Avicenna's Medicine

A New Translation of the 11th-Century Canon with Practical Applications for Integrative Health Care

Mones Abu-Asab, Hakima Amri, Marc S. Micozzi

• Publisher: Healing Arts Press
• Year: 2013
• ISBN:
  9781620551707
• Topic: Medicine
• Subtopic: Alternative & Complementary Medicine

The first contemporary translation of the 1, 000-year-old text at the foundation of modern medicine and biology • Presents the actual words of Avicenna translated directly from the original Arabic, removing the inaccuracies and errors of most translators • Explains current medical interpretations and ways to apply Avicenna's concepts today, particularly for individualized medicine • Reveals how Avicenna's understanding of the "humors" corresponds directly with the biomedical classes known today as proteins, lipids, and organic acids A millennium after his life, Avicenna remains one of the most highly regarded physicians of all time. His Canon of Medicine, also known as the Qanun, is one of the most famous and influential books in the history of medicine, forming the basis for our modern understanding of human health and disease. It focused not simply on the treatment of symptoms, but on finding the cause of illness through humoral diagnosis—a method still used in traditional Unani and Ayurvedic medicines in India. Originally written in Arabic, Avicenna's Canon was long ago translated into Latin, Persian, and Urdu, yet many of the inaccuracies from those first translations linger in current English translations. Translated directly from the original Arabic, this volume includes detailed commentary to explain current biomedical interpretations of Avicenna's theories and ways to apply his treatments today, particularly for individualized medicine. It shows how Avicenna's understanding of the humors corresponds directly with the biomedical definition of proteins, lipids, and organic acids: the nutrient building blocks of our blood and body. With this new translation of the first volume of his monumental work, Avicenna's Canon becomes just as relevant today as it was 1, 000 years ago.

CHAPTER 1

Concepts of Unani Medicine

• • • • • • • • • • •

A Primer

Although the predecessors of the current Western medical system (WMS) descended from antecedents within the Unani tradition, the WMS certainly does not presently resemble the classical Unani medicine in any aspect—not even in the concepts that form the bedrock of Unani theory and practice. The two systems now are so different in theory and practice that they appear to have evolved from two different origins. As it evolved from its predecessors, the WMS medical community slowly abandoned the theoretical frameworks represented in Unani for what it thought would be more precise markers of disease.

Instead of using the classes of humors as indicators for health assessment, the WMS has now adopted a long list of single blood markers (or individual blood markers, i.e., glucose, cholesterol, triglycerides, C-reactive protein, etc., referred to as laboratory tests in the clinical jargon). This shift from the historic emphasis on changes that can be observed within a class of markers (i.e., the humors) to that of only single, isolated, biochemical markers has helped transition the WMS to a new reductionist framework of disease diagnosis and management, as well as one-drug-fits-all treatments that differ from the fundamentally preventive and personalized care of Unani medicine.

The blood markers of clinical tests today are mainly used to confirm the presence of illness. They are not used as a preventive tool and do not emphasize population variations, let alone individual specificity. A given disease may often arise through different pathways (a process described as heterogeneity), which gives rise to several subtypes; therefore, single biochemical tests of “biomarkers” are not good indicators of the disease process or its subtypes. In the WMS, what is labeled as a disease, pathologically, is based on the abnormal appearance of tissue cells under a microscope. When the dynamic homeostatic processes of the body are disrupted, creating functional complaints (which can be observed empirically as in the Unani tradition even before the result is biomedically defined as “disease”), the tissue cells eventually respond by becoming abnormal, losing their normal appearance. There are only a few ways that the cells can change in response to disease processes, and standard tissue “pathology” appears relatively late in the process, after the tissues have exhausted their energetic and metabolic means of responding (or reacting) to the disease and trying to maintain homeostasis and “normality.”

Additionally, other available biomedical tools have been unable to clearly discern molecular variations and define the boundaries of the disease process to predict its course. Furthermore, the WMS tests cannot be used for early detection of serious illnesses like cancer since they are poor markers of early disease transformation.^*15 Thus, the WMS physician must work without time-tested theories and tools to help make an independent assessment of health status, and has now become a “manager” of disease who must primarily or solely rely on expensive testing machines to diagnose and assess recovery and progress. Physical examination and diagnosis of the WMS patient have been replaced by reading test results, which, in any case, are already delayed messages from a point past where the patient is now.

The effect of the current WMS paradigm on the pharmaceutical industry turned out to be catastrophic (for the patient). The rash of drug recalls that has been beleaguering the pharmaceutical industry in the last twenty years is a direct manifestation of drug design based on an incomplete and often incorrect biological and clinical paradigm. Why has the pharmaceutical industry not been capable of producing new drugs that are safe and without severe side effects, that would represent true “therapeutic breakthroughs,” like we were used to seeing in the middle of the twentieth century? Why are the “blockbuster” drugs of recent decades not the safe, therapeutic “breakthroughs” our parents had come to trust in?

The unfortunate fact, coming out of the side effects of many drugs, is that they damage the mitochondria, the energy generators of the cells, thus, in the timeless terms of Unani medicine, “extinguishing the innate heat of the affected organ.”^*16 As the reader will discover in this book, problems that affect the mitochondria are the basic cause of disease; as Avicenna long ago stated in the 3rd Lesson, 2nd Art, “When the organ function becomes abnormal, then there is a problem with its energy, and a problem with organ’s energy causes a disease in the organ.”

The conceptual framework of Unani medicine encompasses universal principles. Avicenna repeatedly asserts and highlights in his Canon that these principles are borrowed from the relatively sophisticated physical sciences of his own era. And that the physician does not need to prove their validity because it is the scientists’ duty to do that, and not the physician’s. That also implies that in understanding biological function and metabolism we should be able to use physics as the basis for chemistry, inorganic chemistry as the basis for organic chemistry, organic chemistry as the basis for biochemistry, biochemistry as the basis for molecular biology and cellular physiology, cell physiology as the basis for biology and physiology, and biology and physiology as the basis for medicine. Instead each of these fields of study, while required, is isolated from the others and does not compute in terms of the concepts and terminology (jargon) of one another. Anyone who has gone through premedical, medical, and postgraduate medical training struggles in vain to discover any underlying concepts and principles that universally apply. Instead, studying each part is like starting over, studying a new language, and often with a new alphabet!

As quaint as it may seem, in our modern medical “tower of Babel,” the consistent concepts of Unani medicine include the elements, temperaments, humors, “spirit,” and innate heat. Avicenna accepts these concepts as axioms since according to him they have been proven by the scientists (whom he calls the natural philosophers, as we in the West did until the nineteenth century; scientists in those days were still called philosophers).

As we discuss in several places in this book, the Unani concepts have stood the test of time, and they are on solid ground from a scientific point of view. The theory of evolution provides a modern framework for biological sciences, where explanations of biological phenomena are compatible with evolutionary biology (called Darwinian medicine and evolutionary medicine). The same compatibility may be applied to Unani concepts; the medical practice and its pharmacology are functional within this conceptual framework.

Readers who are knowledgeable in the theory of evolution will also realize that Unani principles are compatible with the evolutionary framework. Take, for example, the Unani emphasis on innate heat as the measure of health; it is an extension of the fact that symbiotic evolution of the eukaryotic cell provides a better supply of energy to the cell and enables it to carry out differentiation and specialized functions. Without adequate energy production in the cells (i.e., innate heat), cells do not function properly, and that is the Unani definition of disease (see 3rd Lesson, 2nd Art).

Drawing on the above argument, we are listing and discussing in this primer brief descriptions and interpretations of Unani concepts and a few important terms that are used and repeated in the 1st Book of the Canon. We aim here to facilitate the reading and understanding of the translated original text.

NOTE ON THE CURRENT TRANSLATION

The current translation is of the 1st Book of the Canon, which is largely considered among the best on the theory of Unani medicine. In addition to the theoretical issues, the book encompasses many procedures for disease prevention and health preservation. We have kept the style, as much as possible, close to the original by aiming for clarity. The original writing style of Avicenna is precise, consistent, accurate, and scientific; he has been known to rewrite and edit his work several times before sharing it with his students. Where the knowledge was not supported by clear evidence, or he himself did not have direct experience, Avicenna uses “may be” to denote that, as you will see in the text.

We have adhered to the original organization of the book. However, we have opted to keep out the part on anatomy because we felt that it does not add to the understanding of Unani principles, and it has been superseded by existing (or modern) publications on the topic. The Arabic and Farsi (Persian) names and terms have been placed next to the English translation to facilitate for researchers comparison with the original text. The scientific names of plants have been added after the English names to lessen the ambiguity about the exact plants that Avicenna had listed. Terms and names as well as other Arabic or Farsi words are listed in a glossary at the end of this book. We believe such a glossary is helpful to those who like to refer to the original text or plan on working on similar books (or works).

TERMINOLOGY OF ELEVENTH-CENTURY SCIENCE

The state of knowledge and the lack of sufficient scientific instrumentation in the eleventh century were limiting factors for the resolution of many issues of the time. To compensate for such shortcomings, the scientist of that time resorted to deductive reasoning, observations, and descriptions to fill the void. Such an approach produced occasionally ambiguous terminology that broadly defined phenomena, concepts, and processes. Despite some ambiguity, the terminology was mostly accurate and reflected a wide consensus of the scientists of the time, and even that which extended over a period measured in hundreds or thousands of years. Although old terms like spirit, humor, and elements seem to us as inaccurate generalizations that do not stand the scrutiny of today’s scientific rigor, a closer analysis tells us that they are descriptive terms for the unknown of that time, for now we can translate them as follows:

• spirit as referring to oxygen (in fact, inspiration can describe taking a breath or being filled with spirit—a connection among mind-body-spirit that the ancients understood better than we do today)

• humors as referring to classes of biochemical compounds in the human body, and

• elements as referring to the physical states of matter and their corresponding characteristics.

There are more such terms in Avicenna’s writings. In this primer we are focusing on the elucidation of some Unani concepts and terms that may become problematic when casting them into the same current usage of the terms, in order to bring out their original meanings as intended by Unani physicians.

CONCEPTS IN UNANI TIBB: MODERN EXPLANATIONS

The Elements: The Four-Element Concept

The well-known cliché about the elements that is repeated over and over is that the ancients thought that all matter is made of four elements. This is actually a blithe distortion of the real meaning of the term and its intended applications. Traditionally, the English translations of the term had ignored the other terms that are actually more informative, as is discussed in the introduction of the 1st Art in this book.

There are a number of terms listed by Avicenna, such as origins and basics, that denote that these objects can not be divided into smaller units retaining the same characteristics. The eleventh-century scientists were aware of elements such as iron, copper, gold, silver, and such as elements in our modern sense. However, the four-elements concept is a different system of classification of matter than is our periodic table of elements; it is based on the physical state (solid, liquid, gas, energy), acceptance or rejection of moisture (wet, dry), acceptance or rejection of heat (hot, cold), and relationship to other elements (inner, middle, outer, mixed). Why is such a classification needed? The answer is simple: because it is compatible with the biological nature of living organisms. The physical state, heat, and water are three criteria that can describe the conditions of a biological entity—organs, structures, biochemical compounds, liquids, and such. The combinations of the three physical characteristics of the four elements give rise to the temperaments.

THE TEMPERAMENTS

The temperament (mizaj,

) is a concept and a method by which physicians assess the deviation of the body or any of its organs from normal homeostasis in comparison to the patient’s population, race, and species. Simply, it is the expression that Unani...

Table of contents

• Cover Image
• Title Page
• Dedication
• Epigraph
• Table of Contents
• Foreword: In Defense of Medical Tradition by Alain Touwaide
• Preface
• Introduction: Why Revisit a Thousand-Year-Old Book?
• Chapter 1: Concepts of Unani Medicine
• First Art: Definition of Medicine and Its Topics
• Second Art: Disease, Causes, and General Symptoms
• Third Art: Health, Disease, and the Necessity of Death
• Fourth Art: Aspects of Treatments according to General Diseases
• Epilogue
• Footnotes
• Arabic–English Glossary of the Canon
• Bibliography
• Index
• About the Authors
• About Inner Traditions • Bear & Company
• Copyright & Permissions