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The Important Influence Of Baghdad On The Development Of Western Medicine (Part 2)
In 931 A.D. Caliph Al-Muqtadir learned that a patient in Baghdad had died as the result of a physician's error and he ordered his chief physician, Sinan-ibn Thabit bin Qurrah to regulate all those who practiced medicine in Mesopotamia. In the first year of the decree, more than 860 doctors were examined in Baghdad alone. This led to the introduction of new examinations and a Licensing Board was established under a government official called Muhtasib. European medical schools followed the Baghdad pattern and even in the early nineteenth century, students at the Sorbonne could not graduate without reading Ibn Sina's Qanun (Cannon).
During this period, Al-Razi moved to Baghdad where he became the Chief Physician of the Baghdad Hospital and the Court-Physician of the Caliph. He published several medical books, which were translated into Latin, French, Italian, Hebrew, and Greek including the differentiating between smallpox and measles, two diseases that were hitherto thought to be one single disease. It is also written that when he was asked to choose a site for a new hospital in Baghdad, he deduced which was the most hygienic area by observing where the fresh pieces of meat he had hung in various parts of the city decomposed least quickly.
He also published a book called "Al-Murshid, in which he described the different types of fever including continuous, relapsing, and hectic. He stated that fever can be a symptom of a disease or a disease in itself. He introduced mercury as a therapeutic drug for the first time in history, which was later adopted in Europe. Al-Razi is attributed to be the first to use animal gut for sutures. He is credited with many contributions, which include being the first to describe true distillation, corrosive sublimate, arsenic, copper sulphate, iron sulphate, saltpetre, and borax in the treatment of disease. He introduced mercury compounds as purgatives (after testing them on monkeys); mercurial ointments and lead ointment." His interest in urology focused on problems involving urination, venereal disease, renal abscess, and renal and vesical calculi. He described hay fever or allergic rhinitis. He stressed the continued medical education of the physician advising him to record his own observations and encouraging him to meet with other physicians to discuss medical problems. The new Al-Adudi hospital in Baghdad was built in 981 A.D. and had interns, residents, and 24 consultants. An Abbasid minister, Ali ibn Isa, requested the court physician, Sinan ibn Thabit, to organise regular visiting of prisons by medical officers.
Many other Islamic physicians and surgeons of the period influenced the Baghdad School. In 930 A.D., Al-Zahrawi was born in Al-Zahra, a suburb of Cordova and later attended the University of Cordova, which had a long tradition of excellence. At that time, Cordova had a population of one million. Al-Zahrawi became an eminent surgeon being appointed as the Court-Physician of King Abdel-Rahman III. He was to influence the Baghdad School of Medicine through his four books, one of which "Al-Tastif Liman Ajiz'an Al-Ta'lif' is still considered the best medieval surgical encyclopaedia and was used in medical schools in Europe until the 17th century. Al-Zahrawi described the ligature of arteries long before Ambrose Pare and he also used cautery to control bleeding. Interestingly, he also used wax and alcohol to stop bleeding from the skull during cranial surgery long before Sir Victor Horsley used it to effect in the late eighteen hundreds. His preparation made up of seven parts beeswax and one part almond oil is still known today as Horsley's Wax. Al-Zahrawi was also the first to in history to use cotton (Arabic word) in surgical dressings in the control of haemorrhage, as padding in the splinting of fractures, teach the lithotomy position for vaginal operations, to describe and use alcohol as a surgical preparation. He distinguished between goitre 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. In orthopaedic surgery he introduced what is called today Kocher's method of reduction of shoulder dislocation and patelectomy, 1,000 years before Brooke reintroduced it in 1937. He described tracheotomy, orthodontia and described the different types of fracture before the introduction of X Rays.
In the rest of the Islamic world, the Iranian Ibn Sina (Avicenna 980-1037 A.D) suggested the communicable nature of tuberculosis long before the infectious nature of the pathogen was discovered. He was also the first to describe the use silk sutures for haemostasis and the first to use alcohol as an antiseptic. Ibn Sina originated the idea of the use of oral anaesthetics and he recognised opium as the most powerful mukhadir (an intoxicant or drug). He also used less powerful anaesthetics such as mandragora, poppy, hemlock, hyoscyamus, deadly nightshade (belladonna), lettuce seed, and snow or ice cold water. He introduced the soporific sponge, soaked with aromatics and narcotics, which was the precursor of modem anaesthesia. In his masterpiece Al-Quanun (Canon), he described complete studies of physiology, pathology, and hygiene.
However, the turning point in the great age of Islam's contribution to medicine came when a confederation of nomadic tribes led by Genghis Khan, first conquered China, and then spread out to attack the rest of the Muslim Empire. By 1220, they had conquered Samarkand and Bukhara and by the mid-century, they had taken Russia, Central Europe, northern Iran, and the Caucuses. In 1258, Hulagu Khan invaded Baghdad and destroyed the ancient systems of irrigation with such extensive devastation that even today agricultural recovery in this nation is still incomplete. While in Baghdad, Hulagu made a pyramid of the skulls of Baghdad's scholars, religious leaders, and poets, and he deliberately destroyed what remained of Iraq's canal headworks. The medical knowledge of centuries was swept away and Mesopotamia became a neglected frontier province ruled from the Mongol capital of Tabriz in Iran.
In 1380, another Turko-Mongol confederation was organised by Tamerlane the Great, who claimed descent from Genghis Khan. They swept down on Baghdad again destroyed the hospitals and burnt the libraries with their irreplaceable works. It is said that the waters of the Tigris ran blue with the ink of the medical and scientific works destroyed by these barbarians. The result was to wipe out much of the priceless cultural, scientific, and medical legacy that Muslim scholars had been preserving and enlarging for some five hundred years. A minor scion of the Mamluk dynasty took refuge in Egypt and the 'Abbasid caliphate continued the practice of medicine there late into the sixteenth century. In 1401, he sacked Baghdad and massacred many thousands of its inhabitants. Like Hulagu, Tamerlane had a penchant for building pyramids of skulls. His rule virtually extinguished Islamic dominance of medicine and Baghdad, long a centre of trade suffered severe economic depression. The medico-social innovations of the Baghdad scholars totally disintegrated. To make matters worse, the southern province of Basra, which had been a key transit point for seaborne commerce was circumvented after the Portuguese discovered a shorter route around the Cape of Good Hope. Mesopotamia's once-extensive irrigation system fell into disrepair, creating swamps and marshes at the edge of the delta. The rapid deterioration of settled agriculture led to the growth of tribally based pastoral nomadism. By the end of the Mongol period, the medical knowledge of the people of Mesopotamia had shifted from the urban-based Abbasid culture to the tribes of the river valleys, where it has remained well into the twentieth century.
Maybe, for a moment if we considered Baghdad's great contribution to the world of Western medicine, we would not be so quick to see this nation as radically demonic and possibly even learn to respect the descendants of these original scholars who today still die suffering along the shores of the Tigris, sacrificed on yet another altar of human indifference.
About the Author Dr. Patrick Treacy is a cosmetic expert. He is Medical Director of Ailesbury Clinics Ltd and the global Cosmetic Medical Group. He is Chairman of the Irish Association of Cosmetic Doctors and is Irish Regional Representative of the British Association of Cosmetic Doctors. He is European Medical Advisor to Network Lipolysis and the UK's largest cosmetic website Consulting Rooms. He practices cosmetic medicine in his clinics in Dublin, Cork, London and the Middle East. Dr. Treacy is on the Specialist Register in the UK and Ireland and holds higher qualifications in Dermatology and Laser technology and skin resurfacing. He was amongst the first doctors worldwide to use the permanent facial endoprosthesis BioAlcamid for HIV Lipodystrophy patients. He was also the first person to introduce many techniques such as Radiofrequency assisted lasers, Fibroblast transplant and Contour Threads to Irish patients. Dr. Treacy is the European Representative for the NetWork-Lipolysis where he is on the Medical Advisory Board and the Scientific Advisory Board. Ailesbury Clinics Ltd Suite 6 Merrion Road Ailesbury Road Dublin 4 Ireland Phone +35312692255/2133 Fax +35312692250 www.ailesburyclinic.ie
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