THE PROCESS OF RECEPTION AND
ASSIMILATION: ARABIC MEDICINE IN HISTORICAL PERSPECTIVE
No culture of the world is immune from the process of reception and assimilation
of ideas from other cultural sources. The Arab conquest of Iran on the one
hand, and
of the Middle East, especially of Egypt, on the other, acquainted the Arabs
with two great civilizations of the world, namely, the Iranian and the Roman,
although in decline and in decadence. Before the advent of Islam, Hellenistic,
Alexandrian, Syrian and Hindu philosophy and sciences had spread out to the
Sasanian centres of learning, within the Persian Empire and when the tradition
of Greek education had faded away in Europe in the early Christian centuries,
when the Academy of Athens was closed in 529 A.D., by Emperor Justinian,
and when the Nestorian Christians were being driven from cities and academies
that were under orthodox Christian domination, it was in Sasanian Persia,
under King Anushirwan the Just, that Syrian, Alexandrian and Jewish scholars
found refuge. The Muslims preserved those traditions, improved upon them
and added to them and later passed on through Islamic scholarship to European
educators.
There is no doubt that the Arabic medicine benefited from the theories and
practices of Persian, Indian and Alexandrian or Greek medicine within the
general framework of the Islamic belief-system. After the conquest
of Iran, the Arabs came in contact with the Jundishapur School of Medicine.
Jundishapur was a Persian city in the province of Ahwaz with pre-historic
traditions. It was founded by Shapur 1, the second Sasanian King. It became
a major centre of learning when the physicians of Edess took refuge in that
city. Edess was closed by order of the Byzantine Emperor after 489 A.D. It
was here that Greek medicine with Zoroastrian ideas and local Persian medical
practice, flourished. It was also here that the last philosophers and scientists
of Athens took refuge when Justinian ordered the school of Athens to be closed
in 529 A.D., as aforesaid. It was during the reign of Anushirwan the Just
that Indian medicine reached Iran during the sixth century when the King
sent his Vizier to India to learn the sciences of the Indians and bring Indian
physicians and books to Iran. The 'Fables of Bidpai', reached there through
his good self. The medicine, synthetic in nature, combining the Greek, Persian
and Indian theories and practices, was already in practice at the Jundishapur
School. Islam reached here when the school was at the height of its career.
Being a most important medical centre it flourished during the Abbasid period
and served as a direct bridge between Islamic and pre-Islamic medicine.
The Alexandrian School, once the greatest centre of Hellenistic sciences
in Egypt, as mentioned above, had combined Egyptian theories and practices
with those of the Greeks, but had now ceased to operate as a creative centre.
And the Arabs, after the conquest of Egypt in the sixth century, were acquainted
with the Graeco-Egyptian medical practice in Alexandria. Khalid ibn-Yazid,
the Umayyad prince, went to Alexandria later to master alchemy and was responsible
for the first translation of Greek texts into Arabic. The Muslims thus came
into contact with Greek medicine in Alexandria, although the contact was
insignificant as compared with the Jundishapur School, which was at the height
of its activity during the early Islamic period.
Arabic medicine, being blended with the Islamic belief-system of Tawhid,
never lost its own world view. It received inspiration from the Qur'anic
verses and the Prophetic traditions. The allusions made repeatedly in the
Qur'an about the creation of man (Takhliq-i-Adam), his humble origin, pre
and post-natal life, his physical form and nature in the embryo, formations
of bones and flesh, organs of hearing, seeing and thinking, along with the
gift of other faculties given to man by God (LXXVI:2) etc., became subjects
of medical inquiries. Since the voluntary directive energy of the central
nervous system, directing all actions of man, organic and physical, lie in
the spinal cord and in the brain and since the spinal cord was continuous
with the medulla oblongata in the brain (LXXXVI:5-7), the human body, being
a macrocosm, became an attractive object of medical studies and a source
of strengthening faith in God. In addition to the Qur'anic verses the Prophetic
Ahadith strengthened the new emerging school of Islamic medicine and both
the Greek or other foreign medicinal systems were received with reservation.
Seeing that Islam laid stress on seeking knowledge in all its dimensions,
the Arabs did not hesitate from studying medicine either at the Jundishapur
or Alexandrian schools. The Arab physician, Harith ibn-Kalada, a contemporary
of the Prophet, had studied medicine at Jundishapur. The stress that the
Prophet laid on medicine and medical treatment, hygiene, sickness and health,
diet etc., inspired the believers to study medicine. They regarded medical
studies as a part of faith and Tibb-an-Nabawi (The Prophetic Medicine), became
an initial guideline. Imam Bukhari, in his most authentic collection, has
mentioned many sayings about illness and its treatment. These Prophetic Ahadith
directed the course of Islamic medicine in the future and determined many
of the Muslims dietary and hygienic habits. Moreover, the Tibb-an-Nabawi
became the first book to be studied by a medical student before he studied
the usual compendia of medical science. The Qur'anic verses and Ahadith thus
played an important role in creating the Islamic frame of mind for the future
physicians.
It was in this historical background that Arabic or Islamic medicine developed
and many towering personalities like ar-Razi, Ibn-Sina, Ibn-Rushd and others
appeared on the scene of medical sciences. A cursory glance over the influences
of Jundishapur and Alexandrian schools over the Arab thinking will further
help us in understanding the process of reception and assimilation in historial
perspectives.
It was during the reign of the second 'Abbasid Caliph al-Mansur, the founder
of the city of Baghdad, that the direct contact between Baghdad and Jundishapur
was established. A physician from Jundishapur was invited to Baghdad to treat
the Caliph who had been suffering from dyspepsia. The successful treatment
of the Caliph by Jurjis marked the beginning of the close liasion. The medical
centre of Jundishapur was eventually transferred to Baghdad. Renowned physicians
such as Masawaih, a celebrated ophthalmologist, who worked at the hospital
of Jundishapur for about thirty years, came to Baghdad. His son, known as
Ibn-Masawaih, wrote the first treatise in Arabic on ophthalmology. Thus an
organic link between the hospitals of Baghdad and Jundishapur were founded.
The early medical texts were translated into Arabic, mostly by the Christians
or the Jews. The first text translated into Arabic, which appears in the
Pandects of an Alexandrian priest Ahrun, was made by a Jewish scholar
from Basra, during the Umayyad period. The translations of Greek or Pahlavi
medical literature started during the 'Abbasid period. Ibn-Muqaffa translated
from Pahlavi into Arabic. The viziers of the 'Abbasids, the Barmacides, encouraged
the translations and Mikna the Indian physician was encouraged by them to
translate Indian medical literature into Arabic. Hunain ibn-Ishaq, himself
an outstanding physician of his day, a student of Jundishapur Medical Centre
and a colleague of Ibn-Masawaih, translated texts from Greek into Syriac
and Arabic. He and his school translated the 95 works of Galen into Syriac
and 99 into Arabic. Thabit ibn-Qurr'ah, in addition to the translations,
himself wrote several medical books of which the "Treasury' is well known.
But despite all these facts no creative nation can ever thrive either on
translations or on imitation. Intellectual interaction through such works
can never build the pyramids of a new culture. The newly emerging culture
of Islam, already in its offing, had to take off even without the help of
translations. As an Iqra-Community, the Arabhad to read, study and examine
the international intellectual heritage, lying around them. It does not mean
that they were the borrowers of alien cultures or their culture was a loan-culture
as the Orientalists hold. Muslim apologists also surrender their judgements
to the Orientalists who assert that the works of ar-Razi, Ibn-Sina, Ibn-Rushd,
Ibn-Baitar and others were either the catalogues of Greek works or the collection
of excerpts from Galen and Hippocrates.
The contributions made by the Arab medical experts for the advancement of
knowledge in the field of medical sciences, have already been highlighted.
The first major work entitled 'Firdaws al-Hikma', written in Arabic by' Ali
ibn-Rabban, at-Tabari, a convert to Islam, cannot be regarded as a carbon
copy of the Greek thought. Its 360 chapters, summarizing the various branches
of medicine, are not catalogues and its value in the field of pathology,
pharmacology and diet (Aghdhiya) can not be minimized. It is the first large
compendium of its kind in Arabic medicine. It was original and creative.
How can the celebrated works of ar-Razi, such as 'Kitab al-Mansur' and' Al-Hawi',
which dominated the medical science in Europe for six centuries (from twelfth
to the seventeenth century), be treated as excerpts from Greek works? How
can ar-Razr and Ibn-Sina, who were held in higher esteem in Europe than even
Hippocrates and Galen, be regarded as imitators? Ar-Razi, the director of
Rayy and Baghdad Medical Centre, emerged as the greatest original clinical
and observational physician. Being skilful in prognosis and in his analysis
of symbols of diseases, its treatment and cure, his medical case studies
served as guidelines for others and his treatment by means of psychological
shock has been described by Nizami 'Arudi as unique in his Chahar Maqala
(Four Discourses). The science of anatomy was developed in 'Kitab al-Mansur',
in which ar-Razi deals with veins (chapter 5), arteries (chapter 6), disposition
of the heart (chapter 14) etc., which displays the adequacy of anatomical
knowledge among the Arabs. His treatises on measles and smallpox became so
popular that they were published in Europe many times until the eighteenth
century. His 'Al-Hawi', being the most voluminous work ever written in Arabic,
has been a basic source for the study of clinical aspects of Islamic medicine.
Ar-Razi did not neglect spiritualism. His treatment of the soul along with
the body is significant. He wrote a book on the medicine of the soul. Thus
he became a master of psychosomatic medicine and psychology long before the
West. Now, maladies of the soul became the object of medical treatment. He
also composed a work on the medicine of the soul and demonstrated how to
overcome the moral and psychological illnesses, which ruin both mind and
the body of man, upsetting the total state of health. Ar-Razi, in his book
'Spiritual Physique' deals in twenty chapters with various ailments that
beset the soul and body of man. The use of wine and drunkedness (which has
become a curse of modern civilization) have been condemned by him as a disease
of both soul, and body.
Other physicians, such as, 'Ali-ibn al-'Abbas al-Majusi (Latin: Haly Abbas)
a Muslim of Zoroastrian descent, in his 'Kitab al-Maliki' (The Royal Book),
evaluates critically the virtues and shortcomings of both the Greek and Islamic
physicians who preceded him. He was not an imitator. His 'Kamil as-Sina'a
(The Perfection of Art), is well known and a best written book in Arabic
which remained a standard work until the works of Ibn-Sina appeared on the
scene. Being the most outstanding physician after ar-Razi he flourished during
the second half of the tenth century. An imitator can not analyse the works
of the Greeks critically, as was done by al-Majusi.
Neither the peerless Ibn-Sina could have dominated the medical scene in Europe
for many centuries, nor could he be honoured for centuries as a 'Prince of
physicians', had he been an imitator of the Greeks. And why should the Europeans
follow Ibn-Sina instead of Hippocrates and Galen? Being well versed in every
domain of knowledge including peripatetic philosophy, he emerged in the field
of medicine as victorious. After having unified and systematized all the
medical theories and practices of the earlier centuries into a vast synthesis,
he wrote a large number of original medical works in Arabic. The 'Canon of
Medicine' (Ash-Shifa'), being his magnum opus, dominated the Occident for
centuries. Its Latin translation by Gerard of Cremona was frequently printed
during the Renaissance. He was the first to describe many diseases correctly.
His clinical insight, understanding of philosophical principles of medicine,
and case histories are now classics in Islamic medical literature. The 'Canon'
became the final authority in the medical profession. Both Ibn-Sina and ar-Razi
reigned supreme as medical authorities in the West until the seventeenth
century. This was not possible without being original, creative, as well
as critical of Greek works. They had transcended the bounds of Greek medical
knowledge.
The creative traditions in the field of medical sciences continued until
the end of the sixteenth century in Egypt, Syria, Maghrib, Andalusia, Persia
and other parts of the Muslim lands. Ophthalmology was developed in Egypt
where the illness of the eye was a common affliction. 'Ali ibn-Ridwan made
his contributions to this field. Ibn-Nafis (d.687/1288) discovered the lesser
or pulmonary circulation, which was a major discovery of Islamic medicine.
It was unfortunately attributed to Michael Servetus. His creative vision
can be evaluated from his critical studies of the anatomical works of Galen
and also of Ibn-Sina, which he published as the 'Epitome of the Canon'. The
last creative figures emerging from Egypt in the field of ophthamological
literature were al-Akfani and Sadagah ibn-Ibrahim ash-Shadhili. Daud al-Antaki
(d.1008/1599) wrote original treatise during the sixteenth century. It was
about this time that Europe was emerging in the field of sciences as a dynamic
force.
The Western lands of the Muslim World, such as Spain and Maghrib, also did
not lag behind in the medical field. Cordova was a centre of medical learning.
'Arib ibn-Sa'd al-Katib wrote on gynecology and al-Qasim az-Zahrawi appeared
as the greatest surgeon in the fifteenth century. His renowned 'Concession',
translated by Gerard of Cremona in Latin was studied in Europe for several
centuries. Ibn-Zuhr's family dominated the field of medicine in Spain for
two generations. Abu-Marwan 'Abd-al-Malik (d.556/1161 in Seville) wrote so
many books of which the 'Book of Diets' is the most famous. He is regarded
second only to ar-Razi in clinical aspects of medicine. Among the medical
philosophers of Spain, Ibn-Tufail the author of the philosophical romance
'Living Son of the Awake' and his successor Ibn-Rushd, merit special mention.
Both were physicians. The latter wrote a medical encyclopaedia entitled 'The
Book of Generalities on Medicine'. He also wrote commentaries upon the medical
works of Ibn-Sina. Maimonides, born in Cordova in 530 / 1136 (settled in
Egypt), wrote ten medical works in Arabic of which the most famous is 'The
Book of Aphorisms', concerning medicine. The physicians in Spain and Maghrib
also promoted the study of plants and discovered their medical properties
(drugs). Ibn- Tufail's commentary is renowned. Similar works have been done
by Tunisian physician Abu-'l Salt. His 'Book of Simple Drugs' is well known.
The best description of plants are given by al-Ghafiqi, the most original
of the Muslim pharmacologists, in his 'Book of Simple Drugs'. Ibn-al-Baitar
(died in Damascus in 646/1248) was another Spanish genius who completed the
works of al-Ghafaqi a century later. Being the greatest of the Muslim botanists
and pharmacologists, he collected all the information in the field, in addition
to three hundred drugs, not described previously in his books, namely,
'The Complete Book of Simple Drugs' and
'The Adequate Book of Simple drugs'
These works were most original works producedby the creative and not imitative
brain.
The medical activities also continued in the Eastern lands of Islam, such
as Persia and India. Isma'il Sharaf ad-Din al-Jurjani, the author of the
'Treasury', produced the most important medical encyclopaedia in Persian.
Its size and the merit of the work is estimated between the 'Canon' and 'Al-Hawi'.
It is a treasury of pharmacology and medical theory. Even during the colossal
destruction of the Mongol invasion, four great authorities on the history
of medicine, namely,
Ibn-al-Qifti
Ibn-'Ali Usaibi'ah
Ibn-Khallakan and
Barhebraeus,
appeared in the East. The Mongols, who had destroyed the medical centres,
themselves became great patriots of medical sciences. Qutb ad-Din ash-Shirazi,
the pupil of at-Tusi, wrote a commentary on the 'Canon' entitled, 'The Present
to Sa'd'. The Vizier of II-Khanids, Rashid ad-Din Fadl-Allah, authoritative
historian of the Mongol period, wrote a medical encyclopaedia. Rashid would
offer prizes to anyone who would write a book in his honour. Authors from
Spain, Tunisia and Tripoli responded to his call. The veterinary medicine
and anatomy were promoted during the fourteenth century. Muhammad ibn-Ahmad
Ilyas produced his 'Illustrated Anatomy', the first of its kind, in 1396.
Muhammad Hussaini Nurbakshi (d.913/1507), the greatest physician of the Safavid
period, wrote his famous book 'The Quintessence of Experience', in which
the clinical prowess of the author is quite manifest. C. Elgood regards the
Safavid period as the golden age of pharmacology in Islam. Shafi'i medicine,
written in 1556, was the most important work which served the foundation
of Fr. Angelus's 'Pharmacopoedia Persica', the first European study of Persian
medicine.
Medical studies continued in India until the seventeenth century. 'Ain al-Mulk
of Shiraz, who migrated to India, composed a Vocabulary of Drugs' in 1629
A.D. and dedicated it to Shah Jahan. He was also involved in the preparation
of 'The Medicine of 'Dara Shukuh', which is said to be the last great medical
encyclopaedia in Islam. Muhammad Akhtar shah Arzani Shirazi, composed the
'Scales of Medicine' in the eighteenth century. This reveals that Islamic
medicine flourished in India even during the eighteenth century, and even
today it is a living school for medicine and has been competing with European
medicine.
Can such works of original nature in Arab medicine be branded as imitations
from Hippocrates and Galen and can the Arabic medical literature be regarded
as carbon copies or adaptations of the Greeks? These are questions for both
the Orientalists and their supporters the Muslim apologists, who themselves
are unaware of the Arabic medical literature and of the medical philosophy
in Islam. One cannot complain against the Orientalists for they have pre-conceived
notions about Islam and they need to be redirected from their biased and
subjective standpoints.