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1 The presentation about Arabic Medicine Arabic Medicine

2 The new Arabic Medicine. The young doctors take care about the child.

3 Islamic cultures are among the most interesting, complex, and dynamic in the world. At the same time, they are among the least known in the West. From its dramatic rise in the seventh century A. D. to the present, Islamic civilization has covered a large part of the globe, incorporating many subcultures and languages into its orbit, and vigorously engaging the peoples around it.

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5 Medicine was a central part of medieval Islamic culture. Disease and health were of importance to rich and poor alike, as indeed they are in every civilization. Responding to circumstances of time and place, Islamic physicians and scholars developed a large and complex medical literature exploring and synthesizing the theory and practice of medicine. This extensive literature was not specialized in the sense that modern medical literature is. Rather, it was integrated with learned traditions in philosophy, natural science, mathematics, astrology, alchemy, and religion.

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7 Islamic medicine was built on tradition, chiefly the theoretical and practical knowledge developed in Greece and Rome. For Islamic scholars, Galen (d. ca. 210 AD) and Hippocrates (5th century BC) were pre-eminent authorities, followed by Hellenic scholars in Alexandria. Islamic scholars translated their voluminous writings from Greek into Arabic and then produced new medical knowledge based on those texts. In order to make the Greek tradition more accessible, understandable, and teachable, Islamic scholars ordered and made more systematic the vast and sometimes inconsistent Greco-Roman medical knowledge by writing encyclopedias and summaries

8 Islamic medicine drew upon Hellenic medical tradition to form its own. Likewise, medieval and early modern scholars in Europe drew upon Islamic traditions and translations as the foundation for their medical enterprise. It was through Arabic translations that the West learned of Hellenic medicine, including the works of Galen and Hippocrates. Of equal if not of greater influence in Western Europe were systematic and comprehensive works such as Avicenna's Canon of Medicine, which were translated into Latin and then disseminated in manuscript and printed form throughout Europe. During the fifteenth and sixteenth centuries alone, the Canon of Medicine was published more than thirty-five times.

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10 Ibn al-Nafis. in 1242, Ibn al-Nafis was the first to describe pulmonary circulation and coronary circulation, [50] which form the basis of the circulatory system, for which he is considered the father of the theory of circulation. [51] He also described the earliest concept of metabolism, [52] and developed new systems of physiology and psychology to replace the Avicenna’s and Galen’s systems, while discrediting many of their erroneous theories on the four humours, pulsation, [53] bones, muscles, intestines, s ensory organs, bilious canals, esophagus, stomach, etc.Ibn al-Nafispulmonary circulationcoronary circulation [50]circulatory system [51]metabolism [52]physiologypsychologyAvicennaGalenfour humourspulsation [53]bonesmusclesintestiness ensory organsbiliouscanalsesophagusstomach

11 Abu al-Qasim (Abulcasis), regarded as the father of modern surgery, [41] wrote the Kitab al- Tasrif (1000), a 30-volume medical encyclopedia which was taught at Muslim and European medical schools until the 17th century. He used numerous surgical instruments, including the instruments unique to women, ] as well as the surgical uses of the catgut and forceps, the ligature, the surgical needle, the scalpel, the curette, the retractor, the surgical spoon, the sound, the surgical hook, the surgical rod, and the specula, bone saw, and plaster. Abu al-Qasimsurgery [41]al- Tasrifencyclopediamedical schoolssurgical instrumentscatgutforcepsligaturesurgical needlescalpelcuretteretractorspoonsoundrodspeculasawplaster

12 Abulcasis.

13 Anatomy and physiology In anatomy and physiology, the first physician to refute Galen's theory of humorism was Muhammad ibn Zakar ī ya R ā zi (Rhazes) in his Doubts about Galen in the 10th century. He criticized Galen's theory that the body possessed four separate "humors" (liquid substances), whose balance are the key to health and a natural body-temperature. Razi was the first to prove this theory wrong using an experiment. He carried out an experiment which would upset this system by inserting a liquid with a different temperature into the body resulting in an increase or decrease of bodily heatanatomyphysiologyGalenhumorism

14 which resembled the temperature of that particular fluid. Razi noted particularly that a warm drink would heat up the body to a degree much higher than its own natural temperature, thus the drink would trigger a response from the body, rather than transferring only its own warmth or coldness to it. This line of criticism was the first comprehensive experimental refutation of Galen's theory of humors and Aristotle's theory of the four classical elements on which it was grounded. Razi's own chemical experiments suggested other qualities of matter, such as "oiliness" and "sulfurousness", or inflammability and salinity, which were not readily explained by the traditional fire, water, earth and air division of elementsclassical elementschemicaloilinesssulfurousnessinflammabilitysalinity

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16 Clinical pharmacology Avicenna's contribution to pharmacology and the pharmaceutical sciences in The Canon of Medicine (1020s) include the introduction of systematic experimentation and quantification into pharmacology and the study of physiology, [27] the introduction of clinical pharmacology, [34] experimental medicine, [28] evidence- based medicine, clinical trials, [29] randomized controlled trials, [30][31] efficacy tests, [32][33] the experimental use and testing of drugs, a precise guide for practical experimentation in the process of discovering and proving the effectiveness of medical substances, [40] and the first careful descriptions of skin troubles, sexually transmitted diseases, perversions, and nervous ailments, [17] as well the use of ice to treat fevers, and the separation of medicine from pharmacology, which was important to the development of the pharmaceutical sciences. [37] The Canon laid out the following rules and principles for testing the effectiveness of new drugs and medications, which still form the basis of clinical pharmacology [34] and modern clinical trialspharmaceutical sciencesThe Canon of Medicine [27]clinical pharmacology [34] [28]evidence- based medicineclinical trials [29]randomized controlled trials [30][31]efficacy tests [32][33]substances [40] [17] [37]medications [34]

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18 "The drug must be free from any extraneous accidental quality." "It must be used on a simple, not a composite, disease." "The drug must be tested with two contrary types of diseases, because sometimes a drug cures one disease by Its essential qualities and another by its accidental ones." "The quality of the drug must correspond to the strength of the disease. For example, there are some drugs whose heat is less than the coldness of certain diseases, so that they would have no effect on them." "The time of action must be observed, so that essence and accident are not confused." "The effect of the drug must be seen to occur constantly or in many cases, for if this did not happen, it was an accidental effect." "The experimentation must be done with the human body, for testing a drug on a lion or a horse might not prove anything about its effect on man."

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22 ABU AL-QASIM AL-ZAHRAWI ( C.E.) Abu Qasim Khalaf ibn al-Abbas al-Zahrawi (known in the west as Abulcasis) was born in 936 C.E. in Zahra in the neighborhood of Cordova. He became one of the most renowned surgeons of the Muslim era and was physician to King Al-Hakam-II of Spain. After a long medical career, rich with significant original contribution, he died in 1013 C.E.

23 ABU AL-QASIM AL-ZAHRAWI He is best known for his early and original breakthroughs in surgery as well as for his famous Medical Encyclopedia called Al- Tasrif, which is composed of thirty volumes covering different aspects of medical science. The more important part of this series comprises three books on surgery, which describe in detail various aspects of surgical treatment as based on the operations performed by him, including cauterization, removal of stone from the bladder, dissection of animals, midwifery, styptics, and surgery of eye, ear and throat. He perfected several delicate operations, including removal of the dead fetus and amputation.

24 ABU AL-QASIM AL-ZAHRAWI Al-Tasrif was first translated by Gherard of Cremona into Latin in the Middle Ages. It was followed by several other editors in Europe. The book contains numerous diagrams and illustrations of surgical instruments, in use or developed by him, and comprised a part of the medical curriculum in European countries for many centuries. Contrary to the view that the Muslims fought shy of surgery, Al-Zahrawi's Al-Tasrif provided a monumental collection for this branch of applied science.

25 ABU AL-QASIM AL-ZAHRAWI Al-Zahrawi was the inventor of several surgical instruments, of which three are notable: (i) an instrument for internal examina- tion of the ear, (ii) an instrument for internal inspection of the urethra, and (iii) and instrument for applying or removing foreign bodies from the throat. He specialized in curing disease by cauterization and applied the technique to as many as 50 different operations.

26 ABU AL-QASIM AL-ZAHRAWI In his book Al-Tasrif, Al-Zahrawi has also discussed the preparation of various medicines, in addition to a comprehensive account of surgical treatment in specialized branches, whose modern counterparts are E.N.T., Ophthalmology, etc. In connection with the preparation of medicines, he has also described in detail the application of such techniques as sublimation and decantation. Al- Zahrawi was also an expert in dentistry, and his book contains sketches of various instruments used thereof, in addition to a description of various important dental operations. He discussed the problem of non-aligned or deformed teeth and how to rectify these defects. He developed the technique of preparing artificial teeth and of replacement of defective teeth by these. In medicine, he was the first to describe in detail the unusual disease, hemophilia.

27 ABU AL-QASIM AL-ZAHRAWI There can be no doubt that Al-Zahrawi influenced the field of medicine and surgery very deeply and the principles laid down by him were recognized as authentic in medical science, especially surgery, and these continued to influence the medical world for five centuries. According to Dr. Cambell (History of Arab Medicine), his principles of medical science surpassed those of Galen in the European medical curriculum. Almost a thousand years ago at a time when Spain (Andalucía) was part of the Islamic empire, there lived near the capital city of Cordoba one of the great, but now largely forgotten, pioneers of surgery. He was known as El Zahrawi, though in European languages his name is written in over a dozen different ways: Abulcases, Albucasis, Bulcasis, Bulcasim, Bulcari, Alzahawi, Ezzahrawi, Zahravius, Alcarani, Alsarani, Aicaravi, Alcaravius, Alsahrawi etc.

28 ABU AL-QASIM AL-ZAHRAWI El Zahrawi is believed to have been born in the city of El-Zahra, six miles northwest of Cordoba, sometime between 936 and 940. It was here that he lived, studied, taught and practiced medicine and surgery until shortly before his death in about 1013, two years after the sacking of El-Zahra. Because El-Zahra was pillaged and destroyed, little is known about its illustrious son El Zahrawi. He was first mentioned by the Andalusian scholar Abu Muhammad bin Hazm ( ), who listed him among the great physician- surgeons of Moorish Spain. The first known biography of El Zahrawi, however, appeared in al-Humaydi's Jadhwat al-Muqtabis (On Andalusian Savants), completed six decades after El Zahrawi's death.

29 ABU AL-QASIM AL-ZAHRAWI It is clear from El Zahrawi's life history and from his writings that he devoted his entire life and genius to the advancement of medicine as a whole and surgery in particular. El Zahrawi wrote a medical encyclopedia spanning 30 volumes which included sections on surgery, medicine, orthopedics, ophthalmology, pharmacology, nutrition etc. This book was known as At-Tasrif and contained data that El Zahrawi had accumulated during a career that spanned almost 50 years of training, teaching and practice. He apparently travelled very little but had wide experience in treating accident victims and war casualties.

30 ABU AL-QASIM AL-ZAHRAWI In At-Tasrif, El Zahrawi expressed his concern about the welfare of his students whom he called "my children". He emphasized the importance of a good doctor patient relationship and took great care to ensure the safety of his patients and win their trust irrespective of their social status. El Zahrawi's clinical methods showed extreme foresight - he promoted the close observation of individual cases in order to establish the most accurate diagnosis and the best possible treatment. He insisted on compliance with ethical norms and warned against dubious practices adopted by some physicians for purposes of material gain. He also cautioned against quacks who claimed surgical skills they did not possess.

31 ABU AL-QASIM AL-ZAHRAWI At-Tasrif contains many original observations of historical interest. In it, El Zahrawi elaborates on the causes and symptoms of disease and theorises on the upbringing of children and youth and on the care of the aged and convalescent. In the section on pharmacology and therapeutics, he covers areas such as cardiac drugs, emetics, laxatives, cosmetology, dietetics, materia medica, weights and measures and drug substitution. Perhaps the most importance treatise is the one on surgery. This monumental work was the first in Arabic to treat surgery independently and in detail. It included many pictures of surgical instruments, most invented by El Zahrawi himself, and explanations of their use. El Zahrawi was the first medical author to provide illustrations of instruments used in surgery. There are approximately 200 such drawings ranging from a tongue depressor and a tooth extractor to a catheter and an elaborate obstetric device.

32 ABU AL-QASIM AL-ZAHRAWI The variety of operations covered is amazing. In this treatise El Zahrawi discussed cauterization, bloodletting, midwifery and obstetrics and the treatment of wounds. He described the exposure and division of the temporal artery to relieve certain types of headaches, diversion of urine into the rectum, reduction mammoplasty for excessively large breasts and the extraction of cataracts. He wrote extensively about injuries to bones and joints, even mentioning fractures of the nasal bones and of the vertebrae. In fact 'Kocher's method' for reducing a dislocated shoulder was described in At-Tasrif long before Kocher was born! El Zahrawi outlined the use of caustics in surgery, fully described tonsillectomy, tracheotomy and craniotomy- operations he had performed on a dead fetus. He explained how to use a hook to extract a polyptiom the nose, how to use a bulb syringe he had invented for giving enemas to children and how to use a metallic bladder syringe and speculum to extract bladder stones.

33 ABU AL-QASIM AL-ZAHRAWI El Zahrawi was the first to describe the so-called "Walcher position" in obstetrics; the first to depict dental arches, tongue depressors and lead catheters and the first to describe clearly the hereditary circumstances surrounding hemophilia. He also described ligaturing of blood vessels long before Ambroise Pare. Once At-Tasrif was translated into Latin in the 12th century, El Zahrawi had a tremendous influence on surgery in the West. The French surgeon Guy de Chauliac in his 'Great Surgery', completed in about 1363, quoted At-Tasrif over 200 times. El Zahrawi was described by Pietro Argallata (died 1423) as "without doubt the chief of all surgeons". Jaques Delechamps ( ), another French surgeon, made extensive use of At-Tasrif in his elaborate commentary, confirming the great prestige of El Zahrawi throughout the Middle Ages and up to the Renaissance

34 ABU AL-QASIM AL-ZAHRAWI At-Tasrif was translated into Latin by Gerard of Cremona in the 12th century and alongside Avicenna's Canon, played a major role as a medical text in the universities of Europe from the 12th to the 17th century AD. Two of El Zahrawi's treatises deserve special mention. Firstly his 28th treatise, known in Latin as Liber servitors' de preeparatione medicinarum simplicium, describes chemical preparations, tablet making, filtering of extracts and related pharmaceutical techniques. This treatise was printed in Venice in 1471 by Nicolaus Jensen.


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