Medieval Masters of Medicine

Arabic manuscript illustrating Albucasis’ surgical instruments

Many aspects of modern medicine may not be as modern as some think. In fact, a number of today’s common medical practices were already in place centuries ago in some lands. Consider, for example, the history of medicine in medieval times in the Middle East.

In 805 C.E., CALIPH HARUN AR-RASHID established a hospital in his capital, Baghdad. From the 9th century through the 13th, other rulers built and maintained hospitals throughout the Islamic empire, from Spain to India.

These hospitals welcomed the rich and the poor of all religions. Professional physicians not only treated the sick there but also did research and trained new practitioners. Separate wards were set aside for different specialties—internal medicine, ophthalmology, orthopedics, surgery, contagious disease, and mental infirmity. Doctors, accompanied by their students, examined the sick each morning and prescribed diets and drugs for them. And in-house pharmacists dispensed medicines. A managerial staff took care of keeping records, controlling expenditures, and supervising food preparation, as well as other administrative tasks—just like today.

Historians consider these hospitals “one of the great achievements of medieval Islamic society.” Throughout the Islamic empire, “the hospital as an institution was being developed in revolutionary ways that would shape the course of health sciences and health care right down to modern times,” says author and historian Howard R. Turner.

RHAZES was born in the mid-ninth century in the ancient city of Rayy, now a suburb of Tehran. He is dubbed “the greatest physician and clinician of Islam and indeed of the whole Middle Ages.” For the benefit of other practitioners, this scientific thinker recorded his experimental methods, conditions, apparatuses, and results. And he advised all doctors to keep up-to-date with the latest developments in their field.

Rhazes had a number of achievements. For instance, his medical writings are featured in the 23-volume Al-Hawi (Comprehensive Book), which ranks among the great medical texts. It is claimed that the origins of obstetrics, gynecology, and ophthalmic surgery are traced to this book. Among his 56 works on medical topics are the oldest reliable descriptions of smallpox and measles. Rhazes also discovered that fever is one of the body’s defenses.

Moreover, he ran hospitals in Rayy and in Baghdad, where his work with the mentally ill led to his being acclaimed the father of psychology and psychotherapy. In addition to medicine, Rhazes also found time to write books on chemistry, astronomy, mathematics, philosophy, and theology.

AVICENNA, another leader in the medical field, hailed from Bukhara, in modern Uzbekistan. He became one of the great physicians, philosophers, astronomers, and mathematicians of the 11th century. Avicenna wrote an encyclopedia, The Canon of Medicine, which covered the whole range of known medical knowledge.

Avicenna stated in his Canon that tuberculosis is contagious, that disease can spread  through water and soil, that emotions affect physical well-being, and that nerves transmit both pain and impulses for muscle contraction. The Canon described some 760 pharmacological preparations—their properties, actions, and indications—and provided principles for testing new drugs. Translated into Latin, this text remained in use in European medical schools for hundreds of years.

ALBUCASIS also stands tall in the history of medicine. This tenth-century innovator, from Andalusia, in modern Spain, produced a 30-volume compendium, including a 300-page treatise on surgery. In it, he described such advanced procedures as the use of catgut for internal stitching, the removal of bladder stones using an instrument inserted through the urinary passage, thyroidectomy, and the removal of cataracts.

Albucasis used what are described as “relatively modern clinical techniques” to simplify difficult births and treat dislocated shoulders. He introduced cotton as a surgical dressing and used plaster casts for setting bones. He also described techniques to reimplant dislodged teeth, make false teeth, correct misaligned teeth, and remove dental tartar.

 Albucasis’ treatise on surgery illustrated the surgeon’s tools for the first time. It presented clear drawings of some 200 surgical instruments and gave direction on how and when to use them. Some of his designs have undergone few changes in a millennium.

Avicenna oversees the preparation of remedies for smallpox

Knowledge Spreads to the West

In the 11th and 12th centuries, scholars began to work on Latin translations of Arabic medical texts, particularly in Toledo, Spain, and in Monte Cassino and Salerno, Italy. Physicians then studied those translations in universities throughout Latin-speaking Europe. Middle Eastern medical knowledge thus “penetrated deep into Europe in the following centuries, perhaps more so than any other Islamic science,” says science writer Ehsan Masood.

Clearly, the discoveries and inventions of medieval masters like Rhazes, Avicenna, Albucasis, and their contemporaries can rightly be described as the foundation of what we today call modern medicine.