الثلاثاء، 19 مايو 2015

Muslims: Pioneers of pharmacology


Muslim pharmacy (Saydalah) as a profession and a separate entity from medicine was recognised by the beginning of the ninth century. This century not only saw the founding and increase in the number of privately owned pharmacy shops in Baghdad and its vicinity, but in other Muslim cities as well. Many of the pharmacists who managed them were skilled in the apothecary's art and quite knowledgeable in the compounding, storing, and preserving of drugs. 

State-sponsored hospitals also had their own dispensaries attached to manufacturing laboratories where syrups, electuaries, ointments, and other pharmaceutical preparations were prepared on a relatively large scale. The pharmacists and their shops were periodically inspected by a government appointed official, 'Al-Muhtasib', and his aides. These officials were to check the accuracy in weights and measures as well as the purity of the drugs used. Such supervision was intended to prevent the use of deteriorating compounded drugs and syrups, and to safeguard the public. 
    
This early rise and development of professional pharmacy in Islam - over four centuries before such development took place in Europe - was the result of three major occurrences: the great increase in the demand for drugs and their availability on the market, professional maturity, and the outgrowth of intellectual responsibility by qualified pharmacists. 
    
The ninth century in Muslim lands witnessed the richest period thus far in literary productivity insofar as pharmacy and the healing arts were concerned. This prolific intellectual activity paved the way for still a greater harvest in the succeeding four centuries of both high and mediocre calibre authorship. For pharmacy, manuals on materia medica and for instructing the pharmacist concerning the work and management of his shop were circulating in increasing numbers. A few authors and their important works will be briefly discussed and evaluated.

Abu Hasan At-Tabari:     
One of the contributors to Muslim Pharmacy was Abu Hasan 'Ali At-Tabari. He was born in 808. At about thirty years of age, he was summoned to Samarra by Caliph al-Mu'tasim (833-842), where he served as a statesman and a physician. At-Tabari wrote several medical books, the most famous of which is his Paradise of Wisdom, completed in 850. It contains discussions on the nature of man, cosmology, embryology, temperaments, psychotherapy, hygiene, diet, and diseases - acute and chronic - and their treatment, medical anecdotes, and abstracts and quotations from Indian source material. In addition, the book contains several chapters on materia medica, cereals, diets, utilities and therapeutic uses of animal and bird organs, and of drugs and methods of their preparation.
    
At-Tabari urged that the therapeutic value of each drug be utilised in accordance with the particular case, and the practitioner should always choose the best of samples. He explained that the finest types of samples come from various places: black myrobalan comes from Kabul; clover dodder from Crete; aloes from Socotra; and aromatic spices from India. 

He was also precise in describing his therapeutics. He said, 'I have tried a very useful remedy for the swelling of the stomach; the juices of the liverwort (water hemp) and the absinthium after being boiled on fire and strained to be taken for several days. Also, powdered seeds of celery (marsh parsley) mixed with giant fennel made into troches and taken with a suitable liquid, release the wind in the stomach, joints and back (arthritis).' 

To strengthen the stomach and to insure good health he prescribed 'black myrobalan powdered in butter, mixed with dissolved plant sugar extracted from liquorice and this remedy should be taken daily.' For storage purposes he recommended glass or ceramic vessels for liquid (wet) drugs; special small jars for eye liquid salves; lead containers for fatty substances. For the treatment of ulcerated wounds, he prescribed an ointment made of juniper-gum, fat, butter, and pitch. In addition, he warned that one Mithqaal (about 4 grams) of opium or henbane causes sleep and also death.
    
The first medical formulary to be written in Arabic is Al-Aqrabadhin by Saboor bin Sahl, who died in 869 AH. In it, he gave medical recipes stating the methods and techniques of compounding these remedies, their pharmacological actions, the dosages given of each, and the means of administration. The formulas are organised in accordance with their types of preparations into which they fit, whether tablets, powders, ointments, electuaries or syrups. Each class of pharmaceutical preparation is represented along with a variety of recipes made in a specific form; they vary, however, in the ingredients used and their recommended uses and therapeutic effects. Many of these recipes and their pharmaceutical forms are remindful of similar formulas given in ancient documents from the Middle East and the Greco-Roman civilisations. What is unique is the organization of Saboor's formulary-type compendium purposely written as a guidebook for pharmacists, whether in their own private drugstores or in hospital pharmacies.

Hunayn bin Is'haaq:
He was an Arab scholar who died in 873 AH. His translations of Plato, Aristotle, Galen, Hippocrates, and the Neoplatonists made accessible to Arab philosophers and scientists the significant sources of Greek thought and culture.

Hunayn was a Nestorian Christian who studied medicine in Baghdad and became well versed in ancient Greek. He was appointed by Caliph Al-Mutawakkil to the post of chief physician to the court, a position that he held for the rest of his life. He travelled to Syria, Palestine, and Egypt to gather ancient Greek manuscripts. From his translators' school in Baghdad, he and his students transmitted Arabic and (more frequently) Syriac versions of the classical Greek texts throughout the Islamic world. Especially important are his translations of Galen, most of the original Greek manuscripts of which are lost.

Hunayn's book of the Ten Treatises on the Eye was completed in 860 AH. After finishing the ninth treatise, the author felt the need for a closing treatise to be devoted to compounded drugs for eye medication. He extracted some recipes from earlier treatises and added more prescriptions recommended by Greek authors.

As one obvious example of the uses and therapeutic values of using compounded drugs, Hunayn gave that of the theriac - the universal antidote against poisoning. Hunayn, who knew Greek, defined the Greek word theriac as an animal that bites or snaps. Since these antidotes were used against animal bites, the word eventually was applied to all antidotes, especially when snake flesh was incorporated. 

Hunayn corrected the translation in Arabic of the major part of Dioscorides', Materia Medica, undertaken by his associate Istifaan bin Basil (about mid ninth century) in Baghdad. Due to the influence of this work, several books of materia medica were written in Arabic. Dioscorides definitely influenced the writing and direction of Sabur's formulary, which has been mentioned earlier. 

Hunayn’s Herbal Treatise established the basis for Arabic pharmacology, therapy, and medical botany. It also provided a description of the physical properties of drugs, types, and means of testing their purity, and usefulness. As a result, Muslim pharmacology advanced beyond the Greco-Roman contribution. In turn, this helped and influenced a similar development in Europe through the Renaissance. 

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