With Costa the second stage in the Arab Renaissance came to an end. All the work accomplished at Bagdad up to this period in our history received its inspiration from the different Caliphs belonging to the Abbaside Dynasty. But now the political conditions in the East underwent a change, and other Arabian dynasties, each in its turn, gained control of the power previously wielded by Almansur, Haroun Alraschid and their successors. Fortunately, all of these new rulers seem to have been favorably inclined toward the revival of literature, and consequently the Arabs continued to take an active part in the advance of medical knowledge during the tenth and eleventh centuries. Bagdad, however, ceased to be the centre of all this intellectual activity, and eventually Cordova in Spain almost rivaled the capital of ancient Greece in the eagerness with which she sought to increase her stores of books, and in her readiness to honor scholars. By this time the Arabs controlled, not only Persia and Arabia, but also Egypt, Palestine, Syria, Marseilles, the coast of Asia Minor, Greece, Sicily, the northern part of Africa and Spain. Owing to the limited space at my command I shall be obliged to confine my account to the more salient features of the progress made during this later or third stage of the Arab Renaissance.
Already as early as toward the end of the ninth century the number of physicians in the East had increased so greatly, and the territory where well-educated medical men were to be found had broadened to such an extent, that I shall now be obliged, in order to maintain some approach to chronological order in my account of the evolution of medical science, to treat the subject according to countries. If the men who stand out foremost in this third stage of the scientific renaissance are not in every instance Arabs or Persians or Syrians, I may at least claim that they are the product, directly or indirectly, of the great Arab movement. The countries in which their best work was done are the following: Persia (apart from Bagdad and its immediate neighborhood), Egypt, Magreb (the modern Algiers and Tunis), Fez and Spain. But, before I consider the progress of medicine in these different parts of the Orient, I should say at least a few words about the events which characterized the cessation of literary work at Bagdad. As might be expected, that city, after the Greek medical and scientific treatises had all been translated into Arabic, gradually lost its pre-eminence as a centre of learning, and new centres developed in other cities throughout the vast Musulman Empire. It must not be inferred, however, that this change was wholly or even largely due to the cessation of literary work. Other factors contributed to this result, viz.: the decadence of the caliphate and the fact that the caliphs themselves appeared to lose their interest in promoting the sciences actively. It was not until during the tenth century that any further interest in the advancement of medical science was taken by those in authority at Bagdad. Then the Emir Adhad Eddoula built a splendid hospital, and organized it on the basis of several separate services—one for fever cases, another for accidental injuries, a third for ophthalmic cases, and so on. Twenty-four physicians, who had been selected because of their special aptitude for some particular class of medical work, were appointed to take charge of the different services; and it is interesting to note that nearly all of these men bear Arab names. Nevertheless, for a still further period of many years, says Le Clerc, there continued to be as many Christian as Mohammedan physicians in Bagdad.
In the tenth century other hospitals were established in Bagdad. Thus, in 914 A. D., the Vizir Ali ben Issa founded one which he endowed in the most liberal manner. This Vizir must have been a most humane person, for, when the physician-in-charge wrote to him for further instructions regarding the course which he should pursue with respect to people of different religions, the Vizir replied: “Use the fund for the benefit of all classes alike, and be sure to remember the animals.”
Persia.—Rhazes, whose full name is Abou Beer Mohammed ben Zakarya, is generally admitted to have been the most illustrious of Persia’s physicians, and probably the most distinguished representative of Arab medical learning. He was born at Raj, in the Province of Khorassan, about 850 A. D. After he had received his professional training at Bagdad, he settled at Raj and was soon afterward appointed director of the local hospital. At a later date he was placed in charge of the hospital at Bagdad, but before many months had elapsed he returned to Raj, his native town, and here he spent most of the remaining years of his long life. The date of his death is stated by Haeser as either 923 or 932 A. D., but Le Clerc mentions only the latter date.
Rhazes was a very hard worker and was highly esteemed by his fellow countrymen, who called him the Arabian Galen. The total number of writings which he left behind him at the time of his death was 237, most of them dealing with medical subjects. A few of them, however, were devoted to the discussion of chemical, anatomical and philosophical questions. To-day we possess only 36 of the treatises written by Rhazes, and of this number only six have been printed in Latin. His greatest work, as all critics admit, is that which is commonly known as the “Continens” (or “El Haouy”). In this work, which is divided into twenty-two books, Rhazes gives in a condensed form the views entertained by all his predecessors regarding the more important questions in medical science, and then adds thereto the conclusions which his own experience has led him to form.
He also wrote a second treatise (in ten books) which was esteemed by the physicians of that and later periods almost as highly as the Continens. It was called the “Mansoury,” and its contents are distributed as follows: I., Anatomy; II., the Different Temperaments; III., Alimentary Substances and Drugs; IV., Hygiene; V., Cosmetics; VI., the Regimen to be adopted in Traveling; VII., Surgery; VIII., Poisons; IX., Maladies in General; X., Fevers.
A third treatise of considerable importance is that which is devoted by Rhazes to the description and treatment of small-pox and measles. So far as is known at the present time this is the first treatise that has been written on these diseases, and its celebrity rests, not only upon this circumstance, but also upon the facts that its author is evidently familiar with the different types of small-pox and with the characteristic features which distinguish this disease from measles. Freind, in commenting upon this treatise, says that Rhazes assigned for small-pox a cause “entirely new in physick, a sort of an innate contagion. This is a ferment in the blood, like that in must, which purifies itself sooner or later by throwing off the peccant matter at the glands of the skin; an hypothesis since applied, though upon very slight grounds, to feavers in general by many moderns.” From this account it is fair to conclude that Rhazes, in the tenth century of the Christian era, as clearly suspected the germ origin of certain febrile diseases as Liebermeister did toward the end of the nineteenth, or as Fracastoro did in the sixteenth. And one cannot help exclaiming: How many centuries had to elapse, and what an immense amount of other facts had still to be discovered—facts in anatomy, in physiology, in chemistry, in optics, etc.—before it became possible to convert this suspicion, this simple product of the reasoning faculty, into an actual demonstration of the truth in pathology!
Among the Arabian physicians of the eleventh century Avicenna is certainly one who should be placed in the first rank. He was born in 980 A. D. at Afschena, a village in the Province of Khorassan, Persia, and spent his youth in Bokhara, where his father held some high office under the Government. His great intellectual capacity was revealed at an early age. It is said, for example, that already before he was ten years old he had committed the entire Koran to memory; and it is added, further, that when he was only seventeen years old he had already acquired such knowledge of medicine that he was invited to take part in a consultation regarding some malady with which the Emir Nuch ben Mansur was affected. The advice which he gave on this occasion was followed, and in the sequel it proved so good that he was granted, as a reward, unrestricted access to the royal library,—a privilege which he utilized to the very best advantage. When his father died Avicenna came into possession of a large fortune, which enabled him to indulge in a great deal of traveling. In this way he visited one Persian Court after another throughout a period of several years. Finally, during a residence at Hamadan, the Prince Schems ed-Daula, whom Avicenna had successfully treated for some malady, made him his Vizir. While he held this office he managed, without neglecting his official duties, to continue his scientific studies; but he was not able entirely to keep out of political intrigues, and as a consequence his life was for a short time in some danger. He was confined for several months in a fortress, from which, however, he managed eventually to make his escape to the Court of Ibn Kakujah, in Ispahan. He resided in that city during the following fourteen years, and it was there that he wrote his two principal works—the famous medical treatise known as the “Canon,” and the equally celebrated cyclopaedic work on philosophy. Worn out by his incessant and most exhausting literary labors and by his excesses in other directions, Avicenna died in June, 1037 A. D., while he was accompanying the Emir on his expedition to Hamadan. His tomb may still be seen in the latter city.
Neuburger, from whose excellent History of Medicine the preceding details have been gleaned, makes the statement that the treatise in which Avicenna’s clinical experience was recorded has not come down to our time, and that, consequently, we lack the means of estimating just how great a physician—just how close a clinical observer and how wise a practitioner—he really was. So far, however, as may be judged from the evidence furnished by the Canon, Avicenna was not the equal, in all practical matters relating to medicine, of Haly Abbas and of Rhazes. He was perhaps too much inclined to “look at bedside phenomena through the spectacles of preconceived theories.” In brief, he was, first and foremost, a philosopher, and only in a subordinate degree a physician, although a most excellent one. In Book III., where he discusses certain surgical procedures, statements are made which justify the belief that Avicenna was acquainted with intubation of the larynx.
Le Clerc mentions six other Persians who, during the tenth century of the present era, gained more or less distinction as physicians. In the following paragraphs brief notices are given of each of these men.