Al-Razi the Medical Scholar

Al-Razi was "a writer of rare and incredible productiveness as well as the greatest clinician of Islam." The great works of Al-Razi are of immense significance in the study of medicine.

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The physician Razi (circa 865-925 C.E.) at the bedside of a young patient afflicted with measles.

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The majority of the works by Al-Razi have been translated into Latin and printed many times, principally in Venice in 1509 and in Paris in 1528 and 1548; his treatise on small verole, for instance, was reprinted in 1745. Courses in medical schools and universities of Europe have always relied on his works; along with those of Ibn Sina, they were the foundation of teaching in Louvain up to the seventeenth century as seen by the 1617 settlement hence the need for some works to be re-printed until the 18th century. The same settlement shows that Greek authors had little place with the exception of the aphorisms of Hippocrates and the Ars parva of Galen.

About the age of thirty, Al-Razi made his first visit to Baghdad where he had a life-changing experience. He decided to visit the Muqtadiri Hospital out of curiousity and became interested in a conversation with an old pharmacist. He returned the following day and happened to meet a physician at the hospital who showed him a human foetus with two heads. So interested was he in this and in what he heard from the druggist that he became determined to study medicine. He stayed in Baghdad and there received a thorough grounding in his new profession, although it is usually asserted that he made his medical studies in Rayy.

On his return to Rayy, Al-Razi became the mutavalli or administrator of the city's hospital but he did not hold this post for long. Some time between 902 and 907 he returned to Baghdad and took charge of the Muqtadiri Hospital. As chief physician of Baghdad the fame of Al-Razi spread through the lands of the caliph and his services were in constant demand even in distant cities. Al-Razi ultimately became chief physician of the hospital at Rayy which he attended regularly, surrounded by his pupils and the students of his pupils; every patient who presented himself was first examined by the latter; and if the case proved too difficult for them it was passed on to the Master's immediate pupils then finally, if necessary, to himself. It is clear that al-Razi, in diagnosing illness as well as in treating it, sought to follow the dictates of practical common sense.

In the recording of the writings of al-Razi, the Fihrist of Ibn al-Nadim, the oldest authority, enumerates 113 major and 28 minor works by him. Al-Razi wrote an entertaining tract on the success of charlatans and quacks in acquiring fame often denied to the competent and properly qualified physician but of his general works on medicine the two most important were his Mansuri, known in Latin as Liber Almansoris, and his monumental and most important work, the al-Hawi. The treatise known as Mansuri is primarily a treatise on anatomy where each bone, muscle, or organ is described in the light of its function and purpose; its novelty being that the terminology used throughout is in Arabic. The Kitab al-Hawi was translated in the medieval period as 'liber Continens' and was mistaken at first, in view of its length, for an encyclopaedia prepared by Al-Razi's disciples from his collected papers. Its appearance is an event rare enough to merit emphasis due to its being an absolutely first-rate dossier of available clinical observations quite undogmatically assembled.

Browne points out how the study of the Hawi is fraught with peculiar difficulties, for not only has it never been published in the original, but no complete manuscript exists and, indeed,

`so far as my present knowledge goes,' Browne points out, `I doubt if more than half of this immense work exists at all at the present day, while the extant volumes are widely dispersed, three volumes in the British Museum, three in the Bodleian, four or five in the Escurial, others at Munich and Petrograd and some abridgments in Berlin. Moreover there is some uncertainty as to the number and contents of the volumes which the work comprises, for while the Fihrist enumerates only twelve, the Latin translation contains twenty-five, nor is there any correspondence in subject matter or arrangement. This confusion arises partly, no doubt, from the fact that the Hawi was a posthumous work, compiled after the death of Razi by his pupils from unfinished notes and papers which he left behind him, and lacking the unity of plan and finishing touches which only the author's hand could give, and partly from the fact that the same title seems to have been sometimes applied to another of his larger works. Moreover the Hawi, on account of its enormous size and the mass of detail which it contained, appalled the most industrious copyists, and was beyond the reach of all save the most wealthy bibliophiles, so that Ali ibn ul-Abbas (Haly Abbas) who wrote only 50 or 60 years after Razi's death, tells us that in his day he only knew of two complete copies.'

Of Al-Razi's many monographs the most celebrated in Europe is his treatise on smallpox and measles, known in Latin as De Peste or De Pestilentia. This work of importance on small pox and measles is the oldest reliable account of these two diseases. According to Neuburger, it ranks high in importance in the history of epidemiology not just as the earliest monograph upon smallpox, it also shows us Al-Razi as a conscientious practitioner, almost free from dogmatic prejudices. As a sample of Al-Razi pioneering spirit on the subject, we pick extracts from Dunlop which show Al-Razi's treatment of some parts of the body

`As soon as the symptoms of smallpox appear, drop rose-water into the eyes from time to time, and wash the face with cold water several times in the day, and sprinkle the eyes with the same. For if the disease be favourable and the pustules few in number, you will by this mode of treatment prevent their breaking out in the eyes. This indeed is to be done for greater caution; for when the smallpox is favourable, and the matter of the disease is scanty, it seldom happens that any pustules break out in the eyes. But when you see that the ebullition is vehement and the pustules numerous in the beginning of the eruption, with itching of the eyelids and redness of the whites of the eyes, some places of which are redder than others, in this case pustules will certainly break out there unless very strong measures be adopted; and therefore you should immediately drop into the eyes several times in the day rose-water in which sumach has been macerated. It will be still more efficacious to make a collyrium of galls in rose-water, and drop some of it into the eyes; or to drop into them some of the juice of the pulp of the acid pomegranate, first chewed, or squeezed in a cloth. Then wash the eyelids with the collyrium composed of the red horn poppy, the juice of unripe grapes, rusot, aloe and acacia, of each one part, and a tenth part of saffron; and if you also drop some of this collyrium into the eyes, it will be useful at this time.'

Dunlop then elaborates further on al-Razi's treatment of the same disease when it reached violent stages, as well as other matters, all needless to repeat here, but well summed up by Dunlop's erudition.

Yet it is as a clinical, accurate observer that al-Razi excelled. One of the most telling of these notes is to be found in the Bodleian Library. This has been translated by Browne as follows:

`Abdu'llah Abd Allah ibn-Sawada used to suffer from attacks of mixed fever, sometimes quotidian, sometimes tertian, sometimes quartan and sometimes recurring once in six days. These attacks were preceded by a slight rigor, and micturition was very frequent. I gave it as my opinion that either these accesses of fever would turn into quartan, or that there was ulceration of the kidneys. Only a short while elapsed when the patient passed pus in his urine. I thereupon informed him that these feverish attacks would not reoccur, and so it was. The only thing which prevented me at first from giving it as my definite opinion that the patient was suffering from ulceration of the kidneys was that he had previously suffered from tertian and other mixed types of fever, and this to some extent confirmed my suspicion that this mixed fever might be from inflammatory processes which would tend to become quartan when they waxed stronger. Moreover, the patient did not complain to me that his loins felt like a weight depending from him when he stood up; and I neglected to ask him about this. The frequent micturition also should have strengthened my suspicion of ulceration of the kidneys.... So when he passed the pus I administered to him diuretics until the urine became free from pus, after which I treated him with terra siflil- lata, Boswellia thurifera and Dragon's Blood, and his sickness departed from him, and he was quickly and completely cured in about two months. That the ulceration was slight was indicated to me by the fact that he did not complain to me at first of weight in the loins. After he had passed pus, however, I enquired of him whether he had experienced this symptom, and he replied in the affirmative. Had the ulceration been extensive, he would of his own accord have complained of this symptom. And that the pus was evacuated quickly indicated a limited ulceration. The other physicians whom he consulted besides myself, however, did not understand the case at all, even after the patient had passed pus in his urine.'

The following outline derived from Dunlop is a very good window to show how Muslim science, in general, and Al-Razi's medical science in particular, passed into Europe well into the 18th century.

`For knowledge of Al-Razi in Europe,' Dunlop writes, `the date 1766 is of considerable importance. In that year the Londoner John Channing published, for the first time, a work of Al-Razi in the original Arabic—an edition, Arabic and Latin, of the Kitab fi al-jadar oa'l-Hasba (On Smallpox and Measles), which had already in 1747 attracted the attention of the celebrated Dr Mead (1673- 1754) and which has been described as 'the oldest and most important original work on smallpox and measles' and as 'probably the most concise and most original treatise in Muslim medical literature'. Mead knew no Arabic, but had given a Latin translation with the help of several eighteenth-century Orientalists, Salomon Negri, J. Gagnier and Thomas Hunt. Channing used the same basis as his predecessors, a Leiden manuscript of the Arabic original, which had belonged to the collection of Levinus Warner, and he was now able to produce an elegantly printed if not very correct Arabic text and a readable and clear Latin version. Channing says of his method of translation: The version is what is called a literal one. It is close and renders word for word as far as possible, while avoiding incorrect expressions, so that not only Al-Razi's sentences but also his way of thinking, words and style are exhibited. Where the genius of the Latin language did not admit this, the Arabic phrase is noted at the bottom of the page. The reader is not to be irritated by Arabic words appearing in the Latin text, the explanation of which you will see in the margin. These have not been translated because no Latin word exactly corresponds to their sense, or because the meaning is doubtful. We do not possess, as it happens, any medieval translation of the work on smallpox and measles with which Channing's may be compared, but it is interesting to observe the learned eighteenth- century translator adopting exactly the same practice of retaining in the text difficult Arabic words as a Gerard of Cremona in the twelfth century. Nor are the Latinized Arabic words which Channing cites here noticeably closer to their originals than their medieval counterparts.'

To Al-Razi, Wiet et al conclude, the Muslim world owed its first formulation of the faith in a continuous scientific advance, with emphasis on the provisional nature of all research whose conclusions can be revised at all times.

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