Abu Al-Qasim Al-Zahrawi | Father of Surgery

Al-Qsim Khalaf ibn al-‘Abbs al-Zahrawi al-Ansari (Arabic: أبو القاسم خلف بن العباس الزهراوي;‎ 936–1013), also known as Al-Zahrawi (الزهراوي), and Latinized as Abulcasis (from Arabic Ab al-Qsim), was an Arab Andalusian physician, surgeon, and chemist. He lived from 936 to 1013. He is regarded as the greatest surgeon of the Middle Ages and is known as the “father of modern surgery.”(Al-Ghazal, 2007)

Alzahrawi, who is justifiably recognized as the father of modern surgery, is one of many Moslem intellectuals who contributed to illuminating the way of medical human understanding. His thorough medical texts, which were written before the Renaissance and later, helped to shape European surgical practices. He was a great surgeon, a pioneer in surgical innovation, and an excellent teacher. His patients and students were the focus of his life’s work. No other surgeon of his time could be compared to him, and the entire illustrious Renaissance surgeon had quoted him. He was unquestionably the top surgeon.

Place of Birth

Between 328 and 404 H., Abulqasim Khalaf Ibn Al-Abbas AlZahrawi lived (936-1013 AD). He was raised in Alzahraa, an area of the renowned city of Cordova in Andalusia (Spain) , which carried the torch of knowledge, wisdom, and civilization for the rest of what is now known as Europe while it was still in the dark ages of the Middle Ages. His family is said to be descended from Al-Ansar (the adherents of the Prophet Mohammad, peace be upon him), who first immigrated to Spain from Al Madina Al Monawara in Saudi Arabia. After Alzahraa was destroyed during the subsequent Spanish – Moorish conflicts, little information about this outstanding surgeon’s life was left behind, except his written work.He was initially recorded in the works of Ibn Hazm, who ranked him among the finest healers of Moorish Spain (993–1064 AD). But six decades after Alzahrawi’s passing, Al humaydi: Jadwat Almugtabis [on Andalusian savants] published the first in-depth biography of him.

Names in Latin literature

In western literature, Alzahrawi is referred to as Albucasis, Abulcasis, and Bucasis (all of which are distorted versions of his Arabic “koniah” (nickname), Abul-Qasim), and Zahravius, which is the Latinization of his Arabic birth name Alzahrawi.(Elgohary, 2006)

Childhood and early life

From Cordoba, he received his secondary and postsecondary education. He spent the majority of his life in Cordoba, where he studied, taught, and practiced medicine and surgery. Zahrawi had the good fortune to reside in Cordoba during the height of Islamic culture and civilization, where he was succeeding. The perfect harmony between the three major religions of the medieval era—Christianity, Islam, and Judaism—enabled enormous advancements in the arts, sciences, trade, and medical fields.

Al Zahrawi flourished in the heyday of Cordoba’s Umayyad dynasty. Al-Zahrawi worked as a physician for both the military Caliph, Al-Mansur, and the Umayyad Caliph Al-Hakam II. He provided his medical services for more than 50 years while continuing to be protected by the Al-Andalusia Caliphate authorities, who gave him proper recognition for his scientific achievements.

Al-Zahrawi insisted on treating patients regardless of their social and economic background since he was an utterly egalitarian physician who treated all patients equally, unlike many doctors and hospitals in the current world.He left behind a highly useful text of medical knowledge that he termed Al Thasreef liman Ajaza aniTha’leef since he saw a wide variety of patients every day and recorded his treatment of the patient.

Personal life and Legacy

He loved reading. He was well-versed in the works of Paul and Ataius Al-Amidi, as well as Al-Hawi and Mansouriof Al-Razi, the Royal Book of the Magusian, the Book of Law for Ibn Sina, and other authors that helped him develop his medical character and quality. Reading and staying educated gave him the knowledge he needed about illnesses and how to cure them. He was concerned about patient care and thought that the doctor should perform the procedure themselves rather than delegating it to others, like barbers.Zahrawi is the first to perform surgery by himself, despite the criticism that was directed at him up until the point where he was designated as a flag referee of surgery. The doctors were above the surgical procedures and thought of it as a despicable and contemptible profession that did not fit with them. Surgery is seen as a separate field that does not belong to other medical sciences because of Al-Zahrawi. The stories claim that he was a revered figure who practiced medicine without payment for his services. According to medical literature, women were only treated by midwives. It is obvious that Al-Zahrawi has roots in Eastern Arab origins because his residence doubled as a school and a hospital.He gained notoriety in the field of surgery as a result of accurately reading several of his forebears’ publications, which allowed him to excel in them.

He started to have faith in others who had come after him. At that period, doctors were highly esteemed. At a time when the annual cost of living was 1000 Dhs per person per year, a physician’s annual income might reach 4.9 million Dhs. In these wonderful conditions, Al-Zahrawi had distinguished himself in both medicine and surgery. He spent the big part of his life in Alzahraa. It was where he trained as a physician, lectured, and studied.

Al-Zahrawi passed away in 1013 CE, two years after Alzahra was taken over. In his hometown of Cordoba, a street bears the eminent surgeon’s name. The Spanish Board of Tourism has taken great care to maintain the house where he lived (House No. 6), which is still standing on the street.

Al-Zahrawi Students

Al-Zahrawi cared about instructing his pupils. His objectives were to develop the scientific underpinnings for them and to effectively communicate his scientific message. He wanted the students to clearly understand this through his approach to teaching. He forced them to perform the operation  themselves. Among his most significant pupils:

 

  • Abu Omar bin Yahya bin Ahmed bin Sumiq AlQurtubi arrived in Toledo and was updated by Ibn Sumiq (d. 451 AH). He had a long life of eighty years and was a major participant in several disciplines of science.
  • One of the best doctors in the world, particularly in the field of individual medicine, Abu Al-Murtaf Abdulrahman bin Mohammed bin Abdul-Kabir, is represented by Abin Wafid (d. 467H). He combined the ideas of Descordis and Galen to write a fantastic work. Ibn al-Nun stated that he had established the renowned Mamoun ibn Nun’s garden in Toledo and had been to Cordoba to meet with Zahrawi and learn about medicine firsthand. Al-Wasasadah in medicine, Rashadad, and medical studies are a few of his books.
  • The father of Alhakam Amribn Ahmed, a scientist from Cordoba who excelled in mathematics and engineering, is Abu Bakr al-Karamani (458 AH). He journeyed to Harran, Iraq, where he studied medicine and arithmetic before coming back to Andalusia and settling in Zaragoza. He was skilled at gluing, tightening, cutting, and ironing.
  • Abu Bakr Ahmad bin al-Khayyat, who passed away in 447 CE, had experience with the production of medicines and precise medical care. He is one among many students studying under Abu Qasim Maslama bin Ahmed al-Marhaity, including Abu Aarab Yusuf bin Mohammed, Joseph Ben Ahmed Hassadi, and Abdul Hasan bin Abdul Rahman al-Darami.

Impact on West

Because surgery was a despised profession in his day, Al-Zahrawi is renowned in the field of medicine. He took action right away to change it from a profession that was hated to one that was crucial to human existence. Arab and Western scientists, particularly other doctors of his era, have acknowledged him. The originator of wisdom, devotion, piety, and religion is Al-Zahrawi. He is the author of The Discharge, a book that was created for the surgical community.

Al Zahrawi had an impact on following generations of western scholars, resulting in the translation of his works into western languages by well-known western scholars and translators. Because of Al-praise Zahrawi’s the real cautery, it was widely used throughout the world during the middle centuries, particularly in Western Europe.

According to the reports, Al-Zahrawi was adept in medicine. The “Kitab al Tasrif” and his discoveries for surgery and surgical instruments, which are most well-known and have been studied in Europe for many centuries, are a testament to his brilliance, nobility, and skill in the area of medicine.

Al-Zahrawi has likely received more citations and references than any other doctor, modern or historical.His surgical techniques and treatments had a significant impact on other parts of the world after his death, including Christendom as well as other regions of the world, according to numerous historians and chroniclers of Arabic and Islamic medicine.

The medical book “Cerrahiye-tu I-Hanniye,” written by Serefuddin Sabuncuoglu, was essentially an interpretation of “Kitab Al-Tasrif.” Serefuddin nevertheless included his findings and provided commentary on the surgical techniques. The French surgeon Guy de Chauliac heavily relied on “Kitab-al-Tasrif” and quoted it more than 200 times. 500 years after it was written, Al-masterpiece Zahrawi’s was still having an impact on medical professionals.

“The famous Andalusian surgeon has made many improvements not only in the science of surgery, but in the healing of wounds and surgeons, ophthalmologists, and European teeth with the essential machines for surgery,”

Zigried Honka wrote about Abul Qasim in her book Shams al-Arab.

Abul Qasim is the father of modern surgery, according to Scott. He was praised by Major Physiology Professor Haller, who noted that all European surgeons after the fourteenth century were inspired by his writings. According to Gustav LeBon, Abu Al-Qasem is among the best surgeons in history and is credited with breaking the bladder stones.

In comparison to Hippocrates and Galenus, according to Lucler, Abu al-Qasim was one of the most well-known thinkers of the Middle Ages and was referenced in French academic institutions. And claimed that he had a wealth of personal experiences that led him to believe that the name Abu Qasim al-Zahrawi was a representation of Arab surgery.

Western surgeons have referred to Zahrawi as the finest surgeon in history and regarded his treatise on surgery as the best work produced throughout the Middle Ages. It is evident that al-Zahrawi received praise from Western scholars who were generally more accurate than those from the East. This proves the significance of al-Zahrawi and his scientific accomplishments, which led Europe to study his books, cite doctors and scientists from them, and elevate him to the status of the founder of surgery.(K and 2019)

Al-Zahrawi was the first to

  1. Use cotton in surgical dressings, bleeding control measures, and as padding for fracture splints.
  2. Clearly describe the rare condition haemophilia.
  3. Described the ligation of arteries much before Ambrose Pare and used cautery, wax, and alcohol to prevent bleeding from the skull during cranial surgery.
  4. Show patients how to perform lithotomies in the vaginal position. The ectopic pregnancy was first described by him as a surgeon.
  5. Describe the tracheotomy procedure that was carried out on one of his servants in an emergency.
  6. Write about orthodontics and explain how to fix crooked teeth.(Elgohary, 2006)

Surgical career

Al-Zahrawi specializes in using cauterization to treat sickness. He created a number of tools that are used during surgery for tasks including inspecting the interior of the urethra and inserting and removing foreign objects from the ear, throat, and other body parts. Additionally, he was the first to use an iron tube and caustic metal as a boring device to treat a wart. He was also the first to demonstrate the various cannulae.

While al-Zahrawi never underwent tracheotomy surgery, he did treat a slave girl who had slit her own throat in an effort at suicide. The girl healed after Al-Zahrawi closed the wound with stitches, demonstrating that a laryngeal incision could heal.He wrote the following when outlining this significant case history:

“So, I hurriedly sutured the wound and treated it until healed. No harm was done to the slave-girl except for a hoarseness in the voice, which was not extreme, and after some days she was restored to the best of health. Hence, we may say that laryngotomy is not dangerous”.

In addition, Al-Zahrawi invented neurological diagnostics and neurosurgery. He is reported to have treated headaches, hydrocephalus, subdural effusions, spinal injuries, and head and skull fractures with surgery. Al-Zahrawi provided the first clinical description of a surgical technique for hydrocephalus, clearly describing the removal of superficial cerebral fluid in hydrocephalic children. 

Kitab al-Tasrif

An extensive range of medical themes were covered in Al-thirty-volume Zahrawi’s medical encyclopedia, Kitab al-Tasrif, which was finished in the year 1000 CE. These topics included dentistry, childbirth, pathology, pharmacology, orthopedics, ophthalmology, and surgery. The encyclopedia’s first volume deals with general medical principles, the second with pathology, and the majority of the remaining volumes with pharmacology and drug-related topics. The final and most well-known treatise on surgery is on the subject. Al-Zahrawi claimed that he decided to cover surgery in the final volume because it is the highest form of medicine and one shouldn’t perform it until they have a thorough understanding of all other specialties. A 1500-page illustrated encyclopedia of medicine and surgery is called Al-Tasrif.

 

The study included information that had been gathered over the course of a nearly 50-year career that included training, instruction, and practice. In it, he also discussed the value of a strong doctor-patient bond and talked adoringly about his students, referring to them as “my children.” He also underlined the value of providing care to people regardless of their social standing. He urged a careful examination of each case in order to arrive at the most precise diagnosis and the most effective course of action.

Modern analysis of the al-Tasrif text has uncovered early descriptions of several medical operations that were ascribed to later physicians but were not always correctly credited. For instance, Al-al-Tasrif Zahrawi detailed the “Walcher position” in obstetrics as well as what would later be referred to as “Kocher’s way” for treating a dislocated shoulder. Al-Tasrif was also the earliest known book to explain the genetic nature of hemophilia and provided instructions on how to ligature blood vessels about 600 years before Ambroise Paré. Nearly 600 years before Pare documented that he had ligated his own temporal artery for headaches that conform to modern descriptions of migraine, it was also the first to describe a surgical treatment for ligating the temporal artery for the condition.Al-Zahrawi was thus the first to describe the migraine surgery technique that is currently seeing a rebirth in the 21st century, led by South African surgeon Elliot Shevel.

Surgery and Instruments

The thirty-first and final volume of Kitab al-Tasrif are titled On Surgery and Instruments. It is without a doubt his most significant work, and it is the one that gave him lasting authority in Europe. The first ever illustrated surgical manual was On Surgery and Instruments. Its descriptions and contents have influenced numerous medical technical advancements, particularly the choice of instruments for a particular surgery. Al-Zahrawi illustrates each tool used in various operations in his book to make it clear how to carry out the processes of each therapy. Three books make up the whole text, which is aimed at medical students who want to learn more about the techniques and equipment required in the field of surgery.

He structured the chapter on surgery in Al-Tasrif into three pieces: one on cauterization (56 sections); one on surgery (97 sections); and one on orthopaedics (35 sections).

  • Surgery involves the throat, ears, and eyes. He went into detail about tracheostomy and tonsillectomy.
  • He created tools for an inside ear examination.
  • He created a tool for removing or putting things down the throat.
  • He explained how to remove a polyp from the nose using a hook.
  • He explained how to expose and divide the temporal artery to treat specific headache kinds.
  • He used cauterization, typically to treat open abscesses or skin cancers. He performed up to 50 different procedures using the cauterization technique.
  • Application of a ligature to a bleeding vessel and catgut internal stitching. He existed five centuries before Ambroise Pare (1510–1590), a well-known French military physician who is credited with being the first to use sutures in Europe.
  • Anal fistula treatment.
  • Fixing broken and dislocated bones. He used a similar procedure to Kocher’s for establishing and decreasing dislocated shoulders centuries before Kocher did so for European medicine.
  • Removal of bladder calculi in the urine. He suggested that the treating doctor should place a finger into the patient’s rectum, slide the stone to the bladder’s neck, then make an incision in the rectal wall or the perineum to remove it.
  • He created tools for inspecting the urethra.
  • He is recognised as being the pioneer in ectopic pregnancy description.
  • He created many dental tools including animal bone-based prosthetic teeth.
  • Operative surgery is credited to Al Zahrawi as its founder. He is recognised as having completed the first thyroidectomy. His extensive work “On Surgery,” which was written in chapters, has a section on surgical equipment.By all accounts, the number of surgical instruments he introduced—more than 200—is astounding. He provided in-depth explanations of how to use hooks, scalpels, and surgical blades. Additionally, he developed and created obstetric forceps, gripping forceps, and surgical scissors. The first surgical instrument images for use in instruction and methods of production were those of him.

Gerard of Cremona translated the work into Latin in the 12th century. It quickly gained traction in Europe and established itself as a basic text at all significant medical universities, including those in Salerno and Montpellier. For the following 500 years, it served as the principal source of surgical knowledge in Europe, and according to Arturo Castiglioni, a medical historian, al-treatise Zahrawi’s “had the same authority in surgery as did the Canon of Avicenna in medicine.”

Al-Zahrawi claims in the introduction of his book that the underdeveloped state of surgery in the Islamic world and the poor regard in which doctors held it at the time are the reasons he decided to write this treatise. Al-Zahrawi attributed this deterioration to anatomical ignorance and ignorance of human physiology. Surgery requires a person to be well-versed in the science of anatomy.

Noting the importance of anatomy, he wrote

“Before practicing surgery one should gain knowledge of anatomy and the function of organs so that he will understand their shape, connections and borders. He should become thoroughly familiar with nerves muscles bones arteries and veins. If one does not comprehend the anatomy and physiology one can commit a mistake which will result in the death of the patient. I have seen someone incise into a swelling in the neck thinking it was an abscess, when it was an aneurysm and the patient dying on the spot.”

Al-Zahrawi invented more than 200 surgical tools, such as various scalpels, retractors, curettes, pincers, and specula, as well as tools for his preferred cauterization and ligation techniques. He also created surgical hooks with a double tip. Many of these tools had never been utilized by any surgeons before.

Modern surgery still uses a catgut to suture internal organs nowadays. The body seems to accept the catgut as the only naturally occurring substance that can dissolve. An observation was made by Al-Zahrawi after his monkey consumed the oud’s strings. According to an illustration in the Al-Tasrif, Al-Zahrawi also created the forceps used to remove a dead fetus.(Ahmed, 2022)

Other Contributions

He also worked on midwifery, meteriamedica, cooking and dietetics, weight and measures, foundational medical chemistry, therapeutics, and the treatment of wounds in addition to medicine and surgery. In his compendium, he also provides technical terms. Since several branches of knowledge were combined and integrated during his time, In the name of specialization, he attempted to divide other fields of study from medicine. Alchemy, theology, and philosophy are a few such subjects that many experts in the field were fusing with medical research.

Chemistry and Cosmetology

 

The 19th volume of Kitab al Tasrif, written by the chemist Abul Qasim, contains a chapter on cosmetology. He developed a number of medicated cosmetics, detailing their in-depth ingredients and advantages, such as underarm deodorants, hair removal sticks, hand lotions, hair colors for turning human hair blond or black, and hair care for gathering kinky or curly hair, and early suntan lotions. He offered cinnamon, nutmeg, cardamom, and chewing on coriander leaves as remedies for terrible deaths brought on by eating garlic or onions. Aside from mineral oils used for aesthetic and beautifying purposes, he also created solid lipsticks, which were made of perfumed stocks that were rolled and pressed in certain molds.Additionally, he discussed the maintenance and enhancements of the hair, skin, teeth, and other aspects of the body that are advised in Islamic hadiths. He discussed techniques for gum support in aesthetic dentistry as well as the use of tooth whiteners for tooth whitening. His compendium popularised the practice of bringing flowers when visiting a sick person in the hospital. He made significant advancements in the field of fragrance and created perfumed stocks, which are roll-on deodorants that are pressed and rolled in particular molds.

Pharmacology

 

Pharmacology encompasses a field that is concerned with correctly identifying and labeling medications using knowledge of the Arabic and Greek languages.Volumes of the Zahrawi compendium were devoted to providing translations and explanations for the names of medications in many languages (e.g. Arabic and Spanish).

In his writings, where he provided an extensive list of prescriptions for a wide range of illnesses, medicines, and drug therapy were given significant attention. Each prescription specifies the quantity or weight of the ingredients, the preparation and compounding process, the dose, and the administration route. The medications are given in a variety of dosage forms, including tablets, syrups, decoctions, and potions.There was a lot of discussion about practical pharmacology, materia medica, and drug manufacture. He enumerated the weights and measurements used throughout the Eastern Caliphate in addition to Greek and Egyptian ones (Hamarneh, 1959). Al-chapters Tasrif’s on therapeutics covered a variety of subjects, including the use of pharmaceuticals in place of invasive procedures and the use of diuretics, heart drugs, Materia medica, cosmetics, and emetics (Cosman, 2009). The issue of how long a drug’s potency lasted was one of obvious importance to pharmacists and their clients. In his book Minhaj al-dukkan, Al-Kuhin Al-Attar recommended that readers pay attention to what al-Zahrawi has to say about the matter.

The durations of the effectiveness of basic pharmaceuticals and compound medicines are discussed in the fourth chapter of the 25th volume of Al-Tasrif. Al-Zahrawi gave mineral medications more consideration, pointing out that gold and rubies are less corruptible than silver, copper, and iron. The 29th volume was extremely valuable to apothecaries and pharmacists because it featured multilingual listings of drug names and synonyms that appeared in it, along with information about their stability.

Psychology

 

As a psychiatrist, he provided his patients with opium-based medications that encouraged happiness and joy. After taking the dose, it calms the mind, banishes negative thoughts and anxieties, controls tempers, and treats the patient in other ways. He also covered the technical steps involved in manufacturing and purifying chemicals like litharge, ceruse (white lead), iron pyrite (crystalline marcasile), vitriots, and verdigris for use as medicines.

Medication

 

In his chapter on cosmetics, Al-Zahrawi discussed a range of treatments he invented. He developed the drugs Lafayfe and Ghawali to treat epilepsy and seizures. He created Muthallaathat, a remedy for common colds that was made from camphor, musk, and honey and was comparable to modern Vicks Vapour Rub. He also created powerful mouthwashes, hand creams, and nasal sprays.

Hematology and Heredity

 

Al Zahrawi, a specialist in hematology, described hemophilia, a hereditary genetic illness, for the first time in his compendium. He described an Andalusian family whose male members passed away from bleeding after suffering minor injuries.(K and 2019)

Legacy

 

Al-Tasrif was cited more than 200 times by the French surgeon Guy de Chauliac in the fourteenth century. Al-Zahrawi was referred to as “without a doubt the chief of all surgeons” by Pietro Argallata (d. 1453). Al-Tasrif was frequently mentioned by French surgeon Jacques Daléchamps (1513–1588), demonstrating that al-impact Zahrawi’s persisted for at least five centuries and reached into the Renaissance.

Calle Albucasis, the street in Cordova where he resided, is named in his honor. He resided in House No. 6 on this street, which is still standing today thanks to the Spanish Tourist Board. A bronze plaque bearing the inscription “This was the house where Al-Zahrawi lived” was presented to the property in January 1977.

Conclusion

Al-Zahrawi was a renowned educator, psychiatrist, and one of the greatest surgeons of medieval Islam, so to sum it up. To child education and behavior, table manners, school curricula, and academic specialization, he devoted a sizable section in the Tasrif. Galen’s methods were surpassed by Albucasis’, and they remained in vogue in medieval Europe for 500 years after their usefulness had expired. Although he acknowledged that “this part of surgery has passed into the hands of vulgar and uncultivated minds, for which reason it has fallen into disdain,” he nevertheless contributed to elevating the reputation of surgery in Christian Europe.After Guy de Chauliac (d.1368), a French surgeon who practiced in the 14th century, the Albucasis procedure was firmly grafted onto the medical landscape of Europe. Over 200 times, he cited al-Tasrif. Al-Zahrawi was referred to as “without a doubt the chief of all surgeons” by Pietro Argallata (d. 1453). Al-Tasrif was frequently mentioned by French surgeon Jacques Daléchamps (1513–1588), demonstrating that al-impact Zahrawi’s persisted for at least five centuries and reached into the Renaissance

AHMED, N. 2022. Al-Zahrawi, the father of Surgery [Online]. Available: https://historyofislam.com/2022/01/14/al-zahrawi-the-father-of-surgery/ [Accessed 07/21/22].

AL-GHAZAL, S. K. 2007. Al-Zahrāwī (Albucasis) the Great Andalusian Surgeon.

ELGOHARY, M. A. 2006. Al Zahrawi: The father of modern surgery. Ann Ped Surg, 2, 82-7.

K, M. S. & 2019. Abul Qasim Al Zahrawi:The Father of Modern Surgery

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