On Medical Milestones, Being Racist, and Textbooks, Part I

Because my family allegedly loves me very much, and shows that by sending me screen shots of things that are guaranteed to wind me up, my cousin sent me a screen shot from her actual fucking university level textbook this weekend. This particular picture was so wrong, so ignorant, and has wound me up for so many reasons that I am going to have to spread my rage about it over two blog posts.

Are you ready for it?

You are not.

OK, look here it is, with my cousin’s own helpful highlights:

chart 1

This little baby, which may have been created in a lab to enrage medieval historians, comes to us courtesy of one J. Stuart Showalter in The Law of Healthcare Administration, the eighth edition, naturally.[1] You will be pleased to note, in the words of my cousin Leslie, that it was “[p]eer reviewed by a whole damn editorial board”, the  Association of University Programs in Health Administration (AUPHA). [2] So that’s nice. We like that, don’t we? It’s great.

Now, regular readers are probably going to guess the first thing here that is completely wrong and also made me yell “Oh COME ON!”, which startled the cat. (You have a lot to answer for, AUPHUA. For shame.) Yes, that is right, I am extremely – you might even say big – mad at the idea that during the early Middle Ages there was “widespread ignorance in Europe”, as opposed to right now in America where accredited Health Administrators are totally not ignorant about things like medical history, amiright?

Haha, anyway, so I have already written lavishly, extensively, and lugubriously on the fact that the early medieval period was not, in fact, an ignorant time, so we don’t need to go into that again right here. I can, however, say that our good friends at the AUPHUA have some assigned reading to do before they go around green-lighting trash like this. Having said that, I very much appreciate the rare chance to see people confront the fact that we no longer use the term Dark Ages, but still internalising the myth that “Dark Ages” meant “bad time”, which is why we had to retire the term. Just absolutely stellar work all around.

This Extremely WrongTM graph also gets a few pity points for noting that “Islamic physicians make scientific progress” during this time. That is what we are going to talk about today because it is what we in the history game call a “massive understatement”. (It’s a technical term.)

It is a certifiable fact that the Islamic world had good medicine on lockdown in the medieval period. One reason for that was the House of Wisdom, or the Great Library of Baghdad, which was established in the eighth century by the Caliph Harun al-Rashid. We’re not sure exactly whether the House of Wisdom was founded as an active learning institution or just a really nice library that had tonnes of good books, but by the reign of Al-Ma’mun it was a public learning institution. We know that in the House of Wisdom they certainly compiled, copied, and disseminated any medical texts they could get their hands on.

And here is the thing – they could get their hands on kinda a lot of stuff, actually, because they were positioned between the Eastern Roman Empire, aka Byzantium, and Asia. They were therefore perfectly placed to amalgamate various medical traditions. They worked with the texts of Galen and Hippocrates, which underpinned medieval European ideas of medicine, but also brought in Persian medical tradition including The Vendidad which is one of the world’s earliest medical texts and covers herbal medicine, surgical medicine, and prayer. They were also able to incorporate Indian Ayurvedic traditions.

Al-Adudi Hospital, Baghdad, 9th century

Not only did they have cutting edge medicine, but they also had a range of really great hospitals that you could rock up to and get cared for in. For Islamic rulers endowing a hospital was a big deal, much like supporting monasteries and nunneries (which served the function of hospitals) was for Christian rulers back in Europe. I mean rulers still do this, at least here in the UK.[3] (Yay. Love 2 be a subject.)

This excellent tradition gave birth to one Muhammad ibn Zakariya al-Razi, or al-Razi, or Rahzes if you need the white people version. He, like most of this blog’s important favs (heeeeey Hildegard) was a polymath and wrote something like 200 hundred manuscripts on various topics from medicine to physics, as you do. More to the point for this discussion, he was one of the first people to advocate for experimental medicine, and because he was an alchemist (calm down, it’s like being a chemist, it’s not about making gold) he came up with chemical alcohol and sulfuric acid, very important medical compounds. He was also one of the first people to use humoral theory to differentiate various sicknesses. One of his most famous works specifically did this with measles and smallpox. As if that wasn’t enough, he was also the first person to notice and write about the pupil’s reaction to light. In other words, he was a big fucking medical deal in the early medieval period and doing really serious work.

So, yeah this graph is not incorrect there. The early medieval Islamic world was certainly making strides during that extremely specific time period. But here’s a thing that we would call “problematic”: we are here talking about how Islamic medicine was good at the time but for some reason al-Razi, the physician so good that students came from China to learn from him, doesn’t get a mention.[4]

Weirdly, and even more appallingly, it also cuts off right before Ibn Sina, aka Avicenna, aka arguably the other most important medieval medical mind is born (c. 980). Ibn Sina was also, you will be unsurprised to learn, a polymath. He worked on everything from astronomy to theology, alchemy and astronomy. What medieval people really lost their minds over were his works The Book of Healing and The Cannon of Medicine two absolutely core texts of medieval medical science. These texts became the standard medical texts even outside of the Islamic world. In European medieval universities like Salerno, and were such important game changers that they remained pretty much the core medical texts into the seventeenth century. As a result, medieval and early modern people would mention him in pretty much the same breath as Galen or Hippocrates. You couldn’t talk about medicine without talking about all of them, which is why the seventeenth-century picture at the top of this post exists. 

Ibn Sina, I’m sorry bb you deserve better.

So yeah, why would this graph do that? Why would it cut off just before introducing one of the biggest medical thinker of the medieval period, and just totally overlook the other? Well, the answer to that is that it is just straight up racist.

You’ll notice that two of the medieval and early-modern big three – Hippocrates and Galen are introduced on this timeline –  as is Aristotle’s tiresome woman-hating ass, but when al-Razi and Ibn Sina remix that work and break new ground that’s not enough to get a shout out. These are the most influential medical thinkers of a thousand-year period, and we’re just not gonna talk about it, apparently.

There is absolutely no reason to leave these men off the chart. But they aren’t because the textbook author needs you to believe that “Islamic physicians make scientific progress that goes unnoticed elsewhere” is a thing. If no one else was listening then why bother learning the names of two fathers of medicine? Well one, because they are important in and of themselves, but also you should probably include them because that statement is not true. I suppose the author is trying to say that “elsewhere” means “outside of the Middle East”, but as al-Razi’s Chinese student could have told you, that certainly wasn’t the case. So who do they mean is ignoring it? Europeans. They mean Europeans. And they are wrong.

Islamic medicine absolutely got into Europe because, as I will never tire of pointing out, in the early medieval period a whoooole big piece of Europe was Islamic. You know, pretty much the entire Iberian peninsula? Al Adaluz? Where women were partying, date palms were growing, and I can absolutely assure you they had Islamic medicine? Yeah, there. Or how about in Islamic Sicily, where Muslims ruled comfortably from the ninth century until the Normans showed up in the twelfth? (That’s where the term al arrabiata comes from for spicy Sicilian pasta sauces. They are modified Arabic recipes. There you go, your trivia fact of the day.) People were certainly taking notice of Islamic medicine there, but the graph doesn’t want you to consider that because Islamic people were doing it, so it doesn’t count even when it happens in Europe.

Even if you are going to go out of your way to ignore the fact that there were whole-ass Islamic European kingdoms indicates, it’s also not like there was no contact between the Islamic and Christian world and that medical tracts didn’t move back and forth. The barriers between Islamic and Christian kingdoms are in flux during this time. Territory and people moved back and forth more or less constantly, and they took things with them when they went. Especially good stuff like advanced medical techniques. Both men’s books show up all over Europe and have even made it as far as back-water England by the late medieval period. Peterborough Abbey alone was bragging about having ten books of al-Razi’s in the fourteenth century.[5]

Two physicians advising an apothecary.

The fact of the matter is that medieval European people were THIRSTY for Islamic medicine and absolutely took notice of what was going on with it. Sure, a lot of that uptake happened after the stated time period, and more generally in the high to late medieval period, but it isn’t like they didn’t know it was happening. Just because not all Europeans had access to Islamic medicine that doesn’t make it an irrelevancy. Not all Americans have access to medicine now, that doesn’t mean it doesn’t exist. (*sips tea*)

So sure this is all racist and wrong, but why does it matter? It matters because a text book leading with the idea that the Early Medieval period was a time of stagnation and ignorance, before casually mentioning the great advances that Islamic medicine made in this period, is staunchly upholding the idea that white people are and always have been the centre of the world. For the author of this text and – one more time – an entire editorial board to write off a whole time period because Europe wasn’t necessarily at the cutting edge of scientific advancement is ridiculous. It is not only European integration of a concept which makes it worth noting.

This mindset is a difficult one to overcome because, fundamentally, it is a belief system that our society perpetuates in order to justify our current world and our own colonial and imperial apologist mindset. And this is how that very specific narrative is perpetuated. It goes unchallenged in peer reviewed textbooks and is passed on to everyone who reads them as an accepted truth that has been rigorously researched. It is no such thing.

Anyway, this graph is so massively, incomprehensibly wrong, and its inclusion in a textbook is so galling that we’ll be talking more about it next week, as well as why this racist nonsense helps to underpin Whiggish conceptualisations of our trash society. We just need to face up to the racism before we can do literally anything else.

I am very tired.

[1] J. Stuart Showalter in The Law of Healthcare Administration, 8th Edition, (Chicago: Health Administration Press, 2017).

[2] Leslie Lane, via WhatsApp, 3/09/2019.

[3] Huge shout out to Ahmed Ragab’s excellent The Medieval Islamic Hospital: Medicine, Religion, and Charity (New York: Cambridge University Press, 2015) here.

[4]  Jacques Gernet, A History of Chinese Civilization, (Cambridge: Cambridge University Press, 1996). p. 34.

[5] Simon Gunton, The History of the Church of Peterborough, (Peterborough and Stamford: Clay, Tyas, and Watkins, 1990 ), pp. 187–188.

For more on medieval medicine, see:
On medieval healthcare and American barbarism

For more on Islam in the medieval period, see:
Islam was the party religion, or, why it is lazy and essentialist to say that Islam oppresses women

For more on myths about the medieval period, see:
I assure you, medieval people bathed.
On colonialism, imperialism, and ignoring medieval history
That’s not what chivalry is, but OK
“I wasn’t taught medieval history so it is not important” is not a real argument, but ok
There’s no such thing as the ‘Dark Ages’, but OK

Author: Dr Eleanor Janega

Medieval historian, lush, Kendrick Lamar enthusiast.

2 thoughts on “On Medical Milestones, Being Racist, and Textbooks, Part I”

  1. Your whole post was informative, entertaining, and well-constructed in its telling of history and yet this contemporary commentary might be my favorite part:

    “mad at the idea that during the early Middle Ages there was “widespread ignorance in Europe”, as opposed to right now in America where accredited Health Administrators are totally not ignorant about things like medical history, amiright?” 🙄

    I look forward to next week.


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