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Frontespiece of Arabic edition
of Al-Qanun fi'l at-Tibb

The Canon of Medicine

Composed in five long volumes, the Canon drew together all of the medical knowledge that existed in the world up to his time---including the systems of the Greeks, Europeans, East Indians, Persians, Arabs, Chinese, Tibetians and others---which he refined and codified into The Standard Principles of Medicine.

   The Canon of Medicine was translated into virtually every other language of the civilized world: Persian, Russian, Hebrew, French, German and other Romance languages. Twenty-eight editions existed in Latin alone.

   The Canon and other of Avicenna's works became the basis of thought in most of the Medaevial schools of knowledge, especially that of the Franciscians. The Canon of Avicenna is the source of authority for all modern therapeutics, and its influence upon the development of medicine cannot be overestimated. It has maintained its authority through ten centuries of medical teaching and practice, and today remains the handbook for all practitioners of Unani medicine.

   Not content merely to compile data, Avicenna set forth the principles upon which medicinal chemistry, botany, and pharmacy are based, founded hospitals, and developed the chemical processes of filtration, sublimation and calcination. Of special note is that Avicenna invented the process of distillation and was the first to distil oil of rose.

   Besides his vast grasp of dietetics, Avicenna developed a codified science of urinalysis, pulse diagnosis, classifications of pain, and an exhaustive pharmacology of hundreds of plant substances.

Origins of Modern Medicine

From the tremendous impetus supplied by Avicenna, during the next several centuries medicine developed as never before. Muslims took the masses of pathetically ill and established them in sleek and elegant hospitals. These hospitals were immense structures with courtyards, and featured lecture halls, libraries, mosques and chapels (they treated people of all religious beliefs), charity wards, kitchens and dispensaries. All patients were attended by qualified male and female nurses. The mood at the magnificient Mansur Hospital in Cairo is reflected in the following account of the amenities arranged for the benefit of all patients:

   "Day and night, fifty reciters intoned the Qur'an aloud. At nightfall, musicians played soft melodies to induce drousiness in the patients. Professional storytellers entertained the sick with their tales. When the patient left the hospital, he or she was given enough money so that they would not have to resume work immediately."

   By the time of the early 18th century, the Unani system was the basis of virtually all medicine in the Western civilized world, including Europe. According to scholars, the British Formulary was based entirely upon the Canon up until the end of the 18th century. Significant influences of Avicenna can be found in virtually all of the European nature cure movements, and even in the doctrines and early experiments in homeopathy of Samuel Hahneman (1755-1843), who is reputed to have known Arabic and traveled widely in the Islamic world and India.

Herbal Medicine in the West

   Herbal medicine as it developed in the United States shows little evidence of direct influence of Avicenna. While many of the European nature cure systems that were transported here were derived from Unani, contemporary American herbology was perhaps most shaped by Samuel Thomson. Born in New Hampshire in 1769, he was a self-educated healer who accidentally discovered the properties of lobelia and cayenne pepper. Simply via intuition, Thomson realized that most illnesses resulted from lowered life force in the body, and he correctly applied the intense heat of lobelia and cayyene in combination to raise the metabolic level, a process that lies at the heart of Avicenna's medicine.

But considering the force and impact of Avicenna on the history and development of medicine throughout the world, one may legitimately wonder why his system has not gained prominence in the West today.

   There are two reasons. The first complaint against Avicenna came in the late 1700s, from biologists and scientists who argued that one cannot determine the reality of the humors, metabolic sub-cellular forces that underlie Avicenna's notion of causes of disease. Since the humors could not be extractly and measured, when technological advances permitted scientists to peer into micro life forms, Avicenna's medicine was viewed with skepticism.

   Secondly, and even more significantly, Avicenna---while admitting to the existence of bacteria and viral forms of life---rejected the idea that they were the primary cause of disease, but rather a result of a disordered metabolism.

   It was only during the third quarter of the nineeteenth century (1860-1890), that the basic conception of disease was altered by the advent of the etiological school, which introduced the bacteriological origin of disease. In the past, physicians believed that disease symptoms revealed some organic malfunction. But with the bacterioloigcal school, this idea was discarded in favor of the notion that there was a 'special cause'---usually a microbe or virus---which was responsible for the lesion or other symptom. As the microbial theory of medicine gained prominence, not only Avicenna but also other systems such as homeopathy were swept aside.

For Avicenna and also his contemporary followers, there could be no such thing as a 'single' cause of disease---be it a germ or other factor. The concept of a single cause or mode of classification was rejected as an illogical fiction, because common sense and reason compel one to admit that every morbid condition is the result of not one, but many factors, almost always occurring in combination.

   On first encounter with Avicenna's Canon, one is overwhlemed, awed, by the scope of his genius. Even more remarkable, is that the 1,000 years since he wrote apparently have dimmed whatsoever the validity of his doctrines. Indeed, even modern hospital medicine is searching ever more frantically for the pre-disposing factors of disease.

   Avicenna's therapeutics---scientific, perfectly in accord with Nature, including human nature, and stated with profound clarity---certainly bear close investigation by contemporary alternative healing advocates.

The Key Concepts of Unani Healing

   Unani medicine is based upon two important concepts. First, the Doctrine of the Naturals establishes the standards of the human body, from which disease states are deduced by deviation from the norms; second, the Doctrine of Causes identifies and explains the reasons for the deviations from the norms. Efforts at diagnosis the main symptoms as signs leading to the underlying imbalance (Avicenna uses the word 'intemperament') that allowed the disease symptoms to arise in the first place.

   Avicenna sets forth six primary factors which are evaluated in depth to discern the cause of a disease: 1) the air of one's environment; 2) food and beverages; 3) movement and rest; 4) sleep and wakefulness; 5) evacuation and eating; and 6) emotions.

While some may feel these six factors are self-evident and simplistic, the exhaustive analysis of them by Avicenna seems practically miraculous. For example, "air" is not considered simply as the air one breathes, but includes the rhythm of inhalation and exhalation, atmospheric effects, seasonal changes, winds and other factors which may influence these elements such as types of trees and vegetation, mines and mineral deposits in the locale, cemeteries, dead animals, putrid water, muddy swamps and similar things.

Unani Food & Dietetics

   But the heart of Avicenna's therapeutics is found in the importance he places on food and diet. Avicenna writes: "Most illnesses arise solely from long-continued errors of diet and regimen." My teacher Hakim Sherif was fond of summing up Unani with two pithy remarks: "The stomach is the home of illness; diet is the main medicine."

   Avicenna views the process of digestion as one by which the nutrient substances (foods and beverages) are heated or 'cooked' by the body. By this is meant that the foods are altered from their state when taken into the mouth, and refined, or broken down, into ever-smaller nutrient parts. The process of heating---the grinding of food by teeth, action of oral enzymes, hydrochloric acid, and direct heat of the liver---all are part of the body's own 'cooking' of the nutrients according to Avicenna. Thus, the dietetics of Unani are concerned first and primarily with evaluating foods according to their ability to enhance or impede this innate metabolic action of the body. While the Unani physicians agree with developments in biochemistry, such as the discovery of vitamins, which occurred since the time of Avicenna, they still insisit that the primary focus and attention must be on total and effecient metabolism.

   Foods are said to be either 'hot' (garmi) or 'cool' (sardi). This classification is consistent with other systems that endeavor to obtain an overview of the metabolic process, such as the East Indian Ayurvedic medicine, which assigns identical heating and cooling values to foods. Generally speaking, Avicenna's values of foods corresponds to the macrobiotic yin (cool) and yang (warm).

   Foods that are sardi, or cooling, place several burdens on the body: 1) they are harder to digest (initial breakdown in mouth and stomach); 2) they are harder to assimilate (absorption of micro-nutrients into the blood stream and cells; and 3) consequently, they leave a greater residue of superfluous waste products.

   The following chart shows the metabolic values assigned to many common foods by Avicenna.

Metabolic Values of Foods

Heating (Garmi) Foods

Meat and Fish: lamb, liver, chicken, eggs, goat (male), fish (general).

Dairy Products: sheep's milk, cream cheese, cream, clarified butter (ghee).

Vegetables and Beans: beet, radish, onion, mustard greens, red lentils, white lentils, kidney beans, leek, eggplant, chick peas, red pepper, green pepper, carrot seed, squash.

Fruits: peach, plum, orange, lemon, mulberries, red raisins, green raisins, olive, ripe grapes, pumpkin, all dried fruits.

Seeds and Nuts: sesame, almond, pistachio, apricot kernels, walnut, pine nuts.

Grains: thingrain rice, basmati rice.

Oils: sesame oil, corn oil, castor oil, mustard oil Be ~ gts black tea, coffee.

Herbs: cinnamon, cardamom, cloves, fenugreek, ginger, celery seed, anise seed, rue, saffron~ garam masala (blend), curry powder (blend).

Other: honey, rock candy, all sweet things, salt, all modern medicine.

Cooling (Sardi) Foods

Meat: rabbit, goat (female), beef.

Dairy Products: cow's milk, mother's milk, goat's milk, butter, buttermilk, dried cheeses, margarine.

Vegetables and Beans: lettuce, celery, sprouts (general),  zucchini, spinach, cabbage, okra, cauliflower, broccoli, white potato, sweet potato, carrot, cucumber, soybeans, tomato, turnip, peas, beans (general).

Fruits: melons (general), pear, coconut, fig, banana, pomegranate.

Seeds and Nuts: none.

Grains: brown rice, thick grain rice.

Oils: sunflower oil, coconut oil.

Beverages: green teas.

Herbs: coriander (dry), dill, henna.

Other: refined sugar, vinegar, bitter things, sour things.

   The typical cuisine of cultures adapted to the Unani system reflect a diet comprised of approximately 60-80 percent of those foods considered to be metabolically heating: Basmati rice, clarified butter, onion, lentils, leek, eggplant, chick peas, pepper, dried fruits, nuts and tea. Foods from the cooling list enter into the diet more as seasonal variations on the basic components of the diet.

   Meat, while permitted, is consumed in far smaller quantities than in a typical American home---usually a modest protion one or twice per week. Consumption of pork is shunned, as are alcoholic beverages, banned because of its ability to destroy human reason.

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