Everything about The Canon Of Medicine totally explained
The Canon of Medicine (original title in
Persian:
Qanun" which translates to The Law of Medicine
),قانون, is a 14-volume Persian medical encyclopedia written by the Persian Muslim scientist and physician Ibn Sīnā (Avicenna) and completed in 1025. Written in Arabic, the book was based on a combination of his own personal experience, medieval Islamic medicine, the writings of the Greek physician Galen, the Indian physicians Sushruta and Charaka, and ancient Arabian and Persian medicine. The Canon
is considered one of the most famous books in the history of medicine.
Also known as the Qanun, which means "law" in
Arabic and
Persian, the
Canon of Medicine remained a
medical authority up until the 18th century and early 19th century. It set the standards for medicine in
Europe and the
Islamic world, and is Avicenna's most renowned written work.
Qanun was used at many medical schools—at
University of Montpellier,
France, as late as 1650. The principles of medicine described by him ten centuries ago in this book, are still taught at
UCLA and
Yale University, among others, as part of the history of medicine.
Among other things, the book is known for the introduction of systematic
experimentation and
quantification into the study of
physiology,
the discovery of the contagious nature of
infectious diseases,
randomized controlled trials,
efficacy tests,
clinical pharmacology,
neuropsychiatry,
George Sarton, the father of the
history of science, wrote in the
Introduction to the History of Science:
Overview
The book explains the causes of
health and
disease. Ibn Sina believed that the
human body can't be restored to health unless the causes of both health and disease are determined. Ibn Sina stated that medicine (
tibb) is the
science by which we learn the various states of the human body when in health and when not in health, and the means by which health is likely to be lost, and when lost, is likely to be restored. In other words, medicine is the science whereby health is conserved and the art whereby it's restored after being lost.
Avicenna regarded the causes of good health and diseases to be:
- The Material Causes
- The Elements
- The Humors
- The Variability of the Tumors
- The Temperaments
- The Psychic Faculties
- The Vital Force
- The Organs
- The Efficient Causes
- The Formal Causes
- The Vital Faculties
- The Final Causes
The
Qanun distinguishes
mediastinitis from
pleurisy and recognises the
contagious nature of phthisis (
tuberculosis of the lung) and the spread of disease by water and soil. It gives a scientific
diagnosis of
ankylostomiasis and attributes the condition to an intestinal worm. The
Qanun points out the importance of
dietetics, the influence of
climate and
environment on health, and the surgical use of oral
anaesthetics. Ibn Sina advised
surgeons to treat
cancer in its earliest stages, ensuring the removal of all the diseased tissue.
Clinical pharmacology
The
Canon laid out the following rules and principles for testing the effectiveness of new
drugs and
medications, which still form the basis of
clinical pharmacology
Pharmaceutical sciences
Avicenna's contribution to the
pharmaceutical sciences include the introduction of systematic experimentation and quantification into
pharmacology and the study of physiology,
and the discovery of the
healing property of gaseous
mercury besides its
poisonous quality;
Pharmacotherapy
Avicenna wrote a separate supplement treatise dedicated to the
pharmacotherapy of "Hindiba", a compound drug he suggested for the treatment of
cancer and other
tumors (see
Cancer therapy below) and which could also be used for treating other
neoplastic disorders. He gives details on the drug's properties and uses, and then gives instructions on its preparation as
medication.
Writings on
anatomy in the
Canon are scattered throughout the text in sections regarding to illnesses related to certain body parts. The
Canon included numerous discussions on anatomy and diagrams on certain body parts, including the first diagrams of the
cranial sutures.
Blood pressure
Avicenna dedicated a chapter of the
Canon to
blood pressure. He was able to discover the causes of
bleeding and heamorrhage, and discovered that heamorrhage could be induced by high blood pressure because of higher levels of
cholesterol in the blood. This led him to investigate methods of controlling blood pressure.
Neuroanatomy and neurophysiology
Avicenna discovered the
cerebellar vermis—which he named "vermis"—and the
caudate nucleus, which he named "tailed nucleus" or "nucleus caudatus". These terms are still used in modern
neuroanatomy and
neurophysiology.
Ophthalmology
Avicenna's contributions to
ophthalmology in medieval Islam include his descriptions and explanations on the physiology of
eye movements, which still forms a basis of information for modern
ophthalmology. He also provided useful information on the
optic nerves,
iris, and central and peripheral
facial paralyses. Galen also erroneously believed that "every part of an
artery pulsates simultaneously" and that the motion of the pulse was due to natural motions (the arteries expanding and contracting naturally) as opposed to foced motions (the
heart causing the arteries to either expand or contract).
The first correct explanation of pulsation was given by Avicenna, after he refined Galen's theory of the pulse and discovered the following in
The Canon of Medicine:
Avicenna also wrote a treatise on diagnosing diseases using only the methods of feeling the pulse and observing
inhalation. He was often capable of finding the symptoms of certain diseases only by feeling a patient's pulse.
Avicenna also distinguished between
mediastinitis and
pleurisy, provided careful descriptions of skin troubles,
perversions, and
nervous ailments."
Since the
Canon,
Bimaristan hospitals were created with separate wards for specific
illnesses, so that people with contagious diseases could be kept away from other patients who don't have any contagious diseases.
Bacteriology and microbiology
The
Canon stated that bodily
secretions are contaminated by "foul foreign earthly bodies" before a person becomes infected, but he didn't view these bodies as primary causes of
disease.
Cancer therapy
In
cancer therapy, Avicenna recognized
cancer as a
tumor. He noted that a "cancerous tumour progressively increases in size, is destructive and spreads roots which insinuate themselves amongst the tissue elements." He also attempted the earliest known treatments for cancer. One method he discovered was the "Hindiba", a herbal compound drug which
Ibn al-Baitar later identified as having "anticancer" properties and which could also treat other
tumors and
neoplastic disorders. After recognizing its usefulness in treating neoplastic disorders, Hindiba was
patented in 1997 by Nil Sari, Hanzade Dogan, and John K. Snyder.
Another method for treating cancer first described by Avicenna was a surgical treatment. He stated that the
excision should be radical and that all diseased
tissue should be removed, which included the use of
amputation or the removal of
veins running in the direction of the
tumor. He also recommended the use of
cauterization for the area being treated if necessary.
Hepatology
Avicenna's advances in
hepatology include his introduction of new methods of
hepatitis treatment. One such
case study is when a prince of Persia had melancholia and suffered from the
delusion that he's a
cow, and who would low like a cow crying "Kill me so that a good stew may be made of my flesh" and would never eat anything. Avicenna was persuaded to the case and sent a message to the patient, asking him to be happy as the butcher was coming to slaughter him, and the sick man rejoiced. When Avicenna approached the prince with a knife in his hand, he asked "where is the cow so I may kill it." The patient then lowed like a cow to indicate where he was. "By order of the butcher, the patient was also laid on the ground for slaughter." When Avicenna approached the patient pretending to slaughter him, he said, "the cow is too lean and not ready to be killed. He must be fed properly and I'll kill it when it becomes healthy and fat." The patient was then offered food which he ate eagerly and gradually "gained strength, got rid of his delusion, and was completely cured."
Among the many other
psychological disorders that he described in the
Qanun, one is of unusual interest:
love sickness. Ibn Sina is reputed to have diagnosed this condition in a Prince in Jurjan who lay sick and whose malady had baffled local doctors. Ibn Sina noted a fluttering in the Prince's pulse when the address and name of his beloved were mentioned. The great doctor had a simple remedy: unite the sufferer with the beloved.
Neurology and neuropathology
Avicenna's contributions in
neurology and
neuropathology include his diagnosis of
facial nerve paralysis, his distinction between brain
paralysis and
hyperaemia, and most importantly his discovery of
meningitis. He diagnosed meningitis as a disease induced by the
brain itself and differentiated it from infectious brain disease, and was also able to diagnose and describe the type of meningitis induced by an infection in other parts of the body. Avicenna dedicated three chapters of
The Canon of Medicine to neuropsychiatry.
He defined
madness (
Junun) as a mental condition in which
reality is replaced by
fantasy, and discovered that it's a disorder of
reason with its origin in the middle part of the
brain. He also discovered a condition resembling
schizophrenia which he described as
Junun Mufrit (severe madness), which he clearly distinguished from other forms of madness such as
mania,
rabies, and
manic depressive psychosis. He observed that patients suffering from schizophrenia-like severe madness show
agitation, behavioural and sleep disturbance, give inappropriate answers to questions, and in some cases are incapable of speaking at times. He wrote that such patients need to be restrained, in order to avoid any harm they may cause to themselves or to others.
Avicenna also dedicated a chapter of the
Canon to
mania and
rabies, where he described mania as bestial madness characterized by rapid onset and
remission, with
agitation and
irritability, and described rabies as a type of mania.
Psychophysiology and psychosomatic medicine
Ibn Sina was a pioneer in
psychophysiology and
psychosomatic medicine, and the first to recognize '
physiological psychology' in the treatment of illnesses involving
emotions, and developed a system for associating changes in the
pulse rate with inner feelings, which is seen as an anticipation of the
word association test attributed to
Carl Jung. Avicenna identified
love sickness (
Ishq) when he was treating a very ill patient by "feeling the patient's pulse and reciting aloud to him the names of provinces, districts, towns, streets, and people." He noticed how the patient's pulse increased when certain names were mentioned, from which Avicenna deduced that the patient was in love with a girl whose home Avicenna was "able to locate by the digital examination." Avicenna advised the patient to marry the girl he's in love with, and the patient soon recovered from his illness after his marriage.
Avicenna also gave psychological explanations for certain
somatic illnesses, and he always linked the physical and psychological illnesses together. He described
melancholia (
depression) as a type of
mood disorder in which the person may become suspicious and develop certain types of
phobias. He stated that
anger heralded the transition of melancholia to
mania, and explained that
humidity inside the head can contribute to mood disorders. He recognized that this occurs when the amount of
breath changes:
happiness increases the breath, which leads to increased moisture inside the brain, but if this moisture goes beyond its limits, the brain would lose control over its
rationality and lead to mental disorders. He also wrote about symptoms and treatments for
nightmare,
epilepsy, and weak
memory.
Surgery
In
surgery, Avicenna was the first to describe the surgical procedure of
intubation in order to facilitate
breathing.
Other contributions
Chromotherapy
Avicenna, who viewed colour to be of vital importance in
diagnosis and
treatment, made significant contributions to
chromotherapy. He wrote that "Color is an observable symptom of disease" and also developed a chart that related colour to the
temperature and physical condition of the body. His view was that red moved the blood, blue or white cooled it, and yellow reduced muscular pain and inflammation. He further discussed the properties of colours for healing and was "the first to establish that the wrong colour suggested for therapy would elicit no response in specific diseases." As an example, "he observed that a person with a nosebleed shouldn't gaze at things of a brilliant red color and shouldn't be exposed to red light because this would stimulate the humor, whereas blue would soothe it and reduce blood flow."
Phytotherapy
In
phytotherapy, Avicenna introduced the medicinal use of
Taxus baccata L. He named this herbal
drug as "Zarnab" and used it as a
cardiac remedy. This was the first known use of a
calcium channel blocker drug, which were not used in the
Western world until the 1960s.
Temperaments
The Canon of Medicine adopted the ancient theory of
Four Humours and
Four Temperaments and extended it to encompass "
emotional aspects,
mental capacity,
moral attitudes,
self-awareness, movements and
dreams." Avicenna summarized his own theory of four
temperaments in a
table presented as follows:
[
]
| Avicenna's four primary temperaments |
| Evidence |
Hot |
Cold |
Moist |
Dry |
| Morbid states |
inflammations become febrile |
fevers related to serious humour, rheumatism |
lassitude |
loss of |
| Functional power |
deficient energy |
deficient digestive power |
difficult digestion |
|
| Subjective sensations |
bitter taste, excessive thirst, burning at cardia |
Lack of desire for fluids |
mucoid salivation, sleepiness |
insomnia, wakefulness |
| Physical signs |
high pulse rate, lassitude |
flaccid joints |
diarrhea, swollen eyelids, rough skin, acquired habit |
rough skin, acquired habit |
| Foods & medicines |
calefacients harmful, infrigidants beneficial |
infrigidants harmful, calefacients beneficial |
moist articles harmful |
regimen harmful, humectants beneficial |
| Relation to weather |
worse in summer |
worse in winter |
|
bad in autumn |
Further Information
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