Arch Iranian Med 2008; 11 (2): 229 – 234

History of Ancient Medicine in Iran

Zakariya Razi The Iranian Physician and Scholar

Touraj Nayernouri MD•*

Introduction ccording to Biruni,1 Abu Bakr historians as to where and from whom Razi gained Mohammad Zakariya Razi (Latin his medical knowledge but both ‘Jamal al-din al A Rhazes) was born in Rayy (an ancient Ghefti5 and ‘Ibn Abi Usaibia’4 mention that his town south of present day Tehran) in the year 865 teacher was ‘Ali Ibn Rabban Tabari’ which is C.E. (251 A.H.) and died there in 925 C.E. (313 almost certainly incorrect, as ‘Tabari’ died at 861 A.H.) or a few years later at the age of 60 or so. C.E. (247 A.H.) while Razi was not born until 865 As Biruni mentions in his “Catalogue”, Razi C.E. (251 A.H.). It is possible, however, that Razi spent his youth as an alchemist but around the age had studied Tabari’s medical texts (such as of thirty, due to failing vision, gave up alchemy ‘Ferdows al Hakameh’) and thus he had referred to and started his career as a physician. him as his teacher of medicine. There is scant information available regarding In the same vein, his teachers in alchemy and Razi’s personal life, but it seems that he played the philosophy have been recounted as ‘Jabber Ibn lute in his youth2 and wrote an encyclopedia of Hayyan’ and ‘Abu Zeid Balkhi’, respectively music. 3 which I shall discuss later in the appropriate At that time, he was apparently a goldsmith by sections. profession and as Ibn Abi Usaibia recounts in his It is uncertain whether Razi acquired his “Lives of the Physicians” (1245 C.E.) he had come medical knowledge in Rayy or Baghdad but it is across an old manuscript of “Kitab al-Mansuri fi well known that he spent at least ten years Tebb” hand written by Razi himself in which he between 896 (282 A.H.) and 906 C.E. (292 A.H.) had inscribed the title of the author as “Mohammad during the reign of the Khalif ‘Motazed Abbasi’ in Zakariya al Razi al-Seirafi (the goldsmith).4 Baghdad and that he was the chief physician of the During the period of his life that Razi spent as a ‘al-Motazedi’ Hospital. goldsmith, he performed a great deal of research as On his return to Rayy, he was appointed as the an alchemist and in fact laid the foundations of chief physician of the hospital there by the ruler of scientific chemistry having written several books Rayy ‘Amir Abdu Saleh Mansour Ibn Ishagh’.5 and treatise in the field. During this period he formed a close From the age of thirty, when Razi started his relationship with ‘Amir Mansour’ as his physician medical career, he wrote many books and articles and companion and wrote his book ‘Tebb-e in that field for which, he later became renowned Mansouri’ for him as well as the book ‘Tebb-e in the world, but his writings on chemistry and Rohani’ on his request. philosophy attracted little attention until recently. In the year 903 C.E. (295 A.H.) ‘Amir There is a difference of opinion between Mansour’ went to the town of Neishapur as the ruler of Khorasan Province and was accompanied by Razi. Author’s affiliation: Academy of Medical Sciences of I.R. of It is of interest to note that the historian Iran, Tehran, Iran. 6 •Corresponding author and reprints: Touraj Nayernouri MD, ‘Nezami Arouzi Samarghandi’ in his book Academy of Medical Sciences of I.R. of Iran, Tehran, Iran. ‘Chahar Maghaleh’ has incorrectly reported this Telefax: +98-212-293-8051, journey as to Fararood (Transoxania) and the name E-mail: [email protected] Accepted for publication: 12 January 2008 of the ruler as ‘Mansour Ibn Nooh’.

Archives of Iranian Medicine, Volume 11, Number 2, March 2008 229 Zakariya Razi The Iranian physician and scholar

Mahmood Najmabadi has written in his to be inaccurate or incomplete. ‘History of Medicine in Iran’2 that Razi was blind Razi wrote several books and treatise criticizing and miserable for the last few years of his life and and questioning the writings of his predecessors. haunted by his opponents such that he was In the introduction to his book ‘Doubts about unwilling to undergo surgery for the possible Galen’ he writes: return of his eye-sight and that he tells his student “Everyone is aware of the authority and the that “supposing you performed surgery and I could status of Galen in medical matters and thus some once again see this world, yet I feel so less gifted individuals have been outraged by my disappointed by it that I have no wish to do so”. criticism of him, but the wise and the sage shall not think less of me for they know that in science and Razi’s writings philosophy, imitation is not wisdom but that reason Najmabadi7 mentions two hundred and seventy- and logic must guide ones thoughts and if Galen three of Razi’s books and treatise in the fields of was alive today he would have praised me for this medicine, pharmacology, alchemy, philosophy, writing”. cosmology, and theology which he has extracted And later in the same introduction he writes from the lists of ‘Ibn Nadim’,8 ‘Biruni’,1 al Ghefti,5 that “…In medicine and philosophy blind and ‘Ibn Abi Usaibia’.4 But unfortunately only a obedience and surrender to authority is few of those writings are extant today and the rest unacceptable and Galen himself had chastised are only mentioned or referred to in the writings of those who attempted to impose their opinions on others. their students without reason or logic.10 In this article, I shall refer to only a few of Of further significance is that Razi changed the Razi’s writings in the fields of medicine, alchemy, classical theoretical medicine into an empirical and and philosophy in order to throw some light on his experimental one as evidenced by his thirty- three achievements in the history of scientific thought. case histories which he describes in ‘al-Hawi’. He kept individual files for each patient and made Medicine daily notes recording the progress of their disease Razi’s most influential book on medicine is ‘al- and their response to the treatments prescribed.7 Hawi’ known in Europe as ‘The Large Razi also initiated the ‘Residency System’ of Comprehensive’ or ‘Liber Continens’, which was teaching medical students such that he conducted in effect an encyclopedia of medicine composed of clinical rounds in the hospital with his students as more than twenty volumes which, in Razi’s life well as an ‘out-patient’ clinic. time, was probably in the form of scattered notes As ‘Ibn Nadim’ recounts in his ‘al Fihrist’8 and and was compiled posthumously by his students is mentioned in Edward Browne’s ‘Arabian into a single complete work. According to Medicine’9 that “…Razi is an elderly man with a Professor Edward Browne in his book ‘Arabian large head. When he sits at his place, his students Medicine,9 there is probably no complete copy of sit below him and further down their students take this work extant today and as even ‘Ali Ibn Abbas their place. When a patient arrives he is attended Ahwazi Majoosi’ (Haly Abbas as he was known in by the first group of students. If they are unable to the West) wrote only fifty years after Razi’s death, diagnose and treat him, he attends the higher tier of that he was aware of only two complete copies of students until finally Razi gives his pronouncement ‘al-Hawi’ existing in his day. and discusses the problem…”. This book was a main medical text taught for A further innovation of Razi was his method of several centuries at medical schools in the Islamic experiment and observation in medical treatment. East as well as medieval Europe, together with An example is from his twentieth volume of Galen’s works and Avicenna’s ‘Canon of ‘al-Hawi’ where he is describing the medicinal Medicine’. properties of rice. After he describes the opinions The significance of ‘al-Hawi’ is that Razi of ‘Dioscorides’, ‘Galen’, and ‘Ibn Massouyeh’ he compiled the medical opinions of his predecessors relates his own experience thus “…I tried the such as Hippocrates and Galen regarding each effects of rice on a group of people of thin disease and their treatments in a systematic fashion physique with a warm temperament and noticed and then added his own meticulous clinical that it caused an inflammation in their body. One observations and experience, correcting the of that group was myself”.11 opinions of his predecessors where he found them Abdolhamid Nayernouri in his book ‘Iran’s

230 Archives of Iranian Medicine, Volume 11, Number 2, March 2008 T. Nayernouri

Contribution to the World Civilization’12 writes treatise were written by Iranians, Syrians, and Jews that “…in fact Razi was probably the first and to a lesser extent by Greeks and only an physician who used animal experimentation to test insignificant number of them were actually written the effects of novel treatments and if they had no by Arabs.” untoward effects in the animal he would prescribe In the Middle Ages when the Europeans came them for his patients”. into contact with the Islamic empire, they Razi writes that “…as far as I am aware, pure translated many works of science and philosophy mercury can not be dangerous but causes severe from Arabic into Latin and thus called all the abdominal pains and is excreted unchanged. I gave Islamic scholars that had written in Arabic as some mercury to a monkey that I used to keep in ‘Arabs’ whereas they were mostly Iranians. my house. The poor animal gritted his teeth and This practice seems suspiciously strange since was squeezing his abdomen with his hands…” no European scholar who wrote in Latin in all of After this experiment Razi prescribed pure Christendom was ever referred to as a ‘Latin’ or mercury for several of his patients with ‘lower ‘Christian’ but were all known by their country of intestinal blockage”. origin. Amongst Razi’s other important works in As Dr. Cyril Elgood mentions in his ‘History of medicine, apart from ‘Tebb-e Mansouri’ which Medicine in Iran’3 Razi’s ‘al-Hawi’ (‘Liber was mentioned earlier, there are several which Continens’) was translated into Latin in 1297 C.E. were translated into Latin during the Middle Ages by ‘Faraj Ibn Salem’ for Charles the king of Anjou and brought him fame in Europe. and it was later printed several times from 1486 In his book ‘al-Judari wa al-Hasbeh’ (smallpox C.E. onwards. and measles) Razi described for the first time the This book and the ‘Canon’ of Ibn-Sina were differential diagnosis between smallpox and taught as the standard medical texts in European measles and furthermore he gave a description of medical schools for almost seven centuries. chicken pox. Professor Edward Browne names four great This book was translated into Latin by Valla ‘Arab’ (or Muslim) and I have added a fifth, Venezia in 1498 C.E. and then through the next physicians who lived during the two centuries (10th few centuries into English and French and was – 12th C.E.) which orientalist scholars describe as later printed in Basel, Gotingen, London, and Paris the ‘golden age’ of ‘Arab’ or ‘Islamic’ medicine. through at least forty editions. 1. Ali Ibn Rabban Tabari, the author of ‘Ferdows In a small treatise named ‘Resaleh Shamieh’ or al-Hakameh; ‘the sense of smelling’ which he wrote in response 2. Mohammad Ibn Zakariya Razi; to ‘Abu Zeid al Balkhi’s request Razi described 3. Abu Sahl Ishag Ibn Yahyay Massihi Gorgani; allergic rhinitis due to smelling roses at spring 4. Ali Ibn Abbas Majoossi Ahwazi (known in the time. West as ‘Haly Abbass’); and 5. Abu Ali al-Hosseini Abdollah Ibn Sina, the Arabic Medicine and Razi’s fame in Europe author of ‘Cannon of Medicine’. Professor Edward Browne gave a series of In reality all these physicians were Iranian. lectures at Cambridge University in 1921 which was published as a book entitled ‘Arabian Alchemy and the science of chemistry Medicine’.9 This book was later translated into Hassanali Sheibani in his introduction to the Farsi by Massoud Rajabnia who changed the title translation of Razi’s ‘al Madkhal al-Taalimi’14 to ‘Tebb-e-Islami’ or ‘Islamic Medicine”.13 gives a list of twenty-four books and treatise Edward Browne writes that “I have used the written by Razi on alchemy of which only four term ‘Arab civilization’ in preference to ‘Islamic books and two chapters from another are extant civilization’ for reasons that I shall give bellow. As today. Latin was the language of science and culture in These four books are: ‘al Madkhal al-Taalimi’, Europe during the Middle Ages, so was Arabic the ‘Shavahed, ‘Assrar’, and ‘Seir al-Assrar’. language of science and culture in the Islamic One of Razi’s innovations in chemistry was that world and thus it must be noted that the terms he classified matter (Aghaghir) into three groups ‘Arab science’ or ‘Arab medicine’ are terms viz. ‘Ajssad’ (solids), ‘Miah’ (liquids); and applied only to what was written in Arabic and has ‘Arvah’ (Gases) and subdivided naturally no other implications. Most of these scientific occurring matter into animal, vegetable, and

Archives of Iranian Medicine, Volume 11, Number 2, March 2008 231 Zakariya Razi The Iranian physician and scholar mineral. Naser Khossrow, an Ismaeelieh theologian, He then described chemical compounds or reacted to these principles vehemently, writing that ‘Mavalid’ and wrote the techniques for making “…there can not be a fowler statement as to metal alloys. consider the creator on par with his creation”.17 As is evident from his books ‘Madkhal al Regarding the soul, Seyed Hossein Nasr writes Taalimi’ and ‘Assar’ unlike his predecessors who that “Razi’s theory of the soul, in contrast to other cloaked their alchemical writings in a shroud of aspects of his philosophy, which have a mystery and occult practices, Razi expounded his ‘materialistic’ tinge, reflects mystical methods in a simple and clear fashion. interpretations of the entanglement of the soul in He described his alchemy in three sections viz: the prison of the body”.18 knowledge of chemical substances; knowledge of As for ‘Hayoola’ or matter, Razi had an original instruments; and knowledge of its methods atomistic theory rather different from the atomism (Tadbir) to achieve specific chemical reactions. of Democritius, asserting that this world of matter It has been due to the great scholarly efforts of has been created out of the mixture of the original Paul Kraus,15 J. Ruska,16 and Hassanali Sheibani,14 eternal atoms and thus producing the five elements in the midtwentieth century that the chemical of this world. theories and practices of Razi have been This concept seems to have arisen from the rediscovered, translated, and publicised. Zoroastrian belief that ‘Minoo’, the spiritual world Hassanali Sheibani writes in his introduction to is eternal, whereas ‘Geety’, the material world, has the book of ‘al Madkhal al Taalimi’14 that by been created from the preexisting elements of the transmutation, Razi meant changing the physical former. properties of some metals by forming alloys and As opposed to Plato’s ideas, Razi believed that not necessarily the alchemical dream of the precedence of the spiritual world to that of the transmutating base metals into gold. And he further material world does not imply the superiority of writes in that same introduction that Razi took that the former to the latter but that the material world first significant step of changing alchemy from an is the product of an ‘evolution’ from the spirit to occult practice into the logical and empirical this more complex form, and as Razi says “…in science of chemistry. the universe nothing new comes forth but from It seems that Razi had studied the alchemical some preexisting thing”. writings of the ‘Haranian’ and ‘Sabeiin’ without It might be of interest that very similar regard that these people were considered as principles were expounded by Leibniz, including infidels and thus he would be criticized severely his concept of monads, in the seventeenth century. for having done so. In fact some scholars believe Razi distinguished between absolute time, that Razi pretended that these treatise were in fact which he developed from the Zervanistic notion of written by ‘Jabber Ibn Hayyan’ in order to escape eternal or ‘unbound’ time (Akarnea) and ‘limited’ such accusations and hence it may be for this time which according to him resulted from reason that some believe that ‘Jabber’ was in fact ‘…measuring the movement of stars and the rising his teacher in alchemy. and setting of the sun’. He also distinguished between an absolute Philosophy and metaphysics unbound space as opposed to a limited one in Razi’s significance in philosophy was his which the observable universe existed, which is not individual approach to metaphysics, which in dissimilar from the Newtonian concept of space. contrast to most of his contemporaries, opposed Such questions as whether the universe is those of Aristotle and thus caused great eternal (Ghadim) or has been created (Hadess) controversies during his life and for centuries have occupied philosophers since his time through thereafter. His philosophical works have been the middle ages and still continues to vex rediscovered only recently and again through the philosophers as well as cosmologists. efforts of Paul Kraus.15 The essence of his metaphysical thoughts were Razi’s personality crystallized in his concept of the five coexisting But what of Razi as a man? What did he think principles. and what ideals did he adhere to? These five principles were the Creator, the It might be possible to tease out from between Soul, Matter, absolute Time, and absolute Space. what little the historians have said of him, from his

232 Archives of Iranian Medicine, Volume 11, Number 2, March 2008 T. Nayernouri own writings, and from what his opponents have believed in the power of reason which forced him criticized in him, a sketch of his personality. to battle against the dark forces of prejudice, What is certain is that he was studious to the superstition and religious dogma which was rife in extreme. his world? ‘Ibn Nadim’ in his catalogue ‘al Fihrist’ quotes As mentioned above he had written several ‘Mohammad Hassan Varragh’ saying that Razi treatise criticizing Galen and Aristotle in certain ‘…was never separated from his books and his aspects of their medical and philosophical opinions writings and whenever I visited him he was always and he also wrote several books opposing the busy reading or writing”.8 thoughts of his contemporaries including ‘Shahid Razi himself has written in his ‘al-Seiratol Ibn al Hossein Balkhi’, ‘Abu Abdolah Ahmad Ibn Falsafiah’ that “…my quest for knowledge and my Ibrahim Moaddab Motakalem’, ‘Mohammad Ibn lust for learning has been such that since my youth al-Laiss al Rasseli’; and several others. I have dedicated my life to it and if it happened The only contemporary philosopher who that I had not read a book or met a scholar I would escaped his venom was that same ‘Abu Zeid not rest until I had achieved my goal and my Balkhi’, for whom he had written the treatise on efforts were such that on several subjects I have his allergy to the smell of roses in spring and from written up to twenty thousand pages in small script whom he had acquired his Neo-Pythagorean ideas, and have dedicated fifteen years of my life to the although philosophically their thoughts were compilation of ‘al-Hawi’, and for these reasons my diametrically opposed. It is this same ‘Balkhi’ who sight has deteriorated and the muscles of my hands is reported to be Razi’s teacher in philosophy. have weakened which has prevented me from Razi in his ‘al Seriat al Phalsaphia’ writes reading and writing and yet my thirst for “…and so if what I have said concerning practical knowledge remains unquenched and I have others philosophy lowers my esteem in the eyes of my to read and write for me’. opponents and they wish to pursue a different path His kindness to his patients and his generosity then I wish that they would show me so that if it be to the poor have been documented by several superior to my way I shall adopt it or if I should historians including ‘Ibn Nadim’.8 find faults with it that I may advise them”. In medicine he introduced a systematic “In practical matters I can accept that there may classification of diseases and their symptoms based be different and better paths than that which I have on empirical observations and experimentation and chosen and I can concede to my opponents. But he changed alchemy from an occult and what of my scientific thoughts”? superstitious practice into a rational and practical “I beseech those that find my science and science. philosophy incomplete or offensive that they Razi’s importance in the history of science is should advise me and if I find their thought not merely that he discovered alcohol, sulfuric acid superior I shall admit so and will correct my and ammonium chloride nor that he described and thoughts and if I find theirs incorrect I will advise differentiated measles and smallpox or allergic them but if otherwise then let them forgive me my rhinitis for the first time, but it is of greater way of life, and leave me in peace yet I hope that significance that he based his scientific opinions on they may at least accept my science’’. a rational and empirical methodology similar to Despite all this, Razi was never left in peace that which Francis Bacon introduced in European and was constantly harassed and hounded by thought in the seventeenth century. religious extremists and men of much less caliber His crusade against prejudice and superstition than he. under the social and historical circumstances of his And so in conclusion, who was Razi? What did time is salutary. he say? And what did he achieve? He had written three treatises concerning why Razi was an Iranian scholar and a liberal thinker ignorant and superstitious people seek medical from Rayy. treatment from unqualified practitioners and He never accepted irrational thoughts and was witches as opposed to trained physicians. constantly battling ignorance and superstition. And finally, was Razi belligerent and quarrel- He upheld systematic reasoning and logical some considering all the books and treatise that he rationality and innovated empirical and wrote against the opinions of his predecessors and experimental sciences of chemistry and medicine. contemporaries or was he merely a rationalist who His conduct was gentle and kind and his

Archives of Iranian Medicine, Volume 11, Number 2, March 2008 233 Zakariya Razi The Iranian physician and scholar mentality wise and discerning. Tajaddod is the translator] He was a scholar and truly a universal man. 9 Browne EG. Arabian Medicine. Cambridge: Cambridge University Press; 1921. Unlike Newton, Razi had no shoulders to stand 10 Azkaei P (Spitman). Rhazes the Sage [in Persian].Tehran: upon, yet he managed to see further than most of Tarhn-e-No Publishing; 2006: 136. his contemporaries. 11 Mohammad Ibn Zakariya Razi. Al-Hawi. Vol 20. Tehran: Academy of Medical Sciences of I.R. of Iran; 2006. [ References Mohammad Ibn Zakariya Razi is the author; Soleiman Afsharipour is the translator] 1 Abu Rayhan Biruni. Catalogue of Books of Mohammad 12 Nayernouri AH. Iran’s Contribution to the World Ibn Zakariya Razi [in Arabic]. Paris: Paul Kraus; 1936. Civilization. Tehran: Ministry of Culture and Arts Press; [Abu Rayhan Biruni is the author; Paul Kraus is the 1971. editor] 13 Browne EG. Islamic Medicine [in Persian]. Tehran: 2 Najmabadi M. History of Medicine in Iran After Islam [in Nashr Ketab; 1988. [ Browne EG is the author; Masoud Persian]. 3rd ed. Tehran: Tehran University; 1996: 330. Rajabnia is the translator] 3 Cyril Elgood. A Medical History of Persian and the 14 Mohammad Ibn Zakariya Razi. Al Madkhal al Taalimi Eastern Caliphate. Cambridge: Cambridge University [in Persian]. Tehran: Tehran University; 1967. Press; 1951. 15 Mohammad Ibn Zakariya Razi. Opera Philosophica. 4 Ibn Abi Usaibia. Uyun al Anba fi Tabagaqat al Atebba Cairo: Pars Prior; MCMXXXIX. [ Mohammad Ibn [in Arabic]. Beirut: Asdar Dar al-fekr; 1965. Zakariya Razi is the author; Paul Kraus is the Editor] 5 Jamal aldin al Ghefti. Akhbar al Ulama be Akhbar al 16 Ruska J. Al-Biruni als Quelle fur das Leben une die Hokama [in Arabic]. Leipzig: Julius Lippot; 1903. Schriften al-Razi’s. Isis. 1924; 5: 26 – 50. 6 Ahmad Ibn Omar Ibn Ali Nezami Samarghandi. Chahar 17 Azkaei P (Spitman). Rhazes the Sage [in Persian]. Maghaleh [in Persian]. Leyden: Brill; 1327 A.H. Tehran: Tarh-e-No Publishing; 2006: 386. 7 Najmabadi M. History of Medicine in Iran After Islam [in 18 Nasr SH. Philosophy and Cosmology. In: Frye RN. The Persian]. Tehran: Tehran University; 1996: 357. Cambridge History of Iran. Vol 4. Cambridge: 8 Ibn Nadim. Al Fihrist [in Persian]. Tehran: Ibn Sina Cambridge University Press; 1975: 424. Publishing; 1964. [Ibn Nadim is the author; Reza

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