Syria.—In the thirteenth century Damascus, the capital of Syria, assumed considerable importance as a centre of medical activity. Bagdad and Cairo had by this time lost the greater part of their attractiveness for those who wished to perfect their knowledge of the healing art, and the vandalism of the so-called Soldiers of the Cross had put an end for many years to come to all hopes of making Constantinople once more the home of scientific or artistic effort. There was one branch of medical practice, however, in which the Cairo physicians excelled all others—that, namely, of ophthalmology. This is explained by the well-known fact that at all periods of her history Egypt has been afflicted with ophthalmias to a much greater degree than any of the other countries of the Mediterranean basin. The great wealth accumulated in Damascus, the large number of hospitals which were located in the city, and the attractiveness of the town as a place of residence undoubtedly had much to do with the fact that it attained at this period so great popularity as a centre of medical activity.
Spain.—During the tenth century of the present era the Moslem reign in Spain flourished greatly under the two enlightened rulers of the Ommiade Dynasty—Abdurrahman Ennasser and Hakem, and medicine shared fully in this prosperity. During Abdurrahman’s reign the Emperor Romanus at Constantinople sent an embassy to Cordova in Spain, and among the gifts which they took with them for the Prince, was a copy of the treatise of Dioscorides in the original Greek, illustrated by marvelously beautiful paintings of the different medicinal plants. But there was nobody in Cordova at that time who could read Greek. Accordingly, Abdurrahman begged the Emperor to send him a man who was familiar with both the Greek and the Latin tongues, and it was in answer to this request that the monk Nicholas was sent to Cordova (951 A. D.). Working in conjunction with several of the most distinguished physicians of that city he succeeded in identifying nearly all of the plants mentioned by Dioscorides.
Among the physicians of Arab, Persian or Jewish extraction who, during the eleventh and twelfth centuries, practiced their profession in Spain and attained considerable celebrity, the following deserve to receive special mention here: Abulcasis, Avenzoar, Averroes and Maimonides.
Abulcasis.—Abulcasis is universally credited with being the greatest surgeon of whom the Arabs may rightfully boast. He was born at Zahra near Cordova in 936 A. D., and his death occurred 1013 A. D. Quite early in his professional career (before he had reached his twenty-fifth year) he was appointed one of Abdurrahman’s private physicians. Although he owes his reputation chiefly to the treatises which he wrote on surgery Abulcasis was also the author of several medical works. He published a collection of all his writings under the title of “The Tesrif,” which is divided into thirty parts or books, and which—according to Lucien Le Clerc—constitutes a veritable encyclopaedia. During the course of the twelfth century Gerard of Cremona translated into Latin the part relating to surgery; it is not known at what time or by whom the remainder of the collection was translated. The author’s name in the Latin edition is given, not as Abulcasis, but as Alsaharavius.
During the lifetime of Abulcasis his writings, and especially his work on surgery, were not very highly appreciated in Spain. This was largely due to the fact that the Mohammedan inhabitants of that country did not look upon surgery with any degree of favor. The Arabs of the East held Abulcasis in much greater honor. Guy de Chauliac, the famous French surgeon of the fourteenth century, in his treatise on surgery, quotes Abulcasis no less than two hundred times. Le Clerc, in the course of his remarks upon the value of the surgical treatise written by Abulcasis, says: “This book will always be considered, in the history of medicine, to represent the first formal and distinct scientific treatise on surgery.” At the same time, the prevailing testimony makes it appear that the book contains only a small portion of original matter, a large part of its substance having been borrowed from the work of the Greek author, Paulus Aegineta. Its chief merit consists in the orderly and very clear manner in which the facts are presented, and doubtless the popularity of the book was materially increased by the fact that many of the instruments required for the different operations were illustrated pictorially.
Lucien Le Clerc has published (Paris, 1861) a French translation of Abulcasis’ Treatise on Surgery, and on page 71 of this version the following statement will be found:—
... you may also introduce into the cannula a specially adapted piston in copper, or a stylet the end of which is armed with cotton. Then fill the cannula with oil or some other suitable fluid, introduce into one end the stylet armed with cotton, and push it onward until the liquid enters the ear.
Edouard Nicaise, commenting on these words in his version of Guy de Chauliac’s La Grande Chirurgie (page 690), says that they constitute the first reference, thus far discovered in medical literature, to the use of the instrument known as a syringe.
Avenzoar.—Avenzoar was born in Seville, in the southern part of Spain, during the latter part of the eleventh century. The exact date is not known. His father was a physician of some distinction, and his son also attained considerable eminence in the same profession. According to Neuburger, Avenzoar died, at an advanced age, in 1162 A. D., and was buried in Seville.
It is said that in actual practice Avenzoar, who was a man of some wealth, confined himself to consultation work. He considered it beneath the dignity of a physician to prepare drugs, to apply leeches, or to perform certain surgical operations—as, for example, lithotomy; but Le Clerc seems disposed to believe that Avenzoar did not adopt this view until after he had become somewhat celebrated and had accumulated a fortune. Neuburger ranks him next to Rhazes as a clinical observer and a practitioner of sound common sense, and he speaks of his great medical work, the Teïssir, as a treatise that abounds in most interesting histories of cases of disease. Among these will be found the account of an attack of mediastinitis which occurred in his own person, and which ended in suppuration that found a vent for its products by way of one of the bronchi.[51] As this disease is of rare occurrence, and as Freind’s account of the attack is presumably a translation of the original report in Arabic made by Avenzoar, its reproduction here may be interesting. I shall take the liberty of modernizing the text very slightly and of abbreviating it in one or two places.