Islam’s Impact on Medicine – A Western Perspective

1. Islam’s Impact on Medicine – A Western Perspective A Sampler ShakeelShareef, MD Associate Professor University of Rochester School of Medicine and Dentistry Rochester, NY

2. The Eurocentric Attitude • Europeans • For the most part, credit is given to Greece, Rome, Byzantium, Africa • Muslims are given credit for acting as a surrogate mother for preserving works in Arabic for 500 years • Thanks! We did it all afterwards to bring about the true Renaissance!

3. “History books are written by winners for public relations” - A Retired English Professor

4. Why Focus From A Western Point of View? • What do they say about us? • Did Islam simply preserve Greco-Roman achievements in Arabic until translated into Latin to spark the European Renaissance? • What contributions did Islam make to the Sciences during the ‘Golden’ Age (9th-13th Century)?

5. Why Focus From A Western Point of View? • What was the driving force? • Did Islam contribute directly to the European Renaissance? • What was the cause of decline? • What lessons can we glean from this as ‘Ilm Summit’ students of knowledge?

6. Minimizing Bias • University Academic Librarian: Literature Search – Over 750 publications identified • Review limited to Peer Reviewed Journals published last 10 years • www.MuslimHeritage.com • Encyclopedia of The History of Arabic Science; Editor RoshdiRashed(Vol. 1-3); Vol. 3:Medicine • Howard Turner – Science in Medieval Islam (1999): Research for ‘The Heritage of Islam’ Exhibition of Historic Islamic Arts and Science displayed in 5 major museums (‘92 – ’95) • en.wikipedia.org/wiki/Islamic_medicine • Avoided Barnes & Nobles: Anti-Islam Books

7. The Heritage of Islam Museum Tour

8. Historical Perspective – What Do They Say About Us? British Medical Journal (2005) - “Western world might look very different without the legacy of Muslim Scholars in Baghdad, Cairo, Cordoba, and elsewhere” The FASEB Journal (2006) - “The Golden Age” was based on several factors. Muslims followed the guidelines of the Prophet, studied and searched for knowledge” Nature (2004) -“Arab world was guardian of the ancient Greek’s scientific knowledge during Middle Ages” The Lancet (2006) “Contributions made by physicians of the Middle East must be respected & remembered

9. Historical Perspective – Commitment to Worship of God • Howard Turner: “Heirs to earlier cultures of Asia, classical Greece and Rome, as well as Byzantium and Africa, Muslims took possession of their mixed heritage, preserving much of it and transforming much of it. Their cultural and political experience had a profound influence on .. Western Europe where Muslim achievements played an essential part in the evolution of the Renaissance .. The formation of later societies, including our own”

10. Historical Perspective – Power of Arabic Language • Within a century after the Prophet’s death, Islam spanned southern Europe, North Africa, Central Asia, India • Arabic language became a unifying factor • Assimilation, dissemination of knowledge of other cultures flourished • Translations from Greek, Latin, and Chinese into Arabic – innumerable • Removed language barriers for scholars; medium of scholarly work

11. Historical Perspective • Arabs learned from Chinese how to produce paper and books published en masse • Libraries established: Cairo, Aleppo, Bagdad, Iran, Central Asia, Spain • Bookshops had thousands of titles in several cities • Assimilation, dissemination of knowledge of other cultures flourished

12. Points to Ponder Over • Islam did not destroy the culture/civilization - it preserved much of it: respect for knowledge • Reality of History – Discoveries do not happen in a vacuum. Civilizations are interdependent and build on past experience of others • To suggest otherwise is against common sense! Ford Model T 1912 BMW January 2007

13. What was the Driving Force? • according to several hadiths in the Sahih al-Bukhari, SunanAbiDawood and Al-Muwatta attributed to Muhammad, such as: • "There is no disease that Allah has created, except that He also has created its treatment. [Bukhari] • "Make use of medical treatment, for Allah has not made a disease without appointing a remedy for it, with the exception of one disease, namely old age.” and "Allah has sent down both the disease and the cure, and He has appointed a cure for every disease, so treat yourselves medically.][abidawud] • "The one who sent down the disease sent down the remedy.[muwatta] http://en.wikipedia.org/wiki/Islamic_medicine

14. Merits of Knowledge in Qur’an • Prophet Muhammad (peace upon him) is commanded to say (20:114): My Lord! Increase me in knowledge • Say: Are they equal those who know and those who do not? It is those embued with understanding who receive admonition (39:9) • The Most God-fearing are the scholars who are the most knowledgeable

15. Emphasis on Knowledge • Prophetic Tradition: • The best of you are those who learn the Qur’an and teach it to others’. Thus, emphasis on written materials in Islam • Seeking knowledge is obligatory on every believing male and female • Islam came to eradicate ignorance. Seek knowledge from the cradle to the grave

16. Genesis of Islamic Science The Transmission of Science from Antiquity to the Middle Ages George Sarton – Science Historian H. Turner – Science in Medieval Islam (1999)

17. Kitab al-Tiryaq(Book of Antidotes) – 13th Century Portraits of nine Greek physicians based on works Galen

18. Greek Medical Translation – De MateriaMedica, 13th Century Iraq Herbal Preparation for Headache – Physician’s Assistant preparing for Aggressive treatment Diseased Dog Biting a Man’s Leg – Reflects life situations observed by Muslims – many antidotes developed

19. Contributions – too many to mention • fields of allergology, anatomy, bacteriology, botany, dentistry, embryology, environmentalism, etiology, immunology, microbiology, obstetrics, ophthalmology, pathology, pediatrics, perinatology, physiology, psychiatry, psychology, pulsology and sphygmology, surgery, therapy, urology, zoology, and the pharmaceutical sciences such as pharmacy and pharmacology, among others • In other words, they gave birth to many new disciplines little known in the West

20. Islam and Astronomy • The science of astronomy was important to Muslims because it could be used to figure out the direction of Mecca, so that people knew which way to face during prayers. • Many observatories built the world over – Jaipur, India; Istanbul, Turkey, Persia

21. Artistic Creativity

22. History of Hospitals in the USA Published in 1991

23. History of Hospitals in the USA • First hospitals – poorhouses, sheds • 1st Built 1658, known now as Bellevue in NYC • Pest houses – Those with smallpox, yellow fever, plague were sent to die! • Crimean and American Civil War (1854-1865): • Mortality reduced by providing patients with fresh air, clean surroundings • Practical use of hospital-based nursing care • Nightingale Plan (1872): wards + nurse station

24. Medieval Muslim Hospitals “Hospitals as we know them today were first developed in Islamic lands more than a thousand years ago (8th century). Paid for and maintained by endowments .. Managed by highly educated and professional staffs. Separate wards were provided for male and female patients. Special wards were maintained for internal diseases, ophthalmic disorders .. Orthopedic cases … mentally ill, and patients with contagious diseases.” Hospitals were centers of medical education

25. Hospital of Qalaoun, Cairo – Built 13th Century NOTE: Separate Nurses and Physicians Wards, Prayer Area

26. Hospitals Divrigi Hospital, Turkey – Built 13th Century Prior to building hospital, pieces of meat on sticks placed to attract maggots. Least of those sites used to build the hospital! NOTE: Wide open spaces, corridors – ventilation to clean out germs; running Water to avoid stagnation and disease Vaccination against smallpox introduced to Europe (8th Century)

27. Hospital Based Training • Systematic Education System: • Basic Sciences (alchemy, anatomy, botany, etc) • Clinical Training in Hospitals (Physical Exams, rounding on Wards, attending lectures) • Pass oral/practical exams for licensure • Medicine not just a science but had a standard code of ethics: Physician’s behavior, obligations to patients, colleagues and the community

28. Islamic Code of Ethics • Life is a test. Prophetic Tradition (Rules of Engagement): • Your Lord has a right on you (worship) • Those whom you associate with have a right on you (your parents, spouse, children, relatives, neighbors, enemies) • Your body has a right on you It requires knowledge to fulfill these rights!

29. Hospital Functioning • Outreach Clinics; apprenticeships; traveling clinics; dispensaries • Licensing and certification • Hospitals known as ‘Bimaristans’ developed all over Arab world. • Detailed medical records • First hospital established in Damascus 706 CE • In 805, under Caliph Haroun al-Rashid, 1st hospital in Baghdad founded

30. Hospital Complex of Beyazit II, Ederine, Turkey (15th century)

31. Baghdad – Learning Center of The World IbnSina (Avicenna) “The prince of physicians” In the West City was enclosed within itself and offered All aspects of daily life House of Wisdom Established 1004 CE An Academic Institution

32. 18th Century Persian Barber’s Pocket Kit – Handy Medical Practitioner • Case contains razor, pen, knife, scissors, file, powder spoon and saw • “Barber-Surgeon” – qualified to do minor operations, pulling teeth, barber functions • Provided regional network of care • Periodically inspected and examined to practice legally Measures 4 inches high, 2 inches wide

33. Medical Treatments Treating Scalp Condition Hip Dislocation Treatment Treating a Boil

34. Tashrih al-badan– Anatomy of the Human Nervous System • Diagram in Text by Mansur ibn Muhammad ibn al-FaqihIlyas(15th century) • Muslim Physicians added significant knowledge of anatomy and physiology

35. Anatomy Study of Horse – Egyptian (15th Century) • Arab tradition of horse breeding • Texts by IbnAkhiHizam (9th century, Baghdad) and Abu Bakr al-Baytar a veterinarian at court of Nasir Muhammad IbnQalaoun(14th century)

36. Pharmacology – A separate discipline from Medicine Pharmacists preparing medicine From honey Translation of De MateriaMedica, Iraq 13th Century Pharmaceutical Packaging – A Drug Jar Ceramic, Syria (13th Century)

37. Famous Figures and Books These figures were all Polymaths • Al-Zahrawi (surgeon) – ‘Tasrif’; leading medical text in Univ. in Europe; catgut sutures; 200 surgical instruments • Al-Razi (Rhazes) [865] – Kitab Al-Mansuri– 10 volume treatise in Greek Medicine; published smallpox & measles • IbnSina (Avicenna) – al-Qanunfi’ltibb(The Canon of Medicine) – final authority on medicine in Europe for 500 years with 35 editions • Other contributors: Scientific Peer-Review

38. An Arabic manuscript, dated 1200 CE, titled Anatomy of the Eye, authored by al-Mutadibih

39. HunaynibnIshaq – 10th Century Treatise • Kitab al-AshrMaqalatfi’l ‘Ayn(Book of Ten Treatises on the Eye) • Described anatomy, physiology; diagrams profound influence in Europe/ophthalmology • Translated into Arabic many writings of Aristotle 13th Century Copy (Egypt)

40. Ibn al-Haytham– “Father of Optics”(965-1040) – a.k.a. Alhazen in West • Kitab al-Manazir – Optics became a mathematical discipline. • Greeks proposed eye emits rays of fire whose emissions form the object looked at • Experimentally showed how we receive images through pupil to brain • Studied solar eclipse – (Camera Obscura) modern photography is based on his experiments – next time you buy a camera, think of him 11th Century Copy (Istanbul)

41. Ibn al-Haytham– “Father of Optics”(Book of Optics) • Investigated virtually every aspect of light/human sight: • Refraction (bending) of light through air, water, mirrors • Rainbow, sunlight • Explained correctly why sun and moon diameter increases as they approach horizon (Harvest Moon) • Institute of Optics at U of R leading center telescopes and looking at a single cell in the eye Precise Geometric Description -Theory of Vision Diagram Kitab al-Manzir 14th Century)

42. Kamal al-Din al-Farisi • Elaborated work of IbnHaytham’s Camera Obscura: • Showed formed image inside device turns top to bottom and left to right • Demonstrated images focus sharper when the aperture gets smaller • Try it by making a pinhole with your fingers 14th Century Copy (Istanbul)

43. German Encyclopedic Translation Muslim work in Ophthalmology

44. IbnNafis – Father of PhysiologyDiscovered Pulmonary Circulation Polymath – Anatomy; Physiology; Psychology Described Mechanism of Micturition: Bladder Constricts When Full The Concise Book (Kitab Al-Mujazfi al-Tibb) – A Handbook for Medical Students and Practitioners (13th Century)

45. Ibn al-Nafis (Born 1213) Damascus -Physician) • Described pulmonary circulation • This knowledge remained relatively unknown until over 400 years when William Harvey took credit • Father of Physiology • Pioneer of Scientific Peer Review The Lancet (March 2006)

46. Qur’an and Modern Western Science • Sex determination (1959) Jacobs et al. • Allah (swt) informs us 1400 + years ago: وَأَنَّهُ ۥ خَلَقَ ٱلزَّوۡجَيۡنِ ٱلذَّكَرَ وَٱلۡأُنثَىٰ  مِن نُّطۡفَةٍ إِذَا تُمۡنَىٰ He did create the pairs, male and female from a sperm drop when lodged [Najm: 45-6] – in the womb • In surahQiyaamah: 75:39 فَجَعَلَ مِنۡهُ ٱلزَّوۡجَيۡنِ ٱلذَّكَرَ وَٱلۡأُنثَىٰٓ • And He out of semen made both sexes male and female

47. Qur’an and Modern Western Science • Carriage of characteristics of parents to the child • Prophet (saws) said: “Um Salama came to Allah’s Messenger and said, ‘Is it necessary for a woman to take a bath after she has a wet dream?” The Prophet replied, “Yes, if she notices a discharge.” Um Salama then covered her face [shyly] and asked, “O Allah’s Messenger! Does a woman get a discharge [Fertile fluid]?” He replied, “Yes and that is why the child also resembles the mother.” [Sahih al-Bukhari]

48. Qur’an and Modern Western Science his finding in 1677 of “little animals” (animalcules) in semen (LA BERGE, 1999). He found these animalcules in semen from men but also from roosters and in the semen of different mammals. So Van Leeuwenhoek became an “animalculist” or “spermist” who thought that later the embryo was formed from one of these little animals (Fig. 2) or spermatozoa (Von Baer used this word). According to Van Leeuwenhoek, De Graaf’s egg, if it did anything, provided no more than nourishment to the embryo

49. Women participate equally in process of fertilization • Hamm and Leeuwenhoek, after seeing sperm for the first time in their experiments, proposed that each sperm contained small fully formed babies:

50. Challenges Ahead • If Muslims made such great contributions, how come we don’t hear about them? • Although European Libraries and museums collected Arabic scripts, they sat in obscurity as they were largely indecipherable (FASEB 2006) • Hundreds, even 1000s of manuscripts produced (500-1000) years ago remain in archives around the world • Resources needed to assist in the study, translation, and publication to better understand the historic scientific achievement during Islam’s Golden Era Howard Turner (1999)