Indian and Greek medicine competing in eighth-century Baghdad

In Caliph al-Rashīd’s court in late eighth-century Baghdad, Indian medical knowledge vied for prominence with Greek medical knowledge.  The illustrious Bakhtīshū` family of physicians were leaders in Greek medicine, meaning the tradition that Hippocrates and Galen headed.  The Barmakids, a family with connections to India, patronized Indian physicians and sponsored Arabic translations of Indian scholarship.  Story-telling and courtly politics, rather than medical effectiveness, seems to have determined which medical tradition was more influential in the Islamic world for the next millennium.

A courtly story celebrates the superiority of Indian medicine.  This story pits Saleh ibn Bahlah, an Indian physician, against Jibrā’īl ibn Bakhtīshū`, a famous and wealthy member of the Bakhtīshū` family of Greek medical scholars. According to the story, Jibrā’īl arrived late for a meal with Caliph al-Rashīd.  Jibrā’īl responded to the irate Caliph by declaring that the Calph should be “weeping for his cousin, Ibrāhīm ibn Saleh, instead of cursing me.”[1]  Jibrā’īl explained that he had been caring for Ibrāhīm, and he declared that Ibrāhīm would not survive past the evening prayers.  Grieving intensely for his cousin, al-Rashīd ordered the meal to be ended.

Ja`far ibn Yahyā, a leading member of the Barmakids family, suggested that the calph seek the opinion of an Indian physician.  Ja`far ibn Yahyā said to the caliph:

O, Emir of the Faithful, Jibrā’īl’s medicine is Roman {Greek} medicine. And Saleh ibn Bahlah the Indian in his knowledge of the ways of the Indian people in medicine is like Jibrā’īl in his knowledge of the Roman {Greek} methods. Maybe the Emir would care to summon him and send him to his cousin, so that we may learn from him what Jibrā’īl has told us.

The caliph agreed. The Indian physician Saleh ibn Bahlah went to the sick man and “examined his pulse.” That’s a prognostic mode that characterizes Greek medicine.  Saleh ibn Bahlah’s deportment, however, differed sharply from Jibrā’īl’s.  Saleh ibn Bahlah insisted on revealing his prognosis only to the caliph, and he addressed the caliph modestly and deferentially:

O, Emir of the Faithful, you are the Imam, the bestower of authority on rulers, whatever you decree, no judge can revoke.  You and all who are present are hereby witnesses to my statement that if Ibrāhīm ibn Saleh dies tonight, or of his present malady, all that belongs to Saleh ibn Bahlah may be taken from him.  Every animal may be given to the needy, all his money should be donated to the poor, and all his wives shall be thrice divorced according to the laws of Islam.

The caliph responded:

Woe unto you, you have sworn about the unknown!

Saleh ibn Bahlah replied:

No, Emir of the Faithful.  The unknown is that of which no one has an inkling.  I only say what is clear to me from reliable indications.

Jibrā’īl, as a leader in Greek medicine, claimed expertise in predicting the course of an illness from reading the sick person’s pulse.  Saleh ibn Bahlah thus directly challenged Jibrā’īl’s medical expertise.

The competition between these medical authorities played out dramatically.  The narrative makes a double-reversal:

Al-Rashīd appeared relieved by these words {Saleh ibn Bahlah’s prognosis of survival}.  He began to eat and drink.  When it was time for the evening prayer, a note came from Baghdad, announcing the death of Ibrāhīm ibn Saleh. Al-Rashīd turned to Ja`afar and blamed him bitterly for having recommended Saleh ibn Bahlah.  He cursed India and its physicians, exclaiming: ‘Shame on me in the eyes of God that I was drinking while my cousin lay on his deathbed!’  Then he ordered a bottle of wine and water to be brought, into which he put some salt.  He drank and vomited all the food and drink that was in his stomach.

Ibrāhīm ibn Saleh’s body was treated with preservatives and wrapped in a shroud.  That would seems to be preparation for burial. Nonetheless, the story lights a pyre for additional drama:

No one spoke to him {Saleh ibn Bahlah} until the smell rose from the burning cinders. At that moment, Saleh shouted: ‘Allāh, Allāh, O, Emir of the Faithful, if you order me to divorce my wife and take her, give her to someone else, who does not fulfill the religious requirements, so that I can be her legal husband again. By Allāh, if you take my money away from me, while I have uttered no untruth, you will be burying your consin alive. For as Allāh is my witness, he is not dead. Allow me to go in and look at him.’ He repeated these words over and over, until he was eventually granted permission.

Saleh ibn Bahlah then engaged in medical practices not associated with Greek medicine.  The courtly narrator-observer reports:

We began to hear the sound of a hand beating on a body. Then this stopped, and we heard: Allāh is great! Saleh emerged, repeating this phrase, and said: ‘O, Emir of the Faithful, come with me and I will show you a miracle.’ … Saleh took Ibrāhīm’s hand, produced a needle, and inserted it between the left thumbnail and the flesh. Then Ibrāhīm drew his hand to his body and Saleh said:  ‘O, Emir of the Faithful, does a corpse feel pain?’  Al-Rashīd said: ‘No,’ and Saleh continued: ‘If you wish him to speak to you now, he will do so.’

Al-Rashīd entreated for his presumed-dead cousin to speak.  But Saleh, reversing himself, objected to that action:

O Emir, I am afraid that if I treat him and he wakes up while he is dressed in a shroud, with the smell of preservative, he will die of shock, and then I will have no way of bringing him back to life. But if you order the shroud to be removed and that Ibrāhīm be taken to the washing room, cleansed and dressed in his everyday clothes, perfumed with his usual perfume, and brought back to his own bedchamber, I will treat him in your presence, and he will speak to you directly.

Ibrāhīm’s body was restored to its courtly appearance.  Then Saleh re-animated it:

Saleh asked for bellows from the cupboard and started to apply them close to the sick man’s nose for twenty minutes. The body shuddered, and the patient sneezed and then sat up before al-Rashīd.  Ibrāhīm kissed his hand, and al-Rashīd asked what had happened to him.  Ibrāhīm told him that he had slept so soundly that he did not remember anything, but he had dreamed that a dog was attacking him and that he had defended himself with his hand. It gave his left thumb such a bite that it woke him, and he now felt pain there. He indicated the thumb which Saleh had pricked with the needle.

This story surely was crafted as dramatic courtly entertainment.  But it is not mere entertainment.  Competition between Indian and Greek medical authorities in al-Rashīd’s court is highly plausible historically.[2]  Dramatic stories are key tools in political competition.

When the Barmakids suddenly fell from power in 803, Greek medicine gained a decisive advantage over Indian medicine.  The historical facts of the Barmakids’ downfall aren’t clear.  Some sensational story apparently prompted or justified that dramatic loss of courtly favor.[3]  The Bakhtīshū` family of physicians, in contrast, continually served Abbisid caliphs for the next 250 years.  With Bakhtīshū` physicians at its forefront, formal medical scholarship in the Islamic world built upon Greek medical thinking much more than upon Indian medical thinking.  From a modern perspective, ancient medicine of both scholarly traditions had little objective merit.  Greek medicine prevailed under the Abbasids at least in part through story-telling and courtly politics.  The survival of a highly entertaining story celebrating the superiority of Indian medicine suggests that the story-telling competition was intense.

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Notes:

[1] HP p. 604.  Subsequent quotations are from HP pp. 604-7.  Ibn Abi Usaybi’ah, writing in the thirteenth century, described the story’s source thus: “Abū Hassan Yūsuf al-Haseb, known as Ibn al-Dayah, said that Ahmad ibn Rashīd al-Qatib, patron of Salam al-Abrash, related to him that his master had told him as follows….”  Salam al-Abrash was a court eunuch under al-Rashīd.  Al-Dayah may have been a ninth-century scholar.

[2] According to Herodotus, the Persian king Darius (Darius I, reigned 522 BGC to 486 BGC) questioned and compared Greeks and Indians about funerary rites. Herodotus, Histories 3.38.

[3]  One story is that al-Rashīd erotically loved the Barmakid Ja’far ibn Yahyā, and arranged a merely formal marriage between Ja’far and al-Rashīd’s sister, ‘Abbasa.  However, the couple consummated their marriage and had a child.  Al-Rashīd, furious at this development, executed Ja’far and confiscated all the Barmakids’ wealth.  A scholar recently observed:

In the medieval chronicles, there are as many reasons given for the caliph’s destruction of the Barmakids as there are known victims of the affair.  Historians have long noted the contradictions in and occasional triviality of these reasons and have admitted that it is very hard to discern the true reason.

El-Hibri (1999) p. 18.  See also pp. 45-58.  That the downfall of the Barmakids was sudden is uncontested.  That suggests a dramatic story at least put forward as justification for decisive action.

References:

HP: Ibn Abi Usaybi’ah, Ahmad ibn al-Qasim. English translation of History of Physicians (4 v.) Translated by Lothar Kopf. 1971. Located in: Modern Manuscripts Collection, History of Medicine Division, National Library of Medicine, Bethesda, MD; MS C 294Online transcription.

El-Hibri, Tayeb. 1999. Reinterpreting Islamic historiography: Hārūn al-Rashīd and the narrative of the ʻAbbasid caliphate. New York: Cambridge University Press.

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