Editorials

How Islam changed medicine

BMJ 2005; 331 doi: https://doi.org/10.1136/bmj.331.7531.1486 (Published 22 December 2005) Cite this as: BMJ 2005;331:1486

"never perform an operation without first watching it performed by others and without having experience of the technique ..."

EDITOR - We would like to congratulate Dr. Majeed on his interesting
article on the role of Muslim physicians and scholars in modern
medicine,[1] and all the authors who responded to it.[2,3,4] We have
thoroughly enjoyed reading it and wish that more historical articles of
the same standard could find a place in the BMJ Journal. At any rate, we
would also like to underline some information that we consider stricking
to make the due worth to the contribution of Islam to modern medicine.

It is too often forgotten that the Arabs were responsible for
preventing much of the well known medical practices from antiquity being
lost. This is especially true of surgery which was neglected by the church
for centuries.

Religious reasons constrained a group of Aramaeans belonging to the
Nestorian sect to emigrate from Syria to Persia around the 5th century
A.D. Aimed to transmit the medical knowledge acquired studying the
numerous treatises inherited from the legendary library of Alexandria,
they founded Gandi-Sopor,[5] the world’s first teaching hospital. In this
way Arabs received translations of Greek and Latin medical literature
adopting in particular the Galenic medicine principles and the Nestorian
system of teaching. New hospital institutions were then established in
Bagdad, Cairo, Aleppo and Damascus, where for the first time the medical
specialties of psychiatry and ophthalmology were taught.

Embracing scientific knowledge received from the Nestorians allows
muslim medical culture to grow up exponentially, reaching its peak with
the encyclopaedic work on medicine and surgery El Tariff or Tasrif (The
Method) by Abul Quazim Halaf Ibn’Abbas az-Zahrawi, better known as
Albucasis (936–1013 A.D.) the greatest Arab surgeon in history.[6]
Albucasis is considered to be one of the moving spirits behind the rebirth
of surgery, because it was through his teachings that the practice spread
from Cordoba across Western Europe. The book became rapidly the leading
medical text in all European universities during the later Middle Ages.
Its section on surgery contains illustrations of surgical instruments of
elegant, functional design and great precision. Other chapters describe
amputations, ophthalmic and dental surgery, and the treatment of wounds
and fractures. He developed new surgical technologies and invented several
devices used during surgery. “… Never perform an operation without first
watching it performed by others and without having experience of the
technique” was the basic principle of his modern medical teaching.”[5]

The most free-thinking of the major philosophers of Islam al-Razi
(Rhazes) (860–932) with his magnus opus Kitab Al-Mansuri (The Great
Medical Compendium) and Ibn Sina (Avicenna) (980–1037) who gained a
reputation as “father of the modern medicine”[7] with his two masterworks
al-Qanun fi’l tibb (The Canon of Medicine) and Kitab al-shifa (The Book of
Healing) brought fame and immortality to the medical Arab School of that
time.[1] Despite their most loved field of study was philosophy, they were
speculatively interested in the art and profession of medicine. Ibn Rushd
(Averroe) too wrote an important book on medical theories and precepts.

The contribution to optics of Ibn al-Haytham (Alhacen or Alhazen) has
been already reported.[4] However in this field we cannot neglect to
mention another great muslim physician who gave important contribution to
medical development. The Iraqi/Egyptian surgeon Ammar ibn Ali al-Mawsili
(al-Musali) created a syringe in the 9th century using a hypodermic
needle, a hollow glass tube, and suction to remove cataracts from
patients' eyes, a practice that remained in use up until at least the 13th
century and which came into renewed use in the 20th century.

Ibn Zuhr, known as Avenzoar, was the first to describe pericardial
abscesses and to recommend tracheotomy when necessary as well as being a
skilled practical physician. He is considered the father of experimental
surgery, for introducing the experimental method into surgery in his Al-
Taisir.[8] He was the first to employ animal testing in order to
experiment with surgical procedures before applying them to human
patients.[8] He also performed the first dissections and postmortem
autopsies on humans as well as animals.[8]

In his book De Gradibus the Arab Iraqi polymath Abu Yusuf Yaqub ibn
Ishaq (Al-Kindi) demonstrated the application of mathematics to medicine,
particularly in the field of pharmacology. He introduces mathematical
scale to quantify the strength of drugs, and a system that would allow a
doctor to determine in advance the most critical days of a patient's
illness.[9]

Ibn al-Lubudi (1210-1267) rejected the theory of four humours,
discovered that the body and its preservation depend exclusively upon
blood, rejected Galen's idea that women can produce sperm, and discovered
that the movement of arteries are not dependent upon the movement of the
heart, that the heart is the first organ to form in a fetus' body (rather
than the brain as claimed by Hippocrates), and that the bones forming the
skull can grow into tumors.[10]

When the Black Death bubonic plague reached al-Andalus in the 14th
century, Ibn Khatima and Ibn al-Khatib proposed the theory of contagion
hypothesizing that infectious diseases were caused by ‘minute bodies’:
"The fact infection becomes clear to the investigator, whereas he who is
not in contact remains safe," and described how transmission is effected
through garments, vessels, and earrings.[11]

The Tashrih al-badan (Anatomy of the body) of Mansur ibn Ilyas (ca
1390) contained comprehensive diagrams of the body's structural, nervous
and circulatory systems.[12]

Other medical innovations first introduced by Muslim physicians
include the discovery of the immune system, and the combination of
medicine with other sciences (including agriculture, botany, chemistry,
and pharmacology).[13]

REFERENCES

1. Majeed A. How Islam changed medicine. BMJ. 2005 24; 331: 1486-7.

2. Cattermole GN. How Islam changed medicine: Al-Nafis, Servetus, and
Colombo. BMJ 2006; 332: 120-1.

3. Urquhart J. How Islam changed medicine: Ibn Sina (Avicenna) saw
medicine and surgery as one. BMJ 2006; 332: 120.

4. Masoud MT, and Masoud F. How Islam changed medicine Ibn al-Haytham
and optics. BMJ 2006; 332: 120.

5. Santoni-Rugiu P, and Sykes P. The contribution of Arabs. In: A
history of plastic surgery. The Springer-Verlag Berlin and Heidelberg GmbH
& Co. KG; 2007: pp. 50-2.

6. Leclerc L. La chirurgie d’Albucasis. Bailliere, Paris, 1861

7. Sarton G. Introduction to the History of Science. Baltimore: Johns
Hopkins University Press, 1947

8. Abdel-Halim RE. Contributions of Ibn Zuhr (Avenzoar) to the
progress of surgery: A study and translations from his book Al-Taisir.
Saudi Med J. 2005; 26: 1333-9.

9. Klein-Frank F. Al-Kindi. In Leaman O, and Nasr H. History of
Islamic Philosophy. London: Routledge, 2001: p. 165

10. Leclerc L. Histoire de la medecine Arabe, vol. 2. Paris: Ernest
Ledoux, 1876, p. 161.

11. Syed IB. Islamic Medicine: 1000 years ahead of its times. Journal
of the Islamic Medical Association. 2002; 2: 2-9.

12. Turner HR. Science in Medieval Islam: An Illustrated
Introduction. Austin: University of Texas Press, 1997: p. 136-8.

13. Saad B, Azaizeh H, and Said O. Tradition and Perspectives of Arab
Herbal Medicine: A Review. Evid Based Complement Alternat Med. 2005; 2:
475-9.

Competing interests:
None declared

Competing interests: No competing interests

08 January 2010
Davide Lazzeri
Plastic surgeon
Stefano Lazzeri*, Michele Figus*, Marco Nardi*, and Marcello Pantaloni
Plastic and Reconstructive Surgery Unit and *Ophthalmology Unit, 56100, Hospital of Pisa, Italy.