Ibn Sina's "Canon of Medicine" was the main textbook prescribed for many Arabic medical schools all over the Islamic Empire. Those schools were located .in the Bimaristans (university hospitals). However the book was shunned and criticised by many scholars such as Ibn Zuhr who preferred to it the Arjozah (Poem on Medicine), and Abdul Lateef al-Baghdadi who considered it the nonsense he could at last get rid of. Among the book's critics was also the Swiss physician, Paracelse (1493-1541) who burned it along with other books at Bal in Switzerland where he was studying medicine and got dismissed for it. Yet, the book enjoyed a high prestige and was taught up to the 18th century. The last school of medicine where it was used as a textbook was at Tuvan in Belgium. Even today it is still being studied and applied in India by Hakims who practise Unani medicine.
The Canon was the work of a genius who put into it all the medical information available at his time in an exquisitely logical order. As it was beyond the comprehension of beginners the book had to be . explained by successive scholars. Therefore, summaries, comments and interpretations of the book abounded.When Ibnul-Nafees (1211-1288) became well known as a scholar and a professor he, too, had to explain the Canon and write a summary of it. "Sharhul Kulliyyat" (a commentary on the general principles) and "Sharhul Tashreeh" (Commentary on Anatomy) were the two works he wrote abo4t the Canon. About "Sharhul order of al-Qanoon except where it comes to anatomy and pharmacopeia. I have seen fit to set aside a special book for anatomy to follow commentaries on the other topics of (al-Qanoon) Canon's first volume known as the General Principles".*
Thus Ibnul-Nafees explained the first and third volumes because Ibn Sina had divided anatomy into two parts:
What may be called general anatomy, i.e. skeleton, muscles, nerves, etc.
"Sharhul Tashreeh al-Qanoon" by Ibnul-Nafees was similarly divided into two parts: the first comments on anatomical topics discussed in Canon's first volume, and the second on Canon's third volume.
Ibnul-Nafees's book was not confined to providing explanations, but also contained critical comments on the anatomical information given by Canon. The criticism was levelled at both Galin and Ibn Sina, and even at all preceding writers on anatomy. Sometimes he criticised anatomists without identifying them.
I think that Ibn Sina had seldom practised dissection, whereas Sharhul Tashreeh contained a great deal of new information in addition to scientifically objective criticism, which indicates that Ibnul-Nafees must have actually practised dissection.
It is curious and worth noting that he says in the book, "The most important muscles of a human body total 529, details of which you will read in a book we are writing on medicine with full investigations into their shapes, functions, tendons, and origins. The forthcoming book will also contain details about proper anatomy since what is said about it here, is short and brief".2
* He reaffirms
the same idea when he says, "In the major book we are writing about
the medical profession we intend to simplify talk about this and similar
Some volumes in Ibnul-Nafees's own handwriting are still kept at the library of Cambridge University in England waiting for the investigator who would shake the dust off them and present to the world the fruit of the genius of this Muslim Arab scholar. There is so much that can be said about Sharhul Tas- hreeh. But I have just finished editing the book and am in the process of writing a whole book about it. So, under the pressure of time limit I will have to content myself with taking up one important issue: has Ibnul-Nafees dissected the human body?
There are three different views about this question. The first denies that Ibnul-Nafees or, for that matter, any other Muslim Arab scholar has ever practised any sort of dissection. According to the sec- ond view, Ibnul-Nafees has practised dissection, but only of animals, just like Galin. The third view holds that Ibnul-Nafees has dissected the human body.
Among advocates of the first view is the German orientalist, Max Mayerhoff (1874-1945). He said, "In the earlier days of Islamic Shariah, the study of virtually all sciences was permissible. But since the appearance of the renowned Islamic Theologian and philosopher, al-Ghazzali (1111 A.D.), a religious clamp down was imposed on such studies as they allegedly might lead to scepticism in the basic tenets about the origin of the world and the existence of the Creator." 3 Yet, he admits that '.this situation was not sufficient to preclude the emergence of scientific thinkers. But the religious oppression was undoub- tedly an important factor in stifling their voices".
then, asserts that:
2. The reason why scientific studies at the time were meagre was the emergence of Ghazzali and his teachings. It is true that he wrote his famous book entitled "Tahafutil Falasifa" (the collapse of philosophers) but the freedom enjoyed at that time by the scholars prompted Ibn Rushd (Averroes) to issue his rejoinder .'Tahafutil Tahafut" (the collapse of collapse). Ibn Rushd (1126-1198) was a philosopher and a physician. In his book '.Faslul Maqal" (the last word or the final decision) he says, '.Knowledge of the ways of creation leads to intimate knowledge of the Creator. The better you know these ways the more intimate your knowledge of the Creator will be. The canonical law of Islam has urged people to ponder everything in existence".4 '.Practice of dissection strengthens the faith," is also a well known quotation from Ibn Rushd.
3. According to Mayerhoff, Ghazzali's teachings did not stand in the way of free thinkers like Ibnul- -Nafees.
As a matter of fact, the idea behind prohibiting the dissection of the human body emanated from the common people's reverence of their ancestors and their dead. It had nothing to do with true religion. This is what we can deduce from notes written by Klut Bey, Mohammed Ali's physician, who established Abu Zaabal's School of Medicine in Cairo. There was a strong opposition to including dissection into the school's program and Klut Bey had to take the matter up in a meeting he held with Sheikh Arousi, a leading religious figure at that time. From the notes he took down about that meeting it became obvious that the reason behind prohibiting d!ssection was fear of stirring up public feelings. In his notes, Klut Bey says, " I think his hesitation to approve (of dissection) was caused by his fear to run up against traditional beliefs more than by scepticism in a line of thought he was half convinced of. What confirms this is that he gave me implicit approval to go ahead with the course but not before making me promise that I should take every precaution to do it in discreet secrecy".5
I can personally see a strange similarity and complete identity between the attitudes of both Sheikh Arousi and Ibnul-Nafees. Both approved of dissection but "with great precaution and discreet secrecy" for "fear of running up against traditional beliefs" , That is why Ibnul-Nafees said' in the introduction to Sharhul Tashreeh, "We have been dissuaded from actual practice of dissection by fear of violating the Shariah and on a9count of the mercy that is inherent in our manners",2
It is well known that ah author writes his introduction only after finishing his book. Ibnul-Nafees might have noticed that the information provided by his book would clearly indicate that he must have based it on personal experience. Hence, he must have deemed it proper to disclaim any such practice right at the outset by writing this statement in his introduction, especially as the book was esoteric in nature and the few available copies would probably be read by only a small minority of interested people. Mayerhoff, Shacht and others considered this statement as a clear evidence that Ibnul-Nafees had never practised dissection. However, a thorough reading of the book would undoubtedly refute the statement. And when Mayerhoff came to the pages where Ibnul-Nafees described the heart anatomy and the pulmonary blood circulation he did not have the courage to admit his mistake. Instead, he sought a way out by saying that the discovery was the result of a happy hypothesis "which luckily coincided with the facts", 6 Shacht interpreted Ibnul-Nafees's discovery of the minor blood circulation as a result of clever deduction from theoretical argumentation.
Let's now go back to what Ibnul-Nafees said about heart anatomy. He said, "But there is not a vent between them (the heart ventricles). The mass of the heart there is thick with neither an apparent vent, as some thought, nor with an invisible vent through which blood might pass as Galin believed."2
I do not want to proceed any further with what is known only too well about the heart anatomy. Suffice it to quote Charles Leschtantiller, professor of medical history at Lousan and Hamburg. He said, "Nobody could have given such a full description unless he had actually put his finger in the heart cavities."8
In the following section Ibnul-Nafees gives himself away when he says, "Their claim (meaning pre- ceding physicians and anatomists) to have dissected and seen what they say they have seen, is something that I do not believe or can be certain about. On many occasions I have seen what disproves their claims which are based on what they have allegedly found out by repeated dissections," 2 Here he asserts beyond any doubt that he has seen "differently from what they said about dissection".
The second team of research workers, including colleague Dr, Abdul Kareem Shehada and Dr. Amin As'ad Kheralla, say that Ibnul-Nafees did dissect, but only animals.6 Galin had previously done that. He based his books of anatomy on what he had found out when he dissected animals. He says, "The sys- tem of the animal's body whose members we can identify through dissection looks very close to that of a human body. However, we can easily presume that the bodies of certain animals are by far very dissimilar to man's body, These would include birds, fish, snakes, worms, wasps and bugs." 6 Galin meant that if he dissected animals whose bodies were closely similar to human bodies, he could get a fairly good idea of what a man's body looked like. Galin, therefore, asserts that his anatomical description is, in a way, humanitarian. He says, "It is for man that we have written this book. Our aim is to describe the morphology of his body ..." 10 Again he says, ' , As for man, for whose sake we have written this treatise..." 10 and "One day we may talk about other animals. As for man to whom we have devoted this book..." The book he meant is "The Functions of the Members" translated by Hunayn Ibn Ishaq. In this book he says, "1 do not intend to describe the odaxetic members existent in all animals because I have not in fact mentioned the morphology of any of their members (meaning the animals) unless it was extremely necessary and as a point of departure to describe the members of man's body. If we are not interrupted by the fate of death we will deal one day with the constitution of animals' bodies with an accurate anatomical description of each member of their bodies along the same lines as we are now fol- lowing with respect to man's body". Evidence of Ibnul-Nafees's dissection of animals can be found in his criticism of both Galin and Ibn-Sina concerning what they said about bones in the heart. Galin says, .'The bones that some people think are found only in big animals and not in all animals are in fact found also in other animals, though they are more like cartilage than real bones."'2
Ibn Sina reiterates the same view adding, '.Bones have been found in bulky animals, especially in bulls. This bone is rather cartilage-like with larger and stronger types found in the hearts of elephants." '3 Galin had mentioned the elephant's heart saying, "A big elephant was slain in Rome not long ago. A large number of physicians gathered around it to study its anatomy and to determine whether its heart was with one or two caputs and with one, two or three cavities. Before they went ahead with actual dissection I had asserted that they would find the same anatomy as that to be found in all air-breathing animals, which was later established by the dissection they had undertaken. I also found quite easily the heart bones."'4
But Ibnul-Nafees proved both to be wrong. He says, "This is not true. There are absolutely no bones beneath the heart as it is positioned right in the middle of the chest cavity where there are no bones at all. Bones are only found at the chest periphery not where the heart is positioned."2
The advocates of the theory that Ibnul-Nafees has dissected animals thus thought that this excerpt confirmed their view. The fact of the matter is that there is nothing that looks like bones inthe hearts of animals except in anomalous cases which were considered exceptions to a rule. Cuvier, the renowned French zoologist, says, "But this bone is not found in all specimens of the same species of animals. It is nothing more than organic anomaly and cannot be considered a rule." '5
The third team, including me as well as Dr. Haddad, are of the opinion that Ibnul-Nafees has dis- sected the human body. Sharhul Tashreeh abounds with examples some of which we cite here for the purpose of illustration.
Galin says, "The blood reaches the brain itself at the section called forebrain through the duramater which divides the vault longitudinally into two equal halves at the sagittal suture." 16
Ibnul-Nafees's reply to that is that, The blood (animal soul) permeates first to the back ventricle (hindbrain) then to the other two ventricles. Dissection confirms this and disproves what they say. The permeation of arteries into the cranium is well known not to be from the front ventricle." 2 Which is quite true.
ancient anatomists considered the cranial nerves to be seven beginning
with the optic nerve as they did not consider the olfactory nerve to be
a nerve at all, but part of the brain. To them, the fifth pair of nerves
is in fact the confluence of facial nerve (seventh in modern numeration)
with the sigmoid nerve (8 th) That is, these two nerves constituted to
them only one nerve, the fifth pair. The sixth pair is the confluence
of three branches: glossopharyngeal (9 th), vagus (10 th) and accessory
(11 th). According to the ancient anatomists the three formed one nerve,
the sixth pair. Ibn Sina says, "After arising from the hindbrain,
the sixth nerve is so firmly attached to the fifth through membranous
facia that both nerves look like one. After a short distance it leaves
the fifth nerve and emerges as three branches from the
Translating this into contemporary scientific terminology, it means that the ninth: tenth, and eleventh nerves arise from the nerve ganglion. They are attached to the seventh and eighth nerves through membranous facia so that these five nerves look like one nerve emerging as three branches from the back foramen lacerum. Criticising this, Ibnul-Nafees says, " About what he said (meaning Ibn Sina) concerning the sixth nerve being attached to the fifth through membranous facia, I have not so far found a g od reason for that attachment, and I have not even verified it. This sixth pair both arises and emerges fr m behind the fifth, so there is no way it could be attached to it."2
The criticism is well founded. We should take note of the part where he says, "I have not verified it, which indicates that he must have looked and searched but found it was not true. In other words, he must have dissected that part of the brain and discovered the mistakes of both Galin and Ibn Sina.
I do not think Ibnul-Nafees's description applies to the brain of a sheep as some would like to think t at he dissected that and not a human body.
Galin says about the anatomy of the bilious canals, "You will find on dissection that the canal extends from the gall bladder to the onset of the duodenum, a little beneath the portal vein. In some a imals, you can see the spot where the end of the small intestine gets enlarged around the portal vein. A the same time you will see a small canal going down with the vein extending to the duodenum." 18 Ibn Sina says the same thing, adding, "Most tributaries of this (bilious) canal go to the duodenum. A little sub-branch might be attached to the lower part of the stomach".
If we turn back to the book written by A. Vesalius 19 (1514-1564), who is considered by the West to : b the founder of anatomy, we will find that he made the same mistake. So did Leonardo Da Vinci 20 , (1 52-1519) in his paintings. They all reiterated what Galin had said, but they were all mistaken except Ibn ul-Nafees who says in criticism of Galin, "He (Galin) claims that another canal goes from the gall bladder to the intestinal cavaties. This is completely wrong. We have seen the gall bladder several times a d failed to see anything going from it either to the stomach or to the intestines." 2 And he is right. He had thus corrected Galin several centuries before Western anatomists.
Another example: The crucifix crossing of the optic nerve:
this nerve, Galin says, "The (optic) nerve which comes from the right
side of the brain goes to the right eye, and the nerve which comes from
the left side goes to the left eye." 21 After reviewing Galin's description,
Ibnul-Nafees comments by saying, "In fact it is not like that",
but, "each r rve goes to the opposite side".
The examples I have cited here are very few. Sharhul Tashreeh, indeed, abounds with criticism, remarks and sights of the anatomy of almost all parts of the human body: bones, muscles, intestines, sensory organs, etc. Each example cited here deserves a detailed and extensive study. However, we c n safely say:
1. Ibnul-Nafees has actually dissected the human body, but in secret for fear of stirring up public fe lings. That is why I described in the scenario of the film about Ibnul-Nafees a scene that confirms this.
2. All papers presented so far about Ibnul-Nafees's discoveries are confined to the minor blood circulation. But Ibnul-Nafees has in fact many other discoveries about the bilious canals, the esophagus, th stomach, etc.
3. As said by Ibnul-Nafees himself, Sharhul Tashreeh is only a short and brief outline of his views. Further research, therefore, must be carried out to find his other works, edit them and have them published.
4. I believe that Ibnul-Nafees genius was not less, if not more, than that of Ibn Sina or al-Razi. He W s perhaps ahead of them when it came to discoveries and innovations. He seems to have said, "By God, had I not known that my books would be read for the coming two millennia I would not have written them". I think he was not wrong there, because we shall continue for a long time to study his works and will always find in them something new.