Medieval Islamic Medicine
Peter E. Pormann + Emilie Savage-Smith
Edinburgh University Press 2007
Medieval Islamic Medicine is more a long essay than a comprehensive survey, but it makes good use of details, with quotes and excerpts and a few illustrations, to put some flesh on the skeleton. It discusses sources and problems of evidence as well as using modern studies, but doesn't go into textual or archaeological details.
Islamic medicine had its fundamental source in Greek medicine, in some cases mediated through or augmented by Sasanian and Syriac traditions, along with some Arabian and Indian and Chinese influences. Translations played a key role in shaping these, especially Graeco-Arabic translations, sometimes via Syriac; these reached their peak with the master-translator Hunayn ibn Ishaq.
"The omnipresence of Arabic as the lingua franca of science in large parts of the Muslim world might also explain why so few medical works in Syriac survive today. One could even say that Hunayn himself created the conditions for the loss of his own Syriac versions. The vast corpus of Greek medical texts in Arabic proved so popular and influential that interest in Syriac works waned. Hunayn operated in a world in which Greek medical and philosophical thought dominated; the interest of the age, however, was not limited to Greek ideas, but also extended to other cultural traditions."
So Islamic medical theory was largely taken from the Greeks, in particular Galen. It built on a core theory of humoral pathology, within a holistic approach emphasizing regimen and nutrition, and incorporated pharmacology, diseases, surgery, and ophthalmology. Theory was not always reflective of practice, however, and some procedures were possibly never carried out.
"Despite less than enthusiastic reception in Muslim Spain, it was the Canon of Ibn Sina that came to dominate in the medieval Islamic world and eventually in Europe as well. ... Numerous abridgements of the Canon were produced to make the ideas more readily accessible, as well as commentaries to clarify the contents."
Turning to the social context of medical practice, a chapter covers the education and regulation of physicians, the geography of medical treatment in markets, hospitals and private houses, and topics such as ethics, charlatans, women as practitioners and patients, rural areas, public health and the state, and Christians and Jews.
"the medieval Islamic hospital was a more elaborate institution with a wider range of functions than the earlier poor and sick relief facilities offered by some Christian monasteries and hospices. The care for the insane in hospitals was unprecedented and an important part of even the earliest Islamic hospitals."
Evidence for medical practice comes from a few case histories and clinical notes, along with incidental references or depictions in other sources. It appears that "the first line of treatment for virtually all complaints was diet and regimen", but treatments included drug therapy, bloodletting and cauterisation, trachoma and eye surgery, cataract surgery, and anaesthesia and antisepsis. The removal of cataracts using a hollow needle illustrates the problems of evidence.
"conflicting evidence regarding the removal of cataracts by a hollow needle is difficult to interpret, but at the very least we can say that the operation was rarely, if ever, undertaken and then probably unsuccessfully."
Alongside the scholarly medical tradition there was a thriving popular tradition, which involved amulets and talismans, magical methods, and astrology and divination, as well as Prophetic Medicine. The surviving artifacts, however, suggest there was a divide between theory and practice here as well.
"It is evident from both written sources and preserved artifacts of the material culture that, throughout the medieval Islamic world, people of all classes and all religious persuasions had frequent recourse to magical therapy, often turning to the preventive and curative power of talismans, amulets, and other magical equipment."
"Virtually none of the artifacts preserved today were actually based on the detailed instructions presented in the popular medieval treatises."
Islamic medicine had a huge influence on Europe, which persisted longer than is often thought. Despite the Renaissance emphasis on original Greek texts, "not only medical theory and learning, but also practice, continued to be informed and defined by a Galenism in Latino-Arabic garb. Ibn Sina's Canon, for instance, dominated the medical discourse and was printed in various forms at least sixty times between 1500 and 1674." Medieval traditions continued directly under the Ottomans, though they faced the gradual intrusion of European ideas. And in India and Pakistan "Unani medicine" persists and is recognised by governments alongside Ayurvedic and Western traditions.
Each chapter is fully referenced with endnotes, but also contains a brief "Suggested Reading" guide. Medieval Islamic Medicine could be used as the core of a university course or as an introduction for the lay reader.