<Home> <Muslim Scientists> <Ibn Al-Nafis> <Inbn Al-Nafis's Contribution to the Discovery of Circulation>

Dr. Paul Ghalioungui
Egypt.

Few would doubt today that Ibn al-Nafis was the first to describe the lesser circulation.  But this contribution was much wider.  It included:

1. Denying the existence of any pores through the interventricular septum.

2.  The flow of blood from the right ventricle to the lungs where its lighter parts filter into the pulmonary vein to mix with air.

3.  The notion that blood, or spirit from the mixture of blood and air, passes from the lung to the left ventricle, and not in the opposite direction.

4.  The assertion that there are only two ventricles, not three as stated by Avicenna.

5.  The statement that the ventricle takes its nourishment from blood flowing in the vessels that run in its substance (i.e. the coronary vessels) and not, as Avicenna maintained, from blood deposited in the right ventricle.

6.  A premonition of the capillary circulation in his assertion that the pulmonary vein receives what comes out of the pulmonary artery, this being the reason for the existence of perceptible passages between the two.

This is the minimum that could be granted to this genial physician.  But even this bare minimum has been hardly acknowledged by the West as its debt to Arabian medicine.   Western authors seemed indeed infuriated at seeing the credit of such a momentous discovery escape from its scholars in favour of an Arab, and they were particularly intent at denying any connection between Ibn al-Nafis and Harvey, going as far as asserting that even Arab authors, his contemporary or followers, were totally ignorant of his discovery, and that Harvey and his Italian predecessors had arrived independently at the same conclusions.

Sarton, after reading Meyerhof's publication of Ibn al-Nafis's manuscript seemd to doubt even this German authority: "If the authenticity of Ibn al-Nafis' theory is confirmed his importance will increase enormously for he must be considered one of the man forerunners of William Harvey and the greatest physiologist of the Middle Ages.  But we need confirmation.  The relevant Arabic text was edited (on the basis of Berlin MSS) together with a partial German translation full of mistakes, by an Egyptian Physician..." as if the mere fact that the author was Egyptian threw doubt on its authenticity.  Ralph Major stated that the admirable observation of Ibn al-Nafis remained unknown to the Western world during seven centuries, that is, until a copy of Ibn al-Nafis's manuscript was discovered by Tatawy.  Cisneros wrote that Ibn al-Nafis wrote commentaries on Galen, Hippocrates and Avicenna, in one of which he denied the existence of interventricular passages and outlined a description of the circulation, but that his was not known to the West.  Temkin, likewise, denied any connection.   Even Meyerhof who recognised that the text of Servetus was nothing more than a faithful extract of the writings of Ibn al-Nafis, was of the same opinion.

Were the teachings of Ibn Al-Nafis really forgotten both in our countries and abroad until Tatawy rediscovered them in 1924?

In Arab countries it would have been extraordinary indeed for a physician who attained such fame to have sunk into total oblivion.

The first argument brought forward was the absence of any mention of Ibn al-Nafis in Ibn Abi-Usaybica's collection of biographies. This was based on Muller's edition, and it was suggested that professional jealousy between the two Arab physicians was the reason of the biographer's omission 6. It is known now that Muller's edition, published in 1882, was incomplete for Dr. Youssef is 7 discovered in 1947 a fragment of Ibn Usaybica's work unknown to Muller, in which the greatest respect for Ibn al-Nafis is expressed.

As to ignorance of Ibn al-Nafis's discovery by his contemporaries, incontrovertible evidence was recently found that proved that he was fully acknowledged8.
 1. Ibn al-Nafis's theories are repeated almost word for word in a manuscript by Zain al-Masry, in which the reasons why they were apparently forgotten are explained. It is known that Ibn al-Nafis wrote a commentary of the whole canon in parts, each dealing with a particular subject. Zain al-Masry stated that Ibn al-Nafis wrote his commentary on anatomy only after terminating the other parts, shortly before his death. After he died, his disciples hoarded it to the point that when Qutb al-Din al-Shirazy attempted to obtain it he received a reply that Ibn al-Nafis had died without completing it. Qutb al-Din had to repeat his request but he could get it only a few days before his death after the Sultan had personally insisted that it be sent to him. "
2. Nevertheless, a word for word copy of the same commentary is found in Sharh ul-Kulliyat that was completed by Kazrouny in 1344 A.D., less than sixty years after Ibn al-Nafis's death.
3. In addition, a detailed expose of Ibn al-Nafis's theory, with a most laudatory comment is quoted in a 17th century manuscript by an unknown author (Paris Ms.5776) 9.

The rigid belief in the ignorance of Arab authors in respect of the work of Ibn al-Nafis cannot therefore be maintained. As Iskandar  8 to whom we owe the previous knowledge commented: these discoveries may serve to reopen discussions..." The question now is: Did the- Latin West have access to Ibn al-Nafis?

Around the end of the fifteenth century, the Italian Physician Andrea Alpago spent many years in Damascus and in the Arab East to learn the language and study the Arab manuscripts, among which there were possibly copies of the commentaries of Kazrouny and Zain al-Masri. On his return he published (in 1547) in Venice that then ruled Padua a Latin translation of the part of Ibn al-Nafis's commentary dealing with pharmacopeia. He might conceivably have translated also the rest of transmitted, orally or in hitherto unknown writings the rest of the Commentary to his colleagues in Italy, specifically in Padua, where a sudden explosion of this knowledge was soon to happen.

From the death of Ibn al-Nafis in 1288 to the date of the publication of Harvey's De Motu Cordis in 1622, Arab authors used Ibn al-Nafis's Commentary. Around 1500, Alpago was back in Italy. In 1543, Vesalius in "De Corporis humani fabrica" denied the existence of pores in the ventricular septum. In 1547, Alpago's translation was published in Venice. Six years after him, in 1553, the Spaniard Miguel Servet published in his theological work "Christianismi Restitutio" his view that blood passes from the right to the left ventricles not through the septum as was commonly believed but by a lengthy passage through the lungs in the course of which it becomes elaborated and acquires a crimson colour. In spite of the Spaniard's statement to the contrary Serveto was not the first to notice this change in colour for it was already known to Galen 9.
     Six years after Serveto, in 1559, Realdo Colombo in "De Re Anatomica" wrote: "There is a septum between the ventricles through which it is thought that blood from the right ventricle passes to the left; but they are very much in error, for the blood is carried by the pulmonary artery to the lungs, from where it passes with the air by the pulmonary vein to the left ventricle of the heart".

Another twelve years and in 1571 Andrea Cesalpino wrote in" Questionum Peripateticarium" that the notipn of the circulation of the blood from the right ventricle to the left ventricle through the lungs conforms to facts that are apparent from dissection. He then described the systemic circulation, using the wdrd circulation in that connection for the first time. In this book, he also described experiments with vein ligature that are identical with those that Harvey published in "De Motu" 51 years later, and we knpw what Harvey owed to his Paduan masters.

1288: Death of Ibn al-Nafis
14th: 17th centuries: Arab commentators
1500: Alpago back in Italy
1543: Vesalius: "De humani corporis fabrica"
547: Alpago's translation
1553: Miguel Serveto's Christianismi Restitutio
1559: Realdo Colombo's De re anatomica
1571: Cesalpino's Quaestionum Peripateticarum
1597-1602: Harvey at Padua
                   Fabrizio defines the role of the venous valves in "De venarum osteolis"
1616: Harvey lectures on his theory
1628: De Motu Cordis

But the most venomous denial came from Curiese del Agua who, in a totally biased attempt to vindicate the priority of his countryman Servet 10 blindly denied' the very existence of Ibn al-Nafis. He started with the usual argument of his like, flatly denying any original contribution of the Byzantine or the Arabs to medicine, who, he said, were mere compilers and copyists and were content to follow the doctrines of Plato, Aristotle, and Galen without, to his knowledge, adding a single new observation, as could be seen by reading Oribasius, Tralles, Paulus Eginetus from Byzantium, Avicenna of Baghdad (or so he says), and Abulcasis, Averroes; and Maimonides from Cordoba. He admitted that they enriched the materia medica but he claimed that they eliminated from medicine any original interpretation or new clinical observation and were not even all.