Avicenna (AD 980 to 1037) and the Care of the Newborn Infant and Breastfeeding
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Journal of Perinatology (2008) 28,3–6 r 2008 Nature Publishing Group All rights reserved. 0743-8346/08 $30 www.nature.com/jp SPECIAL FEATURE Avicenna (AD 980 to 1037) and the care of the newborn infant and breastfeeding HD Modanlou Division of Neonatology, Department of Pediatrics, University of California, Irvine, CA, USA Avicenna was born in 980 AD in Afshana, near Bukhara, Iran A brief historical review of medicine during the fourth century Islamic (now part of Uzbekistan) into a Persian family (his mother tongue civilization or eleventh century AD in Persia or Iran was undertaken with its was Farsi or Persian) and died in 1037 AD while traveling from focus on Avicenna. A physician–philosopher, named Ibn Sina or Avicenna central city of Esfahan to Hamadan, located in western Iran, where (980 to 1037), followed and further expanded the tradition of western he is buried. He lived in the fourth century of the Islamic era, the philosophy and medicine by Aristotle, Hippocrates and Galen. Avicenna, a flourishing Abbasid (Islamic caliphate-dynasty-rulers) period in physician, philosopher, astrologist, anatomist, pharmacologist, ethicist and regard to learning and knowledge. Islamic culture reached its peak poet wrote, the Canon of Medicine, the most comprehensive medical around the time of Avicenna’s birth and in subsequent years.3,4 His textbook of its time. This important textbook was extensively used in earliest education was in Bukhara under the direction of his father, European medical schools for centuries after Avicenna’s death. In the who was the governor of a village in one of Nuh ibn Mansur’s Canon of Medicine, a chapter is dedicated to the care of the newborn infant estates. Since the house of his father was a meeting place for dealing with hygiene, breastfeeding and upbringing of the child. learned men, from his earliest childhood Avicenna was able to Journal of Perinatology (2008) 28, 3–6; doi:10.1038/sj.jp.7211832; profit from the company of the outstanding masters of his day published online 6 September 2007 (Abu Bakr Ahmad b. Muhammad al-Barqi al-Khwarizmi: Arabic Keywords: Avicenna; Canon of Medicine; Breastfeeding; Islamic and Quran; Mahmud al-Massah: philosophy, geometry, medicine mathematics, arithmetic, algebra and astrology; Ismail al-Zahid al-Bukhari: Islamic law and Sufism; and Abu Abdallah al-Natli: Historical background philosophy). A precocious child, gifted with an exceptional memory that he retained throughout his life, he had memorized the Quran Ibn Sina (Farsi), in full Abu Ali al-Husayn ibn Abd Allah ibn Sina and much Arabic poetry by the age of 10 years.1 Regarding the (Arabic), a Persian/Iranian physician, known in Europe as learning of medicine, Avicenna says ‘Then I desired to study Avicenna, is one of the most famous and influential of the medicine, and took to reading the books written on this subject. philosopher–scientists of Islam. He was particularly noted for his Medicine is not one of the difficult sciences, so naturally I became contributions in the fields of Aristotelian philosophy and medicine. He composed the Kitab al-Shifa (‘Book of Healing’), a vast proficient in it in the short time, until the excellent scholars of philosophical and scientific encyclopedia, and the Canon of medicine began to study under me. I began to treat patients, and through my experience I acquired an amazing practical knowledge Medicine (both texts were written in Arabic), which is among the 3 most famous books in the history of medicine.1 This massive general and ability in methods of treatment.’ His intellectual development medical encyclopedia consists of five books. It was composed, was significantly aided by his access to the rich royal library of the F starting about 1012 AD, over a lengthy period of time as Avicenna Samanids the first great native dynasty that arose in Iran after moved westward from Gurgan in northern Iran, where the work the seventh century AD Arab conquest of the Persian Empire. was begun, to Ray near modern Teheran and then to Hamadan.2 Before he was 16 years, he had mastered what was to be learned of Greek, Latin, physics, mathematics, logic and metaphysics; at Correspondence: Dr HD Modanlou, Division of Neonatology, Department of Pediatrics, the same age, he began the study and practice of medicine; and University of California Irvine Medical Center, 101 City Drive South, Building 56, Suite 600, Orange, CA 92868, USA. before he had completed his 21 years, he wrote the Canon of E-mail: [email protected] Medicine. The latter and part of his other writings were translated This work was presented at the 2007 Pediatric Academic SocietyFSociety for Pediatric into Latin toward the end of twelfth century AD by Gerard of 5 Research meeting, Toronto, Canada. Cremona, Dominicus Gundissalinus and John Avendeath. The Received 17 July 2007; revised 1 August 2007; accepted 7 August 2007; published online Canon of Medicine became a reference source and the principal 6 September 2007 authority for medical studies in the universities of Europe and Asia Avicenna: care of the newborn HD Modanlou 4 from the twelfth century until the end of the seventeenth century.3,5 influential on western civilization five centuries later at the coming Between 1500 and 1674, some 60 editions of part or whole of the of the Renaissance.13 Avicenna was revered by his contemporaries Canon of Medicine were published in Europe, mostly intended for who named him the Prince of Eastern Philosophers and use in university medical training.2 A Latin copy of the Canon of Physicians.13 William Osler has described Avicenna as the ‘author Medicine, dated 1484, is located at the PI Nixon Medical Historical of the most famous medical textbook ever written.’ He noted that Library of the University of Texas Health Science Center at San the Canon remained ‘a medical bible for a longer time than any Antonio (TX, USA). In 1977, the Institute of the History of Medicine other work.’14 Avicenna became to be known as the ‘doctor of and Medical Research of New Delhi assembled a team of translators doctors.’15 Darmani16 states ‘Avicenna’s Canon of Medicine is to do an English translation using the Istanbul manuscript of 1220 thought to be the most famous medical textbook ever written. 6 AD, the oldest extant manuscript of the Canon. Another English European medical historians consider him to be one of the most translation of Book 1 of the Canon of Medicine was published in famous scientists of Islam.’ Perhaps, the best characterization of 1999.7 Avicenna can be found in a letter written by John Urquhart, Avicenna’s view of medicine was based on the synthesis of professor of biopharmaceutical sciences, University of California at Aristotelian natural philosophy with Galenic humoral physiology. San Francisco, to the British Medical Journal in 200617 regarding At the same time it draws on clinical experience in the Hippocatic how Islamic scholars changed medicine. Ibn Sina (Avicenna) saw tradition and comparative assessment of observational medicine and surgery as one. The letter contrasted Ibn Sina’s experiments.8 The Canon of Medicine was the final codification of Canon of Medicine with Osler’s Principles and Practice of Greco-Islamic medicine. The first four books were based on the Medicine. The author wrote: principles of Galen and Hippocrates, with the addition of the ‘I asked if the year were 1900 and you were marooned and in need teachings of Islamic physicians and Avicenna’s own observations. of a guide for practical medicine, which book you would want by The fifth book, a formulary of drugs, was a new Islamic your side?’ My choice will be Ibn Sina. A leading reason is that Ibn 9 contribution to medicine of inestimable importance. Like another Sina gives an integrated view of surgery and medicine, whereas Persian alchemist–physician–philosopher Mohammad Zakariyya Osler largely shunned surgical intervention. Ibn Sina, for example, Razi or Rhazes (865 to 925 AD), Avicenna challenged the thoughts tells how to judge the margin of healthy tissue to take with an and writings of Socrates, Aristotle and Galen regarding the amputation, a basic topic uncovered by Osler. dichotomy of the mind and body and espoused the concept of The letter concluded that, the gap between medicine and surgery is mental health and self-esteem as being essential to a patient’s now closing, with the advent of interventional cardiology, welfare. He noted the close relationship between emotions and the gastroenterology, radiology and other procedural specialties, a physical condition and felt that music had a definite physical and synthesis that Ibn Sina correctly foretold in seeing medicine and psychological effect on patients. Furthermore, he stated that the surgery as a one therapeutic whole. Avicenna’s portrait hangs in etiology of the disease must be understood; only then is it possible the hall of the Faculty of Medicine in the University of Paris. to begin treatment. Care of the newborn infant Characterization of Avicenna The Canon of Medicine, Book 1, contains four chapters on the The formative period of western intellectual tradition would be hygiene of newborn infants, including the disease of infancy, and difficult to imagine without Avicenna’s influence on specific the care of the newborn infant, the period from birth to the individuals in addition to his many-layered complex legacy in commencement of weaning. What follows is an abbreviated version diverse areas.8 Avicenna was one of the most brilliant figures in the of what appears in the Canon of Medicine. history of medicine. He was described as having the mind of Goethe and the genius of Leonardo da Vinci.9 Dante acknowledged him in Care of the umbilical cord: Immediately after birth the the Divina Comedia, and Chaucer in the Canterbury Tales.