The Millennium Anniversary of Al-Zahrawi (Albucasis): An Editorial

The year 2013 was the millennium anniversary of the death of the distinguished surgeon Abul-Qasim Khalaf Ibn Abbas Al-Zahrawi, who lived in the period from 930-1013. However, still little is known about his pivotal role, like other medieval Islamic scholars, not only in preserving and critically evaluating the surgical and medical heritage of the ancient and Greco-Roman civilizations but also in having integrated surgery into scientific medicine through his careful observations, vast personal experience and documented original contributions.

Al-Zahrawi was born and raised in Alzahraa, a suburb of the town of Qurttoba (Cordova) in Andalucia (now in Spain). It is narrated that his family tree was originally from Al-Ansar of Al-Madina Al-Monawara (now in Kingdom of Saudi Arabia). He is known in the Western literature as Albucasis, Abulcasis, Bucasis (Latinized forms of his Arabic nickname Abul-Qasim).

He was an innovative surgeon who added many original contributions to surgery and medicine. During his lifetime, doctors used to travel from faraway places in order to learn from him. During the Middle Ages and Renaissance in Europe, he remained a renowned teacher of surgery through his well-known single, practical and encyclopaedic work Al-Tasrif Liman Aajaz Aan Al-Taaleef (The disposal of medical knowledge to he who is not able to get it by himself from the other compilations), particularly its thirtieth volume (treatise, ‘maqalah’) devoted to surgery and operative intervention. That volume is a landmark in the history of surgery. It is the first rational and complete illustrated treatment of its subject, and the many surgical procedures and instruments described and illustrated in it do not appear in any other work at or prior to his time.  It was translated to Latin in 1150 AD by Gerard of Cremona, thus helping its spread to all of Europe, where it remained, through several famous printings, the most important reference book on surgery until the end of eighteenth century. Its first translation to a modern European language was Lucien Leclerc French version published in Paris in 1861 as ‘La Chirugie d’ Albucasis’ with an introduction that, interestingly enough, ended with the closing remark ‘el hamdu Lillah’!

The original Arabic text of the 30th volume of Al-Tasrif was made available with an English translation and a commentary in 1973 through the classic work of Lewis and Spink; ‘Albucassis on Surgery and Instruments’ published by Wellcome Institute of the History of Medicine; London, United Kingdom. Another printing of the Arabic text of volume 30 of Al-Tasrif  was published  in Riyadh  in 1993 as  Al-Jiraha, Al-Maqala Al-Thalathoon, Al-Tasreef Liman Aajaz Aan Al-Taaleef’ edited by Al-Naser A and Al-Twaijri A, and published by Al-Farazdaq Press  and sixteen years later in Damascus as ‘Kitab Al-Zahrawi Fi Al-Tibb Liamal Al-Jarrahin’ edited by Zakoor M Y and published by the Syrian Ministry of Culture.

Furthermore the operative technique of Al-Zahrawi as documented in the 30th volume of his Al-Tasrif together with his contributions to the progress of general surgery and its various branches were critically evaluated in several studies performed and published by surgeons interested in history of medicine during the second half of last century. A good example of those studies is the work done by Prof. Rabie E Abdel-Halim at the urology departments of King Abdel-Aziz  and King Saud Universities  with results published in the years 1985-2003. In a modest effort to commemorate the millennium anniversary of the death of Al-Zahrawi, it is a great pleasure for the editorial board of the MuslmHeritage.com to republish, in a special memorial page, some of those above-mentioned studies with due acknowledgment to the original publishers and authors.  This Millennium Memorial page also includes links to other articles as well as a selected bibliographic list about Al-Zahrawi’s massive contributions to the progress of surgery and other medical sciences.

It is also to be noted that in the published editions of the 30th volume of Al-Tasrif (the operative surgery section of the book), there are still many general and special surgical topics not yet subjected to contemporary evaluation.  The volume contains the operative parts of general surgery, pediatric surgery, gynecology and obstetrics as well as orthopedics including, in each entry, the indications, the operative procedures in details, the possible complications and recommended management in addition to the rest of post-operative care in a style not much different from any current operative surgery manual.

Similarly, although 1000 years had passed since the death of Al-Zahrawi, it was only the 30th volume (maqala) of his book al-Tasrif that became edited and, thus, made available for researchers and academicians. Other than Maqala No. 28 on the preparation of different types of simple drugs which was the subject of a Latin translation towards the end of the 13th century (the famous pharmaco-chemical Liber Servitoris) followed, like the Latinized 30th maqala, by several printings in various parts of medieval Europe, the other 28 maqalas remained totally inaccessible being in the form of unedited manuscripts dispersed all over the world. However in 1963, Sami Khalaf Hamarneh and Glen Sannedecker, in their classic work: ‘A Pharmaceutical View of Abulcasis Al-Zahrawi in Moorish Spain’, translated and commented on excerpts of  the twenty fifth Maqala of Al-Tasrif dealing with the ingredients and manufacturing  of ointments ‘Adhan’ and its uses in medical treatment, thus raising fresh interest in the medical therapy, material medica and pharmacy aspects of Al-Tasrif almost overlooked by the widespread   fame of the surgical aspects of its thirtieth maqala. Still, until now, there are 25 more pharmaceutical maqalas in the Al-Tasrif encyclopedia of Alzahrawi  not yet fully edited or studied.  

It is welcomed news, hence, that in 2004 the Kuwait Foundation for the Advancement of Sciences published the first and second maqalas of Al-Zahrawi’s Tasrif as edited by Dr Sobhi Mahmoud Hamami. This is a remarkable step forwards in the study of the anatomical and pathophysiological basis of Al-Zahrawi’s surgical and medical practice as well as the clinical methods he used. Furthermore, the study of those two maqalas will help in identifying the scientific method used by Al-Zahrawi and discovering the reasons behind his ingenuity and originality. All this will open up a multitude of research opportunities that will help to restore continuity to the progress of medicine, surgery and pharmacy as a joint global contribution of the whole world. Phase after phase, the progress circles of medical theory and practice continued to expand. Indeed, as Durant put it, “civilizations are units in a larger whole, whose name is: ‘history’; they do not disappear. The past always rolls into the present”.

 

 

The Millennium Anniversary of Al-Zahrawi (Albucasis): A Piece of Advice from Him to His Trainees

In the first book (Bab) I spoke of all diseases for which cauterisation is of value, either the actual cautery or that done with caustic medicines; and of their reasons and causes; also the instruments and the shapes of the cauteries. This I set out in chapters from head to heel.

 In this book, I shall proceed along the same route so that it will be easy for the enquirer to find what he is looking for. But before I begin this, you ought first to know, my sons, that in this book there is more risk than in the first, which treats of cauterisation. Wherefore, in this matter, there should be greater circumspection.  For in the course of the work of which this book treats, there often occurs effusion of the blood upon which life depends, in the opening of a blood vessel or the incision of a tumour or the perforation [drainage] of an abscess or the treatment of a wound or the extraction of an arrow or in the incising for a calculus or similar case; all of which are accompanied by uncertainty and fear; and in most death will supervene.

So I warn you against undertaking any case in which there is any element of doubt to you; for in the exercise of art you will be mobbed by all kinds of persons with all manner of affliction; some being so weary of their sickness that death itself is a relief on the account of the extent of their sufferings and the length of their miseries, their illness being so settled as to presage death. Some will lavish their wealth on you and enrich you, in the hope that they may be curable, when their disease is mortal. You should not assist any of this kind who approach you; let your caution be stronger than your greed and desire for gain and do not embark anything of this kind unless you have positive knowledge, which you judge adequate, about the way of bringing the patient a good outcome. In treating every patient be prescient  and foretell the means whereby health may be restored to him. That will help you to obtain renown, glory, fame and praise. May God inspire you, my sons, with His guidance and grant that you hit the mark and succeed; for it is in His hand; there is no God but He.

I have arranged this book in sections as I did with the previous book on cauterisation, from head to heel; so you will find in it what you seek [God willing]”.

 

Quotation from the Second Bab of the 30thMaqala of Kitab Al-Tasrif Liman A’jaz A’an Al –Ta’alif’ by Al-Zahrawi.

Translated from the original Arabic by Lewis MS and Spink IL[1].The bolding is by Abdel-Halim R E.

 



[1] Spink MS, Lewis IL. Albucassis on surgery and instruments (a definitive edition of the Arabic text with English translation and commentary). London : Wellcome Institute of the History of Medicine; 1973. pp 166-169

 

 

A Quotation from Al-Zahrawi in a Letter to the BMJ Editor

Never perform an operation without first watching it performed by others and without having experience of the technique…

Davide Lazzeri, Plastic surgeon, Stefano Lazzeri*, Michele Figus*, Marco Nardi*, and Marcello Pantaloni, Plastic and Reconstructive Surgery Unit and *Ophthalmology Unit, 56100, Hospital of Pisa, Italy.
Letter to the BMJ Editor on 8th of January 2010 in response to:
How Islam Changed Medicine
Majeed A. How Islam changed medicine. BMJ. 2005 24; 331: 1486-7)

“….Embracing scientific knowledge received from the Nestorians allows Muslim medical culture to grow up exponentially, reaching its peak with the encyclopedic work on medicine and surgery El Tasrif or Tasrif (The Method) by Abul Quazim Khalaf Ibn’Abbas az-Zahrawi, better known as Albucasis (936–1013 A.D.) the greatest Arab surgeon in history.[6] Albucasis is considered to be one of the moving spirits behind the rebirth of surgery, because it was through his teachings that the practice spread from Cordoba across Western Europe. The book became rapidly the leading medical text in all European universities during the later Middle Ages. Its section on surgery contains illustrations of surgical instruments of elegant, functional design and great precision. Other chapters describe amputations, ophthalmic and dental surgery, and the treatment of wounds and fractures. He developed new surgical technologies and invented several devices used during surgery. “… Never perform an operation without first watching it performed by others and without having experience of the technique” was the basic principle of his modern medical teaching.”[5]

References:
5. Santoni-Rugiu P, and Sykes P. The contribution of Arabs. In: A history of plastic surgery. The Springer-Verlag Berlin and Heidelberg GmbH& Co. KG; 2007: pp. 50-2.
6. Leclerc L. La chirurgie d’Albucasis. Bailliere, Paris, 1861

For the full text of the article including the rest of the references and contributions of some other scholars from the Medieval Islamic era, please click here.