Many, perhaps most, societies have tended to hold medical practitioners in awe, sometimes hoping against hope, given their historically often-limited scientific knowledge, that the right doctor called at the right time can restore health to a suffering patient or even prevent him from slipping away entirely into the next world.
Doctors with the right track record and bedside manner can expect to earn hefty sums, especially when they have famous patients, and they can also become minor celebrities in their own right. However, as a new translation of medical anecdotes by the mediaeval Arab writer Ibn Abi Usaybiah reveals, the one thing that patients, famous or not, cannot reasonably have expected to receive when they did the mediaeval equivalent of picking up the phone to summon a physician was the guarantee of a cure.
Calling in a doctor may have served all sorts of purposes, from psychological reassurance to the sense that one had done the right thing, but any treatment prescribed would have been a pretty hit-and-miss affair, and if the patient did get better it was unlikely to have been because of anything prescribed or carried out by a medical practitioner. Most of the time it is hard not to feel that medieval medicine, at least as described in Ibn Abi Usaybiah’s anecdotes, would have made patients worse.
Born in Damascus in the early 13th century and practising medicine at the Nasiri Hospital in Cairo, Ibn Abi Usaybiah, more fully Ahmed ibn Al-Qasim ibn Khalifah Al-Khazraji Muwaffaqeddin Abul-Abbas, originally qualified in ophthalmology, though we get little sense from his book about what that entailed. He then moved into general practice before combining the practice of medicine with writing books or treatises about it.
According to the informative introduction to the present translation by Geert Jan van Gelder, formerly professor of Arabic at Oxford University in the UK, Ibn Abi Usaybiah — his name means “son of the father of the little finger” — was also employed by members of the ruling Ayoubid Dynasty that ruled Egypt and Syria at the time and had been founded by its most illustrious member, the originally Kurdish conqueror and scourge of the European Crusaders Salaheddin ibn Ayoub, or Saladin.
Ibn Abi Usaybiah seems to have fitted into a slot that has perhaps always been available for doctor-writers, or doctors who also want to make a splash in the literary world, which is that of the insider who allows the curious outside reader a glimpse behind usually closed sickroom doors. He has little to say about the scientific underpinnings of mediaeval medicine, or of what went on in the period’s famous hospitals, such as those whose remains still dot the streets of Islamic Cairo, since his intention was to retail juicy stories about the personal habits of famous members of a professional caste.
What were the foibles of famous doctors? Did they have famous cases or famous patients with unusual illnesses? Were there spectacular failures or remarkable successes? Ibn Abi Usaybiah’s book is celebrity medicine as imagined for readers of tabloid newspapers, where remarkable cures, especially when experienced by famous patients, could lead to the payment of enormous sums and failures could lead to imprisonment or worse.
Van Gelder says that there is no evidence that Ibn Abi Usaybiah was “a particularly outstanding physician, either practical or theoretical,” so his posthumous reputation has to rest on his anecdotes about doctors in a book that van Gelder says is “Herodotean” in scope.
The upside of this is that like the ancient Greek historian Herodotus Ibn Abi Usaybiah’s curiosity did not stop at the limits of his own society. Instead, his book includes details of over 430 physicians “in a tour through some 1,850 years of medics, patients, and patrons from ancient Greece and Rome to India and the lands in between,” in van Gelder’s words. The downside is that a lot of what he has to say looks trivial if what one wants to know is how the medicine described actually worked.
Yet, despite the limitations of Ibn Abi Usaybiah’s methods there is much to be learned from this remarkably readable translation of medical anecdotes, made by members of the Literary History of Medicine Group at Oxford University and published in an abridged paperback edition as well as a complete translation with Arabic text and introductory material online.
The Arabic text, entitled Uyun al-anba fi tabaqat al-atibba, “on the classes of physicians”, and running to some 326,000 words, was published in a first modern edition by the German orientalist August Muller in Cairo in 1882. A new critical edition by Amir Al-Naggar appeared in Cairo in six volumes between 1996 and 2004. The paperback edition of the new English translation, the first ever done, represents around 20 per cent of the Arabic text and comes with van Gelder’s broad-ranging introduction and helpful notes.
A typical Ibn Abi Usaybiah anecdote involves a famous doctor, a preferably famous patient suffering from florid systems, and, if possible, a successful outcome — though that may not matter much if the other two conditions are observed.
While a miracle cure is always welcome since it underlines the author’s decision to remember the doctor concerned, a negative outcome can be a good second best as then the doctor can be thrown into prison or worse by the patient or his relatives, turning the story into a kind of morality tale of the misfortunes that can afflict the famous or the hubris that comes before a fall.
In his section on “Famous Physicians in Egypt”, for example, Ibn Abi Usaybiah describes the work of doctors attending the country’s Arab governor Ahmed Ibn Toloun, now perhaps chiefly known for the vast mosque that bears his name in Islamic Cairo. A demanding employer to say the least, Ibn Toloun seems to have got through doctors at a steady pace, chiefly because they could be made to pay such a very high price if they failed.
Poor Al-Hassan ibn Zirak (died 882 CE), for example, failed to remedy Ibn Toloun’s vomiting and diarrhoea. “Sending for Al-Hassan ibn Zirak, he [Ibn Toloun] said to him: ‘I believe what you prescribed for me today was not correct.’ To which Al-Hassan ibn Zirak replied: ‘Let the emir, may God help him, summon all the physicians of Fustat [the first Arab capital of Egypt] to his residence… I have administered nothing to you except those things whose composition merits your confidence, and all of them stimulate the retentive faculty in your stomach and liver. ‘By God,’ answered Ibn Toloun, ‘if you do not succeed in the treatment of my illness, I will cut off your head.’”
Al-Hassan survived that threat, though not for long, as according to Ibn Abi Usaybiah the anxiety of treating such a patient finally killed him. Then there was Said ibn Tawfil, another physician treating Ibn Toloun. In one case, Ibn Abi Usaybiah says, the emir did not follow the course of treatment prescribed to him and suffered for it as a result. “He called for whips and gave Said ibn Tawfil 200 lashes and had him led around on a camel with a crier proclaiming, ‘this is the reward of one who was trusted but was disloyal.’”
“By God, my service to him would be like that of a mouse to a cat, or a lamb to a wolf. Indeed, I’d rather be killed than attend on him,” Said ibn Tawfil recalls.
If there are many such disasters, there are also some miraculous cures, though one gets the impression that these are due more to the personal charisma of the physician than to any special pretention to scientific knowledge. There are also some celebrity doctors of an entirely different kind, such as are recalled in anecdotes of the mediaeval Jewish philosopher Maimonides (Moses ben Maimon, 1138-1204 CE), born in Muslim Spain but working and practicing in Cairo, the philosopher Ibn Al-Haitham (965-1040), perhaps best known for his book on optics, and the famous translator from Greek into Arabic Hunayn ibn Ishaq (809-873) working at the caliphal library in Baghdad, among others.
No one would want to rely on Ibn Abi Usaybiah for a sense of what makes these men important or of the major achievements of their careers. But his anecdotes help to indicate the high esteem in which they were held throughout the mediaeval Islamic world and the perception that any crumbs of information about them, even as inconsequential as those retailed here, were worth preserving, above all in a compendium that aimed to be as comprehensive as possible in collecting anecdotes about the medical practitioners of the then known world.
Ibn Abi Usaybiah, Anecdotes and Antidotes. A Mediaeval Arabic History of Physicians. Translated by Geert Jan van Gelder et al., Oxford: Oxford University Press, 2020, pp348.
*A version of this article appears in print in the 3 September, 2020 edition of Al-Ahram Weekly