Avicenna:
The Prince of Physicians and A Giant in Pharmacology

 


From the Department of Pharmacology
Kirksville College of Osteopathic Medicine
Kirksville, Missouri

Reprint Requests: Dr. N. A. Darmani
Associate Professor
Department of Pharmacology
Kirksville College of Osteopathic Medicine
Kirksville, Missouri 63501
USA


 

 

Often Western historians consider the era between the sixth and the 12th centuries A.D. as one of the earth's darkest periods of history. Although Europe had lapsed into an epoch of ignorance, some parts of the world continued to grow and flourish during this period. Specifically, in the Islamic world (Afghanistan, Arabian countries, Iran and Turkey), a golden age had dawned, and achievements in the arts and sciences of the time can be seen clearly in the development of the medical sciences. Babylonia, Phoenicia, and Judaeh were the most ancient centers of learning and culture from which the Greeks derived their inspirations. Greek wisdom flowed to the East through the Syrian Christian translators who passed Hellenism to the Islamic world. Among the Muslim scholars and philosophers who diverted their legacy to the West and awakened Europe to the dawn of Renaissance, Ibn Sina occupies a prominent place.

'Abu 'Ali al-Husin ibn 'Abdullah ibn Sina was born in August 980 A.D. (Safar 370 A.H.) in the village of Afshana near Bukhara to Abdullah, from Balkh, the local governor of Kharmaithan, and his wife Sitareh, from Afshana (1). Ibn Sina is known to the West by the Europeanised Hebrew translation of his name, Avicenna (Aven Sina). Avicenna was born at a time when Bukhara was the capital and intellectual center of the Samanid dynasty, which ruled over much of Eastern Iran (Persia) and Afghanistan (Khurasan) until the rise of Mahmud of Ghazna of Afghanistan.

 

Place of Birth and Adventures

Figure 1. Place of birth and adventures of Avicenna

According to his autobiography, at the age of five Avicenna moved with his family to the city of Bukhara where he had a greater opportunity to study (1). His early education was religious, and by the age of 10, he knew by heart the whole Qur'an and other available Persian and Arabic literature. Because of Avicenna's remarkable talent, his father employed a private teacher, al-Natali, to instruct him in arithmetic, geometry, logic, natural sciences, and astronomy. Avicenna then turned his attention to physics, metaphysics and medicine. By the time he was 16, Avicenna had mastered all the sciences of his day and was well-known as a practicing physician. Fame and recognition came quickly to the young physician when the Sultan of Bukhara, Nuh ibn Mansur al-Samai, fell seriously ill with a disease that baffled the experienced court physicians, but was successfully treated by Avicenna. For his services, Avicenna was awarded free access to the Sultan's rich library. By the age of 21, Avicenna wrote his first collection of books which include "Kitab al-Majmu" (The Compendium), on mathematics and sciences of the day, "Kitab al-Hasil w'al-Mahsul" (The Import and the Substance), 20 volumes on jurisprudence, and "Kitab al-Birr w'al-Ithm" (Good Work and Evil), on ethics.

During the first part of the ninth century, the strong authority of the Abbasid empire began to experience political decentralization which led to the emergence of many local monarchs. Although many local kings devoted their main energies to ventures of the sword, they sought to emulate the cultural patterns of Abbasid court life by allowing eminent poets, distinguished scholars, and renowned theologians at their courts. Thus, Avicenna did not have to worry about finding a receptive patron.

 

Following the death of his father, Avicenna left Bukhara for Jurjaniyah and offered his services to the Khawarzmian dynasty. In this court, he wrote "Kitab al-Tadaruk li-anwa al-Khata' fi'l-Tadbir" and "Qiyam al-'Ard fi wasat al-Sama'" on mathematics and astronomy, respectively. During this period, Sultan Mahmud of Ghazna had also gathered in his court many intellectuals and poets including al-Firdusi, who is considered to be the father of Persian language. Unfortunately, Mahmud of Ghazna was filled with envy at the brilliance of men of science like Avicenna at the Khawarazm court and demanded Avicenna's attendance in his own royal court. However, Avicenna chose to escape to Gurgan and then to Jurjan. Here, he was joined with his lifetime companion Juzjani and composed the "Kitab-al-Mukhtasar al-Awsat," "Kitab al-Mabda' w'al-Ma'ad," and "al-Arsad alKulliyyah," along with chapters which later formed parts of "al-Najat" and "al-Qanun." He then journeyed to Ray and later took service with Prince Shams-ul-Dawlah whose headquarters were at Hamadan. He attained the position of prime minister, an appointment which displeased the military, agian forcing Avicenna into exile. Soon, however, the prince became sick, recalled Avicenna, and, after being cured, reinstated him as the prime minister. Avicenna wrote his peripatetic philosophy, "Kitab al-Shifa" (The Book of the Remedy) and "al-Adwiyat al-Qalbiyyah" The Remedies of the Heart) while he was burdened with state duties. On the death of Shams-ul-Dawlah, his successor offered to keep Avicenna in his post, but he refused, was jailed, and subsequently escaped and went on to Isphahan to serve Prince 'Al-ul-din. During the 15 years of his stay in Isphahan, he compsed numerous books including the "Kitab al-Najat" (The Book of Deliverance) and the "Danishnama-yi Alai" (The Alai-i-Book of Knowledge) which he wrote in Farsi (2). Avicenna died at an early age of 58 while on a journey back to Hamadan (Iran) wher he rests today.

 


Avicenna was a prolific writer. He wrote "al-Shifa'" (The Healing) at a pace of 50 pages a day while living in hiding from Sama ul-Dawlah. During the four months of imprisonment, he composed a summary of his philosophical system. "al-Hidayah" (The Guidance), the Hayy ibn Yaqzan allergory (Treatise on living, the son of the vigilant), and a short medical treatise on colic "al-Qulanj." These publications cover a variety of subjects, including principles of medicine, diagnosis, diseases, remedies, philosophy, logic, definitions, properties of soul and body, cosmology, metaphysics, mathematics, astronomy, theology, and asceticism. In addition, several works by Avicenna were lost in part or in toto when Sultan Mas'ud, son of Mahmud of Ghazna, attacked Isphahan (3). Avicenna was entitled al-Shaikh al-ra'is (the chief teacher) by his compariots, or just Shaikh by his disciples. Within a few years of his death, he was referred to as the "Second Teacher," either Galen or Hippocrates being the first (4). His works gradually filtered to europe where they were received with almost as great an esteem. "Al-Qanun fi-l-tibb" (The Canon of Medicine) is the work that provoked the Latin scholars to call him"Medicorum Principes." the Prince of Physicians (5). The tremendous popularity enjoyed by the Canon in Europe can be best judged from the fact that its Latin version by Gerard was re-issued sixteen times during the years 1470-1500 and went through 20 editions during 1500-1600. The Canon became, by means of its Latin translation, the medical Bible of all the universities in Europe. The grandeur of the Canon becomes more apparent when one compares it with one of the current leading textbooks of medicine. The 11th edition of Harrison's Principles of Internal Medicine summarizes the current medical knowledge in about 2.8 million words and cites more than 280 contributing authors and six editors. The Canon contains over one million words and has a single author. Indeed, Osler has described Avicenna as the "author of the most famous medical textbook ever written (6).

Avicenna's influence can be seen in Europe even in comparatively recent times as judged from the fact that during the two years, 1899 and 1900, four theses were submitted to the University of Berlin by J. Cueva, P. Upensky, E. Michailowsky, and T. Bernikov, all containing partial translation of the Canon in German.

The Canon states the following: "Medicine is the science by which we learn the various states of the human body, in health, when not in health, the mean by which health is likely to be lost, and when lost, is likely to restored to health." This important book came into being at the city of Gurganj and was completed at Ray. It is in five volumes and contains the medical knowledge of the day. The Canon was the fruit of extensive reading and personal reserach in the clinical field. The first volume discusses the general principles of physiology and hygiene. The second volume treats simple drugs and their effects and was based mainly on writings of Aristotle and Galen. For a long period of time, this volume served as the most complete treatise on medical plants and herbs, containing more than 800 paragraphs. The third and fourth volumes are on pathology and deal with various diseases such as fevers, tumors, rashes, poisons, etc. The fifth volume deals with combinations of various drugs into remedies and, along with the second volume, forms a complete pharmacopoeia. These remedies contain the traditional Greek remedies as well as the remedies of the Indian, Arabian, and Persian cultures along with Avicenna's. An endless series of powders, theriacs, electuaries, leeches, mixtures and tablets of various types, decoctions, ointments and plasters were discussed and classified. With the composition of the Canon, Avicenna placed the keystone in the arch that bridges the medical system of Hippocrates, Galen, and Harvey with modern medicine. Avicenna is also known in the medical world for his smaller work, "al-Arjuzat fi'l-tibb" (The Poem on Medicine), which has enjoyed a Western as well as Eastern position close to that of "al-Qanun."

 


Avicenna was more than a renowned medical practitioner; throughout his life, he was engaged in medical experiments. Furthermore, he was not just a compiler of information, but contributed significantly in many fields. Avicenna's original observations lie scattered throughout his works. He discovered and described the insertions of the instrinsic muscles of the eye. He suggested that certain diseases were water-born, the cause being minute animals that lived in the water, too small to be viewd by the human eye. Avicenna was very near to the microbic theory when he wrote "at certain times the air becomes infected and anyone breathing the infected air falls sick." He was the first to attempt to differentiate between obstructive and hemolytic jaundice. Some of his clinical descriptions are excellent, expecially the sections on nervous, cutaneous, and genitourinary diseases. He was far in advance of his age in his condemnation of astrology in affecting health and in his attempt to divorce that science from medicine. He taught a theory of vision which we now know to be correct, although all of his contemporaries, and many of his successors too, were arrayed against him. He maintained that "it is not the ray that leaves the eye amd meets the object that give rise to vision, but rather the form of perceived object passes into the eye and is transmuted by the transparent body, that is, the lens." In the Canon he describes 15 types of pain: boring, compressing, corrosive, dulll, fatigue, heavy, incisive, irritant, itching, pricking, relaxing, stabbing, tearing, tension, and throbbing. In the chapter of sphygmology, he described 10 features of the pulses and 22 types of abnormal pulses. In the chapter on uronoscopy, great attention was given to the examination of urine: its quantity, odor, color, foam, texture, clearness, and sediment. Diseases were classified and treated accordingly.

His pharmacological views appear to be quite modern, as he suggested that polyphaymacotherapy and "drug mixtures" should be considered only when the disease apprears to be compounded and that single drugs should be used for uncomplicated conditions. He further stressed the importance of dose, and route of administration and defined a schedule for drug administration. Unfortunately, some modern physicians still tend to ignore these basic pharmacological dogmas. On the subject of cannabis, Avicenna is much more specific than the Greeks. He described several varieties and referred to them as carminative and desiccative. Regarding analgesics, he was remarkably current: "The most powerful of the stupefacients is opium. Less powerful are: seeds and rootbarks of mandrake (contains the alkaloid mandragorine, a narcotic and hypnotic); poppy (morphine and papaverine); hemlock (conium, an alkaloid that produces motor paralysis without loss of sensation or alteration of consciousness); white and black hyoscyamus (hyoscymine and scopolamine with atropine-like effects); deadly nightshade (belladonna); lettuce seed (hyoscymus and mannitol)." The properties of these and more than 800 other drugs and their clinical applications were fully described in the Canon. Furthermore, he gave seven rules for a reliable experimental investigation of the effects of drugs that are as stringent as today's standards. It is no wonder why he has been further honored as a giant in pharmacology (1) .


The secret of Avicenna's success is that he was both a philosopher and a physician, even greater perhaps as a philosopher and as a theorist. It is beyond the scope of this paper to indulge in Avicenna's philosophical and religious views (2,8). In summary, he has been described as possessing the mind of Goethe and the genius of Leonardo da Vinci. (9,10). In the words of Sarton, he is the most famous scientist of Islam and one of the most famous of all races, palce and times (11). Avicenna has been resting for more than 1000 years, but his ideals still cure the old and the young in the many hospitals that are build in his name in Iran and the Arab countries as well as in the shattered land of his father, my beloved Afghanistan.

References:

1. Juzjani U: Sarguzasht-i-Ibn-i Sina.
Translated by S. Nafisy Tehran, 1952.

2. Nasr SH: An introduction to Islamic cosmological doctrines.
State University of New York, Albany 1993; 177-96.

3. Mahdavi Y: Bibliographi d'Ibn Sina.
Tehran, 1954.

4. Elgood C: Medicine in Persia.
PB Hoeber Inc., New York 1978: 41-51.

5. Krueger HC: Avicenna's poem on medicine.
CC Thomas Publisher, Springfield, Illinois 1963: 9-12.

6. Osler W: The evolution of modern science.
New Haven: Yale University Press, 1921: 243

7. Bender GA: Great moments in pharmacy. A history of pharmacy in pictures. (Painting by RA Thom)
Detriot: Northwood Institute Pres, 1967.

8. Heath P: Allegory and Philosophy in Avicenna.
Philadelphia: University of Pennsylvania Press, 1992: 18-31.

9. Major RH: A history of medicine.
Springfield, Illinois: CC Thomas Publisher 1954: 563-564.

10. Sadi LM: Glimpses into the history of Arabic medicine.
Bull Med Libr. Assoc 1958; 46:206-18.

11. Sarton G: Avicenna, physician, scientist, philosopher.
Bull New Acad Med 1955; 31: 307-17.


© This article was previously been published in "The Journal Of Islamic Medical association Of North America" Volume 26, Pages 78-81, 1995. The Article was Retyped and published on Afghan Network by Walid Sharif.