There was once a civilisation that saved medicine, at a time when many cultures feared science and the new ideas it brought. The Golden Age of this civilisation, between the ninth and the thirteenth centuries, safeguarded ancient learning from extinction, modified it – adding new discoveries – and spread this knowledge in an enlarged and enriched form.
This was, of course, the medieval Arabic civilisation (ca. 800 to 1300 CE), which was a shining beacon of scientific and medical progress. It was a period when Arabic was the international language of science, and scholars and men of learning thrived in the region. Medicine flourished from the translation of ancient Egyptian and Greek texts, as did new research. Clinical work and patient care were also advocated – medieval Islamic hospitals were advanced, custom-designed institutions. Facilities such as Al-‘Adudi Hospital in Baghdad (981 CE), Al-Nuri Hospital in Damascus (1154 CE) and Al-Mansuri Hospital in Cairo (1248 CE) were hospitals in the modern sense of the word. They were also teaching facilities, providing first-hand practical and theoretical lessons for students, just as medical residents receive today.
What was amazing about these medieval Islamic scientists was their insatiable thirst for the practical application of knowledge – to improve the quality of life of people. In fact, early Arabic society developed a healthcare system which pioneered, among other things, surgery, ophthalmology, urology, pharmacology and hospital care.
Al-Razi was not only a pre-eminent physician, but also a philosopher and alchemist. He is considered to have had an encyclopaedic mind, writing on subjects as varied as logic, mathematics, medicine, theology and philosophy, publishing around 200 books. Al-Razi’s 20-volume Kitab al-Hawi fi ‘al-Tibb (Comprehensive Book of Medicine) covers every known branch of medicine and is a vital source of information on medieval Arabic medicine, and also earlier Greek, Indian and Arabic writings which would – if not for his meticulous referencing – have otherwise have been lost. Meanwhile, his medical handbook Kitab al-Mansouri fi al-Tibb (Book of Medicine Dedicated to Al-Mansur) was translated into Latin as Liber ad Almansoris and remained one of the most frequently-used medical textbooks in the western world until 7 centuries after his death.
Ibn Sina (known as Avicenna in the West) was for some a philosopher, but for others he was the ‘Prince of Physicians’ during the Middle Ages. Code of Laws in Medicine (also known as The Canon of Medicine) was his most important work and has been described as the most famous medical textbook ever written. The Canon was made up of five books, the fourth of which was, in part, dedicated to fractures. In it, he wrote about the metacarpal injury which is now known as a Bennett’s fracture, 1000 years before Bennett himself described the condition. These were such advanced observations that it led to the popular European saying of old: ‘Anyone who wants to be a good doctor must be an Avicennist1.’
Al-Zahrawi (Abulcasis) was a leading scholar of the Islamic Golden Age who transformed surgery into an independent science using his knowledge of anatomy. His development of advanced surgical instruments (more than 200) and his systematic use of catgut for suturing remain Al-Zahrawi’s most memorable innovations. His medical encyclopaedia Kitab al-Tasrif is divided into 30 volumes, constituting not only a collection of quotations from the medical literature known to the author, but also the personal work of a physician and surgeon with extensive experience – evident on almost every page. This book was the first to illustrate innovations such as surgical instruments via drawings, helping to keep his contribution to surgery alive to this day.
For many centuries, direct observation was at the heart of all scientific knowledge. In order to understand how something worked, you had to see it with your own eyes; only then could you write it down. Ibn al-Haytham was one of the first people to test his theories with experiments, establishing one of the cornerstones of scientific methodology – to prove what you believe.
That the work of many prominent medieval Arabic physicians was later translated into Latin – making them accessible to the whole of Europe – is apposite to their dedication to knowledge sharing and their global, holistic approach to medicine.
To summarise, perhaps we can say that ‘medicine was absent until Hippocrates created it, dead until Galen revived it, dispersed until Al-Razi collected it, and deficient until Ibn Sina completed it1.’
Over the past 5 years, through the published papers on the Legacy of Arabic Medicine in our Journal, I wanted to remind my young colleagues about the forgotten history of innovation which helped pave the way for the European Renaissance and medicine as we know it today.
Finally, for me personally as Editor-In-Chief of the Aspetar Sports Medicine Journal, it has been a privilege to delve into the fascinating period of Medieval Islamic Medicine. We have been fortunate to build a collection of papers from expert scholars around the world, all of whom I would like to thank for their contribution. I have found their writings to be absorbing, yet a revitalising break from the intense and hectic schedule of modern medical practice. I hope our readers have also enjoyed these lessons on the Legacy of Arabic Medicine.
Nebojsa Popovic MD PhD
Editor-In-Chief
References
1. Al-Hassani STS, ed. 1001 Inventions: The Enduring Legacy of Muslim Civilization, 3rd ed Washington DC: National Geographic Society 2012. p. 168-169