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A History of Muslim Pharmacy:

Arabic Alchemy During the Fourth/Tenth Century

Throughout the third/ninth and fourth/tenth centuries, alchemy continued to win adherents, as well as arouse opponents to its validity. In this study, only certain important aspects of its development will be briefly discussed. One aspect is the peculiarity that some learned men of high caliber and great prestige would propagate this art. Another oddity is the fact that literary contributions by some alchemists lured many a scholar to stand in awe of these magical procedures and operations and the elegance with which they were described. A good example is the biography of Abu Bakr Mohammed ar-Razi (250-312/865-925), and his alchemical writings. He was one of the greatest physicians in Islam, but at the same time an ardent supporter of the art of alchemy. To a great extent, he influenced the development of alchemy, pharmacy, and medical therapy throughout the Middle Ages. For this reason, his literary contributions to these areas of Islamic Science will be discussed briefly.

Ar-Razi's interest in alchemy and his strong belief in the possibility of transmutation of lesser metals to silver and gold was confirmed half a century after his death by Ibn an-Nadim. He attribute a series of twelve books to ar-Razi, then seven more, including his refutation to al-Kindi's denial of the validity of alchemy, and finally, ar- Razi's two best known alchemical texts; al-Asrar and Sirr al-Asrar (the secrets, and secret of secrets). These two works were not only among ar-Razi's last publications on alchemy, but they superseded his earlier ones as the final representation of his alchemical teachings. The latter text incorporates much of the former (al-Asrar).

Therefore, a survey of the Sirr al-Asrar will hopefully throw some light on ar- Razi's rational approach and technical procedures, and which represent the highest expression of alchemical knowledge during this period.

This book was written in response to a request from ar-Razi's close friend, colleague, and former student, Abu Mohammed b. Yunis of Bukhara, a Muslim mathematician, philosopher, and ia natural scientist of good stature In Sirr al-Asrar, ar-Razi divides his subject matter into three categories as he did in his book al-Asrar.

1. Knowledge and identification of drugs from plant, animal, and mineral origins and the choicest type of each for utilization in treatment.
2. Knowledge of equipment and tools used, which are of interest to both the alchemist and the apothecary.
3. Knowledge of the seven alchemical procedures and techniques such as sublimation and condensation of mercury, precipitation of sulphur and arsenic calcination of minerals (gold, silver, copper, lead, and iron), salts, glass, talc, shells, and waxing.

This last category contains, in addition, a description of other methods and piratical applications used in transmutation: the admixture and uses of solvent vehicles, the amount of heat (fire) used, 'bodies and stones' that can or cannot be transformed into corporal substances of metals at Id salts, and the liquid mordant that quickly and permanently color lesser metals for better sales and profits.

Similar to the discussion on the third/ninth-century text on Amalgams ascribed to Jabir, ar-Razi describes methods and procedures or coloring (gold leafing) a silver object to imitate gold.  Also described is the reverse technique for removing the color and returning it to silver. Gilding and silvering of other metals ( alum, calcium salts, iron, copper, and tutty) are also described, as well as how colors will stay for years without tarnishing or changing. The procedures involved no deceptive motive, but rather technical and economic deliberations. This is evident from the author's quotation of market prices and the technical triumph of artisan, craftsman, or , alchemist in declaring the results of their efforts so that 'it will look exactly like gold!   There was, however, another similar motive involved, namely, to manufacture something to resemble gold for easy sale to help a good friend who happen to be in need of quick money.  It could be due to this trend in ar-Razi's alchemical technique for silvering and gilding of metal that man,.' Muslim biographers concluded that he was first a jeweler before he turned to alchemy.

Of interest in the text is ar-Razi's classification of minerals into six divisions,  giving his discussion a modern chemical connotation:
1.  Four spirits: mercury, sal ammoniac, sulphur, and arsenic.
2.  Seven bodies; silver, gold, copper, iron, black lead (plumbago), zinc, and tin.
3 . Thirteen stones including marcasite, magnesia, malachite, tutty, talcum, lapis lazuli, gypsum, and glass (then identified as as made of sand an d alkali of which the transparent crystal Damascene is considered the best).
4. Seven vitriols including alum, and white, black, red, and yellow vitriols (the impure sulphates of iron, copper, etc.).
5. Seven borates including the tinkar, natron, and impure sodium borate.
6. Eleven salts including brine, common (table) salt, ashes, naphtha, live lime, and urine, rock, and sea salts. Then he separately defines and describes each of these
substances and their choicest kinds and colors and possible adulterations.

Concerning the tools and equipment of the alchemist, ar-Razi classifies them into two kinds:

1. Utensils used for the dissolving and melting of bodies such as the furnace, bellows, crucible, holder (tongue or ladle), macerator, pot, stirring rod, cutter, and grinder.
 2. Utensils use(j to carry out the operation of transmutation, such as the retort, alembic, receiver, other parts of the distilling apparatus, oven (stove), cups, bottles, jars, pans, and blowers.

The instructions given are minute and detailed showing intimate knowledge of the procedures, materials, and technology involved.

To illustrate one aspect of this operation, ar-Razii relates the following story. He once went on a trip to Baghdad. There, the scholar al-Hakim al-Hamadani heard of ar-Razi's visit and came with his friends to welcome him. Among the subjects they discussed was alchemy. Ar-Razi, using the elixir, gilded two metals so that they looked exactly like true gold. His viewers watched with admiration and astonishment.

Later alchemists, nonetheless, departed greatly from these leading guidelines that ar-Razi had described with precision and thoroughness in his two books. As a result, the whole art suffered disrepute and setbacks, especially during the latter period of medieval Islamic science.

In addition to ar-Razi's alchemical writings, Ibn an-Nadim mentions 115 works and 30 epistles, a majority of them on natural sciences and the healing arts, including commentaries, abstracts, and refutations. Ibn an-Nadim also identifies briefly the five areas in which ar-Razi distinguished himself:

1. Ar-Razi was recognized as the best physician of his time who had fully absorbed the Greek medical learning.
2. He traveled in many lands. His repeated visits to Baghdad and his services to many princes and rulers are known from many sources.
3. He was a medical educator who attracted many students, both beginners and advanced.
4. He was compassionate, kind, upright, and devoted to the service of his patients whether rich or poor.
5. He was a prolific reader and writer and has authored many books, the titles of which were cited by Ibn an-Nadim and other Muslim biobibliographers of physicians and philosophers.

The best survey of ar-Razi's works from the medieval period seems to be an epistle by al-Biruni written about 4:28/1037.  Through this epistle, can be seen concealed sides of ar-Razi's life and his contributions as a prolific author and compiler to pharmacy, pharmacology, and medical therapy. To understand and appreciate him fully, however, one should look upon him as the product and in the context of his time (250-312 / 865-925). For in the West and Byzantium this was an. Age of Faith,  important to our discussion here, therefore, is his courageous attack of errors in the medical and philosophical teachings of the ancients. For it was ar-Razi who wrote a book, Shukuk 'ala Nazariyat jalinus, in which he doubted the accuracy in many medical, physiological, and therapeutic concepts, theories, and procedures as stated by Galen and which were blindly accepted and transmitted by his followers and later compilers and commentators.

Interestingly, ar-Razi foresaw that mainly because of his doubts on Galen, many would attack him bitterly and accuse him of ignorance, malice and misconception, a fact that no sooner was reported as having been said than his expectations were confirmed. Yet it was ar-Razi who repeatedly expressed praises and gratitude to , Galen for his commendable contributions and labors. Ar-Razi explained in the introduction to his Shukuk, 'I prayed to Allah 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 servant (disciple). But all this reverence and appreciation will and should not prevent me from doubting, as I did, what is erroneous among his theories. I imagine and feel deep in my heart that Galen has chosen me to undertake this task, and if he was 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 to bring light out of darkness. Indeed I wish he was alive to read what I have published'.

Thereafter, ar-Razi, with a view to vindicate Galen's greatness and to justify his criticism of him, lists four reasons why great men make errors more than others:
1. Because of negligence, as a result of too much self confidence.
2. Because of unmindfulness (indifference) which often leads to errors.
3. Because of enticements to follow one's Own fancy or impetuosity in imagining that what he does or says is right.
4. Crystallization of ancient knowledge in view of the dynamic nature of science so that present day knowledge must of necessity surpass that of previous generations. This is because of the continuous discoveries of new data and new truths. Ar-Razi believed, and rightly so, that contemporary scientists and scholars, because of accumulated knowledge at their disposal. are, by far, better equipped, more knowledgeable, and competent than the ancients.  Indeed, what ar-Razi did in attempting to overthrow blind reverence and the unchallenged authority of ancient sages was, by itself, a great step in the right direction. This impetus encouraged and stimulated research and advances in the arts, 'technology, and the sciences. It unshackled the human spirit for greater and more fasting achievements.

On the professional level, ar-Razi introduced many useful, progressive, medical and psychological ideas. He also attacked charlatans and fake doctors who roamed the cities and the countryside selling their nostrums and 'cures'. At the same time, he warned that even highly educated doctors did not have the answers for all medical problems and could not cure all sicknesses or heal every disease. Humanly speaking, this is an impossibility. Nonetheless, to be more useful in their services and truer to their calling, ar-Razi exhorted practitioners to keep up with advanced knowledge by Continually studying medical books and expose themselves to new information. He further classified diseases into three categories: those which are curable; those that can be cured; and those which are incurable. On the latter, he cited advanced cases of cancer and leprosy which if not cured, the doctor should not take blame. Then, on the humorous side, ar-Razi pitied physicians caring for the well being of princes, nobility, and women, for they did not obey doctor's orders for restricted diet and medical treatment, thus making most difficult the task of their doctor.

This writer is inclined to believe that ar-Razi was the first in Islam to deliberately Write a book -home medical (remedial) advisor -entitled Man la Yahduruhu Tab for the general public. He dedicated it to the poor, the traveler, and the ordinary citizen who could consult it for treatment of common ailments when the doctor was not available. This book, of course, is of special interest to the history of pharmacy since books on the same theme continued to appear and has found acceptance by readers to the present century. In its 36 chapters, ar-Razi described diets and drugs that can be found practically every where in apothecary shops, the market place, in well-equipped kitchens, and in military camps. Thus, any intelligent mature person can follow its instructions and prepare the right recipes for good results. Some of the illnesses treated are headaches, colds, coughing, melancholy, and diseases of the eye, ear, and stomach. In 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 'seven drams of dried violet flowers with twenty pears, macerated and mixed well, then strained. To the filtrate, twenty drams of sugar is added for a draft'. In cases of melancholy, he invariably recommended prescriptions including either poppies or their juices (opium) or clover dodder (Curcuma epithymum Muss.) or both. For an eye remedy, he recommended myrrh, saffron, and frankincense, two drams each to be mixed with one dram of yellow arsenic and made into tablets. When used each tablet was to be dissolved in a sufficient quantity of coriander water and used as eye drops.

Ar-Razi followed the same method in his book Bur as-Sa'ah, in which he prescribed remedies to cure ailments in one hour, or at least in a short time, so that the patient did not need frequently to call on his doctor and to pay larger fee.

In his other book on diets, their uses and disadvantages, Mnafi' al-Aghdhiyyah, ar-Razi followed a pattern that had been introduced earlier by Galen. In it, ar-Razi attempted to correct several errors made by Galen and to introduce new data missed by the latter.

Ibn Masawayh was another physician who wrote on the same topic. According to ar-Razi, Ibn Masawayh did more harm than good in his exposition of the subject. These misgivings challenged ar-Razi to undertake the writing of a comprehensive study, Manafi', which is of great interest not only to pharmacy and medicine but to the history of the culinary art as well. Emphasizing specific matters and general regulations for healthy living, ar-Razi discussed breads, waters, dairy products, fruits, vegetables, spices, meats, and fishes. He explained in detail their kinds, methods of preparation, physical properties, and therapeutic modes of action, and pointed out when they were useful and when not. Of wines, for example, he mentioned whether they were made of grapes of raisins, their color, taste, and preferred use in the particular situations. He concluded by describing the disadvantages of frequent consumption of wines leading to alcoholism, 'which often causes many serious diseases as epilepsy, paralysis, senile tremor in older people, cirrhosis, hepatitis, mental disorders, visionary distortions, obesity, debility, and impotence.

While ar-Razi paid much attention to curing the body's ills, he did not ignore cures for infirmities of the soul. The proof of his concern for psychotherapy seems quite evident. On completing his medical encyclopedia, al-Mansuri, on the diagnoses and treatment of body diseases, he filled in the gap by writing a counterpart at- Tibb ar-Ruhani on the medicine of the soul. Both works (completed about 293-294/ 906-907 respectively) were written for, and dedicated to, ar-Razi's great patron, Prince Abu Sajih Mansur b. Ishaq b. Ahmad b. Asad. In the twenty chapters of at-Tibb ar-Ruhani, ar-Razi, discussed with objectivity, farsightedness, and mature understanding of human nature and desires, such topics as human passions, vices, pleasures, lust, anger, pain, miserliness, drunkenness, virtue and death.  His concern for, and penetration into, human nature, its complexities, and the directions leading into it, confirm his appreciation of the importance of psychotherapy and psychology as two important parts of the healing art.

In his famous al-Mansuri, however, ar-Razi devoted four out of the book's total of ten treatises, to diets and drugs, medicated cosmetics, toxicology and antidotes, amelioration of laxatives, and compounded remedies, all of which are of pharmaceutical interest.

Ar-Razi's last and largest medical encyclopedia is his al-Hawi fit-Tibb, which embraces all areas of medical knowledge of the time. This huge compilation of sayings and interpretations by the ancients, Arabic physicians, and ar-Razi was gathered and edited after the author's death by h is students. Inevitably, 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 Islam and in the West during the Middle Ages.

In his use of mineral drugs as external and internal remedies, including vitriols, copper, mercuric and arsenic salts, sal ammoniac, gold scoria, chalk, clay (as in the terra sigillata and Armenian clay), coral, pearl, tar, and bitumen, ar-Razi, encouraged and pioneered chemotherapy in Islamic medicine.

Although he recommended poppies and opium internally as somniferous agents and to quiet coughing, and externally to relieve eye and wound pains, he warned against their deadly effects (two drams are fatal).

Attention to diet and drug therapy was likewise emphasized by Ahmad b. Abi al-Ash'ath in his two books; Quwa al-Adwiyyah and al-Ghadhi wal-Mughtadhi (com- completed around 353/965).

In his Quwa, in three treatises, Ibn Abi al-Ash'ath discusses general rules and regulations for medicinal treatment; the properties of vegetable, animal, and mineral drugs obtained from the three natural kingdoms and those mineral-like drugs manufactured by man, such as cinnabar and tutty, and their uses and advantages. The book was dedicated to the author's two students, Mohammed b. Ayyub Ibn ath-Thallaj of Mosul, and Ahmad b. Mohammed al-Baladi. Ibn Abi al-Ash'ath described the three principles connected with sickness and health: receptive body; apparent symptoms; and unavoidable operative causes. Medicine, therefore, explores general laws of body conditions; symptoms and their interpretations; and causes and their effects.  He explained that the five principles concerned with conditions of sickness and health -the air we breath and that surrounds us sleep and wakefulness rest and motion, infusion and evacuation, and psychic manifestations -all generate and evolve within our bodies. But what comes to our bodies and affects us from the outside is the principle that involves what we eat and drink as well as the drugs we use to restore health or to cure diseases.

To simple drugs, the author assigned primary efficacy functions (generating powers): heat, moisture, dryness and cold; and secondary efficacy functions, e.g., their uses and pharmacological advantages. He warned against charlatans and ignorant doctors' and encouraged academic training for practitioners and continued medical education for hospital internship, residency and beyond. He concluded, 'For those who collect money are always afraid to lose it, but those (like physicians) who accumulate knowledge endeavor to increase it

In his earlier work, al-Ghadhi, in two treatises, Ibn Abi al-Ash'ath not only described the anatomy and physiology of body organs but also animal organs used in diet therapy.

Of interest to psychotherapy, however, is the author's treatise on sleep and wakefulness, in six chapters. In it he confirms that the act of sleep is under the control (or one of the functions) of the brain, just as jaundice is connected with the liver. Sleep is not to be compared with death; they are two different things.  Sleep gives rest from labor (active motion) of the brain which consists of contemplation, memory (reminiscence), and imagination. Sleep increases with cold. When the brain reacts to slumber, one awakens. The author concluded by dividing sleep into three types: the first stage; sleep with dreams; and deep sleep without dreams.

Little is known of Ibn Abi al-Ash'ath's younger contemporary and countryman, al-Majusi. He received his medical training under the tutorship of Abu Mahir Musa b. Sayyar. AI-Majusi served King' Adud ad-Dawlah (d. 372/983) to whom he dedicated his only known medical compendium, al-Maliki (Liber Rigius). This encyclopedia consists of twenty treatises on the theory and practice of medicine (ten on each). In them, the author encourages the use of indigenous medicinal plants, as well as animal and mineral products. Using minerals -chalk, Armenian clay (bole), red ochre, terra sigillata, marcasite (Pyrites), natron, sal ammoniac, vitriols, burned copper, and ii naphtha -internally and externally encouraged chemotherapy as utilized by his predecessors, ar-Razi (d. 312/925), and others.   He emphasized in the treatment of patients that in addition to natural principles, age, sex, dichotomy of colors, and facial complexions should also be taken into consideration.

Interesting also were some of al-Majusi's physiological interpretations. He spoke of the two opposing movements generated by the animal vital spirit: expansion and contraction which in regard to heart and arteries constitute the diastole and systole, and inspiration and expiration with regard to the respiratory organs. He compared these two opposing movements to a bellows. The difference is that they are produced by an internal (innate) spirit, while an external force operates the bellows. He then explained that after lungs inhale air from the outside, they expel the vaporized (smoky) superfluities during exhalation. When the heart draws air from the lungs, it mixes with the blood and augments the vital spirit. He defined temperaments as pertaining to the management of life, and action as tools to help carryon the functions of nature and the soul in animals and plants. He described the veins as haying pores that open toward the arteries and pass light blood. He cited as proof the fact that if a vein is cut, it spews out all the blood it contains. Respiration, he continued, takes place through contraction and expansion during which the arteries, especially those close to the heart, evacuate air and blood; and through expansion draw air and light blood from the heart to fill the vacuum created by contraction. Blood formation and body growth results from digested and assimilated food, and takes place in three stages, through the natural faculties which attract, hold, digest, and expel.

Concerning physical exercises, al-Majusi explained that they increase and nourish innate heat for a better metabolism, to widen the pores, to rid the body of superfluities and to strengthen the organs.

Also of interest in al-Majusi's al-Maliki, are the two sections devoted to specific skin diseases such as leprosy, sores, skin ulcers, abscesses, pimples, swellings, car- buncles, rashes, wounds, and poisonous animal bites, as well as dermatology at large.

Al-Majusi divided drugs according to their pharmacological action as hymnotics, sedatives, antipyretics, laxatives, demulcents, diuretics, emetics, emollients, astringents, and digestants. He described medicinal plants and their parts used as remedial agents: seeds, leaves, flowers, fruits, and roots. He also had special chapters on gums, extracts, and plant juices, as well as mineral drugs used for external or internal treatment. He urged practitioners to collect them until need for their use arose. He seemed to have little use for pharmacists, and wanted physicians to compound or to supervise the preparation of their own medications. He recommended application of a purity test against drug adulteration. He said, for example, that the best kind of aloes is reddish in color and which turns darker when breathed upon (introducing  carbon dioxide).

In the preparation of compounded remedies, the author advised doctors to increase or decrease the amount of each included ingredient according to need. Quantities for each dosage in each case, al-Majusi confirmed, should be determined only by the practitioner himself. Finally, he described compounded drugs in the various pharmaceutical forms: lohocks, decoctions, powders, robs, and dentifrices.

Al-Majusi's al-Maliki was translated first in part by Constantine Africanus (d. 479/1087), under the title Pantegno. A complete and much better translation, however, was made in 520/1127 by Stephen of Antioch. It was printed first in Venice in 897/1492 by Bernard Rici de Novaria, and in 929/1523 in Venice and Lyons with annotation by Micheal de Capella.48This work, like those of ar-Razi's, thus continued to circulate and influence medicine and pharmacy in the West for over five hundred years.