The Canon of Medicine
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[[Image:Canons of medicine.JPG|thumb|right|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]].]]
{{Avicenna}}
'''''The Canon of Medicine''''' ([[Arabic language|Arabic]]: '''القانون في الطب''' '''''Al-Qanun fi al-Tibb''''' "''The Law of Medicine''"; [[Persian language|Persian]]: '''قانون''' '''''Qanun''''' "''Law''") is a 14-volume [[Islamic medicine|Arabic medical encyclopedia]] written by the [[Iranian peoples|Persian]] [[Islamic science|Muslim scientist]] and physician [[Avicenna|Ibn Sīnā]] (Avicenna) and completed in [[1025]].<ref name=Stanley>{{citation|title=Origins of Neuroscience: A History of Explorations Into Brain Function|first=Stanley|last=Finger|year=1994|publisher=[[Oxford University Press]]|isbn=0195146948|page=70}}</ref> Written in [[Arabic language|Arabic]], the book was based on a combination of his own personal experience, medieval [[Islamic medicine]], the writings of the [[Greeks|Greek]] physician [[Galen]],<ref>[http://www.experiencefestival.com/a/Islamic_Golden_Age_-_Medicine/id/1433472 Islamic Golden Age - Medicine]</ref> the [[Ayurveda|Indian physicians]] [[Sushruta]] and [[Charaka]], and ancient [[Arab]]ian and [[Ancient Iranian Medicine|Persian medicine]].<ref>Hakeem Abdul Hameed, [http://www.salaam.co.uk/knowledge/hakeems.php Exchanges between India and Central Asia in the field of Medicine]</ref> The ''Canon'' is considered one of the most famous books in the [[history of medicine]].<ref>{{cite web|url=http://www.britannica.com/eb/topic-92902/The-Canon-of-Medicine|title=“The Canon of Medicine” (work by Avicenna)|publisher=''[[Encyclopædia Britannica]]''|date=2008|accessdate=2008-06-11}}</ref>
Also known as the '''''Qanun''''', which means "law" in [[Arabic]] and [[Persian language|Persian]], the ''Canon of Medicine'' remained a [[Medicine|medical]] authority up until the 18th century<ref>[[Ziauddin Sardar]], [http://www.cgcu.net/imase/islam_science_philosophy.htm Science in Islamic philosophy]</ref> and early 19th century.<ref>Amber Haque (2004), "Psychology from Islamic Perspective: Contributions of Early Muslim Scholars and Challenges to Contemporary Muslim Psychologists", ''Journal of Religion and Health'' '''43''' (4), p. 357-377 [375].</ref> It set the standards for medicine in [[Europe]] and the [[Islamic Golden Age|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.<ref>[http://www.britannica.com/eb/topic-92902/The-Canon-of-Medicine The Canon of Medicine (work by Avicenna)], [[Encyclopædia Britannica]]</ref> The principles of medicine described by him ten centuries ago in this book, are still taught at [[UCLA]] and [[Yale University]], among others, as part of the history of medicine. The ''Canon'' is also considered the first [[pharmacopoeia]].<ref>[[Philip Khuri Hitti|Philip K. Hitti]] (cf. Dr. Kasem Ajram (1992), ''Miracle of Islamic Science'', Appendix B, Knowledge House Publishers. ISBN 0911119434).</ref><ref>Dr. Z. Idrisi, PhD (2005). [http://www.muslimheritage.com/uploads/AgricultureRevolution2.pdf The Muslim Agricultural Revolution and its influence on Europe]. The Foundation for Science, Technology and Civilization, UK.</ref>
Among other things, the book is known for the introduction of systematic [[experiment]]ation and [[quantification]] into the study of [[physiology]],<ref>Katharine Park (March 1990). "''Avicenna in Renaissance Italy: The Canon and Medical Teaching in Italian Universities after 1500'' by Nancy G. Siraisi", ''The Journal of Modern History'' '''62''' (1), pp. 169-170:
{{quote|"Students of the history of medicine know him for his attempts to introduce systematic experimentation and quantification into the study of physiology."}}</ref>
the discovery of the contagious nature of [[infectious disease]]s,<ref name=Zahoor/>
the introduction of [[quarantine]] to limit the spread of contagious [[disease]]s, and the introduction of [[evidence-based medicine]], [[experimental medicine]],<ref name=Huff/> [[clinical trial]]s,<ref name=Tschanz>David W. Tschanz, MSPH, PhD (August 2003). "Arab Roots of European Medicine", ''Heart Views'' '''4''' (2).</ref>
[[randomized controlled trial]]s,<ref name=Eldredge>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].</ref><ref name=Bloom>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].</ref>
[[efficacy]] tests,<ref name=Brater-449>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].</ref><ref name=Daly>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]].</ref>
[[clinical pharmacology]],<ref name=Brater-448>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 [448].</ref> [[neuropsychiatry]],<ref name=Workman/> [[physiological psychology]],<ref name=Syed-7/> [[risk factor]] analysis, and the idea of a [[syndrome]] in the [[diagnosis]] of specific diseases.<ref name=Goodman>Lenn Evan Goodman (2003), ''Islamic Humanism'', p. 155, [[Oxford University Press]], ISBN 0195135806.</ref>
[[George Sarton]], the father of the [[history of science]], wrote in the ''Introduction to the History of Science'':
{{quote|"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 [[Heart|Cardiac]] [[drug]]s. The 'Qanun fi-l-Tibb' is an immense encyclopedia of medicine. It contains some of the most illuminating thoughts pertaining to distinction of [[mediastinitis]] from [[pleurisy]]; [[Infectious disease|contagious nature]] of [[phthisis]]; distribution of diseases by water and soil; careful description of skin troubles; of [[sexual disease]]s and [[perversion]]s; of [[Anxiety|nervous ailments]]."<ref name=Zahoor>[[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>}}
==Overview==
[[Image:Avicenna Persian Physician.jpg|thumb|<center>[[Avicenna|Ibn Sīnā]] (Avicenna)]]
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. Ibn Sina stated that medicine (''tibb'') is the [[science]] by which we learn the various states of the human body when in health and when not in health, and the means by which health is likely to be lost, and when lost, is likely to be restored. In other words, medicine is the science whereby health is conserved and the art whereby it is restored after being lost.
Avicenna regarded the causes of good health and diseases to be:
# The Material Causes
# The Elements
# The Humors
# The Variability of the Tumors
# The Temperaments
# The Psychic Faculties
# The Vital Force
# The Organs
# The Efficient Causes
# The Formal Causes
# The Vital Faculties
# 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 [[diet (nutrition)|dietetics]], the influence of [[climate]] and [[social environment|environment]] on health, and the surgical use of oral [[anaesthetic]]s.<ref>[http://www.unani.com/avicenna%20story%203.htm The Canon of Medicine], The American Institute of Unani Medicine, 2003.</ref> Ibn Sina advised [[surgery|surgeons]] to treat [[cancer]] in its earliest stages, ensuring the removal of all the diseased tissue.<ref name=Patricia/> The ''Qanun'' 's ''materia medica'' considers some 760 [[Medication|drugs]], with comments on their application and effectiveness. He recommended the [[animal testing|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]].
===Influence in Europe===
The Arabic text of the ''Qanun'' was translated into Latin as ''Canon medicinae'' by [[Gerard of Cremona]] in the [[12th century]] and into [[Hebrew language|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 [[encyclopedia|encyclopaedic]] content, its systematic arrangement and [[philosophy|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." 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 language|English]] was made.
==Experimental medicine==
''The Canon of Medicine'' was the first book dealing with [[evidence-based medicine]], [[experimental medicine]],<ref name=Huff/> [[clinical trial]]s, [[randomized controlled trial]]s,<ref name=Eldredge/><ref name=Bloom/> [[efficacy]] tests,<ref name=Brater-449/><ref name=Daly/> [[risk factor]] analysis, and the idea of a [[syndrome]] in the [[diagnosis]] of specific diseases.<ref name=Goodman/>
According to Toby Huff and A. C. Crombie, the ''Canon'' contained "a set of rules that laid down the conditions for the [[experiment]]al use and testing of [[drug]]s" which were "a precise guide for practical experimentation" in the process of "discovering and proving the effectiveness of [[Medication|medical substances]]."<ref name=Huff>{{Citation
|first=Toby
|last=Huff
|year=2003
|title=The Rise of Early Modern Science: Islam, China, and the West
|page=218
|publisher=[[Cambridge University Press]]
|isbn=0521529948
}}</ref>
===Clinical pharmacology===
Avicenna's emphasis on tested medicines laid the foundations for an experimental approach to [[pharmacology]].<ref>{{citation|last=Jacquart|first=Danielle|journal=European Review|volume=16|issue=2|pages=219–227 [219 & 222-5|title=Islamic Pharmacology in the Middle Ages: Theories and Substances}}</ref> The ''Canon'' laid out the following rules and principles for testing the effectiveness of new [[drug]]s and [[medication]]s, which still form the basis of [[clinical pharmacology]]<ref name=Brater-448/> and modern [[clinical trial]]s:<ref name=Tschanz/>
#"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."
===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''. Ibn Sina contributed inventively to the development of [[inductive reasoning|inductive logic]], which he used to pioneer the idea of a [[syndrome]] in the [[diagnosis]] of specific diseases. In ''The Canon of Medicine'', Avicenna was the first to describe the [[Mill's Methods|methods of agreement, difference and concomitant variation]] which are critical to inductive logic and the [[scientific method]].<ref name=Goodman>Lenn Evan Goodman (2003), ''Islamic Humanism'', p. 155, [[Oxford University Press]], ISBN 0195135806.</ref><ref>Lenn Evan Goodman (1992), ''Avicenna'', p. 33, [[Routledge]], ISBN 041501929X.</ref>
===Pharmaceutical sciences===
Avicenna's contribution to the [[pharmaceutical sciences]] include the introduction of systematic experimentation and quantification into [[pharmacology]] and the study of physiology,<ref name=Park/> the introduction of [[experimental medicine]], [[evidence-based medicine]], [[clinical trial]]s,<ref name=Tschanz/>
[[randomized controlled trial]]s,<ref name=Eldredge/><ref name=Bloom/>
[[efficacy]] tests<ref name=Brater-449/><ref name=Daly/>
and [[clinical pharmacology]];<ref name=Brater-448/> the first careful descriptions of [[skin]] troubles, [[sexually transmitted disease]]s, [[perversion]]s and [[Nervous system|nervous]] [[ailment]]s;<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>
and the discovery of the [[healing]] property of gaseous [[Mercury (element)|mercury]] besides its [[poison]]ous quality;<ref name=Aydin/>
as well as the use of [[ice]] to treat [[fever]]s, and the separation of [[medicine]] from [[pharmacology]], which was important to the development of the [[pharmaceutical sciences]].<ref name=Saad>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]].</ref>
;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 [[tumor]]s (see [[#Cancer therapy|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]].<ref name=Sari/>
;Pharmacy
Ibn Sina described no less than 700 preparations of [[medication]]s, their properties, mode of action and their indications. He devoted in fact a whole volume to simple and compound [[drug]]s in ''The Canon of Medicine''. He credits many of them to a variety of Arabic, Greek and Indian authors, and also includes some drugs imported from [[Traditional Chinese medicine|China]], along with many of his own original contributions. Using his own expertise, he was often critical of the descriptions given by previous authors and revised many of their descriptions.<ref>{{citation|last=Jacquart|first=Danielle|journal=European Review|volume=16|issue=2|pages=219–227 [219 & 222-5|title=Islamic Pharmacology in the Middle Ages: Theories and Substances}}</ref>
==Anatomy and Physiology==
The contributions of Avicenna's ''Canon'' to [[physiology]] include the introduction of systematic [[experiment]]ation and [[quantification]] into the study of physiology.<ref name=Park>Katharine Park (March 1990). "''Avicenna in Renaissance Italy: The Canon and Medical Teaching in Italian Universities after 1500'' by Nancy G. Siraisi", ''The Journal of Modern History'' '''62''' (1), p. 169-170.</ref>
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]].<ref>[http://www.nlm.nih.gov/hmd/arabic/E8.html The Canon on Medicine], [[United States National Library of Medicine]].</ref>
===Blood pressure===
Avicenna dedicated a chapter of the ''Canon'' to [[blood pressure]]. He was able to discover the causes of [[bleeding]] and heamorrhage, and discovered that heamorrhage 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.<ref name=Aydin>Professor Dr. İbrahim Hakkı Aydin (2001), "Avicenna And Modern Neurological Sciences", ''Journal of Academic Researches in Religious Sciences'' '''1''' (2): 1-4.</ref>
===Dissection===
Avicenna distinguished anatomy "from other aspects of medicine by its need for a different methodology." He thus stated in the ''Canon'':<ref>{{citation|first=Emilie|last=Savage-Smith|title=Attitudes Toward Dissection in Medieval Islam|journal=Journal of the History of Medicine and Allied Sciences|year=1995|volume=50|issue=1|publisher=[[Oxford University Press]]|pages=67-110 [92-3]}}</ref>
{{quote|"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]].<ref name=Aydin/>
He was also the earliest to note that intellectual dysfunctions were largely due to deficits in the [[brain]]'s middle [[Ventricular system|ventricle]], and that the [[frontal lobe]] of the brain mediated [[common sense]] and [[reasoning]].<ref name=Millon>{{citation|title=Masters of the Mind: Exploring the Story of Mental Illness from Ancient Times to the New Millennium|first=Theodore|last=Millon|year=2004|publisher=[[John Wiley & Sons]]|isbn=0471679615|page=38}}</ref>
===Ophthalmology===
Avicenna's contributions to [[ophthalmology in medieval Islam]] include his descriptions and explanations on the physiology of [[eye movement]]s, which still forms a basis of information for modern [[ophthalmology]]. He also provided useful information on the [[optic nerve]]s, [[Iris (anatomy)|iris]], and central and peripheral [[Facial nerve paralysis|facial paralyses]].<ref name=Aydin/>
Another contribution Avicenna made to [[ophthalmology]] was his suggestion that "the [[optic nerve]]s did cross."<ref name=Stanley/>
===Pulsology and sphygmology===
Avicenna was a pioneer 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>Rachel Hajar (1999), "The Greco-Islamic Pulse", ''Heart Views'' '''1''' (4): 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 (d. 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."}}
Avicenna 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>Rachel Hajar (1999), "The Greco-Islamic Pulse", ''Heart Views'' '''1''' (4): 136-140 [139-140].</ref>
Avicenna also wrote a 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]], Avicenna discovered 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 name=Sarton/> He fully understood the [[pathology]] of contagious disease.<ref>[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>
Avicenna also distinguished between [[mediastinitis]] and [[pleurisy]], provided careful descriptions of skin troubles, [[perversion]]s, and [[Nervous system|nervous]] [[ailment]]s."<ref name=Zahoor/> [[Meningitis]] was also first described in ''The Canon of Medicine''. He 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''</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>[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>
===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>Ibrahim B. Syed, Ph.D. (2002). "Islamic Medicine: 1000 years ahead of its times", ''[[The Islamic Medical Association of North America|Journal of the Islamic Medical Association]]'' '''2''', p. 2-9.</ref>
===Cancer therapy===
In [[unproven cancer therapy|cancer therapy]], Avicenna 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.<ref name=Sari>{{cite web|author=Prof. Nil Sari ([[Istanbul University]], Cerrahpasha Medical School)|title=Hindiba: A Drug for Cancer Treatment in Muslim Heritage|publisher=FSTC Limited|date=06 June, 2007|url=http://muslimheritage.com/topics/default.cfm?ArticleID=707}}</ref> 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>
Another method for treating cancer first described by Avicenna was a surgical treatment. He stated that the [[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/>
Avicenna's ''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===
Avicenna's advances in [[hepatology]] include his 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, Ibn Sina noted the close relationship between [[emotions]] and the physical condition, and 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>Amber Haque (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 [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>Amber Haque (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 [376].</ref>
Among the many other [[Mental disorder|psychological disorders]] that he 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. Ibn Sina 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===
Avicenna's contributions in [[neurology]] and [[neuropathology]] include his diagnosis of [[facial nerve paralysis]], his distinction between brain [[paralysis]] and [[hyperaemia]], and most importantly his discovery of [[meningitis]]. He diagnosed meningitis as a disease induced by the [[brain]] itself and differentiated it from infectious brain disease, and 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===
Ibn Sina was a pioneer of [[neuropsychiatry]] and [[neuropsychology]]. He first described numerous neuropsychiatric conditions, including [[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> Avicenna dedicated three chapters of ''The Canon of Medicine'' to neuropsychiatry.<ref name=Dening>Hanafy A. Youssef, Fatma A. Youssef and T. R. Dening (1996), "Evidence for the existence of schizophrenia in medieval Islamic society", ''History of Psychiatry'' '''7''': 55-62 [56].</ref>
He 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>Hanafy A. Youssef, Fatma A. Youssef and T. R. Dening (1996), "Evidence for the existence of schizophrenia in medieval Islamic society", ''History of Psychiatry'' '''7''': 55-62 [56-57].</ref> He also discovered a condition resembling [[schizophrenia]] which he described as ''Junun Mufrit'' (severe madness), which he clearly distinguished from other forms of madness such as [[mania]], [[rabies]], and [[Bipolar disorder|manic depressive]] [[psychosis]]. He observed that patients suffering from schizophrenia-like severe madness show [[Agitation (emotion)|agitation]], behavioural and sleep disturbance, give inappropriate answers to questions, and in some cases are incapable of speaking at times. He wrote 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>Hanafy A. Youssef, Fatma A. Youssef and T. R. Dening (1996), "Evidence for the existence of schizophrenia in medieval Islamic society", ''History of Psychiatry'' '''7''': 55-62 [57].</ref>
Avicenna also dedicated a chapter of the ''Canon'' to [[mania]] and [[rabies]], where he described mania as bestial madness characterized by rapid onset and [[Remission (medicine)|remission]], with [[Agitation (emotion)|agitation]] and [[irritability]], and described rabies as a type of mania.<ref name=Dening-57/>
===Psychoanalysis===
In ''The Canon of Medicine'', Avicenna extended the theory of [[temperament]]s to encompass "[[emotion]]al aspects, mental capacity, [[moral]] attitudes, [[self-awareness]], movements and [[dream]]s." Avicenna's work is thus 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===
Ibn Sina was a pioneer 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'') when he was treating a very ill patient by "feeling the patient's pulse and reciting aloud to him the names of provinces, districts, towns, streets, and people." He noticed how the patient's pulse increased when certain names were mentioned, from which Avicenna deduced that the patient was in love with a girl whose home Avicenna was "able to locate by the digital examination." Avicenna advised the patient to marry the girl he is in love with, and the patient soon recovered from his illness after his marriage.<ref name=Syed-7>Ibrahim B. Syed PhD, "Islamic Medicine: 1000 years ahead of its times", ''[[The Islamic Medical Association of North America|Journal of the Islamic Medical Association]]'', 2002 (2), p. 2-9 [7].</ref>
Avicenna also gave psychological explanations for certain [[Somatic psychology|somatic illnesses]], and he always linked the physical and psychological illnesses together. He 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. He stated that [[anger]] heralded the transition of melancholia to [[mania]], and explained that [[humidity]] inside the head can contribute to mood disorders. He 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. He also wrote about symptoms and treatments for [[nightmare]], [[epilepsy]], and weak [[memory]].<ref name=Amber-366>Amber Haque (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 [366].</ref>
==Surgery==
In [[surgery]], Avicenna 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 [[Avicenna]] in ''The Canon of Medicine''. He 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>Nurdeen Deuraseh, "Ahadith of the Prophet (s.a.w) on Healing in Three Things (al-Shifa’ fi Thalatha): An Interpretational", ''Jounal of the International Society for the History of Islamic Medicine'', 2004 (3): 14-20 [18].</ref>
==Other contributions==
===Chromotherapy===
Avicenna, who viewed colour to be of vital importance in [[diagnosis]] and [[treatment]], made significant contributions to [[chromotherapy]]. He wrote 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. He 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>Samina T. Yousuf Azeemi and S. Mohsin Raza (2005), "A Critical Analysis of Chromotherapy and Its Scientific Evolution", ''Evidence-Based Complementary Alternative Medicine'' '''2''' (4): 481–488.</ref>
===Endocrinology===
In [[endocrinology]], Avicenna (980-1037) 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, Avicenna recognized a primary and secondary diabetes. He 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. Avicenna 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>
===Phytotherapy===
In [[phytotherapy]], Avicenna 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>Yalcin Tekol (2007), "The medieval physician Avicenna used an herbal calcium channel blocker, Taxus baccata L.", ''Phytotherapy Research'' '''21''' (7): 701-2.</ref>
===Temperaments===
''The Canon of Medicine'' adopted the ancient theory of [[Humorism|Four Humours]] and [[Four Temperaments]] and extended it to encompass "[[emotion]]al aspects, [[Mental health|mental capacity]], [[moral]] attitudes, [[self-awareness]], movements and [[dream]]s." Avicenna summarized his own theory of four [[temperament]]s in a [[Table (information)|table]] presented as follows:<ref name=Lutz/>
{| class="wikitable"
|-
|bgcolor="#00FFFF" colspan="5" | <center>'''[[Avicenna]]'s four primary [[temperament]]s'''<center>
|-
|bgcolor="#77AAFF" | Evidence
|bgcolor="#B0C4DE" | Hot
|bgcolor="#B0C4DE" | Cold
|bgcolor="#B0C4DE" | Moist
|bgcolor="#B0C4DE" | Dry
|-
| bgcolor="#B0C4DE" | Morbid states
| [[inflammation]]s become [[Fever|febrile]]
| [[fever]]s related to serious humour, [[rheumatism]]
| [[Fatigue (medical)|lassitude]]
| loss of [[wiktionary:vigour|vigour]]
|-
| bgcolor="#B0C4DE" | Functional power
| deficient [[energy]]
| deficient [[Digestion|digestive]] power
| difficult [[digestion]]
|
|-
| bgcolor="#B0C4DE" | Subjective sensations
| [[Taste#Bitterness|bitter taste]], excessive [[thirst]], burning at [[cardia]]
| Lack of desire for [[fluid]]s
| [[Mucous connective tissue|mucoid]] [[saliva]]tion, [[Somnolence|sleepiness]]
| [[insomnia]], [[wakefulness]]
|-
| bgcolor="#B0C4DE" | Physical signs
| high [[pulse]] rate, [[Fatigue (medical)|lassitude]]
| [[flaccid]] joints
| [[diarrhea]], [[Eye puffiness|swollen eyelids]], [[Roughness|rough]] skin, acquired [[Habit (psychology)|habit]]
| [[Roughness|rough]] skin, acquired [[Habit (psychology)|habit]]
|-
| bgcolor="#B0C4DE" | Foods & medicines
| [http://www.thefreedictionary.com/calefacient calefacients] harmful, [http://www.thefreedictionary.com/Infrigidate infrigidants] beneficial
| [http://www.thefreedictionary.com/Infrigidate infrigidants] harmful, [http://www.thefreedictionary.com/calefacient calefacients] beneficial
| [[Moisture|moist]] articles harmful
| [[wiktionary:dry|dry]] regimen harmful, [[humectant]]s beneficial
|-
| bgcolor="#B0C4DE" | Relation to weather
| worse in [[summer]]
| worse in [[winter]]
|
| bad in [[autumn]]
|}
==See also==
* [[Avicenna]]
** [[Avicennism]]
** ''[[The Book of Healing]]''
* [[Ibn al-Nafis]]
** ''[[Ibn al-Nafis#Commentary on Anatomy in Avicenna's Canon|Commentary on Anatomy in Avicenna's Canon]]''
* [[Abu al-Qasim al-Zahrawi]]
** ''[[Al-Tasrif]]''
* [[Medical literature]]
==References==
{{reflist|2}}
==External links==
* [http://www.ummah.net/history/scholars/ibn_sina/ Biography of Avicenna]
* [http://ddc.aub.edu.lb/projects/saab/avicenna/contents-eng.html A scanned copy of "Kitab alQanun fi alTibb" (Book {of} the Canon of Medicine)]
* [http://www.akdn.org/agency/aktc_museum.html Aga Khan Museum Project (to include oldest known copy of the Canon of Medicine)]
* [http://www.akdn.org/news/toronto_101002.html Aga Khan Museum Project Press Release]
{{DEFAULTSORT:Canon of medicine}}
[[Category:1020s books]]
[[Category:History of medicine]]
[[Category:Islamic medicine]]
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[[Category:Arabic books]]
[[Category:Islamic books]]
[[Category:Medical books]]
[[ar:القانون في الطب]]
[[es:Canon de medicina]]
[[fa:قانون در طب]]
[[fr:Qanûn (Avicenne)]]
[[it:Il canone della medicina]]
[[nl:Canon van de geneeskunde]]
[[no:Medisinens Kanon]]
[[pl:Kanon medycyny]]
[[ru:Канон врачебной науки]]
[[su:Hukum Kadokteran]]