The Dramatic History of Islamic Medicine

Muhammad Al-Razi, known as the father of Islamic medicine, was the greatest medical scholar and practitioner of his day. Many of his medical texts continued to be consulted in the Middle East and Europe hundreds of years after his death in 925.

Watch Lecture 13 from the series The History and Achievements of the Islamic Golden Age, and follow along with the summary below.

Al-Razi

• Muhammad ibn Zakariya al-Razi—better known to us in English as Rhazes—was born in 854 in the Persian city of Rey. Rey is one of modern Iran’s oldest cities, with a history of

  

  settlement dating back to approximately 6000 B.C. Situated on the ancient Silk Road, it was an important center of trade and scholarship. Today it is part of greater Tehran, the nation’s capital.

• Verifiable facts about al-Razi’s life are scant, as is the case with most people from this period. That said, all sources agree that he developed a talent for music early in life, becoming an accomplished oud player. An oud is a stringed instrument similar to a lute.
• When he reached adulthood, al-Razi put music aside and took up alchemy, mathematics, philosophy, and literature. By turns he excelled at—and then tired of—these subjects before taking up medicine around the age of 30. It is this subject to which he dedicated the rest of his life.
• Al-Razi left Persia to study medicine in the greatest city in the Islamic world at the time: Baghdad. In Baghdad, he had access to Arabic translations of the most important medical men from the ancient world. Of these, the earliest was Hippocrates the Greek physician of the 4th century B.C. considered the father of Western medicine. The second was Galen, a Greek doctor who worked in the Roman Empire during the 2nd century A.D.

  

  In Baghdad, Al Razi had access to Arabic translations of the most important medical men from the ancient world. Of these, the earliest was Hippocrates the Greek physician of the 4th century B.C. considered the father of Western medicine.

• Like any good scholar, al-Razi acknowledged the brilliance of these ancient Greeks and the enormous debt that scholarship owed them and others of their day. However, like any great scholar, he built on their foundational texts. When he surpassed them, he said so.
• In his book Doubts about Galen, al-Razi challenged the theory of the four humors, which was thought to explain most human sickness. Al-Razi suggested that there were a number of other elements that Galen failed to consider, such as oiliness, saltiness, inflammability, and sulfurousness. He also attacked the writings of Hippocrates for being disorganized and too brief, and he then wrote a lengthier, corrective text.
• Al-Razi wrote extensively about medical ethics, and—in a book called Medical Ethics—he talks about the importance of morality in medicine. For al-Razi, it wasn’t enough for the physician to be good at his job; he should also be a role model for his patients.
• Al-Razi was convinced of the mind-body connection in the pursuit of good health, as well as the importance of exercise and a healthy diet. Other important factors in general good health were good doctor-patient relations and having a family doctor who would understand the patient’s body over time.
• Al-Razi has been acknowledged as the first person to fully and accurately describe smallpox and measles, noting the important differences between the two and offering possible remedies. His book The Diseases of Children was also the first to deal with pediatrics as an independent field of medicine.
• Al-Razi’s medical notes and surgical observations—along with numerous new diagnoses and suggested treatments—were compiled after his death in what’s now known as the Comprehensive Book of Medicine. This book was not just a tribute to al-Razi’s brilliance; it also presents a complete catalogue of all existing medical scholarship then available. In this way, it was one of the earliest medical encyclopedias. So vast and detailed was this text that European medical students were still using Latin translations 700 years after al-Razi’s death.
• Under al-Razi’s strictly rationalist, scientific approach, every disease was thought to have a cause or origin that could ultimately be understood through research. Sickness, he held, was not—as some men of religion claimed—a punishment from God. He encouraged doctors to read the latest medical treatises to keep up with developments that they might otherwise be ignorant of.

  al Razi encouraged doctors to read the latest medical treatises to keep up with developments that they might otherwise be ignorant of.

• Al-Razi wrote the first medical manual for home use, titled Medical Advisor for the General Public. This helpful compendium would remain a popular reference for many in the West until the early 20th The manual included treatments for everyday complaints, such as headaches, coughs, colds, and indigestion, as well as for more serious ailments. For melancholia, he advised taking extract of poppies—i.e., opium—for its euphoric qualities.
• Unfortunately, for all of his medical knowledge and insight, al- Razi was unable to do anything to correct his own failing eyesight. Toward the end of his life, when al-Razi was fully blind, a trusted surgeon offered to operate to try to restore his eyesight. Al-Razi replied, “I’ve seen enough of this old world, and I do not cherish the idea of suffering the ordeal of an operation for the hope of seeing more of it.”

The Development of Hospitals

• One of the most famous hospitals in the pre-Islamic world was in Gundeshapur, Persia. Founded in the late 3rd century, Gundeshapur was similar to a modern teaching hospital, a place both for treating the sick and training the next generation of medical practitioners.

  

• In the Byzantine Empire, a decree was issued in A.D. 325 at the Council of Nicaea that a hospital should be established in every cathedral town of the empire.
• Following the early Muslim conquests, the conquering Arabs found themselves ruling over large territories with non- Muslim majorities. They also found themselves exposed to far more sophisticated cultures, particularly in the major cities of the Byzantine Empire and Persia.
• The first doctors under Muslim rule
 were mostly Jews, Christians, and 
Zoroastrians. Only later would Muslims produce their own medical practitioners, who worked alongside and learned from their peers from other cultures.
• The first notable medical facility in the new Muslim Middle East was founded in Damascus around 707. Established with help from Jewish and Christian doctors, this was less a hospital than a leperosia—a place to isolate those suffering from leprosy.
• The first proper hospitals in the Islamic world were built in Baghdad during the reign of Harun al-Rashid from 786–809. These hospitals were known by the Persian word bimaristan. By the year 1000, there were at least 30 hospitals across the Islamic world.
• The development of hospitals was necessitated by the growth of ever-larger cities. More people living in closer proximity meant that diseases spread more rapidly through urban populations.
• To maintain healthy subjects, the government paid for the building and maintenance of hospitals. At the same time, government services were unable to keep up with demand, so private donors also funded the establishment of medical centers that were open to the general public.
• The provision of health care was seen in part as a religious duty, and all treatment was free.

  The provision of health care was seen in part as a religious duty, and all treatment was free.

  Nevertheless, hospitals remained essentially secular institutions, in that they were obliged to treat patients regardless of religion, race, citizenship, or gender. There was no limit to how long a patient could stay admitted; hospitals were required to keep patients until they were fully recovered.
• Hospitals were required to have separate but equally equipped wards for men and women, with patients attended to by gender- segregated nurses and staff. Patients were kept in wards for either the contagious or noncontagious, and there were separate wards for mental health, eye diseases, and surgery.

Ibn Sina

• Born around 980 in modern-day Uzbekistan, Ibn Sina—or Avicenna, as he’s better known in the West—wrote approximately 450 titles in his lifetime, of which more than half survive. Around 40 of these titles deal with medicine, including the five-volume The Canon of Medicine, completed around the year 1025.
• Ibn Sina was widely described in medieval Europe as the father of early modern medicine, though his work as a philosopher was even more important. He began studying medicine at the tender age of 13, and he was practicing by the age 16. When he was still a teenager, his medical knowledge saved the life of the local Samanid ruler.
• The Canon of Medicine was arguably the greatest medical text in history at the time it was written. Inspired by Galen and originally compiled to be used as a textbook for students under Ibn Sina’s tutelage, the text would go on to be translated and studied by generations of scholars for centuries to come.
• Ibn Sina is credited with advancing medical knowledge through original discoveries and with improvements to the existing 
body of knowledge. One of his most important discoveries was the recognition of the potential for the airborne transmission of disease. He was also the first to correctly identify the distinction between central and peripheral facial paralysis, and he conducted groundbreaking research on psychiatric conditions.
• Other of Ibn Sina’s writings cover the treatment of kidney diseases, the production and use of heart medicines, and a series of experiments that demonstrated the connection between word association and heart rate. Ibn Sina’s experiments with word association prefigured by some 900 years the experiments Carl Jung would become famous for in the 20th

Questions to Consider

• What can modern medicine learn from the writings of medical men from the Islamic Golden Age, such as al-Razi and Ibn Sina?
• Medical advances made during the Islamic Golden Age bene ted from numerous other traditions. Do you think such open-mindedness is typical today, either in the Middle East or elsewhere?

From the lecture series The History and Achievements of the Islamic Golden Age
Taught by Eamonn Gearon, Ph.D.