he made a special dissection room available for his use, and he used to have apes specially brought for hirn from Nubia in Africa.
• Hunain ibn Ishaq (Johanitius), was probably the greatest translator in Arab history. He had a superlative knowledge of Syriac, Greek, and Arabic, and carried out a large number of translations from Greek scientific and philosophical manu-scripts into Arabic. These included most of the works of Hippo crates and Galen. After his death, much of this work was continued by his pupils and by his nephew Hubaish. This man Hubaish also wrote books on medicine, among which was a treatise on nutrition.
• There are many other translators who were prominent writers and philosophers. Thabit ibn Qurrah, who wrote many books on a variety of medical topics as well as on philosophy and astronomy;  Qusta ibn Luqa, a contemporary of AI-Kindi, who translated many books into Arabic. There was also Mankah the Indian, who translated from Sanskrit into Arabic, and translated a treatise on poisons written by the Indian physician Shanaq.
• The Abbassid Caliphs were not only concerned with translation. They were also interested in public health, and it was an Abbassid minister, Ali ibn Isa, who requested the court physician, Sinan ibn Thabit, to organize regular visiting of prisons by medical officers. The first hospital in the Muslim empire was built in the ninth century in Baghdad, by the Abbassid Caliph Haroun al-Rashid; after that many other hospitals were built in the Muslim world. The first hospital to be built in Cairo was at the time of the governor of Egypt, Ibn Tulun, in AD872. These hospitals were remarkably advanced in design, for they contained pharmacies, libraries, lecture-rooms for medical students, and separate wards for men and women.
• The age of translation paved the way for the age of composition and innovation. The latter half of the ninth and the tenth centuries form the most creative period in the history of Muslim science and learning.
• Al-Tabari was a native of Tabaristan who was physician to two of the Abbassid Caliphs. He wrote an encyclopedic work on medicine, philosophy, zoology, and Astronomy, and was greatly influenced by the writings of Aristotle and Galen.
• Ai-kazi (Rhazes), AD865 to 925, was a Persian and the pupil of Al-Tabari. He was one of the greatest of Muslim physicians and a most prolific writer. He took a great interest in chemistry and is said to have prepared absolute alcohol from fermented sugars, and to have invented a scale for measuring the specific gravity of fluids. But his great farme rests on his supreme abilities as a clinician, and his descriptions of the clinical signs of many illnesses were unsurpassed. He investigated women's diseases and midwifery, hereditary diseases, and eye diseases. He wrote an account of smallpox and measles, and books on chemistry and pharmacy, but the most famous of his bnoks is Al-Hawi, "the Continence", aq large encycopaedia on medicine in 24 volumes. It was translated into Latin by Sicilian Jewish, it made a great mark on the European thinking in medicine.
• Al-Majusi was also born in Persia. He wrote a medical book called Al-Maliki, known as Liber Regius in Latin translation. It was widely used as a reference work in the Middle Ages. Al-Majusi was the first physician to explain that the foetus does not leave the uterus by its own efforts, but rather that it is extruded by the contractions of the uterus.
• Ibn Sina (Avicenna) was born in 980 and died aged fifty-three. He wrote copiously and on many subjects, but the most famous of his books was The Canon of Medicine. This is an encyclopedic work in fourteen volumes, and embodies the combination of Greek and Arabic medical systems, with the addition of Ibn Sina's personal experience. It deals with diseases, their classification, description, and causes; with therapeutics and the classification of simple and compound medicines; with hygiene, the functions of parts of the body, and with many other topics. In particular, Ibn Sina noted the fact that pulmonary tuberculosis was contagious, and he thought that it spread through soil and water. He also described accurately the symptoms of diabetes mellitus and some of its complications. He was very interested in the effect of the mind on the body, and wrote a great deal on psychological disturbance. The Canon was translated into Latin and published many times. It had the most fundamental influence in Europe during the Middle Ages, and was a standard reference book in universities right up until the seventeenth century.
• The other major cultural center of the Muslim world was Cordova in Spain. The library was reputed to have over 600,000 books. Among the greatest men whom Spain produced was Abu al-Qasim al-Zahrawi (Albucasis), who was born in Al-Zahra in AD936. He is regarded as the most famous of the Arab surgeons, but he was also skilled in the use of simple and compound remedies, and was thus sometimes described as "the pharmacist surgeon". He wrote the famous manual on surgery, called Al-Tasrif, although it also includes sections on the preparation and dosage of drugs, nutrition, public health, and anatomical dissection. The celebrated sections on surgery are illustrated with drawings of about one hundred surgical instruments. There are descriptions of techniques for operating to relieve various conditions, including the amputation of limbs, the removal of foreign bodies, and the crushing of bladder stones. He invented many of the instruments in his book, and in particular ge devised a pair of forceps for use in midwifery. Al-Zahrawi was no mean dentist either; it is said that he per-formed cosmetic operations to correct dental irregularities. His book became famous in the universities of Europe in the Middle Ages. It was translated into Latin by Gerard of Cremona in 1187, and it was the chief reference work for surgery in the universities of Italy and France.
• Ibn Rushd (Averroes) was a twelfth-century physician, philosopher, and astronomer of Cordova. He was primarily concerned with philosophy and wrote an extensive commentary on the philosophical works of Aristotle. But he also practiced medicine and wrote a medical work entitled Al-Kulliyat, which became known in the Latin West as Colliget. Among his many original contributions was the observation that smallpox can only infect once.
• The family of Ibn Zuhr produced through six consecutive generations a number of famous physicians, men and warnen. The most celebrated of them was Ibn Marwan ibn Zuhr (Aven-zoar). He was a contemporary of Ibn Rushd and an extremely able clinician. His book Al-Teisir was among those which were translated early on into Latin and thus passed into Europe.
• Two other physicians who belonged neither to Baghdad nor to Cordova are worthy of note in this survey. Ibn Abi Usaybi'ah was born in Syria and practiced medicine for a while in Cairo. His major contribution to medicine was his large biographical work on the physicians who had preceded him. The second physician of note is Ibn al-Nafis, also born in Syria; he too practiced medicine in Cairo. He refuted what Galen had said about the passage of blood through invisible pores in the septum which separates the right and left ventricles of the heart. He described the lesser (pulmonary) circulation for the first time in history before the English Harvy. It is a regrettable fact that this signal achievement of Ibn al-Nafis received very little notice through the ages and his views were ignored for centuries.

This has been a brief survey of the medical contributions made by some of the most prominent people in Arabic Muslim cultural history.

These pages are edited by Prof. Hamed Abdel-reheem Ead, Professor of Chemistry at the Faculty of Science -University of Cairo, Giza, Egypt and director of the Science Heritage Center

Edited and Prepared By Prof. Hamed A. Ead, Professor of Chemistry, Cairo University

[8th August 1998, Heidelberg, Germany]

 

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