Original contributions to medicine
The bulk of the contributions of physicians during the Islamic era were medical. These can be studied under two heads: original medical contributions, and contributions to medical literature.
1) Yuhanna ibn Masawayh (777-857 AD) undertook the dissection of apes. Being unable to obtain human bodies, Yuhanna dissected apes in a special hall built on the banks of the river Tigris. A particular species of apes, considered to closely resemble humans, was supplied to him under the orders of the Caliph A-Mu'tasim.
2) The first description of the laryngeal branch of the recurrent laryngeal nerve was given by Al-Razi.
3) Al-Baghdadi conclusively demonstrated that the mandible was a single bone and not two bones as was mistakenly assumed by Greek physicians. This conclusion was arrived at after a thorough examination of several hundred mandibles from a heap of bones found by Al-Baghdadi in the vicinity of Cairo.
4) Ibn Nafis was the first physician to describe pulmonary circulation of blood. A description of his discovery of the lesser circulation (the pulmonary circulation) is to be found in his Sharh Tashrih al-Qanun (Commentary on the Anatomy of the Cannon). He contradicts Galen who thought that blood passed from one side of the heart to the other through septal pores. He categorically affirmed that there were no pores in the cardiac septum but that blood flows from the right heart via the pulmonary artery to the lung, where it is aerated and purified in the alveoli to become fit for nourishment, and returns via the pulmonary veins to the left side of the heart. After the publication of the Latin translation of Ibn Nafis' book in 1547, several Western authors (Servet in 1553, Vesalius in 1553, and Colombo in 1559) described pulmonary circulation in terms similar to those described by Ibn Nafis. There is no doubt about the originality of the discovery of Ibn Nafis and about the fact that these three gentlemen drew on his work. In fact, the first edition of Vesalius' treatise (1542) does not mention pulmonary circulation.
During the Islamic era, several medical substances were described for the first time, including the following:
1) The symptomatology of peptic ulcer was described by Masarjuwayh.
2) Pruritus due to food allergy was described by Ibn Masaway.
3) Dracunculus medinensis was described by Qusta ibn Luqa.
4) Al-Razi (Rhazes) described the clinical condition of Abu Zayd Al-Balji, the famous geographer, who had recurrent coryza in the spring when roses bloom. This is the first case ever to be described of what we today describe as hay-fever or allergic rhinitis.
5) Al-Razi was also the first to differentiate between smallpox and measles, two diseases which were hitherto confused with each another.
6) Al-Razi described neuropathic bladder caused by a tumour compressing the spinal cord.
7) Al-Razi reported the case of a patient called "Amruwayh" who developed a brain abscess following otitis media.
8) The arthropod that causes scabies was described by Ahmad al-Tabari in his Al-Mualajat al Buqratiyya. Today it is called Acarus or Sarcoptes scabiei.
9) Extra-uterine pregnancy was described by Al-Zahrawi.
10) Placenta accreta was first described by Al-Zahrawi.
11) Al-Zahrawi was not only the greatest Arab surgeon but also a pioneering clinician who first described a sex-linked inheritable bleeding tendency which today is called haemophilia.
12) Al-Zahrawi described tuberculosis of the spine which is today called Pott's disease.
13) Ibn Sina was the first to describe incompetence of the aortic valve.
14) He also described anthrax which he called Persian fire.
15) Intestinal tuberculosis was described by Ibn Zuhr.
16) Mediastinitis was described by Ibn Zuhr.
17) Pharyngeal paralysis was described by Ibn Zuhr.
Al-Razi used animal gut as a ligature in surgical operations and hot moist compresses to cover the exposed intestines during abdominal operations. The use of alcohol and cotton in surgical operations was popularised by A-Razi who also advocated the operation of patellectomy in the treatment of certain patellar fractures. The earliest reference in medical literature to patellectomy in the treatment of patellar fractures occurs in Al-Razi's classic work Al-Hawi. It precedes by over 1000 years the recent re-introduction of this procedure by Brooke in 1937. Al-Zahrawi also introduced the use of cotton in surgical dressings, in the control of haemorrhage, as a padding in the splinting of fractures, as a vaginal packing in fractures of the pelvic bone and in dentistry. He recommended mastectomy for breast cancer and wrote about thyroidectomy. He recommended and performed transverse tracheostomy as a life-saving procedure. He was the first to suture traumatic wounds of the trachea. He described Kocher's method of reducing dislocations of the hip, vaginal uretero-lithotomy, and lithotripsy. Al-Zahrawi suggested the use of giant ants for the closure of wounds of the intestinal gut, Trendelenburg's position, Walcher's position, and the extraction of a dead foetus with hooks. Al-Zahrawi also gave the earliest description of the operation for varicose veins. After the usual definitions and a description of the pre-operative preparation, he describes the treatment of varicose veins by clot evacuation with the cautery and finally describes the surgical excision of varicose veins through multiple closely spaced small incisions.
Al-Zahrawi described over 200 surgical instruments in the surgical part of his monumental work Al-Tasrif. Almost all of these instruments were illustrated and many of them were designed by him. A few years ago, a Spanish historian made these instruments following the description given Al-Zahrawi and had the whole set exhibited at Museo Vivo de Andalus in Cordoba.
In dentistry, which was part of surgery, Al-Zahrawi described the first successful re-implantation of teeth. Two other contributions to surgery are worthy of mention: total hysterectomy by Ibn Zuhr and urethral dilatation by Al-Dhahabi.