Medieval Arabic Mideast and Spain

Around 610 AD, in the city of Mecca, in what is now Saudi Arabia, a merchant call Muhammad began to have religious visions. By the time he died in 632, he had established a new monotheistic religion, Islam, with a large following of Arabs throughout Arabia. By the time a century had passed, his religious followers were in political and religious control of what are now the countries of Syria, Palestine, Egypt, North Africa, Spain and part of France. Their religious center was Mecca and their sacred book was the Quran.

In urban areas throughout the Muslim empire, significant scientific and philosophical advances were made. Toledo, in Spain, and Baghdad, in Iraq, became important centers of Muslim learning and living.

By the ninth century, Arab physicians had translated most of the Hippocratic Corpus into Arabic. Al Rhazes (865-925), for example, made fundamental and enduring contributions to science and medical practice. He wrote over 180 books and articles on different aspects of philosophy and medicine that were later translated into Latin and became influential in the awakening going on in 13th century Latin West. Similarly, Avicenna, contributed significantly to science and medicine both during his own time and later, when his writings were translated into Latin. And Averroes's philosophic view of the world was to become an important point of contention among scholastics and clergy in the Latin West who were trying to reconcile their religion with the classic and medieval philosophies of their predecessors.

Medieval Arabic medicine

The Muslim emphasis on social well-being fostered significant advances in public health. They built vast urban hospital complexes, as well as intricate systems of sanitation, public baths, and fresh-water supplies. Like the Christians, Arabic practitioners in Baghdad studied classic books of the ancients, included the writings of Greek and Roman physicians. Scholars, often clerics, lived in Arabic countries that are now Syria, Iraq, Iran, Egypt and Spain. They translated ancient Greek and Latin medical texts into Arabic.

These same authors made contributions to medical theory, through new classifications, and treatment of disease. For example, the Arabic medical practitioners of medieval times provide an integrated ventricular theory drawn from the tenets of Aristotle, Hippocrates, and Galen, producing complex discussions of various diseases (Karenberg & Hort, 1998b, p. 174). Muslim practitioners were first to diagnose smallpox, measles, and hemophilia. They used pharmacology and advanced surgical techniques to treat eye ailments. They also invented the vaginal speculum and forceps, used animal gut for suturing wounds, and used cotton to dress wounds.

Most Arabic medieval practitioners based their medical practices on humor theory, systemizing the early theories of ancient Greeks and Romans such as Aristotle, Hippocrates and Galen. In so doing they developed a coherent outline of the etiology, the prognosis, and treatment of disease (Arikha, 2007).

One of the earliest and most prominent of these Arabic medieval practitioners was Al Rhazes (865-925) a Persian Muslim physician, philosopher, pharmacist, and scholar, who made fundamental and enduring contributions to science and medical practice. He wrote over 180 books and articles on different aspects of philosophy and medicine.

Al Razi's medical practices were heavily drawn from the works of ancient physicians Hippocrates and Galen as well as from his teacher Ali Bin Rabban Al-Tabari (838-870). However, his research as a pharmacist in the field of alchemy led him to challenge the humor theory of his precedessors. He discovered through experimentation that objects that had qualities such that of oil and sulpher which were not readily explained by humor theory. This led him to consider a more complex elemental makeup of the world. He discovered sulfuric acid and ethanol and refined them for both medical and scientific use. Razi was also the first to describe small pox and to distinguish it from measles.

Al Rhazes was the medical head of the hospital in his home city of Rayy, near today's Tehran in Iran. He later headed a hospital in Baghdad, where he carried out research and taught students. His medical textbook the al Hawi, or "Comprehensive Work on Medicine" was assembled by his students after Al Razi's death. It was translated by Europeans in 1279 and served as a standard medical textbook in the Western world until the 1700s. It contains over 1000 of his case histories.

In his medical and surgical encyclopedia Continens, Al Razi described voice problems, including hoarseness. He ascribed the problems to laryngeal lining, recurrent nerves, laryngeal muscles the respiratory system and the brain. For therapy he recommended respiratory exercises and vocal training (e.g., singing the musical scales).

This synthesis of earlier theories and expansion on them was also exemplified by the Muslim Persian physician and mathematician Avicenna (980-1037) in his Canon of Medicine, written in the 11th century. His book was later translated from Arabic into Latin and reprinted in the West well into the seventeenth century.

Avicenna wrote over 100 books on science, religion and philosophy, with the most famous being his textbook, Canon of Medicine. The Canon contained a comprehensive review of medicine and medical practice of the time. Central to Avicenna's medicine was the theory of humors as developed most fully by Galen. Avicenna's Canon was used for several decades after his death, both in the Islamic world and in Europe.

Avicenna, like Namesius, subscribed to a version of ventricular theory wherein the four ventricles of the brain and/or the meninges surrounding them were seen as the locales in which in the sensory and cognitive processing took place. Avicenna's Canon also includes data on laryngeal anatomy and physiology that contains material on the production of voice and voice disturbances. His picture of tongue musculature, drawn from an earlier work of Galen, became a classic and influenced views of the tongue for many years.

Some medieval physicians, such as the Muslim Haly Abbas (982-994), also emphasized disease prevention. Haly Abbas (sometimes called Ali ibn Abbas al-Majusi, or Masoudi) was a Persian physician most famous for his 980 AD book called Complete book of the medical art, later called the Complete art of medicine. His focus was on good health, through diet and on treating disease through natural healing. He also called for good medical practices, including the need for a healthy relationship between doctors and patients, the importance of good medical ethics, and for the use of good scientific methods.

One interesting phenomena of this period was the important contribution made to medical advancement by Jewish scholars and physicians, who lived in Arabic countries and embraced the Arabic language and culture. Moses Maimonides (1138-1204), for example, was a Jewish physician, philosopher, and theologian who was born and raised in the Arab Moorish city of Cordoba, Spain. He both spoke and wrote Arabic. Maimonides wrote ten books on medicine, synthesizing the works of the ancients, and adding to them his own observations and medical beliefs.

Late in the middle ages, around 1450 AD, there was an introduction of astrology into medicine. Medieval Arabic astrologers thought that different signs of the zodiac and planets can be associated with or can rule over different parts of the body. They also associated different planets with different diseases and drugs.

Medieval Arabic oratory and rhetoric

Along with medical contributions, medieval Arabic scholars made advances in theorizing about how the mind and body were used in cognition and communication. The philosopher, Averroes (1126-1198) for example, believed that every human mind was in contact with an intelligence greater than itself. This commanding intelligence not only formed universal concepts for all mankind but also stored and kept the concepts when made. Thus man could neither form intellectual concepts for himself nor keep them in himself when formed. His act of understanding, in fact, was done for him, and put into him from without. Man by himself was highest of sentient natures, but a sentient nature in contact with an even higher intelligence. By his senses man gets impressions that are stored in him as sensory images, or phantasms. The external intelligence then joins a corresponding idea with the mind's phantasm. Once his own phantasm is conjoined with an idea belonging to another, man has an intelligent view of what the phantasm represents, and thus understands it and uses in speaking and understanding language.

Averroes' doctrine, called the doctrine of the 'Unity of the intellect' created immense excitement in its time. It freed individuals from responsibility, argued against individual rational souls, and, in so doing, led to arguments in favor of universal mortality.

Medieval Arabic views of disability

In general, citizens of the Muslim society were more accepting of people with disabilities than were those from the Greek East or the Latin West. Al Jahiz, an influential Muslim writer, for example, in his work entitled Katib al Bursan, argued that physical infirmities should not hinder an individual from being active in the Muslim community. Such ailments, he argued are not stigmas but "signs of divine blessing or favor".

Attitudes toward those in the medieval Arab world with mental health issues were also more progressive than those in the Christian societies. The Koran, the holy writings of the Muslim faith, contains the following verse:

Do not give your property which God assigned you to manage to the insane, but feed and cloth the insane with this property and tell splendid words to him" (Sura 4: 5)

The Muslims provided hospice for the sick and disabled. As early as 707, Al Walid a Muslim ruler, created a bimaristan or health center. Among those served with disabilities were the blind, physically disabled, and the mentally ill.

There are indications that those who were deaf and blind were part of mainstream Muslim culture during medieval times. Tritton (1957) provides evidence that those who were blind or deaf served as teachers.

It was possible to communicate with a deaf teacher by writing in the air or on his hand; he understood the latter even in the dark. Another was expert at lip reading and knew if his students were reading correctly. Men read to a deaf teacher and knew that he followed their reading because he pronounced benedictions on the prophet and the Companions as their names occurred (Tritton, 1957, p. 60).

Disability in medieval Muslim society was sometimes treated from a medical perspective. For example, in keeping with the theory of humors, Avicenna depicted stuttering as being caused by a softening and moisture of the tongue (Wollock, 1997, p. 208 fn. 43) and voice problems as being caused by moisture (hoarseness) cold (weak), dryness (irritated) and heat (loud) (O'Neill, 1980, p. 110).

Medieval Arabic education and rehabilitation

Arabic medieval education centered on the teaching of the Koran, Hadith (legal and historical interpretations of Mohammad), and Muslim jurisprudence. The goals of the curriculum not only included mastering of subject-matter, but also learning to be pious.

Speech therapies in this Medieval Arabic tradition included practice and drill, approaches that are still evident today. Tritton (1957), for example, describes a medieval version of phonetic placement and drill for remediating an articulation problem:

… A boy pronounced Ghain instead of ra. A man examined his tongue, told him that the organ was sound and asked him to produce ra with his tongue in the roof of his mouth; he did so but the sound was not right. The man kept at him, now coaxing how scolding, making him put his tongue in various positions and say ra in them. When the sound was not right, he moved the tongue many times till the boy could say ra; he was then made to repeat this till the right sound became easy to him and the "thickness" disappeared (Tritton, 1957, p. 60-61).