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Science in a Golden Age - Al-Razi_ Ibn Sina and the Canon of Medicine
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Modern high-tech advances in medicine and health
are of course the result of many centuries of development, research, and experimentation
much of which took place in the Islamic world between the 9th and 14th centuries
A "Golden Age" of science
During this time, scholars in the Islamic world made huge contributions to medicine,
and created a body of knowledge that was tremendously important and influential around the world
for many hundreds of years.
I'm Jim al-Khalili, British professor of theoretical physics, but born in Baghdad.
I'll be exploring state-of-the-art biomedical science
and uncovering the contribution made to the field by the scholars of the Golden Age.
It was during the Islamic Golden Age that medicine started to be treated as a true science
with emphasis on empirical evidence
and repeatable procedures.
During that time, medical books were written that became standard texts throughout the world for many hundreds of years.
I've come here to the Hamad Hospital in Doha, Qatar, to see the how the ideas of the scholars from
the medieval Islamic world compare to our modern medicine.
The hospital's neonatal unit deals with premature and newborn babies
who are suffering from a variety of conditions.
It's the only one of its kind in Qatar
and babies are referred here from across the country.
[Dr. Lutfi:] All in all, through our doors,
we probably have close to 17 to 18 hundred babies.
And that amounts to about 10 to 11 percent of the total births [in Qatar], that occurs in this hospital.
So it is, by comparison,
one of the biggest units in the world.
We do look after babies who are as small as 23 or 24 weeks gestation.
So we are looking at a 5 months pregnancy, 5 months and 1 week pregnancy, basically
[Al-Khalili:] And that in itself is incredible, I mean not that long ago, 23, 24 week old gestation -
There's no way they'd survive outside the womb.
Absolutely. And we've come a long way.
At this hospital, they're carrying out pioneering research
to improve the treatment of babies born with neonatal encephalopathy.
That is, babies born with serious neurological damage
because of a problem with oxygen or blood supply in the womb.
The gold standard of treatment is putting these babies on a cooling mattress
to try to reduce their temperature
and limit the potential ongoing damage that could ensue in the brain
However, it does not really provide an appropriate success rate world wide
Here we're trying a simple remedy that we believe has potential
which is the addition of a drug called magnesium sulfate
that has never been tried in combination with the cooling method.
[Al-Khalili] To improve the reliability of their research,
The hospital's using what we call a "control group."
Some of the babies receive magnesium sulfate.
Whereas a separate group, the control group, don't receive it.
This allows the hospital to compare fairly the effects of the treatment with and without the drug.
So this particular study is a double blind placebo control
which means that we are offering some of our babies a placebo
and some who are getting the magnesium sulfate - we don't really know which are which, and that's -
That's - otherwise we'd be biased, exactly
One thing that's of tremendous interest to me is that this idea of a control group
actually goes all the way back over a thousand years
to a Persian physician by the name of Ar-Razi
who built the first hospitals in Baghdad
who was looking into the causes and treatments of meningitis
and I believe he had not only his sample of patients, but he had a control group
to which he wasn't administering the treatment, in that case it was bloodletting, which we know isn't the way you treat meningitis -
But the idea of a control group goes all the way back to Ar-Razi
This is actually one of the most important components of research
that we do have a control group to try to ensure that our studies come out as non-biased as possible
[Al-Khalili] to compare against [Dr. Lutfi] yeah, absolutely
Ar-Razi was born in the city of Ray near Tehran
in the mid 9th century
and he was an early proponent of applying a rigorous scientific approach to medicine
During his distinguished career
He served as chief physician of hospitals in both Ray and Baghdad.
In the early 10th century, the ruling caliph in Baghdad, Al-Muqtafi
asked Ar-Razi where in the city he should build a new hospital
So Ar-Razi designed an experiment
He hung meat up around different locations
to see how quickly they rotted - and so determined the place with the cleanest air.
This was typical of Ar-Razi
You have a problem, you design an experiment to find the answer.
During the Golden Age, the dissection of human bodies was considered disrespectful
but there was one group of people who knew quite a bit about anatomy
butchers - albeit the anatomy of animals rather than humans
Well even though this is just a lamb's heart, not a human heart,
We can still see quite clearly the different compartments, the different chambers, within the heart
This would've been something very familiar to these early physicians of the medieval age
Shukraan
In the 17th century, William Harvey famously carried out his ground-breaking research into the circulation of blood and the function of the heart
But in 1924, an ancient document was discovered
This was a text written by Ibn al-Nafis
a 13th century Arab physician
In it, he described the basics of pulmonary circulation
how blood doesn't move across from one side of the heart to the other
but has to take the long way around - around the body
This, 400 years before Harvey
Building on the writings of physicians like Ibn al-Nafis and William Harvey
our understanding of the heart has continued to develop
Harefield Hospital in the UK is part of the country's largest center for heart and lung disease
Their cutting edge treatments build on the work of Professor Magdi Yacoub
one of the world's leading heart specialists
who set up the hospital's busy transplant unit
and who's received a knighthood in Britain for his services to medicine
[Dr. Yacoub] The heart is such a.. like a magic opal
The more learn about it, the more I respect it, because it goes on incessantly
beating
quietly
maintaining life
Professor Yacoub is also interested in the history of medicine
As part of a paper he commissioned for a medical journal, he's researched the life and work of Ibn al-Nafis.
Here we have a scholar
born in Syria
in the early part of the 13th century
he was a polymath
because he was studying... he was a theologian, he was a "scientist" if you like, he was a discoverer...
[Al-Khalili] But arguably, his most important contribution was his commentary on medicine
in which he looked at how blood moves through the heart
So this is the heart, and you can see,
quite clearly
the right ventricle and the left ventricle
and these are two completely separate chambers
the question has been, "how does blood go from the right ventricle to the left ventricle
[Al-Khalili] For centuries, the accepted view had been that of the renowned Greek physician Galen
Galen said that blood passes directly between the right and left ventricles of the heart
through tiny holes in the sceptum
the dividing wall that separates them
Ibn Al-Nafis was the first to challenge Galen's view; he established that there weren't any holes, so there had to be another way to pass fro right to left
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