THE INTERPRETATION OF AVICENNA By O. C. GRUNER, M.D.

LEEDS, ENGLAND

IS some nine hundred years since the some four hundred years later than the Canon of Medicine of Avicenna first author of the Canon, he was doing for us ITsaw the light. For four hundred years what Farabi, the Sufi interpreter of Aris- it has been so little esteemed that no totle, did for Avicenna at a time when the further editions have been issued. At the latter was so anxious to discover the true present day we have translations of Hippo- meaning of the “Metaphysics.” In his crates into English, of Galen into French, youth, while searching through the contents but we have none of Avicenna excepting of second-hand bookstalls, Avicenna found the Latin editions up to 1595, of which the copy of Farabi’s book, and welcomed very few copies are to be found. Other it with delight, as proving ultimately of works by Avicenna have been recently greater value to him than all the other books translated direct from the Arabic into he had read, put together. French, and a masterly monograph on the The “De viribus cordis” occupies some man and his time was issued at Paris in twenty pages of foolscap size, closely 1900. printed in double column. Space would More important than translations is the not permit of a reproduction of the transla- matter of interpretation. Taken on their tion of the whole, but the few brief extracts face value, many of the statements of here given will serve to show the kind of ancient medicine appear useless, and the matter of which it is composed. revival of Avicenna’s writings would not The first chapter of this Libellus deals reveal very much difference from that with with “The Source of the Breath,” saying: which historians have become familiarised God caused the breath to be a vehicle for through Galen. It is not till Avicenna’s conveying the powers of the mind into the works other than on medicine are gone into, several members of the physical part of the that a new light begins to shine upon the human being. Accordingly, He brought it ancient system. There is a small treatise, about that the breath should be the rallying- called “De viribus cordis,” included in point of the forces of the mind, and at the same certain editions of the Canon (such as the time become an emanation into the various edition preserved in the McGill University tissues and organs of the body. Now He pro- Library), which provides the key by which duced the breath from the finer parts of the to interpret the greater book. And as body-fluids, and separated out the body itself Avicenna may be regarded as the fountain- from their coarser components (their earthiness) head of Arabian medicine, it provides the ... In essence, the breath is really a divine key for the proper understanding of the emanation. It can neither be added to nor taken whole of that period of history. from. Once it has been fully built up, its nature may be said to depend upon the particular Some have been disposed to regard the proportions of the various constituents and the Libellus as an interpolation. Even were it so, disposition of these components in relation to it was a wise act to introduce it into the one another; thus it depends also upon the volume. To print a cipher, and also to favour member or organ in which it occurs. It is the reader with the key, in the same volume, correct to say that the psychic, the vital and is more than fortunate. Were it really the the natural breaths derive their substance from case that the author of the Libellus lived the fine parts of the body-fluids. Nevertheless, their substance has a particular character, change of meaning assigned to this word, which depends on the relative proportions of it conveys an entirely different idea today. the component fluids and on the particular form This accounts for the fact that mediaeval which they assume after being minlged. Al- medical literature seems impossible and though the body consists of several members, even absurd to us today. The word “spirit” there is only one member underlying them. usually conveys the idea of personality with The opinions as to what this member exactly it; but the “breath” is impersonal. We is are very diverse. Yet it is true that the first must come to light before the other members shall find it used impersonally in books of can arise out of it. Eastern Wisdom, now available in English Exactly in the same way, though there are translations. several breaths in us, there is only one single The words “heart,” “liver,” “brain,” breath underlying them all—namely, that which at once suggest that the writer means arises in the heart. This breath passes from the certain viscera. But the further one goes heart to the other centres, lingering in them into the book under consideration, the until they impart to it their particular character. clearer it is that to Avicenna they are not From this moment the breath possesses the limited in this way. When he speaks of the power of linking the Person to the powers heart, he means a certain physiological which lie at his disposal. Lingering in the brain, tout ensemble—the whole arterial system, the brain imparts its character, from which whose focus is the literal heart. For him, the moment the breath acquires the power of brain is something more than the mass of sensation and motion. In the liver, this organ nervous substance in the skull. The word imparts its character to the breath and enables it for the first time to enter the cycle of metab- “liver” merely forms a convenient focus olism and growth. In the testes, these organs into which to gather the whole of the nutri- impart their character to the breath, and, the tional-complex of the body. Even had two being in joint relation, the breath enters Avicenna known all we know about the the generative cycle. microscopic physiology and pathology of the human body, it would not have In the next chapter, it is written, “the altered his conception of the function as breath is a luminous substance. It is a ray enacted in a mind-body first, and in the of light. ” physical body secondarily. And the breath From these passages it is clear that this belongs to still another plane, to which treatise on disorders of the heart approaches both mind-body and physical-body are the matter from an entirely different stand- subservient. point to that to which we are accustomed. A very simple diagram enables the reader In no part of the treatise is there any of Avicenna to perceive clearly where he mention of valvular disease, of pericarditis, stands. Three horizontal lines, A, B, and C hypertrophy or dilatation, and so forth; may be drawn, placing A farther from B but there is a careful analysis of the rela- than B is from C. C represents everything tions between the emotions and the heart’s in the phenomenal world, B represents action, a fact of interest to those who like to everything in the noumenal world, and A find analogies between modern researches represents a world beyond each. C = and the knowledge of the ancients. materies; B = substantia; A = spiritus. The whole doctrine centers on the doc- Everything on C belongs to the concrete trine of “the breath.” The Latin equivalent human body of the anatomist. And the is “spiritus,” the Greek equivalent is breath (of plane A) is conceived of as “pneumo.” and the mediaeval English is continually circulating, operating at one “spirit.” With the steady and insidious time on the components of plane B, at another on those of plane C. As we read regards this doctrine as fanciful, childish, Avicenna, we must follow his thought as he and a cloak of ignorance. No doubt it passes from plane to plane, and back again; has often been so, in practice. But it is and we must follow him with the same possible to arrive at the rationale underly- dexterity (which almost seems to be in- ing it. The elements—earth, water, fire, consequence) with which he himself passes air, ether—are forms of a vibration which from one to another during his expositions is constantly changing in amplitude in an of abstruse processes. orderly cyclical fashion, just as the breath It is easier to understand the process of changes. The elements interact with the “breath” passing from B to C, when this breath, the visible organs change according indefinable agent is understood as a form of to the change in the elements, and, through vibration which changes in degree of coarse- the latter, become the points d’appui of the ness. As the vibration becomes coarser, so “breath.” Both sides are necessary. To the more nearly is it related to substances give an instance: a change in the rhythm on plane C; as it becomes finer the more of the breath may be the beginning of a does it approach those on plane B. There loss of immunity to bacterial agents. is a continuous cycle, passing from fine Further, though the cycle of the breath is vibrations to coarse and back again. To always in action, it is not always one and those who would be inclined to doubt the same wave. Sometimes it is quick, whether such conclusions can be drawn sometimes slow; sometimes hourly, some- from the material available, an enquiry times twice a day, sometimes once a day, into Eastern philosophy may furnish the once a week, once a month, seasonal. critical evidence required. For, in many of Every family, every race, has its type of the scholarly translations produced during breath. Hence by this philosophy we have recent years, we find considerations which the key to many anomalies of human life, indicate that the ancient teachings survive as well as to pandemic diseases. and are still extant among certain schools As long as it was supposed that the in the East. Carra de Vaux, in his study of ancient elements were on a par with the Avicenna (Paris, 1900) shows the impor- modern chemical elements, there could tance of entering into the Eastern atmos- only be confusion. The elements of ancient phere before the significance of Avicenna’s medicine were on plane B. The chemical philosophy can be correctly dealt with, and elements are on plane C. “Water” is not he also provides evidence which shows that H2O. A substance may be “moist” although Avicenna was a “Sufi,” from which it it contains only an infinitestimal amount of becomes clear to the earnest enquirer that H2O in it. If the word “water” were repre- many of his terms are technical terms only sented by a circle drawn on a piece of paper, to be rightly interpreted in terms of Sufi the modern reader, from his education, philosophy. Translations of many Sufi clas- believes he should write H2O, or H, OH sics are now available, and from them we inside the circle to picture the meaning see why Avicenna should have been a of the word; but in Sufic terms, H, OH recognised master not only of medicine, should be written in a little circle inscribed but of commerce, law, philosophy and excentrically within the first circle. “Air” mathematics. ordinarily means “atmosphere;” but CO2 is Next to the doctrine of “the breath,” also “air;” even if CO2 be solid, it is still that of the “elements” is a conspicuous “air.” “Fire” is not merely flame, or heat. feature not only of Arabian medicine but The chemical group CH2 is also “fire,” and of all ancient medicine. The historian so on. This might perhaps appear to be very confusing, but closer scrutiny will 1 being minimal, five maximal, one person’s show the value of the conception. constitution may be E1W4F1A3Ae5, and Glucose, for instance, which is so impor- another’s E2W2F3A2Ae2. If these formulae tant a constituent of the human being, describe their constitution on plane B, contains two molecules of H2O, two of CO2, the former would be saintly, the latter and four of CH2. In ancient nomenclature would be pugnacious. The “fire”—element it could be described as made of two parts may be gentle in the former, explosive in of “water,” two of “air,” and four of the latter. Therefore this element reaches “fire” bound together by a cohesive force; its climax in a moment in the latter, and this force may be neutralised by another of may take weeks to do so in the former; by opposite magnetic sign. In this way the that time all need for action may have “air” may be liberated, and the other two dissipated, and the equable temperament remain coherent, as occurs when alcohol is of the saintly person prove a source of formed from it, the once-named “fire- admiration to one who is irascible. water.” Although the internal molecular The application of the doctrine of tem- arrangements are more intricate, so that perament, of constitution, to the science of this comparison contains important inac- pharmacology appears in the ninth chapter curacies, it is also true that the ancient of the “De viribus,” where the properties “elements” are not ponderable. One cannot of medicines are discussed. The plants are reduce them to chemical equations. But the regarded as sharing in the general law of illustration is applicable in a certain sense. temperament, and the relations between The subject of “constitution” also forms their active principles and the successive a conspicuous feature of the ancient medi- planes of the human organism are viewed cine. This word is also liable to misinterpre- on the same lines. The interaction between tation through believing all physiological drugs and emotions can hardly be gainsaid, questions belong to plane C of the diagram and is certainly entirely out of the range of given. There is a constitution on plane C, physiological recording-apparatus, except and there is a constitution on plane B. The perhaps the electrocardiogram. Avicenna latter is the outcome of the arrangement of sees everything on plane B, and thus comes the “elements.” There is also a constitution to be reasonable instead of, as hitherto, an on plane A, since the breath has a constitu- expositor of things obviously at variance tion. As Avicenna says: “Although it is with “facts” known to us. The “facts” true that the same person can be sad and are the tangible things belonging to glad, yet one person has a cheerful disposi- plane C. tion, another is a pessimist. It is altogether It would lead too far to take up many of a different thing to pass one’s life in a body the conceptions which we find in the pages whose breath has a glad tendency, to of the Canon, and show how they can be passing one’s life in a body with a depressed translated into modern language. Nothing or morbid disposition.” A “moody” person short of a voluminous exposition would is one whose breath changes more rapidly, suffice to demonstrate the fundamental and also causes a greater change in the accuracy of this ancient Master of Medicine. constituents belonging to plane B. Saintli- Although there is one master-key, that of ness of disposition is therefore the attribute “the breath,” which is necessary to unlock of a certain formula of breath. For instance, the treasuries of the past, there are several representing the component elements by other keys which are necessary to open the the initial letters, and representing the doors beyond the central hall of the treasure- relative proportions in terms of grades 1-5, house, as it were. All these keys can be found once it is believed possible that the However, all periods of the history of great minds of the past were perfectly sound, medicine hang together. Rather may one but they are elusive to those who believe that see them all as successive chapters of one every mind of the past was unintelligent, single book, in which no one chapter is and not as evolved as the minds of today. better or wiser than another, than regard While modern science brings to light more them as discrete periods, or as struggles of a and more details about entities in their groping humanity towards light. The spirit concrete phase, Avicenna was quite familiar of the human race has always known the with them in their abstract phase. Even truth, but at each epoch it has developed granting that the number of those who first one aspect, then another. When all really understood his Canon may have been parts of the one truth have been duly small, so that, in a sense, Arabian Medicine surveyed, then we, who stand at that point was not continuously as enlightened as its of vantage, can piece it all together, and founder, it becomes clear that it was part approach the masters of the past in order to of a great treasury of knowledge which gather together all the seemingly isolated opens out more and more to the enquirer fragments into one true and complete who is willing to adopt the Sufi mode of picture of the nature of health and disease. viewing the world of Nature. In doing so, the searcher after truth After this, we can look down the vista of perceives the wisdom of the words of the medical history, and perceive that for Sufi Persian poet, when he speaks of the certain periods of time, minds were directed “hair dividing the false from the true.” It first at one aspect of the human being, is not that one thing is false in itself, and then at another. As one generation passed another true in itself. As soon as one stands away the next lost touch with the dominant between the two, one is enabled to observe conception held by its parents. The doc- that there are things on one plane, or on trine of the “pneuma” held the minds of another, and that it is only a matter of view- those who sought to explain all processes point, or even of description, that enables in terms of the “breath,” and neglected one to regard one as definitely false, and the other aspects of the complete entity, the other as equally definitely true. People man. The period of the “humoral theory” who are confined by habit of thought to one was one where attention was concentrated plane will believe the others false, and on the humours, trying to find out more and conversely. There is a proper place for more about them, trying to make them each, and the best place is to be between the more and more concrete. In doing this two. The study of Avicenna as a great Sufi they abandoned the truth of the Pneuma work brings a glimpse of this position. and in fact believed it to be a false doctrine. Hence, however false the great system of Then the period of “cellular pathology,” ancient Eastern Medicine may seem to us, of today, concentrates all attention on the the science of the West can receive nothing workings of tissue-units; some admitting but gain from ripening an acquaintance the part played by the sera, and therefore with her, and even if the two finally cele- allowing the “humours” to a certain extent, brated their nuptials, no doubt it would others placing this aspect as much in the only bring to light that one harmonious background as possible; all ignore the whole, the complete story of the nature “breath.” The vitalist of an earlier age falls of the human body, which all desire to into discredit, in consequence. realise.