Physician Avicenna

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1. Unani medicine

Ibn Sina (Persian ÇÈä ÓíäÇ or ÇÈæ Úáí ÓíäÇ; August c. 980 - June 1037), commonly known as Ibn Sînâ, or in Arabic writing Abû ?Alî al-?usayn ibn ?Abd Allâh ibn Al-Hasan ibn Ali ibn Sînâ[2] (Arabic ÃÈæ Úáí ÇáÍÓíä Èä ÚÈÏ Çááå Èä ÓíäÇ) or by his Latinized name Avicenna, was a Persian polymath, who wrote almost 450 works on a wide range of subjects, of which around 240 have survived. In particular, 150 of his surviving works concentrate on philosophy and 40 of them concentrate on medicine.

His most famous works are The Book of Healing, a vast philosophical and scientific encyclopedia, and The Canon of Medicine, which was a standard medical text at many medieval universities. The Canon of Medicine was used as a textbook in the universities of Montpellier and Leuven as late as 1650. Ibn Sînâ's Canon of Medicine provides an overview of all aspects of medicine according to the principles of Galen (and Hippocrates).

His corpus also includes writing on philosophy, astronomy, alchemy, geology, psychology, Islamic theology, logic, mathematics, physics, as well as poetry. He is regarded as the most famous and influential polymath of the Islamic Golden Age.

2. Circumstances

Avicenna created an extensive corpus of works during what is commonly known as the Islamic Golden Age, in which the translations of Greco-Roman, Persian, and Indian texts were studied extensively. Greco-Roman (Mid - and Neo-Platonic, and Aristotelian) texts by the Kindi school were commented, redacted and developed substantially by Islamic intellectuals, who also built upon Persian and Indian mathematical systems, astronomy, algebra, trigonometry and medicine. The Samanid dynasty in the eastern part of Persia, Greater Khorasan and Central Asia as well as the Buyid dynasty in the western part of Persia and Iraq provided a thriving atmosphere for scholarly and cultural development. Under the Samanids, Bukhara rivaled Baghdad as a cultural capital of the Islamic world.

The study of the Quran and the Hadith thrived in such a scholarly atmosphere. Philosophy, Fiqh and theology (kalaam) were further developed, most noticeably by Avicenna and his opponents. Al-Razi and Al-Farabi had provided methodology and knowledge in medicine and philosophy. Avicenna had access to the great libraries of Balkh, Khwarezm, Gorgan, Rey, Isfahan and Hamadan. Various texts (such as the 'Ahd with Bahmanyar) show that he debated philosophical points with the greatest scholars of the time. Aruzi Samarqandi describes how before Avicenna left Khwarezm he had met Rayhan Biruni (a famous scientist and astronomer), Abu Nasr Iraqi (a renowned mathematician), Abu Sahl Masihi (a respected philosopher) and Abu al-Khayr Khammar (a great physician).

3. BiographyEarly life

The only source of information for the first part of Avicenna's life is his autobiography, as written down by his student Jûzjânî. In the absence of any other sources it is impossible to be certain how much of the autobiography is accurate. It has been noted that he uses his autobiography to advance his theory of knowledge (that it was possible for an individual to acquire knowledge and understand the Aristotelian philosophical sciences without a teacher), and it has been questioned whether the order of events described was adjusted to fit more closely with the Aristotelian model; in other words, whether Avicenna described himself as studying things in the 'correct' order. However given the absence of any other evidence, Avicenna's account essentially has to be taken at face value.

Avicenna was born c. 980 in Afšana, a village near Bukhara (in present-day Uzbekistan), the capital of the Samanids, a Persian dynasty in Central Asia and Greater Khorasan. His mother, named Setareh, was from Bukhara; his father, Abdullah, was a respected Ismaili[19] scholar from Balkh, an important town of the Samanid Empire, in what is today Balkh Province, Afghanistan. His father was at the time of his son's birth the governor in one of the Samanid Nuh ibn Mansur's estates. He had his son very carefully educated at Bukhara. Ibn Sina's independent thought was served by an extraordinary intelligence and memory, which allowed him to overtake his teachers at the age of fourteen. As he said in his autobiography, there was nothing that he had not learned when he reached eighteen.

A number of different theories have been proposed regarding Avicenna's madhab. Medieval historian ?ahîr al-dîn al-Bayhaqî (d. 1169) considered Avicenna to be a follower of the Brethren of Purity. On the other hand, Dimitri Gutas along with Aisha Khan and Jules J. Janssens demonstrated that Avicenna was a Sunni Hanafi. However, Shia faqih Nurullah Shushtari and Seyyed Hossein Nasr, in addition to Henry Corbin, have maintained that he was most likely a Twelver Shia. Similar disagreements exist on the background of Avicenna's family, whereas some writers considered them Sunni, more recent writers thought they were Shia.

According to his autobiography, Avicenna had memorised the entire Quran by the age of 10. He learned Indian arithmetic from an Indian greengrocer, and he began to learn more from a wandering scholar who gained a livelihood by curing the sick and teaching the young. He also studied Fiqh (Islamic jurisprudence) under the Hanafi scholar Ismail al-Zahid.

As a teenager, he was greatly troubled by the Metaphysics of Aristotle, which he could not understand until he read al-Farabi's commentary on the work. For the next year and a half, he studied philosophy, in which he encountered greater obstacles. In such moments of baffled inquiry, he would leave his books, perform the requisite ablutions, then go to the mosque, and continue in prayer till light broke on his difficulties. Deep into the night, he would continue his studies, and even in his dreams problems would pursue him and work out their solution. Forty times, it is said, he read through the Metaphysics of Aristotle, till the words were imprinted on his memory; but their meaning was hopelessly obscure, until one day they found illumination, from the little commentary by Farabi, which he bought at a bookstall for the small sum of three dirhams. So great was his joy at the discovery, made with the help of a work from which he had expected only mystery, that he hastened to return thanks to God, and bestowed alms upon the poor.

He turned to medicine at 16, and not only learned medical theory, but also by gratuitous attendance of the sick had, according to his own account, discovered new methods of treatment. The teenager achieved full status as a qualified physician at age 18, and found that «Medicine is no hard and thorny science, like mathematics and metaphysics, so I soon made great progress; I became an excellent doctor and began to treat patients, using approved remedies.» The youthful physician's fame spread quickly, and he treated many patients without asking for payment.

4. Adulthood

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A drawing of Avicenna from 1271

Ibn Sina's first appointment was that of physician to the emir, Nuh II, who owed him his recovery from a dangerous illness (997). Ibn Sina's chief reward for this service was access to the royal library of the Samanids, well-known patrons of scholarship and scholars. When the library was destroyed by fire not long after, the enemies of Ibn Sina accused him of burning it, in order for ever to conceal the sources of his knowledge. Meanwhile, he assisted his father in his financial labors, but still found time to write some of his earliest works.

When Ibn Sina was 22 years old, he lost his father. The Samanid dynasty came to its end in December 1004. Ibn Sina seems to have declined the offers of Mahmud of Ghazni, and proceeded westwards to Urgench in modern Turkmenistan, where the vizier, regarded as a friend of scholars, gave him a small monthly stipend. The pay was small, however, so Ibn Sina wandered from place to place through the districts of Nishapur and Merv to the borders of Khorasan, seeking an opening for his talents. Qabus, the generous ruler of Tabaristan, himself a poet and a scholar, with whom Ibn Sina had expected to find asylum, was on about that date (1012) starved to death by his troops who had revolted. Ibn Sina himself was at this time stricken by a severe illness. Finally, at Gorgan, near the Caspian Sea, Ibn Sina met with a friend, who bought a dwelling near his own house in which Ibn Sina lectured on logic and astronomy. Several of Ibn Sina's treatises were written for this patron; and the commencement of his Canon of Medicine also dates from his stay in Hyrcania.

Ibn Sina subsequently settled at Rey, in the vicinity of modern Tehran, the home town of Rhazes; where Majd Addaula, a son of the last Buwayhid emir, was nominal ruler under the regency of his mother (Seyyedeh Khatun). About thirty of Ibn Sina's shorter works are said to have been composed in Rey. Constant feuds which raged between the regent and her second son, Shams al-Daula, however, compelled the scholar to quit the place. After a brief sojourn at Qazvin he passed southwards to Hamadãn where Shams al-Daula, another Buwayhid emir, had established himself. At first, Ibn Sina entered into the service of a high-born lady; but the emir, hearing of his arrival, called him in as medical attendant, and sent him back with presents to his dwelling. Ibn Sina was even raised to the office of vizier. The emir decreed that he should be banished from the country. Ibn Sina, however, remained hidden for forty days in sheikh Ahmed Fadhel's house, until a fresh attack of illness induced the emir to restore him to his post. Even during this perturbed time, Ibn Sina persevered with his studies and teaching. Every evening, extracts from his great works, the Canon and the Sanatio, were dictated and explained to his pupils. On the death of the emir, Ibn Sina ceased to be vizier and hid himself in the house of an apothecary, where, with intense assiduity, he continued the composition of his works.

Meanwhile, he had written to Abu Ya'far, the prefect of the dynamic city of Isfahan, offering his services. The new emir of Hamadan, hearing of this correspondence and discovering where Ibn Sina was hiding, incarcerated him in a fortress. War meanwhile continued between the rulers of Isfahan and Hamadãn; in 1024 the former captured Hamadan and its towns, expelling the Tajik mercenaries. When the storm had passed, Ibn Sina returned with the emir to Hamadan, and carried on his literary labors. Later, however, accompanied by his brother, a favorite pupil, and two slaves, Ibn Sina escaped from the city in the dress of a Sufi ascetic. After a perilous journey, they reached Isfahan, receiving an honorable welcome from the prince.

5. Later life and death

Avicenna's tomb in Hamadan, Iran.

The inside view of Avicenna's tomb in Hamadan, Iran.

The first page of a manuscript, authored by Ibn Sina.

The remaining ten or twelve years of Ibn Sînâ's life were spent in the service of the Kakuyid ruler Muhammad ibn Rustam Dushmanziyar, whom he accompanied as physician and general literary and scientific adviser, even in his numerous campaigns.

During these years he began to study literary matters and philology, instigated, it is asserted, by criticisms on his style. A severe colic, which seized him on the march of the army against Hamadan, was checked by remedies so violent that Ibn Sina could scarcely stand. On a similar occasion the disease returned; with difficulty he reached Hamadan, where, finding the disease gaining ground, he refused to keep up the regimen imposed, and resigned himself to his fate.

His friends advised him to slow down and take life moderately. He refused, however, stating that: «I prefer a short life with width to a narrow one with length». On his deathbed remorse seized him; he bestowed his goods on the poor, restored unjust gains, freed his slaves, and read through the Qur'an every three days until his death. He died in June 1037, in his fifty-eighth year, in the month of Ramadan and was buried in Hamadan, Iran.

6. Avicenna's philosophy

Ibn Sînâ wrote extensively on early Islamic philosophy, especially the subjects logic, ethics, and metaphysics, including treatises named Logic and Metaphysics. Most of his works were written in Arabic - which was the scientific language of the time in the Middle East, and some were written in the Persian language. Of linguistic significance even to this day are a few books that he wrote in nearly pure Persian language (particularly the Danishnamah-yi 'Ala', Philosophy for Ala' ad-Dawla'). Ibn Sînâ's commentaries on Aristotle often criticized the philosopher, [citation needed] encouraging a lively debate in the spirit of ijtihad.

In the medieval Islamic world, due to Avicenna's successful [citation needed] reconciliation between Aristotelianism and Neoplatonism along with Kalam, Avicennism eventually became the leading school of Islamic philosophy by the 12th century, with Avicenna becoming a central authority on philosophy.

Avicennism was also influential in medieval Europe, particular his doctrines on the nature of the soul and his existence-essence distinction, along with the debates and censure that they raised in scholastic Europe. This was particularly the case in Paris, where Avicennism was later proscribed in 1210. Nevertheless, his psychology and theory of knowledge influenced William of Auvergne, Bishop of Paris and Albertus Magnus, while his metaphysics had an impact on the thought of Thomas Aquinas.

scientist physician avicenna medicine

7. Metaphysical doctrine

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Early Islamic philosophy and Islamic metaphysics, imbued as it is with Islamic theology, distinguishes more clearly than Aristotelianism between essence and existence. Whereas existence is the domain of the contingent and the accidental, essence endures within a being beyond the accidental. The philosophy of Ibn Sînâ, particularly that part relating to metaphysics, owes much to al-Farabi. The search for a definitive Islamic philosophy separate from Occasionalism can be seen in what is left of his work.

Following al-Farabi's lead, Avicenna initiated a full-fledged inquiry into the question of being, in which he distinguished between essence (Mahiat) and existence (Wujud). He argued that the fact of existence can not be inferred from or accounted for by the essence of existing things, and that form and matter by themselves cannot interact and originate the movement of the universe or the progressive actualization of existing things. Existence must, therefore, be due to an agent-cause that necessitates, imparts, gives, or adds existence to an essence. To do so, the cause must be an existing thing and coexist with its effect.

Avicenna's consideration of the essence-attributes question may be elucidated in terms of his ontological analysis of the modalities of being; namely impossibility, contingency, and necessity. Avicenna argued that the impossible being is that which cannot exist, while the contingent in itself (mumkin bi-dhatihi) has the potentiality to be or not to be without entailing a contradiction. When actualized, the contingent becomes a 'necessary existent due to what is other than itself' (wajib al-wujud bi-ghayrihi). Thus, contingency-in-itself is potential beingness that could eventually be actualized by an external cause other than itself. The metaphysical structures of necessity and contingency are different. Necessary being due to itself (wajib al-wujud bi-dhatihi) is true in itself, while the contingent being is 'false in itself' and 'true due to something else other than itself'. The necessary is the source of its own being without borrowed existence. It is what always exists. The Necessary exists 'due-to-Its-Self', and has no quiddity/essence (mahiyya) other than existence (wujud). Furthermore, It is 'One' (wahid ahad) since there cannot be more than one 'Necessary-Existent-due-to-Itself' without differentia (fasl) to distinguish them from each other. Yet, to require differentia entails that they exist 'due-to-themselves' as well as 'due to what is other than themselves'; and this is contradictory. However, if no differentia distinguishes them from each other, then there is no sense in which these 'Existents' are not one and the same. Avicenna adds that the 'Necessary-Existent-due-to-Itself' has no genus (jins), nor a definition (hadd), nor a counterpart (nadd), nor an opposite (did), and is detached (bari) from matter (madda), quality (kayf), quantity (kam), place (ayn), situation (wad), and time (waqt).

Al-Biruni correspondence

Correspondence between Ibn Sina (with his student Ahmad ibn 'Ali al-Ma'sumi) and Abû Rayhân al-Bîrûnî has survived in which they debated Aristotelian natural philosophy and the Peripatetic school. Abu Rayhan began by asking Avicenna eighteen questions, ten of which were criticisms of Aristotle's On the Heavens.

Theology

Ibn Sînâ was a devout Muslim and sought to reconcile rational philosophy with Islamic theology. His aim was to prove the existence of God and His creation of the world scientifically and through reason and logic. Avicenna wrote a number of treatises dealing with Islamic theology. These included treatises on the Islamic prophets, whom he viewed as «inspired philosophers», and on various scientific and philosophical interpretations of the Quran, such as how Quranic cosmology corresponds to his own philosophical system.

Ibn Sînâ memorized the Quran by the age of ten, and as an adult, he wrote five treatises commenting on suras from the Qur'an. One of these texts included the Proof of Prophecies, in which he comments on several Quranic verses and holds the Quran in high esteem. Avicenna argued that the Islamic prophets should be considered higher than philosophers.

8. Thought experiments

While he was imprisoned in the castle of Fardajan near Hamadhan, Avicenna wrote his famous «Floating Man» - literally falling man - thought experiment to demonstrate human self-awareness and the substantiality and immateriality of the soul. Avicenna believed his «Floating Man» thought experiment demonstrated that the soul is a substance, and claimed humans cannot doubt their own consciousness, even in a situation that prevents all sensory data input. The thought experiment told its readers to imagine themselves created all at once while suspended in the air, isolated from all sensations, which includes no sensory contact with even their own bodies. He argued that, in this scenario, one would still have self-consciousness. Because it is conceivable that a person, suspended in air while cut off from sense experience, would still be capable of determining his own existence, the thought experiment points to the conclusions that the soul is a perfection, independent of the body, and an immaterial substance. The conceivability of this «Floating Man» indicates that the soul is perceived intellectually, which entails the soul's separateness from the body. Avicenna referred to the living human intelligence, particularly the active intellect, which he believed to be the hypostasis by which God communicates truth to the human mind and imparts order and intelligibility to nature. Following is an English translation of the argument:

One of us has to consider (yatawaham) that one has been just created in a stroke, and that one has been thus created fully developed and perfectly complete (kâmilan), yet [created] with one's vision shrouded [or veiled] (hujiba ba?arahu) from watching [perceiving] (mushâhadât) external entities created falling [floating] (yahwa) in the air on in empty space (al-khalâ?) in a fall not buffeted by any felt air that buffets it [i.e. the Person in question]; its limbs separated and not in contact nor touching on another. Then let it contemplate (yata?amal) whether it would affirm the existence of its own self. It would not then doubt the affirmation that its self is existent (mawjûda), yet not affirming the existence of any other limbs nor inner bowels, nor heart, nor brain, nor anything of the external things. Rather it was affirming the existence of its-self without affirming that it had length, breadth, or depth. And if it were possible for it, in such a state, to imagine (yatakhayal) a hand or any other limb, it would not then imagine it to be part of its-self nor to be condition of it [i.e. its-self existence]. And you know that what is affirmed is distinct from what is not affirmed, and what is implied is distinct from what is not implied. Therefore the nafs [self, soul], whose existence the person has affirmed, is its [the person's] characteristic identity that is not identical to its body nor its limbs [whose existence] it did not affirm. Therefore, the attentive (al-mutanabih) [to this situation] has a means of realizing (yatanabah) that the affirmation of the existence of its-self (soul, al-nafs) is distinct from the body and something that is quite non-body [i.e. that the mind/soul (al-nafs) is distinct from the body (jism)]; this is known though self-consciousness and if one was distracted from it, one needs to knock one's baton [as to be alerted to it].

- Ibn Sina, Kitab Al-Shifa, On the Soul

The original Arabic text reads as follows:

íÌÈ Ãä íÊæåã ÇáæÇÍÏ ãäÇ ßÃäå ÎáÞ ÏÝÚÉð æÎáÞ ßÇãáÇð áßäå ÍÌÈ ÈÕÑå Úä ãÔÇåÏÉ ÇáÎÇÑÌÇÊ æÎáÞ íåæì Ýí åæÇÁ Ãæ ÎáÇÁ åæíÇð áÇ íÕÏãå Ýíå ÞæÇã ÇáåæÇÁ ÕÏãÇð ãÇ íÍæÌ Åáì Ãä íÍÓ æÝÑÞ Èíä ÃÚÖÇÆå Ýáã ÊÊáÇÞ æáã ÊÊãÇÓ Ëã íÊÃãá åá Ãäå íËÈÊ æÌæÏ ÐÇÊå æáÇ íÔßß Ýí ÅËÈÇÊå áÐÇÊå ãæÌæÏÇð æáÇ íËÈÊ ãÚ Ðáß ØÑÝÇð ãä ÃÚÖÇÆå æáÇ ÈÇØäÇð ãä ÃÍÔÇÆå æáÇ ÞáÈÇð æáÇ ÏãÇÛÇð æáÇ ÔíÆÇð ãä ÇáÃÔíÇÁ ãä ÎÇÑÌ Èá ßÇä íËÈÊ ÐÇÊå æáÇ íËÈÊ áåÇ ØæáÇð æáÇ ÚÑÖÇð æáÇ ÚãÞÇð æáæ Ãäå Ããßäå Ýí Êáß ÇáÍÇáÉ Ãä íÊÎíá íÏÇð Ãæ ÚÖæÇð ÂÎÑ áã íÊÎíáå ÌÒÁ ãä ÐÇÊå æáÇ ÔÑØÇð Ýí ÐÇÊå æÃäÊ ÊÚáã Ãä ÇáãËÈÊ ÛíÑ ÇáÐí áã íËÈÊ æÇáãÞÑÈå ÛíÑ ÇáÐí áã íÞÑÈå ÝÅÐä ááÐÇÊ ÇáÊí ÃËÈÊ æÌæÏåÇ ÎÇÕíÉ Úáì ÃäåÇ åæ ÈÚíäå ÛíÑ ÌÓãå æÃÚÖÇÆå ÇáÊí áã ÊËÈÊ ÝÅÐä ÇáãËÈÊ áå ÓÈíá Åáì Ãä íËÈÊå Úáì æÌæÏ ÇáäÝÓ ÔíÆÇð ÛíÑ ÇáÌÓã Èá ÛíÑ ÌÓã æÃäå ÚÇÑÝ Èå ãÓÊÔÚÑ áå æÅä ßÇä ÐÇåáÇð Úäå íÍÊÇÌ Åáì Ãä íÞÑÚ ÚÕÇå.

- Ibn Sina, Kitab Al-Shifa, On the Soul

However, Avicenna posited the brain as the place where reason interacts with sensation. Sensation prepares the soul to receive rational concepts from the universal Agent Intellect. The first knowledge of the flying person would be «I am,» affirming his or her essence. That essence could not be the body, obviously, as the flying person has no sensation. Thus, the knowledge that «I am» is the core of a human being: the soul exists and is self-aware. Avicenna thus concluded that the idea of the self is not logically dependent on any physical thing, and that the soul should not be seen in relative terms, but as a primary given, a substance. The body is unnecessary; in relation to it, the soul is its perfection. In itself, the soul is an immaterial substance.

The Canon of Medicine

A Latin copy of The Canon of Medicine, dated 1484, located at the P.I. Nixon Medical Historical Library of The University of Texas Health Science Center at San Antonio, US

An Arabic copy of The Canon of Medicine, dated 1593

About 100 treatises were ascribed to Ibn Sina. Some of them are tracts of a few pages. Others are works extending through several volumes. His 14-volume The Canon of Medicine (Al-Qanoon fi al-Tibb, The Laws of Medicine) was a standard medical text in Europe and the Islamic world until the 17th century.

Medicine and pharmacology

The book is known for its description of contagious diseases and sexually transmitted diseases, quarantine to limit the spread of infectious diseases, and testing of medicines. Like the Greeks, Ibn Sînâ supported the miasma theory of disease, which postulates that vapors in the air are the cause of epidemics. It classifies and describes diseases, and outlines their assumed causes. Hygiene, simple and complex medicines, and functions of parts of the body are also covered. The Canon agrees with Aristotle (and disagrees with Hippocrates) that tuberculosis was contagious, a fact which was not universally accepted in Europe until centuries later. It also describes the symptoms and complications of diabetes. Both forms of facial paralysis were described in-depth.

The Canon of Medicine discussed how to effectively test new medicines:

The drug must be free from any extraneous accidental quality.

It must be used on a simple, not a composite, disease.

The drug must be tested with two contrary types of diseases, because sometimes a drug cures one disease by Its essential qualities and another by its accidental ones.

The quality of the drug must correspond to the strength of the disease. For example, there are some drugs whose heat is less than the coldness of certain diseases, so that they would have no effect on them.

The time of action must be observed, so that essence and accident are not confused.

The effect of the drug must be seen to occur constantly or in many cases, for if this did not happen, it was an accidental effect.

The experimentation must be done with the human body, for testing a drug on a lion or a horse might not prove anything about its effect on man.

Danishnama-i 'ala'i (The Book of Scientific Knowledge), ed. and trans. P Morewedge, The Metaphysics of Avicenna, London: Routledge and Kegan Paul, 1973.

Kitab al-Shifa' (The Book of Healing). (Ibn Sina's major work on philosophy. He probably began to compose al-Shifa' in 1014, and completed it in 1020.) Critical editions of the Arabic text have been published in Cairo, 1952-83, originally under the supervision of I. Madkour.

Kitab al-Najat (The Book of Salvation), trans. F. Rahman, Avicenna's Psychology: An English Translation of Kitab al-Najat, Book II, Chapter VI with Historical-philosophical Notes and Textual Improvements on the Cairo Edition, Oxford: Oxford University Press, 1952. (The psychology of al-Shifa'.)

Hayy ibn Yaqdhan a Persian myth. A novel called Hayy ibn Yaqdhan, based on Avicenna's story, was later written by Ibn Tufail (Abubacer) in the 12th century and translated into Latin and English as Philosophus Autodidactus in the 17th and 18th centuries respectively. In the 13th century, Ibn al-Nafis wrote his own novel Fadil ibn Natiq, known as Theologus Autodidactus in the West, as a critical response to Hayy ibn Yaqdhan.

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