Medicine in the Golden Age of Islam

10th Century

At the height of the Islamic Golden Age in Al-Andalus, in the 10th Century Abu al-Qasim Khalaf ibn al-Abbas Al-Zahrawi an Arab physician, surgeon, chemist, ophthalmologist and dentist lived (936-1036). He is often referred to as Abulcasis in Europe or as the father of Modern Surgery.

Little is known on Abulcasis's life but his most notable and only work is Kitab Al-Tasrif Latinised as Concessioei data qui componerehaud valet is the reason he became well known. The book is a medical encyclopaedia split into 30-volumes and is believed to have been completed in the early 11th century. The book became a standard reference in Islamic and European medicine for over 500 years for many medical students. Since each volume is independent of the one before many people believed he had more than one book. This was a popular thought as the last few volumes were very popular for those interested in medicine where it contained his main findings compared to the first few volumes which had some content from the works of Hippocrates and Galen.

In the first two volumes Abulcasis classifies 325 diseases discussing their symptoms and treatments. This includes being the first ever person to describe the disease haemophilia and its hereditary nature as he told and described how unaffected women transmit the disease to their male children who died from uncontrolled bleeding after trauma.

In pharmacy and pharmacology, Al-Zahrawi pioneered the preparation of medicines by sublimation and distillation. He dedicated the 28th chapter of his book to pharmacy and pharmaceutical techniques. The chapter was later translated into Latin under the title of Liber Servitoris, where it served as an important source for European herbalists and botanists. The book is of particular interest, as it provides the reader with recipes and explains how to prepare the "simples" from which were compounded the complex drugs then generally used.

The 30th volume consisted of 300 pages which solely focused devoted to surgery. It was the first of its kind which contained various branches of surgery which were developed by Abulcasis ranging dentistry to ophthalmology and general surgery, obstetrics and gynaecology. This volume is a direct reason that Abulcasis managed to obtain the title of The Father of Modern Surgery.

Using Kitab Al-Tasrif as a confirmation, it is evident that Abulcasis was the first to use cotton in surgical dressings, in the control of haemorrhage and as padding in the splinting of fractures. This was very effective as cotton fibres are very good absorbents which are needed especially in surgery to prevent leaking blood. He also was the first to use cautery, wax and alcohol to control bleeding from the skull during cranial surgery which was a very difficult operation at the time.

In terms of surgery, he described the ligature of arteries before Ambrose Pare and described the tracheotomy operation as he performed it as an emergency on a female servant that attempted suicide by cutting her throat, thus proving that a cut in the larynx could heal. He also was the first surgeon to describe ectopic pregnancy even though he may have been indirect.

The importance of a doctor-patient relationship was a very vital subject that was emphasised in the book. Abulcasis disregarded social status of patients as each patient was equal as well as an individual case, that should be taken into consideration to make the most accurate and best possible diagnosis. This was also highlighted as Abulcasis emphasised the importance of anatomy as a fundamental condition especially in cases that required surgery.

His book was also the first of its kind documenting several dental procedures. He wrote an orthodontic and described how to treat misaligned teeth (figure X on left). He used gold and silver wires to ligate loosened teeth. It is also evident that he invented equipment to scale calculus from teeth as a prevention from periodontal disease (figure X on right).

Considering that Kitab al-Tasrif covered a broad range of medical topics that spanned over almost 50 years, it is therefore, no surprise that Abulcasis had devised a range of instruments covering a range of purposes. In fact, about 200 instruments were illustrated and described in Kitab Al-Tasrif by Abulcasis having no similarity with surviving Greek-Roman instruments to which we have currently have access to. Many of these tools were copied in following centuries such as the cataract needle and obstetric tools. Other tools and instruments were developed such as an early version of the inhaler (figure X on right).

Considering that Abulcasis specialised in curing disease by cauterization. The devices he invented were focused on making it easier for inspection. This encouraged him to create devices to inspect and apply his knowledge in the removal of foreign bodies through body organs such as the throat and ears.

Al-Tasrif had a large impact considering that it was an accumulated encyclopaedia of knowledge. After it's translation into Latin by Gerard of Cremona in the 12th century it was used as a primary source for European medical knowledge and served as a reference for doctors and surgeons worldwide for approximately five centuries during the European Middle Ages. This is quite evident as the French surgeon Guy de Chauliac quoted al-Tasrif over 200 times in the 14th century in his book The Great Surgery. Abulcasis's influence extended till renaissance verified by the sixteenth of the French surgeon Jaques Delechamps, extensive use of Kitab Al-Tasrif in his elaborate commentary, confirming the tremendous contributions of Abulcasis's in the field of surgery.