Islamic Medicine: 1,000 Years Ahead Of Its Time

Arabic pharmacy

By Ibrahim B. Syed

Within a century after the death of Prophet Muhammad, peace and blessings be upon him, the Muslims not only conquered new lands, but also became scientific innovators with originality and productivity. They hit the source ball of knowledge over the fence to Europe. By the ninth century, Islamic medical practice had advanced from talisman and theology to hospitals with wards, doctors who had to pass tests, and the use of technical terminology. The then Baghdad General Hospital incorporated innovations which sound amazingly modern. The fountains cooled the air near the wards of those afflicted with fever; the insane were treated with gentleness; and at night the pain of the restless was soothed by soft music and storytelling. The prince and pauper received identical attention; the destitute upon discharge received five gold pieces to sustain them during convalescence. While Paris and London were places of mud streets and hovels, Baghdad, Cairo and Cordova had hospitals open to both male and female patients; staffed by attendants of both sexes. These medical centers contained libraries, pharmacies, the system of interns, externs, and nurses. There were mobile clinics to reach the totally disabled, the disadvantaged and those in remote areas. There were regulations to maintain quality control on drugs. Pharmacists became licensed professionals and were pledged to follow the physician’s prescriptions. Legal measures were taken to prevent doctors from owning or holding stock in a pharmacy. The extent to which Islamic medicine advanced in the fields of medical education, hospitals, bacteriology, medicine, anesthesia, surgery, pharmacy, ophthalmology, psychotherapy and psychosomatic diseases are presented briefly.

INTRODUCTION

Complex of Mansur Qalaun

Prophet Muhammad, peace and blessings be upon him, who is ranked number one by Michael Hart, a Jewish scholar, in his book The 100: The Most Influential Persons in History, was able to unite the Arab tribes who had been torn by revenge, rivalry, and internal fights, and produced a strong nation acquired and ruled simultaneously, the two known empires at that time, namely the Persian and Byzantine Empires. The Islamic Empire extended from the Atlantic Ocean on the West to the borders of China on the East. Only 80 years after the death of their Prophet, the Muslims crossed to Europe to rule Spain for more than 700 years. The Muslims preserved the cultures of the conquered lands. However, when the Islamic Empire became weak, most of the Islamic contributions in science were destroyed. The Mongols burnt Baghdad (1258 A.D.) out of barbarism, and the Spaniards demolished most of the Islamic heritage in Spain out of hatred.

The Islamic Empire for more than 1,000 years remained the most advanced and civilized nation in the world. This is because Islam stressed the importance and respect of learning, forbade destruction, developed in Muslims the respect for authority, discipline and tolerance for other religions. The Muslims recognized excellence, and hungering intellectually were avid for the wisdom of the world of Galen, Hippocrates, Rufus of Ephesus, Oribasius, Discorides and Paul of Aegina. By the tenth century their zeal and enthusiasm for learning resulted in all essential Greek medical writings being translated into Arabic in Damascus, Cairo and Baghdad. Arabic became the International Language of learning and diplomacy. The center of scientific knowledge and activity shifted eastward, and Baghdad emerged as the capital of the scientific world. The Muslims became scientific innovators with originality and productivity. Islamic medicine is one of the most famous and best known facets of Islamic civilization, and in which the Muslims most excelled. The Muslims were the great torchbearers of international scientific research. They hit the source ball of knowledge over the fence to Europe. In the words of Campbell, “The European medical system is Arabian not only in origin but also in its structure. The Arabs are the intellectual forebears of the Europeans.”

The aim of this paper is to prove that Islamic Medicine was 1,000 years ahead of its time. The paper covers areas such as medical education, hospitals, bacteriology, medicine, anesthesia, surgery, ophthalmology, pharmacy, and psychotherapy.

MEDICAL EDUCATION

In 636 A.D., the Persian City of Jundi-Shapur, which originally meant beautiful garden, was conquered by the Muslims with its great university and hospital intact. Later the Islamic medical schools developed on the Jundi-Shapur pattern. Medical education was serious and systematic. Lectures and clinical sessions included in teaching were based on the apprentice system. The advice given by `Ali Ibnul-`Abbas (Haly Abbas: -994 -A.D.) to medical students is as timely today as it was then. “And of those things which were incumbent on the student of this art (medicine) are that he should constantly attend the hospitals and sick houses; pay unremitting attention to the conditions and circumstances of their intimates in company with the most astute professors of medicine; and inquire frequently as to the state of the patients and symptoms apparent in them, bearing in mind what he has read about these variations, and what they indicate of good or evil.”

Razi (Rhazes: 841-926 A.D.) advised medical students while they were seeing a patient to bear in mind the classic symptoms of a disease as given in text books and to compare them with what they found.

The ablest physicians such as Razi (Al-Rhazes), Ibn-Sina (Avicenna: 980-1037 A.D.) and Ibn Zuhr (Avenzoar: 116 A.D.) performed the duties of both hospital directors and deans of medical schools at the same time. They studied patients and prepared them for student presentation. Clinical reports of cases were written and preserved for teaching. Registers were maintained.

Training in Basic Sciences:

Only Jundi-Shapur or Baghdad had separate schools for studying basic sciences. Candidates for medical study received basic preparation from private tutors through private lectures and self-study. In Baghdad, anatomy was taught by dissecting apes, skeletal studies and didactics. Other medical schools taught anatomy through lectures and illustrations. Alchemy was once of the prerequisites for admission to medical school. The study of medicinal herbs and pharmacognosy rounded out the basic training. A number of hospitals maintained barbell gardens as a source of drugs for the patients and a means of instruction for the students.

Once the basic training was completed the candidate was admitted as an apprentice to a hospital where, at the beginning, he was assigned in a large group to a young physician for indoctrination, preliminary lectures, and familiarization with library procedures and uses. During this pre-clinical period, most of the lectures were on pharmacology and toxicology and the use of antidotes.

Clinical Training:

The next step was to give the student full clinical training. During this period students were assigned in small groups to famous physicians and experienced instructors for ward rounds, discussions, lectures and reviews. Early in this period therapeutics and pathology were taught. There was a strong emphasis on clinical instruction and some Muslim physicians contributed brilliant observations that have withstood the test of time. As the students progressed in their studies they were exposed more and more to the subjects of diagnosis and judgment. Clinical observation and physical examination were stressed. Students (clinical clerks) were asked to examine a patient and make a diagnosis of the ailment. Only after a student had failed would the professor make the diagnosis himself. While performing physical examination, the students were asked to examine and report six major factors: the patients’ actions, excreta, the nature and location of pain, and swelling. Also noted was color and feel of the skin- whether hot, cool, moist, dry or flabby. Yellowness in the whites of the eye (jaundice) and whether or not the patient could bend his back (lung disease) was also considered important.

After a period of ward instructions, students, were assigned to outpatient areas. After examining the patients they reported their findings to the instructors. After discussion, treatment was decided on and prescribed. Patients who were too ill were admitted as inpatients. The keeping of records for every patient was the responsibility of the students.

Curriculum:

There was a difference in the clinical curriculum of different medical schools in their courses; however the mainstay was usually internal medicine. Emphasis was placed on clarity and brevity in describing a disease and the separation of each entity. Until the time of Ibn Sina the description of meningitis was confused with acute infection accompanied by delirium. Ibn Sina described the symptoms of meningitis with such clarity and brevity that there is very little that can be added after 1,000 years. Surgery was also included in the curriculum. After completing courses, some students specialized under famous specialists. Some others specialized while in clinical training. According to Elgood, many surgical procedures such as amputation, excision of varicose veins and hemorrhoids were required knowledge. Orthopedics was widely taught, and the use of plaster of Paris for casts after reduction of fractures was routinely shown to students. This method of treating fractures was rediscovered in the West in 1852. Although ophthalmology was practiced widely, it was not taught regularly in medical schools. Apprenticeship to an eye doctor was the preferred way of specializing in ophthalmology. Surgical treatment of cataract was very common. Obstetrics was left to midwives. Medical practitioners consulted among themselves and with specialists. Ibn Sina and Razi both widely practiced and taught psychotherapy. After completing the training, the medical graduate was not ready to enter practice until he passed the licensure examination. It is important to note that there existed a Scientific Association which had been formed in the hospital of Mayyafariqin to discuss the conditions and diseases of the patients.

Licensing of Physicians:

In Baghdad in 931 A.D., Caliph Al-Muqtadir learned that a patient had died as the result of a physician’s error. Thereupon he ordered his chief physician, Sinan Ibn Thabit Ibn Qurrah to examine all those who practiced the art of healing. In the first year of the decree more than 860 were examined in Baghdad alone. From that time on, licensing examinations were required and administered in various places. Licensing Boards were set up under a government official called Muhtasib, or inspector general. The Muhtasib also inspected weights and measures of traders and pharmacists. Pharmacists were employed as inspectors to inspect drugs and maintain quality control of drugs sold in a pharmacy or apothecary. What the present Food and Drug Administration (FDA) is doing in America today was done in Islamic medicine 1,000 years ago. The chief physician gave oral and practical examinations, and if the young physician was successful, the Muhtasib administered the Hippocratic oath and issued a license. After 1,000 years, licensing of physicians has been implemented in the West, particularly in America by the State Licensing Board in Medicine. For specialists we have the American Board of Medical Specialties including medicine, surgery, radiology, etc. European medical schools followed the pattern set by the Islamic medical schools and even in the early nineteenth century, students at the Sorbonne could not graduate without reading Ibn Sina’s Qanun (Cannon). According to Razi, a physician had to satisfy two conditions for selection: firstly, he was to be fully conversant with the new and the old medical literature and secondly, he must have worked in a hospital as house physician.

HOSPITALS

Sultan Al-Mu'ayyad's Maristan in Cairo - Egypt

The development of efficient hospitals was an outstanding contribution of Islamic medicine. Hospitals served all citizens free without any regard to their color, religion, sex, age or social status. The hospitals were run by the government and the directors of hospitals were physicians.

Hospitals had separate wards for male patients and female patients. Each ward was furnished with a nursing staff and porters of the sex of the patients to be treated therein. Different diseases such as fever, wounds, infections, mania, eye conditions, cold diseases, diarrhea and female disorders were allocated different wards. Convalescents had separate sections within them. Hospitals provided patients with unlimited water supply and with bathing facilities. Only qualified and licensed physicians were allowed by law to practice medicine. The hospitals were teaching hospitals educating medical students. They had housing for students and house-staff. They contained pharmacies dispensing free drugs to patients.

Hospitals had their own conference room and expensive libraries containing the most up-to-date books. According to Haddad, the library of the Tulun Hospital which was founded in Cairo in 872 A.D. (1100 years ago) had 100,000 books. Universities, cities and hospitals acquired large libraries (Mustansiriyya University in Baghdad contained 80,000 volumes; the library of Cordova 600,000 volumes; that of Cairo 2,000,000 and that of Tripoli 3,000,000 books) and physicians had their own extensive personal book collections at a time when printing was unknown and book editing was done by skilled and specialized scribes putting in long hours of manual labor.

For the first time in history, these hospitals kept records of patients and their medical care.

From the point of view of treatment, the hospital was divided into an outpatient department and an inpatient department. The system of the inpatient department differed only slightly from that of today. On admission at Tulun hospital, patients were given special apparel while their clothes, money, and valuables were stored until the time of their discharge. On discharge, each patient received five gold pieces to support himself until he could return to work.

The hospital and medical school at Damascus had elegant rooms and an extensive library. Healthy people are said to have feigned illness in order to enjoy its cuisine. There was a separate hospital in Damascus for lepers, while in Europe even six centuries later, condemned lepers were burned to death by royal decree.

The Qayrawan Hospital (built in 830 A.D. in Tunisia) was characterized by spacious separate wards, waiting rooms for visitors and patients, and female nurses from Sudan, an event representing the first use of nursing in Arab history. The hospital also provided facilities for performing prayers.

The Al-Adudi hospital (built in 981 A.D. in Baghdad) was furnished with the best equipment and supplies known at the time. It had interns, residents and 24 consultants attending its professional activities. An Abbasid minister, `Ali Ibn `Isa, requested the court physician, Sinan Ibn Thabit, to organize regular visiting of prisons by medical officers. At a time when Paris and London were places of mud streets and hovels, Baghdad, Cairo, and Cordova had hospitals which incorporated innovations which sound amazingly modern. It was chiefly in the humaneness of patient care, however, that the hospitals of Islam excelled. Near the wards of those afflicted with fever, fountains cooled the air; the insane were treated with gentleness; and at night music and storytelling soothed the patients.

The Bimaristans (hospitals) were of two types - the fixed and the mobile. The mobile hospitals were transported upon beasts of burden and were erected from time to time as required. The physicians in the mobile clinics were of the same standing as those who served the fixed hospitals. Similar moving hospitals accompanied armies in the field. Field hospitals were well equipped with medicaments, instruments, tents and a staff of doctors, nurses, and orderlies. The traveling clinics served the totally disabled, the disadvantaged and those in remote areas. These hospitals were also used by prisoners, and by the general public, particularly in times of epidemics.

BACTERIOLOGY

Al-Razi was asked to choose a site for a new hospital when he came to Baghdad. First he deduced which was the most hygienic area by observing where the fresh pieces of meat he had hung in various parts of the city decomposed least quickly.

Ibn Sina stated explicitly that bodily secretion is contaminated by foul foreign earthly body before getting the infection. Ibn Khatima stated that man is surrounded by minute bodies which enter the human system and cause disease.

In the middle of the fourteenth century, “black death” (the plague) was ravaging Europe and before which Christians stood helpless, considering it an act of God.

At that time Ibn Al-Khatib of Granada composed a treatise in the defense of the theory of infection in the following way:

To those who say, “How can we admit the possibility of infection while the religious law denies it?” We reply that the existence of contagion is established by experience, investigation, the evidence of the senses and trustworthy reports. These facts constitute a sound argument. The fact of infection becomes clear to the investigator who notices how he who establishes contact with the afflicted gets the disease, whereas he who is not in contact remains safe, and how transmission is effected through garments, vessels and earrings.

Al-Razi wrote the first medical description of smallpox and measles - two important infectious diseases. He described the clinical difference between the two diseases so vividly that nothing since then has been added. Ibn Sina suggested the communicable nature of tuberculosis. He is said to have been the first to describe the preparation and properties of sulfuric acid and alcohol. His recommendation of wine as the best dressing for wounds was very popular in medieval practice. Razi, however, was the first to use silk sutures and alcohol for hemostatis. He was the first to use alcohol as an antiseptic.

ANESTHESIA

Ibn Sina originated the idea of the use of oral anesthetics. He recognized opium as the most powerful mukhadir (anesthetic). Less powerful anesthetics known were mandragora, poppy, hemlock, hyoscyamus, deadly nightshade (belladonna), lettuce seed, and snow or ice cold water. The Arabs invented the soporific sponge which was the precursor of modern anesthesia. It was a sponge soaked with aromatics and narcotics and held to the patient’s nostrils.

The use of anesthesia was one of the reasons for the rise of surgery in the Islamic world to the level of an honorable specialty, while in Europe, surgery was belittled and practiced by barbers and quacks. The Council of Tours in 1163 A.D. declared that surgery was to be abandoned by the schools of medicine and by all decent physicians. Burton stated that “anesthetics have been used in surgery throughout the East for centuries before ether and chloroform became the fashion in civilized West.”

SURGERY

Al-Razi is attributed to be the first to use the seton in surgery and animal gut for sutures.

Abu Al-Qasim Khalaf Ibn `Abbas Al-Zahrawi (930-1013 A.D.) known to the West as Abulcasis, Bucasis or Alzahravius is considered to be the most famous surgeon in Islamic medicine. In his book Al-Tasrif, he described hemophilia for the first time in medical history. The book contains the description and illustration of about 200 surgical instruments, many of which were devised by Zahrawi himself. In it Zahrawi stresses the importance of the study of anatomy as a fundamental prerequisite to surgery. He advocates the re-implantation of a fallen tooth and the use of dental prosthesis carved from a cow’s bone, an improvement over the wooden dentures worn by the first President of America, George Washington, seven centuries later. Zahrawi appears to be the first surgeon in history to use cotton (a word of Arabic origin) in surgical dressings in the control of hemorrhage, as padding in the splinting of fractures, as a vaginal padding in fractures of the pubis and in dentistry. He introduced the method for the removal of kidney stones by cutting into the urinary bladder. He was the first to teach the lithotomy position for vaginal operations. He described tracheotomy, distinguished between goiter and cancer of the thyroid, and explained his invention of a cauterizing iron which he also used to control bleeding. His description of varicose veins stripping, even after ten centuries, is almost like modern surgery. In orthopedic surgery he introduced what is called today Kocher’s method of reduction of shoulder dislocation and patelectomy, 1,000 years before Brooke reintroduced it in 1937.

Ibn Sina’s description of the surgical treatment of cancer holds true even today after 1,000 years. He says the excision must be wide and bold; all veins running to the tumor must be included in the amputation. Even if this is not sufficient, then the area affected should be cauterized.

The surgeons of Islam practiced three types of surgery: vascular, general and orthopedic. Ophthalmic surgery was a specialty which was quite distinct both from medicine and surgery. They freely opened the abdomen and drained the peritoneal cavity in the approved modern style. To an unnamed surgeon of Shiraz is attributed the first colostomy operation. Liver abscesses were treated by puncture and exploration.

Surgeons all over the world practice today unknowingly several surgical procedures that Zahrawi introduced 1,000 years ago.

MEDICINE

The most brilliant contribution was made by Al-Razi who differentiated between smallpox and measles, two diseases that were hitherto thought to be one single disease. He is credited with many contributions, which include being the first to describe true distillation, glass retorts and luting, corrosive sublimate, arsenic, copper sulfate, iron sulphate, saltpeter, and borax in the treatment of disease. He introduced mercury compounds as purgatives (after testing them on monkeys); mercurial ointments and lead ointment. His interest in urology focused on problems involving urination, venereal disease, renal abscess, and renal and vesical calculi. He also described hay-fever or allergic rhinitis.

Some of the Arab contributions include the discovery of itch mite of scabies (Ibn Zuhr), anthrax, ankylostoma and the guinea worm by Ibn Sina and sleeping sickness by Qalqashandy. They described abscess of the mediastinum. They understood tuberculosis and pericarditis.

Al-Ash`ath demonstrated gastric physiology by pouring water into the mouth of an anesthetized lion and showed the movements of the stomach, preceding Beaumont by about 1,000 years. Abu Shal Al-Masihi explained that the absorption of food takes place more through the intestines than the stomach. Ibn Zuhr introduced artificial feeding either by gastric tube or by nutrient enema. Using the stomach tube the Arab physicians performed gastric lavage in case of poisoning. Ibn Al-Nafis was the first to discover pulmonary circulation.

Ibn Sina in his masterpiece Al-Quanun (Canon), containing over a million words, described complete studies of physiology, pathology and hygiene. He specifically discoursed on breast cancer, poisons, diseases of the skin, rabies, insomnia, childbirth and the use of obstetrical forceps, meningitis, amnesia, stomach ulcers, tuberculosis as a contagious disease, facial tics, phlebotomy, tumors, kidney diseases and geriatric care.

OPHTHALMOLOGY

The doctors of Islam exhibited a high degree of proficiency and certainly were foremost in the treatment of eye diseases. Words such as retina and cataract are of Arabic origin. In ophthalmology and optics, Ibn Al-Haytham (965-1039 A.D.) known to the West as Alhazen, wrote the Optical Thesaurus from which such worthies as Roger Bacon, Leonardo da Vinci and Johannes Kepler drew theories for their own writings. In his Thesaurus he showed that light falls on the retina in the same manner as it falls on a surface in a darkened room through a small aperture, thus conclusively proving that vision happens when light rays pass from objects towards the eye and not from the eye towards the objects as thought by the Greeks. He presented experiments for testing the angles of incidence and reflection, and a theoretical proposal for a magnifying lens (made in Italy three centuries later). He also taught that the image made on the retina is conveyed along the optic nerve to the brain. Razi was the first to recognize the reaction of the pupil to light and Ibn Sina was the first to describe the exact number of extrinsic muscles of the eyeball, namely six. The greatest contribution of Islamic medicine in practical ophthalmology was in the matter of cataract. The most significant development in the extraction of cataract was developed by Ammar Ibn Ali of Mosul, who introduced a hollow metallic needle through the sclerotic and extracted the lens by suction. Europe rediscovered this in the nineteenth century.

PHARMACOLOGY

Pharmacology took roots in Islam during the 9th century. Yuhanna Ibn Masawayh (777-857 A.D.) started scientific and systematic applications of therapeutics at the Abbasids capital. His students Hunayn Ibn Ishaq Al-Ibadi (809-874 A.D.) and his associates established solid foundations of Arabic medicine and therapeutics in the ninth century. In his book Al-Masail, Hunayn outlined methods for confirming the pharmacological effectiveness of drugs by experimenting with them on humans. He also explained the importance of prognosis and diagnosis of diseases for better and more effective treatment.

Pharmacy became an independent and separate profession from medicine and alchemy. With the wild sprouting of apothecary shops, regulations became necessary and imposed to maintain quality control. The Arabian apothecary shops were regularly inspected by a syndic (Muhtasib) who threatened the merchants with humiliating corporal punishments if they adulterated drugs. As early as the days of Al-Ma’mun and Al-Mu`tasim, pharmacists had to pass examinations to become licensed professionals and were pledged to follow the physician’s prescriptions. Also by this decree, restrictive measures were legally placed upon doctors, preventing them from owning or holding stock in a pharmacy.

Methods of extracting and preparing medicines were brought to a high art, and their techniques of distillation, crystallization, solution, sublimation, reduction and calcination became the essential processes of pharmacy and chemistry. With the help of these techniques, the Saydalanis (pharmacists) introduced new drugs such as camphor, senna, sandalwood, rhubarb, musk, myrrh, cassia, tamarind, nutmeg, alum, aloes, cloves, coconut, nuxvomica, cubebs, aconite, ambergris and mercury. The important role of the Muslims in developing modern pharmacy and chemistry is memorialized in the significant number of current pharmaceutical and chemical terms derived from Arabic: drug, alkali, alcohol, aldehydes, alembic, and elixir among others, not to mention syrups and juleps. They invented flavor extracts made of rose water, orange blossom water, orange and lemon peel, tragacanth and other attractive ingredients. Space does not permit me to list the contributions to pharmacology and therapeutics made by Razi, Zahrawi, Biruni, Ibn Butlan, and Tamimi.

PSYCHOTHERAPY

From freckle lotion to psychotherapy- such was the range of treatment practiced by the physicians of Islam. Though freckles continue to sprinkle the skin of 20th century man, in the realm of psychosomatic disorders both Al-Razi and Ibn Sina achieved dramatic results, antedating Freud and Jung by a thousand years. When Razi was appointed physician-in-chief to the Baghdad Hospital, he made it the first hospital to have a ward exclusively devoted to the mentally ill.

Razi combined psychological methods and physiological explanations, and he used psychotherapy in a dynamic fashion. He was once called in to treat a famous caliph who had severe arthritis. He advised a hot bath, and while the caliph was bathing, Razi threatened him with a knife, proclaiming he was going to kill him. This deliberate provocation increased the natural caloric which thus gained sufficient strength to dissolve the already softened humors, and as a result the caliph got up from his knees in the bath and ran after Razi. One woman who suffered from such severe cramps in her joints that she was unable to rise was cured by a physician who lifted her skirt, thus putting her to shame. “A flush of heat was produced within her which dissolved the rheumatic humor.”

The Arabs brought a refreshing spirit of dispassionate clarity into psychiatry. They were free from the demonological theories which swept over the Christian world and were therefore able to make clear-cut clinical observations on the mentally ill.

Najab ud din Muhammad, a contemporary of Razi, left many excellent descriptions of various mental diseases. His carefully compiled observation on actual patients made up the most complete classification of mental diseases theretofore known. Najab described agitated depression, obsessional types of neurosis, Nafkhae Malikholia (combined priapism and sexual impotence). Kutrib (a form of persecutory psychosis), Dual-Kulb (a form of mania).

Ibn Sina recognized ‘physiological psychology’ in treating illnesses involving emotions. From the clinical perspective, Ibn Sina developed a system for associating changes in the pulse rate with inner feelings, which has been viewed as anticipating the word association test of Jung. He is said to have treated a terribly ill patient by feeling the patient’s pulse and reciting aloud to him the names of provinces, districts, towns, streets and people. By noticing how the patient’s pulse quickened when names were mentioned, Ibn Sina deduced that the patient was in love with a girl whose home Ibn Sina was able to locate by the digital examination. The man took Ibn Sina’s advice, married the girl, and recovered from his illness.

It is not surprising to know that at Fez, Morocco, an asylum for the mentally ill had been built early in the 8th century, and insane-asylums were built by the Arabs also in Baghdad in 705 A.D., in Cairo in 800 A.D., and in Damascus and Aleppo in 1270 A.D. In addition to baths, drugs, kind and benevolent treatment given to the mentally ill, musico-therapy and occupational therapy were also employed. These therapies were highly developed. Special choirs and live music bands were brought daily to entertain the patients by providing singing and musical performances and comic performers as well.

CONCLUSION

1,000 years ago Islamic medicine was the most advanced in the world at that time. Even after ten centuries, the achievements of Islamic medicine look amazingly modern. 1,000 years ago the Muslims were the great torchbearers of international scientific research. Every student and professional from each country outside the Islamic Empire, aspired, yearned, and dreamed to go to the Islamic universities to learn, work, live and lead a comfortable life in an affluent and most advanced and civilized society. Today, in this twentieth century, the United States of America has achieved such a position. The pendulum can swing back. Fortunately, Allah the Almighty has given a bounty to many Islamic countries - an income over 100 billion dollars per year. Hence Islamic countries have the opportunity and resources to make Islamic science and medicine number one in the world, once again.

Edited by Shahid Athar M.D. is Clinical Associate Professor of Internal Medicine and Endocrinology, Indiana University School of Medicine Indianapolis, Indiana, and a writer on Islam.

Man Brought Back To Life After Being Clinically Dead For 40 Minutes

39-year old Colin Fielder from Victoria, Australia was clinically dead for 40 minutes—that is until a new resuscitation technique from The Alfred Hospital in Melbourne brought him back to life, according to Herald Sun.

The new technique is one of two being performed by the hospital. They have already resuscitated three patients who were clinically dead—including Melbourne—with deaths spanning from 40 minutes to an hour.

The hospital is experimenting with a mechanical CPR machine which executes continual chest compressions. They are also experimenting with a portable heart-lung machine, most commonly used in theater, which maintains blood and oxygen flow to the brain and vital organs.

The Auto Pulse Machine and extracorporeal membrane oxygenation have been used to treat seven patients so far.

The treatments allow doctors to figure out the cause of the heart attack, treat it, and maintain blood and oxygen flow. This decreases the risk for permanent disability. All three patients that were revived returned home without disability.

The treatment calls for three doctors trained in intensive-care and all the machinery being ready to go on site, said Bernard, which is not available at any other hospital in Victoria.

First Antibiotic-Resistant Gonorrhea Cases Detected In North America

Gonorrhea infects close to 700,000 Americans each year.

Completely Incurable Gonorrhea May Be At Hand

JASON KOEBLER reports,

The fears of major health organizations have come true: Gonorrhea that is immune to the last remaining effective oral antibiotic has been detected in at least nine North American patients, meaning the era of "incurable" gonorrhea could be close.

In a study released Tuesday in the Journal of the American Medical Association, a group of scientists led by Vanessa Allen of Public Health Ontario, found that 6.7 percent of patients with gonorrhea at a Toronto clinic still had the disease after a round of cephalosporins, the last effective oral antibiotic used to treat the disease. Of 133 patients who returned for a "test of cure" visit, nine remained gonorrhea-positive. This is the first time cephalosporin-resistant gonorrhea has been found in humans in North America.

Last year, both the World Health Organization and the Centers for Disease Control warned that untreatable gonorrhea—the world's second most common sexually transmitted infection—could soon be a reality as the bacteria showed increasing resistance to cephalosporins in lab tests.

"These are the clinical cases we've been waiting for," Allen says. "This is the translation of the lab information into what the clinical consequence is."

Previously, there had been a couple individual case reports of untreatable gonorrhea cases in the United Kingdom, Austria, France, Norway, and Japan. In an accompanying editorial, Robert Kirkcaldy of the CDC writes that gonorrhea is quickly becoming a more threatening disease.

"Cephalosporin treatment failures have now been documented in North America," he writes. "Although this milestone was expected, its arrival is deeply troubling."

Gonorrhea is estimated to infect close to 700,000 Americans each year. Symptoms include painful urination, abdominal pain, genital discharge, itching, and infertility in women. Women who have both HIV and gonorrhea are more likely to pass HIV to their offspring than women with just HIV.

Less than a year ago, Gail Bolan, director of the CDC's sexually transmitted disease prevention program, wrote that the "threat of untreatable gonorrhea is emerging rapidly." At the time, just 1.7 percent of gonorrhea isolated in the lab were considered resistant to cephalosporins. Allen says her study shows just how fast antibiotic resistance is evolving in the organisms.

"Our results aren't generalizable to the overall concentration because they all came from one clinic," she says. "But basically, the problem appears worse than we originally thought."

Although each of the nine patients in Canada were cured with the injectable antibiotic known as ceftriaxone, Allen warns that there's been "a parallel increase" in resistance to that antibiotic.

"I think without a doubt this will become a bigger problem," Allen says. "The next threat is when, not if, the same thing happens with ceftriaxone. And then what?"

According to Kirkcaldy, "clinicians now face the emergence of cephalosporin-resistant [gonorrhea] without well-studied, effective backup treatment options."

Via: "US News"

The Portable X-Ray

The hand-held scanners, or tricorders, of the Star Trek movies and television series are one step closer to reality now that a University of Missouri engineering team has invented a compact source of X-rays and other forms of radiation. The radiation source, which is the size of a stick of gum, could be used to create inexpensive and portable X-ray scanners for use by doctors, as well as to fight terrorism and aid exploration on this planet and others.

“Currently, X-ray machines are huge and require tremendous amounts of electricity,” said Scott Kovaleski, associate professor of electrical and computer engineering at MU. “In approximately three years, we could have a prototype hand-held X-ray scanner using our invention. The cell-phone-sized device could improve medical services in remote and impoverished regions and reduce health care expenses everywhere.”

Kovaleski suggested other uses for the device. In dentists’ offices, the tiny X-ray generators could be used to take images from the inside of the mouth shooting the rays outward, reducing radiation exposure to the rest of the patients’ heads. At ports and border crossings, portable scanners could search cargoes for contraband, which would both reduce costs and improve security. Interplanetary probes, like the Curiosity rover, could be equipped with the compact sensors, which otherwise would require too much energy.

The accelerator developed by Kovaleski’s team could be used to create other forms of radiation in addition to X-rays. For example, the invention could replace the radioactive materials, called radioisotopes, used in drilling for oil as well as other industrial and scientific operations. Kovaleski’s invention could replace radioisotopes with a safer source of radiation that could be turned off in case of emergency.

“Our device is perfectly harmless until energized, and even then it causes relatively low exposures to radiation,” said Kovaleski. “We have never really had the ability to design devices around a radioisotope with an on-off switch. The potential for innovation is very exciting.”

The device uses a crystal to produce more than 100,000 volts of electricity from only 10 volts of electrical input with low power consumption. Having such a low need for power could allow the crystal to be fueled by batteries. The crystal, made from a material called lithium niobate, uses the piezoelectric effect to amplify the input voltage. Piezoelectricity is the phenomenon whereby certain materials produce an electric charge when the material is under stress.

Kovaleski’s team published “Investigation of the Piezoelectric Effect as a Means to Generate X-Rays” in the journal IEEE Transaction on Plasma Science. Kovaleski is interim department chair of the Electrical & Computer Engineering in MU’s Department of Engineering.

Via: "University Of Missouri"

Ancient Egyptian Fake Toes Earliest Prosthetic Devices In Existence

Two ancient Egyptian wooden toes have been confirmed as the world's oldest prosthetics, according to scientific tests.

"A brief paper was published in the Lancet in February 2011, but it did not contain the data from the study," Jacqueline Finch, a researcher at the University of Manchester’s KNH Centre for Biomedical Egyptology, said in a statement.

Discovered in the necropolis of Thebe near present-day Luxor, the two artificial toes -- the so-called Greville Chester toe housed in the British Museum and the Tabaketenmut toe at the Egyptian Museum in Cairo -- have been called by several experts the earliest prosthetic devices in existence.

Exquisitely crafted from cartonnage (a sort of papier maché mixture made using linen, glue and plaster) the Greville Chester toe dates from before 600 BC and comes in the shape of the right big toe and a portion of the right foot.

The other false toe, a three-part wood and leather artifact dating from between 950 to 710 B.C., was found attached to the right toe of a mummy identified as Tabaketenmut. She was a priest's daughter who might have lost her toe following gangrene triggered by diabetes.

"There are many instances of the ancient Egyptians creating false body parts for burial, but the wear, plus their design, both suggest they were used by people to help them to walk," Finch said.

"To try to prove this has been a complex and challenging process involving experts in not only Egyptian burial practices, but also in prosthetic design and in computerized gait assessment," she added.

According to the pressure measurements, there were no overly high pressure points in both volunteers, indicating that the false toes were comfortable and not causing any tissue damage.

The performance and perceived comfort of this replacement means that "nascent prosthetic science may have been emerging in the Nile Valley as early as 950 to 710 B.C.," Finch and colleague Ann Rosalie David, professor of biomedical Egyptologyat the University of Manchester, wrote.

The three-part example pre-dates by some 400 years what is currently thought to be the oldest, although untested, prosthetic device. This is a Roman leg made out of bronze and wood in around 300 B.C, known as the Capua leg.

Via: "Discovery News"

FDA OK’s Ingestible Sensor Chip

Proteus Digital Health, Inc. announced Monday that the U.S. Food and Drug Administration (FDA) has cleared its ingestible sensor for marketing as a medical device.

The ingestible sensor (formally referred to as the Ingestion Event Marker or IEM) is part of the Proteus digital health feedback system, an integrated, end-to-end personal health management system designed to help improve patients’ health habits and connections to caregivers.

“The FDA validation represents a major milestone in digital medicine,” said Dr. Eric Topol, professor of genomics at The Scripps Research Institute and author of The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Healthcare. Directly digitizing pills, for the first time, in conjunction with our wireless infrastructure, may prove to be the new standard for influencing medication adherence and significantly aid chronic disease management,”

The Proteus ingestible sensor can be integrated into an inert pill or other ingested products, such as pharmaceuticals. Once the ingestible sensor reaches the stomach, it is powered by contact with stomach fluid and communicates a unique signal that determines identity and timing of ingestion.

This information is transferred through the user’s body tissue to a patch worn on the skin that detects the signal and marks the precise time an ingestible sensor has been taken. Additional physiologic and behavioral metrics collected by the patch include heart rate, body position and activity.

The patch relays information to a mobile phone application. With the patient’s consent, the information is accessible by caregivers and clinicians, helping individuals to develop and sustain healthy habits, families to make better health choices, and clinicians to provide more effective, data-driven care.

Via: "Kurzweil AI"

The RoboDoctor Will Virtually See You Now

 iRobot announced its Healthcare Robotics division in 2009.

RP-VITA stands for "Remote Presence Virtual + Independent Telemedicine Assistant." Beyond simply providing a doctor with the ability to directly interact with patients from just about anywhere in the world, here's a brief rundown on what makes the RP-VITA unique among other telepresence platforms, straight from the press release:

• An enhanced navigation capability that enables the RP-VITA to better manage driving and navigation elements so the health care professional can put more focus on patient care tasks. State‐of‐the-art mapping and Obstacle Detection Obstacle Avoidance (ODOA) technologies allow safe, fast, and highly flexible navigation in a clinical environment.
• An additional capability for the RP-VITA incorporates autonomous navigation and is being submitted to the FDA for 510(k) clearance. This capability will allow a remote clinician or bedside nurse to send the RP-VITA to a target destination with a single click, enabling a number of breakthrough clinical applications. InTouch Health anticipates clearance for this feature in Q4 2012.
• Real-time access to important clinical data, enabling a range of new workflow improvements for physicians, nurses and other patient care team members. For example, the RP-VITA can be integrated with live patient data from the electronic medical record and is equipped with the ability to connect with diagnostic devices such as otoscopes and ultrasound. It comes equipped with the latest electronic stethoscope.
• A new, simple to use iPad1 user interface will enable quick and easy navigation to anywhere the RP-VITA needs to go, as well as interaction with the patient, family and care team.

InTouch, it's important to note, already has a fairly sophisticated telemedicine platform: the RP-7. InTouch knows what it's like to intermix robots with doctors and patients in a hospital environment, but there's more to this than just functionality: as a medical device controlled by a doctor who may be making critical care decisions, the robot itself has to be approved by the U.S. Food and Drug Administration. And that's just for telepresence: RP-VITA still has to go through a separate certification process to allow it to navigate autonomously in places where having a software or hardware issue could have immediate consequences to patients, and to make this work, Ava's original sensor suite has been optimized for performance in a hospital environment, giving the robot the ability to spot things like IV lines and glass doors. This "point and go" style of navigation, where a doctor can just click somewhere on a map of the hospital and the robot will get itself there safely, makes the RP-VITA uniquely user-friendly.




To make a remote doctor as effective as possible, the RP-VITA allows all kinds ofClass II medical devices to be plugged directly into the robot, which will stream data back to the physician in real time. A digital stethoscope is built right in, but you can also plug in (for example) an ultrasound machine, and the doctor will be able to see streaming video. Also, to the extent that the hospital has digitized medical records, all of that information can be made available through the RP-VITA interface as well. 


Looking farther ahead, iRobot wants to expand the hybrid autonomous telepresence capabilities of this platform to tasks like business telepresence and industrial security. The former will be an interesting category for iRobot to tackle: there are already a fair number of players in that space (including Vgo, Anybots, and Suitable Technologies, to name just a few), and it's been hard for anybody to really get a foothold. If iRobot can leverage RP-VITA's skill at autonomous navigation in dynamic environments, there could certainly be some potential there, and we'll be watching closely over the next six months to a year to see how this new telemedicine platform ultimately plays out.


Via: "Spectum"

Meet A Paralyzed Man Who Tweets With His Eyes

Post by "CavalierZee"



How a stroke victim who lost all motor control used Twitter for the first time this week

This is Tony Nicklinson. For the past seven years he's lived in a state of complete paralysis after suffering a stroke. Nicklinson is in the midst of a court battle for the right to end his own life -- he's called his post-accident existence "dull, miserable, demeaning, undignified and intolerable" -- but on June 13, the Brit did something uniquely remarkable: he made his debut on Twitter using only his eyes.

Nicklinson's lost all motor function as a result of his stroke, although his powers of thinking and reasoning are undiminished. The only remaining parts of his body that can move are his eyes. It's symptomatic of a condition called locked-in syndrome, named for the way in which patients who suffer from it are effectively trapped inside their own bodies.

With the help of a computer that tracks his pupil activity, Nicklinson logged onto Twitter from his wheelchair Wednesday and sent a single tweet. Within 24 hours, he had racked up nearly 2,500 followers. In the days since, Nicklinson's sent a handful of new messages, but follows only one other account --@C4Dispatches, operated by the British television channel that produced a video of Nicklinson's tweeting.





Courtesy Of "The Atlantic"

Mind Melding

By Yasmin Anwar, 
Media Relations 
September 22, 2011 
Courtesy Of "UC Berkeley News Center"



Using functional Magnetic Resonance Imaging (fMRI) and computational models, UC Berkeley researchers have succeeded in decoding and reconstructing people’s dynamic visual experiences – in this case, watching Hollywood movie trailers.

As yet, the technology can only reconstruct movie clips people have already viewed. However, the breakthrough paves the way for reproducing the movies inside our heads that no one else sees, such as dreams and memories, according to researchers.

“This is a major leap toward reconstructing internal imagery,” said Professor Jack Gallant, a UC Berkeley neuroscientist and coauthor of the study published online today (Sept. 22) in the journal Current Biology. “We are opening a window into the movies in our minds.”

Eventually, practical applications of the technology could include a better understanding of what goes on in the minds of people who cannot communicate verbally, such as stroke victims, coma patients and people with neurodegenerative diseases.

It may also lay the groundwork for brain-machine interface so that people with cerebral palsy or paralysis, for example, can guide computers with their minds.

Previously, Gallant and fellow researchers recorded brain activity in the visual cortex while a subject viewed black-and-white photographs. They then built a computational model that enabled them to predict with overwhelming accuracy which picture the subject was looking at.

In their latest experiment, researchers say they have solved a much more difficult problem by actually decoding brain signals generated by moving pictures.

“Our natural visual experience is like watching a movie,” said Shinji Nishimoto, lead author of the study and a post-doctoral researcher in Gallant’s lab. “In order for this technology to have wide applicability, we must understand how the brain processes these dynamic visual experiences.” 

Nishimoto and two other research team members served as subjects for the experiment, because the procedure requires volunteers to remain still inside the MRI scanner for hours at a time.

They watched two separate sets of Hollywood movie trailers, while fMRI was used to measure blood flow through the visual cortex, the part of the brain that processes visual information. On the computer, the brain was divided into small, three-dimensional cubes known as volumetric pixels, or “voxels.”

“We built a model for each voxel that describes how shape and motion information in the movie is mapped into brain activity,” Nishimoto said.

The brain activity recorded while subjects viewed the first set of clips was fed into a computer program that learned, second by second, to associate visual patterns in the movie with the corresponding brain activity.

Brain activity evoked by the second set of clips was used to test the movie reconstruction algorithm. This was done by feeding 18 million seconds of random YouTube videos into the computer program so that it could predict the brain activity that each film clip would most likely evoke in each subject.

Finally, the 100 clips that the computer program decided were most similar to the clip that the subject had probably seen were merged to produce a blurry yet continuous reconstruction of the original movie.

Reconstructing movies using brain scans has been challenging because the blood flow signals measured using fMRI change much more slowly than the neural signals that encode dynamic information in movies, researchers said. For this reason, most previous attempts to decode brain activity have focused on static images.

“We addressed this problem by developing a two-stage model that separately describes the underlying neural population and blood flow signals,” Nishimoto said.

Ultimately, Nishimoto said, scientists need to understand how the brain processes dynamic visual events that we experience in everyday life.

“We need to know how the brain works in naturalistic conditions,” he said. “For that, we need to first understand how the brain works while we are watching movies.”

Other coauthors of the study are Thomas Naselaris with UC Berkeley’s Helen Wills Neuroscience Institute; An T. Vu with UC Berkeley’s Joint Graduate Group in Bioengineering; and Yuval Benjamini and Professor Bin Yu with the UC Berkeley Department of Statistics.