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The Islamic Medicine in the Period of Islamic Epoch

The most famous and notable physican of this time and perhaps of the entire early Islamic era is no doubt Muhammad ibn Zakariyya al-Razi(born 251 AH/865 AD; died 312 AH/925 AD) called Rhazes by his Latinized name. Born in Rayy in northern Persia not much is known about his early life or his medical educartion. His fame starts with the establishment of a hospital in Baghdad of which he was the chief.

The story of how he picked the site of the Hospital when asked to select one, has become one of the classical legends of Islamic Medicine. He had pieces of meat hung in various quarters of the city and had them examined for putrefaction and reccomended the site where the meat had decayed the least as the most suitable site thus making him the first physician to infer indirectly the bacteriologic putrefaction of meat, and suggesting the environmental role that contaminated air plays in the spread of infection, predating by centuries the modern concept of air borne infection.

But besides this astute observation Al-Razi is known for numerous other original contributions to the Art and Science of Medicine. Although not the first to describe the diffeences between Small Pox and Chicken Pox and give an indepth description of measles in his famous work Kitab al Jadari wa'l-hsbah (Tretise on Small Pox and Measles) his was the one that became well known in the west because of frequent translations. He described allergy to roses in one of his classical cases. The famous Islamic hisrtorian and scientist al-Biruni has listed 56 medical works of al-Razi the most famous being al-Hawi or the Continens which is an Encyclolpedia of medical knowledge based on his personmal observations and experiences.

A scribed copy of this book was recently exhibnited by the National Library of Medicine in Bethesda, Maryland USA celebrating 900th Anniversary of its completion by an unknown sribe., and recorded as the third oldest Medical manuscrript preserved in the world today. A shorter medical textbook was dedicated to al-Mansur and hence called Kitab al-Mansuri.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Adapted from the book: "Islamic Medicine" by: "Husain F.Nagamia"

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