864-930 * Al-Razi (Rhazes)

864-930 * Al-Razi (Rhazes)

Kedokteran, Ilmu Kedokteran Mata, Ilmu Kimia

Muhammad ibn Zakariyā Rāzī (854 CE – 925 CE),

(Persian: محمد زکریای رازی‎ Mohammad-e Zakariā-ye Rāzi, also known by

his Latinized name Rhazes or Rasis) was a Persian [3][4] polymath, physician, alchemist and chemist, philosopher and important figure in the history of medicine.

Abu Bakr Mohammad Ibn Zakariya al-Razi (864-930 C.E.) was born at Ray, Iran. Initially, he was interested in music but later on he learnt medicine, mathematics, astronomy, chemistry and philosophy from a student of Hunayn Ibn Ishaq, who was well versed in the ancient Greek, Persian and Indian systems of medicine and other subjects.

A comprehensive thinker, Razi made fundamental and enduring contributions to various fields of science, which he recorded in over 200 manuscripts, and is particularly remembered for numerous advances in medicine through his observations and discoveries.[5] An early proponent of experimental medicine, he became a successful doctor; he was appointed a court physician, and served as chief physician of Baghdad and Rey hospitals.[2][6] He was among the first to use humorism to distinguish one contagious disease from another and has been described as a doctor's doctor,[7] the father of pediatrics,[8] and a pioneer of ophthalmology.

As a practicing physician, Razi wrote a pioneering book about smallpox and measles providing clinical characterization of the diseases.[9] Through translation, his medical works and ideas became known among medieval European practitioners and profoundly influenced medical education in the Latin West.[2] Some volumes of his work Al-Mansuri, namely "On Surgery" and "A General Book on Therapy", became part of the medical curriculum in Western universities.[2] As a teacher of medicine, he attracted students of all backgrounds and interests and was said to be compassionate and devoted to the service of his patients, whether rich or poor.[10] Edward Granville Browne considers him as "probably the greatest and most original of all the physicians, and one of the most prolific as an author".[11]

Colophon of Razi's Book of Medicine.

Razi was born in the city of Rey situated on the Great Silk Road that for centuries facilitated trade and cultural exchanges between East and West.[12] His name Razi in Persian means "from the city of Rey", an ancient town called Ragha in old Persian or Ragâ in old Bactrian.[13] It is located on the southern slopes of the Alborz Range situated near Tehran, Iran.

In his youth, Razi moved to Baghdad where he studied and practiced at the local bimaristan (hospital). Later, he was invited back to Rey by Mansur ibn Ishaq, then the governor of Rey, and became a bimaristan's head.[2] He dedicated two books on medicine to al-Mansur, The Spirtual Physic and Al-Mansūrī on Medicine.[2][14][15][16] Because of his newly acquired popularity as physician, Razi was invited to Baghdad where he assumed the responsibilities of a director in a new hospital named after its founder al-Muʿtaḍid (d. 902 CE).[2]

He spent the last years of his life in his native Rey suffering from glaucoma. His eye affliction started with cataracts and ended in total blindness.[17] The cause of his blindness is uncertain. One account attributed the cause to a blow to his head by his patron, al-Mansour; while Abulfaraj and Casiri claimed that the cause was a diet of beans only.[18][19] Another source attributed the cause of his blindness to a beating presumably ordered by a mullah who was offended by his work, al-Hawi; currently, Razi is described by scholars as an "outspoken deist" and a "full-time freethinker".[20][21] The beating was administered with the manuscript of the work.[22] Allegedly, he was approached by a physician offering an ointment to cure his blindness. Al-Razi then asked him how many layers does the eye contain and when he was unable to receive an answer, he declined the treatment stating "my eyes will not be treated by one who does not know the basics of its anatomy".[23]

The lectures of Razi attracted many students. As Ibn al-Nadim relates in Fihrist, Razi was considered a shaikh, an honorary title given to one entitled to teach and surrounded by several circles of students. When someone raised a question, it was passed on to students of the 'first circle'; if they did not know the answer, it was passed on to those of the 'second circle', and so on. When all students would fail to answer, Razi himself would consider the query. Razi was a generous person by nature, with a considerate attitude towards his patients. He was charitable to the poor, treated them without payment in any form, and wrote for them a treatise Man la yahdurub al-tabib, or Who has no Physician to Attend Him, with medical advice.[24] One former pupil from Tabaristan came to look after him, but as al-Biruni wrote, Razi rewarded him for his intentions and sent him back home, proclaiming that his final days were approaching.[25] According to Biruni, Razi died in Rey in 925 sixty years of age.[26] Biruni, who considered Razi as his mentor, among the first penned a short biography of Razi including a bibliography of his numerous works.[26]

After his death, his fame spread beyond the Middle East to Medieval Europe, and lived on. In an undated catalog of the library at Peterborough Abbey, most likely from the 14th century, Razi is listed as a part author of ten books on medicine.[27]

Contributions to medicine

Smallpox vs. measles

"Smallpox appears when blood 'boils' and is infected, resulting in vapours being expelled. Thus juvenile blood (which looks like wet extracts appearing on the skin) is being transformed into richer blood, having the color of mature wine. At this stage, smallpox shows up essentially as 'bubbles found in wine' - (as blisters) - ... this disease can also occur at other times - (meaning: not only during childhood) -. The best thing to do during this first stage is to keep away from it, otherwise this disease might turn into an epidemic."

This diagnosis is acknowledged by the Encyclopaedia Britannica (1911), which states: "The most trustworthy statements as to the early existence of the disease are found in an account by the 9th-century Persian physician Rhazes, by whom its symptoms were clearly described, its pathology explained by a humoral or fermentation theory, and directions given for its treatment."

Razi's book: al-Judari wa al-Hasbah (On Smallpox and Measles) was the first book describing smallpox and measles as distinct diseases.[citation needed] It was translated more than a dozen times into Latin and other European languages. Its lack of dogmatism and its Hippocratic reliance on clinical observation show Razi's medical methods. For example:

"The eruption of smallpox is preceded by a continued fever, pain in the back, itching in the nose and nightmares during sleep. These are the more acute symptoms of its approach together with a noticeable pain in the back accompanied by fever and an itching felt by the patient all over his body. A swelling of the face appears, which comes and goes, and one notices an overall inflammatory color noticeable as a strong redness on both cheeks and around both eyes. One experiences a heaviness of the whole body and great restlessness, which expresses itself as a lot of stretching and yawning. There is a pain in the throat and chest and one finds it difficult to breathe and cough. Additional symptoms are: dryness of breath, thick spittle, hoarseness of the voice, pain and heaviness of the head, restlessness, nausea and anxiety. (Note the difference: restlessness, nausea and anxiety occur more frequently with 'measles' than with smallpox. At the other hand, pain in the back is more apparent with smallpox than with measles). Altogether one experiences heat over the whole body, one has an inflamed colon and one shows an overall shining redness, with a very pronounced redness of the gums."[citation needed]

Pharmacy

Razi contributed in many ways to the early practice of pharmacy by compiling texts, in which he introduces the use of 'mercurial ointments' and his development of apparatus such as mortars, flasks, spatulas and phials, which were used in pharmacies until the early twentieth century.

Ethics of medicine

On a professional level, Razi introduced many practical, progressive, medical and psychological ideas. He attacked charlatans and fake doctors who roamed the cities and countryside selling their nostrums and "cures". At the same time, he warned that even highly educated doctors did not have the answers to all medical problems and could not cure all sicknesses or heal every disease, which was humanly speaking impossible. To become more useful in their services and truer to their calling, Razi advised practitioners to keep up with advanced knowledge by continually studying medical books and exposing themselves to new information. He made a distinction between curable and incurable diseases. Pertaining to the latter, he commented that in the case of advanced cases of cancer and leprosy the physician should not be blamed when he could not cure them. To add a humorous note, Razi felt great pity for physicians who took care for the well being of princes, nobility, and women, because they did not obey the doctor's orders to restrict their diet or get medical treatment, thus making it most difficult being their physician.

He also wrote the following on medical ethics:

"The doctor's aim is to do good, even to our enemies, so much more to our friends, and my profession forbids us to do harm to our kindred, as it is instituted for the benefit and welfare of the human race, and God imposed on physicians the oath not to compose mortiferous remedies."[28]

Books and articles on medicine

The Virtuous Life (al-Hawi الحاوي).

This monumental medical encyclopedia in nine volumes — known in Europe also as The Large Comprehensive or Continens Liber (جامع الكبير) — contains considerations and criticism on the Greek philosophers Aristotle and Plato, and expresses innovative views on many subjects.[29][30][31] Because of this book alone, many scholars consider Razi the greatest medical doctor of the Middle Ages.

The al-Hawi is not a formal medical encyclopedia, but a posthumous compilation of Razi's working notebooks, which included knowledge gathered from other books as well as original observations on diseases and therapies, based on his own clinical experience. It is significant since it contains a celebrated monograph on smallpox, the earliest one known. It was translated into Latin in 1279 by Faraj ben Salim, a physician of Sicilian-Jewish origin employed by Charles of Anjou, and after which it had a considerable influence in Europe.

The al-Hawi also criticized the views of Galen, after Razi had observed many clinical cases which did not follow Galen's descriptions of fevers. For example, he stated that Galen's descriptions of urinary ailments were inaccurate as he had only seen three cases, while Razi had studied hundreds of such cases in hospitals of Baghdad and Rey.[32]

A medical adviser for the general public (Man la Yahduruhu Al-Tabib) (من لا يحضره الطبيب)

Razi was possibly the first Persian doctor to deliberately write a home medical manual (remedial) directed at the general public. He dedicated it to the poor, the traveler, and the ordinary citizen who could consult it for treatment of common ailments when a doctor was not available. This book, of course, is of special interest to the history of pharmacy since similar books were very popular until the 20th century. Razi described in its 36 chapters, diets and drug components that can be found in either an apothecary, a market place, in well-equipped kitchens, or and in military camps. Thus, every intelligent person could follow its instructions and prepare the proper recipes with good results.

Some of the illnesses treated were headaches, colds, coughing, melancholy and diseases of the eye, ear, and stomach. For example, he prescribed for a feverish headache: " 2 parts of duhn (oily extract) of rose, to be mixed with 1 part of vinegar, in which a piece of linen cloth is dipped and compressed on the forehead". He recommended as a laxative, " 7 drams of dried violet flowers with 20 pears, macerated and well mixed, then strained. Add to this filtrate, 20 drams of sugar for a drink. In cases of melancholy, he invariably recommended prescriptions, which included either poppies or its juice (opium), Cuscuta epithymum (clover dodder) or both. For an eye-remedy, he advised myrrh, saffron, and frankincense, 2 drams each, to be mixed with 1 dram of yellow arsenic formed into tablets. Each tablet was to be dissolved in a sufficient quantity of coriander water and used as eye drops.

Doubts About Galen (Shukuk 'ala alinusor)

In his book Doubts about Galen, Razi rejects several claims made by the Greek physician, as far as the alleged superiority of the Greek language and many of his cosmological and medical views. He links medicine with philosophy, and states that sound practice demands independent thinking. He reports that Galen's descriptions do not agree with his own clinical observations regarding the run of a fever. And in some cases he finds that his clinical experience exceeds Galen's.

He criticized moreover Galen's theory that the body possessed four separate "humors" (liquid substances), whose balance are the key to health and a natural body-temperature. A sure way to upset such a system was to insert a liquid with a different temperature into the body resulting in an increase or decrease of bodily heat, which resembled the temperature of that particular fluid. Razi noted that a warm drink would heat up the body to a degree much higher than its own natural temperature. Thus the drink would trigger a response from the body, rather than transferring only its own warmth or coldness to it. (Cf. I. E. Goodman)

This line of criticism essentially had the potentiality to destroy completely Galen's Theory of Humours including Aristotle's theory of the Four Elements, on which it was grounded. Razi's own alchemical experiments suggested other qualities of matter, such as "oiliness" and "sulphurousness", or inflammability and salinity, which were not readily explained by the traditional fire, water, earth, and air division of elements.

Razi's challenge to the current fundamentals of medical theory were quite controversial. Many accused him of ignorance and arrogance, even though he repeatedly expressed his praise and gratitude to Galen for his contributions and labors, saying:

"I prayed to God to direct and lead me to the truth in writing this book. It grieves me to oppose and criticize the man Galen from whose sea of knowledge I have drawn much. Indeed, he is the Master and I am the disciple. Although this reverence and appreciation will and should not prevent me from doubting, as I did, what is erroneous in his theories. I imagine and feel deeply in my heart that Galen has chosen me to undertake this task, and if he were alive, he would have congratulated me on what I am doing. I say this because Galen's aim was to seek and find the truth and bring light out of darkness. I wish indeed he were alive to read what I have published."

Crystallization of ancient knowledge, and the refusal to accept the fact that new data and ideas indicate that present day knowledge ultimately might surpass that of previous generations.

Razi believed that contemporary scientists and scholars are by far better equipped, more knowledgeable, and more competent than the ancient ones, due to the accumulated knowledge at their disposal. Razi's attempt to overthrow blind acceptance of the unchallenged authority of ancient sages encouraged and stimulated research and advances in the arts, technology, and sciences.

The Diseases of Children

Razi's The Diseases of Children was the first book to deal with pediatrics as an independent field of medicine.[8]

Mental health

As many other theorists in his time of exploration of illnesses he believed that mental illnesses were caused by demons. Demons were believed to enter the body and possess the body.

Books on medicine

This is a partial list of Razi's books and articles in medicine, according to Ibn Abi Usaybi'ah. Some books may have been copied or printed under different names.

al-Hawi (الحاوي), al-Hawi al-Kabir (الحاوي الكبير). Also known as The Virtuous Life, Continens Liber. The large medical Encyclopedia containing mostly recipes and Razi's notebooks.

Isbateh Elmeh Pezeshki (Persian اثبات علم پزشكى), ("Proving the Science of Medicine").

Dar Amadi bar Elmh Pezeshki (Persian درآمدى بر علم پزشكى) ("Outcome of the Science of Medicine").

Rade Manaategha 'tibb jahez

Rade Naghzotibbeh Nashi

The Experimentation of Medical Science and its Application

Guidance

Kenash

The Classification of Diseases

Royal Medicine

For One Without a Doctor (من لايحضره الطبيب)

The Book of Simple Medicine

The Great Book of Krabadin

The Little Book of Krabadin

The Book of Taj or The Book of the Crown

The Book of Disasters

Food and its Harmfulness

al-Judari wa al-Hasbah, Translation: A treatise on the Small-pox and Measles[33]

Ketab dar Padid Amadaneh Sangrizeh (‍Persian كتاب در پديدآمدن سنگريزه) ("The Book of Formation of small stones (Stones in the Kidney and Bladder)")

Ketabeh Dardeh Roodeha (Persian كتاب درد روده‌ها) ("The Book of Pains in the Intestine")

Ketab dar Dard Paay va Dardeh Peyvandhayyeh Andam (Persian كتاب در درد پاى و درد پيوندهاى اندام) ("The Book of Pains in Feet/Legs and Pains in Linked Limbs")

Ketab dar Falej

The Book of Tooth Aches

Dar Hey'ateh Kabed ‍(Persian در هيأت كبد) ("About the Liver")

Dar Hey'ateh Ghalb (About Heart Ache) ‍(Persian در هيأت قلب) ("About the Heart")

About the Nature of Doctors

About the Earwhole

Dar Rag Zadan (Persian در رگ زدن) ("About Handling Vessels")

Seydeh neh/sidneh

Ketabeh Ibdal

Food For Patients

Soodhayeh Serkangabin (Persian سودهاى سركنگبين) or Benefits of Honey and Vinegar Mixture

Darmanhayeh Abneh

The Book of Surgical Instruments

The Book on Oil

Fruits Before and After Lunch

Book on Medical Discussion (with Jarir Tabib)

Book on Medical Discussion II (with Abu Feiz)

About the Menstrual Cycle

Ghi Kardan or vomiting (Persian قى كردن)

Snow and Medicine

Snow and Thirst

The Foot

Fatal Diseases

About Poisoning

Hunger

Soil in Medicine

The Thirst of Fish

Sleep Sweating

Warmth in Clothing

Spring and Disease

Misconceptions of a Doctor's Capabilities

The Social Role of Doctors

Translations[edit]

Razi's notable books and articles on medicine (in English) include:

Mofid al Khavas, The Book for the Elite.

The Book of Experiences

The Cause of the Death of Most Animals because of Poisonous Winds

The Physicians' Experiments

The Person Who Has No Access to Physicians

The Big Pharmacology

The Small Pharmacology

Gout

Al Shakook ala Jalinoos, The Doubt on Galen

Kidney and Bladder Stones

Ketab tibb ar-Ruhani, The Spiritual Physik of Rhazes.

Alchemy[edit]

Muhammad ibn Zakariya ar-Razi (Rhazes) isolated many chemical substances, produced many medications, and described many laboratory apparatus.

The transmutation of metals[edit]

Razi's interest in alchemy and his strong belief in the possibility of transmutation of lesser metals to silver and gold was attested half a century after his death by Ibn an-Nadim's book (The Philosophers Stone-Lapis Philosophorum in Latin). Nadim attributed a series of twelve books to Razi, plus an additional seven, including his refutation to al-Kindi's denial of the validity of alchemy. Al-Kindi (801-873 CE) had been appointed by the Abbasid Caliph Ma'mum founder of Baghdad, to 'the House of Wisdom' in that city, he was a philosopher and an opponent of alchemy. Razi's two best-known alchemical texts, which largely superseded his earlier ones: al-Asrar (الاسرار "The Secrets"), and Sirr al-Asrar (سر الاسرار "The Secret of Secrets"), which incorporates much of the previous work.

Apparently Razi's contemporaries believed that he had obtained the secret of turning iron and copper into gold. Biographer Khosro Moetazed reports in Mohammad Zakaria Razi that a certain General Simjur confronted Razi in public, and asked whether that was the underlying reason for his willingness to treat patients without a fee. "It appeared to those present that Razi was reluctant to answer; he looked sideways at the general and replied":

"I understand alchemy and I have been working on the characteristic properties of metals for an extended time. However, it still has not turned out to be evident to me, how one can transmute gold from copper. Despite the research from the ancient scientists done over the past centuries, there has been no answer. I very much doubt if it is possible..."

According to one legend he could have been blinded by steaming vapors during an accident in one of his experiments. He managed to escape with no injuries.[34][verification needed]

Chemical instruments and substances

Razi developed several chemical instruments that remain in use to this day. He is known to have perfected methods of distillation and extraction. ar-Razi dismissed the idea of potions and dispensed with magic, meaning the reliance on symbols as causes. Although Razi does not reject the idea that miracles exist, in the sense of unexplained phenomena in nature, his alchemical stockroom was enriched with products of Persian mining and manufacturing, even with sal ammoniac, a Chinese discovery. He relied predominantly on the concept of 'dominant' forms or essences, which is the Neoplatonic conception of causality rather than an intellectual approach or a mechanical one).[citation needed] Razi's alchemy brings forward such empiric qualities as salinity and inflammability -the latter associated to 'oiliness' and 'sulphurousness'. These properties are not readily explained by the traditional composition of the elements such as: fire, water, earth and air, as al-óhazali and others after him were quick to note, influenced by critical thoughts such as Razi had.

Major works on alchemy

Razi's achievements are of exceptional importance in the history of chemistry, since in his books we find for the first time a systematic classification of carefully observed and verified facts regarding chemical substances, reactions and apparatus, described in a language almost entirely free from mysticism and ambiguity. Razi's scheme of classification of the substances used in chemistry shows sound research on his part.

The Secret (Al-Asrar)

This book was written in response to a request from Razi's close friend, colleague, and former student, Abu Mohammed b. Yunis of Bukhara, a Muslim mathematician, philosopher, a highly reputable natural scientist.

In his book Sirr al-Asrar, Razi divides the subject of "Matter' into three categories as he did in his previous book al-Asrar.

Knowledge and identification of drug components of plant-, animal- and mineral-origin and the description of the best type of each for utilization in treatment.

Knowledge of equipment and tools of interest to and used by either alchemist or apothecary.

Knowledge of seven alchemical procedures and techniques: sublimation and condensation of mercury, precipitation of sulfur and arsenic calcination of minerals (gold, silver, copper, lead, and iron), salts, glass, talc, shells, and waxing.

This last category contains additionally a description of other methods and applications used in transmutation:

* The added mixture and use of solvent vehicles.

* The amount of heat (fire) used, 'bodies and stones', ('al-ajsad' and 'al-ahjar) that can or cannot be transmuted into corporal substances such of metals and Id salts ('al-amlah').

* The use of a liquid mordant which quickly and permanently colors lesser metals for more lucrative sale and profit.

Similar to the commentary on the 8th century text on amalgams ascribed to Al- Hayan (Jabir), Razi gives methods and procedures of coloring a silver object to imitate gold (gold leafing) and the reverse technique of removing its color back to silver. Gilding and silvering of other metals (alum, calcium salts, iron, copper, and tutty) are also described, as well as how colors will last for years without tarnishing or changing. Behind these procedures one does not find a deceptive motive rather a technical and economic deliberation. This becomes evident from the author's quotation of market prices and the expressed triumph of artisan, craftsman or alchemist declaring the results of their efforts "to make it look exactly like gold!". However, another motive was involved, namely, to manufacture something resembling gold to be sold quickly so to help a good friend who happened to be in need of money fast. Could it be Razi's alchemical technique of silvering and gilding metals which convinced many Muslim biographers that he was first a jeweler before he turned to the study of alchemy?

Of interest in the text is Razi's classification of minerals into six divisions, showing his discussion a modern chemical connotation:

Four spirits (AL-ARWAH) : mercury, sal ammoniac, sulfur, and arsenic sulphide (orpiment and realgar).

Seven bodies (AL-AJSAD) : silver, gold, copper, iron, black lead (plumbago), zinc (Kharsind), and tin.

Thirteen stones : (AL-AHJAR) Pyrites marcasite (marqashita), magnesia, malachite, tutty Zinc oxide (tutiya), talcum, lapis lazuli, gypsum, azurite, magnesia, haematite (iron oxide), arsenic oxide, mica and asbestos and glass (then identified as made of sand and alkali of which the transparent crystal Damascene[disambiguation needed] is considered the best),

Seven vitriols (AL-ZAJAT) : alum (al-shabb الشب), and white (qalqadis القلقديس), black, red (suri السوري), and yellow (qulqutar القلقطار) vitriols (the impure sulfates of iron, copper, etc.), green (qalqand القلقند).

Seven borates : natron, and impure sodium borate.

Eleven salts (AL-AMLAH): including brine, common (table) salt, ashes, naphtha, live lime, and urine, rock, and sea salts. Then he separately defines and describes each of these substances and their top choice, best colors and various adulterations.

Razi gives also a list of apparatus used in alchemy. This consists of 2 classes:

Instruments used for the dissolving and melting of metals such as the Blacksmith's hearth, bellows, crucible, thongs (tongue or ladle), macerator, stirring rod, cutter, grinder (pestle), file, shears, descensory and semi-cylindrical iron mould.

Utensils used to carry out the process of transmutation and various parts of the distilling apparatus: the retort, alembic, shallow iron pan, potters kiln and blowers, large oven, cylindrical stove, glass cups, flasks, phials, beakers, glass funnel, crucible, alundel, heating lamps, mortar, cauldron, hair-cloth, sand- and water-bath, sieve, flat stone mortar and chafing-dish.

Secret of Secrets (Sirr Al-asrar)

This is Razi's most famous book which has gained a lot of recognition in the West. Here he gives systematic attention to basic chemical operations important to the history of pharmacy.

Books on alchemy[edit]

Here is a list of Razi's known books on alchemy, mostly in Persian:

Modkhele Taalimi

Elaleh Ma'aaden

Isbaate Sanaa'at

Ketabeh Sang

Ketabe Tadbir

Ketabe Aksir

Ketabe Sharafe Sanaa'at

Ketabe Tartib, Ketabe Rahat, The Simple Book

Ketabe Tadabir

Ketabe Shavahed

Ketabe Azmayeshe Zar va Sim (Experimentation on Gold)

Ketabe Serre Hakimaan

Ketabe Serr (The Book of Secrets)

Ketabe Serre Serr (The Secret of Secrets)

The First Book on Experiments

The Second Book on Experiments

Resaale'ei Be Faan

Arezooyeh Arezookhah

A letter to Vazir Ghasem ben Abidellah

Ketabe Tabvib

Philosophy

On existenceRazi is known to have been a free-thinking philosopher, since he was well-trained in ancient Greek science and philosophy although his approach to chemistry was rather naturalistic. Moreover, he was well versed in the theory of music, as so many other scientists of that time.

Metaphysics

His ideas on metaphysics were also based on the works of the ancient Greeks:

"The metaphysical doctrine of Razi, insofar as it can be reconstructed, derives from his concept of the five eternal principles[disambiguation needed]. God, for him, does not 'create' the world from nothing but rather arranges a universe out of pre-existing principles. His account of the soul features a mythic origin of the world in which God out of pity fashions a physical playground for the soul in response to its own desires; the soul, once fallen into the new realm God has made for it, requires God's further gift of intellect in order to find its way once more to salvation and freedom. In this scheme, intellect does not appear as a separate principle but is rather a later grace of God to the soul; the soul becomes intelligent, possessed of reason and therefore able to discern the relative value of the other four principles. Whereas the five principles are eternal, intellect as such is apparently not. Such a doctrine of intellect is sharply at odds with that of all of Razi's philosophical contemporaries, who are in general either adherents of some form of Neoplatonism or of Aristotelianism. The remaining three principles, space, matter and time, serve as the non-animate components of the natural world. Space is defined by the relationship between the individual particles of matter, or atoms, and the void that surrounds them. The greater the density of material atoms, the heavier and more solid the resulting object; conversely, the larger the portion of void, the lighter and less solid. Time and matter have both an absolute, unqualified form and a limited form. Thus there is an absolute matter - pure extent - that does not depend in any way on place, just as there is a time, in this sense, that is not defined or limited by motion. The absolute time of al-Razi is, like matter, infinite; it thus transcends the time which Aristotle confined to the measurement of motion. Razi, in the cases of both time and matter, knew well how he differed from Aristotle and also fully accepted and intended the consequences inherent in his anti-Peripatetic positions." (Paul E. Walker)[page needed]

Excerpt from The Philosophical Approach[edit]

"(...) In short, while I am writing the present book, I have written so far around 200 books and articles on different aspects of science, philosophy, theology, and hekmat (wisdom). (...) I never entered the service of any king as a military man or a man of office, and if I ever did have a conversation with a king, it never went beyond my medical responsibility and advice. (...) Those who have seen me know, that I did not into excess with eating, drinking or acting the wrong way. As to my interest in science, people know perfectly well and must have witnessed how I have devoted all my life to science since my youth. My patience and diligence in the pursuit of science has been such that on one special issue specifically I have written 20,000 pages (in small print), moreover I spent fifteen years of my life -night and day- writing the big collection entitled Al Hawi. It was during this time that I lost my eyesight, my hand became paralyzed, with the result that I am now deprived of reading and writing. Nonetheless, I've never given up, but kept on reading and writing with the help of others. I could make concessions with my opponents and admit some shortcomings, but I am most curious what they have to say about my scientific achievement. If they consider my approach incorrect, they could present their views and state their points clearly, so that I may study them, and if I determined their views to be right, I would admit it. However, if I disagreed, I would discuss the matter to prove my standpoint. If this is not the case, and they merely disagree with my approach and way of life, I would appreciate they only use my written knowledge and stop interfering with my behaviour."

"In the "Philosophical Biography", as seen above, he defended his personal and philosophical life style. In this work he laid out a framework based on the idea that there is life after death full of happiness, not suffering. Rather than being self-indulgent, man should pursue knowledge, utilise his intellect and apply justice in his life.

According to Al-Razi: "This is what our merciful Creator wants. The One to whom we pray for reward and whose punishment we fear."

In brief, man should be kind, gentle and just. Al-Razi believed that there is a close relationship between spiritual integrity and physical health. He did not implicate that the soul could avoid distress due to his fear of death. He simply states that this psychological state cannot be avoided completely unless the individual is convinced that, after death, the soul will lead a better life. This requires a thorough study of esoteric doctrines and/or religions. He focuses on the opinion of some people who think that the soul perishes when the body dies. Death is inevitable, therefore one should not pre-occupy the mind with it, because any person who continuously thinks about death will become distressed and think as if he is dying when he continuously ponders on that subject. Therefore, he should forget about it in order to avoid upsetting himself. When contemplating his destiny after death, a benevolent and good man who acts according to the ordinances of the Islamic Shari`ah, has after all nothing to fear because it indicates that he will have comfort and permanent bliss in the Hereafter. The one who doubts the Shari`ah, may contemplate it, and if he diligently does this, he will not deviate from the right path. If he falls short, Allah will excuse him and forgive his sins because it is not demanded of him to do something which he cannot achieve." (Dr. Muhammad Abdul-Hadi Abu Reidah)

Books on philosophy

This is a partial list of Razi's books on philosophy. Some books may have been copied or published under different titles.

The Small Book on Theism

Response to Abu'al'Qasem Braw

The Greater Book on Theism

Modern Philosophy

Dar Roshan Sakhtane Eshtebaah

Dar Enteghaade Mo'tazlian

Delsoozi Bar Motekaleman

Meydaneh Kherad

Khasel

Resaaleyeh Rahnamayeh Fehrest

Ghasideyeh Ilaahi

Dar Alet Afarineshe Darandegan

Shakkook

Naghseh Ketabe Tadbir

Naghsnamehyeh Ferforius

Do name be Hasanebne Moharebe Ghomi

Notable books in English:

Spiritual Medicine

The Philosophical Approach (Al Syrat al Falsafiah)

The Metaphysics

Views on religion

A number of contradictory works and statements about religion have been ascribed to Razi. According to al-Biruni's Bibliography of Razi (Risāla fī Fihrist Kutub al-Rāzī), Razi wrote two "heretical books": "Fī al-Nubuwwāt (On Prophecies) and "Fī Ḥiyal al-Mutanabbīn (On the Tricks of False Prophets). According to Biruni, the first "was claimed to be against religions" and the second "was claimed as attacking the necessity of the prophets."[35] In his Risala, Biruni further criticized and expressed caution about Razi's religious views, noting an influence of Manichaeism. However, Biruni also listed some others works of Razi on religion, including Fi Wujub Da‘wat al-Nabi ‘Ala Man Nakara bi al-Nubuwwat (Obligation to Propagate the Teachings of the Prophet Against Those who Denied Prophecies) and Fi anna li al-Insan Khaliqan Mutqinan Hakiman (That Man has a Wise and Perfect Creator), among others, listed under his works on the "divine sciences",[35] None of his works on religion are still extant.

Other views and quotes that are often ascribed to Razi are found in a book written by Abu Hatim al-Razi, called Aʿlām al-nubuwwa, and not in any extant work of Razi. Abu Hatim was an Isma'ili missionary who debated Razi, but whether he has faithfully recorded the views of Razi is disputed. According to Abdul Latif al-'Abd, Islamic philosophy professor at Cairo University, Abu Hatim and his student, Ḥamīd al-dīn Karmānī (d. 411AH)[citation needed], were Isma'ili extremists who often misrepresented the views of Razi in their works.[36] This view is also corroborated by early historians like al-Shahrastani who noted "that such accusations should be doubted since they were made by Ismāʿīlīs, who had been severely attacked by Muḥammad ibn Zakariyyā Rāzī".[37] Al-'Abd also points out that the views allegedly expressed by Razi contradict what is found in Razi's own works, like the Spiritual Medicine (Fī al-ṭibb al-rūḥānī). Al-'Abd considers the content of the Spiritual Medicine to be a refutation to the claims made by Abu Hatim about Razi's religious views.[36]

According to Abu Hatim, Razi offered harsh criticism concerning religions, in particular those religions that claim to have been revealed by prophetic experiences.[38][39][40] Razi asserted that "[God] should not set some individuals over others, and there should be between them neither rivalry nor disagreement which would bring them to perdition."[41] He argued,

On what ground do you deem it necessary that God should single out certain individuals [by giving them prophecy], that he should set them up above other people, that he should appoint them to be the people's guides, and make people dependent upon them?[41]

Concerning the link between violence and religion, Razi expressed that God must have known, considering the many disagreements between different religions, that "there would be a universal disaster and they would perish in the mutual hostilities and fighting. Indeed, many people have perished in this way, as we can see."[41]

He was also critical of the lack of interest among religious adherents in the rational analysis of their beliefs, and the violent reaction which takes its place:

If the people of this religion are asked about the proof for the soundness of their religion, they flare up, get angry and spill the blood of whoever confronts them with this question. They forbid rational speculation, and strive to kill their adversaries. This is why truth became thoroughly silenced and concealed.[41]

Al-Razi believed that common people had originally been duped into belief by religious authority figures and by the status quo. He believed that these authority figures were able to continually deceive the common people "as a result of [religious people] being long accustomed to their religious denomination, as days passed and it became a habit. Because they were deluded by the beards of the goats, who sit in ranks in their councils, straining their throats in recounting lies, senseless myths and "so-and-so told us in the name of so-and-so…"[41]

He believed that the existence of a large variety of religions was, in itself, evidence that they were all man made, saying, "Jesus claimed that he is the son of God, while Moses claimed that He had no son, and Muhammad claimed that he [Jesus] was created like the rest of humanity."[41] and "Mani and Zoroaster contradicted Moses, Jesus and Muhammad regarding the Eternal One, the coming into being of the world, and the reasons for the [existence] of good and evil."[41] In relation to the Hebrew's God asking of sacrifices, he said that "This sounds like the words of the needy rather than of the Laudable Self-sufficient One."[41]

On the Qur'an, Razi said:

You claim that the evidentiary miracle is present and available, namely, the Koran. You say: "Whoever denies it, let him produce a similar one." Indeed, we shall produce a thousand similar, from the works of rhetoricians, eloquent speakers and valiant poets, which are more appropriately phrased and state the issues more succinctly. They convey the meaning better and their rhymed prose is in better meter. … By God what you say astonishes us! You are talking about a work which recounts ancient myths, and which at the same time is full of contradictions and does not contain any useful information or explanation. Then you say: "Produce something like it"‽[41]

The above is a translation of a quote from al-Razi's now lost treatise, Mahariq al anbiya مخارق الانبياء (The Prophets' Fraudulent Tricks), in Abu Hatim al-Razi's refutation, A'lam al-Nubuwwah (Signs of Prophecy).[42] Another, longer, translation of the same passage is also available.[43]

From the beginning of the human history, all of those who claimed to be prophets were, in his worst assumption, tortuous and devious and with his best assumption had psychological problems.[38][39][40]

Razi's masters and opponents

Razi studied medicine under Ali ibn Sahl, however, Ibn al-Nadim indicates that he studied philosophy under al-Bakhi, who had travelled much and possessed great knowledge of philosophy and ancient sciences.

Razi's hamud opponents, on the contrary, are well-known. They are the following:

Abu al-Rabban al-Balki, chief of the Mu'tazilah of Baghdad (d. 319 AH/931 CE), a contemporary of Razi who wrote many refutations about Razi's books, especially in his Ilm al-Ilahi. His disagreements with Razi entailed his thoughts on the concept of 'Time'.

Shuhaid ibn al-Husain al-Balkhi, with whom Razi had many controversies; one of these was on the concept of 'Pleasure', expounded in his Tafdll Ladhdhat al-Nafs which abu Sulaiman al-Mantiqi al-Sijistani quotes in his work Siwan al-Hikmah. Al-Balkhi died prior to 329 AH/940 CE.

Abu Hatim al-Razi (Ahmad ibn Hamdan). an Isma'ili missionary, was one of his most influential opponents (d. 322 AH/933-934 CE). He published his controversies with Razi in his book A'lam al-Nubuwwah. Because of this book, Razi's thoughts on Prophets and Religion are preserved to the present time.

Ibn al-Tammar (seemingly being abu Bakr Husain al-Tammar, according to Kraus) was a physician who had some disputes with Razi, as documented by Abu Hatim al-Razi in A'lam al-Nubuwwah. Ibn al-Tammar disagreed with Razi's book al-Tibb al-Ruhani but Razi rebutted him in two antitheses:

First refutation of al-Tammar's disagreement with Misma'i concerning 'Matter'.

Second refutation of al-Tammar's opinion of 'the Atmosphere of subterranean habitations'.

Following are authors as described by Razi in his writings:

Al-Misma'i, a Mutakallim, who opposed 'materialists', counteracted Razi's treatise.

Jarir, a physician who had a theory about 'The eating of black mulberries after consuming water-melon'.

Al-Hasan ibn Mubarik al-Ummi, to whom Razi wrote two epistles with commentaries.

Al-Kayyal, a Mutakallim: al-Razi wrote a book on about his Theory of the Imam.

Mansur ibn Talhah, being the author of the book "Being", which was criticized by al-Razi.

Muhammad ibn al-Laith al-Rasa'ili whose opposition against alchemists was disputed by al-Razi.

Ahmad ibn al-Tayyib al-Sarakhasi (d. 286 AH/899 CE), was an older contemporary of al-Razi. Al-Razi disagreed with him on the question of 'bitter taste'. He moreover opposed his teacher Ya'qub ibn Ishaq al-Kindi, regarding his writings, in which he discredited alchemists.

More names could be added to this list of all people opposed by al-Razi, specifically the Mu'tazilah and different Mutakallimin.

Criticism[Al-Razi's religious and philosophical views were later criticized by Abu Rayhan Biruni and Avicenna in the early 11th century. Biruni in particular wrote a short Risala treatise dealing with al-Razi, criticizing him for his sympathy with Manichaeism,[44] his Hermetical writings, his religious and philosophical views,[45] for refusing to mathematize physics, and his active opposition to mathematics.[46] Avicenna, who was himself a physician and philosopher, also criticized al-Razi.[47] During a debate with Biruni, Avicenna stated:

Or from Muhammad ibn Zakariyyab al-Razi, who meddles in metaphysics and exceeds his competence. He should have remained confined to surgery and to urine and stool testing—indeed he exposed himself and showed his ignorance in these matters.[48]

Quotes about Razi

"Rhazes was the greatest physician of Islam and the Medieval Ages."– George Sarton[49]

"Rhazes remained up to the 17th century the indisputable authority of medicine."– The Encyclopaedia of Islam[page needed]

"His writings on smallpox and measles show originality and accuracy, and his essay on infectious diseases was the first scientific treatise on the subject." – The Bulletin of the World Health Organization (May 1970)

"In today's world we tend to see scientific advance as the product of great movements, massive grant-funded projects, and larger-than-life socio-economic forces. It is easy to forget, therefore, that many contributions stemmed from the individual efforts of scholars like Rhazes. Indeed, pharmacy can trace much of its historical foundations to the singular achievements of this ninth-century Persian scholar." — Michael E. Flannery[page needed]

Legacy

The modern-day Razi Institute in Tehran, and Razi University in Kermanshah were named after him, and 'Razi Day' ('Pharmacy Day') is commemorated in Iran every August 27.[50][51]

In June 2009 Iran donated a scholar pavilion to United Nations Office in Vienna which is placed in the central Memorial Plaza of the Vienna International Center.[52] The Persian Scholars Pavilion at United Nations in Vienna, Austria is featuring the statues of four prominent Iranian figures. Highlighting the Iranian architectural features, the pavilion is adorned with Persian art forms and includes the statues of renowned Iranian scientists Avicenna, Abu Rayhan Biruni, Razi and Omar Khayyam.[53][54]

He also studied under Ali Ibn Rabban.  The practical experience gained at the well-known Muqtadari Hospital helped him in his chosen profession of medicine. At an early age he gained eminence as an expert in medicine and alchemy, so that patients and students flocked to him from distant parts of Asia.

He was first placed in-charge of the first Royal Hospital at Ray, from where he soon moved to a similar position in Baghdad where he remained the head of its famous Muqtadari Hospital for along time. He moved from time to time to various cities, specially between Ray and Baghdad, but finally returned to Ray, where he died around 930 C.E. His name is commemorated in the Razi Institute near Tehran. Razi was a Hakim, an alchemist and a philosopher. In medi-42 cine, his contribution was so significant that it can only be compared to that of Ibn Sina. Some of his works in medicine e.g. Kitab

al- Mansoori, Al-Hawi, Kitab al-Mulookiand Kitab al-Judari wa alHasabahearned everlasting fame. Kitab al-Mansoori, which was translated into Latin in the 15th century C.E., comprised ten volumes and dealt exhaustively with Greco-Arab medicine. Some of

its volumes were published separately in Europe. His al-Judari wal Hasabahwas the first treatise on smallpox and chicken-pox, and is largely based on Razi's original contribution: It was translated into various European languages. Through this treatise he became the first to draw clear comparisons between smallpox and chicken-pox. Al-Hawiwas the largest medical encyclopaedia composed by then. It contained on each medical subject all important information that was available from Greek and Arab sources, and this was concluded by him by giving his own

remarks based on his experience and views. A special feature of his medical system was that he greatly favoured cure through correct and regulated food. This was combined with his emphasis on the influence of psychological factors on health. He also tried proposed remedies first on animals in order to evaluate in their effects and side effects. He was also an expert surgeon and was the first to use opium for anaesthesia. In addition to being a physician, he compounded medicines and, in his later years, gave himself over to experimental and theoretical sciences. It seems possible that he developed his chemistry independently of Jabir Ibn Hayyan. He has portrayed in great detail several chemical reactions and also given full descriptions of and designs for about twenty instruments used in chemical investigations. His description of chemical knowledge is in plain and plausible language. One of his books called Kitab-al-Asrardeals with the preparation of chemical materials and their utilization. Another one was translated into Latin under the name Liber Experimentorum, He went beyond his predecessors in dividing substances into plants, animals and minerals, thus in a way opening the way for inorganic and organicchemistry. By and large, this classification of the three kingdoms still holds. As a chemist, he was the first to produce sulfuric acid together with some other acids, and he also prepared alcohol by fermenting sweet products. His contribution as a philosopher is also well known. The basic elements in his philosophical system are the creator, spirit, matter, space and time. He discusses their characteristics in detail and his concepts of space and time as constituting a continuum are outstanding. His philosophical views were, however, criticised by a number of other Muslim scholars of the era.

He was a prolific author, who has left monumental treatises on numerous subjects. He has more than 200 outstanding scientific contributions to his credit, out of which about half deal with medicine and 21 concern alchemy. He also wrote on physics, mathematics, astronomy and optics, but these writings could not be preserved. A number of his books, including Jami-fi-al-Tib, Mansoori, al-Hawi, Kitab al-Jadari wa al-Hasabah, al-Malooki, Maqalah fi al- Hasat fi Kuli wa al-Mathana, Kitab al-Qalb, Kitab al-Mafasil, Kitab-al- 'Ilaj al-Ghoraba, Bar al-Sa'ah,and al-Taqseem wa al-Takhsir, have been published in various European languages. About 40 of his manuscripts are still extant in the museums and libraries of Iran, Paris, Britain, Rampur, and Bankipur. His contribution has greatly influenced the development of science, in general, and medicine, in particular.

1. Anaesthesia and resuscitation in the medicine of Islamic era

Figure 1: Page from The Result of Thinking about the Cure of Eye Diseases (Natijat al-fikar fi `ilaj amrad al-basar) written in Cairo by Fath al-Din al-Qaysi (d. 1259/657 H). Copy finished by unnamed scribe on 16 November 1501 (5 Jumada I 907 H). National Library of Medicine, Bethesda, Maryland, MS A48, fols. 7b-8a (Source).

Little is known about the history of anaesthesia in the period of more than 1000 years between Graeco-Roman times and the 16th century when the Renaissance started. In Europe, that period is usually referred to as the Dark Ages when no progress was made in medical science [1] [2] [3] [4]. However, the situation in the East was different [2] [5] [6] [7]. The following section is dedicated to survey the development of anaesthesia during that period by reviewing the following books: Al-Hawi fit-tibb (The Continence) [8], Al-Qanun fi-al-tibb (The Cannon of Medicine) [9], Al-Tasrif [10], Al-Mukhtarat fit-tibb [11], Al-'Umda Fil Al-Jiraha [12], and Al-Taysir [13]. The authors of these books are respectively Al-Razi, Ibn Sina, Al-Zahrawi, Al-Bagdagi, Ibn al-Quff and Ibn Zuhr. Those authors were medical scholars who lived in the period between the 9th and the 14th centuries. Their contribution to pain relief has been recently evaluated [14]. In the following section, we will evaluate their contributions to anaesthesia and resuscitation.

1.1. Anaesthesia

1.1.1. Documentation of the use of AI-Murquid

Both of the historians, Ibn Khallikan [15] in the 13th century, and Ibn Kathir [16] in the 14th century, documented that Urwa Ibn AI-Zubair in the beginning of the 8th century developed leg gangrene for which amputation was required. The doctors of the Ummayad Caliph Al-Walid Ibn Abdel Malek in Damascus offered him Al-Murquid to be put to sleep for the operation.

Literally, the word 'Al-Murquid' in Arabic means a drug that induces deep sleep. Evidence about the popularity of this anaesthetic comes from finding entries about Al-Murquid in four general-purpose Arabic language dictionaries compiled during that era [17] [18] [19] [20].

Also in the literary book Sayd Ul-Khatir, Ibn al-Jawzi in the 12th century referred to the anaesthetizing effect of Bhanj [21].

1.1.2. Anaesthesia techniques

Al-Murquid was used either by ingestion or inhalation or rectally [14]. In the form of infusion, they used particular types of solanum, cannabis, opium and mandrake by ingestion. The last three drugs were also administered rectally on a plug which had to be changed hourly. On the other hand, opium, mandrake and henbane were also used by inhalation in the form of odorants. As wild lettuce has a mild soporific effect it was used, whether fresh or boiled, as an adjuvant to any of the previous ones or in cases of insomnia [14]. They not only precisely determined the required dose of each drug but also they were able to fix the length of time which the anaesthesia was to last with great precision, for example, Ibn Sina [9] gave a dose of one 'mithkal' of mandrake for 3-4 hours of general anaesthesia.

However, Ibn al-Quff [12] most probably in an attempt to reduce the dose used, and hence decrease the risks of toxic effects, advised care on the part of the surgeon to use operative techniques that minimized pain.

1.1.3. Anaesthesia personnel

The knowledge and practice of anaesthesia reached its peak in the beginning of the 14th century as evidenced in Ibn al-Quff's book on surgery Al-'Umda Fi-'l-Jiraha [12] (the mainstay in surgery). Unlike Paulus of Aegineta [22], Ibn al-Quff gave detailed information in his book on the phenomenon of pain and clearly stated that pain relief during surgery should be the responsibility of a second medical man other than the surgeon performing the operation. Al- Tabaaei (meaning the physician) was to look after pain relief by giving AI-Murquid to allow Al-Jaraaehi (meaning the surgeon) to perform the operation. This represents the first report, in the literature, on the role of the anaesthetist.

1.1.4. Monitoring

In that era they also realized the importance of monitoring during anaesthesia as, according to Sigrid Hunke [23] a third medical man used to be present putting a finger on the pulse during the operation. It is interesting to note this method of monitoring, by palpating the pulse is still practiced nowadays and is referred to in anaesthesia text-books as a simple non-invasive method.

1.2. Resuscitation

Figure 2: Manuscript page of Kitab Kamil al-sina'ah al-tibbiyah al-ma'ruf bi-al-Malaki by Ali ibn al-'Abbas al-Majusi (10th/11th centuries). This Arabic manuscript on general medicine in 497 leaves is held at Yale University Library, Historical Medical Library: Cushing Arabic Ms. 4 (Source).

1.2.1. Resuscitation team

In the memoirs of Prince Osama Ibn Al-Munquiz [24] we found evidence that the Tabaaei (physician) and Jaraaehi (surgeon) also worked together as a resuscitation team. Both were called for the resuscitation of a warrior who collapsed immediately after an arrow hit him.

1.2.2. Nutrition

For the resuscitation of patients with severe weakness and cachexia due to dysphagia, Ibn Zuhr [13], in the 12th century, recommended enteral feeding through a tube made of silver or strengthened tin introduced into the throat gently and gradually, to avoid its nauseating effect. Contrary to his predecessors, Ibn Zuhr also advocated rectal enteral feeding and described how the bladder of a goat filled up with the nutrient fluid and fitted with a silver tube tied to its mouth could be used for this purpose.

1.2.3. Management of upper airway obstruction

For the resuscitation of suffocation due to upper airway obstruction Ibn Sina [9], in the 10th century recommended the introduction of a tube made of gold or silver, or similar metal, to assist breathing. In agreement with Brendt & Georig [25], this represents the first reported use of an endotracheal tube. However, before attempting intubation, Ibn Sina [9] tried conservative measures including clearing the secretions using a wicker stick covered with a piece of cotton-wool. If such measures failed and the patient's life was threatened, Ibn Sina recommended tracheotomy. According to Adams and Spink & Lewis [27], Aretaeus in the 2nd century and Caelius Aurelinus in the 4th century did not approve of tracheotomy. Therefore, although Paulus [22] (7th century) quoting Antyllus (2nd century), described the technique of tracheotomy, the operation remained in disfavour. This state of affairs lasted until the Islamic era when AI-Razi [8] (9th century) and later Ibn Sina [9] (10th century) spoke favourably of the operation and refined the technique.

Although AI-Razi spoke of tracheotomy as a drastic measure he reported seeing patients with wounds in the throat through which breath came out, yet the wounds eventually healed and patients survived. However, the credit for proving that tracheotomy is not a dangerous operation goes to Al-Zahrawy [28] in the 10th to 11th century and Ibn Zuhr [13] (12th century). Al-Zahrawi, in his book Al-Tasrif liman 'ajaza 'an al-ta'lif reported from his own experience the successful management of a suicidal cut wound of the trachea and concluded that tracheotomy is not a dangerous procedure. On the other hand, Ibn Zuhr [13] in his book AI-Taysir described in detail his animal experiment of performing tracheotomy on a goat that completely recovered following the operation and lived for a long period thereafter. Ibn Zuhr's application of an experimental model to a clinical problem was the forerunner of the method by which many current surgical procedures were developed. The authors who came after AI-Zahrawi and Ibn Zuhr such as AI-Bagdadi [11] and Ibn al-Quff [12] recommended tracheotomy unreservedly in life-threatening upper airway obstruction not relieved by other means, and described the technique with more refinements and in more detail. It is interesting to note that Ibn al-Quff's indications for tracheotomy specifically included the failure to introduce cool air to the interior.

1.2.4. Use of bellows

Ibn Abi Usaybi'a [29] in the 13th century in his book of medical biographies 'Uyun al-anba' fi-tabaqat aI-atibba' documented a case in which a critically ill patient already pronounced dead was successfully resuscitated by the physician Saleh Ibn Bahla who elicited that the patient still responded to painful stimuli, then with the use of bellows, insufflated air and soap root powder into his nose. According to Jaser [30], this clinical case report documented the use of bellows for respiratory resuscitation 900 years before it was first reported in Europe.

The contributions of the above mentioned authors were translated into Latin as early as the middle of the 12th century and greatly influenced the European mediaeval schools of medicine well into the 18th century [2] [3] [4] [7] [31] [32] [33] [34] [35] [36].

narcotics for pain

The following research article in a particular field of the history of medicine, written by two eminent experts, Drs Adnan A. Al-Mazrooa and Rabie E. Abdel-Halim, is composed of two parts. This first part surveys the use of narcotics for pain relief from Antiquity up to the Renaissance; the second part is a historical investigation in the contribution of the Islamic medical tradition to develop anaesthesia methods and uses. Reviewing some of the medical texts written by Muslim scholars from the 9th to the 14th century, the authors present evidence that anaesthesia monitoring and resuscitation were practised by Muslim scientists more than 1000 years ago.

artikel penelitian berikut dalam bidang tertentu dari sejarah kedokteran, yang ditulis oleh dua ahli terkemuka, Drs Adnan A. Al-Mazrooa dan Rabie E. Abdel-Halim, terdiri dari dua bagian. Ini pertama survei bagian penggunaan narkotika untuk menghilangkan rasa sakit dari Antiquity hingga Renaissance; bagian kedua adalah penyelidikan sejarah dalam kontribusi tradisi medis Islam untuk mengembangkan metode anestesi dan penggunaan. Meninjau beberapa teks medis yang ditulis oleh cendekiawan Muslim dari tanggal 9 hingga abad ke-14, penulis memberikan bukti bahwa pemantauan pembiusan dan penyadaran yang dilakukan oleh para ilmuwan Muslim lebih dari 1000 tahun yang lalu.

Pain is a subjective experience which requires the presence of consciousness. Over the ages there has been a demand for methods of relief. In the following sections, we present a brief report about the use of narcotics for pain relief from antiquity up to the Renaissance, in Greek and Roman medicine and in the Middle Ages, before turning to analyse the anaesthesia in the Islamic medical tradition.

Nyeri adalah pengalaman subjektif yang mengharuskan adanya kesadaran. Selama berabad-abad telah ada permintaan untuk metode lega. Pada bagian berikut, kami menyajikan laporan singkat tentang penggunaan narkotika untuk menghilangkan rasa sakit dari jaman dahulu hingga Renaissance, dalam pengobatan Yunani dan Romawi dan Abad Pertengahan, sebelum berbalik untuk menganalisis anestesi dalam tradisi medis Islam.

1.       Narcotics in Greek and Roman medicine

Though Celsus [1], in the 1st Century, used opium and mandrake for pain relief, Galen in the 2nd century (as stated by Cumston [2] and De Moulin) recommended great care with the use of powerful narcotics such as opium, considering it a dangerous drug. According to Campbell [4] and Cumston [2], Galen was looked upon as one of the great physicians. He summarized the knowledge accumulated in Greek medicine up to his time and studied every aspect of medicine. In cases of colic or other very violent pains, he used only opium.

Celsus [1], di abad ke-1, yang digunakan opium dan mandrake untuk menghilangkan rasa sakit, Galen pada abad ke-2 (seperti yang dinyatakan oleh Cumston [2] dan De Moulin) direkomendasikan hati-hati dengan penggunaan narkotika yang kuat seperti opium, mengingat itu obat yang berbahaya. Menurut Campbell [4] dan Cumston [2], Galen dipandang sebagai salah satu dokter yang besar. Ia meringkas pengetahuan akumulasi dalam kedokteran Yunani sampai waktu dan mempelajari setiap aspek kedokteran. Dalam kasus kolik atau sakit sangat keras lainnya, ia hanya digunakan opium.

Figure 1: Drawing of the cross section of the Brain and the Eyes made by the 13th century Khalifa ibn Abi Al Mahasin Al-Halabi (from Aleppo) in his book Al-Kafi Fi Al-Kuhl (The Book of Sufficient Knowledge in Ophthalmology) (Source).

After Galen, Greek medicine produced four writers who did not contribute any advancement. Their works mainly consisted of quotations from Hippocrates and Galen [4]. As a consequence, the strong narcotic drug mandrake used by Celsus [1] seems to have fallen into neglect; confirmation of this is that Paulus [5] in the 7th Century, who is regarded as having summed up all medical knowledge accumulated up to his time, did not use it in his trochisci as an anodyne.

Paulus did not give the toxic dose or details of the specific actions of either mandrake or opium. It seems that there was no standardization or regulation of dosage [6] [7]. It was therefore impossible to standardize the results [6] [8] [9] and, attempts at the conquest of pain were sporadic [10].

Setelah Galen, obat Yunani menghasilkan empat penulis yang tidak memberikan kontribusi kemajuan apapun. Karya-karya mereka terutama terdiri dari kutipan dari Hippocrates dan Galen [4]. Akibatnya, mandrake obat narkotika yang kuat yang digunakan oleh Celsus [1] tampaknya telah jatuh ke dalam kelalaian; konfirmasi ini adalah bahwa Paulus [5] di abad ke-7, yang dianggap telah menyimpulkan semua pengetahuan medis perolehan sampai waktunya, tidak menggunakannya dalam trochisci sebagai seorang anodyne.

Paulus tidak memberikan dosis toksik atau rincian dari tindakan spesifik baik mandrake atau opium. Tampaknya tidak ada standarisasi atau regulasi dosis [6] [7]. Hal yang mustahil untuk membakukan hasil [6] [8] [9] dan, upaya penaklukan nyeri yang sporadis [10].

2. Narcotics in The Middle Ages and Islamic era

In the Middle Ages, Christian Europe was in a state of intellectual stagnation [2] [4] [7] [11] [12] and the theological doctrine that pain serves God's purpose and must not be alleviated militated against the improvement in methods of narcosis. Nuland [7] points out that the Middle Ages in Europe were dark ages so far as advances in the pharmacology of anaesthesia was concerned. However in the East, with the firm establishment of the Muslim supremacy between the 9th and 16th centuries, the study of medicine along with other branches of science revived and acquired a truly scientific nature [2] [4] [13] [14] [15].

Therefore, not only Ibn Sina (Avicenna) [16] but also Al-Razi [17], Al-Baghdadi [18] and Ibn al-Quff [19], paid great attention to the phenomenon of pain. They attributed it not only to a breach of continuity, as stated by Galen, but also to a sudden change of temperament (by only heat, cold or dryness) with or without abnormal humours. Hence, for pain relief, they stressed the treatment of the underlying cause and they subsequently developed a large number of analgesics with variable modes of action. The anaesthetics they described included a wide range of medical plants as well as ice or very cold iced water as an efficient and safe mode of local anaesthesia even though there might be an increase in the pain at the beginning. Refrigeration anaesthesia which is considered by some to be a modern discovery, thus, had its origin in the medicine of the past.

They attributed the anaesthetic action of the various medical plants used to a specific poisonous property of variable strength, and thus according to Ibn Sina (Avicenna) [16], opium is the most powerful, then mandrake, papaveris, henbane or hyocyamus, hemlock, solanum and wild lettuce. These drugs, especially opium, were used as local anaesthetics in dental cases, earache, eye pain and joint pain (especially in gout).

2. Narkotika di Abad Pertengahan dan era Islam

Pada Abad Pertengahan, Eropa Kristen berada dalam keadaan stagnasi intelektual [2] [4] [7] [11] [12] dan doktrin teologis yang sakit melayani tujuan Allah dan tidak harus diringankan militated terhadap perbaikan dalam metode pembiusan. Nuland [7] menunjukkan bahwa Abad Pertengahan di Eropa adalah zaman kegelapan sejauh kemajuan dalam farmakologi anestesi prihatin. Namun di Timur, dengan pembentukan perusahaan supremasi Muslim antara tanggal 9 dan 16 abad, studi kedokteran bersama dengan cabang-cabang ilmu pengetahuan lainnya dihidupkan kembali dan memperoleh sifat yang benar-benar ilmiah [2] [4] [13] [14] [ 15].

Oleh karena itu, tidak hanya Ibnu Sina (Avicenna) [16] tetapi juga Al-Razi [17], Al-Baghdadi [18] dan Ibn al-Quff [19], menaruh perhatian besar terhadap fenomena nyeri. Mereka dikaitkan tidak hanya untuk pelanggaran kontinuitas, seperti yang dinyatakan oleh Galen, tetapi juga untuk tiba-tiba berubah temperamen (dengan hanya panas, dingin atau kering) dengan atau tanpa humor yang abnormal. Oleh karena itu, untuk menghilangkan rasa sakit, mereka menekankan pengobatan penyebab yang mendasari dan mereka kemudian mengembangkan sejumlah besar analgesik dengan mode variabel tindakan. Anestesi mereka dijelaskan termasuk berbagai tumbuhan obat serta es atau air es yang sangat dingin sebagai modus efisien dan aman anestesi lokal meskipun mungkin ada peningkatan rasa sakit di awal. Anestesi pendinginan yang dianggap oleh beberapa orang untuk menjadi penemuan modern, dengan demikian, memiliki asal dalam pengobatan masa lalu.

Mereka disebabkan tindakan anestesi berbagai tumbuhan obat yang digunakan untuk properti beracun tertentu kekuatan variabel, dan dengan demikian menurut Ibnu Sina (Avicenna) [16], opium adalah yang paling kuat, maka mandrake, papaveris, semacam tumbuhan atau hyocyamus, hemlock, Solanum dan selada liar. Obat ini, khususnya opium, digunakan sebagai anestesi lokal dalam kasus gigi, sakit telinga, sakit mata dan nyeri sendi (terutama di gout).

In dentistry, they used opium, mandrake root or henbane juice in the form of pastes, patches or fillings. Gargles from decoctions of mandrake root, henbane root or seeds or the root of solanum were also used.

Opium drops in rose oil, infusion of root of solanum, decoction of papaveris, oil or juice of henbane and angelica juice were used for earache. The relief of eye pains was achieved by either using dressings from mandrake leaves or mixing the eye medicines with mandrake tears or juice of hemlock. Embrocations of the juice of henbane leaves or seeds were also used on the eye and, for joint pains, dressings from mandrake leaves or embrocations from opium, hemlock, henbane or cannabis.

In addition, because it was noticed that severe pain may lead to death, the soporific action of these drugs was employed especially pre-operatively in the cases of amputation, cautery, circumcision and lacerations. They were administered by ingestion, inhalation or rectally. Infusions of solanum, cannabis, opium and mandrake were given orally or rectally on a plug which has to be changed hourly. Opium, mandrake and henbane were also used by inhalation in the form of odorants.

Figure 3: Page of a manuscript copy of al-Razi's Kitab al-Hawi fi al-tibb [The comprehensive book of medicine], as copied by an unnamed scribe in 1441. © Bodleian Library, University of Oxford, MS Marsh 156, folio 2r. (Source).

The wild lettuce has a mild soporific effect. It was used either fresh or boiled as an adjuvant to any of the previous medications or alone in cases of insomnia.

These physicians not only determined the required dose in each drug precisely but also were able to fix the length of time which the anaesthesia was to last with great precision. Avicenna for example, gave the dose of one 'mithkal' of mandrake for 3-4 hours of general anaesthesia.

Unlike Paulus [5], Ibn Sina [16], AI-Razi [17], Al-Baghdadi [18], Ibn EI-Quff [19] and Ibn al-Baytar [20] in the light of their own experiments and observations, described the general and special botanical characters of the plants in detail as well as indicating their habitats and what was best selected from each. They also specified methods for obtaining the active ingredients whether as juice or in the various medical forms that can be prepared as infusions, decoctions or dressings.

They also described the specific actions and side effects on the various systems of the body and stated with great accuracy the required dosage from juice, bark or decoctions as well as the toxic dose. Finally, they outlined the action of antidotes, adjuvants and alternative remedies.

The Muslims must be given the credit for developing the science of botany [12] [13] [21]. Ibn al-Baytar is one of the greatest Arabian botanists [2] [20] [22] [23]. His book Al-Gami' Al-Kabir is the most original among the Arabic materia medica texts of the mediaeval period. Arabic materia medica had a considerable impact on European herbal and antidotarium authors from the 12th to the 17th century [2] [4] [24] [25]. Constantine wrote nothing original; all his books are plagiarisms or skilfully disguised translations from the Arabic. The medicinal remedies reported by Dioscorides are thus of Islamic origin [2]. The same may be said of the work of Celsus which was hardly noticed by the Greeks and overlooked in the Middle Ages [26]. In the section on emollients (vol. 2), Celsus describes one of them as the invention of a certain Arab, and some of his recipes are based on Arabic materia medica with its tables of weights and measures (pound, dirham and dinarium or dinarii).

Dalam kedokteran gigi, mereka menggunakan opium, mandrake root atau jus semacam tumbuhan dalam bentuk pasta, patch atau tambalan. Gargles dari decoctions akar mandrake, semacam tumbuhan akar atau biji atau akar Solanum juga digunakan

Opium tetes minyak mawar di, infus akar Solanum, rebusan papaveris, minyak atau jus semacam tumbuhan dan angelica jus digunakan untuk sakit telinga. Relief sakit mata dicapai dengan baik menggunakan dressing dari daun mandrake atau mencampurkan obat mata dengan air mata mandrake atau jus dari hemlock. Embrocations dari jus daun semacam tumbuhan atau biji juga digunakan pada mata dan, untuk nyeri sendi, dressing dari daun mandrake atau embrocations dari opium, hemlock, semacam tumbuhan atau ganja.

Selain itu, karena itu melihat bahwa rasa sakit yang parah dapat menyebabkan kematian, tindakan obat tidur obat ini dipekerjakan terutama pre-operatif pada kasus amputasi, kauter, sunat dan laserasi. Mereka diberikan oleh konsumsi, inhalasi atau dubur. Infus Solanum, ganja, opium dan mandrake diberikan secara oral atau rektal pada steker yang harus diubah per jam. Opium, mandrake dan semacam tumbuhan juga digunakan jika terhirup dalam bentuk aroma.

Gambar 3: Halaman dari salinan naskah al-Razi Kitab al-Hawi fi al-tibb [Buku komprehensif kedokteran], sebagaimana disalin oleh penulis yang tidak disebutkan namanya di 1441. © Bodleian Library, Universitas Oxford, MS Marsh 156, folio 2r. (Sumber).

The liar selada memiliki efek obat tidur ringan. Itu digunakan baik segar atau direbus sebagai adjuvant ke salah satu obat sebelumnya atau sendirian dalam kasus insomnia.

Dokter tersebut tidak hanya ditentukan dosis yang diperlukan dalam masing-masing obat secara tepat, tetapi juga mampu memperbaiki lamanya waktu yang anestesi itu berlangsung dengan tepat. Avicenna misalnya, memberikan dosis satu 'mithkal' dari mandrake selama 3-4 jam anestesi umum.

Tidak seperti Paulus [5], Ibnu Sina [16], AI-Razi [17], Al-Baghdadi [18], Ibnu EI-Quff [19] dan Ibn al-Baytar [20] dalam terang percobaan dan pengamatan mereka sendiri , menggambarkan karakter botani umum dan khusus dari tanaman secara rinci serta menunjukkan habitat mereka dan apa yang terbaik yang dipilih dari masing-masing. Mereka juga ditentukan metode untuk memperoleh bahan aktif baik sebagai jus atau dalam berbagai bentuk medis yang dapat disiapkan sebagai infus, decoctions atau dressing.

Mereka juga menggambarkan tindakan tertentu dan efek samping pada berbagai sistem tubuh dan menyatakan dengan akurasi besar dosis yang diperlukan dari jus, kulit kayu atau decoctions serta dosis toksik. Akhirnya, mereka diuraikan aksi penangkal, ajuvan dan pengobatan alternatif.

Kaum Muslim harus diberi kredit untuk pengembangan ilmu botani [12] [13] [21]. Ibn al-Baytar adalah salah satu ahli botani Arab terbesar [2] [20] [22] [23]. Bukunya Al-Gami 'Al-Kabir adalah yang paling asli di antara teks materia medica Arab periode abad pertengahan. Arab materia medica memiliki dampak yang cukup besar pada penulis herbal dan antidotarium Eropa dari 12 ke abad ke-17 [2] [4] [24] [25]. Constantine menulis apa-apa asli; semua buku-bukunya adalah penjiplakan atau terjemahan terampil menyamar dari bahasa Arab. Obat obat yang dilaporkan oleh Dioscorides demikian asal Islam [2]. Hal yang sama dapat dikatakan dari karya Celsus yang hampir tidak diperhatikan oleh orang-orang Yunani dan diabaikan pada Abad Pertengahan [26]. Pada bagian atas emolien (vol. 2), Celsus menggambarkan salah satu dari mereka sebagai penemuan dari Arab tertentu, dan beberapa resep didasarkan pada Arab materia medica dengan meja-meja yang bobot dan ukuran (pound, dirham dan dinarium atau dinarii ).

The only conclusion possible is that the writings of the Muslim scholars in their Latin form influenced European medical thought over a very considerable period.

3. Notes and refe Keywords: ScienceMedicinePharmacyHistoryPeopleFeaturedIslamic medicineHistory of anaesthesiaHistory of anaesthesia monitoring and resuscitationMedieval Muslim scientistsAl-Hawi fit-tibbThe ContinenceAl-Qanun fi al-tibbThe Cannon of MedicineAl-TasrifAl-Mukhtarat fi-tibbAl-'Umda Fi Al-JirahaAl-TaysirAl-RaziRhazesIbn SinaAvic

 [1] Celsus, De Medicina. London: Heinemann; Cambridge: Harvard University Press, 1938, vols 1-3.

[2] Cumston C G, An introduction to the history of medicine from the time of the Pharoahs to the end of the XVIII Century. London: Dawsons, 1968.

[3] De Moulin D, "A historical phenomenological study of bodily pain in Western man", Bull Hist Med 1974; 48: 540-70.

[4] Campbell DC, Arabian medicine and its influence on the Middle Ages. Amsterdam: Philo Press, 1974, (reprint).

[5] Paulus Aegineta, The seven books of Paulus Aegineta, translated by F. Adams. London, Sydenham Society, 1844-1847, vols 1-3.

[6] Keys T, The history of surgical anaesthesia, New York: Schuman's, 1945.

[7] Nuland SB, The origins of anaesthesia. Birmingham: The Classics of Medicine Library, 1983.

[8] Tallmadge GK, "Some anaesthetics of antiquity". J Hist Med All Sci 1946: 1: 515-20.

[9] Horine FE, "Episodes in the history of anaesthesia". J Hist Med All Sci 1946; 1: 521-6.

[10] Kitz RJ, Vandam LD, "A history and the scope of anaesthetic practice". In: Miller RD ed., Anaesthesia vol 1, 2nd ed., New York: Churchill Livingstone, 1986, 3-25.

[11] Bickers W, "Adventures in Arabian Medicine". J Roy Coll Surg Ir 1969; 5: 5-14.

[12] Desnos E, "The history of urology up to the latter half of the thirteenth century". In: Murphy LJT, ed., The history of urology. Springfield: Thomas, 1972.

[13] Dickinson EH, The medicine of the ancients. Liverpool: Holden, 1875.

[14] Kirkup JR, "The history and evolution of surgical instruments. I. Introduction". Ann Coll Surg Engl 1981; 63: 279-85.

[15] Sigrid Hunke. Allah's sonne uber dem abendland unser Arabische erbe, Arabic Translation by F. Baidoon and K. Dosoky, 6th Ed. Beirut: Dar AI-Aafak AI-Jadida, 1981.

[16] Ibn-Sina, Kitab aI-qanun fi al-tibb, Beirut: Dar Sadir, reprint of Cairo Boulak edition, 1877.

[17] Al-Razi, Kitab al-Hawi fi al-tibb (Rhazes Liber Continens), vol 23, 1st ed., Hyderabad: Osmania Oriental Publications, Osmania University, 1961. De Moulin D, "A historical phenomenological study of bodily pain in Western man". Bull Hist Med 1974; 48: 540-70.

[18] AI-Baghdadi, Kitab aI-mukhtarat fi al-tibb, vols 1-4, 1st ed. Hyderabad: Osmania Oriental Publications, Osmania University, 1942-1944.

[19] Ibn al-Quff, AI-'Umda fi al-jiraha, vol 1-2, 1st ed. Hyderabad: Osmania Oriental Publications, Osmania University, 1936.

[20] Ibn al-Baytar, Jami' mufradat al-adwia wa-'I-aghzia (A Dictionary of simple drugs), MS No. 3979, Chester Beatty Library in Dublin, Microfilm at Imam Ibn Saud University Library, Riyadh.

[21] Margotta R, in: Lewis, P, ed., An illustrated history of medicine. Feltham: Hamlyn, 1968.

[22] Hamerna SK. "Tareekh Al-Tibb Wa Assaidala End Al-Arab". Vol 1-2. Cairo: 1967.

[23] Ibn Abi Usaybi'a, 'Uyun al-anba' fi tabaqat aI-atibba' (The sources of the knowledge of classes of doctors). Beirut: Dar Maktabat al-Hayat, 1965.

[24] Garrison FH, An introduction to the history of medicine, 3rd ed. Philadelphia and London: Saunders, 1924.

[25] Dunlop DM, "Arabic medicine in England". J Hist Med 1956; 2: 166-82.

[26] Guthrie D, A history of medicine. London: Thomas Nelson, 1945. Dunlop DM, "Arabic medicine in England". J Hist Med 1956; 2: 166-82.

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Notes and references

[1] Bickers W, "Adventures in Arabian medicine". J R ColI Surg Irel 1969: 5: 5-14.

[2] Cumston CG, "An introduction to the history of medicine from the time of the pharoahs to the end of the XVIII century". In: Islamic medicine, London: Dawsons of Pall Mall, 1968: 23-26, 185-212.

[3] Desnos E, "The history of urology up to the latter half of the nineteenth century, Chapter 3". In: Murphy LJT, ed. and translator, The history of urology. Springfield: Charles C Thomas, 1972: 34.

[4] Margotta R, "The Dark Ages, the decline of Rome". In: Lewis P, ed. An illustrated history of medicine. Middlesex: Hamlyn, 1968: 100-105.

[5] Dickinson EH, The medicine of the ancients. Liverpool: Holden, 1875: 37-39.

[6] Kirkup JR, "The history and evolution of surgical instruments. Introduction". Ann R ColI Surg Eng 1981; 63: 279-285.

[7] Campbell DC, Arabian medicine and its influence on the middle ages. 1st edition (reprint), Amsterdam: Philo Press, 1974: pp. XI-XV.

[8] AI-Razi, Kitab al-Hawi fi al-tibb, op. cit., vol.3: pp. 225-233; vol. 23: pp. 225-242.

[9] Ibn Sina, Kitab aI-qanun fi al-tibb, op. cit., vol. 1: pp. 334; vol. 2: pp. 200-205.

[10] AI Zahrawi, Al-Tasrif liman 'agaz 'an-al-ta'lif. In: Spink MS, Lewis CL, eds and trans. Albucasis on surgical instruments. London: Wellcome Institute of the History of Medicine, 1973: 338-339.

[11] AI-Bagdadi, Kitab aI-mukhtarat fi al-tibb, op. cit., vol. 1: p. 141; vol. 3: p. 190.

[12] lbn al-Quff, AI-'Umda fi 'I-jiraha, op. cit., vol. 2: pp. 104-105; vol. 1: p. 205.

[13] Ibn Zuhr, AI-Taysir fi-'l-mudawat wa-'l-tadbir, Alkhoury M, ed. Damascus: The Arabic Organisation for Education, Culture and Science, 1983: 149-155.

[14] Al Mazrooa AA, Abdel-Halim RE. "Anaesthesia 1000 years ago". In: Atkinson RS, Boulton TB, eds. The history of anaesthesia. London, New York: Royal Society of Medicine Services and the Parthenon Publishing Group, 1989: 46-48.

[15] lbn Khallikan, Wafayat al-a'yan, ed. Mohamed Mohyuldeen, Maktabt al-Nahda, 1948: 418-428.

[16] lbn Khathir, Al-bidaya wa-'l-nihaya, 3rd ed. Abu Mohem A. et al. eds. Beirut: Dar al-kutub al-'ilmiya, 1987; 4: 108.

[17] Mohamed bin Yagab AI Firouz-Abadi, Al-Qamus al-muhit, 3rd ed. Cairo: AI-Matba'a al-Masriya, 1933; I: 295.

[18] Ibn Manzur, Lisan al-'Arab, AI-Kabir A et al. eds. Cairo, Egypt: Dar aI-Ma'arif, 3: 1206; Ibn al-Jawzi, Sayd aI-Khatir, Abdul Kader A, ed. Beirut: Al-maktaba 'l-'ilmiya (undated): 18.

[19] Al-Razi, Muktamal-Sihah. Beirut: Dar al-kitab al-'arabi, 1981: 252.

[20] AI-Zamakhshari, Asas al-Balagha. Beirut: Dar al-fikr (undated): 244.

[21] Ibn al-Jawzi, Sayd aI-Khatir, Abdul Kader A, ed. Beirut: Al-maktaba Al-'ilmiya (undated): 18.

[22] Paulus of Aegineta, The seven books of Paulus of Aegineta, 6th book. Adams F, trans. London: Sydenham Society, 1846: pp. 1-3.

[23] Sigrid Hunke, Allah's sonne uber dem abendland unser Arabische erbe, 6th ed. Baidoon F, Dosoky K, Arabic trans. Beirut: Dar Al-afaq aI-jadida, 1981: 239.

[24] 0sama Ibn Al-Munquiz, Kitab al-I'tibar, Samaraaei Q, ed. Riyadh: Dar Al-assala for culture, Publication and Information, 1987: 75.

[25] Brendt L, Georig M. "Die Oeschichte der Tracheotomie". Anaesthetist 1986; 35: 279-283.

[26] Adams F., Translation of: The seven books of Paulus Aegineta. London: Sydenham Society 1846; 2: 301-303.

[27] Spink MS, Lewis CL. Albucasis on surgery and instruments. London: Wellcome Institute of the History of Medicine, 1973: 336.

[28] Al-Zahrawi, AI-Tasrif liman 'ajaza 'an aI-ta'lif. Istanbul, Besiraga Collection Suleymaniye Library, MS 502. Reproduced and edited by Fuat Sezgin, Frankfurt: Institute for the History of Arabic-Islamic Science, 1986, vol. 2: p. 498.

[29] Ibn Abi Usaybi'a, 'Uyun al-anba' fi tabaqat aI-'atibba', Nizar Reda, ed., op. cit., pp. 475-477.

[30] Jaser MT, "Anaesthesia in the history of Islamic medicine". In: Atkinson RS, Boulton TB, eds., The history of anaesthesia. London, New York: Royal Society of Medicine Services and the ParthenoQ Publishing Group, 1989: 48-50.

[31] Ullman M., Islamic medicine (Islamic Surveys Series, N° 11). Edinburgh: Edinburgh University Press, 1978: 52-54.

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[33] Gruner OC. A Treatise on the Canon of Medicine of Avicenna incorporating a translation of the first book. London: Luzac, 1930: 18.

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[35] Radbill SX. "The first treatise on paediatrics". Am J Dis Child 1971; 122: 369-376.

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