Free admission to teaching hospitals, formally structured medical schools, mind-body medicine and medical ethics may all seem to be modern concepts - but in medieval times these ideas were common in the Islamic empire.
This medieval Islamic empire - comprising of today’s nations of the Middle East as well as Iran, North Africa and Spain - was inspired by a core of religious values and ideologies that are found in the Qu`ran and Hadith.
Islam encouraged actions that led to good health - such as eating in moderation and maintaining personal hygiene. Conforming to the precept ‘cleanliness is half of [faith]` Moslems were instructed to bathe regularly, perform ablutions before prayer, brush and floss teeth and wash after going to the toilet. These habits of personal hygiene were important in minimising the spread of infectious diseases. Hygiene and personal cleanliness in Islam are not merely concepts, but more importantly are considered acts of worship.
Hospital in Baghdad
One of the first hospitals to house and care for the sick was built during the reign of Caliph al-Rashid in 9th century Baghdad. Such clean and well-organised institutions had separate areas designated for patients with different diseases (such as digestive ailments, eye conditions, infectious diseases, mental illnesses and surgical ailments) and even incorporated out patient clinics and pharmacies. Similar to today’s public hospitals, food, medicine and accommodation were free (although physicians could charge a fee for their services!).
These hospitals were also places of training - aspiring physicians underwent an apprenticeship at the end of which they had to take examinations before being granted a licence to practise. The Prophet Muhammad said ‘A person who practises the art of healing when he is not acquainted with medicine, he will be responsible for his actions’. In the Islamic empire, physicians required licences to practice and regular checks were made to ensure that only those who were licensed practised medicine.
Islamic Medical Texts
The book ‘The Prophetic Medicine’ by Ibn Qayyim Al-Jawziyya , written in the fourteenth century by this renowned theologian provides a wealth of information about the sayings of the Prophet as well as herbal and medical practices current at the time. Islamic medicine recognised the importance of involving the patient in the consultation and enquiring about his or her beliefs - in contrast to the traditional European paternalistic model of the doctor-patient relationship.
Written in the 9th century, al-Ruhawi’s Physician’s Code of Ethics and Abu Hasan al Tabari’s The Paradise of Wisdom advised physicians at all times to behave ethically and empathetically towards patients, be aware of their responsibility to the population and treat colleagues with respect. All patents were to be treated fairly regardless of race, creed, social status or gender.
From the instructions he gave his followers, such as not to share towels to prevent the spread of infectious disease, it can be inferred that the Prophet himself displayed great practical knowledge. It is reported on authority that the Prophet himself stated, "Verily, Allah did not create a disease except that He also has created the treatment for it."
One of the best known of the Islamic physicians, Al Razi (Rhazes) wrote many books including a textbook of medicine Kitab al-Tibb al-Mansouri (The Book of Medicine for Mansour). He was one of the first to use opium as anaesthesia and established the use of alcohol in medicine.
The Canon of Avicenna
Like Al Razi, Ibn Sina (Avicenna) laid great importance on psychology, describing ‘modern’ ideas about human welfare and psychotherapy and postulating a link between emotional and physical states. One of Ibn Sina’s most important works is Kitab al Qanoun fi Al Toubb (known in English as The Canon ), in which he expanded on all that was known before him and accumulated the best medical knowledge of the time into a single three volume work. Along with Al Razi’s writings, The Canon was used for many centuries in Europe’s medical schools.
Many other Moslem physicians contributed significantly to medicine. In the 12th century, Ibn al Khatib described epidemics in terms of contagion, a concept unknown in Europe until the 19th century. Ibn al Nafis postulated that blood circulated between the heart and lungs in the 13th century, well before William Harvey described the systemic circulation in the 17th century. One of the first accurate anatomical diagrams of the eye was made in the 9th century by Hunayn Ibn Ishaq, while Anatomy of the Body by Mansur ibn Muhammad ibn al-Faqih Ilyas, written in the 15th century, contains one of the most thorough collections of diagrams of the skeleton, circulatory and nervous systems. Al Zahrawi, a surgeon at the turn of the 11th century, wrote Book of Concessions containing descriptions of medical instruments and surgical techniques.
Living in the 21st century which is blessed with so many medical advances, it is easy to overlook the history behind today’s achievements. The medieval Islamic empire contributed much to the science, the art and the ethics of the medicine practised today - and exerted a not inconsiderable influence on modern medicine.
Reference:
Dr Sameera Nawaz: The Islamic Roots of Medicine (Sunday Island, December 2005)
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