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A History of Muslim Pharmacy:
The Final Stage in Medieval Arabic Pharmacy

As was the case in Europe and America up to modern times, many prominent physicians in Islam, too, prepared the necessary medications for their patients. Al-Majusi, az-Zahrawi, and Ibn Sina (d. 428/1037} are good examples. But the importance of the role played by educated pharmacists in the medical field and in society was never ignored. One of the finest definitions of the pharmacist, his role and his profession, was given by the illustrious scholar Abu ar-Rayhan al-Biruni (born in Birun near Khiva 362/973, and died in Ghazna, Afghanistan, 439/1048).

In a book on pharmacy, as-Saydanah fit-Tibb, al-Biruni defined the Pharmacist (as-Saydanani} as the professional who is specialized in the collection of all drugs, choosing the very best of each simple or compound, and in the preparation of good remedies from them following the most accurate methods and techniques as recommended by experts in the healing arts. As part of the health profession, pharmacy became independent of medicine, just as language books (grammars) are separate from the art of composition and prosody from poetry, and logic from philosophy. Pharmacy, therefore, provides the tools to help in the healing art but is not a part of (or a unit with) medicine. Unfortunately, al-Biruni lamented that many so-called pharmacists were not worthy of the name. All they knew was a tradition copied from hearing what others had to say about making remedies; not realizing that pharmaceutical progress resulted only from training academically oriented disciples of intelligent and industrious students who also did not neglect day-to-day practical experiences with drugs. As a result, these trainees would become more and more familiar with the shapes, physical properties, and kinds of drugs. They would then be able to differentiate one from the other and would possess the know-how, a knowledge that could not be taken away from them.

Al-Biruni confirmed that the word Saydanani came from the Indian (Sanskrit) chandanani (or jandanani). In India sandalwood (Sanskrit, chandan or jandan) was used extensively, more than other aromatic woods. Since in Arabic the person who sells amber ('anbar) is called 'anbari, so the person who traded in sandalwood Or chandan was called sandanani) and later sandalani or saydalani. By the same token the apothecary (al-'attar) in Arabic was called ad-dari, since it was reported that ships carrying musk, aromatics, and spices from India and the Orient landed in Darien port. The Arab apothecaries ( 'attarin ), who sold perfumes and aromatics, did not use sandal as often as the Indians. They excluded sandalwood, primarily, because it was not a popular wood in Arabia. Therefore, they applied the title Sandalani (which according to al-Biruni is the most appropriate Arabic rendering of the title) to the highly qualified pharmacist as a dealer of drugs and rare aromatic simples and compounded remedies. The word drug ('uqqar), al-Biruni stated, comes from the Syriac word for the stump of a tree ( root, and Greek rizoma). This word ( uqqar) was later applied to all the parts of the tree and was taken by the Arabs to mean a materia medica and in plural, 'uqaqir'.

Then al-Biruni divided the substances taken internally into three categories:
1. Diets that adapt to the powers and functions of the body and are digested and assimilated to replace what has been lost. Thus) diets were first affected by the   body and then they affected it for its own good (and nourishment).
2. Poisons that act forcibly on the body's functions to the highest degree and cause sickness or death depending on their toxicity and potency, as well as on the body's resistance. In India, there is a special class of 'toxicologists', who treat patients by the use of poisons, he explained.
3. Drugs fall between diets and poisons and their efficacy and advantages as cures depend on the talents, competence and skills of the physician who prescribes them. For this reason physicians prefer to use diets first for treatment. If there is further need, they use simples. They do not resort to compounded drugs except when necessary.

Al-Biruni further defined pharmacy as the art of knowing the types, kinds, shapes, and physical properties of simples and of knowing how to compound them into remedies according to doctors' prescriptions. The pharmacist should also be able to substitute or to discard one drug for another. The knowledge of how drugs work on the body (pharmacology), however, is more important than the mere skill of preparing them. In substituting one drug for another the various actions of each
should be considered and accounted for. Cure can be sought through a draft, ointment, anointing oils, or by fumigation. Thus, in seeking a substitute, all these and  other applications should be considered. Without this knowledge one falls short of professional goals. Physicians, therefore, should help develop the art 'by the two  wings of science (theoretical knowledge) and experience, and then hand their efforts to social minded pharmacists to carryon excellent professional services'. Enthusiasm for the study of drugs from natural resources and their actions, al-Biruni observed, is much stronger in North Africa (Algeria, Morocco, Tunisia) and Spain than in the Eastern caliphate. Still greater activities are known to exist in India, but these follow, different principles and approaches from those practiced in the Muslim lands, mainly through Greek influence. These differences have made contact and dissemination between the two regions (the Muslim world and India) very difficult.

From his early youth, al-Biruni was very interested in acquiring knowledge. When once he became acquainted with a man residing in the area who knew Greek, he approached him with grains, seeds, fruits, and various herbs, seeking his aid for identification and to familiarize himself with their synonyms. To illuminate his point, al-Biruni told of a prescription calling for a drug that only one pharmacist out of many who were requested to dispense, was able to recognize. He was able to dispense and sell it because he knew that the name was synonymous for the dried roots of licorice, which the others did not know. Al-Biruni, therefore, studied drugs, physical properties and their synonyms both in books and by examining available specimens. This he did over the years to prepare himself to write his treatise on pharmacy. He systematically arranged all simples discussed in alphabetical order. His friend, Ahmad an-Nahsha'i, who likewise was interested in the subject, helped in authoring the book.

To illustrate al-Biruni's approach and methodology, a free translation of three materia medica items included in the text is attempted here. Under the letter 'S' (sad), al-Biruni discussed sandalwood. 'The kind which was reddish in color was called rakht chandan in India. Some preferred the yellowish, heavy, fatty and soft kind with the pleasant aroma. The coarse whitish type with a reddish shade is more used by pharmacists for internal medicine'.

Another example is the aristoloch; 'of which the rounded apple of earth (Aristo- lochia rotunda L. ) is stronger than the tall birth-wort, which has longer leaves (A. rotunda L.). A third type resembled the shed of the vine tree. The first kind had a pleasant aroma, a rounded rind (not the flowers), many long branches, and a bitter taste. Apothecaries used the rind for the preservation of anointing oils in many perfumes and in parturition.

A third and final example is al-Biruni's description of hellebore (under h, harbaq), of which there are two types: 'black from Asia Minor (Greek's land) with long, thin branches (a finger's width) with black to reddish knots; and white hellebore (mainly the bark) brought from Transoxiana (the land beyond the Oxus river in Turkistan, USSR today). In Syriac it is known as hur yakhana or faggusha. It was mentioned by Galen, Oribasius, Ibn Masawayh, and ar-Razi. It is poisonous if taken in large quantities'.

Of interest in the history of pharmacy is al-Biruni's book on precious and semiprecious stones, al-Jamahir. It gives another example of the development of the lapidary art in Islam. This tradition had started by the early third/ninth century and reached a high level in the works of al-Kindi (d. ca. 260/874) and other contemporaries. Al-Biruni's text contains many original ideas and personal observations.  Muslim lapidarists influenced similar developments in Europe.

Another theme of pharmaceutical interest that continued to draw attention during the fifth/eleventh century was toxicology. A good example is al-Munqidh, by al-Husayn b. al-Mubarak, completed about 483/1091, and dedicated to the wazir al- Mufaddal b. Abi al-Barakat in San'a, Yemen. Ibn al-Mubarak explained that there were two dangers the wise ought to avoid by all means. One, spiritual, meant getting rid of hatred, envy, malice, and the like. In so doing one avoided troubles and illness , for the body and the soul. The second danger was related to poisons that are fatal to the body in the shortest possible time. Poisons are hidden weapon in the hands of enemies to take revenge and to kill. Ibn al-Mubarak was concerned with the safety of , his master, the wazir al-Mufaddal, who was always exposed to servants and ministers, and decided to write a book on all types of poisons and poisoning in foods, drinks, and things to be smelled. Then he recommended antidotes, many of which he copied from the ancient sages of India and, elsewhere. The Indians he observed, 'paid special attention to these studies' and many of their books were available for him to read. He compiled manual in three treatises. In these he explained the need, especially for the kings and high government officials, for such information to keep them out of trouble, free of dangers to health. This seemed even more important, he wrote, when one considered the good, such as prosperity and national security, that will be caused by the leaders' safety; and the chaos and evil that could result if they were injured or killed.

He described drugs that were familiar and how to be on guard against intrigues by relatives, attendants, and opponents. He described poisonous symptoms and physical properties of poisoned substances for foods. He spoke highly of rue, dandelion, holly wormwood (Artemisia santonicum L. ), and wild mustard as antidotes to poisonous animals. Other antidotes included I.aurel and juniper seeds and asafetida and an extract of balm (duhn) dissolved in milk. If milk or butter was poisoned it showed up like an iris with many colors ranging from green to yellow to red and foam-like whitish. Butter became moist and putrid; sour milk showed reddish dots or lines and oils displayed rosy coloration like a sunset and putrefaction while sesame oil exhibited a dark, cloudy appearance. White linen clothes turned yellow if poisoned; colored clothes were bleached. Incenses and amber became inflammable, leaving dark ashes and giving off bad odors and cloudy smoke. Poisoned iron utensils, arrows, and swords show grey, swarthy colors. Ibn al-Mubarak devoted, in addition, a section, to theriacs and general antidotes.

In the sixth/twelfth century, Ibn at- Tilmidh (d. 560/1165) of Baghdad wrote an antidotarium al-Aqrabadhin, in twenty chapters, in which he followed with some improvements and modifications, the pattern followed by Sabur in mid-third/ninth century. In his detailed discussions of pharmaceutical dosage forms and preparations and methods of collecting, identifying and preserving drugs, Ibn at- Tilmidh showed his competence in the subject. He preferred experimentation over methodology and emphasized empiricism and personal observation of individual simples as well as their pharmacological action on the individual patient. He urged also the weighing of exact doses of drugs in medications and outlined ways of administering them in each case.

A century later, al-Minhaj, a manual on practical pharmacy by Abu al-Muna Ibn al-'Attar of Cairo, was completed about 658/1260. Ibn al-'Attar, an experienced pharmacist, dedicated the manual to his son, also a pharmacist, who was about to take charge of the business in place of his aged father. He gave attention to the important practical aspects of pharmacy, the upkeep of the drug store, and good management. Like az-Zahrawi, he also emphasized skill in the technique of compounding and dispensing pharmaceutical preparations, and knowledge of the materia medica.

Throughout all this period in Islam there were many regulations and documentation that were highly regarded and meticulously followed by social minded and educated Muslim pharmacists who respected these regulations and were, in turn, highly esteemed in their communities. In great centers like Baghdad, rulers occasionally issued decrees regulating pharmacy practice, whenever the situation demanded it. There were also government officials, such as al-Muhtasib and his aides, who supervised markets, sales of commodities, weights and measures, and the professions, including pharmacy and medicine, to curb adulteration and social violations and crimes and to guard the safety of the public. Rulers as well as patrons of learning gave support and protection to practitioners of the health professions. The public as well paid homage to eminent and honest pharmacists and physicians. Furthermore, expanding trade in the vast Muslim world and the great demand for medications and spices brought added prestige to the profession. Under these circumstances Muslim pharmacy, from the third/ninth through the seventh/thirteenth centuries, developed and matured. Literary contributions of practitioners were noteworthy. These commendable developments influenced the rise of professional pharmacy in Europe and enriched available literature in pharmacy and related fields.

This study was supported in part by a Smithsonian Research Grant.