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Abubakr Muhammad Ibn Zakaria Razi, Rhazes (865-925)

Article  in  Child s Nervous System · December 2007

DOI: 10.1007/s00381-007-0368-8 · Source: PubMed

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Childs Nerv Syst (2007) 23:1225–1226
DOI 10.1007/s00381-007-0368-8

COVER PICTURE

Abubakr Muhammad Ibn Zakaria Razi,

Rhazes (865–925 AD)
R. Shane Tubbs & Mohammadali M. Shoja &
Marios Loukas & W. Jerry Oakes

Published online: 31 May 2007

# Springer-Verlag 2007

While scientific productivity became stagnant in the West, such
ancient Islamic scientists as Rhazes continued the mission of
advancing science and medicine. Rhazes (Fig. 1) (Persian:
Arabic:
also known as Ibn Zakariya, ar-Razi, or Razi, was born in
Ray, a city a just south of modern Tehran in 865 AD.
Although this monumental Persian physician wrote more
than 200 books, he died a blind pauper [6]. He was a pupil
of al-Tabari once removed. This influential Persian was an
early pioneer in many areas including pediatrics and neuro-
surgery [6]. Two major contributions of Rhazes to medicine
were the book Kitab al-Mansuri (Liber Al Mansuri), which
was dedicated to the Samanid ruler of Ray and Kitab al-
Hawi (Liber Continens, meaning a comprehensive book or
R. S. Tubbs (*) : W. J. Oakes
Section of Pediatric Neurosurgery, Children’s Hospital,
1600 7th Avenue South ACC 400,
Birmingham, AL 35233, USA
e-mail: rstubbs@uab.edu
R. S. Tubbs
Department of Cell Biology,
University of Alabama at Birmingham,
Birmingham, AL, USA
M. M. Shoja
Tuberculosis and Lung Disease Institute,
Tabriz Medical University,
Tabriz, Iran
M. Loukas
Department of Anatomical Sciences, St. George’s University,
Grenada, WI, USA
M. Loukas
Department of Education and Development,
Harvard Medical School,
Boston, MA, USA
encyclopedia) [4]. The anatomy section of Kitab al-Mansuri
was organized into different chapters devoted to structures
such as bones, nerves, muscles, veins and arteries, and
) organs such as the eyes, nose, heart, and intestines. Rhazes
was the first to utilize neuroanatomy in the localization of
lesions of the nervous system and to correlate them with
clinical signs. He described nerves as having motor and
sensory functions while enumerating seven cranial nerves
from the optic to the hypoglossal nerves and 31 spinal nerves
[6]. He considered the olfactory nerve as part of the brain
and thus did not include it as a cranial nerve. The third and
fourth cranial nerves were parts of the trigeminal nerve and
the fifth cranial nerve was considered the combined facial
and vestibulocochlear nerves. The sixth cranial nerve was
the combined glossopharyngeal, vagus, and spinal accessory
nerves. Rhazes gave elaborate descriptions of the spinal
nerves and their intervertebral foramina. Some anatomical
descriptions that Rhazes proposed were original and had not
been reported before him. For example, he first described the
recurrent laryngeal nerve as a mixed sensory and motor
nerve [1].
A pioneer of applied neuroanatomy, Rhazes used the
differential diagnosis approach for the evaluation of his
patients, an approach that continues to be used in modern
medicine [5, 6]. He noted that different diseases might have
similar signs and symptoms. Rhazes described a patient
who became paraplegic after spinal trauma without upper
extremity involvement and accurately deduced that the
extremities were spared because the cervical spine that
provides their innervation remained intact [6]. He also
appreciated that nerve function was abolished when a nerve
was totally transected but may regenerate when compres-
sive lesions were reversed or if the nerve was cut
longitudinally. Rhazes may have reported the first case of
ulnar nerve radiculopathy following neck trauma.
1226
Fig. 1 Drawing of Rhazes (865–925 AD)
Rhazes used music for promoting healing (music
therapy). He was one of the first to appreciate the influence
of diet on the function of the body and predisposition to
disease [6]. Neurologically, Rhazes described sciatic nerve
disease, facial nerve paralysis, neurotrauma, tremors, epilep-
sy, headaches, and hemiplegia. Rhazes was the first to clearly
recognize a concussion [3]. The distinction between con-
cussion and severe brain injury was a critical turning point in
our understanding of this condition [3]. Rhazes described
tracheostomy and facial plastic surgery in Kitab al-Hawi [1].
Neurosurgically, he advocated surgery for penetrating inju-
ries of the skull [2]. He was an alchemist, mathematician,
philosopher, and astronomer as well [7]. When confronted
with the need for eye surgery, Rhazes refused a doctor that
had not mastered the anatomy of the eye.
Rhazes rejected several claims made by Greek physi-
cians regarding the alleged superiority of Greek language
and medicine. Although an avid follower of Galenic
thought, Rhazes rejected many teachings of Galen in his
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Childs Nerv Syst (2007) 23:1225–1226
book Shukuk ‘ala alinusor (Doubts About Galen). For
example, Rhazes disagreed that the brain, spinal cord, and
ventricles were formed in pairs. He also disagreed with
Galen who did not relate hemiplegia to hemisphere
involvement but rather to ventricular involvement. Rhazes
wrote of his gratitude to Galen for his commendable
contributions saying: “I prayed to God to direct and lead
me to the truth in writing this book. It grieves me to oppose
and criticize the man Galen from whose sea of knowledge I
have drawn much. Indeed, he is the Master and I am the
disciple. Although this reverence and appreciation will and
should not prevent me from doubting, as I did, what is
erroneous in his theories. I imagine and feel deeply in my
heart that Galen has chosen me to undertake this task, and if
he were alive, he would have congratulated me on what I
am doing. I say this because Galen’s aim was to seek and
find the truth and bring light out of darkness. I wish indeed
he were alive to read what I have published” (http://en.
wikipedia.org/wiki/Rhazes).
Our current surgical knowledge is based on pioneers
such as Rhazes. His contributions to medicine are still
honored each year in his homeland as his birthday (27
August) is celebrated each year as the day of the
Pharmacist.
References
1. Farhadi M, Behzadian Nejad G, Bagbanzadeh A (1996) Papers of
the international congress of the history of medicine in Islam and
Iran (Persian), vol 2. Iranian Institute for Science and Research
Expansion, Tehran, Iran
2. Goodrich JT (1997) Neurosurgery in the ancient and medieval
worlds. In: Greenblatt SH (ed) A history of neurosurgery in its
scientific and professional contexts. American Association of
Neurological Surgeons, Park Ridge, IL, USA
3. McCrory PR, Berkovic SF (2001) Concussion. The history of
clinical and pathophysiological concepts and misconceptions.
Neurology 57:2283–2289
4. Naji MR (1999) The Islamic history and civilization in the Samanid
realm (Persian). Symposium on the Samanid Civilization, History
and Culture Press, Tehran, Iran
5. Souayah N, Greenstein JI (2005) Insights into neurologic localiza-
tion by Rhazes, a medieval Islamic physician. Neurology 65:125–
128
6. Tan SY (2002) Medicine in stamps Rhazes (835–925 A.D.) Medical
scholar of Islam. Singap Med J 43:331–332
7. Wakim KG (1944) Arabic medicine in literature. Bull Med Libr
Assoc 32:96–104