Healers and Achievers: Physicians Who Excelled in Other Fields and the Times in Which They Lived

By Raphael S. Bloch

Summary of Healers and Achievers (ID No. 110473) by Raphael S. Bloch, M.D.


It is not widely known that throughout history physicians have contributed more than just
medical care to civilization. Healers and Achievers is a series of biographies of doctors from
ancient Egypt to the twenty-first century who distinguished themselves with lasting
non-medical accomplishments. They include the architect of the first Egyptian pyramid, a
pope, the "Fathers" of astronomy, geology, magnetism, and taxonomy, American Founding
Fathers, French Revolutionaries, a buccaneer, world-class athletes, a spy, and an astronaut.
Their life stories are told in the context of the eras in which they lived, and their fields of
medical and non-medical expertise are explained in terms comprehensible to both laymen
and physicians.

• Language: English
• Publisher: Xlibris US
• Release date: May 31, 2012
• ISBN: 9781469192482

Book preview

Copyright © 2012 by Raphael S. Bloch, M.D.

Library of Congress Control Number:   2012905781

ISBN:      Hardcover      978-1-4691-9247-5

                Softcover       978-1-4691-9246-8

                Ebook            978-1-4691-9248-2

All rights reserved. No part of this book may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from the copyright owner.

IMAGE CREDITS – Science Museum, London: 17. Wellcome Library, London: 77, 88, 127, 138, 153, 175, 185, 239, 310, 385, 508. Bridgeman Art Library: 253. Corbis: 641, 687. Sherman Bull: 712. All other images are in the public domain.

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110473

Contents

Preface

Acknowledgments

1.   Imhotep (circa 2670-2600 BC)

Architect of the First Egyptian Pyramid, Grand Vizier,

High Priest, Scribe, Poet

2.   Empedocles of Acragas (ca. 493-415 BC)

Poet, Philosopher, Statesman, Scientist

3.   Celsus (ca. 25 BC-AD 50)

Encyclopedist

4.   Johannitius (Hunayn ibn Ishaq, 809-873)

Nestorian Christian Translator, Philologist,

Conservator of Greek Scholarship

5.   Avicenna (Abu Ali al-Husein ibn Sina, 980-1037)

Philosopher, Administrator, Mathematician, Astronomer, Encyclopedist, Poet

6.   Averroës (Abu al-Walid Muhammad ibn Rushd, 1126-1198)

Philosopher, Jurist, Astronomer

7.   Moses Maimonides (Moshe ben Maimon, ca. 1138-1204)

Rabbi, Jurist, Philosopher, Astronomer, Community Leader

8.   Peter Juliani (John XXI, ca. 1215-1277)

Pope, Philosopher

9.   Thomas Linacre (ca. 1460-1524)

Translator, Humanist, Philologist, Medical Reformer, Priest

10.   Mikolaj Kopernik (Nicolaus Copernicus, 1473-1543)

Astronomer, Church Canon, Economist, Translator,

Diplomat, Soldier

11.   Girolamo Fracastoro (Hieronymus Fracastorius, ca. 1478-1553)

Poet, Epidemiologist, Astronomer, Geographer, Philosopher

12.   Georgius Agricola (Georg Bauer, 1494-1555)

Mineralogist, Mayor, Diplomat, Historian

13.   François Rabelais (ca. 1495-1553)

Author, Satirist, Monk, Priest

14.   Michael Servetus (Miguel Serveto, 1511-1553)

Theologian, Church Reformer, Geographer, Martyr

15.   Conrad Gesner (1516-1565)

Encyclopedist, Naturalist, Bibliographer, Philologist, Mountaineer

16.   William Gilbert (1544-1603)

Physicist

17.   Nicolaas Tulp (Claes Pieterszoon, 1593-1674)

Mayor of Amsterdam

18.   John Locke (1632-1704)

Philosopher

19.   Niels Stensen (Nicolaus Steno, 1638-1686)

Anatomist, Geologist, Priest, Bishop

20.   Hans Sloane (1660-1753)

Naturalist, Inventor, Antiquary, Collector,

Founder of British Museum of London

21.   Thomas Dover (1662-1742)

Adventurer, Mariner, Swashbuckler, Inventor

22.   Carl Linnaeus (Carl von Linné, 1707-1778)

Botanist, Naturalist, Taxonomist, Explorer, Inventor

23.   Josef Leopold Auenbrugger (1722-1809)

Musician, Opera Librettist

24.   Joseph Black (1728-1799)

Chemist, Physicist

25.   Paul Revere (1734-1818)

American Patriot, Artisan, Equestrian, Soldier, Entrepreneur

26.   Joseph Warren (1741-1775)

American Patriot, Orator, Soldier, Martyr

27.   Benjamin Rush (1745-1813)

American Patriot, Social Reformer, Signer of the Declaration

of Independence

28.   Luigi Galvani (1737-1798)

Electric Battery Originator, Electrophysiology Researcher

29.   Peter Mark Roget (1779-1869)

Lexicographer, Scientist, Inventor

30.   Jean Paul Marat (1743-1793)

French Revolutionary, Author, Physicist,

Political Journalist, Martyr

31.   Joseph-Ignace Guillotin (1738-1814)

Humanitarian, French Revolutionary,

Deputy to French National Assembly

32.   Thomas Young (1773-1829)

Physicist, Physiologist, Egyptologist, Linguist

33.   Mary Edwards Walker (1832-1919)

Medal of Honor Recipient, Union Spy,

Reformer, Suffragist, Author

34.   Roger Bannister (b. 1929)

Athlete

35.   Tenley Albright (b. 1935)

Figure Skater, Public Health Advocate

36.   Sherman Bull (b. 1936)

Mountaineer, Oldest Climber to Summit Mount Everest (2001)

37.   Laurel Clark (1961-2003)

Astronaut, Navy Submarine and Diving Officer

Book Summary

Author Bio

To my parents

Abraham and Belle Bloch

Who enabled me to become a healer.

And to my wife

Dorothy

Who enabled me to become an author.

Preface

The medical profession can justifiably take pride in its many scientific achievements that have been successfully applied to the betterment of the human condition. Antisepsis, antibiotics, immunizations, anesthetics, and organ transplants are just a few of the great breakthroughs that have saved countless lives and limbs. Numerous books have been written about these revolutionary accomplishments and their originators. The present work has a different purpose, i.e., to inform the reader of the nonmedical contributions to civilization made by selected physicians from ancient times to the present.

Modern public opinion surveys have repeatedly shown that the medical profession, a vocation devoted to the health of humanity, is among the most widely respected. As a career choice, it is often admired as stable, gratifying, prestigious, and bespeaking intelligence and dedication. There is humor, but often a grain of truth, in the well-known stereotype of the parents from various ethnic groups who insist that their son or daughter become a doctor (or at least marry one). Paradoxically, there is also a minority perception in the United States that physicians are unidimensional, inept in and indifferent to most nonmedical matters, and obsessed with their incomes and golf scores. I was first exposed to this canard shortly after finishing medical training and moving to Stamford, Connecticut. My wife and I were invited to a large social gathering in the course of which the hostess blurted to her guests that Doctors are smart, but they’re also the most boring people I’ve ever met! At the time, I dismissed this generalization as cocktail banter. I have since heard similar uninformed comments on occasion from patients and other acquaintances. No reasonable physician would pretend that he and his colleagues are untouched by the many foibles and fallacies to which all other human beings are prone. The notion of doctors as a class having narrow horizons, however, is unfounded. Having worked closely with many of them over several decades, I know most to be as deeply interested and involved in the larger world around them as their professional obligations allow. Hence one motive for writing this book was to demonstrate to the public and to my colleagues that physicians have historically contributed much, beyond health care, to society’s progress.

A second inducement to undertake this project was a perceived gap in my own education. I am grateful to have been the beneficiary of very solid scientific and medical teaching on the undergraduate and postgraduate levels. Throughout this twelve-year experience, however, virtually no attention was directed toward the history of medicine, i.e., how health care evolved over the millennia from the shamanic incantations of the Stone Age to the stereotactic neurosurgery and interventional cardiology of today. One contemporary American healer and achiever, Dr. Lewis Thomas (1913-1993), posited in 1978 that medicine’s reticence vis-à-vis its own history was a consequence of the profession’s less-than-laudable state prior to the past two centuries. His own words are as follows:

The history of medicine has never been a particularly attractive subject in medical education and one reason for this is that it is so unbelievably deplorable… bleeding, purging, cupping and the administration of infusions of every known plant, solutions of every known metal, every conceivable diet… concocted out of nothing but thin air—this was the heritage of medicine until a little over a century ago.

In my view, much of the profession’s past is indeed lamentable, but as I hope this book will help demonstrate, there were instances of rationalism and effective therapy scattered throughout medicine’s previous eras. I believe that at the present it is because of the overwhelming imperative for students’ time to be focused on the vast data of current basic and clinical sciences that medical history is largely ignored in most modern academic centers. In an attempt to correct my own inadequacies in this regard, long after graduation, I began to read such sterling works as R. Porter’s The Greatest Benefit to Mankind (1997), S. Nuland’s Doctors: The Biography of Medicine (1988), and A. Castiglioni’s A History of Medicine (1941), among others. An eye-opening aspect of this endeavor was my discovery of the meaningful contributions that many medics have also made to the arts and sciences, literature, philosophy, religion, linguistics, government, exploration, military affairs, athletics, etc. To give just a few examples in the field of government alone, the past two centuries have witnessed the work of such physicians as Anson Jones (1798-1858, the last president of the Republic of Texas, who presided over its annexation to the United States), Sun Yat-sen (1866-1925, first president of the Republic of China), Georges Clemenceau (1841-1929, prime minister of France in the final year of World War I), and Howard Dean (b. 1948, former governor of Vermont and candidate for president of the United States). One can speculate that many of these healers may have been inspired in their nonmedical labors by the cardinal therapeutic imperative to Make it better! In accord with the academic adage that if you want to learn a subject well, write a book on it! I chose to compile these biographies with the hope of learning well the history of medicine (and perhaps also the history of civilization).

Healers and Achievers is not meant to be all-inclusive. There have been, and continue to exist today, many more multitalented physicians than the mere thirty-seven whose lives and work are herein described. Nor is this book intended to be exclusive, i.e., the far greater number of nonphysicians who have enlightened and benefited the human race through their versatility is unequivocally acknowledged. Da Vinci, Leibniz, Goethe, and Franklin are a few names that immediately come to mind. A question that has been asked to me repeatedly is if an equivalent volume could be written on the extravocational achievements of other professionals, e.g., accountants, lawyers, and engineers. My response is a presumptive yes, and I would certainly welcome such an endeavor as a positive addition to biography literature. To the best of my knowledge, this has not yet been attempted.

One may reasonably ask why these particular thirty-seven individuals were chosen to represent all the multifaceted physicians of the past and present. There was a conscious effort to select subjects from the major historical periods of Western civilization, i.e., the eras of ancient Egypt, Greece, Rome, the Middle Ages, Renaissance, etc. Beyond this historical criterion, I must confess that the choices were often subjective and based upon the men and women I personally found most interesting. While most of the physician subjects would qualify as intellectuals, their diversity extends well beyond this vague designation. My cast of characters includes an architect, three priests, a pope, rabbi, astronomer, several holders of honorific paternity titles (Father of Mineralogy, Bibliography, Magnetism, Taxonomy), an opera librettist, two athletes, a swashbuckler, and a spy. It is my hope that the reader will find their exploits and accomplishments, both medical and nonmedical, as fascinating as I did.

RSB

Stamford

February 2012

Acknowledgments

The research for this eclectic work compelled me to delve deeply into subject matter long forgotten or never before encountered. My efforts were greatly facilitated by the instruction and guidance received decades ago as an undergraduate. I am deeply indebted to Professors Eli Levine and Samuel Soloveichik for sharing their erudition in chemistry, to Seymour Lainoff in English language and literature, to Robert Weisbord in the history of Western civilization, and to Jonah Mann in mathematics. In the formative four-year medical school experience, a large number of knowledgeable scientists and clinicians gave of their time and energy to mold my class into physicians. Among those with the most enduring and positive impact upon me were Doctors Peter Barland in internal medicine, Ronald Dee in surgery, Lewis Fraad in pediatrics, and John Gray in obstetrics.

My eternal gratitude goes to Dr. Samuel Gartner, the late chairman of ophthalmology at Montefiore Medical Center in New York City, who took a chance and offered me a residency position despite the imminent risk of my being drafted out of the program and into military service. He taught me much about being a physician and undertook, in his own words, the hard job of teaching residents how to operate, and the much harder job of teaching them when not to operate. Drs. Herman Barest and Gerald Kolbert of the Montefiore attending staff were superb clinicians and teachers, and they invited me to join them in practice. I am forever thankful to have learned from and shared in patient management with each of them over three decades.

Numerous knowledgeable friends and acquaintances have assisted my efforts in writing this volume with their comments and expertise. Gil Orbach, a Princeton-educated scholar of the ancient world, was my first consultant; he fortunately corrected, among other items, an ambiguity in the book’s opening sentence. Doctors Sharon Lattig, a professor of English, and David Sperling, a professor of Bible and a friend since high school, both offered invaluable editorial suggestions. Zach Pishnov, Arnold Weiss, and Drs. Lester and Seth Kosowsky helped clarify important concepts in physics, mathematics, and engineering. Colleagues who assisted on medical issues were Drs. Shara Israel in infectious disease, Stuart Apfel in neurology, Mark Banschick in psychiatry, Steven Thau in pulmonolgy, and Jeffrey Cahn in dentistry. Others who read selected chapters and shared their insight were James Smart, Esq., in legal history, Gideon and Miriam Pell in Britain’s past, and Joanna Dunne in the Civil War era. Ms. Christine Bloom provided pivotal support when my attempts at translating French sources proved inadequate. My two superb figure skating instructors, Fran Gold Lind and Terri Lowenthal, read and advised on the relevant material in their field. I am much indebted to Wendy Fellows, a fellow skater and also a skilled graphic artist, for executing the book cover.

Finally, my deepest thanks must be extended to my wife and lifetime companion, Dorothy, who read and critiqued each chapter and whose computer expertise rescued me countless times when the device refused to cooperate. After writing nearly a million words in the various drafts of this book, I cannot find any to adequately express how much her help and support have meant to me.

Healers and Achievers consists essentially of two components, i.e., historical facts and the conclusions drawn from those facts. For any errors that have crept into either group, I accept full responsibility.

RSB

Chapter 1

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Credit: Science Museum, London

Imhotep

Imhotep (circa 2670-2600 BC)

Architect of the First Egyptian Pyramid, Grand Vizier,

High Priest, Scribe, Poet

Western civilization can trace some of its earliest roots to ancient Egypt. The predictable annual flooding of the Nile River valley generated a bountiful harvest that nourished an independent Egyptian national entity lasting about 2,500 years. Under the Old Kingdom (ca. 2680-2190 BC), the Middle (ca. 2060-1665), and New (ca. 1570-1080) Kingdoms and through thirty-two royal dynasties extending nearly to the Common Era, the ancient Egyptians distinguished themselves as innovators in art, architecture, literature, engineering, and medicine. One of the very few ancient Egyptian commoners to achieve renown and deification was a multitalented Old Kingdom physician.

Although the names of hundreds of physicians have been found in the ancient Egyptian inscriptions and writings, the individual first and most famously associated with the healing arts in that civilization was Imhotep, who lived during the Third Dynasty (ca. 2680-2600 BC) in the Old Kingdom.¹ Sir William Osler (1849-1919), perhaps the greatest clinician and teacher of medicine in the modern era, described Imhotep as the first figure of a physician to stand out clearly from the mists of antiquity. Little is known of his personal history. Osler’s description, while accurate, is not based on sources contemporaneous with Imhotep but rather on his reputation as established centuries after his death. He was born a commoner near Memphis, the Egyptian capital in the lower (northern) Nile valley, about twelve miles south of modern Cairo. His father was Kanofer, the first in a long familial line of royal administrators, and his mother’s name Khreduonkh. Imhotep rose through the ranks of the royal civil service and was ultimately promoted, as one contemporary stone inscription reveals, to Chancellor of the King, High Priest, Chief Sculptor, Chief Carpenter. As the king’s vizier, he supervised the government’s military, judicial, financial, and agricultural affairs. In later generations Imhotep was also venerated as a scholar, scribe, poet, astronomer, and philosopher.

A specific incident involving Imhotep and King Zoser (reigned ca. 2635-2610) was recorded in stone on the Nile island of Sehel near Aswan in Upper (southern) Egypt. The inscription on the Famine Stele describes a seven-year failure of the Nile to flood, resulting in a severe drought. The king sought counsel from his vizier on how to deal with the calamity. Imhotep advised his lord to placate the god Khnum, one of the deities believed to control the unknown source of the Nile. After suitable propitiations from the king at the god’s temple, Khnum appeared to Zoser in a dream and promised to restore the river’s rhythmic resurgence. With the ensuing overflow of the Nile’s banks, the relieved monarch presented lavish gifts to the temple and the grateful populace sang the praises of the wise vizier.²

Our knowledge of ancient Egyptian medicine is primarily derived from inscriptions on monuments and tombs and from papyri. The most complete and revealing of these are the Edwin Smith Papyrus,³ dating back to ca. 1600 BC, and the Georg Ebers Papyrus,⁴ ca. 1550 BC. The former is mainly surgical in scope, while the latter is medical. Egyptologists agree that both documents are compilations of material that had already been known and used in practice during the previous one thousand years. It may be assumed that a rudimentary knowledge of gross anatomy, and even gross pathology, was acquired through the practice of evisceration that routinely preceded the ritual mummification of the dead. Medical practice as applied to living patients was essentially the province of the priestly class and was divided among generalists and specialists in a single body part or a single disease. The priest/physician would obtain a history and then proceed to an examination consisting of inspection and palpation. Treatment was a combination of invocation of divine assistance and the application of drugs and surgery. The medications were compounded from a wide variety of animal, vegetable, and mineral sources. Most were of no therapeutic value as judged by the standards of the twenty-first-century AD. But some were likely to have been very effective, e.g., opium for pain relief and ox liver (now known to be a rich source of retinol—vitamin A) for malnutrition-induced night blindness. Surgical procedures were superficial and included suturing of lacerations, wound care, drainage of abscesses, and reduction of fractures and dislocations.

As a physician, Imhotep left no written medical treatise. James H. Breasted (1865-1935), renowned American Egyptologist and historian, suggested that he might have been the original source of the forty-eight case reports in the Edwin Smith Papyrus. This was admittedly conjectural as the document itself was unattributed and transcribed by hand approximately one millennium after Imhotep’s death. If true, however, Imhotep had extensive experience in the surgical and medical management of injuries to the head, neck, and trunk and a remarkable understanding of anatomy and physiology for his time. In the papyrus a detailed description of the skull and its contents was provided, including the brain, meninges, and even the cerebrospinal fluid. Compound and comminuted fractures were specifically defined.⁵ Clinical post-trauma sequelae were reported, including such ominous neurologic deficits as limb paralysis, aphasia (impaired communication), and urinary incontinence. Each case was examined and evaluated, with a rational conclusion drawn from observed facts. A diagnosis and prognosis were then determined, upon which treatment was or was not recommended. Imhotep’s basic approach to patient evaluation and management would be familiar to any scientifically trained health care professional in the current era.

Besides the distinction of being the first named physician in history, there are other firsts that immortalize Imhotep’s extensive résumé. He was the first named architect in history, designing and constructing the first pyramid in Egypt. This was the Step Pyramid at Saqqara, built to house King Zoser’s tomb. Saqqara, just to the west of Memphis, was the capital’s huge necropolis.⁶ Prior to Imhotep, the Egyptian burial chambers had been situated beneath a mastaba, a flat one-story rectangular mud-brick shelter. Imhotep’s innovations were to build with stone and to add five successively smaller tiers above the base mastaba, creating a symbolic stairway to facilitate the pharaoh’s ascent to heaven. The rectangular base of the Step Pyramid measured 352 by 396 feet, and the six steps progressively diminished in height from the bottom tier at thirty-eight feet to the topmost at twenty-nine. The result was a two hundred-foot tall edifice, the world’s largest man-made stone structure up to that time. Beneath the pyramid, there was a labyrinth of tunnels, vertical shafts, galleries, and burial chambers extending ninety-five feet down into bedrock. The surrounding rectangular walled complex at ground level covered about thirty-five acres and included temples, colonnades, courtyards, and storerooms. It is estimated that the entire project took twenty years and 850,000 tons of stone to complete. The success of this construction inspired subsequent pharaohs to build larger and more spectacular pyramids, most notably the colossal Great Pyramid of King Khufu (Cheops in Greek) erected at Giza, about twelve miles north of Saqqara, during the Fourth Dynasty (ca. 2530 BC). The Step Pyramid, still standing today, was the prototype for a style of royal funerary architecture that became a universally recognized icon of Egyptian civilization to the present time. Other Egyptian monuments that may have been Imhotep’s work include the unfinished pyramid of Sekhemkhet (King Zoser’s successor), just to the southwest of the Step Pyramid complex, and the Edfu Temple, located between Luxor and Aswan in Upper Egypt.

Other roles in which Imhotep served during the Third Dynasty were those of high priest and philosopher/poet. In the former capacity he directed the priesthood of the sun-god Ra. His routine clerical duties entailed recitation from holy texts during religious services; the numerous surviving bronze statues of Imhotep depict him thus, typically in the seated position with an open scroll on his lap. In addition he presided over the important funeral rites for the deceased, transforming their lifeless bodies into a state suitable for passage to the next world. As a philosopher/poet Imhotep was widely admired, and his many aphorisms were orally passed down through the generations. A poem partially attributed to him and found in the Harris Papyrus and an Eighteenth Dynasty tomb inscription is selectively quoted as follows:

The gods of old rest,

And the mummies of men long dead,

The same for both rich and poor.

The words of Imhotep I hear,

The words of Horotef ⁷ that say:

What is property?—Tell!

The fences and walls are destroyed,

Their houses exist no more.

And no man returns from the tomb,

To tell of what passes below.

Anoint yourselves, clothe yourselves well,

Use the gifts that the gods bestow,

Fulfill your desires on Earth.

Feast in tranquility now,

For none takes his goods below to the tomb,

And none comes thence back again.

The underlying theme of Eat, drink, and be merry, for tomorrow we die! should be apparent to the reader. The same sentiments (not necessarily condoned) appeared thousands of years later in the Old Testament (Isaiah 22:13) and the New (1 Corinthians 25:32).

Imhotep lived to an advanced age and apparently died in the reign of King Huni, the last ruler of the Third Dynasty. He is believed to be buried in the Step Pyramid complex at Saqqara. Despite vigorous efforts by archeologists, however, his tomb has not yet been located. About one hundred years following his death, Imhotep was elevated to the status of a demigod, and by the sixth century BC, he was fully deified as the chief healing god of Egypt. There were at least three centers of Imhotep worship, at Memphis, Philae, and Thebes, where sick and lame pilgrims would seek his favor and assistance (antedating by about 2,500 years the analogous Christian shrine at Lourdes, France). Subsequently, when Greek influence became predominant in Egypt and throughout the Mediterranean, his name was merged with that of Asclepius, the Greek god of medicine, to be known as Asclepius-Imhoutes. As late as the first century AD, the Roman emperors Tiberius and Claudius paid him homage with inscriptions on their Egyptian temples. Other Roman-era epigraphs lauding Imhotep’s therapeutic powers and found in Egyptian shrines include Heals all disease in Egypt (Edfu), Cures diseases in his own fashion (Esna), and Makes limbs healthy (Philae). It is said that his preeminence as a divine healer persisted in Egypt until the suppression of polytheism by the Muslim-Arab invasion of North Africa in the seventh century AD. In 2006 the Egyptian Supreme Council of Antiquities opened the Imhotep Museum near the Saqqara complex to honor the ancient polymath and display locally uncovered archeologic treasures. In American popular culture, Imhotep’s name lives on to the present time as fictional characters portrayed by Boris Karloff in the 1932 film The Mummy and by Arnold Vosloo in the 1999 film of the same title. In a more scholarly context, the aforementioned great Egyptologist James Breasted memorialized him with the following statement:

In priestly wisdom… in the formulation of wise proverbs, in medicine and architecture, this remarkable figure of Zoser’s reign left so notable a reputation that his name is not forgotten to this day.

References

Badawy, A. Imhotep. In Placzek, A., ed. Macmillan Encyclopedia of Architects. New York: Macmillan Publishing Co., 1982.

Baker, R., Baker, C. Ancient Egyptians: People of the Pyramids. Oxford: Oxford University Press, 2001.

Breasted, J. A History of the Ancient Egyptians. New York: Scribner, 1908.

Breasted, J. The Edwin Smith Surgical Papyrus. Chicago: University of Chicago Press, 1930.

David, R. Imhotep. In Bynum, W., Bynum, H., eds. Dictionary of Medical Biography. Westport: Greenwood Press, 2007.

Hurry, J. Imhotep: The Vizier and Physician of King Zoser and Afterwards the Egyptian God of Medicine. Chicago: Ares Publishers, 1978.

Major, R. A History of Medicine. Springfield: Charles C. Thomas, 1954.

Osler, W. The Evolution of Modern Medicine. New Haven: Yale University Press. 1923.

Radwan, A. The Step Pyramids. In Hawass, Z., ed. Pyramids. Vercelli: White Star Publishers, 2007.

Risse, G. Imhotep and Medicine: A Reevaluation. West Jnl Med 144(5):622-624, 1986.

Sigerist, H. Imhotep and Aesculapius. In The Great Doctors: A Biographical History of Medicine. Garden City: Doubleday & Company, 1958.

Verner, M. The Pyramids: The Mystery, Culture, and Science of Egypt’s Great Monuments. New York: Grove Press, 2001.

Chapter 2

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Empedocles

Empedocles of Acragas (ca. 493-415 BC)

Poet, Philosopher, Statesman, Scientist

Ancient Greece was the preeminent cultural foundation of the Western world. Its pioneers in philosophy, government, literature, art, science, and athletics set the standards that inspired generations of successors through the subsequent 2,500 years. In the field of medicine, principles of health care articulated by ancient Hellenic physicians have both guided and misguided practitioners ever since. One of the early Greek healers, Empedocles of Acragas, formulated a paradigm of the natural world engendering principles of science and of medical therapy that remained virtually unchallenged until the modern era.

The Greek pantheon was a hierarchy of interacting gods and goddesses who controlled all natural phenomena and every facet of human experience. Healing was the domain of Apollo, son of Zeus, who also served as god of light, truth, and music. His mortal son, Asclepius, was trained to be a physician and became so adept and successful that, upon his demise, he was deified as the god of medicine. Several of Asclepius’s children took up their father’s vocation, including his sons Machaon and Podaleirios, cited for their surgical skills during the Trojan War in Homer’s Iliad, and his daughters Hygieia and Panacea. A healing cult developed around the memory of Asclepius and his distinguished family, and temples of worship appeared throughout the expanding Greek world in the subsequent centuries. Initially established to invoke supernatural intervention for the sick and injured, these Asculepieia evolved into a blend of religious shrine, spa, and hospital in which more natural therapies, e.g., baths, exercise, drugs, and surgery were increasingly employed.

Simultaneously with the evolution of the Asculepieia in the seventh and sixth centuries BC, there appeared at numerous locations in the Greek world individual philosophers (from the Greek philo, loving + sophia, wisdom) who employed reason, rather than religious dogma, as the guiding force in their inquiries. Thales, Anaximander, Anaximenes, Pythagoras, Democritus, and Empedocles were among those who used their own powers of observation and analysis to explain the nature of the universe. As a group we refer to them as the pre-Socratics, the thinkers who laid the intellectual groundwork upon which the fifth—and fourth-century luminaries Socrates, Plato, and Aristotle built so prodigiously. Another parallel development in the scattered Greek outposts of the Mediterranean was the emergence of schools of medicine, where groups of secular practitioners and students implemented a strictly rational approach to evaluating patients and their illnesses. The most influential were the schools at Cnidos and Cos in the eastern Aegean. At these centers, careful attention was devoted to the patient’s history, followed by a meticulous physical examination. Over the centuries, sufficient experience was accumulated to allow classification of diseases by symptoms or by affected organs. The goal was to successfully prognosticate and, if possible, to treat. The entire process culminated in the work and teachings of Hippocrates of Cos (ca. 460-370 BC), forever after known as the Father of Medicine.

As is true of all the pre-Socratic philosophers, our knowledge of Empedocles is fragmentary. About 470 lines of verse survive (estimated to have originally numbered 6,000) from his hexameter poems Peri Physeos (On Nature) and Katharmoi (Purifications), and there are references to his life and work from subsequent Greek and Roman authorities. He was born circa 493 BC to a wealthy Greek family in Acragas (the Roman Agrigentum, currently Agrigento), a city on the southwest coast of Sicily.⁸ Empedocles’s father was Meton, an aristocrat active in the municipal government; his grandfather, also named Empedocles, was a victorious equestrian racer in the 496 BC Olympic Games at Olympia, Greece.⁹ Educated in the Pythagorean school, the young student was allegedly expelled for revealing some of its esoteric doctrine. Other important philosophers who influenced him were the Italian-born Parmenides (late sixth-mid-fifth century), under whom he may have studied directly, and the Ionian Heraclitus (ca. 540-480). Empedocles traveled through the Greek world, offering medical advice to the sick and promoting the Pythagorean ideals regarding purity of body, mind, and actions, as well as moderation in diet and exercise. Back in his native city, the Sicilian Greek led a revolt against the ruling aristocracy and then refused the grateful rebels’ offer of dictatorship in favor of establishing a democracy. His poems were later cited for their excellence by both Aristotle and the Roman poet Lucretius (ca. 99-55 BC), and the former credited Empedocles with originating the principles of rhetoric. As a scientist, he demonstrated experimentally that air was a material substance rather than empty space. In the realm of theoretical science, he suggested the concept that sunlight travels to Earth with a finite velocity and anticipated Darwin by postulating a process of biological evolution that included the survival of the fittest.¹⁰ His multiplicity of talents was aptly recognized by Will Durant, renowned twentieth-century historian, who characterized Empedocles with a Renaissance metaphor as the Leonardo of Acragas.

Few details are known of Empedocles’s medical skills, but his clinical counsel was eagerly sought and his success widely applauded, even at the quadrennial Olympic Games. It is said that in the Sicilian city of Selinus he conquered an epidemic of fever, possibly malarial, by draining the surrounding swamps. Another feat of environmental engineering attributed to him was the modification of Acragas’s climate by closing a windblown cleft in the adjacent mountainside. He introduced some of the pivotal physiologic principles in Greek medicine. Empedocles taught that the heart is the center of the vascular system, that blood flows to and from it, and that pneuma (a vital force, presumably analogous to what we currently identify as oxygen) is channeled through the blood vessels to every organ and limb. He postulated a cooling function of respiration and described a respiratory action of skin pores. The philosopher/physician’s understanding of organ function also included the beliefs (now known to be erroneous) that the heart is the center of consciousness and that the liver is the source of blood production. Six centuries later, Galen (ca. AD 130-200), the Greco-Roman physician who was one of the most influential figures in the history of medicine, described Empedocles as the founder of medicine in Italy.

The most enduring legacy that Empedocles bequeathed to his philosophic and scientific heirs was his doctrine of the four elemental rhizai (roots) of the natural world. While the nature of the world’s fundamental building blocks had long been the subject of speculation among the pre-Socratics, Empedocles was the first named individual to hypothesize the joint participation of earth, water, air, and fire. The elements are initially veiled in mythical metaphors as follows:

Hear first the four roots of all things—

Dazzling Zeus, life-breathing Hera,

Aidoneus, and

Nestis who moistens mortals’ springs with her tears. (On Nature, Fragment 6)¹¹

Later the poet articulates more specifically his concept of the cosmos’s irreducible constitutents:

At times the solitary one grows out of many,

At times the many out of one—

Water, Fire, Earth, and the immense heights of Air.

Apart from them—Strife, uniformly dense and destructive,

Among them—Love, stretching in every dimension. (On Nature, Fragment 17)

In Empedocles’s system, the interactions of the four elements result in both the synthesis and degradation of all matter, animate and inanimate. Each of the four classical elements has a combination of traits, i.e., hot, cold, wet, and dry, and the forces of philia (love) and neikos (strife) induce them to join or separate in whole-number proportions. This hypothesis is analogous to the modern concept of intermolecular forces of attraction and repulsion in chemical reactions. Empedocles and/or his Hippocratic successors extended the schema one step further for the human body. They posited that health was determined by a proper balance of four humors, i.e., blood, phlegm, yellow bile, and black bile, corresponding and exhibiting traits similar to the four elements. The physician’s function was to determine which humor was excessive or deficient in a given malady and to institute corrective measures to restore the balance. It is impossible to overstate the influence of this system on science and on medicine for the subsequent 2,300 years. To this day, the human temperaments labeled sanguine, phlegmatic, choleric, and melancholic reflect the ancient fanciful notion of an excess of one of these humors. In the modern era, the periodic table of approximately one hundred chemical elements has replaced the classical four, and in physiology the homeostatic balances of acid-base, fluid and electrolytes, hormones, and enzymes have supplanted those of the four humors.

Toward the end of his life, Empedocles turned his attention to expanding the Pythagorean belief in reincarnation to include plants, animals, humans, and gods. He was convinced that in previous lives he had existed in each category and was equally certain of a destiny to return to divine status. There are several accounts of his death. One describes a political miscalculation in 415 BC when he allegedly opposed the ill-fated Athenian invasion of Syracuse, an overseas campaign of the Peloponnesian War (431-404 BC). This struggle for supremacy within the Greek Empire, primarily between the two major city-states of Athens and Sparta, would ultimately lead to the defeat of Athens. In the traditional ancient Greek method of dealing with malcontents, Empedocles’s fellow citizens of Acragas banished him, and he soon thereafter died ignominiously on the Greek mainland. Another equally apocryphal story tells of a therapeutic triumph in which he restored an apparently dead woman to life. After a celebratory feast the physician became the first individual to climb to the summit of Mount Etna in Sicily, where he then threw himself into its active volcanic crater in the hope of confirming his divinity.¹² This vain attempt at apotheosis was recounted in the three unfinished plays Der Tod des Empedokles (The Death of Empedocles) by the German lyric poet Johann Hölderlin (1770-1843); the dramas formed the basis for the 1987 film of the same name by the French filmmakers Jean-Marie Straub and Danièle Huillet. The Greek’s life and tragic fall were also memorialized in the poem Empedocles on Etna, published by the Victorian poet Matthew Arnold in 1852. Arnold’s admiration for the philosopher/physician is summarized in the following few verses:

But his power

Swells with the swelling evil of this time,

And holds men mute to see where it will rise.

He could stay swift diseases in old days,

Chain madmen by the music of his lyre,

Cleanse to sweet airs the breath of poisonous streams,

And in the mountain-chinks inter the winds.

This he could do of old.

References

Bidez, J. La Biographie d’Empédocle. Ghent: Chez Clemm, 1894.

Durant, W. The Story of Civilization. Part 2, The Life of Greece. New York: Simon and Schuster, 1939.

Graham, D. Empedocles and Anaxagoras: Responses to Parmenides. In Long, A., ed. The Cambridge Companion to Early Greek Philosophy. Cambridge: Cambridge University Press, 1999.

Hamilton, E. Mythology. New York: Little, Brown and Company, 1969.

Kingsley, P. Ancient Philosophy, Mystery, and Magic: Empedocles and Pythagorean Tradition. Oxford: Clarendon Press, 1995.

Lombardo, S. Parmenides and Empedocles: The Fragments in Verse Translation. San Francisco: Grey Fox Press, 1982.

Wright, M. Empedocles: The Extant Fragments. London: Bristol Classic Press, 1995.

Rocca, J. Empedocles of Acragas. In Bynum, W., Bynum, H., eds. Dictionary of Medical Biography. Westport: Greenwood Press, 2007.

Chapter 3

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Celsus

Celsus (ca. 25 BC-AD 50)

Encyclopedist

Ancient Rome succeeded ancient Greece as the dominant influence in the development of the Western world. In the course of half a millennium (508-30 BC), the Roman Republic grew from an upriver village to the sole Mediterranean power; over the next five centuries (27 BC-AD 476), the Roman Empire grew and then declined as a world superpower. Culturally, the Latins were imitative of their Greek forerunners in art, science, literature, and theology and innovative in the more practical fields of law, government administration, military science, engineering, and architecture. One of the great compilers of broad contemporary knowledge in the early empire was Celsus, a patrician physician.

In the formative years of the Roman Republic, health care was primarily home based, with each family administering its own herbal remedies and appealing to a myriad of household gods for medical help. By the third century BC, with increasing commercial and military contact between Rome and its Mediterranean neighbors, Greek physicians appeared and practiced in the Roman metropolis. Their services initially received mixed reviews, as some had limited medical training and others were outright charlatans. Cato the Elder (234-149 BC), a widely respected and vocal proponent of traditional Roman values, vigorously opposed the infiltration of Greek culture generally and Greek physicians in particular. Over the ensuing centuries, however, with an influx of better trained physicians from the various Greek schools and especially from the center of Hellenistic learning at Alexandria, standards of medical practice improved significantly. A major professional milestone was reached in 46 BC when physicians were enfranchised in Rome under the dictatorship of Julius Caesar. His heir and successor, Augustus Caesar, the first Roman emperor (reigned 27 BC-AD 14), extended this official recognition in AD 10 by exempting all physicians from taxation as a gesture of gratitude for a cure administered by the Greek physician, Antonius Musa. Among the many Greeks who participated in elevating medicine to a respectable profession in Rome were Asclepiades of Bithynia (first century BC, clinician, physiologist), Rufus of Ephesus (ca. AD 100, clinician, anatomist), Dioscorides of Cilicia (first century AD, Roman army surgeon, medical botanist), Soranus of Ephesus (second century AD, obstetrician-gynecologist), and Galen of Pergamon (AD 131-201, physician, surgeon, prolific medical writer).

It is ironic that in this era of dominance of health care by Greek physicians, one of the most extensive and informative medical treatises was written by a Roman. Aulus¹³ Cornelius Celsus was born into the aristocratic Cornelii family circa 25 BC and apparently lived the privileged existence of a wealthy landowner. This provided him with the time and resources to devote himself to scholarly pursuits. He joined the ranks of several other Roman encyclopedists, e.g., Cato the Elder, Marcus Varro (116-27 BC), and Pliny the Elder (AD 23-79), in attempting to collect and summarize all the accumulated erudition of their day in a broad range of fields. Celsus’s complete work, De Artibus (On the Sciences), was probably written in the years AD 25-35 during the reign of Tiberius, the second Roman emperor. The encyclopedia consisted of at least twenty-one books on the subjects of agriculture, rhetoric, jurisprudence, military science, philosophy, and medicine. Two of Celsus’s younger contemporaries, i.e., Columella and Quintilian, themselves authors of voluminous (and extant) works on agriculture and rhetoric respectively, praised his magnum opus. Unfortunately, all of De Artibus has been lost to posterity except for the eight-volume dissertation on medicine.

Celsus’s De Re Medicina (On Medicine) was written in very elegant and precise Latin, making it comprehensible to his contemporaries in the literate Roman world. There is a long preface with the first written account of the history of medicine from mythical times to his own. The body of the work is organized into eight books, discussing preventive medicine, systemic and organ-specific signs and symptoms, pharmacopeia, medical and surgical therapy of systemic and organ-specific diseases, and trauma. Celsus recognized the importance of a knowledge of anatomy in surgery and favored cadaver dissection as performed by the Hellenistic physicians of Alexandria despite the centuries-old ban on this practice by both Greek and Roman religion.¹⁴ He was familiar with the various Greek schools of medical practice, e.g., the Dogmatic, Empiric, and Methodist, and selected what he viewed as the best elements of each approach in patient care.¹⁵ With respect to diagnosis and therapy, he quoted over seventy Greek medical authorities as sources and relied particularly on the teachings of Hippocrates of Cos (ca. 460-370 BC) who was already then considered the Father of Medicine. As did Hippocrates, the Roman nobleman stressed the need for observation, reasoning, and experience to successfully manage disease. The many pathologic entities he discussed included those currently recognized as pneumonia, asthma, tuberculosis, appendicitis, gout, malaria, and tetanus. Among the innovations he described were surgical ligation of blood vessels, nutritive enemas as an alternative to oral hydration and alimentation, treatment of the insane, and various surgical procedures in many specialty areas, including urology, gynecology, orthopedics, and ophthalmology. Celsus was the first to list the cardinal signs of inflammation, i.e., rubor (redness), calor (heat), tumor (swelling), and dolor (pain), which remain the initial descriptive clinical features of this process found in medical texts to the present time. His translation of Greek anatomical and medical terms into Latin formed the basis of the nomenclature used ever since in the Western medical vocabulary.

Little is known of Celsus’s personal history, and it has long been a matter of debate as to whether he was actually a physician. The comprehensive scope and authoritative detail of De Re Medicina suggest authorship by a practicing medical professional. And yet references to Celsus by his contemporaries, Pliny the Elder and Quintilian, describe him only as a writer, orator, and philosopher. The consensus among classics scholars has been that Celsus was not a physician, and this view is consistent with a common belief that health care practice in Roman society was deemed to be menial work, beneath the dignity of the patrician elite. It is important to note, however, that four of Medicina’s translators into English (James Grieve—1756, G. F. Collier—1831, Alexander Lee—1831, and Walter G. Spencer—1926), all physicians or surgeons, were convinced of the author’s status as an ancient professional colleague. As evidence they pointed to his frequent use in the text of the first person (singular or plural) of a verb in discussing patient care, and the numerous occasions when he employed the emphatic pronoun ego (I).¹⁶ These scholars were also likely the most competent to judge the depth of Celsus’s familiarity with the challenges of medical diagnosis and treatment. A more recent analysis (Spivack) of the terminology and ideas expressed in De Re Medicina, and of the references to Celsus by Pliny and Quintilian, argues forcefully that the Roman was a knowledgeable practicing physician. Some commentators have chosen to compromise in the dispute by positing that Celsus, as was true of other Roman large estate owners, limited his practice of medicine to his household, acquaintances, and slaves.

Despite the scholarship and completeness of De Re Medicina, the treatise was largely ignored by Celsus’s medical contemporaries. This was probably because it was written in the Latin vernacular rather than the Greek felt to be more appropriate for scholarly publication at that time. The work was lost completely during the Middle Ages and then rediscovered and resurrected in 1443 by Tomaso de Sarzana (subsequently Pope Nicholas V) in a papal library in Milan. Its value was soon recognized by Renaissance savants and physicians, and De Re Medicina became the first medical work to be printed (1478) after Gutenberg’s epochal invention of the printing press. There were scores of subsequent editions and numerous translations. If Celsus was not a physician, he nevertheless became the published teacher to thousands of them. De Re Medicina became required reading for students of medicine throughout Europe and the New World until the dawn of the twentieth century. His Latin prose earned him the metaphoric title of Cicero Medicorum (Cicero of the Physicians),¹⁷ and his clinical erudition established his lasting distinction, alongside Hippocrates and Galen, as one of the pillars of ancient medicine. One can only speculate as to what additional acclaim Celsus might have earned had his five nonmedical encyclopedic works in De Artibus survived.

References

Castiglioni, A. A History of Medicine. New York: Alfred A. Knopf, 1941.

Celsus, A. De Medicina With an English Translation by W. G. Spencer. Cambridge: The Loeb Clssical Library, 1935.

Collier, G. A Translation of the Eight Books of Aulus Cornelius Celsus on Medicine. London: Simpkin and Marshall, 1831.

Durant, W. The Story of Civilization. Part 3, Caesar and Christ. New York: Simon and Schuster, 1944.

Garrison, F. An Introduction to the History of Medicine, 4th ed. Philadelphia: W. B. Saunders, 1929.

Porter, R. The Greatest Benefit to Mankind: A Medical History of Humanity. New York: W. W. Norton, 1997.

Rhodius, J. The Life of Aurelius Cornelius Celsus. In Lee, A., (transl.). Aur. Cor. Celsus on Medicine in Eight Books, Latin and English. London: E. Cox, 1831.

Rocca, J. Celsus, Aulus Cornelius. In Bynum, W., Bynum, H., eds. Dictionary of Medical Biography. Westport: Greenwood Press, 2007.

Spencer, W. Celsus’ De Medicina: A Learned and Experienced Practitioner Upon What the Art of Medicine Could Then Accomplish. Proc Roy Soc Med 19 (Sect Hist Med):129-139, 1926.

Spivack, B. A. C. Celsus: Roman Medicus. Jnl Hist Med Allied Sci 46(2):143-157, 1991.

Chapter 4

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Johannitius (Hunayn ibn Ishaq)

Johannitius (Hunayn ibn Ishaq, 809-873)

Nestorian Christian Translator, Philologist,

Conservator of Greek Scholarship

The Roman Empire, at the height of its expansion in the second century AD, extended from Scotland to Syria and included the entire Mediterranean basin. In the subsequent two centuries, the massive challenges of administering and defending this huge imperium resulted eventually in its division into western and eastern halves, each with its own bureaucracy and with capitals in Italy (Ravenna) and Byzantium (Constantinople), respectively. During the same period, Christianity in the empire evolved and grew from a persecuted cult to the official state religion. Theodosius I was the last emperor to rule (392-395) over the nominally united realm. The western, Latin-speaking empire fell to the barbarian invaders in 476; the eastern, Greek-speaking empire outlasted its western counterpart by a thousand years, ultimately falling to the Ottoman Turks in 1453. By convention, these two years bracket the historical period known as the Middle Ages.

As their name implies, the Middle Ages were an intermission, in terms of both time and creativity, between the preceding Greco-Roman and the succeeding Renaissance eras. During this medieval period, Europe was divided into numerous nation-states, each having a monarch at the apex of a loosely-governing pyramid of nobility. A polyglot patchwork of Romance and Germanic tongues replaced the Latin vernacular of the former western Roman Empire. The only strong central authority throughout the continent was the Catholic Church that preached a theocratic morality promoting law and order but also discouraging secular intellectual pursuits by the laity. In the West, knowledge of Greek and the original works of literature, philosophy, and science by ancient Greek thinkers disappeared. Surviving Latin records of classical learning were sequestered in monasteries and church libraries; access and exposure to them was limited to the only intellectual class, indeed the only literate class, i.e., the Christian clergy. In the Byzantine East, by contrast, ancient Greek culture was vigorously preserved and studied, both in the ecclesiastical and secular schools. Many Byzantine emperors and church patriarchs were scholars themselves, and they encouraged the growth of an educated class to staff the bureaucracy as well as the church. Western Europe was first reintroduced to the vast corpus of classical Greek scholarship centuries after its disappearance by the circuitous route of Greek-to-Arabic-to-Latin translations. One of the great pioneers in the early stage of this massive effort was Hunayn ibn Ishaq, a ninth-century Middle Eastern Christian physician.

During the early Middle Ages, the Arabian Peninsula, southeast of Byzantium, was inhabited mainly by scattered nomads, pagan in faith and loyal only to local tribal chiefs. Their Arabic language was complex and expressive although most Arabs were illiterate. In 570, Muhammad was born into the Quraish tribe at Mecca. Six years later, he was orphaned and then raised by relatives who apprenticed him into their merchant caravans. At age forty, he experienced the first of a lifelong series of divine revelations in which he was purportedly appointed the messenger of Allah, the god of a new monotheistic faith, Islam. In the ensuing years, Muhammad preached the new faith, initially to his family, then to skeptical neighbors in Mecca, and subsequently to the more receptive citizens of Medina. In 630, after extensive proselytizing and violent confrontations with nonbelievers, he returned to Mecca as a conqueror, destroyed its idols, and proclaimed it to be the Muslim holy city. Two years later, Muhammad died, having converted about one-third of Arabia to Islam. Several years thereafter, the dictated accounts of his numerous revelations were collected and edited, yielding the written text of the Koran, the Muslim bible.

In the century following Muhammad’s death, hordes of Muslim-Arab horsemen, driven by the potent combination of evangelical zeal and lust for booty, lunged repeatedly eastward and westward as invaders. By 712, the Muslim Empire stretched from the Indus River of India to the Atlantic coast of North Africa and into Spain. Like the vast Roman Empire before it, this expanse was too cumbersome to control and administer from one center; it ultimately split into an eastern caliphate under the Abbasids in Baghdad and a western caliphate under the Umayyads in Cordova, Spain. Fortunately for posterity, the caliphs of both halves of the empire recognized the backwardness of the Arabs in the learned fields of philosophy, science, and mathematics. They left intact the academies of higher learning in the newly conquered territories, e.g., at Alexandria (Egypt), Antioch (currently Antakya in Turkey), and Jundi-Shapur (Persia), and encouraged Muslims to partake of the rich educational opportunities available. It soon became apparent that a huge legacy of Greek knowledge and erudition required translation into Arabic to be accessible to the embryonic world of Arab scholarship.

The Nestorian Christians were the major conveyors of Hellenic culture to the Arab establishment. Nestorius, a theologian who was the patriarch of the church at Constantinople (429-431), espoused some unorthodox views on the status of Mary, the mother of Jesus. In short order, the Church Council of Ephesus, with the support of Pope Celestine I, had him deposed, excommunicated, and then banished to the Egyptian desert. His followers were forced to flee, first to Syria and subsequently to Persia, where they founded their own churches and schools. One of the latter, at Jundi-Shapur, became renowned for centuries as a beacon of Greek philosophy and science. In its medical school, the extensive works of Hippocrates and Galen were taught by Nestorian physicians in the classroom and at the bedside, along with the contributions of Jewish, Hindu, and Persian healers appointed by the Persian kings. The Greek texts were translated by the Nestorians and the Jews into Syriac (Aramaic), a Semitic tongue that became the language of the medical school. After the Arab conquest of Persia, the school’s graduates and faculty were eagerly solicited by the caliphs of Baghdad to become their court physicians, as well as their translators of Greek manuscripts.

Hunayn ibn Ishaq, later known in the West by his Latinized name Johannitius, was born in 809 into a Syriac-speaking Nestorian Christian family in Hirah, near Baghdad. His father was a pharmacist, and Hunayn’s knowledge of drugs earned him a position working under the most eminent physician of Baghdad, the Nestorian Yuhanna ibn Masawayh (Mesue Senior, 777-857). Ibn Masawayh had been a student and teacher at Jundi-Shapur and received appointments from the Abbasid caliph Harun al-Rashid (ruled 786-809, of Tales of a Thousand and One Nights fame) to be his personal physician, to head the new hospital in Baghdad, and to translate medical texts. At some point in their teacher-student relationship, ibn Masawayh rebuked Hunayn for asking too many questions. Hunayn abruptly left and was not seen again until several years later when an old classmate spotted him, disheveled and wandering the streets of Baghdad, reciting from Homer in the original Greek. Hunayn reported that he had decided to postpone his medical education until he mastered Greek and inquired if his former teacher would be interested in seeing a translation of Hippocrates’s Aphorisms that he had written. Upon reading this work, ibn Masawayh was astounded by its excellence, and a prompt reconciliation ensued. Hunayn then completed his medical training, and the two became colleagues and collaborators.

Harun al-Rashid was the first of a series of caliphs who patronized and subsidized scholarly work. His son, al-Ma’mun, founded an academy at Baghdad in 830 called the Bait al-Hikmah (House of Wisdom) that included an observatory, a public library, and a translation institute. Hunayn ibn Ishaq was appointed the head of the translators and served in this capacity throughout his life under Al-Ma’mun and eight succeeding caliphs. In addition to translation, his role extended to the acquisition of source texts, and Hunayn traveled at length through the eastern caliphate in search of manuscripts. It was largely due to the endeavors at the House of Wisdom, and to the translations of Hunayn ibn Ishaq and his many disciples, that the Arab world experienced in the ninth to thirteenth centuries a flourishing of science, art, and literature (the golden age of Islam) comparable to the Italian Renaissance that began in the fourteenth. Edward Withington, the nineteenth-century British medical historian, recognized this achievement by lauding Hunayn ibn Ishaq as the Erasmus of the Arabic Renaissance.¹⁸ Some other scholars have praised the head translator with the more poignant metaphor of Midwife of the Arab Renaissance.

It was Hunayn’s practice to work, when possible, from at least three manuscripts of a Greek source in order to convey in the other language concepts that most closely reflected the original author’s intent. By his own description, ibn Ishaq translated about one hundred of Galen’s works into Syriac and thirty-nine into Arabic. Many of these treatises in the original Greek have been lost and survive only in Hunayn’s editions. The translations were so accurate and expressive that Galen became the most widely quoted authority in the Arab medical community, as well as in Europe when sequentially rendered into Latin centuries later. Other medical works translated into Arabic by the Nestorian physician included the entire corpus of Hippocrates, the classic pharmacology text Materia Medica of Dioscorides, and the Synopsis by Oreibasios of Byzantium. Hunayn’s efforts were not confined to the medical field however. Among the nonmedical classic works ibn Ishaq and his subordinates made available to Arab scholars were Plato’s Republic and Laws, Aristotle’s Organon on logic and Ethics, Euclid’s Elements on geometry, Ptolemy’s Almagest on astronomy, and the Old Testament from the Septuagint. It is said that Caliph al-Ma’mun was so pleased with the quality and eloquence of Hunayn’s work that he paid for each volume with its weight in gold.

Despite the demands of his duties at the House of Wisdom, Hunayn ibn Ishaq continued to practice medicine throughout his career. In 847, Caliph al-Mutawakkil appointed him the chief physician of his court, and he retained this position until his death. To his credit, he still found the time to author numerous original medical works, only a few of which are extant. His Kitab al-Ashr Maqalat fi’l Ayn (Book of the Ten Treatises of the Eye) is the oldest systematic textbook of ophthalmology and contains the earliest known diagrams of ocular anatomy; its organization into sections on anatomy, physiology, disease classification, and medical and surgical therapy is remarkably modern. The physician’s best known original publication was Kitab al-Masail fi’l Tibb (Book of Questions on Medicine), a manual on diagnosis and therapy. In the eleventh century in Italy, this work was translated into Latin as the Liber Ysagogarum (Introductory Book) and became a basic text for medical students in Italy and France. The Liber Ysagogarum, together with Hippocrates’s Aphorisms and Prognostics and two other medical treatises were thereafter collectively known as the Ars medicinae (Art of Medicine),¹⁹ and their study marked a watershed in the revival of medicine in the West.

The career of Hunayn ibn Ishaq reached both its highest and lowest points under the al-Mutawakkil caliphate (847-861). He was recognized as the leading medical authority in Baghdad as well as the foremost philologist in the House of Wisdom. The caliph, while supportive of his work, was a despotic and cruel monarch. At one point, al-Mutawakkil asked Hunayn to compound a subtle poison to eliminate one of the caliph’s enemies. When Hunayn refused, his library was confiscated and he was imprisoned. After a year of harsh incarceration, the caliph again ordered him to obey or suffer the death penalty. Once more, the physician refused, explaining that both his Christian faith and his professional scruples forbade harming a fellow human being. Chastened by this selfless display of moral conviction, the autocrat pardoned and reinstated him. At great personal risk, Hunayn ibn Ishaq proved himself a superb exemplar of Hippocratic medical ethics.

References

Castiglioni, A. A History of Medicine. New York: Alfred A. Knopf, 1941.

Johna, S. Hunayn Ibn-Ishaq: A Forgotten Legend. The American Surgeon 68(5):497-499, 2002.

Loriaux, D. Avicenna. The Endocrinologist 8(5):319-322, 1998.

Porter, R. The Greatest Benefit to Mankind: A Medical History of Humanity. New York: W. W. Norton, 1997.

Prioreschi, P. A History of Medicine. Volume IV: Byzantine and Islamic Medicine. Omaha: Horatius Press, 2001.

Whipple, A. Role of the Nestorians as the Connecting Link between Greek and Arabic Medicine. Ann Med Hist 8:313-323, 1936.

Chapter 5

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Avicenna

Avicenna (Abu Ali al-Husein ibn Sina, 980-1037)

Philosopher, Administrator, Mathematician, Astronomer, Encyclopedist, Poet

In the course of several centuries following the death of the prophet Muhammad at Medina on the Arabian Peninsula in 632, while Christian Europe stagnated in the intellectual hibernation known as the Dark Ages, Muslim civilization experienced its golden age of achievement. The Arab/Muslim Empire extended from central Asia to the Atlantic Ocean. Its many widespread heroes distinguished themselves in such diverse areas as government, philosophy, art, literature, mathematics, science, and medicine. The initial phase of this enlightenment was manifest in a prodigious translation effort, making the classical works of Greek thinkers, and to a lesser degree Persian and Hindu texts, available to Arabic-speaking scholars. Several renowned physicians had pivotal roles as translators in the state-sponsored program, including ibn Masawayh (Mesue Senior, 777-857), al-Kindi (Alkindus, 800-873), and Hunayn ibn Ishaq (Johannitius, 809-873).²⁰

By 850, most of the translations were completed. At this