Walk along the narrow twisted alleyways of a
Middle Eastern souk, or marketplace, past the displays of wicker
baskets, abas, knives and gold jewelry. Eventually you’ll round a
corner and be pleasantly overwhelmed by the sights and smells of
herbs and spices piled high in the stalls and shops. Bright orange
saffron, terra-cotta cinnamon, dark green thyme and dozens of
other herbs weave a carpet of diverse patterns, while the sweet
odors of cloves and cardamom waft through the air.
In the Middle East, herbs are not only used to flavor food. Many
also are used as medicine, based on recipes and formulas derived
from careful observation and experimentation performed more than a
thousand years ago by Islamic scientists and scholars. In fact,
without the work of medieval Muslim pharmacists, much of what we
take for granted in Western medicine might have been lost
From the Arabian Sands
In the middle of the seventh century, Europe was mired in
intellectual stagnation. Barbarians from Germany and Asia had
destroyed libraries and, with them, irreplaceable manuscripts
collected over centuries. The achievements of a thousand years of
Hellenistic civilization in the arts, sciences, and humanities had
been erased in a few short decades of destruction.
During this time, European medicine was severely restricted and
conducted in an atmosphere where pain, suffering, and illness were
seen as expressions of Divine will and beyond human intervention.
Hospitals offered compassion, but little else, and the Church
outlawed surgery. The works of Aristotle, Galen, Hippocrates and
Dioscorides were unknown. What passed for scholarship consisted of
written commentaries on the works of illustrious predecessors who
couldn’t be challenged or questioned.
For Europe it was the Dark Ages. But while Europe lost, and then
forgot, its intellectual heritage, a new force emerged from the
sandy wastes of the Arabian Peninsula.
The spread of Islam was a great historical watershed, one that
continues to reverberate thirteen centuries after the cry of the
first muezzin, the Muslim caller of daily prayer. In less than a
century, the Muslims, driven by passion and fervor, swept aside the
Byzantine empire, overthrew the centuries-old Persian dynasty, and
reached into India and France, beginning an unprecedented era of
growth in all branches of learning.
By the tenth century, a single language linked people from
northwestern India to the south of France, and Arabic became to the
East what Latin and Greek had been to the West—the language of
literature, the arts and sciences, and the common tongue of the
A New Way to Heal
Medicine was the first of the Greek sciences to be studied in
depth by Islamic scholars. During the ninth century and into the
tenth, the spiritual head of Islam, Harun al-Rashid (of Arabian
Nights fame), and his son, al-Ma’mun, sent embassies to collect
Greek and other scientific works from throughout the region. These
were taken to the “House of Wisdom,” where the entire body of Greek
medical texts, including all the works of Galen, Oribasius, Paul of
Aegina, Hippocrates, and Dioscorides, were translated into
Arabic—manuscripts so important that one of the translators was
paid for each translation by its equivalent weight in gold.
But translation was only a first step. Hellenistic, Persian, and
Indian concepts fell on fertile Islamic minds, whose perception of
medicine and illness differed from that of their European
contemporaries. God did not punish sins by inflicting illness on
his subjects. Rather, sickness was the result of bodily imbalances,
and these imbalances could be restored if the physician were
competent enough. Muslim physicians believed that preserving health
was the goal of medicine, and if health were lost, medicine should
help restore it.
The Muslim physicians’ resulting contributions form a lengthy
list, including the development of medical school, medical
licensing, cataract surgery, discovery of the circulation of the
blood, the idea of infectiousness, the concept of quarantine, the
development of pharmacy as an institution and hundreds more.
Part of the Plan: Herbal Remedies
The search for cures in the natural world stemmed directly from
the Prophet Mohammed, who taught that “God has provided a remedy
for every illness.” Mankind, Mohammed said, must seek out those
remedies, learning to use them with skill and compassion.
Islamic knowledge of medicinal substances was originally based
on the 500 substances described by the first-century Greek
physician Dioscorides in his De Materia Medica, a reference book
that is still used today. To this book, Muslim scholars added herbs
that grew on the Arabian Peninsula and those imported from India,
Persia, and China.
Islamic medical texts usually had at least one section on herbs
and other natural remedies, and another consisting of instructions
for compound remedies, with descriptions of the geographical
origin, physical properties, and methods of application. Many
formularies were composed as larger independent collections of
simples (single herbs with medicinal value) and compound recipes.
Some were written specifically for use in hospitals.
By the start of the ninth century, pharmacy was a profession
practiced by highly skilled specialists called saydalani who were
required to pass licensing examinations and monitored by the state.
The dispensing of medication was remarkably exact—Arab pharmacists
used balances that were accurate to 0.3 mg. In their laboratories,
the saydalani evaporated, filtrated, crystallized and distilled
raw drugs, mixing them with syrups, gums and fruit rinds when
necessary to improve taste.
A Pharmacy Full of Herbal Medicines
Arab pharmacists introduced many new drugs to clinical practice,
including senna, camphor, sandalwood, musk, myrrh, cassia,
tamarind, nutmeg, cloves, aconite, ambergris and mercury. The
saydalani also developed new ways of administering drugs—ointments,
conserves, elixirs, pills, confections, tinctures, suppositories,
inhalations, syrups and juleps and pleasant solvents such as
rosewater and orange-blossom water—always providing carefully
detailed instructions in the formularies.
They used scientific principles to determine which herbs to
administer and thoroughly studied the actions of medicinal plants,
often drawing upon careful experimentation on humans while
meticulously recording their observations on potency, dosage, and
possible toxicity. Their collections of case histories were then
studied in medical schools.
Because Arab pharmacopoeia came from so many sources—as far
afield as China, Southeast Asia, the Himalayas, southern India and
West Africa—it was enormous. In his second volume of the Canon of
Medicine, Ibn Sina (a.d. 980–1037, also known as Avicenna)
describes 235 remedies, of which 97 still appear in the official
British Pharmacopoeia, as well as 760 medicinal plants and their
uses. Ibn Sina also laid out the rules that are the basis of
clinical trials today.
Islamic pharmacists responded by devising a reliable
preparation to temper the herb’s ferocity but retain its
Like most medieval medicine, the Islamic viewpoint was an
outgrowth of Galen’s Humoral Theory and focused on the need to
balance the humors, or bodily fluids.
Cathartics, purges and laxatives were considered essential to
this goal. The most popular herb—an enduring favorite today—was
senna, a low bush with small yellow flowers, greenish yellow
leaves, and fat seed pods. The leaves have a distinctive smell, and
the infusion made from them has a nauseatingly sweet taste; taken
alone, the infusion does indeed produce nausea. The Arabs calmed
both taste and effect by adding aromatic spices.
The Arabs also introduced manna and tamarind as safe, mild and
reliable laxatives. Scammony, a climbing plant of the morning glory
family that has thick roots with medicinal value, was a
controversial herb in Europe, where some practitioners declared its
violent laxative action unsafe to use under any conditions, while
others said they could not function without it. Islamic pharmacists
responded by devising a reliable preparation to temper the herb’s
ferocity but retain its potency. They did this by first boiling the
scammony root inside a fruit called a quince; the scammony was then
discarded and the quince pulp mixed with the soothing, gooey seeds
of psyllium. The preparation was known as “diagridium.”
Formulation developed into an art involving many steps and
ingredients. Ar-Razi, Islamic medicine’s greatest clinician and
most original thinker, combined bitter almonds with an ounce of
raisin rob, or pulp, to treat kidney stones. For the same ailment,
a clinician named Haly Abbas recommended boiling jujubes, fruits of
sebesten, white maude, and seeds of smallage, fennel, caltrop and
In addition to compounds, the Arabs valued hundreds of simple
herbal remedies. They used sesame oil to relieve coughs and soften
rawness of the throat. Juice from the stalk and leaves of the
licorice plant was considered good for respiratory problems,
swollen glands, and clearing the throat, whereas the root was used
to treat foot ulcers and wounds.
Cardamom was believed to cool the body and aid digestion; it has
endured as a principal ingredient in Arabic coffee. Cumin was, and
still is, used as an antiflatulent and to relieve stomach cramps.
Fennel was used to prevent obesity.
Myrrh, primarily known in the West as a gift from one of the
Three Wise Men, was highly valued for its medicinal properties as
an astringent and was also used to treat dyspepsia, chronic
bronchitis, leukorrhea and as a topical application in gum
disease. In fact, it is a primary ingredient in many commercial
Islamic simples also included a variety of analgesics. Ranking
them according to their potency, Ibn Sina’s Canon lists opium
poppy, two other varieties of poppy, mandrake, henbane, black
nightshade and lettuce seed as effective pain relievers.
Aconite, which, Ibn Sina cautioned, could also be used as a
poison, was prescribed for rheumatism, gout, whooping cough,
asthma and fever. Cloves were used for toothaches and to control
vomiting. The medieval Arabs were the first to use cassia and
appreciated its mild laxative action, which made it a popular
herbal remedy for young children and the elderly. Caraway oil,
which remains a common herbal remedy, was taken to aid digestion.
Boiled thyme was prescribed for colds and in its natural form was
considered a treatment for indigestion and tooth pain. Baked with
bread (Arabs spread thyme mixed with a small amount of olive oil on
half of the dough, which is then folded and baked), thyme remains a
common breakfast herb valued for its breath-freshening
Muslim doctors employed walnut oil for stomach and kidney
ailments, “especially for the well fed,” according to Ibn Sina. Abu
Mansur described sweet almond oil as “good for opening the bowels
and useful for pains affecting the stomach, kidney, liver, chest
and lungs.” Infusions of absinthe were used to treat diabetes,
African rue was used for headaches, and pomegranate peels were
placed on skin ulcers. These are only a few of the herbs that Arabs
valued and recognized for their healing properties and as buffers
and vehicles for making medicines more palatable.
An Ancient Tradition Survives
Arab pharmacology was not only extensive but also the strongest
empirically based biological science. Ibn Sina’s Canon laid out the
basic rules of clinical drug trials, ones that are still followed
today: A drug being tested must be pure, and it must work on all
cases of the disease. Testing in humans, with careful notation of
the drug’s effectiveness under different conditions, was the
necessary final step. Observation and experimentation were the sole
determinants of the value (or lack of value) of a potential
Not surprisingly, when Europe began to stir from a thousand
years of intellectual slumber, it turned to the Islamic world. It
was no coincidence that Salerno, Europe’s first great medical
center, was close to Arab Sicily, or that the first outstanding
medical university, Montpellier, was located in southern France,
near the Andalusian border.
The returning Crusaders introduced to Western practice the
entire Arab materia medica, including herbs that today are known
mainly as food flavorings, such as nutmeg and saffron.
Arabic pharmacology formed the basis of Western prescriptions
until well into the nineteenth century before being abandoned in
favor of synthetically produced drugs. Until that time, Arabic
medicine was used by millions of people in Africa, Asia and
Europe, both in home remedies and as a systematized branch of
Respect for natural remedies is still strong in the Islamic
world. Muslims, whether city folk or desert-roaming Bedouins,
continue to view nature as the mother of all treatments, firmly
convinced that it provides therapies for nearly all illnesses and
diseases. Recently, in Abu Dhabi, capital city of the United Arab
Emirates, UAE president Sheikh Zayed Bin Sultan Al Nahyan
established the Zayed Foundation for Research and Traditional
Medicine. The foundation conducts biological research on the active
components of natural medications such as plants and herbs.
Treatment is also offered at the foundation, along with the
production of natural pharmaceuticals—a 1,300-year-old tradition
that continues to grow.
David Tschanz lives with his family in Saudi Arabia, where he is
an epidemiologist with Saudi Aramco. Tschanz holds master’s degrees
in epidemiology and history, and writes frequently about the
history of medicine. This is his first article for Herbs for
Aqrabadhin of Al-Kindi. Translated by Martin Levey. Madison: The
University of Wisconsin Press, 1966.
Kamal, Hassan. Encyclopedia of Islamic Medicine. Cairo: General
Egyptian Book Organization, 1975.
Levey, Martin. Early Arabic Pharmacology. Leiden, Netherlands:
E. J. Brill, 1973.
Savage-Smith, Emilie. Islamic Culture and the Medical Arts.
Bethesda, Md.: National Library of Medicine, 1994.
Siddiqi, Muhammad Zubayr. Studies in Arabic and Persian Medical
Literature. Calcutta: Calcutta University Press, 1959.
Usama, Ibn Shuraik. Sunna Abu-Dawud, Book 28, No. 3846 (part of
the hadith, a narrative record of the sayings of Mohammed and his