Arch Iranian Med 2008; 11(6): 673 – 677 History of Medicine A Tribute to Zakariya Razi (865 – 925 AD), An Iranian Pioneer Scholar Houchang D. Modanlou MD•* Abstract The resurgence of Islamic Civilization in the Near Introduction East in the 7th century AD and its expansion to rom antiquity to the modern era, Persian Empire and Westward provided infectious diseases have played a opportunities of access Persian, Hellenic, and significant role in determining the course Roman writings in philosophy and medicine. Based F on their observations and experiences, Islamic of human civilization. Written records and physician-philosophers expanded upon those paleopathologic evidence reveal the lasting impact writings and at times challenged them. Among of infectious diseases caused by viruses, bacteria, these physician-philosophers admiring and spirochetes, and parasites have had on human challenging Galen was Zakariya Razi described as the greatest physician of Islam and Medieval Ages. history. At the present time, the infectious diseases A search of electronic and written materials with the greatest impact on humans in the about early Islamic Medicine was carried out developing countries are tuberculosis, malaria, and focusing on Persian physician-philosophers human immunodeficiency virus (HIV), while Zakariya Razi. sexually transmitted diseases, HIV, and Abu Bakr Mohammad Ibn Zakariya al-Razi, known nosocomial infections are among the most in the West as Rhazes, was born in 865 AD in the significant in the industrialized countries of the ancient city of Rey, Near Tehran. A musician during his youth he became an alchemist. He discovered world. alcohol and sulfuric acid. He classified substances A review of historical evidence strongly as plants, organic, and inorganic. At age 30, he supports the significance of two specific undertook the study of medicine. He was a prolific exanthemata in any number of epidemics described writer with more than 184 texts in medicine in ancient civilizations. Descriptions resembling attributed to him with 40 of them currently available. Among them are Kitab al-Mansoori, Kitab al-Hawi, smallpox appear in the earliest Egyptian, Indian, 1 and Kitab al -Judari wa al-Hasabah. The latter is the and Chinese writings. The mummy of Pharaoh first scientific description for the recognition and Ramses V reveals that an acute illness was the differentiation of smallpox and measles. The probable cause of his death at age 40 in 1157 BC. Bulletin of the World Health Organization of May 1970 pays tribute to Razi by stating “His writings on The Pharaoh was described as having a striking smallpox and measles show originality and rash of yellowish blisters and pustules which Archive of SID 1–3 accuracy, and his essay on infectious diseases was closely resembles smallpox. Some believe that the first scientific treatise on the subject”. Razi the plague of Athens, starting in 430 BC, as established qualifications and ethical standards for described by Thucydides, was probably due to the the practice of medicine. effects of a smallpox epidemic.4 Similar to Zakariya Razi was not only one of the most important Persian physician-philosophers of his era ,but for centuries his writings became fundamental Author's affiliation: *Department of Pediatrics, University of teaching texts in European medical schools. Some California, Irvine Medical Center, U.S.A. important aspects of his contributions to medicine •Corresponding author and reprints: Houchang D. Modanlou are reviewed. MD, Department of Pediatrics, University of California, Irvine Medical Center, Building 56, Suite 600, 101 The City Drive South, USA. Keywords: History of medicine • Iran • Razi Tel: +714-456-6933, Fax:+714-456-7658, E-mail: [email protected] Accepted for publication: 24 September 2008 Archives of Iranian Medicine, Volume 11, Number 6, November 2008 673 www.SID.ir A tribute to Zakariya Razi smallpox, measles appears to have existed since of the limits of scientific chemistry: “I understand antiquity. Like smallpox, the origin of measles is alchemy and I have been working on the not clear.4 Introduced by colonizers to the New characteristic properties of metals for an extended World, smallpox and measles caused epidemics time. However, it still has not turned out to be with devastating effects upon the immunologically evident to me, how one can transmute gold from naïve native population. These two highly copper. Despite the research from the ancient contagious diseases were difficult to differentiate scientists done over the past centuries, there has during the early stages as the skin rash and fever been no answer. I very much doubt if it is are common to both.5 The first clear description possible.” However, he described the techniques and distinction between the two diseases, the for making metal alloys. Twenty books and treatise differential diagnosis and noting the complications in chemistry, written in the Persian language of these illnesses, was provided by the Persian (Farsi), are known to be the work of Razi. alchemist-physician-philosopher Zakariya Razi.6,7 According to al-Biruni, as noted by Nayernouri,9 Razi stopped his studies in alchemy Zakariya Razi because the chemical experiments caused him an Abu Bakr Mohammad Zakariya al-Razi eye-disease. At age 30, Razi began his medical and (Persian Razi, Latin Rhazes), a versatile physician- philosophical studies under Ali Ibn Rabban al- philosopher or Hakim, was born in 865 AD in the Tabari, a physician-philosopher from the ancient the ancient city of Rey, a provincial capital of The city of Merv in western Iran. Nayernouri9 disputes Samanid Dynasty, near the present city of Tehran, the accuracy of al-Tabari as Razi’s mentor in Iran. He died there in 925 AD, although some medicine. He states that Razi may have utilized al- scholars suggest he was born in 864 AD and died Tabari’s texts in medicine since al-Tabari may in 930 AD. He is best known for his contributions have died prior to Razi’s birth. Razi gained to alchemy, medicine and philosophy, ethics in practical experience as the director of the Royal medicine, and metaphysics and authored 184 Hospital at Rey. Another of his teachers of books and treatise on these subjects. Razi was medicine was the well-known physician Ali Ibn well- versed in the ancient Greek language and he Sahl (a Jewish convert to Islam, belonging to the was an admirer and critic of Galen. There is little famous medical school of Tabaristan or Hyrcania). information regarding Razi’s early life, but it is Soon he surpassed his teachers in medical written that he played lute in his youth and wrote knowledge and practice. Later, by invitation of the an encyclopedia of music.8 Unable to make a Islamic ruler he became the head of Muqtadari comfortable living with music, he changed his Hospital for a long time. It has been written that interest to alchemy. As a genuine chemist and the same Caliph asked Razi to build a hospital, but physicist, he performed a great deal of research before doing so, Razi put fresh pieces of meat in and laid the foundation for scientific chemistry to various places in the city of Baghdad, Iraq. Some replace alchemy, having written several books and time later, he checked each piece of meat to find treatise in the field.9 He discovered and purified the least spoiled one and chose that place as the alcohol (ethanol) and pioneered its use in site for the hospital. Because of his high reputation medicine. Also, he is credited with the discovery as a physician-philosopher and teacher, students of sulfuric acid, the “work horse” of modern flocked to him from all over the Islamic territories. chemistry and chemicalArchive engineering. The ofIn his book SID entitled Shukuk ‘ala Jalinus (Doubt discovery of ammonium chloride and other acids about Galen), he praised Galen’s commendable are also attributed to Razi. His achievements are contribution to medicine. However, he rejected particularly important in the history of chemistry Galen’s claim of the superiority of the Greek for his systematic classification of chemical language and many of his medical views since substances, chemical reactions, and the apparatus Galen’s description of some diseases did not agree used in his laboratory. In two important books, with his own clinical observations, i.e., the run of Kitab al-Asrar (The Book of Secrets) and Sirr al- fever. In some cases Razi believed that his clinical Asrar (The Secret of Secrets) he classified matter experience exceeded that of Galen. Further, he into three categories as of plant, animal, and rejected Socrates and Aristotle’s thoughts about the mineral origin. When asked if he had obtained the dichotomy of mind-body and pioneered the knowledge of turning iron and copper into gold, he concept of mental health and self-esteem as being replied with heretofore not described appreciation essential to a patient’s welfare. The “sound mind, 674 Archives of Iranian Medicine, Volume 11, Number 6, November 2008 www.SID.ir H. D. Modanlou healthy body” connection prompted him to was Razi’s book of medicine, a short general communicate frequently with his patients on a textbook in ten chapters based largely on Greek personal rather than the patronizing level which science and entitled Kitab al- Mansuri (Liber was characteristic for that time. He encouraged Almansoris) which he dedicated in 903 to the them to heed his advice as a path to their recovery Samanid prince Abu Salih al-Mansur Ibn Ishaq, and bolstered their fortitude and determination to Governor of Rey.15 This treatise was subsequently resist the illness resulting in a speedy recovery. In translated into Latin in Toledo, Spain, by Geraldo his book about spiritual medicine, Razi presented di Cremona in 13th century AD. A third and ethical views of the physician-scientist.