History of Medicine in the Middle East

History of Medicine in the Middle East
Name
Institutional Affiliation
 
History of Medicine in the Middle East
1.0 Introduction
The practice of medicine in the Middle East has a long history of interchanges with the Western approaches. The deeper societal understanding of the interests of diversity and globalism has resulted in the less Western-centric, increased appreciative interchanges, and a geographically broader history of medicine of differing cultural and racial composition and pluralities in diverse health contexts (Andrews, 2011). During the late medieval period, there was a massive transfer of scientific and medical knowledge from the Arabic world to the Western Europe, and the modern colonial period saw the western European states medicalizing a number of the new states in the Middle East. According to Shaki, Carniel and Mostafavi, 2016), prior to the 19th century, many of these new states were yet to be constituted as independent countries. In addition, much of the contemporary work in the history of medicine in the Middle East has largely focused on the imperial use of medicine as a way of cultural subjugation and repression in the formulation of nation-states. Almost the entire area of the Middle East, which stretches from Morocco in North of Africa to Iran, was at some point in the 19th and 20th century occupied by imperial powers, primarily the British and the French (Sharaki, Carniel, & Mostafavi, 2016). Although many cultures in the Middle East clearly had their own unique local medical practices beginning from the 8th century CE and onwards, they shared medical systems, which were centred on three interlinking medical systems whose formulations differed from place to place over some time (de Vetten, 2018). These systems included the Graeco-Arabic medicine, Quranic medicine, and the “vernacular medicine” as known to many modern practitioners.
During the medieval period, the Persians and the Arabs were keen translators of the Greek knowledge, and the term Graeco-Arabic medicine stems from the combination of both the Galenic and Hippocratic medical ideas and the indigenous Arabic healing beliefs (Saad & Said, 2011). Some of the Arabic medical doctrines were borrowed from Ayurveda in India and other forms of medical practices in the East. Scientific learning was highly valued and promoted within the Islamic world, leading to the classic Islamic medical scholars such as Ibn Razi Ibn Rushd, and Ibn Sina to polish and advance the Greek medicine during the golden age of Islamic medicine (Hajar, 2013). There was great emphasis placed on public health nutrition, and the connection between the soul and body. Later, the ethical approach to healthcare merged with the growing area of Quranic medicine that endorsed the approach to welfare, which drew on the Quran and hadith, “sayings” of Prophet Mohammed. Saad and Said (2011) content that in some instances, this approach involved the use of amulets that were inscribed with Quranic verses, prayers, and tinctures from Quranic ink, but also shared common beliefs in astrology in Graeco-Arabic healing. The healing approaches were supplemented by “vernacular medicine” that was largely based on pre-Islamic herbalism and the modern science of pharmacology developed in the medieval Arab-Islamic era. To understand the history of medical science in the Middle East, this paper explores the genesis and contributions of early physicians and scientists in the region, the knowledge about medical ethics at the time, the establishment of hospitals and pharmacies, and the role of Christians and women in the early history of medicine in the Middle East.
2.0 Background and Important Literature
In the Middle East, medicine dates back to medieval times, and it was influenced by various factors such as location, time, Islamic physicians, and the practice of medicine. In the past, the practice and study of medicine were regarded as an act of piousness that was based on the doctrines of Tawakkukul (trust) and Imaan (faith). Teb Al Nabawi, the prophet invited physicians and was involved in instructing people on ways of using drugs. In the 14th century, a collection was made on Muhammad's ideas on health habits that can result in a healthy lifestyle (Nayernouri & Azizi, 2011). The works of Ibn Khaldun titled Muqaddimah analyses what is known as the “art and craft of medicine,” and it separates medicine from religion. Although classical scholars rarely examined prophetic medicine, evidence indicates this medical practice was practiced for several centuries in the Middle East. From 10th to 11th century, old Arabs used Al-Biruni’s work known as Book of Remedies (Kitab as-Saidana) as a medical reference. Most probably, medical practitioners in the Middle East became familiar with the Hellenistic and Graeco-Roman medicine by directly interacting with the physicians who were operating in the surrounding regions, instead of having to read the translated or original works. Syrian medicine facilitated the contact, and it became part of the ancient tradition (Masic et al. 2017). Ibn Atai was one of the early physicians, and he founded the Umayyad dynasty. However, he destroyed his works in order to eradicate his enemies. Abu I-Hakam was tasked with the role of preparing drugs, and his sons and grandsons worked under Ummayyad dynasty. This evidence indicates that medical practitioners in the Middle East had familiarized themselves with classical medical traditions during the period of the Umayyads. Alexandria was the main source of the medical knowledge, which was later adopted by Syrian scholars and then spread across the Middle East.
Little information exists pertaining to how the Middle East received and used medical knowledge between the 7th and 9th centuries. Nevertheless, Umar ibn is said to be responsible for transferring the Alexandria medical school to Antioch. This played an instrumental role in enhancing the adoption of medical knowledge during this period. Book of poisons (Jabir ibn Hayyans) is also part of the early traditions that were adopted during the second half of the 8th century. He cites the works of scholars such as Aristotle, Plato, Pythagoras, and Hippocrates, and he mentions medical plants and drugs using Persian names (Azaizeh, Saad, Cooper & Said, 2008). In 825, Abbasid caliph Al-Ma’mun in Baghdad founded the House of Wisdom, and a Christian physician known as Hunayn ibn Ishaq with the assistance of Byzance managed it. The House managed to translate the works of Plato and the scholars mentioned above, including information from the antique world. Currently, it is evident that medical information in the Middle East was directly informed from Greek sources retrieved from the Academy of Alexandria. The information was later translated into Arabic. The Middle East utilized ancient literature from Greece, Rome and the Hellenistic period. Since the 7th century, numerous translations have been done on these ancient medical texts, with the leader of the House of Wisdom playing an essential role in the translation of the entire works referred to as corpus of classical medical literature (Gallagher, 2012). Caliph Al-Ma’mun sent envoys to the Byzantine emperor seeking classical medical literature that was present. Therefore, the medical texts that were collected were those from famous scholars such as Galen and Hippocrates, and they were later translated into the Arabic language. Medical works associated with Aristotle, Plato, and other scholars were also translated, and most of this information was translated from original texts.
When it comes to the later Hellenistic periods, the works that stand out include those of Oribasius who was a health practitioner in Rome in the 4th century. Muhammad ibn Zakariya al-Razi (Rhazes) frequently cited Oribasius' works, and this is an indication that they have a close association with the medical history in the Middle East. Another famous physician of the 4th century is Philagrius of Epirus, and his quotations have been translated into the Arabic language. John the Grammarian was a philosopher and a medical practitioner and his contributions during the 6th century have led to compilations of numerous books (Azaizeh, Saad, Cooper & Said, 2008). Other physicians from the Middle East include Gessios of Petra and Palladios and they have been cited for having contributed to the medical development during the ancient times. Rhazes also cited Alexander of Tralles who was a Roman medical practitioner during the 6th century. Ahron made a medical compilation known as Kunnas, and it was translated from Greek into Syrian. During the fourth caliph Marwan I, the complication was translated into Arabic. The history of medicine in the Middle East can also be observed from the medical literature that was compiled in Syria and Persia. During the 10th century, Ibn Wahshiyya compiled medical texts by Nabataeans. Moreover, Sergius of Reshaina who was a scholar from Syria translated different medical information by Galen and Hippocrates. Currently, the pharmacological book, as well as different parts of other two books, are already preserved, and Hunayn ibn Ishaq has translated these works into Arabic. These works greatly influenced medical literature in the Middle East, with the earliest literature such as Kunnas of the scholar Ahron being translated from Greek, to Syrian language, and then into Arabian (Gallagher, 2012). In addition, the Academy of Gondishapur was instrumental in ensuring that the Persian medical knowledge was passed to Arabian medical practitioners. The Academy trained physicians from the Middle East who later established early ideologies of Islamic medicine. For instance, Al-Tabari published his works titled The Paradise of Wisdom (Firdaus al-Hikma), and he only mentioned a few words medical terms in Persia particularly when describing specific illnesses. Nevertheless, he used Persian names when describing numerous medicinal herbs and drugs and medical practitioners in the Middle East later translated these.
3.0 Polymaths in the History of Medical Advancement in Middle East
The contributions of Islamic scholars in diverse fields of knowledge between the 8th and 16th centuries were phenomenal (Hajar, 2013). However, a period that followed the 16th century, the larger part of the Islamic world witnessed a range of tumultuous events, which led to its economic and political decline, resulting in abject poverty and low participation in science. Hajar (2013) points that the most notable worst events during this period included the Mongol invasions, Crusades, loss of international trade, natural calamities rise of the European imperialism and the capitulations of the Ottoman Empire to the interests of the West. Ibn Khaldun, one of the renowned historian and historiographer once said that science could only progress in affluent societies. Khadun’s words have passed the test of time since in historical records, science has advanced when nations or empires are rich and mighty because its development largely depends on infrastructure that is supplied by affluence (Hajar, 2013). Among the early contributors to the field of medicine in the Islamic world was Muhammad Ibn Zakariya al-Razi, who lived between 865 and 925. Al-Razi, including other scholars such as Ibn al Nafis and Ibn Sina were polymaths (sages or hakims) or scholars who studied a wide range of subjects, including medicine. Besides medicine, these authors were instrumental in modern knowledge in embryology, ophthalmology, psychology, theology, philosophy, and law. The most important scientific contributors in the Middle East have always been polymaths and their role in science advancement has been central (Hajar, 2013). As a polymath, Abu Bakr Muhammad Ibn Zakariya Al-Razi is considered one of the most important contributors to the modern understanding in medicine. Al-Razi was born in Al Rayy, a city on the southern slopes of El Burz Mountains adjacent to the modern Tehran, Iraq in 864 AD.
In the Middle East history of medicine, Al-Razi is widely regarded as a physician, a philosopher, and an alchemist (Amr & Tbakhi, 2007). While his early interests were mainly in music, he started studying alchemy at the age of thirty following an eye irritation by a chemical substance to which he was exposed. In alchemy, Al-Razi is credited for his discovery of ethanol and sulphuric acid. His medical science instructor was Ali Ibn Sahl Rabban al-Tabar, a philosopher and physician born in Tabaristan or the modern Iran. Al-Razi gained fame after the hospitals site selection experiment when he decided that the health care facility should be built in an area where the pieces of meat placed in different sites in Baghdad stayed fresh because the air was fresher and healthier. He wrong more than 200 books in various subjects, with the most important work being the medical encyclopaedia Al-Hawi fi al-Tibb or “Liber Continens”, which is a compilation of his readings of Roman and Greek medicine. Overall, his writings and work in medical science, alchemy, and philosophy have had a significant impact in human civilization particularly in Europe. Among his other books include Kitab Al Mansuri Fi al-Tibb, a concise medical science handbook, Kitab Bur al-Sa’ah, short essays of diseases he claims to be treatable within an hour, and Kitab al-Tibb ar-Ruhani, the Book of Spiritual Medicine (Amr & Tbakhi, 2007). Other contributors credited for scientific and medical science advancements include al-Ridha, al-Tabari, al-Tamimi, al-Majusi, and Ibn-Sina (Masic et al. 2017). Together with other medical and scientific scholars in the world, the Middle East early scientists and physicians helped shape the field of medicine as known today.
3.0 Major Contributions to Medical Practice
Ibn al-Nafis made important discoveries in the advancement of human physiology and anatomy, but it is not clear if this was done through human dissection. It is believed that Greek physicians were instrumental in enabling information on human blood to reach the Middle East. During the 13th century, Ibn al-Nafis made a discovery that blood did not move from the right ventricle to the left. His discovery became the first description and analysis of pulmonary circulation, but his descriptions were discovered in the 20th century (Horden, 2009). Ibn al-Haytham who is an Iraqi scientist managed to develop a new concept of human vision in the 11th century. Another popular physician from Iraq known as Ahmad ibn Abi al-Ash'ath discussed the stomach’s physiology on a book entitled al-Quadi wa al-muqtadi. He argued that the sto...