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The Maristan of Granada. Symbol and Institution of Andalusian Medicine El Maristán De Granada

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The Maristan of Granada. Symbol and Institution of Andalusian Medicine El Maristán De Granada THE MARISTAN OF GRANADA. SYMBOL AND INSTITUTION OF ANDALUSIAN MEDICINE EL MARISTÁN DE GRANADA. ESCENARIO Y SÍMBOLO DE LA MEDICINA ANDALUSÍ ANTONIO CAMPOS MUÑOZ PROFESSOR AT THE FACULTY OF MEDICINE OF THE UNIVERSITY OF GRANADA [email protected] FERNANDO GIRÓN IRUESTE PROFESSOR OF HISTORY OF SCIENCE AT THE UNIVERSITY OF GRANADA [email protected] RESUMEN: con motivo de las obras de restauración del Maristán de Granada, se estudia y analiza en el pre- sente trabajo su significado en el contexto de la cultura médica de su tiempo y el legado que puede seguir teniendo en la Granada de nuestros días. A tal efecto se describen en distintos apartados las bases teóricas de la medicina medieval, las relaciones médico paciente en la baja Edad Media, las características de los hospitales y maristanes en el espacio urbano del mundo latino e islámico y, finalmente, la creación del Ma- ristán en siglo XIV, así como sus distintas características. Se analiza por último la revitalización del legado del Maristán que implica su restauración; primero, como símbolo representativo de una ciudad vinculada al progreso y la innovación médica y, segundo, como recurso imprescindible para una educación sanitaria de la población que potencie y valore con perspectiva histórica el progreso y los avances en salud. PALABRAS CLAVES: maristán, Granada, legado ABSTRACT: on the occasion of the restoration of the Maristán of Granada, its meaning is studied and analyzed in the context of the medical culture of its time and the legacy it can continue to have in Granada at the present moment. To this end, the theoretical bases of medieval medicine, the doctor-patient relations- hips in the late Middle Age, the characteristics of hospitals and maristanes in the urban space of the Latin and Muslim world, and finally the creation of the Maristan in Granada during the XIV century as well as its different characteristics. Finally, the revitalization of the Maristan’s legacy that involves its restoration is analyzed; first, as a representative symbol of a Granada linked to medical progress and innovation and, second, as an useful resource for a better health education for the population in order to give value to health advances from a historical perspective. KEYWORDS: maristán, Granada, legacy CÓMO CITAR / HOW TO CITE: CAMPOS MUÑOZ, A; GIRÓN IRUESTE, F. El maristán de Granada. Escenario y símbolo de la medicina andalusí, Cuaderno de la Alhambra. 2020, 49, págs. 281-293, ISN 0590-1987 CUADERNOS DE LA ALHAMBRA I núm. 49 I 2020 I págs. 281-293 Recibido: 25 julio 2020 | Revisado: 8 septiembre 2020 | Aceptado: 6 octubre 2020 | Publicado: 24 diciembre 2020 ISSN: 0590 - 1987 I eISSN: 2695-379X I Depósito legal: GR 70-1965 282 ANTONIO CAMPOS Y FERNANDO GIRÓN Theoretical bases of 14th century medicine Medieval medicine, regardless of the field under consideration, whether Latin or Arabic, is made up of a set of concepts of belief and rationality. Leaving aside the first –astrological medicine, popular belie- fs, ejaculatory and talismans– we can establish that the world of medieval medical knowledge is within the framework of what is known as galenism2. Ga- len (129-210/216) was a Greek doctor born in Per- gamon (Asia Minor) who worked for a long time in the Rome of the Caesars, where he achieved enor- IL. 1. Representation of Hippocrates, Galen and Avicena, authors mous prestige. He was also responsible for the ori- on whose doctrines medieval medicine is based. Cover of the Latin Canon edition (1512) . Pavia. gin of a medical doctrine, with Hippocratic roots, which remained without much criticism from the Introduction 3rd to the 16th century. Medieval writers of diffe- rent origins, Arabic, Latin or Hebrew, confirmed, The commencement of the restoration and rein- retouched or questioned, in each case, the primiti- forcement works on the Maristan, driven by the ve Galenic doctrines, but contributed to the secular Patronage of the Alhambra and the Generalife, re- survival of the same with their writings (Il. 1). presents not only the satisfaction of protecting and demonstrating the value of the historical heritage As far as diseases are concerned, for the majority of Hispanic-Muslim medical culture, but also the of them, with the exception of trauma, the galenic opportunity to reflect on its meaning for Granada doctrine stated that these were caused by one of the and the medicine of its time, and on the legacy that four humours, blood, yellow bile, phlegm or black its presence, preserved and restored, can continue bile, being altered in the human anatomy, which having for Granada and for the medicine of today. would have serious effects. It could also be due to a pernicious mixture of humours or the excessive To address the challenge of such a reflection, this accumulation of one or more of them, even if these paper will be divided into several sections. In the were not altered. In addition, according to medical first section we will establish the different theoretical doctrines in use, we should also take into account bases of medieval medicine, without the knowledge the presence of the so-called temperaments, also of which it would be very difficult to understand the known as complexions, of which there were five. context that surrounds the process of creation of the Certain men and women would have a balanced Maristan of Granada. In the second section we will temperament, especially those of noble birth. This deal with the figure of the doctor and the patient in could be hot and wet, since it was dominated by the the late Middle Ages and the relationship between blood humour and also blood temperament. Or it the two, which is influenced by the social context in could be hot and dry, as was the case with yellow which this relationship develops. In the third section bile, giving rise to a bilious temperament. Cold and we will analyse the characteristics of the hospitals wet like phlegm: a phlegmatic temperament. And and maristans1 as urban healthcare spaces and their links to the social, religious and political structure of their time. In the fourth section we will describe the different characteristics of the Maristan of Gra- nada especially during its time as a hospital and its evolution up to today. Lastly, in the final section we 1. From now on, we will use the word maristanes, Anglicising the will evaluate the current legacy of a health institution Arabic māristānāt, plural of māristān. created in the 14th century and the future impact of 2. GARCÍA BALLESTER,L. Galeno en la sociedad y en la ciencia de its forthcoming restoration. su tiempo: (c. 130-c. 200 d. de C.). Madrid: Guadarrama, 1972. CUADERNOS DE LA ALHAMBRA I núm. 49 I 2020 I págs. 281-293 THE MARISTAN OF GRANADA. SYMBOL AND INSTITUTION OF ANDALUSIAN MEDICINE 283 finally, cold and dry like black bile, which would ted by the appearance of the so–called «doctrine of correspond to an atrabiliary or melancholic tempe- degrees», of galenic origin, which was confirmed rament. This was important because the effect of a and structured in the Islamic world by Abū Yūsuf disease in which coldness prevailed over a body that Ya´qūb ibn Isḥāq al-Kindī, in the 9th century4. It was also cold, melancholic or phlegmatic in nature, goes without saying that all the degrees, of diseases would be harmful. and of medicines, were only the product of utmost speculation. Finally, there were the so-called six «unnatural», or «necessary», things that were not part of the In relation to the above, the doctor would also con- patient, but related to him, and that could be a sider the age and sex of the patient when prescri- cause of illness. These were: the air and the en- bing medicines. Generally speaking, children had a vironment; food and drink; work and rest; sleep hot and wet nature; young people dry and hot; ma- and wakefulness; secretions and excretions and, ture men cold and wet and old men cold and dry. oddly, movements of the soul. The curious thing To treat an old man with a dry and cold medicine is that these causes, converted into «things», and was to condemn him ahead of time, for this would skilfully handled by the doctor, allowed him to pre- increase two harmful conditions in his body: a lack serve the health of his patients. And as soon as the of moisture and a lack of heat. As far as women are disease appeared, they could be used as curative concerned, we must say that there is a major gap in remedies3. medical texts about them, as their existence is hard- ly taken into account, except in cases of pregnancy, Let us now look at the procedure for treating the childbirth, breastfeeding and little else. In any case, sick. The doctor began his work by making changes one should consider that their nature was always to the patient's daily life, which may have been so- colder and wetter than that of men, at any age. As a mewhat disorganised. To do so, he may have chan- final resource, once the dietary and pharmacologi- ged the place of residence, or at least the ventilation cal possibilities had been exhausted, surgery could of the same. The patient would be ordered to rest be used, but only if it was absolutely necessary. or advised to keep certain company to stimulate his soul. The treatment continued, almost invariably, One essential question underlies this. Were the with the use of bleeding, being in urgent cases the patients cured of their condition? We estimate that most immediate treatment, which was intended to only in very few cases.
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