Al Razi (Rhazes)- (860-925)

 Basher Ahmed M.D
President Institute of medieval and post medieval studies.

Basheer Photo

Abu Bakr Mohammad Ibn Zakariya Al Razi (known in the west as Rhazes) was born in Rayy (which today is adjacent to Tehran, Iran) in 860 CE (AD).  He became one of the most renowned physicians of the period when Abbasid caliphs reigned (750-1258 CE).  Initially he studied mathematics, astronomy, philosophy, chemistry and music. He gave a brilliant account of his knowledge of music in the book “Fi Jamal il Mauseeqi” (on the beauty of music).  He became interested in Medicine at the age of 30 when he visited Baghdad. He studied the writings of Greek medical scholars including Hippocrates, Galen, and others but developed his own methods of diagnosis and treatment.  He traveled to Egypt and Spain but finally returned to Baghdad as a Chief Physician of Bimaristan and later took charge of Muqtadari Hospital, which was known to be the world’s biggest center for treatment and teaching. It is said that when he was choosing the location to build the hospital, he hung a peace of meat at each of the possible sites.  After a few days, he chose the site where meat showed the least putrefaction.  He was the first physician to infer indirectly the bacteriological putrefaction of meat and environmental contamination, long before the modern concept of airborne infection.

He is considered as one of the greatest clinicians of the medieval period, an original thinker and a researcher. He had a great influence on the development of pharmacy and medicine in the 9th century and his influence in the West lasted until long after the European Renaissance. He  wrote over 200 books of outstanding merit on various medical subjects.  His most famous books are ‘Al Hawi Fil Tib’, ‘Kitab-Al-Mansuri’, and ‘Kitab-Ul-Maliki Jami’. His book, ‘Al-Hawi’ in 20 volumes was written in a span of 20 years.  Al-Hawi (translated as Liber Continens) was an encyclopedia of medical knowledge based on his personal observation and experiences. He cites Greek, Iranian and Arab authorities in respect of every single disease and then adds his own observations and recommendations. One of the important features of this book is that Al-Razi included several sections related to “pharmacy in the healing art”. He arranged data about the drugs in alphabetical order including compound drugs, pharmaceutical dosage and toxicology. This book became one of the standard medical reference works in Renaissance Europe. He published research work on kidney and bladder stone in the 9th volume of Al-Hawi, which was published in its original form with French translation, in Laden, France, in 1896. The National Library of Medicine, in Bethesda, Maryland, U.S.A, while celebrating the 900th anniversary of Al-Razi, recently exhibited a manuscript of this book.

His book on the diseases of childhood was one of the first medical books written on children’s diseases and thus he is known as the father of pediatrics. He also discussed the subject of homosexuality. He  wrote extensively on the causes and on different modalities of treatment. He was the first physician who described homosexuality in clinical terms. He was among the first clinicians who described the disadvantages of excessive consumption of wine, leading to physical and mental illness including cirrhosis of the liver, impotence, and mental deterioration. Although he recommended use of opium for relieving insomnia and cough, he warned against its severe side effects and fatality if used in excessive amounts.

Another book, “Kitab Al-Mansoori” dedicated to Caliph Al Mansur, became famous and remained in the curriculum of European medical schools for centuries.  It consists of 10 sections on anatomy, wounds, injuries, poison, diseases of the body from head to foot, fevers, diet, hygiene, and the influence of psychological factors on health. He also emphasized “Tibb-e-roohani” (spiritual medicine). This showed his interest,  concern for, and penetration into human nature, its complexities and the directions leading into it. This further confirms his appreciation of the importance of psychotherapy and psychology as two important parts of healing art.

In his book “Judari Wal Hasbah”, he described in detail small pox and measles, distinguishing the two diseases from each other. He introduced for the first time the use of mercurial ointment in medicine and he was the first clinician to identify hay fever and its causes.

Another of his books that became famous is Kitab-ul-Jame (encyclopedia).  It has 12 sections describing various aspects of the practice of medicine.  The section on therapeutics discussed the substitutes of many diets and medicines, the method of determining expiration date, and enumerated names of medicines in Persian, Greek and Arabic.  The other sections contained a description of subjects such as the anatomy of eye, ear, liver, heart, joint & testes.  He also wrote on allergy, frostbite, emetics and purgatives.

He strongly discouraged the practice of medicine without knowledge of anatomy, physiology, pathology and pharmacology.  He expected high professional standards and insisted on continuing education for physicians. He even refused to submit to an operation on his eyes when a surgeon who offered to operate could not satisfy him on the question of the number of membranes the eye contains.  Al Razi earned his reputation on clinical observation. He wrote case histories with detailed description of patients and their symptoms.  He also wrote details of clinical trials of treatment in his “chapter on illustrated accounts of patients”.  In his writings he initially followed the pattern developed by famous physician Galen but corrected several errors made by Galen and introduced new data. This was a courageous step to take as medical therapeutic concepts and procedures stated by Galen were blindly accepted and transmitted by his followers and commentators.

Al-Razi’s books were translated into Latin by order of King Charles of France and taught in European medical schools until the 16th century. He was the first to give an account of the operation for the extraction of cataracts. He was also the first to apply chemistry for the preparation of drugs. He is regarded the first Iatric-chemist of the 10th century.

Al-Razi was one of the first physicians to establish medical education for physicians. According to Al-Razi, a physician had to satisfy two conditions: to be eligible to practice medicine in a hospital; he should be well versed in new and old medical literature and he must have worked in a hospital as a trainee.

His works were printed in Europe when printing was still in its infancy.  He exercised a remarkable influence on the minds of scholars of the West for centuries after his death and it passes on to present day in the history of medicine.  His portrait, along with that of Avicenna, still adorns the great halls of the School of Medicine at the University of Paris. He was a major contributor to the advancement of science, medicine, and civilization. The prestigious Razi Institute in Tehran is named for him.