[Music] thank you [Music] what would you do if you noticed a sudden and severe deterioration in your eyesight almost without warning your vision has become hazy you see rainbow colored circles and bright lights your eyes hurt and you're suffering from headaches you'd probably consult your doctor who'd hopefully arrange for you to see an eye specialist as soon as possible the symptoms I've described are sometimes associated with glaucoma a collection of eye diseases that the World Health Organization identifies as the second most common cause of blindness while many forms of glaucoma are treatable with medicine or an operation this wasn't the case in the 10th century one 10th Century Persian sufferer was an elderly scholar named Muhammad IBN zacharya al-razi he relates to us how he was approached by a man who had some eye drops for sale that supposedly would cure him rather than dig into his purse al-razzi's response was to quiz the man who claimed to be a doctor how many layers are there in a human eye al-razi asked the Healer didn't know so the sufferer sent him away saying why should I trust a medicine peddled by a man without even a basic grasp of anatomy at that time there was perhaps No One Alive better qualified than al-razi known to us in English as razis to challenge the credentials of such a snake oil salesman why because al-razi was the greatest medical scholar and practitioner of his day he wrote more than 200 manuscripts over the course of his lifetime and many of his medical texts became Classics that were still consulted in the Middle East and Europe hundreds of years later it's no wonder that he would become known as the father of Islamic medicine never regained his eyesight but while he had it his achievements were legendary in this lecture we'll look at al-razzi's life and work and explore progress in medicine and the development of hospitals all across the greater Middle East from the middle of the 9th century forward will also devote some time to one of the greatest medical minds of all time IBN Cena better known in the west Oz avicenna so let's start our journey by going back to al-razi's early life before he was losing his eyesight grazis was born in 854 in the Persian city of Rey hence his family name of algrazi Rey is one of modern Iran's oldest cities with a history of settlement dating back to about 6000 BC situated on the ancient Silk Road it was an important center of trade and scholarship today it's part of Greater Tehran the capital of Iran verifiable facts about al-razi's life are scant as is the case with most people from this period that said all sources agree he developed a talent for music early in life becoming an accomplished ode player an ode is a stringed instrument not unlike a loot when he reached adulthood he put music aside and took up Alchemy mathematics philosophy and literature by turns he excelled at and then tired of all these subjects eventually taking up medicine at around the age of 30. and it's this subject to which he dedicated the rest of his life [Music] left Persia in order to study medicine in the greatest City in the Islamic world at that time Baghdad in Baghdad he had access to Arabic translations of the most important medical men from the ancient world of these the earliest was Hippocrates the 4th Century BC Greek physician who was considered the father of Western medicine and from whom we get the Hippocratic Oath second name was Galen a Greek Doctor Who worked in the Roman Empire during the second Century A.D like any good scholar al-razzi acknowledged the Brilliance of these ancient Greeks and the enormous debt that scholarship owed them and others from their day however like any great scholar he built on their foundational texts and when he surpassed them he said so in his book doubts about Galen al-razzi challenged the theory of the four humors which if they're not in Balance was thought to explain most human sickness suggested there were a number of other elements that Galen had failed to consider such as oiliness saltiness inflammability and sulfurousness even so al-qrazi was humble enough to add the following it Grieves me to criticize the man Galen from whose sea of knowledge I have drawn so much indeed he is the master and I am the disciple but this reverence and appreciation should not prevent me from doubting as I did what is erroneous in his theories he also attacked the writings of Hippocrates for being disorganized and too brief before he would go on to write a lengthier corrective text of his own al-razi also wrote extensively about medical ethics and in a book called medical ethics he talks about the importance of morality in medicine for al-razi it wasn't enough for the physician to be good at his job he should also be a role model for his patients he was also convinced of the mind-body connection in pursuit of good health as well as the importance of exercise and a healthy diet as he wrote if a patient refuses to take responsibility for their lifestyle including overeating or not exercising then there is nothing a doctor can do to help them another important factor in general good health was good doctor-patient relations as well as having a family doctor who would understand the patient's body over time changing doctors on a regular basis he said was a bad idea that could do little more than waste a patient's health wealth and time not to mention wasting the doctor's time as well [Music] further al-grazi has been acknowledged as the first person to fully and accurately describe smallpox and measles noting the important differences between the two as well as offering possible remedies his book The diseases of children was also the first to deal with Pediatrics as an independent field of Medicine 's medical notes surgical observations along with numerous new diagnoses and suggested treatments were compiled after his death in what's now known in English as the comprehensive book of Medicine the comprehensive book of medicine was not only a tribute to Al harazi's brilliance but because he was so diligent about quoting his sources it also presents a complete catalog of all existing medical scholarship then available from ancient Greece India and elsewhere in this way it was one of the earliest medical encyclopedias so vast and detailed was this text that European medical students were still using Latin translations 700 years after al-razzi's death under al-razi's strictly rationalist scientific approach every disease was thought to have a cause or origin that could ultimately be understood through research sickness he held was not as some men of religion claimed a punishment from God he encouraged doctors to read the latest Medical treatises in order to keep up with developments that they might otherwise be ignorant of and for those who might not want to consult a doctorate at the first sign of an illness he wrote the first medical manual for home use entitled a medical advisor for the General Public this helpful compendium would remain a popular reference for many in the west until as late as the early 20th century al-razi's manual included treatments for everyday complaints such as headaches coughs colds and indigestion as well as for more serious ailments for Melancholia he advised taking extract of poppies I.E opium because of its euphoric qualities unfortunately for all of his medical knowledge and insight he was unable to do anything for his own failing eyesight towards the end of his life when fully blind a trusted surgeon offered to operate to try to restore his eyesight al-razi replied I've seen enough of this old world and I do not cherish the idea of suffering the ordeal of an operation for the hope of seeing more of it I'm going to broaden our Horizon now to look beyond the numerous innovations that al-razzi introduced for the treatment of individual patients to look at the work he and others did to help improve care for the sick as a whole I.E in the development of hospitals one of the most famous hospitals in the pre-islamic world or before the 7th century was in Gunda shapur Persia founded in the late 3rd Century records show that Gunda shapur was not unlike a modern teaching Hospital that's to say a place both for treating the sick and for training the next generation of medical practitioners in the Eastern Roman or Byzantine Empire a decree was issued in 325 A.D at the Council of nicaea that a hospital should be established in every cathedral town of the empire so what changed after the dawn of Islam and the conquests of this new military and political force for one thing the Conquering Arabs found themselves ruling over large non-muslim majority territories also the Arabs found themselves exposed to far more sophisticated cultures not least in the major cities of the Byzantine Empire to the west and Persia to the east of the Arabian Desert Heartland the first doctors under Muslim rule were mostly Jews Christians and zoroastrians only later would Muslims produce their own medical practitioners who worked alongside and learned from their peers from other cultures after all like science in general medicine is a religious I should mention in passing that there is something called prophetic medicine but this relates specifically and very narrowly to the traditional medical practices from Muhammad's Lifetime and upon which Muhammad himself offered an opinion it is said for instance that Muhammad believed every disease had both a cause and a cure one of the more famous sayings on this subject attributed to Muhammad says make use of medical treatment for God has not made a disease without appointing a remedy for it with the exception of one disease namely old age many suggested cures involved ingesting a particular food or drink honey was thought to Aid all kinds of healing while olive oil was recommended for numerous internal complaints so too I should mention was a mixture of camel urine and milk I think I'll stick to the olive oil the first notable medical facility founded in the new Muslim Middle East was in Damascus Syria in around 707. established with the help of Jewish and Christian doctors this was less a hospital per se than a leprosia a place to isolate those suffering from leprosy the first proper Hospital built in the Islamic world was in Baghdad during the reign of the caliph Haroon al-rasheed of Arabian Nights Fame that's to say between 786 and 809. these hospitals were known by the Persian word by maristan Stan means place as in Uzbekistan place of the uzbeks while baimar means sick thus the place of the sick just as the German word krankenhaus means the house for the sick the growth of ever larger cities is precisely what necessitated the development of hospitals more people living in closer proximity meant that diseases could and did spread more rapidly through urban populations in order to maintain healthy subjects the government paid for the building and maintenance of these hospitals at the same time government services were unable to keep up with demand so private donors also funded the establishment of medical centers that were open to the General Public in both cases the provision of Health Care was in part seen as a religious Duty and so all treatment was free yet hospitals remained essentially secular institutions in that they were obliged to treat patients regardless of religion race citizenship or gender nor was there a limit to how long a patient could stay admitted hospitals were required to keep patients until they were fully recovered by the 9th century baghdad's Hospital employed 25 staff Physicians as Baghdad grew so that its need for more hospitals and here again we see al-hazi at work commissioned to build a new hospital al-razi ordered that animal carcasses be hung in various parts of the city once in place he observed the different rates at which each carcass rotted and ordered the new hospital to be built where putrification was slowest noting that this was probably the part of the city with the best healthiest air al-razi's hospital had a lecture hall kitchen Pharmacy Library mosque and a chapel for Christian patients recognizing the importance of a healthy mind in a healthy body recreational materials were also made available and musicians were employed to entertain the patients and as I've mentioned the hospital wasn't just a treatment center but it was also a medical school basic science was taught through a combination of private tutors self-study and public lectures students were also responsible for keeping patient records another Innovation from this period by this time doctors had to be registered and licensed in order to practice and hospitals were supervised by a combination of doctors and lay administrators by the year a thousand there were at least 30 hospitals noted from Islamic Spain to Tunisia and Egypt and North Africa to Persia in the east hospitals were also required to have separate but equally equipped Wards for men and women with patients attended to by gender segregated nurses and staff patients were kept in separate Wards for either the contagious or non-contagious and there were also separate wings for mental health eye diseases and surgery now let's turn our attention to one of the greatest polymaths of all time with expertise in numerous different areas of study this was IBN Cena or avicenna as he's better known in the West born around 980 in modern day Uzbekistan he wrote about 450 titles in his lifetime of which more than half survive about 40 of these deal with medicine including the five volume Cannon of medicine completed around the year 1025. ibncena was widely described in medieval Europe as the father of early modern medicine though his work as a philosopher was even more important but that's a story for another day ibncena began studying medicine at the tender age of 13 and was practicing at 16. while still a teenager his medical knowledge saved the life of the local samonid or Persian Sunni ruler his Cannon of medicine was arguably the greatest medical text ever written up to that point in history it's also one of the most influential over time with this million word manuscript still being used as a standard text in European universities during the 18th century inspired by Galen and originally compiled to be used as a textbook for students under his tutelage it been seen as Canon would go on to be translated and studied by generations of Scholars for centuries to come divided into five volumes the first part is a compendium of medical principles including anatomy and regimen which is to say prescribed causes of treatment and changes in lifestyle or Diet to promote the restoration of good health Volume 2 is a Materia Medica or alphabetical list of about 800 simple as opposed to compound medical substances with notes on their properties and uses volume 3 outlines the function of each organ and body part before offering the diagnoses and treatments for the diseases that can affect each body part in turn organized literally as a head to toe guide volume 4 deals with ailments that affect more than one part of the body at a time or indeed the entire body such as a fever and Volume 5 is a formulary of some 650 compound medicines then in use translated into Latin by Gerard of cremona in the late 13th century IBN seen as Canon quickly became the standard text for medical students in Europe and would remain so in universities from Oxford to Paris and Padua in Italy until the start of the 17th century apart from its encyclopedic nature its continuing popularity was probably helped by the memorable aphorisms that scatter the text for instance noting the importance of exercise and diet for good health IBN Cena wrote movement can replace many drugs but no drug can ever replace movement and another if you have eaten too much stay hungry the next day even more dramatically it been seen opined that an ignorant doctor is the aid DeCamp of death you have been warned ebencina is credited with advancing medical knowledge through original discoveries and with improvements to the existing body of knowledge one of his most important discoveries was his recognition of the potential for the Airborne transmission of disease he was also the first to correctly identify the distinction between central and peripheral facial paralysis and he accurately described the curse of infection from the guinea worm IBN Cena also conducted groundbreaking research in psychiatric conditions never the most glamorous branch of Medicine in his time many less scientifically minded people saw mental illness as a punishment from God and so in some sense something not to be meddled with other writings cover the treatment of kidney diseases the production and use of heart medicines and a series of experiments that demonstrated the connection between word association and heart rate and which led to a successful diagnosis of Love sickness as proof of this a king's nephew was brought to IBN Cena and he was told to diagnose the young man's ailment the prince apparently a healthy young man nevertheless was suffering from sleeplessness loss of appetite dizziness and a raft of other symptoms IBN Cena after considering his options set about monitoring the young man's heart rate while carefully uttering the names of different districts in the city noting that the young man's heart fluttered when a certain District was mentioned he then mentioned the names of streets within that District again monitoring the young man's pulse finally he went through a list of women's names and again noted the prince's reaction at the end of his experiment ibncena told the patient that he was in love with a certain woman and that the best cure was marriage embarrassed the prince admitted that IBN Cena was right the King was told a marriage was arranged and the symptoms disappeared literally overnight while a Charming Story the most important factor to note is that Eben Cena's experiments with word association pre-figured by some 900 years the very same experiments that Carl Jung was famous for in the 20th century as we approach the end of this lecture let's consider in Broad terms the growth in medical knowledge during the Islamic golden age medieval Islam's receptiveness to new ideas and heritages helped it make major advances during this time adding to earlier medical ideas and techniques this expanded the Health Sciences and corresponding institutions and Advanced Medical knowledge in areas such as surgery and understanding of the human body independent of Greek Roman or Persian influence these advances were indeed remarkable yet when we talk about medicine or for that matter mathematics chemistry or any of the Sciences we should also remember that the subject is not Islamic per se lancing a boil or amputating your limb is no more Islamic than it is Jewish Christian or Buddhist medicine is medicine and science is science however the vast majority of scholarship that took place in the medical Sciences in the Muslim Middle East at this time was initially written down in Arabic this was true for the translations and compilations made of earlier Greek texts and for the mass of original scholarship that also took place at this time few if any credible Scholars of the day claimed that Islam was the key to all their knowledge or proof of the rightness of their vision of the one God now at various times during the Islamic Golden Age there were prohibitions on Muslims visiting Jewish and Christian doctors in case they prescribed a course of treatment or medicine that would harm or even kill it's been noted however that such injunctions were almost universally ignored then as now anyone in need of medical help couldn't care less about a doctor's religious Faith but rather his or her skill and track record as a doctor there were also periodic debates among Muslim theologians as to whether Muslim Physicians should use Greek Chinese and Indian medical techniques seen by many as pagan typically those lacking imagination or common sense lost out to the more broad-minded men of both religion and science and Islamic Physicians were given free reign to study and adopt any techniques they wished even so both al-razi and avicenna were accused by critics of atheism during their lifetimes serious charge indeed both men were certainly critical of certain aspects of organized religion and in particular of poorly educated religious authorities who praised Blind Faith over rational thought al-hazi believed that the common people had been duped into belief by religious authority figures and by the status quo as a result he criticized religious adherence for not more actively challenging their received wisdom with rational analysis instead he contended the faithful sometimes acted violently when asked to defend their faith said if the people of this religion are asked about the proof for the soundness of their religion they flare up get angry and spill the blood of whoever confronts them with this question they forbid rational speculation and strive to kill their adversaries this is why truth became thoroughly silenced and concealed writing about the God of the Old Testament demanding sacrifices al-razi wrote this sounds like the words of the needy rather than of the laudable self-sufficient one al-razi believed that the existence of many different religions was in itself evidence that religion was the creation of humans rather than the divine but al-qhazi does not own the final word in the ongoing debate between agnostics atheists and the faithful Eben rushed argued to the contrary that whoever becomes fully aware of the wonders of human anatomy and physiology will find his faith in God increases