Ibntofayl’s new approach to medical diagnosis and dietary cures
Although the western Omeyyad caliphatehad brought ancient knowledge across to North Africa and Spain,yet in the 10th century the famous physician AzZahrawi[i] (d.1013C.E.) was complaining “that medical science had regressed to the extent that no longer was anyone acquainted with anatomy let alone surgery”. It seemedto him that most of the ancient heritage was being lost due to neglect and lack of research. Hence he was insisting that the functions of all organs, their interrelation and the role of the nerves, veins and arteries should be seriously studied.
After the fall of the Omeyyads (1031 C.E.) and 60 years of stagnation of progress under the petty Kings (1031-1086 C.E.), there was scant chance of AzZahrawi’s wishes being fulfilled. However, with the arrival of the Al Moraviddynasty (1085 C.E.), the late 11th century witnessed new studies and experiments hitherto unheard of. New learning centres appeared in all walks of life and revolutionary discoveries were made. The propagation of this learning in Western Islam added to the development of the Islamic Agricultural Revolution[ii] through which plants were coming from all parts of the known world. This led to the formation of a new materia medica.
Consequently, 150 years after AzZahrawi’s complaint, the time was now ripe for radicaladvances in medical sciences. The preparation of medicines by sublimationand distillation caused a whole range of new drugs to becomeavailable, based on vegetable and mineral products. Plant cultivation, botany[iii] and chemistry were all linked forpreserving health in both man and animal. Althoughin the 12th century the East kept IbnSina as their major source, by contrast in Western Islamic countries IbnTofayl[iv] (d. 1185 C.E.) was revealing his unique medical reasoning.
In his role as a minister to the Al Mohad caliph Abu YaqubYusuf (d.1184 C.E.), IbnTofayl had both the perceptiveness and the experience that facilitated a rare insight into many spheres. His work was always achieved through a process of incessantinvestigation that drew on severaldisciplines. His philosophical oeuvre reveals the creative thinking of a genius; it appraises the role of IbnTofayl’s empiricism and enlightenment in provoking a paradigm shift from philosophy to science. Thus this Ashᶜariscientist of 12th century Marrakech and Seville became an important emancipator of the mind byliberating the world from obscurantism and opening the door to “scientific reasoning“, thereby underlining the link between scientific and social progress. On the one hand his philosophical work “HayyIbnYaqdan“[v] stimulated European mainstream thinkers from the 13th[vi] to the 19th century, whilst his message to mankind, “reasoning is the only regulator of society” evoked discussions for more than 700 years after his death.[vii] His readers became disciples of humanity as they were drawn ever further into a study of the transformation of “self”.
The other valid evidence for appraising Ibn Tofayl is his 7,700-verse medical poem “Urjuzah fi tibb“[viii] written in simple rajazverse. This work prevails over IbnSina’s 1000-verse qanunthat had hitherto been the standard medical work of reference. This literary legacy defined a new methodology of approach that medical students learnt by heart to detect the symptoms, discern the causes and prescribe cures for disease. Herethe encyclopaedic scholar Ibn Tofayl demonstrated a high degree of pre-occupation with man’s health and wellbeing, indicated by his awareness of the importance of chronobiology in his dietary treatment.Specific foods for specific conditions was the basis for good health combined with those required to make a nutritional blueprint that is best for man in all seasons.Furthermore the topographical manner in which he set out his observations revealed his detailed knowledge of anatomy, illustrating how he must have derived this information from pertinent dissection. This Urjuzah follows the presentation “mina al qarnila al qadam” (from head to toe) method where each chapter is devoted to one illness, where the name of the illness is mentioned followed by its causes, its symptoms and the diet protocol. It is the most thorough and complete of all medieval medical works, seven times the length of IbnSina’sqanun. It liststreatments type by type: anti-inflammatory, anti-spasmodic, salt free diet, appetiteenhancement during pregnancy etc.
He would not write a treatment as long as he could prescribe a diet. If he did so he would go for a simple rather than a compound one. His emphasis upon regimen and diet was predominant, even to the extent of using diet as a diagnostic tool. The Urjuzah was a literary legacy of tremendous importance to the history of medicine and therapeutics in the middle of the 12th century. It demonstrates the high degree of competence that IbnTufayl had reached in the medical art. The details that he gave of the function of the organs effectivelymade him the first recorded physiologist (ᶜilm al ᵓaᶜdaᵓ). Further more he described blood circulation, thereby preceding its “discovery” by IbnNafis (d.1285 C.E.) by a whole century. The object of this work was to acquaint student physicians with IbnTofayl’s novel methodology of approach, to be able to observe symptoms using their senses: sight, smell, hearing and touch. The overall purpose of writing the Urjuzahwas to keep the ummah disease free and drug free. These nutritherapyprotocols were utilized by traditional Muslim physicians long after his death, sincenutrition and cure formed the logical route to health[ix].
- Address the whole patient, as body and mind are interconnected.
- Treat underlying causes.
- Take an integrated approach.
- Focus on diet, lifestyle and preventive measures.
- Focus on subjective information, e.g. how the patient is feeling?
- The physician is a partner in the healing.
- The patient is in charge of health care choices.
- Emphasize achieving good health.
- Breathing, exercising, bathing, light baths with essential oils.
- Less purging, less cautery and phlebotomy than with classical physicians.
- Massage with essential oils.
The above paradigm in medicine is the model that was used to explain events and the evolution of knowledge of the human body. IbnTufayl’s medicine was designed to train physicians to seek underlying causes of a disease rather than to simply suppress the symptoms.
Hence the knowledge that had been brought to the West by the Omeyyads was now available to return in a radically improved form. A remarkable example of such movement was the Moroccan Jewish scholar Maimonides (IbnMaymun, d. 1204 C.E.), who embodied the best of philosophical and medical advances from theIbnTufayl school.When he left Fes for the East in 1165 C.E., he was fully loaded with manuscripts showing new discoveries[x]. Everything he took with him was unique. He was welcomed at the court of the sultan Salah Eddine Al Ayubi (d. 1193 C.E.). Consequently the Jewish community in the near East became famous and wealthy after IbnMaymun’spropagation of medical discoveries from the Western Islamic area. Arabic manuscripts from the Al Mohad dominions were transcribed in Hebrew letters to escape detection by their authorities.[xi] Language scholars and fuqahaᵓ from Arabic grammar schools helped to decipher these works and record them in their original language.
Finally, IbnTufayl’s great purpose in writing his painstaking 7,700-verse Urjuzahwas the conservation of man and the progress of the art of healing that was so important in Islam. IbnTofayl’s approach has been followed in traditional Islamic medicine for the last 900 years. Unfortunately, those who plagiarised this medical lore after IbnTufayl’s death did so for unethical material gain. However, after their death it remained locked in their boxes forever as they had failed topropagate this life-saving learning. Consequently, Ibn Sina and AzZahrawi remained the sole medical sources in the East[xii], widely copied and translated into many languages, a situation that endured until the 20th century.
[i]Albucasis – On surgery and Instruments – 30 vols – Kitab al-tasrif li-man ‘ajiza ‘an al-ta’alif(Abu QasimKhalafibn Abbas Az-Zahrawi d.1013) Welcome Institute London 1973.
[ii]Dr ZohorIdrisiTheOxford Encyclopedia of Philosophy, Science and Technology in Islam OUP NewYork 2013 pp 14-19.
[iii] Dr Zohor Idrisi Ibn Al-Baytar Al-Malaqi y la Ciencia Arabe- Servicio de Publicaciones e IntercambioCientifico de la Universidad de Malaga 2008 pp 13-34.
[iv] Abu BakrMuhammed Ibn Abdal Malik Ibn Muhammed Ibn Tofayl Al Qaisi.
[v]Hayy ibn YaqzanLeonGauthier – Editions de la Méditerranée 1981.
[vi]Frederick II (d.1250 C.E.) Emperor and King of Naples, grandson of Roger II of Sicily ‘’Philosophe en même temps que naturaliste….grand patron de la doctrine pharmaceutique arabe’’ p 104 – ‘’Les meilleurs médecins et pharmaciens au milieu du 12ème siècle venaient d’Espagne ou de Sicile’’ p 90 La Pharmacie à travers les siècles – Emile Gilbert imprimerie Vialelle&cie Toulouse 1886.
[vii]Albert the Great(Albertus Magnus d.1280 C.E.)Dominican friar, influenced by IbnTofayl’s work,introduced his students to natural science. The latter included Thomas Aquinas and Vincent de Beauvais, whobecame “le premier naturaliste dans les arcanes de la nature”p 108 – ‘’Louis IX nomma Beauvais comme précepteur du Prince: un philosophe qui interroge la nature‘’op.cit. Emile Gilbert p 109.
[viii]Manuscript N°1969Qarawiyyin library Fés.
[ix]La médecine arabe au XVIII Siècle à travers al “UrdjuzaAsh-Shaqaruniya’’ Dr Badr Tazi L’Organisation Egyptienne Générale du Livre Cairo 1984.
[x]Medical Aphorisms Treatises- A parallel Arabic-English translation by GerritBos University of Chicago press 2004.
[xi]The development of mathematics had prompted an increase in Jewish esoteric mysticism. La Kabbale Maurice-Reuben Hayoun- Ellipses Edition Marketing Paris 2011[xi]The development of mathematics had prompted an increase in Jewish esoteric mysticism. La Kabbale Maurice-Reuben Hayoun- Ellipses Edition Marketing Paris 2011.
[xii] There was no improvement in medical science in the Ottoman Empire, except renewals of IbnSina and AzZahrawi until the 16th century when, according to Professor Nil Sari, (Head of the History of Medicine and Ethics Department of Istanbul University), an innovation came with the Swiss Chemist/Astrologer Paracelcius (Barakelsus) influencing their medical works Tibb i Jadid.