EXPERIMENTAL AND CLINICAL TRANSPLANTATION

Objectives: Abū Bakr Muḥammad ibn Zakariyyã al-Rãzî is a historical physician who made theoretical and practical contributions to medicine. The aim of al-Rãzî’s book, Man lã yaḥḍuruhu al-ṭabîb, is to provide a valuable benefit to the general public. The book was written for people who do not have access to physicians, critical medical manuscripts, and medications. Our study aimed to add to the literature and discuss the issues concerning urinary tract problems in al-Rãzî’s Man lã yaḥḍuruhu al-ṭabîb.
Materials and Methods: The sections of al-Rãzî’s Man lã yaḥḍuruhu al-ṭabîb dealing with the urinary system were discussed and translated from Arabic to English.
Results: Urinary system problems are discussed in al-Rãzî’s book under the headings of “Pains in the kidneys and bladder (nephritis and cystitis) and stones in the kidneys,” “Hematuria,” “Pyuria and painful micturition/dysuria,” “Prescription for medicine on this subject,” and “Drug for the difficulty of passing urine/strangury.” The relevant sections mention drugs and approach to be used, particularly in the face of problems, rather than theoretical explanations. Changes in practice and treatment have been suggested in various symptomatic situations.
Conclusions: Rather than theoretical and etiological explanations for urinary problems, al-Rãzî provides accessible and applicable practical drugs and approaches for the general public, which can be considered suitable for the purpose mentioned in al-Rãzî’s introduction to the book.

Key words : Abū Bakr Muḥammad ibn Zakariyyã al-Rãzî, History of medicine, Man lã yaḥḍuruhu al-ṭabîb, Urinary tract diseases

Abū Bakr Muḥammad b. Zakariyyã al-Rãzî/Rhazes (865-925 AD) was a physician and a philosopher who lived during the Middle Ages and the Golden Age of Islam.¹ His writings became standard textbooks in European medical schools. He wrote more than 200 books on various subjects (mostly medicine), including Kiṭãb al-ḥãwî fî al-ṭibb/Liber Continens, Kitãb al-ṭibb al-Manṣūrî/Liber Medicinalis ad Almansorem, Kitãb al-Judarî wa al-ḥasba/Liber de Pestilentia, Kitãb al-Tajãrib (The Book of experiences/The Casebook), and Risãla fî ṭibb al-Aṭfãl/Practica Puerorum. These works are primarily intended for physicians. In this study, we focused on al-Rãzî’s Man lã yaḥḍuruhu al-ṭabîb (a book for those who do not attend the physician), also known as The Poor Man’s Book of Medicine, which he wrote for the public in areas where physicians are unavailable or inaccessible. The general purpose of Rhazes’ work is explained as follows:

“Faqîr Muḥammad ibn Zakariyyã al-Rãzî (Rhazes), may Allãh have mercy on him, says that when I see virtuous people exaggerate in their books and talk about medicines and foods that are hardly found unless in the treasury of the rulers, about the cure of diseases; I wished to make a concise article, as it would be most beneficial to the majority of humanity in treatment and removing diseases with foods and medicines that are known and accessible to all. I followed/researched the way/tradition of the sheikhs/elderly in going down from head to toe, talking about sickness and disease, treatment and cure, thanking Allãh for their efforts, and I named it ‘for those who do not attend the physicians’.”²

This thought is also consistent with al-Rãzî’s attitude toward indiscriminately benefiting all people and their health.³ In this study, it was seen that the book’s contents were related to urinary system problems and intended to address this issue. In this context, we aim to add to the literature and discuss the issues concerning urinary tract problems in al-Rãzî’s Man lã yaḥḍuruhu al-ṭabîb.

Materials and Methods

The sections of al-Rãzî’s Man lã yaḥḍuruhu al-ṭabîb dealing with the urinary system were discussed and translated from Arabic to English. In this context, the urinary system was studied in the printed copy of the work, Man lã yahḍuruhu al-ṭabîb aw ṭabîbuka qabla wuṣūl al-ṭabîb.² Urinary system-related contexts are presented in the Results section, and quotations related to the subject are included in Tables ^1-6.

Al-Rãzî discussed urinary system problems under the headings of “Pains in the kidneys and bladder (nephritis and cystitis) and stones in the kidneys,” “Hematuria,” “Pyuria and painful micturition/dysuria,” “Prescription for medicine on this subject,” and “Drug for the difficulty of passing urine/strangury.”

Pains in the kidneys and bladder (nephritis and cystitis) and stones in the kidneys
The chapter begins with a discussion of a drug. Under the title, al-Rãzî continues to provide drug-related information. Then, he provides the differential diagnostic information that may affect the medications or treatments mentioned. Rhazes concludes the section with a discussion on the etiology of stones and a drug that might be useful for stones. He then suggests a pain reliever. Quotations relating to this section are presented in Table 1.

Hematuria
In this section, al-Rãzî focuses on a drug administered after blood is drawn from a basilic vein. Quotations relating to this section are presented in Table 2.

Pyuria and painful micturition/dysuria
In this section, al-Rãzî provides a drug recipe with general benefits for these conditions. Then, different uses of the drug or different ingredients are added depending on the symptoms, and some features are mentioned. Quotations relating to this section are presented in Table 3.

Prescription for medicine on this subject
In this section, al-Rãzî recommends a drug in various combinations for different clinical situations. At the end of this section, al-Rãzî provides some information on foods and drinks that can be beneficial when taking this drug. Quotations relating to this section are presented in Table 4.

Drug for the difficulty of passing urine/strangury
In the first section, al-Rãzî discussed a drug that helps with urinary problems such as strangury. Quotations relating to this section are presented in Table 5.

Then, in some cases, al-Rãzî recommends intraurethral interventions. Quotations relating to these interventions are presented in Table 6.

It is noteworthy that Man lã yaḥḍuruhu al-ṭabîb was written for the general public rather than for physicians or students. It is well known that al-Rãzî was kind and generous to his patients, treating them humanely and without charge.³ On this basis, the book’s purpose is meaningful. It was a common practice in the Middle Ages for writers to dedicate their works to rulers.⁴ Al-Rãzî’s medical handbooks, such as the Manṣūrî, were dedicated to Manṣūr b. Ishaq, the Samanid governor of Rayy, and the Mulukî was dedicated to ʽAlî b. Wahsudhan of Tabaristan.⁵ However, no rulers were mentioned in Man lã yaḥḍuruhu al-ṭabîb. This finding appears to be consistent with al-Rãzî’s intention for the general public.

The tenth book of Kitãb al-ḥãwî fî al-ṭibb/Liber Continens, entitled fî amrãḍ al-kulã wa majãrî al-bawl wa ghayrihã, is about kidney, urinary tract, and other diseases. Unlike the previous works, this book includes quotations from various physicians. It has the features of a textbook.⁶ In this regard, the work under consideration is practical rather than theoretical. Besides this, the book reflects a general synthesis of al-Rãzî’s knowledge, because no individual is mentioned.

Al-Rãzî did not recommend any surgical procedure in Man lã yaḥḍuruhu al-ṭabîb, except for some intraurethral interventions. This finding is consistent with al-Rãzî’s ethical care, particularly knowledge-based practices.^7,8 In other words, he did not advise performing sophisticated operations that required expertise.

Although it is infrequent, the prognosis is mentioned in Kitãb al-Tajãrib but not in Man lã yaḥḍuruhu al-ṭabîb. Kitãb al-Tajãrib contains approximately 40 cases on issues of the kidney and bladder, as well as coitus.⁹ While the patients’ histories, symptoms, and treatment recommendations were included in these cases, the content of this book was not as extensive.2 The diversity of prescriptions is also noteworthy. This distinction is understandable, as al-Rãzî refers to drugs readily available to the public in Man lã yaḥḍuruhu al-ṭabîb. While diabetes is mentioned in Kitãb al-Tajãrib,⁹ there is no mention of it in Man lã yaḥḍuruhu al-ṭabîb. Diabetes could be interpreted as severe thirst and polyuria, as mentioned in Man lã yaḥḍuruhu al-ṭabîb.

Ağirakça¹⁰ claimed that works similar to al-Rãzî’s book were written by Rufus of Ephesus, Philagrius, Oribasius, ʽîsã b. Mãssa, and Ibn al-Jazzãr. According to Ibn al-Nadîm’s al-Fihrist, Rufus, Philagrius, and ʽîsã b. Mãssa wrote works similar to al-Rãzî’s Man lã yaḥḍuruhu al-ṭabîb.¹¹ Ibn Abî Uṣaybiʽa’s¹² ʽUyūn al-Anbãʽ fî ṭabaqãt al-Aṭibbãʽ (The Best Accounts of the Classes of Physicians) also mentions books by ʽîsã b. Mãssa, al-Rãzî, and Ibn al-Jazzãr. Al-Rãzî referred to Rufus’s book, Kitãb ilã man lã yajidu ṭabîbãn, in the Kitãb al-ḥãwî fî al-ṭibb/Liber Continens.¹³ It is known that Ibn al-Jazzãr (died 979), one of al-Rãzî’s successors, wrote a book for the poor, K. ṭibb al-fuqarãʽ (Medicine for the poor), and for those who could not reach physicians for a similar purpose.¹⁰ It is possible to assert that there was a medical tradition for the poor and those who could not access a physician and that al-Rãzî followed it. However, it cannot be said that there are enough studies on this tradition or texts. In this respect, our study on al-Rãzî’s book, Man lã yaḥḍuruhu al-ṭabîb, can contribute to the literature and provide a starting point for future research.

The fact that al-Rãzî wrote a book for the public appears to be significant in demonstrating his level of knowledge. In terms of the paradigm of his time, he distinguishes between current advanced knowledge and information that will help the patients without harming them.

Man lã yaḥḍuruhu al-ṭabîb is useful and beneficial to the public. Because of the easily accessible materials, drug recommendations are available to the general public. Understandable symptomatic differences and appropriate drugs for them are mentioned in some places. Al-Rãzî rarely mentions the theoretical content. All of the book’s characteristics are interpreted as being consistent with al-Rãzî’s intentions in writing Man lã yaḥḍuruhu al-ṭabîb. Comparative analyses with similarly titled works written by al-Rãzî’s predecessors and successors should be conducted in future studies.

Volume: 21 Issue: 6 June 2023 - Supplement - 2

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