By Syed Aslam
Abu Qasim ibn al-Zahrawi also known in west as Abulcasis was born in the town of al-Zahra, close to Cordoba, Spain, in the year 993CE. His ancestors were Ansar Arabs who settled in Spain in the eighth century. He lived most of his life in Cordoba, where he received his education. After his education he taught and practiced medicine and surgery in Cordoba and became the physician of Caliph al-Hakim II. He died at Cordoba in the year 1064 CE. The street where he lived is named after him (Calle Albucasis), and his house has been preserved by the Spanish Government in his honor.
Al-Zahrawi is considered the father of modern surgery. A physician and surgeon, he also had an interest in chemistry and cosmetology. His 30 volume encyclopedia of medical practices Kitab al-Tasrif is considered his greatest contribution in the field of medicine and surgery. The encyclopedia included a large section on surgery and also covered medical topics such as orthopedics, pharmacology, ophthalmology, nutrition, dentistry and childbirth.
Al-Zahrawi emphasized the importance of a good doctor patient relationship and took great care to ensure the safety of his patients and win their trust irrespective of their social status. His clinical methods showed foresight and promoted the close observation of patients. He warned against dubious practices adopted by some physicians for purposes of material gain and warned against deviation from medical ethics. He also cautioned against quacks who claimed surgical skills they did not possess. His treatise contains many original observations of great interest in the field of medicine. He has given great importance to the causes and symptoms of diseases.
Two volumes of his treatise are very important, dealing with materia medica, like weights, measures, and drug substitution. In the area of pharmacology and therapeutics he discussed cardiac drugs, emetics, laxatives, cosmetology etc. In other treatise he describes the preparations of medicine by the extraction from different herbs, tablet making, chemical preparation of medicine and other related pharmaceutical techniques which included sublimation and distillation.
The most important treatise is the one which deals with surgery and surgical instruments. This monumental work was unique, in it al-Zahrawi provided illustrations of the instruments used in surgery. He invented all the instruments himself, two hundred of them, and explained their use. The instruments included tooth extractors, tong depressors, catheters, and an elaborate obstetric device, to name a few. He discussed a variety of operations which included cauterization, bloodletting, midwifery, obstetrics and the treatment of wounds.
He described the exposure and division of the temporal artery to relieve certain types of headaches, and the extraction of cataracts from the eyes. He wrote extensively about injuries of bones and joints, fractures of the nasal bones, and the vertebrae. In fact â€˜Kocherâ€™s methodâ€™ for fixing a dislocated shoulder was explained by al-Zahrawi long before Kocher was even born. He outlined the use of caustics in surgery, fully described tonsillectomy and tracheotomy operations he had performed. He explained how to use a hook to extract a polyp from the nose, how to use a bulb syringe he had invented for giving enemas to children, how to use a metallic bladder syringe and speculum to extract bladder stones. He discussed of non-aligned teeth and showed a way to correct them. He also developed the technique of replacing defective teeth with artificial teeth.
Al-Zahrawi was the first to describe the Welcher position in obstetrics, first to describe dental arches, first to explain the hereditary circumstances surrounding hemophilia, first to write about ectopic pregnancy and the first to use forceps which he invented for the delivery of babies and removal of a dead fetus.
Al-Zahrawi invented the surgical needle, and described its use. He used catgut (cord made from intestines of sheep and goat) for the first time for internal stitching–which is still used in modern surgery. Catgut is the only natural substance capable of dissolving and acceptable to the human body.
There is no doubt that al-Zahrawi was a rare genius in the field of medicine. His treatise was translated into Latin in the 12th century and became the standard book in the universities of Europe for 500 years. His book was the primary source of medical knowledge of surgery for the physicians of Europe and thus had a huge influence on them in the practice of surgery. A 14th century French surgeon–Guy de Chauliac–quoted Al-Tasrif over 200 times in his book; The Great Surgery. Pietro Argallata, a 15th century European surgeon, says of him â€œwithout doubt he was the chief of all surgeons.â€ Jaques Delechamps, another 16th century French surgeon made extensive use of his treatise in his elaborate commentary, confirming the tremendous contributions of al-Zahrawi in the field of surgery.