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==Book 4==
==Book 4==
Book 4 covers diseases that affect the whole body like fevers.
Book 4 covers diseases that affect the whole body like fevers.
==Cardiovascular system==
In its explanation of the [[Circulatory system|cardiovascular system]], ''The Canon of Medicine'' "erroneously accepted the Greek notion regarding the existence of a hole in the ventricular septum by which the blood traveled between the ventricles." This would not be corrected until [[Ibn al-Nafis]]' ''Commentary on Anatomy in Avicenna's Canon'' provides the first description of the [[pulmonary circulation]] in 1242.<ref name=Cardiology/> Ibn al-Nafis also criticized the ''Canon'' for its "statement that the blood that is in the right side is to nourish the heart", which he replaced with a theory showing insight into the [[coronary circulation]]: "the nourishment to the heart is from the blood that goes through the vessels that permeate the body of the heart."<ref name="Nagamia">{{citation | author = Nagamia Husain F | year = 2003 | title = Ibn al-Nafīs: A Biographical Sketch of the Discoverer of Pulmonary and Coronary Circulation | url = | journal = Journal of the International Society for the History of Islamic Medicine | volume = 1 | issue = | pages = 22–28 }}</ref> Despite these criticisms, Avicenna "had a vision of blood circulation," and "correctly wrote on the [[cardiac cycle]]s and [[Heart valve|valvular]] function."<ref name=Cardiology>{{citation|title=Vasovagal syncope in the Canon of Avicenna: The first mention of carotid artery hypersensitivity|last=Mohammadali M. Shojaa, R. Shane Tubbsb, Marios Loukasc|first=Majid Khalilid, Farid Alakbarlie, Aaron A. Cohen-Gadola|journal=International Journal of Cardiology|volume=134|issue=3|date=29 May 2009|publisher=[[Elsevier]]|doi=10.1016/j.ijcard.2009.02.035|pages=297–301|pmid=19332359|last2=Tubbs|first2=RS|last3=Loukas|first3=M|last4=Khalili|first4=M|last5=Alakbarli|first5=F|last6=Cohen-Gadol|first6=AA}}</ref>

===Cardiology===
In [[cardiology]], ''The Canon of Medicine'' is the first book to mention the [[Vasovagal episode|vasovagal syncope]] and [[carotid sinus hypersensitivity]]. According to several scholars, "Article 5 from Book III of this encyclopedia described [[drop attack]]s following compression of the [[Common carotid artery|carotid artery]], [[yawn]]ing, [[Fatigue (medical)|fatigue]] and [[Flushing (physiology)|flushing]], which together resemble [[Nervous system|neurogenic]] [[Syncope (medicine)|syncope]]. Such a description is most likely the first mention of carotid sinus hypersensitivity and vasovagal syncope." The chapter was dedicated to “brain diseases effecting intentional movements”, and refers to carotid sinus hypersensitivity as ''Al-Lawa'', meaning "[[Wiktionary:torsion|torsion]]".<ref name=Cardiology/>

===Pulsology and sphygmology===
The ''Canon'' was a pioneering text in [[Pulse|pulsology and sphygmology]]. In ancient times, [[Galen]] as well as [[Traditional Chinese medicine|Chinese physicians]] erroneously believed that there was a unique type of [[pulse]] for every [[organ (anatomy)|organ]] of the body and for every [[disease]].<ref name=Hajar>{{citation | author = Hajar Rachel | year = 1999 | title = The Greco-Islamic Pulse | url = | journal = Heart Views | volume = 1 | issue = 4| pages = 136–140 [138] }}</ref> Galen also erroneously believed that "every part of an [[artery]] pulsates simultaneously" and that the motion of the pulse was due to natural motions (the arteries expanding and contracting naturally) as opposed to foced motions (the [[heart]] causing the arteries to either expand or contract).<ref>Nahyan A. G. Fancy (2006), "Pulmonary Transit and Bodily Resurrection: The Interaction of Medicine, Philosophy and Religion in the Works of Ibn al-Nafīs (died 1288)", pp. 224-228, ''Electronic Theses and Dissertations'', [[University of Notre Dame]].[http://etd.nd.edu/ETD-db/theses/available/etd-11292006-152615]</ref>

The first correct explanation of pulsation was given by Avicenna, after he refined Galen's theory of the pulse and discovered the following in ''The Canon of Medicine'':<ref name=Hajar/>

{{quote|"Every beat of the pulse comprises two movements and two pauses. Thus, expansion : pause : contraction : pause. [...] The pulse is a movement in the heart and arteries ... which takes the form of alternate expansion and contraction."}}

The ''Canon'' also pioneered the modern approach of examining the pulse through the examination of the [[wrist]], which is still practiced in modern times. His reasons for choosing the wrist as the ideal location is due to it being easily
available and the patient not needing to be distressed at the exposure of his/her body. The Latin translation of his ''Canon'' also laid the foundations for the later invention of the [[sphygmograph]].<ref>{{citation | author = Hajar Rachel | year = 1999 | title = The Greco-Islamic Pulse | url = | journal = Heart Views | volume = 1 | issue = 4| pages = 136–140 [139–40] }}</ref>

Avicenna also wrote a supplemental treatise on diagnosing diseases using only the methods of feeling the pulse and observing [[inhalation]]. He was often capable of finding the symptoms of certain diseases only by feeling a patient's pulse.<ref name=Aydin/>

==Etiology and pathology==
In [[etiology]] and [[pathology]], the ''Canon'' described the contagious nature of [[infectious disease]]s such as [[phthisis]] and [[tuberculosis]], the distribution of [[disease]] by [[water]] and [[soil]], and the existence of [[sexually transmitted disease]].,<ref>[[Hakim Syed Zillur Rahman]], ''Ilmul Amraz'' (Based on [[Avicenna]]'s tract on [[Pathology]] in [[Urdu language|Urdu]]), First edition 1969, Second edition 1990, Third edition 1994, Tibbi Academy, Aligarh, India</ref><ref name=Sarton>[[George Sarton]], ''Introduction to the History of Science''.<br />([[cf.]] Dr. A. Zahoor and Dr. Z. Haq (1997), [http://www.cyberistan.org/islamic/Introl1.html Quotations From Famous Historians of Science], Cyberistan.</ref> The ''Canon'' provides a full understanding of the [[pathology]] of contagious disease.<ref name="Medicine And Health">[http://www.bookrags.com/history/islam-science-technology-health/sub12.html Medicine And Health], "Rise and Spread of Islam 622-1500: Science, Technology, Health", ''World Eras'', [[Thomson Gale]].</ref>

The ''Canon'' also distinguished between [[mediastinitis]] and [[pleurisy]], provided careful descriptions of skin troubles, [[perversion]]s, and [[Nervous system|nervous]] [[ailment]]s." [[Meningitis]] was also first described in ''The Canon of Medicine'', which also described the first known treatments for [[cancer]].<ref name=Patricia>Patricia Skinner (2001), [http://findarticles.com/p/articles/mi_g2603/is_0007/ai_2603000716 Unani-tibbi], ''Encyclopedia of Alternative Medicine''unreliable source</ref>{{Verify source|date=June 2011}} The book also recognized the [[parasitic disease]]s of [[Ascaris]], [[Enterobius]], [[tapeworm]]s, and [[Guinea worm]]s.<ref>{{citation|title=History of human parasitic diseases|first=Francis E. G.|last=Cox|journal=Infectious Disease Clinics of North America|volume=18|issue=2|date=June 2004|pages=171–88|doi=10.1016/j.idc.2004.01.001|pmid=15145374}}</ref>

Since the ''Canon'', [[Bimaristan]] hospitals were created with separate wards for specific [[illness]]es, so that people with contagious diseases could be kept away from other patients who do not have any contagious diseases.<ref name="Medicine And Health"/>

===Bacteriology and microbiology===
The ''Canon'' stated that bodily [[secretion]]s are contaminated by "foul foreign earthly bodies" before a person becomes infected, but he did not view these bodies as primary causes of [[disease]].<ref>{{Citation | author = Syed Ibrahim B., Ph.D. | year = 2002 | title = Islamic Medicine: 1000 years ahead of its times | url = | journal = [[The Islamic Medical Association of North America|Journal of the Islamic Medical Association]] | volume = 2 | issue = | pages = 2–9 | postscript = . }}</ref>

===Cancer therapy===
In [[unproven cancer therapy|cancer therapy]], the ''Canon'' recognized [[cancer]] as a [[tumor]]. He noted that a "cancerous tumour progressively increases in size, is destructive and spreads roots which insinuate themselves amongst the tissue elements." He also attempted the earliest known treatments for cancer. One method he discovered was the "Hindiba", a herbal compound drug which [[Ibn al-Baitar]] later identified as having "anticancer" properties and which could also treat other [[tumor]]s and [[neoplastic]] disorders. After recognizing its usefulness in treating neoplastic disorders, Hindiba was [[patent]]ed in 1997 by Nil Sari, Hanzade Dogan, and John K. Snyder.<ref>{{patent|US|5663196|Methods for treating neoplastic disorders}}</ref> The preferred medication the ''Canon'' recommended for [[skin cancer]] and [[skin condition]]s in general was [[zinc oxide]].<ref name=Harding/>

Another method for treating cancer first described in the ''Canon'' was a surgical treatment. It stated that the [[wiktionary:excision|excision]] should be radical and that all diseased [[Tissue (biology)|tissue]] should be removed, which included the use of [[amputation]] or the removal of [[vein]]s running in the direction of the [[tumor]]. He also recommended the use of [[cauterization]] for the area being treated if necessary.<ref name=Patricia/> However, the ''Canon'' notes that surgery should only be used as a last resort and that caution should be taken, pointing out that "most of the time, excision increases the cancer."<ref name="Harding"/>

The ''Canon'' was also the first to describe the symptoms of [[esophageal cancer]] and the first to refer to it as "cancer of the [[esophagus]]."<ref>{{citation|title=The Historical Basis for the AEsophageal Cancer Belt of South-Central Asia|last=Saidi|first=F., MD|journal=Archives of Iranian Medicine|volume=2|issue=1|date=January 1999}}</ref>

===Hepatology===
The advances of the ''Canon'' in [[hepatology]] includes its introduction of new methods of [[hepatitis]] treatment.<ref name=Aydin/>

===Quarantine===
The ''Canon'' introduced [[quarantine]] as a means of limiting the spread of contagious diseases.<ref name=Tschanz/>

==Neurosciences and psychology==
In [[Islamic psychology]] and [[neuroscience]]s, the ''Canon'' noted the close relationship between [[emotions]] and the physical condition, and the author felt that [[music]] had a definite physical and psychological effect on patients.

===Clinical psychology and psychotherapy===
In [[clinical psychology]] and [[psychotherapy]], Avicenna often used psychological methods to treat his patients.<ref name=Amber-366>{{citation | doi = 10.1007/s10943-004-4302-z | author = Haque Amber | year = 2004 | title = Psychology from Islamic Perspective: Contributions of Early Muslim Scholars and Challenges to Contemporary Muslim Psychologists | url = | journal = Journal of Religion and Health | volume = 43 | issue = 4| pages = 357–377 [366] }}</ref> One such [[case study]] is when a prince of Persia had melancholia and suffered from the [[delusion]] that he is a [[cow]], and who would low like a cow crying "Kill me so that a good stew may be made of my flesh" and would never eat anything. Avicenna was persuaded to the case and sent a message to the patient, asking him to be happy as the butcher was coming to slaughter him, and the sick man rejoiced. When Avicenna approached the prince with a knife in his hand, he asked "where is the cow so I may kill it." The patient then lowed like a cow to indicate where he was. "By order of the butcher, the patient was also laid on the ground for slaughter." When Avicenna approached the patient pretending to slaughter him, he said, "the cow is too lean and not ready to be killed. He must be fed properly and I will kill it when it becomes healthy and fat." The patient was then offered food which he ate eagerly and gradually "gained strength, got rid of his delusion, and was completely cured."<ref>{{citation | doi = 10.1007/s10943-004-4302-z | author = Haque Amber | year = 2004 | title = Psychology from Islamic Perspective: Contributions of Early Muslim Scholars and Challenges to Contemporary Muslim Psychologists | url = | journal = Journal of Religion and Health | volume = 43 | issue = 4| pages = 357–377 [376] }}</ref>

Among the many other [[Mental disorder|psychological disorders]] described in the ''Qanun'', one is of unusual interest: [[love sickness]]. Ibn Sina is reputed to have diagnosed this condition in a Prince in Jurjan who lay sick and whose malady had baffled local doctors. He noted a fluttering in the Prince's pulse when the address and name of his beloved were mentioned. The great doctor had a simple remedy: unite the sufferer with the beloved.

===Neurology and neuropathology===
The book's contributions in [[neurology]] and [[neuropathology]] include its diagnosis of [[facial nerve paralysis]], its distinction between brain [[paralysis]] and [[hyperaemia]], and most importantly the discovery of [[meningitis]]. It diagnosed meningitis as a disease induced by the [[brain]] itself and differentiated it from infectious brain disease, and its author was also able to diagnose and describe the type of meningitis induced by an infection in other parts of the body.<ref name=Aydin/>

===Neuropsychiatry and neuropsychology===
The ''Canon'' was a pioneering text in [[neuropsychiatry]] and [[neuropsychology]]. It first described the neuropsychiatric conditions of [[hallucination]], [[insomnia]], [[mania]], [[nightmare]], [[melancholia]], [[dementia]], [[epilepsy]], [[paralysis]], [[stroke]], [[Vertigo (medical)|vertigo]] and [[tremor]].<ref name=Workman>S. Safavi-Abbasi, L. B. C. Brasiliense, R. K. Workman (2007), "The fate of medical knowledge and the neurosciences during the time of Genghis Khan and the Mongolian Empire", ''Neurosurgical Focus'' '''23''' (1), E13, p. 3.</ref> Three chapters of ''The Canon of Medicine'' were dedicated to neuropsychiatry.<ref name=Dening>{{citation | doi = 10.1177/0957154X9600702503 | author = Youssef Hanafy A., Youssef Fatma A., Dening T. R. | year = 1996 | title = Evidence for the existence of schizophrenia in medieval Islamic society | url = | journal = History of Psychiatry | volume = 7 | issue = 25| pages = 55–62 [56] | pmid=11609215}}</ref>

The book defined [[Insanity|madness]] (''Junun'') as a mental condition in which [[reality]] is replaced by [[fantasy]], and discovered that it is a disorder of [[reason]] with its origin in the middle part of the [[brain]].<ref>{{citation | doi = 10.1177/0957154X9600702503 | author = Youssef Hanafy A., Youssef Fatma A., Dening T. R. | year = 1996 | title = Evidence for the existence of schizophrenia in medieval Islamic society | url = | journal = History of Psychiatry | volume = 7 | issue = 25| pages = 55–62 [56–57] | pmid=11609215}}</ref> It also described a condition resembling [[schizophrenia]] which it referred to as ''Junun Mufrit'' (severe madness), which was clearly distinguished from other forms of madness such as [[mania]], [[rabies]], and [[Bipolar disorder|manic depressive]] [[psychosis]]. The author observed that patients suffering from schizophrenia-like severe madness show [[wikt:restlessness|agitation]], behavioural and sleep disturbance, give inappropriate answers to questions, and in some cases are incapable of speaking at times. The book states that such patients need to be restrained, in order to avoid any harm they may cause to themselves or to others.<ref name=Dening-57>{{citation | doi = 10.1177/0957154X9600702503 | author = Youssef Hanafy A., Youssef Fatma A., Dening T. R. | year = 1996 | title = Evidence for the existence of schizophrenia in medieval Islamic society | url = | journal = History of Psychiatry | volume = 7 | issue = 25| pages = 55–62 [57] | pmid=11609215}}</ref>

A chapter of the ''Canon'' was also dedicated to [[mania]] and [[rabies]]. It described mania as bestial madness characterized by rapid onset and [[Remission (medicine)|remission]], with [[wikt:restlessness|agitation]] and [[irritability]], and described rabies as a type of mania.<ref name=Dening-57/>

===Psychoanalysis===
''The Canon of Medicine'' extended the theory of [[temperament]]s to encompass "[[emotion]]al aspects, mental capacity, [[moral]] attitudes, [[self-awareness]], movements and [[dream]]s." This work may thus be considered a "forerunner of twentieth century [[psychoanalysis]]."<ref name=Lutz>{{citation|first=Peter L.|last=Lutz|year=2002|title=The Rise of Experimental Biology: An Illustrated History|page=60|publisher=[[Humana Press]]|isbn=0896038351}}</ref>

===Psychophysiology and psychosomatic medicine===
The ''Canon'' was an early text in [[psychophysiology]] and [[psychosomatic medicine]], and the first to recognize '[[physiological psychology]]' in the treatment of illnesses involving [[emotion]]s, and developed a system for associating changes in the [[pulse]] rate with inner feelings, which is seen as an anticipation of the [[word association]] test attributed to [[Carl Jung]]. Avicenna identified [[love sickness]] (''Ishq'') ... illnesses together. It described [[melancholia]] ([[Depression (mood)|depression]]) as a type of [[mood disorder]] in which the person may become suspicious and develop certain types of [[phobia]]s. It stated that [[anger]] heralded the transition of melancholia to [[mania]], and explained that [[humidity]] inside the head can contribute to mood disorders. It recognized that this occurs when the amount of [[breath]] changes: [[happiness]] increases the breath, which leads to increased moisture inside the brain, but if this moisture goes beyond its limits, the brain would lose control over its [[rationality]] and lead to mental disorders. It also described symptoms and treatments for [[nightmare]], [[epilepsy]], and weak [[memory]].<ref name="Amber-366"/>

===Sleep Medicine===
An early psychological perspective on [[bedwetting]] was given in ''The Canon of Medicine'':<ref>{{citation|title=Sleep Psychiatry|last=Alexander Z. Golbin|first=Howard M. Kravitz, Louis G. Keith|publisher=[[Taylor and Francis]]|year=2004|isbn=1842141457|page=171}}</ref>

{{quote|"Urinating in bed is frequently predisposed by deep sleep: when urine begins to flow, its inner nature and hidden will (resembling the will to breathe) drives urine out before the child awakes. When children become stronger and more robust, their sleep is lighter and they stop urinating."}}

==Surgery==
In [[surgery]], the ''Canon'' was the first to describe the surgical procedure of [[intubation]] in order to facilitate [[breath]]ing.<ref name=Patricia/>

===Anesthesia===
The ''Canon'' described the "soporific sponge", an [[Anesthesia|anasthetic]] imbued with [[aromatics]] and [[narcotics]], which was to be placed under a patient's nose during surgical operations.<ref name=Patricia/>

===Cancer therapy===
:''See [[#Etiology and pathology|Etiology and Pathology]] above''

===Hirudotherapy===
[[Hirudotherapy]], the use of [[medicinal leech]] for medical purposes, was introduced by ''The Canon of Medicine''. It considered the application of [[leech]] to be more useful than [[cupping]] in "letting off the [[blood]] from deeper parts of the body." He also introduced the use of leech as treatment for [[skin disease]]. Leech therapy became a popular method in [[medieval Europe]] due to the influence of his ''Canon''.<ref>{{citation | author = Deuraseh Nurdeen | year = | title = Ahadith of the Prophet on Healing in Three Things (al-Shifa' fi Thalatha): An Interpretational | url = | journal = Journal of the International Society for the History of Islamic Medicine | volume = 2004 | issue = 3| pages = 14–20 [18] }}</ref>

==Other contributions==
===Chromotherapy===
The ''Canon'', which described colour to be of vital importance in [[medical diagnosis|diagnosis]] and [[therapy|treatment]], made significant contributions to [[chromotherapy]]. It stated that "Color is an observable symptom of disease" and also developed a chart that related colour to the [[temperature]] and physical condition of the body. His view was that red moved the blood, blue or white cooled it, and yellow reduced muscular pain and inflammation. The author further discussed the properties of colours for healing and was "the first to establish that the wrong colour suggested for therapy would elicit no response in specific diseases." As an example, "he observed that a person with a nosebleed should not gaze at things of a brilliant red color and should not be exposed to red light because this would stimulate the [[wiktionary:sanguineous|sanguineous]] humor, whereas blue would soothe it and reduce blood flow."<ref>{{citation | doi = 10.1093/ecam/neh137 | author = Samina T. Yousuf Azeemi, Raza S. Mohsin | year = 2005 | title = A Critical Analysis of Chromotherapy and Its Scientific Evolution | url = | pmc = 1297510| journal = Evidence-Based Complementary Alternative Medicine | volume = 2 | issue = 4| pages = 481–488 | pmid=16322805}}</ref>

===Dermatology===
In [[dermatology]], the preferred medication the ''Canon'' recommended for [[skin condition]]s, including [[skin cancer]], was [[zinc oxide]]. Though today it is no longer used for treating skin cancer, it is still widely used today to treat a variety of other skin conditions, in products such as [[baby powder]] and creams to treat [[diaper rash]]es, [[calamine]] cream, anti-[[dandruff]] [[shampoo]]s, and [[antiseptic]] ointments.<ref name=Harding>{{citation|title=Breast Cancer: Cause - Prevention - Cure|first=Fred John|last=Harding|publisher=Tekline Publishing|year=2007|isbn=0955422108|page=82}}</ref>

===Endocrinology===
In [[endocrinology]], the ''Canon'' provided a detailed account on [[diabetes mellitus]] in ''The Canon of Medicine'', "describing the abnormal appetite and the collapse of sexual functions and he documented the sweet taste of diabetic urine." Like [[Aretaeus of Cappadocia]] before him, the ''Canon'' recognized a primary and secondary diabetes. It also described diabetic [[gangrene]], and treated diabetes using a mixture of [[lupin]]e, [[trigonella]] ([[fenugreek]]), and [[zedoary]] seed, which produces a considerable reduction in the excretion of sugar, a treatment which is still prescribed in modern times. It also "described diabetes insipidus very precisely for the first time", though it was later [[Johann Peter Frank]] (1745–1821) who first differentiated between diabetes mellitus and diabetes insipidus.<ref>{{citation|journal=International Journal of Endocrinology and Metabolism|year=2003|volume=1|pages=43–45 [44–5]|title=Clinical Endocrinology in the Islamic Civilization in Iran|last=Nabipour|first=I.}}</ref>

===Gerontology and Geriatrics===
''The Canon of Medicine'' was the first book to offer instruction for the care of the [[Ageing|aged]], foreshadowing modern [[gerontology]] and [[geriatrics]]. A chapter entitled "Regimen of Old Age" stated that "old folk need plenty of sleep. Time spent on the couch should be liberal—more than is legitimate for adults." It further stated that after waking up, the body should be [[Anointing|anointed]] with [[oil]] "to stimulate the sensitive faculties". Regarding [[exercise]], it recommended [[walking]] or [[Equestrianism|horse-riding]]. It stated:<ref name=Howell-58>{{citation|last=Howell|first=Trevor H.|title=Avicenna and His Regimen of Old Age|journal=Age and Ageing|year=1987|volume=16|issue=1|pages=58–59 [58]|doi=10.1093/ageing/16.1.58|pmid=3551552}}</ref>

{{quote|"The factors to consider in regard to exercise in old people are the various bodily states of different persons; the sequels likely to arise from their [[Illness|ailments]]; and their previous habits as regards exercise."}}

The book said that if the body is healthy, it can perform attempered exercises, but if one part of the body is infirm, "then that part should not be exercised until after the rest", and that exercises are not to be strictly graduated "as if the body were to be strengthened". The ''Canon'' recognized four periods of [[life]]: the period of [[Human development (biology)|growth]], [[Adult|prime of life]], period of [[Middle age|elderly decline]] (from forty to sixty), and [[Muscle weakness|decrepit]] age. He states that during the last period, "there is hardness of their [[bone]]s, roughness of the [[skin]], and the long time since they produced [[semen]], [[blood]] and vaporal [[Breathing|breath]]". However, he agreed with [[Galen]] that the [[Earth (classical element)|earth element]] is more prominent in the aged and decrepit than in other periods. Avicenna did not agree with the concept of infirmity, however, stating:<ref name=Howell-58/>

{{quote|"There is no need to assert that there are three states of the human body—sickness, health and a state
which is neither health nor disease. The first two cover everything."}}

[[Dissertation|Thesis]] III of the ''Canon'' discussed the [[diet (nutrition)|diet]] suitable for [[Old age|old people]]. Avicenna wrote that they should be given [[food]] in small amounts at a time and that they can have two to three meals a day, divided up according to the digestive powers and general condition of the old person in question. He also recommended [[fruit]]s, such as [[Ficus|figs]] and [[prune]]s. He also stated:<ref name=Howell-59>{{citation|last=Howell|first=Trevor H.|title=Avicenna and His Regimen of Old Age|journal=Age and Ageing|year=1987|volume=16|issue=1|pages=58–59 [59]|doi=10.1093/ageing/16.1.58|pmid=3551552}}</ref>

{{quote|"Some laudable nutrition may be allowed at bedtime, [but] robust old folk may have a more liberal supper, as long as they avoid any gross [[Nutrition|aliment]]... all hot, sharp or [[Desiccation|dessicative]] foods, such as [[Dish (food)|dishes]] made with [[vinegar]], [[salt]], hot [[Aromaticity|aromatics]], [[seasoning]]s and [[Pickling|pickles]]. [Milk is good for the aged, being] nutritious and humectant in nature. [Yet] articles of food with a laxative action are most appropriate for the elderly."}}

The book also dedicated several sections of its Thesis III to elderly patients who become [[Constipation|constipated]], and wrote:<ref name=Howell-59/>

{{quote|"Strong clysters ([[enema]]ta) must be avoided because they dry up the [[Gastrointestinal tract|gut]]. An unctuous enema is
beneficial in cases where the [[bowel]]s have been constipated for several days. ... Evacuations must be procured with as little stress as possible in the aged and decrepit, for it is to their advantage to get bowels opened gently."}}

===Phytotherapy===
In [[phytotherapy]], the ''Canon'' introduced the medicinal use of [[Taxus baccata]] L. He named this herbal [[drug]] as "Zarnab" and used it as a [[Heart|cardiac]] remedy. This was the first known use of a [[calcium channel blocker]] drug, which were not used in the [[Western world]] until the 1960s.<ref>{{citation | doi = 10.1002/ptr.2173 | author = Tekol Yalcin | year = 2007 | title = The medieval physician Avicenna used an herbal calcium channel blocker, Taxus baccata L. | url = | journal = Phytotherapy Research | volume = 21 | issue = 7| pages = 701–2 | pmid = 17533639 }}</ref>


==Collection of the Canon of Medicine==
==Collection of the Canon of Medicine==

Revision as of 00:29, 9 June 2011

Persian version of The Canon of Medicine located at tomb of Avicenna in Hamedan
File:IbnSina-Dushanbe.jpg
"Avicenna statue"

The Canon of Medicine is an encyclopedia of Galenic medicine in five books compiled by Ibn Sīnā (Avicenna) and completed in 1025.[1] It presents a clear and organized summary of all the medical knowledge of the time.[2] Originally written in Arabic language, the book was later translated into a number of other languages, including Latin, Chinese, Hebrew, German, French, and English.[3] The Canon is considered one of the most famous books in the history of medicine.[4]

Also known as the Qanun, which means "law" in both Arabic and Persian, the Canon of Medicine remained a medical authority up until the 18th century[5][dead link] and early 19th century.[6] It set the standards for medicine in Europe and the Islamic world, and is Avicenna's most renowned written work. Qanun was used at many medical schools—at University of Montpellier, France, as late as 1650.[7] Much of the book was also translated into Chinese as the Huihui Yaofang (Prescriptions of the Hui Nationality) by the Hui people in Yuan China.[8] The Canon also formed the basis of Unani medicine, a form of traditional medicine practiced in India. The principles of medicine described by the Canon ten centuries ago are still taught at UCLA and Yale University, among others, as part of the history of medicine.

George Sarton, the father of the history of science, wrote in the Introduction to the History of Science:

"One of the most famous exponents of Muslim universalism and an eminent figure in Islamic learning was Ibn Sina, known in the West as Avicenna (981-1037). For a thousand years he has retained his original renown as one of the greatest thinkers and medical scholars in history. His most important medical works are the Qanun (Canon) and a treatise on Cardiac drugs. The 'Qanun' is an immense encyclopedia of medicine. It contains some of the most illuminating thoughts pertaining to distinction of mediastinitis from pleurisy; contagious nature of phthisis; distribution of diseases by water and soil; careful description of skin troubles; of sexual diseases and perversions; of nervous ailments."

Influence in Western world

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.

The Persian text Qanun was translated into Latin as Canon medicinae by Gerard of Cremona in the 12th century and into Hebrew in 1279. Henceforth the Canon served as the chief guide to medical science in the West and is said to have influenced Leonardo da Vinci. Its encyclopaedic content, its systematic arrangement and philosophical plan soon worked its way into a position of pre-eminence in the medical literature of Europe, displacing the works of Galen and becoming the text book for medical education in the schools of Europe. The text was read in the medical schools at Montpellier and Leuven as late as 1650, and Arnold C. Klebs described it as "one of the most significant intellectual phenomena of all times."[citation needed] In the words of Dr. William Osler, the Qanun has remained "a medical bible for a longer time than any other work". The first three books of the Latin Canon were printed in 1472, and a complete edition appeared in 1473. The 1491 Hebrew edition is the first appearance of a medical treatise in Hebrew and the only one produced during the 15th century. In the last 30 years of the 15th century it passed through 15 Latin editions. In recent years, a partial translation into English was made.

The influential Canadian physician, Sir William Osler, described the Canon as "the most famous medical textbook ever written" noting that it remained "a medical bible for a longer time than any other work."[9] In 2006, Professor John Urquhart noted the relevance of the Canon to modern medicine, comparing it to an influential medical work of the 19th century, The Principles and Practice of Medicine (1892) by Osler himself, and concluded:

"If the year were 1900 and you were marooned and in need of a guide for practical medicine, which book would you want by your side?" My choice was Ibn Sina. A leading reason is that Ibn Sina gives an integrated view of surgery and medicine, whereas Osler largely shuns intervention. Ibn Sina, for example, tells how to judge the margin of healthy tissue to take with an amputation, a basic topic uncovered by Osler. The gap between medicine and surgery is now closing, with the advent of interventional cardiology, gastroenterology, radiology, etc. Ibn Sina correctly saw medicine and surgery as one.[10]

Mona Nasser Aida Tibi and Emilie Savage-Smith note: "The enduring respect in the 21st century for a book written a millennium earlier is testimony to Ibn Sina's achievement."[11]

Overview

Book 1 part 1 Humours and temperaments

Four Humours

The Canon of Medicine supports the ancient theory of Four Humours, but refines in various ways. In disease pathogenesis, for example, Avicenna "added his own view of different types of spirits (or vital life essences) and souls, whose disturbances might lead to bodily diseases because of a close association between them and such master organs as the brain and heart. An element of such belief is apparent in the chapter of al-Lawa" (see Cardiology section), which relates "the manifestations to an interruption of vital life essence to the brain." He combined his own view with that of the Four Humours to establish a new doctrine to explain the mechanisms of various diseases in another work he wrote, Treatise on Pulse:[3]

“From mixture of the four [humors] in different weights, [God the most high] created different organs; one with more blood like muscle, one with more black bile like bone, one with more phlegm like brain, and one with more yellow bile like lung.

[God the most high] created the souls from the softness of humors; each soul has it own weight and amalgamation. The generation and nourishment of proper soul takes place in the heart; it resides in the heart and arteries, and is transmitted from the heart to the organs through the arteries. At first, it [proper soul] enters the master organs such as the brain, liver or reproductive organs; from there it goes to other organs while the nature of the soul is being modified in each [of them]. As long as [the soul] is in the heart, it is quite warm, with the nature of fire, and the softness of bile is dominant. Then, that part which goes to the brain to keep it vital and functioning, becomes colder and wetter, and in its composition the serous softness and phlegm vapor dominate. That part, which enters the liver to keep its vitality and functions, becomes softer, warmer and sensibly wet, and in its composition the softness of air and vapor of blood dominate.

In general, there are four types of proper spirit: One is brutal spirit residing in the heart and it is the origin of all spirits. Another – as physicians refer to it – is sensual spirit residing in the brain. The third – as physicians refer to it – is natural spirit residing in the liver. The fourth is generative – i.e. procreative – spirits residing in the gonads. These four spirits go-between the soul of absolute purity and the body of absolute impurity.”

Four Temperaments

The Canon also adopted the ancient theory of Four Temperaments and extended it to encompass "emotional aspects, mental capacity, moral attitudes, self-awareness, movements and dreams." It summarized Avicenna's own theory of four temperaments in a table presented as follows:[12]

Avicenna's four primary temperaments
Evidence Hot Cold Moist Dry
Morbid states inflammations become febrile fevers related to serious humour, rheumatism lassitude loss of vigour
Functional power deficient energy deficient digestive power difficult digestion
Subjective sensations bitter taste, excessive thirst, burning at cardia Lack of desire for fluids mucoid salivation, sleepiness insomnia, wakefulness
Physical signs high pulse rate, lassitude flaccid joints diarrhea, swollen eyelids, rough skin, acquired habit rough skin, acquired habit
Foods & medicines calefacients harmful, infrigidants beneficial infrigidants harmful, calefacients beneficial moist articles harmful dry regimen harmful, humectants beneficial
Relation to weather worse in summer worse in winter bad in autumn

The book explains the causes of health and disease. Ibn Sina believed that the human body cannot be restored to health unless the causes of both health and disease are determined. He defined medicine (tibb) as follows:

"Medicine is the science by which we learn the various states of the body; in health, when not in health; the means by which health is likely to be lost; and, when lost, is likely to be restored. In other words, it is the art whereby health is concerned and the art by which it is restored after being lost."[13]

Avicenna regarded the causes of good health and diseases to be:

  1. The Material Causes
  2. The Elements
  3. The Humors
  4. The Variability of the Tumors
  5. The Temperaments
  6. The Psychic Faculties
  7. The Vital Force
  8. The Organs
  9. The Efficient Causes
  10. The Formal Causes
  11. The Vital Faculties
  12. The Final Causes

The Qanun distinguishes mediastinitis from pleurisy and recognises the contagious nature of phthisis (tuberculosis of the lung) and the spread of disease by water and soil. It gives a scientific diagnosis of ankylostomiasis and attributes the condition to an intestinal worm. The Qanun points out the importance of dietetics, the influence of climate and environment on health, and the surgical use of oral anaesthetics.[14][verification needed] Ibn Sina advised surgeons to treat cancer in its earliest stages, ensuring the removal of all the diseased tissue.[15][verification needed] The Qanun 's materia medica considers some 800 tested drugs, with comments on their application and effectiveness.[16] He recommended the testing of a new drug on animals and humans prior to general use.

The earliest known copy of the Canon of Medicine dated 1052 is held in the collection of the Aga Khan and is to be housed in the Aga Khan Museum planned for Toronto, Ontario, Canada.

Book 1 part 2 general Anatomy and physiology

Writings on anatomy in the Canon are scattered throughout the text in sections regarding to illnesses related to certain body parts. The Canon included numerous discussions on anatomy and diagrams on certain body parts, including the first diagrams of the cranial sutures.[17]

Blood pressure

Avicenna dedicated a chapter of the Canon to blood pressure. He was able to discover the causes of bleeding and haemorrhage, and discovered that haemorrhage could be induced by high blood pressure because of higher levels of cholesterol in the blood. This led him to investigate methods of controlling blood pressure.[18][verification needed]

Dissection

The Canon distinguished anatomy "from other aspects of medicine by its need for a different methodology." It thus stated:[19]

"As for the parts of the body and their functions, it is necessary that they be approached through observation (hiss) and dissection (tashrih), while those things that must be conjectured and demonstrated by reason are diseases and their particular causes and their symptoms and how disease can be abated and health maintained."

Neuroanatomy and neurophysiology

Avicenna discovered the cerebellar vermis—which he named "vermis"—and the caudate nucleus, which he named "tailed nucleus" or "nucleus caudatus". These terms are still used in modern neuroanatomy and neurophysiology.[18][verification needed]

The Canon was also the earliest text to note that intellectual dysfunctions were largely due to deficits in the brain's middle ventricle, and that the frontal lobe of the brain mediated common sense and reasoning.[20]

Ophthalmology

The contributions of the Canon to ophthalmology in medieval Islam include its descriptions and explanations on the physiology of eye movements, which still forms a basis of information for modern ophthalmology. He also provided useful information on the optic nerves, iris, and central and peripheral facial paralyses.[18][verification needed]

Another contribution the Canon made to ophthalmology was the suggestion that "the optic nerves did cross."[1]

Book 2 (materia medica) and Book 5 (compound drugs)

The Canon of Medicine was the first book dealing with evidence-based medicine, experimental medicine,[21] clinical trials, randomized controlled trials,[22][23] efficacy tests,[24][25] risk factor analysis, and the idea of a syndrome in the diagnosis of specific diseases.[26]

According to Toby Huff and A. C. Crombie, the Canon contained "a set of rules that laid down the conditions for the experimental use and testing of drugs" which were "a precise guide for practical experimentation" in the process of "discovering and proving the effectiveness of medical substances."[21]

Clinical pharmacology

The emphasis of the Canon on tested medicines laid the foundations for an experimental approach to pharmacology.[27] The Canon laid out the following rules and principles for testing the effectiveness of new drugs and medications, which still form the basis of clinical pharmacology[28] and modern clinical trials:[29]

  1. "The drug must be free from any extraneous accidental quality."
  2. "It must be used on a simple, not a composite, disease."
  3. "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."
  4. "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."
  5. "The time of action must be observed, so that essence and accident are not confused."
  6. "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."
  7. "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."

The Canon lists 800 tested drugs, including plant and mineral substances, with comments on their application and effectiveness. For each one, he described their pharmaceutical actions from a range of 22 possibilities (including resolution, astringency and softening), and their specific properties according to a grid of 11 types of diseases.[16]

Inductive logic

While Ibn Sina often relied on deductive reasoning in The Book of Healing and other writings on logic in Islamic philosophy, he used a different approach in The Canon of Medicine. This text contributed to the development of inductive logic, which it used to develop the idea of a syndrome in the diagnosis of specific diseases. The Canon of Medicine was the first to describe the methods of agreement, difference and concomitant variation which are critical to inductive logic and the scientific method.[26][30][31]

Pharmaceutical sciences

The book's contribution to the pharmaceutical sciences include the introduction of experimental medicine, evidence-based medicine, clinical trials,[29] randomized controlled trials,[22][23] efficacy tests[24][25] and clinical pharmacology;[28] the first careful descriptions of skin troubles, sexually transmitted diseases, perversions and nervous ailments; and the discovery of the healing property of gaseous mercury besides its poisonous quality;[18] as well as the use of ice to treat fevers, and the separation of medicine from pharmacology, which was important to the development of the pharmaceutical sciences.[32]

Pharmacotherapy

Avicenna wrote a separate supplement treatise dedicated to the pharmacotherapy of "Hindiba", a compound drug he suggested for the treatment of cancer and other tumors (see Cancer therapy below) and which could also be used for treating other neoplastic disorders. He gives details on the drug's properties and uses, and then gives instructions on its preparation as medication.

In inhalational drug therapy, the Canon described the inhalation of essential oils from pine and eucalyptus to alleviate respiratory symptoms. Both of these compounds are still present in modern-day proprietary inhalational medicines.[33]

Pharmacy

The Canon described no less than 700 preparations of medications, their properties, mode of action and their indications. He devoted in fact a whole volume to simple and compound drugs in The Canon of Medicine. It credits many of them to a variety of Arabic, Greek and Indian authors, and also includes some drugs imported from China, along with many of Ibn Sina's own original contributions. Using his own expertise, he was often critical of the descriptions given by previous authors and revised many of their descriptions.[16]

Book 3

Book 3 is arranged from head to toe covering the function and diseases of each organ.

Book 4

Book 4 covers diseases that affect the whole body like fevers.

Collection of the Canon of Medicine

The library of Ibn Sina Academy of Medieval Medicine and Sciences owns following collected works of the Canon of Medicine (“Al-Qanun fi al-Tibb”)

  • Urdu translation of all 5 volumes by Hakim Ghulam Hasnain Qantori in the late 19th century by Nawal Kishore Press, Lucknow. Recently, the Facsimile of these 5 volumes have also been printed from Pakistan.
  • Urdu translation of all 5 volumes by Jamia Hamdard, New Delhi. It was translated under the guidance of Hakim Abdul Hameed.
  • English translation of the first and second volumes by Jamia Hamdard, Delhi.
  • English translation of the first volume by Laleh Bakhtiar (ed.), Oskar Cameron Gruner (trans.) and Mazhar H. Shah (trans.)
  • The Japanese translation of the first volume by Hitoshi IGARASHI Tatsuo Sato and Shuntaro ITO Asahi-Shuppan, Tokyo, Japan
  • Russian translation of all 5 volumes
  • Uzbek translation of all 5 volumes
  • Persian translation of all 5 volumes

See also

Notes and references

  1. ^ a b Finger, Stanley (1994), Origins of Neuroscience: A History of Explorations Into Brain Function, Oxford University Press, p. 70, ISBN 0195146948
  2. ^ "Encyclopædia Iranica". Retrieved 9 July 2010. {{cite web}}: Unknown parameter |unused_data= ignored (help)
  3. ^ a b Cite error: The named reference Cardiology was invoked but never defined (see the help page).
  4. ^ ""The Canon of Medicine" (work by Avicenna)". Encyclopædia Britannica. 2008. Retrieved 11 June 2008. {{cite web}}: Italic or bold markup not allowed in: |publisher= (help)
  5. ^ Ziauddin Sardar, Science in Islamic philosophy[dead link]
  6. ^ Haque Amber (2004), "Psychology from Islamic Perspective: Contributions of Early Muslim Scholars and Challenges to Contemporary Muslim Psychologists", Journal of Religion and Health, 43 (4): 357–377 [375], doi:10.1007/s10943-004-4302-z
  7. ^ The Canon of Medicine (work by Avicenna), Encyclopædia Britannica
  8. ^ Jan Van Alphen, Anthony Aris, Fernand Meyer, Mark De Fraeye (1995), Oriental Medicine, Serindia Publications, p. 201, ISBN 0906026369{{citation}}: CS1 maint: multiple names: authors list (link)
  9. ^ Osler, William (2004), The Evolution Of Modern Medicine, Kessinger Publishing, p. 71, ISBN 1419161539
  10. ^ Professor John Urquhart (14 January 2006), "How Islam changed medicine: Ibn Sina (Avicenna) saw medicine and surgery as one", BMJ, 332 (7533): 120, doi:10.1136/bmj.332.7533.120-b, PMC 1326980, PMID 16410600
  11. ^ Mona Nasser Aida Tibi, Emilie Savage-Smith; Tibi, A; Savage-Smith, E (2009), "Ibn Sina's Canon of Medicine: 11th century rules for assessing the effects of drugs", Journal of the Royal Society of Medicine, 102 (2): 78–80, doi:10.1258/jrsm.2008.08k040, PMID 19208873
  12. ^ Cite error: The named reference Lutz was invoked but never defined (see the help page).
  13. ^ Howell, Trevor H. (1987), "Avicenna and His Regimen of Old Age", Age and Ageing, 16 (1): 58–59, doi:10.1093/ageing/16.1.58, PMID 3551552
  14. ^ The Canon of Medicine, The American Institute of Unani Medicine, 2003.
  15. ^ Cite error: The named reference Patricia was invoked but never defined (see the help page).
  16. ^ a b c Jacquart, Danielle, "Islamic Pharmacology in the Middle Ages: Theories and Substances", European Review, 16 (2): 219–227 [223] Cite error: The named reference "Jacquart" was defined multiple times with different content (see the help page).
  17. ^ The Canon on Medicine, United States National Library of Medicine.
  18. ^ a b c d Professor Dr. İbrahim Hakkı Aydin (2001), "Avicenna And Modern Neurological Sciences", Journal of Academic Researches in Religious Sciences, 1 (2): 1–4
  19. ^ Savage-Smith, Emilie (1995), "Attitudes Toward Dissection in Medieval Islam", Journal of the History of Medicine and Allied Sciences, 50 (1), Oxford University Press: 67–110 [92–3], doi:10.1093/jhmas/50.1.67, PMID 7876530
  20. ^ Millon, Theodore (2004), Masters of the Mind: Exploring the Story of Mental Illness from Ancient Times to the New Millennium, John Wiley & Sons, p. 38, ISBN 9780471469858
  21. ^ a b Huff, Toby (2003), The Rise of Early Modern Science: Islam, China, and the West, Cambridge University Press, p. 218, ISBN 0521529948
  22. ^ a b Jonathan D. Eldredge (2003), "The Randomised Controlled Trial design: unrecognized opportunities for health sciences librarianship", Health Information and Libraries Journal 20, p. 34–44 [36].
  23. ^ a b Bernard S. Bloom, Aurelia Retbi, Sandrine Dahan, Egon Jonsson (2000), "Evaluation Of Randomized Controlled Trials On Complementary And Alternative Medicine", International Journal of Technology Assessment in Health Care 16 (1), p. 13–21 [19].
  24. ^ a b D. Craig Brater and Walter J. Daly (2000), "Clinical pharmacology in the Middle Ages: Principles that presage the 21st century", Clinical Pharmacology & Therapeutics 67 (5), p. 447-450 [449].
  25. ^ a b Walter J. Daly and D. Craig Brater (2000), "Medieval contributions to the search for truth in clinical medicine", Perspectives in Biology and Medicine 43 (4), p. 530–540 [536], Johns Hopkins University Press.
  26. ^ a b Lenn Evan Goodman (2003), Islamic Humanism, p. 155, Oxford University Press, ISBN 0-19-513580-6.
  27. ^ Jacquart, Danielle, "Islamic Pharmacology in the Middle Ages: Theories and Substances", European Review, 16 (2): 219–227 [219 & 222–5]
  28. ^ a b Brater D. Craig, Daly Walter J. (2000), "Clinical pharmacology in the Middle Ages: Principles that presage the 21st century", Clinical Pharmacology & Therapeutics, 67 (5): 447–450 [448], doi:10.1067/mcp.2000.106465, PMID 10824622
  29. ^ a b Tschanz David W., MSPH (2003), "Arab Roots of European Medicine", Heart Views, 4: 2
  30. ^ Lenn Evan Goodman (1992), Avicenna, p. 33, Routledge, ISBN 0-415-01929-X.
  31. ^ James Franklin (2001), The Science of Conjecture: Evidence and Probability Before Pascal, pp. 177-8, Johns Hopkins University Press, ISBN 0-8018-6569-7
  32. ^ Bashar Saad, Hassan Azaizeh, Omar Said (October 2005). "Tradition and Perspectives of Arab Herbal Medicine: A Review", Evidence-based Complementary and Alternative Medicine 2 (4), p. 475-479 [476]. Oxford University Press.
  33. ^ Ian M. Adcock & Kian Fan Chung (2008), Overcoming Steroid Insensitivity in Respiratory Disease, John Wiley & Sons, pp. 263–4, ISBN 0470058080
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