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The Case History in Medieval Islamic Medical Literature: Tajārib and Mujarrabāt as Source
Published online by Cambridge University Press: 17 May 2012
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1 See Cristina Álvarez Millán, ‘Practice versus theory: tenth-century case histories from the Islamic Middle East’, Soc. Hist. Med., 2000, 13(2): 293–306, (special issue, Peregrine Horden and Emilie Savage-Smith (guest eds), The year 1000: medical practice at the end of the first millenium). The same applies to medieval Islamic surgical treatises traditionally praised by scholarly literature, which have been proved to follow a literary tradition and which contain a number of statements suggesting that the Islamic physicians who wrote them never carried out—and never heard of anyone who had performed—some of the invasive surgical techniques described in their works. See Emilie Savage-Smith, ‘The practice of surgery in Islamic lands: myth and reality’, Soc. Hist. Med., 2000, 13(2): 307–21; idem, ‘The exchange of medical and surgical ideas between Europe and Islam’, in John A C Greppin, Emilie Savage-Smith and John L Gueriguian (eds), The diffusion of Greco-Roman medicine into the Middle East and the Caucasus, Delmar, NY, Caravan Books, 1999, pp. 27–55; idem, ‘Tashrīḥ’, The encyclopaedia of Islam, new ed., 11 vols, Leiden, Brill, 1960–2002, vol. 10, pp. 354–6.
2 Cristina Álvarez Millán, ‘Graeco-Roman case histories and their influence on medieval Islamic clinical accounts’, Soc. Hist. Med., 1999, 12 (1): 19–43.
3 Al-Rāzī, Kitāb al-Tajārib, Topkapi Saray Library, Istanbul, Col. Ahmed III, MS. 1975; Aḥmad b. ‘Īsà al-Hāšimī, Kitāb al-Maŷālis fī l-ṭibb, ed. S Kaddouri, Madrid, CSIC, 2005; Abū l-‘Alā’ Zuhr, Kitāb al-Muŷarrabāt, ed. with Spanish transl. and study by Cristina Álvarez Millán, Madrid, CSIC, 1994. An edition of the first work has been published by Khālid Ḥarbī (Kitāb al-Tajārib li-Abī Bakr Muḥammad b. Zakarīyā’ al-Rāzī, Alexandria, Dār al-Thaqāfa al-‘Ilmīya, 2006), although the texts included in this article do not always coincide or appear in that printed version.
4 Different in purpose, included in larger works and collected by the author himself, are the group of thirty-three case histories found in al-Rāzī’s Kitāb al-Ḥāwī, and by the same author, the third chapter of his treatise entitled Sirr ṣinā‘at al-ṭibb (The Secret of the Medical Art). Al-Rāzī, Kitāb al-Ḥāwī fī l-ṭibb, 23 vols, Hyderabad, Osmania Oriental Publications Bureau, 1955–68, vol. 16, pp. 189–208; Max Meyerhof, ‘Thirty-three clinical observations by Rhazes’, Isis, 1935, 23: 321–56 (reprinted in Studies in medieval Arabic medicine, ed. Penelope Johnstone, London, Variorum, 1984); Owsei Temkin, ‘A medieval translation of Rhazes’ Clinical observations’, Bull. Hist. Med., 1942, 12: 102–17; Rosa Kuhne Brabant, ‘El Sirr ṣinā‘at al-ṭibb de Abū Bakr Muḥammad b. Zakariyyā’ al-Rāzī’, Al-Qanṭara, 1982, 3: 347–414; 1984, 5: 235–92; 1985, 6: 369–95. For an analyisis of literary and stylistic features of these two groups of case histories, see Álvarez Millán, op. cit., note 2 above, pp. 37–41.
5 Lynn Thorndike, A history of magic and experimental science during the first thirteen centuries of our era, 4th ed., 8 vols, New York, Columbia University Press, 1923–1958, vol. 2, pp. 751–74.
6 Manfred Ullmann, Die Medizin im Islam, Leiden, Brill, 1970, pp. 311–13.
7 For a survey of the contents of this work, see Cristina Álvarez Millán, ‘El Kitāb al-Jawāṣṣ de Abū l-‘Alā’ Zuhr: materiales para su estudio’, Asclepio, 1994, 46: 151–74. On the sources employed for the compilation of this work, see Nikolaj Serikoff, ‘Dog-knights and elulargency: Greek ghost-words in medieval Arabic sources’, in Claudia Sode and Sarolta A Tákacs (eds), Novum millennium: studies in Byzantine history and culture in honor of Paul Speck, Aldershot, Ashgate, 2001, pp. 357–68.
8 Attributed to Hermes. Abū l-‘Alā’ Zuhr, Kitāb al-Khawāṣṣ, Topkapi Saray Library, Istanbul, Col. Ahmad III, MS. 2068, fol. 2a; Kitāb Mujarrabāt al-Khawāṣṣ, Bodleian Library, Oxford, Oriental Collections, MS. Marsh 520, fol. 1b. All translations are mine unless otherwise indicated.
9 Attributed to Kimās. Abū l-‘Alā’ Zuhr, Kitāb al-Khawāṣṣ, op. cit., note 8 above, fol. 12a, and Mujarrabāt al-Khawāṣṣ, op. cit., note 8 above, fol. 12a.
10 Abū l-‘Alā’ Zuhr, Kitāb al-Khawāṣṣ, op. cit., note 8 above, fols. 70a-b; Mujarrabāt al-Khawāṣṣ, op. cit., note 8 above, fol. 74b.
11 See William Eamon, Science and the secrets of nature: books of secrets in medieval and early modern culture, Princeton University Press, 1994. On sympathetic therapy in medieval Islamic literature, see Manfred Ullmann, Die Natur- und Geheimwissenschaften im Islam, Leiden, Brill, 1972, pp. 393–416. For magical practices in medieval Islamic medicine, see Peter E Pormann and Emilie Savage-Smith, Medieval Islamic medicine, Edinburgh University Press, 2007, pp. 144–61; Michael W Dols, Majnūn: the madman in medieval Islamic society, ed. Diana E Immisch, Oxford, Clarendon Press, 1992, ch. 9, ‘The theory of magic in healing’, pp. 261–73 (reprinted in Emilie Savage-Smith (ed.), Magic and divination in early Islam, Aldershot, Ashgate Variorum, 2004.
12 Rosa Kuhne Brabant, ‘Hacia una revisión de la bibliografía de Abū l-‘Alā’ Zuhr (m. 1130/1)’, Al-Qanṭara, 1992, 13 (2): 581–5.
13 Abū l-‘Alā’ Zuhr, op. cit., note 3 above, pp. 125, 193.
14 Ibn Sīnā, Al-Qānūn fī l-ṭibb, 3 vols, Beirut, s.n., n.d., vol. 3, p. 318. Al-Shilthā (edited in the Qānūn as shīlthā, and two lines below as shalīthā) is a compound remedy made of zedoary, doronicum, unbored pearls, coral, raw silk, alum, silver, gold, malabathrum, honey, pepper, saffron and musk among other simple drugs. See Martin Levey, Substitute drugs in early Arabic medicine, Stuttgart, Wissenschaftliche Verlagsgesellschaft, 1971, p. 73, n.292.
15 Al-Rāzī, op. cit., note 3 above, fol. 6a (which diverges from the corresponding printed text edited by K ḥarbī, p. 93). As for the word ṭifshīl, it is a dish made of leguminous vegetables such as beans and chickpeas. See Ibn al-ḥashshā’, Glossaire sur le Mans’uri de Razès, ed. G S Colin and H P J Renaud, Rabat, Institute des Hautes-Études Marocaines, 1941, p. 61.
16 Al-Hāshimī, op. cit., note 3 above, pp. 21–2.
17 Ibn Sīnā, op. cit., note 14 above, vol. 1, p. 279.
18 Gerrit Bos and Y Tzvi Langermann, ‘Pseudo-Galen, al-Adwiya ’l-maktūma, with the commentary of ḥunayn ibn Isḥāq’, Suhayl (Journal for the History of the Exact and Natural Sciences in Islamic Civilisation), 2006, 6: 81–112, p. 95.
19 Attributed to Dioscorides. Joshua O Leibowitz and Shlomo Marcus, Sefer hanisyonot: the book of medical experiences attributed to Abraham ibn Ezra, Jerusalem, The Magnes Press, The Hebrew University, 1984, p. 255. According to Savage-Smith and Pormann (op. cit., note 11 above, pp. 148, 160), this is a Hebrew translation of the treatise on khawāṣṣ by the tenth-century Andalusi author Abū al-Muṭrib ‘Abd al-Raḥmān b. Isḥāq b. al-Khaytham.
20 Ibn Durayhim al-Mawṣilī, Kitāb Manāfi‘ al- Ḥayawān (Libro de las utilidades de los animales). Facsimile edition with Spanish translation by Carmen Bravo Ruiz-Villasante, 2 vols, Madrid, Kaydela and Editora Patrimonio Nacional, 1990, vol. 1, fol. 3a, vol. 2, p. 5. For a description of this manuscript, see Anna Contadini, ‘The Kitāb Manāfi‘ al-Ḥayawān in the Escorial Library’, Islamic Art, 1988–89, 3: 33–52.
21 This pattern also applies to a Hebrew–Spanish aljamiado manuscript containing a collection of prescriptions by the physician Meir Alguades (c.1350–c.1410). See, Luis García Ballester, La búsqueda de la salud: sanadores y enfermos en la España medieval, Barcelona, Península Ediciones, 2001, pp. 473–84.
22 This is the case, for instance, of the fourteenth-century work by Abū Bakr b. Muḥammad al-Fārisī, Kitāb al-Durra al-muntakhaba fi l-adwiya al-mujarraba (Book of Selected Pearls on Tested Drugs). See Al-Khizāna al-Malakīya, Rabat, MS 2995.
23 Wellcome Library, London, WMS Or. 13, and Real Academia de la Historia, Madrid, Colección Gayangos, MS CLIII. Although unreliable as an edition and wrongly attributed to al-Rāzī, see the Arabic text published by Khālid ḥarbī, Jirāb al-Mujarrabāt wa-Khizānat al-Aṭibbā’ li-Abī Bakr Muḥammad b. Zakarīyā’ al-Rāzī, Alexandria, Dār al-Thaqāfa al-‘Ilmīya, 2006.
24 See B Lewin, ‘Akrābadhīn’, Encyclopaedia of Islam, op. cit., note 1 above, vol. 1, pp. 354–5.
25 For an analysis of the clinical account in the Greco-Roman period and the progressive shift of features and focus, see Álvarez Millán, op. cit., note 2 above.
26 Al-Rāzī, Kitāb al-Ḥāwī, op. cit., note 4 above, vol. 17, p. 25; translation by William A Greenhill, A treatise on the small-pox and measles, London, Sydenham Society, 1848, pp. 120–1, slightly amended.
27 Al-Rāzī, op. cit., note 3 above, fol. 72b (missing in K ḥarbī’s edition).
28 See Peter E Pormann, ‘Theory and practice in the early hospitals in Baghdad. Al-Kaškarī on rabies and melancholy’, Zeitschrift für Geschichte der Arabisch-Islamischen Wissenschaften, 2002–2003, 15: 197–248, pp. 197, 227 (examples on pp. 246–7, §17–18).
29 See Ibn Bashkwāl, Kitāb al-ṣila, ed. F Codera, 2 vols, Madrid, imprenta José de Rojas, 1882–1883, vol. 1, p. 217, biography 615.
30 I wish to thank Prof. Federico Corriente and Dr Joaquín Bustamante for their assistance in the interpretation of the Arabic word “jinjallah”. The first considered the term to be the Arabized Latin word from which the Spanish term “cizalla” (wire cutters) is derived, and the second interpreted it as the Arabic name for the Spanish town Chinchilla (Albacete), an important rug manufacturing centre in medieval Spain. Despite the lexical discrepancy, the point is that the student compares the scissors used by al-Taymī with those employed by rug weavers to finish off their work.
31 Al-Hāshimī, op. cit., note 3 above, p. 84.
32 Dimitri Gutas, ‘Medical theory and scientific method in the age of Avicenna’, in David C Reisman (ed.), Before and after Avicenna. Proceedings of the First Conference of the Avicenna Study Group, Leiden and Boston, Brill, 2003, pp. 145–62, on p. 157.
33 For a description of his life and his surgical treatise, see Eloísa Llavero Ruiz, ‘La medicina granadina del siglo XIV y Muḥammad al-Šafra’, Revista del Centro de Estudios Históricos de Granada y su Reino, new series, 1992, 6: 129–50.
34 Abū ‘Abd Allāh Muḥammad b. ‘Alī b. Faraŷ al-Qirbilyānī, conocido por al-Ŝafra, Kitāb al-Istiqṣā’ (Libro de la indagación exhaustiva), ed. with Spanish transl. by Eloísa Llavero Ruiz, 3 vols, Alicante, Instituto Alicantino de Cultura Juan Gil-Albert, 2005, vol. 2, pp. 123–4, and vol. 3, p. 27.
35 For his biography, see Cristina Álvarez Millán, ‘Ibn Zuhr’, in Thomas F Glick, Steven J Livesey and Faith Wallis (eds), Medieval science, technology and medicine: an encyclopaedia, London and New York, Routledge, 2005, pp. 259–61. For a full biography, description of the contents of his works, extant manuscripts and bibliography, see Rosa Kuhne Brabant and Cristina Álvarez Millán, ‘Abū Marwān ‘Abd al-Malik b. Zuhr’, in Jorge Lirola (ed.), Biblioteca de al-Andalus, 7 vols, Almería, Fundación Ibn ṭufayl, 2004– (vols 1 and 7, forthcoming), vol. 6, pp. 352–68.
36 See the following by Rosa Kuhne Brabant: El Kitāb al-Iqtiṣād de Avenzoar según el ms. n° 834 de la Biblioteca del Real Monasterio de San Lorenzo de El Escorial (extracto de tesis doctoral), Madrid, Facultad de Filosofía y Letras, 1971; ‘Avenzoar y la cosmética’, in J M Barral (ed.), Orientalia hispanica: sive studia F. M. Pareja octogenario dicata, Leiden, Brill, 1974, pp. 428–37; ‘Zīna e IṣlāḤ. Reflexiones para entender la medicina estética del joven Abū Marwān b. Zuhr’, Al-Andalus—Magreb, 1996, 4: 281–98.
37 Abū Marwān ‘Abd al-Malik b. Zuhr, Kitāb al-Iqtiṣād fi iṣlāḤ al-anfus wa-l-ajsād, Real Biblioteca del Monasterio, El Escorial, MS 834, fols 33a–33b. I owe a debt of gratitude to the late Dr Kuhne Brabant for her permission to include that source in this paper, as well as for providing me with her edition of the Arabic text and Spanish translation, which will be published posthumously.
38 For comparison, see Galen’s collection of major cases, On prognosis, ed., transl. and commentary by Vivian Nutton, Berlin, 1979 (Corpus Medicorum Graecorum, V 8.1). See also, ‘Galen and medical autobiography’, in Vivian Nutton, From Democedes to Harvey: studies in the history of medicine from the Greeks to the Renaissance, London, Variorum Reprints, 1988, pp. 50–62.
39 Ibn Zuhr, Kitāb al-Taysīr fi mudāwāt wa-l-tadbīr, ed. G Khoury, Damascus, 1983, p. 70: “Fa-innī matā ra’aytu al-jirāḥāt ḍa‘ifat nafsī ḥattā akāda an yaghshá ‘alayya wa-lā ra’aytu qiṭṭ māddah illā wa-tahawwa‘at ma‘idatī wa-rubbama taqayya’tu”.
40 Kuhne Brabant, op. cit., note 4 above. See also Álvarez Millán, op. cit., note 2 above, pp. 40–1.
41 See Lawrence I Conrad, ‘Scholarship and social context: a medical case from the eleventh-century Near-East’, in Don Bates (ed.), Knowledge and the scholarly medical traditions, Cambridge University Press, 1995, pp. 84–100.
42 For a comprehensive biography, description of the contents of his works, extant manuscripts and bibliography, see Cristina Álvarez Millán, ‘Abū l-‘Alā’ Zuhr’, Biblioteca de al-Andalus, op. cit., note 35 above, vol. 6, pp. 340–50.
43 See Cristina Álvarez Millán, ‘Medical anecdotes in Ibn Juljul’s biographical dictionary’, Suhayl (Journal for the History of the Exact and Natural Sciences in Islamic Civilization), 2004, 4: 141–58.
44 Ibn Abī Uṣaybi‘a, ‘Uyūn al-anbā’ fī ṭabaqāt al-aṭibbā’, ed. Gustav Müller, 2 vols, Cairo, Bulāq, 1882 (reprint F Sezgin, Frankfurt am Main, Institute for the History of Arabic Islamic Science at the Johann Wolfgang Goethe University, 1995), vol. 2, p. 66.
45 See Ullmann, op. cit., note 6 above, pp. 152–6; M Mahdi, et. al., ‘Avicenna’, in Ehsan Yarshater (ed.), Encyclopaedia Iranica, 8 vols, London and New York, Routledge & Kegan Paul, 1985–[1998], vol. 3, pp. 66–110; A M Goichon, ‘Ibn Sīnā’, in Encyclopaedia of Islam, op. cit., note 1 above, vol. 3, pp. 965–72; Floréal Sanagustin, ‘Ibn Sīnā, ou la raison médicale maitrisée’, Medicina nei Secoli, 1994, 6: 393–406.
46 For a description of the structure of the contents, see Emilie Savage-Smith, ‘Medicine’, in Roshdi Rashed (ed.), Encyclopedia of the history of Arabic science, 3 vols, London and New York, Routledge, 1996, vol. 3, pp. 921–2; and B Musallam, ‘Avicenna, X: biology and medicine’, Encyclopaedia Iranica, op. cit., note 45 above, vol. 3, pp. 94–9.
47 See Danielle Jacquart and Françoise Micheau, La médecine arabe et l’Occident médiéval, Paris, Maisonneuve et Larose, 1990; Nancy Siraisi, Avicenna in Renaissance Italy: the Canon and medical teaching in Italian universities after 1500, Princeton University Press, 1987; Emilie Savage-Smith, ‘Europe and Islam’, in Irvine Loudon (ed.), Western medicine: an illustrated history, Oxford University Press, 1997, pp. 40–53, on p. 45.
48 Ibn Abī Uṣaybi‘a, op. cit., note 44 above, vol. 2, pp. 2–20. The text has been edited and translated into English by William E Gohlman, The life of Ibn Sina : a critical edition and annotated translation, Albany, NY, State University of New York Press, 1974. See also the thorough analysis of Avicenna’s autobiography by Dimitri Gutas, ‘Avicenna, II: biography’, Encyclopaedia Iranica, op. cit., note 45 above, vol. 3, pp. 67–70, and idem, Avicenna and the Aristotelian tradition: introduction to reading Avicenna’s philosophical works, Leiden, Brill, 1988, pp. 22–30, 194–98.
49 Gohlman, op. cit., note 48 above, p. 35.
50 Ibid., p. 37.
51 Ibid., p. 57.
52 Ibid., p. 73–75
53 For a discussion of Ibn Sīnā’s originality, see Albert Z Iskandar, A catalogue of Arabic manuscripts on medicine and science in the Wellcome Historical Medical Library, London, Wellcome Historical Medical Library, 1967, pp. 29–32. See also Martin Plessner, ‘The natural sciences and medicine’, in Joseph Schacht and C E Bosworth (eds), The legacy of Islam, Oxford, Clarendon Press, 1974, p. 449; and Irene Fellmann, ‘Ist der Qānūn des Ibn Sīnā ein Plagiat des K. al-Hāwī von ar-Rāzī?’, Zeitschrift für Geschichte der Arabisch-Islamischen Wissenschaften, 1984, 1: 148–54.
54 Gohlman, op. cit., note 48 above, p. 75.
55 Ibn Sīnā, op. cit., note 14 above, vol. 2, pp. 31–42. Ibn Sīnā describes twenty types of headache and their corresponding therapies, consisting of simple drugs, such as cooling or warming agents, dressings, plasters, compound medicines, diet, sleep, bloodletting and various means of evacuation, steam-bath, aromatherapy, etc., according to the headache’s nature or cause.
56 Walther Hinz, Islamische Masse und Gewichte. Umgerechnet ins metrische System, Leiden, Brill, 1955, pp. 16–23.
57 It is no wonder that Ibn Sīnā was reluctant to mention the quantity of this preparation that the woman consumed when he proudly reported this treatment in his Qānūn. Ibn Sīnā, op. cit., note 14 above, vol. 2, p. 259.
58 Gohlman, op. cit., note 48 above, pp. 81–2.
59 According to medieval medical ideas, inherited from the classical tradition, sexual indulgence caused a number of ailments, such as depression, tremblings, swelling of the stomach, physical weakness, or sight troubles, in addition to the shortening of life expectancy. See Danielle Jacquart and Claude Thomaset, Sexuality and medicine in the Middle Ages, Cambridge, Polity Press, 1988, pp. 118–19.
60 Gohlman, op. cit., note 48 above, p. 83.
61 Ibid., pp. 85–9.
62 See Edward G Browne, Chahār maqālah (“Four discourses”) of Nizámí-i-‘Arúdí of Samarqand, London, printed by the Cambridge University Press for the Trustees of the E J W Gibb Memorial and published by Luzac, 1921, pp. 88–90.
63 J C Bürgel, ‘Psychosomatic methods of cures in the Islamic Middle Ages’, Humaniora Islamica, 1973, 1: 157–72, esp. pp. 165–7; Luis García Ballester and Julio Samsó, ‘Tradición y novedad en el galenismo árabe de los siglos IX y XI: la doctrina del pulso, el pronóstico y un caso de aplicación de “masaje cardiaco”’, Al-Andalus, 1972, 38: 337–51, esp. pp. 339–41; Helen King, Hippocrates’ woman: reading the female body in Ancient Greece, London and New York, Routledge, 1998, p. 47.
64 Brown, op. cit., note 62 above, pp. 91–3.
65 For a description of cases dealing with mental disorders, see Álvarez Millán, op. cit., note 1 above, p. 296.
66 Gohlman, op. cit., note 48 above, p. 47–9.
67 See Mona Nasser, Aida Tibi, and Emilie Savage-Smith, ‘Ibn Sīnā’s Canon of medicine: 11th-century rules for assessing the effects of drugs’, J. R. Soc. Med., 2009, 102: 78–80 (originally published on-line in ‘The James Lind Library’ (http://www.jameslindlibrary.org). For a somewhat over-enthusiastic interpretation of this same text, see Mohammad M Sajadi, Davood Mansouri and Mohammad-Reza M Sajadi, ‘Ibn Sīnā and the clinical trial’, Annals of Internal Medicine, 2009, 150: 640–3.
68 Philip J van der Eijk, ‘Towards a rhetoric of ancient scientific discourse’, in Egbert J Bakker (ed.), Grammar as interpretation: Greek literature in its linguistic contexts, Leiden, Brill, 1997, pp. 77–129, on p. 84.
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