The Forgotten Medicine of 1370 AD: From Spain to Muslim World
It is 1370 AD. The world is still young. It is open to some of the greatest discoveries that shook the world (as we know it today) and changed the course of our history forever. The time is 5 am in Granada (southern Spain). A young woman cannot sleep. She keeps turning from side to side. When she can no longer bear the pain, she utters a cry that makes her parents come running into her room.
An hour later, she is lying in a warm, airy room where the lights of dawn are creeping shyly about. There is the sound of water running. Beautiful, glorious, silent….. Her pain has not gone but it is bearable. The quiet harmony, the peace is soothing her. Her mind has ceased to worry about the disturbing revelation that she has an abscess and needs to be operated on immediately.
The above is a situation purely from imagination….but it is one that uses facts rather than wishful thinking. Surgery did exist at the time. In fact, in Spain, which was then ruled by Muslims, it was almost as developed as we know it today…and anyone reading the above passage might be mistaken it for taking place in much modern times. It is fortunate that the women was living in Granada and not any other part of Europe for back in 1163 AD, the council of Tours CE declared “Surgery is to be abandoned by the schools of medicine and by all decent physicians.” However, thanks to discoveries made by Muslim physicians, surgery was practiced with dignity and anesthesia (which was not to be introduced in other parts of the world until around the 18th century) would be given to patients so they would not feel pain.
Surgery was regarded as butchery in most parts of the world. In the 16th century surgery did become a little more advanced. Leonardo Da Vinci (1452-1519) dissected some human bodies and made accurate drawings of what he saw. Had they looked to their eastern counterparts, they would have learnt much. Simple medical facts that took centuries to be discovered could have been known overnight. For it was under the Muslim empire that medicine flourished with passion, dignity, a sense of community and obligation. It was practiced with the proper balance of the lost art of humanity and the art of medicine.
For the sake of knowledge, let us allow our minds to devour the facts as they are (and have been read and appreciated by eminent western doctors even today). Surgery, anesthesia, medical ethics back in the 14th century was not a dream. It was a living reality….at-least in the Muslim Empire.
According to Dr Shahid Athar, “Muslims raised the dignity of the medical profession from that of a menial calling to the rank of one of the learned professions. They were the first to introduce systematically in their medical writings small-pox and measles, the treatment of cerebral hemorrhage and apoplexy, allergy, tracheostomy, operation for cataract, paediatrics, anaesthesia and many other specialities on which thousands of books have been written. Islamic medicine has been nurtured by Muslims in the light of the Quranic edicts and Prophetic directions which led the scholars of mysticism and spiritualism to the determination between the Nature and the bodies and between the material and the spiritual worlds. The patients were treated through a scheme starting with physiotherapy and diet; if this failed, drugs were used, and at last, surgery would be resorted to. The physiotherapy included exercises and water baths. The Arabs had an elaborate system of dieting and were aware of food deficiencies. Proper nutrition was an important item of treatment.”
We now look at some of the most important aspects of medicine in that period: surgery and anesthesia.
As mentioned before, surgery was banned in most parts of the world other than the Muslim Empire. But that was primarily because anesthesia was not discovered there. So the surgeon had to resort to cutting into the patient’s body and subjecting the latter to unimaginable and excruciating pain. On the other hand, in the Muslim Empire, anesthesia was used regularly as has been described by the famous traveler, Sir Richard Burton, “Anesthetics have been used in surgery throughout the East for centuries before ether and chloroform became the fashion in the civilized West”
It was Ibn-e-Sina who discovered the use of oral anesthetics. He recognized opium as a powerful intoxicant. Amongst others were poppy hemlock, lettuce seeds and even snow or ice cold water! The Arabs even came up with the idea of a ‘sporific sponge’ which would be soaked with narcotics and aromatic and held to the patient’s nostrils. The sponge was as mentioned by Dr. Shahid Athar, as “the precursor of modern anesthesia’
To mention only a few names, the most notable surgeons in that time were Al-Razi, Al-Zahrawi and Ibn-e-Sina. Al-Razi is attributed to be the first to use the seton in surgery and animal gut for sutures. Ibn-e-Sina’s medical triumph included describing the surgical treatment of cancer which holds true even today. According to him, “the excision must be wide and bold; all veins running to the tumor must be included in the amputation”. Al-Zahrawi was perhaps the most famous surgeon of his time and his achievements speak louder than words.
Dr Shahid Ather summarized succinctly that, “In his book Al-Tasrif, he described hemophilia for the first time in medical history. The book contains the description and illustration of about 200 surgical instruments many of which were devised by Zahrawi himself. In it Zahrawi stresses the importance of the study of Anatomy as a fundamental prerequisite to surgery. Zahrawi appears to be the first surgeon in history to use cotton in surgical dressings in the control of hemorrhage, as padding in the splinting of fractures, as a vaginal padding in fractures of the pubis and in dentistry. He introduced the method for the removal of kidney stones by cutting into the urinary bladder. He was the first to teach the lithotomy position for vaginal operations. He described tracheotomy, distinguished between goiter and cancer of the thyroid, and explained his invention of a cauterizing iron which he also used to control bleeding. His description of varicose veins stripping, even after ten centuries, is almost like modern surgery.”
Prominent hospitals were built in Baghdad, Jerusalem, Cairo, Granada etc. The names of such diverse cities, is a tribute to how far the Muslim empire extended. Hospitals served all people irrespective of religion, cast or creed. There were separate wards for men and women. Baths and water supplies were available. More importantly, for the first time in history, the hospital kept a record of all their patients.
Much evidence about the Muslim Empire was lost after its fall. Yet, what has been unearthed reveals a picture of a dynasty so strong and influential. It cannot be denied that medicine would not be what it is today had it not been for the surviving bits of knowledge.
“Mathematics, astronomy, botany, history, philosophy and jurisprudence were to be mastered in Spain, and Spain alone. Whatever makes a kingdom great and prosperous, whatever tends to refinement and civilization, was found in Muslim Spain…” Stanley Lane-Pool.
Source: All factual details have been taken from the book, ‘Islamic Medicine’ by Shahid Athar, MD
Editor’s Note: The article contains few sentences from the book, “Islamic Medicine”.
About the author: Butool Hisam, is a medical student from Dow Medical College, Karachi, Pakistan. She holds interests in medical research, history and current-affairs. She can be reached at [email protected].
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