Surgical, medical and anesthesia in the Middle East: Notes on Ancient and medieval practice with reference to Islamic-Arabic medicine

Abstract

In the Middle East, historians consider that the world civilization, started along the major rivers, namely the Nile valley and in between the rivers Euphrates and Tigris in the land of Mesopotamia 4000 years ago. The oldest medical writings are found in cuneiform tablets, which is known as the oldest medical handbook, and in Ancient Egypt in medical pyperi, Especially Eber pyperus. Both texts (the tablets and pyperus) contain medical text describing the surgical, medical and herbal treatments The Assyrians herbal contained: Belladonna, Cannabis and Mandragora. The Ancient Egyptians used opium poppy and influenced the Greek medicine. Indian and Chinese influences and later on Alexandrian medicine influence the teaching of medicine to lesser extent. Both the Assyrian and Egyptian physicians obtained artificial sleep for their patients by quickly compressing the Carotid vessels of the neck, this practice was followed as well by the Greek physicians. Arabic translation of the Greek medicine helped to make Islamic physicians supreme in the middle Ages. Baghdad became the world's leading medical and drug center. With the skill of the Arab Alchemists, the art of drug making began to evolve into the science of Pharmacology. Western physicians emerging from the Middle Ages found the Arab pharmacopoeia (based on the Greek and enriched by Arab herbiest), in which a list of medicinal plants composed the anesthetic armamentarium of our forefathers. Ibn al Nafis (1208-1288) the Arabic scholar who descried the pulmonary circulation, mentioned in his book Shamel a paragraph on how patient could be restrained during surgery and his remarks do not mention anesthesia. The reason may be that he worked as ophthalmologist. His pupil Ibn Koff (1232-1286 AD) wrote a complete chapter on pain relief in his book Al Omdah Fi Sinaat Jirahah. He differentiated between true and non-true pain relief considering non-true pain relief the Anesthetic which the surgeon may use for treatment of pain or to be able to institute the surgical treatment. The method mentioned by some historians regarding anesthetic sponge (the predecessor of inhalational anesthesia) may need further documentation and research to elicit its mode of action, and the extent of its use.