Here goes another article which is somewhat related to my previous article on Scientific Achievements in History: Physics and Technology. Hope you find this more or less enjoyable and above all informative. Dont forget to let me know of your comments. Enjoy... 
Scientific Achievements in History: Surgery
Another really fascinating article by Prof. Dr. I N
(UK):
The Islamic Empire for more than 1,000 years remained the most advanced and civilized nation in the world. This is because Islam stresses the importance and respect of learning, discipline, tolerance for other religions, and forbids destruction. The Muslims recognized excellence and by the tenth century their zeal and enthusiasm for learning resulted in all essential Greek medical writings being translated into Arabic, as it became the international language of learning and diplomacy. Muslim scientists greatly improved and built upon the work of the ancients. The centre of scientific knowledge and activity shifted eastward, and cities like Baghdad, Damascus and Cordova in Muslim Spain emerged as the capitals of the scientific world. This was the Golden era of Islam, which lasted from early 8th century to late 15th century, almost coincidental with Dark Ages in the rest of Europe.
Islamic medicine is one of the most famous and best known facets of Islamic civilization, and in which the Muslims most excelled (S. H. Nasr, “Science and Civilization in Islam” New American Library, Inc. New York, 1968, pp. 184-229). The Muslims were the great torchbearers of international scientific research.
In the words of historian 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.”
(D. Campbell, “Arabian Medicine”, Cambridge University Press, 1921, 99.56-57)
The aim of this article (which was also published in a leaflet by Al-Nasr Trust) is to highlight in a concise manner how Muslim Surgeons were 1,000 years ahead of their times.
Over five hundred years before the French surgeon Ambroise Pare introduced the concept rational surgery in Europe in 1545, Islamic Spain’s illustrious surgeon Abu al-Qasim Khalaf Ibn Abbas al-Zahrawi (930-1013 CE) known to the west as Abulcasis, Bucasis, or Alzahravius began ligating arteries with fine sutures. Zahrawi was the most famous rational surgeon in Islamic medicine. In his illustrated encyclopedia of the practice medicine and surgery, Al-Tasrif, he described the use of about 200 surgical instruments, many of which were devised by Zahrawi himself (C. Singer and A. A. Underwood, “A Short History of Medicine”, 2nd edition, Oxford University Press, New York, 1962, p. 76). Al-Tasrif, became one of the world’s most famous and influential textbooks. It was translated into Latin by Gerard Cremona (1114-1187) and it went into at least ten Latin editions between 1497 and 1544. The book was used as standard reference work in all the universities of Europe for over five hundred years. It was intended for medical students and the practicing physician, for whom it was a ready and useful companion in a multitude of situations since it answered all kinds of clinical problems.
The last edition was that of John Channing in Oxford (1778). This contains both the original Arabic text and its Latin translation on alternate pages. Almost all European authors of surgical texts from 12th to the 16th centuries referred to Zahrawi’s surgery and copied from him. They included Roger of Salerno (d. 1180), Guglielmo Salicefte (1201-1277), Lanfranchi (d. 1315), Henri de Mondeville (1260-1320), Mondinus of Bologna (1275-1326), Bruno of Calabria (1352), Guy de Chaulliac (1300-1368), Valescus of Taranta (1382-1417), Nicholas of Florence (d. 1411), Leonardo da Bertapagatie of Padua (d. 1460).
Zahrawi’s surgical masterpiece was the first book of this size devoted solely to surgery, which at that time also included dentistry and what one may term as surgical dermatology. Zahrawi had developed all aspects of surgery including ophthalmology, diseases of the ear, nose, and throat, and of the head and neck, general surgery, obstetrics, gynaecology, military medicine, urology, and orthopaedic surgery. He divided the book into three parts:
1. on cauterization (56 sections)
2. on surgery (97 sections)
3. on orthopaedic (35 sections)
Zahrawi stressed the importance of the study of Anatomy as a fundamental prerequisite to surgery. He advocated the reimplantation of a fallen tooth and the use of dental prosthesis carved from cow’s bone, an improvement over the wooden dentures worn by the first President of America, George Washington, seven centuries later (B. Miller, Mankind, 6( 8 ): 8-40, 1980). Zahrawi perfected the use of animal gut for sutures after it was first introduced in the 10th century AD by Al-Razi (A. Castiglioni, “A History of Medicine”, E. Krumhbhaar (trans), Alfred A. Knopf, New York, 1958, p.268).
Zahrawi also appears to be the first surgeon in history to use cotton (Arabic word) in surgical; dressings in the control of hemorrhage, as a vaginal padding in fractures of the pubic, and in dentistry. He introduced the method for the removal of kidney stones by cutting into the urinary bladder. He was the first to teach the lithotomy position for vaginal operations (A. A. Khairallah, Ann. Medical History. 34: 409-415, 1942).
He also described tracheotomy, distinguished between goiter and cancer of the thyroid, and the invention of a cauterizing iron, which he also used to control bleeding. His description of varicose veins stripping, even after ten centuries, is very similar to modern surgery (Al-Okabi, Hospital Medical Practice, Cairo, 1: 14-29, 1971).
In orthopedic surgery he introduced what is called today Kocher’s method of reduction of shoulder dislocation and patelectomy 1,000 years before Brook reintroduced it in 1937 (F. S. Haddad, “XXI Int. Cong. Hist. Med.”, (Vienna 1968, Sep. 22), 1970, pp. 1600-1607.
The surgical use of anesthesia and antiseptics was one of the reasons for the rise of surgery in the Islamic world to the level of an honorable specialty, while in Europe, surgery was belittled and practiced by barbers and quacks. The Council of Tours in 1163 CE declared “Surgery is to be abandoned by the schools of medicine and be all decent physicians”. Burton stated that, “Anesthetics have been used in surgery throughout the East for centuries before ether and chloroform became fashion in civilized west.” (L. Burton, “1001 Nights (Six Volumes), 1884)
The famous physician Ibn Sina (date) originated the idea of the use of oral anesthetics. The Muslims invented the soporific sponge, which was the precursor of modern anesthesia. It was a sponge soaked with aromatics and narcotics and held to the patient’s nostrils (T. E. Keys, K. G. Wakim, Mayo Clinic Proceedings of the Staff Meeting, 28: 423-437, 1953). By contrast in the west the first recorded case of surgery under inhalation anesthesia, was conducted by C.W. Long, an American, many hundreds of years later in 1845.
The first scientific use of antiseptics in surgery in Europe was by the British surgeon Joseph Lister in 1865. As early as the 10th century, Muslim physicians and surgeons were applying purified alcohol to wounds as an antiseptic agent. Surgeons in Islamic Spain utilized special methods for maintaining antisepsis prior to and during surgery. They also originated specific protocols for maintaining hygiene during the post-operative period. Their success rate was so high that dignitaries throughout Europe came to Cordova in Spain, to be treated at what was comparably the “Mayo Clinic” of the Middle Ages.
Ibn Sina also described surgical treatment of cancer, which holds true even today after 1,000 years. He says the excision must be wide and bold: all veins running to the tumor must be included in the amputation. Even if this is not sufficient, then the area affected should be cauterized. His recommendation of wine as the best dressing for wounds was very popular in practice (F. H. Garrison, “History of Medicine”, 4th Edition, W. B. Saunders Co., Philadelphia, 1929. p.134).
In summary, the surgeons of Islam practiced three types of surgery: vascular, general, and orthopedic. Ophthalmic surgery was a specialty, which was quite distinct both from medicine and surgery. They freely opened the abdomen and drained the peritoneal cavity in the approved modern style. To an unnamed surgeon of Shiraz, is attributed the first colostomy operation. Liver abscesses were treated by puncture and exploration. In fact, surgeons all over the world practice today unknowingly several procedures that Muslim surgeons introduced 1,000 years ago. Some techniques in orthopedic surgery performed by these early Muslim Surgeons have even been reintroduced in the 20th century.
Even after ten centuries, the achievements of Islamic Medicine and Surgery look amazingly modern. 1,000 years ago, the Muslims were the great torchbearers of international scientific research. Every student and professional from each country outside the Islamic Empire, aspired, yearned, and dreamed to go to the Islamic Universities to learn, to work, to live and to lead a comfortable life in an affluent and most modern and civilized society. Islamic countries have the opportunity and resources to make Islamic Medicine and Surgery number one in the world, once again.
seeking.knowledge@hotmail.co.uk
