ISLAMIC MEDICINE: HISTORY AND PRINCIPLES
Medicine is among the most famous and best known sectors of Islamic civilization, being one of the branches of science where Muslims stood out most. Not only were Muslim doctors seriously studied in the West in the Middle Ages, but still in the Renaissance and in the eleventh / seventeenth centuries their teachings continued to weigh in Western medical circles. In fact, only a century and a half ago the study of Islamic medicine was completely omitted from the curriculum of medical schools throughout the Western world. In the East, despite the rapid spread of Western medical education, Islamic medicine continues to be studied and practiced, and is far from being merely of historical interest.
This school of medicine, which arose early in the history of Islam, is of great importance not only for its intrinsic value, but also because it has always been intimately connected with other sciences, and especially with philosophy. The essay, or hakīm, which was in the whole history of Islam the central figure in the propagation and transmission of the sciences, was usually also a physician. The relationship between the two is in fact so close that both the sage and the physician are called hakīm; many of Islam's best-known philosophers and scientists, such as Avicenna and Averroes, were also doctors, and made a living by practicing medical art. (The same is true, by the way, for the Jewish philosophers, like Maimonides, who, besides being a great thinker, was also the doctor of Saladin).
This close relationship between the philosopher-sage and the physician had a great influence on the position occupied by the practitioner of medical art in Islamic society, and on the conception that the community had of him. It was generally expected of the physician that he was a man of a virtuous nature, combining scientific insight and moral qualities, and that his intellectual strength was never separated from a deep religious faith and trust in God.
Despite the high position occupied by the doctor and the dignity in which his function was held, one should not think that everyone in the Islamic world had an absolute faith in medical art. Many, especially among the Arabs, continued to harbor a lack of trust in this art (which had been, after all, adopted by foreign sources) and remained skeptical of the physician's ability to treat diseases of the body.
In opposition to such a skeptical view, however, there were some who promptly accepted the claims of medical art, and which nurtured respect for those who practiced it. Even among the Arabs themselves, who during the first centuries were usually less inclined towards this art than the Persians, Christians or Jews, medicine ended up integrating into the fabric of their language. The Arabs began to talk about it in their daily lives, and soon they created an excellent technical vocabulary, for terms of Greek origin, and also pehlevica and Sanskrit, which greatly facilitated the study of medicine in Arabic. The interest in various medical matters in everyday life became in fact so great that many Arab poets wrote verses on medical subjects. The beautiful poetry on fever composed by al-Mutanabbī, the famous Arab poet who was seized by the fever in Egypt in the 348 / 960, attests the penetration of medical ideas into Islamic culture.
Islamic medicine arose as a result of the integration of the Hippocratic and Galenic traditions of Greek medicine with the theories and practices of the Persians and Indians, within the general context of Islam. It is therefore synthetic in nature, combining the experimental and concrete approach of the Hippocratic school with the theoretical and philosophical method of Galen, and adding the theories and experiences of Persian and Indian doctors to the already vast patrimony of Greek medical knowledge, especially in pharmacology. Moreover, Islamic medicine remained mostly closely related to alchemy, investigating - as did Hermetic and Stoic physics - the concrete causes of individual phenomena rather than the general causes sought by the peripatetic "natural philosophy". In this way it also maintained its links with a numerical and astrological symbolism, which had already become an important element of Alexandrian Hermeticism before the advent of Islam.
The link between Islamic medicine and the oldest schools is found in the school of Jundishapur, which must be considered the most vital organic connection between the Islamic medical tradition and previous traditions. Jundishapur, whose site was near the current Persian city of Ahwaz, has an ancient history dating back to prehistoric times, when it was called Genta Shapirta, or "The Beautiful Garden". The city was refounded at the end of the 3rd century by Shāpūr (Flavor) I, the second Sassanid king, a short time after he defeated the Byzantine emperor Valeriano and conquered Antioch. The Persian monarch thought of making the city a cultural center that could rival Antioch and even overcome it, and then called it Vehaz-Andev-i Shāpūr, or "that of Shāpūr better than Antioch." The name "Jundishapur", with which the city became famous in the Islamic period is, in all likelihood, a simplification of the name given to it by Shāpūr I, but at the same time resembles the earlier name mentioned above. Jundishapur quickly became a leading cultural center, especially Hippocratic medicine. Its importance increased even more after the 489 AD, when by order of the Byzantine emperor the school of Edessa was closed and its doctors sought refuge in that city. Shāpūr II expanded Jundishapur and established a regular university there, in which various medical schools are intertwined. It was here that the Nestorian doctors taught and practiced Greek medicine, while Zoroastrian ideas and local Persian medical practice continued to exert great influence; the last philosophers and scientists of Athens also sought refuge when, in 529 AD, Justinian ordered that the school of Athens be closed. In addition, Jundishapur gradually began to feel the influence of Indian medicine, especially during the sixth century, under the reign of Anūshīrawān the Just, who sent his vizier Burzūyah (or Perzoe) to India to learn the sciences from the Indians. Burzūyah, returning to Persia, brought not only the tales of Bidpai, but also a knowledge of Indian medicine, as well as various Indian doctors. He is credited with a book called Wisdom of the Indians, translated from Arabic into Greek in the 462 / 1070 by Simeon of Antioch.
The school of Jundishapur thus became the meeting ground for Greek, Persian and Indian medicine. His activities continued to expand and there, in a cosmopolitan and free atmosphere, a new school arose, which was a synthesis of the various medical traditions. The Jundishapur school was at the height of its evolution at the beginning of the Islamic era, and prospered well in the Abbasid period, when its doctors were slowly transferred to Baghdad. Still in the 8th / 14th century, Muslim travelers and geographers spoke of the city as a prosperous city, even though its scientific activity had already moved elsewhere. And today, on the site of the ancient city, stands the village of Shahabad, which attests to the existence of a once thriving metropolis, seat for several centuries of the most important medical center of Western Asia, and the most direct bridge between medicine Islamic and pre-Islamic.
At the beginning of the Islamic period Greek medicine continued to be practiced in Alexandria, once the greatest center of Hellenistic science. This school, which combined Egyptian theories and practices with those of the Greeks, had ceased already some time before the advent of Islam to produce prominent physicians; as far as the practice is concerned, it seems that everything leads one to think that Hellenistic medicine was still alive when the Muslims conquered Egypt in the I / VII century. The traditional Islamic sources speak especially of John the Grammatic, a Jacobite bishop of Alexandria who was held in high esteem by 'Amr ibn al-'s, the conqueror of Egypt. (This John should not be confused with the philosopher Giovanni Filopono, also called "the Grammar." The latter, whose criticisms of some theses of the Aristotelian theory of motion were well known to Muslim philosophers, flourished a century earlier, and he is not particularly famous for his medical knowledge.)
Whatever the measure of the vitality of the Greco-Egyptian medical practice in Alexandria may have been, there is no doubt that, through the doctors of that city, and also through the medical works that still survived in its libraries, Muslims acquired a certain degree of familiar with Greek medicine. Many of the most frequently cited Greek authors - such as Hippocrates, Galen, Rufus of Ephesus, Paul of Aegina and Dioscorides - as far as the materia medica was concerned - probably first became known to Muslims through Alexandria. Furthermore, the certainly authentic reports of the Umayyad prince Khālid ibn Yazīd, who went to Alexandria to learn alchemy and who had the first translations of Greek texts carried out in Arabic, attest to the existence of some tradition of teaching in Alexandria. era, even if it is certain that what survived in that period could not be in any way comparable with the school of a few centuries earlier. Similarly, the famous library of Alexandria, whose fire has been wrongly attributed by many Western scholars to Caliph 'Umar, had been largely destroyed long before the advent of Islam. In any case, there is little doubt that Muslims made some kind of contact with Greek medicine in Alexandria, although this contact was far less significant than that which occurred in Jundishapur, where the medical school was at the height of its activity during the early Islamic period.
The Arabs who, under the banner of Islam, conquered both Alexandria and Jundishapur and took possession of the main centers of science and medicine, also had their own primary medicine, which did not undergo any change unchanged with the advent of Islam , but had to wait until the II / VIII century to be transformed by Greek medicine. The first Arab doctor whose name is mentioned in later chronicles is al-æārith ibn Kaladah, who was a contemporary of the Prophet and who had studied medicine at Jundishapur. However, the Arabs of his time remained largely skeptical about this foreign form of medicine. Much more significant to them were the Prophet's sayings about medicine, hygiene, diet, etc., which they accepted unconditionally and which followed with all the burning faith that characterized the first Muslim generations.
Islam, as a guide for all aspects of human life, also had to deal with the more general principles of medicine and hygiene. There are various verses of the Qur'an in which very general medical questions are discussed; there are also many sayings of the Prophet dealing with health, illness, hygiene and other matters pertaining to the field of medicine. Diseases such as leprosy, pleurisy and ophthalmia are mentioned; remedies such as cups, cautery and the use of honey are proposed. This corpus of statements about medical issues was systematized by later Islamic authors, and became known as the Medicine of the Prophet (Tibb al-Nabī). The beginning of the fourth volume of the collection of prophetic traditions of Bukhārī, which is among the most authoritative sources of its kind, consists of two books in which are collected, in 80 chapters, the sayings about the disease, its treatment, the patient etc. . There are also other medical books of a religious nature, in particular the medical work attributed to the sixth Imam Shiite, Ja'far al-Sādiq.
Since all the sayings of the Prophet are fundamental indications for the life of the devout Muslim, these last sayings, though not containing an explicit system of medicine, have played a major role in determining the general atmosphere in which Islamic medicine is come to be practiced. Their indications have been followed over the centuries by all successive generations of Muslims; they have determined many of the dietary and hygienic habits of Muslims. In addition, the Medicine of the Prophet became the first book to be studied by a medical student, before embarking on the task of mastering the usual compendiums of medical science. It therefore always played an important role in creating the mental arrangement with which the future physician undertook the study of medicine.
The first direct influence of Jundishapur on Islamic environments occurred in 148 / 765, when the second Abbasid caliph, the founder of the city of Baghdad, al-Mansūr, who suffered from dyspepsia for many years, sought the help of Jundishapur's doctors. For some time the hospital and the medical center of that city had been led by Jirjīs Bukhtyishū '(Syriac name which means "Jesus saved"), the first famous doctor of a family that would become one of the most important families of doctors of the Muslim world, whose members continued to be eminent physicians in the 5th / 11th century. The reputation of Jirjīs as a competent physician had already reached the ear of the caliph, who asked that this Christian doctor be brought to his court. The success of Jirjīs in the care of the caliph was the beginning of a process that over time transferred the medical center of Jundishapur to Baghdad, and that paved the way for the advent of the first famous Muslim doctors. Towards the end of his life Jirjīs returned to Jundishapur to die in the native city of his ancestors. His disciples, as well as his descendants, however, returned to Baghdad, thus forming the organic link between this school and the first medical centers in the Abbasid capital.
Another family of doctors who originally came from Jundishapur and then moved to Baghdad, which rivals the importance of the Bukhtyishū family, is that of Māsawaih (or Māsūyah, in his Persian pronunciation). The ancestor of this family, Māsawaih, was a physician and pharmacologist without education, who spent thirty years getting medical experience in the dispensary of Jundishapur hospital. When he was forced to retreat, he went to Baghdad, looking for his fortune in that thriving capital. Quivi became a famous ophthalmologist and private doctor of the vizier of Hārūn al-Rashīd. Even his three sons became doctors; among them, Yuáannā ibn Māsawaih (the Latin Mesuè il Vecchio or "Janus Damascus") must be considered one of the important physicians of this period. Ibn Māsawaih, the author of the first ophthalmological treatise in Arabic, became the most distinguished physician of his time. His sharp tongue, his rebellious character and skepticism towards Christianity - to which he formally adhered - created him many enemies; but he succeeded, thanks above all to his unparalleled mastery of medical art, to retain his position of eminence until his death in the 243 / 857.
The medieval West also knew another Mesuè figure (called "the Younger" to distinguish it from the older Mesuè) with the name of Mesuè. Although the pharmacological and medical works attributed to Mesuè the Younger - including Grabadin - were among the most read of their kind in the Latin world, little is known of the true identity of this character, which medieval Latinists called the evangelist Pharmacopoeorum. Giovanni Leone Africano writes that he was born in a village of Iraq called Marind, and is therefore called Māsawaih al-Mārindī. Some modern scholars have even doubted its existence; others, like C. Elgood, whose masterly study of Arabian medicine presents him as one of the major authorities in this field, believe that he can be one with Mesuè il Vecchio. But whatever the origin of this figure, at least his work, added to that of Mesuè il Vecchio, has contributed to making the name of Mesuè one of the most famous in the Western image of Islamic medicine.
The first translators of medical texts in Arabic, like the first doctors, were mostly Christians and Jews. The first translation known in Arabic appears in the Pandects of an Alexandrian priest named Ahrūn; it was performed by a Jewish scholar from Basra, known in the West as Masarjoyah, who lived during the Umayyad period. This work has been held in high esteem by most of the later medical authors, and the name of this first translator of medical texts became famous in later works of medical history.
Interest in Greek culture, which had gradually developed during the latter part of the Umayyad government, took on unprecedented dimensions during the Abbasid period, when, as we saw in a previous chapter, it was done by the government and individuals. influential a joint effort to have translations into Arabic. In the early years of the Abbasid dynasty Ibn Muqaffa 'began his translation of medical texts from the pehlevico into Arabic, followed a generation later by Mesuè il Vecchio. Particularly important among the private patrons of this movement were the members of the Barmecidi family, who were the viziers of the Abbasids. It was the Barmedice Yahyā to hire the Indian doctor Mikna to translate works on Indian medicine into Arabic; one of them, entitled Sarat, has survived until today.
The greatest of all translators of this period was however Hunain ibn Ishāq, or Johannitus Onan, as he knew the medieval West. Hunain was not only a very competent translator; he was also one of the most eminent doctors of his time. His medical research led him to Jundishapur, where he studied with Ibn Māsawaih. The latter, however, was disappointed with him, and tried to discourage him from continuing the study of medicine. Without losing heart, he continued to master the discipline and became one of the most important personalities in the formation of the Islamic sciences of the time.
Helped by his nephew Hubaish and his son Ishāq, Hunain often translated texts from the Greek into Syriac, leaving the translation from Syriac to Arabic to his disciples, and especially to Hubaish. In these cases he reviewed the final translation, and compared it himself with the Greek original. At other times he would have translated directly from the Greek into Arabic. In this way, Hunain and his school performed a large number of excellent translations, including 95 works by Galen in Syriac and 99 in Arabic. There were other famous translators, such as Thābit ibn Qurrah, mathematician from Harran or Ellenopolis, who also translated and wrote various medical works, of which the Treasury is the best known. None of these figures, however, can compete with that of Hunain, whose mastery both as a translator and as a doctor qualifies him to be considered one of the fundamental figures in the history of Islamic medicine.
With medical texts of Greek origin, pehlevica and Sanskrit translated into Arabic, and a healthy, well-founded technical vocabulary, the ground was ready for the appearance of those few giants whose works have dominated Islamic medicine ever since. The author of the first major work of Islamic medicine was' Alī ibn Rabban al-Tabarī, a convert to Islam, who wrote, in the 236 / 850, the Paradise of Wisdom (Firdaus al-Hikmah). The author, who was also the teacher of al-Rāzī, drew mainly on the teachings of Hippocrates and Galen, and also by Ibn Māsawaih and Hunain. In 360 chapters he summarized the various branches of medicine, dedicating the last discourse, which consists of 36 chapters, to a study of Indian medicine. The work, the first major compendium of its kind in Islam, has a particular value in the fields of pathology, pharmacology and dietetics, and clearly shows the synthetic nature of this new school of medicine that was now rising.
Al-Tabarī's disciple, al-Rāzī, was undoubtedly the greatest clinical and observational physician of Islam and, together with Avicenna, the most influential, both in the East and in the West. We will have occasion to discuss him later, in the chapter dedicated to alchemy; here we take care of the results he achieved in medicine, which remain the most valid part of his work, the main cause of his fame. Attracted in old age by medicine, al-Rāzī became director of the hospital in his hometown of Rayy, and later director general of the main hospital in Baghdad. Thus he acquired a great practical experience, which had a small part in making him the greatest clinician of the medieval period.
The ability of al-Rāzī in the prognosis, and his analysis of the symptoms of a disease, his way of treatment and care, have made his studies of clinical cases famous among the later doctors.
The work of al-Rāzī best known in the Western world is his treatise on measles and smallpox, which was published many times in Europe, again in the eighteenth century. In addition to this, and many other short treatises on various diseases, al-Rāzī also composed several large medical works, including the Compendium, Sufficiente, Introductio maior e minor, the Guide, the medical books Liber regius and Splendido, besides the Book of al-Mansūr and the Kitāb al-Hāwī (Continens), which are his two greatest masterpieces. The Continens is the most voluminous medical work ever written in Arabic. It must be considered the most fundamental source for the study of the clinical aspects of Islamic medicine. It was avidly studied in the Western world from the 6th / 12th centuries to the 11th / 17th centuries, when al-Rāzī and Avicenna were held in a higher esteem than even Hippocrates and Galen, and constitute one of the main points of the traditional medical curriculum in the world Islamic.
As a master of psychosomatic medicine and psychology, al-Rāzī treated the diseases of the soul along with those of the body, and never completely separated them. He actually composed a work on the medicine of the soul in which he sought to demonstrate the way to defeat those moral and psychological illnesses which spoil the mind and body and upset that total state of health which the physician seeks to preserve. In this book, titled in the English translation Spiritual Phisick, al-Rāzī devotes twenty chapters to the various diseases that afflict the soul and body of man.
Al-Rāzī's contributions to medicine and pharmacology, as contained in his many medical writings - al-Bīrūnī mentions 56 -, are numerous. He was the first to identify several important diseases, such as smallpox, and to treat them successfully. He is generally attributed the isolation and use of alcohol as an antiseptic and the use, for the first time, of mercury as a purgative, which became known in the Middle Ages as "Album Rhasis". Although vehemently criticized by both Sunnis and Shiites for his "anti-prophetic" philosophy, his medical opinions became the undisputed authority wherever medicine was studied and taught; he came to exercise on Latin science an influence greater than that of any other Muslim thinker, if we exclude Avicenna and Averroes, whose great influence was exercised in the field of philosophy.
After al-Rāzī, the most eminent physician, whose writings were of universal importance, was' Ali ibn al-'Abbās al-Majūsī (Latin 'Haly Abbas'). As its name indicates, it was of Zoroastrian ancestry (Majūsī means Zoroastrian), but he himself was a Muslim. Although little is known of his life, from the dates of some of his contemporaries we can deduce that he flourished during the second half of the fourth / tenth century, who died around the 385 / 995 and that came from Ahwaz, near Jundishapur. Haly Abbas is best known for his Kāmil al-Sinā'ah (The perfection of art) or Kitāb al-malikī (Royal Book or Liber Regius), which is one of the best medical works written in Arabic and which remained a text base up to the appearance of the works of Avicenna. The Liber Regius is of particular interest because in it Haly Abbas discusses the Greek and Islamic doctors who had preceded him, giving a frank judgment on their virtues and their shortcomings. Haly Abbas has always been considered one of the leading authorities in Islamic medicine, and many anecdotes have been recorded revealing his insight in dealing with various diseases.
Haly Abbas' works, like those of most of the early doctors of Islam, were overshadowed by those of Avicenna, the most influential of all Islamic physicians and philosophers, who for many centuries held in the West the title "Prince of doctors "and dominated until today Islamic medicine in the East. The name of Avicenna and its influence are recognizable in every place and at any time when the sciences have been studied and cultivated in the Muslim world, and especially in medicine, where the perfection and lucidity of his works have overshadowed many treaties front. Like many other celebrated philosophers and scientists of Islam, Avicenna practiced medicine to earn a living, while his love of knowledge led him to take care of all the areas of philosophy and the sciences of his time. In many of these he became unparalleled, especially in the Peripatetic philosophy, which reached his apogee with him. However, this intense devotion to philosophy did not in any way make him an incapable doctor. On the contrary, his intellectual gifts allowed him to unify and systematize all the theories and medical practices of the previous centuries in a vast synthesis that clearly shows the imprint of his genius.
Avicenna wrote a large number of medical works in Arabic, and also some in Persian, including treated on specific diseases, as well as poems that summarize the basic principles of medicine. His masterpiece, however, is the Canon of Medicine (Canon medicinae), which was certainly the most read and influential work of Islamic medicine. This vast work, which was among the most frequently printed books in Europe during the Renaissance, in the Latin translation of Gerardo da Cremona, includes five books: general principles, simple medicines, diseases of particular organs, local diseases that tend to spread over the 'whole body, like fever, and compound drugs. In these books Avicenna summarized the theory and medical practice in such a way that the Canon became once and for all the authoritative source of Islamic medicine.
Avicenna possessed a great clinical penetration, and was given the first description of various drugs and diseases, including that of meningitis, which was the first to describe correctly. But he is celebrated essentially for his penetration and his understanding of the philosophical principles of medicine on the one hand, and for his mastery in the psychological treatment of physical infirmities, or in "psychosomatic medicine", as we would say today, on the other .
Many stories of clinical cases have been attributed to Avicenna, which have become an integral part of Persian and Arabic literature, and have crossed the boundaries of medical science. Some of these stories have become so famous that they have been adopted and transformed into Gnostic tales by the Sufis, while others have entered into the folklore of the Islamic peoples.
With al-Rāzī and Avicenna Islamic medicine reached its apogee, and was incorporated into the writings of these men in the final form that it would take for subsequent generations of students and practitioners. Medical students usually began their formal studies with the Hippocratic Aphorisms, the Hunain ibn Ishāq Issues, and the al-Rāzī Guide; then they passed to the Treasury of Thābit ibn Qurrah and al-Mansūr's Book of al-Rāzī; finally they addressed the study of the Sixteen treatises of Galen, of the Continens and of the Canon medicine. The Canon of Avicenna thus became the final authority in the field of the medical profession, its study and its understanding being the goal towards which the entire medical curriculum was oriented. Even in later centuries, when many other important medical encyclopedias were written in both Arabic and Persian, Canon continued to maintain its privileged position. Its author, together with al-Rāzī, was considered the supreme authority in the field of medicine, in the West until the seventeenth century, and in the East until today.
The medical tradition, based on the works of Avicenna, al-Rāzī and other ancient masters, continued to flourish in Egypt and Syria, in the Maghreb and in Andalusia, in Persia and in the other eastern countries of Islam. In Egypt, where eye diseases were always widespread, ophthalmology developed in particular, leaving a profound mark even in the West, as can be seen in Arabic words such as retina and cataracts. Even in pre-Islamic times, Egyptian ophthalmologists such as Antillo and Demostene Filalete were well known. In the Islamic period studies in this field continued with the same intensity. The first major treatise on the eye was the notebook of the oculists of 'Alī ibn' Isā (Jesus Haly) of Baghdad, composed at the end of the fourth / tenth century, and followed a short distance from the Book of Selections on the treatment of the Canamusal eye , who was the doctor of the Egyptian sovereign al-hākim. These works remained authoritative in their field in the West until the publication of Kepler's Dioptrice; they continued to be consulted until the eighteenth century, when the study of this branch of medicine was resumed in France. The court of al-hākim was also the scene of the activities of Alhazen, who, as we have seen, was the greatest Muslim optician, and also performed many studies on the structure and disease of the eye, especially as regards the problem of vision.
Egypt was also the center of activity of many other famous doctors, such as' Alī ibn Riḍwān (the Latin «Haly Rodoam»), who lived in the V / XI century, who wrote commentaries on Galen's works and led a series of harsh controversy with Ibn Butlān, the author of the Health Calendar, which had settled in Cairo from Baghdad. The hospitals and libraries of Cairo always attracted doctors from every place, as when, for example, two centuries later Ibn Nafis, who was born in Damascus, finally settled in Cairo, dying in 687 / 1288.
Ibn Nafis, who has attracted the attention of scholars only from a generation, was the discoverer of the small circulation or pulmonary circulation, while it was thought until recently that it had been discovered in the sixteenth century by Michele Serveto. Ibn Nafis made a critical study of the anatomical works of Galen and Avicenna, publishing it with the title Epitome del Canone. It became a work of folk medicine, and was translated into Persian.
Of the later doctors, we can cite, from the VIII / XIV century, alAkfānī and Sadaqah ibn Ibrāhīm al-Shādhilī, the author of the last important ophthalmological treatise coming from Egypt. Also important was Dā'ūd al-Anøāki, who died in Cairo in the 1008 / 1599, whose Treasury, not without originality, is an indication of the state of Islamic science and medicine during the sixteenth century, when the current of the European science was beginning to move in a new direction, away from the mainstream in which it had been maintained for so many centuries.
Even Spain and the Maghreb, or the Western countries of Islam, which formed a cultural unity, were the home of many great doctors. Especially Cordova was a center of medical activity; there, in the fourth / tenth century, the Hebrew scholar Hasday ben Shaprūø translated Dioscorides' Materia medica, which was then corrected and commented by Ibn Juljul, who also wrote a book on the life of doctors and philosophers. Also of Córdoba was' Arīb ibn Sa'd al-Kātib, who composed a famous treatise on gynecology. He was followed in turn, in the first part of the V / XI century, by Abū'l-Qāsim al-Zahrāwī (the Latin "Albucasis"), who was the greatest Muslim surgeon. Based on the work of Greek physicians, and particularly of Paul of Aegina, but also adding a lot of original material, Albucasis composed his famous Concession or Concessio, which was translated into Latin by Gerardo from Cremona, and which was also studied for several centuries in Hebrew and Catalan translation.
Islamic medicine in Spain owes much to the family of Ibn Zuhr or Avenzoar, who produced several famous doctors for two generations, and also a doctor who gained renown for her ability in the art of healing. The most famous member of the family was Abū Marwān 'Abd al-Malik, who died in Seville around the 556 / 1161. He left several works, the most important of which is the Book of Diets. These writings make him the greatest Andalusian doctor in the clinical aspects of medicine, second in this field only to al-Rāzī.
Among the Andalusian doctors there were also various well-known medical philosophers. Ibn ßufail, the author of the philosophical novel "Living Son of the Awakened" (Vivens, filius vigilantis, later known in Europe as Philosophus autodidactus) was also a skilled physician, like the one who succeeded him on the philosophical scene, Averroes. This famous philosopher, which we will deal with most extensively in the chapter on philosophy, was officially a physician, and composed various medical works, including a medical encyclopaedia entitled Book of general notions on medicine, and comments on Avicenna medical works. The career of Averroes was followed, in a certain sense, also by Maimonides. Born in Cordoba in 530 / 1136, he left early for the East, eventually settling in Egypt. By birth and early education, however, belongs to the Spanish scene. Maimonides wrote ten works of medicine, all in Arabic, the most famous of which is the Book of aphorisms on medicine, which, like his other works, was also translated into Hebrew.
Spanish doctors and scientists must also be remembered for their special contribution to the study of plants and their medical properties. It is true that important works on drugs had been composed in the East - such as the Foundations of the True Properties of Remedies by Abū Mansūr al-Muwaffaq (XNUMXth / XNUMXth century), which is the first prose work in modern Persian, or the works on pharmacology by Mesue the Younger. However, it was the Spanish and Maghrebi scientists who made the greatest contributions in this field, intermediate between medicine and botany. Ibn Juljul's commentary on Dioscorides was followed in the XNUMXth / XNUMXth century by the Book of Simple Medicines by the Tunisian doctor Abū'l-Salt. He was in turn followed a few years later by al-Ghāfiqī, the most original among Muslim pharmacologists, who gave in the aforementioned work, also entitled Book of simple drugs, the best description of plants found in Muslim authors .
The work of al-Ghāfiqī, as we have already mentioned, was completed one century later by another Andalusian, Ibn al-Baitār, who was born in Malaga and who died in Damascus in the 646 / 1248. Of this figure, who was the greatest Muslim botanist and pharmacologist, several works have survived, including the Complete Book of Simple Medicines and the Sufficient Book of Simple Medicines, in which he was recorded alphabetically and discussed in detail everything that was known to pharmacologists, as well as three hundred drugs never before described. These works, which are among the most important fruits of Islamic science in the field of natural history, became the source of much later literature in this field in the East. However, they had little influence in the West, belonging to a period when most of the translations from Arabic to Latin had already taken place, and in which the intellectual contact that had been established between Christianity and Islam in the centuries V / XI and VI / XII was starting at the end. As far as Islamic science is concerned, Ibn al-Baitār represents the last important figure of a long series of great Spanish botanists and pharmacologists, who, from that country of magnificent gardens and with a varied flora, dominated this field of knowledge, a part of natural history and botany, as well as medicine.
In Persia itself, the scene of so much of the first medical activity, Avicenna was followed, a generation later, by Ismā'īl Sharaf al-Dīn al-Jurjānī, the author of the Treasury dedicated to the king of Khwārazm, which is the most important encyclopedia medical in Persian. The dimensions, as well as the style, of the work place it between the Canon and the Continens; it is a treasure house not only of medieval medical theory but also of pharmacology, for which it presents the additional interest of containing the names of plants and drugs in Persian. The Treasure, although never printed, has always been very popular in Persia and India and has been translated into Hebrew, Turkish and Urdu.
Among those who collected the legacy of Avicenna in the 6th / 12th century, Fakhr al-Dīn al-Rāzī, the sixth / twelfth century theologian, author of the Book of the sixty sciences mentioned earlier, is also important. AlRāzī was also a capable physician and, although he had made very severe criticisms of Avicenna's philosophical writings, he wrote a commentary on Canon medicine and clarified many of his difficulties. He also started a great medical work, called Great Medicine, which was never completed.
The seventh and thirteenth centuries, despite its turbulent political life underlined by the Mongol invasion, and the destruction of many schools and hospitals, nonetheless witnessed the production of various important medical works. It is curious, first of all, that the four most important historians of medicine in Islam - Ibn al-Qiføī, Ibn Abī Uöaibi'ah, Ibn Khallakān and Barebreo - all flourished in the middle of this century. Secondly, it is noteworthy that the Mongols, who at first did so much to destroy the institutions where medicine was practiced and taught, soon became its patrons, so that in their courts some of the most famous doctors of Islam. Quøb al-Dīn al-Shīrāzī, the most famous disciple of Nasīr al-Dīn al-Tūsī, was also a physician and wrote a commentary to Canon, which entitled Homage to Sa'd. He was followed at the beginning of the 8th / 14th century by Rashīd al-Dīn FaÑlallāh, the learned vizier of the Ilkhānidi, who wrote the most authoritative history of the Mongol period, as well as a medical encyclopedia. Rashīd al-Dīn was also an ardent patron of culture and, in the capital Tabriz, he built many schools and hospitals. It is interesting to note, as a sign of the still close connection between the various parts of the Islamic world, that when Rashid al-Din offered prizes to anyone who had written a book in his honor, several of those who responded were Andalusian, and some from Tunisia and from Tripoli. Despite the Mongol invasion, the unity of the Islamic world was still well enough to allow rapid communication on medical and scientific issues among the most distant countries. (It is legitimate to doubt, despite all the current technical possibilities, the existence of an equally rapid response on problems of a scientific nature between countries as distant from each other in today's Islamic world).
The VIII / XIV century is also marked by a new interest in veterinary medicine; date back to this period several treatises on horses, one of which attributed to Aristotle, along with a few others that were translated from Sanskrit. This was also the period of intense interest in anatomy, shared by the doctor and the theologian, and the era of the appearance of the first illustrations for anatomy texts. The first illustrated work of anatomy known is the one composed in 798 / 1396 by Muhammad ibn Ahmad Ilyās and titled Anatomia illustrated. This period also includes another very well-read work, the anatomy of al-Mansūr, in which ideas of embryology are discussed, combining Greek and Indian concepts with those of the Koran.
The Safavid period, which marks a revival of Persian art and philosophy, was also the period when Islamic medicine was profoundly revised. The greatest physician of this period, Muhammad Husainī Nūrbakhshī, who died in 913 / 1507, wrote an extensive work of medicine entitled Quintessence of Experience, which reveals the clinical capabilities of the author. He was the first to identify and treat several common diseases, including hay fever and whooping cough. This period was also characterized by the emergence of expert pharmacologists, and was defined by Elgood as "the golden age" of pharmacology in Islam. The most important work in this field was the Medicine Shāfi'ī, composed in 963 / 1556; it served as a basis for Francesco Angeli's Pharmacopoeia Persica, the first European study on Persian medicine. At this time, even if written a century later, belongs the Gift of the two Mu'min, which is a book still widely read in the East, and shows the rising of the wave of Indian influence at that time.
The X / XVI and XI / XVII centuries were also the period of the spread of Islamic medicine in India, through the works of various Persians who had settled there. In the 1037 / 1629 'Ain al-Mulk of Shiraz he composed the Vocabulary of drugs, dedicated to Shāh Jahān. He also probably contributed to the composition of Dārā Shukūh Medicine, which was the last great medical encyclopedia in Islam. Dārā Shukūh, the Mughal prince who was also a Sufi and a Vedanta scholar, is famous for his translations of Sanskrit metaphysical works in Persian, and especially of the Upanishads, which Anquetil-Duperron translated into Latin from his Persian version, thus making this work for the first time available in Europe. This was the version that William Blake, among many other more or less famous characters, read in the nineteenth century, probably without knowing anything about the Mughal prince who had prepared the way. The real translation of a vast medical encyclopedia by Dārā Shukūh, however, seems unlikely; the work was most likely performed under his patronage and his direction by competent doctors, such as' Ain al-Mulk.
Islamic medicine continued to prosper in India during the 12th / 18th century, when works such as the Scales of medicine of another Persian physician, Muhammad Akbar Shāh Arzānī of Shiraz were composed. It is quite interesting to note that with the invasion of India by Nādir Shāh in the 12th / 18th century, Islamic medicine received a new impulse in this country the very moment in which Persia itself was weakening, as a consequence of the advent of European medicine. Today, Islamic medicine continues to thrive as a living medical school, especially in the Indo-Pakistani subcontinent, in competition with Ayurveda and modern European medicine, which in some movements, such as neo-Freediving, has begun to show some interest in medical philosophy from which it was detached several centuries ago.
"Medicine", as Avicenna states at the beginning of the Canon, "is a branch of knowledge that deals with the health and disease conditions of the human body, with the intent of using suitable means to preserve and restore health". The task of medicine is therefore that of restitution or preservation of that state of equilibrium called health. Following the humoral pathology of Hippocrates, Islamic medicine considers "elements" of the body the blood, the phlegm, the yellow bile and the black bile (or atrable). These four humors are for the body what the four elements - fire, air, water and earth - are for the world of Nature. It is not surprising, in fact, to discover that Empedocles, to whom this theory of the four elements is generally attributed, was also a physician. Like the elements, each mood has two natures: the blood is hot and humid, the phlegm is cold and wet, the yellow bila is hot and dry and the black bile is cold and dry. Just as in the world of generation and corruption everything is generated through the mixture of the four elements, so in the human body there is a humoral constitution, generated by the mixture of the four humors, which determines the state of health. Furthermore, the particular constitution or temperament of each person is unique; there are no two people who can be treated as if they were exactly the same subject, with identical reactions to external stimuli.
The body has that power to preserve and restore that balance that characterizes its state of health - that power of self-preservation which is traditionally called vis medicatrix naturae. The role of medicine then boils down to helping this ability to function properly, and to remove any obstacles in its path. The process of regaining health is therefore carried out by the body itself, and drugs are only an aid to this natural force, which exists within each body and is a characteristic of life itself.
The uniqueness of the temperament of each individual indicates that each microcosm is a world unto itself, not identical with any other microcosm. However, the reappearance of the same fundamental moods in each constitution demonstrates the fact that each microcosm has a morphological similarity with other microcosms. There is also an analogy between the human body and the cosmic order, as revealed by the correspondence between the humors and the elements. In the hermetic-alchemical natural philosophy, which in Islam was always closely linked to medicine, there is a fundamental doctrine of correspondence between all the various orders of reality: the intelligible hierarchy, the celestial bodies, the order of numbers, the parts of the body, the letters of the alphabet which are the "elements" of the Holy Book etc. The seven cervical vertebrae and the twelve dorsal ones correspond to the seven planets and the twelve signs of the zodiac, as well as the days of the week and the months of the year; and the total number of discs of the vertebrae, believed to be twenty-eight, corresponds to the letters of the Arabic alphabet and the stations of the Moon. There is therefore a numerical and astrological symbolism connected to medicine, even if the proximity of the relationship has not been the same in all periods of Islamic history, nor in all the authors of medicine. But correspondence and "sympathy" (in the original sense of the term sympathia) between various orders of cosmic reality form the philosophical background of Islamic medicine.
The destruction of the balance of the four humors is, as we have seen, the cause of the diseases; its restoration is the task of the doctor.
The human body, with all its different organs and elements, and with its physical, nervous and vital systems, is unified by a vital force or spirit that somewhat resembles the basic metabolic energy of modern medicine. The three systems of the body each have their own functions, differentiated and interrelated at the same time by the vital spirit - which must not, however, be confused with the soul.
Elements and organs, biological systems and their functions all serve to maintain the balance of the four humors, and the state of equilibrium is determined by the particular nature of each human body. There are, however, models and general causes for the variation of temperaments, which include factors such as race, climate, age, sex, etc. So an Indian or a Slav, or a man of sixty and a woman of twenty, would have completely different temperaments, while Indians or Slavs as racial groups, or people of sixty years as an age group, would have a similar temperament , even if not identical.
The treatment of diseases also depends on these factors. In Islamic medicine all foods and drugs are classified according to their quality - ie heat, cold, etc. - and also according to their power. Thus a person with a choleric temper usually needs foods and drugs in which cold and damp qualities predominate, in order to counterbalance the heat and dryness of yellow bile. The same food or drug will have the opposite effect on a person with a phlegmatic temperament. In this way the pharmacology, following the theories of medicine, divided all the drugs according to their qualities. The whole range of dietary habits of Islamic countries has been established according to this theory, so that in a normal meal the various qualities and natures are well balanced.
In his attempt to view man as a whole, as a single entity in which the soul and the body are united, and in trying to connect man to the total cosmic environment in which he lives, Islamic medicine is remained faithful to the unifying spirit of Islam. Although originating from the earlier medical traditions of Greece, Persia and India, Islamic medicine, like many other pre-Islamic sciences, became deeply Islamized and penetrated deeply into the general structure of Islamic civilization. Up to now his theories and his ideas have dominated the daily dietary habits of the Islamic population; they still serve as a general framework for a unifying vision of man, as a being in which body and soul are closely interconnected, and in which the state of health is realized through harmony and balance. Since these ideas are all closely related to the Islamic vision of things, they have contributed to making this tradition of medicine one of the most widespread and lasting sciences cultivated within the Islamic civilization throughout its history.