"The aim of this paper is to prove that the Islamic Medicine was 1000 years ahead of its times. The paper covers areas such as medical education, hospitals, bacteriology, medicine, anesthesia, surgery, ophthalmology, pharmacy, and psychotherapy.



by Ibrahim B. Syed. Edited by Shahid Athar, M. D.

Within a century after the death of Prophet Muhammad (peace be upon him) the Muslims not only conquered new lands, but also became scientific innovators with originality and productivity. They hit the source ball of knowledge over the fence to Europe. By the ninth century, Islamic medical practice had advanced from talisman and theology to hospitals with wards, doctors who had to pass tests, and the use of technical terminology. The then Baghdad General Hospital incorporated innovations which sound amazingly modern. The fountains cooled the air near the wards of those afflicted with fever; the insane were treated with gentleness; and at night the pain of the restless was soothed by soft music and storytelling.

The prince and pauper received identical attention; the destitute upon discharge received five gold pieces to sustain them during convalescence. While Paris and London were places of mud streets and hovels, Baghdad, Cairo and Cardboard had hospitals open to both male and female patients; staffed by attendants of both sexes. These medical centers contained libraries pharmacies, the system of interns, externs, and nurses. There were mobile clinics to reach the totally disabled, the disadvantaged and those in remote areas. There were regulations to maintain quality control on drugs. Pharmacists became licensed professionals and were pledged to follow the physician's prescriptions. Legal measures were taken to prevent doctors from owning or holding stock. in a pharmacy.

The extent to which Islamic medicine advanced in the fields of medical education, hospitals, bacteriology, medicine, anesthesia, surgery, pharmacy, ophthalmology, psychotherapy and psychosomatic diseases are presented briefly.

INTRODUCTION Prophet Muhammad (peace be upon him) who is ranked number one by Michael Hart, a Jewish scholar, in his book The 100: The Most Influential Persons in History, was able to unite the Arab tribes who had been tom by revenge, rivalry, and internal fights, and produced a strong nation acquired and ruled simultaneously, the two known empires at that time, namely the Persian and Byzantine Empires. The Islamic Empire extended from the Atlantic Ocean on the West to the borders of China on the East. Only 80 years after the death of their Prophet, the Muslims crossed to Europe to rule Spain for more than 700 years.

The Muslims preserved the cultures of the conquered lands. However when the Islamic Empire became weak, most of the Islamic contributions in an and science were destroyed. The Mongols bunt Baghdad (1258 A.D.) out of barbarism, and the Spaniards demolished most of the Islamic heritage in Spain out of hatred. The Islamic Empire for more than 1000 years remained the most advanced and civilized nation in the world. This is because Islam stressed the importance and respect of learning, forbade destruction, developed in Muslims the respect for authority and discipline, and tolerance for other religions. The Muslims recognized excellence and hungering intellectually, were avid for the wisdom of the world of Galen, Hippocrates, Rufus of Ephesus, Oribasius, Discorides and Paul of Aegina. By the tenth century their zeal and enthusiasm for learning resulted in all essential Greek medical writings being translated into Arabic in Damascus, Cairo, and Baghdad.

Arabic became the International Language of learning and diplomacy. The center of scientific knowledge and activity shifted eastward, and Baghdad emerged as the capital of the scientific world. The Muslims became scientific innovators with originality and productivity. Islamic medicine is one of the most famous and best known facets of Islamic civilization, and in which the Muslims most excelled. The Muslims were the great torchbearers of international scientific research. They hit the source ball of knowledge over the fence to Europe. In the words of Campbell' The European medical system is Arabian not only in origin but also in its structure. The Arabs are the intellectual forebears of the Europeans.

The aim of this paper is to prove that the Islamic Medicine was 1000 years ahead of its times. The paper covers areas such as medical education, hospitals, bacteriology, medicine, anesthesia, surgery, ophthalmology, pharmacy, and psychotherapy. MEDICAL EDUCATION In 636 A.D., the Persian City of Jundi-Shapur, which originally meant beautiful garden, was conquered by the Muslims with its great university and hospital intact. Later the Islamic medical schools developed on the Jundi-Shapur pattern. Medical education was serious and systematic. Lectures and clinical sessions included in teaching were based on the apprentice system.

The advice given by Ali ibnul-Abbas (Haly Abbas: -994 -A.D.) to medical students is as timely today as it was then'. And of those things which were incumbent on the student of this art (medicine) are that he should constantly attend the hospitals and sick houses; pay unremitting attention to the conditions and circumstances of their intimates, in company with the most astute professors of medicine, and inquire frequently as to the state of the patients and symptoms apparent in them, bearing in mind what he has read about these variations, and what they indicate of good or evil. Razi (Rhazes: 841-926 A.D.) advised the medical students while they were seeing a patient to bear in mind the classic symptoms of a disease as given in text books and compare them with what they found (6).The ablest physicians such as Razi (Al-Rhazes), Ibn-Sina (Avicenna: 980-1037 A.D.) and Ibn Zuhr (Avenzoar: 116 A.D.) performed the duties of both hospital directors and deans of medical schools at the same time.

They studied patients and prepared them for student presentation. Clinical reports of cases were written and preserved for teaching'. Registers were maintained. Training in Basic Sciences Only Jundi-Shapur or Baghdad had separate schools for studying basic sciences. Candidates for medical study received basic preparation from private tutors through private lectures and self study. In Baghdad anatomy was taught by dissecting the apes, skeletal studies, and didactics. Other medical schools taught anatomy through lectures and illustrations. Alchemy was once of the prerequisites for admission to medical school.

The study of medicinal herbs and pharmacognosy rounded out the basic training. A number of hospitals maintained barbel gardens as a source of drugs for the patients and a means of instruction for the students. Once the basic training was completed the candidate was admitted as an apprentice to a hospital where, at the beginning, he was assigned in a large group to a young physician for indoctrination, preliminary lectures, and familiarization with library procedures and uses.

During this pre-clinical period, most of the lectures were on pharmacology and toxicology and the use of antidotes. Clinical training: The next step was to give the student full clinical training. During this period students were assigned in small groups to famous physicians and experienced instructors, for ward rounds, discussions, lectures, and reviews. Early in this period therapeutics and pathology were taught. There was a strong emphasis on clinical instruction and some Muslim physicians contributed brilliant observations that have stood the test of time. As the students progressed in their studies they were exposed more and more to the subjects of diagnosis and judgment. Clinical observation and physical examination were stressed. Students (clinical clerks) were asked to examine a patient and make a diagnosis of the ailment.

Only after an had failed would the professor make the diagnosis himself. While performing physical examination, the students were asked to examine and report six major factors: the patients' actions, excreta, the nature and location of pain, and swelling and effuvia of the body. Also noted was color and feel of the skin- whether hot, cool, moist, dry, flabby. Yellowness in the whites of the eye (jaundice) and whether or not the patient could bend his back (lung disease) was also considered important (8).After a period of ward instructions, students, were assigned to outpatient areas. After examining the patients they reported their findings to the instructors. After discussion, treatment was decided on and prescribed. Patients who were too ill were admitted as inpatients.

The keeping of records for every patient was the responsibility of the students. Curriculum: There was a difference in the clinical curriculum of different medical schools in their courses; however the mainstay was usually internal medicine. Emphasis was placed on clarity and brevity in describing a disease and the separation of each entity. Until the time of Ibn Sina the description of meningitis was confused with acute infection accompanied by delirium. Ibn Sina described the symptoms of meningitis with such clarity and brevity that there is very little that can be added after I 000 yearS6. Surgery was also included in the curriculum. After completing courses, some students specialized under famous specialists. Some others specialized while in clinical training. According to Elgood9 many surgical procedures such as amputation, excision of varicose veins and hemorrhoids were required knowledge.

Orthopedics was widely taught, and the use of plaster of Paris for casts after reduction of fractures was routinely shown to students. This method of treating fractures was rediscovered in the West in 1852. Although ophthalmology was practiced widely, it was not taught regularly in medical schools. Apprenticeship to an eye doctor was the preferred way of specializing in ophthalmology. Surgical treatment of cataract was very common. Obstetrics was left to midwives. Medical practitioners consulted among themselves and with specialists.

Ibn Sina and Hazi both widely practiced and taught psychotherapy. After completing the training, the medical graduate was not ready to enter practice, until he passed the licensure examination. It is important to note that there existed a Scientific Association which had been formed in the hospital of Mayyafariqin to discuss the conditions and diseases of the patients. Licensing of Physicians: In Baghdad in 931 A.D. Caliph Al-Muqtadir learned that a patient had died as the result of a physician's error. There upon he ordered his chief physician, Sinan-ibn Thabit bin Qurrah to examine all those who practiced the art of healing. In the first year of the decree more than 860 were examined in Baghdad alone. From that time on, licensing examinations were required and administered in various places. Licensing Boards were set up under a government official called Muhtasib or inspector general .