Ophthalmology

Eye Specialists in Islam

Dr Ibrahim Shaikhemail: info@fstc.co.uk

Professor J Hirschberg, a renowned German eye ophthalmologist, addressed the American Medical Association, California, on 11-14th July 1905. The subject of his work "Arab Ophthalmologists" or occulist. He began:

"I invite you... to go back with me 1000 years to consider the fascinating history of the Arabian Ophthalmology which I have studied in the past five years.

Two questions at first must be addressed:

What were the sources of information at the disposal of these Arab Ophthalmologists?

What is the contribution of the Arabian work in ophthalmology?

One of the outstanding classical works "Memorial of Ophthalmology" written by Ali Ibn Isa (1000 CE) was compiled from Greek material "The Ten Treatises of the Eye" of Galen and he added new knowledge." An eye specialist is known in Arabic as Al-Kahhal from the word Kuhl (Kollyre). Hirschberg considered this work to be as important as the contribution of the Muslims to the Mosque of Cordoba (Spain). The textbook of Kalifah (written around 1260 C.E) lists eighteen works on Ophthalmology. Muslims in just 250 years produced eighteen written works on ophthalmology. Whilst the Greek work from Hippocrates to Paulus, spanning one thousand years, produced only five books on this subject. In all there are some thirty ophthalmology textbooks produced by the Muslims. The most important of these were written by specialists and infact fourteen still exist today. Hirschberg then went on to mention some of the more notable names and gave an account of their work.

ALI IBN ISA

The most famous of all the occulists of Islam was born in Baghdad (Iraq). His work, "Tazkiratul-Kahhaleen" (Notebook of the Occulist), the best and most complete text book on diseases of the eye, was translated with commentary into German by Hirschberg and Lippert (1904) and into English by Casey Wood (1936). Isa's book was the most widely referred to textbook by later ophthalmologists. It was first translated into Persian and then into Latin and printed in Venice in 1497 C.E. Famous contemporaries of Isa Ibn Ali were Ammar Ibn Ali Al-Mosuli (see below) and Abul Hasan Ahmed Ibn Muhammad Al-Tabari who in his work "Kitab-ul Mu'Alaja-ul Buqratiyya" (Book of Hippocratic Treatment) says that he wrote a long treatise on diseases of the eye. Unfortunately this treatise is no longer available.

AMMAR IBN ALI AL-MOSULI

Ammar, from Mosul in Iraq, fluorished around 1010 C.E. He wrote a book entitled "Kitab-ul Muntakhab fi Ilaj-ul ‘Ayn" (Book of Choices in the Treatment of Eye Diseases) and practiced mainly in Egypt. His book deals with anatomy, pathology and describes six case histories for cataract operation and a case of optic neuritis! Hirschberg writes that Ammar was "The most clever eye surgeon of the whole Arabian Literature". Ammar discussed some 48-eye diseases in a short work of about 1500 words (the shortest work of its kind). This manuscript (No. 894) can be found in the Escorial Library in Madrid (Spain). Although shorter than the book of Isa Ibn Ali it contains many more original remarks and observations. Until the 20th century Ammar's work was only available in Arabic and a Hebrew translation made by Nathan the Jew in the 13th century. This work was translated into German by professor J Hirschberg in 1905. Ammar was the inventor of the cataract operation by suction, using a fine hollow needle inserted through the limbus (where the cornea joins the conjunctiva). This was the best-performed operation of its time. This type of cataract operation among others is still carried out today. The operation of "couching" i.e. violent displacement of the lens dates back to Babylonian times, but this had its obvious complications and risks. Ammar throughout his work, as a surgeon and researcher, never forgot that he was a Muslim first and scientist second. This is seen by his compassionate attitude towards his patients. On his travels he fulfilled his religious duties, visiting Medina and performing Hajj at Makkah.

ZARRINDAST (Gold Hand)

Abu Ruh Muhammad Ibn Mansur Bin Abdullah , otherwise known as Al-Jurjani, an excellent surgeon from Persia who fluorished around 1088 C.E., wrote a book, entitled "Nur-ul-'Ayun" (The Light of the Eyes). The book, much of which is original, was written during the reign of Sultan Malikshah and consists of ten chapters. In the seventh chapter he describes some 30-eye operations including 3 types of cataract operation. He also deals with anatomy and physiology of the eye and eye diseases. One chapter is devoted to eye diseases which can be seen such as cataract, trachoma, scleral and corneal diseases and problems of the eyelids. Another chapter deals with diseases that lie hidden (the signs are exhibited in the eye and vision but the cause may be elsewhere) i.e. 3rd nerve paralysis, blood disorders, toxicity etc. The book mentions curable and incurable diseases and gives methods of treatment. A large section is about surgery of the eye. There is section on drugs employed by the occulists.

Another name mentioned by Hirschberg in his address to the American Medical Association (1905) was Abu Muttarif from Seville (Spain) who flourished around the 11th century. Besides being an eye specialist he was also a Wazir. Unfortunately, his work is entirely lost.

AL-GHAFIQI

Muhammad Ibn Qassoum Ibn Aslam Al-Ghafiqi or simply known as Al-Ghafiqi (died 1165 C.E), also from Spain, wrote a book in the 12th century called "Al-Murshid fil Kuhl" (The Right Guide in Ophthalmology). The book is not just confined to the eye but gives details of the head and diseases of the brain. Al-Ghafiqi used Ammar's treatise as a reference for his work. Today a tourist visiting Cordoba can see the commemorated bust of Muhammad Al-Ghafiqi, a tribute paid from the people of Cordoba to an outstanding Muslim eye specialist. The bust with full Arab Ammama can be seen in the quadrangle of a municipal hospital in Cordoba, Spain. It was erected in 1965 to commemorate the eight hundredth anniversary of his death.

KALIFAH of Haleb

Kalifah Ibn Al-Mahasin of Allepo or Haleb (Syria) who flourished around 1260 CE wrote a book of 564 pages in which he describes and gives drawings of various surgical instruments including 36 instruments for eye surgery. He also discusses the visual pathways between the eye and the brain. He also writes about twelve kinds of cataract operations. The term for cataract in Arabic is Al-Ma' Nazul Ayn. Ma' means water or water descending onto the eye i.e. water accumulates in the lens and it becomes "soggy" thus making it cloudy. This cloudiness is sucked out by the use of hollow needle, thus the cataract is removed and the patient is once again able to see.

SALAHUDDIN

Salahuddin Ibn Yusuf from Hammah (Syria) in 1290 C.E. wrote a book called "The Light of the Eyes" in which he discussed new work on the optical theory of vision. He also quoted many extracts from Ammar's treatise. He did work on the eye from a more general medical point of view, as did other notables such as Az-Zahrawi, Ibn Zuhr and Ibn Rushd.

IBN HAITHAM

Ibn Haitham born in 965 C.E. was the first to explain that all vision was made possible because of refraction of light rays (see Islamic Banner issue no. 12 "Newton or Ibn Haitham"). The work of Ibn Haitham was repeated and expanded upon by a Persian by the name of KAMAL-UDDIN (died 1320 C.E) who observed the path of rays of light in the interior of a glass sphere in order to examine the refraction of sunlight in rain drops. This led him to an explanation of the genesis of primary and secondary rainbows.

"From 800-1300 C.E. the World of Islam produced not less than 60 renowned Eye Specialists or Occulists, authors of textbooks and producers of monographs in Ophthalmology. Meanwhile in Europe prior to the 12th century an Occulist was unheard of." Hirschberg

Professor J. Hirschberg told this to an enthralled audience at the American Medical Association. It was not until the 18th century that the method of removal of cataract by a hollow needle was employed in Europe.

The Muslims produced many original works on the anatomy of the eye. Their studies were, however, limited because they carried out their observations only on animal eyes. The dissection of any part of the human body was considered disrespectful in principle. These works give us the oldest pictures of the anatomy of the eye.

The original work of the Arabs includes the introduction of terms such as Eyeball, Conjunctiva, Cornea, Uvea and Retina. Muslims also did operations on diseases of the lids such as Trachoma, a hardening of the inside of the lid. Glaucoma (an increase in the intra-ocular pressure of the eye) under the name of "Headache of the pupil" was first described by an Arab. However, the greatest single contribution, in ophthalmology, by the Arabs was in the matter of cataracts.
According to the Journal of the American Medical Association (1935) there is, in the Vatican Library, a unique manuscript ascribed to Ibn Nafis, died in 1288 C.E (see Islamic Banner issue no.24 "Pulmonary Circulation") entitled "Kitab-ul Muhazzab fi Tibb-il ‘Ayn" (A Book of Corrections in the Medicine of the Eye). It contains a description of the eyes of animals and a discussion on the varieties and colours of the human eye. Ibn Nafis died in 1288 C.E.

Gerard of Cremona in Toledo (Spain) spent 40 years of his life (1147-1187 C.E.) translating the work of Muslims including the works of Ar-Razi and Ibn Sina. This fact has been attributed on a Spanish postal stamp. Arab physicians have been in the forefront of the effort to prevent blindness since 1000 C.E, when Ar-Razi became the first doctor to describe the reflex action of the pupil. At about the same time, Ammar Bin Ali Al-Mosuli invented the technique of suction removal of cataracts by the use of a hollow needle." (Optometry Today, publication of the Association of Optometrists, England, March 28, 1987)

Professor J Hirschberg concluded his address to the American Medical Association with the words:
"During this total darkness in medieval Europe they (the Arab Muslims) lighted and fed the lamps of our science (ophthalmology) - from the Guadalquivir (in Spain) to the Nile (in Egypt) and to the river Oxus (in Russia). They were the only masters of ophthalmology in medieval Europe." Professor J. Hirschberg.

So we can see from Hirschberg's work that the Muslim Ophthalmologists of the 10th-13th century were many hundreds of years ahead of their time.

by: Dr. Ibrahim Shaikh, Thu 20 December, 2001