Islam's Forgotten Contributions to Medical Science

The Left Atrium

Past progressive Islam’s forgotten contributions to medical science

he transmission of medical knowledge can be traced to T some of the earliest writings in human history. Yet a particularly fruit- ful period for advancement in medical science emerged with the rise of Is- lam. For the most part, Western schol- arship belittles the contribution of the physicians of the Islamic world. They are usually perceived as simple purvey- ors of Greek science to the scholars of the Renaissance. However, the facts show otherwise. For example, the 11th-century Iraqi scientist Ibn al-Haytham, known as Al- hazen in Latin, developed a radically new concept of human vision. Ancient Greek notions of a visual spirit emanat- ing from the eyes and allowing an ob- ject to be perceived were replaced by a

straightforward account on the eye as Bodleian Library, University of Oxford, 2007. MS Marsh 54, fol. 68v an optical instrument. Ibn al- Fig. 1: Vaginal speculum (left), 2 types of forceps and double-edged scalpel (sus- Haytham’s detailed description of ocu- pended). From a 1271 Arabic copy of al-Zahrawi’s Surgery, written in the 10th century. lar anatomy forms the basis for his theory of image formation, which is explained through the refraction of blood in the right ventricle must be became integrated into scientific medi- light rays passing between 2 media of carried to the left by way of the cine instead of being a practice left to different densities. Ibn al-Haytham de- lungs.3,4 The description of the pul- cuppers and barbers.5,6 rived this fundamentally new theory monary circulation by Ibn al-Nafis Al-Zahrawi’s work had a profound from experimental investigations.1 His was a breakthrough in the under- influence on the emerging medical sci- Book of Optics was translated into standing of human anatomy and ence in medieval and early modern Eu- Latin in the 12th century and continued physiology. His approach to the study rope, where the author was known as to be studied both in the Islamic world of medicine was exemplary for a sci- Abulcasis or Albucasis. However, for and in Europe until the 17th century.2 entist of his time as he demonstrated centuries the quality of the translations Ibn al-Nafis, a 13th-century Syrian the need to evaluate the existing from Arabic into Latin and the accom- physician, re-addressed the question knowledge and reject those concepts panying illustrations were less than sat- of blood movement in the human that were inaccurate as shown by his isfactory. For example, al-Zahrawi’s body. The authoritative explanation own observations. Thus he was able treatise contained an illustration of a had been given by the Greek physi- to further the medical learning that vaginal speculum and 2 types of forceps cians more than 1000 years earlier. was inherited from the Greeks. for extracting a dead fetus (Fig. 1). The But what had caused them a major The 10th-century physician Abu speculum was operated by a screw problem was how the blood flowed ’l-Qasim al-Zahrawi, from Muslim mechanism (at the top; see illustration) from the right ventricle of the heart to Spain, was clearly frustrated by the and had functional blades. The Arabic the left, prior to being pumped out state of the art in surgery during his caption informs us that the spear-like into the body. According to Galen time. In order to advance surgical feature suspended behind the right side (2nd century), blood reached the left knowledge, he wrote a book that de- of the speculum is a separate instru- ventricle through invisible passages scribed surgical procedures and gave ment, namely a double-edged scalpel in the septum. Referring to evidence detailed illustrations of the necessary (and therefore not connected with the derived from dissection, Ibn al-Nafis surgical instruments — several of speculum). A 14th-century Latin copy of described the firm, impenetrable na- which were devised by the author him- al-Zahrawi’s work, however, shows that ture of the ventricular septum and self — together with his observations the Western illustrator was entirely un- made it clear that there were no pas- and comments based on experience. familiar with the speculum and its me-

DOI:10.1503/cmaj.061464 sages in it. Instead, he concluded, the We owe it to al-Zahrawi that surgery chanical principles (Fig. 2). He drew it

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This mode of thinking was best ex- Ingrid Hehmeyer pressed by the 12th-century physician Assistant Professor of History and philosopher from Muslim Spain of Science and Technology Ibn Rushd, known in Latin as Aver- Department of History roes, who stated: “He who is engaged Ryerson University in the science of anatomy, increases Toronto his belief in God.”11 However, the Aliya Khan anatomical study of the human body Professor of Clinical Medicine Divisions of Endocrinology and was problematic because it required Geriatrics dissection. A number of scholars — re- McMaster University ligious scholars in particular — seem Hamilton, Ont. to have been opposed to the practice since it implied mutilation of God’s Acknowledgement: Dr. Emilie Savage-Smith, most noble creation. The medical texts Professor of the History of Islamic Science, the on the other hand — particularly those Oriental Institute, University of Oxford, England, for her helpful review of this article. By permission of the British Library, Add. MS 36617 fo. 28v of the 12th and 13th centuries — make frequent references to dissection, both Fig. 2: Vaginal speculum. From a 14th- animal and human, and include de- century Latin copy of al-Zahrawi’s REFERENCES Surgery. tailed descriptions of the practices 1. Russell GA. The emergence of physiological optics. involved. For a discussion of the com- In: Rashed R, editor. Encyclopedia of the history of Arabic science. Vol. 2. London and New York: plex issue of human dissection in the Routledge; 1996. p. 672-715. [p. 676, 686-99] upside down, with the blades being medieval Islamic world, see Savage- 2. Rashed R, editor. Geometrical optics. In: Encyclope- 12 dia of the history of Arabic science. Vol. 2. London mistakenly depicted as a decorative bar. Smith. and New York: Routledge; 1996. p. 643-71. [p. 661] The 6-lobed shape at the foot of the il- The important point here is that 3. Ullmann M. Islamic medicine. (Islamic Surveys II). 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