The Instruction of Amenemope (Egyptian), the Book of Proverbs (Hebrew), and Hippocrates’ Aphorisms (Greek) have survived from more than 2400 years ago to the present.  While these collections of maxims, proverbs, and aphorisms have specific attributions, wise sayings historically have been highly mobile across cultures and authorities.

In ninth-century Baghdad, Hunayn ibn Ishaq wrote a collection of aphorisms of philosophers and scholars.  Among those aphorisms were a set of sayings inscribed on philosophers’ rings:

• The stone of Hippocrates’ signet-ring bore the inscription: “A patient who feels a desire has, in my opinion, better chances than a healthy person who feels no desire for anything.”
• The seal of Socrates’ ring was engraved with the words: “Whoever lets his mind be carried away by his passion is dishonored.”
• The seal of Plato’s ring was engraved with the words: “It is easier to move that which is at rest than to stop that which is moving.”
• The stone in Aristotle’s ring was engraved with the inscription: “He who admits ignorance of what he does not know is more learned than he who affirms what he knows.”
• The stone in Galen’s ring was engraved with the inscription: “He who conceals his malady will never be cured.” [1]

These sayings don’t highlight a prominent feature of the corresponding philosopher’s life or thought.  Moreover, the sayings cannot be found in the corresponding philosopher’s writings.  Such attributions apparently were a Persian literary device for conveying wisdom.[2]  The ancient Greek authorities invoked suggest that the leading ancient Greek authorities in Sassanid Persia were the same as those in Western thought today.  Nonetheless, attribution of a saying to a particular ancient sage has often been whimsical in wisdom literature.

In another section of Hunayn’s text, Aristotle speaks a stream of wisdom to a king within a Persian courtly fable.  The king had placed his son under Plato’s tutelage, but the son had a poor mind.  Aristotle, in contrast, quickly memorized Plato’s philosophy and literary discourse.  Presented to the king’s court to display his learning, the king’s son failed to produce any learning and collapsed into Plato’s arms.  Aristotle, stepping forward in ragged clothes, delivered a lengthy discourse covering all of Plato’s philosophy and science. The fable ends with Aristotle speaking a stream of wisdom to the king and court:

I am Aristotle the son of Philip, the orphan serving Nitaforos, the son of the great king. I have learnt to praise and worship God the Just, the First Cause. O my hearers, men are distinguished by their minds, not by their origin. I learnt from Plato the Sage that philosophy is the fountainhead of the sciences and the arts, the source of all understanding and the mind’s attainments. Penetrative thought leads to sound opinion, patience paves the way to one’s goal, and pleasant speech perpetuates friendship in the heart. Humility is the means to success, good manners beautify our lives and perfect our joys. Science is dignity, and logic enhances our importance and honor. Honesty is the key to our relations with others, and modesty augments love. Forgiveness purifies our actions, and virtue leads to masterly performance. Justice conquers our enemies and wisdom wins us many supporters. Pity tends the heart and mercy is the essence of goodness. Benevolence is true dignity and giving is the hallmark of brotherhood. Charity is virtue and kindliness is worthy of imitation. … [3]

Much of this wisdom can be traced to a Persian text translated into Arabic early in the ninth century.[4]  A closely related section of text has been traced to the Zoroastrian Mobed Mihr Adharjushnasp, probably writing in the Sassanid Empire under Khosrau I (Anushirwan) in 531-579.[5]  Ancient Greek characters transmitted both Greek wisdom and Persian wisdom.

Wisdom isn’t bound to specific authorities or contained within political boundaries. The Egyptian Instruction of Amenemope shares a section with the Hebrew Book of Proverbs.  Hippocrates’ Aphorisms was probably studied at the Academy of Gondishapur in Persia in the sixth and seventh centuries.  Hunayn ibn Ishaq’s anecdotes and aphorism of ancient sages almost surely included Persian material — the philosophers’ ring inscriptions and the story of Aristotle and the king’s son as good and bad students of Plato — as well material from the Greek tradition of Alexander romance (pseudo-Callisthenes).  Al-Ansari’s work, Adab al-falasifa, was probably a compilation that included some of Hunayn ibn Ishaq’s work, some of Hunayn’s son’s work, and some of al-Rayhani’s work.[6]  It was translated into Hebrew and Spanish in the thirteenth century, and subsequently into Latin and Ethiopian.[7]  Wisdom of ancient Greek philosophers in medieval Europe came through cultures from North Africa to Persia.

Communication networks much less technologically advanced than the Internet have in the long run circulated wisdom widely.  That shared wisdom has been continually embedded in new contexts and put to particular local uses.

*  *  *  *  *

Relevant work: The Sharing Ancient Wisdoms project promises to collect, analyze, and make available online historical collections of ancient wisdom sayings.

Related posts:

• a saying from Galen transmitted to the first book printed in English
• making news from “redde rationem villicationis tuae”
• popular work in ancient Greek epigrams

Notes:

[1] HP pp. 55, 91, 99, 113, 170.  Ibn Abi Usaibia gives various titles for Hunayn’s work containing the sayings: “Anecdotes of Philosophers and Savants,” “Aphorisms of Philosophers and Physicians,” “Anecdotes of Philosophers and Physicians,” “Anecdotes of Great Philosophers and Physicians,” “Anecdotes of Great Philosophers,” “The Aphorisms of the Learned Philosophers and Maxims of the Ancient Scholars” and “The Book of Unique Reports about the Philosophers and Savants and the Habits of the Ancient Teachers.”  Philosophers, savants, physicians, scholars, and teachers were all closely associated.  The various titles may imply a work of several sections. Hunayn’s son Ishaq’s similar work includes 16 such ring inscriptions, but the inscriptions differ in order and attribution.  al-Ansari’s Adab al-falasifa includes twenty-six ring inscriptions.  That section was apparently transmitted to al-Mubashsir ibn Fatik’s Mukhtar al-hikam and to the Spanish and Hebrew translations of Adab al-falasifa.  al-Rayhani’s earlier Jawahir includes anonymously ten of these twenty-six sayings.  See Zakeri (2004) p. 180.  Ibn Abi Usaibia, who cites ibn Fatik’s Mukhtar al-hikam explicitly and repeatedly, attributed the ring sayings to Hunayn.  Ibn Abi Usaibia more generally commonly includes sayings attributed to the physician-scholar for whom he is giving an account.

[2] Swain (2006) p. 410 states the ibn al-Washsha’s tenth-century Kitab Al-Muwashsha (“Book of Brocade”) included such ring inscriptions. in a description of courtly etiquette.  Hunayn’s ninth-century record of such inscriptions probably comes from a Persian source, according to Zakeri (2004) p. 180.  Adrados (2009) p. 274 describes these sayings as involving “arbitrary attributions to various philosophers.”  That’s a generally recognized pattern in wisdom literature.  The prologue to al-Ansari’s Adab al-falasifa includes Hunayn stating that he is translating the text from Greek (see Adrados (2009) p. 15).  However, that’s apparently not true for all of Hunayn’s text.  The ring inscriptions include at least one Christian figure (Gregory) and one Arab-Islamic figure (Lokman).

[3] HP pp. 120-4.  The stream of aphorisms placed in Aristotle’s mouth continues much longer.

[4] Twenty of the inscriptions are also found in ‘Ali b. ‘Ubayda al-Rayhani’s Jawahir al-kalim, which translates sayings from Persian into Arabic.  Zakeri (2004) p. 182-3, Zakeri (2007).

[5] Adab al-falasifa (“Aphorisms of the Philosophers”), written by al-Ansari in the eleventh century and attributed to Hunayn ibn Ishaq, apparently contains much of Hunyan’s work.   So too does al-Mubashshir ibn Fātik’s eleventh-century book, Mukhtar al-hikam (“Choice Maxims and Best Sayings”).  Both contain a section of sayings associated with an unknown figure Mihraris or Mahadharijis.  Zakeri (1994) identified that section with work of the Persian Mobed Mihr Adharjushnasp.

[6] Zakeri (2004) pp. 185-90.  HP, p. 387,  list among the works of Ishaq ibn Hunayn, “The Habits of the Philosophers and Interesting Reports about Them.” Zakeri (2004) p. 179, translates Ibn Abi Usaibia’s reference to this title as “Teachings of the philosophers and their apophthegms.”

[7] The Spanish translation is titled Libro de los buenos proverbios.  Bandak (2007) surveys available manuscript sources and provides a critical text.

References:

Adrados, Francisco Rodríguez, and Joyce Greer. 2009. Greek wisdom literature and the Middle Ages: the lost Greek models and their Arabic and Castilian translations. Bern: Peter Lang.

Bandak, Christy, and Ḥunayn ibn Isḥāq al-ʻIbādī. 2007. Libro de los buenos proverbios: estudio y edición crítica de las versiones castellana y árabe. Zaragoza: Instituto de Estudios Islámicos y del Oriente Próximo.

HP: Ibn Abi Usaybi’ah, Ahmad ibn al-Qasim. English translation of History of Physicians (4 v.) Translated by Lothar Kopf. 1971. Located in: Modern Manuscripts Collection, History of Medicine Division, National Library of Medicine, Bethesda, MD; MS C 294.  Online transcription.

Swain, Simon. 2006. “Beyond the Limits of Greek Biography: Galen from Alexandria to the Arabs,” in Brian McGing and Judith Mossman (eds.), The limits of ancient biography. Swansea: Classical Press of Wales.

Zakeri, Mohsen. 1994. “ʿAlī ibn ʿUbaida ar-Raiḥānī: A Forgotten Belletrist (adīb) and Pahlavi Translator.” Oriens, vol. 34, pp. 76-102.

Zakeri, Mohsen. 2004. “Ādāb al-falāsifa: The Persian content of an Arabic collection of aphorisms.” Mélanges de l’Université Saint-Joseph, vol. 57, pp. 173-190.

Zakeri, Mohsen. 2007.  Persian wisdom in Arabic garb: ʻAlī b. ʻUbayda al-Rayḥānī (d. 219/834) and his Jawāhir al-kilam wa-farāʾid al-ḥikam. Leiden ; Boston: Brill.

Tagged: Ibn Abi Usaibia

Vigorous book production and circulation occurred in the ancient Islamic world without a legal regime of copyright.  When the Chief Physician of Baghdad’s ‘Abudi Hospital died in 1065, the books from his personal library were carried off on the backs of twelve camels.[1]  A reasonable load for a camel is 300 lbs, hence this personal library had a total weight of roughly 3600 lbs.  Another physician who lived in Kairouan, Tunisia, about a century earlier left an estate that included “25 hundredweight of medical and other books.”[2]  These two libraries thus had roughly similar book weights.  Given the different units of reporting, that similarity suggests that these figures aren’t wild exaggerations.

Personal libraries in the ancient Islamic world had value on the order of an agricultural estate.  A physician who was a high official in late-eleventh-century Baghdad purchased an agricultural estate for 2000 dinars, with a promise to pay 1000 dinars more when the proceeds of its crops were received. The harvest failed.  Pressed for payment, the physician pawned his personal book collection for 500 dinars.[3]  His personal book collection thus had collateral value equal to one-sixth the value of the agricultural estate.

Personal libraries contained as many as tens of thousand of books.  Abu ‘l-Musaffar, a scholar who lived in twelfth-century Cairo, possessed “many thousands of books.”  Writing about 1245, Ibn Abi Usaibia reported:

{Abu ‘l-Musaffar} was keenly interested in alchemy and was eager to meet its adepts.  With his own hand he copied an immense number of books on that subject, as well as numerous medical and philosophical books.  He was most ardent to acquire books and study them.  Shaikh Sadid al-Din al-Mantiqi told me that Balmuzaffar {Abu ‘l-Musaffar} had in his house a large room whose shelves were crammed with books.  In that room, he spent most of his time, writing, reading and copying.  …  I have seen a great number of medical and philosophical works that formerly belonged to Abu ‘l-Musaffar and had his name inscribed on them, each bearing on it some interesting notes and sundry remarks pertinent to its contents.[4]

Ifra’im ibn al-Zaffan, a Jewish physician who served caliphs in early twelfth-century Cairo, continually employed copyist to make books for his personal library.  Ifra’im’s book collection became a matter of national pride.  Ibn Abi Usaibia observed:

My father told me that a man from Iraq once came to Egypt in order to buy books and take them with him. He met Ifra’im, who sold him 10,000 volumes from among the books in his possession. At that time, al-Afdal, the son of the commander-in-chief of the army, was governor {of Cairo}. When he heard of the transaction, he wanted those books to remain in Egypt and so he sent to Ifra’im from his own treasury the amount of money which had been agreed upon, between Ifra’im and the Iraqi as the purchasing price. The books were transferred to al-Afdal’s library and his honorific names were inscribed in them. This is why I have come across a great number of medical and other books bearing the name of Ifra’im and also the honorific names of al-Afdal.  Ifra’im left {at his death} more than 20,000 books and a great deal of money and valuables.[5]

Muwaffaq al-Din ibn al-Mutran, a Christian who became the physician to Saladin, founder of the Ayyubid dynasty in late twelfth-century Damascus, also acquired a large personal library.    Ibn Abi Usaibia stated:

Muwaffaq al-Din ibn al-Mutran was a great collector of books, so that, when he died, about ten thousand medical and other works were found in his library, besides those he had copied. He was much concerned with copying and correcting books, and there were three copyists in his permanent service. They received a salary and gifts from him.  One of them as Jamal al-Din, known as ibn al-Jamala, who wrote a neat well-proportioned hand.  Ibn al-Mutran copied many books himself; I have seen several such copies, and found them to be unsurpassable as to script, correctness and expressiveness. He read a great deal — in fact, most of the time.  The majority of the books in his possession contain his corrections and notes in his handwriting. Many small books and individual medical essays were found in his library combined into single volumes; they had been accurately and neatly copied, in half one-eighth of Baghdadi script, some of them in his own hand.  There were a great many of these small collections. [6]

In mid-twelfth century Damascus, the vizier Amin al-Dawlah stated that his personal library contained “more than twenty thousand volumes.”  Amin Al-Dawlah made this statement to Ibn Abi Usaibia’s father nearly contemporaneously with the completion of Ibn Abi Usaibia’s History of Physicians.[7]  Ibn Abi Usaibia and readers of his book could have verified the size of the Amin Al-Dawlah’s library, which was a significant matter in a culture that highly valued learning.  Ibn Abi Usaibia’s reports on the other large personal libraries describe his personal inspection of books from these libraries.  His statements concerning the sizes of personal libraries are credible.

A story of a distraught wife underscores the attraction of a personal library.  Al-Mubashshir ibn Fatik, an eleventh-century scholar in Cairo, acquired a huge number of books.  Books surviving from this scholar’s library were discolored.  A story explained the physical condition of those books:

On coming home, {ibn Fatik} spent most of his time with {his collection of books}, finding no better occupation than reading and writing and convinced that this was the most important pursuit. He had a wife of noble descent like him, of the family of one of the state dignitaries. After his death — may Allah have mercy upon him — she betook herself with her maids to his library. She bore a grudge against the books, since her husband had devoted himself to them and neglected her. While bewailing him, she, together with her maids, threw the books into a large water basin at the center of the building. Later the books were retrieved and this is why the many books of ibn Fatik which have been preserved are in such a state.[8]

While this story may be apocryphal, it indicates both that ibn Fatik acquired many books and that a large collection of books was understood to be alluring to scholars.

Producing the books in large personal libraries required thousands of scribe-years of work.  In eleventh-century Cairo, a physician who cultivated ascetic habits and lived in a mosque subsisted on copying two or three books a year.[9]  Ten professional scribes in thirteenth-century Damascus copied in two years the eighty volumes of The History of Damascus.[10]  Their average copying rate was thus four books per year.  At a copying rate of four books per year, a library of 20,000 books would require 5,000 scribe-years to copy.  Many persons, both professional scribes and practicing scholars, surely were engaged in copying books.

Freedom to copy books existed in conjunction with vigorous interest in authoring books.  Patronage, personal scholarly motivation, and intellectual status competition seems to have supported authorship.  In addition, freedom to copy books brought into the present the past thousand years of authorial work.  While a common direction of authorship was to write a commentary on one of Galen’s works, authorship encompassed a wide range of subjects and styles.  Ibn Sina (Avicenna), who flourished in early eleventh-century Persia, is thought to have authored more than 450 works.  Ibn al-Hazen (Alhazen), who worked mainly in eleventh-century Cairo, wrote more than 200 works.  Al-Razi (Rhazes) and Thabit ibn Qurra also authored more than 200 works.  In addition to these highly productive scholars, many others also authored books.  Ibn Abu Usaibia provided lists of authored books for about 120 scholars who interests related to medicine.  Among those authors, 31 authored 10 or more titles.[11]

In the ancient Islamic world, the book economy prospered in conjunction with widespread copying of books.  Persons acquired large personal libraries through both buying and copying texts.  Amin Al-Dawlah “purchased many magnificent editions of various scientific works and always kept copyists in his service.”[12] Because calligraphy was highly valued, the value of a copy could be higher than the value of the original.  Marginal comments, commentary, and dedications written into a manuscript also significantly affected its value.  Adding value in copying and augmenting the text supported both the copying business and the product-differentiated book-selling business.

Content businesses today are greatly concerned about uncompensated copying.  The ancient Islamic world shows that eliminating freedom to copy books isn’t necessary for a vibrant book economy.   Suppressing copying probably also isn’t necessary for vigorous growth in other content forms.

*  *  *  *  *

Related posts:

• intellectual heritage of the Islamic world
• costs of false copyright

Notes:

[1] HP p. 499, referring to Amin al-Dawlah ibn al-Tilmidh, a Christian who died in Baghdad in 1165.  Ibn Abi Usaibia described him as having “left great wealth, and property and books which had no equal in quality.”  Hence low-quality books did not create the mass of the books.  Note also that books were put in series with wealth (money) and property (land).

[2] HP p. 615, referring to Abu Ja’far Ahmad ibn al-Jazzar.  He left an estate valued at 24,000 dinars.  Comparing these and other currency values is difficult because dinars and dirhams varied significantly in metallic content and across places and times.

[3] HP p. 483, referring to Abu Sa’id ibn al-Mu’awwaj.  Abu Sa’id acquired the estate at the time when he was appointed head of the state council.  The connection between these two events is unclear.  The physician Ibn al-Wasiti redeemed Abu Sa’id’s pawned books and give him and his retinue lavish gifts, including an additional gift of 50 dinars.

[4] HP p. 723.

[5] HP p. 718.  At HP p. 717, Ibn Abi Usaibia noted:

In consequence of his eagerness to acquire books and have books copied, he eventually built up a large collection of medical and other works.  He constantly employed copyists, whose upkeep he undertook, among them Muhammad ibn Sa’id ibn Hisham al-Hagari, known as Ibn Malsaka.  I have seen a number of books in the latter’s handwriting, which he wrote for Ifra’im and which were signed by the latter himself.

[6] HP p. 824.  The collections of various works apparently amounted to 3,000 volumes.  HP p. 825.

[7] HP p. 899.  Amin al-Dawlah Kamal, whose full name was Amin al-Dawlah Kamal al-Din Sharaf al-Milla Abu al-Hasan ibn Ghazal ibn Abi Sai’id, described his library in the context of requesting a copy of Ibn Abi Usaibia’s History of Physicians.  Ibn Abi Usaibia dedicated that book to Amin al-Dawlah Kamal.  HP p. 3.

[8] HP p. 705. Ibn Fatik’s book, Choice Maxims and Sayings (written about 1053) was translated into Spanish, Latin, French, and English.  It was highly popular in Europe from the fourteenth to the sixteenth centuries.

[9] HP p. 703, referring to Ibn al-Haitham.  The books he copied every year were Euclid’s Elements, the al-Mutawassitat, and Ptolemy’s Almagest.  HP p. 701 indicates that he copied every year two books, Euclid and the Almagest.  Ibn al-Haitham also authored more than 200 books, so all his time wasn’t spent copying.

[10] HP p. 898.  The History of Damascus was 80 volumes “in petite script.” The vizier Amin al-Dawlah Kamal ordered the scribes’ work and kept all the volumes that they produced.

[11] See spreadsheet of authored title counts for scholars included in Ibn Abi Usaibia’s History of Physicians (Excel version).

[12] HP p. 898.  A street in tenth-century Baghdad was known as the “Street of the Booksellers.”  HP. p. 451.  That indicates vigorous book-selling activity.

Reference:

HP: Ibn Abi Usaybi’ah, Ahmad ibn al-Qasim. English translation of History of Physicians (4 v.) Translated by Lothar Kopf. 1971. Located in: Modern Manuscripts Collection, History of Medicine Division, National Library of Medicine, Bethesda, MD; MS C 294.

Tagged: Ibn Abi Usaibia

A pharmacist demonstrated to the ninth-century Abbasid caliph al-Ma’mun that the pharmaceutical profession was poorly regulated.  The pharmacist told al-Ma’mum:

it is a fact that a pharmacist will always have everything he is asked for, whether he really has it or not. He would hand over something he has in his shop and say that this is what is needed.

The pharmacist proposed an experiment to demonstrate his factual claim:

{The pharmacist said to al-Ma’mun} ‘if the Emir of the Faithful wishes, let him choose an unknown name and send a group of people to the different pharmacists to try and buy it.  We shall then see what happens.’  Al-Ma’mun said:  ‘I have already chosen a name — it is Saqatitha, which is the name of an estate not far from Baghdad.’  Al-Ma’mun sent several envoys to ask the pharmacists for Saqatitha.  The pharmacists all said they had it, took the price from the envoys and gave them some object from their shop. They returned to al-Ma’mun with various objects — seeds, a piece of stone, hair, etc.

In addition to poor professional ethics among these pharmacists, an underlying regulatory problem is that drug buyers cannot effectively verify the properties of the drugs that they buy.

Medical patients also cannot easily know the effects of medical treatments.  The personal physician to ninth-century Abbasid caliph al-Mu’tasim criticized another prominent physician, Yuhanna ibn Masawayhi:

The first thing in medicine is to know the measure of the illness, and to cure it with the appropriate treatment; Yuhanna, however, is the most ignorant of all God’s creatures as to the right measure of both illness and treatment.  When he tends a person afflicted with fever, he gives him cooling medicines and food that induces cold and everything that might do away with his temperature, thus subjecting the patient’s stomach and body to a cold that needs treatment in its turn, by medicines and foods which induce heat.  He treats this new condition in the way he did the first, with exaggeration, in order to do away with the cold, so that the sufferer falls ill from excessive heat.  This way his master is always sick, either from heat or from cold. [2]

Some unethical doctors then and now treat patients to make them dependent on the doctor.  At the same time, doctors often feel pressured by those under their care to “do something,” e.g. prescribe medicine, in response to their patients’ complaints.   An eleventh-century physician in Cairo advised:

When summoned to a patient, first given him a medicine that is innocuous until you have diagnosed his illness, only then may you treat it. [3]

That advice implicitly recognizes patients’ demand for medicine, a demand that can be satisfied with medicine that has no effect.

Because the human mind and body are physically one, medicine cannot treat just the patient’s body.  A physician working in twelfth-century Baghdad had a patient who believed that a jar was perpetually resting on his head. The patient’s behavior was consistent with that belief:

Whenever he walked he used to avoid places with low ceilings, move gently and not let anyone get close to him, lest the jar incline or fall off his head.

The physician arranged with his servants for an imaginative treatment. When the patient arrived, the physician chatted with him and, setting up psychological tension, dismissed the patient’s report of a jar. Then the physician gestured to his servant:

The servant came and said, “By Allah, I have no other way but to break this jar in order to relieve you of it.”  The servant swung the plank and struck at the air about an arm’s length above the patient’s head.  At that moment the other servant cast down the jar from the roof. It made a tremendous crash and broke into fragments.  When the sick man realized what had been done to him and saw the broken jar, he cried out in grief, being sure that this was his jar.  This hallucination had such an effect on him that he recovered from his illness. [4]

The patient’s mental illness was real, and so was the cure.

Medical treatments historically have often been worse than the illness.  A ninth-century physician, a favorite of Abbasid caliph al-Mu’tasim, taught the wisdom, “An ignorant physician instigates death.”[5]  An eleventh century Cairo-based physician mocked a fellow physician with this poem:

Abu 'l-Khair in the treatment of patients,
Has a hand that never fails.
Everyone seeking his assistance
Is buried after two days. [6]

Physicians commonly practiced bloodletting in response to a wide variety of symptoms.  Bloodletting is now generally regarded as harmful.  Physicians also commonly prescribed the medical concoction theriac for a wide variety of symptoms.  Theriac, which had diverse and semi-secret ingredients, probably hurt most patients more than it helped.

Physicians who considered themselves experts struggled to have their expertise recognized.  A physician working in twelfth-century Cairo wrote “an epistle on why it is difficult to find a competent physician and why ignoramuses are numerous”[7]  Al-Razi (Rhazes), who practiced as a physician in early tenth-century Baghdad and Rey (near Tehran), wrote a series of works indicating professional frustration and defensiveness:

• a treatise on the motives which drive most people to seek the worst physicians rather than the best
• a treatise on why simple folk despise the expert physician
• an epistle on compound causes, the blamelessness of the physician, and the like
• an epistle on maladies which are fatal because of their severity and because of their unexpected occurrence, factors that prevent the physician from combating them, and his blamelessness in this respect
• an epistle on the fact that even the expert physician cannot cure all illnesses,  for this would be an impossibility even for one with the skill of Hippocrates; but the physician deserves to be praised and thanked and the art of medicine glorified and honored, even though the physician cannot cure all illnesses even after he has risen above his contemporaries
• an epistle on the fact that the professional known by his profession is not to be found in the best fields, and not only in medicine; on the reason that the ignorant physicians, the boors and the women in the towns sometimes have more success in the treatment of certain maladies than the learned physicians, and the excusability of the latter

Al-Razi, who harshly criticized Islam, prophets, and revealed religion, engaged in extensive study of alchemy.  He thus contributed significantly to the scientific development of chemistry.  In retrospect, al-Razi’s expertise as a physician probably had little objective merit.

Ancient physicians’ wisdom has enduring value.  A physician who practiced in eleventh-century Toledo advised:

drugs should not be used when it is sufficient to have recourse to an alimentary regime or the like.  If it was absolutely necessary to employ drugs, he did not use compound ones {e.g. theriac} before trying the simple ones {e.g. an herb}.  If he was forced to use the compound drugs, he restricted himself to as small dosages as possible.[9]

A physician in seventh-century Alexandria similarly advised, “Put the drug aside as long as your body can bear the illness.”[10]  Human beings are wonderfully complex.  Medical knowledge, the pharmaceutical industry, and the medical profession remain imperfect.  Those realities should weigh in rational choice of medical treatment today.

*  *  *  *  *

Related posts:

• transforming medicine into a non-hereditary profession
• intellectual heritage of the Islamic world
• social reality of scholarly peer review

Notes:

[1] HP p. 301.  The previous quote above is from id.  In the translation, I have substituted the term pharmacist for the British-English term chemist.

[2] HP pp. 321-2.  The criticizing physician was Salmawayhi ibn Bunan.  According to Ishaq ibn Hunayn:

When Salmawayhi fell ill, al-Mu’tasin visited him and said, weeping: “Would you advise me what will be good for me after you have gone?”  Salmawayhi replied: “You are very dear to me, my master, but you must turn to that bore Yuhanna ibn Masawayhi.  When you complain of anything to him, and he prescribes different things for it, take the least complicated.”

Under treatment from Yuhann ibn Masawayhi, al-Mu’tasim died several months after Salmawayhi died.  HP pp. 315-6.  Yuhanna ibn Masawayhi’s treatment reportedly caused Salmawayhi’s death.

[3] HP p. 712 (advice of Ali ibn Ridwan).

[4] HP p. 504 (treatment of Awhad al-Zaman).  The ninth-century Persian physician al-Razi was known for saying:

A physician must always be encouraging to his patient abut his health and hope for it, even when he entertains doubts, for the state of the body follows that of the spirits.

[5] HP p. 532 (saying of Ibn Raban al-Tabari).

[6] HP p. 720 (poem of Jurjis from Antioch, called in the West Abu-l-Baida).  The mocked physician, Abu ‘l-Khair, was also known as Salama ibn Rahmun.

[7] HP p. 722 (epistle of Ibn al-Ainzarbi).

[8] HP pp. 547, 552.  Al-Razi’s frustration and concern about competitors also extended to his fellow physicians.  Among the sayings for which Al-Razi was known are these:

• The physicians who are ignorant and copiers and the young ones who have no experience and no knowledge, only desires, are all murderers.
• A patient must stick to one reliable physician only, for an error on his part, compared to his rightness, would be a trifling one.
• A patient who consults many physicians causes each one of them to fall into error.

HP p. 543.

[9] HP p. 637 (advice of Ibn Wafid).

[10] HP p. 222 (advice of Ibn Abjar).  Similar wisdom occurs in a saying attributed to the seventh-century physician Nafi ibn al-Harith: “Avoid the use of remedies as long as possible; take them only when it is absolutely necessary, for whatever their benefit, the harm they do is as great.”  HP p. 214.

Reference:

HP: Ibn Abi Usaybi’ah, Ahmad ibn al-Qasim. English translation of History of Physicians (4 v.) Translated by Lothar Kopf. 1971. Located in: Modern Manuscripts Collection, History of Medicine Division, National Library of Medicine, Bethesda, MD; MS C 294.

Tagged: Ibn Abi Usaibia

In his thirteenth-century History of Physicians, Ibn Abi Usaibia describes Hippocrates as transforming medicine into a non-hereditary profession.  According to Ibn Abi Usaibia’s history, Asclepius, the first physician, taught medical knowledge orally only to members of his family. That professional structure was not sufficient to preserve medical knowledge.  Hippocrates thus changed the transmission of medical knowledge:

Hippocrates, on seeing that medicine was on the verge of extinction, that its mark was being erased from the descendants of Asclepius (among whom he himself was included), sought to revive it by disclosing it to and propagating it among strangers and also by setting it down in books in order to establish it and make it widely known. [1]

The Hippocratic Oath supported a non-hereditary medical profession.   A person who recited the Hippocratic Oath declared:

I swear by Apollo Physician and Asclepius and Health {Hygieia} and Panacea and all the gods and goddesses, making them witnesses, that I will make complete this oath and this written covenant according to my ability and discernment .. {I swear to} make an imparting of the set of rules and lecture and all the rest of instruction to my sons and those of my teacher, and to those pupils who have been indentured and who have taken an oath according to the medical law, but to no one else. … [2]

Most of the Hippocratic Oath addresses proper practice of medicine.  Yet the oath itself, and a minor proviso within it, opened the medical profession to persons other than physicians’ sons.  In ancient regulations, as well as in modern ones, important changes are often buried in the details.

Ibn Abi Usaibia recognized the relationship between the Hippocratic Oath and the opening of the medical profession.  He listed under Hippocrates’ books:

“The Covenant,” also known as “The Book of Oaths.”  Hippocrates wrote this for his pupils and also for those they would treat, in order that they might be guided by it and not offend against the stipulation he therein imposed on them and in order to dispel by his statements the odium he incurred for transferring this art from hereditary transmission to free dissemination. [3]

Incumbents typically don’t favor entry into their field.  The Hippocratic Oath provided alternative regulation of entry in a way that was both open to more persons and that promoted proper professional practice.

The Hippocratic Oath probably didn’t govern access to medical books.  Writing is not necessarily associated with an open-access regime for knowledge.  Means other than the Hippocratic oath could have restricted access to medical books.  However, according to Ibn Abi Usaibia, Hippocrates wrote medical books to make medical knowledge widely known.   As a cosmopolitan physician, scholar, and writer in the thirteenth-century Islamic world, Ibn Abi Usaibia apparently regarded the preservation and dissemination of medical knowledge as an activity that did not just concern medical practitioners.  Throughout his History of Physicians, Ibn Abi Usaibia celebrates the development and dissemination of knowledge.  He understood that activity as an open, heroic human profession in which everyone should have an interest.

*  *  *  *  *

Notes:

[1]  HP p. 27.  Roger Pearse discovered this translation in the U.S. National Library of Medicine.  He is doing painstaking work to create a digital version.   Ibn Abi Usaibia’s work shows a vibrant intellectual culture spanning Europe, North Africa, and southwest Asia and encompassing knowledge from ancient Egypt, classical Greece, Rome, Judaism, Christianity, and Islam.  The U.S. government commissioned Kopf’s translation, which subsequently and sadly attracted no attention.  Advancing study and public discussion of Ibn Abi Usaibia’s work surely is an important contribution to the public interest.

[2] From Howard Herrell’s “literal translation” of the Hippocratic Oath from an early Greek manuscript.  Ibn Abi Usaibia preserves a version of the Hippocratic Oath edited to lessen its association with polytheism.  Ibn Abi Usaibia’s version of the Hippocratic Oath begins:

I swear by God, the master of life and death, the giver of health and the creator of healing and every cure, and I swear by Asclepius and by all those close to God, both men and women, making them all my witnesses, that I will keep this oath and pledge…

HP p. 49.  The Testament of Hippocrates, which Ibn Abi Usaibia includes, HP p. 51-2, restricts students of medicine to persons of “free birth, good nature, young age, medium stature, and well-proportioned limbs,” as well as describing other character requirements.  The Testament of Hippocrates probably dates to no earlier than the first century.  It does exist in ancient Greek and Latin manuscripts.  See Temkin (1991) p. 142, ft. 84.

[3] HP p. 65.

References:

HP: Ibn Abi Usaybi’ah, Ahmad ibn al-Qasim. English translation of History of Physicians (4 v.) Translated by Lothar Kopf. 1971. Located in: Modern Manuscripts Collection, History of Medicine Division, National Library of Medicine, Bethesda, MD; MS C 294.

Temkin, Owsei. 1991. Hippocrates in a world of pagans and Christians. Baltimore: Johns Hopkins University Press.

Tagged: Ibn Abi Usaibia