Figure 15.--Metallic syringe for injecting solutions into the bladder. Top, from original Arabic manuscript (Bes. 503), courtesy Süleymaniye Umumi Kütüphanesi Müdürlüğü. Bottom, from Argellata 1531, courtesy National Library of Medicine.
Figure 16.—Metallic or porcelain syringes for injection of enemas. Top, from original Arabic manuscript (Ali 2854), courtesy Süleymaniye Umumi Kütüphanesi Müdürlüğü. Bottom, from Argellata 1531, courtesy National Library of Medicine.
Of special interest in chapter 59 is the metallic "syringe" ([fig. 15]) used to inject medicinal solutions into the bladder: "The hollow passage [of the syringe] should be exactly equal to the plunger it contains and no more, so that when such fluids from an excess of humors are aspirated they will be drawn out, and likewise when the solutions are injected they will be pushed in easily." Such description of the use of a "bladder syringe" in the late 10th century clearly points to the practical and interesting approach to surgery in al-Taṣrīf. Moreover, his description of the removal of a stone from the bladder—an operation we now call lithotomy—is considered a contribution to bladder surgery.
One of the earliest recorded operations for the extractions of two dead fetuses from the womb is clearly described in chapter 76. The account of this case shows not only al-Zahrāwī’s intelligent approach as a shrewd observer but also his clinical and surgical ability.
Drawings of bulb-syringe instruments used for administering enemas in ailments of the rectum and for the treatment of diarrhea and colic are depicted in chapter 83. The text describes several kinds of syringes made of silver, porcelain, and copper in various sizes ([fig. 16]). Of particular interest is an illustration of a syringe, especially recommended for children, to which a piece of leather (jildah) is attached ([fig. 17]). This instrument is a precursor of our modern bulb syringe.
In chapter 84 al-Zahrāwī turns to the treatment of various wounds. He prescribes the following powder formula for use: "Take olibanum [frankincense] and dragon’s blood,[27] two parts of each, and three parts of slaked or unslaked lime. Pound them well, pass through a sieve and apply the powder to the wound." In cases of damaged blood vessels, he tied the arteries by ligature, a practice of which he was a pioneer. In another chapter he describes four methods for suturing the intestines.
Al-Zahrāwī, being associated with war casualties and writing his treatise about the end of the 10th century, no doubt had the experience of dealing with cases involving injuries caused by arrows. The text in chapter 94 discloses his observations in elaborate investigations regarding the extraction of various kinds of arrows from the body.[28] Accordingly, several kinds of hooks and forceps for removing arrows are described and depicted in the treatise (see [fig. 18]). Al-Zahrāwī’s mention of Turkish bows and arrows led Freind to believe, erroneously, that the author of the treatise must have lived in the 12th century,[29] notwithstanding the fact that Turkish bows and arrows were in common use in the latter part of the 10th century.