Ibn al-Nafis

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Muslim scholar
Ibn al-Nafis
Born 1213
Damascus
Died 17 December 1288 (aged 74–75)
Cairo
Ethnicity Arab
Era Islamic Golden Age
Region Syria and Egypt
Main interest(s) Medicine, Anatomy
Notable work(s) Commentary on Anatomy in Avicenna's Canon

Ala-al-din abu Al-Hassan Ali ibn Abi-Hazm al-Qarshi al-Dimashqi (Arabic: علاء الدين أبو الحسن عليّ بن أبي حزم القرشي الدمشقي ), known as Ibn al-Nafis (Arabic: ابن النفيس ), was a physician who is mostly famous for being the first to describe the pulmonary circulation of the blood. Work of Al-Nafis regarding the right sided (pulmonary) circulation pre-date the work of William Harvey in "De motu cordis" much later in 1628. Both theories attempt to explain circulation as we know it. Together, these works represent the earliest and best of Eastern and Western medicine towards a common understanding of cardiac physiology.

Apart from medicine, Ibn al-Nafis learned jurisprudence, literature and theology. He became an expert on the Shafi'i school of jurisprudence and an expert physician.[1] He also performed several human dissections during the course of his work.[2] The number of medical textbooks written by al-Nafis in his lifetime is estimated to have surpassed 110 volumes.[3]

Biography[edit]

He was born in a village called al-Qurashiyya by the River Oxus near Damascus. His family originally came from the River Oxus. He studied medicine at Nuri Hospital in Damascus. The hospital was founded by the Turkish Prince Nur-al Din Muhmud ibn Zanki, a Turkish prince, in the 12th century. Ibn al-Nafis was taught by the founder of a medical school in Damascus, Muhadhdab al-Din ‘Abd al-Rabin ib ‘Ali al-Dakhwar. Al-Nafis taught and practiced at his own hospital in Egypt; however, the hospital wasn’t very well-known during his time. He became the chief physician of the hospital and a personal physician for high-up political leaders. This promotion gave him the responsibility to tell the other medical practitioners how to practice medicine. Prior to his death, Ibn al-Nafis donated his house and his personal library to Qalawun Hospital or as it was also known, the House of Recovery. He died on December 17, 1288, in Cairo.[4]

He also taught jurisprudence in Cairo at al-Masruriyya. His name is included in with the names of other scholars, which gives insight on how well he was received in this field. This is a field that practices religious law. He wrote Kitab al-Shamil fi ‘l-Sina’a al-Tibbiyya (Comprehensive Book in the Art of Medicine) around his 30s and it comprised 300 volumes of notes but only 80 of these were published. His writings are cataloged in many libraries around the world, including the Cambridge University Library, the Bodleian Library, and the Lane Medical Library at Stanford University.[5]

Kitab al-Shamil is a book that went unpublished but it gives insight on how he viewed medicine and human relations. His surgical technique had three stages that he always followed. Step one was to give the patient the information on how it was performed and the knowledge behind the operation. The second step was to perform the surgery itself. The final step was to have a post-surgery appointment and due a routine of checkups on his patient to ensure that they were doing well after the surgery. This gives a strong description of what he believed surgeons job was when dealing with nurses, patients, and other surgeons.[6]

In 1236, Al-Nafis moved to Egypt.

Writings[edit]

The opening page of one of Ibn al-Nafis's medical works. This is probably a copy made in India during the 17th or 18th century.

The most voluminous of his books is Al-Shamil fi al-Tibb, which was planned to be an encyclopedia comprising 300 volumes, but was not completed as a result of his death. The manuscript is available in Damascus.

His book on ophthalmology is largely an original contribution. His most famous book is The Summary of Law (Mujaz al-Qanun). Another famous book, embodying his original contribution, was on the effects of diet on health, entitled Kitab al-Mukhtar fi al-Aghdhiya.

His Al-Risalah al-Kamiliyyah fil Siera al-Nabawiyyah, translated in the West under the title Theologus Autodidactus, has been argued to be the first theological novel.

He also wrote a number of commentaries on the topics of law and medicine. His commentaries include one on Hippocrates' book, and several volumes on Avicenna's The Canon of Medicine. Additionally, he wrote a commentary on Hunayn Ibn Ishaq's book.

Other works include: Sharh Tabi’at al-Insan li-Buqrat (“Commentary on Hippocrates’ ‘Nature of Man’”), Sharh Tashrih al-Qanum (“Commentary on Anatomy in Books I and II of Ibn Sina’s Kitab al-Qanu”), This book is in four parts: “A Commentary on Generalities” “A Commentary on Materia Medicine and Compound Drugs” “A Commentary on Head-to-Toe Diseases” “A Commentary on Diseases Which Are Not Specific to Certain Organs”, Sharh Abidhimya li-Buqrat (“Commentary on Hippocrates’ Endemics), Sharh Masa’il Hunayn (“Commentary on Hunayn [Ibn Ishaq’s] Questions”), al-Muhadhdhab fi ‘l-Kuhl (“Polished Book for Physicians”), Bughyat al-Talibin wa Hujjat al-Mutatabbibn (“Reference Book for Physicians”).[7]

Discovery of pulmonary circulation[edit]

In 1924, an Egyptian physician, Muhyo Al-Deen Altawi, discovered a script titled, Sharh tashrih al-qanum li’ Ibn Sina, or "Commentary on Anatomy in Avicenna's Canon" in the Prussian State Library in Berlin while studying the history of Arab Medicine at the medical faculty of Albert Ludwig’s University in Germany. This script covers in detail the topics of anatomy, pathology and physiology. This was the earliest description of pulmonary circulation.[1]

The most commonly accepted theory of heart performance prior to Al-Nafis was that of Galen. Galen taught that the blood reaching the right side of the heart went through invisible pores in the cardiac septum, to the left side of the heart, where it mixed with air to create spirit, and was then distributed to the body. According to Galen's views, the venous system was quite separate from the arterial system, except when they came in contact through the unseen pores.

Translations of this text by Max Meyerhof reveal critiques on Galen’s theory, including a discussion on the pores of the heart. Based on animal dissection, Galen hypothesized that the muscle separating the two sides of the heart had to be porous in order for blood to travel within the heart. He further added that this transit was facilitated by the lungs. However, Galen could not observe pores on the heart and believed that the pores were too small to see. “Ibn al-Nafīs’s reforms were the result of two processes: an intensive theoretical study of medicine, physics and theology in order to fully understand the nature of the living body and its soul; and an attempt to verify physiological claims through observation, including dissection of animals.” [8] Al-Nafis rejected Galen’s pore theory with the following passage:[9][10]

“The blood, after it has been refined in [the right] cavity, must be transmitted to the left cavity where the (vital) spirit is generated. But there is no passage between these cavities, for the substance of the heart is solid in this region and has neither a visible passage…”[11]

He posited that the “pores” of the heart are closed, that there isn't a passage between the two chambers, and the substance of the heart is thick. Instead of the pore theory, al-Nafis hypothesized that the blood rose into the lungs via the arterious vein and then circulated into the left cavity of the heart. [12] Paul Ghalioungui also had theories concerning the structure of the heart. He believed that the blood(spirit) and air passes from the lung to the left ventricle, and not in the opposite direction. [13] Some points that conflicted with the views of Al-Nafis' included that he believed there were only two ventricles instead of three and that the ventricle gets its energy from the blood flowing in the vessels that run in the coronary vessels, not from the blood deposited in the right ventricle.[14]

Based on his anatomical knowledge, Al-Nafis stated that:

"the blood from the right chamber of the heart must arrive at the left chamber but there is no direct pathway between them. The thick septum of the heart is not perforated and does not have visible pores as some people thought or invisible pores as Galen thought. The blood from the right chamber must flow through the vena arteriosa (pulmonary artery) to the lungs, spread through its substances, be mingled there with air, pass through the arteria venosa (pulmonary vein) to reach the left chamber of the heart and there form the vital spirit..." [15][16]

Al-Nafis also did not agree with Galen’s theory that the heart's pulse is created by the arteries’ tunics. He believed that "the pulse was a direct result of the heartbeat, even observing that the arteries contracted and expanded at different times depending upon their distance from the heart. He also correctly identified that the arteries contract when the heart expands, and expand when the heart contracts.” [17]

Elsewhere in his book, he said:

"The heart has only two ventricles ...and between these two there is absolutely no opening. Also dissection gives this lie to what they said, as the septum between these two cavities is much thicker than elsewhere. The benefit of this blood (that is in the right cavity) is to go up to the lungs, mix with what is in the lungs of air, then pass through the arteria venosa to the left cavity of the two cavities of the heart and of that mixture is created the animal spirit."

In describing the anatomy of the lungs, Al-Nafis said:

"The lungs are composed of parts, one of which is the bronchi; the second, the branches of the arteria venosa; and the third, the branches of the vena arteriosa, all of them connected by loose porous flesh."

He then added:

"the need of the lungs for the vena arteriosa is to transport to it the blood that has been thinned and warmed in the heart, so that what seeps through the pores of the branches of this vessel into the alveoli of the lungs may mix with what there is of air therein and combine with it, the resultant composite becoming fit to be spirit, when this mixing takes place in the left cavity of the heart. The mixture is carried to the left cavity by the arteria venosa." [1]

It is also found that "in the lungs, some blood was filtered through the two tunics (coverings) of the vessel that brought blood to the lungs from the heart. Ibn al-Nafīs called this vessel the ‘artery-like vein’, but we now call it the pulmonary artery." [18]

Al-Nafis also postulated that nutrients for heart are extracted from the coronary arteries:

"again his (Avicenna's) statement that the blood that is in the right side is to nourish the heart is not true at all, for the nourishment to the heart is from the blood that goes through the vessels that permeate the body of the heart."

Practice of dissection[edit]

There is some debate about whether or not Ibn al-Nafis participated in dissection to come to his conclusions about pulmonary circulation. Although he states in his writings that he was prevented from practicing dissection because of his beliefs, other scholars have noted that al-Nafis must have either practiced dissection or seen a human heart in order to come to his conclusions.[19] According to one view, his knowledge about the human heart could have been derived from surgical operations rather than dissection.[20] Other comments found in al-Nafis’s writings such as dismissing earlier observations with a reference to dissection as proof, however, support the view that he practiced dissection in order to come to his conclusions about the human heart and pulmonary circulation. [21] Ibn al-Nafis’s comments to the contrary and the alternate explanations, however, keep his possible practice of dissection in question.

Ibn-al Nafis’ Influencers and People He Influenced[edit]

Ibn al-Nafis was most well-known for his work on the pulmonary circulation of the blood. One of the people that influenced his work on the pulmonary circulation of the blood was Galen. Years before Ibn al-Nafis was born, Galenic physiology and anatomy dominated the Arabic medical tradition from the time of Ḥunayn ibn Isḥāq (AD 809–873).[22] Medical authorities at the time seldom challenged the underlying principles of the Galenic system.[23] What made Al-Nafis special as a physician was that he was not afraid to challenge Galen’s work. By criticizing the entire basis of the Galenic system, Al-Nafis was able to come up with medical theories of his own. Thus, in a way, Galen was one of Al-Nafis’ influencers on his work in the medical field.

Avicenna (AD 980–1037) was another person who influenced Al-Nafis because Avicenna “undertook the first rigorous attempt to align Galenic medicine with a philosophically sound understanding of the nature of the living body, and in so doing modified certain aspects of physiology”.[24] This influenced Al-Nafis to seek his own understanding of the nature of the living body and its soul through theoretical study of medicine, physics, and theology.[25]

As for the people who was influenced by Al-Nafis’ work, there was William Harvey. Al-Nafis’ reform of the entire basis of Galenic medicine laid the foundations for William Harvey’s (AD 1578-1657) theory of blood circulation.[26]


Possible Western Influence[edit]

There is currently a debate over Ibn al-Nafis’ influence on later western anatomists such as Realdo Columbo and William Harvey.[27][28]

In AD 1344, Kazrouny wrote a verbatim copy of Ibn al-Nafis’s commentary on Canon in his Sharh al-Kulliyat.[29][30] In AD 1500, Andrea Alpago returned to Italy after studying in Damascus.[31][32] Alpago’s 1547 A.D. publication of Libellus de removendis nocumentis, quae accident in regimime sanitatis, there is a Latin translation containing part of Ibn al-Nafis’ commentary on pharmacopeia.[33][34] These publications took place in Venice during its rule over Padua.[35][36] Harvey arrived at Padua in AD 1597.[37][38]

The debate currently rests on whether there is a connection between these events or if they are historical coincidences.[39]

See also[edit]

References[edit]

  1. ^ a b c Haddad, Sami; Amin A. Khairallah (1936). "A FORGOTTEN CHAPTER IN THE HISTORY OF THE CIRCULATION OF THE BLOOD.". Annals of Surgery 104.1. pp. 1–8. Retrieved 16 January 2015. 
  2. ^ Patrice Le Floch-Prigent and Dominique Delaval (April 2014). "The discovery of the pulmonary circulation by Ibn al Nafis during the 13th century: an anatomical approach". The FASEB Journal 28. 
  3. ^ Numan, Mohammed T. (6 August 2014). "Ibn Al Nafis: His Seminal Contributions to Cardiology". Pediatric Cardiology 35 (7): 1088–1090. doi:10.1007/s00246-014-0990-7. PMID 25096906. 
  4. ^ Iskandar, Albert Z. Dictionary of Scientific Biography. pp. 602–606. 
  5. ^ Iskandar, Albert Z. Dictionary of Scientific Biography. pp. 602–606. 
  6. ^ Iskandar, Albert Z. Dictionary of Scientific Biography. pp. 602–606. 
  7. ^ Iskandar, Albert Z. Dictionary of Scientific Biography. pp. 602–606. 
  8. ^ Fancy, Dr. Nayhan. "IBN AL-NAFĪS AND PULMONARY TRANSIT". Qatar National Library. Retrieved 22 April 2015. 
  9. ^ "Knowledge of the circulation of the blood from Antiquity down to Ibn al-Nafis". Hamdard medicus 37 (1): 24-26. 1994. 
  10. ^ Fancy, Dr. Nayhan. "IBN AL-NAFĪS AND PULMONARY TRANSIT". Qatar National Library. Retrieved 22 April 2015. 
  11. ^ "Knowledge of the circulation of the blood from Antiquity down to Ibn al-Nafis". Hamdard medicus 37 (1): 24-26. 1994. 
  12. ^ "Knowledge of the circulation of the blood from Antiquity down to Ibn al-Nafis". Hamdard medicus 37 (1): 24-26. 1994. 
  13. ^ "Knowledge of the circulation of the blood from Antiquity down to Ibn al-Nafis". Hamdard medicus 37 (1): 24-26. 1994. 
  14. ^ "Knowledge of the circulation of the blood from Antiquity down to Ibn al-Nafis". Hamdard medicus 37 (1): 24-26. 1994. 
  15. ^ The Pursuit of Learning in the Islamic World, 610-2003 By Hunt Janin, Pg99
  16. ^ Saints and saviours of Islam, By Hamid Naseem Rafiabadi, Pg295
  17. ^ Fancy, Dr. Nayhan. "IBN AL-NAFĪS AND PULMONARY TRANSIT". Qatar National Library. Retrieved 22 April 2015. 
  18. ^ Fancy, Dr. Nayhan. "IBN AL-NAFĪS AND PULMONARY TRANSIT". Qatar National Library. Retrieved 22 April 2015. 
  19. ^ Said, Hakim Mohammed (1994). "Knowledge of the circulation of the blood from antiquity down to Ibn al-Nafis". Hamdard Medicus 37 (1): 29. 
  20. ^ Said, Hakim Mohammed (1994). "Knowledge of the circulation of the blood from antiquity down to Ibn al-Nafis". Hamdard Medicus 37 (1): 29. 
  21. ^ Said, Hakim Mohammed (1994). "Knowledge of the circulation of the blood from antiquity down to Ibn al-Nafis". Hamdard Medicus 37 (1): 31. 
  22. ^ Fancy, Dr. Nayhan. "IBN AL-NAFĪS AND PULMONARY TRANSIT". Qatar National Library. Retrieved 22 April 2015. 
  23. ^ Fancy, Dr. Nayhan. "IBN AL-NAFĪS AND PULMONARY TRANSIT". Qatar National Library. Retrieved 22 April 2015. 
  24. ^ Fancy, Dr. Nayhan. "IBN AL-NAFĪS AND PULMONARY TRANSIT". Qatar National Library. Retrieved 22 April 2015. 
  25. ^ Fancy, Dr. Nayhan. "IBN AL-NAFĪS AND PULMONARY TRANSIT". Qatar National Library. Retrieved 22 April 2015. 
  26. ^ Fancy, Dr. Nayhan. "IBN AL-NAFĪS AND PULMONARY TRANSIT". Qatar National Library. Retrieved 22 April 2015. 
  27. ^ Said, Hakim. "Knowledge of the circulation of the blood from Antiquity down to Ibn al-Nafis", Hamdard medicus,, p35, 1994
  28. ^ Ghalioungui, P. "Was Ibn al-Nafis unknown to the scholars of the European Renaissance?", Clio medica,, p37, 1983
  29. ^ Said, Hakim. "Knowledge of the circulation of the blood from Antiquity down to Ibn al-Nafis", Hamdard medicus,, p32, 1994
  30. ^ Ghalioungui, P. "Was Ibn al-Nafis unknown to the scholars of the European Renaissance?", Clio medica,, p38, 1983
  31. ^ Said, Hakim. "Knowledge of the circulation of the blood from Antiquity down to Ibn al-Nafis", Hamdard medicus,, p34, 1994
  32. ^ Ghalioungui, P. "Was Ibn al-Nafis unknown to the scholars of the European Renaissance?", Clio medica,, p38, 1983
  33. ^ Said, Hakim. "Knowledge of the circulation of the blood from Antiquity down to Ibn al-Nafis", Hamdard medicus,, p34, 1994
  34. ^ Ghalioungui, P. "Was Ibn al-Nafis unknown to the scholars of the European Renaissance?", Clio medica,, p38, 1983
  35. ^ Said, Hakim. "Knowledge of the circulation of the blood from Antiquity down to Ibn al-Nafis", Hamdard medicus,, p34, 1994
  36. ^ Ghalioungui, P. "Was Ibn al-Nafis unknown to the scholars of the European Renaissance?", Clio medica,, p38, 1983
  37. ^ Said, Hakim. "Knowledge of the circulation of the blood from Antiquity down to Ibn al-Nafis", Hamdard medicus,, p36, 1994
  38. ^ Ghalioungui, P. "Was Ibn al-Nafis unknown to the scholars of the European Renaissance?", Clio medica,, p38, 1983
  39. ^ Said, Hakim. "Knowledge of the circulation of the blood from Antiquity down to Ibn al-Nafis", Hamdard medicus,, p36, 1994
  • Bayon, H. P. (1941). Significance of the demonstration of the Harveyan circulation by experimental tests. Isis 33, 443-453

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