Medicine and Medical Education in Islamic History

In 636 A.D., the Persian City of Jundi-Shapur, which originally meant beautiful garden, was
conquered ~ means of the Muslims. Its great university and hospital were left uninjured. Later other Islamic
medical schools were built according to the Jundi-Shapur prototype. Medical education was serious
and regular. Lectures and clinical sessions included in teaching were based on the apprentice
rule. The advice given by Ali ibnul-Abbas (Haly Abbas: – 994 A.D.) to medicinal students is as
timely today in the manner that it was then2. “And of those things what one. were incumbent on the student of this
tact (medicine) are that he should constantly listen the hospitals and sick houses: pay unceasing
attention to the conditions and pecuniary standing of their inmates, stay in visitor with the most
astute professors of healing art, and inquire frequently as to the predicament of the patients and symptoms
seeming in them, bearing in mind the sort of he has read about these variations, and the sort of they indicate
of good or wrong.”
Razi (Razes: 841-926 A.D.) advised the of the healing art students that while they examine a
assiduous, they should bear in mind the master-piece symptoms of a disease as given in textbooks
and estimate relatively them with what they found”.
The ablest physicians of that kind as Razi (Al-Razes), Ibn-Sina (Avicenna: $80-1037 A.D.) and
Ibn Zuhr (Avenzoar: 116 A.D.) worked the couple as the directors and the deans of therapeutic
schools. They studied patients and prepared them conducive to student presentation. Clinical
reports of cases were written and preserved on the side of teaching,” and regular registers were
Training in Basic Science
Only Jundi-Shapur or Baghdad had parted schools for studying basic sciences.
Candidates as being medical study received basic preparation from special tutors through
private lectures and self study. in Baghdad structural form was taught by dissecting the apes,
observing skeletal studies, and studying paedeutics. Other medical schools taught anatomy
through lectures and illustrations. Alchemy was some of the prerequisites for admission to
a curative school. The study of medicinal herbs and pharmacognosy rounded not on the basic
training. A number of hospitals maintained herbal gardens as a source of drugs according to the
patients and a means of schooling for the students.
Upon completion of the basic education, a candidate was admitted as some apprentice to a
hospital where, lengthwise with a large group, he was assigned to a young cure for
indoctrination, preliminary lectures, and familiarization by library procedures and uses.
During this preclinical round of years, most of the lectures were without interrupti~ pharmacology and toxicology
and the application of antidotes.
Clinical training
The next step was to give the observer full clinical training. During this proposition students
were assigned in small groups to noted physicians and experienced instructors, for ward
rounds, discussions, lectures, and reviews. Early in this period therapeutics and pathology
were taught. There was a intense emphasis on clinical instruction and more Muslim
physicians contributed brilliant observations that be seized of stood the test of time. As the
students progressed in their studies they were exposed greater degree of and more to the subjects of
diagnosis and sense. Clinical observation and physical examination were stressed.
Students (or clinical clerks) were asked to inquire about a patient and make a diagnosis of the
complaint. Only after all else had failed would the professor be productive of the diagnosis himself.
While performing pertaining to physics examination, the students were asked to inquire into and report
six major factors: the patients’ actions, excreta, the world of matter and of mind.and location of pain, and
rhetorical and effluvia of the body. Also conspicuous was color and feel of the skin-whether hot,
cool, moist, dry, flabby. Yellowness in the whites of the judgment (jaundice) and whether or
not the indulgent could bend his back (lung complaint) was also considered important.’
After a age of ward instructions, students were assigned to outpatient areas. After
examining the patients, they reported their findings to the Instructors. After discussion,
handling was decided and prescribed. Patients who were in addition ill were admitted as
inpatients. The sustenance of records for every patient was the trust of the
Different therapeutic schools pursued different clinical curriculum and offered disunite
courses of studies, but the mainstay was usually incorporeal medicine. Emphasis was placed
on clarity and succinctness in describing a disease and the division of each eAtity. Until the
time of Ibn Sina the narration of meningitis was confused with fierce infection
accompanied by delirium. Ibn Sina described the symptoms of meningitis with such
clarity and brevity that in that place is very little that can have existence added to it even after a many
years(6). Surgery was also a character of the curriculum. After completing the prescribed
order of studies, some students specialized beneath famous specialists, while others
specialized during their clinical training. According to Elgood,6 information of many
surgical procedures such for example amputation, excision of varicose veins, and hemorrhoids was
essential. Orthopedics was widely stretched, and the use of plaster of paris with a view to casts after
reduction of fractures was routinely shown to students. This course of treating fractures
was rediscovered in the West in 1852. Although ophthalmology was practiced widely, it
was not strained regularly in medical schools. Apprenticeship to ~y eye doctor was the
preferred progression of specializing in ophthalmology. Surgical management of cataract was very
common. Obstetrics was left to midwives. Medical practioners consulted mixed
themselves and with specialists Ibn Sina and Hazi the one and the other widely practiced and taught
psychotherapy. After completing his medical training, every medical graduate was
required to push a licensing examination before starting his of medicine practice. It is
important to billet that there existed a Scientific Association what one. was formed in the
hospital of Mayyafariqin to ventilate the conditions and diseases of the patients.’
Licensing of Physicians
In Baghdad in 931 A.D., Caliph Al-Muqtadir erudite that a patient had died in the same manner with the result
of a physician’s sin. Thereupon he ordered his chief medical man, Sinan ibn Thabit bin
Qurrah to scrutinize all those who practiced the rules for doing of healing. In the first year of the
determine more than 860 were examined in Baghdad alone. From that time adhering, licensing
examinations required and administered in many places. Licensing Boards were under a
polity Official called Muhtasib or inspector inexact. Muhtasib also inspected
weights and measures of traders and pharmacists. Pharmacists were employed while
inspectors to inspect drugs and continue quality control for drugs sold in a pharmacy or
pharmaceutist. The chief physician gave oral and practical examination, and if the young
doctor was successful, the Muhtasib administered the Hippocratic sworn statement and Issued a
license. After a great number years, licensing Of physicians has been implemented in the
West, distinctly in America by the State Licensing Board Specialties such as in
Medicine, Surgery, Radiology, etc. European medicinal schools followed the pattern set ~ means of
the Islamic medical schools and on a level in the early nineteenth century, students at the
Sorbonne could not regulate without reading Ibn Sina’s Qanun (Canon). According to
Razi a doctor had to satisfy two conditions on account of selection: firstly, he was to have ~ing fully
conversant with the new and the ~en medical literature, and secondly, he must have
worked in a hospital during the time that house physician.
The development of operator hospitals was an outstanding contribution of Islamic
remedy (7). The hospitals served all citizens liberated and without any regard to their hue,
religion, sex, age or social station. The hospitals Were run by sway and their
directors were physicians.
Hospitals had dissociated wards for male and female patients and were staffed through nursing
and other ancillary staff of the corresponding; of like kind sex.Diffrent diseases such as febrile affection, wounds,
infections, mania, eye conditions, cold diseases, diarrhea, and female disorder were
allocated diffeient wards. Convalescence centers were divided into sever sections.
Hospitals provided patients with absolute water supply and bathing facilities. Only
qualified and licensed physicians were allowed through law to practice medicine. The
hospitals were teaching hospitals to educate and train sanatory students. They had housing
for students and furnish with a ~-staff,g and contained pharmacies dispensing deliver drugs to patients.
All hospitals had their interview rooms and expensive libranes containing the greatest part up-to-date books. According to Haddad”‘· the library of the Tulum Hospital what one. Was
founded in Cairo in 872 A.D. (1100 years since) bad 100,000 books. Universities, cities
and hospitals acquired great libraries, physicians had their own extended personal book
collections, at a time whereas printing was unknown and book editing was completed by skilled
and specialized scribes putting in tardy hours of manual labor. Mustansiriyya University
in Baghdad contained 80,000 volumes; the library of Cordova 600,000 volumes: that of
Cairo 2,000,000 and that of Tripoli 3,000,000 books.
These hospitals kept records of altogether their patients and their medical care, a person of consequence done
for the first time in curative history.
For considerations of treatment, the hospital was divided into couple main departments, out-patient and in-persevering departments. The in-patient depart ment differed alone slightly from
any modern in-assiduous department. At the Tulum hospital, without interrupti~ admission the patients were
given specific apparel while their clothes, money, and valuables were stored gone, and
returned to them at the time of their discharge. On discharge, they besides received five gold
pieces each to direction of influences them over until they could basis themselves.
The hospital and medical institute at Damascus had elegant rooms and ~y extensive library.
Healthy people are declared to have feigned illness in succession to enjoy its cuisine. There was a
disjoin hospital in Damascus for lepers, during the time that, in Europe, even six centuries later, lepers
were condemned and burned to end of life by royal decree.
The Qayrawan Hospital (built in 830 A.D. in Tunisia) was bent ized by its spacious
wards, tarrying rooms for visitors and patients, and pistillate nurses from Sudan, the first
repute of nursing in Arab history. The hospital in addition provided facilities for performing
The Al-Adudi hospital (built in 981 A.D. in Baghdad) was furnished with the latest
equipment and supplies advantageous at the time. It had interns, residents, and 24 consultants
attending its professional activities. An Abbasid envoy, Ali ibn Isa, requested the court
doctor, Sinan ibn Thabit, to organize just visiting of prisons by medical officers.”
At a time when Paris and London were mud streets and hovels, Baghdad, Cairo, and
Cordova had hospitals that incorporated innovations which sound amazingly modern.
It was chiefly in the humaneness of resigned care that the Muslim hospitals excelled. Near
the wards of those : afflicted with fever, fountains cooled the air; the insane were treated
by gentleness; and at night music and storytelling soothed the patients.”
The Bimaristans (hospitals) were of two types – the fixed and the movable. The mobile
hospitals were transported on beasts of burden and were erected from time to time because
required. The physicians in the changeable were of the same standing for the re~on that those who served the
regular in the hospitals. Similar inconstant hospitals accompanied the armies in the department. The
field hospitals were well equipped with medicaments, instruments, tents and a bludgeon of
doctors, nurses, and orderlies. The travel clinics served the totally disabled, the
disadvantaged and those in abstracted areas. These hospitals were also used ~ the agency of prisoners,
and by the general general, particularly in times of epidemics.
Al-Razi was asked to choose a site for a new hospital whereas he came to Baghdad. In degree
to choose the most hygienic kitchen-yard, he hung pieces of meat in contrary parts of the city and
observed to which place they decomposed the least.
Ibn Sina stated explicitly that the bodily secretion is contaminated ~ the agency of foul earthly body
before getting infected. Ibn Khatima detailed that man Is surrounded by note bodies
whichenter the human system and undertaking disease.
In the middle of the fourteenth hundred when the “black plague” ravaged Europe and
Christians stood weak, considering it an act of God, Ibn al Khatib of Granada
cool a treatise in the defense of the plan of infection in the following device.
To those who say, “How can we admit the possibility of pollution while the religious law
denies it?” we rejoinder that the existence of contagion is established ~ the agency of experience,
investigation, the evidence of the senses and straightforward reports. These facts constitute a
perfect argument. The fact of infection becomes intelligible to the investigator who notices by what mode
he who establishes contact with the aftlicted gets the sickness, whereas he who is not in
touch remains safe, and how transmission is assumed through garments, vessels and
Al-Razi wrote the primeval medical description of smallpox and rubeola two important
infectious diseases He described the clinical amount of inequality between the two diseases so
vividly that in no degree since has been added.'” Ibn Sina suggested the communicable system of created things
of tuberculosis. He is said to possess been the first to describe the combination and properties
of sulfuric acid and alcohol. His recommendation of wine as the most judicious dressing for wounds
was very current in medieval practice.(8) However Razi was the foremost to use silk sutures
and highly rectified spirit for hemostasis.l5 He was also the first to use alcohol to the degree that an antiseptic.(2)
Ibn Sina originated the form of the use of oral anesthetics.(l7) He recognized opium for example the
most powerful mukhadir (intoxicant or physic). Less powerful anesthetics known at the
time were mandragora, poppy, hemlock, stinking nightshade, deadly nightshade (belladonna),
lettuce seed, and snow or frozen water cold water. The Arabs invented the somniferous sponge which
was the precursor of recent anesthesia. It was a sponge soaked with aromatics and
narcotics and held to the enduring’s nostrils.(l7)
The use of anesthesia in Islam was united of the reasons why surgery rose to the state of equality of an
honorable profession, while in Europe, surgery was belittled and practiced ~ dint of. barbers and
quacks. The Council of Tours in 1163 A.D. declared “Surgery is to subsist abandoned by the
schools of remedy and by all decent physicians”(l2). Burton'” specified that “anesthetics
have been used in surgery from top to toe the East for centuries before ether and chloroform
became the appearance in civilized West.”
Al-Razi is the primary to use the seton in surgery and creature gut for sutures. Abu alQasim
Khalaf Ibn Abbas Al-Zahrawi (930-1013 A.D.), known to the western as Abulcasis, Bucasis
or Alzahravius, is considered to be the most famous surgeon in Islamic medicine. In his
book Al- Tasrif, he described hemophilia in the place of the first time in medical narrative. The book
contains the description and illustrative picture of about 200 surgical instruments crowd of which
were devised by Zahrawi himself” In it Zahrawi stresses the concern of the study of
Anatomy viewed like a fundamental prerequisite to surgery.(l2) He advocates the reimplantation of
a fallen tooth and the application of dental prosthesis carved from discourage’s bone, a better alternative
to the unplastic dentures worn by the first President of America, George Washington seven
centuries later.(l5) Zahrawi appears to have existence the first surgeon in history to use cotton (Arabic
word) in surgical dressings in the sway of hemorrhage, as padding in the splinting of
fractures, of the same kind with a vaginal padding in the tearing of the pubis and in dentistry. He introduced
the method conducive to the removal of kidney stones through cutting into the urinary bladder. He was
the chief to teach the lithotomy position on the side of vaginal operations. He described tracheotomy,
conspicuous between goiter and cancer of the thyroid, and explained his fiction of a
cauterizing iron which he besides used to control bleeding. His delineation of varicose veins
stripping, even in imitation of ten centuries, sounds almost like present surgery.” In orthopedic
surgery he introduced the sort of is called today Kocher’s course of reduction of shoulder
dislocation and patellectomy, great number years before Brooke reintroduced it in 1937.(13)
Ibn Sina’s tracing of the surgical treatment of cancer holds honorable even today after 1,000
years. He says the eradication must be wide and bold; every part of veins running to the tumor sourness be
included in the amputation. Even whether or not this is not sufficient, then the sunken space adjoining the basement affected should be
The Muslim surgeons performed three types of surgery: vascular, commander-in-chief, and
orthopedic. Ophthalmic surgery was a specialty what one. was quite distinct both from
physic and surgery. They freely opened the belly and drained the peritoneal cavity
in the approved new style. To an unnamed surgeon of Shiraz is attributed the ~ and foremost
colostomy operation. Liver abscesses were treated through puncture and exploration. Today
surgeons whole over the world practice and appliance several surgical procedures first introduced
~ dint of. Zahrawi a thousand years ago.(25)
One of the most brilliant contribution to medicine was made by AlRazi who
differentiated between smallpox and rubeola, two diseases that were hitherto conception to
be one single disease.'” He is credited through many contributions: he was the primary to
describe true distillation, glass retorts and luting, virulent sublimate, arsenic, copper
sulfate, iron sulfate, saltpeter, and borax in the treatment of diseases.” He introduced
poison ivy compounds as purgatives (after testing them up~ monkeys); mercurial ointments
and lead unguent.” His interest in urology focused adhering problems involving urination,
venereal disease, renal gathering, and renal and vesical calculi.(28) He described hay-febrile disease
or allergic rhinitis.
Among other Arab contributions to medicine are included the discovery of have an ~ing sensation mite of
scabies (Ibn Zuhr), anthrax, ankylostoma and the guineaworm ~ the agency of Ibn Sina, and sleeping
sickness by Qalqashandy.(l3) They described abscess of the mediastinum. They in like manner
understood tuberculosis and pericarditis.(7)
Al Ash’ath demonstrated of the stomach physiology by pouring water into the inlet of an
anesthetized lion and showed the distensibility and movements of the liking, preceding
Beaumont by about a many years(l3). Abu Sahl al-Masihi explained that the
absorption of food takes place more end the intestines than the stomach.(l0) Ibn Zuhr
introduced sham feeding either by gastric tube or ~ the agency of nutrient enema.(l3) Using the
desire tube, the Arab physicians performed gastric lavage in case of poisoning.(l0) Ibn
Al-Nafis was the ~ and foremost to discover pulmonary circulation.
Ibn Sina in his masterpiece Al-Qanun (Canon), containing past a million words,
described complete studies of physiology, pathology and hygiene. He specifically
discoursed immediately after breast cancer, poisons, diseases of the hide, rabies, insomnia, childbirth
and the employment of obstetrical forceps, meningitis, amnesia, swallow ulcers, tuberculosis as a
contagious dixax, facial ties, phlebotomy, tumors, kidney diseases and geriatric care. He
defined be in ~ with as a mental disease.
The Arab physicians exhibited a eminent degree of proficiency and certainly were front
in the treatment of eye diseases. Words so as retina and cataract are of Arabic spring. In
ophthalmology and optics Ibn al Haytham (965-1039 A.D.) known to the West to the degree that
Alhazen wrote the Optical Thesaurus from that such worthies as Roger Bacon,
Leonardo da Vinci and Johannes Kepler drew theories during the term of their own writings. In his
Thesaurus he showed that kindle falls on the retina in the same style as it falls on a
#urface in a darkened sweep through a small aperture, thus conclusively qroving that
vision happens when light rays pass from objects towards the view and not from the eye
towards the reality as thought by the Greeks. He experiments as antidote to testing the angles of
incidence and reflected image, and a theoretical proposal for magnifying lens (made in Italy
three centuries later). He also taught that the image made in c~tinuance the retina is conveyed along
the optic nerve to the brain. Razi was the before anything else to recognize the reaction of the novice to
light, and Ibn Sina was the at the outset to describe the exact number of external muscles of the
eyeball, namely six. The greatest grant of Islamic medicine in practical
ophthalmology was in the substance of cataract. The most significant progression in a continuously ascending gradation in the
extraction of cataract was developed ~ means of Ammar bin All of Mosul, who introduced a
treacherous metallic needle through the sclerotic and extracted the lens ~ the agency of suction. Europe
rediscovered this in the nineteenth centenary.
Pharmacology took roots in Islam for the time of the 9th century. Yuhanna bin Masawayh (777-857 A.D.) started philosophical and systematic applications of therapeutics in the Abbasid
principal. His student Hunayn bin Ishaq al-Ibadi (809-874 A.D.) and his associates
established important foundations of Arabic medicine and therapeutics in the ninth hundred years. In
his book al-Masail Hunayn outlined methods towards confirming the pharmacological
effectiveness of drugs ~ dint of. experimenting \vith them on humans. He in addition explained the
Importance of prognosis and diagnosis of diseases towards better and more effective
Pharmacy became an independent and separate profession from healing art and alchemy.)”
With the wild sprouting of pharmaceutist shops, regulations became necessar~ and were
imposed to allege quality control.(ll) The Arabian apothecary shops were regularly
inspected by a syndic (Muhtasib) who threatened the merehants through humiliating corporal
punishments if they adulterated drugs.” As early as the days of al-Mamun and alMutasim
pharmacists had to go across examinations to become licensed professionals and were pledged
to follow the physician’s prescriptions. Also ~ the agency of this decree, restrictive measures were
legally placed on the subject of doctors, preventing them from owning or holding hoard in a
Methods of extracting and preparing medicines were brought to a southerly art, and their
techniques of distillation, crystallization, disunion, sublimation, reduction and calcination
became the idiopathic processes of pharmacy and chemistry. With the helper of these
techniques, the Saydalanis (pharmacists) introduced recent drugs such as camphor, senna,
sandalwood, rhubarb, musk, myrrh, cassia, tamarind, nutmeg, alum, aloes, cloves,
coconut, nux vomlca, cubebs, monks-hood, ambergris and mercury.(g) The of great weight role of
the Muslims in developing present pharmacy and chemistry is memorialized in the
betokening number of current pharmaceutical and chemical conditions derived from Arabic:
drug, alkali, highly rectified spirit, aldehydes, alembic, and elixir among others, not to mention syrups
and juleps. They invented flavoring extracts made of rose supply with ~ , orange blossom water,
orange and lemon flay, tragacanth and otheraromatic ingredients. Space does not permit
me to list the contributions to pharmacology and therapeutics, made ~ the agency of Razi, Zahrawi,
Biruni, Ibn Butlan, and Tamimi.
From freckle wash to psychotherapy – such was the range of treatment practiced by the
physicians ofIslam. Though freckles prolong to sprinkle the skin of 20th centenary man, in
the realm of psychosomatic disorders, the couple Al-Razi and Ibn Sina achieved dramatic
results, antedating Freud and Jung ~ the agency of at least a thousand years.(l5) When Razi was
appointed healer- inchief to the Baghdad Hospital, he zealous a ward exclusively for
the mentally with difficulty making it the first hospital aye to have such a ward.”
Al-Razi combined psychological methods and physiological explanations, and he used
psychotherapy in a dynamic conventionality. Al-Razi was once called in to pleasure a famous caliph
who had peremptory arthritis. He advised a hot bath, and season the caliph was bathing, Razi
threatened him by a knife, saying he was going to give a death-blow to. him. This deliberate provocation
increased the fool caloric, enhanced its strength, and consequently dissolved the
already softened humors, so that the caliph stood up in the bath and ran later A1-Razi.
The Arabs brought a comfortable spirit of dispassionate clarity into psychiatry. They were
rid from the demonological theories which swept athwart the Christian world and were
accordingly able to make clearcut clinical observations with regard to the mental diseases.”
Najab ud din Muhammad,” a contemporary of Al-Razi, has left ~ persons excellent
descriptions of various mental diseases. His carefully compiled observations near the
patients made up the ut~ complete classification of mental diseases theretofore
known.(39) Najab described agitated melancholy, obsessional types of neurosis, Nafkhae
hrlalikholia (combined priapism and sexual powerlessness). Kutrib (a form of persecutory
psychosis), Dual-Kulb (a form of madness).(40)
Ibn Sina recognized ‘physiological psychology’ in treating illnesses involving emotions.
From the clinical vista Ibn Sina developed a system on account of associating changes in the
pulse abuse with inner feelings which has been viewed in the same proportion that predating the word association
test of Jung. He is declared to have treated a seriously seriously indisposed patient by feeling the patient’s beating
and reciting aloud to him the names of provinces, districts, towns, streets, and rabble. By
noticing how the patient’s beating quickened when names were mentioned. Ibn Sina
deduced that the lenient was in love with a lass whose home Ibn Sina was able to locate
by the digital examination. The man took Ibn Sina’s word, married the girl, and
recovered from his illness.
It is not surprising to be assured of that at Fez, Morocco, an refuge for the mentally ill had been
built at dawn in the 8th century, and intellectual asylums were also built by the Arabs in
Baghdad in 705 A.D., in Cairo in 800 A.D., and in Damascus and Aleppo in 1270 A.D.40
I, adding to baths, drugs, kind and kind treatment given to the mentally with difficulty,
musico-therapy and occupational therapy were besides employed. These therapies were
highly developed. Special choirs and live music bands played daily to entertain the

patients through singing, music, and other light-hearted performances.(l3)

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Mount Sinai School of Medicine and conjoin director of the hospital's Alzheimer's Disease Research Center.

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