Muslim Contribution to Modern Science Highly Questionable
With the world ever developing at a dizzying pace, there is a serious question out there that has not been sufficiently addressed. What contribution have Muslims made to civilization and science in the 20th - and now the 21st - century?
Sure, Muslims have claimed several accolades as proof of their contribution to scientific prowess. The most recent example of that is Dr. Ahmed Zewail, who won the 1999 Nobel Prize. Others have made contributions to the field, but on a much less notable level.
Having said that, there is no doubt that our contribution in proportion to the world's population is highly questionable, with much of the blame being attributed to Muslims' poor attitude towards science and the understanding of science, technology and the policies as well as allocation of resources to education and research by those in power.
In a live dialogue at Islam Online with Dr. Syed Imtiaz Ahmad on May 2, Ahmad discussed issues dealing with the role of science and technology in Islamic civilization. Muslims from around the world participated with their questions.
He believes that the known period of monumental contributions by Muslims was that of pre-renaissance. During that period of time, Muslims contributed works to every scientific field, from biology to astronomy. "The impact of science and technology on Islamic civilization has been the recognition of the contributions of Muslim scientists in the pre-renaissance era, accelerating the renaissance by at least 100 years in Europe," Ahmad said.
However, today we face many obstacles in our struggle to return to that eminence. One such obstacle was discussed in the dialogue dealing with the fact that the languages of the Muslim lands have not been modernized, causing a separation between those dialects and the scientific language of our times. Ahmad said, "I know that in my own studies of the writings of Islamic scholars, the words used by them particularly on concepts and results of science are highly questionable." He continued, saying, "I am not quite sure of the reasons for this but it may stem from a lack of culture in science and technology."
Ahmad believes that this was not the case in early Islamic civilization, with the rendering of scientific concepts and results in Arabic being very precise and forming the basis in translated works. "The scientists of that period understood sciences, even when reading in languages other than Arabic, enough to render it in Arabic precisely," he said.
Another obstacle that stands in our way is getting started on this path. Because there is either a lack of interest or finances going towards scientific research and study on the part of Muslim countries, many scholars are strapped with inadequate instruments by which to perform their various fields of research. In the end, this has caused some of the greatest Muslim thinkers to migrate to western countries.
On this issue, Ahmad said, "At the time that science and technology thrived among the Muslims, they were inspired by the Islamic spirit [in] the quest for knowledge, and often were supported with appropriate resources in the Muslim lands. These two things have to happen again - an intense activity in science and technology that is supported with resources, even if not quite understood by those in positions of power."
When asked what he thought it would take to have a reawakening of sorts amongst Muslim thinkers, Ahmad said, "It will take the Muslims what it took the early Muslims - a quest for knowledge, knowing the knowledge as it exists regardless of its source and having the drive to discover and make a contribution to civilization."
It was appropriate that Ahmad concluded the live chat session with a quote from Mohammad Khawarizmi, an Iraqi mathematician, astronomer and geographer from the 9th century. Khawarizmi was perhaps one of the greatest mathematicians who ever lived, as, in fact, he was the founder of several branches and basic concepts of mathematics.
In the words of Phillip Hitti, Khawarizmi influenced mathematical thought to a greater extent than any other medieval writer. His work on algebra was outstanding, as he not only initiated the subject in a systematic form but he also developed it to the extent of giving analytical solutions of linear and quadratic equations, which established him as the founder of Algebra. The very name Algebra has been derived from his famous book Al-Jabr wa-al-Muqabilah.
His arithmetic synthesized Greek and Hindu knowledge and also contained his own contribution of fundamental importance to mathematics and science. Thus, he explained the use of zero, a numeral of fundamental importance developed by the Arabs. Similarly, he developed the decimal system so that the overall system of numerals, "algorithm" or "algorizm" is named after him. In addition to introducing the Indian system of numerals (now generally known as Arabic numerals), he developed at length several arithmetical procedures, including operations on fractions. It was through his work that the system of numerals was first introduced to Arabs and later to Europe, through its translations in European languages.
The Khawarizmi quote that Ahmad used was: "That fondness for science... that affability and condescension which God shows to the learned, that promptitude with which he protects and supports them in the elucidation of obscurities and in the removal of difficulties, has encouraged me to compose a short work on calculating by al-Jabr [algebra] and al-Muqabala, confining it to what is easiest and most useful in arithmetic."
With the world ever developing at a dizzying pace, there is a serious question out there that has not been sufficiently addressed. What contribution have Muslims made to civilization and science in the 20th - and now the 21st - century?
Sure, Muslims have claimed several accolades as proof of their contribution to scientific prowess. The most recent example of that is Dr. Ahmed Zewail, who won the 1999 Nobel Prize. Others have made contributions to the field, but on a much less notable level.
Having said that, there is no doubt that our contribution in proportion to the world's population is highly questionable, with much of the blame being attributed to Muslims' poor attitude towards science and the understanding of science, technology and the policies as well as allocation of resources to education and research by those in power.
In a live dialogue at Islam Online with Dr. Syed Imtiaz Ahmad on May 2, Ahmad discussed issues dealing with the role of science and technology in Islamic civilization. Muslims from around the world participated with their questions.
He believes that the known period of monumental contributions by Muslims was that of pre-renaissance. During that period of time, Muslims contributed works to every scientific field, from biology to astronomy. "The impact of science and technology on Islamic civilization has been the recognition of the contributions of Muslim scientists in the pre-renaissance era, accelerating the renaissance by at least 100 years in Europe," Ahmad said.
However, today we face many obstacles in our struggle to return to that eminence. One such obstacle was discussed in the dialogue dealing with the fact that the languages of the Muslim lands have not been modernized, causing a separation between those dialects and the scientific language of our times. Ahmad said, "I know that in my own studies of the writings of Islamic scholars, the words used by them particularly on concepts and results of science are highly questionable." He continued, saying, "I am not quite sure of the reasons for this but it may stem from a lack of culture in science and technology."
Ahmad believes that this was not the case in early Islamic civilization, with the rendering of scientific concepts and results in Arabic being very precise and forming the basis in translated works. "The scientists of that period understood sciences, even when reading in languages other than Arabic, enough to render it in Arabic precisely," he said.
Another obstacle that stands in our way is getting started on this path. Because there is either a lack of interest or finances going towards scientific research and study on the part of Muslim countries, many scholars are strapped with inadequate instruments by which to perform their various fields of research. In the end, this has caused some of the greatest Muslim thinkers to migrate to western countries.
On this issue, Ahmad said, "At the time that science and technology thrived among the Muslims, they were inspired by the Islamic spirit [in] the quest for knowledge, and often were supported with appropriate resources in the Muslim lands. These two things have to happen again - an intense activity in science and technology that is supported with resources, even if not quite understood by those in positions of power."
When asked what he thought it would take to have a reawakening of sorts amongst Muslim thinkers, Ahmad said, "It will take the Muslims what it took the early Muslims - a quest for knowledge, knowing the knowledge as it exists regardless of its source and having the drive to discover and make a contribution to civilization."
It was appropriate that Ahmad concluded the live chat session with a quote from Mohammad Khawarizmi, an Iraqi mathematician, astronomer and geographer from the 9th century. Khawarizmi was perhaps one of the greatest mathematicians who ever lived, as, in fact, he was the founder of several branches and basic concepts of mathematics.
In the words of Phillip Hitti, Khawarizmi influenced mathematical thought to a greater extent than any other medieval writer. His work on algebra was outstanding, as he not only initiated the subject in a systematic form but he also developed it to the extent of giving analytical solutions of linear and quadratic equations, which established him as the founder of Algebra. The very name Algebra has been derived from his famous book Al-Jabr wa-al-Muqabilah.
His arithmetic synthesized Greek and Hindu knowledge and also contained his own contribution of fundamental importance to mathematics and science. Thus, he explained the use of zero, a numeral of fundamental importance developed by the Arabs. Similarly, he developed the decimal system so that the overall system of numerals, "algorithm" or "algorizm" is named after him. In addition to introducing the Indian system of numerals (now generally known as Arabic numerals), he developed at length several arithmetical procedures, including operations on fractions. It was through his work that the system of numerals was first introduced to Arabs and later to Europe, through its translations in European languages.
The Khawarizmi quote that Ahmad used was: "That fondness for science... that affability and condescension which God shows to the learned, that promptitude with which he protects and supports them in the elucidation of obscurities and in the removal of difficulties, has encouraged me to compose a short work on calculating by al-Jabr [algebra] and al-Muqabala, confining it to what is easiest and most useful in arithmetic."
The origin of Bimaristans (hospitals) in Islamic medical history
The word Bimaristan - which is of Persian origin - has the same meaning of hospital as (Bimar) in Persian means disease and (stan) is location or place, i.e. location or place of disease (1).
Although it was known that the Prophet Mohamed (may peace be upon him) was the first to order the establishment of small mobile military Bimaristan , and Rofaidah was the first female nurse to look after wounded Muslims followers in her mobile military tent (2), Noushirawy (3) in his new book on Islamic Bimaristans in the Middle Ages mentioned that the first proper Bimaristan built in Islam was in Damascus, by al-Waleed bin Abdel Malek and built in 86 Hijri (707 A.D.) . The aim of its building was treating patients and the care of affected chronic patients (as lepers and blind people... etc.) . The leprosy patients were treated freely and given money. In the Bimaristan there were more than one physician. It is obvious that Noushirawy adopted what was mentioned in (Al-kamel) of Ibn AL-Atheer (4) on this point specifically.
1- The Bimaristan system:
The people who are interested in establishing any institution must set an administrative or technical system to be followed. Of course the physicians in the Islamic world put in mind to follow a precise system inside the hospitals so that it would be based upon academic graduation which fulfills two amis: First, the welfare of the patients to be dealt with their treatment according to the updated rules of medical treatment. Second, Bimaristans used for teaching medicine to the newly graduated physicians responsible to treat patients successfully. Therefore the Bimaristans in the Islamic world were followed all the technical rules that fulfilled the two purposes together. (5,6,7,8).
Concerning the technical choice of bimaristanic site they used to choose the best location with regard to the health conditions. They preferred to build the Bimaristans over hills or by rivers. Al Adhodi's Bimaristan is a good example of this; it was built by Adhodo al-Dawla (9) in Baghdad by the River Dejlah and the water of the river flowed through its courtyard and halls and returned to pour into Dejlah.
Haroon Al-Rashid asked Al-Razi to build the first general hospital, so Al-Razi selected the place after putting few pieces of meat in different places in Baghdad to check the least spoiled one with the best fresh air.
Concerning organization, it was natural that the physicians comprehended the necessity of separating men and women, therefore they took into consideration as much as possible to divide the Bimaristan into two sections, one for men and the other for women. Each section was independent, each having large halls for the patients.
Concerning the administrative organization of the Bimaristan, it was as follows: each section contained a hall for each type of disease, while each hall had one physician or more and each group of doctors in a section had a chief doctor. The halls were specialized: a hall for internal diseases another for splinted patients (trauma and fractures) , and another one for delivery a special hall for each type of disease including communicable diseases .
Ibn Abi Usaibi'ah described in his book (Uyun al-Anba) the halls of internal medicine which frequently included a section for the patients affected by fever and another one for patients having mania. All sections of the Bimaristan were equipped with all the medical instruments and apparatuses necessary for the physician.
Ibn Abi Usaibi'ah tells us (10) that Adhod al Dawla set a test for a hundred physicians, when he decided to build the Adhodi Bimaristan on the Western side of Baghdad, and he chose twenty four physicians out of the hundred to work in the Bimaristan.
The chief of all physicians in the hospital was called (Al Saoor). The administrative and medical system in the hospital was based upon using boys who worked as employees or health workers, assistants or dressers; some of them were servants and they cleaned the Bimaristan and cared after the patients when necessary.
According to this order and system the Bimaristan was performing its medical job from a diagnostic point of view, disease definition and prescription of treatment. Moreover, they understood the necessity of adjoining a pharmacy to the Bimaristan to give out the drugs, which were given according to the physician's prescription, and the pharmacy was called «Al Sharabkhana» .
And as it is the case today, they used to inspect the Bimaristan. This was the responsibility of an employee assigned by the minister or the Caliph and given the authority to enter the hospital to be acquainted with the patients' status and the care offered to them, the food given to them and whether the boys were serving them or not. Whether the physician is performing his duty perfectly or he neglecting it. This system assured the stay and continuity of the Bimaristan in a serious way that allowed it to work with a high competence technically, scientifically and administratively.
It is worth mentioning that each patient had his own card on which the physician recorded his observations while treating him or her. Also the physician had his own special register to record his observations on the diseases he was treating. The physician performed his experiments and tests according to his observations. If the physician faced any problem in any matter of diagnosis, he went to the head of his division or the chief physician. Frequently the physicians held meetings to discuss cases. Undoubtedly these discussions and consultations were considered as a small scientific conference of physicians. We do the same today! .
In 1248 Al-Mansouri Hospital was built in Cairo (Egypt) , large hospital (with 8000 beds) and many specialized wards (general medicine, surgery, fractures, fever, eye diseases, ....) . Al-Mansouri hospital was provided by mosque for Muslim patients and chapel for Christians. Admission regardless race, colour or religion. There was no limited time for in-patient treatment , and patient stays till he/she is fully recovered ( the sign of recovery was the ability to eat full chicken !) . On discharge the patient is given clothes and pocket money also !!
In Damascus there was Bimaristan Al-Noori in a very similar way .
We notice that the historians of Arab medicine wrote special long pages on the medical personalities about whom discussions were held to set the work system in the hospital, or the Bimaristan between the physicians. There were shifts for the doctors, some worked in the morning and others at night, some worked a certain time in the morning and another period at night, so that they cared for the patient. At the same time they could get enough rest to allow them to continue working in the Bimaristan, supervise the treatment system and medical care of the patients.
Al-Maqrizi mentioned in his plans (11) that the patients were registered at the admission in the Bimaristan, their clothes were taken away and their money put in trust by the Bimaristan guardian. The patients received clean clothes instead of those taken from them, and they were given drugs and food under the supervision of the physicians freely till they were cured.
Ibn al-Okhowa described in his book (al-Hisba) the entrance of the patient to the outpatient clinic to see the physician. He said in a very important text :
'' the physician asks the patient about the cause of his illness and the pain he feels. He prepares for the patient syrups and other drugs, then he writes a copy of the prescription to the parents attending with the patient. Next day he re-examines the patient and looks at the drugs and asks him if he feels better or not, and he advises the patient according to his condition. This procedure is repeated on the third day and the fourth... till the patient is either cured or dead. If the patient is cured, the physician is paid. If the patient dies, his parents go to the chief doctor, they present the prescriptions written by the physician. If the chief doctor judges that the physician has performed his job perfectly without negligence, he tells the parents that death was natural; if he judges otherwise, he tells them: take the blood money of your relative from the physician; he killed him by his bad performance and negligence. In this honorable way they were sure that medicine is practiced by experienced well trained persons '' (12).
2- Bimaristan Varieties according to different Purposes:
Each type of diseases might require a special Bimaristan for a group of patients. This can be noticed at least by specialization of Bimaristans for leprotics and mentally affected patients.
a) Mental Disease Bimaristan
Muslims realized the importance of the care for mentally affected patients. They frequently added to the big Bimaristans special places isolated by iron bars, specially for patients with mental diseases (13) , to avoid the aggression of these patients on the others.
Muslim physicians knew that psychiatric and mental diseases required a special type of care and that the physician must be acquainted with the etiology of the disease from which the patient is suffering.
It is worth mentioning that Ibn Abi Usaibi'ah (14) tells us in his book (Uyun al-Anba) about some cases of this type of disease and how the skilled doctor Waheed al-Zaman could treat them.
b) Leprosy Bimaristan:
This was built specially for patients with leprosy. At the start of our talk about Bimaristans we referred to what Nushirawy mentioned about al-Waleed bin Abdul al-Malek saying that ''he was the first who was interested in establishing such types of Bimaristans''.
According to Ibn al-Qifi (15) , the first who wrote a book on «Leprosy» was Yohana bin Masaway. The cause of interest in such a disease arises from the Muslim's idea of isolating the patients who had communicable diseases from the rest of the society. We find the same behavior with the doctors of today towards such diseases.
c) Road Bimaristan:
Arabs knew this type of Bimaristans and they realized its importance, because the pilgrimage to Macca and the Holy places or the commercial caravans that travailed for long distances required care for the travelers, such as treating wounded persons or saving a person asking for help.
Ibn Katheer (16) pointed out in his book (The Beginning and the End) that road Bimaristans were conducted by a wise director who knew how to give treatment: The rich people, who had the ability to equip the caravans with medical missions supported those Bimaristans financially.
d) Prison Bimaristan:
The Muslims cared medically for the imprisoned the same way they did for people outside the prison. This is clear from the letter the minister, Issa bin Ali al-Garrah (17) Minister of al-Moktader, to Sanan bin Thabit (Al-Tabeeb Al-Natassi) who was distinguished in Arab medicine and who embraced Islam at the hands of Al-Qaher. After Issa bin Ali had visited the prisons, he found it was necessary to treat the patients and preserve their humanity so, he sent his famous letter to Sanan in which he said: ''I thought of the imprisoned people and what they are exposed, due to their big number and their hard situation, to diseases; they are incapable to deal with their excretions or to meet doctors to seek their advice about diseases. You have - May God grant you honor - to assign physicians to visit them daily and they should carry with them drugs and syrups and all they need to treat the patients and cure illnesses with God's will ''. Sinan followed this advice. Also according to what Ibn al-Qifti mentioned al Moktader asked Sinan bin Thabit to build a Bimaristan and give it his name. He ordered one at Bab Al-Sham and called it The Moktader Bimaristan and financed it with 200 Dinars monthly . This was in 306 Hijri and Sanan bin Thabit was assigned as chief doctor. When al-Moktader was told that one of his physicians had killed a man by mistake, he ordered Sinan to perform a test for the physicians. So, they were tested in Baghdad and their number became eight hundred physicians .
e) The Mobile Bimaristan:
This type of Bimaristan visited villages, peripheries and cities caring for the health of people who lived away from the state capital and allowed the state services to reach anyone who needed treatment in the state.
Ali bin Issa al-Garrah - al Muqtadir's minister - ordered the first state physician Sinan bin Thabit, in a written letter, to let doctors travel to the peripheries of the state. He said in his letter '' I thought of people who live in the peripheries and that among them are patients who do not receive any medical care because there are no doctors there. So, assign - May God prolong your life - some physicians to visit the peripheries; also a pharmacy containing drugs and syrups. They have to travel all through the peripheries and stay in each region enough time to perform treatment of patients, then they move to another one ''.
It was the state's responsibility to care for the Bimaristans. The senior physicians were aware of establishing work rules and bases to teach the students who came to learn medicine from everywhere. Therefore, medicine schools were established in the Islamic world, in which teaching was performed by two methods:
1- The theoretical method in the medical schools, and 2- A practical method for training and practice where students gathered around the doctor in chief to see and examine the patients and the treatment he prescribed. When the students finished the studying period they applied for an exam, took an oath and got their certificates. When they started to practice medicine, they always worked under the state's supervision. This means of course that Bimaristans were institutes for teaching medicine and to complete the study for junior doctors (18) . From a practical point of view, the professors prescribed the treatment for the patients, examined them in the presence of the students . They performed these instructions in an organized way and they did a follow up to the patients and hence they acquired the necessary practical experience for a medical student.
------------------------------------------------------------
References :
1- Ibn Abi Usaibi'ah, Uyun al Anba, P. 45.
2- Isa, A., The History of Bimaristans in Islam, Damascus, 1939, P. 9.
3- Noshrawy, A.R., The Islamic Bimaristans in the Middle Ages, Arabic Translation by M. Kh. Badra, The Arab Legacy Bul. No. 21, P 202.
4- Ibn Al-Atheer, Al-Kamel Fi al-Tareikh, The perfect in History, Cairo, 1290 H. V. 4P. 219.
5- Ibn Joubir, Rehlat Ibn Jouber, The Journey of Ibn Jouber, Cairo, 1358 H.
6- Isa Bey, A., The History of the Bimaristans in Islam, PP. 20, 40.
7- Khayrallah, A., Outline of Arabic Contributions to Medicine and Allied Sciences, Beirut, 1946, PP.63-68.
8- Noushirawy, A.R., The Islamic Bimaristan, P. 201.
9- Ibn Abi Usaibi'ah, Uyun al Anba, P. 415.
10- Ibn Abi Usaibi'ah, Uyun al Anba, PP. 415.
11- Al Maqrizi, Kitab, al-Mawa'es Wa al-Eitbar, V. 2, P. 405.
12- Ibn al Okhwa, Ma'alem al-Qurba fi Talab al-Hisba, The Features of Relations in al-Hisba, Cambridge, 1937, P. 167.
13- Noshrawy, A.R., The Islamic Bimaristans, P.202.
14- Ibn Abi Usaibi'ah, Uyun al-Anba, P. 337.
15- Al-Qifti, Tarikh al-Hukama, P. 249.
16- Ibn Katheer, Al-Bidaya wa al-Nihaya, The beginning and the End, The Library of knowledge, Beirut, 1966, Vol. 12 P. 188.
17- Al-Qifti, Tarikh al Hukama, P. 132.
18- Marhaba, A. R., The Course in the History of Arab Science, The Lebanese Publishing House, Beirut, 1970, P. 50.
The word Bimaristan - which is of Persian origin - has the same meaning of hospital as (Bimar) in Persian means disease and (stan) is location or place, i.e. location or place of disease (1).
Although it was known that the Prophet Mohamed (may peace be upon him) was the first to order the establishment of small mobile military Bimaristan , and Rofaidah was the first female nurse to look after wounded Muslims followers in her mobile military tent (2), Noushirawy (3) in his new book on Islamic Bimaristans in the Middle Ages mentioned that the first proper Bimaristan built in Islam was in Damascus, by al-Waleed bin Abdel Malek and built in 86 Hijri (707 A.D.) . The aim of its building was treating patients and the care of affected chronic patients (as lepers and blind people... etc.) . The leprosy patients were treated freely and given money. In the Bimaristan there were more than one physician. It is obvious that Noushirawy adopted what was mentioned in (Al-kamel) of Ibn AL-Atheer (4) on this point specifically.
1- The Bimaristan system:
The people who are interested in establishing any institution must set an administrative or technical system to be followed. Of course the physicians in the Islamic world put in mind to follow a precise system inside the hospitals so that it would be based upon academic graduation which fulfills two amis: First, the welfare of the patients to be dealt with their treatment according to the updated rules of medical treatment. Second, Bimaristans used for teaching medicine to the newly graduated physicians responsible to treat patients successfully. Therefore the Bimaristans in the Islamic world were followed all the technical rules that fulfilled the two purposes together. (5,6,7,8).
Concerning the technical choice of bimaristanic site they used to choose the best location with regard to the health conditions. They preferred to build the Bimaristans over hills or by rivers. Al Adhodi's Bimaristan is a good example of this; it was built by Adhodo al-Dawla (9) in Baghdad by the River Dejlah and the water of the river flowed through its courtyard and halls and returned to pour into Dejlah.
Haroon Al-Rashid asked Al-Razi to build the first general hospital, so Al-Razi selected the place after putting few pieces of meat in different places in Baghdad to check the least spoiled one with the best fresh air.
Concerning organization, it was natural that the physicians comprehended the necessity of separating men and women, therefore they took into consideration as much as possible to divide the Bimaristan into two sections, one for men and the other for women. Each section was independent, each having large halls for the patients.
Concerning the administrative organization of the Bimaristan, it was as follows: each section contained a hall for each type of disease, while each hall had one physician or more and each group of doctors in a section had a chief doctor. The halls were specialized: a hall for internal diseases another for splinted patients (trauma and fractures) , and another one for delivery a special hall for each type of disease including communicable diseases .
Ibn Abi Usaibi'ah described in his book (Uyun al-Anba) the halls of internal medicine which frequently included a section for the patients affected by fever and another one for patients having mania. All sections of the Bimaristan were equipped with all the medical instruments and apparatuses necessary for the physician.
Ibn Abi Usaibi'ah tells us (10) that Adhod al Dawla set a test for a hundred physicians, when he decided to build the Adhodi Bimaristan on the Western side of Baghdad, and he chose twenty four physicians out of the hundred to work in the Bimaristan.
The chief of all physicians in the hospital was called (Al Saoor). The administrative and medical system in the hospital was based upon using boys who worked as employees or health workers, assistants or dressers; some of them were servants and they cleaned the Bimaristan and cared after the patients when necessary.
According to this order and system the Bimaristan was performing its medical job from a diagnostic point of view, disease definition and prescription of treatment. Moreover, they understood the necessity of adjoining a pharmacy to the Bimaristan to give out the drugs, which were given according to the physician's prescription, and the pharmacy was called «Al Sharabkhana» .
And as it is the case today, they used to inspect the Bimaristan. This was the responsibility of an employee assigned by the minister or the Caliph and given the authority to enter the hospital to be acquainted with the patients' status and the care offered to them, the food given to them and whether the boys were serving them or not. Whether the physician is performing his duty perfectly or he neglecting it. This system assured the stay and continuity of the Bimaristan in a serious way that allowed it to work with a high competence technically, scientifically and administratively.
It is worth mentioning that each patient had his own card on which the physician recorded his observations while treating him or her. Also the physician had his own special register to record his observations on the diseases he was treating. The physician performed his experiments and tests according to his observations. If the physician faced any problem in any matter of diagnosis, he went to the head of his division or the chief physician. Frequently the physicians held meetings to discuss cases. Undoubtedly these discussions and consultations were considered as a small scientific conference of physicians. We do the same today! .
In 1248 Al-Mansouri Hospital was built in Cairo (Egypt) , large hospital (with 8000 beds) and many specialized wards (general medicine, surgery, fractures, fever, eye diseases, ....) . Al-Mansouri hospital was provided by mosque for Muslim patients and chapel for Christians. Admission regardless race, colour or religion. There was no limited time for in-patient treatment , and patient stays till he/she is fully recovered ( the sign of recovery was the ability to eat full chicken !) . On discharge the patient is given clothes and pocket money also !!
In Damascus there was Bimaristan Al-Noori in a very similar way .
We notice that the historians of Arab medicine wrote special long pages on the medical personalities about whom discussions were held to set the work system in the hospital, or the Bimaristan between the physicians. There were shifts for the doctors, some worked in the morning and others at night, some worked a certain time in the morning and another period at night, so that they cared for the patient. At the same time they could get enough rest to allow them to continue working in the Bimaristan, supervise the treatment system and medical care of the patients.
Al-Maqrizi mentioned in his plans (11) that the patients were registered at the admission in the Bimaristan, their clothes were taken away and their money put in trust by the Bimaristan guardian. The patients received clean clothes instead of those taken from them, and they were given drugs and food under the supervision of the physicians freely till they were cured.
Ibn al-Okhowa described in his book (al-Hisba) the entrance of the patient to the outpatient clinic to see the physician. He said in a very important text :
'' the physician asks the patient about the cause of his illness and the pain he feels. He prepares for the patient syrups and other drugs, then he writes a copy of the prescription to the parents attending with the patient. Next day he re-examines the patient and looks at the drugs and asks him if he feels better or not, and he advises the patient according to his condition. This procedure is repeated on the third day and the fourth... till the patient is either cured or dead. If the patient is cured, the physician is paid. If the patient dies, his parents go to the chief doctor, they present the prescriptions written by the physician. If the chief doctor judges that the physician has performed his job perfectly without negligence, he tells the parents that death was natural; if he judges otherwise, he tells them: take the blood money of your relative from the physician; he killed him by his bad performance and negligence. In this honorable way they were sure that medicine is practiced by experienced well trained persons '' (12).
2- Bimaristan Varieties according to different Purposes:
Each type of diseases might require a special Bimaristan for a group of patients. This can be noticed at least by specialization of Bimaristans for leprotics and mentally affected patients.
a) Mental Disease Bimaristan
Muslims realized the importance of the care for mentally affected patients. They frequently added to the big Bimaristans special places isolated by iron bars, specially for patients with mental diseases (13) , to avoid the aggression of these patients on the others.
Muslim physicians knew that psychiatric and mental diseases required a special type of care and that the physician must be acquainted with the etiology of the disease from which the patient is suffering.
It is worth mentioning that Ibn Abi Usaibi'ah (14) tells us in his book (Uyun al-Anba) about some cases of this type of disease and how the skilled doctor Waheed al-Zaman could treat them.
b) Leprosy Bimaristan:
This was built specially for patients with leprosy. At the start of our talk about Bimaristans we referred to what Nushirawy mentioned about al-Waleed bin Abdul al-Malek saying that ''he was the first who was interested in establishing such types of Bimaristans''.
According to Ibn al-Qifi (15) , the first who wrote a book on «Leprosy» was Yohana bin Masaway. The cause of interest in such a disease arises from the Muslim's idea of isolating the patients who had communicable diseases from the rest of the society. We find the same behavior with the doctors of today towards such diseases.
c) Road Bimaristan:
Arabs knew this type of Bimaristans and they realized its importance, because the pilgrimage to Macca and the Holy places or the commercial caravans that travailed for long distances required care for the travelers, such as treating wounded persons or saving a person asking for help.
Ibn Katheer (16) pointed out in his book (The Beginning and the End) that road Bimaristans were conducted by a wise director who knew how to give treatment: The rich people, who had the ability to equip the caravans with medical missions supported those Bimaristans financially.
d) Prison Bimaristan:
The Muslims cared medically for the imprisoned the same way they did for people outside the prison. This is clear from the letter the minister, Issa bin Ali al-Garrah (17) Minister of al-Moktader, to Sanan bin Thabit (Al-Tabeeb Al-Natassi) who was distinguished in Arab medicine and who embraced Islam at the hands of Al-Qaher. After Issa bin Ali had visited the prisons, he found it was necessary to treat the patients and preserve their humanity so, he sent his famous letter to Sanan in which he said: ''I thought of the imprisoned people and what they are exposed, due to their big number and their hard situation, to diseases; they are incapable to deal with their excretions or to meet doctors to seek their advice about diseases. You have - May God grant you honor - to assign physicians to visit them daily and they should carry with them drugs and syrups and all they need to treat the patients and cure illnesses with God's will ''. Sinan followed this advice. Also according to what Ibn al-Qifti mentioned al Moktader asked Sinan bin Thabit to build a Bimaristan and give it his name. He ordered one at Bab Al-Sham and called it The Moktader Bimaristan and financed it with 200 Dinars monthly . This was in 306 Hijri and Sanan bin Thabit was assigned as chief doctor. When al-Moktader was told that one of his physicians had killed a man by mistake, he ordered Sinan to perform a test for the physicians. So, they were tested in Baghdad and their number became eight hundred physicians .
e) The Mobile Bimaristan:
This type of Bimaristan visited villages, peripheries and cities caring for the health of people who lived away from the state capital and allowed the state services to reach anyone who needed treatment in the state.
Ali bin Issa al-Garrah - al Muqtadir's minister - ordered the first state physician Sinan bin Thabit, in a written letter, to let doctors travel to the peripheries of the state. He said in his letter '' I thought of people who live in the peripheries and that among them are patients who do not receive any medical care because there are no doctors there. So, assign - May God prolong your life - some physicians to visit the peripheries; also a pharmacy containing drugs and syrups. They have to travel all through the peripheries and stay in each region enough time to perform treatment of patients, then they move to another one ''.
It was the state's responsibility to care for the Bimaristans. The senior physicians were aware of establishing work rules and bases to teach the students who came to learn medicine from everywhere. Therefore, medicine schools were established in the Islamic world, in which teaching was performed by two methods:
1- The theoretical method in the medical schools, and 2- A practical method for training and practice where students gathered around the doctor in chief to see and examine the patients and the treatment he prescribed. When the students finished the studying period they applied for an exam, took an oath and got their certificates. When they started to practice medicine, they always worked under the state's supervision. This means of course that Bimaristans were institutes for teaching medicine and to complete the study for junior doctors (18) . From a practical point of view, the professors prescribed the treatment for the patients, examined them in the presence of the students . They performed these instructions in an organized way and they did a follow up to the patients and hence they acquired the necessary practical experience for a medical student.
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References :
1- Ibn Abi Usaibi'ah, Uyun al Anba, P. 45.
2- Isa, A., The History of Bimaristans in Islam, Damascus, 1939, P. 9.
3- Noshrawy, A.R., The Islamic Bimaristans in the Middle Ages, Arabic Translation by M. Kh. Badra, The Arab Legacy Bul. No. 21, P 202.
4- Ibn Al-Atheer, Al-Kamel Fi al-Tareikh, The perfect in History, Cairo, 1290 H. V. 4P. 219.
5- Ibn Joubir, Rehlat Ibn Jouber, The Journey of Ibn Jouber, Cairo, 1358 H.
6- Isa Bey, A., The History of the Bimaristans in Islam, PP. 20, 40.
7- Khayrallah, A., Outline of Arabic Contributions to Medicine and Allied Sciences, Beirut, 1946, PP.63-68.
8- Noushirawy, A.R., The Islamic Bimaristan, P. 201.
9- Ibn Abi Usaibi'ah, Uyun al Anba, P. 415.
10- Ibn Abi Usaibi'ah, Uyun al Anba, PP. 415.
11- Al Maqrizi, Kitab, al-Mawa'es Wa al-Eitbar, V. 2, P. 405.
12- Ibn al Okhwa, Ma'alem al-Qurba fi Talab al-Hisba, The Features of Relations in al-Hisba, Cambridge, 1937, P. 167.
13- Noshrawy, A.R., The Islamic Bimaristans, P.202.
14- Ibn Abi Usaibi'ah, Uyun al-Anba, P. 337.
15- Al-Qifti, Tarikh al-Hukama, P. 249.
16- Ibn Katheer, Al-Bidaya wa al-Nihaya, The beginning and the End, The Library of knowledge, Beirut, 1966, Vol. 12 P. 188.
17- Al-Qifti, Tarikh al Hukama, P. 132.
18- Marhaba, A. R., The Course in the History of Arab Science, The Lebanese Publishing House, Beirut, 1970, P. 50.
The Medicine of the Prophet: A Message Par Excellence
The traditions (sunnah) of the Prophet Muhammad (may the peace and blessings of Allah be upon him) are rich in advice and instructions on such matters as hygiene, sanitation, and treatment of disease through the use of medication. Referred to as Al-Tibb Al-Nabawi (prophetic medicine) by Muslims the world over, about 50 prophetic traditions on specific ailments and their remedies have been grouped together under the chapter referred to as Kitab-al-Tibb (the book of medicine) in the well-known collections of Hadith(prophetic sayings)by Bukhari, Muslim, Abu Dawud, At-Tirmidhi, and more.
Also, more than 300 traditions on aspects of hygiene, cleanliness, habit of eating and drinking, etc. find mention in these same collections. All these traditions, which number about 400, constitute what is referred to as prophetic medicine, and can be found together in the classic books of Ibn al-Qayyim Aljouzi (8th century Hijrah), Abu Nu`aim (5th century Hijrah), Abu Abdullah al-Dhahbi (8th century Hijrah), and Abu Bakr ibn al-Sani (4th century Hijrah). Most of these original Arabic treatises have been translated into English and other languages.
Islamic Foundations of Well-Being
The Prophet Muhammad laid down the foundation for a social order in which every member of society was advised to maintain a healthy life, physically, psychologically, and spiritually. No aspect of life was to be disregarded.
In the opinion of Douglas Guthrie (A History of Medicine, 1945), great advances in medicine made by Muslims during the Middle Ages were mainly due to the impact of the traditions of the Prophet Muhammad. Guthrie writes, “Had not the Prophet Muhammad himself said, ‘O Servant of God, use medicine, because God hath not created a pain without a remedy for it’”? Guthrie failed to quote the source of this important prophetic saying, but it is obvious that he was referring to the famous hadith from Tirmidhi(one of the six most important collections of prophetic traditions).
As a matter of fact, there are several such sayings in which the Prophet laid great stress on medicine and discouraged seeking help through amulets, relics, and charms. For instance, the Prophet once said, “There is a remedy for every malady and when the remedy is applied to the disease, it is cured.” This and several such hadiths have been described in Bukhari, Muslim, and Abu Dawud.
Once the Prophet was asked by one of his companions, “Is there any good in medicine?” To this he emphatically replied, “Yes.” As a result, Islamic teachings make it the duty of every society or group of people to conduct research and discover the remedy for diseases that afflict human beings. The concept of incurable diseases is thus alien to Islam.
Changing Age-Old Attitudes
There were several occasions when the Prophet visited the sick, and after enquiring about the ailments advised to take the medicine prescribed from experienced physicians. On several occasions he advised the sick to approach Harith bin Kalda, a well-known Jewish physician of Thaqif(a place near Madinah, Saudi Arabia where the Prophet resided at the time). On one particular occasion the Prophet visited Sa`d ibn Abi Waqqas who had suffered a heart attack. When the Prophet placed his hand on the chest of Sa`d he felt great relief, but the Prophet cautioned him and said, “You’ve had a heart attack and therefore should consult Harith Bin Kalda, who is the expert physician.” It is these and many other similar occasions that greatly changed the attitude of the Arabs towards diseases. Arabs, during the pre-Islamic period, depended mainly on invoking supernatural aid or different deities for the treatment of disease.
The Prophet Muhammad, realizing the consequences of infectious epidemics, advised his companions that, “When you hear about a break of plague in any area, do not enter there and when it has broken in a land where you are, then do not run way from it (and thus spread it elsewhere).” On the basis of this hadith, Muslims considered precaution and vigilance against infectious epidemics as the command of God.
The Prophet also opposed charms and incantations as a form of remedy for diseases. On some occasions, however, when physical remedy (medicine) was not available, he allowed, mainly for psychological reasons, the recitation of an incantation that has definite meaning. He also declared the victims of epidemics such as cholera and the plague as martyrs. This was a great consolation for those who suffered from it and realized the fatal consequences.
The Prophet always cautioned physicians to take extreme care in treating their patients and warned those not well-versed in the skill of medicine not to attempt treating the ill lest they might be held responsible for any complications. Quackery is, therefore, forbidden in Islamic medical ethics.
The Prophet Muhammad advised his followers to always care for their health, and whenever they were ill, whether seriously or otherwise, consoled them and told them not to feel that they were victims of the wrath of Allah. “Disease,” he said, “is not the wrath of Allah, because Prophets also suffered great pains, much greater than ordinary people.” Imagine what a solace these sayings would have provided to the followers of Islam.
Hope as Medicine
There are many Prophetic hadiths in Bukhari, Muslim and others that show that people were accustomed to go to the Prophet regularly and tell him about their ailments. He would advise them to resort to medicine first and then pray to God to get rid of the disease. On several occasions he would himself suggest certain medicines. For instance, in case of loss of appetite he frequently advised his followers to take talbina, a preparation made from barley. For constipation he used to recommend the use of senna. He was also in favor of regular use of honey for keeping fit. Similarly, for different ailments he would advise the use of olives, black cumin, chicory, endive fenugreek, ginger, marjoram, saffron, vinegar, and watercress. Hadiths on these medicines and others show the concern of the Prophet for the welfare and good health of his followers. For even apparently small matters like drinking water, eating food, and keeping clean and tidy he also gave advice. He is noted to have said, “Cleanliness is half of faith.”
Some of the hadiths on black cumin, senna, and watercress are very thought provoking. For instance, the Prophet is reported to have said that, “Black cuminis a remedy for every disease except death.” The Prophet expressed similar views on the efficacy of senna and cress.
The style and language of these hadiths are a clear indication of the fact that the Prophet placed great stress on medicines. These hadiths also put emphasis on confidence building of the ill towards their diseases and agonies suffered. Very rational advice was given that none should be disheartened by the intensity and duration of the disease because remedies have been provided by nature. They were also advised not to be afraid of impending death.
Once during the time of the Prophet, a person committed suicide as he could not bear the agony of his disease. The Prophet condemned the act and refused to participate in the last rites. Thus, hopelessness, despondency, dejection and frustration on account of serious disease and pain are against the spirit and tenets of Islamic medical ethics, as shown by the tradition of the Prophet.
Charms and Incantations: A Thing of the Past
There are several authentic hadiths, according to which people were said to come to the Prophet for spiritual remedies for their illnesses and that of their kith and kin. The Prophet, of course, prayed for them, but only after suggesting remedies in the form of medicines. Often he would advise the patients to consult the best physician in the area. On one occasion a lady came to the Prophet with her child who was bleeding because of a throat infection. He admonished her and advised her to treat the disease by using the extract of costus and pseudo-saffron. Similarly, once his wife complained of an abscess on her finger. The Prophet suggested an application of sweet flag on the fingers and then asked her to pray to Allah for recovery. There was also an occasion when a scorpion bit the Prophet himself. He immediately asked for hot water to which salt was added. The hot solution was poured on his bitten fingers while he recited Qur’anic verses.
These occasions and Prophetic hadiths led Muslims to believe in the rationale of using medicine rather than resorting to charms and incantations. On several occasions he exhorted them not to depend on supernatural methods of healing. He is also reported to have said, “charm is nothing but a work of Satan.”
The Human Prophet
Although the Prophet on one hand gave suitable advice to his followers on earthly affairs when such situations were brought to his attention, on the other hand he tried his best to create confidence in themselves so that they could act according to their own experience and opinions. Once, while withdrawing his advice given earlier on the cross pollination of date palm he said, “Whenever I command you to do something related to religion, do obey. And if I command you something about earthly matters, act on your own (experience) and (do remember) I am a human being.”
Putting Prophetic Medicine Into Perspective
In recent years, several books on prophetic medicine have been published, particularly in India and Pakistan, which do not project the true essence of the Prophet’s message. For instance, the author of a recently published book entitled Tibbe Nabwi Aur Jadid Science (Prophetic Medicine and Modern Science), claims that Prophetic treatment of heart attack by eating seven dates, as was suggested to Sa`d ibn Abi Waqqas, should still be preferred over modern by-pass surgery for the disease, provided people have faith in the treatment of the Prophet. The learned author failed to understand that the Prophet, while suggesting to Sa`d to take dates as temporary relief, also advised him to consult the expert physician Harith bin Kalda for treatment.
As a matter of fact, it is not desirable to consider the Prophet’s traditions on medicine as similar to the prescription of a physician. In this connection, the opinion of Ibn Khaldun (14th century AD) is highly relevant and realistic. He says, “The Prophet’s mission was to make known to us the prescription of the Divine Law and not to instruct us in medicine of the common practice of ordinary life” (Muqqaddima). In his opinion, even very authentic hadiths cannot be taken as a mere medicinal prescription, which is the duty of an experienced physician. He says, however, that “with sincere faith, one may derive from them [hadiths] great advantage though this forms no part of medicine as it is properly called.” To emphasize his point of view, Ibn Khaldun refers to occasions when the Prophet tried to create confidence in his followers by advising them to take their own judgments in worldly affairs.
Prophetic medicine is a message par excellence. It is an advice to keep a healthy body and soul and to have faith in both physical and spiritual treatment. It is a command to us to strive hard to find newer medicines and newer remedies. It is a warning to those who consider diseases as the will of God for which no remedy is needed. It is an admonition for us to keep away from so-called spiritual treatment based on superstitions like sorcery, amulets, and charms.
The traditions (sunnah) of the Prophet Muhammad (may the peace and blessings of Allah be upon him) are rich in advice and instructions on such matters as hygiene, sanitation, and treatment of disease through the use of medication. Referred to as Al-Tibb Al-Nabawi (prophetic medicine) by Muslims the world over, about 50 prophetic traditions on specific ailments and their remedies have been grouped together under the chapter referred to as Kitab-al-Tibb (the book of medicine) in the well-known collections of Hadith(prophetic sayings)by Bukhari, Muslim, Abu Dawud, At-Tirmidhi, and more.
Also, more than 300 traditions on aspects of hygiene, cleanliness, habit of eating and drinking, etc. find mention in these same collections. All these traditions, which number about 400, constitute what is referred to as prophetic medicine, and can be found together in the classic books of Ibn al-Qayyim Aljouzi (8th century Hijrah), Abu Nu`aim (5th century Hijrah), Abu Abdullah al-Dhahbi (8th century Hijrah), and Abu Bakr ibn al-Sani (4th century Hijrah). Most of these original Arabic treatises have been translated into English and other languages.
Islamic Foundations of Well-Being
The Prophet Muhammad laid down the foundation for a social order in which every member of society was advised to maintain a healthy life, physically, psychologically, and spiritually. No aspect of life was to be disregarded.
In the opinion of Douglas Guthrie (A History of Medicine, 1945), great advances in medicine made by Muslims during the Middle Ages were mainly due to the impact of the traditions of the Prophet Muhammad. Guthrie writes, “Had not the Prophet Muhammad himself said, ‘O Servant of God, use medicine, because God hath not created a pain without a remedy for it’”? Guthrie failed to quote the source of this important prophetic saying, but it is obvious that he was referring to the famous hadith from Tirmidhi(one of the six most important collections of prophetic traditions).
As a matter of fact, there are several such sayings in which the Prophet laid great stress on medicine and discouraged seeking help through amulets, relics, and charms. For instance, the Prophet once said, “There is a remedy for every malady and when the remedy is applied to the disease, it is cured.” This and several such hadiths have been described in Bukhari, Muslim, and Abu Dawud.
Once the Prophet was asked by one of his companions, “Is there any good in medicine?” To this he emphatically replied, “Yes.” As a result, Islamic teachings make it the duty of every society or group of people to conduct research and discover the remedy for diseases that afflict human beings. The concept of incurable diseases is thus alien to Islam.
Changing Age-Old Attitudes
There were several occasions when the Prophet visited the sick, and after enquiring about the ailments advised to take the medicine prescribed from experienced physicians. On several occasions he advised the sick to approach Harith bin Kalda, a well-known Jewish physician of Thaqif(a place near Madinah, Saudi Arabia where the Prophet resided at the time). On one particular occasion the Prophet visited Sa`d ibn Abi Waqqas who had suffered a heart attack. When the Prophet placed his hand on the chest of Sa`d he felt great relief, but the Prophet cautioned him and said, “You’ve had a heart attack and therefore should consult Harith Bin Kalda, who is the expert physician.” It is these and many other similar occasions that greatly changed the attitude of the Arabs towards diseases. Arabs, during the pre-Islamic period, depended mainly on invoking supernatural aid or different deities for the treatment of disease.
The Prophet Muhammad, realizing the consequences of infectious epidemics, advised his companions that, “When you hear about a break of plague in any area, do not enter there and when it has broken in a land where you are, then do not run way from it (and thus spread it elsewhere).” On the basis of this hadith, Muslims considered precaution and vigilance against infectious epidemics as the command of God.
The Prophet also opposed charms and incantations as a form of remedy for diseases. On some occasions, however, when physical remedy (medicine) was not available, he allowed, mainly for psychological reasons, the recitation of an incantation that has definite meaning. He also declared the victims of epidemics such as cholera and the plague as martyrs. This was a great consolation for those who suffered from it and realized the fatal consequences.
The Prophet always cautioned physicians to take extreme care in treating their patients and warned those not well-versed in the skill of medicine not to attempt treating the ill lest they might be held responsible for any complications. Quackery is, therefore, forbidden in Islamic medical ethics.
The Prophet Muhammad advised his followers to always care for their health, and whenever they were ill, whether seriously or otherwise, consoled them and told them not to feel that they were victims of the wrath of Allah. “Disease,” he said, “is not the wrath of Allah, because Prophets also suffered great pains, much greater than ordinary people.” Imagine what a solace these sayings would have provided to the followers of Islam.
Hope as Medicine
There are many Prophetic hadiths in Bukhari, Muslim and others that show that people were accustomed to go to the Prophet regularly and tell him about their ailments. He would advise them to resort to medicine first and then pray to God to get rid of the disease. On several occasions he would himself suggest certain medicines. For instance, in case of loss of appetite he frequently advised his followers to take talbina, a preparation made from barley. For constipation he used to recommend the use of senna. He was also in favor of regular use of honey for keeping fit. Similarly, for different ailments he would advise the use of olives, black cumin, chicory, endive fenugreek, ginger, marjoram, saffron, vinegar, and watercress. Hadiths on these medicines and others show the concern of the Prophet for the welfare and good health of his followers. For even apparently small matters like drinking water, eating food, and keeping clean and tidy he also gave advice. He is noted to have said, “Cleanliness is half of faith.”
Some of the hadiths on black cumin, senna, and watercress are very thought provoking. For instance, the Prophet is reported to have said that, “Black cuminis a remedy for every disease except death.” The Prophet expressed similar views on the efficacy of senna and cress.
The style and language of these hadiths are a clear indication of the fact that the Prophet placed great stress on medicines. These hadiths also put emphasis on confidence building of the ill towards their diseases and agonies suffered. Very rational advice was given that none should be disheartened by the intensity and duration of the disease because remedies have been provided by nature. They were also advised not to be afraid of impending death.
Once during the time of the Prophet, a person committed suicide as he could not bear the agony of his disease. The Prophet condemned the act and refused to participate in the last rites. Thus, hopelessness, despondency, dejection and frustration on account of serious disease and pain are against the spirit and tenets of Islamic medical ethics, as shown by the tradition of the Prophet.
Charms and Incantations: A Thing of the Past
There are several authentic hadiths, according to which people were said to come to the Prophet for spiritual remedies for their illnesses and that of their kith and kin. The Prophet, of course, prayed for them, but only after suggesting remedies in the form of medicines. Often he would advise the patients to consult the best physician in the area. On one occasion a lady came to the Prophet with her child who was bleeding because of a throat infection. He admonished her and advised her to treat the disease by using the extract of costus and pseudo-saffron. Similarly, once his wife complained of an abscess on her finger. The Prophet suggested an application of sweet flag on the fingers and then asked her to pray to Allah for recovery. There was also an occasion when a scorpion bit the Prophet himself. He immediately asked for hot water to which salt was added. The hot solution was poured on his bitten fingers while he recited Qur’anic verses.
These occasions and Prophetic hadiths led Muslims to believe in the rationale of using medicine rather than resorting to charms and incantations. On several occasions he exhorted them not to depend on supernatural methods of healing. He is also reported to have said, “charm is nothing but a work of Satan.”
The Human Prophet
Although the Prophet on one hand gave suitable advice to his followers on earthly affairs when such situations were brought to his attention, on the other hand he tried his best to create confidence in themselves so that they could act according to their own experience and opinions. Once, while withdrawing his advice given earlier on the cross pollination of date palm he said, “Whenever I command you to do something related to religion, do obey. And if I command you something about earthly matters, act on your own (experience) and (do remember) I am a human being.”
Putting Prophetic Medicine Into Perspective
In recent years, several books on prophetic medicine have been published, particularly in India and Pakistan, which do not project the true essence of the Prophet’s message. For instance, the author of a recently published book entitled Tibbe Nabwi Aur Jadid Science (Prophetic Medicine and Modern Science), claims that Prophetic treatment of heart attack by eating seven dates, as was suggested to Sa`d ibn Abi Waqqas, should still be preferred over modern by-pass surgery for the disease, provided people have faith in the treatment of the Prophet. The learned author failed to understand that the Prophet, while suggesting to Sa`d to take dates as temporary relief, also advised him to consult the expert physician Harith bin Kalda for treatment.
As a matter of fact, it is not desirable to consider the Prophet’s traditions on medicine as similar to the prescription of a physician. In this connection, the opinion of Ibn Khaldun (14th century AD) is highly relevant and realistic. He says, “The Prophet’s mission was to make known to us the prescription of the Divine Law and not to instruct us in medicine of the common practice of ordinary life” (Muqqaddima). In his opinion, even very authentic hadiths cannot be taken as a mere medicinal prescription, which is the duty of an experienced physician. He says, however, that “with sincere faith, one may derive from them [hadiths] great advantage though this forms no part of medicine as it is properly called.” To emphasize his point of view, Ibn Khaldun refers to occasions when the Prophet tried to create confidence in his followers by advising them to take their own judgments in worldly affairs.
Prophetic medicine is a message par excellence. It is an advice to keep a healthy body and soul and to have faith in both physical and spiritual treatment. It is a command to us to strive hard to find newer medicines and newer remedies. It is a warning to those who consider diseases as the will of God for which no remedy is needed. It is an admonition for us to keep away from so-called spiritual treatment based on superstitions like sorcery, amulets, and charms.
Prophet Mohammad guides scientists to medicine
Establishing a healthy society can be just achieved when healthy prophetic guidance is applied, said doctors in a scientific symposium organized by Life Makers Forum on the occasion of World Health Day, April 7.
The symposium, held at the University of Science and Technology, has tried to discuss the health principals depending on Prophet Mohammad’s traditions, practice and sayings on hygiene, sanitation and treatment of diseases called al-Tibb al-Nabawi, the prophetic medicine, by Muslims all over the world.
Global pharmaceutical institutions recently found that chemical therapies or medicines cannot completely cure mental, physical or psychological illnesses, doctors said. So, they began to look for another kind of therapies in the roots of medicine, including the Prophet Mohammed’s traditions which are rich in advice and instructions on such matters.
Prophetic medicine has been founded in preventive health which is preceding the medical therapies and considered the base of any healthy society. The Prophet Mohammad, peace be upon him, laid down the foundation for a social order in which every member of society was advised to maintain a healthy life, physically, psychologically, and spiritually. No aspect of life was to be disregarded.
As a matter of fact, there are several such sayings in which the Prophet laid great stress on how to prevent your body from the different diseases by taking or doing some simple preventive things. For instance, the Prophet once said, “When one of you yawns, he should try to restrain it with the help of his hand since it is the devil that enters therein.”
Yawning is a common physiological event. However, when a person yawns, he deeply inspires breathing in the germs in the air. So, the prophet stressed on the hand to be placed before mouth when the person yawns.
In recent times, various studies have proven that sleeping on right side is the best position to get a perfect sleeping. Such thing was practiced by the Prophet before around 14 centuries when he used to sleep on his right side, putting his right hand under his right cheek and encourage his friends to do it.
Thus, sleeping on the right side is the correct position as the left lung is smaller than the right one and the pressure on the heart would therefore be less, the liver would not be suspended, and the stomach would be on it and so emptying its contents would be quicker. Moreover sleeping on the right side is one of the best medical interventions to facilitate the excretion of the mucous secretions of the left respiratory bronchioles.
For the practicing Muslim, prayer forms the pillars of his day. He wakes at dawn to pray, breaks at noon to pray, again in the later afternoon, again at dusk, and prays one last time before retiring to bed. He washes up briefly before prayer, and then retires to a clean spot in a room to bow and prostrate symbolically to God, turning to Him for guidance and expressing gratefulness for all God has given him.
These physical movements that a Muslim does during prayer have been proven to be a good exercise for heart, spine, memory and concentration abilities. Moreover, they strengthen the joints and muscles and stimulate blood circulation. Consequently, they also prevent the stagnation of blog in the veins of the legs which may lead to coagulation and other problems.
“O you who believe fasting is prescribed to you as it was prescribed to those before you so that you can learn Taqwa” (Quran). For much of human history, fasting has been guided by intuition and spiritual purpose. Today, the understanding of human physiology confirms the powerful healing effects of fasting.
Besides nurturing resistance and ability to face hardships and endurance, fasting reflects on outward physical appearance by cutting out gluttony and getting rid of excess fat. The benefits of fasting on health do not stop there but are instrumental in alleviating a number of physical diseases, including those of the digestive systems, such as chronic stomachache, inflammation of the colon, liver diseases, indigestion, and conditions such as obesity, arteriosclerosis, high blood pressure, asthma, diphtheria and many other maladies.
The Prophet Mohammed, realizing the bad consequences of dental health on the digestive system and its different organs, advised his companions to keep their teeth clean as much they can. So, many Muslims have used to clean their teeth, using miswak (siwak) or teeth cleaning sticks on the recommendation of the Prophet Mohammed who said, “Siwak cleanses the mouth and pleases the Lord”, and “if I had not found it hard for my followers or the people, I would have ordered them to clean their teeth with siwak for every prayer.”
Research indentified a total of 19 natural substances found within the miswak that benefit dental health. It contains a number of natural antiseptics that kill harmful microorganisms in the mouth; tannic acids that protect the gums from disease; and aromatic oils that increase salivation. Doctors in the symposium, titled The Scientific Miracles in the Prophetic Medicine, also laid great stress on the prophet’s daily common food to show its amazing benefits. For example, the Prophet used to take a honey drink, a teaspoon of honey mixed well with a cup of honey, in the early morning before eating anything.
The recent medicine discovers that such drink is working to activate the digestive system to work in a better way. Furthermore, honey has been shown to be far superior to conventional antibiotics in treating infections and without the negative side effects associated with antibiotic use. It is amazing that the bacteria-killing properties of honey increase two-fold when diluted with water.
Although the Prophet lived around 14 centuries ago in simple surrounding environment without technology or advanced devices, he pay more great attention to the blood and its affect on the person’s life. Hejama, cupping, is one of the therapeutic processes practiced by the Prophet for removing unclean blood from his body. It was narrated that the Prophet used to undergo hejama on the head and between his shoulders and he used to say, “Whosoever removes this blood, it will not harm him that he does not take any other medical treatment.”
The hejama is advised for disease caused by dampness, such as low back pain, lumbago, sciatica, pain in the arms and shoulders, pain in the legs and muscular parts of the body, stomachache, vomiting, headache, migraine, sprains, insomnia, etc. The prophetic medicine is rich of advices to be a clear massage for Muslims to keep a healthy body and soul and to have faith in both physical and spiritual treatment. It is also a command to people to strive hard to find newer medicines and newer remedies. “The medicine will not stop at the medical discoveries found today in the medicine of the Prophet Mohammed. It will keep on discovering many new amazing things everyday in such prophetic medicine and many scientific miracles in the Holy Quran,” said Dr. Adel Hassan, a consultant of internal diseases at the Science and Technology University Hospital.
Establishing a healthy society can be just achieved when healthy prophetic guidance is applied, said doctors in a scientific symposium organized by Life Makers Forum on the occasion of World Health Day, April 7.
The symposium, held at the University of Science and Technology, has tried to discuss the health principals depending on Prophet Mohammad’s traditions, practice and sayings on hygiene, sanitation and treatment of diseases called al-Tibb al-Nabawi, the prophetic medicine, by Muslims all over the world.
Global pharmaceutical institutions recently found that chemical therapies or medicines cannot completely cure mental, physical or psychological illnesses, doctors said. So, they began to look for another kind of therapies in the roots of medicine, including the Prophet Mohammed’s traditions which are rich in advice and instructions on such matters.
Prophetic medicine has been founded in preventive health which is preceding the medical therapies and considered the base of any healthy society. The Prophet Mohammad, peace be upon him, laid down the foundation for a social order in which every member of society was advised to maintain a healthy life, physically, psychologically, and spiritually. No aspect of life was to be disregarded.
As a matter of fact, there are several such sayings in which the Prophet laid great stress on how to prevent your body from the different diseases by taking or doing some simple preventive things. For instance, the Prophet once said, “When one of you yawns, he should try to restrain it with the help of his hand since it is the devil that enters therein.”
Yawning is a common physiological event. However, when a person yawns, he deeply inspires breathing in the germs in the air. So, the prophet stressed on the hand to be placed before mouth when the person yawns.
In recent times, various studies have proven that sleeping on right side is the best position to get a perfect sleeping. Such thing was practiced by the Prophet before around 14 centuries when he used to sleep on his right side, putting his right hand under his right cheek and encourage his friends to do it.
Thus, sleeping on the right side is the correct position as the left lung is smaller than the right one and the pressure on the heart would therefore be less, the liver would not be suspended, and the stomach would be on it and so emptying its contents would be quicker. Moreover sleeping on the right side is one of the best medical interventions to facilitate the excretion of the mucous secretions of the left respiratory bronchioles.
For the practicing Muslim, prayer forms the pillars of his day. He wakes at dawn to pray, breaks at noon to pray, again in the later afternoon, again at dusk, and prays one last time before retiring to bed. He washes up briefly before prayer, and then retires to a clean spot in a room to bow and prostrate symbolically to God, turning to Him for guidance and expressing gratefulness for all God has given him.
These physical movements that a Muslim does during prayer have been proven to be a good exercise for heart, spine, memory and concentration abilities. Moreover, they strengthen the joints and muscles and stimulate blood circulation. Consequently, they also prevent the stagnation of blog in the veins of the legs which may lead to coagulation and other problems.
“O you who believe fasting is prescribed to you as it was prescribed to those before you so that you can learn Taqwa” (Quran). For much of human history, fasting has been guided by intuition and spiritual purpose. Today, the understanding of human physiology confirms the powerful healing effects of fasting.
Besides nurturing resistance and ability to face hardships and endurance, fasting reflects on outward physical appearance by cutting out gluttony and getting rid of excess fat. The benefits of fasting on health do not stop there but are instrumental in alleviating a number of physical diseases, including those of the digestive systems, such as chronic stomachache, inflammation of the colon, liver diseases, indigestion, and conditions such as obesity, arteriosclerosis, high blood pressure, asthma, diphtheria and many other maladies.
The Prophet Mohammed, realizing the bad consequences of dental health on the digestive system and its different organs, advised his companions to keep their teeth clean as much they can. So, many Muslims have used to clean their teeth, using miswak (siwak) or teeth cleaning sticks on the recommendation of the Prophet Mohammed who said, “Siwak cleanses the mouth and pleases the Lord”, and “if I had not found it hard for my followers or the people, I would have ordered them to clean their teeth with siwak for every prayer.”
Research indentified a total of 19 natural substances found within the miswak that benefit dental health. It contains a number of natural antiseptics that kill harmful microorganisms in the mouth; tannic acids that protect the gums from disease; and aromatic oils that increase salivation. Doctors in the symposium, titled The Scientific Miracles in the Prophetic Medicine, also laid great stress on the prophet’s daily common food to show its amazing benefits. For example, the Prophet used to take a honey drink, a teaspoon of honey mixed well with a cup of honey, in the early morning before eating anything.
The recent medicine discovers that such drink is working to activate the digestive system to work in a better way. Furthermore, honey has been shown to be far superior to conventional antibiotics in treating infections and without the negative side effects associated with antibiotic use. It is amazing that the bacteria-killing properties of honey increase two-fold when diluted with water.
Although the Prophet lived around 14 centuries ago in simple surrounding environment without technology or advanced devices, he pay more great attention to the blood and its affect on the person’s life. Hejama, cupping, is one of the therapeutic processes practiced by the Prophet for removing unclean blood from his body. It was narrated that the Prophet used to undergo hejama on the head and between his shoulders and he used to say, “Whosoever removes this blood, it will not harm him that he does not take any other medical treatment.”
The hejama is advised for disease caused by dampness, such as low back pain, lumbago, sciatica, pain in the arms and shoulders, pain in the legs and muscular parts of the body, stomachache, vomiting, headache, migraine, sprains, insomnia, etc. The prophetic medicine is rich of advices to be a clear massage for Muslims to keep a healthy body and soul and to have faith in both physical and spiritual treatment. It is also a command to people to strive hard to find newer medicines and newer remedies. “The medicine will not stop at the medical discoveries found today in the medicine of the Prophet Mohammed. It will keep on discovering many new amazing things everyday in such prophetic medicine and many scientific miracles in the Holy Quran,” said Dr. Adel Hassan, a consultant of internal diseases at the Science and Technology University Hospital.
Ibn Sina (Avicenna) - doctor of doctors
Ibn Sina was born in 980 C.E. in the village of Afshana near Bukhara which today is located in the far south of Russia. His father, Abdullah, an adherent of the Ismaili sect, was from Balkh and his mother from a village near Bukhara.
In any age Ibn Sina, known in the West as Avicenna, would have been a giant among giants. He displayed exceptional intellectual prowess as a child and at the age of ten was already proficient in the Qur'an and the Arabic classics. During the next six years he devoted himself to Muslim Jurisprudence, Philosophy and Natural Science and studied Logic, Euclid, and the Almeagest.
He turned his attention to Medicine at the age of 17 years and found it, in his own words, "not difficult". However he was greatly troubled by metaphysical problems and in particular the works of Aristotle. By chance, he obtained a manual on this subject by the celebrated philosopher al-Farabi which solved his difficulties.
By the age of 18 he had built up a reputation as a physician and was summoned to attend the Samani ruler Nuh ibn Mansur (reigned 976-997 C.E.), who, in gratitude for Ibn Sina's services, allowed him to make free use of the royal library, which contained many rare and even unique books. Endowed with great powers of absorbing and retaining knowledge, this Muslim scholar devoured the contents of the library and at the age of 21 was in a position to compose his first book.
At about the same time he lost his father and soon afterwards left Bukhara and wandered westwards. He entered the services of Ali ibn Ma'mun, the ruler of Khiva, for a while, but ultimately fled to avoid being kidnapped by the Sultan Mahmud of Ghazna. After many wanderings he came to Jurjan, near the Caspian Sea, attracted by the fame of its ruler, Qabus, as a patron of learning. Unfortunately Ibn Sina's arrival almost coincided with the deposition and murder of this ruler. At Jurjan, Ibn Sina lectured on logic and astronomy and wrote the first part of the Qanun, his greatest work.
He then moved to Ray, near modern Teheran and established a busy medical practice. When Ray was besieged, Ibn Sina fled to Hamadan where he cured Amir Shamsud-Dawala of colic and was made Prime Minister. A mutiny of soldiers against him caused his dismissal and imprisonment, but subsequently the Amir, being again attacked by the colic, summoned him back, apologised and reinstated him! His life at this time was very strenuous: during the day he was busy with the Amir's services, while a great deal of the night was passed in lecturing and dictating notes for his books. Students would gather in his home and read parts of his two great books, the Shifa and the Qanun, already composed.
Following the death of the Amir, Ibn Sina fled to Isfahan after a few brushes with the law, including a period in prison. He spent his final years in the services of the ruler of the city, Ala al-Daula whom he advised on scientific and literary matters and accompanied on military campaigns.
Friends advised him to slow down and take life in moderation, but this was not in character. "I prefer a short life with width to a narrow one with length", he would reply. Worn out by hard work and hard living, Ibn Sina died in 1036/1 at a comparatively early age of 58 years. He was buried in Hamadan where his grave is still shown.
Al-Qifti states that Ibn Sina completed 21 major and 24 minor works on philosophy, medicine, theology, geometry, astronomy and the like. Another source (Brockelmann) attributes 99 books to Ibn Sina comprising 16 on medicine, 68 on theology and metaphysics 11 on astronomy and four on verse. Most of these were in Arabic; but in his native Persian he wrote a large manual on philosophical science entitled Danish-naama-i-Alai and a small treatise on the pulse.
His most celebrated Arabic poem describes the descent of Soul into the Body from the Higher Sphere. Among his scientific works, the leading two are the Kitab al-Shifa
(Book of Healing), a philosophical encyclopaedia based
upon Aristotelian traditions and the al-Qanun al-Tibb
which represents the final categorisation of Greco-Arabian thoughts on Medicine.
Of Ibn Sina's 16 medical works, eight are versified treatises on such matter as the 25 signs indicating the fatal termination of illnesses, hygienic precepts, proved remedies, anatomical memoranda etc. Amongst his prose works, after the great Qanun, the treatise on cardiac drugs, of which the British Museum possesses several fine manuscripts, is probably the most important, but it remains unpublished.
The Qanun is, of course, by far the largest, most famous and most important of Ibn Sina's works. The work contains about one million words and like most Arabic books, is elaborately divided and subdivided. The main division is into five books, of which the first deals with general principles; the second with simple drugs arranged alphabetically; the third with diseases of particular organs and members of the body from the head to the foot; the fourth with diseases which though local in their inception spread to other parts of the body, such as fevers and the fifth with compound medicines.
The Qanun distinguishes mediastinitis from pleurisy and recognises the contagious nature of phthisis (tuberculosis of the lung) and the spread of disease by water and soil. It gives a scientific diagnosis of ankylostomiasis and attributes the condition to an intestinal worm. The Qanun points out the importance of dietetics, the influence of climate and environment on health and the surgical use of oral anaesthetics. Ibn Sina advised surgeons to treat cancer in its earliest stages, ensuring the removal of all the diseased tissue. The Qanun's materia medica considers some 760 drugs, with comments on their application and effectiveness. He recommended the testing of a new drug on animals and humans prior to general use.
Ibn Sina noted the close relationship between emotions and the physical condition and felt that music had a definite physical and psychological effect on patients. Of the many psychological disorders that he described in the Qanun, one is of unusual interest: love sickness! ibn Sina is reputed to have diagnosed this condition in a Prince in Jurjan who lay sick and whose malady had baffled local doctors. Ibn Sina noted a fluttering in the Prince's pulse when the address and name of his beloved were mentioned. The great doctor had a simple remedy: unite the sufferer with the beloved.
The Arabic text of the Qanun was published in Rome in 1593 and was therefore one of the earliest Arabic books to see print. It was translated into Latin by Gerard of Cremona in the 12th century. This 'Canon', with its encyclopaedic content, its systematic arrangement and philosophical plan, soon worked its way into a position of pre-eminence in the medical literature of the age displacing the works of Galen, al-Razi and al-Majusi, and becoming the text book for medical education in the schools of Europe. In the last 30 years of the 15th century it passed through 15 Latin editions and one Hebrew. In recent years, a partial translation into English was made. From the 12th-17th century, the Qanun served as the chief guide to Medical Science in the West and is said to have influenced Leonardo da Vinci. In the words of Dr. William Osler, the Qanun has remained "a medical bible for a longer time than any other work".
Despite such glorious tributes to his work, Ibn Sina is rarely remembered in the West today and his fundamental contributions to Medicine and the European reawakening goes largely unrecognised. However, in the museum at Bukhara, there are displays showing many of his writings, surgical instruments from the period and paintings of patients undergoing treatment. An impressive monument to the life and works of the man who became known as the 'doctor of doctors' still stands outside Bukhara museum and his portrait hangs in the Hall of the Faculty of Medicine in the University of Paris.
Ibn Sina was born in 980 C.E. in the village of Afshana near Bukhara which today is located in the far south of Russia. His father, Abdullah, an adherent of the Ismaili sect, was from Balkh and his mother from a village near Bukhara.
In any age Ibn Sina, known in the West as Avicenna, would have been a giant among giants. He displayed exceptional intellectual prowess as a child and at the age of ten was already proficient in the Qur'an and the Arabic classics. During the next six years he devoted himself to Muslim Jurisprudence, Philosophy and Natural Science and studied Logic, Euclid, and the Almeagest.
He turned his attention to Medicine at the age of 17 years and found it, in his own words, "not difficult". However he was greatly troubled by metaphysical problems and in particular the works of Aristotle. By chance, he obtained a manual on this subject by the celebrated philosopher al-Farabi which solved his difficulties.
By the age of 18 he had built up a reputation as a physician and was summoned to attend the Samani ruler Nuh ibn Mansur (reigned 976-997 C.E.), who, in gratitude for Ibn Sina's services, allowed him to make free use of the royal library, which contained many rare and even unique books. Endowed with great powers of absorbing and retaining knowledge, this Muslim scholar devoured the contents of the library and at the age of 21 was in a position to compose his first book.
At about the same time he lost his father and soon afterwards left Bukhara and wandered westwards. He entered the services of Ali ibn Ma'mun, the ruler of Khiva, for a while, but ultimately fled to avoid being kidnapped by the Sultan Mahmud of Ghazna. After many wanderings he came to Jurjan, near the Caspian Sea, attracted by the fame of its ruler, Qabus, as a patron of learning. Unfortunately Ibn Sina's arrival almost coincided with the deposition and murder of this ruler. At Jurjan, Ibn Sina lectured on logic and astronomy and wrote the first part of the Qanun, his greatest work.
He then moved to Ray, near modern Teheran and established a busy medical practice. When Ray was besieged, Ibn Sina fled to Hamadan where he cured Amir Shamsud-Dawala of colic and was made Prime Minister. A mutiny of soldiers against him caused his dismissal and imprisonment, but subsequently the Amir, being again attacked by the colic, summoned him back, apologised and reinstated him! His life at this time was very strenuous: during the day he was busy with the Amir's services, while a great deal of the night was passed in lecturing and dictating notes for his books. Students would gather in his home and read parts of his two great books, the Shifa and the Qanun, already composed.
Following the death of the Amir, Ibn Sina fled to Isfahan after a few brushes with the law, including a period in prison. He spent his final years in the services of the ruler of the city, Ala al-Daula whom he advised on scientific and literary matters and accompanied on military campaigns.
Friends advised him to slow down and take life in moderation, but this was not in character. "I prefer a short life with width to a narrow one with length", he would reply. Worn out by hard work and hard living, Ibn Sina died in 1036/1 at a comparatively early age of 58 years. He was buried in Hamadan where his grave is still shown.
Al-Qifti states that Ibn Sina completed 21 major and 24 minor works on philosophy, medicine, theology, geometry, astronomy and the like. Another source (Brockelmann) attributes 99 books to Ibn Sina comprising 16 on medicine, 68 on theology and metaphysics 11 on astronomy and four on verse. Most of these were in Arabic; but in his native Persian he wrote a large manual on philosophical science entitled Danish-naama-i-Alai and a small treatise on the pulse.
His most celebrated Arabic poem describes the descent of Soul into the Body from the Higher Sphere. Among his scientific works, the leading two are the Kitab al-Shifa
(Book of Healing), a philosophical encyclopaedia based
upon Aristotelian traditions and the al-Qanun al-Tibb
which represents the final categorisation of Greco-Arabian thoughts on Medicine.
Of Ibn Sina's 16 medical works, eight are versified treatises on such matter as the 25 signs indicating the fatal termination of illnesses, hygienic precepts, proved remedies, anatomical memoranda etc. Amongst his prose works, after the great Qanun, the treatise on cardiac drugs, of which the British Museum possesses several fine manuscripts, is probably the most important, but it remains unpublished.
The Qanun is, of course, by far the largest, most famous and most important of Ibn Sina's works. The work contains about one million words and like most Arabic books, is elaborately divided and subdivided. The main division is into five books, of which the first deals with general principles; the second with simple drugs arranged alphabetically; the third with diseases of particular organs and members of the body from the head to the foot; the fourth with diseases which though local in their inception spread to other parts of the body, such as fevers and the fifth with compound medicines.
The Qanun distinguishes mediastinitis from pleurisy and recognises the contagious nature of phthisis (tuberculosis of the lung) and the spread of disease by water and soil. It gives a scientific diagnosis of ankylostomiasis and attributes the condition to an intestinal worm. The Qanun points out the importance of dietetics, the influence of climate and environment on health and the surgical use of oral anaesthetics. Ibn Sina advised surgeons to treat cancer in its earliest stages, ensuring the removal of all the diseased tissue. The Qanun's materia medica considers some 760 drugs, with comments on their application and effectiveness. He recommended the testing of a new drug on animals and humans prior to general use.
Ibn Sina noted the close relationship between emotions and the physical condition and felt that music had a definite physical and psychological effect on patients. Of the many psychological disorders that he described in the Qanun, one is of unusual interest: love sickness! ibn Sina is reputed to have diagnosed this condition in a Prince in Jurjan who lay sick and whose malady had baffled local doctors. Ibn Sina noted a fluttering in the Prince's pulse when the address and name of his beloved were mentioned. The great doctor had a simple remedy: unite the sufferer with the beloved.
The Arabic text of the Qanun was published in Rome in 1593 and was therefore one of the earliest Arabic books to see print. It was translated into Latin by Gerard of Cremona in the 12th century. This 'Canon', with its encyclopaedic content, its systematic arrangement and philosophical plan, soon worked its way into a position of pre-eminence in the medical literature of the age displacing the works of Galen, al-Razi and al-Majusi, and becoming the text book for medical education in the schools of Europe. In the last 30 years of the 15th century it passed through 15 Latin editions and one Hebrew. In recent years, a partial translation into English was made. From the 12th-17th century, the Qanun served as the chief guide to Medical Science in the West and is said to have influenced Leonardo da Vinci. In the words of Dr. William Osler, the Qanun has remained "a medical bible for a longer time than any other work".
Despite such glorious tributes to his work, Ibn Sina is rarely remembered in the West today and his fundamental contributions to Medicine and the European reawakening goes largely unrecognised. However, in the museum at Bukhara, there are displays showing many of his writings, surgical instruments from the period and paintings of patients undergoing treatment. An impressive monument to the life and works of the man who became known as the 'doctor of doctors' still stands outside Bukhara museum and his portrait hangs in the Hall of the Faculty of Medicine in the University of Paris.
Arab Medical Schools during the 12th and 13th centuries
The status of Medicine in the Islamic World
The Scientific movement in the early Islamic centuries has various aspects. One of them is the contribution of the early Arab Scientists, which took different forms, their role in scientific progress, the theories they have provided us with, and their methods and influence on the western world which started, as a result, viewing science in a new light during the middle ages.
In fact it is not easy to divide the whole unity of science, and claim that this science belongs completely to the Greeks or the Arabs or the West. It is not possible to divide science because it does not belong to one nation, nor to one race. It is the result of co-operation, and communication, among scientists and many other factors. This paper considers the case of medicine in the Arab Islamic World and investigates its nature and schools.
To understand the nature of Arab medical schools in the Arabic Islamic World, we have to deal with the status of medicine before the 12th century; the Bimaristans: their system and different purposes; medical educational assemblies: their role in configurating physicians' minds and the method that was followed and then conclude with the results. It is worth noticing that examples have been provided.
Medicine was the first science that the Muslims knew in their environment. The ancient Arabic sources mention Al-Harith Ibn Keladah (d. 634 A.D), the Arabian who travelled from the Arab peninsula to Persia to study medicine in Jundisabur where there was a well known Bimaristan (hospital). After he had finished his studies in Jundisabur, Al-Harith returned home to practise his science and to treat those who were in need of his knowledge.
The ancient sources inform us about Al-Harith especially Ibn Golgol , the most famous historian in the fourth century of Hijra (10th century), who said that Al-Harith «studied medicine in Persia and Yemen and was alive in the days of the Prophet(1). According to other sources (2) , the Prophet advised Saad Ibn Abi Waq'qas when he was sick to consult Al-Harith, the physician.
The power and authority of physicians began to increase during the rule of Mu'awiyah (660-680), who founded the Umayyad state. Mu'awiyah ordered his men to bring the best physicians from Jundisabur to care for his health, specially that he was afraid his enemies (3) might poison his food.
No doubt the successive physicians made great contributions and were the pioneers of medicine during the rule of Mu'awiyah and his sons. During the rule of Umayyad Caliph Marawan Ibn al-Hakam (d. 685), the Persian physician Masarjawayh played a vital and effective role, when he started, by order of Marawan, to translate the Medical Encyclopaedia of the Alexandrian priest Ahrun, from Syriac into Arabic. Masarjawyh's translation of Ahrun's book is considered to be the first translation of a medical book in Islam from a foreign language into Arabic (4) .
The Abbasids represent a very strong and important stage in the development of science, because they encouraged scientists, and tried to establish a solid scientific movement in the Islamic world, especially after they chose Baghdad to be the new capital, instead of Damascus. As we know the Abbasids were rationalistic. Most of the Caliphs were among the "Mutazilah scientists. The adoption of rationalism led to the flourishing of the sciences through the Islamic academy of science "Bayet al-Hikma" (5) (the House of Wisdom).
Practising medicine in Baghdad during the Abbasids rule was the responsibility of two families: (1) The family of Bukhtishu, and (2) the family of Masaway.
The Bukhtishu family came to Baghdad by the order of the Caliph Al-Mansour who was sick and suffering from pain in his stomach. He sent his men to bring Georges b. Jibril b. Bukhtishu to treat him in the year (148H. / 765). Georges was the chief physician (rais al atibba) in Jundisabur (6) .
When Georges left to Jundisabur after four years he ordered his son to stay in Baghdad to continue his mission. Both father and son wrote medical books in Syriac which were later translated into Arabic by Hunain b. Ishaq .
Hunain b. Ishaq (194-264 H.) who took the lead in the official movement of translation, was one of the most important figures both in translation and medicine. He translated the books of Hippocrates and Galen, and wrote down many medical books among which is his famous one about the eye (Al Ashr Maqalat fi al-'Ayn) The Ten Treatise on the Eye - Max Meyerhof verified and studied it critically (7) . The book of Hunain is considered the first scientific attempt towards Ophthalmology.
While the process of translation was going on, The Arabs began to organise Medicine as a profession, especially the bimaristans (hospitals) and practicing medicine among people.
Ancient Arabic sources - like al-Qifti (8) and Ibn Usaibi'ah (9) - mentioned that the real organisation of medicine took place by the order of al-Muqtadir who wrote to Sinan Ibn Thabit b. Qurrah to examine those who want to practice medicine and give them Ijaza (certificate). This was in the tenth century.
No doubt we have some good knowledge about the contribution of the Arab Muslim physicians who took part in the process of developing medicine (10) , such as al-Razi (Rhazes 850-923), Ibn Sina (Avicenna 980-1037), al-Zahrawi (Abulcasis 1013) and Ibn an-Nafis. let us look at the case of al-Razi and Ibn Sina, and their effect in medicine.
Al-Razi was one of the well known Muslim physicians in the West during the Middle Ages. Ibn al-Nadim enumerated the works of al-Razi among which are these major works: (1) Kitab al-Asrar The Book of Secrets,
Kitab al-Tib al-Mansuri Liber Almansouris, (3) Kitab al-Hawi (11) The Comprehensive Book, and (4) A Treatise on al-Judari wa al-Hasbah Small pox and measles.
Kitab al-Asrar was first translated into Latin by Gerard of Cremona (d. 1187), while Kitab al-Tib al-Mansouri appeared in the Latin translation in Milan in 1480, and so did the treatise on al-Judari wa al-Hasbah. As for al-Hawi (Continens) its translation had been made by Faraj Ibn Salim in 1279, and reprinted many times in Latin. This book had a great influence in Europe. Montgomery Watt, while dealing with al-Razi said "His greatest work is one translated into Latin as the Continens, The Comprehensive Book. It was an encyclopedia of all medical science up to that time, and had to be completed by his disciples after his death. For each disease he gave the views of Greek, Syrian, Indian, Persian and Arab authors, and then added notes on his clinical observations and expressed a final opinion." (12)
2- Ibn Sina was known as a philosopher and physician. His fame in these two fields was the cause of his influence in the West. Here we are dealing with his medical contribution that became so evident in his famous work Kitab al-Qanun fi al-Tib. The Organon in Medicine. This book was translated by Gerard of Cremona into Latin and published in Europe several times. The importance of al-Qanun came from two things:
Its well organized data, its method and scientific style. This is because Ibn Sina was a good philosopher and had an organized logical mind.
His description of some diseases such as mediastinitis and pleurisy. Also he mentioned the nature of phthisis and the spreading of diseases by water and soil, and gave the right diagnosis of ankylostomiasis (13) .
-II-
Bimaristans in the Islamic World
Those who learn and study medicine and practice it as a profession must work in hospitals to get experience and practice the medical profession, so that they gain this experience from the cases they examine under the supervision of master scientists. Von Grunebaum says about the necessity of hospital visits for medical students "The medical student must always visit the hospitals and must be very careful of the conditions and situations of the persons found there, while he is accompanied by the most intelligent medical teachers, and must ask about patients' conditions, their symptoms, remembering what he read about changes and their significance whether good or bad. If he understands these things he will achieve a high rank in his profession (14) . So, it is evident that the medical - teaching in that time - had bases and rules and was practiced in the Bimaristans. To be acquainted with the rules of the process of medical teaching that dominated. The Islamic world, we have to study first the origin of the Bimaristans and their development in order to know their importance for medical teaching generally.
Ibn Abi Usaibia'h said: "Hippocrates cared greatly about his patients and their treatment. It is said that he was the first to invent and build the Bimaristan and the first to renew it, by allocating - near his house - part of his garden for the patients and assigned some servants to perform the treatments. He called this the «Akhssendokin», i.e. a patient complex. Also the word Bimaristan-which is of Persian origin-has the same meaning as (Bimar) in Persian means disease and (stan) is location or place, i.e. location or place of disease (15). This is the text we find in the «Uyun al-Anba» of Ibn Abi Usaibi'ah about the historical development of the Bimaristans or hospitals. But Max meyerhof (16) mentioned that the first hospital to be built in the Islamic world is that which was based in Baghdad by the order of Harun al-Rashed; then hospitals were built successively everywhere. Does Meyerhof's opinion present the absolute truth, or does this opinion contain some clear fallacies?
Ibn Qutayibah al-Dainuri was interested in his book Leadership and Politics (17) in throwing light on some important matters relating to Islamic history. He mentioned that the first Bimarastan or hospital was built for the Muslim army-after Abdallah Ibn al-Zoubair when he was blockaded in Mecca, built a tent on one side of the Mosque, so that when one of the Sahaba (Prophet's followers) was wounded he would be brought inside the tent to be treated and to be cared for by skilled persons. That is how the first type of Bimarastan (hospital) was built in Islam. This is the Arab Bimarastan (hospital).
Moreover we find other proofs in (Ibn al-Atheer) in al-Kamel (18) and al Maqrizi in Maqrizi Plans (19) which denote that al-Waleed ibn Abdel Malik was the first to build a Bimaristan it the real meaning of the word in Islam in 88 Hijri. Noushirawy (20) in his new book on Islamic Brimaristans in the Middle Ages seemed to adopt this opinion and he mentioned that the first Bimaristan built in Islam was in Damascus, by al-Waeed b. Abdel Malik (705-715 A.D) and built in 86 Hijri (706-707 A.D.). The aim of its building was treating patients and the care of affected chronic patients-as lepers and blind people... etc. The leprotics were imprisoned, treated freely and given money. In the Bimaristan there were more than one physician. It is obvious that Noushirawy adopted what was mentioned in (al-kamel) of Ibn AL-Atheer on this poing specifically. A person has great importance and consideration on this subject, is Ahmed Bey Issa (21) who was the first to write clearly about the development of the Bemaristan and its history in Islam, and he mentions that the Prophet Mohamed (may peace and prayer be upon him) was the first to order the establishment of mobile military Bimaristans. It is natural that this last opinion has its importance and consideration, because Muslims were rushed in many invasions in which they were attacked and injured. There was lots of chaos, and men were wounded or killed here and there. It was normal that there should be those who cared for these people and looked after their treatment, and hence complete care was provided for the fighters. This last opinion agrees with what Ibn Qutaiba al-Daynuri mentioned.
1- The Bimaristan system: The people who are interested in establishing any institution must set an administrative or technical system to be followed. Of course the physicians in the Islamic world put in mind to follow a precise system inside the hospitals so that it would be based upon academic graduation which fulfills two amis: First, the welfare of the patients to be dealt with their treatment according to the updated rules of medical treatment. Second, Bimaristans used for teaching medicine to the newly graduated physicians responsible to treat patients successfully. Therefore the Bimaristans in the Islamic world were followed all the technical rules that fulfilled the two purposes together.
Ibn Jubair (22) mentioned what he observed in the hospitals concerning work. Also Ahmed Bey Issa mentioned in his book (23) Bimaristans in Islam Amin Assaad Khayrallah (24) in his book Arab Medicine and Nushirawy (25) in his book Islamic Bimaristans in Middle Ages mentioned the administrative, technical and teaching organization existing in that period in the hospitals.
Concerning the technical choice of bimaristanic site they used to choose the best location with regard to the health conditions. They preferred to build the Bimaristans over hills or by rivers. Al Adoudi's bimaristan is a good example of this; it was built by Adoud al-Dawla b. Bawaih (26) in Baghdad by the River Deglah and the water of the river flowed through its courtyard and halls and returned to pour into Deglah.
Concerning organization, it was natural that the physicians comprehended the necessity of separating men and women, therefore they took into consideration as much as possible to divide the Bimaristan into two sections, one for men and the other for women. Each section was independent, each having large halls for the patients.
Concerning the administrative organization of the Bimaristan, it was as follows: each section contained a hall for each type of disease, while each hall had one physician or more and each group of doctors in a section had a chief doctor. The halls were specialized: a hall for internal diseases another for splinted patients, another for oculists, and another one for delivery a special hall for each type of disease including communicable diseases (27) .
Ibn Abi Usaibi'ah discribed in his book Uyun al-Anba (28) , the halls of internal medicine which frequently included a section for the patients affected by fever and another one for patients having mania. All sections of the Bimaristan were equipped with all the medical instruments and apparatuses necessary for the physician.
Ibn Abi Usaibi'ah tells us (29) that Adoud al Dawla set a test for a hundred physicians, when he decided to build the Adoudian Bimaristan on the Western side of Baghdad, and he chose twenty four physicians out of the hundred to work in the Bimaristan.
The chief of all physicians in the hospital was called (AI Saoor). The administrative and medical system in the hospital was based upon using boys who worked as employees or health workers, assistants or dressers; some of them were servants and they cleaned the Bimaristan and cared after the patients when necessary.
According to this order and system the Bimaristan was performing its medical job from a diagnostic point of view, disease definition and prescription of treatment. Moreover, they understood the necessity of adjoining a pharmacy to the Bimaristan to give out the drugs, which were given according to the physician's prescription, and the pharmacy was called «Al Sharabkhana» (30) .
And as it is the case today, they used to inspect the Bimaristan. This was the responsibility of an employee assigned by the minister or the Caliph and given the authority to enter the hospital to be acquainted with the patients' status and the care offered to them, the food given to them and whether the boys were serving them or not. Whether the physician is performing his duty perfectly or he neglecting it. This system assured the stay and continuity of the Bimaristan in a serious way that allowed it to work with a high competence technically, scientifically and administratively.
It is worth mentioning that each patient had his own card on which the physician recorded his observations while treating the patient. Also the phsician had his own special register to record his observations on the diseases he was treating. The physician performed his experiments and tests according to his observations. If the physician faced any problem in any matter of diagnosis, he went to the head of his division or the chief physician. Frequently the physicians held meetings to discuss cases. Undoubtedly these discussions and consultations were considered as a small scientific conference of physicians. We do the same today.
We notice that the historians of Arab medicine wrote special long pages on the medical personalities about whom discussions were held to set the work system in the hospital, or the Bimaristan between the physicians. There were shifts for the doctors, some worked in the morning and others at night, some worked a certain time in the morning and another period at night, so that they cared for the patient. At the same time they could get enough rest to allow them to continue working in the Bimaristan, supervise the treatment system and medical care of the patients.
Al-Maqrizi mentioned in his plans (31) that the patients were registered at the admission in the Bimaristan, their clothes were taken away and their money put in trust by the Bimaristan guardian. The patients received clean clothes instead of those taken from them, and they were given drugs and food under the supervision of the physicians freely till they were cured.
Ibn al-Okhowa described in his book (al-Hisba) the entrance of the patient to the outpatient clinic to see the physician. He said in a very important text «the physician asks the patient about the cause of his illness and the pain he feels. He prepares for the patient syrups and other drugs, then he writes a copy of the prescription to the parents attending with the patient. Next day he re-examines the patient and looks at the drugs and asks him if he feels better or not, and he advises the patient according to his condition. This procedure is repeated on the third day and the fourth... till the patient is either cured or dead. If the patient is cured, the physician is paid.
If the patient dies, his parents go to the chief doctor, they present the prescriptions written by the physician. If the chief doctor judges that the physician has performed his job perfectly without negligence, he tells the parents that death was natural; if he judges otherwise, he tells them: take the blood money of your relative from the physician; he killed him by his bad performance and negligence. In this honorable way they were sure that medicine is practiced by experienced well trained persons (32) .
2- Bimaristan Varieties according to different Purposes
In the early Islamic state, Muslims comprehended the different form and purposes that should be considered in Bimaristans. Normally, they should deal with this point seriously, precisely due to its importance to the patient and the physician as well as the desired degree of care for the patient. Certainly the Bimaristan established to serve the fighters in the battle field during the hustle of the battle must differ from that built for the patients affected by mental disease who do not have to hustle, but doctors might hustle away from them but this is different, or those built for a commercial caravan or the pilgrimage to Al-Kaaba.... and so on.
Each type of diseases might require a special Bimaristan for a group of patients. This can be noticed at least by specialization of Bimaristans for leprotics and mentally affected patients.
a) Mental Disease Bimaristan
Muslims realised the importance of the care for mentally affected patients. They frequently added to the big Bimaristans special places isolated by iron bars, specially for patients with mental diseases (33) , to avoid the aggression of these patients on the others.
Muslim physicians knew that psychiatric and mental diseases required a special type of care and that the physician must be acquainted with the etiology of the disease from which the patient is suffering.
It is worth mentioning that Ibn Abi Usaibi'ah (34) tells us in his book (Uyun al-Anba) about some cases of this type of disease and how the skilled doctor Waheed al-Zambian could treat them. One of the patients thought that he had a tun over his head that never leaves him; he was afraid that the tun might break while he was walking, therefore he walked carefully to avoid breaking it. Some doctors tried to treat him but they failed. Lastly he saw Waheed al-Zaman who realized that the man was suffering from illusions. He told his family: «bring him to the hospital. Waheed al-Zaman ordered one of his boys to bring a big stick and hit the head of the patient-while Waheed al-Zaman talks to him-as if he wants to break the tun that the patient pretends having on his head, in the same time he asked another boy to throw a tun- that he prepared for him-from the house top, the moment the first boy hits above the head of melancholic patient, to the ground. When the patient came, Waheed al-Zaman started to talk to him, disapproved he was carrying the tun, he gave the boy a signal and he started to hit over the head of the patient with the woody stick, in this moment the other boy threw the tun from the house top which caused a great noise and broke to many pieces. When the patient saw what happened to him and saw the broken tun he did not doubt that it was the tun he was carrying -in his imagination - this influenced him and he was cured from his illness.
b) Leprotic Bimaristan:
This was built specially for leprotics. At the start of our talk about Bimaristans we referred to what Nushirawy mentioned about al-Waleed b. Abd al-Malek saying that he was the first who was interested in establishing such types of Bimaristans.
According to Ibn al-Qifi (35) , the first who wrote a book on «Leprosy» was Yohan b. Masaway. The cause of interest in such a disease arises from the Muslim's idea of isolating the patients who had communicable diseases from the rest of the society. We find the same behaviour with the doctors of today towards such liseases.
c) Road Bimaristan:
Arabs knew this type of Bimaristans and they realized its importance, because the pilgrimage to Holy places or the commercial caravans that travailed for long distances required care for the travelers, such as treating wounded persons or saving a person asking for help.
Therefore, they equipped the caravans with medical missions where physicians worked and had boys to help them. Ibn al Qifti presented to us an important test while he was talking about «Al-Hakam b. Ali al-Hakam al-Damaski», he said «he was a doctor in the beginning of «Al Abbassid state», Mu'awiyah b. Abi Sofian sent him as a doctor with his son Yazeed to Mecca when he sent Yazeed as Emeer of the pilgrimage in that epoch. Al-Hakam said: He is the doctor my father sent with Yazeed when he went to Mecca and I was the doctor who went with Abd al Samad b. Ali b. Abd Alla b. Abbas to Mecca (36) .
Undoubtedly, Ibn al-Qifti's text we just mentioned kept the oldest idea about this type of Bimaristans. Ibn Katheer (37) pointed out in his book (The Beginning and the End) that road Bimaristans were conducted by a wise director who knew how to give treatment: The rich people, who had the ability to equip the caravans with medical missions supported those Bimaristans financially.
d) Prison Bimaristan:
The Muslims cared medically for the imprisoned the same way they did for people outside the prison. This is clear from the letter the minister, Issa b. Ali al-Garrah (38) Minister of al-Moktader, to Sanan b. Thabit al-Tabeib al-Natassi who was distinguished in Arab medicine and who embraced Islam at the hands of Al-Qaher. After Issa b. Ali had visited the prisons, he found it was necessary to treat the patients and preserve their humanity so, he sent his famous letter to Sanan in which he said: «I thought-May God prolong your life-of the imprisoned and they are exposed, due to their big number and their hard situation, to diseases; they are incapable to deal with their excretions or to meet doctors to seek their advice about diseases. You have - May God grant you honor - to assign physicians to visit them daily and they should carry with them drugs and syrups and all they need to treat the patients and cure illnesses with God's will. Sinan followed this advice» Also according to what Ibn al-Qifti mentioned al moktader asked Sinan b. Thabit to build a Bimaristan and give it his name. He ordered one at Bab Al-Sham and called it The Moktader Bimaristan and financed it with 200 Dinars monthly (39) This was in 306 Hijri and Sanan b. Thabit was assigned as chief doctor. When al-Moktader was told that one of his physicians had killed a man by mistake, he ordered Sinan to perform a test for the physicians. So, they were tested in Baghdad and their number became eight hundred physicians (40) .
It was Sinan b. Thabit who financially supported al-Sayeda Bimaristan, according to what Ibn al-Qifti said «On the first of Moharam 306 Hijri, Sinan b. Thabit inaugurated Bimaristan al-Sayeda in the Yahia Market and he stayed in it and he organized the work of physicians in it. Each month 600 Dinars were spent on the Bimaristan by Youssef b. Yahia al-Monajem because Sinan did not contribute to the expenditure of the bimaristan (41) .
e) The Mobile Bimaristan:
This type of Bimaristan visited villages, peripheries and cities caring for the health of people who lived away from the state capital and allowed the state services to reach anyone who needed treatment in the state.
Ali b. Issa al-Garrah - al Muqtadir's minister - ordered the first state physician Sinan b. Thabit, in a written letter, to let doctors travel to the peripheries of the state. He said in his letter «I thought of people who live in the peripheries and that among them are patients who do not receive any medical care because there are no doctors there. So, assign - May God prolong your life-some physicians to visit the peripheries; also a pharmacy containing drugs and syrups. They have to travel all through the peripheries and stay in each region enough time to perform treatment of patients, then they move to another one (42) .
It was the state's responsibility to care for the Bimaristans. The senior physicians were aware of establishing work rules and bases to teach the students who came to learn medicine from everywhere. Therefore, medicine schools were established in the Islamic world, in which teaching was performed by two methods:
1- The theoretical method in the medical schools, and 2- A practical method for training and practice where students gathered around the doctor in chier to see and examine the patients and the treatment he prescribed. When the students finished the studying period they applied for an exam, took an oath and got their certificates. When they started to practice medicine, they always worked under the state's supervision. This means of course that the Bimaristans were institutes for teaching medicine and to complete the study for junior doctors (43) . From a practical point of view, the professors prescribed the treatment for the patients, they examined them in the presence of the students who received their learning through professors, they writing their instructions. They performed these instructions in an organized way and they did a follow up to the patients and hence they acquired the necessary practical experience for a medical student. Muslim contribution in the field of medicine can be exposed throughout three main points which are, (1) the medical assemblies, (2) Al-bimaristan, and (3) the method that they followed.
-III-
Medical Educational Assemblies
Educational assemblies spread throughout the Islamic world through a methodological system. They were sometimes sponsored by the state but most often by the scientists. This has always been their system. We know that a scientist is known by his assembly, his students, and followers, as well as by the influence he has on the following generations, as each of his pupils reflects him; therefore scientist are always careful to teach pupils in their assemblies in a special way different from other teachers.
The Arab Historian Ibn Abi Usaibi'ah, recognized and wrote down many things related to science and scientists in his book (Uyun al-Anba Fi Tabaqat al-Atibba) Sources of Information on the Classes of Physicians. He mentioned many characteristics concerning scientists assemblies. The medical assembly of Amin al-Dawla b. al-Thalmeed who knew many languages specially Syriac and Pahlavy as well as Arabic (44) , devoted himself to teach new generations, with the condition that they should master the Arabic language, and if any of his students committed grammar mistakes or if his Arabic seemed not good in construction he sent him to a grammarian to take care of and examine him after that. The assembly of Amin al-Dawla b. al-Thalmeed was probably the biggest assembly of science held at that time. Ibn Abi Usaibi'ah mentions a quotation by Mowafak al-Deen Abdel Latif b. Youssef to have said: «A man entered upon him bleeding in summer time so he asked his pupils who were approximately fifty and they did not know the illness» (45) .
Scientifc assemblies between physicians sometimes were held in the Bimaristans, we find Zahed al-Ulama who established al-Farki Bimaristan assembling his pupils there to answer their queries (46) .
Most educational assemblies acquired the form of a debate. Seif al-Deen al-Amidi's assembly adopted this form and eventually people praised «his eloquence in debating and research» (47) . So did the assembly of Shams al-Deen Ibn Al-Laboudi who «became strong in arguments, good at debating» (48) .
Sometimes during science assemblies, a physician wrote books for the students who had graduated under his teaching and who had become themselves teachers of science. The writing of books in this case was not meant for teaching or dictating but they were meant to urge the students to more studies and comprehension (49) .
Arab physicians' way of teaching had its characteristics and Abou Bakr al-Razi, maybe the physicians' leader and one of the best physicians of his time to preserve for us in their writings the essentials that a physician should know well, and that teachers should engrave in the pupils mind.
These teachings were not just theoretical, but they came out of experience and practice, Abou Bakr al-Razi was the best clinical physician, had no competitor in this field, beside being a good teacher of medicine and its writing. His book (The Guide or al-Fusul) is a good example. During his teaching sessions pupils crowded around him in circles according to the precedence of their joining these sessions. He used to present them patients and let them ask about the illness and try to diagnose it; if they failed he would intervene and give the final decision» (50) .
This quotation refers to many things in the field of medical education by these professors and their assemblies either in the Bimaristans or outside them. Al-Razi's educational assembly was of two kinds, one for theoretical teaching the other for the practical one (51) . Theoretical teaching took the form of debates between three groups of students; the group in the circle nearest to him were the more advance in learning and practice. Next came the second group of those with less experience and last came the third circle in which new students were grouped. He read to them, explained, argued and listened to their debates answering their queries. Whenever he detected an intelligent pupil he moved him to a circle nearer to him in which he had to spend three years. So he spent one year in each circle. During this period he was taught anatomy, physiology or organ properties and pathology.
As for the practical teachings, like during his theoretical ones, students placed themselves in circles around the patient's bed in the hospital. He explained to them rare cases one after the other. In this way al-Razi used the patient as a book to be read daily and continuously to be able to understand the symptoms of his illness (52) .
The most important thing in this matter, is that the teacher explained to his pupils in the assemblies each case he examined and noted his questions and his observations in a special page. He started by asking the patient, and the pupils around him, asking his name, age, country of origin, trips and his illness, the date it started, place of pain and symptoms. He assured that the patient was the best person to explain the extent of what he feels. He also asked the patient about his family and its members, and whether they felt the same symptoms.
To achieve all that, al-Razi examined his pupils and graduates. He asked first in the field of anatomy, and if the pupils failed to answer, he did not continue the clinical examination because their failure in this subject made them unworthy even if they passed the clinical exam (53) .
Mohazb al-Deen abd Al-Rahim b. Ali al-Dakhwar's assembly in the second half of the sixth century Hijri and the first quarter of the seventh century Hijri, was the same. Students used to gather around him in the Bimaristans while he examined patients. He taught them and explained the cases in front of them. One of his students, Ibn Abi Usaibi'ah, says: «I saw him once in the hall of the fevered; doctors felt the pulse of one patient and diagnosed weakness and prescribed chicken soup to give him strength, he said that his speech and the look of his eyes denoted weakness, then he felt the pulse of his right hand then of the other and said: Feel the pulse of his left hand, we found it strong, he then said: look at his right hand and how near his elbow the vein divides in two branches one remains and can be felt the other moves over the ulna towards the fingers, which we found true. He then said: this is a rare case but some people show this phenomena, and many physicians diagnose it wrong as weak pulse but it is just that they are feeling half the vein (54) . This is the scientific point of view of al-Dakhwar he had inherited from his medical ancestors who had laid the foundation of medical practice in the Islamic world. This is not strange, as al-Dakhwar studied al-Razi's writings and understood it well. He absorbed the instructions and descriptions of clinical cases that al-Razi mentioned in his book (Al-Hawi).
When al-Dakhwar finished in the Bimaristan he devoted his time first to transcription, studying and reading, then to his pupils. He asked them in «They came in and so did groups of doctors and practitioners, each read his lesson, discussed it with him explained it as much as he could then if there was need for further explanation or if there was a problem he would discuss it with the best of the attendants (55) . This was his system, and he explained the introduction of medicine in the same way, explaining its meanings and construction facilitating it to students.
Al-Dakhwar's system in theoretical teaching had a special character. He scrutinized the next he had, and tried as much as possible to bring out a text without mistakes, whenever someone read to him, "he would have a copy of the text in his hands, he looked at it, and compared it, if he found a mistake in the copy being read he would order its correction" (56) . Al-Dakhwar persisted in the accuracy and precision of the copy, Ibn Abi Usaibi'ah says: Sheikh Mohazab al-Deen's copies that were read to him were very accurate, most of them were in his hand writing. He surrounded himself with all he needed of medical books language books Abou Hanifa al-Danoury's botany book (57) . These are the tools that a scientist needs to perfect his research. After Al-Dakhwar's assembly was over and the attedants left, he returned to his private life ate something then spent the rest of the day studying and reading and stayed a good part of the night working (58) .
This was al-Dakwar's scientific assembly, where, he taught many pupils and physicians. He wanted scientists to remember him and commemorate him, therefore he transformed his home into a school for medicine, and it was considered one of the best known schools in Damascus, and was known in the history of Arab medicine as the Dakhwarian school the reputation of which in the seventeenth century Hijri spread all over the world. And from it graduated many well known doctors who spread all over the world presenting mankind their knowledge and studies.
Al Dakhwar succeeded in inspiring his students with the correct scientific doctrines which he himself had learned in his teacher, Tag al-Deen al-Kindi's assembly. This was very clear in his other interests besides medicine.
Actually, Ibn Abi Usaibi'ah preserved for us a great treasure in his book (Uyun al-Anba fi Tabaqat al-Atiba). In this book he deals with physicians not history, but at the same time he praises the interest in history, al-Dakhwar was not only a great figure in medicine during Ibn Usaibi'ah lifetime, nor was he only a Sheikh who taught this historian doctor, nor only did he establish a school well known in the Islamic world, and that became a true science institute attracting researches from all places, but he also wrote the history of medicine in consecutive periods, relating to his pupils among whom was Ibn Abi Usaibi'ah what he remembered, and what he heard from his elders about the science and views of his predecessors. This is not strange as al-Dakhwar the scientist and doctor was a descendant of Tag al-Deen al-Kanadi, who taught him how to look for the truth and seek its origin, this is the characteristic of a true scientist who ascribes sayings to their owners and not take the credit himself for science and learning and diminish others' abilities, as some ignorant people do nowadays pretending to know everything and deny the merit to others.
We have many examples of what Ibn Abi Usaibi'ah wrote, which show al-Dakhwar's views who connected good ideology to good morals and so spoke truthfully and honestly (59) .
-IV-
The Fundamentals of Method
The method is considered to be the core idea that characterizes any science. Scientists who work without a method will never achieve a scientific discovery and will never get the chance for any scientific addition and hence will repeat opinions of others. Arab scientists and physicians realized the importance of concluding the ideas after following a clear method in their researches and following certain rules. Therefore they brought both sense and reason (intellect), they discussed intellectually and logically what sense exposed in the light of what previous scientists had recorded.
Though it is difficult to claim that Muslims had clearly written about method - as it is the case today - it is obvious from their writings that they followed a precise scientific method in studying and teaching when they talked about the topics they wrote and wanted people to learn.
Scientists and physicians in the period of the flourishing Islamic state achieved brilliant scientific results, which - for certain - were transmitted to the Western world, to Latin Europe, and European science benefited from them, during the Renaissance epoch. This made Ali Sami al-Nashar, when speaking about influence of the Islamic method on the West, assert while writing his introduction "I knew for sure that I am in front of the greatest discovery that the European world had ever known which is the discovery of experimental methods of the Islamic world in its most perfect form" (60) .
The talk about method could be divided into two parts:
A- The steps followed during research and study.
B- The characteristic and general features that characterized the method and allowed it to serve the purposes of scientific research and reflection upon the scientific works, the character and the nature of genuiness and seriousness, and hence allowed them to achive important scientific discoveries by which they went ahead of the European world for many centuries.
A- The steps followed in the research:
As previously mentioned, the method is the core of scientific research so that if you start the study of any topic without following a specific method to treat the topic through it, or without following a specific plan during your research, you will achieve nothing, i.e. you will not get any useful research result to be used theoretically and practically.
Though scientists in the capital of the Islamic state and in its peripheries did not have specialized clear writings - which we call method - the rules and regulations and the steps were clear in their minds and they used to draw the attention of the reader and the student to its importance from time to time.
We can conclude from their several writings, the general rules followed in the medical researches that led to the flourishing of that science in a way that astonished the Latin world.
1- Observation and Description
It is familiar to find some diseases that have similar symptoms to the extent that makes the distinction between them require a highly skilled physician. Muslim physicians have dealt frequently with such matters. We know this through several examples and observations found in the history of Arab Medicine. Here is al-Razi (61) who was known by his medical and scientific skills an intellect whom European medicine acknowledged before even Arabic medicine. He described in his study (Small Pox and Measles) the symptoms of small pox - which he saw himself - as follows: "the appearance of small pox is preceded by a continuous fever that causes back ache and itching in the nose and shivering during sleep".
Scientists have comprehended the steps of observation, description, comparison and detection of points of similarities and differences. They realized that there are qualitative observations that explain to us the different sides of what we are studying.
Example 1: Qualitative Observation Al-Bughdady was interested in the study of Diabetes Mellitus symptoms. He mentioned in two successive paragraphs "while examining the urine you must observe the amount whether a little or a lot, the colour of urine, its taste, and consistency i.e. whether it is thin or thick...". In another paragraph he said «while examining the urine we should examine three things: the colour, the consistency and weight, in addition we have to examine the odour, the temperature by putting your finger in it, as well as its sour taste» (62) .
Example 2: Comparative observation and the relation between sensation and intellect Al-Bughdady did not stop following his observation. He proved that Galen committed mistakes. Galen mentioned that the lower jaw in human beings consists of two parts attached together by a joint at the chin, but al-Bughdady could - through his precise observation - describe the real situation which is: the lower jaw in the mammalians consists of two parts which unite together sooner or later, the degree of union increases or decreases to form strong symphysis at the middle of the chin in different types of mammalians. In high mammalians and human beings the union of bone at the middle of the chin occurs strongly immediately after the delivery so that the lower jaw forms a single bone (63) .
Al-Bughdady was acquainted with the reasons of Galen's opinion on this point, but his observations contradicted what Galen assumed and hence he could, through concentrating his attention on what he observed, realise the point of similarities and differences of what he had in front of him, being provided with an ability of precise distinction and understanding.
Al-Bughdady found in a certain place near Cairo a Tomb full of human bones where he counted more than two thousands skulls. When he examined the shape of the bones and joints and the way of their articulation, he proved that the lower jaw is formed of one piece rather than two as Galen assumed in the sixth chapter of his book «The Children Bones» where he said that: «The lower jaw is formed of two parts which is proved by the fact that it can be cracked at its middle when it is crumbled».
But according to the precise observations of al-Bughdady «if the lower jaw was formed of two attached parts by a joint, we could see that joint at least in the brittle decayed bones, because the crumbling of bones starts firstly at the joints» (64) .
We can notice from all these examples, the importance of the step of precise scientific observation to the Arab scientists and the degree of correlation between the observation and the continuous description directly from reality, and the extent of their thinking to correlate between the parts of the observed subjects that they describe. This is proved by the example given by al-Bughdady which was just mentioned, that shows how just one empirical observation acquainted him with a wrong opinion that dominated for a long period and was adopted by the physicians since Galen. We will ascertain more precise observations while we review some important points.
But we are concerned mostly to demonstrate that al-Bughdady-and other scientists also-did not rely upon Galen and other persons sayings. This will become evident in case of Ibn al-Nafis. The sensational observations of those scientists were accompained with good works of mind in what the sense was exposed to. The sense might be wrong but the mind should correct this mistake.
2- Experimental and Testing:
Muslim physicans were concerned with referring to experiment because it is the best witness to the correctness of an opinion. That is why al-Razi mentioned in his book (The Characteristics of Things) many texts on experiment, "we add what we know by experiment and people know that we do not give our confidence to anything except after its test and experimentation" (65) .
Al-Razi believes also that the skilled physician must have two characteristics together "one, he should be skilled in the scientific art of medicine and the other, he must have at the same time a lot of experiences" (66) .
From this point of view, we find that al-Razi was committed always to experiment as it is considered the principal criterion in judging things. As long as experiment is the criterion that the physician always resorts to "to distinguish between the truth and the falsehood in what concerns these caracteristics that might be submitted to the denial of those who could not understand the aims of science" (67) .
Such texts and others reveal to what extent, the scientists of that epoch were concerned with the establishing of science upon correct scientific basis. It is impossible to use standards through which the science works today in the twentieth century as a basis to judge a science produced by the Islamic mind more than a thousand years ago approximately.
Muslims were skilled in the art of medicine and they achieved important achievements, they attributed in the way of distinction between one disease and another and the definition of many of communicable diseases which can be called epidemics. They did not only distinguish between communicable diseases, but they described each disease separately from the observations they made and the signs of disease occurrence and progress. There are many examples to demonstrate this fact. For example, al-Razi was the first to describe precisely and clearly small pox and measles (68) . Ibn Zahr was the first to describe mediastinal puncture, dry peritonitis and peritoneal effusion" (69) .
We can notice the precision of that description which al-Razi presented in the distinction between small pox and measles where he says "the appearance of small pox is preceded by a continuous fever which causes backache and itching in the nose and shivering during sleep. The important symptoms that denote its occurrence: backache with fever and burning pain all over the body, facial congestion and sometimes facial contractions, acute redness of the cheeks, eyes pressure sensation in the body which extends to the muscles, throat and chest pain accompanied with difficulty of breathing, cough and restlessness. Irritability, nausea, anxiety are more pronounced in measles than in small pox (70) . Al-Razi mentioned the cough of hereditary infections. The opinions presented by al-Razi were not only the results of his own efforts, but when he talked about many of the diseases, he gathered, first the opinions mentioned on the disease, by the Greeks, Syriac, Indians, Persians and Arabs, then he presented his own opinion and the experiment he performed and the observations he achieved after the process of diagnosis and treatment. In surgeries, he was a head of his contemporaries because he treated renal and bladder stones surgically. As Hitti descriped him in the field of surgery he was one of the first to use the seton.
Among other examples we find Avicenna who "distinguished between pneumonia and pleurisy, acute and secondary meningitis, intestinal and renal colics" (71) . Also, there were some important additions presented by Avicenna, where we find" the first description of anthrax which the Arabs called "The Persian Fire (72) . Avicenna mentioned that the infection occurs through water and dust. He described the life cycle of Ankylostomiasis (73) and he showed its effect on the body. Anatomically, Avicenna described all the organs, even the anatomy of teeth and jaw bones. When talking about the nerves and muscles he included the nerves of the face, forehead, eye globe, eye lids, cheeks, lils, tongue as well as the nerves of the marrow and chest. When he talked about "the nerves", he studied cases of paralysis. He described hemiplegia and distinguished between two main types: the first is the facial palsy resulting from a central cause in the brain and the second due to a local or peripheral cause (74) . It seems that the treatment of the causes of paralysis were familiar to the physicians of the Islamic world of that epoch. This was the result of their interest in treating skillfully mental diseases. They specified particular words in the Bimaristans - as for example they used one of three methods to treat such cases (we mean caes of paralysis and neurogenic diseases). In cases of paralysis they resorted to cooling drugs in contradiction with the familiar Greek method, which used the hot methods of treatment; or they resorted to methods similar to electricial shocks used in our days, as we have been told by some contemporary historians. Muslims were the first to use electricity to treat epilespy and neurogenic diseases by using a certain type of fish called Torpedo or cramp fish, which was put alive in water which was then connected to two straps of steel. When the patient held them, which he could not do but for a short time, he shivered and would throw them to the ground. After some days of this treatment he was cured from epilepsy (75) . The third method was based on psychiatric treatment and there are many examples for this. Harun al-Rashed had a slave maid attained by a certain type of hysterical paralysis. When she raised her hand upwards, the hand stayed hanging up. The physicians were perplexed in her treatment, therefore al-Rushed brought Gabriel Ibn Bachtishou to treat her. He asked for his safety while he performed the treatment in front of him and he said "if the Caliph will not be angry with me I have some tricks for her" al-Rashed said" and what are they?" the doctor said "the slave must come here in the presence of everyone till I do what I want and you must give me time and not be angry with me quickly. Al-Rashed ordered to bring her, when Gabriel saw her, he walked quickly towards her and bent her head and caught the tail of her dress as if he wanted to undress her in front of all the people; she was shocked and worried by this behaviour and her shyness obliged her to drop her hand downwards to hold her dress and to cover her body. At this moment, the physician turned towards the Caliph and said: "She is cured now" (76) .
These three examples reveal the intelligence of the physicians in the Islamic World and their insight about the cases presented to them and the way of giving successful treatment to such diseases after they examined them carefully and recognized its etiology and the facts and the way of its progress through scientific observations.
We find also that Muslims knew in detail other important diseases whose diagnosis was not known in the old medicine (77) . They were "the first to write about leprosy and the repair of the not known in the old medicine. They were " the first to write about leprosy and the repair of the teeth closure defects and tooth arches. They correlated piles with gastric contraction and recommended plant foods for its treatment". They were also "the first to draw attention to the shape of the nails of the tuberculous; they described treatment of jaundice and cholera, they used opium in certain doses to treat haemorrhage, and they treated shoulder disclocation by the surgical method known as sudden resistance reduction (78) . Moreover, al-Tabari was the first to discover the insect causing scabies.
Among the medical features of Muslims worth mentioning is Surgery. They were the first to use anaesthesia in surgical operations (79) . Abu al-Kaseem al-Zahrawi (Abulcasis) is considered "the greatest one to perform manual works skillfully in surgical operations and to use surgical instruments. His book presentation to those who failed to write consists of three parts: the first in medicine, the second in pharmacology and chemistry, and the third in surgery (80) . The previously mentioned reference of al-Zahrawi is considered to be one of the most important text books in the description of instruments used in performing surgical operations and the way to use them, kwith the detailed description of each instrument through illustrations and he acquired a great importance because he was the first in this subject (81) . Al-Zahrawi was the first to succeed in tying arteries to stop haemorrhage (82) . The Arabs knew in this epoch the anatomy of pulmonary arteries and veins. Not only this but Iban al-Nefis presented to us for the first time in history a complete description of the blood circulatory system.
The belief that predominated since the epoch of Galen till the time when Ibn al-Nafis first appeared was that blood originates in the liver from which it is transported to the right ventricle in the heart, then it flows in the veins to the different body organs to nourish them, some of the blood enters the left ventricle through pores in the diaphragm, where it is mixed with the air coming from the lungs. But, Ibn al-Nafis found that the process of blood purification occurs in the lungs due to its union with the air and hence it is purified, then it is transported to the left ventricle hence the small blood circulation discovered by Ibn al-Nafis. As the historians of science assert «Ibn al-Nafis, described precisely the blood circulation eight hundred years before the Portuguese Servit to which this discovery is attributed (83) . Muslims were skilled also in another medical branch which is Ophthalmology. The nature of hot environment of their countries encouraged them to study this branch of medical specialities and to contribute to it in an evident way which called for astonishment. The book of Salah Ibn Yousif al Kahhal on the eye might be the greatest reference that gathers all eye diseases. He wrote chapters on: eye description, sight description, eye diseases and their etiology, their symptoms, the care for the eye, eyelid diseases and diseases of the cornea and iris, and those diseases far from the senses, also eye treatments» (84) .
B- The Characteristics of the Methods
There were general characteristics ascribed to the method used by the different scientists and physicians, during the flourishing of Islamic development. These characteristics can be described as follows (85) :
1- Debating and not accepting ideas without proof.
2- Conscious and accurate analysis.
3- Scientific honesty. This feature characterised the books written by Arab scientists through the ages. Scientific honesty can be put in the following order:
a) Refer opinions to their owners.
b) Not to take credit for others' creativity.
c) Arab scientists used some statements that indicated complete uncertainty such as: «Some physicians told me» or «Aleppo citizens told me» or «I copied from some history books» or «I found in some books».
4- Freedom of opinion and stating observations without adhering to ancient theories.
5- Arab scientists were self confident and esteemed the bold scientific opinion, and their writings were characterized by fluent style and accuracy of presentation and being free of contracdictions and they sometimes depended on using equivocations.
Results
It cannot be said that the study of the history and development of Arab medicine has been completed, as we cannot also say that Arab physicians were just copiers from the Greek medicine heritage they had studied and understood. In reality they were aware of the details of medical theories specially those reached by Hippocrates and Galen. This did not stop them from having their own participation, and of correcting some mistakes in old theories.
Although many Orientalist studies deprived Arab and Islamic share in the medical heritage from its seriousness and originality in relation to theory and application, this opinion was mainly due to racism or misunderstanding.
This study we cannot be considered to have covered all aspects of the problem, or to have defined the development in a decisive manner. We cannot ascertain that. But this study gave us some important results, which if added to the results of other studies could help in better writting the history of the development of Arab medicine theoretically and from the view point of application.
The indications of this study could be stated in the following points.
Scientists throughout the Islamic world understood the Greek medical heritage, first they translated it magnificently by the care of Hunain b. Ishaq who travelled the nations in all directions searching for manuscripts and lost pieces (shreds of them. Ibn Al-Nadim, Ibn Golgol, Ibn al-Qifti, and Ibn AbiUsaibi'ah, confessed that Hunain's translations and his school played a great role in understanding this heritage. These writings also transferred to us some of Hunain's pupils translations, details of the translations and whether translated from Greek or Syriac. It is clear that there were medical assemblies, the most famous of which was that of «Yuhanna b. Massoyweh» Hunain b. Ishaq's teacher. These asemblies played a good role in increasing the growth of medical knowledge. Al Razi's assembly was a real school for teaching pupils. These assemblies of teaching medicine, were propagated between the fifth and the seventh century of the Hijri. After the translation era, started a period of flourishing and development as physicians had the opportunity to study from text books and to make clinical observations.
The period between the twelfth and thirteenth century was characterized by the propagation of medical assemblies. These assemblies were usually held in physician's homes. These can seen by the assemblies of Ibn al-Thalmeed and al-Dakhwar, students read with their professors important books and teachers explained the difficult parts.
The practical side of the study took place in the Bimaristan under the supervision of great physicians. In this light the bimaristans could be considered as true faculties for medicine paractical study.
In different periods of Islamic development, physicians encouraged Caliphs and men of influence and power to build hospitals which were called Bimaristans. From what we reviewed, we see that the building of Bimaristans started in an early stage of the history of the Islamic nation. They were built in all parts of the Islamic world. Physicians also understood, in those times, that medicine needed to be practiced in hospitals with precise organization both in management and treatment. New physicians were subject to pass an examination, and the profession itself was controlled by the government, through a man called Al-Mohtasib (Health Inspector). They had to pass examinations and get certificates. This proves the precision used in the practice of medicine in the Islamic world. The Bimaristans were of different types differing according to the type of disease treated in each, this shows us the precise understanding of the nature of diseases.
Study in the bimaristan meant the presence of clinical cases (the patient) in front of the student who osculated him and noted the course of the illness and observed any change in the symptoms. There were different kinds of bimaristans throughout the Islamic world, and these were under strict control.
Students attended physicians' teaching sessions in the bimaristans, after having completed the studies. They were examined theoretically and practically by the physician and were given certificates of graduation but had to practice medicine in the bimaristans under the professors' supervision.
Physicians taught in a scientific way, so, for the theoretical part of the study, there were certain books a student had to read and understand under the surpervision of his teacher, these books were those of Hippocrates, Galen, Hunain, al-Razi and Ibn Sina. The student also had to note the teacher's lectures, and that, led to the many versions for one writing. For the practical part, the students watched the teacher's way of diagnosis, and also attended the debates between the professors on some diseases.
Scientific method was systematically the most important pillar for medical practice and for understanding it in a scientific way. The different writings of physicians of that time show this clearly, as we find them following the trial rules of scientific method in its best form even before this method was discovered or created in the West. In this field the study points out that the many participations had special common characteristics that could be summarized as follows:
Medical study depended on observing and describing, as we found detailed descriptions of illnesses that physicians teated.
Physicians made comparisons between different illnesses specially that some of these had similar manifestations.
Cases were diagnosed after a meticulous clinical examination of the patient and after a proper understanding of the illness.
Physicians often turned to experiments, and we met many texts refereing to this fact.
Descriptive comparison of some studies showed mistakes made by the Greek physicians, specially Galen, and this drove Muslim physicians to correct them.
They used instruments and tools in the many surgeries they performed.
Physicians studied and criticized the Greek heritage.
We, often, find that physicians followed the meticulous analytic system in using the heritage they came about.
The studies that were done in the Islamic world were strictly scientifically honest. Never did any physician claim the merit for another's work, but always quoted other's ideas using precision in referring them to their owner, this gave them greater self confidence and a free courageous opinion.
The status of Medicine in the Islamic World
The Scientific movement in the early Islamic centuries has various aspects. One of them is the contribution of the early Arab Scientists, which took different forms, their role in scientific progress, the theories they have provided us with, and their methods and influence on the western world which started, as a result, viewing science in a new light during the middle ages.
In fact it is not easy to divide the whole unity of science, and claim that this science belongs completely to the Greeks or the Arabs or the West. It is not possible to divide science because it does not belong to one nation, nor to one race. It is the result of co-operation, and communication, among scientists and many other factors. This paper considers the case of medicine in the Arab Islamic World and investigates its nature and schools.
To understand the nature of Arab medical schools in the Arabic Islamic World, we have to deal with the status of medicine before the 12th century; the Bimaristans: their system and different purposes; medical educational assemblies: their role in configurating physicians' minds and the method that was followed and then conclude with the results. It is worth noticing that examples have been provided.
Medicine was the first science that the Muslims knew in their environment. The ancient Arabic sources mention Al-Harith Ibn Keladah (d. 634 A.D), the Arabian who travelled from the Arab peninsula to Persia to study medicine in Jundisabur where there was a well known Bimaristan (hospital). After he had finished his studies in Jundisabur, Al-Harith returned home to practise his science and to treat those who were in need of his knowledge.
The ancient sources inform us about Al-Harith especially Ibn Golgol , the most famous historian in the fourth century of Hijra (10th century), who said that Al-Harith «studied medicine in Persia and Yemen and was alive in the days of the Prophet(1). According to other sources (2) , the Prophet advised Saad Ibn Abi Waq'qas when he was sick to consult Al-Harith, the physician.
The power and authority of physicians began to increase during the rule of Mu'awiyah (660-680), who founded the Umayyad state. Mu'awiyah ordered his men to bring the best physicians from Jundisabur to care for his health, specially that he was afraid his enemies (3) might poison his food.
No doubt the successive physicians made great contributions and were the pioneers of medicine during the rule of Mu'awiyah and his sons. During the rule of Umayyad Caliph Marawan Ibn al-Hakam (d. 685), the Persian physician Masarjawayh played a vital and effective role, when he started, by order of Marawan, to translate the Medical Encyclopaedia of the Alexandrian priest Ahrun, from Syriac into Arabic. Masarjawyh's translation of Ahrun's book is considered to be the first translation of a medical book in Islam from a foreign language into Arabic (4) .
The Abbasids represent a very strong and important stage in the development of science, because they encouraged scientists, and tried to establish a solid scientific movement in the Islamic world, especially after they chose Baghdad to be the new capital, instead of Damascus. As we know the Abbasids were rationalistic. Most of the Caliphs were among the "Mutazilah scientists. The adoption of rationalism led to the flourishing of the sciences through the Islamic academy of science "Bayet al-Hikma" (5) (the House of Wisdom).
Practising medicine in Baghdad during the Abbasids rule was the responsibility of two families: (1) The family of Bukhtishu, and (2) the family of Masaway.
The Bukhtishu family came to Baghdad by the order of the Caliph Al-Mansour who was sick and suffering from pain in his stomach. He sent his men to bring Georges b. Jibril b. Bukhtishu to treat him in the year (148H. / 765). Georges was the chief physician (rais al atibba) in Jundisabur (6) .
When Georges left to Jundisabur after four years he ordered his son to stay in Baghdad to continue his mission. Both father and son wrote medical books in Syriac which were later translated into Arabic by Hunain b. Ishaq .
Hunain b. Ishaq (194-264 H.) who took the lead in the official movement of translation, was one of the most important figures both in translation and medicine. He translated the books of Hippocrates and Galen, and wrote down many medical books among which is his famous one about the eye (Al Ashr Maqalat fi al-'Ayn) The Ten Treatise on the Eye - Max Meyerhof verified and studied it critically (7) . The book of Hunain is considered the first scientific attempt towards Ophthalmology.
While the process of translation was going on, The Arabs began to organise Medicine as a profession, especially the bimaristans (hospitals) and practicing medicine among people.
Ancient Arabic sources - like al-Qifti (8) and Ibn Usaibi'ah (9) - mentioned that the real organisation of medicine took place by the order of al-Muqtadir who wrote to Sinan Ibn Thabit b. Qurrah to examine those who want to practice medicine and give them Ijaza (certificate). This was in the tenth century.
No doubt we have some good knowledge about the contribution of the Arab Muslim physicians who took part in the process of developing medicine (10) , such as al-Razi (Rhazes 850-923), Ibn Sina (Avicenna 980-1037), al-Zahrawi (Abulcasis 1013) and Ibn an-Nafis. let us look at the case of al-Razi and Ibn Sina, and their effect in medicine.
Al-Razi was one of the well known Muslim physicians in the West during the Middle Ages. Ibn al-Nadim enumerated the works of al-Razi among which are these major works: (1) Kitab al-Asrar The Book of Secrets,
Kitab al-Tib al-Mansuri Liber Almansouris, (3) Kitab al-Hawi (11) The Comprehensive Book, and (4) A Treatise on al-Judari wa al-Hasbah Small pox and measles.
Kitab al-Asrar was first translated into Latin by Gerard of Cremona (d. 1187), while Kitab al-Tib al-Mansouri appeared in the Latin translation in Milan in 1480, and so did the treatise on al-Judari wa al-Hasbah. As for al-Hawi (Continens) its translation had been made by Faraj Ibn Salim in 1279, and reprinted many times in Latin. This book had a great influence in Europe. Montgomery Watt, while dealing with al-Razi said "His greatest work is one translated into Latin as the Continens, The Comprehensive Book. It was an encyclopedia of all medical science up to that time, and had to be completed by his disciples after his death. For each disease he gave the views of Greek, Syrian, Indian, Persian and Arab authors, and then added notes on his clinical observations and expressed a final opinion." (12)
2- Ibn Sina was known as a philosopher and physician. His fame in these two fields was the cause of his influence in the West. Here we are dealing with his medical contribution that became so evident in his famous work Kitab al-Qanun fi al-Tib. The Organon in Medicine. This book was translated by Gerard of Cremona into Latin and published in Europe several times. The importance of al-Qanun came from two things:
Its well organized data, its method and scientific style. This is because Ibn Sina was a good philosopher and had an organized logical mind.
His description of some diseases such as mediastinitis and pleurisy. Also he mentioned the nature of phthisis and the spreading of diseases by water and soil, and gave the right diagnosis of ankylostomiasis (13) .
-II-
Bimaristans in the Islamic World
Those who learn and study medicine and practice it as a profession must work in hospitals to get experience and practice the medical profession, so that they gain this experience from the cases they examine under the supervision of master scientists. Von Grunebaum says about the necessity of hospital visits for medical students "The medical student must always visit the hospitals and must be very careful of the conditions and situations of the persons found there, while he is accompanied by the most intelligent medical teachers, and must ask about patients' conditions, their symptoms, remembering what he read about changes and their significance whether good or bad. If he understands these things he will achieve a high rank in his profession (14) . So, it is evident that the medical - teaching in that time - had bases and rules and was practiced in the Bimaristans. To be acquainted with the rules of the process of medical teaching that dominated. The Islamic world, we have to study first the origin of the Bimaristans and their development in order to know their importance for medical teaching generally.
Ibn Abi Usaibia'h said: "Hippocrates cared greatly about his patients and their treatment. It is said that he was the first to invent and build the Bimaristan and the first to renew it, by allocating - near his house - part of his garden for the patients and assigned some servants to perform the treatments. He called this the «Akhssendokin», i.e. a patient complex. Also the word Bimaristan-which is of Persian origin-has the same meaning as (Bimar) in Persian means disease and (stan) is location or place, i.e. location or place of disease (15). This is the text we find in the «Uyun al-Anba» of Ibn Abi Usaibi'ah about the historical development of the Bimaristans or hospitals. But Max meyerhof (16) mentioned that the first hospital to be built in the Islamic world is that which was based in Baghdad by the order of Harun al-Rashed; then hospitals were built successively everywhere. Does Meyerhof's opinion present the absolute truth, or does this opinion contain some clear fallacies?
Ibn Qutayibah al-Dainuri was interested in his book Leadership and Politics (17) in throwing light on some important matters relating to Islamic history. He mentioned that the first Bimarastan or hospital was built for the Muslim army-after Abdallah Ibn al-Zoubair when he was blockaded in Mecca, built a tent on one side of the Mosque, so that when one of the Sahaba (Prophet's followers) was wounded he would be brought inside the tent to be treated and to be cared for by skilled persons. That is how the first type of Bimarastan (hospital) was built in Islam. This is the Arab Bimarastan (hospital).
Moreover we find other proofs in (Ibn al-Atheer) in al-Kamel (18) and al Maqrizi in Maqrizi Plans (19) which denote that al-Waleed ibn Abdel Malik was the first to build a Bimaristan it the real meaning of the word in Islam in 88 Hijri. Noushirawy (20) in his new book on Islamic Brimaristans in the Middle Ages seemed to adopt this opinion and he mentioned that the first Bimaristan built in Islam was in Damascus, by al-Waeed b. Abdel Malik (705-715 A.D) and built in 86 Hijri (706-707 A.D.). The aim of its building was treating patients and the care of affected chronic patients-as lepers and blind people... etc. The leprotics were imprisoned, treated freely and given money. In the Bimaristan there were more than one physician. It is obvious that Noushirawy adopted what was mentioned in (al-kamel) of Ibn AL-Atheer on this poing specifically. A person has great importance and consideration on this subject, is Ahmed Bey Issa (21) who was the first to write clearly about the development of the Bemaristan and its history in Islam, and he mentions that the Prophet Mohamed (may peace and prayer be upon him) was the first to order the establishment of mobile military Bimaristans. It is natural that this last opinion has its importance and consideration, because Muslims were rushed in many invasions in which they were attacked and injured. There was lots of chaos, and men were wounded or killed here and there. It was normal that there should be those who cared for these people and looked after their treatment, and hence complete care was provided for the fighters. This last opinion agrees with what Ibn Qutaiba al-Daynuri mentioned.
1- The Bimaristan system: The people who are interested in establishing any institution must set an administrative or technical system to be followed. Of course the physicians in the Islamic world put in mind to follow a precise system inside the hospitals so that it would be based upon academic graduation which fulfills two amis: First, the welfare of the patients to be dealt with their treatment according to the updated rules of medical treatment. Second, Bimaristans used for teaching medicine to the newly graduated physicians responsible to treat patients successfully. Therefore the Bimaristans in the Islamic world were followed all the technical rules that fulfilled the two purposes together.
Ibn Jubair (22) mentioned what he observed in the hospitals concerning work. Also Ahmed Bey Issa mentioned in his book (23) Bimaristans in Islam Amin Assaad Khayrallah (24) in his book Arab Medicine and Nushirawy (25) in his book Islamic Bimaristans in Middle Ages mentioned the administrative, technical and teaching organization existing in that period in the hospitals.
Concerning the technical choice of bimaristanic site they used to choose the best location with regard to the health conditions. They preferred to build the Bimaristans over hills or by rivers. Al Adoudi's bimaristan is a good example of this; it was built by Adoud al-Dawla b. Bawaih (26) in Baghdad by the River Deglah and the water of the river flowed through its courtyard and halls and returned to pour into Deglah.
Concerning organization, it was natural that the physicians comprehended the necessity of separating men and women, therefore they took into consideration as much as possible to divide the Bimaristan into two sections, one for men and the other for women. Each section was independent, each having large halls for the patients.
Concerning the administrative organization of the Bimaristan, it was as follows: each section contained a hall for each type of disease, while each hall had one physician or more and each group of doctors in a section had a chief doctor. The halls were specialized: a hall for internal diseases another for splinted patients, another for oculists, and another one for delivery a special hall for each type of disease including communicable diseases (27) .
Ibn Abi Usaibi'ah discribed in his book Uyun al-Anba (28) , the halls of internal medicine which frequently included a section for the patients affected by fever and another one for patients having mania. All sections of the Bimaristan were equipped with all the medical instruments and apparatuses necessary for the physician.
Ibn Abi Usaibi'ah tells us (29) that Adoud al Dawla set a test for a hundred physicians, when he decided to build the Adoudian Bimaristan on the Western side of Baghdad, and he chose twenty four physicians out of the hundred to work in the Bimaristan.
The chief of all physicians in the hospital was called (AI Saoor). The administrative and medical system in the hospital was based upon using boys who worked as employees or health workers, assistants or dressers; some of them were servants and they cleaned the Bimaristan and cared after the patients when necessary.
According to this order and system the Bimaristan was performing its medical job from a diagnostic point of view, disease definition and prescription of treatment. Moreover, they understood the necessity of adjoining a pharmacy to the Bimaristan to give out the drugs, which were given according to the physician's prescription, and the pharmacy was called «Al Sharabkhana» (30) .
And as it is the case today, they used to inspect the Bimaristan. This was the responsibility of an employee assigned by the minister or the Caliph and given the authority to enter the hospital to be acquainted with the patients' status and the care offered to them, the food given to them and whether the boys were serving them or not. Whether the physician is performing his duty perfectly or he neglecting it. This system assured the stay and continuity of the Bimaristan in a serious way that allowed it to work with a high competence technically, scientifically and administratively.
It is worth mentioning that each patient had his own card on which the physician recorded his observations while treating the patient. Also the phsician had his own special register to record his observations on the diseases he was treating. The physician performed his experiments and tests according to his observations. If the physician faced any problem in any matter of diagnosis, he went to the head of his division or the chief physician. Frequently the physicians held meetings to discuss cases. Undoubtedly these discussions and consultations were considered as a small scientific conference of physicians. We do the same today.
We notice that the historians of Arab medicine wrote special long pages on the medical personalities about whom discussions were held to set the work system in the hospital, or the Bimaristan between the physicians. There were shifts for the doctors, some worked in the morning and others at night, some worked a certain time in the morning and another period at night, so that they cared for the patient. At the same time they could get enough rest to allow them to continue working in the Bimaristan, supervise the treatment system and medical care of the patients.
Al-Maqrizi mentioned in his plans (31) that the patients were registered at the admission in the Bimaristan, their clothes were taken away and their money put in trust by the Bimaristan guardian. The patients received clean clothes instead of those taken from them, and they were given drugs and food under the supervision of the physicians freely till they were cured.
Ibn al-Okhowa described in his book (al-Hisba) the entrance of the patient to the outpatient clinic to see the physician. He said in a very important text «the physician asks the patient about the cause of his illness and the pain he feels. He prepares for the patient syrups and other drugs, then he writes a copy of the prescription to the parents attending with the patient. Next day he re-examines the patient and looks at the drugs and asks him if he feels better or not, and he advises the patient according to his condition. This procedure is repeated on the third day and the fourth... till the patient is either cured or dead. If the patient is cured, the physician is paid.
If the patient dies, his parents go to the chief doctor, they present the prescriptions written by the physician. If the chief doctor judges that the physician has performed his job perfectly without negligence, he tells the parents that death was natural; if he judges otherwise, he tells them: take the blood money of your relative from the physician; he killed him by his bad performance and negligence. In this honorable way they were sure that medicine is practiced by experienced well trained persons (32) .
2- Bimaristan Varieties according to different Purposes
In the early Islamic state, Muslims comprehended the different form and purposes that should be considered in Bimaristans. Normally, they should deal with this point seriously, precisely due to its importance to the patient and the physician as well as the desired degree of care for the patient. Certainly the Bimaristan established to serve the fighters in the battle field during the hustle of the battle must differ from that built for the patients affected by mental disease who do not have to hustle, but doctors might hustle away from them but this is different, or those built for a commercial caravan or the pilgrimage to Al-Kaaba.... and so on.
Each type of diseases might require a special Bimaristan for a group of patients. This can be noticed at least by specialization of Bimaristans for leprotics and mentally affected patients.
a) Mental Disease Bimaristan
Muslims realised the importance of the care for mentally affected patients. They frequently added to the big Bimaristans special places isolated by iron bars, specially for patients with mental diseases (33) , to avoid the aggression of these patients on the others.
Muslim physicians knew that psychiatric and mental diseases required a special type of care and that the physician must be acquainted with the etiology of the disease from which the patient is suffering.
It is worth mentioning that Ibn Abi Usaibi'ah (34) tells us in his book (Uyun al-Anba) about some cases of this type of disease and how the skilled doctor Waheed al-Zambian could treat them. One of the patients thought that he had a tun over his head that never leaves him; he was afraid that the tun might break while he was walking, therefore he walked carefully to avoid breaking it. Some doctors tried to treat him but they failed. Lastly he saw Waheed al-Zaman who realized that the man was suffering from illusions. He told his family: «bring him to the hospital. Waheed al-Zaman ordered one of his boys to bring a big stick and hit the head of the patient-while Waheed al-Zaman talks to him-as if he wants to break the tun that the patient pretends having on his head, in the same time he asked another boy to throw a tun- that he prepared for him-from the house top, the moment the first boy hits above the head of melancholic patient, to the ground. When the patient came, Waheed al-Zaman started to talk to him, disapproved he was carrying the tun, he gave the boy a signal and he started to hit over the head of the patient with the woody stick, in this moment the other boy threw the tun from the house top which caused a great noise and broke to many pieces. When the patient saw what happened to him and saw the broken tun he did not doubt that it was the tun he was carrying -in his imagination - this influenced him and he was cured from his illness.
b) Leprotic Bimaristan:
This was built specially for leprotics. At the start of our talk about Bimaristans we referred to what Nushirawy mentioned about al-Waleed b. Abd al-Malek saying that he was the first who was interested in establishing such types of Bimaristans.
According to Ibn al-Qifi (35) , the first who wrote a book on «Leprosy» was Yohan b. Masaway. The cause of interest in such a disease arises from the Muslim's idea of isolating the patients who had communicable diseases from the rest of the society. We find the same behaviour with the doctors of today towards such liseases.
c) Road Bimaristan:
Arabs knew this type of Bimaristans and they realized its importance, because the pilgrimage to Holy places or the commercial caravans that travailed for long distances required care for the travelers, such as treating wounded persons or saving a person asking for help.
Therefore, they equipped the caravans with medical missions where physicians worked and had boys to help them. Ibn al Qifti presented to us an important test while he was talking about «Al-Hakam b. Ali al-Hakam al-Damaski», he said «he was a doctor in the beginning of «Al Abbassid state», Mu'awiyah b. Abi Sofian sent him as a doctor with his son Yazeed to Mecca when he sent Yazeed as Emeer of the pilgrimage in that epoch. Al-Hakam said: He is the doctor my father sent with Yazeed when he went to Mecca and I was the doctor who went with Abd al Samad b. Ali b. Abd Alla b. Abbas to Mecca (36) .
Undoubtedly, Ibn al-Qifti's text we just mentioned kept the oldest idea about this type of Bimaristans. Ibn Katheer (37) pointed out in his book (The Beginning and the End) that road Bimaristans were conducted by a wise director who knew how to give treatment: The rich people, who had the ability to equip the caravans with medical missions supported those Bimaristans financially.
d) Prison Bimaristan:
The Muslims cared medically for the imprisoned the same way they did for people outside the prison. This is clear from the letter the minister, Issa b. Ali al-Garrah (38) Minister of al-Moktader, to Sanan b. Thabit al-Tabeib al-Natassi who was distinguished in Arab medicine and who embraced Islam at the hands of Al-Qaher. After Issa b. Ali had visited the prisons, he found it was necessary to treat the patients and preserve their humanity so, he sent his famous letter to Sanan in which he said: «I thought-May God prolong your life-of the imprisoned and they are exposed, due to their big number and their hard situation, to diseases; they are incapable to deal with their excretions or to meet doctors to seek their advice about diseases. You have - May God grant you honor - to assign physicians to visit them daily and they should carry with them drugs and syrups and all they need to treat the patients and cure illnesses with God's will. Sinan followed this advice» Also according to what Ibn al-Qifti mentioned al moktader asked Sinan b. Thabit to build a Bimaristan and give it his name. He ordered one at Bab Al-Sham and called it The Moktader Bimaristan and financed it with 200 Dinars monthly (39) This was in 306 Hijri and Sanan b. Thabit was assigned as chief doctor. When al-Moktader was told that one of his physicians had killed a man by mistake, he ordered Sinan to perform a test for the physicians. So, they were tested in Baghdad and their number became eight hundred physicians (40) .
It was Sinan b. Thabit who financially supported al-Sayeda Bimaristan, according to what Ibn al-Qifti said «On the first of Moharam 306 Hijri, Sinan b. Thabit inaugurated Bimaristan al-Sayeda in the Yahia Market and he stayed in it and he organized the work of physicians in it. Each month 600 Dinars were spent on the Bimaristan by Youssef b. Yahia al-Monajem because Sinan did not contribute to the expenditure of the bimaristan (41) .
e) The Mobile Bimaristan:
This type of Bimaristan visited villages, peripheries and cities caring for the health of people who lived away from the state capital and allowed the state services to reach anyone who needed treatment in the state.
Ali b. Issa al-Garrah - al Muqtadir's minister - ordered the first state physician Sinan b. Thabit, in a written letter, to let doctors travel to the peripheries of the state. He said in his letter «I thought of people who live in the peripheries and that among them are patients who do not receive any medical care because there are no doctors there. So, assign - May God prolong your life-some physicians to visit the peripheries; also a pharmacy containing drugs and syrups. They have to travel all through the peripheries and stay in each region enough time to perform treatment of patients, then they move to another one (42) .
It was the state's responsibility to care for the Bimaristans. The senior physicians were aware of establishing work rules and bases to teach the students who came to learn medicine from everywhere. Therefore, medicine schools were established in the Islamic world, in which teaching was performed by two methods:
1- The theoretical method in the medical schools, and 2- A practical method for training and practice where students gathered around the doctor in chier to see and examine the patients and the treatment he prescribed. When the students finished the studying period they applied for an exam, took an oath and got their certificates. When they started to practice medicine, they always worked under the state's supervision. This means of course that the Bimaristans were institutes for teaching medicine and to complete the study for junior doctors (43) . From a practical point of view, the professors prescribed the treatment for the patients, they examined them in the presence of the students who received their learning through professors, they writing their instructions. They performed these instructions in an organized way and they did a follow up to the patients and hence they acquired the necessary practical experience for a medical student. Muslim contribution in the field of medicine can be exposed throughout three main points which are, (1) the medical assemblies, (2) Al-bimaristan, and (3) the method that they followed.
-III-
Medical Educational Assemblies
Educational assemblies spread throughout the Islamic world through a methodological system. They were sometimes sponsored by the state but most often by the scientists. This has always been their system. We know that a scientist is known by his assembly, his students, and followers, as well as by the influence he has on the following generations, as each of his pupils reflects him; therefore scientist are always careful to teach pupils in their assemblies in a special way different from other teachers.
The Arab Historian Ibn Abi Usaibi'ah, recognized and wrote down many things related to science and scientists in his book (Uyun al-Anba Fi Tabaqat al-Atibba) Sources of Information on the Classes of Physicians. He mentioned many characteristics concerning scientists assemblies. The medical assembly of Amin al-Dawla b. al-Thalmeed who knew many languages specially Syriac and Pahlavy as well as Arabic (44) , devoted himself to teach new generations, with the condition that they should master the Arabic language, and if any of his students committed grammar mistakes or if his Arabic seemed not good in construction he sent him to a grammarian to take care of and examine him after that. The assembly of Amin al-Dawla b. al-Thalmeed was probably the biggest assembly of science held at that time. Ibn Abi Usaibi'ah mentions a quotation by Mowafak al-Deen Abdel Latif b. Youssef to have said: «A man entered upon him bleeding in summer time so he asked his pupils who were approximately fifty and they did not know the illness» (45) .
Scientifc assemblies between physicians sometimes were held in the Bimaristans, we find Zahed al-Ulama who established al-Farki Bimaristan assembling his pupils there to answer their queries (46) .
Most educational assemblies acquired the form of a debate. Seif al-Deen al-Amidi's assembly adopted this form and eventually people praised «his eloquence in debating and research» (47) . So did the assembly of Shams al-Deen Ibn Al-Laboudi who «became strong in arguments, good at debating» (48) .
Sometimes during science assemblies, a physician wrote books for the students who had graduated under his teaching and who had become themselves teachers of science. The writing of books in this case was not meant for teaching or dictating but they were meant to urge the students to more studies and comprehension (49) .
Arab physicians' way of teaching had its characteristics and Abou Bakr al-Razi, maybe the physicians' leader and one of the best physicians of his time to preserve for us in their writings the essentials that a physician should know well, and that teachers should engrave in the pupils mind.
These teachings were not just theoretical, but they came out of experience and practice, Abou Bakr al-Razi was the best clinical physician, had no competitor in this field, beside being a good teacher of medicine and its writing. His book (The Guide or al-Fusul) is a good example. During his teaching sessions pupils crowded around him in circles according to the precedence of their joining these sessions. He used to present them patients and let them ask about the illness and try to diagnose it; if they failed he would intervene and give the final decision» (50) .
This quotation refers to many things in the field of medical education by these professors and their assemblies either in the Bimaristans or outside them. Al-Razi's educational assembly was of two kinds, one for theoretical teaching the other for the practical one (51) . Theoretical teaching took the form of debates between three groups of students; the group in the circle nearest to him were the more advance in learning and practice. Next came the second group of those with less experience and last came the third circle in which new students were grouped. He read to them, explained, argued and listened to their debates answering their queries. Whenever he detected an intelligent pupil he moved him to a circle nearer to him in which he had to spend three years. So he spent one year in each circle. During this period he was taught anatomy, physiology or organ properties and pathology.
As for the practical teachings, like during his theoretical ones, students placed themselves in circles around the patient's bed in the hospital. He explained to them rare cases one after the other. In this way al-Razi used the patient as a book to be read daily and continuously to be able to understand the symptoms of his illness (52) .
The most important thing in this matter, is that the teacher explained to his pupils in the assemblies each case he examined and noted his questions and his observations in a special page. He started by asking the patient, and the pupils around him, asking his name, age, country of origin, trips and his illness, the date it started, place of pain and symptoms. He assured that the patient was the best person to explain the extent of what he feels. He also asked the patient about his family and its members, and whether they felt the same symptoms.
To achieve all that, al-Razi examined his pupils and graduates. He asked first in the field of anatomy, and if the pupils failed to answer, he did not continue the clinical examination because their failure in this subject made them unworthy even if they passed the clinical exam (53) .
Mohazb al-Deen abd Al-Rahim b. Ali al-Dakhwar's assembly in the second half of the sixth century Hijri and the first quarter of the seventh century Hijri, was the same. Students used to gather around him in the Bimaristans while he examined patients. He taught them and explained the cases in front of them. One of his students, Ibn Abi Usaibi'ah, says: «I saw him once in the hall of the fevered; doctors felt the pulse of one patient and diagnosed weakness and prescribed chicken soup to give him strength, he said that his speech and the look of his eyes denoted weakness, then he felt the pulse of his right hand then of the other and said: Feel the pulse of his left hand, we found it strong, he then said: look at his right hand and how near his elbow the vein divides in two branches one remains and can be felt the other moves over the ulna towards the fingers, which we found true. He then said: this is a rare case but some people show this phenomena, and many physicians diagnose it wrong as weak pulse but it is just that they are feeling half the vein (54) . This is the scientific point of view of al-Dakhwar he had inherited from his medical ancestors who had laid the foundation of medical practice in the Islamic world. This is not strange, as al-Dakhwar studied al-Razi's writings and understood it well. He absorbed the instructions and descriptions of clinical cases that al-Razi mentioned in his book (Al-Hawi).
When al-Dakhwar finished in the Bimaristan he devoted his time first to transcription, studying and reading, then to his pupils. He asked them in «They came in and so did groups of doctors and practitioners, each read his lesson, discussed it with him explained it as much as he could then if there was need for further explanation or if there was a problem he would discuss it with the best of the attendants (55) . This was his system, and he explained the introduction of medicine in the same way, explaining its meanings and construction facilitating it to students.
Al-Dakhwar's system in theoretical teaching had a special character. He scrutinized the next he had, and tried as much as possible to bring out a text without mistakes, whenever someone read to him, "he would have a copy of the text in his hands, he looked at it, and compared it, if he found a mistake in the copy being read he would order its correction" (56) . Al-Dakhwar persisted in the accuracy and precision of the copy, Ibn Abi Usaibi'ah says: Sheikh Mohazab al-Deen's copies that were read to him were very accurate, most of them were in his hand writing. He surrounded himself with all he needed of medical books language books Abou Hanifa al-Danoury's botany book (57) . These are the tools that a scientist needs to perfect his research. After Al-Dakhwar's assembly was over and the attedants left, he returned to his private life ate something then spent the rest of the day studying and reading and stayed a good part of the night working (58) .
This was al-Dakwar's scientific assembly, where, he taught many pupils and physicians. He wanted scientists to remember him and commemorate him, therefore he transformed his home into a school for medicine, and it was considered one of the best known schools in Damascus, and was known in the history of Arab medicine as the Dakhwarian school the reputation of which in the seventeenth century Hijri spread all over the world. And from it graduated many well known doctors who spread all over the world presenting mankind their knowledge and studies.
Al Dakhwar succeeded in inspiring his students with the correct scientific doctrines which he himself had learned in his teacher, Tag al-Deen al-Kindi's assembly. This was very clear in his other interests besides medicine.
Actually, Ibn Abi Usaibi'ah preserved for us a great treasure in his book (Uyun al-Anba fi Tabaqat al-Atiba). In this book he deals with physicians not history, but at the same time he praises the interest in history, al-Dakhwar was not only a great figure in medicine during Ibn Usaibi'ah lifetime, nor was he only a Sheikh who taught this historian doctor, nor only did he establish a school well known in the Islamic world, and that became a true science institute attracting researches from all places, but he also wrote the history of medicine in consecutive periods, relating to his pupils among whom was Ibn Abi Usaibi'ah what he remembered, and what he heard from his elders about the science and views of his predecessors. This is not strange as al-Dakhwar the scientist and doctor was a descendant of Tag al-Deen al-Kanadi, who taught him how to look for the truth and seek its origin, this is the characteristic of a true scientist who ascribes sayings to their owners and not take the credit himself for science and learning and diminish others' abilities, as some ignorant people do nowadays pretending to know everything and deny the merit to others.
We have many examples of what Ibn Abi Usaibi'ah wrote, which show al-Dakhwar's views who connected good ideology to good morals and so spoke truthfully and honestly (59) .
-IV-
The Fundamentals of Method
The method is considered to be the core idea that characterizes any science. Scientists who work without a method will never achieve a scientific discovery and will never get the chance for any scientific addition and hence will repeat opinions of others. Arab scientists and physicians realized the importance of concluding the ideas after following a clear method in their researches and following certain rules. Therefore they brought both sense and reason (intellect), they discussed intellectually and logically what sense exposed in the light of what previous scientists had recorded.
Though it is difficult to claim that Muslims had clearly written about method - as it is the case today - it is obvious from their writings that they followed a precise scientific method in studying and teaching when they talked about the topics they wrote and wanted people to learn.
Scientists and physicians in the period of the flourishing Islamic state achieved brilliant scientific results, which - for certain - were transmitted to the Western world, to Latin Europe, and European science benefited from them, during the Renaissance epoch. This made Ali Sami al-Nashar, when speaking about influence of the Islamic method on the West, assert while writing his introduction "I knew for sure that I am in front of the greatest discovery that the European world had ever known which is the discovery of experimental methods of the Islamic world in its most perfect form" (60) .
The talk about method could be divided into two parts:
A- The steps followed during research and study.
B- The characteristic and general features that characterized the method and allowed it to serve the purposes of scientific research and reflection upon the scientific works, the character and the nature of genuiness and seriousness, and hence allowed them to achive important scientific discoveries by which they went ahead of the European world for many centuries.
A- The steps followed in the research:
As previously mentioned, the method is the core of scientific research so that if you start the study of any topic without following a specific method to treat the topic through it, or without following a specific plan during your research, you will achieve nothing, i.e. you will not get any useful research result to be used theoretically and practically.
Though scientists in the capital of the Islamic state and in its peripheries did not have specialized clear writings - which we call method - the rules and regulations and the steps were clear in their minds and they used to draw the attention of the reader and the student to its importance from time to time.
We can conclude from their several writings, the general rules followed in the medical researches that led to the flourishing of that science in a way that astonished the Latin world.
1- Observation and Description
It is familiar to find some diseases that have similar symptoms to the extent that makes the distinction between them require a highly skilled physician. Muslim physicians have dealt frequently with such matters. We know this through several examples and observations found in the history of Arab Medicine. Here is al-Razi (61) who was known by his medical and scientific skills an intellect whom European medicine acknowledged before even Arabic medicine. He described in his study (Small Pox and Measles) the symptoms of small pox - which he saw himself - as follows: "the appearance of small pox is preceded by a continuous fever that causes back ache and itching in the nose and shivering during sleep".
Scientists have comprehended the steps of observation, description, comparison and detection of points of similarities and differences. They realized that there are qualitative observations that explain to us the different sides of what we are studying.
Example 1: Qualitative Observation Al-Bughdady was interested in the study of Diabetes Mellitus symptoms. He mentioned in two successive paragraphs "while examining the urine you must observe the amount whether a little or a lot, the colour of urine, its taste, and consistency i.e. whether it is thin or thick...". In another paragraph he said «while examining the urine we should examine three things: the colour, the consistency and weight, in addition we have to examine the odour, the temperature by putting your finger in it, as well as its sour taste» (62) .
Example 2: Comparative observation and the relation between sensation and intellect Al-Bughdady did not stop following his observation. He proved that Galen committed mistakes. Galen mentioned that the lower jaw in human beings consists of two parts attached together by a joint at the chin, but al-Bughdady could - through his precise observation - describe the real situation which is: the lower jaw in the mammalians consists of two parts which unite together sooner or later, the degree of union increases or decreases to form strong symphysis at the middle of the chin in different types of mammalians. In high mammalians and human beings the union of bone at the middle of the chin occurs strongly immediately after the delivery so that the lower jaw forms a single bone (63) .
Al-Bughdady was acquainted with the reasons of Galen's opinion on this point, but his observations contradicted what Galen assumed and hence he could, through concentrating his attention on what he observed, realise the point of similarities and differences of what he had in front of him, being provided with an ability of precise distinction and understanding.
Al-Bughdady found in a certain place near Cairo a Tomb full of human bones where he counted more than two thousands skulls. When he examined the shape of the bones and joints and the way of their articulation, he proved that the lower jaw is formed of one piece rather than two as Galen assumed in the sixth chapter of his book «The Children Bones» where he said that: «The lower jaw is formed of two parts which is proved by the fact that it can be cracked at its middle when it is crumbled».
But according to the precise observations of al-Bughdady «if the lower jaw was formed of two attached parts by a joint, we could see that joint at least in the brittle decayed bones, because the crumbling of bones starts firstly at the joints» (64) .
We can notice from all these examples, the importance of the step of precise scientific observation to the Arab scientists and the degree of correlation between the observation and the continuous description directly from reality, and the extent of their thinking to correlate between the parts of the observed subjects that they describe. This is proved by the example given by al-Bughdady which was just mentioned, that shows how just one empirical observation acquainted him with a wrong opinion that dominated for a long period and was adopted by the physicians since Galen. We will ascertain more precise observations while we review some important points.
But we are concerned mostly to demonstrate that al-Bughdady-and other scientists also-did not rely upon Galen and other persons sayings. This will become evident in case of Ibn al-Nafis. The sensational observations of those scientists were accompained with good works of mind in what the sense was exposed to. The sense might be wrong but the mind should correct this mistake.
2- Experimental and Testing:
Muslim physicans were concerned with referring to experiment because it is the best witness to the correctness of an opinion. That is why al-Razi mentioned in his book (The Characteristics of Things) many texts on experiment, "we add what we know by experiment and people know that we do not give our confidence to anything except after its test and experimentation" (65) .
Al-Razi believes also that the skilled physician must have two characteristics together "one, he should be skilled in the scientific art of medicine and the other, he must have at the same time a lot of experiences" (66) .
From this point of view, we find that al-Razi was committed always to experiment as it is considered the principal criterion in judging things. As long as experiment is the criterion that the physician always resorts to "to distinguish between the truth and the falsehood in what concerns these caracteristics that might be submitted to the denial of those who could not understand the aims of science" (67) .
Such texts and others reveal to what extent, the scientists of that epoch were concerned with the establishing of science upon correct scientific basis. It is impossible to use standards through which the science works today in the twentieth century as a basis to judge a science produced by the Islamic mind more than a thousand years ago approximately.
Muslims were skilled in the art of medicine and they achieved important achievements, they attributed in the way of distinction between one disease and another and the definition of many of communicable diseases which can be called epidemics. They did not only distinguish between communicable diseases, but they described each disease separately from the observations they made and the signs of disease occurrence and progress. There are many examples to demonstrate this fact. For example, al-Razi was the first to describe precisely and clearly small pox and measles (68) . Ibn Zahr was the first to describe mediastinal puncture, dry peritonitis and peritoneal effusion" (69) .
We can notice the precision of that description which al-Razi presented in the distinction between small pox and measles where he says "the appearance of small pox is preceded by a continuous fever which causes backache and itching in the nose and shivering during sleep. The important symptoms that denote its occurrence: backache with fever and burning pain all over the body, facial congestion and sometimes facial contractions, acute redness of the cheeks, eyes pressure sensation in the body which extends to the muscles, throat and chest pain accompanied with difficulty of breathing, cough and restlessness. Irritability, nausea, anxiety are more pronounced in measles than in small pox (70) . Al-Razi mentioned the cough of hereditary infections. The opinions presented by al-Razi were not only the results of his own efforts, but when he talked about many of the diseases, he gathered, first the opinions mentioned on the disease, by the Greeks, Syriac, Indians, Persians and Arabs, then he presented his own opinion and the experiment he performed and the observations he achieved after the process of diagnosis and treatment. In surgeries, he was a head of his contemporaries because he treated renal and bladder stones surgically. As Hitti descriped him in the field of surgery he was one of the first to use the seton.
Among other examples we find Avicenna who "distinguished between pneumonia and pleurisy, acute and secondary meningitis, intestinal and renal colics" (71) . Also, there were some important additions presented by Avicenna, where we find" the first description of anthrax which the Arabs called "The Persian Fire (72) . Avicenna mentioned that the infection occurs through water and dust. He described the life cycle of Ankylostomiasis (73) and he showed its effect on the body. Anatomically, Avicenna described all the organs, even the anatomy of teeth and jaw bones. When talking about the nerves and muscles he included the nerves of the face, forehead, eye globe, eye lids, cheeks, lils, tongue as well as the nerves of the marrow and chest. When he talked about "the nerves", he studied cases of paralysis. He described hemiplegia and distinguished between two main types: the first is the facial palsy resulting from a central cause in the brain and the second due to a local or peripheral cause (74) . It seems that the treatment of the causes of paralysis were familiar to the physicians of the Islamic world of that epoch. This was the result of their interest in treating skillfully mental diseases. They specified particular words in the Bimaristans - as for example they used one of three methods to treat such cases (we mean caes of paralysis and neurogenic diseases). In cases of paralysis they resorted to cooling drugs in contradiction with the familiar Greek method, which used the hot methods of treatment; or they resorted to methods similar to electricial shocks used in our days, as we have been told by some contemporary historians. Muslims were the first to use electricity to treat epilespy and neurogenic diseases by using a certain type of fish called Torpedo or cramp fish, which was put alive in water which was then connected to two straps of steel. When the patient held them, which he could not do but for a short time, he shivered and would throw them to the ground. After some days of this treatment he was cured from epilepsy (75) . The third method was based on psychiatric treatment and there are many examples for this. Harun al-Rashed had a slave maid attained by a certain type of hysterical paralysis. When she raised her hand upwards, the hand stayed hanging up. The physicians were perplexed in her treatment, therefore al-Rushed brought Gabriel Ibn Bachtishou to treat her. He asked for his safety while he performed the treatment in front of him and he said "if the Caliph will not be angry with me I have some tricks for her" al-Rashed said" and what are they?" the doctor said "the slave must come here in the presence of everyone till I do what I want and you must give me time and not be angry with me quickly. Al-Rashed ordered to bring her, when Gabriel saw her, he walked quickly towards her and bent her head and caught the tail of her dress as if he wanted to undress her in front of all the people; she was shocked and worried by this behaviour and her shyness obliged her to drop her hand downwards to hold her dress and to cover her body. At this moment, the physician turned towards the Caliph and said: "She is cured now" (76) .
These three examples reveal the intelligence of the physicians in the Islamic World and their insight about the cases presented to them and the way of giving successful treatment to such diseases after they examined them carefully and recognized its etiology and the facts and the way of its progress through scientific observations.
We find also that Muslims knew in detail other important diseases whose diagnosis was not known in the old medicine (77) . They were "the first to write about leprosy and the repair of the not known in the old medicine. They were " the first to write about leprosy and the repair of the teeth closure defects and tooth arches. They correlated piles with gastric contraction and recommended plant foods for its treatment". They were also "the first to draw attention to the shape of the nails of the tuberculous; they described treatment of jaundice and cholera, they used opium in certain doses to treat haemorrhage, and they treated shoulder disclocation by the surgical method known as sudden resistance reduction (78) . Moreover, al-Tabari was the first to discover the insect causing scabies.
Among the medical features of Muslims worth mentioning is Surgery. They were the first to use anaesthesia in surgical operations (79) . Abu al-Kaseem al-Zahrawi (Abulcasis) is considered "the greatest one to perform manual works skillfully in surgical operations and to use surgical instruments. His book presentation to those who failed to write consists of three parts: the first in medicine, the second in pharmacology and chemistry, and the third in surgery (80) . The previously mentioned reference of al-Zahrawi is considered to be one of the most important text books in the description of instruments used in performing surgical operations and the way to use them, kwith the detailed description of each instrument through illustrations and he acquired a great importance because he was the first in this subject (81) . Al-Zahrawi was the first to succeed in tying arteries to stop haemorrhage (82) . The Arabs knew in this epoch the anatomy of pulmonary arteries and veins. Not only this but Iban al-Nefis presented to us for the first time in history a complete description of the blood circulatory system.
The belief that predominated since the epoch of Galen till the time when Ibn al-Nafis first appeared was that blood originates in the liver from which it is transported to the right ventricle in the heart, then it flows in the veins to the different body organs to nourish them, some of the blood enters the left ventricle through pores in the diaphragm, where it is mixed with the air coming from the lungs. But, Ibn al-Nafis found that the process of blood purification occurs in the lungs due to its union with the air and hence it is purified, then it is transported to the left ventricle hence the small blood circulation discovered by Ibn al-Nafis. As the historians of science assert «Ibn al-Nafis, described precisely the blood circulation eight hundred years before the Portuguese Servit to which this discovery is attributed (83) . Muslims were skilled also in another medical branch which is Ophthalmology. The nature of hot environment of their countries encouraged them to study this branch of medical specialities and to contribute to it in an evident way which called for astonishment. The book of Salah Ibn Yousif al Kahhal on the eye might be the greatest reference that gathers all eye diseases. He wrote chapters on: eye description, sight description, eye diseases and their etiology, their symptoms, the care for the eye, eyelid diseases and diseases of the cornea and iris, and those diseases far from the senses, also eye treatments» (84) .
B- The Characteristics of the Methods
There were general characteristics ascribed to the method used by the different scientists and physicians, during the flourishing of Islamic development. These characteristics can be described as follows (85) :
1- Debating and not accepting ideas without proof.
2- Conscious and accurate analysis.
3- Scientific honesty. This feature characterised the books written by Arab scientists through the ages. Scientific honesty can be put in the following order:
a) Refer opinions to their owners.
b) Not to take credit for others' creativity.
c) Arab scientists used some statements that indicated complete uncertainty such as: «Some physicians told me» or «Aleppo citizens told me» or «I copied from some history books» or «I found in some books».
4- Freedom of opinion and stating observations without adhering to ancient theories.
5- Arab scientists were self confident and esteemed the bold scientific opinion, and their writings were characterized by fluent style and accuracy of presentation and being free of contracdictions and they sometimes depended on using equivocations.
Results
It cannot be said that the study of the history and development of Arab medicine has been completed, as we cannot also say that Arab physicians were just copiers from the Greek medicine heritage they had studied and understood. In reality they were aware of the details of medical theories specially those reached by Hippocrates and Galen. This did not stop them from having their own participation, and of correcting some mistakes in old theories.
Although many Orientalist studies deprived Arab and Islamic share in the medical heritage from its seriousness and originality in relation to theory and application, this opinion was mainly due to racism or misunderstanding.
This study we cannot be considered to have covered all aspects of the problem, or to have defined the development in a decisive manner. We cannot ascertain that. But this study gave us some important results, which if added to the results of other studies could help in better writting the history of the development of Arab medicine theoretically and from the view point of application.
The indications of this study could be stated in the following points.
Scientists throughout the Islamic world understood the Greek medical heritage, first they translated it magnificently by the care of Hunain b. Ishaq who travelled the nations in all directions searching for manuscripts and lost pieces (shreds of them. Ibn Al-Nadim, Ibn Golgol, Ibn al-Qifti, and Ibn AbiUsaibi'ah, confessed that Hunain's translations and his school played a great role in understanding this heritage. These writings also transferred to us some of Hunain's pupils translations, details of the translations and whether translated from Greek or Syriac. It is clear that there were medical assemblies, the most famous of which was that of «Yuhanna b. Massoyweh» Hunain b. Ishaq's teacher. These asemblies played a good role in increasing the growth of medical knowledge. Al Razi's assembly was a real school for teaching pupils. These assemblies of teaching medicine, were propagated between the fifth and the seventh century of the Hijri. After the translation era, started a period of flourishing and development as physicians had the opportunity to study from text books and to make clinical observations.
The period between the twelfth and thirteenth century was characterized by the propagation of medical assemblies. These assemblies were usually held in physician's homes. These can seen by the assemblies of Ibn al-Thalmeed and al-Dakhwar, students read with their professors important books and teachers explained the difficult parts.
The practical side of the study took place in the Bimaristan under the supervision of great physicians. In this light the bimaristans could be considered as true faculties for medicine paractical study.
In different periods of Islamic development, physicians encouraged Caliphs and men of influence and power to build hospitals which were called Bimaristans. From what we reviewed, we see that the building of Bimaristans started in an early stage of the history of the Islamic nation. They were built in all parts of the Islamic world. Physicians also understood, in those times, that medicine needed to be practiced in hospitals with precise organization both in management and treatment. New physicians were subject to pass an examination, and the profession itself was controlled by the government, through a man called Al-Mohtasib (Health Inspector). They had to pass examinations and get certificates. This proves the precision used in the practice of medicine in the Islamic world. The Bimaristans were of different types differing according to the type of disease treated in each, this shows us the precise understanding of the nature of diseases.
Study in the bimaristan meant the presence of clinical cases (the patient) in front of the student who osculated him and noted the course of the illness and observed any change in the symptoms. There were different kinds of bimaristans throughout the Islamic world, and these were under strict control.
Students attended physicians' teaching sessions in the bimaristans, after having completed the studies. They were examined theoretically and practically by the physician and were given certificates of graduation but had to practice medicine in the bimaristans under the professors' supervision.
Physicians taught in a scientific way, so, for the theoretical part of the study, there were certain books a student had to read and understand under the surpervision of his teacher, these books were those of Hippocrates, Galen, Hunain, al-Razi and Ibn Sina. The student also had to note the teacher's lectures, and that, led to the many versions for one writing. For the practical part, the students watched the teacher's way of diagnosis, and also attended the debates between the professors on some diseases.
Scientific method was systematically the most important pillar for medical practice and for understanding it in a scientific way. The different writings of physicians of that time show this clearly, as we find them following the trial rules of scientific method in its best form even before this method was discovered or created in the West. In this field the study points out that the many participations had special common characteristics that could be summarized as follows:
Medical study depended on observing and describing, as we found detailed descriptions of illnesses that physicians teated.
Physicians made comparisons between different illnesses specially that some of these had similar manifestations.
Cases were diagnosed after a meticulous clinical examination of the patient and after a proper understanding of the illness.
Physicians often turned to experiments, and we met many texts refereing to this fact.
Descriptive comparison of some studies showed mistakes made by the Greek physicians, specially Galen, and this drove Muslim physicians to correct them.
They used instruments and tools in the many surgeries they performed.
Physicians studied and criticized the Greek heritage.
We, often, find that physicians followed the meticulous analytic system in using the heritage they came about.
The studies that were done in the Islamic world were strictly scientifically honest. Never did any physician claim the merit for another's work, but always quoted other's ideas using precision in referring them to their owner, this gave them greater self confidence and a free courageous opinion.
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