Abu Bakr al-Razi

Abū Bakr al-Rāzī, also known as Rhazes (full name: ), 864 or 865 – 925 or 935 CE, was a Persian physician, philosopher and alchemist who lived during the Islamic Golden Age. He is widely regarded as one of the most important figures in the history of medicine, and also wrote on logic, astronomy and grammar. He is also known for his criticism of religion, especially with regard to the concepts of prophethood and revelation. However, the religio-philosophical aspects of his thought, which also included a belief in five "eternal principles", are fragmentary and only reported by authors who were often hostile to him. An early proponent of experimental medicine, he became a successful doctor, and served as chief physician of Baghdad and Ray hospitals. As a teacher of medicine, he attracted students of all backgrounds and interests and was said to be compassionate and devoted to the service of his patients, whether rich or poor. Along with Thābit ibn Qurra (836–901), he was one of the first to clinically distinguish between smallpox and measles.

Through translation, his medical works and ideas became known among medieval European practitioners and profoundly influenced medical education in the Latin West. Additionally, he has been described as the father of pediatrics, and a pioneer of obstetrics and ophthalmology.

Biography

thumb|upright=1.4|left|Depiction of al-Razi in a 13th-century manuscript of a work by [[Gerard of Cremona]]

Al-Razi was born in the city of Ray (modern Rey, also the origin of his name "al-Razi"), into a family of Persian stock and was a native speaker of the Persian language. Ray was situated on the Great Silk Road that for centuries facilitated trade and cultural exchanges between East and West. It is located on the southern slopes of the Alborz mountain range situated near Tehran, Iran.

In his youth, al-Razi moved to Baghdad where he studied and practiced at the local bimaristan (hospital). Later, he was invited back to Rey by Mansur ibn Ishaq, then the governor of Ray, and became a bimaristan's head. Because of his newly acquired popularity as physician, al-Razi was invited to Baghdad where he assumed the responsibilities of a director in a new hospital named after its founder al-Muʿtaḍid (d. 902 CE).

He spent the last years of his life in his native Rey suffering from glaucoma. His eye affliction started with cataracts and ended in total blindness. The cause of his blindness is uncertain. One account mentioned by Ibn Juljul attributed the cause to a blow to his head by his patron, Mansur ibn Ishaq, for failing to provide proof for his alchemy theories; while Abulfaraj and Casiri claimed that the cause was a diet of beans only. Allegedly, he was approached by a physician offering an ointment to cure his blindness. Al-Razi then asked him how many layers does the eye contain and when he was unable to receive an answer, he declined the treatment stating "my eyes will not be treated by one who does not know the basics of its anatomy".

The lectures of al-Razi attracted many students. As Ibn al-Nadim relates in Fihrist, al-Razi was considered a shaikh, an honorary title given to one entitled to teach and surrounded by several circles of students. When someone raised a question, it was passed on to students of the 'first circle'; if they did not know the answer, it was passed on to those of the 'second circle', and so on. When all students would fail to answer, al-Razi himself would consider the query. Al-Razi was a generous person by nature, with a considerate attitude towards his patients. He was charitable to the poor, treated them without payment in any form, and wrote for them a treatise Man La Yaḥḍuruhu al-Ṭabīb, or Who Has No Physician to Attend Him, with medical advice. One former pupil from Tabaristan came to look after him, but as al-Biruni wrote, al-Razi rewarded him for his intentions and sent him back home, proclaiming that his final days were approaching. According to Biruni, al-Razi died in Rey in 925 at sixty years of age. Biruni, who considered al-Razi his mentor, among the first penned a short biography of al-Razi including a bibliography of his numerous works.

After his death, his fame spread beyond the Middle East to Medieval Europe, and lived on. In an undated catalog of the library at Peterborough Abbey, most likely from the 14th century, al-Razi is listed as a part author of ten books on medicine.

Contributions to medicine

thumb|upright=1.5|al-Razi examining a patient (miniature painting by [[Hossein Behzad, 1894–1968)]]

Psychology and psychotherapy

Al-Razi was one of the world's first great medical experts. He is considered the father of psychology and psychotherapy.

Smallpox vs. measles

Al-Razi's book "On Smallpox and Measles", is, along with a book of the same name by Thabit ibn Qurra (836–901), among the earliest extant books describing smallpox and measles as distinct diseases. Smallpox was not known in ancient Greek medicine. It was likely differentiated from measles and other similar diseases by authors in late antiquity writing in Medieval Greek and Syriac, whose works were known to Thabit and al-Razi.

Al-Razi's work was translated into Syriac and then into Greek. It became known in Europe through this translation, as well as Latin translations based on the Greek text, and was later translated into several European languages.

Meningitis

Al-Razi compared the outcome of patients with meningitis treated with blood-letting with the outcome of those treated without it to see if blood-letting could help.

Pharmacy

Al-Razi contributed in many ways to the early practice of pharmacy by compiling texts, in which he introduces the use of "mercurial ointments" and his development of apparatus such as mortars, flasks, spatulas and phials, which were used in pharmacies until the early twentieth century.

Ethics of medicine

On a professional level, al-Razi introduced many practical, progressive, medical and psychological ideas. He attacked charlatans and fake doctors who roamed the cities and countryside selling their nostrums and "cures". At the same time, he warned that even highly educated doctors did not have the answers to all medical problems and could not cure all sicknesses or heal every disease, which was humanly speaking impossible. To become more useful in their services and truer to their calling, al-Razi advised practitioners to keep up with advanced knowledge by continually studying medical books and exposing themselves to new information. He made a distinction between curable and incurable diseases. Pertaining to the latter, he commented that in the case of advanced cases of cancer and leprosy the physician should not be blamed when he could not cure them. To add a humorous note, al-Razi felt great pity for physicians who took care for the well-being of princes, nobility, and women, because they did not obey the doctor's orders to restrict their diet or get medical treatment, thus making it most difficult being their physician.

He also wrote the following on medical ethics:

thumb|upright=1.5|Doctor performing [[uroscopy (from a Latin translation of a work by al-Razi, 1466)]]

Books and articles on medicine

Al-Hawi

This 23-volume medical textbook sets the foundation of gynecology, obstetrics, oncology and chemotherapy, and ophthalmic surgery. Because of this book alone, many scholars consider al-Razi the greatest medical doctor of the Middle Ages.

Al-Hawi is not a formal medical encyclopedia but a posthumous compilation of al-Razi's working notebooks, which included knowledge gathered from other books as well as original observations on diseases and therapies based on his own clinical experience. It is significant since it contains a monograph on smallpox, one of the earliest known. It was translated into Latin in 1279 by Faraj ben Salim, a physician of Sicilian-Jewish origin employed by Charles of Anjou, and after which it had a considerable influence in Europe.

Al-Hawi also criticized the views of Galen after al-Razi had observed many clinical cases that did not follow Galen's descriptions of fevers. For example, he stated that Galen's descriptions of urinary ailments were inaccurate as he had only seen three cases, while al-Razi had studied hundreds of such cases in hospitals of Baghdad and Rey.

For One Who Has No Physician to Attend Him (Man la Yahduruhu Al-Tabib) (من لا يحضره الطبيب)

Al-Razi was possibly the first Persian doctor to deliberately write a home medical manual (remedial) directed at the general public. He dedicated it to the poor, the traveller, and the ordinary citizen who could consult it to treat common ailments when a doctor was unavailable. This book is of special interest to the history of pharmacy since similar books were very popular until the 20th century. Al-Razi described in its 36 chapters diets and drug components that can be found in either an apothecary, a marketplace, in well-equipped kitchens, or military camps. Thus, every intelligent person could follow its instructions and prepare the proper recipes with good results.

Some of the illnesses treated were headaches, colds, coughing, melancholy and diseases of the eye, ear, and stomach. For example, he prescribed for a feverish headache: "2 parts of duhn (oily extract) of rose, to be mixed with 1 part of vinegar, in which a piece of linen cloth is dipped and compressed on the forehead". He recommended as a laxative, "7 drams of dried violet flowers with 20 pears, macerated and well mixed, then strained. Add to this filtrate 20 drams of sugar for a drink." In cases of melancholy, he invariably recommended prescriptions, which included either poppies or its juice (opium), Cuscuta epithymum (clover dodder) or both. For an eye-remedy, he advised myrrh, saffron, and frankincense, 2 drams each, to be mixed with 1 dram of yellow arsenic formed into tablets. Each tablet was to be dissolved in sufficient coriander water and used as eye drops.

thumb|upright=1.5|Colophon of al-Razi's Book of Medicine for Mansur

;Book for al-Mansur ()

Al-Razi dedicated this work to his patron Abū Ṣāliḥ al-Manṣūr, the Samanid governor of Ray. It was translated into Latin by Gerard of Cremona around 1180. A Latin translation of it was edited in the 16th century by the Dutch anatomist and physician Andreas Vesalius. al-Razi rejects several claims made by the Greek physician, as far as the alleged superiority of the Greek language and many of his cosmological and medical views. He links medicine with philosophy, and states that sound practice demands independent thinking. He reports that Galen's descriptions do not agree with his own clinical observations regarding the run of a fever. And in some cases he finds that his clinical experience exceeds Galen's.

He criticized Galen's theory that the body possessed four separate "humors" whose balance is the key to health and a natural body temperature. A sure way to upset such a system was to insert a liquid with a different temperature into the body, resulting in an increase or decrease of bodily heat, which resembled the temperature of that particular fluid. Al-Razi noted that a warm drink would heat the body much higher than its natural temperature. Thus, the drink would trigger a response from the body rather than transferring only its warmth or coldness to it. (Cf. I. E. Goodman)

This line of criticism could completely refute Galen's theory of humors and Aristotle's theory of the classical elements on which it was grounded. Al-Razi's alchemical experiments suggested other qualities of matter, such as "oiliness" and "sulphurousness", or inflammability and salinity, which were not readily explained by the traditional fire, water, earth, and air division of elements.

Al-Razi's challenge to the current fundamentals of medical theory was quite controversial. Many accused him of ignorance and arrogance, even though he repeatedly expressed his praise and gratitude to Galen for his contributions and labours, saying:

The Diseases of Children

Al-Razi's The Diseases of Children was the first monograph to deal with pediatrics as an independent field of medicine. Most of his religio-philosophical ideas, including his belief in five "eternal principles", are only known from fragments and testimonies found in other authors, who were often strongly opposed to his thought.

Metaphysics

Al-Razi's metaphysical doctrine derives from the theory of the "five eternals", according to which the world is produced out of an interaction between God and four other eternal principles (soul, matter, time, and place). He accepted a pre-socratic type of atomism of the bodies, and for that he differed from both the falasifa and the mutakallimun. According to these sources, his skepticism of prophecy and view that no one group or religion has privileged access to the truth is driven by his view that all people have an equal basic capacity for rationality and discovery of truth, and that apparent differences in this capacity are simply a feature of interest, opportunity, and effort. However, Biruni also listed some other works of al-Razi on religion, including Fi Wujub Da‘wat al-Nabi ‘Ala Man Nakara bi al-Nubuwwat (Obligation to Propagate the Teachings of the Prophet Against Those who Denied Prophecies) and Fi anna li al-Insan Khaliqan Mutqinan Hakiman (That Man has a Wise and Perfect Creator), listed under his works on the "divine sciences". However, Peter Adamson, Marwan Rashed and others hold that al-Razi did not reject revealed religion, on the basis of more recent evidence found in the writings of the theologian and philosopher Fakhr al-Din al-Razi (died 1210). Adamson states:thumb|upright=0.9|al-Razi as depicted by [[Veloso Salgado ()]]<blockquote>It is worth noting that Stroumsa’s work predates Rashed’s discovery of this evidence in Fakhr al-Dīn, so that she did not have the benefit of being able to consider how this new information could be reconciled with the Proofs. That is the goal I will set for myself in this chapter. I should lay my cards on the table and say that I am persuaded by Rashed’s account, and do not believe that Razi was staging a general attack on prophecy or religion as Abū Ḥātim would have us think.</blockquote>

Debate with Abu Hatim

The views and quotes that are often ascribed to al-Razi where he appears to be critical of religion are found in a book written by Abu Hatim al-Razi, called Aʿlām al-nubuwwa (Signs of Prophecy), which documents a debate between Abu Hatim and al-Razi. Abu Hatim was an Isma'ili missionary who debated al-Razi, but whether he has faithfully recorded the views of al-Razi is disputed.

According to Abdul Latif al-'Abd, Islamic philosophy professor at Cairo University, Abu Hatim and his student, Ḥamīd al-dīn Karmānī (d. after 411AH/1020CE), were Isma'ili extremists who often misrepresented the views of al-Razi in their works. This view is also corroborated by early historians like al-Shahrastani who noted "that such accusations should be doubted since they were made by Ismāʿīlīs, who had been severely attacked by Muḥammad ibn Zakariyyā Rāzī". Peter Adamson concurs that Abu Hatim may have "deliberately misdescribed" al-Razi's position as a rejection of Islam and revealed religions. Instead, al-Razi was only arguing against the use of miracles to prove Muhammad's prophecy, anthropomorphism, and the uncritical acceptance of taqlīd vs naẓar. They suggest that this lost work is either his famous al-ʿIlm al-Ilāhī or another shorter independent work called Makharīq al-Anbiyāʾ (The Prophets' Fraudulent Tricks). Abu Hatim, however, did not explicitly mention al-Razi by name in his book, but referred to his interlocutor simply as the mulḥid (). his Hermetical writings, his religious and philosophical views, for refusing to mathematize physics, and his active opposition to mathematics. Avicenna, who was himself a physician and philosopher, also criticized al-Razi. During a debate with Biruni, Avicenna stated:

Nasr-i-Khosraw posthumously accused him of having plagiarized Iranshahri, whom Khosraw considered the master of al-Razi.

Legacy

The modern-day Razi Institute in Karaj and Razi University in Kermanshah were named after him. A "Razi Day" ("Pharmacy Day") is commemorated in Iran every 27 August.

In June 2009, Iran donated a "Scholars Pavilion" or Chartagi to the United Nations Office in Vienna, now placed in the central Memorial Plaza of the Vienna International Center. The pavilion features the statues of al-Razi, Avicenna, Abu Rayhan Biruni, and Omar Khayyam.

George Sarton remarked him as "greatest physician of Islam and the Medieval Ages".

References

Notes

Citations

Sources

External links

"Dr Al Razi's city tour of Baghdad." Educational podcast released by the Leiden Learning & Innovation Centre as part of the Massive Open Online Course "Cosmopolitan Medieval Arabic World."
"al-Razi" on Islamic Philosophy Online, encyclopedia article about al-Razi by Paul E. Walker.
Lives of the Physicians, dating from 1882, features a biography, in Arabic, about Rhazes.