CHAPTER XIX. Further Advance of the Arab Renaissance During the Ninth and

FURTHER ADVANCE OF THE ARAB RENAISSANCE DURING THE NINTH AND SUCCEEDING CENTURIES OF THE CHRISTIAN ERA

During the latter part of the eighth century the Arab Renaissance, so far at least as the science of medicine was concerned, was controlled and kept in vigorous life almost entirely by physicians who were connected with the school at Djondisabour--one might almost say, by physicians who were members of the Bakhtichou family. To this family, therefore, belongs the chief credit for the admirable results attained during this, the first stage of the Renaissance. But during the ninth century A. D. men who had not received their professional training at this famous school came to the fore and gave a fresh and a more vigorous impulse to the work than their predecessors had given. Under the Bakhtichous the translating had been well started, and in addition a few original medical treatises had been written in the Arabic language. During the period which followed, however, the translating and copying became more active than before, and, in addition, several really valuable treatises were produced by men who wrote in Arabic, and who were--if not racially Arabs--at least the adopted sons of that nation. Of these men none stands out more prominently than Honein, who, according to Le Clerc, “accomplished a marvellous amount of work of the most varied character and of a very high degree of excellence, and that too despite many obstacles. While he was not the originator of the Renaissance in the East, he took the most active part in keeping it up.”

Honein, who may rightly be considered as having at least inaugurated the second stage of the Arab Renaissance, was born in 809 A. D. at Hira, where his father Isaac, a Christian Arab, conducted a pharmacy. The inhabitants of this town were known to be somewhat lacking in cultivation, and it was therefore not surprising that, when Honein went to Bagdad and presented himself to John, the son of Mesué, as one who wished to become his pupil, his request was promptly declined on the general ground that the people of Hira had not received sufficient education to warrant any one of their number in undertaking the study of medicine. This decision was of course a great disappointment to Honein, but it disturbed him only for a short time. Soon afterward he went to Greece where he worked hard to perfect himself in the knowledge of the Greek language. Then, after a residence of two years in that country, he returned to Bagdad, taking with him a considerable supply of Greek books. His next step was directed toward gaining a better knowledge of Arabic, and with this object in view he spent some time in Bassora, a town which was situated not far to the south of Bagdad, and which possessed good educational facilities. While residing there he devoted a certain portion of his time to the translation of Galen’s treatise on anatomy; and he was accordingly prepared, upon his return to Bagdad, to submit to John, the son of Mesué, and to Gabriel, the son of Bakhtichou (who by that time was well advanced in years), a specimen of the work upon which he had been engaged. Both of these men were greatly pleased with the excellence of the translation, and encouraged Honein to go on with the work. El Mâmoun (the second son of Haroun Alraschid), who was the then reigning Caliph, engaged his services both as a translator of Greek writings (into Syriac as well as Arabic) and as a reviser of the translations which had been made by others, and he paid him most generously for these services. According to Le Clerc, the amount of literary work done by Honein was simply prodigious. He translated large portions of the treatises of Galen, Oribasius and Paulus Aegineta, as well as several of the works of Aristotle and of Plato, of the mathematicians and astronomers, and also of the philosophers; and in addition he wrote a large number of original treatises--such, for example, as a complete set of commentaries on the writings of Hippocrates, a practical work on the diseases of the eyes, etc.

The following account of Honein’s experience at the Court of the Caliph Moutaouakkel (middle of the ninth century A. D.) furnishes some insight into his character:--

The Caliph, who had heard of the great learning, ability, and industry of Honein, but who had at the same time feared that he might be in secret communication with the Greeks, decided to subject him to a test that would reveal how far he was venal. Accordingly he sent for him, clothed him in robes of honor, gave him 50,000 drachmae, and then said:

“I wish that thou wouldst prepare for me a secret combination of drugs which will enable me to get rid of one of my enemies.”

Honein replied: “I have no knowledge of any but salutary remedies, and it never occurred to me that the Prince of Believers might ask me to furnish those of a different kind. However, if it be the wish of your Majesty, I will see what I can do; but I shall require plenty of time.”

After waiting in vain for the desired preparation and finding that even threats failed to accomplish anything the Caliph put Honein in prison. Then, at the end of a year, which interval the latter had employed diligently in the work of translating, Moutaouakkel gave orders for the prisoner to be brought into his presence. Before this was done, however, a heap of objects of value was placed on one side of the room and instruments of torture on the other. When Honein was brought in, the Caliph said to him: “Time is passing, and my wishes have not yet been gratified. If thou art now ready to obey my behest, these treasures and many others in addition shall be thine. But, if thou continuest to refuse, I will subject thee to tortures and will finally put thee to death.”

“I have already told the Prince of Believers,” replied Honein, “that my knowledge is limited to the preparation of salutary remedies.”

Whereupon the Caliph said: “Have no fear! I simply wished to test thee! But tell me, what are the reasons upon which thy refusal is based?”

“There are two reasons,” replied Honein: “my religion and my profession. The first teaches us to do good to our enemies; and the second, not to do any harm to the human race. Every physician has registered an oath that he will never administer a poison.”

“Those are two excellent laws,” remarked the Caliph; and he proceeded to load Honein with presents.

Among those who were associated with Honein in his work of translating Greek medical books into Arabic there are three whose names also deserve to be remembered. They are: his son Isaac; his nephew Hobeïch; and a Christian Greek named Costa ben Luca, whose residence was at Baalbek. To men of the present time all these names of oriental physicians are, as a rule, mere meaningless words, conveying no idea of an important relationship to the evolution of medicine. During the ninth and tenth centuries of the present era, however, and indeed for many years subsequent to that time, they were accorded by the physicians of that period almost as much honor for the part which they took in furthering the revival of medicine among the Arabs as was given to Honein himself. It seems therefore appropriate that at least a brief account of the lives of these men and of the work which they did should be given here.

Isaac received his education from his father Honein, and soon after reaching manhood he was set to work translating from the Greek into both Syrian and Arabic--two sister languages. He was a man of great intelligence, and was thought by many to be the equal of his father in the knowledge of Greek, Syriac and Arabic. He also had, like his father, the good fortune to find favor with the rulers of that period. He died in 912 A. D. as the result of a stroke of cerebral apoplexy. In addition to his translations he wrote original treatises on the following topics:--

Simple Medicaments. Origins of Medicine. Correctives of Purgative Remedies. Treatment by Cutting Instruments. The means of Preserving the Health and the Memory.

Hobeïch was the son of Honein’s sister. The date of his birth is not known. He received his training in the languages from his uncle, and in the course of time became associated with the latter in the work of translating. Eventually he reached his uncle’s high standard of scholarship, and the text of his translations was from that time forth accepted without any revision. The Caliph Moutaouakkel appointed him Court Physician, and the immediate successors of this Caliph retained him in the same position. His death occurred during the second half of the ninth century of the Christian era.

Hobeïch translated the “Oath of Hippocrates” and a large number of the more important of Galen’s treatises. In addition, he left to posterity several original writings. Quotations from these are to be found in the works of Rhazes, of Ebn el Beithar, and of Serapion the Younger, and they reveal two important facts: first, that Hobeïch was an excellent practicing physician; and, second, that the Arabs had already at this comparatively early date begun to gather their medical information from other sources than the Greek treatises. The following drugs, for example, are described by Hobeïch in the quotations just mentioned, and yet they do not appear to have been known to the Greek medical writers: Turbith, Convolvulus of the Nile, Nux Vomica, Colocynth, Croton Tiglium, Aloes and Myrobolans.

Costa, the son of Luca, was a Christian Greek from Baalbek, in Syria. The dates of his birth and death are not known, but it is believed that he lived during the first half of the tenth century of the present era. He was an excellent Greek and Arabic scholar and was also familiar with the Syriac language. His translations were esteemed equal to those of Honein. After spending some time in Greece he settled in Irak, a province of Persia, and devoted himself to the translation of the books which he had brought with him from Greece. At a later period of his life he removed to Armenia, a country which lies to the north of Irak, between it and the Black Sea, and it was during his residence there that he wrote a number of treatises. It was in Armenia, also, so far as may be judged from the accounts which we possess, that his death took place. As an evidence of the fact that he was highly esteemed by his contemporaries, his biographer states that a cupola was built over his tomb.

Among the medical works which he translated from the Greek the following are the only ones of special importance: The Aphorisms of Hippocrates, and Galen’s commentaries upon them.

The ninth century, the period during which the major portion of the work described in the preceding part of this chapter was accomplished, is considered by Lucien Le Clerc the most remarkable in the worlds history. He speaks of it in the following terms:--

Its greatness is emphasized by the fact that, except in this one corner of the globe, everything was in a state of decadence.... Great as is the credit due the Abbaside Dynasty and its ministers, still greater is our admiration for the Arab nation on account of the eagerness with which it met the wishes of its rulers and also because it pursued resolutely, and despite all the obstacles (political and religious) which were placed in its way, the course laid down for it to follow.... The Arabs also knew how to choose men who were really eminent and to rescue them from lives which otherwise would probably have been sterile; they claimed the inheritance of Greek science; and they revealed to the world that they were worthy of this inheritance.

Some idea of the completeness of the list of Greek medical works which the Arabs translated may be gained from the fact that Galen’s writings are more complete in the Arabic than they are in the Greek, the language in which they were originally composed.

With Costa the second stage in the Arab Renaissance came to an end. All the work accomplished at Bagdad up to this period in our history received its inspiration from the different Caliphs belonging to the Abbaside Dynasty. But now the political conditions in the East underwent a change, and other Arabian dynasties, each in its turn, gained control of the power previously wielded by Almansur, Haroun Alraschid and their successors. Fortunately, all of these new rulers seem to have been favorably inclined toward the revival of literature, and consequently the Arabs continued to take an active part in the advance of medical knowledge during the tenth and eleventh centuries. Bagdad, however, ceased to be the centre of all this intellectual activity, and eventually Cordova in Spain almost rivaled the capital of ancient Greece in the eagerness with which she sought to increase her stores of books, and in her readiness to honor scholars. By this time the Arabs controlled, not only Persia and Arabia, but also Egypt, Palestine, Syria, Marseilles, the coast of Asia Minor, Greece, Sicily, the northern part of Africa and Spain. Owing to the limited space at my command I shall be obliged to confine my account to the more salient features of the progress made during this later or third stage of the Arab Renaissance.

Already as early as toward the end of the ninth century the number of physicians in the East had increased so greatly, and the territory where well-educated medical men were to be found had broadened to such an extent, that I shall now be obliged, in order to maintain some approach to chronological order in my account of the evolution of medical science, to treat the subject according to countries. If the men who stand out foremost in this third stage of the scientific renaissance are not in every instance Arabs or Persians or Syrians, I may at least claim that they are the product, directly or indirectly, of the great Arab movement. The countries in which their best work was done are the following: Persia (apart from Bagdad and its immediate neighborhood), Egypt, Magreb (the modern Algiers and Tunis), Fez and Spain. But, before I consider the progress of medicine in these different parts of the Orient, I should say at least a few words about the events which characterized the cessation of literary work at Bagdad. As might be expected, that city, after the Greek medical and scientific treatises had all been translated into Arabic, gradually lost its pre-eminence as a centre of learning, and new centres developed in other cities throughout the vast Musulman Empire. It must not be inferred, however, that this change was wholly or even largely due to the cessation of literary work. Other factors contributed to this result, viz.: the decadence of the caliphate and the fact that the caliphs themselves appeared to lose their interest in promoting the sciences actively. It was not until during the tenth century that any further interest in the advancement of medical science was taken by those in authority at Bagdad. Then the Emir Adhad Eddoula built a splendid hospital, and organized it on the basis of several separate services--one for fever cases, another for accidental injuries, a third for ophthalmic cases, and so on. Twenty-four physicians, who had been selected because of their special aptitude for some particular class of medical work, were appointed to take charge of the different services; and it is interesting to note that nearly all of these men bear Arab names. Nevertheless, for a still further period of many years, says Le Clerc, there continued to be as many Christian as Mohammedan physicians in Bagdad.

In the tenth century other hospitals were established in Bagdad. Thus, in 914 A. D., the Vizir Ali ben Issa founded one which he endowed in the most liberal manner. This Vizir must have been a most humane person, for, when the physician-in-charge wrote to him for further instructions regarding the course which he should pursue with respect to people of different religions, the Vizir replied: “Use the fund for the benefit of all classes alike, and be sure to remember the animals.”

Persia.--Rhazes, whose full name is Abou Beer Mohammed ben Zakarya, is generally admitted to have been the most illustrious of Persia’s physicians, and probably the most distinguished representative of Arab medical learning. He was born at Raj, in the Province of Khorassan, about 850 A. D. After he had received his professional training at Bagdad, he settled at Raj and was soon afterward appointed director of the local hospital. At a later date he was placed in charge of the hospital at Bagdad, but before many months had elapsed he returned to Raj, his native town, and here he spent most of the remaining years of his long life. The date of his death is stated by Haeser as either 923 or 932 A. D., but Le Clerc mentions only the latter date.

Rhazes was a very hard worker and was highly esteemed by his fellow countrymen, who called him the Arabian Galen. The total number of writings which he left behind him at the time of his death was 237, most of them dealing with medical subjects. A few of them, however, were devoted to the discussion of chemical, anatomical and philosophical questions. To-day we possess only 36 of the treatises written by Rhazes, and of this number only six have been printed in Latin. His greatest work, as all critics admit, is that which is commonly known as the “Continens” (or “El Haouy”). In this work, which is divided into twenty-two books, Rhazes gives in a condensed form the views entertained by all his predecessors regarding the more important questions in medical science, and then adds thereto the conclusions which his own experience has led him to form.

He also wrote a second treatise (in ten books) which was esteemed by the physicians of that and later periods almost as highly as the Continens. It was called the “Mansoury,” and its contents are distributed as follows: I., Anatomy; II., the Different Temperaments; III., Alimentary Substances and Drugs; IV., Hygiene; V., Cosmetics; VI., the Regimen to be adopted in Traveling; VII., Surgery; VIII., Poisons; IX., Maladies in General; X., Fevers.

A third treatise of considerable importance is that which is devoted by Rhazes to the description and treatment of small-pox and measles. So far as is known at the present time this is the first treatise that has been written on these diseases, and its celebrity rests, not only upon this circumstance, but also upon the facts that its author is evidently familiar with the different types of small-pox and with the characteristic features which distinguish this disease from measles. Freind, in commenting upon this treatise, says that Rhazes assigned for small-pox a cause “entirely new in physick, a sort of an innate contagion. This is a ferment in the blood, like that in must, which purifies itself sooner or later by throwing off the peccant matter at the glands of the skin; an hypothesis since applied, though upon very slight grounds, to feavers in general by many moderns.” From this account it is fair to conclude that Rhazes, in the tenth century of the Christian era, as clearly suspected the germ origin of certain febrile diseases as Liebermeister did toward the end of the nineteenth, or as Fracastoro did in the sixteenth. And one cannot help exclaiming: How many centuries had to elapse, and what an immense amount of other facts had still to be discovered--facts in anatomy, in physiology, in chemistry, in optics, etc.--before it became possible to convert this suspicion, this simple product of the reasoning faculty, into an actual demonstration of the truth in pathology!

Among the Arabian physicians of the eleventh century Avicenna is certainly one who should be placed in the first rank. He was born in 980 A. D. at Afschena, a village in the Province of Khorassan, Persia, and spent his youth in Bokhara, where his father held some high office under the Government. His great intellectual capacity was revealed at an early age. It is said, for example, that already before he was ten years old he had committed the entire Koran to memory; and it is added, further, that when he was only seventeen years old he had already acquired such knowledge of medicine that he was invited to take part in a consultation regarding some malady with which the Emir Nuch ben Mansur was affected. The advice which he gave on this occasion was followed, and in the sequel it proved so good that he was granted, as a reward, unrestricted access to the royal library,--a privilege which he utilized to the very best advantage. When his father died Avicenna came into possession of a large fortune, which enabled him to indulge in a great deal of traveling. In this way he visited one Persian Court after another throughout a period of several years. Finally, during a residence at Hamadan, the Prince Schems ed-Daula, whom Avicenna had successfully treated for some malady, made him his Vizir. While he held this office he managed, without neglecting his official duties, to continue his scientific studies; but he was not able entirely to keep out of political intrigues, and as a consequence his life was for a short time in some danger. He was confined for several months in a fortress, from which, however, he managed eventually to make his escape to the Court of Ibn Kakujah, in Ispahan. He resided in that city during the following fourteen years, and it was there that he wrote his two principal works--the famous medical treatise known as the “Canon,” and the equally celebrated cyclopaedic work on philosophy. Worn out by his incessant and most exhausting literary labors and by his excesses in other directions, Avicenna died in June, 1037 A. D., while he was accompanying the Emir on his expedition to Hamadan. His tomb may still be seen in the latter city.

Neuburger, from whose excellent History of Medicine the preceding details have been gleaned, makes the statement that the treatise in which Avicenna’s clinical experience was recorded has not come down to our time, and that, consequently, we lack the means of estimating just how great a physician--just how close a clinical observer and how wise a practitioner--he really was. So far, however, as may be judged from the evidence furnished by the Canon, Avicenna was not the equal, in all practical matters relating to medicine, of Haly Abbas and of Rhazes. He was perhaps too much inclined to “look at bedside phenomena through the spectacles of preconceived theories.” In brief, he was, first and foremost, a philosopher, and only in a subordinate degree a physician, although a most excellent one. In Book III., where he discusses certain surgical procedures, statements are made which justify the belief that Avicenna was acquainted with intubation of the larynx.

Le Clerc mentions six other Persians who, during the tenth century of the present era, gained more or less distinction as physicians. In the following paragraphs brief notices are given of each of these men.

Eben el Khammar, born in 942 A. D., was a Christian and an excellent practitioner. He was well versed in the science of medicine and a writer of some importance. Date of death unknown.

Abou Sahl el Messihy, who was also a Christian, was a contemporary and intimate friend of Avicenna. He died in 1000 A. D. He was the author of a complete and very useful summary of medicine, entitled “Kitab el Meya”; and the Arab historian Ossaibiah speaks in terms of admiration of another treatise which he wrote and which bears the title, “Exposition of God’s wisdom as Manifested in the Creation of Man.”

Abou Soleiman Essedjestany, commonly called “El Mantaky.” The dates of his birth and death are not known. He wrote a number of treatises, and--among others--one on “The Organization of the Human Faculties.”

Aboul Hassan Ahmed Etthabary, a native of Thabaristan, in the Province of Khorassan. He was employed as a physician by the Emir Rokn eddoula ben Bouïh, and is known as the author of a compendium of medicine entitled: “Hippocratic Methods of Treatment.” He died in 970 A. D.

El Comry was one of the most eminent medical practitioners of his time, and was in high favor with the royal household. He wrote a compendium of medicine which bears the title “R’any ou Many,” and he was also the author of a treatise on the causes of disease. His death occurred toward the end of the tenth century of the Christian era.

Alfaraby, who is highly commended by Avicenna, should be classed among the philosophers rather than among the physicians. He died in 950 A. D.

The sixth Persian physician of some distinction mentioned by Le Clerc is Ali ben el Abbas--usually spoken of as Haly Abbas. The dates of his birth and death are not stated by any of the authorities, but it is known that he was a native of Ahouaz, a small town on the Karun river, to the southeast of Bagdad, and that he was still living in 994 A. D. Haly Abbas, it is claimed, was the first medical writer who ventured to prepare a complete and systematically arranged Practice of Medicine. He gave it the title of Al-Maleky--“The Royal Book,”--and dedicated it to the Emir Adhad-ad-Daula, whose private physician he was. It is a much smaller treatise than the “Continens” of Rhazes, and somewhat more complete than the same author’s shorter work--the “Mansoury.” It covers the entire field of medicine and is distinguished by its very practical character. It was first translated into Latin in 1127 A. D.

Haly Abbas, in one of his treatises, speaks of Hippocrates in the following terms: “Hippocrates, who is the prince of the medical art and the first physician who ever wrote a book on this art, is the author of many treatises on all sorts of medical topics.... But he writes in such a very concise manner that much of what he says is obscure, and as a consequence the reader, if he wishes to understand him, is obliged to seek the aid of a commentary.”

Egypt.--The dynasty of the Fatimides--the descendants of Fatima (the daughter of Mohammed) and of Ismael, a great-grandson of Ali, the fourth of Mohammed’s successors--reigned over Egypt for nearly two centuries (10th to 12th of the present era), and they showed toward the scientists the same spirit of generosity that had been manifested toward them by the Abbasides in the earlier part of their reign. In 970 A. D. Moëz Eddoula drove out the reigning family, assumed the title of Caliph, and founded the city of Cairo. In 972 he built the celebrated mosque Al Azhar and constructed, as a sort of annex to it, a school, a veritable university, where ultimately all the sciences were taught. It throve vigorously, and students flocked to it in great numbers from all quarters of the Moslem empire. During the eleventh and twelfth centuries Egypt was once more, as it had been in the palmy days of Alexandria, the home of many excellent and vigorous institutions of learning. Among the physicians, however, who received their education in medicine at Cairo during this long period, there was not one who attained great eminence.

At the end of the eleventh century the Crusaders, under the leadership of Godfrey de Bouillon and others, made their first serious attack on Palestine and Syria, and from that time onward, for about two centuries, they and the different armies sent out successively from Europe carried on almost constant warfare, which Michaud the distinguished French historian (about 1800 A. D.) calls the product of a pious delirium. Wars of religion are the most savage and pitiless of all wars, says Le Clerc, and this was emphatically true of those waged by the Crusaders. On the other hand, says the same writer, “the tolerance exhibited at that period by the Arabs in religious matters is a well-attested fact, and it owes its origin to the circumstance that their scientific education was conducted by Christians. Of Saladin’s fifteen physicians two-thirds were either Jews or Christians. Cultivation and good training were the characteristics of the Arabs at that period of their history, whereas fanaticism and brute force were the distinguishing features of the European soldiers. Several hundred thousand adventurers first ravaged Europe and then pounced upon Asia. At Antioch Godfrey de Bouillon committed all sorts of excesses, and then, when he had taken Jerusalem, he massacred 70,000 of its inhabitants--Jews and Musulmans. Eighty years later, Saladin retook Jerusalem; and, with the exception of a comparatively small number, he allowed all of his captives to go free. His brother, Malek el Adel, paid the ransom of 2000 of the prisoners. Contrast these fruits of civilization with the barbarism of the European conquerors under Godfrey de Bouillon. Another result of the Crusades was this: The Franks lost a good deal of their savagery through contact with the Arabs. At a still later period Western Europe drew a large part of her supplies of knowledge from Spain--i.e., from the Musulmans.”

Syria.--In the thirteenth century Damascus, the capital of Syria, assumed considerable importance as a centre of medical activity. Bagdad and Cairo had by this time lost the greater part of their attractiveness for those who wished to perfect their knowledge of the healing art, and the vandalism of the so-called Soldiers of the Cross had put an end for many years to come to all hopes of making Constantinople once more the home of scientific or artistic effort. There was one branch of medical practice, however, in which the Cairo physicians excelled all others--that, namely, of ophthalmology. This is explained by the well-known fact that at all periods of her history Egypt has been afflicted with ophthalmias to a much greater degree than any of the other countries of the Mediterranean basin. The great wealth accumulated in Damascus, the large number of hospitals which were located in the city, and the attractiveness of the town as a place of residence undoubtedly had much to do with the fact that it attained at this period so great popularity as a centre of medical activity.

Spain.--During the tenth century of the present era the Moslem reign in Spain flourished greatly under the two enlightened rulers of the Ommiade Dynasty--Abdurrahman Ennasser and Hakem, and medicine shared fully in this prosperity. During Abdurrahman’s reign the Emperor Romanus at Constantinople sent an embassy to Cordova in Spain, and among the gifts which they took with them for the Prince, was a copy of the treatise of Dioscorides in the original Greek, illustrated by marvelously beautiful paintings of the different medicinal plants. But there was nobody in Cordova at that time who could read Greek. Accordingly, Abdurrahman begged the Emperor to send him a man who was familiar with both the Greek and the Latin tongues, and it was in answer to this request that the monk Nicholas was sent to Cordova (951 A. D.). Working in conjunction with several of the most distinguished physicians of that city he succeeded in identifying nearly all of the plants mentioned by Dioscorides.

Among the physicians of Arab, Persian or Jewish extraction who, during the eleventh and twelfth centuries, practiced their profession in Spain and attained considerable celebrity, the following deserve to receive special mention here: Abulcasis, Avenzoar, Averroes and Maimonides.

Abulcasis.--Abulcasis is universally credited with being the greatest surgeon of whom the Arabs may rightfully boast. He was born at Zahra near Cordova in 936 A. D., and his death occurred 1013 A. D. Quite early in his professional career (before he had reached his twenty-fifth year) he was appointed one of Abdurrahman’s private physicians. Although he owes his reputation chiefly to the treatises which he wrote on surgery Abulcasis was also the author of several medical works. He published a collection of all his writings under the title of “The Tesrif,” which is divided into thirty parts or books, and which--according to Lucien Le Clerc--constitutes a veritable encyclopaedia. During the course of the twelfth century Gerard of Cremona translated into Latin the part relating to surgery; it is not known at what time or by whom the remainder of the collection was translated. The author’s name in the Latin edition is given, not as Abulcasis, but as Alsaharavius.

During the lifetime of Abulcasis his writings, and especially his work on surgery, were not very highly appreciated in Spain. This was largely due to the fact that the Mohammedan inhabitants of that country did not look upon surgery with any degree of favor. The Arabs of the East held Abulcasis in much greater honor. Guy de Chauliac, the famous French surgeon of the fourteenth century, in his treatise on surgery, quotes Abulcasis no less than two hundred times. Le Clerc, in the course of his remarks upon the value of the surgical treatise written by Abulcasis, says: “This book will always be considered, in the history of medicine, to represent the first formal and distinct scientific treatise on surgery.” At the same time, the prevailing testimony makes it appear that the book contains only a small portion of original matter, a large part of its substance having been borrowed from the work of the Greek author, Paulus Aegineta. Its chief merit consists in the orderly and very clear manner in which the facts are presented, and doubtless the popularity of the book was materially increased by the fact that many of the instruments required for the different operations were illustrated pictorially.

Lucien Le Clerc has published (Paris, 1861) a French translation of Abulcasis’ Treatise on Surgery, and on page 71 of this version the following statement will be found:--

... you may also introduce into the cannula a specially adapted piston in copper, or a stylet the end of which is armed with cotton. Then fill the cannula with oil or some other suitable fluid, introduce into one end the stylet armed with cotton, and push it onward until the liquid enters the ear.

Edouard Nicaise, commenting on these words in his version of Guy de Chauliac’s La Grande Chirurgie (page 690), says that they constitute the first reference, thus far discovered in medical literature, to the use of the instrument known as a syringe.

Avenzoar.--Avenzoar was born in Seville, in the southern part of Spain, during the latter part of the eleventh century. The exact date is not known. His father was a physician of some distinction, and his son also attained considerable eminence in the same profession. According to Neuburger, Avenzoar died, at an advanced age, in 1162 A. D., and was buried in Seville.

It is said that in actual practice Avenzoar, who was a man of some wealth, confined himself to consultation work. He considered it beneath the dignity of a physician to prepare drugs, to apply leeches, or to perform certain surgical operations--as, for example, lithotomy; but Le Clerc seems disposed to believe that Avenzoar did not adopt this view until after he had become somewhat celebrated and had accumulated a fortune. Neuburger ranks him next to Rhazes as a clinical observer and a practitioner of sound common sense, and he speaks of his great medical work, the Teïssir, as a treatise that abounds in most interesting histories of cases of disease. Among these will be found the account of an attack of mediastinitis which occurred in his own person, and which ended in suppuration that found a vent for its products by way of one of the bronchi. As this disease is of rare occurrence, and as Freind’s account of the attack is presumably a translation of the original report in Arabic made by Avenzoar, its reproduction here may be interesting. I shall take the liberty of modernizing the text very slightly and of abbreviating it in one or two places.

I felt some pain in the region of the mediastinum (the membrane which divides the thorax in the middle) while I was on a journey. As it increased a cough developed, and I observed that my pulse was very hard and that I had an acute fever. On the fourth night I took away a pint of blood, but this gave me very little relief. Being obliged to travel all day I was much fatigued when I retired at night, and I fell asleep. During my sleep the bandage on the arm came off, and when I awoke I found the bed deluged with blood and my strength greatly exhausted. The next day I began to cough up a sanious matter, and my mind wandered at times. Gradually all the symptoms subsided and I recovered my health. Although I partook of large quantities of barley water, I believe that my recovery was not due to this, but rather to the great loss of blood which I had experienced.

Freind adds that “Avenzoar not only takes notice of an abscess in the mediastinum, but in the pericardium likewise; which I don’t find had been described or even observed by any of the Greeks or Arabians: and there is no doubt but this membrane and the mediastinum to which it is contiguous, are subject, as well as the pleura and lungs, to an inflammation.”

It is one of the distinguishing features of Avenzoar’s character that, in his writings, he does not hesitate to differ from his predecessors whenever he believes that their views are erroneous.

Averroes.--Averroes was one of Avenzoar’s most distinguished pupils. Indeed, the latter’s famous work, the Teïssir, is dedicated to Averroes. Thanks to the distinguished French historian and philosopher, Ernest Renan, our knowledge of Averroes has been greatly expanded since 1852. Averroes was born at Cordova in 1126 A. D. His father and his grandfather had both held the office of Cadhi (Alcalde, in Spanish), and were therefore people of importance in that city. His studies were confined at first largely to philosophy, and when he reached mature age he gained a great reputation as the commentator and interpreter of the writings of Aristotle. Still later in life much of his attention was devoted to medicine, and he wrote a book which bears the title “Kitab al-kullidschat” (General principles of Medicine). Among the physicians of the later Middle Ages this work was commonly spoken of as the “Colliget” (from kullidschat), and was almost as highly esteemed as the Canon of Avicenna. The idea of writing a treatise on the individual diseases was first entertained, among Arabian physicians, by Averroes; but on reflection he abandoned the idea, and, instead, urged Avenzoar, his friend and former instructor, to undertake the work in his place. It was in this way that the Teïssir--the finest work on the practice of medicine produced by an Arab writer--came to be written.

The topics treated in the “Colliget” are distributed throughout the seven books in the following manner:--