Ibn al-Nafis
ʿAlāʾ al-Dīn Abū al-Ḥasan ʿAlī ibn Abī Ḥazm al-Qarashī (Arabic: علاء الدين أبو الحسن عليّ بن أبي حزم القرشي ), known as Ibn al-Nafīs (Arabic: ابن النفيس), was an Arab polymath whose areas of work included medicine, surgery, physiology, anatomy, biology, Islamic studies, jurisprudence, and philosophy. He is known for being the first to describe the pulmonary circulation of the blood.[5] The work of Ibn al-Nafis regarding the right sided (pulmonary) circulation pre-dates the later work (1628) of William Harvey's De motu cordis. Both theories attempt to explain circulation. The 2nd century Greek physician Galen's theory about the physiology of the circulatory system remained unchallenged until the works of Ibn al-Nafis, for which he has been described as "the father of circulatory physiology".[6][7][8]
Ibn al-Nafis
17 December 1288
Al-Durra Sharh 'Aqa'id al-Nasafi (Arabic: الدرة شرح عقائد النسفي),[3][4] Commentary on Anatomy in Avicenna's Canon
As an early anatomist, Ibn al-Nafis also performed several human dissections during the course of his work,[9] making several important discoveries in the fields of physiology and anatomy. Besides his famous discovery of the pulmonary circulation, he also gave an early insight of the coronary and capillary circulations.[10][11] He was also appointed as the chief physician at al-Naseri Hospital founded by Sultan Saladin.
Apart from medicine, Ibn al-Nafis studied jurisprudence, literature and theology. He was an expert on the Shafi'i school of jurisprudence and an expert physician.[12] The number of medical textbooks written by Ibn al-Nafis is estimated at more than 110 volumes.[13]
Biography[edit]
Ibn al-Nafis was born in 1213 to an Arab family[14] probably at a village near Damascus named Karashia, after which his Nisba might be derived. Early in his life, he studied theology, philosophy and literature. Then, at the age of 16, he started studying medicine for more than ten years at the Nuri Hospital in Damascus, which was founded by the Turkoman emir of Aleppo and Damascus, Nur-al Din Muhmud ibn Zanki,[15] in the 12th century. He was contemporary with the famous Damascene physician Ibn Abi Usaibia and they both were taught by the founder of a medical school in Damascus, Al-Dakhwar. Ibn Abi Usaibia does not mention Ibn al-Nafis at all in his biographical dictionary "Lives of the Physicians". The seemingly intentional omission could be due to personal animosity or maybe rivalry between the two physicians.[16]
In 1236, Ibn al-Nafis, along with some of his colleagues, moved to Egypt under the request of the Ayyubid sultan al-Kamil. Ibn al-Nafis was appointed as the chief physician at al-Naseri hospital which was founded by Saladin, where he taught and practiced medicine for several years. One of his most notable students was the famous Christian physician Ibn al-Quff. Ibn al-Nafis also taught jurisprudence at al-Masruriyya Madrassa (Arabic: المدرسة المسرورية). His name is found among those of other scholars, which gives insight into how well he was regarded in the study and practice of religious law.
Ibn al-Nafis lived most of his life in Egypt, and witnessed several pivotal events like the fall of Baghdad and the rise of Mamluks. He even became the personal physician of the sultan Baibars and other prominent political leaders, thus showcasing himself as an authority among practitioners of medicine. Later in his life, when he was 74 years old, Ibn al-Nafis was appointed as the chief physician of the newly founded al-Mansori hospital where he worked for the rest of his life.
Ibn al-Nafis died in Cairo after some days of sickness. His student Safi Abu al-Fat'h composed a poem about him. Prior to his death, he donated his house and library to Qalawun Hospital or, as it was also known, the House of Recovery.[17]
Other medical contributions[edit]
Practice of dissection[edit]
There is some debate about whether or not Ibn al-Nafis participated in dissection to come to his conclusions about pulmonary circulation. Although he states in his writings that he was prevented from practicing dissection because of his beliefs, other scholars have noted that Ibn al-Nafis must have either practiced dissection or seen a human heart in order to come to his conclusions.[32] According to one view, his knowledge about the human heart could have been derived from surgical operations rather than dissection.[32] Other comments found in Ibn al-Nafis' writings such as dismissing earlier observations with a reference to dissection as proof, however, support the view that he practiced dissection in order to come to his conclusions about the human heart and pulmonary circulation.[33] Ibn al-Nafis' comments to the contrary and the alternate explanations, however, keep his possible practice of dissection in question.
During Ibn al-Nafis’ studies of the human body, there remains controversy whether he performed dissection, as dissection was mentioned in any texts on jurisprudence or Islamic tradition, and there was no concrete prohibition.[34] Though many scholars would argue that Ibn al-Nafis would have needed to perform dissection to be able to see pulmonary circulation. Greek physician, Aelius Galenus' book, “On the Usefulness of the Parts”, explicitly tells his readers to rely on dissection for anatomical knowledge and not rely on books.[35] Thus would give an indication that dissection was not some otherworldly idea but had been looked as an opportunity to better one's knowledge of the human body.
In the “Commentary of the anatomy of the Canon of Avicenna”, human anatomy experts such as Patrice Le Floch-Prigent and Dominique Delaval, concluded that Ibn al-Nafis used clinical, physiological, and dissection results in discovering and describing the pulmonary heart circulation in humans.[36] Through their study on the “Commentary of the anatomy of the Canon of Avicenna”, they both concluded that Nafis did indeed use dissection to acquire his results, even though the practice of dissection was banned in Muslim tradition.
Urology[edit]
In his book "Al-Mugiza", Ibn al-Nafis distinguishes the difference between kidney stone and bladder stones. He does this by their pathogenesis and clinical picture. He also discussed the difference between kidney and bladder infections, different types of inflammatory and noninflammatory renal swellings, the conservative management of renal stones and commonly used and well known lithontriptic medicaments.[22]
Surgery[edit]
In his Kitab al-Shamil, Ibn al-Nafis gives insight into his view of medicine and human relations. His surgical technique had three stages. Step one which he calls "the stage of presentation for clinical diagnosis" was to give the patient information on how it was to be performed and the knowledge it was based on. Second "the operative stage" was to perform the surgery itself. The final step was to have a post-surgery appointment and a routine of checkups which he calls "the postoperative period". There is also a description of a surgeon's responsibility when working with nurses, patients, or other surgeons.[17]
Metabolism[edit]
Ibn al-Nafis is also credited with providing the earliest recorded reference for the concept of metabolism:[37]
Possible Western influence[edit]
There is currently debate over whether Ibn al-Nafis influenced later Western anatomists such as Realdo Columbo and William Harvey.[41][42] In AD 1344, Kazrouny wrote a verbatim copy of Ibn al-Nafis' commentary on Canon in his Sharh al-Kulliyat.[43][44] In AD 1500, Andrea Alpago returned to Italy after studying in Damascus.[44][45] In Alpago's 1547 A.D. publication of Libellus de removendis nocumentis, quae accident in regimime sanitatis, there is a Latin translation containing part of Ibn al-Nafis' commentary on pharmacopeia.[44][45] This was published in Venice during its rule over Padua.[44][45] Harvey arrived in Padua in AD 1597.[44][46]
The debate currently turns on whether these events are causally connected or are historical coincidences.[46]