Key words : al-Nuzhat al-mubhija fī tashḥīdh al-adhhān wa taʿdīl al-amzija, History of medicine, History of nephrology

Introduction

Dāwūd b. ʿUmar Al-Anṭākī was an Ottoman physician and scholar who wrote medical texts in Arabic in the 16th century.^1,2 Anṭākī was born in the village of Fua in Syria’s Idlib province and moved to Antioch with his family at age 7 years.³ He was taught by an Iranian medical scholar, Muḥammad Sharīf, in the fields of logic, physical sciences, Greek, and medicine at the Habīb Najjār Tomb, one of the most important scientific and cultural centers.^1,4,5

Al-Anṭākī left Antioch in his 20s after his teacher Muḥammad Sharīf left and his father died. By staying in the region known as Bilād al-Shām, which spread to the lands of today’s Syria, Israel, Palestine, Lebanon, and Jordan, he developed himself in general and particularly in the field of medicine.^4,6,7 He interviewed the region’s scholars, learned from them, and examined all available medical resources. In 1568 to 1569, while in Damascus, al- Anṭākī began writing his famous work Tadhkiratu uli l-albāb wa l-jāmiʿ li l-ʿajab al-ʿujāb.^2,6

Dāwūd b. ʿUmar al-Anṭākī settled in Egypt, where he taught at the Zāhiriyya Madrasa and practiced medicine.^7,8 Al-Anṭākī, who went to Mecca at the invitation of the Sharīf of Mecca, Hasan b. Numay, stayed for a year and died there in 1599.^7,9,10

Because al-Anṭākī was born blind, he was called “Darīr,” and because of his knowledge, he was called “Baṣīr,” which means “the person who sees through the eyes of the heart.” Besides his primary identity as a physician, he worked in veterinary medicine, pharmacy, logic, philosophy, astronomy, engineering, algebra, theology, and literature.^2,6,11

Although al-Anṭākī wrote in medical and nonmedical fields, most of the manuscripts that have survived to the present day are related to medicine. It is because medical works attracted a larger audience and were thus more copied.

Important medical manuscripts of Dāwūd b. ʿUmar al-Anṭākī include Tadhkiratu uli l-albāb wa l-jāmiʿ li l-ʿajab al-ʿujāb, al-Nuzhat al-mubhija fī tashḥīdh al-adhhān wa taʿdīl al-amzija, Nuzhat al-adhhān fī iṣlāḥ al-abdān, Mujarrabāt fī al-ṭibb, al-Tuhfa al-Bakriyya fī ahkām al-istiḥmām al-kulliya wa l-juzʾiyya, Macmāʿ al-fawāʾid al-badaniyya, al-Durratu al-muntahaba fī l-adviya al-mujarraba, and Kitāb al-Ihtisār al-ṭibb al-Anṭākī.^1,12,13,14

The subject of the study, Nuzhat al-adhhān fī iṣlāḥ al-abdān, has 6 copies in Turkey, with the copy from Prof. Dr Ilter Uzel’s private library being the copy that we examined. Ankara Adnan Ötüken Public Library (no. 06 Hk 2753), Bağdatlı Vehbi Library (no. 1363), Çorlulu Ali Paşa Library (no. 344), şehit Ali Paşa Library (no. 2112), şehit Ali Paşa Library (no. 2113), and Prof. Dr İlter Uzel’s private library (no number) have copies.^14,15,16,17 There are also 13 copies of Dāwūd b. ʿUmar al-Anṭākī’s work throughout the world’s libraries: 4 are in Egypt, 3 in Germany, 2 in Tunisia, 2 in the United States, 1 in the Netherlands, and 1 in France.^11,13

In this study, al-Anṭākī’s writings on kidney and bladder diseases in his work Nuzhat al-adhhān fī iṣlāḥ al-abdān were examined.^13,18

Materials and Methods

Nuzhat al-adhhān fī iṣlāḥ al-abdān is a medical textbook that includes the following contents^13,18: Introduction, Preface, Section 1: Natural things, Section 2: Anatomy, Section 3: Reasons, Section 4: The condition of the body, Section 5: Recommendations and laws, Section 6: Internal diseases, Section 7: External diseases from head to toe, and Conclusion.

Prof. Dr İlter Uzel’s library has one of the 19 manuscript copies of Nuzhat al-adhhān fī iṣlāḥ al-abdān that remain today. This worn and partially missing copy contains a second-long and integrated medical text in its margin spaces, making it unique.¹⁸

We examined the sections on kidney and bladder diseases and comparing İlter Uzel’s copy of Nuzhat al-adhhān fī iṣlāḥ al-abdān with a printed copy.¹⁸ We compared the relevant sections of Nuzhat al-adhhān fī iṣlāḥ al-abdān with the relevant sections of the other important works of al-Anṭākī, al-Nuzhat al-mubhija fī tashḥīdh al-adhhān wa taʿdīl al-amzija¹⁹ and Tadhkiratu uli l-albāb wa l-jāmiʿ li l-ʿajab al-ʿujāb.²⁰ The similarities and differences between these works were revealed.

Results

Kidney and bladder diseases are briefly discussed in Nuzhat al-adhhān fī iṣlāḥ al-abdān13,18 under the headings “amrāḍ al-kulā wa l-mathāna” (kidney and bladder disease), “al-ḥisā” (bladder stones), and “ḥarqān al-bawl wa taqṭīruhu” (urine burning and dripping).

Kidney and bladder diseases are conditions characterized by heat-induced kidney atrophy and fat deficiency. A large amount of substance in the urine and an increase in humor are the causes of kidney and bladder weakness. These are treated with various medications.^13,18

Blood causes a blockage in the bladder after eating heavy foods, resulting in bladder stones. Heat causes pain and burn. If not, it is due to heaviness and cold in the bladder. These are also treated with various medications.^13,18

The cold causes urine burning, dripping, and whitish fluids if there is no pain. A fever is caused by pain. Nuqta (spot) disease (gonorrhoea) is characterized by liquids coming out in the form of drops, urine dripping, oliguria, and color change. There are also tried and tested agents for this.^13,18

Discussion

The issues concerning kidney and bladder diseases are addressed more briefly in Nuzhat al-adhhān fī iṣlāḥ al-abdān than in al-Nuzhat al-mubhija fī tashḥīdh al-adhhān wa taʿdīl al-amzija.

There are 14 types of kidney and bladder diseases in al-Nuzhat al-mubhija: kidney diseases, urinary tract obstruction, pyogenic nephritis, kidney stone and sand, kidney atrophy, kidney rheum, pyelonephritis, diabetes in the kidney, bladder diseases, burning in the urine, urinary incontinence, enuresis nocturne, globe vesical and urinary hematuria, and clotting.¹⁹

Al-Anṭākī states in his al-Nuzhat al-mubhija regarding kidney and bladder diseases that the cause of pain in bad temperament is the deterioration of humor. Fever, thirst, and weakness are symptoms of a hot temperament. The color of the urine bottle darkens as the libido rises. The opposite of a cold temperament is exhibited. These are also treated with various medications.¹⁹

Al-Anṭākī continues in al-Nuzhat al-mubhija regarding kidney stones and sand that the thick substance found in any part of the body hardens due to heat and its compression in a narrow area. The substance accumulates on the stone as a result of clay accumulation. This could occur in the liver, spleen, kidney, or bladder. Blockages can be caused by dirty water, kashkak (a dish made of pounded meat and wheat), overcooked eggs, and a lack of movement. Heaviness, inflammation, spasm, and restlessness are common symptoms. It worsens when lying face down. Other symptoms include back pain, pubic pain, penile pain, and urinary urgency. When sand is in the urine, the color is red in the kidney and cloudy in the bladder. Kidney stones are more prevalent in the elderly and obese. When the stone forms in the bladder, it is more common in young people, men, and the weakness. The pain is felt in the testis, while standing on the same side. These are also treated with various medications.¹⁹

In al-Nuzhat al-mubhija, special preparation is given to break up kidney and bladder stones. A large male goat, 4 years old, born during the grape ripening season, is slaughtered from the tried ones from Galen’s time. Blood from the goat is placed in a clean pot, covered with a cardigan, and exposed to sunlight. The cardigan is pierced with a needle at regular intervals, and the water part of the blood on the top is removed. This water is gathered, transported, dried, and ground. A dirham is extracted from it and mixed with celery juice before consumption. This will quickly remove the stone. Galen referred to it as God’s hand (Yad-Allāh).¹⁹

Urine burning is caused by inflammation, ulcers, and other factors. It has previously been mentioned. Dark urine and bitter humor are common due to the hot temperament. The only symptom is burning when urinating. These are also treated with various medications.¹⁹

Al-Anṭākī's Tadhkiratu uli l-albāb wa l-jāmiʿ li l-ʿajab al-ʿujāb20 only includes mentions of kidney and bladder stones. The shape, color, and consistency of kidney and bladder stones are mentioned in Tadhkira. The stone’s inheritance and symptoms are discussed. While kidney stones are seen in the overweight, women, and the elderly, bladder stones are more common in the weak, young, and men. Heavy foods, fruits, drinking contaminated water, and inactivity are causes of stones. In kidney stones, symptoms include abdominal and back pain, indigestion, thin urine, and red color. In bladder stones, symptoms include pubis pain, itching in the penis, heaviness in the pubis, and urinary urgency. Urine leaks when pressure is applied to the bladder.²⁰

During the procedure, a finger is passed through the anus, while an instrument is inserted through the urethra. The stone is compressed and attempted to be broken. If the stone does not break, a perineum incision is made, and the stone is attempted to be removed. It does not enter the body through the bladder. Furthermore, drugs of various compositions are used.²⁰

Conclusions

While Nuzhat al-adhhān fī iṣlāḥ al-abdān provided a general overview of the disease and its treatments, al-Nuzhat al-mubhija fī tashḥīdh al-adhhān wa taʿdīl al-amzija examined these issues in detail. Tadhkiratu uli l-albāb wa l-jāmiʿ li l-ʿajab al-ʿujāb, on the other hand, is a dictionary that only includes kidney and bladder stones. When these works are combined, the information in them complements each other.

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