al-Rāzī

Persian physician and philosopher

• Born: c. 864
• Birthplace: Rayy, Persia (now Iran)
• Died: c. 925
• Place of death: Rayy, Persia (now in Iran)

The most original thinker and the keenest clinical observer of all the medieval Muslim physicians, al-Rāzī produced the first clinical account of smallpox and measles as well as a twenty-four-volume compendium of medical knowledge. He also set new standards for medical ethics, the clinical observation of disease, and the testing of medical treatment.

Early Life

There is little information about the life of al-Rāzī (ahl-RAH-zee). He was born in Rayy, a few miles from what is now Tehran, administered a hospital in that town as well as in Baghdad, and died in his hometown about 925. In his youth, music was his chief interest; he played the lute and studied voice. On reaching adulthood, he rejected this pursuit, however, asserting that music produced by grown men lacked charm. He then turned to the study of philosophy, a lifelong interest, and developed decidedly egalitarian views, a keen interest in ethics, and a profoundly questioning stance toward received dogmas, both religious and scientific. In his thirties, he began to pursue medical studies and a career as a physician .

His interest in medicine reportedly arose after a visit to a sick home in Baghdad, where he was so moved by the suffering of the sick and maimed patients that he determined to devote the rest of his life to alleviating human misery through the practice of medicine. Exactly where he acquired his medical training is unknown, although it was most likely in Baghdad, where he lived from 902 to 907. At that time, the city was the leading center of learning in the Middle East and contained fully equipped hospitals, well-stocked libraries, and a sound tradition of research. Successive ՙAbbāsid caliphs, from al-Manṣūr (r. 754-775) and Hārūn al-Rashīd (r. 786-809) to al-Ma՚mūn (r. 813-833), had generously endowed institutes for the study of ancient Greek arts and sciences as well as those of Persia and India. Some scholars suggest that al-Rāzī, who spent most of his life in Iran, probably studied medicine at the University of Jondisabur, a Sāsānid-founded institution, which remained a major medical center in the medieval Muslim East.

Life’s Work

Al-Rāzī, an outstanding clinician and a brilliant diagnostician and medical practitioner, was probably the most learned and original of all the medieval Muslim physicians. His scientific and philosophical writings total some 113 major and 28 minor works, of which 12 discuss alchemy . While chief physician and master teacher of the hospital in Rayy, he produced the ten-volume encyclopedia Kitāb al-tŃibb al-Manṣūrī (c. 915), named for his patron Manṣūr ibn Isḥāq al-Samānī of Sijistān; a Latin translation, Liber Almansoris, was first published in Milan in the 1580’. Al-Rāzī was invariably described as a generous and gracious man with a large head, full beard, and imposing presence. His lectures, which attracted full-capacity crowds of students, were organized so that his senior students handled all questions they could answer, deferring to him only those issues beyond their knowledge.

Early in his career, he earned a reputation as an effective and compassionate healer, which resulted in his appointment in 918 by the ՙAbbāsid caliph al-Muqtadir as physician in chief of the great hospital at Baghdad. In choosing a new site for this main hospital, al-Rāzī is said to have had pieces of meat hung in different quarters of Baghdad, finally selecting the spot where the meat was slowest to decompose, which he deemed the area with the healthiest air. As a result of his compassion for the sick and his contributions to medical ethics, al-Rāzī is justifiably compared to Hippocrates. In his Baghdad hospital, he provided patients with music, storytelling, recitations of the Qur՚ān, and separate convalescent quarters. He not only treated poor patients free of charge but also supported them with his own funds during their convalescence at home. He emphasized a holistic approach to treating illness that the mind as well as the body must be treated but above all insisted that the art of healing must rest on a scientific basis. In his c. 919 treatise on medical ethics, al-Rāzī warns physicians that laypersons think doctors know all and can diagnose a problem with a simple examination. He laments that frustrated patients turn to quacks who may alleviate some symptoms but not effect a cure. Al-Rāzī advises reputable physicians not to despair or promise cures but to use their critical judgment, apply tested treatments to appropriate cases, and be thoroughly familiar with the available medical literature.

Al-Rāzī, like Hippocrates, based his diagnoses on observation of the course of a disease. In administering treatments, he paid serious attention to dietetics and hygienic measures in conjunction with the use of closely monitored drug therapy. His fine powers of observation and detailed clinical descriptions are evident in his best-known monograph, al-Jadarī wa al-Ḥasbah (c. 922; A Treatise on the Small-Pox and Measles, 1848), which is the first clinical account of smallpox. In this work he describes the types of human bodies most susceptible to each disease, the season in which each disease most often occurs, and the varied symptoms indicating the approaching eruption of smallpox and measles. These symptoms included fever, back pain, nausea, anxiety, itching in the nose, and nightmares.

Because al-Rāzī believed that these diseases were caused by fermentation of the blood, his remedy was purification of the blood. The therapeutic measures he employed were based on his readings of the ancient Greeks and his own clinical trials. He devised two different approaches to treatment: to counteract the disease with antidotes such as camphor mixtures, purgatives, bloodletting, and cooling with cold sponges or baths; and to effect a cure with heat, especially steam, to stimulate the eruption of pustules and hasten healing. The choice of treatment depended on the degree of fever and the patient’s general condition. Bloodletting, which was a common practice, he recommended using with caution and not on the very young, the very old, or those with a weak constitution. Al-Rāzī also developed detailed measures for preventing secondary effects from these diseases, such as damage to the eyes, ears, and throat and scarring of the skin.

Possessing an extensive knowledge of pharmacology and therapeutics, al-Rāzī claimed to have acquired much valuable information from women healers and herbalists in his own country and from his travels to Syria, Palestine, Egypt, and Muslim Spain. Other medieval physicians added little to his vast knowledge of drugs. His drug therapy was similar to contemporary practice in that dosage was based on age and weight. Drugs with which he was acquainted included nux vomica, senna, camphor, cardamom, sal ammoniac, and arrack as well as other alcoholic drinks. He used oils, powders, infusions, syrups, liniments, plasters, suppositories, compresses, and fumigations. His diligent search for drugs of therapeutic value and his methods of clinical observation laid the foundation on which future physicians would build.

Al-Rāzī’s extensive medical and pharmacological knowledge is contained in his most important work, al-Kitāb al-hāwī fiՙl tŃibb (c. 930; the comprehensive book), a twenty-four-volume encyclopedia that summarized the medical knowledge of the time, that is, the knowledge of the Greeks, Persians, Indians, and Arabs. It was completed posthumously by his students. First translated into Latin in 1279, it was repeatedly printed from 1486 onward under the title Continens Medicinae and exercised considerable influence in the Latin West. Medieval Muslim knowledge of anatomy and physiology was limited by the Qur՚ānic prohibition against dissection of the human body. Thus, most information on anatomy and surgery in al-Kitāb al-hāwī fiՙl tŃibb was drawn from Greeks such as Galen and Hippocrates. Al-Rāzī provided numerous descriptions of his own surgical procedures, however, including those for intestinal obstructions, various forms of hernia, vesical calculi, tracheotomy, and cancer. In treating cancer, he stressed that there should be no surgical removal of cancerous tissue unless the entire cancer could be removed.

Much of al-Rāzī’s philosophical thinking can be gleaned from two of his treatises on ethics: Kitāb al-tŃibb al-rūḥānī (c. 920; The Book of Spiritual Physick, 1950) and Sīrat al-faylasūf (c. 920; The Philosopher’s Way of Life, 1926). He propounded egalitarian views, rejecting a contemporary argument that humans can be stratified according to innate abilities. Rather, he believed that all people possess the capacity to reason and do not need the discipline imposed by religious leaders. The latter he accused of deception, and the miracles of prophets he regarded as trickery. His critical attitude toward religious authority carried over to the established dogmas of science. Only by questioning and testing received knowledge, he argued, could there be continuing progress in science.

Al-Rāzī asserted that he did not accept Aristotle’s philosophy and that he was a disciple of Plato, with whom he shared certain ideas on matter; his egalitarianism, however, was antithetical to Plato’s political ideas. Al-Rāzī’s attitude toward animals was also part of his ethics. He believed that only carnivores and noxious animals such as snakes should be killed, for he endorsed the doctrine of transmigration, according to which a soul may pass from an animal to a person. Killing an animal set the soul on a path of liberation, while al-Rāzī maintained that only souls occupying human bodies should be liberated. Toward the end of his life, al-Rāzī became blind from cataracts. He reportedly rejected surgery, remarking that he had seen too much of the world already. Some biographers have argued that his interest in alchemy contributed to his blindness; others ascribed it to his excessive consumption of beans. He died around 925 in abject poverty, having given all of his wealth to his impoverished patients.

Significance

Al-Rāzī’s antireligious attitude and his interest in alchemy caused other Muslim intellectuals to criticize his work and question his medical competence. To his credit, his principal work on alchemy, Kitāb al-asrār wa-sirr al asrra (c. 916; the book of secrets), which was translated into Latin in 1187 (De spiritibus et corporibus), was a chief source of chemical knowledge through the fourteenth century. Later, more talented medieval physicians such as Moses Maimonides found fault with his philosophy but not with his medicine. As Aristotelians they were intolerant of his disavowal of Aristotle and his readiness to accept empirical evidence that upset established doctrines. It was in his insistence on rigorous scientific research and valid evidence, however, that al-Rāzī anticipated the position of modern medicine. Moreover, as a conscientious practitioner who stressed qualitative medicine devising the best therapy, based on an evaluation of the patient’s physical and mental condition he set high standards for physicians and paved the way for modern medical practice.

As a result of his many achievements the application of chemistry to medical treatment, the earliest study of smallpox and other epidemiological studies, the elaboration of medical ethics and scientific trials, the invention of the seton for surgery al-Rāzī secured the historical reputation of the medieval Muslim Arab world as the primary center of science and medicine. His Muslim predecessors introduced clinics, hospitals, and pharmacies, but al-Rāzī established more rigorous ethical, clinical, and scientific standards, free from dogmatic prejudices, which foreshadowed those of modern science. For that reason, al-Rāzī’s portrait is one of only two portraits of Muslim physicians (the other being that of Avicenna) that were hung long ago in the great hall of the School of Medicine at the University of Paris as permanent testimony to the West’s debt to the science of medieval Islam.

Bibliography

Amundsen, Darrel W., ed. Medicine, Society, and Faith in the Ancient and Medieval Worlds. Baltimore: Johns Hopkins University Press, 1996. Covers the connections between medicine and religious faith, canon law on medical practice, medical ethics, and more

Bakar, Osman. The History and Philosophy of Islamic Science. Cambridge, England: Islamic Texts Society, 1999. Discusses questions of methodology, doubt, spirituality and scientific knowledge, the philosophy of Islamic medicine, and how Islamic science influenced medieval Christian views of the natural world.

Browne, Edward G. Arabian Medicine. Westport, Conn.: Hyperion Press, 1983. A brief text that contains separate sections on al-Rāzī’s life, writings, influence, and pharmacological contributions. Index.

Campbell, Donald E. H. Arabian Medicine and Its Influence on the Middle Ages. 1926. Reprint. Vol. 1. New York: AMS Press, 1973. Focuses on medieval Muslim contributions to medical history and contains a sympathetic section on al-Rāzī.

Gordon, Benjamin L. Medieval and Renaissance Medicine. New York: Philosophical Library, 1959. A readily available, 843-page volume containing a summary of al-Rāzī’s career and a concise summary of his clinical work in the chapter on smallpox. Bibliography.

Hitti, Philip K. History of the Arabs. 10th ed. New York: St. Martin’s Press, 1974. Still the best and most available text with extensive coverage of the ՙAbbāsid period. Contains a discussion of al-Rāzī’s work within the context of ՙAbbāsid scientific and literary accomplishments. Illustrations, genealogical tables, maps, and bibliographical references.

Huff, Toby E. The Rise of Early Modern Science: Islam, China, and the West. 2d ed. New York: Cambridge University Press, 2003. Provides a strong cross-cultural background for the rise of science and medicine in the Middle East, Asia, and the West. Includes illustrations, a bibliography, and index.

Martin, Richard C., Mark R. Woodward, and Dwi S. Atmaja. Defenders of Reason in Islam: Mutazilism from Medieval School to Modern Symbol. Boston: Oneworld, 1997. Examines Mutazilism, the belief in the primacy of reason over theological teachings, in Islam during the Middle Ages and through the twentieth century. Bibliography, index.

Rāzī, al-. The Spiritual Physick of Rhazes. Translated by Arthur J. Arberry. London: John Murray, 1950. An excellent example of al-Rāzī’s thinking, this slender volume provides clinical information and treatment advice on various issues such as alcoholism, anxiety, and mendacity.

Rāzī, al-. A Treatise on the Small-Pox and Measles. Translated by William Alexander Greenhill. London: Sydenham Society, 1848. A translation of the classic work, the volume provides an excellent example of al-Rāzī’s medieval Muslim thinking, scientific methodology, and medieval Muslim thought in general.

Stroumsa, Sarah. Freethinkers of Medieval Islam: Ibn al-Rāwandī, Abū Bakr al-Rāzī and Their Impact on Islamic Thought. Boston: Brill, 1999. Discusses the contradiction inherent to the brilliance ascribed to so-called free or radical thinkers in Islam, such as al-Rāzī, and their marginalization by historians of Islamic thought. Bibliography, index.