ARABIC MEDICINE AND GREEK MEDICINE IN ROME.*

NEVER more than at the present time, when a heady ferment is working among mankind and threatening with destruction thoughts and ideals and the product of centuries of struggle, was the calming, clarifying influence of history to be desired. This need of historical knowledge is to be detected everywhere, not least in medicine, which has made such wondrous strides • (1) Arabian Medicine. FitzPatrick Lectures, 1919-1920. By Edward G. Browne, H.S., F.B.C.P. Cambridge : at the University Press. [12s. netty (2) Greek Medicine in Rome. FltzPatrick Lectures, 1999-1910. By the t lion. Sir T. Clifford Allbut, K.C.B.. M.A.. M.D.. F.R.C.P.. F.R.S., tte., c. London: DtamtUan. net.1 during the past seventy years that the medical student is threat- ened with mental dyspepsia, or, should he escape that, is prone to overestimate medicine's advance and in rash over-confidence to fall into many a pitfall which a consideration of the lessons of history might have enabled him to avoid. Until recently, however, medical history has been much neglected by the medical profession ; and in view of the dryness of many of the modern historical compilations, excellent as they may be as books of reference, one cannot be altogether surprised at this state of affairs. An accusation of dryness could not be justly brought against the authors of these two groups of FitzPatrick lectures ; certainly by no stretch of imagination could one describe Profes- sor Brown's lectures on Arabian medicine as dry ; indeed, they are extremely fascinating, seeming to exhale an Oriental atmo. sphere, and suggesting here and there stories from The Arabian Nights. This impression is heightened, but only heightened, by the Arabic names and Arabic script dispersed throughout the pages of the book into which the four lectures have been gathered.

Arabian medicine, which, as the lecturer points out, was mainly the work of neither Arabs nor even Mohammedans, but of Syrians, Hebrews, or Persians of the Christian, Jewish, or Magian faith, is of the greatest interest to the student of medical history, as by it the torch of Greek medicine—it is true with its effulgence greatly dimmed—was kept aflame throughout the Dark Ages until the dawn of the Renaissance. It is recalled in these pages that more than a century before the birth of the prophet Mohammed the Byzantine intolerance had driven the Nestorians to seek refuge in Persia, bringing with them much of the ancient Greek learning ; but the acquisition of this learning was greatly stimulated by the Abbasid Caliphs of Baghdad, under whose fostering care learned men were attracted to their courts, and the translation of Greek manuscripts into Arabic was encouraged, nay, more, was commanded. Some Greek manuscripts, lost to us in the original, are preserved in Arabic translations, seven books of Galen's Anatomy being among the number.

It would appear that many of the earlier translations were made from Greek into Syriac, and from the latter language Arabic translations were made later. These translations and re- translations are a cause of great difficulty to the modern investi- gator, and a knowledge of this fact should make us appreciate to the full the care and trouble Professor Browne must have devoted to the preparation of his interesting lectures. The author quotes M. Pognon as writing : " The Syriao version of the aphorisms contained in my manuscript is a very faithful—or rather, too faithful—translation of the Greek text ; sometimes, indeed, it is a literal translation absolutely devoid of sense." And again : " The Syrian translators, when they found a difficult passage, too often contented themselves with rendering each Greek word by a Syriac word without in any way seeking to write an intelligible sentence. . . . In short, I believe that when they did not understand a Greek word the translators did not hesitate to transcribe it in Syriac characters, leaving their readers to conjecture the meaning of these barbarisms which they had created." This same fault, the lecturer shows, is to be found in the translations from the Arabic into Latin of mediaeval times, and of this an amusing example is given in the first lecture : " Thus the first section of the first discourses of the first part of the third book of Avicenna's great Qcinin is entitled in the Latin version Sermo Universali8 de Sochi, but who, not having the original before him, could divine that " soda" stands for the Arabic rude, the ordinary Arabic word for " headache," being the regularly formed noun of " pain " from the verb " to split" ? The translators from the Greek direct into Arabic appear to have been freer from these faults ; but there were occasional bad lapses, so that, as Dr. Browne emphasizes in his last lecture, research in Arabic medicine requires " a scholarly knowledge of Greek, Latin, Syriac, Arabic, and Persian, and, if possible, Sanskrit." As an example of unintelligible transcrip- tion of Arabic words into Latin and the necessity for this wide scholarship, the heading of one of the sections of the Latin translation of Avicenna's Qcfniin, published at Venice in 1544, would be hard to beat. The section is entitled " Serino Univer- sali8 de Karabito." This Karabito the lecturer traces from epci4rts (frenzy), which was transcribed by the Arabs into " farranitis," that is to say a word giving the sound but not the meaning of the Greek word ; and then, in a later Arab manuscript, became " qaranitus." Again, ii/welos was transformed by the Arabs, into " amiss," and this by the Latino-Barbari into " abgaa.'

Verily the paths of those engaged in research in these fields are not smooth !

But Professor Browne has shown in his lectures that he who refuses to be turned back by the obstacles he will certainly meet will find much of interest to beguile the way, and may quite pos- sibly bring to light some Arabic translation of important Greek treatises, instancing the above-mentioned discovery of an Arabic translation of seven books of Galen, completely lost in the original Greek, as the sort of reward that may quite con- ceivably fall to the ardent investigator of the widely scattered manuscripts.

Of progress made by the Arab writers in the science of medicine there is little evidence, and the lecturer does not think that further research will be fruitful in this field ; but the Arabs were keen observers of Nature, and something can be learnt from their clinical work. Thus Rhazes, or to give him his real name, Abii Bakr Muhammad ibn Zakariy$ of Ray, called in Arabic

ar-RiazI, a physician well known to the mediaeval Latinists, gives in his Hdwi or Contineus an excellent account of his diag-

nosis of pyelitis or urinary fever from malaria. It is not so very long ago that the same difficulty in recognizing urinary fever was felt by the modern physician. This same Rhazes wrote what is probably the earliest monograph on smallpox and measles. The story and explanations of the blindness which afflicted him at the end of his life have that smack of the East which make these lectures such interesting reading.

Another physician well known to mediaeval writers of the Renaissance was Avicenna, or Abu 'Ali Husayr ibn Abdullih ibn

Simi, who flourished between A.D. 980-1037, and wrote the celebrated Qdnien. He was a versatile man who by no means confined himself to medicine, being not only a physician, but Prime Minister to the Amir Shamsu'd-Dawla, and a poet who, it is with some plausibility maintained, wrote the quatrain attributed to Omar Khayyam :- " Up from Earth's centre through the Seventh Gate I rose, and on the Throne of Saturn Sate, And many a knot unravelled by the Road, But not the Master-knot of Human Fate."

Readers will be greatly interested in the anecdotes recorded in the third lecture. Rhazes' adoption of heroic measures in the treatment of the Amir Mansfir, who suffered from rheu- matic joints, a combination of psycho- and physio-therapeusis, treatment so heroio that the physician found it necessary to flee from the Court, makes a delightful story ; as does the account of Avicenna's discovery of the source of a young man's illness by feeling his pulse while he mentions the names of peoples and places. A happy marriage cures the fever. By the by, in the Qdnain love is classed under cerebral or mental diseases.

The temptation to mention further anecdotes is almost irre- sistible, but enough has been written to indicate the fascination of the lectures. As Professor Browne has said, the Arabs them- selves were, with few exceptions, not notable physicians, and on occasion disparaging verses were written about the doctors, such as :-

" The physician says to thee ' I can cure thee.'

When ho feels thy wrist and thy arm ; But did the physician know a cure for disease Which would ward off death, he would not himself suffer the

death agony."

But, nevertheless, by their encouragement of others the Arabs have placed the world under a great debt to them, and we are sure the reader will feel that the Arab saying, " At the first bout his quarterstaff was broken," cannot be applied to the author of these FitzPatrick Lectures for his presentation of this historical summary.

Sir Clifford Allbut's lectures,2or rather the extensions of them, which he has now had published, are of quite a different order

from those of Professor Browne. It is true that, like the latter's, they are by no means dry, but, nevertheless, they are, without any question, far more difficult to read. The author has an extra- erdina,ry command of language, and as one reads his writings one feels that Sir Clifford Allbut thinks almost as easily in Greek or Latin, not to mention one or two modern languages, as he does in his mother tongue, in which his vocabulary is very large. That the reader, grown far rustier in his knowledge of the classics than Sir Clifford ever seems to suppose, should have to consult Liddell and Scott's and Smith's dictionaries with great frequency is not surprising, and perhaps the reader has only himself to blame for this state of affairs ; but there are passages, not a few, in which recourse to a large English dictionary-becomes a

necessity, and here the reader will feel he has a quite legitimate grievance. Yet we feel sure that this truly great physician has no desire to plague and mystify lesser minds, but has so fine a sense of the appropriate word to be used, and is so impressed with the errors that have crept into history and science from the loose use of words, that he feels he cannot write otherwise than he has done in these essays. If, therefore, the lectures are not easy reading, they certainly are a very weighty and scholarly addition to a knowledge of the important subject with which they deal.

How much the Romans owed to the Greeks in their laws, their arts, their religion, is still a matter of debate, although the debt must have been very large, but their scientific medicine they received almost entirely from the Greeks. This being so, the lecturer feels it necessary to trace the development of scientific ideas in early Greece. The review is of the greatest interest, and shows how, in the minds of the quick-witted Greeks, the pro- foundest ideas germinated and developed many stages—so many, indeed, that one cannot but be filled with wonder at the retro- grade changes in the world which resulted in these achievements first ceasing and then sinking into oblivion for many hundreds of years. Thales, who lived 640-548 B.C., had already supposed that evolution began from some indifferent primary substance. Parmenides " postulated a doctrine of the conservation of matter " ; Alomaeon " taught that sense perceptions were fused together in the brain, associated into memories, these into inferences, and inferences into reason " ; Empedocles " believed that all Nature was a result of evolution from simple inorganic elements." The " Atomic Theory " was evolved in the fifth century B.C. by Leucippus and Democritus, and built up on the law of evolution by relative proportions, which again was based on the work of Pythagoras on harmonies. How much was lost to the world by the neglect of Greek culture I How much might have been regained at the Renaissance if the old Greek writings had been intelligently studied ! " But," says the lecturer, " the humanists, never very friendly to science, soon began to play us false. Disliking the raw anatomy of knowledge with what they called ' The Classics,' they built a walled pleasaunce for themselves, raising florists' blooms and cut flowers." The result of their activities was that " forms were copied, but original works were driven out, and the spirit —the touch with Nature—was not imparted." Common sense failed to supply the lack of technical knowledge of the physician's art.

This review of Greek science is followed by an account of Greek medicine, especially that of the Alexandrian school, and then the reader is introduced to Greek practitioners in Rome—Asclepiades, Aretaus, and Galen, to mention some of the most famous. The Pneumatists, the Methodists, the Empiricists are expLined with commendable brevity, but space does not permit further reference here to these interest- ing sects, whose influence, whether for good or for evil, has been so marked in medical progress. It must suffice to say that those who would understand the origin of many views that still persist in modern medicine cannot afford to neglect these chapters of the lectures.

The volume contains, besides the FitzPatrick Lectures, other lectures and essays, mostly historical, such as the lectures on Byzantine Medicine and Salerno, but dealing more directly with scientific medicine in the essay, "Medicine in the Twentieth Century." The learning and versatility of the Regius Professor of Physic in the University of Cambridge are thus amply revealed, and the revelation should prove a great stimulus to his many readers. This history of medicine is no repository of dead ideas and systems, but contains that which is the very life of future progress.