Human Civilization Muslims contribution to Medicine & Healthcare Mamdouh EL-Adl Consultant Psychiatrist mamdouh.eladl@nht.northants.nhs.uk

Aim of presentation: To bring to your attention 2 concepts: Unity of the human race. Human Civilization is one continuum.

Contents of Presentation Our parents & the human race. The Human Civilization. Islam & Civilization. Muslims & Medicine. The future.

Our Parents According to the 3 monotheistic religions, God created: - The universe including the mankind. - Adam & Eve (parents of the mankind).

Let us read the books

Adam & Eve in the Bible “ In the beginning God created the heaven & the earth” [Genesis Ch.1, verse 1] “And God said let us make man in our image” [Genesis Ch.1, verse 26] “And Adam, called his wife’s name Eve; because she was the mother of all living” [Genesis Ch.3, verse 20]

In the Noble Qur’ān بسم الله الرحمن الرحيم ”يا أيها الناس انا خلقناكم من ذكر وأنثى وجعلناكم شعوبا وقبائل لتعارفوا, ان أكرمكم عند الله أتقاكم, ان الله عليم خبير“ سورة الحجرات, آيه 13

In the name of Allah, the Most Beneficent, the Most Merciful “Human beings, we created you all from a male (Adam) & a female (Eve, Hawaa), and made you into nations & tribes so that you may know one another. Verily the noblest of you in the sight of Allah (God) is the most God–fearing of you. Surely God is All-knowing, All-Aware. Surah number 49 “Al-Hujarat”, Verse number 13

In the name of Allah, the Most Beneficent, the Most Merciful “O mankind! Be dutiful to your Lord, Who created you from a single person (Adam), and from him (Adam) He created his wife (Eve), and from them both He created many men and women; fear Allah through Whom you demand your mutual (rights) and do not cut the relations of the wombs (Kinship). Surely, Allah is Ever an All-Watcher over you.” Surat An-Nisa (The Women), Verse 1

Hindu Religion* Contrary to popular understanding, Hindus recognise one God (Brahman). Brahman is the eternal origin who is the creator and cause of all existence. Brahman who creates the universe. *www.bbc.co.uk/religions/hinduism. Accessed on 31.08.07

Adam, Eve & their Children Brown

Nations, cultures & Civilizations Human beings differentiated over the decades into: - Tribes & nations. - Different cultures. - Different civilizations. But we need to remember: - One creator - One parent. - One race. we share the same feelings: sadness, happiness, joy, love, fear, worry, anxiety, ….. Same hopes & ambitions and same needs: peace, love, respect, care and more.

Civilization Civis: Latin word for citizen or townsman. Being Civilised: a citizen who is governed by his/her city, town or community. “Civilisation” is the opposite “Barbarity” Civilization: refers to human society as a whole. Civilization is not only about advances in technology but Principles, Morals & Ethics

Each of us influences & is influenced by the other

Race & Racism A characteristic of human beings is to compare themselves to others. Why? - To enhance self esteem - To set boundaries * * Favazza A (2005): Contribution of the Sociocultural Sciences, in Comprehensive Textbook of Psychiatry edited by, 8th Edition, pp: 598–623

Modern Racism* Began in Spain (15th Century), where Christians were divided into old & new. 1. Old Christians: “had purity of blood”. 2. New Christians: converted Jews. On biological grounds, Jews & later Muslims, were declared incorrigibly inferior. They were excluded from mainstream Spanish society. * Favazza A (2005): Contribution of the Sociocultural Sciences, in Comprehensive Textbook of Psychiatry edited by, 8th Edition, pp: 598–623

In the New World Spanish conquerors brutalised & enslaved the local populations to mine for gold. Their justification came from some theologians who declared that Indians lacked rationality & morality and therefore were in Aristotelian terms “Natural Slaves”

Paracelsus: a famous Physician Indians were soulless, inferior beings because they had not descended from the Biblical Adam.

Pope Paul III In 1537, Pope Paul III ruled out that: “The Indians are truly men” However economic interests prevailed, the Papal declaration was ignored and harsh slavery continued for several hundred years.

In 17th century, transatlantic slave trade was developed with the following rationalisations

A. Religious Blacks (many British referred to non-white persons as black) supposedly were cursed by God as descendents of Ham, an Old Testament biblical figure who saw his father naked*. * Favazza A (2005): Contribution of the Sociocultural Sciences, in Comprehensive Textbook of Psychiatry edited by, 8th Edition, pp: 598–623

B. Philosophical Dave Hume: only white persons are capable of creating civilized nations & of producing ingenious manufacture, art & science. John Locke (English Physician-Philosopher) supported the degeneracy theory: “the white European is the normal natural state of human beings & other races developed through biological and psychological degeneration”

C. Scientific Scientists noted that: White was the true colour of nature. Degenerative process found in non-whites. This degeneration might be reversed by exposure to European culture. Non-white were deemed to be psychologically flawed & unable to rule themselves as demonstrated by the ease with which European colonialists subjugated vast areas of the east. As late as 1963, a British historian stated that, although black Africans have darkness, only European have history in Africa.

In USA (19th Century) Samuel Morton (Professor of Anatomy): claimed that cranial capacity of skulls was unchanged for 3000 years, was largest for whites, followed by Asians, native Americans & Africans. Robert Bean (Professor of Anatomy at John Hopkins University,1906) confirmed this finding. He stated that Negroes have well developed lower mental faculties such as smell & melody while whites have well developed higher faculties such as self-control & reason.

American Psychiatry Drapetomania: a term coined by an American Psychiatrist to describe slaves & cats who had irrestrainable propensity to run away from their masters. In 20th century, American Psychiatrists published articles in prestigious Journals demonstrating that lower rate of mental illness among slaves compared to free blacks i.e. slavery protected the mental health of blacks because of the supervision they received. A study in 1914 concluded that: negro mind is irresponsible, unthinking, easily aroused to happiness and rarely experiences depression*. * Favazza A (2005): Contribution of the Sociocultural Sciences, in Comprehensive Textbook of Psychiatry edited by, 8th Edition, pp: 598–623

USA The founding fathers of US wrote a constitution & a bill of Rights proclaiming that all men were created equal & have the right to pursue happiness. Yet slavery was common at the time in Northern & Southern states.

Healthy Cultures* Healthy cultures have the capacity to change their social patterns in response to new ideas, desires and technologies. Change may come: - Gradually especially when many of the perceived inferior group members come to believe that they are truly inferior. - Rapidly with forceful rebellion and civil war. *Favazza A ( 2005): Contribution of the Sociocultural Sciences, in Comprehensive Textbook of Psychiatry edited by, 8th Edition, pp: 598–623

The Islamic Era

Muslims’ Contribution to Medicine Many if not all nations contributed to the development of the human civilization. We may or may not know about all the nations & their contribution. No one nation can claim the credit.

Islamic Values - Monotheism (one God) - Education and Literacy - Modesty and Chastity - Honesty, Humility, Trustworthiness. - Family as a basic unit of society - Consultation and Consensus - Purity of intent and action 37

Islam & Tolerance Freedom of choice is laid down by the Qur'an itself: 'There is no compulsion in religion'. (2:256) The human life and property of all citizens in the society are considered sacred whether a person is Muslim or not. All human beings are equal, no racism. 38

Revealed Prophets - Noah - Abraham - Adam - Isaac - Ishmael - Moses - David - Solomon - Zacharias - Elisha - Elias - John the Baptist - Jesus - Mohammed 39

Islamic Influences Astronomy Mathematics Inventions Medicine discovered stars: Algol Deneb, Betelgeuse, Rigel, Aldebaran compiled astronomical tables and almanacs established observatories translated Ptolemy’s Almagest Mathematics Arabic numerals Zero Algebra, algorithm Inventions quadrant and astrolabe Medicine first hospital – Baghdad 706 A&P: surgery emphasized empirical observation hygiene and pharmacology Universities Al-Zaytunah, Tunis – 732 Al-Azhar, Cairo – 988 Muslim Spain: Granada, Seville, and Cordoba, – 9th c. Literature Religious Toleration 40

Medieval Islamic Scientists Jaber Ibn Haiyan (Geber) alchemist/metallurgist died 803 A.D. Ibn Sina (Avicenna) physician/philosopher 981-1037 A.D. Ar-Razi (Rhazes) physician/ philosopher 864-930 A.D. Abu Al-Qasim Al-Zahravi (Albucasis) surgeon/author 936-1013 A.D. Ibn Rushd (Averroes) physician/philosopher 1128-1198 A.D. Al-Khawarizmi (Algorizm) mathematician/ astronomer 770-840 A.D. Abu al-Qasim b. c. 936,, near Córdoba [Spain] d. c. 1013 also spelled Abul Kasim, in full ABU AL-QASIM KHALAF IBN 'ABBAS AZ-ZAHRAWI, Latin ALBUCASIS, Islam's greatest medieval surgeon, whose comprehensive medical text, combining Middle Eastern and Greco-Roman classical teachings, shaped European surgical procedures until the Renaissance. Abu al-Qasim was court physician to the Spanish caliph 'Abd ar-Rahman III an-Nasir and wrote At-Tasrif liman 'ajaz'an at-Ta'alif, or At-Tasrif ("The Method"), a medical work in 30 parts. While much of the text was based on earlier authorities, especially the Epitomae of the 7th-century Byzantine physician Paul of Aegina, it contained many original observations, including the earliest known description of hemophilia. The last chapter, with its drawings of more than 200 instruments, constitutes the first illustrated, independent work on surgery. Ar-Razi's two most significant medical works are the Kitab al-Mansuri, which he composed for the Rayy ruler Mansur ibn Ishaq and which became well known in the West in Gerard of Cremona's 12th-century Latin translation; and Kitab al-hawi, the "Comprehensive Book," in which he surveyed Greek, Syrian, and early Arabic medicine, as well as some Indian medical knowledge. Throughout his works he added his own considered judgment and his own medical experience as commentary. Among his numerous minor medical treatises is the famed Treatise on the Small Pox and Measles, which was translated into Latin, Byzantine Greek, and various modern languages.The philosophical writings of ar-Razi were neglected for centuries, and renewed appreciation of their importance did not occur until the 20th century. Although he claimed to be a follower of Plato, he consistently disagreed with such Arabic interpreters of Plato as al-Farabi, Avicenna, and Averroës. He was probably acquainted with Arabic translations of the Greek atomist philosopher Democritus and pursued a similar tendency in his own atomic theory of the composition of matter. Among his other works, The Spiritual Physick of Rhazes is a popular ethical treatise and a major alchemical study. 41

The Taj Mahal, Agra, India 42

History of Medicine, why? The concept that medicine is exclusively the product of Western minds, remains unquestioned by most individuals. A review of any of the standard texts or encyclopedias regarding the history of medicine would support this view.

History of Medicine Most texts give little or no mention of the advancements made by ancient Indian, Chinese, Persian or, particularly, Arab & Muslim physicians. George Perkins (A British Surgeon) is considered the pioneer of what is called the Delayed Splintage Theory, while Avicenna (Ibn Sina) wrote about this theory in his book Al-Qanunn 1000 year before Perkins.

History of Medicine George Sarton (1884-1956) was a Belgian-American historian of science. States that modern Western medicine did not originate from Europe and that it actually arose from the orients.

Al-Razi is considered the first who described what is called now Baker’s cyst. Which is attributed to the English surgeon William Baker (1839-1896) who described it in 1877. 46

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The final page of a manuscript of al-Hawi by al-Razi The final page of a manuscript of al-Hawi by al-Razi. It is the oldest manuscript kept in NLM, and the third oldest Arabic medical manuscript The final page of a manuscript of al-Hawi by al-Razi. It is the oldest manuscript kept in NLM, and the third oldest Arabic medical manuscript 48

Treating Patients Muslims believed in finding remedies for disease rather than relying on prayer. As a result Islamic medicine was far more advanced than medicine in Europe. 49

Other points to Remember… Muslims believed that Hygiene was important for health. Charity & caring for others was encouraged. Hospitals set up for sick people. Sick people even given money so they didn’t have to beg or rush back to work. 50

Medical Ethics Medical ethics & regulating medical profession was given a high importance in the Islamic era. Islamic era was much different from its predecessors (e.g. Hamoraby, Ancient Greek) You will find similarity between the principles adopted in Islamic era & our current time e.g. by the UK General Medical Council (GMC).

Medical Responsibility (1) 1. Doctor’s responsibility. 2. Patient’s responsibility. Good Clinical Care: - Doctors must recognise & work within their professional competence. - Be competent when making diagnosis & giving treatment. - Be willing to consult colleagues. (GMC-UK, 1998)

Medical Responsibility (2) Iraq (Hamoraby Law, 1700 y before birth of C): - If a physician treats a seriously wounded man using a scalpel or treated an eye abscess and he recovered, the physician is to be paid 10 Shawaqil of silver. - If the man dies or looses his eyesight, the physician’s hand is to be amputated! Ancient Greek (Aesculapius): A physician who put a condition that if a man wanted to learn medicine, he must be from his own noble family or from a recognised & rich family. They put a system for accountability & a noble man to look into complaints against physicians.

Medical Responsibility (3) Islamic era: Prophet Mohamed’s Hadith ‘A person who practiced medicine, without having the necessary knowledge & skills, is liable’. Ibn Al-Qayim (scholar) had classified physicians regarding medical responsibility into 5 types & as a conclusion: The physician is not deemed liable if he: 1. Has the appropriate knowledge & skills. 2. Intended & aimed to do the patient good. 3. Adheres to the recognised & accepted medical knowledge & rules. 4. Has obtained consent of the patient or his next of ken if appropriate. (Kaadan, Medicoethics, islamicmedicine.org, 2005)

Medical Responsibility (4) With↑numbers of practitioners in Muslim countries, a supervising system was developed (Al-Hisbah). The Chief of Physicians was responsible to (Al-Mohtasib). The Chief of physicians adopted strict rules in supervising the practitioners. These rules included: not to prescribe a harmful medication, not to inform women of drugs that could be used to harm foetus, or men of drugs that could adversely affect fertility, to respect privacy and confidentiality of patient & his family. (Kaadan, Medicoethics, islamicmedicine.org, 2005)

Medical Responsibility (5) Physicians had to undergo a test before having a permission to practice e.g. Alkahaloon (Ophthalmologists): To be examined in: Honain Bin Ishaq book (10 articles about the anatomy and diseases of the eye). Drugs used for treating the eye.

Ibn Sina: (980-1037 A.D.) the Genius Boy Ibn Sina's portrait is in the hall of the Faculty of Medicine in Paris University of. He is known in the West as Avicenna.

Al-Zahravi is called the "father of surgery"(963-1013 AD) .

Hospitals (1) The development of efficient hospitals was an outstanding contribution of Islamic medicine. The hospitals served all citizens free of charge regardless their colour, religion, sex, age or social status. Hospitals had separate wards for male and female

Hospitals (2) Teams: qualified physicians, nurses, pharmacist, ... Baths and water supplies. Medical records. Medical Schools Extensive libraries were attached to the hospitals, containing most up-to-date books. -Tulum Hospital in Cairo in 872 CE had 100,000 books. (Mustansiriyya University in Baghdad had 80,000 volumes. Cordova library had 600,000 volumes; Cairo had 2,000,000 and Tripoli 3,000,000).

SOME FAMOUS HOSPITALS: Al-Nuri Hospital: Damascus in 706 Al-Fustat Hospital: Cairo in 872 Al-Salahani Hospital: Jerusalem in 1055 -Mansuri Hospital: Cairo in 1248 Al-Qayrawan Hospital: Tunisia in 830 Marakesh Hospital: In 1190 Granada Hospital: Spain in 1366 Delhi Hospitals in India

“A man or a woman who has a ghost or a familiar spirit shall be put to death; they shall be pelted with stones; their blood guilt shall be upon them.” Leviticus 20:27 62

The Future!

Better understanding about each other, more achievements & more flowers

Love + Justice  Peace

Thank You