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Chapter 12:
Medicine: The Logical Choice.
As well as enriching European life through a vast range of changes in lifestyle, when Crusader women insisted on the introduction of eastern medicine they also began a health revolution .
William of Tyre makes clear the crucial role of women as a group when he says that the Latin women urged their lords to scorn Latin medicine and trust only the Jews, Samaritans, Syrians and Saracens.
It was well that they did so, and only logical.
Women endured the rigours of childbirth, for which Eastern medicine alone had worthwhile assistance, and it was they who most often suffered the worst of Frankish medicine. This was a compound of superstition, magic and a crude herbalism, as recorded in the observations of the Saracen writer Usama. An eastern Christian named Thabit was called to treat two patients at Moinestre Castle in the Lebanon. One was a knight with abscesses on his leg, another a woman with consumption. Thabit began to cure the two with scientific treatments: a poultice for the leg, which drew out the abscess, and a cleansing diet for the woman.
However, a Frankish doctor intervened and ridiculed the treatment.
"Do you want to live with one leg or die with two?" he asked the knight.
The knight preferred a truncated life. So the doctor called in the services of an axeman, who immediately hacked off the offending limb with two whacks of his weapon. Marrow spurted from the mashed bone, and the patient died instantly.
After this very definite resolution of the illness, the Frank then turned his attention to the woman.
"She has a devil in her head who is in love with her. Cut her hair off!" said the doctor.
She then reverted to her usual diet of food laced with garlic and mustard, which worsened her condition.
The doctor pronounced that the devil had entered her brain. So he took a razor and slashed a cross on her skull, exposing the brain. He then rubbed salt into the brain, and she joined the unfortunate knight.
Thabit found himself no longer in demand: he left, having learnt things about medical methods he had never known.1
The Crusading men seemed relatively slow to acknowledge the worth of Arab medicine.
King Amalric I, for example, died in 1174 from the bleeding practiced by Frankish doctors in an attempt to cure him of dysentery.
But by the 1160's some Franks were beginning to acknowledge the worth of much Eastern medicine. Eastern doctors were licensed to practice by medical boards headed by the local bishops, and that same fatally bled Amalric had hired an Egyptian doctor to try to cure his son Baldwin's leprosy.
In other ways, too, they gradually adapted some Arabic techniques, including imitating hospital practice. The Moslems had put in place large, well organized hospitals by the time the Crusaders invaded. By 850 A.D., around 34 medical facilities were operating, some of them with the support of Caliphs. There were separate hospitals for women, and in 978 the Damascus hospital was staffed with 24 resident doctors. Schools of medicine were attached to the hospitals, there were medical libraries, and a regularised system of education and certification. Perhaps the most famous Arab doctor is Avicenna (980-1037), who wrote nearly a hundred treatises on medicine and related topics, containing Greek and Arabic medical scholarship. Avicenna described 760 drugs, and his study on medicines remained the standard for centuries. The Knights of St John, known as the Hospitallers, and their sister order built a 2,000 bed hospital in Jerusalem, employing four doctors and four surgeons, and using a proper system of rules fo caring for the sick.2
Most importantly for women, the Arabs introduced anaesthetics and performed the earliest medieval Caesarians, using animal gut for sutures.
The gradual adoption of aspects of eastern medical practice into Europe is reflected in Chaucer's fourteenth century portrait of a doctor. Along with his wax effigies and his fake cures, not to mention his trust in the efficacy of the zodiac, the doctor is also learned in the teachings of the ancients. These include Dioscorides, a Greek who flourished 50 A.D.; Hippocrates, the originator of Greek medicine, born about 460 B.C.; and the Persian writer Hali ibn el Abbas died 994. As well, there are references to a medical writer named Serapion, who may have been either an Alexandrian Greek of the second century B.C., a Christian physician of Damascus perhaps of the ninth century, or an eleventh century Arabian. Avicenna, already mentioned, and Averroes were famed not only for their philosophy, but also for their medical knowledge. There may also be references to Johannes Damascenus, alluding to two separate ninth century medical authorities from the east whom the westerners confused into the one identity. And inally, there is a reference to a monk from Carthage, Constantinus Afer, who brought Arabian learning into southern Italy during the eleventh century.
Thus, virtually all the intellectual influences on medical practice represented by Chaucer's doctor originated in Arabic thinking, or were transmitted through their writings.3
The opinions of real life doctor reflects a similar indebtedness. He is Gui de Chauliac, who in the year 1363 was the Pope's private physician.
In his History of Surgery, Gui lists the eastern surgeons Rhazes died c.923, Albucasis died c.1013 and Alcaran (unknown) as the intellectual heirs to Galen. Gui praises their work for the transmission of Galen in their books such as Books for Almansor by Rhazes
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