Pharmacy day:

Biography

Razi was born in the city of Ray (modern Rey) situated on the Great Silk Road that for centuries facilitated trade and cultural exchanges between East and West.[15] His nisba, Râzī (رازی), means "from the city of Ray" in Persian.[16] It is located on the southern slopes of the Alborz mountain range situated near Tehran, Iran.
In his youth, Razi moved to Baghdad where he studied and practiced at the local bimaristan (hospital). Later, he was invited back to Rey by Mansur ibn Ishaq, then the governor of Rey, and became a bimaristan's head.[2] He dedicated two books on medicine to Mansur ibn Ishaq, The Spiritual Physic and Al-Mansūrī on Medicine.[2][17][18][19] Because of his newly acquired popularity as physician, Razi was invited to Baghdad where he assumed the responsibilities of a director in a new hospital named after its founder al-Muʿtaḍid (d. 902 CE).[2] Under the reign of Al-Mutadid's son, Al-Muktafi (r. 902-908) Razi was commissioned to build a new hospital, which should be the largest of the Abbasid Caliphate. To pick the future hospital's location, Razi adopted what is nowadays known as an evidence-based approach suggesting having fresh meat hung in various places throughout the city and to build the hospital where meat took longest to rot.[20]
He spent the last years of his life in his native Rey suffering from glaucoma. His eye affliction started with cataracts and ended in total blindness.[21] The cause of his blindness is uncertain. One account mentioned by Ibn Juljul attributed the cause to a blow to his head by his patron, Mansur ibn Ishaq, for failing to provide proof for his alchemy theories;[22] while Abulfaraj and Casiri claimed that the cause was a diet of beans only.[23][24] Allegedly, he was approached by a physician offering an ointment to cure his blindness. Al-Razi then asked him how many layers does the eye contain and when he was unable to receive an answer, he declined the treatment stating "my eyes will not be treated by one who does not know the basics of its anatomy".[25]
The lectures of Razi attracted many students. As Ibn al-Nadim relates in Fihrist, Razi was considered a shaikh, an honorary title given to one entitled to teach and surrounded by several circles of students. When someone raised a question, it was passed on to students of the 'first circle'; if they did not know the answer, it was passed on to those of the 'second circle', and so on. When all students would fail to answer, Razi himself would consider the query. Razi was a generous person by nature, with a considerate attitude towards his patients. He was charitable to the poor, treated them without payment in any form, and wrote for them a treatise Man La Yaḥḍuruhu al-Ṭabīb, or Who Has No Physician to Attend Him, with medical advice.[26] One former pupil from Tabaristan came to look after him, but as al-Biruni wrote, Razi rewarded him for his intentions and sent him back home, proclaiming that his final days were approaching.[27] According to Biruni, Razi died in Rey in 925 sixty years of age.[28] Biruni, who considered Razi as his mentor, among the first penned a short biography of Razi including a bibliography of his numerous works.[28]
Ibn al-Nadim recorded an account by Razi of a Chinese student who copied down all of Galen's works in Chinese as Razi read them to him out loud after the student learned fluent Arabic in 5 months and attended Razi's lectures.[29][30][31][32]
After his death, his fame spread beyond the Middle East to Medieval Europe, and lived on. In an undated catalog of the library at Peterborough Abbey, most likely from the 14th century, Razi is listed as a part author of ten books on medicine.[33]
Contributions to medicine
Smallpox vs. measles
Razi wrote:
Smallpox appears when blood "boils" and is infected, resulting in vapours being expelled. Thus juvenile blood (which looks like wet extracts appearing on the skin) is being transformed into richer blood, having the color of mature wine. At this stage, smallpox shows up essentially as "bubbles found in wine" – (as blisters) – ... this disease can also occur at other times – (meaning: not only during childhood). The best thing to do during this first stage is to keep away from it, otherwise this disease might turn into an epidemic.
This diagnosis is acknowledged by the Encyclopædia Britannica (1911), which states: "The most trustworthy statements as to the early existence of the disease are found in an account by the 9th-century Persian physician Rhazes, by whom its symptoms were clearly described, its pathology explained by a humoral or fermentation theory, and directions given for its treatment." Razi's book al-Judari wa al-Hasbah (On Smallpox and Measles) was the first book describing smallpox and measles as distinct diseases.[34] It was translated more than a dozen times into Latin and other European languages. Its lack of dogmatism and its Hippocratic reliance on clinical observation show Razi's medical methods. For example, he wrote:
The eruption of smallpox is preceded by a continued fever, pain in the back, itching in the nose and nightmares during sleep. These are the more acute symptoms of its approach together with a noticeable pain in the back accompanied by fever and an itching felt by the patient all over his body. A swelling of the face appears, which comes and goes, and one notices an overall inflammatory color noticeable as a strong redness on both cheeks and around both eyes. One experiences a heaviness of the whole body and great restlessness, which expresses itself as a lot of stretching and yawning. There is a pain in the throat and chest and one finds it difficult to breathe and cough. Additional symptoms are: dryness of breath, thick spittle, hoarseness of the voice, pain and heaviness of the head, restlessness, nausea and anxiety. (Note the difference: restlessness, nausea and anxiety occur more frequently with "measles" than with smallpox. At the other hand, pain in the back is more apparent with smallpox than with measles). Altogether one experiences heat over the whole body, one has an inflamed colon and one shows an overall shining redness, with a very pronounced redness of the gums. (Rhazese, Encyclopaedia of Medicine)
Meningitis
Razi compared the outcome of patients with meningitis treated with blood-letting with the outcome of those treated without it to see if blood-letting could help.[35]
Pharmacy
Razi contributed in many ways to the early practice of pharmacy[36] by compiling texts, in which he introduces the use of "mercurial ointments" and his development of apparatus such as mortars, flasks, spatulas and phials, which were used in pharmacies until the early twentieth century.
Ethics of medicine
On a professional level, Razi introduced many practical, progressive, medical and psychological ideas. He attacked charlatans and fake doctors who roamed the cities and countryside selling their nostrums and "cures". At the same time, he warned that even highly educated doctors did not have the answers to all medical problems and could not cure all sicknesses or heal every disease, which was humanly speaking impossible. To become more useful in their services and truer to their calling, Razi advised practitioners to keep up with advanced knowledge by continually studying medical books and exposing themselves to new information. He made a distinction between curable and incurable diseases. Pertaining to the latter, he commented that in the case of advanced cases of cancer and leprosy the physician should not be blamed when he could not cure them. To add a humorous note, Razi felt great pity for physicians who took care for the well being of princes, nobility, and women, because they did not obey the doctor's orders to restrict their diet or get medical treatment, thus making it most difficult being their physician.
He also wrote the following on medical ethics:
The doctor's aim is to do good, even to our enemies, so much more to our friends, and my profession forbids us to do harm to our kindred, as it is instituted for the benefit and welfare of the human race, and God imposed on physicians the oath not to compose mortiferous remedies.[37]
Books and articles on medicine
The Virtuous Life (al-Hawi الحاوي).
This monumental medical encyclopedia in nine volumes – known in Europe also as The Large Comprehensive or Continens Liber (جامع الكبير) — – contains considerations and criticism on the Greek philosophers Aristotle and Plato, and expresses innovative views on many subjects.[38][39][40] Because of this book alone, many scholars consider Razi the greatest medical doctor of the Middle Ages.
The al-Hawi is not a formal medical encyclopedia, but a posthumous compilation of Razi's working notebooks, which included knowledge gathered from other books as well as original observations on diseases and therapies, based on his own clinical experience. It is significant since it contains a celebrated monograph on smallpox, the earliest one known. It was translated into Latin in 1279 by Faraj ben Salim, a physician of Sicilian-Jewish origin employed by Charles of Anjou, and after which it had a considerable influence in Europe.
The al-Hawi also criticized the views of Galen, after Razi had observed many clinical cases which did not follow Galen's descriptions of fevers. For example, he stated that Galen's descriptions of urinary ailments were inaccurate as he had only seen three cases, while Razi had studied hundreds of such cases in hospitals of Baghdad and Rey.[41]
For One Who Has No Physician to Attend Him (Man la Yahduruhu Al-Tabib) (من لا يحضره الطبيب) – A medical adviser for the general public
Razi was possibly the first Persian doctor to deliberately write a home medical manual (remedial) directed at the general public. He dedicated it to the poor, the traveler, and the ordinary citizen who could consult it for treatment of common ailments when a doctor was not available. This book is of special interest to the history of pharmacy since similar books were very popular until the 20th century. Razi described in its 36 chapters, diets and drug components that can be found in either an apothecary, a market place, in well-equipped kitchens, or and in military camps. Thus, every intelligent person could follow its instructions and prepare the proper recipes with good results.
Some of the illnesses treated were headaches, colds, coughing, melancholy and diseases of the eye, ear, and stomach. For example, he prescribed for a feverish headache: " 2 parts of duhn (oily extract) of rose, to be mixed with 1 part of vinegar, in which a piece of linen cloth is dipped and compressed on the forehead". He recommended as a laxative, " 7 drams of dried violet flowers with 20 pears, macerated and well mixed, then strained. Add to this filtrate, 20 drams of sugar for a drink. In cases of melancholy, he invariably recommended prescriptions, which included either poppies or its juice (opium), Cuscuta epithymum (clover dodder) or both. For an eye-remedy, he advised myrrh, saffron, and frankincense, 2 drams each, to be mixed with 1 dram of yellow arsenic formed into tablets. Each tablet was to be dissolved in a sufficient quantity of coriander water and used as eye drops.
Doubts About Galen (Shukuk 'ala alinusor)
In his book Doubts about Galen, Razi rejects several claims made by the Greek physician, as far as the alleged superiority of the Greek language and many of his cosmological and medical views. He links medicine with philosophy, and states that sound practice demands independent thinking. He reports that Galen's descriptions do not agree with his own clinical observations regarding the run of a fever. And in some cases he finds that his clinical experience exceeds Galen's.
He criticized moreover Galen's theory that the body possessed four separate "humors" (liquid substances), whose balance are the key to health and a natural body-temperature. A sure way to upset such a system was to insert a liquid with a different temperature into the body resulting in an increase or decrease of bodily heat, which resembled the temperature of that particular fluid. Razi noted that a warm drink would heat up the body to a degree much higher than its own natural temperature. Thus the drink would trigger a response from the body, rather than transferring only its own warmth or coldness to it. (Cf. I. E. Goodman)
This line of criticism essentially had the potential to completely refute Galen's theory of humors, as well as Aristotle's theory of the four elements, on which it was grounded. Razi's own alchemical experiments suggested other qualities of matter, such as "oiliness" and "sulphurousness", or inflammability and salinity, which were not readily explained by the traditional fire, water, earth, and air division of elements.
Razi's challenge to the current fundamentals of medical theory were quite controversial. Many accused him of ignorance and arrogance, even though he repeatedly expressed his praise and gratitude to Galen for his contributions and labors, saying:
I prayed to God to direct and lead me to the truth in writing this book. It grieves me to oppose and criticize the man Galen from whose sea of knowledge I have drawn much. Indeed, he is the Master and I am the disciple. Although this reverence and appreciation will and should not prevent me from doubting, as I did, what is erroneous in his theories. I imagine and feel deeply in my heart that Galen has chosen me to undertake this task, and if he were alive, he would have congratulated me on what I am doing. I say this because Galen's aim was to seek and find the truth and bring light out of darkness. I wish indeed he were alive to read what I have published.[42]
Crystallization of ancient knowledge, and the refusal to accept the fact that new data and ideas indicate that present day knowledge ultimately might surpass that of previous generations.
Razi believed that contemporary scientists and scholars are by far better equipped, more knowledgeable, and more competent than the ancient ones, due to the accumulated knowledge at their disposal. Razi's attempt to overthrow blind acceptance of the unchallenged authority of ancient sages encouraged and stimulated research and advances in the arts, technology, and sciences.
The Diseases of Children
Razi's The Diseases of Children was the first book to deal with pediatrics as an independent field of medicine.[14]
Mental health
As many other theorists in his time of exploration of illnesses, he believed that mental illnesses were caused by demons. Demons were believed to enter the body and possess the body.
Books on medicine
This is a partial list of Razi's books and articles in medicine, according to Ibn Abi Usaybi'ah. Some books may have been copied or printed under different names.
• al-Hawi (Arabic الحاوي), al-Hawi al-Kabir (الحاوي الكبير). Also known as The Virtuous Life, Continens Liber. The large medical Encyclopedia containing mostly recipes and Razi's notebooks.
• Isbateh Elmeh Pezeshki (Persian اثبات علم پزشكى), ("Proving the Science of Medicine").
• Dar Amadi bar Elmh Pezeshki (Persian در آمدى بر علم پزشكى) ("Outcome of the Science of Medicine").
• Rade Manaategha 'tibb jahez
• Rade Naghzotibbeh Nashi
• The Experimentation of Medical Science and its Application
• Guidance
• Kenash
• The Classification of Diseases
• Royal Medicine
• For One Without a Doctor (من لايحضره الطبيب)
• The Book of Simple Medicine
• The Great Book of Krabadin
• The Little Book of Krabadin
• The Book of Taj or The Book of the Crown
• The Book of Disasters
• Food and its Harmfulness
• al-Judari wa al-Hasbah, Translation: A treatise on the Small-pox and Measles[43]
• Ketab dar Padid Amadaneh Sangrizeh (Persian كتاب در پديد آمدن سنگريزه) ("The Book of Formation of small stones (Stones in the Kidney and Bladder)")
• Ketabeh Dardeh Roodeha (Persian كتاب درد روده‌ها) ("The Book of Pains in the Intestine")
• Ketab dar Dard Paay va Dardeh Peyvandhayyeh Andam (Persian كتاب در درد پاى و درد پيوندهاى اندام) ("The Book of Pains in Feet/Legs and Pains in Linked Limbs")
• Ketab dar Falej
• The Book of Tooth Aches
• Dar Hey'ateh Kabed (Persian در هيأت كبد) ("About the Liver")
• Dar Hey'ateh Ghalb (About Heart Ache) (Persian در هيأت قلب) ("About the Heart")
• About the Nature of Doctors
• About the Earwhole
• Dar Rag Zadan (Persian در رگ زدن) ("About Handling Vessels")
• Seydeh neh/sidneh
• Ketabeh Ibdal
• Food For Patients
• Soodhayeh Serkangabin (Persian سودهاى سركنگبين) or Benefits of Honey and Vinegar Mixture
• Darmanhayeh Abneh
• The Book of Surgical Instruments
• The Book on Oil
• Fruits Before and After Lunch
• Book on Medical Discussion (with Jarir Tabib)
• Book on Medical Discussion II (with Abu Feiz)
• About the Menstrual Cycle
• Ghi Kardan or vomiting (Persian قى كردن)
• Snow and Medicine
• Snow and Thirst
• The Foot
• Fatal Diseases
• About Poisoning
• Hunger
• Soil in Medicine
• The Thirst of Fish
• Sleep Sweating
• Warmth in Clothing
• Spring and Disease
• Misconceptions of a Doctor's Capabilities
• The Social Role of Doctors