Consider this possibility: As a child, you dreamt of treading down the path of Medicine driven by two possibilities; first, you were an elder child to immigrant parents ( it’s just a joke guys) second, you loved pretending to be a scientist when inspecting ants’ nest in your backyard, watching scientific videos on youtube or playing ‘Operation’ with your friends. Deep down, it was your introspective nature, which encouraged you to try and experiment with everything and know everything there is needed to know.
As you grow up, reality hits you: you may be curious to experiment and discover something new but Medicine is not a field, that allows experimenting with human lives, however noble your intentions might be for the future of the human race. Working at a hospital does not mean that you will be prescribing and injecting numerous drugs into a patient’s body, hoping they survive the side effects, trespassing private property to figure out a diagnosis, and performing illegal ‘ experiments’ on your patients, all the while wearing a smug smirk, strolling down the halls with your walking cane ( Apologies to House MD fans).
However, it can not be denied that the most significant advancements in Medicine were the results of bold experiments, conducted by the most brilliant minds of their time. One such amazing personality is Al Zahrawi, known as the father of Modern surgery.
Abu Qasim Khalaf Ibn Abbas Al Zahrawi ( 936- 1013 AD) belonged to Al Andalus( Arab Spain) during the Golden Age of Islam. He served as a court physician to the Caliph and then shifted all his attention to the advancements of Anatomy. His contributions to Medieval Medicine are endless, shaping the world of Healthcare and modern surgery. The most notable procedures he invented are as follows:
● Development of surgical tools
Al Zahrawi invented tools for the internal examination of the ear, to remove or insert objects into the throat, tools for C-sections and cataracts, and inspection of the urethra.
● His diagnosis and discoveries
He was also the first to discover the root cause of paralysis- the fracturing of the spine.
Once, he came across a baby boy with an unusually large head. He explained how the abnormality was due to the defective drainage of cerebrospinal fluid, a colorless body fluid found in the brain and spinal cord, which is now known as Hydrocephalus. Amongst his other notable diagnoses are Neurological diagnoses of head injuries, spinal injuries, skull fractures, hydrocephalus, and subdural effusions.
● His procedures
Al-Zahrawi not only described the tracheotomy procedure but also successfully performed it as an emergency intervention on one of his servants. He was the first to document the classic surgical approach for breast cancer, introduce lithotripsy for bladder stones, and develop techniques for removing thyroid cysts. His contributions also included the treatment of sebaceous cysts using an exploratory needle and managing lacrimal fistula by converting it into a fistula draining into the nasal cavity through cauterization.
In obstetrics and gynecology, Al-Zahrawi detailed various surgical instruments for childbirth and was the first to describe the Walcher position in obstetrics. Additionally, he was the pioneer in teaching the lithotomy position for vaginal procedures, shaping the foundations of modern gynecological surgery.
● Vanishing Stitches
Zahrawi was also the first one to initiate an advanced practice of using catgut ( fibers from animal intestines) to heal stitches. These would dissolve well into the human flesh, minimizing the risks of bacteria and ensuring a speedy recovery.
● Cauterization
He was able to perfect Cauterization- a technique that involves the use of metals to stop bleeding and prevent infection, a technique used today in electrocautery.
● His ‘ Tasrif’
Around 1000 AD, Zahrawi compiled his life work in a manuscript “Al Tasreef Liman ‘Ajaz ‘Aan Al-Taleef”, which was used as a manual in European universities for over 500 years.
The book contained details on procedures involving eyes; ears, nose, and throat; head and neck; general surgery; obstetrics and gynecology and urology. It also involved methods of dislocating limbs and joints, along with hand-drawn images.
I will end this blog with a quote from the great physician ‘ and’ experimentalist, Al Zahrawi:
“Knowledge without action is useless and action without knowledge is foolish,”
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