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Paper written by Professor Omar Hasan Kasule Sr. MB ChB(MUK), MPH (Harvard), DrPH
(Harvard)
FATHER OF MODERN SURGERY
·
Abu al-Qasim Khalaf ibn al-Abbas Al-Zahrawi
(936–1013G) is the father of modern surgery
·
Kitab al-Tasrif li man ‘ajaza ‘an al ta’aliif, a 30-volume
encyclopedia of medical practices completed in 1000G; 50 years of experience.
First illustrated medical book. Published in Lucknow in 1908G.
·
A;Zahrawi’s surgical procedures and instruments
are still applied in medicine today (?plagiarism / intellectual property?)
·
We should not be complacent with the achievements
of the past. AlZahrawi inspires us to write the future while reading our
history.
·
Innovative and creative. Combination of reading
the 2 books ‘kitaab al wahy’ and ‘kitaab al kawn’
AMONG FIRSTS OF ALZAHRAWI
·
Description of a surgical procedure for
ligating the temporal artery for migraine
·
evacuation of hydrocephalus[2]
SURGICAL INSTRUMENTS
·
Inspection of urethral interior
·
Rremoving foreign bodies from the throat
·
Inspection of the ear
·
Cannulas
·
Hooks with a double tip for surgery
FIRSTS NOT CREDITED
·
Because of limited translations into modern
western languages Al Zahrawi’s achievements were not widely known[3]
·
"Kocher's method" for treating a
dislocated shoulder
·
No charges of plagiarism / violation of
intellectual property were made
PERSONAL DIMENSION
·
Affectionate with his students, whom he
referred to as "my children"
·
Emphasized the importance of treating patients
irrespective of their social status.
·
Encouraged the close observation of individual
cases in order to make the most accurate diagnosis and the best possible
treatment.
·
The historian AlHumaidhi in his book ‘jadhwat
al muqtabas fi akhbaar ulamaa al andalus’ that AlZahrawi was religious.
·
He was known to set aside half of the day to
treat the poor for free
WHAT MADE ALZHRAWI GREAT? evidence-based medicine
·
Two lessons from AlZahrawi:
empirical evidence-based knowledge (hujjiyat al burhan/daliil) and a holistic
approach to medicine (shumuliyyat)
·
AlZahrawi was a great researcher
and based his work on empirical evidence.
·
Insisted on dissection.
·
In the introduction to tasrif he
said that the book contained what he experiences and tried out in 50 years.
·
Muslims inspired by the Qur’an to
follow daliil and burhan and to look in the universes around them for signs of
Allah, ayat al Allah fi al kawn
WHAT MADE ALZHRAWI GREAT? holistic medicine
·
AlZahrawi worked within the
shummuli / holistic context of Islam.
·
Islam is a complete system with
guidelines for all aspects of life
·
The guidelines are general
conceptual principles leaving a lot of room for human effort by ijtihad to
extend the frontiers of knowledge
·
Holism or shumuliyat are based on
tauhid
TAUHID: INTRODUCTION
·
Tauhid encapsulates the integrative Islamic
world view, tasawwur islami
·
The monotheistic creed, ‘aqidat
al tauhid: Oneness of God, tauhid al
dhaat; Oneness of creation, tauhid al
rubuubiyyat, &oneness of worship, tauhid al uluhiyyat.
·
Tauhid has implications for our daily life based on issuing from one
creator: brotherhood and equality, consistent and harmonious physical, social,
economic, political laws as well as holistic medical care.
·
Tauhid provides a paradigmatic basis for resolving problem/crisis of duality
of knowledge, azmatizdiwajiyat al ma’arifat, towards integration of
knowledge, takamul al ma’arifat
·
Tauhid provides a paradigm for research, teaching, and practice of basic
medical sciences, clinical sciences, and medical professionalism
TAUHID: EPISTEMOLOGICAL IMPLICATIONS
·
Knowledge crisis = dichotomy in the education
system: traditional Islamic vs. imported European. Students and their
teachers are confused by the contradictory world-views presented by the two
systems
·
The mission of the knowledge strategy is
conceptual transformation of the education system from kindergarten to post
graduate studies to reflect the tauhidicintegrative paradigm, positive moral
values, objectivity, universality, and serving the larger causes of humanity.
·
Many efforts towards
an integrated education system are acknowledged such as IIIT, IIUM, other
Islamic universities, FWCII etc: there are conceptual & practical problems
not yet resolved but we have come a long way.
TAUHID: BIOLOGICAL IMPLICATIONS
·
Tauhid explains the perfection, optimality, order, harmony, consistency,
co-ordination, and purposive ness and of body
structure and physiology
·
Tauhid explains the consistency of the physical and social laws, sunan
al kawn, that underlie biological phenomena of order (thabaat) and
change (taghyiir) such as homeostasis and negative feedback in human
physiology referable to the Qur’anic concepts of balance (mizan),
equilibrium (e’itidal), and action-reaction (tadafu’u)
·
The purpose of scientific research
is to discover (basic science) and exploit (technology) the sunan al kawn
·
Study of biology reveals signs of
Allah (ayatkawniyyat) in biology: perfection (kamal al khalq),
incomparability (‘azj al shurakaa), functional unity (C-C-C) based on
the nervous and endocrine systems to be read alongside Qur’anic signs (ayatqur’aniyyat)
TAUHID: REJECTION OF MATERIALISM IN MEDICINE
·
Health is holistic including spiritual health,
physical health, psychological and mental health, and social health all
properly balanced. The human body as integrated physiological entity that all
suffers if any part is injured.
·
The biomedical model (BMM) in modern medicine
was characterized by focus on: the physical and rejection of the psychosocial
and spiritual, disease and not illness, disease and not health, quantity and
not quality of life, organ pathology and not the whole patient.
·
BMM commodizes health, medicalizes life,
demystifies the human body, dehumanizes the patient as a machine, depersonalizes
the patient as a pathology, and lacks balance and equilibrium,
TAUHID: PARADIGM SHIFT: THE BIOMEDICAL TO THE HOLISTIC
- Lack of integration due to atomistic view of the cosmos: analytic but not synthetic
- Integration is not addition but is fitting according to the laws, sunan
·
Tauhid motivates the shift from the biomedical to the
holistic model that looks at thepatient, the disease, and the environment as
one system that is in equilibrium;
·
Tauhid
motivates looking at a patient as one organism and not a convenient combination
of organs and pathologies. The patient has physical, social, psychological, and
spiritual dimensions that have to be considered together in an integrated,
holistic, and balanced fashion.
TAUHIDI and HOLISTIC MEDICINE (HM)
·
HM is defined as medicine that focuses on the
‘whole person’ and not the malady itself.
It considers physical, social, psychological, and spiritual aspects of
disease
·
It was the mainstream form of medicine in all
ages (Islamic medicine, unani medicine)
until marginalized by scientific medicine to become a form of
alternative medicine
·
Integrative medicine is when a physician of
modern medicine integrates a holistic approach
·
Return to holistic medicine is return to
tauhidi medicine
TAJDID
& ISLAH
·
This ummat experiences periods of growth and
periods of decline but it always rises up
·
There is a renewal in each century. This
renewal is based on reform of knowledge and education
REFERENCES
[3]Al-Rodhan NR, Fox JL. Al-Zahrawi and Arabian
neurosurgery, 936-1013 AD.Surg Neurol. 1986
Jul;26(1):92-5.