managing patients: physicians serving early Islamic rulers

Physicians were highly influential figures in rulers’ courts in the early Islamic world.  Physicians offered rulers not only treatment for specific ailments and sicknesses, but also ongoing advice about what to eat, where to live, and what activities to pursue.  The early-ninth-century caliph al-Mu`tasim declared:

My physician Salmawayhi is greater in my eyes than the chief judge, as the latter decides about my money, while the former decides about my person, and my life is dearer to me than my money and possessions.[1]

As a trusted personal adviser to al-Mu`tasim, the physician Salmawayhi gained broad powers encompassing those of a judge and vizier:

One can find in the state registers the decrees of al-Mu`tasim in judicial and other matters, all in Salmawayhi’s handwriting, as well as all the orders to the princes and commanders in matters of government and attendance at the Caliph’s court.[2]

Other physicians were less successful in managing their relationship with their ruler-patient.  Consider Daniel the Physician.  He served the eleventh-century Syrian ruler Mu’izz al-Dawlah.  That physician-patient relationship worked out badly for the physician:

Mu’izz al-Dawlah inquired of Daniel, “Do you not maintain that quinces, when eaten before a meal, cause constipation, and when eaten after a meal, have a purging effect?” “Yes, indeed,” replied Daniel.  Whereupon Mu‘izz al-Dawlah said: “As for myself, when I eat them after a meal, they make me costive.” When Daniel answered: “This is not a normal reaction,” Mu‘izz al-Dawlāh punched him in the chest and said: “Get up and learn how to behave in the service of rulers, then you may come back.”  Daniel left, spitting blood. In this condition, he lived on for a short time but then died.[3]

The physician al-Hasan ibn Zairak also suffered serving ninth-century Egyptian ruler Emir Ahmad ibn Tulūn:

Ahmad ibn Tulūn called al-Hasan ibn Zairak and said to him: “I think that the medicine you gave me today was not the proper one.” Ibn Zairak replied: “The Emir, may Allāh lend him support, should order all the physicians of Fustat to assemble at his residence each morning and decide unanimously what the Emir should take. I have administered nothing to you but medicines which were prepared by a person you trust and which are designed to strengthen the retentive powers of your stomach as well as your liver.” Said Ahmad: “By Allāh, if you do not succeed in your treatment, I am determined to have your head cut off. You are merely experimenting on the sick, but can do no real good.” Al-Hasan ibn Zairak left the Emir’s presence trembling. He was a very old man. His liver became inflamed as a result of anxiety and fear and because, owing to his troubled state, he neither ate nor slept. A profuse diarrhea set in, he was overcome with chagrin, and eventually his mind became disturbed and he talked deliriously about Ahmad ibn Tulūn’s ailment. He died the next day.[4]

Ibn Abi Usaybi’ah, who recorded these incidents in his thirteenth-century history of physicians, also preserved a large number of aphorisms from his eminent uncle.  Ibn Abi Usaybi’ah’s uncle was a physician who served rulers and apparently accumulated considerable wealth.  He seems, however, to have cherished the ideal of being a monkish scholar.  Among his aphorisms are:

Avoid the rulers of this world and you will spare yourself the company of evil men.

Whoever is able to live contentedly in accordance with his needs and instead sells his soul to another, spurred by the desire for the luxuries of life, is the stupidest of fools.

If it is possible to live apart from people with the minimum of needs, this is the best situation.[5]

These aphorisms probably draw upon literary platitudes of ascetic scholarship.  At the same time, weariness and frustration surely could occur in a physician’s relationships with his ruler-patients.

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Notes:

[1] HP p. 316.

[2] HP p. 315.

[3] HP. p. 455.  Mu‘izz al-Dawlah was a ruler in Aleppo about 1047 when Ibn Butlān visited that city.  HP p. 464.

[4] HP p. 685.  In attempting to strengthen the retentive powers of Ahmad’s stomach and strengthen his liver, ibn Zairak suffered profuse diarrhea and an inflamed liver.  This transference of ailments from patient to physician suggests that this story was a courtly construction of some literary sophistication.  It probably also generally reflects ibn Zairak’s difficulties serving Ahmad.

[5] HP pp. 918, 925 (#57), 926 (#68).  Ibn Abi Usaybi’ah’s uncle was Rashid al-Dīn `Ālī ibn Khalīfa.  He was born in Aleppo in 1183.  At the young age of 25, he began serving the Sultan al-Malik al-Mu`azzam as a physician.  He died young at age 38. Ibn Abi Usaybi’ah apparently greatly admired his uncle.

Reference:

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.

al-Biruni on pharmacological substitutes

Al-Biruni, a prolific scholar working in eleventh-century Ghazni in present-day Afghanistan, recognized a weakness in lists of pharmacological substitutes that earlier scholars had compiled.  Al-Biruni declared in his own pharmacological treatise:

Whatever has been written by the ancient and modern physicians about substitutes is insufficient.  This is so because each medicament has several characteristics and each characteristic cures one disease or another.  … {A medicament} can be used as a draught, posted for external application only, painted or rubbed on the body, applied as a fomentation, dropped on the body in the form of a hot or cold solution, applied as a washing, or given in the form of a vapour bath.  It is also possible that a substitute may be given to the patient for drinking but not for pasting on the body.  This applies to all medicines. [*]

In other words, specifying substitutes simply as a pair of medicines, like Paulus Aegineta did, ignores relevant medical context.  Nonetheless, al-Biruni explicitly cited substitutes from Paulus Aegineta’s list of substitutes.  Al-Biruni respected Greek medical authority, even when his own reasoning uncovered one of its weaknesses.

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Note:

[*] From al-Biruni, Kitab al-Saydanah fi al-tibb, trans.Ahmad & Said (1973) v. 1, p. 7.  Al-Biruni also notes that he had seen Razi‘s Kitab al-Abdal (Book of Substitutes), but he “derived little satisfaction from it.”  Id. p. 10.  Al-Biruni recognized the value of knowing linguistic equivalents.  He mentioned that he had seen a book called Deh Nam (Ten Names), which provided names of herbs in different languages.  But he complains that the book doesn’t contain names in ten languages.  He reports that the Christian book Bashaq-Samahi, also known as Chahar Nam (Four Names), gives herbs’ names in Roman {almost surely Greek}, Syriac, Arabic, and Persian.  He also states that he has obtained OribasiusKinnash, “containing the Greek equivalents of herbs.” Id. p. 9.

Reference:

Aḥmad, Muḥammad ibn and Hakim Mohammed Said. 1973. al-Biruni’s book on pharmacy and materia medica. Karachi: Hamdard National Foundation.

Ai Weiwei: lies of bankrupt artistic capitalism

Ai Weiwei exhibit perspectives at Sackler Gallery

 

Dear Mr. Ai Weiwei,

I hope you are feeling good.  I saw in Wikipedia that you are very busy.  I’m sorry to bother you.

All I want is to take a photo of your art to show my friends that I saw the art of a famous Chinese artist.  Why can’t I do that?

Please tell the Sackler Gallery in Washington DC to let people take photos of that collection of stuff that you took from Qing dynasty temples.  Taking a photo isn’t like taking something.  Everybody can take photos without taking anyone’s stuff.  Please let me, my friend, and everyone take photos of your stuff!

Sincerely,

Douglas Galbi

P.S. – I’m really looking forward to your exhibit at the Hirshhorn.  I promise that if you let everyone take photos, I’ll send you a photo of me standing next to my favorite piece of yours!

Christian fearlessness under early Roman persecution

Early in the second century, Ignatius of Antioch was executed for his Christian faith at the order of Roman Emperor Trajan.  Ignatius of Antioch was the Christian bishop in Antioch. Ignatius’ surviving letter To the Romans expresses his fearlessness and eagerness to die.  Ignatius wrote:

I am writing to all the Churches and I enjoin all, that I am dying willingly for God’s sake, if only you do not prevent it. I beg you, do not do me an untimely kindness. Allow me to be eaten by the beasts, which are my way of reaching to God. I am God’s wheat, and I am to be ground by the teeth of wild beasts, so that I may become the pure bread of Christ.[1]

Other Christians under Trajan were similarly fearless of death.  Ibn Abi Usaybiah transmits:

In Andronicus’ “History” we read: “Domitian ruled for sixteen years. After him, the Emperor Nerva ruled for one year, and after him, the Emperor Trajan for nineteen years. The latter reconquered Antioch from the Persians. His vicegerent for Palestine wrote to him saying, “The more Christians I kill, the more they love their religion.”  Trajan therefore ordered him to stop using the sword against them.[2]

Andronicus and his history apparently are otherwise unknown.  According to Eusebius’ Chronicle and a text from the late fifth or early sixth century, Ignatius of Antioch was martyred about 108.  Pliny the Younger, probably writing as governor of Bithynia-Pontus c. 110-113, asked Trajan for guidance on punishing Christians.  Trajan concurred with executing Christians who obstinately clung to their faith. He advised forgiving Christians who renounced their faith.  The extract from Andronicus’ History suggests that Trajan subsequently further eased his persecution of Christians.[3]

Christians’ fearlessness in facing torture and death is attested in other early sources.  The indefatigable Christian disciple Paul of Tarsus, writing to the Philippians about 60 GC, proclaimed, “dying is gain.”[4]  In discourses written about 108, the Stoic philosopher Epictetus described “Galileans” (Christians) being fearless of death as a matter of habit.[5] Probably late in the second century, Galen declared, “that {Christians} are free from the fear of death is a fact which we all have observed.”  Tertullian, a Christian scholar writing between 211 and 225 to the Roman Consul Scapula, declared:

Take heed, Scapula, lest we, who undergo such unutterable hardships, should all of us at once break forth and show, that so far from dreading, we spontaneously call for tortures.  While Arrius Antoninus was zealously persecuting the Christians in Asia, they came together uncalled before him.  Having doomed some few of them to death, he said to the rest, “Wretches, if you want to die, you have precipices and rope nooses!”  Should the Christians here act like those of Asia, what would you do to so many thousands — men and women, young and old, and of every station — voluntarily yielding themselves for death at your tribunal! [6]

Early Christians practiced civil disobedience of a radical type.  They welcomed authoritative threats of penal torture and execution.[7]

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Notes:

[1] Ignatius of Antioch, The Epistle of Ignatius to the Romans.  An English translation can be found in the Ante-Nicene Fathers, vol. 1, available at the Tertullian Project and the Christian Classics Ethereal Library.

[2] HP p. 145.  Trajan’s Parthian campaign occurred about 113-115.  The vignette on executing Christians turns upside-down the formula or crowd-rally chant for Christian persecutions: “Let there be no Christians” (Christiani non sint).  That expression is thought to date from the second half of the first century.  Christians who were not Roman citizens could be executed locally.  Ignatius of Antioch was transported to Rome in chains to be executed there.  That probably means that he, like Paul of Tarsus, was a Roman citizen.

[3] The most plausible identity of the vicegerent for Palestine is Tiberianus.  He was Roman legate for Judaea from 114-117, and later became known as governor of the first province of Palestine.

[4] Letter of Paul to the Philippians 1:21.

[5] Epictetus, Discourses 4.7.6, discussed in Benko (1984) p. 40.

[6] The Address of Q. Sept. Tertullian, To Scapula Tertullus, Proconsul of Africa. Tr. by Sir David Dalrymple (1790) via the Tertullian Project.  I have edited the text slightly to modernize and simplify the English.

[7] While Christian were well-known for being fearless of death, that probably didn’t always mean acquiescing to their own execution.  In the first two centuries after Jesus’ birth, persons who were neither Jews nor Christians, such as Galen, did not readily distinguish between Jews and Christians .  The Kitos War, 115-117, and the extraordinarily intense Bar Kokhba Revolt, 132-136, are known as violent Jewish rebellions against the Romans.  At least some Christians probably also violently rebelled with the Jews against the Romans.

References:

Benko, Stephen. 1984. Pagan Rome and the early Christians. Bloomington: Indiana University Press.

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.