Diseases of the Islamic World

The advent of Islamic culture is well defined by the life of the founder of Islam, Muhammad (c. 570 to 632). Shortly after his death, Muslim Arabs began a series of dramatic conquests of the Middle East and North Africa, so that by A.D. 750 their hegemony stretched from Andalusia (southern Spain) to the Sind (modern Pakistan). Islam was gradually established as the predominant religion in these areas, and Arabic became the preeminent language in most of them. In the later Middle Ages, Islam spread appreciably in sub-Saharan Africa, Turkey, eastern Europe, the Indian subcontinent, and Southeast Asia; the only areas in which it retreated were the Iberian Peninsula and eastern Europe.

Most of our information about disease has been derived from literary sources, including Muslim ha-giography and medical texts. The former are biased toward urban conditions, although the majority of the population lived in the countryside at a subsistence level and often at the mercy of nomadic depredations. The medical works have the serious disadvantage of being largely nonclinical and highly derivative of classical medical texts, and the anecdotes of renowned physicians are frequently apocryphal. Yet major features of a "pathological tableau" do emerge, in which illness is inextricably tied to poverty as both cause and effect. Blindness is conspicuous, particularly in Egypt; the result of a number of diseases, blindness seems to have afflicted a large percentage of the population, and the blind were traditionally employed as Koran reciters in mosques. Deafness was often congenital, and mutism was associated with nervous disorders. Paralysis, epilepsy, and mental disorders are frequently described in the medical and nonmedical texts, which include surviving magical incantations and prayers directed against demonic possession.

Among internal maladies, digestive and excretory complaints are commonly referred to; the descriptions suggest dysentery, internal parasites, typhoid-paratyphoid, and cancer. In Moghul India, cholera and dysentery were clearly the major diseases from the sixteenth century; Asiatic cholera does not appear to have afflicted the Middle East until the early nineteenth century. Schistosomiasis (bilharzia) has been present in Egypt since pharaonic times, but it attracted no special interest in the medieval period. Dropsy and elephantiasis are often mentioned in the medical texts. Along with these conditions are observations of muscular problems, fatigue, and general malaise; the last-named might be attributed to malaria, but its endemic and chronic forms were not always recognized as a specific illness and were accepted as a natural state of health.

Some of the most common complaints were derma-tological disorders, which are particularly difficult to distinguish in the historical sources but appear to have aroused considerable apprehension. Skin ulceration, infections, and bleeding disorders appear to have been due to nutritional deficiencies. There is also some evidence of an endemic, nonvenereal form of syphilis in the rural population. More certain are the existence and recognition of smallpox and measles. In the tenth century, Rhazes (al-Razi), who was atypical of Muslim medical writers in giving detailed clinical descriptions of diseases, was the first to provide a complete description of the symptoms of both diseases and their treatment.

Plague (tâ'ûn), leprosy, and syphilis are given special attention here. They seriously endangered personal and public life, and consequently illustrate well Muslim cultural responses to life-threatening diseases. These three diseases were also generally distinguishable in the past because of their distinctive symptoms and, therefore, are amenable to historical investigation.

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