Sunday, April 10, 2011

Avicenna: The Chief Physician


ABU ALI AL-HYSAYN IBN-'ABD-ALLAH IBN-SINA born in 980 AD in Persia was renowned as the prince and chief of Physicians. He was also a polymath and was known to have the knowledge mathematics, geology, music, astronomy and Poetry and Art. He was a famous and eminent person of his times both as a philosopher and as a statesman, for he held the positions equivalent to prime minister in the government of his times. In his Divine Comedy, Dante paid a great tribute to him.[1]

According to a tradition, when he was serving in the court as a vizier, because of his views that created a disturbance in the army, he became a victim of Amir’s wrath and was compelled to flee away to a place where he worked on his famous treatise on medicine known Al-qanoon fil tib, translated as the Cannon of Medicine, in English.

In those days, physicians were not supposed to charge any fee when they visited the ill person during his illness. They had to examine the sick person, had to test the urine, note the pulse and see the appearance of the sick person, and on the basis of information thus collected, physicians had to write a prescription. For the purpose of examination, Avicenna has suggested ten attribute of pulses that are to be focused and he has also mentioned 22 ways in which pulse can be abnormal. Moreover, he has recommended a detailed way of urine analysis, in which the things to be noted are the quantity of urine, its color, odor, clearness, sediment, texture and foam.[2]

Physicians continue their treatment after the examination. In case the sick person recovered from the disease, physicians were a paid a reward, in case the person died their prescription was sent to the Qazi court, where a court physician checked their prescription and gave a verdict about it. In case the court physician found the prescription correct by all means, he acquitted the physician and declared that the person died because his time was over; otherwise if he found something wrong with the prescription, the accused physician had to pay the penalty.[3]

Avicenna’s famous book Cannon of Medicine is divided into five parts:
1-        General principles of Medical Practice
2-        Simple Drugs
3-        Local Disease
4-        General Disease
5-        Compound Medicine

This book is reckoned as the bible of Greek and Arabic medicine, and its initial four parts contained the views of Hippocrates and Galen. However, the fifth and the most important part was based on Avicenna’s experiences with medicine and considered as one of the greatest contribution towards the science of medicine.
Unfortunately his writings were misunderstood till very recent times, owing to substandard translation. It was only in recent past that his works were translated properly and the world recognized the worth and value of his contributions.

According to Avicenna medicine is the science that tells us about the different states of human body, these are the states of health and disease. Medicine also tells us about the causes for the loss of health and the causes that can again restore the body to health. Thus medicine is the science that works to conserve health, and if lost, to restore health.
According to Avicenna diseases occurred when either of the four humors, blood, phlegm, yellow bile or the black bile increase or decrease to disturb the balance of corresponding qualities . These qualities of humors are heat, cold, dryness and moisture.

Avicenna, following the lead from Aristotle, [4]considers the reality as a mixture of four basic elements. These are Earth, Water, air and Fire. Earth is attributed with the qualities of coldness and dryness’, water with that of coldness and moisture, air with that of heat and moisture and fire with that of heat and dryness. Human body is also formed through a mixture of these elements.

However, human body has these elements in the form of four humors, blood, phlegm, yellow and black bile. Blood has the qualities of air, phlegm of water, black bile of earth and yellow bile of heat.

According to Avicenna blood is hot and moist, phlegm is cold and moist, yellow bile is hot and dry and black bile is cold and dry. If a disease occurs in the body it is because either of these qualitative quantities increased or decreased. Medicines are also said to have these four qualities. Medicines are cold, hot, dry and moist in nature. Thus, if a disease is because of the excess of heat it is to be treated with cold natured drugs. Each Disease is to be treated with a drug of opposite nature. But in order to cure a disease the most important thing is to know the causes of disease. Furthermore, according Avicenna if a disease has a psychological origin, for instance, the disease is caused by depression, the physician has to pacify his patient, and this can significantly improve his condition. So, the medicine follows a principle of opposition.

Avicenna considered Aristotle as his guide and teacher, thus even in diagnosing a disease Aristotelian rules are followed. According to Aristotle to know a thing in a scientific manner means: To know that a thing has a certain attribute, to know the cause behind the presence of this attribute, to know that a thing exists and to know the cause for the existence of that thing.

Applying it to medicine one gets the formula like this: if somebody has a sediment urine then to know this fact means to know that this attribute of urine essentially and necessarily belongs to it and that what is the cause behind this link , the why of this attribute, for example a health condition or a mal functioning of an organ. Second, in case one hypothesizes that a certain person has a disease or one of the organs is not functioning properly, then to know means to establish this fact with evidence, as a necessary and essential fact, and to know the cause of this mal function or disease.

Avicenna has talked about a variety of medicines including[5]:

  1. Blood purifying herbs,

  1. Pain relieving analgesics

  1. Antibacterial

  1. Antiseptics

  1. Aphrodisiacs

  1. Astringents that cause tissue contractions,

  1. Decongestants, demulcents that protect the internal tissues of skin and soften it,

  1. Diuretics that increase urine excretion,

  1. Emmenagogues that balance the flow of menstrual blood,

  1. Emollients that softens the external tissues of skin,

  1. Expectorants,

  1. Laxatives,

  1. Nerviness that alleviate nerve disturbances,

  1. Purgatives that expel aqueous contents from intestines,

  1. Sedatives

  1. Vasodilators helpful in treating CFC.

Avicenna has also described certain methods of herbal medicine preparations these include, creams as mixtures of oils and water, decoctions as solutions of the herb prepared through simmering its larger parts like barks or roots, infused oils that are obtained through heating a herb in oils for 3 hours, infusion obtained through pouring boiled water over dried herbs, massage oils, ointments, plasters, tinctures, inhalants, and poultice.[6]

In determining the properties of the herbs, one has to look at the color of herb flowers, the area they grew in, texture and aroma.

According to Color

  1. Purple or Blue Flowers:

These herbs, including, Celery, St. John's Wort, Passion Flower and Mugwort are nervines and sedatives. And are also good blood purifiers.


  1. Yellow Flowers

The herbs like Dandelion, Fennel and Horseradish, Yellow Dock, and Wild Yam, having yellow flowers are used for eradicating toxins and infections. Mostly the herbs with yellow flowers are used to treat urinary tract problems, liver problems and gallbladder problems. For jaundice Marigold and dandelion are effective.

  1. Red Flowers

Red flowered herbs include Burdock Root, Chickweed, Plantain and Raspberry, and are considered as good alterative. Furthermore red flowered herbs are good blood purifiers and antibiotics.

  1. White Flowers

Herbs like Rattlesnake-Master, Yucca, Shepherds Purse and Pasque flower are white flowered and used for treating inflammations and female organs.


Herbs According to the Area of Growth

If herbs grow near fast moving water they are considered as a good diuretic. The next consideration would be the area where the herb is growing.
For instance, herbs that grow near a fast moving body of water are good diuretics. Herbs from a Graveled area are good for treating kidney stones and gallstones, and include, Sassafras, Mullein, and Parsley.
Herbs growing in an area saturated with water, such as; Willow and Elder are good for the treatment of colds, asthma and rheumatic problems,

Herbs According to Texture

  1. Thorny Texture
For sharp pains, herbs with a prickly or thorny texture are used, these include hawthorn which used in heart tonic, white prickly is a general pain killer and thistle is good for almost all organs .Nettle and Mullein are also used in this capacity.



  1. Bark with Fissures or Wrinkles
Barks of the trees like White birch, Elder and Cherry, are useful for skin sores’ treatment. More herbs of this class mosses and lichens.

Aromatic Herbs

Herbs are also classified according to their aromatic properties. Herbs with aroma are considered as antiseptic and also with antibiotic properties. These include, Mint family herbs, Pennyroyal and Tansy. Herbs with strong aroma like Cloves, Rosemary, Sage and Lavender are considered as disinfectants.

Resemblance as Criteria

Owing to their resemblance with human skill, Skullcap and walnut are used for headaches. Herbs like Horehound, Coltsfoot, Peppermint and Slippery Elm are called emollients and are usually soft textured, and used in treating swelling, colds and chest problems. Owing to their heart shaped petals Pansies are used to treat heart problems. Resembling blood vessels, vine, chamomile, passion flower, golden seal, ginseng and lady’s slipper, are used to treat disorders of blood and nervous system. Skin disorders are treated by herbs having thread like thin roots. These include Calendula, Parsley, Sheep sorrel, Gold thread and Pansy (heartsease)[7].

Wine

For Avicenna wine also has certain healing qualities. According to him white wine, since it does not cause headaches, therefore is good for those who have extra heat. Red wine on the other hand is good for cold and for phlegmatic characters. Since wine is a good diuretic, therefore, it is good for those who are predominantly bilious, for it excretes it through urine. Wine is also useful as an antiseptic in treating wounds. Wine is also good for humid characters, for it matures humidity. Avicenna suggests that in case a gnawing feeling follows wine consumption, then one should take pomegranate, cold water and a mixture of absynth next morning.

Avicenna has identified 7 principles for maintain good health. These include:

(1)             Maintaining balanced temperament
(2)             Selection of the articles of food and drink
(3)             Evacuation of the effete matters
(4)             Safeguarding the composite;
(5)             Maintaining the purity of the air respired
(6)             Guarding against extraneous contingencies, and
(7)             Moderation in regard to the movements of the body and the motions of the mind, many of which may be"sleep and wakefulness.[8]


[1] Smith RD: Avicenna and the Canon of Medicine: A
millennial tribute. West J Med 133:367-370, Oct 1980
[2] ibid
[3] ibid
[4] Aristotle, Posterior Analytics, Internet Classic Archives,
[5] Website: http://whisperingwood.homestead.com/Basic_Herb_course.pdf
[6] ibid
[7] Website: http://whisperingwood.homestead.com/Basic_Herb_course.pdf
[8] Smith RD: Avicenna and the Canon of Medicine: A
millennial tribute. West J Med 133:367-370, Oct 1980




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