Medicine was an important part of medieval Islamic life; both rich and poor people were interested in health and diseases. Islamic doctors and a number of scholars wrote profusely on health and developed extensive and complex medical literature on medications, clinical practice, diseases, cures, treatments and diagnoses. Unlike medical literature today, which is specialized, in the medieval Islamic world it was integrated with natural science, astrology, alchemy, religion, philosophy and mathematics.
Islamic medicine built on the legacies left behind by Greek and Roman physicians and scholars. Islamic physicians and scholars were strongly influenced by Galen and Hippocrates, who were viewed as the two fathers of medicine, closely followed by the Greek scholars of Alexandria, Egypt. Most medical literature from both the Greek and Roman civilizations was translated into Arabic, and was later adapted to include their own findings and conclusions.
Islamic scholars were experts in gathering data and placing them in order so that readers could find them easier to understand and search backwards and forwards through various texts. They turned many of the Greek and Roman writings into summaries and encyclopedias.
Put simply, Islamic medicine built on Greek medical tradition and then formed its own. In fact, it was through reading Arabic versions that Western doctors learned of Greek medicine, including the works of Hippocrates and Galen.
Islamic medicine was not a subject in its own right in the medieval Islamic world – it was immersed into the culture. The publication of literature was a prestigious profession – paper making was sophisticated, books had illustrations, calligraphy was considered an art in itself. For readers of medicine at the time, those published in the Islamic world were fascinating to read.
From 661 to 750 AD, an early Islamic period called Umayyad, people generally believed that Allah (God) would provide treatment for every illness. By 900 AD Islam started to develop and practice a medical system slanting towards science.
As people became more interested in health and health sciences from a scientific point of view, Islamic doctors strived to find healing procedures, with Allah’s permission, that looked at the natural causes and potential treatments and cures.
The Medieval Islamic world produced some of the greatest medical thinkers in history, they also made advances in surgery, built hospitals, and welcomed women into the medical profession.
Al-Razi and Ibn Sina, two important medical thinkers
Muhammad ibn Zakariyā Rāzī
Muhammad ibn Zakariyā Rāzī (Al-Razi) (865-925), was a Persian physician, chemist, alchemist, philosopher and scholar. He was the first to distinguish measles from smallpox. He also discovered the chemical kerosene, as well as several other compounds. He became chief physician of Baghdad and Rey hospitals.
The eminent British historian, Edward Granville Browne (1862 – 1926), said that Al-Razi was “probably the greatest and most original of all the physicians and one of the most prolific as an author”. Razi wrote over 200 scientific books and articles.
Al-Razi, known as the “father of pediatrics”, was a great believer in experimental medicine. He wrote a book called The Diseases of Children, which is probably the first ever to place pediatrics as a separate field of medicine. He also pioneered ophthalmology. He travelled all over Persia teaching medicine. He is said to have been compassionate about treating both rich and poor patients equally.
Al-Razi was the first doctor to write about immunology and allergy. He is thought to have discovered allergic asthma. He was the first person to explain that fever is part of the body’s defense mechanism for fighting disease and infection.
He was also a pharmacist and wrote extensively on the subject, introducing the use of mercurial ointments. Many devices are attributed to him, including spatulas, flasks, mortars, and phials. Regarding medical ethics, Al-Razi wrote:
“The doctor’s aim is to do good, even to our enemies, so much more to our friends, and my profession forbids us to do harm to our kindred, as it is instituted for the benefit and welfare of the human race, and God imposed on physicians the oath not to compose mortiferous remedies.”
He also believed that demons could posses the body and cause mental illness; a common belief at the time.
Abū ʿAlī al-Ḥusayn ibn ʿAbd Allāh ibn Sīnā
Abū ʿAlī al-Ḥusayn ibn ʿAbd Allāh ibn Sīnā (c. 980 -1037), often referred to as Ibn Sina or Avicenna (Latinized name) was a Persian polymath (one with numerous skills and professions) who was a prolific writer. Of 450 books and articles written by him, 240 still exist today, of which 40 focus on medicine.
Ibn Sina wrote The Book of Healing, an enormous scientific encyclopedia, as well as The Canon of Medicine, which became essential reading at several medical schools around the world, including the universities of Leuven (Belgium) and Montpellier (France) up to the middle of the sixteenth century. His book was based on the principles of Hippocrates and Galen.
The Canon of Medicine (The Law of Medicine) consists of a 5-volume encyclopedia. It was originally written in Arabic and later translated into several languages, including English, French and German. It is considered one of the most famous and influential books in the history of medicine.
The Canon of Medicine set the standards for medicine in both the Islamic world and Europe. The book is also the basis for a form of traditional medicine in India, known as Unani medicine. The UCLA and Yale Universities in the USA still teach some of the principles described in this work as part of the history of medicine curriculum.
George Sarton (1884-1956), a Belgian chemist and eminent historian, considered as the founder of the discipline of the history of science, wrote in one of his books the Introduction to the History of Science:
“One of the most famous exponents of Muslim universalism and an eminent figure in Islamic learning was Ibn Sina, known in the West as Avicenna (981-1037). For a thousand years he has retained his original renown as one of the greatest thinkers and medical scholars in history. His most important medical works are the Qanun (Canon) and a treatise on Cardiac drugs. The ‘Qanun’ is an immense encyclopedia of medicine. It contains some of the most illuminating thoughts pertaining to distinction of mediastinitis from pleurisy; contagious nature of phthisis; distribution of diseases by water and soil; careful description of skin troubles; of sexual diseases and perversions; of nervous ailments.”
The Canon mentions how new medicines should be tested, below are quotations which have been adapted to modern English:
- The active ingredient must be pure, free from any accidental extraneous quality
- The drug must be used on just one simple disease, not a cluster of diseases
- Test the medication on two contrary types of diseases. Sometimes the essential qualities of a drug may treat one disease effectively, while curing another by accident
- A medication’s quality must match the severity of the disease. The heat of one drug may be less than the coldness of a disease, rendering it ineffective
- The whole process must be timed carefully, so that the drug’s action is clearly noted, rather than any other confounding factor
- The medication’s efficacy must be consistent, with similar results after experimenting with many patients. Otherwise, the trial can’t tell whether accidental effects were in play
- Testing must be done on humans, not animals. Testing on a horse or a lion does not prove it will work on humans
Idn Sina’s views on psychology and mental illness were more practical and scientific than Al Razi’s.
Medieval Islam’s contribution to human anatomy and physiology
Ibn al-Nafi, an Arab physician born in Damascus in 1213, is thought to be the first person ever to describe the pulmonary circulation of blood. He said he did not like dissecting human corpses because of his own compassion for the human body and the shari’a (code of law based on the Koran). Medical historians believe he probably did his research with animals.
The Greek physician, Galen, centuries before had said that blood reached the left ventricle in the heart to the right ventricle through invisible passages in the septum. Al-Nafi believed this was wrong. Al-Nafi wrote:
“The blood from the right chamber of the heart must arrive at the left chamber but there is no direct pathway between them. The thick septum of the heart is not perforated and does not have visible pores as some people thought or invisible pores as Galen thought. The blood from the right chamber must flow through the vena arteriosa (pulmonary artery) to the lungs, spread through its substances, be mingled there with air, pass through the arteria venosa (pulmonary vein) to reach the left chamber of the heart and there form the vital spirit…
“The heart has only two ventricles …and between these two there is absolutely no opening. Also dissection gives this lie to what they said, as the septum between these two cavities is much thicker than elsewhere. The benefit of this blood (that is in the right cavity) is to go up to the lungs, mix with what is in the lungs of air, then pass through the arteria venosa to the left cavity of the two cavities of the heart and of that mixture is created the animal spirit.”
Ancient Greek medicine said that a visual spirit in the eye allowed us to see. Ibn al-Haytham (Al-hazen in Latin) (965-c. 1040), an Iraqi Muslim scientist, explained scientifically that the eye is an optical instrument. He described the anatomy of the eye in great detail and later formed theories on image formation. Al-haytham’s Book of Optics became widely read throughout Europe until the 17th century.
Ahmad ibn Abi al-Ash’ath, an Iraqi doctor, described how a full stomach dilates and then contracts after experimenting on live lions. al-Ash’ath preceded William Beaumont by nearly 900 years in carrying out experiments in gastric physiology.
Abd al-Latif al-Baghdadi (1162-1231), a famous Iraqi physician, historian, Egyptologist and traveler, said that Galen was wrong to say that the lower jaw consists of two parts. On observing the remains of humans who had starved to death in Egypt, he concluded that the lower jaw (mandible) consists of just one bone. In his work, “Book of Instruction and Admonition on the Things Seen end Events Recorded in the Land of Egypt”, he wrote:
“What I saw of this part of the corpses convinced me that the bone of the lower jaw is all one, with no joint nor suture. I have repeated the observation a great number of times, in over two thousand heads…I have been assisted by various different people, who have repeated the same examination, both in my absence and under my eyes..”
Sadly, Al-Badhdadi’s observation was ignored.
Medieval Islamic drugs and remedies
As in Ancient Greece, Rome and Egypt, Medieval Islamic medications consisted of natural substances, many of which were plant based. Most of the remedies had also been used in ancient Greek and Roman medicines.
- Mercuric chloride was introduced by Muslim scholars to disinfect wounds.
- Poppy(Papaver somniferum Linnaeus) – this was used to relieve pain. Poppy seeds contain both codeine and morphine. According to literature, poppy was used to relieve the symptoms of pain from gallbladder stones, fever, toothaches, pleurisy, headaches, and eye pain. It was also used to make people “go to sleep before an operation”. Ali al-Tabariwarned was against taking the extract of poppy leaves, saying they could be deadly, and that opium was a poison.
From 800 AD onwards, the use of poppy was restricted to healthcare professionals.
- Hemp(Cannabis sativa Linnaeus) – Islamic doctors followed Dioscorides’ advice and used the seeds to help during childbirth. Hemp juice was used for earache.
Hemp came into Islamic countries from India around 900 AD.
- Fennel – commonly used to calm people down.
- Garlic – had many uses. It was given to people with heart problems.
- Willow – was used as an antiseptic
Did Medieval Islamic doctors perform surgery?
Islamic society built many hospitals, and there was much more surgery going on compared to ancient Greece and Rome. Hospitals were called Bimaristan, which means “house of the sick” in Persian.
As there were no proper anesthetics like we have today, it was not possible to carry out sophisticated surgery deep inside the human body. However, doctors used opium to induce sleep before operations.
Many procedures were learnt from Greek and Roman texts.
Surgery was rarely practiced outside hospitals, because of the very high death rate.
Ophthalmologists made advances in surgeries of the eye, and treated patients with cataracts and trachoma.
Cauterization (when the skin or the flesh of a wound is burnt) was a common procedure to prevent infection and stem the bleeding of wounds. Doctors heated a metal rod and placed the red-hot metal on the skin or flesh of a wound; the blood would immediately clot and the wound would have a chance to heal.
Bloodletting was used to restore the balance of humors. Blood would be drained from a vein. Sometimes “wet-cupping” was used to draw blood – a small incision is made on the skin and then a heated cupping glass is placed on it.
Records show that male members of the household did not like having their females being examined by male physicians, unless it was a life-or-death situation. They preferred to have their women and girls examined and treated by females, or by themselves. Even the women were not happy about having a male practitioner present during, for example, childbirth.
Of the great civilizations, it was in Medieval Islam that female doctors started to appear in large numbers.
According to the writings of the “medicine of the prophet”, men could treat women and women could treat men, even if this meant exposing their genitals when circumstances made it necessary. Various documents during that period mention female physicians, midwives and wet nurses.
Originally posted: A History Of Medicine