The Canon of Medicine


The Canon of Medicine

"The Canon of Medicine" (Arabic: القانون في الطب "Al-Qanun fi al-Tibb" "The Law of Medicine"; Persian: قانون "Qanun" "Law"; Latin: "Canon Medicinae" "Canon of Medicine"; Chinese: "Hui Hui Yao Fang" "Prescriptions of the Hui Nationality") is a 14-volume Arabic medical encyclopedia written by the Persian Muslim scientist and physician Ibn Sīnā (Avicenna) and completed in 1025.citation|title=Origins of Neuroscience: A History of Explorations Into Brain Function|first=Stanley|last=Finger|year=1994|publisher=Oxford University Press|isbn=0195146948|page=70] Written in Arabic, the book was based on a combination of his own personal experience, medieval Islamic medicine, the writings of the Greek physician Galen, [ [http://www.experiencefestival.com/a/Islamic_Golden_Age_-_Medicine/id/1433472 Islamic Golden Age - Medicine] ] the Indian physicians Sushruta and Charaka, and ancient Arabian and Persian medicine. [Hakeem Abdul Hameed, [http://www.salaam.co.uk/knowledge/hakeems.php Exchanges between India and Central Asia in the field of Medicine] ] The "Canon" is considered one of the most famous books in the history of medicine. [cite web|url=http://www.britannica.com/eb/topic-92902/The-Canon-of-Medicine|title="The Canon of Medicine" (work by Avicenna)|publisher="Encyclopædia Britannica"|date=2008|accessdate=2008-06-11]

Also known as the "Qanun", which means "law" in Arabic and Persian, the "Canon of Medicine" remained a medical authority up until the 18th century [Ziauddin Sardar, [http://www.cgcu.net/imase/islam_science_philosophy.htm Science in Islamic philosophy] ] and early 19th century. [Amber Haque (2004), "Psychology from Islamic Perspective: Contributions of Early Muslim Scholars and Challenges to Contemporary Muslim Psychologists", "Journal of Religion and Health" 43 (4): 357-377 [375] ] It set the standards for medicine in Europe and the Islamic world, and is Avicenna's most renowned written work. "Qanun" was used at many medical schools—at University of Montpellier, France, as late as 1650. [ [http://www.britannica.com/eb/topic-92902/The-Canon-of-Medicine The Canon of Medicine (work by Avicenna)] , Encyclopædia Britannica] Much of the book was also translated into Chinese as the "Hui Hui Yao Fang" ("Prescriptions of the Hui Nationality") by the Hui people in Yuan China. [citation|title=Oriental Medicine|last=Jan Van Alphen, Anthony Aris|first=Fernand Meyer, Mark De Fraeye|publisher=Serindia Publications|year=1995|isbn=0906026369|page=201] The "Canon" also formed the basis of Unani medicine, a form of traditional medicine practiced in India. The principles of medicine described by him ten centuries ago in this book, are still taught at UCLA and Yale University, among others, as part of the history of medicine.

The "Canon" is considered the first pharmacopoeia, [Philip K. Hitti (cf. Dr. Kasem Ajram (1992), "Miracle of Islamic Science", Appendix B, Knowledge House Publishers. ISBN 0911119434).] [Dr. Z. Idrisi, PhD (2005). [http://www.muslimheritage.com/uploads/AgricultureRevolution2.pdf The Muslim Agricultural Revolution and its influence on Europe] . The Foundation for Science, Technology and Civilization, UK.] and among other things, the book is known for the introduction of systematic experimentation and quantification into the study of physiology, [Katharine Park (March 1990). "Avicenna in Renaissance Italy: The Canon and Medical Teaching in Italian Universities after 1500" by Nancy G. Siraisi", "The Journal of Modern History" 62 (1), pp. 169-170:quote|"Students of the history of medicine know him for his attempts to introduce systematic experimentation and quantification into the study of physiology."] the discovery of the contagious nature of infectious diseases,the introduction of quarantine to limit the spread of contagious diseases, and the introduction of evidence-based medicine, experimental medicine, clinical trials,David W. Tschanz, MSPH, PhD (August 2003). "Arab Roots of European Medicine", "Heart Views" 4 (2).]
randomized controlled trials,Jonathan D. Eldredge (2003), "The Randomised Controlled Trial design: unrecognized opportunities for health sciences librarianship", "Health Information and Libraries Journal" 20, p. 34–44 [36] .] Bernard S. Bloom, Aurelia Retbi, Sandrine Dahan, Egon Jonsson (2000), "Evaluation Of Randomized Controlled Trials On Complementary And Alternative Medicine", "International Journal of Technology Assessment in Health Care" 16 (1), p. 13–21 [19] .]
efficacy tests,D. Craig Brater and Walter J. Daly (2000), "Clinical pharmacology in the Middle Ages: Principles that presage the 21st century", "Clinical Pharmacology & Therapeutics" 67 (5), p. 447-450 [449] .] Walter J. Daly and D. Craig Brater (2000), "Medieval contributions to the search for truth in clinical medicine", "Perspectives in Biology and Medicine" 43 (4), p. 530–540 [536] , Johns Hopkins University Press.]
clinical pharmacology,D. Craig Brater and Walter J. Daly (2000), "Clinical pharmacology in the Middle Ages: Principles that presage the 21st century", "Clinical Pharmacology & Therapeutics" 67 (5), p. 447-450 [448] .] neuropsychiatry, physiological psychology, risk factor analysis, and the idea of a syndrome in the diagnosis of specific diseases.Lenn Evan Goodman (2003), "Islamic Humanism", p. 155, Oxford University Press, ISBN 0195135806.]

George Sarton, the father of the history of science, wrote in the "Introduction to the History of Science":

Overview

The book explains the causes of health and disease. Ibn Sina believed that the human body cannot be restored to health unless the causes of both health and disease are determined. Ibn Sina defined medicine ("tibb") as follows:

quote|"Medicine is the science by which we learn the various states of the body; in health, when not in health; the means bywhich health is likely to be lost; and, when lost, is likely to be restored. In other words, it is the art whereby health is concerned and the art by which it is restored after being lost." [citation|last=Howell|first=Trevor H.|title=Avicenna and His Regimen of Old Age|journal=Age and Ageing|year=1987|volume=16|pages=58-59]

Avicenna regarded the causes of good health and diseases to be:

# The Material Causes
# The Elements
# The Humors
# The Variability of the Tumors
# The Temperaments
# The Psychic Faculties
# The Vital Force
# The Organs
# The Efficient Causes
# The Formal Causes
# The Vital Faculties
# The Final Causes

The "Qanun" distinguishes mediastinitis from pleurisy and recognises the contagious nature of phthisis (tuberculosis of the lung) and the spread of disease by water and soil. It gives a scientific diagnosis of ankylostomiasis and attributes the condition to an intestinal worm. The "Qanun" points out the importance of dietetics, the influence of climate and environment on health, and the surgical use of oral anaesthetics. [ [http://www.unani.com/avicenna%20story%203.htm The Canon of Medicine] , The American Institute of Unani Medicine, 2003.] Ibn Sina advised surgeons to treat cancer in its earliest stages, ensuring the removal of all the diseased tissue. The "Qanun" 's "materia medica" considers some 800 tested drugs, with comments on their application and effectiveness. He recommended the testing of a new drug on animals and humans prior to general use.

The earliest known copy of the Canon of Medicine dated 1052 is held in the collection of the Aga Khan and is to be housed in the Aga Khan Museum planned for Toronto, Ontario, Canada.

Influence in Europe

The Arabic text of the "Qanun" was translated into Latin as "Canon medicinae" by Gerard of Cremona in the 12th century and into Hebrew in 1279. Henceforth the "Canon" served as the chief guide to medical science in the West and is said to have influenced Leonardo da Vinci. Its encyclopaedic content, its systematic arrangement and philosophical plan soon worked its way into a position of pre-eminence in the medical literature of Europe, displacing the works of Galen and becoming the text book for medical education in the schools of Europe. The text was read in the medical schools at Montpellier and Leuven as late as 1650, and Arnold C. Klebs described it as "one of the most significant intellectual phenomena of all times." In the words of Dr. William Osler, the "Qanun" has remained "a medical bible for a longer time than any other work". The first three books of the Latin "Canon" were printed in 1472, and a complete edition appeared in 1473. The 1491 Hebrew edition is the first appearance of a medical treatise in Hebrew and the only one produced during the 15th century. In the last 30 years of the 15th century it passed through 15 Latin editions.

In recent years, a partial translation into English was made.

Experimental medicine

"The Canon of Medicine" was the first book dealing with evidence-based medicine, experimental medicine, clinical trials, randomized controlled trials, efficacy tests, risk factor analysis, and the idea of a syndrome in the diagnosis of specific diseases.

According to Toby Huff and A. C. Crombie, the "Canon" contained "a set of rules that laid down the conditions for the experimental use and testing of drugs" which were "a precise guide for practical experimentation" in the process of "discovering and proving the effectiveness of medical substances."Citation
first=Toby
last=Huff
year=2003
title=The Rise of Early Modern Science: Islam, China, and the West
page=218
publisher=Cambridge University Press
isbn=0521529948
]

Clinical pharmacology

Avicenna's emphasis on tested medicines laid the foundations for an experimental approach to pharmacology. [citation|last=Jacquart|first=Danielle|journal=European Review|volume=16|issue=2|pages=219–227 [219 & 222-5] |title=Islamic Pharmacology in the Middle Ages: Theories and Substances] The "Canon" laid out the following rules and principles for testing the effectiveness of new drugs and medications, which still form the basis of clinical pharmacology and modern clinical trials:

#"The drug must be free from any extraneous accidental quality."
#"It must be used on a simple, not a composite, disease."
#"The drug must be tested with two contrary types of diseases, because sometimes a drug cures one disease by Its essential qualities and another by its accidental ones."
#"The quality of the drug must correspond to the strength of the disease. For example, there are some drugs whose heat is less than the coldness of certain diseases, so that they would have no effect on them."
#"The time of action must be observed, so that essence and accident are not confused."
#"The effect of the drug must be seen to occur constantly or in many cases, for if this did not happen, it was an accidental effect."
#"The experimentation must be done with the human body, for testing a drug on a lion or a horse might not prove anything about its effect on man."

The "Canon" lists 800 tested drugs, including plant and mineral substances, with comments on their application and effectiveness. For each one, he described their pharmaceutical actions from a range of 22 possibilities (including resolution, astringency and softening), and their specific properties according to a grid of 11 types of diseases.citation|last=Jacquart|first=Danielle|journal=European Review|volume=16|issue=2|pages=219–227 [223] |title=Islamic Pharmacology in the Middle Ages: Theories and Substances]

Inductive logic

While Ibn Sina often relied on deductive reasoning in "The Book of Healing" and other writings on logic in Islamic philosophy, he used a different approach in "The Canon of Medicine". Ibn Sina contributed inventively to the development of inductive logic, which he used to pioneer the idea of a syndrome in the diagnosis of specific diseases. In "The Canon of Medicine", Avicenna was the first to describe the methods of agreement, difference and concomitant variation which are critical to inductive logic and the scientific method.Lenn Evan Goodman (2003), "Islamic Humanism", p. 155, Oxford University Press, ISBN 0195135806.] [Lenn Evan Goodman (1992), "Avicenna", p. 33, Routledge, ISBN 041501929X.]

Pharmaceutical sciences

Avicenna's contribution to the pharmaceutical sciences include the introduction of systematic experimentation and quantification into pharmacology and the study of physiology, the introduction of experimental medicine, evidence-based medicine, clinical trials,
randomized controlled trials,
efficacy testsand clinical pharmacology; the first careful descriptions of skin troubles, sexually transmitted diseases, perversions and nervous ailments;George Sarton, "Introduction to the History of Science".
(cf. Dr. A. Zahoor and Dr. Z. Haq (1997), [http://www.cyberistan.org/islamic/Introl1.html Quotations From Famous Historians of Science] , Cyberistan.] and the discovery of the healing property of gaseous mercury besides its poisonous quality;as well as the use of ice to treat fevers, and the separation of medicine from pharmacology, which was important to the development of the pharmaceutical sciences.Bashar Saad, Hassan Azaizeh, Omar Said (October 2005). "Tradition and Perspectives of Arab Herbal Medicine: A Review", "Evidence-based Complementary and Alternative Medicine" 2 (4), p. 475-479 [476] . Oxford University Press.]

;Pharmacotherapy

Avicenna wrote a separate supplement treatise dedicated to the pharmacotherapy of "Hindiba", a compound drug he suggested for the treatment of cancer and other tumors (see Cancer therapy below) and which could also be used for treating other neoplastic disorders. He gives details on the drug's properties and uses, and then gives instructions on its preparation as medication.

;Pharmacy

Ibn Sina described no less than 700 preparations of medications, their properties, mode of action and their indications. He devoted in fact a whole volume to simple and compound drugs in "The Canon of Medicine". He credits many of them to a variety of Arabic, Greek and Indian authors, and also includes some drugs imported from China, along with many of his own original contributions. Using his own expertise, he was often critical of the descriptions given by previous authors and revised many of their descriptions. [citation|last=Jacquart|first=Danielle|journal=European Review|volume=16|issue=2|pages=219–227 [219 & 222-5|title=Islamic Pharmacology in the Middle Ages: Theories and Substances]

Anatomy and Physiology

The contributions of Avicenna's "Canon" to physiology include the introduction of systematic experimentation and quantification into the study of physiology.Katharine Park (March 1990). "Avicenna in Renaissance Italy: The Canon and Medical Teaching in Italian Universities after 1500" by Nancy G. Siraisi", "The Journal of Modern History" 62 (1), p. 169-170.]

Writings on anatomy in the "Canon" are scattered throughout the text in sections regarding to illnesses related to certain body parts. The "Canon" included numerous discussions on anatomy and diagrams on certain body parts, including the first diagrams of the cranial sutures. [ [http://www.nlm.nih.gov/hmd/arabic/E8.html The Canon on Medicine] , United States National Library of Medicine.]

Blood pressure

Avicenna dedicated a chapter of the "Canon" to blood pressure. He was able to discover the causes of bleeding and heamorrhage, and discovered that heamorrhage could be induced by high blood pressure because of higher levels of cholesterol in the blood. This led him to investigate methods of controlling blood pressure.Professor Dr. İbrahim Hakkı Aydin (2001), "Avicenna And Modern Neurological Sciences", "Journal of Academic Researches in Religious Sciences" 1 (2): 1-4.]

Dissection

Avicenna distinguished anatomy "from other aspects of medicine by its need for a different methodology." He thus stated in the "Canon": [citation|first=Emilie|last=Savage-Smith|title=Attitudes Toward Dissection in Medieval Islam|journal=Journal of the History of Medicine and Allied Sciences|year=1995|volume=50|issue=1|publisher=Oxford University Press|pages=67-110 [92-3] ]

Neuroanatomy and neurophysiology

Avicenna discovered the cerebellar vermis—which he named "vermis"—and the caudate nucleus, which he named "tailed nucleus" or "nucleus caudatus". These terms are still used in modern neuroanatomy and neurophysiology.

He was also the earliest to note that intellectual dysfunctions were largely due to deficits in the brain's middle ventricle, and that the frontal lobe of the brain mediated common sense and reasoning.citation|title=Masters of the Mind: Exploring the Story of Mental Illness from Ancient Times to the New Millennium|first=Theodore|last=Millon|year=2004|publisher=John Wiley & Sons|isbn=0471679615|page=38]

Ophthalmology

Avicenna's contributions to ophthalmology in medieval Islam include his descriptions and explanations on the physiology of eye movements, which still forms a basis of information for modern ophthalmology. He also provided useful information on the optic nerves, iris, and central and peripheral facial paralyses.

Another contribution Avicenna made to ophthalmology was his suggestion that "the optic nerves did cross."

Pulsology and sphygmology

Avicenna was a pioneer in pulsology and sphygmology. In ancient times, Galen as well as Chinese physicians erroneously believed that there was a unique type of pulse for every organ of the body and for every disease.Rachel Hajar (1999), "The Greco-Islamic Pulse", "Heart Views" 1 (4): 136-140 [138] .] Galen also erroneously believed that "every part of an artery pulsates simultaneously" and that the motion of the pulse was due to natural motions (the arteries expanding and contracting naturally) as opposed to foced motions (the heart causing the arteries to either expand or contract). [Nahyan A. G. Fancy (2006), "Pulmonary Transit and Bodily Resurrection: The Interaction of Medicine, Philosophy and Religion in the Works of Ibn al-Nafīs (d. 1288)", pp. 224-228, "Electronic Theses and Dissertations", University of Notre Dame. [http://etd.nd.edu/ETD-db/theses/available/etd-11292006-152615] ]

The first correct explanation of pulsation was given by Avicenna, after he refined Galen's theory of the pulse and discovered the following in "The Canon of Medicine":

Avicenna also pioneered the modern approach of examining the pulse through the examination of the wrist, which is still practiced in modern times. His reasons for choosing the wrist as the ideal location is due to it being easilyavailable and the patient not needing to be distressed at the exposure of his/her body. The Latin translation of his "Canon" also laid the foundations for the later invention of the sphygmograph. [Rachel Hajar (1999), "The Greco-Islamic Pulse", "Heart Views" 1 (4): 136-140 [139-140] .]

Avicenna also wrote a treatise on diagnosing diseases using only the methods of feeling the pulse and observing inhalation. He was often capable of finding the symptoms of certain diseases only by feeling a patient's pulse.

Etiology and Pathology

In etiology and pathology, Avicenna discovered the contagious nature of infectious diseases such as phthisis and tuberculosis, the distribution of disease by water and soil, and the existence of sexually transmitted disease. He fully understood the pathology of contagious disease. [ [http://www.bookrags.com/history/islam-science-technology-health/sub12.html Medicine And Health] , "Rise and Spread of Islam 622-1500: Science, Technology, Health", "World Eras", Thomson Gale.]

Avicenna also distinguished between mediastinitis and pleurisy, provided careful descriptions of skin troubles, perversions, and nervous ailments." Meningitis was also first described in "The Canon of Medicine". He also described the first known treatments for cancer.Patricia Skinner (2001), [http://findarticles.com/p/articles/mi_g2603/is_0007/ai_2603000716 Unani-tibbi] , "Encyclopedia of Alternative Medicine"]

Since the "Canon", Bimaristan hospitals were created with separate wards for specific illnesses, so that people with contagious diseases could be kept away from other patients who do not have any contagious diseases. [ [http://www.bookrags.com/history/islam-science-technology-health/sub12.html Medicine And Health] , "Rise and Spread of Islam 622-1500: Science, Technology, Health", "World Eras", Thomson Gale.]

Bacteriology and microbiology

The "Canon" stated that bodily secretions are contaminated by "foul foreign earthly bodies" before a person becomes infected, but he did not view these bodies as primary causes of disease. [Ibrahim B. Syed, Ph.D. (2002). "Islamic Medicine: 1000 years ahead of its times", "Journal of the Islamic Medical Association" 2, p. 2-9.]

Cancer therapy

In cancer therapy, Avicenna recognized cancer as a tumor. He noted that a "cancerous tumour progressively increases in size, is destructive and spreads roots which insinuate themselves amongst the tissue elements." He also attempted the earliest known treatments for cancer. One method he discovered was the "Hindiba", a herbal compound drug which Ibn al-Baitar later identified as having "anticancer" properties and which could also treat other tumors and neoplastic disorders.cite web|author=Prof. Nil Sari (Istanbul University, Cerrahpasha Medical School)|title=Hindiba: A Drug for Cancer Treatment in Muslim Heritage|publisher=FSTC Limited|date=06 June, 2007|url=http://muslimheritage.com/topics/default.cfm?ArticleID=707] After recognizing its usefulness in treating neoplastic disorders, Hindiba was patented in 1997 by Nil Sari, Hanzade Dogan, and John K. Snyder. [patent|US|5663196|Methods for treating neoplastic disorders]

Another method for treating cancer first described by Avicenna was a surgical treatment. He stated that the excision should be radical and that all diseased tissue should be removed, which included the use of amputation or the removal of veins running in the direction of the tumor. He also recommended the use of cauterization for the area being treated if necessary.

Avicenna's "Canon" was also the first to describe the symptoms of esophageal cancer and the first to refer to it as "cancer of the esophagus." [citation|title=The Historical Basis for the AEsophageal Cancer Belt of South-Central Asia|last=Saidi|first=F., MD|journal=Archives of Iranian Medicine|volume=2|issue=1|date=January 1999]

Hepatology

Avicenna's advances in hepatology include his introduction of new methods of hepatitis treatment.

Quarantine

The "Canon" introduced quarantine as a means of limiting the spread of contagious diseases.

Neurosciences and Psychology

In Islamic psychology and neurosciences, Ibn Sina noted the close relationship between emotions and the physical condition, and felt that music had a definite physical and psychological effect on patients.

Clinical psychology and psychotherapy

In clinical psychology and psychotherapy, Avicenna often used psychological methods to treat his patients.Amber Haque (2004), "Psychology from Islamic Perspective: Contributions of Early Muslim Scholars and Challenges to Contemporary Muslim Psychologists", "Journal of Religion and Health" 43 (4): 357-377 [366] .] One such case study is when a prince of Persia had melancholia and suffered from the delusion that he is a cow, and who would low like a cow crying "Kill me so that a good stew may be made of my flesh" and would never eat anything. Avicenna was persuaded to the case and sent a message to the patient, asking him to be happy as the butcher was coming to slaughter him, and the sick man rejoiced. When Avicenna approached the prince with a knife in his hand, he asked "where is the cow so I may kill it." The patient then lowed like a cow to indicate where he was. "By order of the butcher, the patient was also laid on the ground for slaughter." When Avicenna approached the patient pretending to slaughter him, he said, "the cow is too lean and not ready to be killed. He must be fed properly and I will kill it when it becomes healthy and fat." The patient was then offered food which he ate eagerly and gradually "gained strength, got rid of his delusion, and was completely cured." [Amber Haque (2004), "Psychology from Islamic Perspective: Contributions of Early Muslim Scholars and Challenges to Contemporary Muslim Psychologists", "Journal of Religion and Health" 43 (4): 357-377 [376] .]

Among the many other psychological disorders that he described in the "Qanun", one is of unusual interest: love sickness. Ibn Sina is reputed to have diagnosed this condition in a Prince in Jurjan who lay sick and whose malady had baffled local doctors. Ibn Sina noted a fluttering in the Prince's pulse when the address and name of his beloved were mentioned. The great doctor had a simple remedy: unite the sufferer with the beloved.

Neurology and neuropathology

Avicenna's contributions in neurology and neuropathology include his diagnosis of facial nerve paralysis, his distinction between brain paralysis and hyperaemia, and most importantly his discovery of meningitis. He diagnosed meningitis as a disease induced by the brain itself and differentiated it from infectious brain disease, and was also able to diagnose and describe the type of meningitis induced by an infection in other parts of the body.

Neuropsychiatry and neuropsychology

Ibn Sina was a pioneer of neuropsychiatry and neuropsychology. He first described numerous neuropsychiatric conditions, including hallucination, insomnia, mania, nightmare, melancholia, dementia, epilepsy, paralysis, stroke, vertigo and tremor.S. Safavi-Abbasi, L. B. C. Brasiliense, R. K. Workman (2007), "The fate of medical knowledge and the neurosciences during the time of Genghis Khan and the Mongolian Empire", "Neurosurgical Focus" 23 (1), E13, p. 3.] Avicenna dedicated three chapters of "The Canon of Medicine" to neuropsychiatry.Hanafy A. Youssef, Fatma A. Youssef and T. R. Dening (1996), "Evidence for the existence of schizophrenia in medieval Islamic society", "History of Psychiatry" 7: 55-62 [56] .]

He defined madness ("Junun") as a mental condition in which reality is replaced by fantasy, and discovered that it is a disorder of reason with its origin in the middle part of the brain. [Hanafy A. Youssef, Fatma A. Youssef and T. R. Dening (1996), "Evidence for the existence of schizophrenia in medieval Islamic society", "History of Psychiatry" 7: 55-62 [56-57] .] He also discovered a condition resembling schizophrenia which he described as "Junun Mufrit" (severe madness), which he clearly distinguished from other forms of madness such as mania, rabies, and manic depressive psychosis. He observed that patients suffering from schizophrenia-like severe madness show agitation, behavioural and sleep disturbance, give inappropriate answers to questions, and in some cases are incapable of speaking at times. He wrote that such patients need to be restrained, in order to avoid any harm they may cause to themselves or to others.Hanafy A. Youssef, Fatma A. Youssef and T. R. Dening (1996), "Evidence for the existence of schizophrenia in medieval Islamic society", "History of Psychiatry" 7: 55-62 [57] .]

Avicenna also dedicated a chapter of the "Canon" to mania and rabies, where he described mania as bestial madness characterized by rapid onset and remission, with agitation and irritability, and described rabies as a type of mania.

Psychoanalysis

In "The Canon of Medicine", Avicenna extended the theory of temperaments to encompass "emotional aspects, mental capacity, moral attitudes, self-awareness, movements and dreams." Avicenna's work is thus considered a "forerunner of twentieth century psychoanalysis."citation|first=Peter L.|last=Lutz|year=2002|title=The Rise of Experimental Biology: An Illustrated History|page=60|publisher=Humana Press|isbn=0896038351]

Psychophysiology and psychosomatic medicine

Ibn Sina was a pioneer in psychophysiology and psychosomatic medicine, and the first to recognize 'physiological psychology' in the treatment of illnesses involving emotions, and developed a system for associating changes in the pulse rate with inner feelings, which is seen as an anticipation of the word association test attributed to Carl Jung. Avicenna identified love sickness ("Ishq") when he was treating a very ill patient by "feeling the patient's pulse and reciting aloud to him the names of provinces, districts, towns, streets, and people." He noticed how the patient's pulse increased when certain names were mentioned, from which Avicenna deduced that the patient was in love with a girl whose home Avicenna was "able to locate by the digital examination." Avicenna advised the patient to marry the girl he is in love with, and the patient soon recovered from his illness after his marriage.Ibrahim B. Syed PhD, "Islamic Medicine: 1000 years ahead of its times", "Journal of the Islamic Medical Association", 2002 (2), p. 2-9 [7] .]

Avicenna also gave psychological explanations for certain somatic illnesses, and he always linked the physical and psychological illnesses together. He described melancholia (depression) as a type of mood disorder in which the person may become suspicious and develop certain types of phobias. He stated that anger heralded the transition of melancholia to mania, and explained that humidity inside the head can contribute to mood disorders. He recognized that this occurs when the amount of breath changes: happiness increases the breath, which leads to increased moisture inside the brain, but if this moisture goes beyond its limits, the brain would lose control over its rationality and lead to mental disorders. He also wrote about symptoms and treatments for nightmare, epilepsy, and weak memory.Amber Haque (2004), "Psychology from Islamic Perspective: Contributions of Early Muslim Scholars and Challenges to Contemporary Muslim Psychologists", "Journal of Religion and Health" 43 (4): 357-377 [366] .]

urgery

In surgery, Avicenna was the first to describe the surgical procedure of intubation in order to facilitate breathing.

Anesthesia

The "Canon" described the "soporific sponge", an anasthetic imbued with aromatics and narcotics, which was to be placed under a patient's nose during surgical operations.

Cancer therapy

:"See Etiology and Pathology above"

Hirudotherapy

Hirudotherapy, the use of medicinal leech for medical purposes, was introduced by Avicenna in "The Canon of Medicine". He considered the application of leech to be more useful than cupping in "letting off the blood from deeper parts of the body." He also introduced the use of leech as treatment for skin disease. Leech therapy became a popular method in medieval Europe due to the influence of his "Canon". [Nurdeen Deuraseh, "Ahadith of the Prophet (s.a.w) on Healing in Three Things (al-Shifa' fi Thalatha): An Interpretational", "Jounal of the International Society for the History of Islamic Medicine", 2004 (3): 14-20 [18] .]

Other contributions

Chromotherapy

Avicenna, who viewed colour to be of vital importance in diagnosis and treatment, made significant contributions to chromotherapy. He wrote that "Color is an observable symptom of disease" and also developed a chart that related colour to the temperature and physical condition of the body. His view was that red moved the blood, blue or white cooled it, and yellow reduced muscular pain and inflammation. He further discussed the properties of colours for healing and was "the first to establish that the wrong colour suggested for therapy would elicit no response in specific diseases." As an example, "he observed that a person with a nosebleed should not gaze at things of a brilliant red color and should not be exposed to red light because this would stimulate the humor, whereas blue would soothe it and reduce blood flow." [Samina T. Yousuf Azeemi and S. Mohsin Raza (2005), "A Critical Analysis of Chromotherapy and Its Scientific Evolution", "Evidence-Based Complementary Alternative Medicine" 2 (4): 481–488.]

Endocrinology

In endocrinology, Avicenna (980-1037) provided a detailed account on diabetes mellitus in "The Canon of Medicine", "describing the abnormal appetite and the collapse of sexual functions and he documented the sweet taste of diabetic urine." Like Aretaeus of Cappadocia before him, Avicenna recognized a primary and secondary diabetes. He also described diabetic gangrene, and treated diabetes using a mixture of lupine, trigonella (fenugreek), and zedoary seed, which produces a considerable reduction in the excretion of sugar, a treatment which is still prescribed in modern times. Avicenna also "described diabetes insipidus very precisely for the first time", though it was later Johann Peter Frank (1745-1821) who first differentiated between diabetes mellitus and diabetes insipidus. [citation|journal=International Journal of Endocrinology and Metabolism|year=2003|volume=1|pages=43-45 [44-5] |title=Clinical Endocrinology in the Islamic Civilization in Iran|last=Nabipour|first=I.]

Gerontology and Geriatrics

"The Canon of Medicine" was the first book to offer instruction for the care of the aged, foreshadowing modern gerontology and geriatrics. In a chapter entitled "Regimen of Old Age", Avicenna wrote that "old folk need plenty of sleep. Time spent on the couch should be liberal—more than is legitimate for adults." He wrote that after waking up, the body should be anointed with oil "to stimulate the sensitive faculties". Regarding exercise, he recommended walking or horse-riding. He stated:citation|last=Howell|first=Trevor H.|title=Avicenna and His Regimen of Old Age|journal=Age and Ageing|year=1987|volume=16|pages=58-59 [58] ]

He said that if the body is healthy, it can perform attempered exercises, but if one part of the body is infirm, "then that part should not be exercised until after the rest", and that exercises are not to be strictly graduated "as if the body were to be strengthened". The "Canon" recognized four periods of life: the period of growth, prime of life, period of elderly decline (from forty to sixty), and decrepit age. He states that during the last period, "there is hardness of their bones, roughness of the skin, and the long time since they produced semen, blood and vaporal breath". However, he agreed with Galen that the earth element is more prominent in the aged and decrepit than in other periods. Avicenna did not agree with the concept of infirmity, however, stating:

quote|"There is no need to assert that there are three states of the human body—sickness, health and a statewhich is neither health nor disease. The first two cover everything."

Thesis III of the "Canon" discussed the diet suitable for old people. Avicenna wrote that they should be given food in small amounts at a time and that they can have two to three meals a day, divided up according to the digestive powers and general condition of the old person in question. He also recommended fruits, such as figs and prunes. He also stated:citation|last=Howell|first=Trevor H.|title=Avicenna and His Regimen of Old Age|journal=Age and Ageing|year=1987|volume=16|pages=58-59 [59] ]

He also dedicated several sections of his Thesis III to elderly patients who become constipated, and wrote:

quote|"Strong clysters (enemata) must be avoided because they dry up the gut. An unctuous enema isbeneficial in cases where the bowels have been constipated for several days. ... Evacuations must be procured with as little stress as possible in the aged and decrepit, for it is to their advantage to get bowels opened gently."

Phytotherapy

In phytotherapy, Avicenna introduced the medicinal use of Taxus baccata L. He named this herbal drug as "Zarnab" and used it as a cardiac remedy. This was the first known use of a calcium channel blocker drug, which were not used in the Western world until the 1960s. [Yalcin Tekol (2007), "The medieval physician Avicenna used an herbal calcium channel blocker, Taxus baccata L.", "Phytotherapy Research" 21 (7): 701-2.]

Temperaments

"The Canon of Medicine" adopted the ancient theory of Four Humours and Four Temperaments and extended it to encompass "emotional aspects, mental capacity, moral attitudes, self-awareness, movements and dreams." Avicenna summarized his own theory of four temperaments in a table presented as follows:

ee also

* Avicenna
** Avicennism
** "The Book of Healing"
** Unani
* Ibn al-Nafis
** "Commentary on Anatomy in Avicenna's Canon"
* Abu al-Qasim al-Zahrawi
** "Al-Tasrif"
* Medical literature

References

External links

* [http://www.ummah.net/history/scholars/ibn_sina/ Biography of Avicenna]
* [http://ddc.aub.edu.lb/projects/saab/avicenna/contents-eng.html A scanned copy of "Kitab alQanun fi alTibb" (Book {of} the Canon of Medicine)]
* [http://www.akdn.org/agency/aktc_museum.html Aga Khan Museum Project (to include oldest known copy of the Canon of Medicine)]
* [http://www.akdn.org/news/toronto_101002.html Aga Khan Museum Project Press Release]


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