Unit 9 · From the Islamic Golden Age to the Renaissance

Picture a large building with courtyards, fountains and separate halls. Some halls are for fevers, some for eye problems, some for broken bones. A pharmacy mixes medicines. Doctors teach students at the bedside. This was a bimaristan, a hospital in the medieval Islamic world.

The word bimaristan comes from Persian and means "place of the sick." Rulers and wealthy families paid for these hospitals through gifts called waqf. A waqf was money or property given forever for a good cause. The income paid for doctors, food, beds and medicine.

Big cities such as Baghdad, Damascus and Cairo had bimaristans. Care was usually free. Men and women, locals and travelers, and people of different faiths could be treated. The goal was to care for anyone who was sick, not only those who could pay.

In Baghdad, the capital of the Abbasid rulers, several hospitals were built in the 800s and 900s. Al-Razi worked in Baghdad. One story says he chose a spot for a new hospital by hanging pieces of meat around the city to see where they spoiled most slowly. Historians are not sure the story is true, but it shows how people remembered him as a doctor who tested things.

In Damascus, the ruler Nur al-Din founded a hospital in the 1150s. Part of its building still stands today. It trained doctors for many years. Students learned from books and from real patients in the wards.

In Cairo, the Sultan Qalawun opened the Mansuri hospital in 1284. It was huge. It had wards for different illnesses, a place for lectures and a large staff. Records describe music and storytelling to comfort patients. These hospitals show a public health idea: a city takes care of its sick people.

Abu Bakr al-Razi lived from about 865 to 925. In Europe he was later called Rhazes. He was born near modern Tehran in Iran and worked in Baghdad and in his home city of Rayy. He wrote many books on medicine, chemistry and ideas.

His most famous short book describes smallpox and measles. Before him, many writers mixed them up. Al-Razi listed the signs of each. Smallpox often began with high fever and back pain, and its bumps filled and scarred. Measles came with red eyes, a cough and flatter spots.

Telling diseases apart is called diagnosis. It matters because different diseases can need different care. Al-Razi also kept records of his patients. He believed a doctor should check old books against what patients actually showed. That habit is at the heart of medicine today.

Ibn Sina lived from about 980 to 1037 in Central Asia and Persia. Europeans called him Avicenna. As a young man he read everything he could find. He was also a philosopher who wrote about logic and the mind.

His biggest medical book is The Canon of Medicine, finished about 1025. A canon is a set of rules or a standard collection. The Canon has five books. They cover how the body works, simple medicines, diseases of each part of the body, illnesses that affect the whole body, and mixed medicines.

Ibn Sina built on Greek writers such as Hippocrates and Galen. He also added his own observations. He described many illnesses with care, and he set out rules for testing whether a new medicine really works. He still used the old Greek idea of four humors, which later science replaced.

Imagine a medical student in Italy around 1500. The main textbook on the desk is not by an Italian. It is a Latin version of Ibn Sina’s Canon, written almost 500 years earlier and far away.

The Canon was clear and well organized, so teachers liked it. Universities in Europe used it into the 1600s. After printing began, it was printed many times in Latin. It was also studied across the Islamic world and in South Asia.

Using one book for so long had good and bad sides. Students shared a common curriculum, a set plan of study. But some teachers trusted the book more than their own eyes. As the next chapter shows, later doctors began to test the old books against real bodies.

Galen, a Greek doctor of the 100s CE, taught that blood seeped through tiny holes in the wall between the two sides of the heart. For about 1,000 years, most doctors agreed. The wall in the middle of the heart is called the septum.

Ibn al-Nafis, a doctor who worked in Damascus and Cairo, disagreed. In a commentary written in the 1200s, he said the septum is thick and has no holes. He reasoned that blood must travel from the right side of the heart to the lungs, mix with air there, and return to the left side.

This path is called the pulmonary circulation. Pulmonary means having to do with the lungs. Ibn al-Nafis was right. But his idea was not widely known in Europe. European doctors described the same path in the 1500s, and historians still discuss whether any of them had heard of his work.

In the 1100s, the city of Toledo in Spain held libraries full of Arabic books. Scholars came from across Europe to read them. One of them, Gerard of Cremona, spent years there. He is credited with translating dozens of works into Latin, including Ibn Sina’s Canon.

Latin was the shared language of learning in Europe. A translation moves a text from one language into another. Earlier, in southern Italy, a scholar named Constantine the African had also translated Arabic medical books near the medical school of Salerno.

These translations carried Greek ideas that Arabic scholars had saved and added to, plus new Arabic work. Words also traveled. Alcohol and syrup, for example, come into English from Arabic. Knowledge moved from Greek to Arabic to Latin, and each step added something.

In a clinic in Delhi or Hyderabad, a patient may visit a hakim, a practitioner of Unani medicine. The hakim asks about sleep, food and mood, and checks the pulse. The advice may include diet changes and herbal mixtures.

Unani comes from an Arabic word for Greek. Unani medicine holds that health depends on a balance of four humors and on a person’s temperament. It grew from Greek writers, Ibn Sina and later scholars. In India, the government recognizes Unani as one of its traditional systems of medicine.

Scientists have tested some plants used in Unani, and a few show effects worth studying. For most Unani remedies, strong evidence from careful trials is still missing. Some herbal products can interact with other medicines. So anyone who uses them should tell their doctor or pharmacist.

Picture a stone monastery in the countryside, around the year 1100. Monks tend a garden of sage, mint and other herbs. Inside, a room called the infirmary holds sick monks and travelers. Another room holds books that monks copy by hand.

A monastery is a community of monks or nuns who live by religious rules. The Rule of Saint Benedict, written in the 500s, told monks to give special care to the sick. Many monasteries became places of rest, food and nursing for people in need.

Hildegard of Bingen, a German abbess who lived from 1098 to 1179, wrote about plants and health. Monks and nuns saved old texts by copying them. Their care was kind and practical, though they did not know what caused most diseases.

In 1347, ships reached Sicily carrying a deadly sickness. Within a few years it spread across Europe, North Africa and the Middle East. People later called it the Black Death. Historians estimate it killed roughly one third to one half of Europe’s people.

Today we know it was plague, caused by a bacterium carried by fleas on rats and other animals. People at the time did not know about germs. Many blamed bad air or the stars. Some cruelly blamed Jewish communities, who were attacked in many towns.

Some cities tried a new idea. In 1377, the port of Ragusa, now Dubrovnik in Croatia, made ships wait before landing. The wait was later set at 40 days. The Italian for 40 days, quaranta giorni, gave us the word quarantine. Today, plague is rare and can be treated with antibiotics.

Galen was born about 129 CE in Pergamon, in what is now Turkey. He cared for gladiators and later for Roman emperors. He wrote hundreds of works. He did clever experiments on animals, such as showing that arteries carry blood, not air.

Roman law and custom did not allow doctors to cut open human bodies for study. So Galen’s anatomy came mostly from apes, pigs and dogs. Anatomy is the study of the body’s parts and how they are arranged. Some animal parts are like ours, and some are not.

After Galen, his books became the main authority in medicine for Arabic, Latin and Greek readers. In medieval classrooms, a professor often read Galen aloud while an assistant cut. If the body did not match, the book usually won.

Andreas Vesalius was born in Brussels in 1514 and taught at the University of Padua in Italy. He did his own dissection, which means carefully cutting open a body to study it. He used the bodies of executed criminals, which the law then allowed.

In 1543 he published On the Fabric of the Human Body, often called the Fabrica. Fabric here means the structure or build of the body. It has about 700 pages and more than 200 woodcut pictures, made by skilled artists. Skeletons and muscle figures stand in landscapes, as if they are alive.

Vesalius pointed out that Galen’s lower jaw, some bones and parts of the liver came from animals. He did not throw out all of Galen. He kept what matched and fixed what did not. That careful checking is why he is often called the founder of modern anatomy.

Before printing, books were copied by hand. Each copy could add small mistakes. A drawing of a muscle copied ten times might end up looking quite different from the first. Over many copies, errors piled up.

The printing press, developed in Europe by Johannes Gutenberg around 1450, changed this. Pictures carved in wood blocks could print the same image thousands of times. Every student could see the same accurate picture.

The Fabrica’s woodcuts were copied across Europe, sometimes without permission. Doctors in many cities could now compare the same pictures with real bodies. Shared, exact pictures made it easier to spot mistakes and agree on what is true.

Galen taught that the liver made new blood from food, and the body used it up, like fuel. William Harvey, an English doctor who had studied at Padua, wondered if this could be true. He decided to measure.

Harvey estimated how much blood the heart pushes out with each beat. Then he multiplied by the number of beats. In just an hour, the total was far more blood than a person could make from food, or even more than a person’s whole weight.

So, he argued, the same blood must go around and around. He called this the circulation of the blood. He published his work in 1628 in a book usually called On the Motion of the Heart. The heart is a pump, and blood makes a loop.

Harvey’s teacher at Padua, Hieronymus Fabricius, had studied and drawn small flaps inside veins. These flaps are called valves. Fabricius did not fully understand what they did. Harvey figured it out.

Harvey tied a band around a person’s upper arm, so the veins below stood out. He pressed on a vein and tried to push the blood away from the heart. It would not go. Blood could only move toward the heart. The valves were one-way doors.

Anyone can see this idea in a simple test. Arteries carry blood away from the heart. Veins bring it back. The valves keep blood in the veins from sliding backward. Harvey’s experiment used no special tools, only careful thinking and a clear test.

Harvey’s loop had a gap. Blood left the heart in arteries and came back in veins. But how did it cross from one to the other? Harvey could not see any link. He predicted there must be tiny passages too small for the eye.

In 1661, the Italian scientist Marcello Malpighi looked at a frog’s lung through a microscope. He saw very tiny vessels joining arteries to veins. These are now called capillaries. They are thinner than a hair.

This shows how science often works. A good idea can make a prediction. Later, a new tool can test it. Harvey died in 1657, just before the capillaries were seen, but his prediction proved right.

In 1537, the French army surgeon Ambroise Paré was treating soldiers near Turin, in Italy. At the time, surgeons believed gunshot wounds were poisoned. The usual treatment was to pour boiling oil into the wound. It was very painful.

One night, Paré ran out of oil. He made a mild dressing instead, from egg yolk, oil of roses and turpentine. He worried all night that those soldiers would die. In the morning, they were resting with little pain and less swelling. The soldiers treated with boiling oil were in fever and pain.

Paré stopped using boiling oil. This was an accidental comparison between two groups. He trusted what he saw over what he had been taught. He later wrote books in French, not Latin, so that more barber-surgeons could read them.

When a surgeon had to remove a badly hurt arm or leg, the patient could bleed to death. For centuries, surgeons stopped the bleeding with a red-hot iron. This is called cautery. It caused terrible pain and burns.

Paré brought back an older idea and made it common in his practice. He tied off the cut arteries with thread. A tie like this is called a ligature. It closed the vessel with less damage than burning. Paré also designed artificial limbs for people who had lost an arm or leg.

Paré is remembered for a humble saying about a patient’s recovery: he treated the wound, and God healed it. He meant that the body does much of its own healing, and a good surgeon helps it.

Antonie van Leeuwenhoek was a cloth seller in Delft, in the Netherlands. He was not trained as a scientist. But he learned to grind very small, very clear glass lenses. His simple microscopes were no bigger than a thumb.

In the 1670s and 1680s he looked at pond water, rainwater and even scrapings from his own teeth. He saw tiny moving creatures. He called them animalcules, meaning little animals. Today we know many were single-celled living things, including bacteria.

Leeuwenhoek wrote long letters about what he saw to the Royal Society in London. Its members checked his claims and confirmed them. No one yet knew that some tiny living things cause disease. That link would come about 200 years later.

Look back over this chapter. Vesalius checked Galen against real bodies. Harvey measured and tested. Paré compared two groups of soldiers. Leeuwenhoek looked where no one had looked before. Each one used observation, careful looking, and experiment, a fair test.

In 1660, a group of thinkers in London formed the Royal Society. Its motto was Latin words meaning, roughly, take nobody’s word for it. Claims had to be shown and checked by others. This process is part of what we now call the scientific method.

Old books were not useless. Galen and Ibn Sina had gathered a lot of real knowledge. But the new rule was that any idea, however famous, could be tested. When the test disagreed with the book, the test should win.