Islamic Civilization

Pharmacy  and Pharmacology

From very early to comparatively late periods of the history of drug-lore, Isaac explains, the preparation, action and uses of drugs were closely associated, often indeed identified, with witchcraft and divination.[1] It is Islam, he pursues, which purged pharmacology of such practices; Islamic pharmaceutical tradition, on the whole, being rational, clean and practical.[2] Isaac notes the saying of the Prophet: ‘li kulli da'in dawa' (for every disease there is a remedy), is a religious explanation: it is left to the physician, through his knowledge and skill, to trace the right drug that God had created.[3] Hamarneh also says that interest in natural products and ecology was ‘a corollary to the Muslim belief that God provides for the creatures He has created.’[4] Hamarneh continues:

‘In Nature  God provides the right medications for man's ailments, when and where they are most needed. Natural medications are tokens of God's generous attitude toward human beings, His ways of enriching their lives and providing for their needs, a belief which prompted Muslim naturalists, herbalists, pharmacists, and physicians to seek remedies in nature.’[5]

Faith aside, the vast, borderless world of Islam stimulated travel over very long distances to procure certain plants or roots not to be found nearer home, or to be obtained in more perfect condition than from ordinary dealers.[6] Ibn al-Baytar (1197-1248), thanks to his travels, managed to accumulate a vast knowledge in the field.  His extensive travels began in 1216-7 in search and collection of plants. In Bejaia , in Algeria, he found and describes at length the Athrilal (Latin : ptychotisverticillata) which a local tribe traded as a specific remedy against leprosy.[7] Ibn al-Baytar made the same discoveries and collections in Constantine, Tunis , Tripoli , and other places he visited.[8] Wherever he went, Ibn al-Baytar entered into contact with local scholars to seek further information on local plants. His Kitab-ul-Jami fil Adwiyah al-Mufradah (Dictionary of Simple Remedies and Food) is the most important treatise of all, describing 3000 simples, all listed in alphabetical order, and dealing with over 150 authors.[9] It includes personal observations by himself.[10] Ibn al-Baytar’s contemporary, Rashid Eddin al-Suri (d. 1241), even used to take a painter with him in his outings in search for medicinal plants, recording each of them by having them painted at different stages of their growth for inclusion in his book.[11]

Muslim pharmacists discovered new and simple drugs in their crude forms, and gave detailed descriptions of their geographical source, physical properties, methods of application, the pharmaceutical forms of the remedies used, and the techniques employed in their manufacture.[12] Some writers emphasised the botanical description of the drugs; others their potency, their mode of operation, their composition, and the forms which the medicaments took (that is to say, preparations like pastes, solutions, tinctures, etc.), and also synonyms for drugs, and other topics.[13] Ibn Sahl (d. 869) was the first physician to initiate pharmacopoeia, describing a large variety of drugs and remedies for ailments.[14] Ibn Sina , described no less than 700 preparations, their properties, mode of action and their indications in his Canon.[15]  Such information can also be found in works (generally bearing the title Jami al-adwiya al-mufrada (Collection of Simples) such as those of Ibn Samjun (d. 1002), al-Ghafiqui (d.1165), Ibn Rumia (1142-1218) and others’ treatises on simples; Ibn Rumia, for instance, introduces new methods of investigating properties and uses of drugs.[16] Al-Biruni  (d 1051), in his Kitab al-Saydalah (Pharmacology), lists and describes the properties of drugs, giving the technical terminology for categories of drugs; the general theory of medicaments, therapeutic properties of substances, etc.[17] In the introduction to his Book of Drugs, Al-Biruni explains:

‘Everything that is absorbed, voluntarily or unconsciously, can be divided first of all into foods and poisons. Remedies are placed half way between these two. Foods receive their qualities from active and passive forces, and primarily from their four degrees, so that the body, in equilibrium, has the power to transform nutriment into its own substance by complete digestion and by assimilation, thus replacing what part of the diet has been lost by disassimilation. That is the reason why the body must act on food before it can derive any benefit from it. As for poisons, they receive their qualities from the same forces but at their highest degree, which is the fourth, in such a way that they overpower the body and subject it to morbid and fatal transformations…. As for drugs, they are placed between the two, because they are corruptive with respect to food and curative with respect to poisons. Their curative action can be wrought only by skilful and scrupulous physicians. In addition, there are the medicinal foods, half way between drugs and food, and the toxic medicaments, half way between drugs and poisons.’[18]

Minerals had great significance as remedies among the Muslims. Antimony is said to have been recommended for ophtalmia by the Prophet himself, and turns up regularly in Arabic literature on eye disease.[19] In dermatology, we find early mention of ointments containing sulphur and mercury.[20] By the time of Al-Zahrawi the external use of these substances was obviously a major concern of the Muslim physicians.[21] In the oldest Muslim lapidary extant, by Utarid Ibn Mohammed al-Hasib (9^th century) Kitab manafi’ al-ahjar or Kitab al-jawahir wa’l Ahjar (The Book of Virtues of Minerals or the Book of Precious Stones and Minerals), the properties of precious stones are described.[22] Ibn Sina  in his Kitab al-Shifa (the Book of Healing), devotes a section to mineralogy, which includes stones and various chemicals.[23] On vitriols, he says:

‘The vitriols are composed of a salty principle, a sulfurous principle and stone, and contain the virtue of some of the fusible bodies (metals). Those of them which resemble qalqand and qalqatar are formed from crude vitriols by partial solution, the salty constituent alone dissolving, together with whatever sulferity there may be. Coagulation follows, after a virtue has been acquired from a metallic ore. Those that acquire the virtue of iron become red of yellow, e.g. qalqatar, while those which acquire the virtue of copper become green. It is for these reasons that they are so easily prepared by means of this art.’[24]

As excellent organisers of knowledge, Levey points out, Muslim writers directed their pharmacological texts along paths which either seemed more promising or more useful to the apothecary and medical practitioner.[25] Ibn Massawayh (Junior) (d.1015), for instance, was to became famous in the Latin  West for his pharmacopoeia, which was divided into several sections, dealing with correctives to medicines, simple purgative remedies, composite medicines and lastly medicines as intended for each of the specific individual diseases.[26] The Muslims also appended to each name its synonyms in other languages in order to arrive at as unambiguous a definition of the drugs as possible.[27] Ibn al-Baytar’s greater merit, for instance, was in the systematisation of the discoveries made by Muslims in the Middle Ages, and he was also concerned with finding the technical equivalents between Arab, Berber, Greek, Latin, Persian and Romance languages.[28] Considering such materials, Dietrich concludes, shows that the Muslim pharmacists did not, after all, compile their material in as cavalier a manner as has sometimes been said of them.[29]

Also, contrary to what is generally assumed, the Muslims largely surpassed their predecessors in the field. First of all in their numbers,  Meyerhof was able to trace about a hundred and ten writers who worked in this field.[30] The Muslims also added several hundred drugs to the stock of medicaments known to the Greeks.[31] Ibn Juljul (d.944), for instance, introduced a whole range of new medical plants into therapeutics.[32] Ibn Juljul was conscious of the fact that since the days of Dioscorides medicine and botany had developed new items used for medication which had come from the East, or were found in Andalus. He produced a Supplement "on those drugs which Dioscorides did not mention", containing around sixty items.[33] Leclerc has calculated that the thirteenth century botanist Ibn al-Baytar listed some 200 plants which were unknown to Dioscorides;[34] others cite an even larger figure approaching a thousand.[35] All in all, and in quantity, the number of simples and compound remedies rose under the Muslims to about 4,000 in the later works, which is a considerable number compared to the mere hundreds in the Greek works.[36]

More importantly, as with every science, the Muslims were not merely followers of the Greek as scholarship tends to accuse them of being. Ibn Wafid (Abenguefith to his Latin  translators), the vizier and director of the botanical garden of the princely house of Toledo , and the author of the earliest pharmacopoeia treatise in the Muslim West, for instance, bases himself on the ancients, but takes into account the remedies he has himself seen used to good effect in Spain.[37] The same with Ibn Juljul, who used and respected the ‘Ancients’ but did not simply transmit the Greek learning; he made valuable contributions to the practical knowledge and use of medicinal plants, and was held in high respect by contemporary and later scholars and physicians.[38]

As pharmacology made progress, Levey points out, other sciences advanced to keep up with it.[39] In the early Muslim period, as he explains, pharmacology was the mother of chemistry. In this way, the Muslims provided ample information  regarding chemicals and their physical and chemical properties and reactions.[40] This process of elaboration was carried on by the scholars of the Christian West until the breakthrough in chemistry a few hundred years ago.[41] Developments in Muslim chemistry including filtration, distillation and crystallisation also had a decisive impact on the rise and growth of modern pharmacy.[42]

Cosmetology is one area, little known, which benefited greatly from progress in pharmacology. Al-Zahrawi, in the 19^th volume of his Al-Tasrif, considers cosmetics a definite branch of medication (Adwiyat al-Zeenah). He looks at the care and beautification of hair (mentioning hair dyes), skin, teeth and other parts of the body. He has his solutions for mouth hygiene, and bad breath for which he suggests cinnamon, nutmeg, cardamom and chewing on coriander leaves. He also includes methods for strengthening gums and bleaching the teeth. He deals with body odours and fighting them with perfumes, scented aromatics and incense, and included under-arm deodorants, hair removing sticks and hand lotions. Al-Zahrawi mentions the benefits of suntan lotions, describing their ingredients in detail, and describes nasal sprays and hand creams. Al-Zahrawi also suggests keeping clothes in an incense filled room to make them carry a pleasant fragrance for the wearer.[43]

Sahlan ibn Kaysan’s (d.990) Mukhtassar fi al-Adwiya al-murakabba al-musta’mala fi akhbar al-amrad (Compounded Drugs Used in Most Ailments) has chapters which deal with myrobalan confections, electuaries, pills, aperients, pastilles, powders, syrups, lohochs, and robs, gargles, collyria, suppositories, pessaries, poultices, oils and lotions, buccal medicines and dentifrices, and pomades.[44] Many variations of this type of text were known.[45]

Likewise, those whose work led to perfumery and distillatory operations learned to provide more suitable raw material for the apothecary and physician.[46]

With pharmacology and its related sciences there naturally developed experimentation. Muslim practioners experimented with drugs in order to learn more about their effect on humans, often using a single drug in the treatment of each ailment in order to determine its precise effect.[47] Experiments were reported in notebook collections of case histories, sometimes known as al-Mujarrabat; whilst other manuals included charts, diagrams, and tables that dealt with drugs and diseases listing their causes and symptoms, their seasonal prevalence, and the dosages of drugs administered.[48] Others included mathematical calculations concerning the potency of drugs and the recommended dosages according to age, sex, and the severity of the sickness.[49] Several physicians prescribed and compounded their own medications, giving them specific names, from the recipes they formulated themselves, often indicating the pharmacological action that would result, a practice usually followed with modern patented medicines.[50] Al-Zahrawi’s (940-1013) al-Tasrif, known in Latin  as liber servitoris de praeparatione medicinarum simplicium, for instance, describes chemical preparations, tablet making, filtering extracts, and related pharmaceutical techniques.[51]

The Islamic impact on the Christian West in the subject was quite enormous, and this is highlighted by the briefest of outlines. In terms of collections of recipes for medicines, the huge corpus of Islamic pharmacology and plant learning influenced these very heavily- indeed some of these works were almost direct cribs from the original works of writers like Ibn Massawayh.[52] The Antidotarium of Ibn  Massawayh (d. 857) (Mesue) was plagiarised and copied into books of medical recipes for six hundred years.[53]  Some of these Western works relying on Islamic pharmacology are almost exclusively medical, for example, Andrew Borde's The Breviarie of Health.[54] Some are a mixture of medicines and handy hints on domestic matters like how to scent gloves, or make marmalade, such as Partridges bestseller The Huswives Closet and its sister volume The Widowes Tresure.[55] In a separate category were the herbals, books which combine some botany with medicine.[56] Herbals were possibly the most popular and long lived of them all-the most famous of them, Culpeper's Herbal, is still in print and can be obtained in any British bookseller to this day, containing recipes which the Islamic writers of one thousand years ago would recognise as their own.[57] The impression that Islamic drugs dominated medical practice is supported by examining customs records or apothecaries books.[58] In the late 17^th century, an edition was made of the London Dispensatory. Its list of botanicals, simples, minerals, compound drugs for external and internal uses, oils, pills, cataplasms, etc, also highlights this Muslim influence.[59] Subsequently, parts of the Latin  version of Ibn al-Baytar’s Simplicia were printed in 1758; whilst Ibn Sarabi and Ibn Massawaih  were studied and summarized for the use of European pharmacopoeias until about 1830.[60] Latin and German translations, and limited Spanish version of Ibn Al-Baytar’s pharmaceutical compendium, Kitab-ul-Jami fil Adwiyah al-Mufradah (Dictionary of Simple Remedies and Food), were made before a complete translation appeared in 1842.[61]

There is today a fairly adequate number of secondary sources dealing with the history of Muslim pharmacy. Meyerhof has written many works of great interest, which constitute major sources of reference.[62] Ulmann is another good source albeit he remains available in German mainly;[63] which is also the case for Meyer.[64] Levey’s work in English on early Muslim pharmacy is excellent.[65]

Original Islamic manuscripts constitute the best source to know more on the subject. However, these manuscripts remain to a great extent untouched. Dietrich observes that approximately a quarter of the extensive Muslim production is probably extant, and very little of it printed, most of it in manuscript form in libraries, especially those of the East.[66] It is all the more crucial to access such sources, because, as Levey insists, the impact of Muslim pharmacology lasted into the 19^th century in the West, and as a result of its accumulation of data from over thousands of years’ experience, this may continue to lead to valuable facts today.[67] Medicinal properties of botanical sources known by Muslim physicians and apothecaries deserve greater attention than has been possible hitherto.[68] Some important medicinal plants have been explored as to their physiologically active principles and chemical activity with success, but more of this remains to be done, for some clues leading to potentially valuable drugs may still be found in the medical Islamic texts.[69] Levey lists some of the works that deserve translation into English:

-Al-Ansari (d. 1292): Al-Simat fi asma' al-Nabat (Special Considerations on Names of Plants); (MS: Bibliotheque Nationale, Paris, Arabe 3004).

-Ishaq B. Sulaiman: (903? 953?): Kitab al-Aghdhiya wa'l adwiya (Book on Nutritives and Drugs); (MS. Munchen 809).   

-Al-Tamimi (late 10th): Kitab al-Murshid ila jawahir al-Aghdhiya waquiwa'l-mufradat min al-Adwiya (Guide Book on Nutritives and the Properties of Simple Drugs); (MS Bibliotheque National Arabe 2870).

-Ibn Jazla (d. 1100): Minhaj al-bayan fima vasta' Miluhu'l-insan (Manual of Explanation in What One Employs); (MS Leiden 1355; MS Shebit Ali 2107).

-Al-Kuhin b.Attar: Minhaj al-Dukkan (Manual of the Pharmacy ); (MS Leiden 1360; MS Munchen 833.)[70]