European Scientific Journal May 2016 /SPECIAL/ edition ISSN: 1857 7881 (Print) e - ISSN 1857- 7431

Abulcasis Al-Zahrawi, The Surgeon Of Al-Andalus

Prof.Dr.Luisa Maria Arvide Cambra

Department of Philology. University of Almeria. Spain

Abstract
Among the many scientists who enriched the scientific panorama in
medieval Spain, one of the greatest is without any doubt the Cordovan
physician and surgeon Abulcasis Al-Zahrawi (circa 936-circa 1013). This
paper is an approach to his figure and work, with special reference to his
main writing, the Kitab al-Tasrif (Book of the medical arrangement) and
analyzes his significance in the history of medicine and surgery.
Keywords: Abulcasis Al-Zahrawi, medieval Arabic science, history of
medicine and surgery in Al-Andalus, scientific knowledge of the Middle
Ages, Kitab al-Tasrif
Introduction
Among the many scientists who enriched the scientific panorama in
medieval Spain, one of the greatest is without any doubt the Cordovan
physician and surgeon Abulcasis Al-Zahrawi (circa 936-circa 1013) (AlDabbi, 1884-1885). His full name is Abu-l-Qasim Khalaf Ibn Abbas AlZahrawi (Ibn Abi Usaybia, 1979) and he is known in the Latin tradition by
several names, being Abulcasis the most usual of all. He was born in the
suburb of Madinat Al-Zahra in Cordova, around 936 and died around 1013
(Ibn Bashkuwal, 1885; Ibn Al-Abbar, 1915). He lived in the golden times of
the Umayyad Caliphate of Al-Andalus but few data of his biography are
known and therefore the available information about him has to be taken
with caution since there are many gaps in this regard (Ibn Al-Khattabi,
1988).
The importance of Abulcasis (Tabanelli, 1961), who was
simultaneously physician, surgeon, phamacist, ophtalmologist and dentist, is
unquestionable (Leclerc, 1876); and this is restricted not only to the history
of Arabic science (Mieli, 1966) but also to the history of the universal
scientific knowledge due to the influence that his achievements had got all
over Europe till late 16th century (Ullmann, 1970).
Abulcasis wrote two works (Sezgin, 1975): a) Kitab al-tasrif li-man
ajiza an al-talif (Book of the medical arrangement for those who are not
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capable of its knowledge by themselves), that is his masterpiece, known as

Kitab al-Tasrif or simply Al-Tasrif; and, b) Kitab fi-l-tibb li-amal aljarrahin (Book of medicine for the practice of the surgeons), not edited yet
and included in the MS Deutsche Staatsbibliothek of Berlin, num.6254,
mf.91, which, according to the explanation of Abulcasis made in the
introduction of the book, is a summary of surgery written by Al-Zahrawi for
his pupils as an appendix of his career of physician and as an abstract of his
experience of surgeon; and it probably is a compendium of the 30th treatise
from Al-Tasrif (Brockelmann, 1937).
The Kitab al-Tasrif
The Kitab al-Tasrif is an encyclopaedic compendium of theoretical
and practical medicine that was written around 1000 (Kahhala, 1988). It is
divided into thirty treatises and is contained in six Hebrew manuscripts:
- Ms Bibliothque Nationale, Paris, num.951,1162,1167,1168 (treatises I-II)
- Ms Bibliothque Nationale, Paris, num.1163 (treatises XVIII-XXX)
- Ms Bibliothque Nationale, Paris, num.1165 (treatise XXV)
- Ms Bibliothque Nationale, Paris, num.1166 (treatise XXX)
- Ms Bibliothque Nationale, Paris, num.1162 (probably complete)
- Ms Bodleain Library, Oxford, num.414,415 (complete)
Al-Tasrif is also contained partially or completely in thirty-nine
Arabic manuscripts distributed worldwide (Arvide Cambra, 1997).
The subject of every treatise is as follows:
- The treatise I is about physiology, humours, natures and natural elements as
well as classification and explanation of the body organs.
- The treatise II is about phatology, the different diseases, symptoms, causes
and treatment.
- The treatise III is about recipes of electuaries, stored and preserved.
- The treatise IV is about theriacs and antidotes for poisons.
- The treatise V is about laxatives and their preservation.
- The treatise VI is about purgative drugs.
- The treatise VII is about emetics and enemas.
- The treatise VIII is about laxatives of good taste.
- The treatise IX is about cardiology and beneficial drugs for heart.
- The treatise X is about electuaries, suppositories and purgatives.
- The treatise XI is about composite medicaments called jawarish and
electuaries prepared with cumin named kammuniyyat.
- The treatise XII is about fattening drugs and diuretics.
- The treatise XIII is about syrups.
- The treatise XIV is about boiled musts, vulcanized and macerated
remedies, laxatives and not laxatives.

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- The treatise XV is about recipes of marmalade electuaries and their

preservation.
- The treatise XVI is about medicinal dusts.
- The treatise XVII is about medicinal pills.
- The treatise XVIII is about inhalants, vapours, gargles, gouts and nasal
anti-haemorrhagic remedies.
- The treatise XIX is about perfumes, fragrances, remedies for body
embellishment and preparation of algalias.
- The treatise XX is about ophtalmology.
- The treatise XXI is about stomatology and odontology.
- The treatise XXII is about remedies for the chest.
- The treatise XXIII is about dressings and bandages.
- The treatise XXIV is about ointments and pomades.
- The treatise XXV is about oils and unguents.
- The treatise XXVI is about the diet in the illness and the health.
- The treatise XXVII is about simple and composite remedies as well as
foods.
- The treatise XXVIII is about preparation of simple remedies and their
benefits, as well as about the therapeutic application of the combustion of the
minerals.
- The treatise XXIX is about the name of the drugs into the differents
languages, synonyms and subtitutes, as well as about weights and measures.
- The treatise XXX is about surgery.
Al-Tasrif is one of the most voluminous works made in the
Islamic medieval world because it comprises a wide spectre of scientific
knowledge prevailing at that time (Lindberg, 1978): medical and surgical
science, both in theory and in practice, diets and pharmacopoeia. The book
was written by Al-Zahrawi as a training manual for the students of his
private school of medicine that he led in Spain with all probability (SavageSmith, 2002).
There is a facsimile edition of the whole book Al-Tasrif made by Fuat
Sezgin according to the Arabic manuscript num.502 from the Sleymaniye
Umumi Ktphanesi Library of Istanbul, which was published by the
Institute for the History of Arabic-Islamic Science at the Johann Wolfgang
Goethe University, Frankfurt am Main (Sezgin, 1986). There are also some
partial editions: Treatise XVI (Arvide Cambra, 1994), according to the
Arabic manuscript num.5772 from the Bibliothque Nationale of Paris and
the Arabic manuscript num.502 from the Sleymaniye Umumi Ktphanesi
Library of Istanbul; Treatise XVII (Arvide Cambra, 1996); Treatise XVIII
(Gil Gangutia, 1995); Treatise XIX, Part II (Arvide Cambra, 2010), facsimile
edition according to the Arabic manuscript num.5772 from the Bibliothque
Nationale of Paris; Treatise XX (Arvide Cambra, 2000), according to the

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Arabic manuscript num.5772 from the Bibliothque Nationale of Paris;

Treatise XXI (Arvide Cambra, 2003), according to the Arabic manuscript
num.5772 from the Bibliothque Nationale of Paris; Treatise XXV
(Hamarneh & Sonnedecker, 1963); and Treatise XXX (Channing, 1778; Pink
& Lewis, 1973).
On the other hand, there are Medieval and Renaissance partial
translations from Arabic: Treatises I-II, tanslated into Hebrew by Chem
Tobb, and by Mechoulan; and translated into Latin with the title of Liber
theoricae nec non practicae Alsaharavii in prisco Arabum medicorum
conuentu facile principis, qui vulgo acararius dicitur. Alzahaavii
compendium artis, which was published at Augsburg in 1490; Treatise
XXVII, translated into Hebrew by Chem Tobb according to the Hebrew
manuscript num.1163 from the Bibliothque Nationale of Paris; Treatise
XXVIII, Liber servitoris, translated into Latin by Simon of Genova and
Abraham Judeus of Tortosa and printed by Nicola Jenson Gallicum at
Venice in 1471; Treatise XXIX, Part V, Explicatio ponderum et mensurarum
in libris medicis accurrentium, translated according to the Arabic manuscript
num.42 from the Bodleian Library in Oxford; and Treatise XXX, translated
into latin by Gerard of Cremona with the title of Albucasis methodus
medendi cum instrumentis ad omnes fere morbis depictes and printed at
Venice in 1497, 1499 and 1500, and many other editions.
There are also partial translations into French, English and Spanish of
contemporay times: a) French translations: Treatise XXIX, Part V (Sauvaire,
1884); and Treatise XXX (Leclerc, 1861); b) English translations: Treatise
XXV (Hamarneh & Sonnedecker, 1963); and Treatise XXX (Pink & Lewis,
1973); c) Spanish translations: Treatise XVI (Arvide Cambra, 1994);
Treatise XVII (Arvide Cambra, 1996); Treatise XVIII (Gil Gangutia, 1995);
Treatise XIX, Part II (Arvide Cambra, 2010); Treatise XX (Arvide Cambra,
2000); and Treatise XXI (Arvide Cambra, 2003).
The Kitab al-Tasrif was used until the 16th century as a reference
manual and textbook by the specialists in East and also, thanks to the Latin
translations, in West in Christian world. This medical compendium contains
a lot of mentions to other works and to Ancient and Islamic authors such as,
for example, Dioscorides, Paulos of Egina, Erasistratos of Keos, Archigenes
of Apamea, Galen, Yuhanna Ibn Masawayh, Al-Razi, Hunayn Ibn Ishaq, Ibn
Al-Jazzar, Al-Hajjaj, Ishaq Ibn Imran, Ibn Juljul and Ibn Haytham, etc. All
this is a testimony of the high scientific knowledge that Abulcasis reached.
The treatise XXX on surgery was translated into Latin by Gerard of
Cremona (d.1187) and was considered during five centuries as the manual of
surgery in the medical school of Salerno in Italy, that of Montpellier in
France and other important European schools of medicine. It contains the
most ancient surgical instruments in history and about two-hundred of these

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instruments are described together with many diagrams and illustrations as

well as with the appropiate instructions for their correct use. These
illustrations are the earliest known to be intended for teaching. These
instruments had a great influence in all the later Arab authors, supported the
surgical basis of Europe and left an important mark on the Christian surgeons
in the Middle Ages and the Renaissance, such as Roger Frugard, Roland of
Parma, Ferrari, Lanfranc, Guy de Chauliac and Walther Hermann Ryff
(Campbell, 1974).
In pharmacology, Al-Tasrif due to its contributions exceeded the
Materia Medica of Dioscorides which Abulcasis had known thanks to Istifan
Basil's Arabic version corrected by Hunayn Ibn Ishaq in the 9th century. In
addition, Al-Zahrawi discussed in the pages of the book about the
preparation of some drugs and described in detail the application of a few
techniques such as sublimation and decantation. Abulcasis is certainly along
with Al-Ghafiqi (d.1165) and Ibn Al-Baytar (d.1248) one of the most
outstanding personages of Islamic science for his contributions to the history
of medieval pharmacopoeia (Levey, 1973).
In medicine, among the most remarkable achievements of Abulcasis,
we have, fo instance:
1) In Al-Tasrifs treatises I and II Abulcasis described in detail for
first time and with accuracy the disease called today haemophilia as "a
haemorrhagic illness transmitted to the male children by women who are not
infected", as well as classified three-hundred twenty five diseases and
discusses their symptomatology and treatment.
2) Moreover, in his work Abulcasis described the hydatid cysts, the
lachrymal fistula and the ear polyps; he made an interesting explanation
about a case of hydrocephalus, resulting from a congenital defect caused by a
blocked drainage in the patient's cerebral fluid; he introduced what is known
now as the Walcher position in obstetrics and devised new obstetrical
forceps.
3) Abulcasis insisted on the usefulness of teaching anatomy and
physiology and the need for training in surgery, etc.
Physiology and surgery in Islam and Christendom during the Middle
Ages had very few competent guarantors and this was largely due to the
taboo existing on human dissection. The surgeons educated in that time
were never considered less important that other specialists but only a few of
them practised surgery because of the risks, difficulties and doubts that were
supposed in this science.
The first basis in the development of this
science was the translation of the ancient texts on anatomy and surgery,
especially the Greek tradition's ones; this labour was principally made by
Hunayn Ibn Ishaq in the 9th century. The Indian, Persian, Egyptian, Roman
and Chinese surgery also had influence upon the Arabic one. Ibn Masawayh

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(d.857) emphasized its importance and Al-Majusi (d.994) wrote about the
transcedence of surgery applied on fractures and treatment of wounds. But,
Al-Zahrawi was the first who devoted to surgery an entire treatise, the
treatise XXX of the Kitab al-Tasrif, which includes cauterizations, removal
of stones from the kidney and the bladder, bloodletting, scarifications,
adjustment of bones and joints, extraction of stinging instruments,
extirpation of polyps, dissection of animals, midwifery, obstetrics and use of
surgical material, treatment of fractures, breaks, incisions, perforations and
wounds, use of several types of sewing thread in surgical operations and
methods for stopping the haemohrrages as well as surgery of eyes, ear and
throat, and many others.
Among the contributions to surgery from Abulcasis, we can underline
that he was the first in recommending surgical removal of a broken patella
and the first in practicing on women the lithotomy. Abulcasis also made
some original descriptions of manufacture and use of probes, surgical knives
and scalpels of diverse shapes and designs; he invented several types of
surgical scissors and forceps, and was the first in describing accurately aural
polyps and lithotomy using special lancets; he described the lachrymal fistula
and other operations of the eyes in which he used pointed blades and
speculums; he made ligatures of arteries and recommended several types of
threads in suturing; he appied plasters and bandages fractures; etc
In addition, he increased the rank of surgery until the same level as
medicine thanks to his ability and his capacity of remark as well as his
careful practice. He perfected some delicate surgical operations, including
removal of dead foetus and amputation of limbs. He introduced new ideas on
cauterization of wounds and insisted upon the need of techniques for
vivisection and dissection. He was the inventor of some instruments, for
example: an instrument for internal examination of ear, an instrument for
internal inspection of the urethra (Otero Tejero & alii, 2007), an instrument
for removal of spines, bones and other sharp elements from the throat, some
obstetrical forceps and several types of scissors, etc.
Abulcasis was also an expert in dentistry and his masterpiece, the
Kitab al-Tasrif, contains sketches of various instruments used in this
scientific field, in addition to a descripction of some important operations.
He discussed the problem of unaligned or deformed teeth and how to correct
these defects, and for that reason he is considered as a precursor of the
modern orthodoncy. Moreover he developed the technique of preparing
artificial teeth and replacing defective teeth. The odontological texts included
in the treatises XXI and XXX from Al-Tasrif contain among other things, for
example, extraction and filling of teeth as well as dental prosthesis besides
many advises for a correct oral health and hygiene, etc.

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The methods employed by Abulcasis eclipsed those of Galen and

maintained a dominant position in the European medicine for longer than
five centuries by means of the Latin translations. And for that reason,
Abulcasis is without any doubt one of the most prominent scienticists in
history and his work one of the most important and representative of the
scientific literature.
Conclusion
Abulcasis Al-Zahrawi is an example of the high scientific level
reached by Arab and Islamic medicine in the Middle Ages. He was the first
surgeon of Muslim world and increased the rank of surgery to the same level
as medicine. The Kitab al-Tasrif is part of the important cultural and
scientific legacy brought by the Arabs and, for this reason, his author is set in
a very outstanding place in history of universal science.
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