11 ms·

Medieval Arabic surgeon Ibn al Quff's account on surgical pain relief

135 points by teleforce 4y ago

lofatdairy 4y ago
I really want to read these texts by early Islamic physicians/polymaths but it's tricky to find translations (though in fairness I haven't dug as deeply as I probably could've). There's some fantastic history there, and I would love to compare them to Renaissance and pre-Renaissance writings. If anyone has any book recommendations or journal publications I'd love to hear them.
- vdfs 4y ago
  I'm native speaker and find reading those manuscript hard, they are like an exclusive club, manuscript scattered in libraries around the world and you have to know the right people or who to ask to get what you want.
  - deleted 4y ago
    [deleted]
  - lofatdairy 4y ago
    Yeah, I imagine it'd be like reading Latin, I even struggle with English texts written only 4 centuries ago, forget 14 centuries ago. Access is a good point too, I think Medieval and Renaissance texts tend to accumulate at Yale, Oxford, Cambridge, etc, at least in the Anglosphere.
    - mulligan 4y ago
      the cool thing is that written Arabic, for the most part, does not suffer from that. A speaker can pick up a book written in the 11th century and find that the grammar, words, structure are all consistent and understandable. it isn't like English and something like the The Canterbury Tales
      - deleted 4y ago
        [deleted]
      - vdfs 4y ago
        True, What i find hard is reading or figuring out the word, it's really easy to read the published book of a manuscript, but only people with experience can read the manuscript. For example these words: Fine, Fun and Fan are all written as Fn, we understand the 3 words but which one they mean depend on the context of speaking
      - omneity 4y ago
        It goes even further than that to a certain extent. In a past wikipedia rabbit hole I was surprised to recognize and understand some (transliterated) sumerian words! Suddenly being thrown 8000 years in the past is not the catastrophic scenario I was worrying about. (native arabic speaker here)
      - marginalia_nu 4y ago
        Latin is largely similar due to an obsession with preserving the language dating all the way back to antiquity. I think the big difference with English (and European vernacular at large) is that spelling was standardized surprisingly late, no earlier than the the 16th century, but with many languages several hundred years later. Before that you had the weird-looking "Thys boke is myne"-style spelling. Sounds weird when you point it out, but the first English dictionary (the "Table Alphabeticall") was printed around the same time Shakespeare died.
- ROTMetro 4y ago
  Why Islamic specifically? What differences do you see from the above linked Arab Christian's writings and what Muslims might write? Is there a specific difference in theology betwen Arab Muslims and Arab Christians that translates to physicians/polymaths that you are interested to explore? I know there are artistic differences but I'm not aware of medical/mathematics ones?
  - lofatdairy 4y ago
    Whoops, that's not what I meant at all. I really just wanted to avoid excluding Persians like Avicenna/Ibn Sina. I actually wasn't aware of al-Quff before this post, nor that he was a Christian before your comment. Goes to show I really have a lot of reading to catch up on.
  - PeterWhittaker 4y ago
    My read of the word "Islamic" in that case was, uh, for want of a better word, inclusive, in that I took it to refer to "the culture that was flourishing in the Arabic world in the 7th C". Given when the subject of the original article was born (c. 630), it is, I think, both harmless and descriptive to conflate the terms Arabic and Islamic: Islam was born in Arabia and was at that time purely Arabic, and it spread quickly enough that most/all of Arabia was Islamic during the physician's lifetime. I don't know how fruitful it is to attempt to determine the extent to which the respect for knowledge then prevalent was a result of Islam or of other factors. The simple fact is that for a period that covered at least the physician's life, preservation and extension of knowledge was prized in that area. Contrast that with the predominantly Christian cultures to the northwest-ish, that were at that time far more concerned with dogma, their own intellectual flourishing still a few centuries. What we in the west know of the ancient Greeks we owe to the Arabs, who were predominantly muslims, of that period. It's far more complicated than that, of course, but to this day, writers conflate "Islamic" and "Arabic" when referring to that period (cf, e.g., [1]), and I think forgivably so. I think. (I hesitate because on the one hand it is both difficult and fraught to tease apart the various influences, on the other hand western society was predominantly Christian and many of the western values I cherish arose and flourished in those Christian societies, on the third hand there was definitely a Jewish influence in some of those societies and an Islamic in other, on the fourth hand I share many of those values despite being none of Christian, Jewish, or anything else theistic, and on the fifth I am often irked when Christians claim (wish I could find a source, but alas, I cannot, but I've seen this many times) that those values could NOT have arisen elsewhere... not enough hands to balance these complexities.) [1] https://greekreporter.com/2022/09/01/how-scholars-islamic-golden-age-saved-ancient-greek-knowledge/ https://greekreporter.com/2022/09/01/how-scholars-islamic-go... (I am often reminded of how applicable to social discourse is Postel's Law, written in regard to TCP, "be conservative in what you send, be liberal in what you accept" - be liberal, be open in one's interpretation of the wording of others, seek neither offence nor exclusion when one can charitably and gracefully assume none was meant. Nope, he didn't mean it that, but it does seem a useful heuristic.)
- nraf 4y ago
  I would recommend looking into the work of Professor George Saliba. He has a bunch of talks on YouTube that I came across recently that I highly recommend, one being: https://youtu.be/JEAfHGBQlkc https://youtu.be/JEAfHGBQlkc For those who understand Arabic, this interview is excellent: https://youtu.be/Sl24jUcidN8 https://youtu.be/Sl24jUcidN8 His book on astronomy might be well worth reading as well (I've ordered a copy as well): https://www.thriftbooks.com/w/a-history-of-arabic-astronomy-planetary-theories-during-the-golden-age-of-islam-new-york-university-studies-in-near-eastern-civilization_george-saliba/1935848/#edition=6882078 https://www.thriftbooks.com/w/a-history-of-arabic-astronomy-...
- nestorD 4y ago
  There appear to be some work done on numerizing these manuscripts and making them available: https://twitter.com/M_T_Miller/status/1339315848373297158/ https://twitter.com/M_T_Miller/status/1339315848373297158/ Translation wise, if you do not read Arabic then you could give ChatGPT a try. I am currently using GPT4 to clean-up+merge several OCRs of a Latin text and then translate it to English: while not perfect the result is very good.
- brenainn 4y ago
  Anecdotes and Antidotes: A Medieval Arabic History of Physicians by Ibn Abi Usaybi'ah. I started reading it last year and got distracted and didn't finish it, but it's very interesting. It's basically a chronicle of all the physicians this guy knew of. There's some genuinely interesting history in there, like how much they respected Galen and still referenced those works. And then there's some esoteric stuff like diagnosing a sick sultan by looking at a vial of his urine, or copious warnings of not to have sex with older women as they'll steal your life-force. Also oddly specific accounts of how much these physicians were paid and what in. Hopefully the sort of thing you're looking for. I just found it in a book store one day. edit: https://en.wikipedia.org/wiki/Ibn_Abi_Usaybi%27a https://en.wikipedia.org/wiki/Ibn_Abi_Usaybi%27a - this fella, as that work goes under a few names.
- 29athrowaway 4y ago
  Read the "Canon of Medicine" by Avicenna (Ibn Sina).
- erie 4y ago
  The Vatican still has some Ibn al Quff's books and probably they have it translated. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4173333/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4173333/
- macrolime 4y ago
  Once ChatGPT opens up the image analysis support of GPT-4, you can probably upload images of manuscripts that you can find online and get them translated.
doomrobo 4y ago
Entirely off-topic, but I immediately noticed that the website uses Fira Sans for all the text. I appreciate open-access journals using open-source fonts.
ogogmad 4y ago
Why does the patient need to be restrained when they're anaesthetised?
- CapstanRoller 4y ago
  Even with modern medicine, sedated patients sometimes perform involuntary movements resembling sleep myoclonus[0] [0] https://en.wikipedia.org/wiki/Hypnic_jerk https://en.wikipedia.org/wiki/Hypnic_jerk
  - Arrath 4y ago
    I can jerk quite strongly when falling asleep, much to the annoyance of my girlfriend and, presumably, our dogs. I really wouldn't want to do the same when someone has a scalpel in my guts.
- boomboomsubban 4y ago
  There is also always a risk of the patient waking up.
- PhasmaFelis 4y ago
  The line between "so sedated you don't feel your guts being cut open" and "so sedated you stop breathing" is frighteningly thin and requires a constant, careful, measured supply of anesthetic. In modern surgeries, there is one guy who goes to school for years to do nothing but monitor the patient's vitals and adjust the flow accordingly. In al Quff's day, I imagine such reliable precision was difficult or impossible, and you'd rather err on the side of pain than death. Which is to say, there's a very real chance of your patient waking up mid-surgery and freaking the fuck out, and you want to be prepared for that.
  - anigbrowl 4y ago
    I've woken up in surgery and though I didn't freak out (or feel much of anything), I still remember the look of horror on the anesthetist's face when he noticed.
- 4y ago
29athrowaway 4y ago
(2010)
- kimburgess 4y ago
  Technically (1286)-ish
Ruthalas 4y ago
Abstract: This is a review of Ibn al Quff's account of surgical pain relief in his surgical book Al Omdah, in which he mentioned the word anesthetic (Al moukhadder) and the involvement of physician (al tabbaaee) to give mixture of drugs to prevent pain in a surgical condition to relieve the patient from pain or to make surgical management possible. Hich indicated one rare occasion to such description in Arabic medical texts. Methods of administration of these drugs were inhalation, ingestion and by rectal suppositories. The drugs used in anesthetic sponges include all the drugs that are recorded in the modern literature of anesthesia. They are as follows: opium, mandrake, Hyocymus albus, belladonna, Cannabis sativus, Cannabis indica, wild lettuce. The anesthetic sponge, mentioned in many references as an inhalation method, may be of symbolic value to surgery. I was unfamiliar with "wild lettuce", but apparently its secretions are somewhat similar in effect to opium.
- giantg2 4y ago
  So that's why people like salads...
  - akiselev 4y ago
    Well the edible species we use in salads is called Lactuca _sativa_
- spiderxxxx 4y ago
  Scopolamine, derived from Hyoscymus Albus is used today for the exact same reasons. The plant is called henbanes, and that name historically refers to a few different plants, but all seem to be exhibiting similar effects.
- NoZebra120vClip 4y ago
  Indeed, Latuca serriola is named "wild opium lettuce" and quite effective for pain relief. 'The sap is a natural latex that can either be taken in pills or smoked in a pipe. It appears to cause a numbing sensation that spreads through the body. It does not normally impart a euphoric "high" feeling.' Opium lettuce does not contain opium. It is also effective against coughs; powdered, it can treat sunburns, and it has probably been in use for eons.
codazoda 4y ago
As far as I can tell this was the 1200’s[1] and this doctor and author explained how to use a lot of our modern anesthesia such as opium, a few types of cannabis, and others. 1] ChatGPT says ~1218 while I calculated 1242, but I don’t know this calendar.
- govg 4y ago
  The title of the actual article gives the exact years in question. The surgeon was alive from 1232 to 1286. The years shown use the "CE/BCE" notation, which is just an alternate to writing "AD/BC". The numbers themselves correspond to the same time.
  - n4r9 4y ago
    Yes, it's also repeated the first line of the main body. Feels like it takes more effort to go and get the wrong figure from ChatGPT.
mlrhazi 4y ago
Should it not be “Arab surgeon “ instead of “Arabic surgeon ”?
- mach1ne 4y ago
  Doesn’t the former imply race and the latter place of living? In which case it would be more scientific to focus on the geography.
  - overbytecode 4y ago
    Arab is for people, Arabic is for the language
    - dghf 4y ago
      And Arabian for the place.
erie 4y ago
The Vatican still has some Ibn al Quff's books,Ibn al Quff (1233 - 1286)a Jordanian who converted to Christianity ,lived studied medicine-1252- in Damascus, and died there.
WeylandYutani 4y ago
Interestingly it was a Russian doctor who started using anaesthesia in the Crimean war (the English were against it at first believing in the stiff upper lip during amputations). Oh yes every new war is just a repeat of an old war.

135 points by teleforce 4y ago

I really want to read these texts by early Islamic physicians/polymaths but it's tricky to find translations (though in fairness I haven't dug as deeply as I probably could've). There's some fantastic history there, and I would love to compare them to Renaissance and pre-Renaissance writings. If anyone has any book recommendations or journal publications I'd love to hear them.

vdfs 4y ago
I'm native speaker and find reading those manuscript hard, they are like an exclusive club, manuscript scattered in libraries around the world and you have to know the right people or who to ask to get what you want.
- deleted 4y ago
  [deleted]
- lofatdairy 4y ago
  Yeah, I imagine it'd be like reading Latin, I even struggle with English texts written only 4 centuries ago, forget 14 centuries ago. Access is a good point too, I think Medieval and Renaissance texts tend to accumulate at Yale, Oxford, Cambridge, etc, at least in the Anglosphere.
  - mulligan 4y ago
    the cool thing is that written Arabic, for the most part, does not suffer from that. A speaker can pick up a book written in the 11th century and find that the grammar, words, structure are all consistent and understandable. it isn't like English and something like the The Canterbury Tales
    - deleted 4y ago
      [deleted]
    - vdfs 4y ago
      True, What i find hard is reading or figuring out the word, it's really easy to read the published book of a manuscript, but only people with experience can read the manuscript. For example these words: Fine, Fun and Fan are all written as Fn, we understand the 3 words but which one they mean depend on the context of speaking
    - omneity 4y ago
      It goes even further than that to a certain extent. In a past wikipedia rabbit hole I was surprised to recognize and understand some (transliterated) sumerian words! Suddenly being thrown 8000 years in the past is not the catastrophic scenario I was worrying about. (native arabic speaker here)
    - marginalia_nu 4y ago
      Latin is largely similar due to an obsession with preserving the language dating all the way back to antiquity. I think the big difference with English (and European vernacular at large) is that spelling was standardized surprisingly late, no earlier than the the 16th century, but with many languages several hundred years later. Before that you had the weird-looking "Thys boke is myne"-style spelling. Sounds weird when you point it out, but the first English dictionary (the "Table Alphabeticall") was printed around the same time Shakespeare died.
ROTMetro 4y ago
Why Islamic specifically? What differences do you see from the above linked Arab Christian's writings and what Muslims might write? Is there a specific difference in theology betwen Arab Muslims and Arab Christians that translates to physicians/polymaths that you are interested to explore? I know there are artistic differences but I'm not aware of medical/mathematics ones?
- lofatdairy 4y ago
  Whoops, that's not what I meant at all. I really just wanted to avoid excluding Persians like Avicenna/Ibn Sina. I actually wasn't aware of al-Quff before this post, nor that he was a Christian before your comment. Goes to show I really have a lot of reading to catch up on.
- PeterWhittaker 4y ago
  My read of the word "Islamic" in that case was, uh, for want of a better word, inclusive, in that I took it to refer to "the culture that was flourishing in the Arabic world in the 7th C". Given when the subject of the original article was born (c. 630), it is, I think, both harmless and descriptive to conflate the terms Arabic and Islamic: Islam was born in Arabia and was at that time purely Arabic, and it spread quickly enough that most/all of Arabia was Islamic during the physician's lifetime. I don't know how fruitful it is to attempt to determine the extent to which the respect for knowledge then prevalent was a result of Islam or of other factors. The simple fact is that for a period that covered at least the physician's life, preservation and extension of knowledge was prized in that area. Contrast that with the predominantly Christian cultures to the northwest-ish, that were at that time far more concerned with dogma, their own intellectual flourishing still a few centuries. What we in the west know of the ancient Greeks we owe to the Arabs, who were predominantly muslims, of that period. It's far more complicated than that, of course, but to this day, writers conflate "Islamic" and "Arabic" when referring to that period (cf, e.g., [1]), and I think forgivably so. I think. (I hesitate because on the one hand it is both difficult and fraught to tease apart the various influences, on the other hand western society was predominantly Christian and many of the western values I cherish arose and flourished in those Christian societies, on the third hand there was definitely a Jewish influence in some of those societies and an Islamic in other, on the fourth hand I share many of those values despite being none of Christian, Jewish, or anything else theistic, and on the fifth I am often irked when Christians claim (wish I could find a source, but alas, I cannot, but I've seen this many times) that those values could NOT have arisen elsewhere... not enough hands to balance these complexities.) [1] https://greekreporter.com/2022/09/01/how-scholars-islamic-golden-age-saved-ancient-greek-knowledge/ https://greekreporter.com/2022/09/01/how-scholars-islamic-go... (I am often reminded of how applicable to social discourse is Postel's Law, written in regard to TCP, "be conservative in what you send, be liberal in what you accept" - be liberal, be open in one's interpretation of the wording of others, seek neither offence nor exclusion when one can charitably and gracefully assume none was meant. Nope, he didn't mean it that, but it does seem a useful heuristic.)
nraf 4y ago
I would recommend looking into the work of Professor George Saliba. He has a bunch of talks on YouTube that I came across recently that I highly recommend, one being: https://youtu.be/JEAfHGBQlkc https://youtu.be/JEAfHGBQlkc For those who understand Arabic, this interview is excellent: https://youtu.be/Sl24jUcidN8 https://youtu.be/Sl24jUcidN8 His book on astronomy might be well worth reading as well (I've ordered a copy as well): https://www.thriftbooks.com/w/a-history-of-arabic-astronomy-planetary-theories-during-the-golden-age-of-islam-new-york-university-studies-in-near-eastern-civilization_george-saliba/1935848/#edition=6882078 https://www.thriftbooks.com/w/a-history-of-arabic-astronomy-...
nestorD 4y ago
There appear to be some work done on numerizing these manuscripts and making them available: https://twitter.com/M_T_Miller/status/1339315848373297158/ https://twitter.com/M_T_Miller/status/1339315848373297158/ Translation wise, if you do not read Arabic then you could give ChatGPT a try. I am currently using GPT4 to clean-up+merge several OCRs of a Latin text and then translate it to English: while not perfect the result is very good.
brenainn 4y ago
Anecdotes and Antidotes: A Medieval Arabic History of Physicians by Ibn Abi Usaybi'ah. I started reading it last year and got distracted and didn't finish it, but it's very interesting. It's basically a chronicle of all the physicians this guy knew of. There's some genuinely interesting history in there, like how much they respected Galen and still referenced those works. And then there's some esoteric stuff like diagnosing a sick sultan by looking at a vial of his urine, or copious warnings of not to have sex with older women as they'll steal your life-force. Also oddly specific accounts of how much these physicians were paid and what in. Hopefully the sort of thing you're looking for. I just found it in a book store one day. edit: https://en.wikipedia.org/wiki/Ibn_Abi_Usaybi%27a https://en.wikipedia.org/wiki/Ibn_Abi_Usaybi%27a - this fella, as that work goes under a few names.
29athrowaway 4y ago
Read the "Canon of Medicine" by Avicenna (Ibn Sina).
erie 4y ago
The Vatican still has some Ibn al Quff's books and probably they have it translated. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4173333/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4173333/
macrolime 4y ago
Once ChatGPT opens up the image analysis support of GPT-4, you can probably upload images of manuscripts that you can find online and get them translated.

doomrobo 4y ago

Entirely off-topic, but I immediately noticed that the website uses Fira Sans for all the text. I appreciate open-access journals using open-source fonts.

ogogmad 4y ago

Why does the patient need to be restrained when they're anaesthetised?

CapstanRoller 4y ago
Even with modern medicine, sedated patients sometimes perform involuntary movements resembling sleep myoclonus[0] [0] https://en.wikipedia.org/wiki/Hypnic_jerk https://en.wikipedia.org/wiki/Hypnic_jerk
- Arrath 4y ago
  I can jerk quite strongly when falling asleep, much to the annoyance of my girlfriend and, presumably, our dogs. I really wouldn't want to do the same when someone has a scalpel in my guts.
boomboomsubban 4y ago
There is also always a risk of the patient waking up.
PhasmaFelis 4y ago
The line between "so sedated you don't feel your guts being cut open" and "so sedated you stop breathing" is frighteningly thin and requires a constant, careful, measured supply of anesthetic. In modern surgeries, there is one guy who goes to school for years to do nothing but monitor the patient's vitals and adjust the flow accordingly. In al Quff's day, I imagine such reliable precision was difficult or impossible, and you'd rather err on the side of pain than death. Which is to say, there's a very real chance of your patient waking up mid-surgery and freaking the fuck out, and you want to be prepared for that.
- anigbrowl 4y ago
  I've woken up in surgery and though I didn't freak out (or feel much of anything), I still remember the look of horror on the anesthetist's face when he noticed.
4y ago

29athrowaway 4y ago

(2010)

kimburgess 4y ago
Technically (1286)-ish

Ruthalas 4y ago

Abstract: This is a review of Ibn al Quff's account of surgical pain relief in his surgical book Al Omdah, in which he mentioned the word anesthetic (Al moukhadder) and the involvement of physician (al tabbaaee) to give mixture of drugs to prevent pain in a surgical condition to relieve the patient from pain or to make surgical management possible. Hich indicated one rare occasion to such description in Arabic medical texts. Methods of administration of these drugs were inhalation, ingestion and by rectal suppositories. The drugs used in anesthetic sponges include all the drugs that are recorded in the modern literature of anesthesia. They are as follows: opium, mandrake, Hyocymus albus, belladonna, Cannabis sativus, Cannabis indica, wild lettuce. The anesthetic sponge, mentioned in many references as an inhalation method, may be of symbolic value to surgery. I was unfamiliar with "wild lettuce", but apparently its secretions are somewhat similar in effect to opium.

giantg2 4y ago
So that's why people like salads...
- akiselev 4y ago
  Well the edible species we use in salads is called Lactuca _sativa_
spiderxxxx 4y ago
Scopolamine, derived from Hyoscymus Albus is used today for the exact same reasons. The plant is called henbanes, and that name historically refers to a few different plants, but all seem to be exhibiting similar effects.
NoZebra120vClip 4y ago
Indeed, Latuca serriola is named "wild opium lettuce" and quite effective for pain relief. 'The sap is a natural latex that can either be taken in pills or smoked in a pipe. It appears to cause a numbing sensation that spreads through the body. It does not normally impart a euphoric "high" feeling.' Opium lettuce does not contain opium. It is also effective against coughs; powdered, it can treat sunburns, and it has probably been in use for eons.

codazoda 4y ago

As far as I can tell this was the 1200’s[1] and this doctor and author explained how to use a lot of our modern anesthesia such as opium, a few types of cannabis, and others. 1] ChatGPT says ~1218 while I calculated 1242, but I don’t know this calendar.

govg 4y ago
The title of the actual article gives the exact years in question. The surgeon was alive from 1232 to 1286. The years shown use the "CE/BCE" notation, which is just an alternate to writing "AD/BC". The numbers themselves correspond to the same time.
- n4r9 4y ago
  Yes, it's also repeated the first line of the main body. Feels like it takes more effort to go and get the wrong figure from ChatGPT.

mlrhazi 4y ago

Should it not be “Arab surgeon “ instead of “Arabic surgeon ”?

mach1ne 4y ago
Doesn’t the former imply race and the latter place of living? In which case it would be more scientific to focus on the geography.
- overbytecode 4y ago
  Arab is for people, Arabic is for the language
  - dghf 4y ago
    And Arabian for the place.

erie 4y ago

The Vatican still has some Ibn al Quff's books,Ibn al Quff (1233 - 1286)a Jordanian who converted to Christianity ,lived studied medicine-1252- in Damascus, and died there.

WeylandYutani 4y ago

Interestingly it was a Russian doctor who started using anaesthesia in the Crimean war (the English were against it at first believing in the stiff upper lip during amputations). Oh yes every new war is just a repeat of an old war.