You Could Look It Up (16 page)

Bald opened up English medicine to the wider world, but his success was limited, and England remained intellectually insular. Bald’s work must have been considered important at one time, because the only surviving manuscript we have was written well after the author’s death—someone thought the old book was valuable enough to copy. But that attitude eventually changed, and Bald exerted hardly any influence on posterity.

There was, however, a center of medical inquiry that was much more vigorous and influential. Just as early medieval Europe lagged behind Islam in its knowledge of geography, it paled in comparison with Muslim knowledge of the natural world. Bald’s book, however seminal, looks unsophisticated when put next to a work published not long afterward.

The Persian polymath Abu ‘Ali al-Husayn ibn ‘Abd Allah ibn Sina Balkhi’, better known in the West as Avicenna, lived at the end of the tenth century and beginning of the eleventh and was one of the most wide-ranging minds of the Islamic world. A physician, poet, musician, astronomer, and politician, he has 450 books to his credit, with demonstrated expertise in a dozen fields of knowledge—among them astronomy, chemistry, mathematics, philosophy, and physics. Of all of his areas of knowledge, though, medicine was the one for which he was most renowned. He was therefore ideally suited to compile the
Qanun
, a compendium of cutting-edge knowledge not only on medicine but on hygiene, on mental well-being, and on humanity’s place in the natural world.

We know more about Avicenna than about most other early compilers of reference books thanks, first, to an autobiography he wrote covering his first thirty years, and then to a biographical sketch written shortly after his death by his friend and disciple al-Juzjani. We know, for instance, that he was born in Afshana, the son of a high-ranking civil servant. Afshana was near the Persian region of Bukhara, the capital of the Persian Samanid dynasty and a great center of learning in the Islamic world. We know, too, that he was mostly self-educated. His father provided him with tutors, but he soon left them behind. By the time he was ten he had memorized the Qur’an; by the age of sixteen, he had learned everything his tutors had to teach him.

Having finished with the course of instruction his teachers had for him, he turned his attention to natural science, metaphysics, and medical theory. He studied Greek logic and mathematics with particular interest. He read Plato, Galen, the Stoics, Ptolemy’s
Almagest
, and Euclid’s
Elements
, as well as Arabic philosophers such as al-Farabi and Abu Abdallah al-Natili. Most of all, though, he read Aristotle, and especially the
Metaphysics
. At last he found something that challenged him.
Having learned the Greek language, he read the original text, trying to make sense of it by reading an Arabic commentary by al-Farabi. He read the book forty times, attempting over and over to plumb its depths. In the words of philosophy professor Coeli Fitzpatrick, “Avicenna’s persistence and self-discipline in learning were legendary.”
6

Writings on medicine were always among those he read most attentively. Even as a teenager he claimed to have read every medical book available in late tenth-century Persia. From theory he turned to practice. Avicenna began treating the ill, and he rapidly developed a reputation as a physician. This reputation reached the very top of the social hierarchy in 997, when Nuh ibn Mansur, Sultan of Bukhara, appointed him one of his personal physicians. Avicenna was just sixteen or seventeen. The time in Mansur’s service was a revelation: Avicenna now had access to the whole of the sultan’s library. The voracious reader made his way through the entire collection by the time he was eighteen. Later in life he reflected, “I now know the same amount as then but more maturely and deeply; otherwise the truth of learning and knowledge is the same.”
7
In his own writings, he combined Greek and Islamic thought, and he organized classical knowledge into a system that made sense in a Muslim context.

Avicenna wrote two major books on medicine. One, the
Kitab al-Shifa
, or
Book of Healing
, is a wide-ranging meditation on the health of the mind. The other,
Kitab al-Qanun fi al-tibb
, or
The Canon of Medicine
, is much more encyclopedic in its organization. Its fourteen volumes and
more than a million words, densely packed with information, were compiled at Isfahan. It is an avowedly eclectic book, combining Galenic medicine, from second-century Greece, with older Aristotelian science and modern Islamic medicine. Avicenna’s interest in reconciling Greek and Arabic thought shows up even in his title: the Arabic word
qanun
is borrowed from the Greek
kanon
‘measuring rod’, meaning “rule” or “standard.” But Avicenna drew from even more distant sources, including Indian medical theory and the
Zhubing Yuanhuo Lun
, an early seventh-century Chinese medical work. He has been praised for his clarity, his arrangement of information for maximal usefulness, and his ability to express complicated matters in the most concise way possible.

“Medicine,” Avicenna wrote in his preface, “is a science from which one learns the status of the human body with respect to what is healthy and what is not, in order to preserve good health when it exists and restore it when it is lacking.”
8
The first book brings Greek medicine to bear on the basic principles of anatomy, health, and illness. The four humors—blood, phlegm, yellow bile, and black bile—were introduced and linked to the four elements—earth, air, fire, and water. Disease emerges from an imbalance of the humors, usually because of some obstruction. To bring them into balance, he prescribed “emetics, cathartics, enemas, sedatives, and other drugs, bleeding, blistering, and cauterization.”
9

The second book moves on to “simples,” the basic medicines that are not compounded of multiple ingredients, and it spells out Avicenna’s conception of what we have come to call the scientific method. Book 3 explores pathology, with a systematic overview of twenty-one bodily organs or systems, while book 4 looks at other sorts of pathologies that span the entire body. This is the part that also introduces the rudiments of surgery. Finally, book 5 provides advice on compounding simples into more sophisticated medicines. Some have called it “the first pharmacopeia,” with its discussion of more than 760 medicines.
10

A medical historian writes of the book’s “practical tenor”: “Ibn Sina’s intent, all too successful, was to give practitioners ready guidelines for immediate application, without too much worry over theory, and with a minimum of skeptical doubt or radical experimentation.”
11
Another describes how the book works as a reference source:

If one wishes to use the
Canon
as a reference tool, the arrangement … works well for some subjects… . One can, for example, relatively easily find an answer to any of the following questions: When and in what conditions is bleeding an appropriate treatment? What are the medicinal powers of cinnamon? What treatments are recommended for deafness? For various kinds of fevers? How is theriac compounded?
12

The
Qanun
is less useful, though, in its anatomical discussions, which are scattered throughout the book and therefore ill-suited to quick reference.

Expectations about medical knowledge were very different a thousand years ago. We now demand our medical textbooks be as up-to-date as possible, but Avicenna, like most writers of his time, demanded ancient authority. “The
Qanun
,” one scholar explains, “remains a compendium largely of traditional material.”
13
Avicenna, for instance, leaned heavily on Galen, whose work was eight centuries old when Avicenna wrote—and even Galen was mostly backward-looking at the time he wrote. Still, Avicenna made some conceptual breakthroughs that are now a standard part of medical thinking. Medicines, for instance, Avicenna argued, should be tested before they are tried—“The experiment must be done on a single, not a composite, condition. In the latter case, if the condition consists of two opposite diseases and the drug is tried and found beneficial in both, we cannot infer the real cause of the cure”—an anticipation of what would become the clinical trial. Predating later medical thought, he suggested that tiny organisms might be responsible for illnesses centuries before science offered a germ theory. He called for explicit attention to observation and experimentation, and he believed in treating the whole patient, integrating body and mind into one concern, making him a forerunner of modern medical practice, including the field of psychiatry.

In fact Avicenna is a forerunner of much later medical thinking. He wrote in Arabic, but the
Qanun
eventually made its way into many of the world’s languages, including Persian, Latin (Gerard of Cremona rendered it as
Canon medicinæ
), Chinese (
Huihui yaofang
, or
Prescriptions of the Hui Nationality
), and Hebrew, as well as most of the major
languages of Europe. It continued to be used—not as a work of antiquarian interest, but as a real medical reference—even into the seventeenth and early eighteenth centuries in Europe. Even today, some practitioners of alternative traditional medicine in the Middle East turn to Avicenna for practical guidance. The
Qanun
, in the words of one historian, “might be called the most famous medical textbook ever written, and it was retranslated and reprinted in Europe down to the middle of the seventeenth century… . Of all the great characters of history Avicenna has an especial interest to medical men.”
14

Bald and Avicenna probably lived within a few decades of each other, but they never knew of each other’s existence. England and Persia were, for all practical purposes, on opposite sides of the world. But they were engaging in the same enterprise, trying to incorporate the best thinking about medical practice from ancient and foreign sources into their own domestic system. For Bald that meant Latin and Byzantine prescriptions; for Avicenna it meant ancient Greek medical theory. And both chose the form of the reference book in which to advance their syncretic conception of medicine, because it was the most reliable way to translate theory into practice. It is a valuable reminder that encyclopedias can be the site of important cross-cultural dialogue.

CHAPTER
6 ½

PLAGIARISM

The Crime of Literary Theft

Thomas Cooper's
Thesaurus
linguæ Romanæ & Britannicæ
(
Treasure-House of the Roman and British Tongue
), a Latin–English dictionary, appeared in
1573
. Shortly afterward, the Puritan pamphleteer known as Martin Marprelate turned his guns on Cooper, accusing him of plagiarism—of lifting entries without acknowledgment from Thomas Elyot's Latin dictionary, Robert Estienne's French dictionary, and John Frisius's German dictionary. And he was right: Cooper had resorted to the pastiche for which teachers castigate dishonest students who think “research” means cutting and pasting from the World Wide Web.

Cooper might have defended himself by pointing out that dictionaries
always
“borrow” from one another. It has been going on from the beginning: as Sidney Landau puts it, “The history of English lexicography”—and it is just as true of other languages and other reference genres—“consists of a recital of successive and often successful acts of piracy.”
1
Even the first monolingual English dictionary, Robert Cawdrey's
Table Alphabeticall
(1604), has been accused of plagiarism. It is hard to imagine how a work that is the first of its kind can steal from predecessors when it has no predecessors, but around half the headwords in Cawdrey's book were taken from a table of difficult words in
The Englishe Schole-Maister
, published by Edmund Coote eight years earlier. Cawdrey got his comeuppance when another lexicographer, John Bullokar, copied many of Cawdrey's entries for his
English Expositor
. Cawdrey's son then revised his father's dictionary, stealing entries back from Bullokar.