THE PROCESS OF RECEPTION AND ASSIMILATION: ARABIC MEDICINE IN HISTORICAL PERSPECTIVE
No culture of the world is immune from the process of reception and assimilation of ideas from other cultural sources. The Arab conquest of Iran on the one hand, and
of the Middle East, especially of Egypt, on the other, acquainted the Arabs with two great civilizations of the world, namely, the Iranian and the Roman, although in decline and in decadence. Before the advent of Islam, Hellenistic, Alexandrian, Syrian and Hindu philosophy and sciences had spread out to the Sasanian centres of learning, within the Persian Empire and when the tradition of Greek education had faded away in Europe in the early Christian centuries, when the Academy of Athens was closed in 529 A.D., by Emperor Justinian, and when the Nestorian Christians were being driven from cities and academies that were under orthodox Christian domination, it was in Sasanian Persia, under King Anushirwan the Just, that Syrian, Alexandrian and Jewish scholars found refuge. The Muslims preserved those traditions, improved upon them and added to them and later passed on through Islamic scholarship to European educators.
There is no doubt that the Arabic medicine benefited from the theories and practices of Persian, Indian and Alexandrian or Greek medicine within the general framework of the Islamic belief-system. After the conquest of Iran, the Arabs came in contact with the Jundishapur School of Medicine. Jundishapur was a Persian city in the province of Ahwaz with pre-historic traditions. It was founded by Shapur 1, the second Sasanian King. It became a major centre of learning when the physicians of Edess took refuge in that city. Edess was closed by order of the Byzantine Emperor after 489 A.D. It was here that Greek medicine with Zoroastrian ideas and local Persian medical practice, flourished. It was also here that the last philosophers and scientists of Athens took refuge when Justinian ordered the school of Athens to be closed in 529 A.D., as aforesaid. It was during the reign of Anushirwan the Just that Indian medicine reached Iran during the sixth century when the King sent his Vizier to India to learn the sciences of the Indians and bring Indian physicians and books to Iran. The 'Fables of Bidpai', reached there through his good self. The medicine, synthetic in nature, combining the Greek, Persian and Indian theories and practices, was already in practice at the Jundishapur School. Islam reached here when the school was at the height of its career. Being a most important medical centre it flourished during the Abbasid period and served as a direct bridge between Islamic and pre-Islamic medicine.
The Alexandrian School, once the greatest centre of Hellenistic sciences in Egypt, as mentioned above, had combined Egyptian theories and practices with those of the Greeks, but had now ceased to operate as a creative centre. And the Arabs, after the conquest of Egypt in the sixth century, were acquainted with the Graeco-Egyptian medical practice in Alexandria. Khalid ibn-Yazid, the Umayyad prince, went to Alexandria later to master alchemy and was responsible for the first translation of Greek texts into Arabic. The Muslims thus came into contact with Greek medicine in Alexandria, although the contact was insignificant as compared with the Jundishapur School, which was at the height of its activity during the early Islamic period.
Arabic medicine, being blended with the Islamic belief-system of Tawhid, never lost its own world view. It received inspiration from the Qur'anic verses and the Prophetic traditions. The allusions made repeatedly in the Qur'an about the creation of man (Takhliq-i-Adam), his humble origin, pre and post-natal life, his physical form and nature in the embryo, formations of bones and flesh, organs of hearing, seeing and thinking, along with the gift of other faculties given to man by God (LXXVI:2) etc., became subjects of medical inquiries. Since the voluntary directive energy of the central nervous system, directing all actions of man, organic and physical, lie in the spinal cord and in the brain and since the spinal cord was continuous with the medulla oblongata in the brain (LXXXVI:5-7), the human body, being a macrocosm, became an attractive object of medical studies and a source of strengthening faith in God. In addition to the Qur'anic verses the Prophetic Ahadith strengthened the new emerging school of Islamic medicine and both the Greek or other foreign medicinal systems were received with reservation. Seeing that Islam laid stress on seeking knowledge in all its dimensions, the Arabs did not hesitate from studying medicine either at the Jundishapur or Alexandrian schools. The Arab physician, Harith ibn-Kalada, a contemporary of the Prophet, had studied medicine at Jundishapur. The stress that the Prophet laid on medicine and medical treatment, hygiene, sickness and health, diet etc., inspired the believers to study medicine. They regarded medical studies as a part of faith and Tibb-an-Nabawi (The Prophetic Medicine), became an initial guideline. Imam Bukhari, in his most authentic collection, has mentioned many sayings about illness and its treatment. These Prophetic Ahadith directed the course of Islamic medicine in the future and determined many of the Muslims dietary and hygienic habits. Moreover, the Tibb-an-Nabawi became the first book to be studied by a medical student before he studied the usual compendia of medical science. The Qur'anic verses and Ahadith thus played an important role in creating the Islamic frame of mind for the future physicians.
It was in this historical background that Arabic or Islamic medicine developed and many towering personalities like ar-Razi, Ibn-Sina, Ibn-Rushd and others appeared on the scene of medical sciences. A cursory glance over the influences of Jundishapur and Alexandrian schools over the Arab thinking will further help us in understanding the process of reception and assimilation in historial perspectives.
It was during the reign of the second 'Abbasid Caliph al-Mansur, the founder of the city of Baghdad, that the direct contact between Baghdad and Jundishapur was established. A physician from Jundishapur was invited to Baghdad to treat the Caliph who had been suffering from dyspepsia. The successful treatment of the Caliph by Jurjis marked the beginning of the close liasion. The medical centre of Jundishapur was eventually transferred to Baghdad. Renowned physicians such as Masawaih, a celebrated ophthalmologist, who worked at the hospital of Jundishapur for about thirty years, came to Baghdad. His son, known as Ibn-Masawaih, wrote the first treatise in Arabic on ophthalmology. Thus an organic link between the hospitals of Baghdad and Jundishapur were founded. The early medical texts were translated into Arabic, mostly by the Christians or the Jews. The first text translated into Arabic, which appears in the Pandects of an Alexandrian priest Ahrun, was made by a Jewish scholar from Basra, during the Umayyad period. The translations of Greek or Pahlavi medical literature started during the 'Abbasid period. Ibn-Muqaffa translated from Pahlavi into Arabic. The viziers of the 'Abbasids, the Barmacides, encouraged the translations and Mikna the Indian physician was encouraged by them to translate Indian medical literature into Arabic. Hunain ibn-Ishaq, himself an outstanding physician of his day, a student of Jundishapur Medical Centre and a colleague of Ibn-Masawaih, translated texts from Greek into Syriac and Arabic. He and his school translated the 95 works of Galen into Syriac and 99 into Arabic. Thabit ibn-Qurr'ah, in addition to the translations, himself wrote several medical books of which the "Treasury' is well known.
But despite all these facts no creative nation can ever thrive either on translations or on imitation. Intellectual interaction through such works can never build the pyramids of a new culture. The newly emerging culture of Islam, already in its offing, had to take off even without the help of translations. As an Iqra-Community, the Arabhad to read, study and examine the international intellectual heritage, lying around them. It does not mean that they were the borrowers of alien cultures or their culture was a loan-culture as the Orientalists hold. Muslim apologists also surrender their judgements to the Orientalists who assert that the works of ar-Razi, Ibn-Sina, Ibn-Rushd, Ibn-Baitar and others were either the catalogues of Greek works or the collection of excerpts from Galen and Hippocrates.
The contributions made by the Arab medical experts for the advancement of knowledge in the field of medical sciences, have already been highlighted. The first major work entitled 'Firdaws al-Hikma', written in Arabic by' Ali ibn-Rabban, at-Tabari, a convert to Islam, cannot be regarded as a carbon copy of the Greek thought. Its 360 chapters, summarizing the various branches of medicine, are not catalogues and its value in the field of pathology, pharmacology and diet (Aghdhiya) can not be minimized. It is the first large compendium of its kind in Arabic medicine. It was original and creative.
How can the celebrated works of ar-Razi, such as 'Kitab al-Mansur' and' Al-Hawi', which dominated the medical science in Europe for six centuries (from twelfth to the seventeenth century), be treated as excerpts from Greek works? How can ar-Razr and Ibn-Sina, who were held in higher esteem in Europe than even Hippocrates and Galen, be regarded as imitators? Ar-Razi, the director of Rayy and Baghdad Medical Centre, emerged as the greatest original clinical and observational physician. Being skilful in prognosis and in his analysis of symbols of diseases, its treatment and cure, his medical case studies served as guidelines for others and his treatment by means of psychological shock has been described by Nizami 'Arudi as unique in his Chahar Maqala (Four Discourses). The science of anatomy was developed in 'Kitab al-Mansur', in which ar-Razi deals with veins (chapter 5), arteries (chapter 6), disposition of the heart (chapter 14) etc., which displays the adequacy of anatomical knowledge among the Arabs. His treatises on measles and smallpox became so popular that they were published in Europe many times until the eighteenth century. His 'Al-Hawi', being the most voluminous work ever written in Arabic, has been a basic source for the study of clinical aspects of Islamic medicine. Ar-Razi did not neglect spiritualism. His treatment of the soul along with the body is significant. He wrote a book on the medicine of the soul. Thus he became a master of psychosomatic medicine and psychology long before the West. Now, maladies of the soul became the object of medical treatment. He also composed a work on the medicine of the soul and demonstrated how to overcome the moral and psychological illnesses, which ruin both mind and the body of man, upsetting the total state of health. Ar-Razi, in his book 'Spiritual Physique' deals in twenty chapters with various ailments that beset the soul and body of man. The use of wine and drunkedness (which has become a curse of modern civilization) have been condemned by him as a disease of both soul, and body.
Other physicians, such as, 'Ali-ibn al-'Abbas al-Majusi (Latin: Haly Abbas) a Muslim of Zoroastrian descent, in his 'Kitab al-Maliki' (The Royal Book), evaluates critically the virtues and shortcomings of both the Greek and Islamic physicians who preceded him. He was not an imitator. His 'Kamil as-Sina'a (The Perfection of Art), is well known and a best written book in Arabic which remained a standard work until the works of Ibn-Sina appeared on the scene. Being the most outstanding physician after ar-Razi he flourished during the second half of the tenth century. An imitator can not analyse the works of the Greeks critically, as was done by al-Majusi.
Neither the peerless Ibn-Sina could have dominated the medical scene in Europe for many centuries, nor could he be honoured for centuries as a 'Prince of physicians', had he been an imitator of the Greeks. And why should the Europeans follow Ibn-Sina instead of Hippocrates and Galen? Being well versed in every domain of knowledge including peripatetic philosophy, he emerged in the field of medicine as victorious. After having unified and systematized all the medical theories and practices of the earlier centuries into a vast synthesis, he wrote a large number of original medical works in Arabic. The 'Canon of Medicine' (Ash-Shifa'), being his magnum opus, dominated the Occident for centuries. Its Latin translation by Gerard of Cremona was frequently printed during the Renaissance. He was the first to describe many diseases correctly. His clinical insight, understanding of philosophical principles of medicine, and case histories are now classics in Islamic medical literature. The 'Canon' became the final authority in the medical profession. Both Ibn-Sina and ar-Razi reigned supreme as medical authorities in the West until the seventeenth century. This was not possible without being original, creative, as well as critical of Greek works. They had transcended the bounds of Greek medical knowledge.
The creative traditions in the field of medical sciences continued until the end of the sixteenth century in Egypt, Syria, Maghrib, Andalusia, Persia and other parts of the Muslim lands. Ophthalmology was developed in Egypt where the illness of the eye was a common affliction. 'Ali ibn-Ridwan made his contributions to this field. Ibn-Nafis (d.687/1288) discovered the lesser or pulmonary circulation, which was a major discovery of Islamic medicine. It was unfortunately attributed to Michael Servetus. His creative vision can be evaluated from his critical studies of the anatomical works of Galen and also of Ibn-Sina, which he published as the 'Epitome of the Canon'. The last creative figures emerging from Egypt in the field of ophthamological literature were al-Akfani and Sadagah ibn-Ibrahim ash-Shadhili. Daud al-Antaki (d.1008/1599) wrote original treatise during the sixteenth century. It was about this time that Europe was emerging in the field of sciences as a dynamic force.
The Western lands of the Muslim World, such as Spain and Maghrib, also did not lag behind in the medical field. Cordova was a centre of medical learning. 'Arib ibn-Sa'd al-Katib wrote on gynecology and al-Qasim az-Zahrawi appeared as the greatest surgeon in the fifteenth century. His renowned 'Concession', translated by Gerard of Cremona in Latin was studied in Europe for several centuries. Ibn-Zuhr's family dominated the field of medicine in Spain for two generations. Abu-Marwan 'Abd-al-Malik (d.556/1161 in Seville) wrote so many books of which the 'Book of Diets' is the most famous. He is regarded second only to ar-Razi in clinical aspects of medicine. Among the medical philosophers of Spain, Ibn-Tufail the author of the philosophical romance 'Living Son of the Awake' and his successor Ibn-Rushd, merit special mention. Both were physicians. The latter wrote a medical encyclopaedia entitled 'The Book of Generalities on Medicine'. He also wrote commentaries upon the medical works of Ibn-Sina. Maimonides, born in Cordova in 530 / 1136 (settled in Egypt), wrote ten medical works in Arabic of which the most famous is 'The Book of Aphorisms', concerning medicine. The physicians in Spain and Maghrib also promoted the study of plants and discovered their medical properties (drugs). Ibn- Tufail's commentary is renowned. Similar works have been done by Tunisian physician Abu-'l Salt. His 'Book of Simple Drugs' is well known. The best description of plants are given by al-Ghafiqi, the most original of the Muslim pharmacologists, in his 'Book of Simple Drugs'. Ibn-al-Baitar (died in Damascus in 646/1248) was another Spanish genius who completed the works of al-Ghafaqi a century later. Being the greatest of the Muslim botanists and pharmacologists, he collected all the information in the field, in addition to three hundred drugs, not described previously in his books, namely,
1. 'The Complete Book of Simple Drugs' and
2. 'The Adequate Book of Simple drugs'
These works were most original works producedby the creative and not imitative brain.
The medical activities also continued in the Eastern lands of Islam, such as Persia and India. Isma'il Sharaf ad-Din al-Jurjani, the author of the 'Treasury', produced the most important medical encyclopaedia in Persian. Its size and the merit of the work is estimated between the 'Canon' and 'Al-Hawi'. It is a treasury of pharmacology and medical theory. Even during the colossal destruction of the Mongol invasion, four great authorities on the history of medicine, namely,
1. Ibn-al-Qifti
2. Ibn-'Ali Usaibi'ah
3. Ibn-Khallakan and
4. Barhebraeus,
appeared in the East. The Mongols, who had destroyed the medical centres, themselves became great patriots of medical sciences. Qutb ad-Din ash-Shirazi, the pupil of at-Tusi, wrote a commentary on the 'Canon' entitled, 'The Present to Sa'd'. The Vizier of II-Khanids, Rashid ad-Din Fadl-Allah, authoritative historian of the Mongol period, wrote a medical encyclopaedia. Rashid would offer prizes to anyone who would write a book in his honour. Authors from Spain, Tunisia and Tripoli responded to his call. The veterinary medicine and anatomy were promoted during the fourteenth century. Muhammad ibn-Ahmad Ilyas produced his 'Illustrated Anatomy', the first of its kind, in 1396. Muhammad Hussaini Nurbakshi (d.913/1507), the greatest physician of the Safavid period, wrote his famous book 'The Quintessence of Experience', in which the clinical prowess of the author is quite manifest. C. Elgood regards the Safavid period as the golden age of pharmacology in Islam. Shafi'i medicine, written in 1556, was the most important work which served the foundation of Fr. Angelus's 'Pharmacopoedia Persica', the first European study of Persian medicine.
Medical studies continued in India until the seventeenth century. 'Ain al-Mulk of Shiraz, who migrated to India, composed a Vocabulary of Drugs' in 1629 A.D. and dedicated it to Shah Jahan. He was also involved in the preparation of 'The Medicine of 'Dara Shukuh', which is said to be the last great medical encyclopaedia in Islam. Muhammad Akhtar shah Arzani Shirazi, composed the 'Scales of Medicine' in the eighteenth century. This reveals that Islamic medicine flourished in India even during the eighteenth century, and even today it is a living school for medicine and has been competing with European medicine.
Can such works of original nature in Arab medicine be branded as imitations from Hippocrates and Galen and can the Arabic medical literature be regarded as carbon copies or adaptations of the Greeks? These are questions for both the Orientalists and their supporters the Muslim apologists, who themselves are unaware of the Arabic medical literature and of the medical philosophy in Islam. One cannot complain against the Orientalists for they have pre-conceived notions about Islam and they need to be redirected from their biased and subjective standpoints.