Islamic Medicine

ISLAMIC MEDICINE

Islamic Medicine in its true context, can be defined
as a body of knowledge of Medicine that wasinherited by the Muslims in the early phase of IslamicHistory (40-247 AH/661 -861 AD) from mostly Greeksources, but to which became added medical knowledge from, Persia, Syria, India and Byzantine.

HALAL AND HARAM
THERAPEUTICS

Some medicine is good and others are bad. Bad medicine is for bidden. Bad medicine causes more harm than benefit.
While seeking treatment, the moral teachings of
Islam must be respected. The end never justifies themeans. Haram material is not allowed as medicine except in special circum stances where the legalprinciple of necessity applies. Alcohol is for example not an accepted cure for any disease; it is actuallyitself a disease.

THE MAIN ISLAMIC PHYSICIANS
AL-RAZI (RAZES) 841-926 A.D

* He defined medicine as "the art concerned in preserving healthy bodies, in combating disease, and in restoring health to the sick." He thus outlined the three aspects of medicine, namely public health, preventive medicine, and treatment of specific diseases.

* He published several books which were translatedinto Latin, French, Italian, He brew, and Creek. One of his mainbooks is "AI-Mansuri" (Liber Al-Mansoris) which he dedicatedto his patron Prince Al-Mansur. It was composed of tentreatises and included all aspects of health and disease.

* He listed seven principles for the preservation of health:

1. Moderation and balance in motion and rest.
2. Moderation in eating and drinking.
3. Elimination of superfluous matter.
4. Improvement and regulation of dwelling places.
5. Avoidance of excesses before they become uncontrollable.
6. Maintenance of harmony in ambitions and resolutions.
7. Acquisition of reticence through possession of good habits
including exercise.

* He also published another book called A-Murshid.In it, he emphasized the important lines of therapy that wementioned earlier.

* Another book written by Al-Razi was named "Al-Hawi", which means the complete text. It was composed of 22 volumes, and it, especially its 9th volume on pharmacology,was used as one of the main text books in the medical schoolof Paris.

* He also wrote a treatise on measles and smallpoxand called it "de Peste or de Pestilentia." It was translated intoLatin in 1565 A.D. It is a masterpiece in clinical medicine(Browne 1962). It describes the clinical difference betweenthe two diseases so vividly that nothing since has been added(Keys 1971).

AL-ZAHRAWI (ABULCASIS, BUCASIS, ALZAHRAVIUS)
931-1013 A.D.

* Al-Zahrawi became an eminent surgeon. He spent a productive life in practicing medicine, especially in surgery and medical writings. He died at the age of 83.

* He authored four main works. One of these is "Al-Tasrif Liman Ajiz 'an AI-Ta'lif' which was the best medieval surgical encyclopedia and was used in Europe until the 17thcentury. Stressing the importance of basic sciences he says:
“Before practicing, one should be familiar with the science of anatomy and the functions of organs so that he will understand them, recognize their shape, understand theirconnections, and know their limitations. Also one should knowthe bones, nerves, and muscles, their numbers, their originand Insertions, the arteries and the veins, their start andend”.

* Al-Zahrawi also used cautery to control bleeding.He used wax and alcohol to stop bleeding from the skullduring cranial surgery. Sprengel said that Al-Zahrawi was thefirst to the lithotomy position for vaginal operations. AI~Zahrawi also described the tracheotomy operation and performed it in an emergency on one of his servants.

* He was the first to write on orthodontia. Heshowed evidence of great experience from details of clinic alpicture and surgical procedures e.g. his description of varicose veins stripping, even after ten centuries, is almost like modern surgery (Al-Okbi 1971).

* He also wrote about fracture of the skull (AI-Okbi
1971).

* Al-Zahrawi described many dental operations suchas dental extractions, fixation, reimplantation, and artificial teeth. He described tooth pain and cautioned the physician against removal of the healthy tooth to which pain is referred.

* He also devoted one whole chapter to midwifery,giving tips to midwives, and describing the problems of difficult labor and obstetrical maneuvers.

* During the time of Al-Zahrawi, surgery in theIslamic world became a respected specialty practiced byreputable physicians. On the contrary in Europe, surgery wasbelittled and practiced by barbers and butchers. In 1163 A.D.,the Council of Tours declared the following resolution "Surgeryis to be abandoned by the schools of medicine and by alldecent physicians."

IBN-SINA (AVICENNA) 980-1037 A.D

*A vicen n a, considered the father of modernmedicine, introduced experimental medicine and systematicexperimentation and quantification in physiology, discoveredthe contagious nature of diseases, and described many
medical treatments, including anesthetics and medical and
therapeutic drugs, in The Canon of Medicine.

IBN-EL-NAFIS 1208 - 1288 A.D.

* On medicine he wrote many books, two of themare "Mujaz Al-Qanun" which means the "Summary of theCanon". In these two books which were based on Avicenna'swritings, he criticized the shortcomings of Avicenna's workand of Galen's views and showed their weaknesses. That iswhy he was called by some as Avicenna the Second.

* Ibn-El-Nafis added to our knowledge of the
physiology of the circulation.

IBN-AL-QUFF(1233-1305)

* Another physician who contributed to perinatology.

MEDICAL THEORY AND THE HUMAN BODY

Islamic theoretical formulations about the human
body were founded on those of classical Greek philosophy and Graeco-Roman medicine, elaborated and developed by individual authors in the ArabIslamic tradition, not always in agreement with one another.

The functions and activities attributed to the systems
of the body, however, and the connections drawn between them, often betrayed the limited extent to which empirical data could be collected and verifiedin the pre-modern age.

Arab-Islamic medicine, like Greek medicine before it,attributed key roles to certain major organs, each of which performed a specific vital function. The heart was the source of the ‘innate heat’ that sustains life.

The brain was the seat of the psychical faculties —reason, imagination, thought, memory, and sense perception all had their origin here.

All of the above are part of what Islamic medicine
called the ‘naturals’: the humours; the basic qualitiesof hot, cold, wet, and dry; personal temperament,and the faculties andpn eu mata — in sum, all thathuman beings really are. In addition, there were twoother sets of factors that were deemed to affect thebody, but that were not regarded as part of it. Thesewere the ‘extra-naturals’ by which was meant illnessand its symptoms, and the ‘non-naturals’ — sixthings external to the body, but vital to the preservation or restoration of health.

The first of the non-naturals was the consideration of air:
good air encouraged and maintained goodhealth, while corrupt air could throw the humours out of balance and cause illness. Epidemics, for example,were routinely attributed to bad or corrupt air.

The second was movement. Islamic medicine placedgreat stress on the role of exercise in main taining health, and prescribed it in moderation as part of are cuperative routine.

The third was eating and drinking:

these were divided into categories of regular foodstuffs,foodstuffs with a remedial function, drugs, andpoisons. Diet was a paramount consideration in both maintenance of health and recovery from illness.This category also covered matters of attire.

Another of the non-naturals was sleep, along with wakefulness. Sleep was deemed to help digest foodand mature humours, since it allowed innate heat tospread through the body. Wake fulness was also important, since too much sleep dulled the mind and could also cool the body.

The fifth non-natural was excretion and retention:this not only had to do with digestive function,including constipation and diarrhoea, but also covered inter course and bathing.

The last of the non-naturals was psychical states,illustrating how mental function was integrated intothe physical and how it was recognized that this could have a decisive impact on one's physical well-being.

The doctrine of the non-naturals highlights the themes of moderation and balance that dominated medieval Islamic thinking on the healthy body.
Method of Therapy in Islamic Medicine

The patients were treated according to a well-defined treatment plan. It began with physiotherapy and diet; if this failed, drugs were used. Only as a last resort was surgery used.

EPIDEMIOLOGY, ETIOLOGY, PATHOLOGY

Inetiology and epidemiology, Muslim physicians
were responsible for the discovery of infectious disease and the immune system and the introduction of bacteriology, microbiology and pathology. Their discovery of contagious disease in particular is considered revolutionary and is one of the most important discoveries in medicine.

By then, the pathology of contagion had been fully
understood, and as a result, hospitals were created with separate wards for specific illnesses, so thatpeople with contagious diseases could be kept away from other patients who do not have any contagious diseases.

In epidemiology, Avicenna introduced the method of
quarantine as a means of limiting the spread ofcontagious diseases, and introduced the method ofrisk factor analysis and the idea of a syndrome in thediagnosis of specific diseases He also described thefirst known surgical treatment for cancer.

PULSOLOGY AND SPHYGMOLOGY

in Muslim physicians were pioneers in pulsology and sphygmology
The first correct explanations of pulsation were given
by Muslim physicians.

Avicenna was a pioneer of sphygmology after he
refined Galen's theory of the pulse and discovered
the following in The Canon of Medicine:
"Every beat of the pulse comprises two movements
and two pauses. Thus, expansion The pulse is a movement inthe heart and arteries ... which takes the form of alternate expansion and contraction."
The Latin translation of hisC an o n also laid the
foundations for the later invention of the
sphygmograph.

ALLERGOLOGY AND IMMUNOLOGY

The study of allergology and immunology originate
from the Islamic world.
Muhammad ibn Zakarīya Rāzi (Rhazes) was
responsible for discovering "allergic asthma", andwas the first physician known to have written articleson allergy and the immune system.

BACTERIOLOGY AND MICROBIOLOGY

In bacteriology, Avicenna stated that bodily secretion
is contaminated by foul foreign earthly bodies before being infected, and gave the first descriptions on bacterial and viral organisms (though he did not viewthem as primary causes of disease).

DENTISTRY

Muslim dentists were pioneers in dentistry,
particularly dental surgery and dental restoration.The earliest medical text to deal with dental surgeryin detail was theA l-Tas rif by Abulcasis. He gave detailed methods for the successful replantation of dislodged teeth.

OPHTHALMOLOGY

1050 A.D. at Baghdad, Ali Ibn-Isa (Jesu Haly) wrote
the classic book on ophthalmology, Tathkirat Al-Kahhalin (A Note for the Occulists). As stated byCunistan(l921), it is the oldest book in its originallanguage on diseases of the eye. Written in a clearand logical style, the author described trachoma,conjunctivitis, and cataract, and prescri bed treatment (Keys 1971). Avicenna described the sixextrinsic muscles of the eyeball.
In the thirteenth century, Ibn Abu-Al-Kawafer wrote a
book on therapeutic ophthalmology entitled "Natigat-El-Fikr fi Ilag Amrad El-Bassar", (Conclusions from Experience on Treatment of Diseases of the Eye).According to Kahil (1920), it is one of several text books on ophthalmology considered to be
superior to any written in Europe up to the
eighteenth century

ANESTHESIA

First, in anaesthesia, they described in detail the
pharmacology of important narcotics such as opium and other central nervous system depressants such as hyoscyamus and hashish (Khairallal 1942).
Modern anesthesia was developed by Muslim
anesthesiologists. They were the first to utilize oral
as well as inhalant anesthetics.
In Islamic Spain, Abu al-Qasim and Ibn Zuhr, among
other Muslim surgeons, performed hundreds ofsurgeries under inhalant anesthesia with the use ofnarcotic-soaked sponges which were placed over theface.
Muslim physicians also introduced the anesthetic
value of opium derivatives during the middle Ages.

OBSTETRICS

Muslim physicians made many advances in
obstetrics, especially perinatology.
In the 10th century, Ali ibn Abbas al-Majusi proved
this theory false as he discovered that uterine contractions are in fact the cause of delivery of thefetus.

EMBRYOLOGY

Embryology was discussed to some extent in early
Islamic literature, including the Qur'an and the
Hadith literature.
Ibn al-Nafis develop his own theories on embryology
and generation.He believed that when a male and female semen mix, and when they create a mixedmatter that has an appropriate temperament toreceive an animal or human soul, God issues a soulto this matter, which then develops into an embryo that grows and generates organs.

The Arab physician Ibn al-Quff (1233-1305), a
student of Ibn al-Nafis, described embryology and
perinatology more accurately in hisA l-J ami.

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.
The Can on laid out the following rules and principles.
for testing the effectiveness of new drugs and medications, which still form the basis of clinical pharmacology and modern clinical trials:

"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 onedisease 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 onthem."

"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 mightnot prove anything about its effect on man."

ANALGESICS, ANTIEMETICS, ANTIPYRETICS,
DIURETICS

In the medical Islamic world, Arabic physicians
discovered the diuretic, antiemetic, antiepileptic,anti-inflammatory, analgesic (pain killing) andantipyretic properties of medical cannabis,specifically cannabis sativa, and used it extensivelyas medication from the 8th to 18th centuries.

ANTISEPTICS

Razi used mercurial compounds as topical
antiseptics. From the 10th century, Muslim physicians and surgeons were applying purified alcohol to wounds as an antiseptic agent. Surgeonsin Islamic Spain utilized special methods for main taining antisepsis prior to and during surgery.They also originated specific protocols for main taining hygiene during the post-operative period.Chemotherapeutical drugs were first developed in
the Muslim world. Muslim physicians used a varietyof specific substances to destroy microbes. Theyapplied sulfur topically specifically to kill the scabiesmite.

MEDICINAL ALCOHOL

Numerous Muslim chemists produced medicinal-
grade alcohol through distillation as early as the 10thcentury and manufactured on a large scale the first distillation devices for use in chemistry. They usedalcohol as a solvent and antiseptic.

SURGERY

Abu al-Qasim (Abulcasis), the father of modern
surgery, performed surgeries under inhalant anesthesia, and invented the plaster and many surgical instruments.

TRACHEOTOMY

The surgical procedure of tracheotomy was invented
by Ibn Zuhr (Avenzoar) in the 12th century.

LITHOTOMY

In lithotomy, Abulcasis performed the first successful
extraction of bladder and kidney stones from theurinary bladder using a new instrument he invented
—a lithotomy scalpel with two sharp cutting edges
—and a new technique he invented
—perinealcystolithotomy
—which allowed him to crush a large stone inside the bladder before its removal,significantly decreasing the death rates previouslycaused by earlier attempts at this operation by theancients.

CIRCUMCISION

Most Fuqaha' (Islamic Jurists) say that circumcision is
obligatory upon the men and this is the opinion of
Jumhur (the majority of the scholars).

SURGICAL INSTRUMENTS

Adhesive bandage and Plaster Catgut and Forceps Cauter and Ligature Cotton dressing and Surgical needle Injection syringe

THERAPY

Aromatherapy

* Steam distillation was invented by Avicenna in the early 11th century for the purpose of producing essential oils, giving rise to aromatherapy. As a result, he is regarded as a pioneer of aromatherapy.

Chemotherapy

*Chemotherapy was pioneered by al-Razi(Rhazes) in the 10th century, when he introduced theuse of chemical substances and drugs as forms ofmedication. These chemicals included vitriol, copper,mercuric and arsenic salts, sal ammoniac, gold scoria,chalk, clay, coral, pearl, tar, bitumen and alcohol.

Hirudotherapy

* Hirudotherapy, the use of medicinal leech for
medical purposes, was introduced by Avicenna in The Canon
of Medicine(1 0 2 0s ).

* He also introduced the use of leech as treatment for skindisease. Leech therapy became a popular method in medieval Europe due to the influence of hisC an on. A more modern usefor medicinal leech was introduced by Abd-el-latif in the 12thcentury, who wrote that leech could be used for cleaning thet issues after surgical operations.

Physiotherapy

* The physiotherapy prescribed by Muslim physicians usually included physical exercise and bathing.Muslim Arab physicians developed an elaborate system ofdieting, in which there was an awareness of food deficiencies,and proper nutrition was an important item of treatment.

SEXUAL HEALTH

In sexual health, Muslim physicians and pharmacists
identified the issues of sexual dysfunction anderectile dysfunction, and they were the first top rescribe medication for the treatment of these problems.
They developed several methods of therapy for this
issue, including the single drug method where a drug is prescribed, and a "combination method of either a drug or food."

NEUROSCIENCE AND PSYCHOLOGY

The concepts of mental health and "mental hygiene"
were introduced by the Muslim physician Ahmed ibn
Sahl al-Balkhi (850-934). In his Masalih al-Abdan wa
al-Anfus(Sustenance for Body and Soul), he was the
first to successfully discuss diseases related to both the body and the mind, and argued that "if thena fs [psyche] gets sick, the body may also find no joy in life and may eventually develop a physical illness."
Avicenna was a pioneer of psychophysiology and
psychosomatic medicine. He recognized'physiological psychology' in the treatment ofillnesses involving emotions, and developed a systemfor associating changes in the pulse rate with inner feelings, which is seen as an anticipation of the word association test attributed to Carl Jung.
Avicenna was also a pioneer of neuropsychiatry. He
first described numerous neuropsychiatric conditions,including hallucination, insomnia, mania, nightmare,melancholia, dementia, epilepsy, paralysis, stroke,vertigo and tremor.
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