It has often been stated on this website
that the Muslim period of Spain’s history (also known as al-Andalus) was
a Golden Age of Islamic civilization and society. Almost utopian
harmony between Islam, Christianity, and Judaism prevailed, great
advancements were made in the sciences, and wealth and stability were
the rule rather than the exception.
One of the great figures of Muslim Spain
was Abu al-Qasim al-Zahrawi, Islam’s greatest medieval surgeon. He
revolutionized how surgery was performed by inventing new methods and
tools to help heal patients. His thirty-volume encyclopedia of medicine
was used as a standard text for medicine throughout Europe for
centuries. The impact he had on how medicine was practiced was truly
revolutionary.
Background
Al-Zahrawi lived during most powerful
period of the Umayyad Caliphate of Cordoba. He was born in 936 and died
in 1013, and served the Umayyad Caliph al-Hakam II and the military
ruler, al-Mansur. Throughout his life, al-Zahrawi was a court physician,
having been patronized by the rulers of al-Andalus and recognized for
his medical genius. He served in such a capacity as a doctor for over 50
years.
Unlike many doctors and hospitals in the
“modern” world today, al-Zahrawi insisted on seeing patients regardless
of their financial status. By seeing a wide variety of patients every
day and recording his treatment of them, he left behind a very valuable
text of medical knowledge that he called al-Tasrif.
Al-Tasrif
A page from the original al-Tasrif written by al-Zahrawi in the 900s
His encyclopedia of medicine is divided
into 30 volumes. Each one of which dealt with a different aspect of
medicine. He discussed how to diagnose diseases in one of the early
volumes. He noted that a good doctor should always rely on his own
observation of the patient and his/her symptoms instead of simply
accepting what the patient says – a practice still employed by doctors
today.
Al-Zahrawi takes a holistic approach to
medicine. Not only does he discuss how to treat diseases, he describes
how to prevent them. He dedicates parts of his books to discussing what
foods should be avoided, how to maintain a healthy diet, and how to use
food as part of a treatment plan. He particularly notes the effects of
alcohol on the body. He states:
“[Alcohol
causes] general weakness of most of the nerves of the body,
difficulties in articulation, weakness of voluntary movements,
arthralgias, gout, etc.. disturbances of the liver which
causes tumors and obstructions which is a definite cause of ascites and
general ill health”1
Surgery
His most influential volume of al-Tasrif is
the 30th, the one dedicated to surgery. In it, he explains in detail
how to perform certain surgeries to cure certain ailments. He insists in
it that all surgeons must first be very well versed in general
medicine, anatomy, and even the writings of philosophers who studied
medicine.
Al-Zahrawi pioneered many of the
procedures and materials still used in operating rooms today. He was the
first to use catgut as the thread for internal stitches. Catgut is a
thread made from the lining of the intestines of animals. It is the only
material that can be used for stitches and still be absorbed by the
body, preventing the need for a second surgery to remove internal
stitches. He invented many tools necessary for modern surgery. He was
the first to use foreceps in childbirth, greatly decreasing the
mortality rate of babies and mothers. He performed tonsillectomies with
the same tongue depressors, hooks, and scissors used today. He used
concealed knifes to cut into patients without making them apprehensive
He used both local and oral anesthesia in order to reduce the pain
patients experienced during surgery. He performed mastectomies removing
a woman’s breast if she had breast cancer, a procedure still done
today. He described how to set bone fractures, amputate limbs, and even
how to crush bladder stones. To describe all his “firsts” in medicine
would take a book of its own.
An early inhaler invented by al-Zahrawi. At the top is the original Arabic while the Latin translation is at the bottom.
Despite his immense knowledge and
ability, he always refused to do risky or unknown surgeries that would
be stressful physically and emotionally for the patient. He believed in
the importance of human life and sought to extend it as long as
possible. His precedent was a prime example for effective bedside manner
that all doctors should exhibit.
Legacy
Al-Tasrif made
its way from al-Andalus throughout the Muslim and Christian worlds.
Over the course of centuries, it was translated into Latin and other
European languages. Thus, many of the procedures he pioneered were given
names that do not indicate that he originated them. For example, the
“Walcher position” of childbirth and the “Kocher method” for fixing
dislocated shoulders were invented by al-Zahrawi but credited to later
European physicians.
Regardless of credit, al-Zahrawi’s
contributions to medicine and particularly surgery were revolutionary
for his time. Without the procedures and tools that he pioneered,
surgery today may still be a barbaric guessing game. His abilities and
his consistent recording of procedures helped advance medicine for
centuries, and we are still in debt to his genius.
Footnotes:
1 – Awadain, M. Reda. “A Recent Look and Study of Some Papers of al-Zahrawi’s Book “al-Tasrif”.” IslamSet. N.p.. Web. 16 Dec 2012.
Bibliography:
al-Hassani, Salim. 1001 Inventions: The Enduring Legacy of Muslim Civilization. Washington D.C. : National Geographic Society, 2012. Print. http://lostislamichistory.com/al-zahrawi/
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