The Paracelsian Influence on Ottoman Medicine

Galen's concept of medicine which dominated the medical world almost nearly for fifteen centuries began to loose its importance in the 16th century. At that time, Paracelsus (1493-1541) introduced a new medical understanding based on chemical principles. The Paracelsian theory, which changed gradually medical practice, influenced modern Ottoman medicine to a great extent. Paracelsus, the Swiss doctor, was introduced in Ottoman medical writings as a German hakîm from Austria. In this artile, the multifaceted influence of his school on Turkish Ottoman medicine is describe by means of various examples.

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Nil Sari* and M. Bedizel Zulfikar**

Table of contents

1. Introduction
2. The textual sources of the Tibb-i Jadîd
3. Influence of the Paracelsusian medicine
4. Medical practice in the light of the Parcelsian influence
5. Evaluation of the Parcelsian influence
6. Bibliography
7. Medical Manuscripts

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This article was first published in the Transfer of Modern Science & Technology to The Muslim World. Proceedings of The International Symposium On "Modern Sciences and the Muslim World", Science and Technology from the West to the Muslim World from the Renaissance to the Beginning of the XXth Century, (Istanbul 2-4 September 1987) (Edited by Ekmeleddin Ihsanoglu), Istanbul 1992, pp. 157-179. We are grateful to Nil Sari, the main author of the article, for allowing publication.

1. Introduction

Galen's concept of medicine which dominated the medical world almost nearly for fifteen centuries began to loose its importance in the 16th century. Paracelsus (1493-1541) [1] who tried to eliminate the old medical concept, introduced a new medical understanding, based on chemical principles.

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Figure 1: Portrait of Galen. Lithograph by Pierre Roche Vigneron. (Paris: Lithographie de Grégoire et Deneux, ca. 1865) (Source).

Besides, iatrochemists [2], iatropysichians [3] mechanists [4] and spiritualists [5] introduced new theories based on anatomy and other natural sciences. Their trends were popular during various periods [6] and consequently medical practice changed as well. Yet in the 18th century, the two fields of study, medicine and philosophy, were not definitely separated from each other [7].

Among these trends, the one that influenced the Ottoman medicine to a great extent was the trend started by Paracelsus and his followers. Paracelsus, whose name was spelled differently, such as "Barakelsus", "Baracelsus" and "Baraklisus", in the Ottoman medical writings, was introduced as a "Cermanî" (German) philosopher, or "hakîm" [8] from "Namca" (German or Austrian peoples) [9]. Paracelsus, a Swiss doctor, who was the representative of Renaissance chemistry, influenced Turkish medicine in many ways. We will try to describe these influences by means of examples.

2. The textual sources of the Tibb-i Jadîd

Although the Tibb-i Jadîd (New medicine) of that period has not yet been specifically studied, the Arabian copies of Sâlih bin Nasrullah's (d. 1669) [10] works have been studied [11]. Considering the importance and influence of the tradition of writing medical works in Turkish, which began in the 14th and 15th centuries and continued all through Ottoman medical history, we based our study on Turkish copies and so studied 17th and 18th centuries medical works highly influenced by Paracelsus [12]. Besides translations, amongst these works, there are also collections from different authors and also compilations and commentaries arranged and classified differently. When Tibb-i Cedîd is concerned, Paracelsus and his followers solely should not be considered. In the Tibb-i Cedîd literature many writers, be they followers of Paracelsus or not, such as Oswald Croll [13], Daniel Floravante [14], Sennert [15], some of them quite well known, others not heard about, were dictated.

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Figure 2: Presumed portrait of Phillip von Hohenheim, known as Paracelsus (1493-1541), attributed to the school of Quentin Matsys (1466-1530). (Image in the public domain).

Sâlih b. Nasrullah who was highly influenced by Paracelsus, translated Fî hâzâ Kitâbu't-Tibb al-Jadîd el-Kimyâvî allazî ihtiraa-i Baraklisus [16] from him [17]. But his work Nuzhat al-Abdân fî Tarcuma-i Gâyat al-'ltkân may be taken as an exception in this respect, not any Paracelsusian influence being observable on it [18]. Because in the whole manuscript of 500 pages, in four long chapters, only one or two compositions of Paracelsus were quoted. In Nuzhat al-Abdân, new and old medicines are given comparatively. There are quotations from the representatives of the new medicine and European doctors and chemical doctors, along with those (such as bleeding) from Galen and Avicenna, the master of all [19]. Although there are a lot of quotations from German authors, such as "Senartus" (Sennert) [20], French "Gorduniyus" [21], and "Ferniliyus" [22], Austrian "Erfil Saksonî" [23], and "Felis" [24], only a few short pieces were quoted from Paracelsus [25]. In the third chapter of the first part "Ispenciyare" and the nineteenth article, instruments necessary for the pharmacologist and technological equipment such as distillatory to produce perfumes and pharmacological material for preparation of medicine, methods long ago known in the world of Islam, are handled. Here, only the technical methods are clearly explained, but theoretical knowledge is not included. The fourth part [26], which is referred as a translation from Paracelsus, in fact has no relation, either with Paracelsus or "Tibb-i Jadîd", the new medicine. Those who study the old medicine can see that this part deals with classical toxicology, beginning with measures to be taken against getting poisoned by metals, ending with the therapy of rabies.

In Tibb-i Kimyâî [27] by Omer Sinan al-Iznîkî, [28] whose works are affected by Paracelsus, "kimyâ" (chemistry) is described as an originally Greek word, the "himya", meaning analysis and decomposition. In this same work, Iznîkî states that some regard this science as the art of Hermes (Sanat-i Hermesiyye) [29] and others as the secrets of oracles (sirr-i kahânat) [30]. According to Iznîkî, the main purpose of these people was to improve the metals and turn copper into silver and silver into gold. In his opinion, this was the case until Paracelsus, a German (Baraklisus el-Cermanî) who came forth and developed the art of chemistry, made it a part of medicine and called it "espâgîrika" (which literally means chemistry).

In the Ottoman literature this art is described as chemical medicine, Tibb-i Kimyâî. This art comprises also philosophy (hikma) [31] and the secrets of nature (asrâr-i tabîat). But its main field of study is about minerals and their analysis and improvement by means of this art. According to the same work, if the primary aim of medical chemistry was improving minerals, the secondary aim was the protection of human health and the treatment of diseases. As we shall see later, Ottoman doctors were more interested in practice than with theories, philosophy and mysticism. However, books started with the theories of chemical physicians, such as Paracelsus' and Crollius', instead of the old theory of the four humours. Besides this, comparative quotations were made from Hermes, Aristotle and Plato. The ideas of Paracelsus and his followers occur intermingled with other philosophers' ideas.

The Kitâb-i Kunûz-i Hayât al-Insan Kavânîn-i Atibbâ-i Feylesofân [32] of Iznîkî consists of two parts. The first part begins with the philosophy of nature and the origin of species, whilst the second contains simple and compound medicine, administered and known to be useful, selected from famous books of skilled Arabian, Persian, Greek and European physicians. They are given under the titles of sap, oil, ointment, spirits, elixir and balsam etc. Here, also, the old and new medicines are intermixed [33].

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Figure 3: Apparatus for distilling essence; furnace and bath (vapor heating). Source: Omer Sifâî, Jawhar al-Farîd fî Tibb al-Jadîd, Suleymaniye Library in Istanbul, MS Hamidiye 1020.

Another Ottoman physician influenced by Paracelsus is Omer Shifâî (death 1742) [34]. Shifâî informs in his book, Javhar al-Farîd fî al-Tibbi ‘l-Jadîd [35] that the selected chemical medicine (Tibb-i Kimyaî) preparations, suitable for the rulers' temperament and the disposition of the noble, quoted from the books of Latin philosopher physicians (Hukemâ-i Latin Feylesoflan) and translated them from various European languages (Frenkce) to western Turkish (Turki-i Rûm) [36]. Shifâî, like Iznîkî, beginning with a definition and short history of chemistry, goes on to inform that a philosopher named the Austrian Paracelsus (Cermanî Baraklisus) came out and described the characteristics of different minerals and their effects, the way these minerals are influenced and directed by the movements of the heavens, and the origin of the plant and animal species. Being familiar with the secrets of stones, he divided the science of chemistry into different subjects, by strange terms and odd words; Paracelsus regarded chemistry as a branch of medicine and called it "Ispenciyâr" [37]. Shifâî is aware of the queerness of Paracelsus' theory; however he quotes this strange theory in his book. The subject matter and the text of this book is similar to that of Iznîkî.

There are quotations from Paracelsus and his followers in Shifâî's works Minhâj al-Sifat fî al-Tibb al-Kimyâî [38] and Tibb-i Jadîd al-Kimyâî [39].

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Figure 4: Several kinds of stills and the double boiler (Bain Marie). Source: O. Sifâî, Jawhar al-Farîd fî Tibb al-Jadîd, Suleymaniye Library, MS Hamidiye 1020.

Gevrekzâde Hafiz Hasan Efendi (d. 1801) [40] states in the beginning of this book Mursid al-Alibba fî Tarcamati Ispagorya [41] that he had made translations from Paracelsus and Crollius and added commentaries to them' [42].

Another important book on the Paracelsusian new medicine (Tibb-i Jadîd) is Kasîr al-Naf', of which the author is unknown [43]. Differing from the books of the above mentioned writers, this book, existing in only one known copy, is the most comprehensive book on the new medicine (Tibb-i Jadîd).

3. Influence of the Paracelsusian medicine

In what way did the Paracelsusian medicine influence the Ottoman medicine?

The main change concerns the philosophy of medicine which had a great impact on the old humoral pathology theory. But from time to time this new theory was mixed up with the humoral theory. According to the humoral theory, which explains the composition of matter and comments on illnesses, everything is composed of four elements, namely fire, air, water and earth. In accordance with the same theory, matter is composed of four properties, coldness, warmness, dryness and moistness; there are four humours in the body: blood, phlegm, yellow bile and black bile, besides four temperaments, sanguine, phlegmatic, choleric, melancholic [44].

The above mentioned elements, which formed the basis of the old medicine, were included in the "great secret" (Sirr-i Akbar). The divine secret implies the creator, indefinable, invisible, unconceivable and indescribable. The whole universe, images, forms, colours, tastes, etc., are born from the divine secret [45]. He also is the beginning of life as well as the beginning of motion, force and dispositions. However, it is also clear that it was not easy to give up the humoral theory which was approved for centuries without a doubt. Therefore, the humoral theory got mixed with the new theory. When God created the matter in its first form (hayûli-i awalî) and the great secret, four elements (anâsir-i arbaa) emerged from it. All living creatures are made up of the four elements. These elements have visible (zâhirî) and invisible (bâtînî) aspects. Internal (bâtînî) secrets are hidden inside. These are impossible to change or spoil. Only the visible form can be disintegrated, spoiled or change form [46].

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Figure 5: Several kinds of apparatus used in the process of sublimation; furnace, the double boiler and stills. (O. Sifâî, Jawhar al-Farîd fî Tibb al-Jadîd, Suleymaniye Library, MS Hamidiye 1020).

According to Paracelsus and his followers, the elements consist in two forms, external and internal. Physic is an example of the external element and the ego or soul (nafs) is an example for the internal element. The internal element is the one that provides for continuation of the species. The external element is the part which can be changed and spoiled [47]. In alchemy and chemistry, the properties of the four elements are described as: earth (the visible solid part), fire (the secret and fine part), water (visible liquid form), and air (the invisible gaseous form) [48].

Paracelsus does not deny completely the role of the four elements as a material factor of illness and health; however they are not as affective as the school of Calinos claims. What is important is the existence of the three principles in each organ. The first principle is combustibility; the second is volatility; and the third is incombustibility and remain as ash. Paracelsus calls the three principles as sulphur, mercury and salt [49].

We find this new point of view reflected in the Ottoman medical literature as in the following phrases [50]:

"Those who are the followers of the new medicine said of the composition of things that, objects are consistent of three essential elements:

Sulphur (kibrît): the solid, stable principle; oiliness (duhniyyet) salt (milh): extract, sap, stable dense earth (sabit galiz arzî);

Mercury (zibak): volatility principle (rutubet-i seyyare); volatile gas (ruh-i tâîre): vaporizable, which could not resist fire.

All matter is composed of these three essences. As a result of this existence in three forms, there is:

Mineral salt, mineral mercury and mineral sulphur; plant salt, plant mercury and plant sulphur; animal salt, animal mercury and animal sulphur. The essence of all poisons is salt [51]."

Figure 6: Turning a fistula into in rhinophyma treatment by a Muslim surgeon. Miniature in Sharaf al-Din Sabuncuoglu's book Cerrahiyat al-Hâniyya. Picture copied by the permission of Nil Sari and Ulker Erke (The 38th International Congress on History of Medicine, Turkish Medical History Through Miniature Pictures Exhibition, responsibles U. Erke and N. Sari, Istanbul 2002).

In medical manuscripts, under the title "Hermes' words", we find this statement:

"Mercury (the volatile principle) is primarily a spirit; sulphur (the solid principle) is primarily the ego (nafs) and salt (extract/hulasa), which is primarily an object" [52].

As a result of Paracelsus and his followers' influence, the Hermetic philosophy gained importance and technical methods such as distillation, boiling and calcification, intermingled with philosophy.

Paracelsus' concept of the Universe was composed of natural magic, Hermetic philosophy, alchemy, astrology and divinity. This new philosophy and practice, based on chemical studies and analogies [53], was introduced into the Ottoman literature as "Tibb-i Jadîd", the new medicine.

Another important change which took place, as a result of the influence of Paracelsus, is the appearance of the philosophy of nature in medical literature.

According to Paracelsus, creation and the appearance of species with their special characteristics, as well as the protection of these characteristics, and also the transformation and the degeneration of the characteristics of species, took place in three phases [54]:

In the first step, the "activating thought" causes plant, mineral and animal species, to mature. In the second phase, the power hidden in the matter makes the first form of the matter. In the third phase, the protection of the species is realized by a divine order.

Yet, some objects, for example celestial elements could not be changed or degenerated. However, some objects can change through the influence of the moon and the stars.

Thus, we see that subjects dealt with in the books of philosophy, astrology and secret sciences, mixed up with theology, began to penetrate into medical literature, a subject not found in the older Ottoman medical manuscripts. Astrology, allegory of micro and micro cosmos [55], the idea that star constellations influence human fate, health and illness, existed since the ancient Greeks. But these were not included in Ottoman medical works, which could be identified as secular, before the new medicine (Tibb-i Jadîd). The idea that stars could cause illness for their distant places did not agree with the old medical thought, which was an extension of the Aristotelian logic and Hippocratic medicine [56].