This article has been produced from Chapter 5 "Contributions of Arab and Islamic Scholars to Modern Pharmacology" of the Book “Greco-Arab and Islamic Herbal Medicine: Traditional System, Ethics, Safety, Efficacy, and Regulatory Issues” by Bashar Saad and Omar Said, Copyright 2011 John Wiley & Sons, Inc.
The culmination of scholars and scientists from the Medieval Muslim world has led in many ways to the development of modern pharmacy as a profession. The Al-Mamun’s caliphate (813-833) in Baghdad encouraged scholars to translate and generate data on natural product-based drugs. Pharmacists, of the time were otherwise referred to as ‘saydalaneh’. They searched herbal-derived ingredients and extracts for use as remedies and went as far as explaining their physicochemical properties. That eventually led to unprecedented growth within the field.
A large number of new drugs were introduced for use in clinical practice, including preparations from senna, camphor, sandalwood, musk, myrrh, cassia, tamarind, nutmeg, cloves, aconite, ambergris, and mercury. Drugs were divided according to their medicinal effects into hypnotics, sedatives, antipyretics, laxatives, demulcents, diuretics, emetics, emollients, astringents, and digestants. Baghdad early pharmacy shops most likely were first to manufacture and distribute medicines commercial. Medicines were dispensed by physicians and pharmacists in a variety of forms including ointments, pills, elixirs, confections, tinctures, suppositories, and inhalants [1–3]. Pharmacists were required both to pass examinations and be licensed. They were monitored by the state.
This paper provides an overview of innovations introduced by Arab and Muslim scholars in the field of pharmacology.
Pharmacy has always existed as a science, but not so as a profession. Medicine and pharmacy were practiced together, so the physician making the diagnosis would also provide the remedy. The medication could be herbs, animal product or an amulet or even a prayer. Occasionally, a physician would hire an assistant to collect herbs and prepare the prescribed medicine.
Many similarities exist between the techniques and the materials used in Mesopotamia and ancient Egypt. The most relevant to pharmacy was the Ebers Papyrus, written around 1500 BC. It contains prescriptions and medical uses of over 700 different remedies. The preparation and the application of these remedies were rooted firmly in magic and religious practices of the time. A skilled healer chose the correct materials and combined them with the right magic to bring about a desirable therapeutic effect. There were many people who practiced related health care services, such as gathering medicinal plants or preparing drugs, under the supervision of the physician.
The Greco-Roman era saw advances in pharmaceutical knowledge; changing towards a rational and empirical approach to a disease and its cause. Things were thought to be derived from four primary elements (water, air fire and earth). This became the foundation of humoral theory and pharmacotherapy. The theory suggests a correspondence of the four elements to phlegm, blood, yellow bile, and black bile which must be in balance in order to maintain health. In order to restore balance, physicians aim to use a variety of natural products in the form of poultices, gargles, pills, and ointments.
In the writing of De Materia Medica, Pedanius Dioscorides describes origin; properties; type of action; medicinal usage and possible side effects; instructions on harvesting; preparation, and storage; and magical and nonmedical uses, of over 600 plants, 35 animal products, and 90 minerals. Later, Galen not only honoured the great advances made at the time, but also organized the drug data under the framework of humoral pathology. The considerable contribution of Galen to the practice of medicine and pharmacy gave to new medicinal preparations with a system of rules and procedures for using them.
Knowledge in medicine and pharmacy in Europe remained stagnant for centuries (Dark Ages) until the advent of Islam. A new paradigm had arisen giving reverence and heavenly reward to seeking of knowledge and its implementation to the benefit of society. This triggered rapid development within various fields including science, technology and medicine. It became apparent that people who dealt with the health of others should acquire a solid education, both professionally and ethically. The simultaneous practice of medicine and pharmacy was seen incompatible. In fact, it was felt that by having mutual control between physician and pharmacist provided a much higher degree of safety. This in turn gave rise to the development to Baghdad’s first official pharmacy in the ninth century. A new discipline spread through the Muslim domain where those who prepared the medicines are professionally independent. A new specialist, the pharmacist, had control over the ever increasing number of drugs, and complexity of preparations. This separation of pharmacy from medicine and alchemy, created a class of formally educated pharmacists. Outnumbered by native drug and spice dealers, proper pharmacy licenses became mandatory and the rule is for the physician to write the prescription and the pharmacy to dispense the drug. This new discipline was sustained over the centuries till the present day.
State-sponsored hospitals had their own dispensaries attached to manufacturing laboratories where syrups, electuaries, ointments, and other pharmaceutical preparations were prepared on a relatively large scale. A periodic inspection by a government appointed official called Al-Muhtasib ( Today’s Health and Safety Officer) and his/her aides, ensured that the pharmacist must be complying with the highest of standards at all times.
In fact, the pharmacist was called to “have deep religious convictions, consideration for others, a general sense of responsibility and be careful and God-fearing.”
The shop had to be clean and well stocked, and profits were to be kept moderate [1–20]. The role of the aides was mainly for checking weights and measures, as well as the purity and adulteration of the medicines sold. Such supervision was intended to prevent the use of deteriorated compounded drugs and syrups and to safeguard the public. Furthermore, a code of ethics was formulated and accepted at this time, an important step in the development of any profession. It is worth noting that the first Muhtasib (Health and Safety Officer) in Islam is reported to have been a lady “medic’ by the name of Al-Shifa bin Abdullah, who was a companion of Prophet Muhammad. When Omar bin Al-Khattab became second Caliph, he appointed her as the Muhtasib of Medina (the first capital of Islam) [26].
“Physician Preparing an Elixir”, Folio from a Materia Medica of Dioscorides dated A.H. 621/ A.D. 1224 Figural book painting started in the Islamic world as an art form in the late Abbasid Iraq of the 13th century. The translation of a Greek manuscript shows a Physician preparing an elixir. (Source)
Valuable Contributions from Muslim Civilisation to the Development of Pharmacy
Rhazes (Al-Razi 864–930) was one of the greatest physicians of Muslim civilization. He was also an enthusiastic supporter of alchemy. To a great extent, he influenced the development of pharmacy and alchemy throughout the medieval period. His interest in alchemy and his strong belief in the possibility of transmutation of lesser metals to silver and gold is observable in his two-best known alchemical texts al-Asrar (The Secrets) and Sirr al-Asrar (Secret of the Secrets). In both the books, he discussed the following three topics:
(1) Knowledge and identification of plant-, animal-, and mineral-based drugs and the choicest type of each for utilization in treatment.
(2) Knowledge of tools used that are of interest to both the alchemist and the pharmacist. He classifies these tools into those used for the dissolving and melting of bodies such as the furnace, bellows, crucible, holder, macerator, pot, stirring rod, cutter, and grinder, as well as utensils used in the transmutation procedure, such as the retort, alembic, receiver, other parts of the distilling apparatus, oven, cups, bottles, jars, and blowers.
(3) Knowledge of the seven alchemical techniques such as sublimation and condensation of mercury, precipitation of sulphur and arsenic, calcination of minerals, salts, glass, talc, shells, and waxing.
Rhazes believed that because of the continuous discovery of new data and new truths, present-day knowledge must, by necessity, surpass that of previous generations. Thus, contemporary scholars, because of the accumulated knowledge at their disposal, are better equipped, more knowledgeable, and more competent than the ancient ones. Indeed, what Rhazes did in attempting to criticize the unchallenged authority of ancient knowledge was, by itself, a great step in the right direction. This impulse stimulated research and advances in medicine, pharmacy, and natural sciences. On the practical level, Rhazes warned that even highly educated physicians could not treat all diseases. Nonetheless, he encouraged physicians to continually study medical books and expose themselves to new information in order to keep up with advanced knowledge.
Rhazes was the first in the Muslim world to write a book for the general public, entitled Man la Yahduruhu Tab. He dedicated it to the poor, the traveller, and the ordinary citizen who could consult it for treatment of diseases, such as headaches, colds, coughing, melancholy, and diseases of the eye, ear, and stomach. In its 36 chapters, he described diets and drugs that were practically available everywhere, in apothecary shops, in the marketplace, and in military camps. For a feverish headache, for example, he prescribed:
“two parts of the duhn (oily extract) of rose, to be mixed with part of vinegar, in which a piece of linen cloth is dipped and compressed on the forehead.”
For a laxative, he recommended:
“27 grams of dried violet flowers with twenty pears, macerated and mixed well, then strained. To the filtrate, twenty drams of sugar is added for a draf.”
On completing his encyclopedia, al-Mansuri, on the diagnoses and treatment of bodily diseases, he added a volume at-Tibb ar-Ruhani, on the medicine of the soul. In his famous al-Mansuri, however, Rhazes devoted 4 out of 10 treatises to diets and drugs, medicated cosmetics, toxicology and antidotes, amelioration of laxatives, and compounded remedies, all of which are of pharmaceutical interest. Rhazes’s last and the largest medical encyclopedia is his al-Hawi fi-Tibb, which embraces all areas of medical knowledge of the time. It included sections related to pharmacy in the healing art, Materia Medica arranged in alphabetical order, compounded drugs, pharmaceutical dosage forms, and toxicology. It also included numerous medical recipes and tested prescriptions that influenced medical therapy in the Muslim world and in Europe during the medieval period. Rhazes stated that:
“if the physician is able to treat with foodstuffs, not medication, then he has succeeded. If, however, he must use medications, then it should be simple remedies and not compound ones.”
Medicines were divided into two groups, simple and compound drugs. Physicians seemed to be aware of the interaction between drugs; thus, they used simple drugs first. If these failed, compound drugs were used. If these conservative measures failed, surgery was carried out [1–12,16,17].
Ibn al-Ash’ath (died 975 CE). Like Rhazes and Avicenna, attention to diet and drug therapy was also emphasized by Ibn al-Ash’ath in his two books Quwa al-Adwiyyah and Al-Ghadhi wal-Mughtadhi. In his Quwa, in three treatises, he discusses general principles and regulations for treatment, as well as the properties of plant-, animal-, and mineral-based medicines. In addition, he explained that the five principles concerned with conditions of sickness and health, the air we breathe that surrounds us, sleep and wakefulness, rest and motion, infusion and evacuation, and psychic manifestations, all generate and evolve within our bodies. In addition to these internal factors, he paid attention to what comes into our bodies and affects us from the outside, for example, what we eat and drink as well as the drugs we use to restore health or cure illness. Like Rhazes, he warned against charlatans and ignorant doctors and encouraged practical and theoretical education for healers and continued medical training for hospital internship, residency, and beyond. He concluded:
“For those who collect money are always afraid of losing it, but those (like physicians) who accumulate knowledge endeavor to increase it.”
Al-Majusi. Ali ibn Abbas al-Majusi (died 994), also known as Masoudi, or Latinized as Haly Abbas, is most famous for the Kitab al-Maliki (Complete Book of the Medical Art), consisting of 20 treatises on theatrical and practical aspects of medicine. He encouraged the use of native medicinal plants, as well as animal- and mineral-based products. Al-Majusi divided drugs according to their pharmacological properties into hypnotics, sedatives, antipyretics, laxatives, demulcents, diuretics, emetics, emollients, astringents, and digestants. He described medicinal plants and their parts used as remedial agents, such as seeds, leaves, flowers, fruits, and roots. Concerning the preparation of compounded remedies, he advised physicians to increase or decrease the amount of each included ingredient according to need. Quantities for dosage in each case, Al-Majusi confirmed, should be determined only by the practitioner himself. Finally, he offered a classification system for drugs based on their properties and also described methods of preparing pills, syrups, powders, ointments, and so forth. Other chapters of the book discuss diet, exercise, and even bathing as they relate to health.
In his Al-Maliki, Al-Majusi states that the best way to determine the effects of a drug is to test it on healthy people as well as the sick and to keep careful records of the results. Al-Maliki was first translated in part by Constantine Africanus under the title Pantegno. A complete and much better translation, however, was made in 1127 by Stephen of Antioch. It was first printed in Venice in 1492 by Bernard Rici de Novaria and in 1523 in Venice and Lyons. This work, as that of Rhazes, Avicenna, and Al-Zahrawi (Albucasis), continued to circulate and influence medicine and pharmacy in Europe for over five centuries [1–12].
Abu ar-Rayhan al-Biruni (973–1050). Important contributions to pharmacy were also made by Al-Biruni, who studied drugs, physical properties, and their symptoms both in books and by examining available specimens. Among Al-Biruni’s works, his as-Saydanah fit-Tib on pharmacy and materia medica are the most notable. It comprises two important, distinct, and separate sections. The first, and the most original, contains authentic definitions of pharmacology, therapeutics, and related fields of the healing arts, lexicology and lexicography, toxicology, omissions and substitutions of drugs, and their synonyms. It also contains important historical and biographical information not found anywhere else in the medieval literature. The second section of as-Saydanah is devoted to materia medica. In this, Al-Biruni explains over 700 natural remedies, conveniently and scrupulously arranged in alphabetical order.
In addition, in his as-Saydanah fit-Tib, Al-Biruni defines the pharmacist as the person who is specialized in the collection of all remedies. It is the responsibility of the pharmacist to choose the best of each simple or compound remedy and prepare good drugs from them, following the most accurate techniques as recommended by skilled physicians. He strongly supported the separation of pharmacy from medicine. He postulated that pharmacy must provide the tools to help in the healing process, but is not a part of medicine. Al-Biruni claimed that many so-called pharmacists were not worthy of the name and that all their knowledge was rooted in hearsay concerning the preparation of drugs. He emphasized that pharmaceutical progress resulted only from academic training and day-to-day practical experiences with remedies. As a result, these trainees would become more and more familiar with the identification of remedies, for example, shapes, physical properties, and kinds of drugs, and would possess skilled and technical knowledge.
According to Al-Biruni, the word saydanani is originated from the Indian jandanani. In India sandalwood (or jandan) was used extensively, more than other aromatic woods. In Arabic, the person who deals with sandalwood or jandan was called sandalani and later saydalaneh. In general, the Arab apothecaries (al-‘attar), who sold perfumes and aromatics, did not use sandalwood as often as the Indians.
Abu ar-Rayhan al-Biruni (973–1050): Al-Biruni gave in his as-Saydanah fit-Tib on pharmacy and materia medica one of the finest definitions of the pharmacist, pharmacy, drugs, and their action. This book represents one of the finest contributions to pharmaceutical science during the medieval period and a great masterpiece of all times. Indeed, it stands as one of the most original texts in Arabic on the subject. The book is republished on the on the occasion of a conference celebrating a 1000 years after Al-Biruni, in Pakistan. See picture of the book cover and a postage stamp in his memory. (Source)
They excluded sandalwood, primarily, because it was not a popular wood in Arab world. The word drug (‘uqqar), Al-Biruni stated, comes from the Syriac word for the stump of a tree (root and Greek rizoma). This word (uqqar) was later applied to all the parts of the tree and was taken by the Arabs to mean a materia medica.
In his as-Saydanah fit-Tib, Al-Biruni classified the substances taken internally into three classes: The first class includes foods that are digested and assimilated to replace what has been lost. Thus, foods were first affected by the body and then they affected it for its own nourishment. The second class includes poisons that negatively affect the body’s activities, inducing diseases or death depending on their potency, as well as the body’s resistance. The third class includes drugs that fall between class one and class two and their effectiveness as remedies depends on the capability and qualifications of the physician who prescribes them.
As-Saydanah fit-Tib represents one of the finest contributions to pharmaceutical science during the medieval period and a great masterpiece of all times. Indeed, it stands as one of the most original texts in Arabic on the subject. how to compound them into drugs according to physician’s prescriptions. Therefore, a qualified pharmacist should also be able to substitute or discard one drug for another. The theoretical knowledge of how drugs affect the body, however, is more important than the mere skill of preparing them. In substituting one drug for another, the various actions of each should be considered and accounted for. Cure can be sought through a draft, ointment, anointing oils, or by fumigation. Therefore, in seeking a substitute, all these and other applications should be taken into account. Without this knowledge, one falls short of professional goals. According to Al-Biruni, enthusiasm for the search for new remedies and their actions was much stronger in the Maghreb (North Africa) and Andalusia than in the Eastern Caliphate. Still greater activities are known to exist in India, but these follow different principles and approaches from those practiced in the Muslim world. These differences have limited the contact and dissemination of knowledge with India [1–12].
Ibn al-Baitar (Died 1248) was one of the greatest scholars of Andalusia and was the greatest botanist and pharmacist of the medieval time. His search for medicinal plants extended over a vast area including Arabia and Palestine that he either visited or managed to collect plants from. Kitab al-Jami fi al-Adwiya al- Mufrada, the major contribution of Ibn al-Baitar, is one of the greatest botanical compilations dealing with medicinal plants in Arabic. It enjoyed a high status among botanists up to the sixteenth century and is a systematic work that embodies earlier works, with due criticism, and adds a great part of original contribution. It comprises some 1400 different items, largely medicinal plants and vegetables, of which about 200 plants were not known earlier. The book refers to the work of some 150 authors, mostly of Arab origin, and it also quotes about 20 early Greek scientists. Kitab al-Jami fi al-Adwiya al-Mufrada was translated into Latin and published in the second half of the eighteenth century.
Kitab al-Mlughni fi al-Adwiya al-Mufrada is an encyclopedia of medicine in which he lists the drugs in accordance with their therapeutic value. Thus, its 20 different chapters deal with the plants bearing significance to diseases of the head, ear, eye, and so on. On surgical issues, he has frequently quoted the famous Muslim surgeon, Abul Qasim Zahrawi. Besides Arabic, Baitar has given Greek and Latin names of the plants, thus, facilitating the transfer of knowledge. Ibn al-Baitar’s contributions are characterized by observation, analysis, and classification and have exerted a profound influence on both Eastern and Western botany and medicine [1–12,15].
Al-Kindi (Alkindus, 800–873). A few books related to pharmacy were written by Al-Kindi, known as the philosopher of the Arabs. He became a prominent figure in the House of Wisdom, and a number of Abbasid Caliphs appointed him to oversee the translation of Greek texts into the Arabic. This contact with “the philosophy of the ancients” had a profound effect on his intellectual development and led him to write original treatises on subjects ranging from Islamic ethics and metaphysics to Islamic mathematics and pharmacology. Al-Kindi was the first to systematically determine the doses to be administered of all the drugs known at his time. This resolved the conflicting views prevailing among physicians on the dosage that caused difficulties in writing recipes [1,2].
Development of Arab–Islamic pharmacy. Chemists such as Jaber ibn Hayan started to search for methods to extract and purify different compounds. Avicenna devoted a whole volume to simple drugs in Canon. He described about 700 preparations and introduced systematic experimentation and quantification into pharmacology. Rhazes promoted the medical uses of chemical compounds. Al-Zahrawi described a large number of recipes and explained how to prepare both simple and complex drugs. Shapur ibn Sahl, was, however, the first physician to initiate pharmacopoeia, describing a large variety of drugs and remedies for ailments. Al-Biruni gave in his as-Saydanah fit-Tib a detailed knowledge of the properties of drugs and outlined the role of pharmacy and the functions and duties of the pharmacist. Al-Kindi introduced the application of mathematics into medicine.
Drug Discovery Methods of Pharmacy used in Muslim Civilisation
The selection of potential natural products was based on knowledge acquired by traditional healers in the pre-Islamic period through a long history of trial and error and then by theoretical and practical knowledge introduced by the Holy Quran or by the Prophet Mohammad (PBUH), for example, honey, milk, dates, black seeds, olive leaf, and olive oil. Furthermore, the vastness of the Arab empire and the fact that Arabs and Muslims from the farthest corners met each other while on pilgrimage to Mecca provided the exchange of both ideas and goods between people from India and China as well as from Spain. Thus, a lot of new medicines were introduced, such as acajou wood, amber, amomum, ammonia gum, areca, berberis, nux vomica, cassia fistula, cubeba, dragonblood, galenga, ginger, jasmin, jujubae, camphor, clove, manna, nutmeg, mace, musk, myrobalanes, oranges, rhubarb, sandalwood, sarcocolla, senna leaves, refined sugar, tamarind, turbith, zedoaria, and so on [3,4,13–20].
Herbal-Based Remedies. Complex pharmaceutical literature on medicinal plants and their preparation and applications was introduced by physicians and pharmacists of Muslim civilisation. These works combined theoretical and practical aspects of medicine, pharmacy, and botany with highly accurate precision and detail. They introduced many new concepts and upgraded knowledge about herbs and their potential medical properties. In pharmacy, books on materia medica and for instructing the pharmacist concerning the work and management of his shop circulated in increasing numbers. To keep within the scope of this paper, only a few authors and their important works will be briefly discussed.
Al-Kindi (Alkindus) introduced for the first time a scale to define the drug degrees in order to allow physicians to quantify the potency of their prescriptions. In addition, he wrote numerous encyclopedias on herbs and their pharmaceutical properties, with highly accuate precision. Al-Dinawari (828–896) is considered to be the founder of Arabic botany for his Book of Plants, in which he described about 640 plants and their growth phases. In 1161, Ibn Abil-Bayan of Spain published The Bimaristan Law in Pharmacopoeia, Materitenses containing 607 detailed medications. Ibn Zuhr (Avenzoar), who lived in Seville (1091–1161), wrote the Al Kitab Al Jami, about liquids and creams. This book includes 230 medications that are mostly herbal, with a few of animal and mineral origin. This book gives a full description of the uses of herbs, including roots, seeds, or leaves. In the early thirteenth century, the Andalusian-Arabian biologist Abu al-Abbas al-Nabati published several books and dictionaries on the use of medicinal plants describing each plant species, the plant parts used, the preparation procedure used for each remedy, and the treatment procedure of certain diseases. Ibn al-Baitar (1197–1248) published The Book on Drinks and Foods, containing 260 references, and it is the most prestigious book in the Arabic pharmacopeia.
Al-Antaki characterized in his Tadhkirat Uli l-al-Bab wa l-Jami li-L-‘Ajab al-‘Ujab 57 plants that were used as sources for simple and complex drugs. These included birthwort (Aristolochia sp.), carob (Ceratonia siliqua), castor oil plant (Ricinus communis), common fennel (Foeniculum vulgare), common myrtle (Myrtus communis), Egyptian balsam (Balanites aegyptiaca), great horsetail (Equisetum telmateia), Leopardus-bane (Doronicum scorpioides), autumnmandrake (Mandragora autumnalis), paper reed (Cyperus papyrus), Persian cyclamen (Cyclamen persicum), saffron (Colchicum sp.), serapias (Polypodium sp.), sycamore fig (Ficus sycamorus), and Syrian bryony (Bryonia certica). Furthermore, Al-Antaki mentioned nonindigenous plants that were brought to the area specifically for their medicinal applications, such as Cornelian cherry (Cornus mas), purging croton (Croton tiglium), and gardenia (Gardenia sp.). He also described pharmacological uses of typical agricultural crops, such as caraway (Bunium pauciflorum), carrot (Daucus carota), wild coriander (Coriandrum sativum), pear (Pyrus communis), quince (Cydonia oblonga), sugarcane (Saccharum officinarum), and walnut (Juglans regia). The traditional and medicinal uses of many of these plants are described in several recent publications [21-25].
Abu Hasan al-Tabari (808–870), a younger colleague of Ibn Masawayh, wrote several medical books, the most famous of which is his Paradise of Wisdom. It discusses the nature of man, cosmology, embryology, temperaments, psychotherapy, hygiene, diet, and diseases, both acute and chronic, and their treatments. In addition, the book contains several chapters on materia medica, diets, utilities, and therapeutic uses of animal and bird organs, as well as of drugs and methods of preparation.
Al-Tabari urged the physicians to choose the best of remedies in accordance with the particular case. He was also precise in describing his therapeutics. He said:
“I have tried a very useful remedy for swelling of the stomach; the juices of the liverwort (water hemp) and the absinthium after being boiled on fire and strained to be taken for several days. Also powdered seeds of celery (marsh parsley) mixed with giant fennel made into troches and taken with a suitable liquid release the wind in the stomach, joints and back (arthritis).” To strengthen the stomach and to ensure good health, he prescribed “black myrobalan powdered in butter, mixed with dissolved plant sugar extracted from the licorice and that this remedy should be taken daily.”
He recommended glass or ceramic vessels for storage purposes of liquid drugs, special small jars for storage of eye liquid salves, and lead containers for storage of fatty substances. Furthermore, he highlighted the importance of the origin of the used remedies. For example, black myrobalan comes from Kabul, clover dodder from Crete, aloes from Socotra, and aromatic spices from India. It is likely that Al-Tabari’s recommendations built the basis for the current WHO guidelines. These WHO guidelines include botanical identity, scientific name, including genus, species, subspecies, or variety and family of the potential plant, and, if available, the local name should also be verified. Furthermore, WHO guidelines highlight the importance of obtaining data regarding environmental conditions, such as soil, climate, and vegetation at the collection site.
Al-Aqrabadhin book, by Sabur ibn Sahl (died 869) represents one of the earliest pharmacopoeias in Arabic. It contains details of pharmaceutical recipes, including methods and techniques of compounding drugs, their actions, dosages, and means of administration. The recipes are organized in accordance with their administration form, for example, tablets, powders, ointments, electuaries, or syrups. Each class of preparation is represented along with a variety of recipes made in a specific form; however, they vary in the ingredients used and their recommended uses and therapeutic effects. Many of these remedies are remindful of similar formulas given in ancient documents from ancient civilizations.
In his Ten Treatises on the Eye, Hunayn ibn Ishaq (809–873) devoted one treatise to compounded drugs for the eye. He extracted some recipes from earlier treatises and added more prescriptions recommended by Greek physicians. As one example of the uses and therapeutic values of using compounded drugs, Hunayn gave that of the theriac, the universal antidote against poisoning. Hunayn defined the Greek word theriake as an animal that bites or snaps. Since these antidotes were used against animal bites, the word eventually was applied to all antidotes, especially when snake flesh was incorporated.
Animal-Based Remedies. A wide range of animals and their products were used as a source for drugs to treat skin diseases, bleeding, wounds, internal disease, hemorrhoids, animal bites, and sex-related diseases. These substances were divided into wild animals, domesticated animals, parasites of humans or domesticated animals, rare animal substances, and exotic animal substances, such as common beaver, musk, pearl, Spanish fly, and spermwhale that were imported from distant lands via the trade routes and therefore were “exotic.”
Al-Antaki described in his Tadhkirat Uli l-al-Bab wa l-Jami li- L-‘Ajab al-‘Ujab the therapeutic effects of many animal-based drugs. For instance, cow cheese was used to treat scabies, to relieve burning sensations in the urinary tract, to treat kidney problems, and as an aphrodisiac. The internal organs of the mule were used as painkillers and to prevent inflammation of the joints. Many of the animals that were mentioned in historical texts of the Greco-Arab and Islamic world currently remain in use in traditional medicine in the Muslim world. For instance, in Iraq 12 kinds of animals are described as medicinal sources, including sea sponge, cow, camel, bee, fish, squid, sheep, nacre, and silkworm.
Minerals and Metals. Like many other early writers, Al-Antaki describes the use of asphalt in medicine. Asphalt was used medicinally to stop a racing heartbeat, strengthen the stomach, treat infections in the spleen and liver, and stop diarrhea. It was also taken as an aphrodisiac. An additional mineral mentioned is the Jew’s stone, also called Zaitun bani Israil, which Al-Antaki identified as a stone found in Jerusalem and Bilad al-Sham. It dissolves kidney and bladder stones, its powder treats wounds, and when mixed with honey, it softens calluses and hard skin. Iron rust was used to treat skin and eye conditions and was used as a cosmetic. Rust was also used as a contraceptive, as well as to eliminate hemorrhoids and treat diarrhea.
Al-Antaki mentioned the medicinal use of dry earth, particularly the Sidon earth, which comes from a cave outside the city of Sidon in Lebanon. This earth was known for its efficacy in knitting together fractured bones. Another type of earth or clay is the mineral hematite, identified by its red–yellow hues, which was used to stop haemorrhage and diarrhea, to treat skin diseases and high fever, to reduce swellings, and to clean infected sores. Petrified spines of sea urchin were used to open obstructions in the renal system and dissolve renal stones (bladder as well as kidney stones). Other uses included treating stings, bites, and wounds and the softening of hard skin [1–3,14].
Pharmaceutical Regulation
Throughout the Islamic Golden Age, from the ninth through the fifteenth centuries, there were many regulations that were highly regarded and strictly followed by educated pharmacists. These pharmacists were highly esteemed in their communities. In centers of science and culture, such as Baghdad, rulers issued decrees regulating pharmacy practice, whenever the situation demanded it. There were also government officials, such as Al-Muhtasib and his aides, who supervised markets, sales of commodities, weights and measures, and the professions, including pharmacy and medicine, to curb adulteration and social violations and safeguard the public. Both rulers and patrons of learning gave support and protection to health practitioners.
Physicians and pharmacists gained great fame and trust among the public. Furthermore, expanding trade in the vast Muslim world and the great demand for medicines brought added prestige to the profession. Under these circumstances, Arab pharmacy developed and matured. Literary contributions of practitioners were noteworthy. These commendable developments influenced the rise of professional pharmacy in Europe and enriched available literature in pharmacy and related fields [1–12].
References
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Bashar Saad, PhD, is Professor of cell biology and immunology at the Arab American university in Jenin, Palestine, and at Al-Qasemi Academic College, Baga Algharbiya, Israel. He made a significant contribution in combining cell biology, immunology, and 3D cell culture techniques with Arab-Islamic herbal wisdom. His research interests include antidiabetic, anti-inflammatory and anticancer properties of medicinal plants. He has written more than 150 original papers as well as review articles and book chapters on Arab-Islamic herbal medicine.
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Omar Said, Phd, is the Chief Research Officer and founder of BeLeaf Pharma. He is a pioneer in the field of Greco-Arab medicine, herbal medicine and pharmacology. He serves as the head of the Arab medicinal plant project in the Galilee Society R&D regional centre, Israel. He has a PhD in Pharmacology. As an expert in the fields of pharmacology and ethnopharmacology, he made a significant contribution in combining this modern science with the medicinal plants’ tradition. His research interests include diabetes, obesity, fertility, psoriasis, acne, hyper-lipidemia, and liver diseases. He has written more than 65 original papers as well as review articles and book chapters on Arab-Islamic herbal medicine.
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