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Medical Summaries in Islam

Beyond translation

Starting in the eighth century, mainly Christian translators rendered in the course of the next two hundred years the bulk of the available ancient Greek philosophical, scientific and medical literature into Arabic (Gutas 1998; Endress 1987, 1992). The translator and physician Ḥunayn ibn Isḥāq (d. 873) and his associates created the vast majority of medical translations, an achievement described in the famous Epistle (al-Risālah, Bergsträßer 1925, 1932), a treatise on Arabic and Syriac Galen translations Ḥunayn addressed to one of his patrons.

The original Arabic-language medical summaries we shall study were written in large numbers during this same period. Most were the work of leading medical authorities or doctor-philosophers and polymaths such as Ḥunayn, al-Rāzī/Rhazes (d. 925), Ibn Rušd/Averroes (d. 1198) and Maimonides (d. 1204). They belong to a culture that was obsessed with writing and reading (Rosenthal 1961; Hirschler 2012; Eche 1967) and operated in a cosmopolitan culture écrite with a highly developed infrastructure of stationers, copyists and booksellers (Montgomery 2013, 3).

The summaries defined the medical knowledge regarded as essential for practitioners, facilitated learning and memorising, demonstrated authors’ and readers’ medical credentials, and often spread new ideas in the highly creative and competitive environment sometimes dubbed the “golden age” of Islamic science.

Greek works and Arabic summaries

The writings of four Greek authors were summarised in particular: Galen, Hippocrates, Dioscurides (d. ca. 90 CE) and Paul of Aegina (d. ca. 690 CE). Galen accounts for the vast majority of the effort: including some three dozen Greek summaries translated into Arabic, more than 200 Arabic Galen summaries are known.

Some authors composed entire series of summaries: Ḥunayn wrote several such sets; 19 of the 43 summaries ascribed to him are extant. Others include Ṯābit ibn Qurrah (d. 901; Rashed 2009, 3–24), a prominent mathematician and astronomer, with 9 extant summaries out of 23 recorded; the philosopher-physician Ibn Zurʿah (d. 1008) wrote 4 surviving summaries; another philosopher-physician, Ibn al-Ṭayyib (d. 1043; Ferrari 2006, 17–31), penned 11 summaries, 10 of which are preserved; the Cairene physician Ibn Riḍwān (d. 1061; Das 2017) produced 11 surviving summaries of Galen’s Hippocratic commentaries (e.g. ed. Lyons 1963, 100–122); for the philosopher Ibn Rušd (al-ʿĀlawī 1986, Druart 1994), 7 out of 8 known summaries are extant (ed. Anawati 1987 and Vázquez de Benito 1984, tr. Anawati and Ghalioungui 1986); the philosopher and physician Maimonides (Davidson 2010) wrote 6 preserved summaries; in the case of the Iraqi physician ʿAbd al-Laṭīf al-Baġdādī (d. 1231; Martini Bonadeo 2013, Joosse and Pormann 2010), none of the 9 summaries attributed to him has so far been discovered.

Geographic and chronological spread

Summaries were written over a wide geographical area, from Islamic Spain to Egypt, Syria and Iraq. The network of scholars and physicians who authored and read these texts covered several linguistic communities, including speakers of Greek, Arabic, Syriac and Persian, and different faiths, including Muslims, Jews, Christians and Sabians.

About 65 summaries can be placed in the ninth century, more than a dozen in the tenth, almost 30 in the eleventh, more than a dozen in the twelfth and 9 in the thirteenth. Thereafter production slowed down considerably. The noticeable decline after the eleventh century reflects a fundamental shift in Islamic medicine: with the publication of the major medical writings of the Persian physician and philosopher Ibn Sīnā/Avicenna (d. 1037), Islamic medicine had matured its synthesis of Galenism. Medical scholars now turned to Ibn Sīnā first, and a majority of them summarised his works as compulsively as they had summarised Galen before (Pormann and Savage-Smith 2007, 71).

Galen summarised

Which Galen texts were summarised? About half of the around 120 Galen writings known and available in Arabic translation were summarised. Some works were summarised once or twice, others again and again for several centuries. Overall, Arabic physicians followed the lead of the late Greek curriculum: of the eighteen Galen writings that attracted most summaries, fourteen were part of the Sixteen Books.

Arabic authors were well aware of the gaps in this syllabus and extended the range of summarised works to include medical fields absent from the Alexandrian curriculum such as pharmacology and dietetics. The philosopher Ibn al-Ḫammār (d. 1020) notes:

“I believe [the Alexandrians] were remiss in their choice of material, because they did not discuss nutrition, drugs or climate … and they were also at fault in the sequence of subjects they followed, for Galen had started with anatomy, then proceeded to faculties and functions and only then to the elements.” (Tibi 2010, 41, slightly modified)

Summaries and medical teaching

At the time the summaries were written medical teaching largely consisted of a practical component, an apprenticeship to a physician (from the tenth century onwards, in a hospital), and a theoretical component. Medical theory was taught in lecture circles where students read texts with a teacher who explained difficult passages and took questions (Pormann and Savage-Smith 2007, 82–83; Bürgel 2016, 107–108). The medical historian Ibn Abī Uṣaybiʿah (d. 1270) collected reports about many such circles. One of his sources attended that of an older contemporary of Ḥunayn, Yūḥanna ibn Māsawayh (d. 857) who himself wrote a Summary of Medicine (Ǧāmiʿ al-ṭibb):

“The teaching of Yūḥannā ibn Māsawayh attracted the largest audience of any I have seen in the city of Baghdad ... for every type of educated person assembled there. Yūḥannā was endowed with a great capacity for being funny, which was the reason why the gatherings were so large. ... His teaching was especially enjoyable ... when he examined phials of urine.” (Müller 1884, 175–176)

The use of summaries in medical education is well attested. Summaries in general (and the ‘Alexandrian Summaries’ in particular) were frequently remarked on by medical authorities, including the ninth-century physician al-Ruhāwī (Gutas 1998, 92–93), al-Rāzī (Iskandar 1976, 241–242; al-Rāzī 1955–1971, XVI: 189), Ibn al-Ḫammār (Tibi 2010, 41–42), his student, Ibn Hindū (d. 1029; Tibi 2010, 41–42), Ibn Riḍwān (Iskandar 1976, 241–242), his Cairene colleague Ibn Ǧumayʿ (d. 1198; Fähndrich 1983, 25, 27–29/Ar.), and ʿAbd al-Laṭīf al-Baġdādī (Joosse and Pormann 2010, 21–23).

While most recognised the value of summaries, if sometimes grudgingly, some blamed them for distorting Galen’s science. They alleged they promoted laziness among students and allowed quacks to pass themselves off as physicians. This ambiguous role led some authorities to commend summaries as valuable tools while others saw them as illegitimate shortcuts and symptoms of decline. Ibn Riḍwān’s verdict is especially harsh:

“I believe that summaries, and the commentaries I have mentioned before, are the main reason why the best qualities of medicine have become extinct: students waste many years of their lives studying them but do not understand the art properly. On the contrary, these books fill their souls with errors and mistakes.” (Ibn Riḍwān, The Nobility of Medicine, ms. Istanbul, Süleymaniye, Hekimoğlu Ali Paşa 691, fol. 120r7–9)

Summaries in everyday use

Other audiences appreciated additional practical advantages. The Egyptian historian al-Qifṭī (d. 1248) reports that summaries were both easier to memorise than the originals and easier to carry (Gutas 1999, 170), which suggests that doctors used them as aides-mémoire when visiting patients. When he compiled the notes and excerpts that became his Comprehensive Book (al-Kitāb al-ḥāwī), al-Rāzī used summaries instead of originals and explicitly praised their usefulness (al-Rāzī 1955–1971, XVI: 189,4–8). Members of the general public probably used summaries to acquire a basic knowledge of Galen, which was regarded as an essential part of a well-rounded education.