Physicians of ancient Persia have played an important role in the development of modern biological regulatory medicine. Muslims in the first period of the Islamic era gathered knowledge from neighboring civilizations, such as Persian, Greek, and Roman medical texts by translating their manuscripts and so promoted medical knowledge in the medieval period.
One in particular, Abu ʻAli al-Husayn Ibn Sina, stands out as a great healer, philosopher and historian. Ibn Sina’s great work al-Qānūn f’l-tibb or ‘The Canon of Medicine has been an enormous contribution to medicine. It has inspired physicians throughout Europe, the Middle East, and South Asia for half a millennium, and continues to be of great potential interest to contemporary practitioners of natural medicine, particularly medical herbalism.
Though ancient traditional Persian medicine is unfortunately little known in the western world, because Ibn Sina’s al-Qānūn f’l-tibb has been translated much of this classic text is now being restudied with the light of science.
Samanid Dynasty Symbol 11th Century
Early Life
Abu ʻAli al-Husayn Ibn Sina was born in Afshana, a village in the outskirts of metropolitan Bukhara (in present-day Uzbekistan), perhaps even as early as 964. It has not been possible to determine the exact year of his birth with precision. His mother, named Sitāra, was from Bukhara, and his father, Abdullāh, was a respected scholar employed by the Persian Samanid dynasty that ruled Transoxania and Khurasan with Bukhara as its capital. Ibn Sina’s father ensured that his son was well tutored. According to most scholars, most of Ibn Sina's family were Sunnis. After five years, his younger brother, Mahmoud, was born.
Ibn Sina was an avid reader and studied the Quran and Persian literature with such passion and brilliance that when he was only 10, he had memorized the entire Quran, thus becoming a hafiz (memorizer; safe keeper of information). Additionally, he mastered many important Persian classics.
Ibn Sina’s thirst for knowledge incessantly grew as he devoured philosophy books, learning in parallel the foundations of Fiqh and Indian arithmetic from any knowledgeable people that he could find. Fiqh is often described as the human understanding of the sharia, or human understanding of the divine Islamic law as revealed in the Quran and the Sunnah.
Young Ibn Sina was taught important philosophical texts such as Porphyry’s Isagoge, also known as ‘Introduction to Aristotle's Categories’, which became a standard textbook on logic for at least a millennium after his death. He also studied Euclid's Elements, and Ptolemy's Almagest.
Born in Afshana, a village in the outskirts of metropolitan Bukhara. Bukhara lies on one of the main trade routes of the Silk Road between Samarkand and Merv, and like these and other cities along the Silk Road, had been economically and culturally active from pre-Islamic times.
Medicine is the science by which we learn
the various states of the body; in health, when not in health; the means by which 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.
Teenage Years
As a teenager, he was perplexed by the Metaphysics of Aristotle, which he could not understand until he read Al-Farabi's commentary on the work. Al-Farabi was a renowned Iranian philosopher who wrote in the fields of political philosophy, metaphysics, ethics and logic. Young Ibn Sina intently studied numerous philosophical works. It is said that when troubled by perplexing thoughts he would go to the mosque and pray till light broke on his difficulties.
At sixteen, Ibn Sina took up an interest in traditional Persian medicine and upon turning eighteen, had achieved the status of a ‘treating physician’. The young physician's skill and fame spread quickly, and he treated many patients without asking for payment. At the age of 21 Ibn Sina lost his father and witnessed the fall of the Samanid dynasty (819 to 999). The new ruler of the region, the Turkish Mahmud of Ghani offered Ibn Sina a position under the new administration, which he refused. Thus, began a tumultuous period in Ibn Sina’s life paralleled with Turkish domination of Persia He began to journey westwards to modern day Uzbekistan. Here he received a small monthly income and spent much of his time through different districts seeking support for his abilities and education.
Philosophical and Spiritual Inquiry
During his travels he went to Khwarizm and became acquainted with Al-Bairuni, a renown Iranian scholar, astronomer and polymath. Eventually, after receiving a small salary from a local vizier in the city of Urgench (in modern Turkmenistan) Ibn Sina started writing some of his most influential works. He eventually settled in Gorgan near the Caspian Sea where he lectured on astronomy and logic and dedicated his time to furthering his knowledge of medical theory and practice.
After his stay in Gorgan, he moved to Hamadan and cured its ruler Prince Emir Shams al-Dawlah of the Buyid dynasty from a severe colic. He became the Emir’s private physician and confidant and was appointed as a Grand Viser (Prime Minister). When Shams al-Dawlah died, Ibn Sina wrote to the ruler of Isfahan for a position at his court. When the Emir of Hamadan became aware of this, he imprisoned Ibn Sina. While in prison, he wrote several books.
On his release Ibn Sina moved to Esfahan, in the service of the ruling prince Abu Ja'far 'Ala Addaula where he completed two of his major works, including the al-Qānūn f’l-tibb ‘Canon of Medicine’, and authored some 200 treatises. He also dedicated some of his time to the composition of his first work on Aristotelian philosophy in the Persian language and concentrated on the study of literature and philology.
In his pursuit of philosophical thought, he began to develop his argument for the existence of God, also known as the ‘proof of the truthful’ relying on unveiling the ‘necessary existent’ which he then meticulously demonstrated to be proof of the existence of God. This paper later became known as the medieval time’s most influential and potent argument for God’s existence, and arguably, one of Ibn Sina’s most important contribution to the development of philosophical thought. Specifically, he combined the disparate strands of philosophical/scientific thinking in Greek late antiquity and early Islam into a rationally rigorous and self-consistent scientific system that encompassed and explained all reality, including the tenets of revealed religion and its theological and mystical elaborations.
Ibn Sina’s most important work of philosophy and science is Kitāb al-shifāʾ, “The Book of Healing”, Latin title Sufficientiae, which is a four-part encyclopedia covering logic, physics, mathematics, and metaphysics. Since science was equated with wisdom, Ibn Sina attempted a broad unified classification of knowledge. For example, in the physics section, nature is discussed in the context of eight principal sciences, including the sciences of general principles, of celestial and terrestrial bodies, and of primary elements, as well as meteorology, mineralogy, botany, zoology, and psychology (science of the soul).
Frontispiece of Arabic edition of Qānūn f’l-tibb printed in Roma in 1593 (from: Tamani G (1988) Il Canon Medicinae di Avicenna Nella Tradizione Ebraica: le Miniature del Manoscritto 2197 della Biblioteca Universitaria di Bologna. Editoriale Programme, Padova, p 48)
al-Qānūn f’l-tibb ( القانون في الطب ) or ‘The Canon of Medicine’
Despite Ibn Sina’s great accomplishments in philosophy, what he became best known for was his practical and academic involvement in the art of medicine. Initiating this work at the age of twenty-two, several years later he published the famous five-volume medical encyclopedia: al-Qānūn f’l-tibb or ‘The Canon of Medicine’. It was completed in 1025, exceeded one million words and contains an extensive account of the medical information that was known up to the 10th century. al-Qānūn f’l-tibb quickly became the definitive text of medical literature. It was taught as a text in the universities in Europe and Middle East until the 17th century. It is the most authoritative and comprehensive codification of the Greco-Arab system of medicine. al-Qānūn f’l-tibb is one of the most influential medical books in history, and its medical theories, observations, Materia medica, and formulary, which inspired physicians throughout Europe, the Middle East, and South Asia for half a millennium, are of great potential interest to contemporary practitioners of natural medicine and medical herbalism. The potential benefits are practical, not simply of historical curiosity. It continues to be studied by thousands of scholars in the East and West.
The first book of al-Qānūn f’l-tibb is made up of six theses which give a general description of medicine – anatomy, physiology, pathology, etiology, hygiene, symptomatology, general rules and methods of treatment. It describes the cosmic elements that make up the cosmos and the human body, the mutual interaction of elements (temperaments), fluids of the body (humors). It is very practical with sections on pulse diagnosis and urinalysis, therapeutic regimens for various ages and conditions, in health and in disease.
The second book is concerned with Materia medica. It lists about 800 "simple" medical substances that were used at the time. The substances are simple in the sense of not being compounded with other substances. The first part gives general rules about medicaments and a treatise on what was called "the science of powers of medicines". The second part is a list of 800 simple herbal, mineral, and animal substances. Each entry contains the substance's name, its benefits (which sometimes describes how the substance is found in nature), and its nature or primary qualities. Next are listed one or more of 22 possible general actions, followed by specific properties listed according to a grid of 11 disease types. Finally, potential substitutes for the substances are given.
The third book deals with diseases or special pathology. It is arranged by body part, progressing from the top of the body to the bottom of the body and covering the function and diseases of each organ, as well as the etiology, symptoms, diagnosis, prognosis, and treatment for each disease discussed. The information presented in book 3 represents some of Ibn Sina’s most important contributions to several modern fields of study, including atherosclerosis, pulse diagnosis, cataracts, vasovagal syncope, headaches (15 types), and neuroscience.
Strokes are also described in extensive detail in Book 3. First, two causes of stroke are identified: blockage of vessels in the brain, and blockage of the affective spirit of the brain, a cause that can only be explained using theories on humoral medicine. The blockage of vessels is then further subdivided into two sub-types: collapse and ischemia.
The fourth book describes diseases that affect the whole body such as fevers or poisons, or conditions that could happen to any part of it such as wounds or bone fractures. The book includes a treatise on personal hygiene, emphasizing care of the hair, skin, nails, body odor, and the treatment of overweight or underweight persons. Large sections of this book were devoted to covering fevers in specific detail. Several types of fevers were distinguished, partly based on the location of the factors causing each specific illness.
The fifth book is entitled al-Adwiya al-murakkaba wa al-aqrābādhīn. It is a formulary that lists 650 compound medicaments attributing them to various Arabic, Indian and Greek sources. Ibn Sina added his own comments, highlighting differences between recipes from different sources, and sometimes giving his own recipe. He also gave his opinion of the effectiveness (or ineffectiveness) of some remedies and gave details of where particular ingredients came from and how they were prepared. He favored proven remedies which had been time tested through experience, cautioning that compounds could have unexpected or much stronger effects than might be expected from the effects of the individual components.
Frontispiece of Latin edition of the Qānūn f’l-tibb which was printed by Junta Press in 1544 in Venice (from: Tamani G (1988) Il Canon Medicinae di Avicenna Nella Tradizione Ebraica: le Miniature del Manoscritto 2197 della Biblioteca Universitaria di Bologna. Editoriale Programme, Padova, p 14)
al-Qānūn f’l-tibb is one of the most influential medical books in history, and its medical theories, observations, Materia medica, and formulary, inspired physicians throughout Europe, the Middle East, and South Asia for half a millennium. It still is of great potential interest to contemporary practitioners of bioregulatory medicine and medical herbalism.
The potential benefits are practical, not simply of historical curiosity. al-
Qānūn f’l-tibb was translated into Latin by Gerard of Cremona (1114–1187) for the first time in the twelfth century. A Latin version was published in Milan in 1473. A Hebrew version appeared in Naples in 1491 and an Arabic edition of al-Qānūn f’l-tibb in Rome in 159. It is stated that in the last 30 years of the 15th century, it passed through 15 Latin editions and one Hebrew edition.
Available online http://data.nur.nu/Kutub/English/Avicenna_Canon-of-Medicine_text.pdf
Ibn Sina’s Depiction of the Nervous System
Qānūn f’l-tibb (Canon of Medicine)
Ibn Sina believed that the human body cannot be restored to health unless the causes of both health and disease are determined. He defined medicine (tibb) as follows:
"Medicine is the science by which we learn the various states of the body; in health, when not in health; the means by which 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."
Ibn Sina Expounded Evidence Based Medicine
Testing for efficacy seems first to have been promoted by Ibn Sina in his Qānūn f’l-tibb He wrote 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. Some writers have interpreted the relevant parts of the Qānūn f’l-tibb as promoting randomized controlled trials. Specifically, Ibn Sina stated seven rules for evaluating a medicament:
• The medicament must be free from any extraneous accidental quality.
• It must be used on a simple, not a composite, disease.
• The medicament must be tested with two contrary types of diseases as sometimes a substances cures one disease by its essential qualities and another by its accidental ones.
• The quality of the medicament must correspond to the strength of the disease. For example, there are some substances 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 medicament 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 medicament on a lion or a horse might not prove anything about its effect on man.
Illustrations of Ibn Sina’s recommended spinal manipulations, from the 1556 edition of Avicenna's The Canon of Medicine, a translation by medieval scholar Gerard of Cremona.
The Reynolds Historical Library, Lister Hill Library, University of Alabama at Birmingham
Later Life and Death
After writing Qānūn f’l-tibb (Canon of Medicine), Ibn Sina moved to Al-Rayy (near modern Tehran) and had a medical practice there. He authored about 30 books during his stay there.
Ibn Sina Examining a Patient
He spent his final years serving its ruler Alā al-Dawlah. While in the company of ʿAlā al-Dawlah, Avicenna fell ill with colic. He treated himself by employing eight self-administered celery-seed enemas in one day. However, the preparation was either inadvertently or intentionally altered by an attendant to include five measures of active ingredient instead of the prescribed two. That caused ulceration of the intestines. A slave attempted to poison Ibn Sina by surreptitiously adding a surfeit of opium. Weakened but indefatigable, he accompanied ʿAlā al-Dawlah on his march to Hamadan. On the way he took a severe turn for the worse, lingered for a while, and died in the holy month of Ramadan in 1037 CE at the age of 57. He was buried in the city of Hamadan. A monument was erected in that city near the site of his grave.
Image of Ibn Sina on the Tajikistani somoni
Ibn Sina’s Mausoleum is a complex located in Hamadan, Iran. In the 1950s his tomb was refurbished and transformed into an impressive mausoleum adorned with an imposing Mughal-inspired tower, and a museum and 8,000-volume library were added as well. His resting place remains a major stop for tourists in the region. Now, as when he was alive, the great physician and philosopher continues to attract the attention of scholars and the public alike.
It is claimed that Ibn Sina had written about 450 works, of which 240 had survived. Some bibliographers list only 21 major and 24 minor works dealing with philosophy, medicine, astronomy, geometry, theology, philology and art. He wrote several books on philosophy, the most significant was “Kitab al Shifa” (The Book of Healing). It was a philosophical encyclopedia that brought Aristotelian and Platonian philosophical traditions together with Islamic theology in dividing the field of knowledge into theoretical knowledge (physics, metaphysics and mathematics) and practical knowledge (ethics, economics and politics). Another book on philosophy was “Kitab al-Isharat wa al tanbihat” (Book of Directives and Remarks).
Avicenna's most important Persian work is the Danishnama-i 'Alai (دانشنامه علائی, "the Book of Knowledge for [Prince] 'Ala ad-Daulah"). Ibn Sina created new scientific vocabulary that had not previously existed in Persian. The Danishnama covers such topics as logic, metaphysics, music theory and other sciences of his time. It has been translated into English by Parwiz Morewedge in 1977. However, his book Qānūn f’l-tibb or now known in the western world as the Canon of Medicine is the most influential medical book ever written by a Persian physician. He was called ‘‘Sheikh-al-Ra’eis’’ in Persia and ‘Prince of Physicians’ in the West. The cultures of both East and West are indebted to this great physician and philosopher.
Statue of Ibn Sina in the United Nations Office in Vienna as a part of the Persian Scholars Pavilion donated by Iran
Resources
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Zargaran, Arman, Mohammad M. Zarshenas, Aliasghar Karimi, Hassan Yarmohammadi, and Afshin Borhani-Haghighi. "Management of stroke as described by Ibn Sina (Avicenna) in the Canon of Medicine." International journal of cardiology 169, no. 4 (2013): 233-237.
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This Video about Avicenna | Ibn Sina Biography in English. Persian philosopher Ibn Sina or Avicenna (c.980-1037) was born in the village of Afshana near the present-day Bukhara (in Uzbekistan) then a leading city in Persia (Iran.) ... His real name is Abu Ali al-Husayn Ibn Abd Allan Ibn Sina, however, he is commonly referred to under his Latinized name Avicenna.
Attar Foundation: Avicenna, was a Persian polymath, who wrote almost 450 treatises on a wide range of subjects, of which around 240 have survived. In particular, 150 of his surviving treatises concentrate on philosophy and 40 of them concentrate on medicine.