OUTLINES OF THE HISTORY OF MEDICINE. By W. B. A. SCOTT, M.D. Ali Abbas.-Avicenna.-Haroun.-Isaac Ben Soleyman. -Serapion the Younger.-Mesuë II.-Albucasis.Avenzoar.-Averroës.-Ebn Beithar.-Close of the Arabian School. A few years later than Rhazes (A.D. 994) flourished Ali Abbas, surnamed the Magician, whose work on medicine, dedicated to his royal master, Adadoddaula, Emir of Bagdad, was esteemed the standard authority, until it was superseded by the more celebrated "Canon" of Avicenna, to which, however, many competent authorities esteem the less pretentious compilation of Ali superior. In fact, this work deserves a higher title than that of a mere compilation, for although Ali expressly acknowledges that he has throughout followed the doctrines of the Greek school, with the additions to the same made by his Persian and Arabian predecessors, his writings are by no means devoid of original observations of his own, the result, doubtless, of the assiduous clinical study which he himself practised, and which he so judiciously inculcates on all medical students as their primary duty. His anatomy and physiology are very much those of Galen, still further corrupted by the teleological proclivities of the later Greek writers-proclivities which, in spite of repeated warnings, have misled so many men of real genius even in still more recent times, and which have, perhaps, done more to impede the progress of true science than any other "infirmity of noble minds." Rather than leave any structure without an assigned office, Ali even went so far as to maintain that the use of the peritoneum was to facilitate the act of vomiting. He describes the eye and the eyelids as furnished with nine muscles; six, namely the four recti and two obliqui for the movement of the eyeball itself, and three for the movement of the eyelids; under the latter he must have included the corrugator supercilii, which however, acts not on the eyelids but on the eyebrows,-unless, indeed, as seems hardly probable, he had observed the small tensor tarsi, now commonly called Horner's muscle. He seems to seek to justify what we cannot but designate as the foeticide too common among both Greeks and Arabians, by a detailed comparison of the embryo with the fruit of a plant, forgetful of the vast moral difference between the two objects, however great the physiological resemblance. He professed to be able to distinguish comparatively harmless cutaneous affections from true leprosy, by rubbing the suspected discolorations with an acetous tincture of alchemilla, when, if innocent, they would disappear, but, if of leprous origin, would persist. This test is said to have been employed in the purchase of slaves. He directs that those who go to reside in foreign countries, should sprinkle a little of the soil of their native land in the drinking-water of their new residence, in order to render it safe as a beverage. His theory of disease is based on the celebrated doctrines of the bodily "faculties," as "attracting," "altering," &c. He speaks of a form of colic accompanied with paralysis (painter's colic?), and seems to have paid special attention to uterine ailments. He also drew particular attention to the variety of melancholy so often characteristic of young persons on the approach of maturity. Sprengel speaks in the highest terms of the directions given by Ali relative to diet and regimen, and the latter insists with great propriety on the paramount necessity of instituting frequent experiments on pharmaco-dynamics. His general treatment of individual disease differed little from that of Rhazes, while his surgery was in the main identical with that of Paul of Aegina, but he has some original remarks on the operation for cataract. Next in order of time comes the celebrated Al Hussein Abu-Ali Ben Abdallah Ebn Sina, familiarly known as AVICENNA, an extraordinary man whose biography must be read by the physician with a regret similar to that which the classical scholar must feel in reading the life of Porson. In both alike, splendid acquirements, rare talents, indefatigable industry, and all but incredible powers of memory, were disgraced by vile and degrading vices, which their high natural endowments only rendered the more inexcusable. As for about six hundred years the name of Avicenna was held in an esteem almost, if not quite, equal to that of Galen, it is right to consider his life and labours in some detail. He was born at Bokhara about A.D. 979, and enjoyed the advantages of a liberal early education, in order to secure which his devoted father spared neither pains nor expense. He is said to have been able to repeat the Koran by heart when only ten years of age, although in later life he sadly transgressed some of its most wholesome precepts. He was instructed in grammar, logic, geometry and astronomy, by a private tutor, from whom however, Avicenna parted in disgust on finding him unable to solve a problem submitted to him by his somewhat bumptious though gifted pupil. He resorted to a merchant for instruction in arithmetic and the Indian system of numerical notation, a scale which, slightly modified, was introduced throughout Christendom, under the name of the Arabic, by Gerbert of Auvergne (afterwards Pope Sylvester II.), towards the close of the tenth century. Avicenna next proceeded to Bagdad, where he studied philosophy under Alfarabi, and A.D. 984 went to Djordschan, having previously studied medicine under the Nestorian Masichi, and, even at the somewhat immature age of sixteen, made himself (according to his biographers) a distinguished physician. He enjoyed the favour of several princes whom he served in his professional capacity, and ultimately attained the rank of Vizir. Having taken part in an insurrection, he was degraded from this dignity and committed to prison, where he profitably employed his enforced retirement in the composition of various medical works. He ultimately effected his escape in disguise, and repaired to the Caliph's court at Ispahan, where he lived in high esteem. His death which happened A.D. 1036, is ascribed to the conjoined effects of a reckless use of powerful clysters (of which he administered to himself no fewer than eight in one day), an overdose of opium, and an unadvised journey with the Caliph to Hamudan, where he died almost immediately after his arrival, and where his tomb may still be seen. His diligence at all times, but more especially in early life; was perfectly amazing, and was crowned with such success, that Aristotle's "Metaphysics" appears to have been the only book which fairly baffled him. This, after forty perusals, he reluctantly laid aside. When perplexed in any of his various studies, he had recourse to prayer for direction, addressed to the Great Author of all wisdom, Whom, he assures us, he never found regardless of his * The introduction of the Arabic numerals exposed Gerbert to the charge of sorcery! entreaties. On some occasions, he says, he has solved problems in dreams which he had found beyond his capacity in his waking hours. It is melancholy to have to relate of this intellectual prodigy, this man of splendid endowments and vast acquirements, and apparently not devoid of natural piety -that he was nevertheless an habitual drunkard and an abandoned profligate. It is even said that his vices were indulged in to such an extent as to have contributed to the occurrence of his last illness. Some partial extenuation of his intemperance may, perhaps, in fairness, be discovered in the fact of its having in all likelihood arisen from an early habit of keeping himself awake for purposes of study by means of copious draughts of wine, but for his profligacy, as for that of others, it is as impossible as it would be undesirable to find any palliation whatever. It was also by no means to his credit, that he should have engaged in an insurrection against his patron-prince, as above related. Doctors, no less than priests, do well to refrain from politics. Notwithstanding his long intellectual reign, Avicenna has passed through evil report as well as good report. Scaliger, indeed, allows no one to be worthy of the name of a physician who has not made a careful study of the works of Avicenna, but, on the other hand Leo* calls him one-eyed in medicine, and wholly blind in philosophy." Manardus and Freind pronounce his writings wholly devoid of originality, and Sprengel makes no secret of his own decided preference for Ali Abbas to his more distinguished successor. It is certainly true that the reputation of the "Canon" survived only during a period of great intellectual darkness, and it is most likely that it owed its supremacy at least as much to the dislike to innovation, distaste for original investigation, and slavish regard to authority, which proved so disastrous alike to science and religion at that period, as even to the comprehensiveness of the work itself. Some Spanish authors have gone so far as to maintain, though apparently on insufficient grounds, that the "Canon" was not the work of Avicenna at all, but the joint compilation of thirty philosophers and physicians. * John Leo, surnamed Africanus, a Moor of Granada, who wrote in Arabic a "Description of Africa,” and the "Lives of the Arabian Philosophers." He died about 1526. Avicenna is said to have displayed at the Court of Cabus at Djordschan the same kind of sagacity which acquired Erasistratus so much renown at the Court of Selencus, by discovering that the supposed disease under which the Prince's nephew laboured was no other than ardent love. Sprengel adduces two passages from the writings of Avicenna in proof of the deficiencies of the latter as an original thinker; (1) the statement (which, however, is somewhat qualified) that jaundice may be cured by causing the patient to contemplate yellow objects, and (2) his comparison of a physician with a priest, which is thus expressed : 66 "A physician, as such, must no more think of employing his reason than may a priest, as such (i.e., as a priest), although both priest and physician, as philoso"phers, are free to exercise their reason.' 66 We hence learn that the distinction between "theological truth" and "philosophical truth" was not confined to the Christians. Avicenna himself rarely ventured to act the part assigned by him to the philosopher; but, wherever he dared to differ from Galen, sought to shield himself under the banner of Aristotle, Aëtius, Rhazes, or some other of his distinguished predecessors. His theory of medicine is based on the working of the "four causes" of the Peripatetics-the material, the efficient, the formal, and the final. The first exist partly in the intestines, partly in the "spirits," and partly in the "humours," though only secondarily in the last; the second in the six non-naturals; the third are the physical temperaments and constitution; and the fourth are the actions or functions of the various parts. 66 The causes of disease are three-fold-antecedent (" predisposing" of Galen, i.e., the patient's constitution), original ("exciting" of Galen, i.e., noxious influences, such as pestilent vapours), and conjoint. He divides the natural faculties" (which he multiplied far beyond what even Galen had done) into those which serve, such as the attracting," retaining," expulsive," &c.; and those which are served, such as nutrition and growth. The "faculty" of nutrition is tripartite: (1) the blood is changed into cambium, or a fluid capable of nourishing the parts; (2) this cambium is united to the parts for which it is destined, to which (3) it is assimilated. His 66 99 66 66 |