Hippocrates (460-370 BCE) devised a theory about bodily health. This was that good health depended on a balance of the humours (bodily fluids) and disease occurred when the humours were unbalanced. The theory described a systematic and rational approach based on the balance between the bodily fluids which were named the Four Humours: blood, yellow bile, black bile and phlegm. If the patient had too much of one or other of these the fluids became unbalanced and disease resulted.
Different diseases were connected to each type of fluid. Black bile was an indication of a melancholy, a fever indicated a problem with the blood, diarrhoea was connected to yellow bile and phlegm was an indication of catarrh. Humoural imbalance was affected by the seasons, weather, food, drink, work and emotion. Treatment to rebalance the humours was directed at removing the fluids by drugs which caused vomiting, purging, urine production or by bloodletting. Foodstuffs or medicines were used to fight disease. For example phlegm was considered to be cold and wet so hot and dry foods were prescribed. If the patient had a fever then cooling foodstuffs such as cool drinks, lettuce and cucumber were prescribed.
These ideas were taken up into Islamic culture between the eighth and eleventh century CE through the translation of the Greek texts written by Hippocrates and other eminent practitioners in the Hellenistic world. With the rise of Islam Muslim scholars wanted to apply medical ideas to theological debates. On a practical and political level, because of the new relationship between the new Islamic dynasty and the Hellenistic world Islamic scholars and practitioners had access to libraries contained manuscripts from which they acquired new medical knowledge.
There may also have been kudos amongst the social elite and the rulers whose wealth funded the translations. Translation of Greek texts was complicated. Complete texts were rare and contained words for diseases and treatments which were non-existent in Arabic. The use of transliteration, translating letter by letter from one language into the other, created new words. Greek practitioners knew the disease epilepsy as ‘the sacred disease’ thought to have been sent by the gods. In Arabic the word translated as ‘al-marad al-ilahi’, the divine disease. All references to gods were discarded and replaced by references to Allah.
The use of remedies containing alcohol or materials from pigs were forbidden by the Qur’an and also removed. In this way the texts were adapted and reinterpreted to suit the culture. During the period 980-1037 CE the chief practitioners of Islamic medicine were Hunayn ibn Ishaq (c. 808–873 CE), (Latin – Joannitius or Johannitius), Abu Bakr Muhammed ibn Zakariya al-Razi (Rhazes) (c. 865–925 CE) and Ibn Sina (Avicenna) (980–1037 CE). They adopted the humoural theory with its accent on diet, lifestyle and environment diagnosing the use of drugs, food and exercise as part of treatment.
Many more drugs were discovered and new ideas and treatments were added to the original theory and in this way they systemised and rationalised the theory. In the late eleventh century CE another phase of translation occurred and texts which had previously been translated from Greek into Arabic were now translated into Latin.
At Monte Cassino monastery, the monk Constantine Africanus translated works by Arabic and Greek authors and some of the works of Galen Africanus was responsible for translations of the Pantegni by Ali ibn al-Abbas al-Majusi (HalyAbbas). Works written by Ibn al Jazzar and Hunayn ibn Ishaq (Johannitius) were also translated by Africanus.
These new translations were similar to the first movement of medical ideas but adaptations were beginning to emerge. By the twelfth century CE Gerard of Cremona in Toledo, Spain had translated various compendia by Islamic authors. For example, al-Razi – Rhazes, Al-Kitab al- mansuri fi l-tibb – The Mansurian Book of Medicine and Canon – Ibn Sina (Avicenna) and some of the surgical sections of Abu Al-Qasim – Albucasis, Chirurgia.
At this time the remaining works of Galen, al-Razi and Ibn Rushd (Averroes) were translated from the original Greek and Arabic into Latin. In early medieval Europe the Greek and Islamic texts were highly valued and works by Galen, Hunayn, Ibn Sina and Hippocrates were studied in the emerging Universities. In Europe the texts had a different impact and although some aspects of Greek humoural medicine had survived, newly translated texts were produced. The new texts still used the rational approach to diagnosis.
The number and sophistication of treatments changed however and adaptations and reinterpretations continued to have an impact. There was an expansion in the array of drugs to treat patients. In their search for knowledge scholars wrote hundreds of new texts which contained case histories, remedies and an overall new practical approach. Anatomy also began to be explored and dissection was practised but only minor improvements on surgical techniques and new operations occurred. In a social context the reclaiming of parts of Europe by Christian princes brought contact between European scholars and Islamic ideas in Spain, southern Italy, Sardinia and Sicily.
‘Curiously, the Crusades – campaigns by Christian Armies to conquer holy sites in the Middle East – did not have major impact on the exchange of medical knowledge between Europe and the Middle East. The key translators were a mix of Muslim, Jewish and Christian scholars who pooled their resources to produce accurate translations of the Arabic texts. At this time there were similar political and social factors prevailing. Economic growth resulted in a population increase. More schools were needed and there was a new interest in intellectual matters.
Scholars were enthusiastic to rediscover Greek knowledge and Arabic philosophy and science. Patrons and the social elite were able afford to pay for translations. Translating the Arabic texts into Latin produced the same problems of transliteration that existed when the Greek medical texts were translated into Arabic.
All references to Allah were removed and a Christian spin was put on the documents. ‘As well as relating each fluid to qualities, elements and seasons, authors linked them to the four evangelists – Matthew, Mark, Luke and John – who wrote the Gospels of the New Testament. ’