al-Zahrawi

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Not to be confused with Al-Qaeda terrorist Ayman al-Zawahiri (1951–2022).

Abū al-Qāsim al-Zahrāwī
أبو القاسم الزهراوي
Abu Muhammad bin Hazm, Guy de Chauliac, Jacques Daléchamps

Abū al-Qāsim Khalaf ibn al-'Abbās al-Zahrāwī al-Ansari

Arabic: أبو القاسم خلف بن العباس الزهراوي;‎ 936–1013), popularly known as al-Zahrawi (الزهراوي), Latinised as Albucasis or Abulcasis (from Arabic Abū al-Qāsim), was a physician, surgeon and chemist from al-Andalus.[2] He is considered one of the greatest surgeons of the Middle Ages.[3][4]

Al-Zahrawi's principal work is the Kitab al-Tasrif, a thirty-volume encyclopedia of medical practices.[5] The surgery chapter of this work was later translated into Latin, attaining popularity and becoming the standard textbook in Europe for the next five hundred years.[6] Al-Zahrawi's pioneering contributions to the field of surgical procedures and instruments had an enormous impact in the East and West well into the modern period, where some of his discoveries are still applied in medicine to this day.[7] He pioneered the use of catgut for internal stitches, and his surgical instruments are still used today to treat people.

He was the first physician to identify the hereditary nature of

plastic surgeon.[8]

Biography

Al-Zahrawi was born in the city of

Arabian peninsula.[2]

He lived most of his life in Cordoba. It is also where he studied, taught and practiced medicine and surgery until shortly before his death in about 1013, two years after the sacking of Azahara.

Few details remain regarding his life, aside from his published work, due to the destruction of El-Zahra during later Castillian-Andalusian conflicts. His name first appears in the writings of

al-Ḥumaydī
's Jadhwat al-Muqtabis (On Andalusian Savants), completed six decades after al-Zahrawi's death.

Al-Zahrawi was a court physician to the

al-Majriti and Artephius. He devoted his entire life and genius to the advancement of medicine as a whole and surgery in particular. As a court physician, Zahrawi had access to the most advanced medical knowledge and resources of the time, allowing him to develop new techniques and instruments for surgical procedures. Zahrawi's time as a court physician to Al-Hakam II allowed him to develop his skills and knowledge as a physician and surgeon, and to make significant contributions to the field of medicine. His work helped to lay the foundation for modern surgical techniques and has had a lasting impact on the practice of medicine.[10][11]

Surgical career

Al-Zahrawi specialized in curing disease by

cannulae and the first to treat a wart with an iron tube and caustic metal as a boring instrument.[12]

While al-Zahrawi never performed the surgical procedure of tracheotomy, he did treat a slave girl who had cut her own throat in a suicide attempt. Al-Zahrawi sewed up the wound and the girl recovered, thereby proving that an incision in the larynx could heal. In describing this important case-history he wrote:[13]

A slave-girl seized a knife and buried it in her throat and cut part of the

laryngotomy
is not dangerous.

Al-Zahrawi also pioneered

hydrocephalic children.[14]

Kitab al-Tasrif

Main article:
Kitab al-Tasrif
Two pages from the Arabic manuscript of the Kitab al-Tasrif. Middle East, 13th century, Chester Beatty Library.
Frontispiece of the Latin translation of al-Zahrawi's Kitab al-Tasrif.

Al-Zahrawi's thirty-volume medical encyclopedia, Kitāb al-Taṣrīf, completed in the year 1000, covered a broad range of medical topics, including on

orthopaedics, ophthalmology, pharmacology, nutrition, dentistry, childbirth, and pathology.[15]
The first volume in the encyclopedia is concerned with general principles of
drugs. The last treatise and the most celebrated one is about surgery. Al-Zahrawi stated that he chose to discuss surgery in the last volume because surgery is the highest form of medicine, and one must not practice it until he becomes well-acquainted with all other branches of medicine
.

The work contained data that had accumulated during a career that spanned almost 50 years of training, teaching and practice. In it he also wrote of the importance of a positive

doctor-patient relationship
and wrote affectionately of his students, whom he referred to as "my children". He also emphasized the importance of treating patients irrespective of their social status. He encouraged the close observation of individual cases in order to make the most accurate diagnosis and the best possible treatment.

Not always properly credited, modern evaluation of Kitab al-Tasrif manuscript[16] has revealed on early descriptions of some medical procedures that were ascribed to later physicians.[17] For example, Al-Zahrawi's Kitab al-Tasrif described both what would later become known as "Kocher's method" for treating a dislocated shoulder and "Walcher position" in obstetrics. Moreover, the Kitab al-Tasrif described how to ligature blood vessels almost 600 years before Ambroise Paré, and was the first recorded book to explain the hereditary nature of haemophilia.[7] It was also the first to describe a surgical procedure for ligating the temporal artery for migraine, also almost 600 years before Pare recorded that he had ligated his own temporal artery for headache that conforms to current descriptions of migraine.[18] Al-Zahrawi was, therefore, the first to describe the migraine surgery procedure that is enjoying a revival in the 21st century, spearheaded by Elliot Shevel a South African surgeon.

On Surgery and Instruments

Page from a 1531 Latin translation by Peter Argellata of Al-Zahrawi's treatise on surgical and medical instruments.

On Surgery and Instruments is the 30th and last volume of the Kitab al-Tasrif. It was without a doubt his most important work and the one which established his authority in Europe for centuries to come. On Surgery and Instruments is the first illustrated surgical guide ever written. Its contents and descriptions has contributed in many technological innovations in medicine, notably which tools to use in specific surgeries. In his book, al-Zahrawi draws diagrams of each tool used in different procedures to clarify how to carry out the steps of each treatment. The full text consists of three books, intended for medical students looking forward to gaining more knowledge within the field of surgery regarding procedures and the necessary tools.

The book was translated into Latin in the 12th century by Gerard of Cremona. It soon found popularity in Europe and became a standard text in all major Medical universities like those of Salerno and Montpellier.[19] It remained the primary source on surgery in Europe for the next 500 years, and as the historian of medicine, Arturo Castiglioni, has put it: al-Zahrawi's treatise "in surgery held the same authority as did the Canon of Avicenna in medicine".[20]

Al-Zahrawi claims that his knowledge comes from careful reading of previous medical texts as well as his own experience: “...whatever skill I have, I have derived for myself by my long reading of the books of the Ancients and my thirst to understand them until I extracted the knowledge of it from them. Then through the whole of my life I have adhered to experience and practice... I have made it accessible for you and rescued it from the abyss of prolixity".[21]

In the beginning of his book, al-Zahrawi states that the reason for writing this treatise was the degree of underdevelopment

anatomical knowledge and a misunderstanding of the human physiology
.

He who devoted himself to surgery
must be versed in the science of
anatomy.[22]

al-Zahrawi,

Kitab al-Tasrif
.

Noting the importance of anatomy he wrote:[23]

"Before practicing surgery one should gain knowledge of anatomy and the function of organs so that he will understand their shape, connections and borders. He should become thoroughly familiar with nerves muscles bones arteries and veins. If one does not comprehend the anatomy and physiology one can commit a mistake which will result in the death of the patient. I have seen someone incise into a swelling in the neck thinking it was an abscess, when it was an aneurysm and the patient dying on the spot."

In

lithotrite which he called "Michaab", he was able to crush the stone inside the bladder without the need for a surgical incision.[24] His technique was important for the development of lithotomy
, and an improvement over the existing techniques in Europe which caused severe pain for the patient, and came with high death rates.

In

periodontics, al-Zahrawi had the most significant contribution out of all Muslim physicians, and his book contained the earliest illustrations of dental instruments. He was known to use gold and silver wires to ligate loosened teeth,[25] and has been credited as the first to use replantation in the history of dentistry.[26][27] He also invented instruments to scale the calculus from the teeth, a procedure he recommended as a prevention from periodontal disease.[28]

Surgical instruments described by al-Zahrawi.

Al-Zahrawi introduced over 200

specula, and also instruments designed for his favoured techniques of cauterization and ligature. He also invented hooks with a double tip for use in surgery. Many of these instruments were never used before by any previous surgeons.[29]

His use of catgut for internal stitching is still practised in modern surgery. The catgut appears to be the only natural substance capable of dissolving and is acceptable by the body. An observation Al-Zahrawi discovered after his monkey ate the strings of his oud. Al-Zahrawi also invented the forceps for extracting a dead fetus, as illustrated in the Kitab al-Tasrif.[30]

Tone

Albucasis blistering a patient in the hospital at Cordova.

Throughout the text, Al-Zahrawi assumes an authoritative tone. In "On

numbness", he declares the procedure "should not be attempted except by one who has a good knowledge of the anatomy of the limbs and of the exits of the nerves that move the body".[31] He warns that another procedure should not be attempted by any surgeon lacking "long training and practice in the use of cautery".[32] He is not afraid to depart from old practice, disparaging the opinions that cauterization should only be used in the spring[33] or that gold is the best material for cauterization: "cauterization is swifter and more successful with iron".[34] In "On cauterization for pleurisy", he notes that the introduction of a red-hot probe into the intercostal space to evacuate pus from an abscess could result in the creation of "an incurable fistula" or even the immediate death of the patient.[35]

Pharmacology and Cosmetics

In

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. 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.[36][37][38]

Al-Zahrawi also touched upon the subject of

aromatics and incense. He also invented a perfumed sticks rolled and pressed in special molds, perhaps the earliest antecedents of present-day lipsticks and solid deodorants.[40]

Legacy

Albucasis street at Cordova
.

Al-Zahrawi was the "most frequently cited surgical authority of the Middle Ages".[41] Donald Campbell, a historian of

Arabic medicine, described Al-Zahrawi's influence on Europe as follows:[42]

The chief influence of Albucasis on the medical system of Europe was that his lucidity and method of presentation awakened a prepossession in favour of Arabic literature among the scholars of the West: the methods of Albucasis eclipsed those of Galen and maintained a dominant position in medical Europe for five hundred years, i.e long after it had passed its usefulness. He, however, helped to raise the status of surgery in Christian Europe; in his book on fractures and luxations, he states that 'this part of surgery has passed into the hands of vulgar and uncultivated minds, for which reason it has fallen into contempt.' The surgery of Albucasis became firmly grafted on Europe after the time of Guy de Chauliac (d.1368).

In the 14th century, the

French surgeon Guy de Chauliac quoted al-Tasrif over 200 times. Pietro Argallata (d. 1453) described Al-Zahrawi as "without doubt the chief of all surgeons". Al-Zahrawi's influence continued for at least five centuries, extending into the Renaissance, evidenced by al-Tasrif's frequent reference by French surgeon Jacques Daléchamps (1513–1588).[43]

The street in Córdoba where he lived is named in his honor as "Calle Albucasis". On this street he lived in house no. 6, which is preserved today by the Spanish Tourist Board with a bronze plaque (awarded in January 1977) which reads: "This was the house where Al-Zahrawi lived."

De Chirurgia gallery

See also

Wikisource has the text of the 1911 Encyclopædia Britannica article "Abu-l-Qasim".

Notes

  1. ^ Hamarneh, Sami Khalaf; Sonnedecker, Glenn Allen (1963). A Pharmaceutical View of Abulcasis Al-Zahrāwī in Moorish Spain: With Special Reference to the "Adhān,". Brill Archive. p. 15.
  2. ^ a b Hamarneh, Sami Khalaf; Sonnedecker, Glenn (1963). A Pharmaceutical View of Abulcasis Al-Zahrāwī Moorish Spain: With a Special Reference to the "Adhān". Brill Archive. p. 15."Al-Zahrawi's ancestry then, one might infer, goes back to the Arabian Peninsula, to the inhabitants of "al-Madinah," the first city that accepted the message of Islam."
  3. ^ *Meri, Josef W. (2005). Medieval Islamic Civilization: An Encyclopedia. Routledge. p. 783."The greatest surgeon of the medieval ages was Abu'l-Qasim az Zahrawi (d. 1010), a most important representative of the Andalusian school."
    • Weinberg, Steven (2015). To Explain the World: The Discovery of Modern Science. Penguin Books Limited."al-Zahrawi (Abulcasis) was born in 936 near Cَrdoba, the metropolis of Andalusia, and worked there until his death in 1013. He was the greatest surgeon of the Middle Ages, and highly influential in Christian Europe."
    • Gerli, E. Michael (2017). Routledge Revivals: Medieval Iberia (2003): An Encyclopedia. Routledge. p. 12."Book 30, on surgery, was translated in the twelfth century by Gerard of Cremona (Liber Alsahravi de cirurgia) and it established the reputation of Abulcasis as the greatest surgeon of the Middle Ages."
  4. ^ Krebs, Robert E. (2004). Groundbreaking Scientific Experiments, Inventions, and Discoveries of the Middle Ages and the Renaissance. Greenwood Publishing Group. p. 95." Al-Zahrawi (930 or 963–1013 C.E.), also known as Abu-Al Quasim Khalaf ibn'Abbas al-Zahrawi, was a court physician.
  5. ISBN 978-0-520-01532-6
    .
  6. ^ "Abū al-Qāsim | Muslim physician and author". Encyclopedia Britannica.
  7. ^
    ISBN 978-0-8160-4887-8
    .
  8. S2CID 57308997
    .
  9. ^ Hamarneh, Sami Khalaf; Sonnedecker, Glenn (1963). A Pharmaceutical View of Abulcasis Al-Zahrāwī Moorish Spain: With a Special Reference to the "Adhān". Brill Archive. p. 15"The incipit to the seventeenth treatise in these manuscripts gives al–Zahrawi the additional title of "al–Ansari," the physician. From this, one could infer that al–Zahrawi is the scion of "al–Ansar, the people of "al–Madinah". and hence the nickname "al–Ansari.".
  10. ^ Azzedine M. Layachi, Abulcasis: The Father of Modern Surgery, The Muslim World, Vol. 89, No. 2 (April 1999), pp. 91-105.
  11. ^ Michael H. Morgan, Lost History: The Enduring Legacy of Muslim Scientists, Thinkers, and Artists, National Geographic Society, 2007, pp. 42-45
  12. S2CID 3121262
    .
  13. ^ Rāshid, Rushdī; Morelon, Régis (1996). Encyclopedia of the History of Arabic Science: Technology, alchemy and life sciences. CRC Press. p. 945.
  14. S2CID 10077885
    .
  15. ^ "Theoretical and Practical Book by Al-Zahrawi". 1519.
  16. ^ "Al-tasreef liman ajiza an al-taaleef (The method of medicine)" (in Arabic). 1699.
  17. ^ Karagِzoğlu, Bahattin (2017). Science and Technology from Global and Historical Perspectives. Springer. p. 155."This last volume is a surgical manual describing surgical instruments, supplies, and procedures. Scholars studying this manual are discovering references to procedures previously believed to belong to more modern times."
  18. S2CID 12318511
    .
  19. ^ Fleischer, Aylmer von. Moorish Europe. Aylmer von Fleischer."His work, Al-Tasrif, later translated into Latin by Gerard of Cremona, became the standard medical text for European Universities such as those at Salerno and Montpellier. This work was widely used by European medical practitioners for centuries."
  20. ^ Castiglioni, Arturo (1958). A history of medicine. A. A. Knopf. p. 274."Abulcasis (Alsaharavius or Abu'l-Qasim) (d. c. 1013) was the author of a surgical treatise which in surgery held the same authority as did the Canon of Avicenna in medicine."
  21. ^ Abū Al-Qāsim Khalaf Ibn ʾabbās Al-Zahrāwī. Albucasis on Surgery and Instruments. Berkeley: University of California Press, 1973. (676)
  22. ^ "Abulcasis, the pharmacist surgeon | Hektoen International". hekint.org. 22 January 2017.
  23. ^ Selin, Helaine (2008). Encyclopaedia of the History of Science, Technology, and Medicine in Non-Western Cultures. Springer Science & Business Media. p. 1545.
  24. ISBN 978-0-398-04374-2
    .
  25. Turfa, Jean MacIntosh
    (2017). The Etruscans and the History of Dentistry: The Golden Smile Through the Ages. Taylor & Francis. p. 146.
  26. ^ Ingle, John Ide; Baumgartner, J. Craig (2008). Ingle's Endodontics. PMPH-USA. p. 1281."The individual first credited with the principle of extraction and replantation was an Arabian physician by the name of Abulcasis who practiced in the eleventh century."
  27. ^ Ingle, John Ide; Bakland, Leif K. (2002). Endodontics. PMPH-USA. p. 727."Abulcasis, an Arabian physician practicing in the eleventh century, is the first credited with recording the principle of extraction/replantation."
  28. ^ Andrews, Esther K. (2007). Practice Management for Dental Hygienists. Lippincott Williams & Wilkins. p. 6."Abu al-Qasim, also known as Abulcasis, wrote an encyclopedia of medicine and surgery (al-Tasrif) that is now kept at Oxford University. His unique contribution to dentistry reported the relationship between calculus and periodontal disease. He promoted prevention by recommending scaling calculus above and below the gums until all accretions were removed even if it takes multiple visits."
  29. ^
    ISBN 978-1-86094-462-8
    .
  30. ^ Ingrid Hehmeyer and Aliya Khan (2007). "Islam's forgotten contributions to medical science", Canadian Medical Association Journal 176 (10).
  31. ^ Abū Al-Qāsim Khalaf Ibn ʾabbās Al-Zahrāwī. Albucasis on Surgery and Instruments. Berkeley: University of California Press, 1973. (146)
  32. ^ Abū Al-Qāsim Khalaf Ibn ʾabbās Al-Zahrāwī. Albucasis on Surgery and Instruments. Berkeley: University of California Press, 1973. (8)
  33. ^ Abū Al-Qāsim Khalaf Ibn ʾabbās Al-Zahrāwī. Albucasis on Surgery and Instruments. Berkeley: University of California Press, 1973. (10)
  34. ^ Abū Al-Qāsim Khalaf Ibn ʾabbās Al-Zahrāwī. Albucasis on Surgery and Instruments. Berkeley: University of California Press, 1973. (14)
  35. ^ Abū Al-Qāsim Khalaf Ibn ʾabbās Al-Zahrāwī. Albucasis on Surgery and Instruments. Berkeley: University of California Press, 1973. (90)
  36. ^ Levey M. (1973), Early Arabic Pharmacology, E. J. Brill, Leiden.[page needed]
  37. ^ A Pharmaceutical View of Abulcasis Al-zahrawi in Moorish Spain. Brill Archive. 1963. p. 19.
  38. ^ See:Luisa Arvide
  39. ^ Epstein, Samuel; Fitzgerald, Randall (2011). Healthy Beauty: Your Guide to Ingredients to Avoid and Products You Can Trust. BenBella Books, Inc.
  40. ^ Snodgrass, Mary Ellen (2015). World Clothing and Fashion: An Encyclopedia of History, Culture, and Social Influence. Routledge. p. 153.
  41. ISBN 978-1-59884-337-8
    .
  42. ISBN 978-0-415-24462-6
    .
  43. ISBN 978-0-262-58063-2
    .

Sources

External links

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