The practice of surgery in Islamic lands: Myth and reality

Social History of Medicine

Volumn 13, Issue 2, 2000, Pages 307-321

  Savage Smith, Emilie ^a  

^a UNIVERSITY OF OXFORD   (United Kingdom)

Author keywords

'Ali ibn al 'Abbas al Majusi (Haly Abbas); Abu al Qasim al Zahrawi (Albucasis); Abu Bakr Muhammad ibn Zakariya' al Razi (Rhazes); Caesarean section; C rdoba; Ibn Sina (Avicenna); Medieval Islamic medicine; Middle East; Ophthamology; Surgery

Indexed keywords

ARTICLE; HISTORY; MIDDLE EAST; PHILOSOPHY; RELIGION; SURGERY;

HISTORY, MEDIEVAL; ISLAM; MIDDLE EAST; PHILOSOPHY, MEDICAL; SURGERY;

EID: 0009955578     PISSN: 0951631X     EISSN: None     Source Type: Journal    
DOI: 10.1093/shm/13.2.307     Document Type: Article

References (64)

1. Hajji Khalifah, Kashf al-zunin, ed. G. Flugel, 2 vols. (Leipzig, 1835-58), II, p. 589, no. 4001.
2. Even some recent scholarly books state unreservedly that Caesarean-section deliveries were performed by medieval Islamic physicians; see, for example, C. Liebeskind, 'Unani Medicine of the Subcontinent', in J. Van Alphen and A. Aris (eds.), Oriental Medicine: An Illustrated Guide to the Asian Arts of Healing (London, 1995), 39-65, esp. p. 43.
3. Edinburgh University Library, MS. Or. 161, fol. 6b, copied in 707 H [AD 1307-8]. See P. Soucek, 'An Illustrated Manuscript of al-Biruni's Chronology of Ancient Nations', in P.J. Chelkowski (ed.), The Scholar and the Saint: Studies in Commemoration of Abu'l-Rayhan al-Biruni and Jalal al-Din aI-Rumi (New York, 1975), 103-68, where Soucek seems to feel that the illustration reflects actual medical practice ('The rather clinical quality of the al-Biruni painting suggests it was taken from an illustrated medical handbook... the presence of such an illustration . . . suggests that the painter was familiar with technical surgical manuals, and perhaps implies that the manuscript was produced for someone with scientific interests', p. 112). The story that Gaius Julius Caesar was extracted from his dead mother's uterus can be traced back to Pliny (d. AD 79); see D. Trolle, The History of Caesarean Section (Copenhagen, 1982), p. 25; and R. Blumenfeld-Kosinski, Not of Woman Born: Representations of Caesarean Birth in Medieval and Renaissance Culture (Ithaca, NY, 1991), pp. 23 and 141-53.
4. Edinburgh University Library, MS. Or. 161, fol. 6b, copied in 707 H [AD 1307-8]. See P. Soucek, 'An Illustrated Manuscript of al-Biruni's Chronology of Ancient Nations', in P.J. Chelkowski (ed.), The Scholar and the Saint: Studies in Commemoration of Abu'l-Rayhan al-Biruni and Jalal al-Din aI-Rumi (New York, 1975), 103-68, where Soucek seems to feel that the illustration reflects actual medical practice ('The rather clinical quality of the al-Biruni painting suggests it was taken from an illustrated medical handbook... the presence of such an illustration . . . suggests that the painter was familiar with technical surgical manuals, and perhaps implies that the manuscript was produced for someone with scientific interests', p. 112). The story that Gaius Julius Caesar was extracted from his dead mother's uterus can be traced back to Pliny (d. AD 79); see D. Trolle, The History of Caesarean Section (Copenhagen, 1982), p. 25; and R. Blumenfeld-Kosinski, Not of Woman Born: Representations of Caesarean Birth in Medieval and Renaissance Culture (Ithaca, NY, 1991), pp. 23 and 141-53.
5. Edinburgh University Library, MS. Or. 161, fol. 6b, copied in 707 H [AD 1307-8]. See P. Soucek, 'An Illustrated Manuscript of al-Biruni's Chronology of Ancient Nations', in P.J. Chelkowski (ed.), The Scholar and the Saint: Studies in Commemoration of Abu'l-Rayhan al-Biruni and Jalal al-Din aI-Rumi (New York, 1975), 103-68, where Soucek seems to feel that the illustration reflects actual medical practice ('The rather clinical quality of the al-Biruni painting suggests it was taken from an illustrated medical handbook... the presence of such an illustration . . . suggests that the painter was familiar with technical surgical manuals, and perhaps implies that the manuscript was produced for someone with scientific interests', p. 112). The story that Gaius Julius Caesar was extracted from his dead mother's uterus can be traced back to Pliny (d. AD 79); see D. Trolle, The History of Caesarean Section (Copenhagen, 1982), p. 25; and R. Blumenfeld-Kosinski, Not of Woman Born: Representations of Caesarean Birth in Medieval and Renaissance Culture (Ithaca, NY, 1991), pp. 23 and 141-53.
6. For examples, see F. Maddison and E. Savage-Smith, Science, Tools & Magic, 2 vols. (London, 1997), I, pp. 27-8.
7. See A. Z. Iskandar, 'al-Razi', in M.J.L. Young et al. (eds.), Religion, Learning, and Science in the 'Abbasid Period (Cambridge, 1990), pp. 370-7; Lutz Richter-Bemburg, "Al-lib. 'Abbas Majusi', in E. Yarshater (ed.), Encyclopaedia Iranica, 7 vols. (London, 1985-to date), I, 837-8; and M. Mahdi, et al., 'Avicenna', in Encyclopaedia lranica, III, 66-110.
8. See A. Z. Iskandar, 'al-Razi', in M.J.L. Young et al. (eds.), Religion, Learning, and Science in the 'Abbasid Period (Cambridge, 1990), pp. 370-7; Lutz Richter-Bemburg, "Al-lib. 'Abbas Majusi', in E. Yarshater (ed.), Encyclopaedia Iranica, 7 vols. (London, 1985-to date), I, 837-8; and M. Mahdi, et al., 'Avicenna', in Encyclopaedia lranica, III, 66-110.
9. See A. Z. Iskandar, 'al-Razi', in M.J.L. Young et al. (eds.), Religion, Learning, and Science in the 'Abbasid Period (Cambridge, 1990), pp. 370-7; Lutz Richter-Bemburg, "Al-lib. 'Abbas Majusi', in E. Yarshater (ed.), Encyclopaedia Iranica, 7 vols. (London, 1985-to date), I, 837-8; and M. Mahdi, et al., 'Avicenna', in Encyclopaedia lranica, III, 66-110.
10. See E. Savage-Smith, 'al-Zahrawi, Abu'l- .l.Kasim', in H. A. R. Gibb, et al. (eds.), The Encyclopaedia of Islam, new edn, 11 vols. (Leiden, 1960-2000), XI (in press).
11. The only Greek surgical treatise known to be illustrated is a tenth-century compilation of texts on orthopaedic surgery and manipulation illustrated with human figures engaged in various procedures (Florence, Biblioteca Medicea Laurenziana, MS. Laur. Plut. 74.7, known as the Niketas codex after its compiler; see Bennett, above, p. 286).
12. See M. Ullmann, Die Medizin im Islam (Leiden, 1970), pp. 86-7.
13. Ibn al-Qifti, Ta'rikh al-hukama', ed.J. Lippert (Leipzig, 1903), p. 243.
14. Kitab al-Umdah fi sina at al-jirahah; see Ullmann, Die Medizin im Islam, pp. 176-7.
15. It seems there were no specialists similar to those for inguinal hernia or urinary stones who practised in Italy in the fourteenth and fifteenth centuries. See K. Park, 'Stones, Bones and Hernias: Surgical Specialists in Fourteenth- and Fifteenth-Century Italy', and M. R. McVaugh, 'Treatment of Hernia in the Later Middle Ages: Surgical Correction and Social Construction', in R. French, J. Arrizabalaga, A. Cunningham, and L. Garcia-Ballester (eds.), Medicine from the Black Death to the French Disease (Aldershot, 1998), 111-30 and 131-55. In England in the fourteenth century, John of Arderne specialized in the surgical treatment of fistula-in-ano; see P. M. Jones, 'John of Arderne and the Mediterranean Tradition of Scholastic Surgery', in L. Garcia-Ballester, R. French,J. Arrizabalaga, and A. Cunningham (eds.), Practical Medicine from Salerno to the Black Death (Cambridge, 1994), 289-321. Michael McVaugh has noted that in the Crown of Aragon there is no evidence for surgical specialization before the fifteenth century; M. R. McVaugh, Medicine before the Plague: Practitioners and their Patients in the Crown of Aragon, 1285-1385 (Cambridge, 1993), pp. 160-1.
16. It seems there were no specialists similar to those for inguinal hernia or urinary stones who practised in Italy in the fourteenth and fifteenth centuries. See K. Park, 'Stones, Bones and Hernias: Surgical Specialists in Fourteenth- and Fifteenth-Century Italy', and M. R. McVaugh, 'Treatment of Hernia in the Later Middle Ages: Surgical Correction and Social Construction', in R. French, J. Arrizabalaga, A. Cunningham, and L. Garcia-Ballester (eds.), Medicine from the Black Death to the French Disease (Aldershot, 1998), 111-30 and 131-55. In England in the fourteenth century, John of Arderne specialized in the surgical treatment of fistula-in-ano; see P. M. Jones, 'John of Arderne and the Mediterranean Tradition of Scholastic Surgery', in L. Garcia-Ballester, R. French,J. Arrizabalaga, and A. Cunningham (eds.), Practical Medicine from Salerno to the Black Death (Cambridge, 1994), 289-321. Michael McVaugh has noted that in the Crown of Aragon there is no evidence for surgical specialization before the fifteenth century; M. R. McVaugh, Medicine before the Plague: Practitioners and their Patients in the Crown of Aragon, 1285-1385 (Cambridge, 1993), pp. 160-1.
17. It seems there were no specialists similar to those for inguinal hernia or urinary stones who practised in Italy in the fourteenth and fifteenth centuries. See K. Park, 'Stones, Bones and Hernias: Surgical Specialists in Fourteenth- and Fifteenth-Century Italy', and M. R. McVaugh, 'Treatment of Hernia in the Later Middle Ages: Surgical Correction and Social Construction', in R. French, J. Arrizabalaga, A. Cunningham, and L. Garcia-Ballester (eds.), Medicine from the Black Death to the French Disease (Aldershot, 1998), 111-30 and 131-55. In England in the fourteenth century, John of Arderne specialized in the surgical treatment of fistula-in-ano; see P. M. Jones, 'John of Arderne and the Mediterranean Tradition of Scholastic Surgery', in L. Garcia-Ballester, R. French,J. Arrizabalaga, and A. Cunningham (eds.), Practical Medicine from Salerno to the Black Death (Cambridge, 1994), 289-321. Michael McVaugh has noted that in the Crown of Aragon there is no evidence for surgical specialization before the fifteenth century; M. R. McVaugh, Medicine before the Plague: Practitioners and their Patients in the Crown of Aragon, 1285-1385 (Cambridge, 1993), pp. 160-1.
18. It seems there were no specialists similar to those for inguinal hernia or urinary stones who practised in Italy in the fourteenth and fifteenth centuries. See K. Park, 'Stones, Bones and Hernias: Surgical Specialists in Fourteenth- and Fifteenth-Century Italy', and M. R. McVaugh, 'Treatment of Hernia in the Later Middle Ages: Surgical Correction and Social Construction', in R. French, J. Arrizabalaga, A. Cunningham, and L. Garcia-Ballester (eds.), Medicine from the Black Death to the French Disease (Aldershot, 1998), 111-30 and 131-55. In England in the fourteenth century, John of Arderne specialized in the surgical treatment of fistula-in-ano; see P. M. Jones, 'John of Arderne and the Mediterranean Tradition of Scholastic Surgery', in L. Garcia-Ballester, R. French,J. Arrizabalaga, and A. Cunningham (eds.), Practical Medicine from Salerno to the Black Death (Cambridge, 1994), 289-321. Michael McVaugh has noted that in the Crown of Aragon there is no evidence for surgical specialization before the fifteenth century; M. R. McVaugh, Medicine before the Plague: Practitioners and their Patients in the Crown of Aragon, 1285-1385 (Cambridge, 1993), pp. 160-1.
19. Zahrawi, XXX, bab 2,fiast 1; Albucasis, On Surgery and Instruments, ed. and trans. M. S. Spink and G. L. Lewis (London, 1973), pp. 170-1. Compare Paul of Aegina, VI.3, The Seven Books of Paulus Aegineta, trans. F. Adams, 3 vols. (London, 1844-7), II, pp. 251-2.
20. Zahrawi, XXX, bab 2,fiast 1; Albucasis, On Surgery and Instruments, ed. and trans. M. S. Spink and G. L. Lewis (London, 1973), pp. 170-1. Compare Paul of Aegina, VI.3, The Seven Books of Paulus Aegineta, trans. F. Adams, 3 vols. (London, 1844-7), II, pp. 251-2.
21. Abu Bakr Muhammad ibn Zakariya' al-Razi, Kitab al-Hawi fi al-tibb, 23 vols. (Hyderabad, 1955-85), III, pp. 225-6; cf. Paul of Aegina, VI.33, trans. Adams, II, pp. 301-2; and al-Majusi, Kamil al-sina'ah, 2 vols. (Bulaq, 1877), II, p. 480 (maqalah IX, bab 38).
22. Abu Bakr Muhammad ibn Zakariya' al-Razi, Kitab al-Hawi fi al-tibb, 23 vols. (Hyderabad, 1955-85), III, pp. 225-6; cf. Paul of Aegina, VI.33, trans. Adams, II, pp. 301-2; and al-Majusi, Kamil al-sina'ah, 2 vols. (Bulaq, 1877), II, p. 480 (maqalah IX, bab 38).
23. Zahrawi, XXX.2.3; trans. Spink and Lewis, pp. 338-9.
24. Zahrawi, XXX.2.54; trans. Spink and Lewis, p. 382. Compare Paul of Aegina, VI.50, trans. Adams, II, pp. 337-40; Majusi, Kamil, IX.41, Bulaq, II, pp. 480-1; and F. Sanagustin, 'La chirurgie dans le Canon de la medecine (aI-Qanun fi-t-tibb) d'Avicenna (Ibn Sina)', Arabica, 33 (1986), 84-122, where references to parallel passages in the Canon in the Bulaq printing of 1877 will be found.
25. Majusi consistently uses the term qarw for hernia (IX.47-51, Bulaq, II, pp. 485-7), and lbn Sina uses fatq (Sanagustin, 'Chirurgie', p. 113).
26. Zahrawi, XXX.2.62, trans. Spink and Lewis, pp. 424-33.
27. Paul of Aegina, VI.62, trans. Adams, II, pp. 365-7.
28. Zahrawi, XXX.2.63, trans. Spink and Lewis, pp. 434-7.
29. See Paul of Aegina, VI.63, trans. Adams, II, p. 369.
30. Majusi, IX.48, Bulaq, II, p. 485.
31. Zahrawi, XXX.2.64, trans. Spink and Lewis, pp. 438-9; cf. Majusi, IX.49, Bulaq, II, pp. 485-6.
32. Zahrawi, XXX.2.66, trans. Spink and Lewis, pp. 446-7; Paul of Aegina, VI.64, trans. Adams, II, pp. 370-1.
33. Majusi, IX.49, Bulaq, II, p. 486.
34. Zahrawi, XXX.2.65, trans. Spink and Lewis, pp. 440-5 with quotation from p. 440.
35. Majusi, IX.50, Bulaq, II, pp. 486-7.
36. Zahrawi, XXX.2.67, trans. Spink and Lewis, pp. 448-9; cf. Paul of Aegina, VI.66, trans. Adams II, pp. 377-8; and Majusi IX.51, Bulaq, II, p. 487.
37. Zahrawi, XXX.1.45, trans. Spink and Lewis, p. 134. The details of the cautery instruments and procedures vary, however, between Zahrawi and Paul.
38. McVaugh, 'Treatment of Hernia'. For three Ottoman Turkish contractual agreements from 1658 between surgeon and patient for treating inguinal hernia (fitik), see R. Murphey, 'Ottoman Medicine and Transculturalism from the Sixteenth through the Eighteenth Century', Bulletin of the History of Medicine, 66 (1992), 376-403, esp. p. 389.
39. McVaugh, 'Treatment of Hernia'. For three Ottoman Turkish contractual agreements from 1658 between surgeon and patient for treating inguinal hernia (fitik), see R. Murphey, 'Ottoman Medicine and Transculturalism from the Sixteenth through the Eighteenth Century', Bulletin of the History of Medicine, 66 (1992), 376-403, esp. p. 389.
40. Paul of Aegina, VI.61, trans. Adams, 11, pp. 340-1; Zahrawi, XXX.2.52, trans. Spink and Lewis, pp. 376-9; Majusi, IX.42, Bulaq, II, pp. 481-2.
41. Zahrawi, XXX.2.85, trans. Spink and Lewis, pp. 536-51; of. Paul of Aegina, VI.52, trans. Adams, II, pp. 342-5; Majusi, IX.43, Bulaq, II, pp. 482-3.
42. Zahrawi, XX.X.2.77, trans. Spink and Lewis, pp. 484-94; of. Paul of Aegina, VI.64, trans. Adams, II, pp. 387-92; Majusi, IX.58, Bulaq, II, pp. 489-90.
43. Bethesda (Maryland), National Library of Medicine, MS. A29.1, fol. 118b.
44. Zahrawi, X.XX.2.60 and 61, trans. Spink and Lewis, pp. 410-23; Paul of Aegina, VI.60, trans. Adams, II, pp. 354-63; Majusi, IX.46, Bulaq, II, pp. 483-4.
45. See Zahrawi, XXX.2.80-81, trans. Spink and Lewis, pp. 502-15; Majusi, IX.60-1, Bulaq, II, pp. 490-1; Paul of Aegina, VI.78-9, trans. Adams, II, pp. 399-40 I.
46. Zahrawi, XXX.2.36, trans. Spink and Lewis, pp. 300-6; Majusi, IX.36, Bulaq, II, p. 379.
47. For example, one of the founding members of the Goon show, Michael Bentine, had his tonsils removed in 1926 in the kitchen of his parents' home in Folkestone; M. Bentine, The Reluctant Jester: My Head-on Collision with the 20th Century (London, 1992), p. 10. While Bentine's surgeon used a crude form of anaesthesia, he appears to have been considerably less skilful than American itinerant surfieons at the turn of the century who used none at all.
48. Zahrawi, XXX.2.46, trans. Spink and Lewis, pp. 356-9.
49. See Zahrawi, XXX.2.87, trans. Spink and Lewis, p. 576. Zahriwi also mentions the case of a man xvho had amputated his own leg at the knee joint, following gangrene, and who then came to him when the gangrene appeared in his fingers; however, Zahrawi refused to amputate the man's hand since the patient's strength was declining, though he later learned that the man returned home and found Someone else who amputated the hand and that he recovered afterwards. See also, Majusi IX.65, Bulaq. II, p. 492; Paul of Aegina, VI.84, trans. Adams, II, pp. 409-14.
50. With regard to medieval European surgery, Nancy Siraisi has remarked that 'in reality, the amputation of limbs through living tissue was probably rare before the sixteenth century'; N. G. Siraisi, Medieval & Early Renaissance Medicine (Chicago, 1990), p. 157.
51. 'Ali ibn 'Isa, Memorandum Book of a Tenth-Century Oculist, trans. C. A. Wood (Chicago, 1936), p. 90.
52. See, M. Meyerhof, 'The History of Trachoma Treatment in Antiquity and During the Arabic Middle Ages', Bulletin of the Ophthalmological Society of Egypt, 29 (1936), 26-87.
53. E. Savage-Smith, 'Ibn al-Nafis's Perfected Book on Ophthalmology and His Treatment of Trachoma and its Sequelae', Journal for the History of Arabic Science, 4 (1980), 147-206.
54. Ibid., pp. 180-1, for an illustration of these instrument charts.
55. 'Ali ibn 'Isa, Memorandum Book, trans. Wood, pp. 183-7.
56. A. Feigenbaum, 'Early History of Cataract and the Ancient Operation for Cataract', American Journal of Ophthalmology, 49 (1960), 305-26.
57. M. Meyerhof, The Cataract Operations of 'Ammar ibn 'Ali al-Mawsili (Barcelona, 1937).
58. Zahrawi XXX.2.23, trans. Spink and Lewis, pp. 256-7.
59. See the instrument illustrated on the right-hand side of the middle row in the manuscript reproduced in Kalifah ibn Abi al-Mahasin al-Halabi, Al - Kafi fi al-kuhl, ed. M. Z. al-Wafai and M. R. Qal'aji (Rabat, 1990), p. 327.
60. M. Feugere, E. Kiinzel, and U. Weisser, 'Le aiguilles a cataracte de Montbellet (Saone-et-Loire): Contribution a l'etude de l'ophtalmologie antique et islamique', Jahrbuch des romisch-germansichen Zentralmuseums Mainz, 32 (1985), 436-508.
61. Bethesda, National Library of Medicine, MS. A29.1, fols. 118a-120b.
62. P. Kraus, Risalat al-Biruni fi filurist kutub Muhammad ibn Zakariya' al-Razi (Paris, 1936), pp. 5-6.
63. See S. K. Hamameh, 'Excavated Surgical Instruments from Old Cairo, Egypt', Annali dell'lstituto e Museo di Storia della Scienza di Firenze, 2 (1977), 3-14; J. Zozaya, 'Instrumentos Quirurgicos Andalusies', Boletin de la Asociacion Española de Orientalistas, 20 (1984), 255-9.
64. See S. K. Hamameh, 'Excavated Surgical Instruments from Old Cairo, Egypt', Annali dell'lstituto e Museo di Storia della Scienza di Firenze, 2 (1977), 3-14; J. Zozaya, 'Instrumentos Quirurgicos Andalusies', Boletin de la Asociacion Española de Orientalistas, 20 (1984), 255-9.