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Medicine and Pharmacology

The history of medicine and pharmacology is a subject whose study should begin with the earliest days of the Islamic civilization. Muslims attached enormous significance to medical knowledge from early on. In fact, in a hadith of the Holy Prophet (PBUH) the science of the bodies (abdan) is said to be superior to the knowledge of religions (adyan). Though, the regular transmission of the medical heritage of Iran, India and Greek started in the 2nd/8th century, the Muslims from the days of the Holy Prophet (PBUH) onward were, in a limited way, familiar with the medical lore of Iran, India and Greek via the school of Jundishapur. For instance, Harith b. Kaldah, the physician contemporary of the Holy Prophet (PBUH) was among those trained at the hospital at Jundishapur. During the days of the caliphs of Damascus there were medical experts such as Masirjuyah who produced works such as Qawiyy al-`aqaqir, al-Manafi` and al-Madarr, which acted as conduit for the transmission of the medical heritage of Iran and India to the Islamic world.

The arrival of Jurjis b. Bakhtishu` in Baghdad from Jundishapur, at the behest of the `Abbasid Mansur, ushered in the period of the transmission of non-Arabic medical lore into the Islamic world. His book of Kunnash, a compendium of various medical and pharmacological topics, is the first work (or among the first works) written during this period. A large group of Bakhtishu`’s colleagues and students from Jundishapur followed in his footsteps and took up residence in Baghdad, especially his children and descendents including: (1) `Isa b. Saharbakht, the author of Qawiyy al-adwiyat al-mufradah; (2) Masawayh, the father of Yuhannah, who was for many decades a pharmacologist in Jundishapur; (3) the son of Yuhanna, a prominent physician and translator of Greek medical works into Arabic, and the author of al-Adwiyat al-muslihah; (4) Hunayn b. Ishaq, a well known ophthalmologist and pharmacologist, the author of al-`Ashar maqalat fi ’l`ayn, Ikhtiyar adwiyah `ilal al-`ayn, and many other important works.

One of the most important phenomena of this period is the spread of the so-called al-tibb al-shar`i (shar`i medicine), which contained points about medical issues and matters of well being gleaned, over time, from the hadiths of the Holy Prophet and Shi`ite Imams (PBUT). Prominent works of this genre include al-Tibb al-nabawi, by Ibn Qayyim Jawziyyah; al-Minhal al-rawi fi ’l-tibb al-nabawi, by Ibn Tutun; al-Tibb fi ’l-kitab wa ’l-sunnah, by `Abd al-Latif Baghdadi; as well as al-Tibb al-Sadiq, al-Tibb al-Rida and al-Tibb al-Baqir. In addition to the medicine of Jundishapur, the medical knowledge of India was transmitted through the translation of such works as Shanaq Hindi’s al-Sumum as well as the medical lore of Greeks such as those of Hippocrates and Galen, which formed the foundation of Islamic medical science. In his al-Fihrist, Ibn Nadim provides a list of Greek, Iranian and Indian medical works. Ibn Ridwan offers a list of over fifty works of Galen. The latter’s al-Fusul was a quite popular work in the Islamic world, with several commentaries written on in by the likes of Ibn Abi Sadiq and Razi, who also produced several commentaries on the works of Galen. The two sciences of medicine and pharmacology, which was known as saydanah or saydalah, were so intimately intertwined from the outset that at times it is well nigh impossible to distinguish the works belonging to either branch. During this period, the best physicians were those who were also considered as expert pharmacologists. However, most pharmacologists were only aware of the characteristics of various simple and compound medications without having any knowledge of their effects on different temperaments (sing. mizaj) and ailments. This is why during this period of the advancement of medical science physicians also supervised (or were directly involved in) the preparation of drugs. Many compiled works on pharmacology alongside their usual medical writings. Their pharmacological works were based on the theory of akhlat (sing. khilt: ingredient) and tabayi` (sing. tabi`ah: nature), a system based on which ailments and drugs are categorized according to the four categories of cold, hot, moist and dry. The imbalance resulting from the excess of one of these ingredients was believed to be at the root of various diseases. Drugs were divided into the two categories of simple (`aqaqir, sing. `uqqar) and compound (qarabadhin, aqrabadhin). Compound drugs were prescribed for creating balance between akhlat and tabayi`, while simple drugs were used as cures for various maladies. Since many drugs were extracted from plants, minerals and animals, pharmacology was intimately related to the fields of botany, biology and alchemy, a fact that is reflected in such works as Firdaws al-hikmah, al-Hawi and Qanun, all of which contain sections on plants and animals.

Ever since the 3rd/9th century, there appeared physicians and pharmacologists whose works contained many new ideas and innovations and which remained as references for many centuries to come. The first 3rd-century physician worthy of mention is Ibn Rabn Tabari whose Firdaws al-hikmah is among the first comprehensive medical manuals which left a deep impress on the future generations. His most important views relate to the fields of pathology, clinical medicine and pharmacology. During the same century al-`Ashr maqalat fi ’l-`ayn established Hunayn b. Ishaq as the founder of the science of ophthalmology in the Islamic civilization. The book of Aqrabadhin by Shapur b. Sahl (d. 255 AH), the head of the hospital at Jundishapur, was for long a work of reference used by hospitals, physicians and pharmacologists. Another prominent work of this period was Nasa’ih al-ruhban fi ’l-adwiyat al-murakkabah.

Other important pharmacological works of the period include Mufradat al-adwiyah, by Ghafi, and al-Mufradat by Ibn Baytar, on simple drugs, and three works by the name of Qarabadhin, by Kindi, Samarqandi and Qalanusi, on compound drugs. These were used as source books for many centuries to come. Other medical works of interest include Fi ’l-Marad al-musamma diyabitiya, by `Abd al-Latif Baghdadi, Fi ’l-Mi`dah wa mudawataha, by Ibn Jazzar Qirawani, and Tadhkirat al-kihalin, by `Ali b. `Isa Jarrah. Among the prominent works of the 4th/10th century is al-Ma`lijat al-Buqratiyyah by Abu al-Hasan Ahmad b. Muhammad Tabari, which gets the accolade of the most useful book by Ibn Abi Usaybi`ah. The period was also witness to the compilation of the greatest medical encyclopedia ever written by a Muslim scholar, i.e. al-Hawi by Muhammad b. Zakariya Razi. His views on smallpox and measles as well as on a number of pharmacological compounds, which take up three volumes of his work, are among the most groundbreaking pieces of medical research. His al-Hawi and Tibb al-Mansuri were both translated into Latin in the 13th – 15th centuries and went through several European editions. Both in his writings and his medical practice, Razi made extensive use of the works of Muslim, Christian, Zoroastrian, Iranian, Indian and Greek physicians, whose names he includes in his works. His Kitab al-Jadari wa ’l-hasbah (Smallpox and Measles) is among the most important works of medical research in Islam and in the history of medicine as a whole. It was translated over a dozen times into Latin and other European languages.

Another noted medical work of the period is Hidayat al-muti`allimin by Abu Bakr Akhwayni Bukhari, which is especially important in terms of its pharmacological content. The work contains Akhwayni’s critical views of earlier pharmacologists, while including discussions of various drugs, most of which are based on first-hand experience. Al-Baniyah `an haqa’iq al-adwiyah, by Abu Mansur Muwaffaq Hirawi contained a classification of drugs and was in wide currency in the eastern lands of Islam. Other popular works included Kunnash fi ’l-tibb, by Ya`qub b. Zakariya Kaskari, al-Adwiyat al-mufradah, by Ahmad b. Abi al-Ash`ath, Amrad al-`ayn, by Abu Mahir Musa b. Sayyar, and Risalah fi Tarkib tabaqat al-`ayn, Ibn Manduyah Isfahani. The last two authors were practicing physicians at the `Adudi Hospital. Abu Mahir’s student, `Ali b. `Abbas Majusi Ahwazi, the author of al-Tibb al-Maliki, or Kamil al-sana`at al-tibbiyah, was the greatest physician before Ibn Sina and his work was a long-standing, popular medical textbook.

However, the Qanun of Ibn Sina was the most well known textbook of the medieval period and later centuries, containing novel anatomical theories as well as exact descriptions of drugs devised by Ibn Sina himself, such as Tiryaq-i Kabir (the Greatest Tiryaq (a prophylactic against poison)), Buzurg Daru (the Great Drug) and the electuary “Firuznush”. Qanun was translated into Latin, French, English, German and Hebrew and was the standard textbook in the European schools up to the 17th century AD. The book was as popular in the Islamic world and numerous commentaries were written on it until recent times, including those of Ibn Nafis, Fakhr al-Din Razi and Qutb al-Din Shirazi.

Abu Rayhan Biruni, a contemporary of Ibn Sina, in his Kitab al-saydanah (the Book of Pharmacology) provided an elaborate account of various drugs and their classifications and qualities, along with their Greek, Syriac, Arabic and Iranian equivalents, a work that is considered as one of the most superb of its kind.Muslims were also quite active in the field of veterinary, a fact that is reflected in a number of surviving works under such common titles as Kitab al-khayl, al-Khayl wa’l-furusiyyah, Kitab al-baytarah, Baytar Namah, Faras Namah and the like.As regards medical education and training it was mainly carried out in the houses of physicians, but also in hospitals and schools. Razi, Ibn Sina and Ibn Maymun were among prominent physicians who held classes at their places of residence. Mosques were also used as venues for medical training, such as the Ibn Tutun Mosque and the Jami` al-Azhar. We have at our disposal a more detailed account of medical textbooks and syllabi. For instance, we know that the major textbooks were those of Hippocrates and Galen, along with the medical works of Muslim physicians such as Hunayn b. Ishaq, Ibn Masawayh, Ibn Sina and Razi, which were studied in a particular order. Medical exams were based on such works as Mihnat al-tabib of Hunayn b. Ishaq, `Ashr maqalat fi ’l-`ayn, on ophthalmology, Kunnash of Bawlas, on orthopedics, al-Tasrif of Zahrawi on surgery, Fi Mihnat al-tabibb of Razi, and sections of Tibb al-Mansuri.

Muslim physicians while concentrating on the diseases of the body were, at the same time, cognizant of the ailments of the soul and the interaction between these two aspects of humans. Two major works focusing on this interface are al-Tibb al-rawhani, by Razi, and al-Tibb wa ’l-ahdath al-nafsaniyyah, by Abi Sa`id b. Bakhtishu`. Also discussed were issues relating to the ethical dimensions of medical practice. Works of this genre include al-Turuq bi ’l-tibb ila ’l-sa`adah, by Ibn Ridwan, Adab al-tabib, by Rahawi, al-Tashwiq al-tibbi, by Sa`id b. Hasan, and al-Nawadir al-Tibbiyyah, by Ibn Masawayh.The provision of medical services and the production and distribution of drugs were governed by a body of rules and regulations whose adherence was mandatory for physicians and druggists and whose implementation fell within the purview of hisba (the moral police) and muhtasibs (enforcers). Among major works dealing with this notion is that of Shizari called Nihayat al-rutbah fi tibb al-hisbah, which sets forth the notion of the muhtasib having the duty to closely supervise the production of drugs. The decline which came to affect various fields of scientific activity in Islam did not spare medicine. In fact, the works produced after 6th/12th century were mostly commentaries on the writings of predecessors, though we still encounter original ideas in such books as Nur al-`ayn by Abu Ruh Muhammad b. Mansur Jurjani, known as Zarrin Dast (the Golden Hand). Other books include those by Sayyid Isma`il Jurjani, the renowned physician of the 6th century AH, such as Dhakirah Khwarazmshahi and al-Aghrad al-tibbiyyah which enjoyed widespread popularity, especially the Dhakhirah which in addition to being a major medical source book contained valuable information on issues of pharmacology.The next physician worthy of mention is Najm al-Din Muhmud b. Ilyas Shirazi, whose al-Hawi fi `ilm al-tadawi is an important work on pathology and symptoms of diseases. Among the physicians of the Mongol and Timurid period mention must be made of Nasir al-Din Yusuf b. Katbi, the author of Ma la Yasa` al-tabib jahluhu, and Najib al-Din Samarqandi, the author of Qarabadhin, al-Asbab and al-Mu`amalat. The last book enjoyed widespread popularity and was commented on by Burhan al-Din Nafis b. `Awd Kirmani. By far, the most significant physician of the period of decline may be considered to be Baha’ al-Dulah Muhammad Husayni Nurbakhsh, whose Khulasat al-tajarib contains important views on diseases relating to a number of organs.

The coming centuries continued to witness the production of a large number of medical works in Egypt, Syria, Iran and the Indian Subcontinent, none of which, however, contained any groundbreaking theories. This trend persisted up to the time of the introduction of modern medicine in the Islamic world, though there arose prominent physicians who devised new methods based on previous views.

* source: Mohaghegh , Mahdi "Islam Entry" The Great Islamic Encyclopedia. Ed. Kazem Musavi Bojnourdi.Tehran: The Center of Great Islamic Encyclopaedia , 1989-, V.8 , pp.462 – 465

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