Concentration in Prayer

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Concentration in Prayer

Concentration in Prayer

Author:
Publisher: www.alhassanain.org/english
English

This book is corrected and edited by Al-Hassanain (p) Institue for Islamic Heritage and Thought

Concentration in Prayer

Author: Jameel Kermalli

Table of Contents

Introduction And Acknowledgments4

Foreword 5

Author’s Biography 6

Part 1: Introduction to Prayer7

Importance Of Prayer7

The Reality Of Prayer8

The Value Of Prayer9

Prayer And The Day Of Judgment10

The Blessings Of Prayer11

Treating Prayer Lightly 11

Genesis Of The Prescribed Prayer13

The Presence Of Heart In Prayer15

Part 2: Strategies for Concentrating In Prayer17

Setting The Prayer Scene And Burning Incense17

Wudhu as A Way To Increase Your Attention 18

The Invocation Of Wudhu 18

Strategy 1: Understanding And Appreciating Allah (SWT)’s Presence19

Strategy 2: Reminding Yourself Of Allah 20

Strategy 3: A Relaxed And Alert State Of Mind 22

Strategy 4: Understanding What You Recite23

Takbir24

Translation of Chapter of al-Hamd 24

Translation of Chapter of al-Ikhlas24

Strategy 5: Proper Pronunciation 26

Strategy 6: Confidence26

Strategy 7: Alternating Recitations27

Strategy 8: Continued Cleanliness27

Strategy 9: Seeking Forgiveness And Accepting Limitatons28

Strategy 10: Trust28

Strategy 11: Stress Management29

Strategy 12: Senseless Conversations30

Strategy 13: Moderation In Eating 31

Strategy 14: Checking And Inspection 31

Strategy 15: Putting Thoughts In Writing 32

Strategy 16: Removing Obstacles32

Strategy 17: Grief-Stricken, Submission And Sadness33

Strategy 18: Patience, Accepting Fault, And Addressing The Problem To Allah (SWT)33

Strategy 19: Fasting 34

Strategy 20: The World And Its Pleasures35

Strategy 21: Arresting Thoughts36

Strategy 22: Remembrance Of Death 38

Strategy 23: Fixing Your Gaze40

Strategy 24: Avoiding The Whisperings Of Shaytan, The Accursed 41

Strategy 25: Exercises To Develop Attention, Meditation 42

1. Focused Meditation Exercise42

2. Blank Meditation Exercise43

3. Breathing Meditation Exercise43

A Note On Respiration 43

The Stages of Breathing, Meditation Exercise44

Part 3: Conclusion 46

Introduction 46

Category One: Knowledge And Awareness46

Category Two: Setting The Scene Of Prayer47

Workout: 30 Days47

CAUTION 49

CAUTION 50

Introduction And Acknowledgments

Praise is to Allah (SWT), The Lord of The Universe!

In His Name, The Most Beneficent, The Most Merciful!

Concentration in Prayer was written over a few years and significant research went into completing this project. The main goal of this book is to educate The Muslims of the importance of The Five Daily Prayer and to explain HOW to create, develop and maintain concentration in Prayer. This is an important aspect of Prayer since Allah (SWT) only requires our undiminished attention during Prayer.

This book on Prayer requires active reading and active participation. Interested readers will find wealth of information, research and exercises one can effectively employ to reap the fruits of the Prayer. It is envisaged that the reader, in particular the youth and leaders of tomorrow, will look up to this book and apply its recommendations on a daily basis. It is definitely not a once-read book! Charts and diagrams have been provided to aid the reader in understanding the nature of this book.

Even though the book quotes many sources, it is sometimes unable to provide specific citing and references because the collection of the traditions in this book began a few years ago. Suffice it to say that the traditions quoted are authentic and form reliable sources. With the help and assistance of learned scholars, the like of my father - Yusuf Kermalli, Ma’alim Muhsin Alidina, Ma’alim Mohamed Raza Dungersi, and a few close friends, this project was recently completed. Once again, I would also like to thank my parents who have provided their unlimited love and support in the production of this book. And finally, my wife and two lovely children that God has blessed me with, for their patience and confidence throughout the write-up and production of this book.

The Chapter of al-Fatiha is requested for the benefit of the soul of my mother and the souls of all believers who have already made their journey into the next world.

Jameel Kermalli

Foreword

This book discusses the importance of The Five Daily Prayer and it’s status with Allah (SWT). The work also discusses strategies you can employ to develop and maintain a high level of attention and concentration whilst communicating with Allah (SWT), Who demands that His servants be most attentive in their Prayer, more than any other worship. He, The Creator and Designer of The Universe, remarks to that individual, who says his Prayer with least attention, alertness of mind and concentration:

O’ Liar! Do you want to deceive Me? I swear by My Splendor and Majesty that I will deprive you the pleasure of your invocations and enjoyment of personal communications with Me.

(Hadith al-Qudsi)

Jameel Kermalli has done painstaking research and has shared his findings with us in a lucid, readable manner.

Muhsin Alidina

Important Note

Author’s Biography

Jameel Kermalli is a graduate of the University of Southampton, U.K., with a Bachelors of Science (Hons.) degree in Psychology, majoring in Health Psychology. He is also a Board Certified Psychotherapist and a Board Certified Biofeedback Practitioner, specializing in EEG Biofeedback. His Doctorate is in Naturopathic Medicine and his areas of specialty include Homeopathic, Nutritional and Herbal Medicines. Jameel is also a Board Certified Nutritional Consultant.

He graduated on top of his class from al-Hussaini Madressa in Dar es Salaam and is a teacher in Islamic studies.

He has his own private practice in Long Island, New York.

Jameel is also part of the team that has developed The Hajj Board Game, the first of its kind, due for release very soon. The Hajj Board Game, resembling monopoly, summarizes The Pilgrimage to The House of Allah, combining education, relaxation and mystery. The Game is suitable for adults and youths, those going to Hajj, those having gone to Hajj and those who have not yet been blessed to undertake this sacred journey. It comes complete with 2 dices with 1 spot, 2 spots and blank, a timer; 4 playing items, 90 A cards, 90 B cards, 90 C cards, 90 D cards, 90 multiple choice cards, and 90 pick up and beware cards.

Jameel is also the author of a highly researched book, The Truth About Islam - A Contemporary Approach Towards Understanding Islamic beliefs and Practices, which is under preparation. This book is a scientific work relating to the Concept of Energy in The Universe, its Intelligence, and how Islamic beliefs and practices accord totally with known scientific and modern discoveries.

Part 1: Introduction to Prayer

Imam al-Sadiq (AS) narrates that it is written in The Torah:

“O’Son of Man, if you empty yourself, i.e. disengage yourself from all other pre-occupations to make yourself available for My worship, I will fill your heart with richness and I will not abandon you to what you seek and long for. And it will be upon Me to close the door of poverty upon you and to fill your heart with awe for Me.

And if you don’t empty yourself for My worship, I will fill your heart with preoccupation with the world. I will not close upon you the door of poverty and will abandon you to what you seek.”

(al-Kulayni (RA), Usul al-Kafi,2, "Kitab al-'Iman wa1-Kufr', "Bab al-‘Ibadah",Tradition number 1)

Importance Of Prayer

Prayer is the most effective way of spiritual migration towards Allah (SWT) and attaining the exalted position of His nearness. When al-Sadiq (AS) was asked what was the best deed that brings human beings close to Allah (SWT) and is also liked by Him? He replied:

After enlightenment of God’s Essence, I do not know anything better than The Prayer. The most esteemed and favorite deed before Allah (SWT) is Prayer. Prayer is the last dying will of all Prophets (AS).

How good it is that a human being takes a bath or performs ablution, then retires into a secluded corner where he is not seen by anyone, and has the honor of performing genuflection and prostration. When a servant bows himself down into prostration and prolongs it, then Shaytan says, ‘O’, Woe Upon Me! This servant has obeyed Allah (SWT), while I transgressed, and he has offered prostration that I refused’.

In Falah al-Sail Page 23, Chapter 2, On the Description of The Prayer, on the authority of al-Sayyid ‘Ali ibn Tawus (RA), al-Sadiq (AS) said:

The Prayer will not be complete except for the one who has full purity and a mature completeness, and is away from temptation and deviation. He knows Allah (SWT) and so stands before Him, submits to Him and persists. He thus, stands between despair and hope, between patience and worry, as if the promises to him have been fulfilled, and the threats upon him have transpired, lowering his fame and manifesting his aim.

He sacrifices for Allah (SWT) his soul, treads upon the road to Him as his goal willingly. He severs the relations of interest for the sake of The One to Whom he bounds and comes, and from Whom he seeks help. Should he achieve all these, The Prayer would be of the ordered type and of the informed about, and it is the very Prayer which forbids evil and vice.

In Mustadrak al-Wasa’il, Book of The Prayer, Muhammad, son of Ya’qub (RA), quotes al-Sajjad (AS) as having said:

As regards the rights of The Prayer, you are to know that it is a visit to Allah (SWT) and that in it you are standing before Him. If you realized that, you would deserve to be, through it, in the position of a slave who is humble, desirous, horrified, frightened, hopeful, distressed, and imploring. He is also glorifying the state of The One in front of Whom he stands with complete stillness, solemnity, submission of the limbs, humility, well supplicating to Him for himself, requesting Him to free his neck, which is encircled by his faults and consumed by his sins. And there is no power except by Allah (SWT).

The Reality Of Prayer

Saying your Prayer on time is a highly recommended act, and none other than Allah (SWT) reminds us of this obligation:

And when he (the worshipper) knows that it is time of Prayer and he does not pray, he is indeed careless about Me.

(Hadith al-Qudsi)

In Wasa’il al-Shi’ah, vol. 3, Page 90, al-Sadiq (AS) is reported to have said:

Whoever performed the obligatory Prayer at the beginning of their times and observed their restrictions, the angels would raise them white and pure into heaven. The Prayer would say (to the performer): ‘May Allah (SWT) preserve you as you preserved me and entrusted me to a generous angel’.

But whoever performed them after the appointed times with no excuse, and did not observe their restrictions, the angels would raise them, black and dark. The Prayer would shout at the performer: ‘You have lost me, may Allah (SWT) lose you, and may He not care for you as you did not care for me’.

Prayer has several built in properties that make the worshipper far better than the angels and makes life worth living. Only when the true reality of Prayer is understood then one is awestruck by its daily performance. In explaining the true nature of Prayer, al-Ridha (AS) comments:

The reason for Prayer is that it is the acknowledgment of The Lordship of Allah (SWT) and negating all kinds of partners and plurality for Him. Prayer is standing before The Omnipotent, with humility, humbleness and confession (of sins), and begging forgiveness of the previous sins. Prayer is placing the face on dust five times a day as (a sign of) recognition and confession of His Greatness.

Prayer is for remembering Him and keeping away from arrogance and negligence. Prayer leads to humility, submission and humbleness towards Allah (SWT), and the enthusiasm for the desire to material and spiritual progress (both in this world and the hereafter).

Moreover, Prayer enables a person to constantly engage in remembering Allah (SWT), both day and night, so as not to forget one’s Lord, Master and Creator, since forgetting will cause rebellion. Man, while offering Prayer, stays in the presence of His Lord and in the state of His remembrance, and this very condition constrains and stops him from sins and many kinds of corruption.

In order for you to be part of manifestation of the authority of Allah (SWT) on this earth, you must pledge complete submission, bondage and servitude to The Lord of the Worlds. You must manifest all this in your behavior, in general, by remembering Allah (SWT) at all times and seeking His Will and specifically, by performing the ritual acts of worship e.g. giving alms, fast, etc.

Scholars have noted that if a man does not fulfill the conditions of this act of Prayer, he defies Allah (SWT) becoming a rebel and a devil. For man to climb higher in the realm of existence, he must lower himself to Allah (SWT). The more he lowers himself to Allah (SWT), the higher he reaches in the realm of existence.

It has been the practice of Allah (SWT) to conceal important grace to mankind, and Prayer is no exception. S. V. Mir Ahmad ‘Ali (RA), in his Commentary of The Qur’an, narrates seven values that have been kept concealed by Allah (SWT), The Most High:

According to some reports, The Night of Power (Qadr) is concealed in the year as a whole. This is because man may ever seek His grace every night as much as he possibly can. Similarly, one of these several nights in the months of Sha’ban and Ramadhan are said be The Night of Qadr, The Night of Grandeur.

The Greatest Name of Allah (SWT), with which one could have everything he desires, is concealed in several names, so that one may remember and recite all the Divine Names of The Lord.

The Prayer al-Wusta or the Middle one of the prescribed Daily Prayer is kept concealed in The Five Daily Prayer so that one may offer every one of them with eagerness to earn its special reward.

In one particular hour of Friday, every week, it is said, the prayer is heard without fail. However, the hour is not disclosed particularly so that one may engage in Prayer the whole day as much as he can.

God’s pleasure is concealed in Prayer so that one may always worship The Lord.

The displeasure of The Lord is mentioned to be in sinning in general so that man may abstain from all kinds of sinning.

The most honorable with Allah (SWT) is the most pious, so that one may acquire piety for himself and seek the friendship of the most honorable ones with The Lord; love the pious and the righteous one, hate impiety, and stay away from disobedience.

The Prophet (S) in his last remaining hours of life further advised his followers to take Prayer seriously, and pray according to what has been prescribed upon them.

The Value Of Prayer

Allah (SWT) manifests Himself to His perfect friends in a kind manner, and the attraction of love becomes their guide. As the tradition says that The Prophet of Allah (S) used to be waiting for the time of the Prayer, his longing ever increasing, until at last he would say to Bilal (The Prophet’s Caller to Prayer): ‘Relieve us, O’ Bilal’.

(al-Mahajjat al-Bayda fi Tahdhib al-Ahya vol. 1, Page 377)

In advising Abu Dhar (RA), The Prophet (S) says:

O’ Abu Dhar! Allah (SWT), Glorious is His Praise, has made the pleasure of my eye in (daily) Prayer, and has made me love Prayer like food is made lovable to the hungry and water to the thirsty. And surely, while the hungry one, when he eats is satiated, and the thirsty one, when he drinks he is quenched; I am not satiated from Prayer.

O’ Abu Dhar! Anyone who voluntarily prays 12 units of Prayer, other than the obligatory, he has earned the right to a House in Paradise.

O’ Abu Dhar! Surely, so long as you are in Prayer, you are knocking on the door of The Great King, and whoever knocks long on the door of The King it will be opened for him.

O’ Abu Dhar! There is no believer that stands in Prayer but falls on him goodness onto what is between him and The Throne. And, an angel is appointed for him that calls out, ‘O’ Son of Adam (AS), if you knew what there is for you in Prayer and whom you are calling, you would not turn away’.

O’ Abu Dhar! Be like him, who in a deserted place (though alone), calls Adhan and Iqamah (Call for Prayer) and says his Prayer. So your Lord says to the angels, ‘Look at My servant! He is praying and no one sees him but Me?’ Then descend 70,000 Angels and pray behind him and seek forgiveness for him until the next day. And a man who stands in the midst of night and prays alone, prostrates, and falls asleep while prostrating, Allah (SWT) says, ‘Look at My servant! His soul is with me and his body is in prostration; and (be like) a man who is in a war and all his companions flee, but he stays firm fighting until he is killed’.

O’ Abu Dhar! No man puts his forehead (in prostration) in any place on earth but that place bears witness of that for him on The Day of Judgment. There is no place that a group of people visit but that it starts either sending salutation on them, or cursing them.

O’ Abu Dhar! Do you know the reason behind revelation of the verse: ‘Be patient, exhort others to be patient, establish Prayer, and fear Allah that you may be successful?’ I said, ‘I don’t know - May my father and mother be sacrificed for you’. The Prophet (S) said, ‘For waiting for the next Prayer after every Prayer’.

Prayer And The Day Of Judgment

On The Day of Judgment, before one is even permitted to present the good deeds that he has performed in this world, the first question asked will relate to Prayer and only then will he be allowed to proceed. The Prophet (S) has made this clear by saying:

All good deeds depend on Prayer. Prayer is the cornerstone of Islam. If Prayer is accepted then the good deeds will be accepted. If Prayer is not accepted, then the good works will not be accepted.

This proclamation becomes clear when we examine Shaykh al-Qummi (RA)’s comments in his Manazil al-Akhirat, that there will be approximately 60 stations over The Bridge on The Day of Judgment. Each one of us will have to answer questions satisfactorily at each of those stations. Only after one is finished with one station, is he going to proceed to the next one. Each station is named and the first station, according to Shaykh al-Qummi (RA), is Prayer.

Therefore, the first station in The Bridge involves Questioning on Prayer and how you fulfilled this obligation. If, in any case, you don’t fulfill the requirements at that station, then unless you get intercession of The Infallible Prophet and Imams (AS) or by your own actions, you would fall down into the bellies of Hell without establishing the remainder of your good deeds in this world. Undoubtedly, the first thing Allah (SWT) will ask on The Day of Judgment is Prayer, and this comes to us from all The Prophets and Imams (AS).

The Blessings Of Prayer

Muhammad, son of Ya’qub, quoting al-Sadiq (AS), says:

When you recite the Adhan and the Iqamah, two rows of angels will perform the Prayer behind you; but if you said the Iqamah (only), one row of angels would perform the Prayer behind you.

(Furu’ al-Kafi, Volume 3, Page. 303)

There are many other traditions to the same effect, some of which say that the length of each row is as the distance between the east and the west.

al-Baqir (AS) has quoted The Prophet of Allah (S) as saying:

When a believing servant stands for the Prayer, Allah (SWT) looks at him until he finishes. Allah’s Mercy shadows over his head, the angels surround him from all sides up to the horizon of the heaven, and Allah (SWT) assigns an angel to stand at his head, saying: ‘0’ Worshipper! If you know who is looking at you, and to whom you are supplicating, you will look nowhere else, nor will you leave your position.’

(Mustadrak al-Wasa’il, Chapter 2, Tradition 22)

He further said:

Whoever performs 2 units of Prayer without paying attention to any worldly matter, Allah (SWT) will forgive him his sins.

(Mustadrak al-Wasa’il, Chapter 2, Tradition 13)

Considerable importance has been attached to Prayer, and no words can describe the amount of reward Allah (SWT) grants to this individual, who is only fulfilling an obligation. The Aimmah (AS) have said:

Prayer is what angels love,

Prayer is the practice of The Prophets (AS),

Prayer is the light of understanding,

Prayer is what makes faith strong,

Prayer is what makes actions accepted,

Prayer increases sustenance,

Prayer keeps you away from illness,

Prayer is what Shaytan hates,

Prayer is a weapon to confront your enemies,

Prayer is what will assist you with The Angel of Death (AS),

Prayer is the light in your grave,

Prayer is an answer to Munkar and Nakeer (AS), and

Prayer is what will help you in the grave till The Judgment Day.

Treating Prayer Lightly

Some wives of The Prophet of Allah (S) have said that:

The Prophet of Allah (SWT) used to talk to us and we used to talk to him. But when the time for the Prayer arrived he appeared as if he did not know us and we did not know him, as his attention was fully directed to Allah (SWT).

(Mustadrak al-Wasa’il, Chapter 2, Tradition 17)

Ibn Tawus (RA) says, in Falah al-Sail, that when al-Husayn (AS) used to perform the wudhu, his face changed color and his joints trembled. Asked about the reason, The Imam said:

When one is going to stand before The Owner of The Throne, his color ought to turn pale and his joints to tremble.

The same narrator also states Al-Hasan, son of ‘Ali (AS) used to experience a similar condition before and during Prayer. (Bihar al-Anwar, Volume 77, Page 346.)

Unfortunately, many of us treat Prayer as another kind of daily entry in our logbook. Some of us not only treat the timely performance of Prayer lightly, but others do not even offer this obligation, which is a duty that carries immense weight. To those who treat Prayer lightly, The Prophet (S) says:

The one who takes Prayer lightly is not of me. No! By Allah (SWT)! Such a person will not reach The Pond of al-Kawthar.

According to The Prophet (S), one who wastes his Prayer will be raised with Qarun and Haman, so that it will be right for Allah (SWT) to put him in Hell together with the hypocrites.

al-Sadiq (AS) said to Zurarah (RA):

Don’t be negligent in regard to your Prayers.Verily, The Prophet (May Peace Be Upon Him And is Progeny) said on his deathbed:

One who makes light of his Prayers does not belong to me, or the one who takes intoxicating drinks. And, by God! He will not reach me at The Pond (of al-Kawthar).

(Furu’ al-Kafi, iii, 269)

al-Kulayni (RA) further reports with his trustworthy narrators, from Abu Basir, that al-Kadhim (AS) said:

At the time of his death my father said to me, ‘My son, the one who makes light of Prayerwill not receive our intercession’.

(Furu` al-Kafi, iii, 270)

al-Khomeini (RA) has the following advice to those people who treat the performance of The Five Daily Prayer lightly and of no concern:

A devout person should be observant of the times of his worship under every circumstance. Of course, he should observe the timings of Prayer, which is the most important of the acts of worship, and carry it out in the most meritorious part of its time, refraining from engaging in any other work during those times.

In the same way as he assigns a certain time to making an earning and for study and debate, he should do the same in respect of these acts of worship. During this time, he must be free from other pre-occupations, so that he can achieve concentration of the heart. This makes up the quintessence and kernel of worship.

But should he, like this author, offer his Prayers out of compulsion and consider the performance of the worship of The Lord as a superfluous matter, he would, of course, delay it as long as it can be delayed. And when he offers it, he offers the Prayer in a perfunctory manner, considering it as an impediment in the way of what he imagines to be important tasks. However, such worship has not only no spiritual brilliance, it deserves divine wrath, and such a person is one who makes light of Prayerand neglects it as something trivial.

I seek refuge in God from making light of Prayerand not giving it its due importance.

(al-Tawhid, Quarterly Islamic Journal. 27th Hadith - Prayer and Concentration)

Genesis Of The Prescribed Prayer

al-Majlisi (RA) writes a long narration in his book Hayaat al-Quloob (Part Two), about one of the incidents that took place during Me’raj:

At Bayt al-Ma’moor, The Prophet (S) beheld The Ka’bah directly under him, so that if he had dropped anything from his hand, it would have fallen on its roof. The Prophet (S) says:

I heard a voice saying, ‘This is the sacred place, and you are the ordained Prophet, imparting honor to the temple. Whatever exists on earth has its similitude in Paradise’.

My Lord then commanded me to open my hand, and take of the water flowing from the right pillar of The Empyrean, which I did; and for this reason it became meritorious to take up water for ablution with the right hand.

A voice then commanded, ‘Wash your face with this water that you may be pure to behold The Light of My Majesty and Glory. Then wash your hands, for you will take My Word. Then draw your wet hands over your head and your feet, which signifies that I will draw The Hand of Mercy over your head, and send down My Blessings on you. Drawing the hand over the foot will elevate you up through several regions where no foot has ever trodden, nor will it ever after you’.

The Most High then commanded, ‘Turn towards The Black Stone which is before you and extol Me according to the number of curtains by saying ALLAHU AKBAR!’ On account, seven repetitions of this phrase have been recommended for Prayer, because there were seven curtains.

He (S) passed the seven heavens and seven curtains of exaltation and glory, and arrived near the place of communion with The Merciful Lord of Glory. Prayer is The Celestial Ascent of The Believer. When the perfect believer thus ascends, and recites the seven Takbeers, the curtains of darkness, which on account of errors of worldly inclination come between him and The Most High, are removed, and he approaches The Lord of The lords.

The Lord then commanded The Prophet (S), ‘Now you have arrived at this place of communion with Me, pronounce My Name’. Accordingly The Prophet (S) said, ‘In the Name of Allah, The Compassionate, The Merciful’, and thus this phrase became established as the beginning to each chapter.

Being commanded to offer praise, he said, ‘Thanks to Allah (SWT), The Lord of The Universe’, and proceeded in this manner till he recited the whole Chapter ‘Praise be to Allah (SWT), The Lord of all creations’.

A voice then commanded him to recite The Chapter of Divine Unity, saying, ‘That Chapter is a description of My Praise and Attributes. What likeness can exist between Me and My creations?’

After I had recited this Chapter, ‘Say! Allah is One; He is Perfect; He neither begets, nor is begotten; and there is none like Him’, the voice said, ‘Bow before My exaltation, and put your hands on your knees and look toward My Empyrean’.

On doing this, Light from The Glory of God overpowered me, and I fell into a swoon, and by divine inspiration, I said, ‘Praise and Thanks to The God of The Glory’. In purity I named the Lord of exaltation, and I am employed in His Praise.

After repeating this I soon recovered, and the tremor of my spirit subsided, when by divine inspiration, I had seven times pronounced the ascription of praise. It was then ordained that this expression of praise should, in the performance of Prayer, be recited in the bending position.

Allah (SWT) then commanded me to raise my head and stand erect, I heard the voices of the angels uttering praises and ascribing unity and thanksgiving to God. I said, ‘Allah (SWT) hears everyone that utters His Praises’.

I looked up and saw a light more intense than that which had caused me to swoon before, and my fear was greater than in the former instance. Out of awe, I fell into prostration before The King, The Lord of The Glory, and placed my face in the dust of humility, and on account of the exaltation, I witnessed, seven times repeated by divine inspiration, ‘Glory and praise to The Exalted Allah’. At each repetition of this ascription, my terror diminished, till I recovered from the state of the overwhelming awe, and attained to perfect knowledge of Allah (SWT).

I then raised my head from prostration, and sat till I recovered from the amazement into which I had fallen. By divine inspiration, I again looked upward, and saw a light more overpowering than I had witnessed before, and again fell involuntarily in prostration before The Lord, and repeated seven times, ‘Glory and praise to Allah’. Thereafter, I was more worthy of beholding the divine lights.

I again raised my head, and sat for a while, and looked toward the angels.

For this reason, al-Majlisi (RA) says, two prostration in (a unit of) Prayer were established, and sitting a short time after them became meritorious.

The Prophet (S) continues,

I then arose and stood in the attitude of a servant before my Lord, when He commanded me to recite again The Chapter of Praise, and afterwards The Chapter of Power (Qadr). I again bent with my hands on my knees, and then prostrated myself with my head on the ground. As I was about to rise, The Most High commanded, ‘Mention My favors to you and pronounce My Name’.

By divine inspiration I said, ‘In The Name of Allah, and by Him, There is no God but Allah, and all perfect names belong to Allah’.

When I had repeated the two testimonies, He commanded, ‘Pronounce blessings on yourself and on your Family’. I prayed, ‘O Allah! Have mercy on me and on my Family’, which was answered with blessings from The Most High.

On looking around, I beheld the angels and spirits of The Prophets arrayed in ranks behind me, and The Most High Commanded me to salute them and I said, ‘Peace be upon you and The Mercy and Blessings of Allah’. The Most High then addressed me saying, ‘I am your Peace, Mercy, and Blessing, and of the Imams after you’.

The Presence Of Heart In Prayer

al-Sadiq (AS) has said:

Dear to me is the believer from among you who attends to God with his heart at the time of Prayer and does not pre-occupy his heart with any mundane matter. For, whenever a devotee turns with his heart to God, The Exalted, during Prayer, God heeds him and turns towards him the hearts of the faithful who regard him with affection, following God’s love of him.

(al-Hurr al-‘Amili, Wasa'ilush-Shi'ah, iv, 686)

The Commander of the Faithful, Imam ‘Ali (AS) says:

If the worshipper knew to what extent His (Allah’s) Mercy surrounded him during Prayer, he would never raise his head from the state of prostration.

According to a number of traditions, the Prayer has been called - a believer’s heavenly journey that protects him from moral indecencies. Ayatullah Ibrahim Amini says in his book Self Building that, ‘it is a pure sparkling stream of spirituality that whosoever enters it five times a day will purify his soul from all sorts of pollution and contamination’. Likewise, a Prayer offered without heart’s presence, although satisfies the performance of compulsory religious obligation, nevertheless, does not help in elevating the worshipper towards higher spiritual realms.

In another tradition, he said:

A Prayer, half of it may be accepted, or one-third, or a quarter, or one-fifth, or even one-tenth. Another Prayer may be folded like an old dress, and be thrown back at the face of its owner. No part of the Prayer is yours except that part which you perform with an attentive heart.

(Bihar al-Anwar, Volume 81, Page 260, Chapter 16, Tradition 59)

A similar tradition is narrated by al-Kulayni (RA) in al-Kafi, 3, page 363. al-Baqir and al-Sadiq (AS) have further said:

Nothing of your Prayer is yours except that which you did with an attentive heart. So, if one performed it completely erroneously, or neglected its disciplines, it would be folded and thrown back at its owner’s face.

(Wasa’ilush-Shi’ah, Volume 4, Page 687, Chapter 3, Tradition 1)

al-Sadiq (AS) warns us that:

When a servant stands to offer Prayer, Allah (SWT) pays attention to him and does not shift His attention until the servant deviates from His remembrance for the third time. When this happens, Allah (SWT) too turns His attention away from the worshipper.

Therefore, the heart’s presence is a must in every single act in Prayer and that is the only way to achieve the merits hidden in this great obligation. It is narrated in Bihar al-Anwar that in the above instances, if the worshipper returns his attention and struggles not to lose his concentration, then his past sins are erased and he shall be granted such blessings that his reward cannot be counted. Allah (SWT) says:

Pay attention to Me, because I and the Angels are paying attention to you (in your Prayer).

According to al-Khomeini (RA), ‘the reality of invocation and remembrance is the invocation of the heart, without which the invocation of the tongue will be futile and worthless. This is referred to in a number of traditions’.

In his book Self Building, al-Amini relates:

In as much as heart’s presence is important and worthwhile, in the same proportion, its attainment is extremely difficult. No sooner a person starts his Prayer, Shaytan whispers in his heart pulling him from one side to another, and continuously engaging him into all sorts of thoughts and memories.

The heart engages itself into accounting, planning, reviewing past and future problems, solving academic problems, very often recollecting during Prayer, and topics, which were forgotten by him completely. And when he returns to himself, he discovers his Prayer are over.

AL-Zahrawi (ABULCASIS, BUCASIS, ALZAHRAVIUS) 930-1013 A.D.

His full name is Abu-Al-Qasim Khalaf Ibn'Abbas Al-Zahrawi . He had been known in the Western World asAbulcasis ,Bucasis orAlzahravius . He is the famous surgeon of the Arabs. In 930 A.D., he was born in Al-Zahra, a suburb of Cordova. He attended the University ofCordova which had been established for one and a half centuries. At thattime Cordova had a population of one million (Hitti 1977). It was the magnificent capital of Al-Andalus where culture and science were at their peak in Europe. In militarypower the Moslems also reached their zenith, not only in Spain but also throughout Europe after King Abdel-Rahman III defeated the Spanish kings of Navarre, Castile, and Leon at the north in 997 A.D.

Al-Zahrawi became an eminent surgeon.lie was appointed as the Court-Physician of King Abdel-Rahman III. He spent a productive life in Practicing medicine,especialy in surgery and medical writings. He died at the age of 83.

He wrote mainly four books. One of them is "Al-Tastif Liman Ajiz'an Al-Ta'lif ' which is the best medieval surgical encyclopedia. Itwas used in Europe until the 17th century. He stressed the importance of basic sciences: "... Before practicing, one should be familiar with the science of anatomy and the functions of organs so that he will understand them, recognize their shape, understand their connections, and know their borders.

Also he should know the bones, nerves, and muscles, their numbers, their origin and insertions, the arteries and the veins, their start and end. These anatomical and physiological bases are important, and as said by Hippocrates: 'These are many physicians by title and a few bypractice.' ... If one does not comprehend the anatomy and physiology, he may commit a mistake that can kill the patient. I have seen someone, who pretended to be a surgeon, incised an aneurysm in the neck of awoman , mistaking it for anabscess.The woman bled to death."

Heller stated that Al-Zahrawi described the ligature of arteries long before Ambrose Pare (Khairallah 1942). Al-Zahrawi also usedcautery to control bleeding. He used wax and alcohol to stop bleeding from the skull during cranial surgery.Sprengel said that Al-Zahrawi was the first to teach thelithotomy position for vaginal operations (Khairallah 1942). Al-Zahrawi also described the tracheotomy operation and performed it as an emergency on one of his servants.

He was the first to write on orthodontia. He showed evidence of great experience from details of clinical picture and surgical procedures e.g. his description of varicose veins stripping, even after ten centuries, is almost like modern surgery (Al-Okbi 1971): "... Have the leg shaved if it is much hairy.

The patient gets a bath and his legis kept in hot water until it becomes red and the veins dilate; or he exercises vigorously. Incise the skin opposite the varicose vein longitudinally either at the ankle or at the knee. Keep the skin opened by hooks. Expose, dissect, and separate the vein.Introducc a spatula underneath it.

When the vein is elevated above the skin level, hang it with a blunt rounded hook. Repeat the procedure about three fingers from the previous site and hang the vein with another hook as previously done. Repeat the procedure at as many sites along the varicose vein as necessary. At the ankle,ligate and strip it by pulling it from the incision just above. When it reaches there, repeat at the higher incision until all of itis stripped .

Ligate the vein and then excise it. If difficulty is encountered in pulling it,ligate its terminal part with astring and pass it under the spatula and dissect it further. Pull gently and avoid its tearing because if it does, it becomes difficult to strip all of it and can cause harm to the patient.

When you have stripped it all, put alcoholspanges at the sites of the skin incisions and take care of the incisions until they heal. If the varicose vein is tortuous, you have to incise the skin more frequently, at each change of direction. Dissectit and hang it with the hooks and strip it as previously described. Do not tear the vein or injure it. If this happens, it becomes difficult to strip it. The hooks used should be blunt, eyeless, androunded, otherwise it can injure the vein".

He also wrote about fracture of the skull (Al-Okbi 197 1): "... The types of skull fractures are numerous, their shapes are different, and their causes are many. For example, some skull fractures are due to a blow by a sword that splits the whole skull and reaches thedura , the same as the ax does to the wood, therefore itis called axial fracture. Sometimes the sword does not split the skullcompletely, it is thus called incomplete axial fracture. Such a fracture can be small or big.

Another type is comminuted fractureWhich can be due to a hit by a stone or a fall on a stone; and this fracture can reach thedura or only be limited to the outer part of the bone. This fracture can also be small or big. A third type is the hairy type of skullfracture which is so tiny and linear like a hair.

A fourth type is the depressedfracture which occurs due to a fail or a blow so the bone is depressed like a brass jar when hit by a blunt instrument. This usually happens when the bone is soft as children. The types of these fracturesare diagnosed by examining the wound, removing the debris and contused pan of the scalp, exposing the skull, and feeling it by the spatulas. The hairy fracture is difficult to discover and can be diagnosed by exposing the skull, and smearing it with ink; the linear fracture thus appears stained."

In the treatment of fractures of the skull, Al-Zahrawi wrote: "... If the patient shows serious signs such as high fever, repeated vomiting,exophthalmos , convulsions, and coma, do not touch him because he is probably going to die. Otherwise, treat him as follows: first shave the patient's head. In comminuted depressed fractures, these pieces of boneshould be removed as will be explained. If in the process of the patient's examination or during surgery bleeding occurs, itcan be controlled by pressure using towels soaked in alcohol and by wax. Then after control of the bleeding, the small pieces of bone are removed using specialforceps .

To remove the depressed fracture, first, make trephines in the healthy bone around it. These trephine instruments should not penetrate beyond the skull into the soft tissues underneath, thus they are callednon penetrating trephines. They have a rounded ring in their proximal end to prevent them from penetrating beyond certain depths. You should have a number of these trephines that can stop at different depths depending on the thickness of the skull. Connect the holes in the skull using special saws.

First, use a fine small saw, then larger ones. These should be sharp and made of steel. Avoid cutting thedura by the trephine or saw. Once the depressed bone is freed, remove it gently,then smoothen the edges of the skull by special instruments. Wash with alcohol and treat the wound with packs soaked with ointment."

Al-Zahrawi described many dental operations such as dental extractions, fixation, re implantation, and artificial teeth. He described referred tooth pain and cautioned the physician against removal of the healthy tooth to which painis referred . He used gold threads to fix teeth because other metals would tarnish and cause a reaction. Chapter 6 of his book was all devoted to foreign bodies of the ear and their treatment. He also devoted one whole chapter to midwifery , giving tips to midwives, and describing the problems of difficult labor and obstetricalmanoeuvre .

He recommended decompression of the fetal head for obstructed labor and described the instruments used. He described the management of liver abscess by treating it into two stages (Khairallah 1942). The first stage was to allow adhesions around it and to close it from the peritoneal cavity. The second stage was to incise it...."If the procedure is done in one stage, the pus may spread to the whole abdomen and the patient may die."

He describeda total of 200 surgical and dental instruments most of them were original (Fig. 3). He said "... Choose your instruments carefully beforehand according to the operation. However, you should design other devices if needed."Thus he encouraged the physician to be innovative.

During the time of Al-Zahrawi , surgery in the Islamic world became a respected specialty practiced by reputable physicians. On thecontrary in Europe, surgery was belittled and practiced by barbers and butchers. In 1163 A.D., the Council of Tours declared the following resolution "Surgery is tobe abandoned by the schools of medicine and by all decent physicians."

Ibn-Sina (AVICENNA) 980-1037 A.D.

Ibn-Sina's full name is Abu-AliHusayn lbn -Abdullahlbn-Sina , and his titles were Al-Shaykh Al-Rais (The chief Master) or Al-Muallim Al-Thani (The Second Teacher), second to Aristotle (Browne 1962). Heis known in the Western World as Avicenna.

In 980A.D. Avicenna was born in Bukhara which is now part of Russia and known asUzben . By the age of 10, he was already proficient in the Qur'an and Arabic classics. By the age of 16, he finished Islamic law studies, geometry, anatomy,logic and philosophy.His metaphysics were influenced by an earlier philosopher in Islam, Al-Farabi . By the age of 18, he completed the study of medicine.

Soon after, he became the Prime Minister (theVisier ) and Court-Physician of PrinceNuli -Ibn -Mansur, theSamanid Ruler ofBukbara . The prince was impressed by the intelligence and endurance of hisVisier and opened for him the royal librarywhich was unique in its literary richness.Ibn -Sina wrote his first book at the age of 21.

Then he becameVisier of Aliibn Maimun , the ruler ofKhawarazm orKhiva .But he ultimately fled to avoid being kidnapped by the Sultan Mohammed El-Ghazin . Ironically, fate played an important role in the life of Avicenna who was a master in planning. The ruler ofHainadan , the southern part of Persia, whowas called AmirShwnsu'd-Dawla , had renal colic.Ibn -Sina treated the Amir's colic. The latter was very pleased and appointedIbn -Sina , not only his Court-Physician but also hisVisier . Avicenna was a proud and arrogant man.

This created enemies leading to a mutiny of the military leaders against him resulting in his dismissal and imprisonment. Fortunately, the Amir got renal colic once more and no one could relieve his pain. He thus summoned back Avicenna who cured him. The Amir apologized to Avicenna and reinstated him.

Avicenna's life during this time was extraordinarily strenuous. All the day he was busy with the Amir's services. The great part of the night was passed in lecturing and writing his books, with intervals ofwine-drinking , music, and minstrelsy. After many vicissitudes, worn out by hard work and hard living, Avicenna died andwas buried in Hamadan, Persia, in 1037 A.D. at a comparatively early age of 57. In his last illness, he treated himself unsuccessfully, so thatit was said by his detractors that neither could his physics save his body nor his metaphysics save his soul (Browne 1962) .

Avicenna wrote I00 treatises, 21 of them were major of which 16 were in medicine. He wrote in philosophy, medicine, named Al-Qanon fi Al-Tibb (Canon of Medicine). It was an encyclopedia containing more than one million words. It was composed of5 volumes:

VolumeI - described the principles and theories of medicine.

Volume II- contained the simple drugs arranged alphabetically.

Volume III- described localized diseases of the body from the head to the toes.

Volume IV-was addressed to generalized diseases of the body e.g. fevers.

Volume V- explained compounddrungs .

The Canon contained all medical knowledge up to the 1Oth century. Itwas translated to many languages and was the reference for medical schools in Europe.

up to the 17th century. Although the Canon was a great book, it overshadowed the important works prior to it by Al-Razi and Al-Zahrawi , and subsequent to it byIbn -Al-Nafis and AliIbn-Abbas , HalleAbbas , (Haddad 1942).

Avicenna wrote Arabic and Persianpoems.The last of his Arabic poem, which is considered a classical beauty, describes the descent of the Soul into the Body from the Higher Sphere which is its home (Browne 1962).

Avicennais considered a great philosopher, and his writings affected the thinkers and influenced many of those who appeared after him. He was a unique phenomenon, not only because ofthis encyclopedic accomplishments in medicine, but also because of the versatility of his genius. Hehas been compared in this respect with Aristotle, Leonardoda Vinci, and Goethe.(Keys 1971).

Ibn-Rushd (AVERROES) 1126-1198 A.D.Ibn - Rashid, or Averroes as known in Europe, was born in Granada in 1126 A.D. He studied philosophy,medicine and law. Hewas appointed as a judge in Seville in 1169 A.D. where he stayed in office for a quarter of a century.He was affected by Aristotle on whom he wrote important commentaries (Black 1970, Al-A'sar 1972) . In theseinterpretations he asserted that the human soul is not independent, but shares a universal mind. This belief caused a great controversy andwas later declared heretical by both the Moslems and Christians alike because it contradicted the doctrine of personal immortality.

He was admired by the Jews of Spain who spread Ws philosophy into Europe especially into Italy and France after they were forced out of Spain . His followers interpreted some of his writings to mean that there are two kinds of truth, aphilosophical and a religious truth. This implied a separation of reason and faith and influenced philosophical and theological speculation for many centuries. Because of his bold ideas, he was dismissed from his work and sent to Morocco where he was kept in prisontill he died on December 12, 1198.his important contribution to medicine was "Al-Kulliyat fi Al-Tibb " (Colliyet ).

It was a summary of the medical science at that time and composed of seven parts. He wrote another book, "Al-Taisir " on practical medicine. It consisted of useful excerpts and a clinical description of diseases including serouspericarditis andmediastinal abscens . He personally suffered from the latter disease and left very careful records of his own symptoms. The bookis not known in Arabic, but there are several Latin editions (Haddad 1942).Ibn-Rushd was another example of the cultured Arabic physician.

IBN-MAIMON (MAIMONEDES) 1135-1204 A.D.

In 1135, MusaIbn-Maimon (Moses Maimonides) was born in Cordova, Spain (Minlcin 1968). His father was a Rabbi and had a great influence of Moses in his interests and future achievements. During that period, the Jews had a golden era in Spain.Minkin (1968), a renowned scholar and an eminent Rabbiwrote "It was Mohammedan Spain, the only land the Jews knew in nearly a thousand years of their dispersion, which made the genius of Moses Maimonides possible."

In1160 A.D.,Moscs emigrated to North Africa to the city ofFas where be studied medicine. In 1165 A.D., he left to Palestine. However, he was dissatisfied with the cultural atmosphere. Therefore, he went to Egypt where he stayed until he died in 1204 A.D. Hewas buried inTeberias , Palestine.

Maimonides first started his career as the Rabbi of thejewish Comniunity of El-Fostat city, the capital of Egypt at that time and part of old Cairo now. Later on in life, he practiced medicine. He became an eminent and respected physician. He served both KingsSalah -El-Din (Saladin) and his elder son Sultan Al-Malik Al-Afdel during his short reign (1198-1200 A.D.). He had the confidence of both. DuringSalali -El-Din war with King Richard, the Lion-Hearted, the latter fell sick.

Although those two kings were at war, they had respect and admiration of each other. Saladin sentIbn -Maimon to Richard to treat him.After being, cured. Rictiard askedIbn -Maimon to join his court.But the latter politely declined and preferred to stay with Saladin (Minkin 1968).

Ibn-Maimon's impact on the Jewish religion is very important. He wrote classical work in the Jewish religion including codification of the Jewish laws (Black and Roth 1970).Hc also wrote in philosophy. His book, "Dalalat Al-Hai'ran " (The Guide of the Perplexed) is an importantachievement which was welcomed not only by those of the Jewish faith but also by Moslems and Christians alike. Hewas affected by his contemporaryIbn -Rushd , and byAristotl'e , but he tried to unite logic and faith. He wrote his book in Arabic. He did not live long enough to see the Hebrew translation of hisbook which would have given him a great satisfaction.

Inmedicine Ibn -Maimon did two important things: First, be translated many Arabic books into Hebrew which were than translated into Latin and other European languages. An example of these books is the Canon of Avicenna. Second, bewrote a few books of his own. One of them is "Magala flTadbir Al-Sihha " (RegimenSanitatis ) which stressed proper diet, personal hygiene, and moderation in the pleasures of life. It was in the form of letters to the Sultan Al-Afdel . The other was "Kitab " Al-Fusal fi Al-Tibb " (Fisul Musa). This was a collection of 1,500 aphorisms extracted from Galen writings together with forty-two critical remarks. Moses also wrote a book on poisons and their antidotes (Al-A'sar 1971).

When he died, the Jewish Community in Egypt built a synagogue named after him.Some Jews, up-till-now, stay overnight in this synagogue in hope of receiving healing through the spirit of this great physician (Minkin 1968).

Ibn -El-Nafis 1208 - 1288 A.D.

In 1208 A.D.,Ala'El-Deen Ibn -El-Nafis was born in a small town near Damascus calledKersh (Fig. 7) (Ibrahim 1971). He learned medicine and philosophy in Damascus and spent most of his life in Cairo. He was a physician, a linguist, a philosopher, and a historian. He was the first chief of Al-Mansuri Hospital in Cairo and the dean of the School of Medicine in 1284 A.D.

During this era, the medicalprofession together with other branches of science were passing a crisis. The Mongol Tartar invasion and destruction of Baghdad in 1258 A.D. caused an injury to the Islamic civilization from which it never recovered. It destroyed forever the Caliphate, symbolic unity of the Arabian Empire, and the preeminence of Baghdad as a center for learning.

Also during thatperiod Islamic culture was declining in Spain. It was then Cairo and Damascus the centers for education and medical prestige. There, the medical professionwas characterized by the freedom of discussion and expression of opinion, something that was very new in medicine and not known to Europe until the 17th century when introduced to England bySedenbam (Ibrahim 1971).

Ibn -El-Nafis was a dedicated person. He used to start his day after dawn prayers by making rounds at the hospital, followed by case discussions with students and colleagues, then hospital administration. His evenings were spent reading,writing and discussing medicine and philosophy with frequent scholar guests at his home in El-Hussein District in Old Cairo. His house was an example of beautiful Arabic architecture, made of marble with a fountain in the central hall.

In the history ofmankind, there are persons whose importance is revealed with the flight of time and their truth glows with the passage of centuries;Ibn -El-Nafis is one of those. He wrote many books, ten of them in medicine and a special one in philosophy. In the latter book "Fadel Ibn -Natik ", he tried to present the counter point of the philosophical view of Avicenna expressed in his book "Hai Ibn-Yakzan ".

He was an authority in theology on which he wrote several books, e.g. "The complete Message of the Prophet" and "Al-Ragol Al-Kamel " (The Perfect Man) supportingunitarianism .Ibn -El-Nafis had an important character, not being a follower but a scholar. This was evident in his writings whether in philosophy or medicine.

Inmedicine he wrote many books, two of them are "Mujaz Al-Qanun " which means the "Summary of the Canon". In these twobooks which were based onavicenna's writings, he criticized the short comings of Avicenna's book and of Galen's views and added to them. That is whyhe was named by some as Avicenna the Second .

Forexample be wrote "... We have relied chiefly on his (Galen) teachings, except in a fewdetails which we think are wrong and were not given after a thorough investigation. In describing the function of the organs, we have depended on careful investigation, observation, and honest study, regardless of whether or not these fit with the teachings and theories of those who have preceded us."

Ibn -El-Nafis added lights to the physiology of the circulation. In the ancient history,Erasistratus of the AlexandriaScbool (310 B.C. - 250 B.C.) believed that blood was contained only in the eight side of the circulation, namely the veins and the fight side of the heart. The left side of the circulation, namely the left side of the heart and the arteries were supposed to contain air because arteries were found empty when an animal was sacrificed, hence the name "arteria ".

When Galen came (131 - 210 A.D.), he described blood to pass from the right side of the heart to the left side through minute openings in the septum of the heart, then it mixed with air from the lungs, andsequently distributed to the whole body. Forcenturies this was the prevalent belief and no one, including the Arab physicians and their eminent writer Avicenna, could dare to challenge this sacred view.Ibn -El-Nafis did. Fivetimes he stated in unmistakable terms that "... the blood from the right chamber of the heart must arrive at the left chamber, but there is no direct pathway between them.

The thick septum of the heart is not perforated and does not have visible pores as some people thought or invisible pores as Galen thought. The blood from the right chamber must flow through the venaarteriosa (pulmonary artery) to the lungs, spread through its substance, he mingled with air, pass through thearteria venosa (Pulmonary vein) to reach the left chamber of the heart..." ( Salem 1968). In describing the anatomy of thelung Ibn -El-Nafis stated: "The lung is composed of.

first, the bronchi: second, the branches of thearteria avenosa ; and third, the branches of the venaarteriosa ; all of these are connected by loose porous flesh The need of the lung for the venaarteriosa is to transport to it the blood that has been thinned and warmed in the heart, so that what seeps through the pores of the branches of this vessel into the alveoli of the lung may mix with what is of air therein and combine with it and the mixture is carried to the left cavity of the heart by thearteria venosa " (Haddad 1936).

Ibn -El-Nafis also made other contributions in the circulation. Avicenna, following Galen's description of the anatomy, stated that the human heart has three ventricles.Ibn -El-Nafis rejected that as he said "...And his statement ((Avicenna's) that the heart has three ventricles is not correct, as the heart has onlytow ventricles..." He was also the first to describe the coronary circulation as he wrote "...Again, his statement (Avicenna's) that the blood in the right side is to nourish the heart is not true at all, for the nourishment of the heart is from the blood that goes through the vessels that permeate the body of the heart... "

Three centuries after the discovery of the pulmonary circulation byIbn - El-Nafis , others, such as Michael Servetus,Realdus Colombus , CarloRuini , AndreaCesalpino , and Francois Rabelais, claimed the same thing (Mayerhof 1935). There is a strong suspicion that these authors obtained their knowledge from the Arabicliterature which was available at that time to the European investigators without giving credit toIbn -El-Nafis (Keys 1971, Haddad 1942).

It is considered to be more than a coincidence that Servetus would discover the pulmonary circulation,and also to write a book, similar to that ofIbn -El-Nafis , on Unitarianism. Servetuswas burnt with his book, "Restitutio Christianismi " in Geneva in October 1553 at the order of Calvin because he was considered heretic.

The ArabsAnd Ophthalmology

The Arabs were much interested in ophthalmology. In the ninth century,Hunayn Ibn-Ishak (Joannitius ) translated to Arabic the Greek literature on the eye. As mentioned before, Al-Razi described the changes in the caliber of the eye produced by relaxation and contraction of the iris. He also described the cataract operation.

In 1050 A.D. at Baghdad, AliIbn -Isa (Jesu Haly ) wrote the classic book on ophthalmology,Tathkirat Al-Kahhalin (A Note for the Oculists). As stated byCunistan (1921), it is the oldest book in its original language on diseases of the eye. In a clear and logical style, the author described trachoma, conjunctivitis, and cataract, and prescribed treatment (Keys 1971).

Avicenna described the six extrinsic muscles of the eyeball.

In the thirteenth century,Ibn Abu-Al-Kawafer wrote a book on therapeutic ophthalmology entitled "Natigat -El-Fikr fi Ilag Amrad El-Bassar " (Conclusions fromExpelience on Treatment of Diseases of the Eye). According toKahil (1929) is one of several textbooks of ophthalmology consideredto be superior to any written in Europe up to the eighteenth century.

ARABS AND ANESTHESIA

Being an obstetric anesthesiologist,I feel obligated to write a little more on the contributions of the Arabs to both anesthesia and obstetrics.

First, in anesthesia, the Arabs described in detail the pharmacology of important narcotics such as opium and other central nervous system depressants such ashyoscyamus and hashish (Khairallal 1942). Burton (1886 A.D.)stated that "anesthetics have been used in surgery throughout the East for centuries before ether and chloroform became the fashion in the civilized West. In a Treatise on the Canon of Medicine byGruner it is stated by Avicenna under the article 8l4 ANESTHETICS:"If it is desirable to get a person unconscious quickly, without him being harmed, add sweet smelling moss to the wine, or lignum aloes.

If it is desirable to procure a deeply unconscious state,so as to able the pain to be borne which is involved in painful applications to a member.place darnel-water into the wine, or administer fumitory,opiuium ,hyoscyamus (half dram doses of each); nutmeg, crude aloes-wood (4 grains of each). Add this to the wine, and take as much as is necessary for the purpose.Or .boil blackhyoscyamus in water, withmandragore bark, until it becomes red. Add this to the wine."

The Arabs also introduced "the Soporific Sponge" which was commonly used for anesthesia in the middle ages. The sponge was soaked with aromatics and narcotics to besucked and then held under the nostril to provide anesthesia prior to surgery (Keys 1971).

Avicenna wrote more than 1,000 years ago about the effect of pain on ventilation: "Pain dissipates the bodily strength and interferes with the normal functions of the organs. The respiratory organs are inhibited from drawing in air, and consequently the act of breathing is interfered with, and the respiration becomes intermittent, rapid, or altogether unnatural in rhythm" (Gruner 1930).

ARABS AND OBSTETRICS

Hynayn Ibn-Ishak (Joannitius , 809-873 A.D.) translated the work of the Greek pioneer in obstetrics, Paul of Aegina, into Arabic.Hunayn also translated to the Arabic world most of the work of Hippocrates, Galen, and Ptolemy. Moreover, he was a gifted physician and philosopher. AliIbn -Al-Abas Al-Majusi (HalleAbbas ) who died in 994 A.D. was the first to describe in his book "Al-Kitab Al-Malaki " (The Royal Book) that the uterine contractions are the cause of delivery of the fetus (Keys 1971). Before him, itwas thought that the uterine contractions were only as indication of the onset of labor; subsequently the fetus would swim its way out of the womb and birth canal.

Most of the deliveries were performed by midwives at home . For complicatedobstetrics Al-Zahrawi offered advice to midwives as mentioned

www.alhassanain.org/english

AL-Zahrawi (ABULCASIS, BUCASIS, ALZAHRAVIUS) 930-1013 A.D.

His full name is Abu-Al-Qasim Khalaf Ibn'Abbas Al-Zahrawi . He had been known in the Western World asAbulcasis ,Bucasis orAlzahravius . He is the famous surgeon of the Arabs. In 930 A.D., he was born in Al-Zahra, a suburb of Cordova. He attended the University ofCordova which had been established for one and a half centuries. At thattime Cordova had a population of one million (Hitti 1977). It was the magnificent capital of Al-Andalus where culture and science were at their peak in Europe. In militarypower the Moslems also reached their zenith, not only in Spain but also throughout Europe after King Abdel-Rahman III defeated the Spanish kings of Navarre, Castile, and Leon at the north in 997 A.D.

Al-Zahrawi became an eminent surgeon.lie was appointed as the Court-Physician of King Abdel-Rahman III. He spent a productive life in Practicing medicine,especialy in surgery and medical writings. He died at the age of 83.

He wrote mainly four books. One of them is "Al-Tastif Liman Ajiz'an Al-Ta'lif ' which is the best medieval surgical encyclopedia. Itwas used in Europe until the 17th century. He stressed the importance of basic sciences: "... Before practicing, one should be familiar with the science of anatomy and the functions of organs so that he will understand them, recognize their shape, understand their connections, and know their borders.

Also he should know the bones, nerves, and muscles, their numbers, their origin and insertions, the arteries and the veins, their start and end. These anatomical and physiological bases are important, and as said by Hippocrates: 'These are many physicians by title and a few bypractice.' ... If one does not comprehend the anatomy and physiology, he may commit a mistake that can kill the patient. I have seen someone, who pretended to be a surgeon, incised an aneurysm in the neck of awoman , mistaking it for anabscess.The woman bled to death."

Heller stated that Al-Zahrawi described the ligature of arteries long before Ambrose Pare (Khairallah 1942). Al-Zahrawi also usedcautery to control bleeding. He used wax and alcohol to stop bleeding from the skull during cranial surgery.Sprengel said that Al-Zahrawi was the first to teach thelithotomy position for vaginal operations (Khairallah 1942). Al-Zahrawi also described the tracheotomy operation and performed it as an emergency on one of his servants.

He was the first to write on orthodontia. He showed evidence of great experience from details of clinical picture and surgical procedures e.g. his description of varicose veins stripping, even after ten centuries, is almost like modern surgery (Al-Okbi 1971): "... Have the leg shaved if it is much hairy.

The patient gets a bath and his legis kept in hot water until it becomes red and the veins dilate; or he exercises vigorously. Incise the skin opposite the varicose vein longitudinally either at the ankle or at the knee. Keep the skin opened by hooks. Expose, dissect, and separate the vein.Introducc a spatula underneath it.

When the vein is elevated above the skin level, hang it with a blunt rounded hook. Repeat the procedure about three fingers from the previous site and hang the vein with another hook as previously done. Repeat the procedure at as many sites along the varicose vein as necessary. At the ankle,ligate and strip it by pulling it from the incision just above. When it reaches there, repeat at the higher incision until all of itis stripped .

Ligate the vein and then excise it. If difficulty is encountered in pulling it,ligate its terminal part with astring and pass it under the spatula and dissect it further. Pull gently and avoid its tearing because if it does, it becomes difficult to strip all of it and can cause harm to the patient.

When you have stripped it all, put alcoholspanges at the sites of the skin incisions and take care of the incisions until they heal. If the varicose vein is tortuous, you have to incise the skin more frequently, at each change of direction. Dissectit and hang it with the hooks and strip it as previously described. Do not tear the vein or injure it. If this happens, it becomes difficult to strip it. The hooks used should be blunt, eyeless, androunded, otherwise it can injure the vein".

He also wrote about fracture of the skull (Al-Okbi 197 1): "... The types of skull fractures are numerous, their shapes are different, and their causes are many. For example, some skull fractures are due to a blow by a sword that splits the whole skull and reaches thedura , the same as the ax does to the wood, therefore itis called axial fracture. Sometimes the sword does not split the skullcompletely, it is thus called incomplete axial fracture. Such a fracture can be small or big.

Another type is comminuted fractureWhich can be due to a hit by a stone or a fall on a stone; and this fracture can reach thedura or only be limited to the outer part of the bone. This fracture can also be small or big. A third type is the hairy type of skullfracture which is so tiny and linear like a hair.

A fourth type is the depressedfracture which occurs due to a fail or a blow so the bone is depressed like a brass jar when hit by a blunt instrument. This usually happens when the bone is soft as children. The types of these fracturesare diagnosed by examining the wound, removing the debris and contused pan of the scalp, exposing the skull, and feeling it by the spatulas. The hairy fracture is difficult to discover and can be diagnosed by exposing the skull, and smearing it with ink; the linear fracture thus appears stained."

In the treatment of fractures of the skull, Al-Zahrawi wrote: "... If the patient shows serious signs such as high fever, repeated vomiting,exophthalmos , convulsions, and coma, do not touch him because he is probably going to die. Otherwise, treat him as follows: first shave the patient's head. In comminuted depressed fractures, these pieces of boneshould be removed as will be explained. If in the process of the patient's examination or during surgery bleeding occurs, itcan be controlled by pressure using towels soaked in alcohol and by wax. Then after control of the bleeding, the small pieces of bone are removed using specialforceps .

To remove the depressed fracture, first, make trephines in the healthy bone around it. These trephine instruments should not penetrate beyond the skull into the soft tissues underneath, thus they are callednon penetrating trephines. They have a rounded ring in their proximal end to prevent them from penetrating beyond certain depths. You should have a number of these trephines that can stop at different depths depending on the thickness of the skull. Connect the holes in the skull using special saws.

First, use a fine small saw, then larger ones. These should be sharp and made of steel. Avoid cutting thedura by the trephine or saw. Once the depressed bone is freed, remove it gently,then smoothen the edges of the skull by special instruments. Wash with alcohol and treat the wound with packs soaked with ointment."

Al-Zahrawi described many dental operations such as dental extractions, fixation, re implantation, and artificial teeth. He described referred tooth pain and cautioned the physician against removal of the healthy tooth to which painis referred . He used gold threads to fix teeth because other metals would tarnish and cause a reaction. Chapter 6 of his book was all devoted to foreign bodies of the ear and their treatment. He also devoted one whole chapter to midwifery , giving tips to midwives, and describing the problems of difficult labor and obstetricalmanoeuvre .

He recommended decompression of the fetal head for obstructed labor and described the instruments used. He described the management of liver abscess by treating it into two stages (Khairallah 1942). The first stage was to allow adhesions around it and to close it from the peritoneal cavity. The second stage was to incise it...."If the procedure is done in one stage, the pus may spread to the whole abdomen and the patient may die."

He describeda total of 200 surgical and dental instruments most of them were original (Fig. 3). He said "... Choose your instruments carefully beforehand according to the operation. However, you should design other devices if needed."Thus he encouraged the physician to be innovative.

During the time of Al-Zahrawi , surgery in the Islamic world became a respected specialty practiced by reputable physicians. On thecontrary in Europe, surgery was belittled and practiced by barbers and butchers. In 1163 A.D., the Council of Tours declared the following resolution "Surgery is tobe abandoned by the schools of medicine and by all decent physicians."

Ibn-Sina (AVICENNA) 980-1037 A.D.

Ibn-Sina's full name is Abu-AliHusayn lbn -Abdullahlbn-Sina , and his titles were Al-Shaykh Al-Rais (The chief Master) or Al-Muallim Al-Thani (The Second Teacher), second to Aristotle (Browne 1962). Heis known in the Western World as Avicenna.

In 980A.D. Avicenna was born in Bukhara which is now part of Russia and known asUzben . By the age of 10, he was already proficient in the Qur'an and Arabic classics. By the age of 16, he finished Islamic law studies, geometry, anatomy,logic and philosophy.His metaphysics were influenced by an earlier philosopher in Islam, Al-Farabi . By the age of 18, he completed the study of medicine.

Soon after, he became the Prime Minister (theVisier ) and Court-Physician of PrinceNuli -Ibn -Mansur, theSamanid Ruler ofBukbara . The prince was impressed by the intelligence and endurance of hisVisier and opened for him the royal librarywhich was unique in its literary richness.Ibn -Sina wrote his first book at the age of 21.

Then he becameVisier of Aliibn Maimun , the ruler ofKhawarazm orKhiva .But he ultimately fled to avoid being kidnapped by the Sultan Mohammed El-Ghazin . Ironically, fate played an important role in the life of Avicenna who was a master in planning. The ruler ofHainadan , the southern part of Persia, whowas called AmirShwnsu'd-Dawla , had renal colic.Ibn -Sina treated the Amir's colic. The latter was very pleased and appointedIbn -Sina , not only his Court-Physician but also hisVisier . Avicenna was a proud and arrogant man.

This created enemies leading to a mutiny of the military leaders against him resulting in his dismissal and imprisonment. Fortunately, the Amir got renal colic once more and no one could relieve his pain. He thus summoned back Avicenna who cured him. The Amir apologized to Avicenna and reinstated him.

Avicenna's life during this time was extraordinarily strenuous. All the day he was busy with the Amir's services. The great part of the night was passed in lecturing and writing his books, with intervals ofwine-drinking , music, and minstrelsy. After many vicissitudes, worn out by hard work and hard living, Avicenna died andwas buried in Hamadan, Persia, in 1037 A.D. at a comparatively early age of 57. In his last illness, he treated himself unsuccessfully, so thatit was said by his detractors that neither could his physics save his body nor his metaphysics save his soul (Browne 1962) .

Avicenna wrote I00 treatises, 21 of them were major of which 16 were in medicine. He wrote in philosophy, medicine, named Al-Qanon fi Al-Tibb (Canon of Medicine). It was an encyclopedia containing more than one million words. It was composed of5 volumes:

VolumeI - described the principles and theories of medicine.

Volume II- contained the simple drugs arranged alphabetically.

Volume III- described localized diseases of the body from the head to the toes.

Volume IV-was addressed to generalized diseases of the body e.g. fevers.

Volume V- explained compounddrungs .

The Canon contained all medical knowledge up to the 1Oth century. Itwas translated to many languages and was the reference for medical schools in Europe.

up to the 17th century. Although the Canon was a great book, it overshadowed the important works prior to it by Al-Razi and Al-Zahrawi , and subsequent to it byIbn -Al-Nafis and AliIbn-Abbas , HalleAbbas , (Haddad 1942).

Avicenna wrote Arabic and Persianpoems.The last of his Arabic poem, which is considered a classical beauty, describes the descent of the Soul into the Body from the Higher Sphere which is its home (Browne 1962).

Avicennais considered a great philosopher, and his writings affected the thinkers and influenced many of those who appeared after him. He was a unique phenomenon, not only because ofthis encyclopedic accomplishments in medicine, but also because of the versatility of his genius. Hehas been compared in this respect with Aristotle, Leonardoda Vinci, and Goethe.(Keys 1971).

Ibn-Rushd (AVERROES) 1126-1198 A.D.Ibn - Rashid, or Averroes as known in Europe, was born in Granada in 1126 A.D. He studied philosophy,medicine and law. Hewas appointed as a judge in Seville in 1169 A.D. where he stayed in office for a quarter of a century.He was affected by Aristotle on whom he wrote important commentaries (Black 1970, Al-A'sar 1972) . In theseinterpretations he asserted that the human soul is not independent, but shares a universal mind. This belief caused a great controversy andwas later declared heretical by both the Moslems and Christians alike because it contradicted the doctrine of personal immortality.

He was admired by the Jews of Spain who spread Ws philosophy into Europe especially into Italy and France after they were forced out of Spain . His followers interpreted some of his writings to mean that there are two kinds of truth, aphilosophical and a religious truth. This implied a separation of reason and faith and influenced philosophical and theological speculation for many centuries. Because of his bold ideas, he was dismissed from his work and sent to Morocco where he was kept in prisontill he died on December 12, 1198.his important contribution to medicine was "Al-Kulliyat fi Al-Tibb " (Colliyet ).

It was a summary of the medical science at that time and composed of seven parts. He wrote another book, "Al-Taisir " on practical medicine. It consisted of useful excerpts and a clinical description of diseases including serouspericarditis andmediastinal abscens . He personally suffered from the latter disease and left very careful records of his own symptoms. The bookis not known in Arabic, but there are several Latin editions (Haddad 1942).Ibn-Rushd was another example of the cultured Arabic physician.

IBN-MAIMON (MAIMONEDES) 1135-1204 A.D.

In 1135, MusaIbn-Maimon (Moses Maimonides) was born in Cordova, Spain (Minlcin 1968). His father was a Rabbi and had a great influence of Moses in his interests and future achievements. During that period, the Jews had a golden era in Spain.Minkin (1968), a renowned scholar and an eminent Rabbiwrote "It was Mohammedan Spain, the only land the Jews knew in nearly a thousand years of their dispersion, which made the genius of Moses Maimonides possible."

In1160 A.D.,Moscs emigrated to North Africa to the city ofFas where be studied medicine. In 1165 A.D., he left to Palestine. However, he was dissatisfied with the cultural atmosphere. Therefore, he went to Egypt where he stayed until he died in 1204 A.D. Hewas buried inTeberias , Palestine.

Maimonides first started his career as the Rabbi of thejewish Comniunity of El-Fostat city, the capital of Egypt at that time and part of old Cairo now. Later on in life, he practiced medicine. He became an eminent and respected physician. He served both KingsSalah -El-Din (Saladin) and his elder son Sultan Al-Malik Al-Afdel during his short reign (1198-1200 A.D.). He had the confidence of both. DuringSalali -El-Din war with King Richard, the Lion-Hearted, the latter fell sick.

Although those two kings were at war, they had respect and admiration of each other. Saladin sentIbn -Maimon to Richard to treat him.After being, cured. Rictiard askedIbn -Maimon to join his court.But the latter politely declined and preferred to stay with Saladin (Minkin 1968).

Ibn-Maimon's impact on the Jewish religion is very important. He wrote classical work in the Jewish religion including codification of the Jewish laws (Black and Roth 1970).Hc also wrote in philosophy. His book, "Dalalat Al-Hai'ran " (The Guide of the Perplexed) is an importantachievement which was welcomed not only by those of the Jewish faith but also by Moslems and Christians alike. Hewas affected by his contemporaryIbn -Rushd , and byAristotl'e , but he tried to unite logic and faith. He wrote his book in Arabic. He did not live long enough to see the Hebrew translation of hisbook which would have given him a great satisfaction.

Inmedicine Ibn -Maimon did two important things: First, be translated many Arabic books into Hebrew which were than translated into Latin and other European languages. An example of these books is the Canon of Avicenna. Second, bewrote a few books of his own. One of them is "Magala flTadbir Al-Sihha " (RegimenSanitatis ) which stressed proper diet, personal hygiene, and moderation in the pleasures of life. It was in the form of letters to the Sultan Al-Afdel . The other was "Kitab " Al-Fusal fi Al-Tibb " (Fisul Musa). This was a collection of 1,500 aphorisms extracted from Galen writings together with forty-two critical remarks. Moses also wrote a book on poisons and their antidotes (Al-A'sar 1971).

When he died, the Jewish Community in Egypt built a synagogue named after him.Some Jews, up-till-now, stay overnight in this synagogue in hope of receiving healing through the spirit of this great physician (Minkin 1968).

Ibn -El-Nafis 1208 - 1288 A.D.

In 1208 A.D.,Ala'El-Deen Ibn -El-Nafis was born in a small town near Damascus calledKersh (Fig. 7) (Ibrahim 1971). He learned medicine and philosophy in Damascus and spent most of his life in Cairo. He was a physician, a linguist, a philosopher, and a historian. He was the first chief of Al-Mansuri Hospital in Cairo and the dean of the School of Medicine in 1284 A.D.

During this era, the medicalprofession together with other branches of science were passing a crisis. The Mongol Tartar invasion and destruction of Baghdad in 1258 A.D. caused an injury to the Islamic civilization from which it never recovered. It destroyed forever the Caliphate, symbolic unity of the Arabian Empire, and the preeminence of Baghdad as a center for learning.

Also during thatperiod Islamic culture was declining in Spain. It was then Cairo and Damascus the centers for education and medical prestige. There, the medical professionwas characterized by the freedom of discussion and expression of opinion, something that was very new in medicine and not known to Europe until the 17th century when introduced to England bySedenbam (Ibrahim 1971).

Ibn -El-Nafis was a dedicated person. He used to start his day after dawn prayers by making rounds at the hospital, followed by case discussions with students and colleagues, then hospital administration. His evenings were spent reading,writing and discussing medicine and philosophy with frequent scholar guests at his home in El-Hussein District in Old Cairo. His house was an example of beautiful Arabic architecture, made of marble with a fountain in the central hall.

In the history ofmankind, there are persons whose importance is revealed with the flight of time and their truth glows with the passage of centuries;Ibn -El-Nafis is one of those. He wrote many books, ten of them in medicine and a special one in philosophy. In the latter book "Fadel Ibn -Natik ", he tried to present the counter point of the philosophical view of Avicenna expressed in his book "Hai Ibn-Yakzan ".

He was an authority in theology on which he wrote several books, e.g. "The complete Message of the Prophet" and "Al-Ragol Al-Kamel " (The Perfect Man) supportingunitarianism .Ibn -El-Nafis had an important character, not being a follower but a scholar. This was evident in his writings whether in philosophy or medicine.

Inmedicine he wrote many books, two of them are "Mujaz Al-Qanun " which means the "Summary of the Canon". In these twobooks which were based onavicenna's writings, he criticized the short comings of Avicenna's book and of Galen's views and added to them. That is whyhe was named by some as Avicenna the Second .

Forexample be wrote "... We have relied chiefly on his (Galen) teachings, except in a fewdetails which we think are wrong and were not given after a thorough investigation. In describing the function of the organs, we have depended on careful investigation, observation, and honest study, regardless of whether or not these fit with the teachings and theories of those who have preceded us."

Ibn -El-Nafis added lights to the physiology of the circulation. In the ancient history,Erasistratus of the AlexandriaScbool (310 B.C. - 250 B.C.) believed that blood was contained only in the eight side of the circulation, namely the veins and the fight side of the heart. The left side of the circulation, namely the left side of the heart and the arteries were supposed to contain air because arteries were found empty when an animal was sacrificed, hence the name "arteria ".

When Galen came (131 - 210 A.D.), he described blood to pass from the right side of the heart to the left side through minute openings in the septum of the heart, then it mixed with air from the lungs, andsequently distributed to the whole body. Forcenturies this was the prevalent belief and no one, including the Arab physicians and their eminent writer Avicenna, could dare to challenge this sacred view.Ibn -El-Nafis did. Fivetimes he stated in unmistakable terms that "... the blood from the right chamber of the heart must arrive at the left chamber, but there is no direct pathway between them.

The thick septum of the heart is not perforated and does not have visible pores as some people thought or invisible pores as Galen thought. The blood from the right chamber must flow through the venaarteriosa (pulmonary artery) to the lungs, spread through its substance, he mingled with air, pass through thearteria venosa (Pulmonary vein) to reach the left chamber of the heart..." ( Salem 1968). In describing the anatomy of thelung Ibn -El-Nafis stated: "The lung is composed of.

first, the bronchi: second, the branches of thearteria avenosa ; and third, the branches of the venaarteriosa ; all of these are connected by loose porous flesh The need of the lung for the venaarteriosa is to transport to it the blood that has been thinned and warmed in the heart, so that what seeps through the pores of the branches of this vessel into the alveoli of the lung may mix with what is of air therein and combine with it and the mixture is carried to the left cavity of the heart by thearteria venosa " (Haddad 1936).

Ibn -El-Nafis also made other contributions in the circulation. Avicenna, following Galen's description of the anatomy, stated that the human heart has three ventricles.Ibn -El-Nafis rejected that as he said "...And his statement ((Avicenna's) that the heart has three ventricles is not correct, as the heart has onlytow ventricles..." He was also the first to describe the coronary circulation as he wrote "...Again, his statement (Avicenna's) that the blood in the right side is to nourish the heart is not true at all, for the nourishment of the heart is from the blood that goes through the vessels that permeate the body of the heart... "

Three centuries after the discovery of the pulmonary circulation byIbn - El-Nafis , others, such as Michael Servetus,Realdus Colombus , CarloRuini , AndreaCesalpino , and Francois Rabelais, claimed the same thing (Mayerhof 1935). There is a strong suspicion that these authors obtained their knowledge from the Arabicliterature which was available at that time to the European investigators without giving credit toIbn -El-Nafis (Keys 1971, Haddad 1942).

It is considered to be more than a coincidence that Servetus would discover the pulmonary circulation,and also to write a book, similar to that ofIbn -El-Nafis , on Unitarianism. Servetuswas burnt with his book, "Restitutio Christianismi " in Geneva in October 1553 at the order of Calvin because he was considered heretic.

The ArabsAnd Ophthalmology

The Arabs were much interested in ophthalmology. In the ninth century,Hunayn Ibn-Ishak (Joannitius ) translated to Arabic the Greek literature on the eye. As mentioned before, Al-Razi described the changes in the caliber of the eye produced by relaxation and contraction of the iris. He also described the cataract operation.

In 1050 A.D. at Baghdad, AliIbn -Isa (Jesu Haly ) wrote the classic book on ophthalmology,Tathkirat Al-Kahhalin (A Note for the Oculists). As stated byCunistan (1921), it is the oldest book in its original language on diseases of the eye. In a clear and logical style, the author described trachoma, conjunctivitis, and cataract, and prescribed treatment (Keys 1971).

Avicenna described the six extrinsic muscles of the eyeball.

In the thirteenth century,Ibn Abu-Al-Kawafer wrote a book on therapeutic ophthalmology entitled "Natigat -El-Fikr fi Ilag Amrad El-Bassar " (Conclusions fromExpelience on Treatment of Diseases of the Eye). According toKahil (1929) is one of several textbooks of ophthalmology consideredto be superior to any written in Europe up to the eighteenth century.

ARABS AND ANESTHESIA

Being an obstetric anesthesiologist,I feel obligated to write a little more on the contributions of the Arabs to both anesthesia and obstetrics.

First, in anesthesia, the Arabs described in detail the pharmacology of important narcotics such as opium and other central nervous system depressants such ashyoscyamus and hashish (Khairallal 1942). Burton (1886 A.D.)stated that "anesthetics have been used in surgery throughout the East for centuries before ether and chloroform became the fashion in the civilized West. In a Treatise on the Canon of Medicine byGruner it is stated by Avicenna under the article 8l4 ANESTHETICS:"If it is desirable to get a person unconscious quickly, without him being harmed, add sweet smelling moss to the wine, or lignum aloes.

If it is desirable to procure a deeply unconscious state,so as to able the pain to be borne which is involved in painful applications to a member.place darnel-water into the wine, or administer fumitory,opiuium ,hyoscyamus (half dram doses of each); nutmeg, crude aloes-wood (4 grains of each). Add this to the wine, and take as much as is necessary for the purpose.Or .boil blackhyoscyamus in water, withmandragore bark, until it becomes red. Add this to the wine."

The Arabs also introduced "the Soporific Sponge" which was commonly used for anesthesia in the middle ages. The sponge was soaked with aromatics and narcotics to besucked and then held under the nostril to provide anesthesia prior to surgery (Keys 1971).

Avicenna wrote more than 1,000 years ago about the effect of pain on ventilation: "Pain dissipates the bodily strength and interferes with the normal functions of the organs. The respiratory organs are inhibited from drawing in air, and consequently the act of breathing is interfered with, and the respiration becomes intermittent, rapid, or altogether unnatural in rhythm" (Gruner 1930).

ARABS AND OBSTETRICS

Hynayn Ibn-Ishak (Joannitius , 809-873 A.D.) translated the work of the Greek pioneer in obstetrics, Paul of Aegina, into Arabic.Hunayn also translated to the Arabic world most of the work of Hippocrates, Galen, and Ptolemy. Moreover, he was a gifted physician and philosopher. AliIbn -Al-Abas Al-Majusi (HalleAbbas ) who died in 994 A.D. was the first to describe in his book "Al-Kitab Al-Malaki " (The Royal Book) that the uterine contractions are the cause of delivery of the fetus (Keys 1971). Before him, itwas thought that the uterine contractions were only as indication of the onset of labor; subsequently the fetus would swim its way out of the womb and birth canal.

Most of the deliveries were performed by midwives at home . For complicatedobstetrics Al-Zahrawi offered advice to midwives as mentioned

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