Ophthalmology in medieval Islam

An Arabic manuscript, dated 1200CE, titled Anatomy of the Eye, authored by al-Mutadibih.

Ophthalmology was one of the foremost branches in medieval Islamic medicine. The oculist or kahhal (کحال), a somewhat despised professional in Galen’s time, was an honored member of the medical profession by the Abbasid period, occupying a unique place in royal households. Medieval Islamic scientists (unlike their classical predecessors) considered it normal to combine theory and practice, including the crafting of precise instruments, and therefore found it natural to combine the study of the eye with the practical application of that knowledge.^[1] The specialized instruments used in their operations ran into scores. Innovations such as the “injection syringe”, a hollow needle, invented by Ammar ibn Ali of Mosul, which was used for the extraction by suction of soft cataracts, were quite common.

Muslim physicians described such conditions as pannus, glaucoma (described as ‘headache of the pupil’), phlyctenulae, and operations on the conjunctiva. They were the first to use the words 'retina' and 'cataract'.

Education and history

To become a practitioner, there was no one fixed method or path of training. There was even no formal specialization in the different branches of medicine, as might be expected. But some students did eventually approximate to a specialist by acquiring proficiency in the treatment of certain diseases or in the use of certain drugs.

Nevertheless, it was standard and necessary to learn and understand the works and legacy of predecessors. Among those one can mention, The alteration of the eye by Yuhanna ibn Masawayh, whose work can be considered the earliest work on Ophthalmology, followed by Hunain ibn Ishaq, known in the west as Johannitius, for his work The ten treatises of the eye. One of Hunain ibn Ishaq's innovations was to describe the crystalline lens as being located in the exact center of the eye.^[2]

Cataract extraction

The next major landmark text on ophthalmology was the Choice of Eye Diseases written in Egypt by the Iraqi Ammar bin Ali Al Mawsili who attempted the earliest extraction of cataracts using suction. He invented a hollow metallic syringe, which he applied through the sclerotic and successfully extracted the cataracts through suction. He wrote the following on his invention:

"Then I constructed the hollow needle, but I did not operate with it on anybody at all, before I came to Tiberias. There came a man for an operation who told me: Do as you like with me, only I cannot lie on my back. Then I operated on him with the hollow needle and extracted the cataract; and he saw immediately and did not need to lie, but slept as he liked. Only I bandaged his eye for seven days. With this needle nobody preceded me. I have done many operations with it in Egypt."^[3]

Other contributions

Avicenna, in The Canon of Medicine (c. 1025), described sight as one of the five external senses.^[4] The Latin word "retina" is derived from Avicenna's Arabic term for the organ.^[5]

In his Coliget, Averroes (1126–1198) was the first to attribute photoreceptor properties to the retina,^[6] and he was also the first to suggest that the principle organ of sight might be the arachnoid membrane (aranea). His work led to much discussion in 16th century Europe over whether the principle organ of sight is the traditional Galenic crystalline humour or the Averroist aranea, which in turn led to the discovery that the retina is the principle organ of sight.^[7]

Ibn al-Nafis wrote a large textbook on ophthalmology called The Polished Book on Experimental Ophthalmology. The book is divided into two sections: "On the Theory of Ophthalmology" and "Simple and Compunded Ophthalmic Drugs".^[8] Other significant works in medieval Islamic ophthalmology include Rhazes’ Continens, Ali ibn Isa al-Kahhal’s Notebook of the Oculists, and the ethnic Assyrian Christian Jibrail Bukhtishu’s Medicine of the Eye, among numerous others.

Ottoman Empire

In the Ottoman Empire, and well into the Republic of Turkey of the 20th century, a class of ambulatory eye surgeons, popularly known as the ‘kırlangıç oğlanları’ (‘sons of the swallow’) operated on cataract using special knives. From contemporary sources can be glimpsed that the reputation of these “blinding frauds” was far from spotless.^[9]

Notes

↑ David C. Lindberg (1980), Science in the Middle Ages, University of Chicago Press, p. 21, ISBN 0-226-48233-2
↑ Leffler CT, Hadi TM, Udupa A, Schwartz SG, Schwartz D (2016). "A medieval fallacy: the crystalline lens in the center of the eye". Clinical Ophthalmology. 2016 (10): 649–662.
↑ Finger, Stanley (1994), Origins of Neuroscience: A History of Explorations Into Brain Function, Oxford University Press, p. 70, ISBN 0-19-514694-8
↑ Finger, Stanley (1994), Origins of Neuroscience: A History of Explorations Into Brain Function, Oxford University Press, p. 71, ISBN 0-19-514694-8
↑ Finger, Stanley (1994), Origins of Neuroscience: A History of Explorations Into Brain Function, Oxford University Press, p. 69, ISBN 0-19-514694-8
↑ Martin-Araguz, A.; Bustamante-Martinez, C.; Fernandez-Armayor, Ajo V.; Moreno-Martinez, J. M. (2002). "Neuroscience in al-Andalus and its influence on medieval scholastic medicine", Revista de neurología 34 (9), p. 877-892.
↑ Lindberg, David C. (1981), Theories of Vision from Al-kindi to Kepler, University of Chicago Press, p. 238, ISBN 0-226-48235-9
↑ Albert Z. Iskandar, "Ibn al-Nafis", in Helaine Selin (1997), Encyclopaedia of the History of Science, Technology, and Medicine in Non-Western Cultures, Kluwer Academic Publishers, ISBN 0-7923-4066-3.
↑ Laban Kaptein (ed.), Ahmed Bican, Dürr-i meknûn, p. 31f. Asch 2007. ISBN 978-90-902140-8-5

References

Ibn Abi Usaybi’ah, Uyun ul-Inba’ fi Tabaqat ul-Atibba, Cairo 1882.
Nizami Arudhi, Chahar Maqalah. Gibb Series. London, 1921.
Zeylessouf-ed-douleh, Matrah ul-anzār. Tabriz, 1916.
Bar Hebraeus, Historia Dynastiarum, Edward Pococke's edition, Oxford 1663.
M. Brett, W. Foreman. The Moors: Islam in the west. 1980.
Cyril Elgood. A Medical history of Persia and the eastern caliphate : the development of Persian and Arabic medical sciences, from the earliest times until the year A.D. 1932. 1979.
Casey Wood. Memorandum book of a tenth-century oculist for the use of modern ophthalmologists : a translation of the Tadhkirat of Ali ibn Isa of Baghdad (cir. 940-1010 CE).

7th century	Al-Harith ibn Kalada and his son Abu Hafsa Yazid Bukhtishu Masarjawaih Ibn Abi Ramtha al-Tamimi Rufaida Al-Aslamia Ibn Uthal

8th century	Bukhtishu family Ja'far al-Sadiq

9th century	Ali al-Ridha Albubather Bukhtishu family Jabril ibn Bukhtishu Jābir ibn Hayyān Hunayn ibn Ishaq and his son Yahya ibn Sarafyun Al-Kindi Masawaiyh Shapur ibn Sahl Ali ibn Sahl Rabban al-Tabari Al-Ruhawi Yuhanna ibn Bukhtishu Salmawaih ibn Bunan

10th century	Qusta ibn Luqa Abu ul-Ala Shirazi Abul Hasan al-Tabari Al-Natili Qumri Abu Zayd al-Balkhi Isaac Israeli ben Solomon 'Ali ibn al-'Abbas al-Majusi Abu Sahl 'Isa ibn Yahya al-Masihi Muvaffak Muhammad ibn Zakariya al-Razi Ibn Juljul Al-Tamimi, the physician Abu al-Qasim al-Zahrawi Ibn al-Jazzar Al-Kaŝkarī Ibn Abi al-Ashʿath Ibn al-Batriq Ibrahim ibn Baks

11th century	Abu 'Ubayd al-Juzjani Ibn al-Haytham Al-Biruni Ali ibn Ridwan Avicenna Ephraim ibn al-Za'faran Ibn al-Wafid Abdollah ibn Bukhtishu Ibn Butlan Ibn al-Kattani Ibn Jazla Masawaih al-Mardini Ali ibn Yusuf al-Ilaqi Ibn Al-Thahabi Ibn Abi Sadiq Ali ibn Isa al-Kahhal

12th century	Abu al-Bayan ibn al-Mudawwar Ahmad ibn Farrokh Ibn Hubal Zayn al-Din Gorgani Maimonides Serapion the Younger Ibn Zuhr Ya'qub ibn Ishaq al-Israili Abu Jafar ibn Harun al-Turjali Averroes Ibn Tufail Al-Ghafiqi Ibn Abi al-Hakam Abu'l-Barakāt al-Baghdādī Al-Samawal al-Maghribi Ibn al-Tilmīdh Ibn Jumay‘

13th century	Sa'ad al-Dawla Al-Shahrazuri Rashidun al-Suri Amin al-Din Rashid al-Din Vatvat Abraham ben Moses ben Maimon Da'ud Abu al-Fadl Al-Dakhwar Ibn Abi Usaibia Joseph ben Judah of Ceuta Abd al-Latif al-Baghdadi (medieval writer) Ibn al-Nafis Zakariya al-Qazwini Najib ad-Din-e-Samarqandi Qutb al-Din al-Shirazi Ibn al-Quff

14th century	Muhammad ibn Mahmud Amuli Al-Nagawri Aqsara'i Zayn-e-Attar Mansur ibn Ilyas Jaghmini Mas‘ud ibn Muhammad Sijzi Najm al-Din Mahmud ibn Ilyas al-Shirazi Nakhshabi Sadid al-Din al-Kazaruni Yusuf ibn Ismail al-Kutubi Ibn al-Khatib Rashid-al-Din Hamadani

15th century	Abu Sa'id al-Afif Muhammad Ali Astarabadi Husayni Isfahani Burhan-ud-din Kermani Şerafeddin Sabuncuoğlu Muhammad ibn Yusuf al-Harawi Nurbakhshi Shaykh Muhammad ibn Thaleb

16th century	Hakim-e-Gilani Abul Qasim ibn Mohammed al-Ghassani Taqi ad-Din Muhammad ibn Ma'ruf Dawud al-Antaki

Concepts

Works

Centers

Influences

Ancient Greek medicine

Influenced

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