‘Abd al-Laṭīf al-Baghdādī (1162-1231) was a major figure in medicine when the Islamic civilization was leading the world in the production of knowledge about…well, everything. Among the many books he wrote in a variety of fields is one titled al-Ifada wal I’tibar fil Umūr al-Mushahada wal Hawadith al-Mu’ayana bi-Arḍi Misr, which in English was boringly translated as Account of Egypt. This English rendering of the title removes a very important aspect behind the intention of al-Baghdādī in writing this book. The full translation of the title is The Benefit and Lessons from Witnessed Matters and Observed Events in the Land of Egypt. It’s really a fascinating read for those interested. The specific point I wish to turn attention to here is from a section on autopsy.
al-Baghdādī found one of the strange things he witnessed was that a group of medical students found Galen’s text on autopsy difficult to decipher due to the deficiency of language in comparison to physical observation. Anyone who studied anatomy will appreciate the difference between anatomy drawings and physically handling preserved specimens. Now imagine sitting around 800 years ago with your classmates trying to work out from a Greek manuscript translated to Arabic and without the aid of computer generated renderings how the ulna articulates with the humerus, and the pronation and supination of the arm is performed by the radial bone which articulates with the ulna but not the humerus. al-Baghdādī wrote:
Of the strange things we witnessed was a group that used to frequent me [to study] medicine had reached the book on autopsy, which they found difficult for their intellects and understanding due to the deficiency of statements compared to observation. We were then told that at al-Maqas is a hill that had many skeletons. We went to it and found a hill made of skeletons stretching a vast distance to the point of almost having its dirt be less than those dead over it. You would estimate what appears to the eyes of them to be twenty thousand or more, and they were set in layers arranged by how recent [each one’s] death was.
So, we saw in the shapes of bones and their joints, and how they were connected and their proportions and placements what we cannot benefit from books either because they were silent about it, their statements were not sufficient to describe it, or what we saw was contrary to what was said about it – and sense [experience] is more powerful than hearing because Galen, even if he was in the highest degree of investigation and reservation to what he beholds and speaks on, sense [experience] is still more truthful than him.
For context, the high death toll was from a recent plague that struck Egypt, and al-Maqas was a village situated where Ramses Square is today. al-Baghdādī goes on in the text to describe the discrepancies between what they saw in the skeletons in terms of the mandible, coccyx, and sacrum bones, and how Galen described them. He noted when he was confident in his observations refuting Galen and when he was a little more equivocal about it if his findings were not internally consistent to sway him one way or another. There are two important points to consider from this excerpt: (1) al-Baghdādī still held Galen in high regard even as he pointed out when he was wrong; and (2) al-Baghdādī emphasized the importance of empirical observation over claims carrying the authority of even the most authoritative figure in medicine.
al-Baghdādī preceded ibn an-Nafīs (1213-1268), who in his turn took on Galen’s description of blood flow in the heart and after having examined the anatomy of its chambers and vessels gave the first accurate description of the pulmonary circulation. ibn al-Nafīs’ critique of Galen was an extension of his critique of ibn Sīna. George Saliba observes in Islamic Science and the Making of the European Renaissance:
[Take] the works of Ibn al-Nafīs in medicine. It was in his commentary of Avicenna’s Cannon that we find his remarkable remark that did not only depart from the teachings of Avicenna, whom he admired greatly, but went further to criticize Avicenna’s original source, Galen himself. With his criticism, he ended up refuting the doctrines of Galen on the basis of his own observations, and thus laid the foundation for the eventual discovery of the pulmonary circulation of the blood. It was in the post-Ghazālī period that such scientists seem to have gained a well-earned confidence in order to challenge their predecessors and through them attack the main Greek legacy that continued to be the site of contention, with such statements as “this is the common opinion, but according to us, it is false” (hādha huwa al-ra’y al-mashhūr. wa-huwa ‘indana bāṭil).
The scientific rigour that ibn al-Nafīs and al-Baghdādī demonstrated was not unique to them. It was a general attitude that can be readily appreciated from the commentaries and original texts written by prominent Muslim physicians and scientists in various fields at the height of Muslim civilization. They didn’t take the words of their Greek predecessors for granted. Instead, they had what can be described as a type of respectful irreverence towards them, applying an empirical scientific method forcefully to test the claims they were receiving as they translated their texts – this is a common opinion, but according to us, it is false. Saliba highlights what distinguished Muslim scientists in the realm of astronomy, which would equally apply to medicine:
[In] Islamic astronomy, it was no longer sufficient to say that a specific predictive mathematical model, such as that of Ptolemy, gave good results about the positions of the planets for a specific time. The new requirement was that the model itself should also be a consistent representation of the cosmological presuppositions of the universe, in addition to its accounting of the observation.
The last point made in the above quote bears repeating. The model itself should be a consistent representation of the cosmological presuppositions of the universe, in addition to its accounting of the observation. What made Muslims advance scientifically and medically to the degree they had in the past was their commitment to ensuring this consistency. When the observations did not fit with the prediction of the model, they pointed it out and proposed a new model that did. They did not cite the authority of the tradition with reverence and rejected the empirical realities that contradicted it. They also never tried to explain inconsistencies between the models and what they empirically observed with flowery language that incorporated elements of al-Ghayb, the Unseen realm, to give these models a spiritual veneer and offer them as the alternative to materialism and rejection of Scientism. Muslims today who engage in practices that collectively fall under the rubric of alternative medicine and claim to represent the traditional way of doing medicine may indeed be representing a tradition – a German, Greek, Hindu, or Chinese tradition given the metaphysical bases of such practices. But they certainly do not represent the tradition of how Muslims did medicine.
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