THE MILLENNIUM OF AR-RAZI (RHAZES)* (850-932 A. D.?) By L. M. SADI, M.D.

DETROIT, MICH.

Truth and certainty in medicine is an aim I once asked an old man of the town of difficult to attain and the healing art as it is Ray about Ar-Razi’s clinic. He said that described in books is far inferior to the prac­ Ar-Razi was a serious old man with a tical experience of a skillful and thoughtful large, drooping head who seated his physician. [Ar-Razi.] pupils in rows according to their grades fr ^HE exact date of Abu Bakr and attainments. It was Ar-Razi’s custom Muhammad ibn Zakariyya to call first upon the lower class to ex­ Ar-Razi’s birth is not known, amine a patient when he reported to the —IL but it is believed to have clinic. If this class failed to diagnose the occurred in the second half of the patient’s ailment he was handed over to ninth century at Ray of Iraq Ajemi. the next higher class, and only after the malady had eluded the knowledge of all The date of his death is generally the disciples did it come to the master’s accepted as 320 a.h. which cor­ attention.1 responds to 932 a.d. Hence this year is his Millennium. In his early life This system of clinical teaching was he was a student of music, a physicist probably an innovation of Ar-Razi’s and an alchemist. Not until the age and presents a striking similarity of forty did he undertake the study to the grading system used today of medicine. His decision to do so was in western medical teaching. the result of his frequent visits to the Having become renowned Ar-Razi hospital of Adudu’d-Dawla and his was called by Adudu’d-Dawla to contact there with the aged dean be the chief physician in the hospital of pharmacists whom he questioned at Bagdad, the final choice of fifty ceaselessly about medical curiosities. qualified applicants for the position. His tutor in the healing art was When a site for the Bagdad Hos­ Ali-ibn-Rabban of Tabaristan whose pital was to be selected Ar-Razi book, “Firdaws al-Hikmat” (Para­ determined it in an interesting way. dise of Wisdom), a treatise on medi­ He hung pieces of flesh in different cine and philosophy, was used as a sections of the city and in that text by Ar-Razi. Ar-Razi then applied district where the flesh showed the himself to the study of medicine and least amount of putrefaction, he lo­ philosophy, reading the works of cated the hospital.* Galen and Hippocrates and also ac­ Ar-Razi’s work, which exceeds two quainting himself with Hindu authors. hundred volumes, includes treatises His knowledge of physics and chem­ on philosophy, chemistry, physics, istry was a great asset to him. For astronomy, mathematics, theology, a while he was made physician-in- music and other subjects. chief to the hospital in his native * Usaybi’a doubts Ar-Razi’s being a contem­ city, Ray. In the Fihrist, Muham­ porary of Adudu’d-Dawla. Usaybi’a’s “Uyun- mad Ibn Hasan al-Warraq is quoted al a’nba,” Arabic edition by Imra-I-Quais-al- as saying: Tahhan. Cairo, Egypt, 1882, 1: 310. *Read before the Journal Club of Detroit College of Medicine and Surgery, November 12, 1932. As it is beyond the scope of this Stones in the kidneys and bladder paper to give a full account of his Reduction of fractures authorships, only a few of his works, Hospitals (their requirements) those that are of medico-historical Hemorrhoids, fistula in ano interest, will be mentioned *here. Burning occurring in the urethra These are as follows: and bladder (Gonorrhea?). Kitabu’L-Hawi or (Continens) Among the chemical treatises, the Al Mansuri (Liber ad Almansorem) “Arcandorum liber” is said by Sarton Kitab al-Jadari Wal-hasba (De Var­ to contain a description of a list of ious et Morbillis) twenty-five pieces of chemical ap­ or (De Peste or De Pestilentia) paratus. He further states that Ar- (monograph on Smallpox and Razi attempted to classify chemical Measles) substances and carried on original in­ Ja’mi (Compendium) vestigations on specific gravity by Kafi (Sufficient) means of the hydrostatic balance.2 Madkhal (Introduction) a. Lesser “Al-hawi” (Continens) b. Greater The work that heads the list, Muluki (The Royal) “AI-Hawi” (Continens), excells all Taksimu-I’ilal (Division of diseases) previous Arabic medical literature. (Divisiones) It was not only Ar-Razi’s most ex­ Fakhir (Splendid) f tensive work, but in it his originality The medicine of the laity. in diagnosis and treatment of diseases On venesection (De venoe-sect’ons) struck a new note in contrast to the A treatise on eye diseases with previous work of Arabic physicians medicine and treatment which consisted mostly of translations An essay on the contraction and from Greek authors. Its style, how­ dilatation of the pupils in light ever, lacked clarity, and its method and darkness. of classification was imperfect. It Also individual books on: embodied his clinical notes which Dietetics were evidently meant only for his own Colic use. Absorbed in his clinic, he prob­ Paralysis (hemiplegia) ably left the compilation of these notes Facial paralysis and remarks to some of his students. The functions of the organs The “Continens” is found only in Essay on rose fever f parts today in several European libra­ Coryza and bronchitis ries and is hardly accessible beyond * A complete list of his work is to be found the wall of these institutions. Authori­ in Ibn-Abi-Usaybi’a’s “Uyun-al a’nba,” Tari- ties differ widely on the number of khuI-Hukma, and Fihrist. Also see Isis, 5: books which it contained. Some of the 26-50, 1923. Latin writers claim that it consists t Authorship is not certain. See Ibn-Abi- of twenty-five volumes, some thirty Usaybi’a’s “Uyun-al a’nba,” Arabic edition by Imra-I-Quais-al-Tahhan Cairo, Egypt, and some, thirty-seven; on the other 1882, 1: 318. hand, the Arabian authors agree on * Ar-Razi observed that a certain Abu- Zaid-al-Balkhi was afflicted with it every “Uyun-al a’nba,” Arabic edition by Imra-I- spring season when the roses bloom. Usaybi’a’s Quais-al-tahhan Cairo, Egypt, 1882, 1: 319. twelve.* Ali Abbas, the magi, in his quartan, and sometimes recurring once work (“Kamil-AI-Sinaat”) describes in six days. These attacks were preceded the “Continens” as: by a slight rigor, and micturition was very frequent. I gave it as my opinion . . . very comprehensive, in that it con­ that either these accesses of fever would tains everything necessary for the student turn into quartan, or that there was of medicine to know in remedying ulceration of the kidneys. Only a short diseases and ailment. But it fails in while elapsed ere the patient passed pus treating temperaments, humor, anatomy in the urine. I thereupon informed him and surgery. The material is unsystem­ that these feverish attacks would not atically compiled. It lacks the classifi­ recur, and so it was. cation necessary for scientific work, which The only thing which prevented me at is expected from so eminent an author. first from giving it as my definite opinion It seems to me, knowing the author as I that the patient was suffering from do, that he intended one of two things: ulceration of the kidneys was that he either that the work be a memorandum had previously suffered from tertian and for his own use, fearing that something other mixed types of fever, and this to might happen to his other works and in some extent confirmed my suspicion that case that the “Continens” might that this mixed fever might be from then suffice for all; or he may have in­ inflammatory processes which would tend tended it to remain as a monument of his to become quartan when they waxed achievement with the expectation of stronger. resuming its revision and classification Moreover the patient did not complain later on. Something must have hindered to me that his loins felt like a weight him, and death terminated his life too depending from him when he stood up; soon for the completion of the task.3 and I neglected to ask him about this. The frequent micturition also should “Continens” was translated into have strengthened my suspicion of ulcera­ Latin and published in i486 a.d. and tion of the kidneys, but I did not know later was given many other Latin that his father suffered from weakness of renditions. So far as we know no the bladder and was subject to this com­ complete Arabic manuscript of it is plaint, and it used likewise to come upon extant, but six volumes of the work him when he was healthy, and it ought in Arabic are treasured in the British not to be the case henceforth, till the end of his life, if God will. Museum and the Bodleian Library. So when he passed the pus I ad­ To these, Edward Browne, Professor ministered to him diuretics until the urine of Arabic at Cambridge University, became free from pus, after which I had access, and from this material treated him with terra sigillata, Boswellia he translated the following case report thurifera, and dragon’s blood, and his which may serve as a sample of Ar- sickness departed from him, and he was Razi’s clinical notes: quickly and completely cured in about two months. That the ulceration was Abdu’IIah ibn Sawada used to suffer slight was indicated to me by the fact from attacks of mixed fever, sometimes that he did not complain to me at first quotidian, sometimes tertian, sometimes of weight in the loins. After he passed pus, however, I enquired of him whether * The Fihrist in enumerating Ar-Razi’s books and essays states that the “Continens,” he had experienced this symptom and he his major work, consists of twelve volumes. replied in the affirmative. Had the Fihrist, Arabic edition by Mustafa Muham­ ulceration been extensive, he would of his mad, Cairo, Egypt, 1348 a. h., 1: 415. own accord have complained of this symptom. And that the pus was evacu­ popular was the ninth book which ated quickly indicated a limited ulcera­ describes the treatment of diseases in tion. The other physicians whom he general. Many well-known medical consulted besides myself, however, did men of the Latin West have written not understand the case at all, even after commentaries on “ AI-Mansuri,” using the patient had passed pus in his urine.4 it as a textbook for their students. In this case report and in others, Now it behooves us to leave the Ar-Razi by emphasizing the case Latinist and turn to the Arabian history, symptoms and signs of dis­ authors. The Fihrist5 mentions “AI- ease, by making a differential diag­ Mansuri” before the “Continens” nosis between a fever due to malaria and notes that “AI-Mansuri” con­ and one due to pyelitis, by shunning sists of ten volumes. theoretical speculation so customary Ibn Khallikan6 stated clearly that in that time, proves himself to be he had seen with his own eyes a copy the greatest clinician of the Middle of “AI-Mansuri” dedicated to Mansur Ages. Ibn Ishaq, the ruler of Khurasan. Usaybi’a agrees with ibn Khallikan “ KiTABU’l-MANSURI ” on the whole that the Arabian authors “ Kitabu’I-Mansuri,” which ranks speak cursorily of “AI-Mansuri” and in importance next to “AI-Hawi” are in agreement as to its contents. (Continens) was dedicated to AI-Man- The Arabic text of “AI-Mansuri” sur Ibn Ishaq, the ruler of Khurasan. has never been published. It is found It is encyclopedic in its classifica­ in parts in manuscripts only in the tion somewhat after the “Canon” of libraries of Dresden, Madrid and Avicenna. Evidently it was written Oxford. It was given a Latin ren­ prior to the Treatise on Smallpox dition by Gerardus Cremonensis and and Measles. The Latinists agree that was published for the first time in the book consists of ten volumes. Milano in 1481. Many editions ap­ Their subjects are as follows: Physiol­ peared thereafter. The ninth book ogy and anatomy; Temperaments; was especially favored. Several com­ Food and simple medicine; The means mentaries were written on it, and it of preserving the health; Skin diseases was frequently used as a textbook in and cosmetics; Diet of persons while medical teaching. journeying; Surgery; Poisons; The treatment of diseases of all parts of “Kitab-al Jadari Wal-Hasba” (Treatise the body; Fevers. on Smallpox and Measles) In this work Ar-Razi has drawn Ar-Razi’s most original work, the considerably on the works of his Treatise on Smallpox and Measles, predecessors, Hippocrates, Galen, Ori- is conceded by most historians of basius, Aetius, Paulus Aegineta; hence medicine to be the first monograph it can be looked upon as a reproduc­ written on the subject. However, tion of Greek medicine and is devoid Ar-Razi with the scientific honesty of the originality manifest in “AI- and the integrity of a true teacher Hawi.” Ar-Razi’s method of compila­ gave Galen credit for mentioning tion, however, was instrumental in smallpox in many of his works. Thus popularizing the book in the Latin he says: “Any physician who claims West during the Middle Ages. Most that the good Galen did not mention smallpox and that he was unaware distemper, and show us, that they were of it is undoubtedly mistaken. Such not at all unacquainted with the differ­ a person probably has either not read ence of the distinct and the confluent Galen’s work at all, or if he has read sort. By the earliest account we have of it his reading was very careless.”7 the Smallpox, we find that it first appeared The belief of Dr. Cornelius Van in Aegypt in the time of Omar successor Dyck, first professor of medicine in to Mahomet, though no doubt, since the Greeks knew nothing of it, the Arabians the American University of Beirut, brought it from their own country.9 is that the translator Hubaish-Ibn-AI- Hasan erred in translating Galen’s However, we know from the Koran9 work by mistaking the word which and the “Arab Chronicles”10 that Galen used to denote acne for the one smallpox had appeared in Arabia as denoting smallpox.8 Freind seems to early as 569 a.d. The Chronicles be of the same opinion. He says: record that it was brought from Africa by an Abyssinian army which, For perhaps from the time of Hippo­ urged on by the Emperor Justinian, crates to this very period, there never happened anything so remarkable in crossed Southern Arabia in 569 with Physick, as the appearance of this new the conquest of Mecca as its objective. and surprising distemper. The original of In this plan it failed, however, for which may be traced up from their own the army was infested by an epidemic authors much further backward, than is of smallpox. The Koran describes the commonly imagined, even up to the skin of the sufferer as resembling famous Epoch of Mahomet himself, in “leaves of plants eaten by worms,”11 the beginning of the seventh century. thus very vividly indicating pock­ The Measles, which was no doubt of the marks. same age (called not improperly by Dr. Van Dyck also believes that Avicenna, Variola Cholerica) they look this epidemic was nothing but the upon as a disease so near akin to the eastward extension of the epidemic Smallpox, that they generally treat of them both together, as if the greater that had broken out in Egypt in included the less. This was a distemper, 542 a.d.* In this he may be mistaken, without dispute, unknown to the Greeks, for a critical examination of the whatever some of the moderns have said account by Procopius leaves little to the contrary; and first observed in this doubt that the epidemic of 542 was nation and described by the Mohametans. not smallpox at all but more likely, And since it is one so extraordinary in its according to the description of the symptoms, so constant and regular in its signs and symptoms, an epidemic stages, and so universally incident to all of bubonic plague. To quote from mankind, it were to be wished, that Procopius: Mr. Le Clerc had thought fit to have given us a short extract at least of what It started from the Aegyptians who these original writers have said of it: dwell in Pelusium.f Then it divided and especially when in its very infancy we moved in one direction towards Alex­ may find the image of this disease very andria and the rest of Aegypt, and in the well painted in their works, and the other direction it came to Palestine on practice clearly enough delivered. That * Dr. Van Dyck in his account gives the Tract of Rhazes alone entitled, a Dis­ date as 544 a.d. course of the Pestilence, would very fully t Pelusium, an ancient city, the ruins of explain to us the idea they had of this which are near the modern city of Damietta. the borders of Aegypt; and from there it case they suffered the characteristic spread over the whole world, always symptoms of the disease. For those who moving forward and travelling at times were under the spell of the coma forgot favourable to it. For it seemed to move all those who were familiar to them and by fixed arrangement, and to tarry for seemed to be sleeping constantly. And if the specific time in each country, casting anyone cared for them, they would eat its blight slightly upon none, but spread­ without waking, but some also were ing in either direction right out to the neglected, and these would die directly ends of the world, as if fearing lest some through lack of sustenance.12 corner of the earth might escape it. If the disease so described was In describing the individuals af­ bubonic plague, it is apparent that flicted with the disease his account the two epidemics were unrelated. continues as follows: And it follows that not until Ar-Razi wrote his monograph was there, so They had a sudden fever, some when far as is known, a systematized epi­ just roused from sleep, others while demiological work on smallpox. To walking about, and others while otherwise him, then should be given the credit engaged, without any regard to what they were doing. And the body showed no for the first lucid and rational account change from its previous colour, nor was of the *disease. it hot as might be expected when attacked Ar-Razi’s monograph is divided by a fever, nor indeed did any inflamma­ into fourteen chapters. The reason tion set in, but the fever was of such a that prompted him to compile it is languid sort from its commencement and stated in the preface thus: up till evening that neither to the sick It was at an evening in a home of a themselves nor to the physicians who virtuous man who happened to be a touched them would it afford any suspi­ prominent patron of the dissemination of cion of danger. It was natural, therefore, useful science that smallpox was men­ that not one of those who had contracted tioned, I discoursed on the subject as far the disease expected to die from it. But as my recollection permitted me that on the same day in some cases, in others evening. My good friend, may Allah on the following day, and in the rest not prolong his life, entreated me to compile many days later, a bubonic swelling an exhaustive and elaborate treatise on developed: and this took place not only smallpox, for he failed to find anything in the particular part of the body which written on the subject until that time— is called “boubon,” that is, below the either modern or ancient. So I have abdomen, but also inside the armpit, and written this treatise in the hope of gaining in some cases also beside the ears, and at the favor and the reward of the different points on the thighs. Up to this Almighty.13 point, then everything went in about the same way with all who has taken the This preface is interesting because disease. But from then on a very marked it throws a sidelight on Ar-Razi’s difference developed: and I am unable to social position and indicates in what say whether the cause of this diversity great esteem learning was held by of symptoms was to be found in the the gentry with whom he associated. difference in bodies, or in the fact that it * Garrison says that Eusebius, Bishop of followed the wish of Him who brought Caesarea, describes a Syrian epidemic of the disease into the world. For there smallpox occurring in Syria in 302 a.d. See ensued with some a deep coma, with Garrison, F. H., History of Medicine. Ed. 4, others a violent delirium, and in either Phila., 1929, p. 125. In this treatise Ar-Razi attributed color and the patient grows weaker and the etiology of smallpox to a ferment the pain becomes intense, or the limb is in the blood, like must in wine. He deeply colored, then death is inevitable. believes that this fermentation caused But if the patient grows stronger he will a change in the blood, as a result of recover but the limb will mortify.14 which the eruption occurred. Probably In his treatment of the disease he for the first time in the history of emphasizes the importance of cold medicine we find a suggestion of an fluid administration, fresh air, fruit approach to the fermentation theory juices of acid and astringent plants of Pasteur. He assumed, however, like pomegranate. “Let their food be that this ferment was *innate and such as to cool the fever like soup of was transmitted to the newly born lentils, broth mixed with the juice from the placenta in the mother’s of unripe grapes, acid minced meat womb. Epidemiologically he asserted etc. Let them drink water cooled with that the disease was more prevalent snow or pure spring water.”15 He during the spring and autumn and resorted to blood-letting in strong also more common during childhood. and vigorous individuals, he also In describing the symptoms of small­ regulated the patient’s bowels, avoid­ pox he stressed the acute fever, severe ing the use of strong cathartics. He pain in the back, terror in sleep, recommended barley water and decoc­ restlessness, dryness of skin, sense tions of figs, raisins and similar mild of heaviness and weight in the head, agents, reserving the use of opiates itching and burning all over the body for the extreme restlessness, sleepless­ and the eruption which follows. He ness and looseness of bowels. In very distinguished between the discrete high fevers he recommended cold and the confluent type, making a water sponging unless contraindicated differential diagnosis between measles by the status of the pulse and respira­ and smallpox, the latter being usually tion. To prevent eye infection in accompanied by a cough and itching smallpox he recommended collyriums; of the nose and ears. for throat infections, gargles; and The cases with good prognosis he ointments for the scab of the pustules. designated as those with a freedom It is very unfortunate to see that this of respiration, clear mentality and rational method of treatment was not a good pulse. The cases with bad usually followed in the sixteenth and prognosis he designated as those in seventeenth centuries, and it is not which the respiration is fast, the pa­ until the latter part of the eighteenth tient is restless, the smallpox pustules century that medical authorities in are dense and confluent with ulcera­ Europe saw the advantage of following tion. He also speaks of the occurrence Ar-Razi’s therapeutic measures. Even of gangrene: the great Sydenham in his early writings advocated drastic methods When towards the end of the disease of bringing out the pustules by ap­ the patient is taken by a very severe plication of heat. Freind says: pain in the leg or hand or other extremi­ Even our countryman Sydenham car­ ties and pustules turn green or black in ried this notion to an extremity in the * Theory of “Innate Contagion”; that first edition of his works: though after­ is why he feels that the disease is so universal. wards he was so wise as to retract a great deal of what he had said, and came into the role played by the heart and the moderate method, as without dispute arteries in spreading infectious dis­ more agreeable to reason, and to the eases to all parts of the body so clearly temper of our Island.16 defined by Ar-Razi should have re­ In other words he used methods ceived so little attention in western similar to those of Ar-Razi; and it medical literature, especially when his may be said that except for the intro­ monograph on Smallpox and Measles duction of preventative cowpox inocu­ has appeared in various languages lation by Edward Jenner in 1798, about thirty-five times over a period there has been little added to the of approximately four hundred years. description and treatment of the dis­ ease in the last thousand years. Ar-Razi’s Personality It is interesting to note that in There will be little doubt from the the last part of the first chapter foregoing that Ar-Razi was a most of his monograph, Razi in explain­ versatile scholar of an indefatigable ing why smallpox is so infrequently industry. His keen sense of observa­ found in old age makes the following tion and ability to learn from nature statement: distinguished him from others of his And as for old men, the Small-Pox country whose main source of medical seldom happens to them, except in knowledge was Hellenic. His clinical pestilential, putrid, and malignant con­ insight was brightened by his knowl­ stitutions of the air, in which this disease edge of humanity. In one of his is chiefly prevalent. For the putrid air, writings entitled “Upon the circum­ which has an undue proportion of heat stances which turn the heart of the and moisture, and also an inflamed air, Most Men from Reputable Physi­ promotes the eruption of this disease, by cian” he says: converting the spirit in the two ventricles of the heart to its own temperament, and Amongst those factors which make the then by means of the heart converting people turn away from the intelligent the whole of the blood in the arteries into physician and place their trust in im­ a state of corruption like itself.17 postors is the delusion that the physician knows everything and requires to ask no This sentence would seem to prove questions. If he inspects the urine or feels beyond doubt (a) that Ar-Razi was the pulse, he is supposed to know what fully aware of the presence of blood the patient has eaten and what he has in the ventricles of the heart and been doing. This is lying and deception arteries; (b) that he realized the and is only brought about by trickery, by spread of the “corruption” from the artful questions and speech, through heart blood to the arterial blood; which the senses of the public are and (c) that the corrupted blood was deceived. Many hire men and women to conveyed by means of the heart to find out all the circumstances of the patient and to report what is told them the arteries. No mention is made by servants, friends and neighbors. I of the heart action or circulation of myself, when I began to practice medi­ the blood in a direct fashion, but it cine, had resolved to ask no questions is most certainly to be inferred from when the urine had been given me, and what he has written that Ar-Razi had been much honoured. Later, when it understood there was a circulation was seen that I made circumstantial of the blood. It seems strange that inquiries, my reputation sank. Another circumstance which brings There are so many little arts used by physicians into contempt is that many Mountebanks and Pretenders to Physick, diseases are too little removed from the that an entire treatise, had I a mind to borderline of health and are thus difficult write one, would not contain them: but to recognize and cure; others, malignant their impudence, and daring boldness is in themselves, externally appear trivial. equal to the guilt and inward conviction When the layman sees that the physician they have of tormenting and putting is in doubt concerning his cure he draws persons to pain in their last Hours, for it as a certain inference that the physician no reason at all. Now some of them will understand still less of severer and profess to cure the Falling-Sickness, and more extensive illnesses. This is a false thereupon make an issue in the hinder analogy. The symptoms of such diseases part of the head, in form of a cross, and are less obvious because they are slighter pretend to take something out of the deviations from the normal, and their opening, which they held all the while in cure is more difficult because no drastic their hands. Others give out, that they remedies can be applied, but only those can draw snakes or lizards out of their the effect of which is gradually brought patients noses, which they seem to per­ about, such as diet, etc. An official of the form by putting up a pointed iron probe, hospital once complained of difficulty in with which they wound the nostrils, moving some of his finger joints on ’till the blood comes: then they draw out account of a small but very hard sore the little artificial animals composed of which had for some time resisted the liver, etc. Some are confident, they can remedies he had applied. He openly take out the white specks in the eye. reviled the physicians, saying: “If your Before they apply the instrument to that art does not suffice to cure a small sore on part, they put a piece of fine rag into the finger, how can you treat broken ribs the eye, and taking it out with the and arms?” He then sought treatment instrument, pretend it is drawn immedi­ from women and from the vulgar.18 ately from the eye. Some again undertake Ar-Razi’s personality portrays a to suck water out of the ear, which they fill with a tube from their mouth, and broad human sympathy. Many of hold the other end to the ear; and so his sayings disclose in what esteem spurting the water out of their mouths, he held his profession. The following pretend it came from the ear. Others brings us nearer to this side of pretend to get out worms, which grow in his personality than any we encoun­ the ear, or roots of the teeth. Others can tered among his contemporaries: “The extract frogs from the under-part of the physician should desire the cure of tongue; and by lancing make an incision, the patient more than his fee, he into which they clap in the frog, and so should also prefer the treatment of take it out. What shall I say of bones the poor to that of the rich, he should inserted into wounds and ulcers, which, be thorough in his instructions and after remaining there for some time, they prodigal in benefiting the public.” take, out again? Some when they have taken out a stone from the bladder, He also wisely realized that our persuade their patients, that still there’s knowledge of the art and science of another left; they do this for this reason, medicine is indeed far from complete, to have it believed, that they have taken showing how humble the true student out another. Sometimes they probe the of medicine should be. bladder, being altogether ignorant and Freind, from his “ AI-Mansuri,” uncertain, whether there be a stone or no. quotes the following account of im­ But if they don’t find it, they pretend at postors : least to take out one they' have in readi­ ness before, and show that to them. swered, “for I have seen so much Sometimes they make an incision in the of the world that I am weary of it.” anus for the piles, and by repeating the And although he enjoyed an enviable operation often bring it to a fistula, or an practice and was the head of the ulcer, when there was neither before. largest hospital in Bagdad, he died Some say they take phlegm, of a sub­ in blindness and poverty. stance like unto glass, out of the penis or other part of the body, by the conveyance References of a pipe, which they hold with water in their mouths. Some pretend, that they 1. Fihrist. Arabic Edition by Mustafa can contract and collect all the floating Muhammad. Cairo, Egypt, 1348 a.h. humors of the body to one place, by p. 415. rubbing it with winter-cherries; which 2. Sarton, G. Introduction to the History causes a burning or inflammation, and of Science. Balt., 1927, 1: 609. then they expect to be rewarded, as if 3. Ali-Abbas. Kamil-AI-Sinaat. Arabic Bu- they cured the distemper; and after they Iaq edition, Cairo, Egypt, 1294 a.h. have suppled the place with oil, the pain (corresponding to 1877 a.d.), i: 5. presently goes off. Some make their 4. Browne, E. Arabian Medicine. London, patients believe they have swallowed 1921, p. 52. 5. Fihrist. Arabic edition by Mustafa glass; so, taking a feather, which they Muhammad. Cairo, Egypt, 1348 a.h., force down the throat, they throw them i: 4I7.‘ into a vomiting, which brings up the fluff 6. The Latinist and the Modern Orientalists they themselves had put in with that very seem to be in doubt as to the identity feather. Many things of that nature do of Mansur, to whom the book was they get out, which these impostors with dedicated, although Ibn Khallikan great dexterity have put in; tending seemed to know that he was the ruler many times to the endangering the health of Khurasan. Ibn Khallikan’s “Wa- of their patients, and often ending in the fayat Al A’yan” (Death of the promi­ death of them. Such counterfeits could nent men). Arabic Bulaq edition, not pass with discerning men, but that Cairo, Egypt, 1299 a.h. (1881 a.d.), 2: 103-107. they did not dream of any fallacies, and 7. Translated from Ar-Razi’s Treatise on made no doubt of the skill of those whom the Smallpox and Measles. Arabic they employed: till at last when they edition of the Syrian Protestant Col­ suspect, or rather look more narrowly lege, Beirut, Syria, 1872, p. 9. into their operations, the cheat is dis­ 8. Translated from Ar-Razi’s Treatise on covered. Therefore no wise men ought to Smallpox and Measles. Arabic edition trust their lives in their hands, nor take of the Syrian Protestant College, any more of their medicines, which have Beirut, Syria, 1872. See footnotes by proved so fatal to many.19 Dr. C. Van Dyck, p. 9, also author’s appendix, p. 75. This vivid account of the quacks 9. Freind, J. The History of Physick. Lon­ and charlatans of his age must have don, 1726, Pt. 2, p. 188. 10. Sheikh Muhammad Al-Koudary. The had a depressing influence on the History of Islamic Nations. Arabic very productive, tireless and devoted edition by Mustafa Muhammad, Cairo, teacher of medicine of the tenth Egypt, 1922, 1: 41. Abrah’s army while century. It is reported that in his attacking Mecca employed on this old age he was totally blind because expedition a number of elephants and this year was afterward known in of the cataract. When a surgeon Arab Chronicles as the Year of Ele­ advised an operation for the recovery phants (569 a.d.). This year is not only of his sight, “No,” the master an­ famous because of the Siege of Mecca but for the birth of the prophet of the Syrian Protestant College, Muhammad. Beirut, Syria, 1872, p. 74. 11. The Holy Koran, Chap, cv, Soura 15. Ibid., p. 61. entitled the “Elephants Revealed at 16. Freind, J. The History of Physick. Mecca.” Dr. Lucien LeCIerc, unfortu­ London, 1726, Pt. 2, p. 202. nately, not thoroughly familiar with 17. Greenhill, W. A. Translation of Ar- Koranic Arabic, takes the word “Aba- Razi’s Treatise on Smallpox and bil ” to denote a certain bird of heaven, Measles for the Sydenham Society, while really the word “Ababil” means London, 1848, p. 30. flocks of birds with no particular speci­ Because the introduction of Ar-Razi’s fication. See LeCIerc, L. Histoire de la conception of the circulation of the Medecine Arabe. Paris, 1876, 1: 20-21. blood may be opposed, the writer, 12. Procopius. History of the Wars. Books whose native language is Arabic, has 1 and 2, Greek text with English trans, chosen in this instance to retain the by Dewing, H. B., London, 1914, 1: excellent translation by William Alex­ 453-457- ander Greenhill. 13. Translated from Ar-Razi’s Treatise on Smallpox and Measles. Arabic edition 18. Ernest Playfair’s English translation of of the Syrian Protestant College, Max Neuburger’s History of Medicine, Beirut, Syria, 1872, p. 6. London, 1910, 1: 363. 14. Translated from Ar-Razi’s Treatise on 19. Freind, J. The History of Physick. Smallpox and Measles. Arabic edition London, 1726, Pt. 2, p. 65.