Abstract
The early medieval era is also called the Islamic Golden Age because of the significant rise in sciences, including medicine. Abū Bakr Rabi’ ibn Ahmad Akhawayni Bukhāri (better known as Akhawayni) was one of the notable medical practitioners in his lifetime. His fame was in neuroscience and he became known as Pezeshk-e-Divanegan (Physician to the Insane). His only surviving book, Hidāyat al-Muta’allimin fi al-Tibb (The Students’ Handbook of Medicine), is the first medical textbook in Persian, after Islam. Akhawayni gathered and categorized available knowledge on neuropsychiatry and added his own. He was the first to describe sleep paralysis and to suggest pragmatic rather than supernatural treatment. He was also the first to present fever cure and his descriptions of meningitis (Lisarghos in Hidāyat), mania, psychosis (Malikhulia), dementia (Ghotrab), etc., are close to current concepts.
Introduction
The renown in medicine in the Islamic Golden Age 1 is indebted to Persian scholars including Haly Abbas (949–982 AD), 2 Rhazes (865–925 AD), 3 Avicenna (980–1032 AD) 4 etc. Muslims, mostly Persians, translated foreign medical manuscripts from Persian, Greek, Indian and Syriac into Arabic, the Linga Franca of that period.5,6 Medical schools (from ancient Persia and other civilizations under the rule of Muslims including Jundishapur) also enjoyed renown and the scientific atmosphere of the period as well as the notable works of Muslim physicians enriched medical sciences in early medieval times in Islamic territories. Among the prominent figures of medicine from this period was Akhawayni, a great physician who made numerous observations in neurology and psychiatry 7 and became famous as ‘Physician to the Insane’ but unfortunately he is not well known today and his works have not been translated into Latin or English.
Biography
Akhawayni (who was called as Joveini in Latin) 8 was born in Bokhara, a city in the north east of Old Persia, in early 10th century AD and thus became known as Al-Bokhari. 9 Bokhara was a great and important city, located on the Silk Road. 10 Persia at that time was ruled by the Samanid dynasty, the first Persian kingdom that rose after the Muslims defeated, in 637 AD, the Sassanid Empire, the last ancient Persian dynasty. Akhawayni lived and worked in Bokhara and also in Tus (a city in eastern Iran). 11 He studied medicine under Abu al-Qasem Maqanei Razi who was the student of Rhazes, the renowned Persian physician and chemist. 12 He documented his 20 years’ experiments of medicine in four manuscripts, Kitab al-Nabz (the book on the pulse), Kitab al-Tashrih (the book on anatomy), Qarabadin (pharmacopeia) and Hidāyat al-Muta’allimin fi al-Tibb (The Students’ Handbook of Medicine, the only book surviving today). 13 Hidāyat is the first medical textbook written in Persian in the Islamic era. In the Islamic Golden Age most of the scientific writings were in Arabic, the Franca Lingua of that period. But Akhawayni broke this tradition and wrote in his native Persian (Farsi). 14 The book includes 184 chapters (Bab) covering wide aspects of medicine. 15
It seems his main interest in medicine was psychiatry and especially melancholy, thus becoming known as Pezeshk-e-Divanegan (Physician to the Insane). He died around 983 AD and was buried in his hometown.
Akhawayni’s works on neurology and psychiatry
In Hidāyat Akhawayni wrote comprehensive chapters on psychiatry and neurology including anatomy, describing the brain and nervous system functions, neuropsychiatric disorders (diagnosis, signs, and symptoms) and treatment, and also his own experiments on his patients. 16 He gathered and categorized available knowledge on neuropsychiatry. In his book we can see citations to Galen, Dioscorides, Tabari, Rhazes, etc. 17 He also added his own findings, including novel works and observations in neuropsychiatry. He was the first to describe sleep paralysis and nightmares and suggested pragmatic rather than supernatural treatment. 18 He is mentioned as the first person to describe the Circle of Willis circle 19 and to present the fever cure in the history of medicine. 20 He also described meningitis (Lisarghos in Hidāyat), mania, psychosis (Malikhulia), dementia (Ghotrab) and other conditions with thoughts that are close to current concepts.21,22
Beside neurology and psychiatry, Akhawayni wrote novel works in other medical fields. He described many kidney and urinary diseases including the presentation of urinary stone, urine retention, urinary incontinence and bladder ulcer, based on his own experience. 23 In cardiology Akhawayni was an expert and his work on the pulse was clearer and more valuable than that of contemporary scholars including Avicenna and Rhazes. 24 He explained the pulmonary circulation too in terms close to current concepts. 25 His book included the role of exercise in health. 26
Conclusion
Akhawayni was influential in the history of medicine. He was the first Persian physician to break the tradition of scientific writing in Arabic by writing in Persian, thus paving the way for Persian to flourish in scientific writing and for Persian doctors to write in their mother tongue. A few centuries later, Persian became the scientific language of the Old Persian era and of related cultures including India.
Akhawayni also had major influence on the progress of medicine especially in neuropsychiatry. As a tradition among Persian scholars, in his book he cited earlier works, of Galen, Dioscorides and Rhazes, and added his own findings. Hidāyat thus became a medical encyclopedia of ancient knowledge of medicine as well as Akhawayni’s.