The science of medicine, in common with the other branches of practical knowledge already enumerated, was introduced into Christendom through the Moslem kingdoms of Southern Europe. The Spanish and Sicilian Arabs were the distributors of the accumulated wisdom of the East. The munificent patronage of their rulers, the enterprise of their merchants, the ambition of their scholars, enabled them to profit by the literary resources and invaluable observations of the great medical schools of Bagdad, Cairo, and Damascus. The Continent of Rhazes, the Canon of Avicenna, the Meliki of Ali-Ibn-Abbas, each a vast compendium of scientific information, whose principles form the basis of all modern practice, were early familiar to the Moorish physicians of the Peninsula. The works of Al-Hazen and Ali-Ibn-Issa, indispensable to oculists, were used by the students of Cordova even before their adoption by the colleges of Teheran and Cairo. Every medical treatise of importance was to be found in the libraries of the khalifate. Nor were the efforts of the Hispano-Arab practitioners limited to the collection of the literary productions of their professional brethren of the Orient. They translated the ancient Greek masters. They composed voluminous commentaries on famous authors whose opinions were regarded as oracular. No names in the long catalogue of Moslem genius stand higher than those of Abulcasis, the originator of modern surgery; than Avenzoar, whose family was prominent for three hundred years in the medical annals of Moorish Spain; than Averroes, whose great professional attainments have been obscured by his pre-eminent reputation as a natural philosopher. Arib-Ibn-Said-al-Khatib, whose works exceeded a thousand in number, composed treatises on gynæcology and obstetrics, and was the author of the Calendar of Cordova, a wonderful compilation of medical truths, surgical maxims, astronomical and agricultural knowledge. Ibn-Wafed, of Toledo, who lived in the tenth century, and whose extraordinary abilities made him conspicuous among hundreds of eminent contemporaries, consumed twenty years in the preparation of his work on the general practice of medicine. Ibn-Zohr, of Seville, was the first to discover that scabies was produced by a diminutive parasite, and to prescribe sulphur as a remedy. The treatise of Mohammed-Ibn-Quassum on diseases of the eye occupied six hundred pages; that of Mohammed-al-Temini on hernia and tumors nearly four hundred. Daoud-al-Agrebi wrote on fumigations, collyriums, hemostatics; he recommends the administration of narcotics in lithotomy, in the incision of abscesses, and in emasculation for the production of eunuchs. Saladin-Ibn-Yusuf published a book on the anatomy of the eye and the theories of vision. The scientific and logical methods inaugurated by the khalifs of the East were perfected in the medical colleges of Mohammedan Spain. The study of anatomy attained a development previously unknown to the traditions and experience of the profession. From the contemplation of bone-heaps in the cemeteries the student advanced to the performance of autopsies; to the determination, by actual survey, of the location and offices of the internal organs; to the vivisection of quadrupeds and criminals. A material advance in general intelligence is implied from the fact that these inquiries, heretofore so repugnant to popular feeling and religious tradition, could be prosecuted in peace. In etiology, pathology, therapeutics, great progress was made. Surgery, whose practice had entailed reproach rather than distinction upon its professors, was, by the removal of the prejudice attaching to anatomical demonstration, relieved of the obloquy with which it was generally regarded. A blind reverence for precedent and authority was not recognized by the practitioners of the Hispano-Arab school. They inculcated the paramount importance of a competent knowledge of the functions of the organs of the human body, which they well knew could only be obtained from the practice of dissection, abhorrent to the minds of both the Moslem and the Jew. They advised great caution in all operations. Every new theory was subjected to severe and exhaustive tests. Heroic treatment was adopted only where milder means had proved unsuccessful. Whenever possible, the curative powers of nature were allowed full exercise; and a change of climate, especially in pulmonary affections, was one of the principal resources of the Moorish physicians. Their works were elucidated by the introduction into the text of drawings of instruments adapted to the removal of the morbid conditions described; and science is indebted to the Spanish Moslems for this innovation, now an essential part of all treatises on surgery. The treatment of the eye received more attention from the Arabs than any other branch of the profession. Their oculists were most accomplished operators; the heat and dryness of the climate being favorable to ophthalmic affections and affording the surgeon varied and incessant practice. They enumerate nine different forms of cataract, which they treated by couching and by puncture. Their needles were both round and triangular; some were hollow and made of glass. The Arabs were the first to perform the important operation of lithotomy and to reduce old dislocations. They knew how to ligature the arteries four centuries before Ambrose Paré. They used hooks for the extraction of polypi. They made frequent and intelligent use of counter-irritants. The seton is their invention. The application of leeches in apoplexy was a common incident in their practice. They were familiar with the effects of caustics and acids as escharotics. They substituted refrigerants for tonics in certain affections of the nerve-centres. They understood the value of cold water in arresting hemorrhage. They originated the modern method of bandaging. The treatment of slow fevers, like typhoid, by baths of low temperature, was frequently employed by them; it was recommended by Rhazes nine hundred years before its announcement to the present generation as a new and remarkable discovery. To Ibn-Zohr medical science owes the operation of tracheotomy and the original description of pericarditis. Abulcasis, in explaining lithotomy, advises the section used by surgeons ever since he wrote, in the tenth century. Nor had the advantages derived from anæsthesia escaped the notice of these profound and ingenious observers. They suggest the administration, in decoction, of darnel—the Lolium Temulentum—and other plants of narcotic properties, until complete loss of consciousness and sensation is obtained, to facilitate the performance of severe operations. Even the results of microbial infection appear to have been recognized by them, although its cause remained unknown. When, in the tenth century, Rhazes was directed by the Khalif to select a hospital site in the city of Bagdad, he caused pieces of meat to be suspended in different localities, and the building was erected in that place where, after a given time, the least putrefaction was visible. Nor in that early day was the care of animals neglected, and the name of Abu-Bekr-Ibn-Bedr has descended to posterity as that of a famous veterinary surgeon.
In their contributions to the pharmacopœia, the Spanish Mohammedans rendered invaluable services to medicine. Abul-Abbas, of Seville, was the first to apply the principles of botanical science—heretofore principally devoted to agriculture—to the purposes of the apothecary and the physician. In the work of Ibn-al-Awam six hundred plants possessing medicinal properties are enumerated; in that of Ibn-Beithar more than three hundred, hitherto unclassified or unknown, are mentioned and described. Ibn-Essouri, in his work on the Materia Medica, painted the herbs which had been the subject of his investigations not only as they grew, but as they appeared, when dried, on the shelves of the druggist; his is the first example of an Arabic book illustrated in colors. The methods of the Moorish practitioners were conservative. They attempted no doubtful or hazardous experiments. They discarded the drastic remedies of the ancients. Profoundly versed in the science of horticulture, they watered the roots of plants and trees with strong infusions of purgative drugs, and afterwards administered their fruits. Their personal attention to the rules of hygiene was often evidenced by their remarkable longevity. Rhazes was in active practice at Bagdad for more than half a century; Abulcasis attained the great age of one hundred and one years.
The superior excellence of the Spanish-Arab school is attributable to the fact that its members devoted their talents to a single profession. For the most part, they avoided the example of the Oriental, whose medical researches were hampered by philosophical speculations, and who turned from the diagnosis of ailments and the application of remedies to the fascinations of alchemy and to vagaries concerning the imaginary relations of humanity to the mysterious influence of the stars. They were not altogether free from these delusions, nevertheless, for they pulverized jewels, supposed to be efficacious in certain diseases, and coated their drugs with gold and silver leaf, a proceeding which to the adept had a profound alchemical significance. From this custom is derived our expression, “to gild the pill.” They usually, however, confined their observations to the legitimate sphere of the physician—to the subjects of medicine, surgery, pharmacy, hygiene.
The various topical applications used at present by the profession—such as unguents, plasters, counter-irritants, and pomades—originated in Mohammedan Spain. The hospital service of that country has received little attention from historians, but it is highly improbable that, in the general advance of civilization, this important auxiliary to medicine should have been at all neglected. It is a singular fact that the only detailed notice of a Moorish hospital in the Peninsula is of that of Algeziras, which was founded in the twelfth century. Tradition reports, however, that fifty public institutions of this kind existed at one time at Cordova. The Hispano-Arab practitioners held consultations at the bedside of the patient; some, employed by the government, visited the sick of remote localities at regular intervals; for the poor there was gratuitous attendance and treatment. The discoveries of Arab medicine were mainly preserved and diffused through the translations of Gerard of Cremona, whose indefatigable industry imposed such lasting obligations on modern science. For fifty years he was employed at Toledo, until his translations reached the enormous number of seventy-six. Had it not been for his efforts, and those of his patient collaborators, the works of the Moorish physicians would have shared the fate of the voluminous collections of Arabic miscellaneous literature. Of the millions of volumes which represented the intellectual glory of the khalifate scarcely a copy exists in Spain. What escaped the malignant vigilance of Ximenes perished at the hands of the Inquisition. It is not generally known that the bulk of the manuscripts of the Escorial library constitutes no part of the literary inheritance of the Moslem domination. They represent the spoil of vessels captured on the coast of Morocco in the early part of the seventeenth century. In nearly all of these the invocation of Allah and Mohammed, with which every important Arabic work begins, has been carefully erased.
Of such a character were the literary and scientific achievements of the Arabs, whose highest mental development was reached under the influence of the Mohammedan dynasties of the Peninsula. In the fierce and relentless struggle prosecuted for centuries between pontifical iniquity and intolerance and Moslem learning, the former ultimately triumphed. It may not be inappropriate at the close of this chapter to recount the consequences of that triumph; to disclose the aims of the victor; to enumerate the sacrifices of the vanquished; to contrast the effects of the supremacy of either upon the welfare of humanity and the march of civilization. From the Arabian Prophet, reared amidst the pastoral simplicity and barbaric ignorance of the Desert, came such utterances as these,—utterances which, if not inspired, are yet certainly of priceless value to the human race: “Teach science: whoever teaches it fears God; whoever desires it adores God; whoever speaks of it praises God; whoever diffuses it distributes alms; whoever possesses it becomes an object of veneration and respect. Science preserves us from error and from sin; it illuminates the road to Paradise; it is our protector in travel, our confidant in the Desert, our companion in solitude. It guides us through the pleasures and the sorrows of life; it serves us alike as an ornament among our friends and as a buckler against our enemies; it is through its instrumentality that the Almighty raises up those whom he has appointed to determine the good and the true. The memories of such men are the only ones which shall survive, for their noble deeds will serve as models for the imitation of the great minds that shall come after them. Science is a potent remedy for the infirmities of ignorance, a brilliant beacon in the night of injustice. The study of letters is as meritorious as fasting; their communication is not inferior in efficacy to prayer; in a generous heart they awaken the most elevated sentiments; to the wicked they impart the corrective and humanizing precepts of virtue.” These words, spoken by Mohammed in the seventh century, were received by the votaries of Islam with the respect due to a revelation destined to guide their policy, with reference to literary pursuits, through all subsequent ages.
Far different was the attitude assumed by the ecclesiastical power whose despotic mandates were for a thousand years recognized and obeyed by the proudest sovereigns of Christendom. It early perceived the incompatibility of its pretensions with the untrammelled exercise of the faculties of the human intellect. Founded upon principles whose acceptance, as maxims of divine origin, necessarily precluded all ideas of improvement and progress, it had no resource but quiescence; it could countenance no condition but that of immobility. It placed a premium upon ignorance, and enjoined the employment of persecution as a virtue. It blighted every noble aspiration which came within the sphere of its destructive energy. Through the oracular mouths of the Fathers it denounced all philosophy as “empty and false.” In its Constitution of Faith, promulgated in the nineteenth century by the Vatican Council,—many of whose articles are indorsed as sound by every consistent member of the Evangelical Communion,—it anathematized all “who shall say that human sciences ought to be pursued in such a spirit of freedom that one may be allowed to hold as true their assertions, even when opposed to revealed doctrine.”
Such were the various aspects under which scientific thought was regarded respectively by the Founder of Islam and the infallible representatives of Christianity. The effects of such spiritual admonitions upon the physical condition of those subjected to their influence are disclosed by the material and intellectual prosperity or debasement of nations. In no examples of the political and economic life of the Middle Ages or of subsequent times are such striking, such incredible, contrasts exhibited as in the annals of Mohammedan Spain and Catholic Europe. In the tenth century Andalusia was traversed in every direction by magnificent aqueducts; Cordova was a city of fountains; its thoroughfares, for a distance of miles, were brilliantly illuminated, substantially paved, kept in excellent repair, regularly patrolled by guardians of the peace. In Paris there were no pavements until the thirteenth century; in London none until the fourteenth; the streets of both capitals were receptacles of filth, and often impassable; at night shrouded in inky darkness; at all times dominated by outlaws; the haunt of the footpad, the nursery of the pestilence, the source of every disease, the scene of every crime. It was not until the close of the reign of Charles II. that even a defective system of street lighting was adopted; in London the mortality of the plague is a convincing proof of the unsanitary conditions that everywhere prevailed; the supply of water was derived from the polluted river or from wells reeking with contamination. Nor did time and experience bring to the public mind a realization of the importance of improvements vitally affecting the health and convenience of every community. As late as 1825, water of doubtful purity was hawked about from door to door in the city of New York; a solitary wooden pump in Chatham Street sufficed for the general necessities of the poor; sewage was carried in tubs on the heads of negroes and thrown into the river; and only three hundred lamps and gas-jets diffused their uncertain and flickering glare through the squares and avenues of the metropolis of the western world.
The annual receipts of the state from all sources under Abd-al-Rahman III. in the first half of the tenth century exceeded three hundred million dollars; the revenues of the English Crown at the close of the seventeenth century were fifteen million; those of the United Provinces less than eighteen million; those of France sixty million, estimated at the present value of money. At the decease of this Moorish sovereign in 961, there were found in the royal coffers five million pieces of gold, equal to one hundred million dollars. When Louis XIV., the greatest potentate of his time, died in 1715, the treasury of France was bankrupt. The inhabitants of England at the death of Elizabeth were about four million; the population of Moorish Spain six centuries previous to that date could not have been less than thirty million, and was probably nearer fifty. In 1700, London, the most populous city of Christian Europe, was only half as large as Cordova was in 900, when Almeria and Seville had each as numerous a population as the capital of the British Empire eight hundred years afterwards. At the dawn of the eleventh century the Moslem dominions of Sicily and Spain presented a picture of universal cultivation and consequent prosperity, where industry was promoted and idleness was punished; where an enlightened spirit of humanity had provided asylums within whose walls the infirm and the aged might pass their remaining days in comfort and peace. Six hundred years afterwards what are now the richest and most valuable agricultural districts of Great Britain were unclaimed and uninhabitable bog and coppice, abandoned to game and frequented by robbers; and one-fourth of the inhabitants of England, incapable of the task of self-support, were during the greater part of the year dependent upon public charity, for which purpose a sum equal to one-half of the revenues of the crown was annually disbursed. In the middle of the tenth century there were nine hundred public baths in the capital of Moorish Spain; in the eighteenth century there were not as many in all the countries of Christian Europe. In the eighth century, the cottages occupied by the lower classes of the Spanish Moslems were embowered in roses, were surrounded by fields of waving grain and orchards of luscious fruits, were furnished with all the comforts and many of the luxuries of life; in the sixteenth century, the peasantry of France and Germany, ill-clad, begrimed with filth, and ignorant of the taste of bread, were living in squalid huts, sleeping upon reeking heaps of straw, drinking the waters of pond and morass, and feeding on carrots and acorns. Seven centuries after the cities of the Peninsula had been drained by a system of great sewers, their streets kept free from rubbish, and subjected to daily cleansing, Paris was still worthy of its ancient appellation of Lutetia, “The Muddy;” the way of the pedestrian was blocked by heaps of steaming offal and garbage; and droves of swine, the only scavengers, roamed unmolested through court-yard and thoroughfare.
Under the conditions of intellectual culture which characterized Moslem and Christian society even a greater inequality prevailed. The library of Mostandir, Sultan of Egypt, contained eighty thousand volumes; that of the Fatimites of Cairo, a million; that of Tripoli, two hundred thousand; in the thirteenth century, when Bagdad was sacked by the Mongols, the books cast into the Tigris completely covered its surface, and their ink dyed its waters black, while a far greater number were destroyed by fire; the public collections of the Moorish khalifate of Spain were seventy in number, and the great library of Al-Hakem II. alone included six hundred thousand volumes. The collections of many private individuals were proportionately large. In that of Ibn-al-Mathran, the physician of Saladin, were ten thousand manuscripts; upon the shelves of Dunasch-ben-Tamin, the great Jewish surgeon of Cairo, were more than twenty thousand. Four centuries afterwards few books existed in Christian Europe excepting those preserved in monasteries; the royal library of France consisted of nine hundred volumes, two-thirds of which were theological works; their subjects were limited to pious homilies, the miracles of saints, the duties of obedience to ecclesiastical superiors,—their sole merit consisted in the elegance of their chirography and the beauty of their illuminations. During the Hispano-Arab domination it was difficult to encounter even a Moorish peasant who could not read and write; during the same period in Europe many great personages could not boast these accomplishments. From the ninth to the thirteenth century the Spanish-Arabs possessed an educational system not inferior to the most improved ones of modern times; they taught astronomy from globes and planispheres; they measured the circumference of the earth; they observed the motions of the planets; they calculated the density of the atmosphere; they were familiar with the natural and artificial conditions under which vapors and gases are generated. For the European of that epoch there were no schools, for popular learning was discountenanced as conducive to heresy; education was confined to the cloister; the stars were but celestial lamps, whose only office was the nocturnal illumination of the earth; the latter was flat, and above it rose, in regular gradation, the seven regions of heaven; the ebullition and the explosion of gases were attributed to demoniac influence and to the agency of mischievous imps and goblins. Five centuries after the Moorish physicians of Spain had treated disease by the rational principles of medicine, surgery, and hygiene, Europe still adhered to the archaic conceptions of barbaric ignorance; to the belief that all illness was a manifestation of divine displeasure; to the possession by evil spirits; to the delusive expedients of priestly artifice,—the exhibition of relics, the muttering of texts, the performance of exorcisms. Six hundred years after the celebrated astronomer, Ibn-Junis—who constructed the Hakemite Table, advanced proofs of the eccentricity of the earth’s orbit, and utilized the pendulum for the purposes of chronometry—was honored and awarded with the friendship of the Khalif of Egypt, Galileo, in the degrading robe of the penitent, horrible with painted flames and devils, was forced, kneeling before the familiars of the Holy Office, to abjure, as dangerous heresies, the scientific truths he had subjected to mathematical and ocular demonstration,—the grand discoveries which have made his name immortal; and Bruno was sent to the stake for admitting the philosophical doctrine of the all-pervading Divine Essence, for teaching the heresy of a plurality of worlds, and for insisting that the earth revolved on its axis and round the sun. Seven hundred years after universal toleration was enforced throughout the domain of the Ommeyade Khalifate,—where even the populace had learned to respect the weaknesses of senile eccentricity, and the belief in demoniacal possession had been contemptuously abandoned to the most ignorant of the provincial rabble,—the Duke of York was subjecting the unhappy Covenanters of Scotland to promiscuous massacre and to the excruciating torture of the boot, and Cotton Mather was burning witches on Salem Common. More than twenty generations had elapsed since the Arab geographer was first regarded by his countrymen as a public benefactor, by his king as worthy of the highest honors that royalty can bestow, by the learned with the respect attaching to the possessor of unusual attainments; when Calvin tortured Servetus at Geneva for publishing the unscriptural assertion that Palestine, so far from being a land flowing with milk and honey, was, in fact, a barren waste of volcanic desolation,—Servetus, the great anatomist, who came within a hair’s-breadth of anticipating Harvey in his discovery of the circulation of the blood. From time immemorial among unenlightened races insanity has been attributed to the influence of malignant spirits, who could only be expelled by the unsparing use of the scourge or by the intervention of the priest. The Arabs were the first of nations to discard this idea, to use kindness and the administration of remedies in the treatment of the demented, and to establish asylums.
These conditions disclose the comparative value of two great politico-religious systems, both claiming divine authority, each uniting in its head the functions of Church and State,—one the exponent and zealous promoter of every scientific impulse, the other the ever-consistent representative of intellectual repression. The influence of Moslem genius is felt to-day in the numerous inventions, the insatiable thirst for knowledge, the marvellous development of art, science, and letters which have made the closing years of the nineteenth century ever memorable in the annals of civilization. Apparently extinguished by the noxious vapors of superstition that had darkened the Christian world for so many ages, the vital spark of learning still remained, which, rekindled in an epoch more propitious to mental culture, was destined to advance in an even more marked degree the material interests, as well as the most noble aspirations, of mankind. The law of human progress even under the most unfavorable conditions is constant, invariable, eternal. Its manifestations differ only in the degree of their advancement. The latter may be checked, but its retardation is only temporary. The ground lost by scientific truth in one century it will surely make up in the next, and, despite the hostile agencies which may conspire for its suppression, it is destined eventually to triumph.