by Michael Tierra, O.M.D., AHG, RH

A typical Western medical text’s description of the Medieval portion of the history of Western medicine might be summarized thus: The classical Greek medical tradition (developed over the sixth century BCE to the first and second centuries CE), from which Western medicine as we know it is derived, was lost to Europe during its Dark Ages (fifth to 14^th centuries AD). Luckily, it was translated and preserved by Arab scholars, and re-emerged during the European Renaissance with little to no influence or development by Arabic or other Eastern healing traditions.

But contrary to this popular notion, history shows that Arab scholars played a much more significant role in the evolution of Western medicine than just preserving the Greek tradition and leaving it as they found it. In fact, they sought not only to preserve classical Greek medicine but also to develop it for further advancement of medical knowledge and science generally.

A closer look at the activity of Middle Eastern scholars during the Medieval period shows that they translated classical medical texts not only from Greece, but also from India and China ‘“ and that knowledge derived from these Far Eastern traditions informed the Arab influence on and development of what we now call Western medicine. This synthesis resulted in a richer, and indeed, more planetary medical tradition, weaving together some of the best of which each system had to offer.

Cultural Milieu of the Middle Ages: A Shift from East to West

In the approximately 1,000 years after the fall of Rome ‘“ better known as the Middle or Dark Ages of European history ‘“ learning became virtually extinct throughout Europe. Without the centralized governing body, security and international network once provided by the Roman Empire, lay intellectual discourse in Europe withered, and learning became an activity reserved mainly for cloistered monks who had little interaction with the world at large.

By the time the Islamic Empire had risen to power in the eighth century, the cultural and intellectual center of the globe had shifted completely from the West to the Arab world. Uniquely situated at the crossroads between East and West, Muslim scholars in the Middle East were quite literally living in the best geographical location to benefit from cross-cultural intellectual exchange.

 

Unlike their early Christian counterparts who persecuted people of other faiths and nations, such an exchange was one the Muslim world fostered and encouraged. One of the main philosophical differences between Christians and most other peoples of the ancient world centered around the role of the sciences — especially medical science — as part of health care. Christian philosophy has always been slanted toward a mind-body split while Eastern philosophies, including Muslim beliefs, are inclined toward a more unified view. A fundamental tenet of Christianity from its inception after the death of Christ was a belief in his imminent second coming. Because of this, gathering knowledge of physical healing was of little concern. As the Church became more powerful, physical healing became entrusted to clergy; it was preferred that healing be credited to saints, miracles and prayer rather than to the aid of medicine at human hands.

Muslims, on the other hand, regarded science and civilization as God-given gifts[1] and sought to develop those gifts by integrating and expounding upon the knowledge of both East and West. They contributed many insights and contributions of their own to the developing canon of medical knowledge while acknowledging their inheritance from other civilizations.

Deliberate or not, one of the reasons the history of Western medicine and Western herbal medicine overlooks or understates the contribution of Arabic medicine made during the Middle Ages is a deep-seated prejudice against Arabs and Jews as being non-Christians. This can be summed up with the following quote by Sir John Bagot Glubb, British lieutenant general and commander of the Arab Legion who served in the Middle East from 1920-1956:

The indebtedness of Western Christendom to Arab civilization was systematically played down, if not completely denied. A tradition was built up, by censorship and propaganda, that the Muslim imperialists had been mere barbarians and that the rebirth of learning in the West was derived directly from Roman and Greek sources alone, without any Arab intervention.” [2]

Arabic Translations from West and East: Traditions and Transformations

During the medieval period, Muslim medical scholars translated Western medical and philosophical classics, including texts by Hippocrates, Plato, Aristotle, Dioscorides, and Galen into Arabic, which was considered at that time to be the language of academia.

As a result of those early translations, much of medieval Arabic medicine is based on the classical Greek four elements first identified by Empedocles (490-430 BCE) and the four humours first described and utilized by Hippocrates (460-370 BCE). In turn, these ideas have similarities to various element models both in China and India, strongly suggesting a past link between these cultures.[3]

 

Middle Eastern scholars uncovered more support for that link when most of Galen’s Greek writings were first translated to Syriac by Nestorian monks in the University of Jundi Shapur, located in Persia (present-day Iran).[4]

 

Then Muslim scholars translated them into Arabic, and along with the Greek classics mentioned above, they became one of the main influences for Persian scholars such as Avicenna and Rhazes.

The most important figure to bridge the medical knowledge of the ancient Greeks with later Roman periods, Galen (131 – 201 CE) embraced the Hippocratic concept of the humours, but he also described a force called pneuma that pervades every living organism. Comparable to the Chinese concept of Qi and the Ayurvedic concept of prana, pneuma was said to activate or stimulate all the faculties of growth, development and nutrition. While the humours were previously associated by Hippocrates with the human body, Galen described how each food has a characteristic humour which led to an elaborate system of dietetics similar to that of Ayurvedic and Chinese medical systems.

Medieval Arabic medicine was also influenced more directly by healing traditions from India and China. Among the many medical and herbal texts translated and studied by Muslim scholars were the two primary texts of Ayurvedic medicine, the Sushruta and Caraka Samhitas. These were translated during the ninth century under the title Kitabi-i-Shaushura-al-Hindi. Ali ibn Rabban Tabari (c. 838’“c. 870 CE), one of the earliest Muslim writers, dedicated a section of his Firdaus-ul Higmat (‘Paradise of Wisdom’) to the discussion of the influence of Ayurveda on Persian medicine.

Medieval Muslim scholars were also aware of and interested in Chinese medicine. In 1313, Rashiel al Din al Hamdani (1247-1318) had an encyclopedia of Chinese medicine that included an Arabic translation of its most important classical text, the Nei Jing, as well as the Mai Jing, major manual on pulse diagnosis by Wang Shu-he. (attribution) The pulse as a diagnostic modality was and is still used by Chinese, Ayurvedic and Middle Eastern Unani-Tibb doctors. Many different pulse qualities similar to the classical 28 Chinese qualities were also studied and part of Western clinical practice up through the mid-20th century.

Outstanding Arab Medical Doctors and Scholars

The unique Arabic influence during the Islamic Golden Age on what we now call Traditional Western Medicine evolved so far that by the 16th and 17th centuries, it bore little resemblance to that which was left by the Greeks 1,500 years before that. Following is a short list of some of the foremost Middle Eastern medical scholars and doctors of that period.

Hunayn Ibn Ishaq (808-873)

Also known in Latin as Johannitus, the Assyrian Christian Hunayn lived in Iraq and was renowned as a physician, scientist and a great translator of the works of Plato, Aristotle, Galen, Hippocrates, Dioscorides and the Arabic Old Testament. In addition he wrote numerous original texts in different fields of medicine, from ophthalmology to odontology. His works on the eye remained influential until the 15th century.

Abu Bakr Muhammad Ibn Zakariya al-Razi (865-925)

Persian physician, alchemist, philosopher and scholar, al-Razi was well-versed in Greek, Persian and Indian medicine. The author of 184 books and articles on medicine and science, he made numerous advances in both fields through his own observations and discoveries. He was an early proponent of experimental medicine, pioneer of neurosurgery and ophthalmology and is regarded as the father of pediatrics. His medical writings greatly influenced the medieval Islamic world and Europe, where he was known under the Latinized form of his name, Rhazes.

Abu al-Qasim Khalaf ibn al-Abbas Al-Zahrawi (936-1013)[5]

Also known in the West as Abulcasis, Abu al-Qasim is considered the greatest surgeon in the Islamic medical tradition. His medical texts, combining Middle Eastern and Greco-Roman classical teachings, influenced European surgical procedures up until the Renaissance. Published in 1000, his greatest work Al-Tasrif was a 30-volume guide to medical practice including dentistry, childbirth and other aspects. Like Ibn Rushd (described above) Abu al-Qasim was very concerned with medical ethics, emphasizing the importance of treating patients regardless of their social status and encouraging close observation to provide the best care for them. In the 12^th century, Al-Tasrif was translated into Latin, and for or perhaps five centuries during the European Middle Ages it was used by surgeons and doctors as the primary reference for medical knowledge.

Avicenna: The Prince of Physicians (980-1037)[6] [7]

The most outstanding doctor of the time, indeed, perhaps of all time, was Ibn Sina, known famously as Avicenna. His fame primarily rests on his writing the monumental Canon of Medicine consisting of five volumes and over a million words in which he refined and codified all of the Greek, Roman and Islamic medical knowledge that existed in the world up to his time. Both The Book of Healing and The Canon of Medicine went through many translations including Latin as well as every other known language and served as the primary medical text and basis of medicine in Europe until the second half of the 17th century. It is still currently used as the basis for Middle Eastern Unani-Tibb medicine and in some countries in the Orient.

Abu ‘l-Walid Muhammad ibn Ahmad Ibn Rushd (1126-1198)

Known in the West as Averroes, Abu ‘˜l-Walid was born in Cordoba, Spain, and died in Marrakech. He was known as a philosopher, jurist and physician and is regarded as the foremost Islamic philosopher. His knowledge of medicine is appreciable and is illustrated by his famous book Kitab al-Kulliyyat fi ‘l Tibb (‘Book of the Generalities in Medicine’), translated into Latin under the title Colliget. [8]

Ibn al-Nafis (1213-1288)

Ibn al-Nafis, whose full name is ‘Ala’ al-Din Abu Al-Hassan al-Qarshi al-Dimashqi, was a physician from Damascus, Syria and he worked also in Egypt. He is mostly famous for being the first to describe the pulmonary circulation of the blood and the coronary blood supply to the heart. The most voluminous and famous of his books is Al-Shamil fi ‘l-Tibb (‘The Comprehensive Book in Medicine’), an 80-volume encyclopedia which was planned to comprise 300 volumes. This encyclopedia and its author eventually eclipsed the knowledge of Avicenna, many of whose medical theories he challenged and corrected.

Ibn al-Nafis also corrected the theory accepted by Galen about the circulation of the blood and proposed a new one based on his anatomical knowledge. He was the first to describe the circulation of the blood from the right chamber of the heart through the pulmonary artery to the lungs where it is mingled there with air, and then how it passes through the pulmonary vein to reach the left chamber of the heart. His description of the anatomy of the heart and of the lungs reflect his attitude in favor of dissection and autopsy, the practice of which clearly gave him the edge over previous doctors on knowledge of anatomy.

Without al-Nafis’ work in this area, the seminal medical discovery on the circulation of blood by renowned English physician William Harvey in 1628 would not have been possible.

In Defense of Planetary Herbology

Modern Western allopathic medicine may look back at classical antiquity and its development over the Middle Ages for its roots, but such a historical review deserves close attention by modern herbalists of all traditions as well, for many of them hold truer to the original energetic and diagnostic models of our common ancestors.[9] After all, the true roots of all modern medicine, allopathic or otherwise, are actual botanical ones.

 

Thanks to their steadfast efforts to translate treasured medical texts from both East and West, Muslim scholars were able to integrate aspects from all traditions into their own already significant advancements of medicine and science, and in turn, provide what could be called a planetary dimension to the ‘Western medicine’ that emerged in the European Renaissance. This attitude of tolerance and acceptance stemming from the inclusive nature Muslim philosophy enabled its scholars to incorporate and expound upon pre-existing Eastern and Western thought, with the intention of furthering the knowledge of medical science as a benefit for all.

In a similar spirit, the first medieval European medical school, the Schola Medica Salernitana, was founded in the ninth century in Salerno, Southern Italy, and represented a meeting of European and Indian traditions along with aspects of Traditional Chinese Medicine. According to legend, the school was founded by four masters: the Jewish Helinus, the Greek Pontus, the Latin Salernus, and the Arab Adela. The school flourished when Europe was at its lowest point culturally, between the 10th and 13th centuries, due in no small part to its inclusive view of medicinal traditions. In fact, its spirit of openness extended to its student body: the Schola Medica Salernitana was among the first medical schools to include women, both as teachers and students.

 

United by the fact that disease is a universal problem faced by all humankind, both Eastern and Western scholars of the Middle Ages were eager to develop a system for the treatment of disease. Students at Salerno and Arabic medical scholars found themselves in places where such an exchange of medical insights and methods was not only put to practical use, but also encouraged and celebrated.

 

This open-minded approach is parallel to the concept of Planetary Herbology, which is based on the integration of the primary herbal medical systems of both the East and West into a new synthesis encompassing diagnostics, classification of medicines and modes of treatment. Some may question a system that integrates knowledge and herbs from such widely diverse cultural traditions, but we see that our own modern medicine is already the result of such an integration led by medieval medical scholars who valued the synthesis of threads of useful knowledge more highly than maintaining the purity of their sources.

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[1] The prophet Muhammad’s hadith, “The ink of the scholar is more holy than the blood of martyrs,” reflects the high value placed on knowledge during the Islamic Golden Age.

[2] From ‘A Short History of the Arab Peoples’ by John Bagot Glubb [3] One possibility might be found with the interaction between the Greeks and people of the Indus valley, the Aryans, who were the predecessors of early Indian civilization and the authors of the Vedas (which includes the early writings on Ayurveda ‘“ Sanskrit for ‘the science of life’). Further shared influences seemed to be one of the positive outcomes of conquest and Alexander the Great’s annexation of the Gandhara region that led to closer ties between Greece and India. Other mutual contacts extended to the Persian kings of mid-first millennium BCE, who employed both Greek and Indian scholars and physicians. Fillozat, Sharma (1992) suggests that both Plato and Hippocrates were influenced by Indian thought and concepts.

[4] Jundi Shapur is considered the home of the oldest known teaching hospital and chiefly followed the Greek and Indian Ayurvedic systems, taking what was most useful from each and adding observations of their own.

[5] http://en.wikipedia.org/wiki/Abu_al-Qasim_al-Zahrawi

[6] http://www.unani.com/avicenna.htm

[7] http://www.afghan-network.net/Culture/avicenna.html

[8] http://www.renaissance.com.pk/jagletf98.html

[9] Evidence for the existence of a well-organized system of medicine in India can be traced back to the archaeological remains of third-millenium BCE Indus Valley civilization city centers Harappa and Mohenjodaro (both now in present-day Pakistan), making Ayurveda the oldest indigenous medical system. Ayurvedic medicine influenced not only Greek medicine but was spread by Buddhist monks to both Tibet and China as well. This provides a common root that accounts for the many similarities between Western and Eastern medical systems, including elemental and humoural theories, medicines (mostly herbs but also some substances of mineral and animal origin), preparations, and various healing modalities including therapeutic diets, cupping, physiotherapies, venesection (bleeding), cauterization (moxabustion) and to a more limited extent, acupuncture, though this modality was uniquely expanded and developed in China. Diagnostic methods based on methods of observation also have similarities with differential assessment of all aspects of general appearance, manner of speech, temperament, urine as well as tongue and pulse diagnosis. The goal was to achieve an understanding not only of the major symptoms and complaints, but of underlying constitutional states that give rise to a particular disease.

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References and Bibliography include the following:

Dr. Hassan Kamal, Encyclopedia of Islamic Medicine, published by General Egyptian Book Organization, 1975

Hakim G.M. Chisti, N.D., The Traditional Healer, published by Healing arts Press, 1988

Amber and Babey, The Pulse in Occident and Orient, published by Santa Barbara Press, 1966

Bendick, Jeanne – Galen and the Gateway to Medicine

Online:

Medicine and surgery before 1800Medieval and Renaissance EuropeSalerno and the medical schools http://www.britannica.com/EBchecked/topic/372460/history-of-medicine/35655/Medieval-and-Renaissance-Europe

Misconceptions about Islamic and Greek Science: Summarised extracts from a full article, see resources below, where end notes, references and bibliography are given. by: Foundation for Science Technology and Civilisation. Info@fstc.co.uk

Ayurveda/Harappa:

Ayurveda, nature’s medicine, introduction, pp 9-10

By David Frawley, Subhash Ranade

Published by Motilal Banarsidass Publ., 2004