Introduction
Bīmāristāns and madrassas were establishments where medical education was done in Islamic countries during medieval times. Either a section was opened in a madrassa or a separate madrassa was built for medical education. Based on this tradition, the Turks also established foundations for medical education. Physicians were educated in bīmāristans/dār al-shifās and madrassas during the Seljukid and Ottoman Era[1] .
Nidhāmī Arūḍī’s Chahār Maqāla contained valuable information regarding the sources of medical education in the Seljuk Empire during the 12th century AD[2] . It also classifed the medical works for students, from beginner to advanced. Here is an interesting statement related to Avicenna’s Canon of Medicine: “If he [the physician] desires to be independent of other works, he may content himself with the Qánún[3] .” As a matter of fact, the Canon of Medicine was one of the main sources of medical education both in the Eastern and the Western world[4] , and it was also a source of inspiration for medical works written after[5] .
During the Turkish history of Anatolia, particular attention was paid to the study of anatomy which was regarded as the sine qua non for medical education. Şehsuvaroğlu, a well-known Turkish historian of medicine, classifed the history of the study of anatomy into four phases in his article related to the study of anatomy in Turkey. He named the frst phase the “madrassa period,” which was between the years 1205 and 1816 AD. The Canon of Medicine written in Arabic was the main source used for medical education during this period[6] . However, there also emerged some Turkish medical books with anatomy sections[7] and also books written solely on anatomy[8] . The Tashrīḥ al-Abdān wa Tarjamān Qibāla Faylasūfān, an illustrated anatomy book written by Shams al-Dīn ʿItāqī, was one of the latter[9] .
Shams al-Dīn ʿItāqī and Tashrīḥ al-Abdān wa Tarjamān Qibāla Faylasūfān
Shams al-Dīn ʿItāqī was born in Shirwan (c. 1570 AD). He studied medicine, mathematics, logic, astronomy, canonical jurisprudence of Islam, and Hadith for twenty years[10]. He was also a poet and ‘Itāqī was his pen name[11]. He left his country because of conficts and stayed abroad for a while, after which he came to İstanbul[12], where Alī Efendi and İbrāhīm Efendi introduced him to Grand Vizier Receb Pasha. He was assigned to Mecca city as Shaikh al-Kharam. While in his sixties, he wrote an anatomy book in Turkish, called Tashrīḥ al-Abdān wa Tarcamān Qibāla Faylasūfān, and dedicated it to the Ottoman Sultan Murad IV (r. 1623–1640 AD)[13].
Kâhya reported that the book was probably written in 1632[14]. There are eight known copies of Tashrīḥ al-Abdān and four of them comprise anatomical illustrations which are one of the most important features of the work[15]. Some of these illustrations look like those of Tashrīḥ al-Abdān min al-Tibb written by Manṣūr b. Muḥammad b. Aḥmad (Figure 1)[16], while others were copied from Andreas Vesalius’s De humani corporis fabrica[17] and/or Juan Valverde de Amusco’s Historia de la composicion del cuerpo humano[18]. Kâhya stated that the last set of illustrations was drawn by the author himself (Figure 2)[19].
Another feature of the work is that Shams al-Dīn ʿItāqī wrote it purely on anatomy, which was rare in the Medieval Islamic world and in the Ottoman Empire. Anatomy was usually considered a section in general medical works[20].
The last feature of the work was that it was written in Turkish, and consequently, it contained anatomical terms in Turkish alongside the Arabic and Persian ones[21]. This makes Tashrīḥ al-Abdān important to the history of Turkish medicine, considering the fact that Arabic was the scientifc language of the Medieval Islamic world.
The main purpose of our study was to determine whether Andreas Vesalius and Juan Valverde de Amusco, together with their works, infuenced Shams al-Dīn ʿItāqī considering the fgures and several statements in Tashrīḥ al-Abdān wa Tarjamān Qibāla Faylasūfān.
Material and Method
In this study, four illustrated copies of Tashrīḥ al-Abdān wa Tarjamān Qibāla Faylasūfān of Shams al-Dīn ʿItāqī were examined among them were copies of the İstanbul Süleymaniye Manuscript Library, Hüsrev Paşa Collection, Nr. 464 used regarding both their content and the fgures[22] they contain originating from the West. Besides, the copy of İstanbul University Rare Works Library, Turkish Manuscripts, TY 2662[23] and the black & white photo prints, which are in the Library of History of Medicine Department, Faculty of Medicine, Ankara University, of the copy of Prof. Uzluk’s personal collection[24] were also analyzed with respect to their fgures originating from the West (Figure 3). The copy of the İstanbul Süleymaniye Manuscript Library, Bağdatlı Vehbi Collection, Nr. 1476 was excluded from the study due to its shortage in these fgures. During this study, Galen’s works[25], alQānūn fī al-Ṭibb of Avicenna[26], De humani corporis fabrica of Andreas Vesalius[27], and Historia de la composicion del cuerpo humano of Juan Valverde de Amusco[28] with its Italian[29] and Latin editions[30], were also used. The statements and fgures in Tashrīḥ al-Abdān wa Tarjamān Qibāla Faylasūfān were compared to those in Galen’s works, al-Qānūn fī al-Ṭibb, De humani corporis fabrica and Historia de la composicion del cuerpo humano and the fndings were evaluated.
Results
The Mandible
We see that although Shams al-Dīn ʿItāqī copied the fgure of the mandible from Andreas Vesalius and/or Juan Valverde, in explaining this fgure he repeated classical anatomical knowledge inherited from Galen[31] and Avicenna[32], by indicating that the mandible consists of two bones[33]. One of the earliest objections to Galen’s authority is seen in Abd al-Laṭīf al-Baghdādī’s (1162–1231 AD) Kitāb al-ʿIfāda wa l-ʿItibār in which he wrote that the mandible is a single bone[34]. Andreas Vesalius also objected to Galen similarly in De humani corporis fabrica libri septem[35]. Juan Valverde’s description of the mandible[36] corresponds to that of contemporary anatomical knowledge (Table 1) (Figure 4)[37]
The Sacrum
ʿItāqī repeated the classical knowledge[38] inherited from Galen[39] and Avicenna[40] regarding the number of vertebrae in the sacrum as three. While Vesalius gave the number of vertebrae in the sacrum as six[41], Valverde considered it as six, and sometimes fve[42]. ʿAbd al-Laṭīf al-Baghdādī wrote that the sacrum [al-ʿajz] with the coccyx [al-ʿajb] consists generally of a single bone, instead of six in his Kitāb al-ʿIfāda wa l-ʿItibār (Table 2) (Figure 5)[43].
Leonardo da Vinci was the frst anatomist who gave the correct number, fve[44]. Saunders and Malley’s comment on the illustration of the sacral bone, which consists of six vertebrae in De humani corporis fabrica, is really interesting:
“Jacobus Sylvius, Vesalius’ teacher in Paris, insisted that the Galenical texts were completely correct with regard to number, hence Vesalius, in order to some extent to accommodate Galen’s opinion, grudgingly allowed that by adding the three sacral to the three coccygeal segments of the ape, and assuming that the rest of the coccyx or caudal vertebrae were not ossifed, he could harmonize opinion. This was one of the reasons that he selected a six-piece sacrum for the illustration below[45].”
This statement corresponds to ʿAbd al-Laṭīf Baghdādī’s acceptance of six fused vertebrae [probably three for the sacrum and three for the coccyx] as a single bone, but not clear enough regarding the coccyx.
The Coccyx
ʿItāqī description of the coccyx[46] was the same as Galen’s[47] and Avicenna’s[48]. Vesalius gave the correct number[49] and Valverde afrmed this number but also wrote a variation comprising three bones (Table 3)[50]. Leonardo da Vinci declared it to be two bones[51].
The Metacarpus & the Phalanges of the Hand
ʿItāqī follows[52] Galen[53] and Avicenna[54] in his description of the number of metacarpal and fnger bones. Although Vesalius[55] and Valverde[56] made some explanations about whether the number of metacarpal bones is four or fve, they also admitted that the metacarpus has four bones, and every fnger of the hand consists of three bones. According to modern anatomical knowledge, the number of metacarpal bones is fve and the total number of fnger bones of the hand is fourteen; two in each thumb, and three in each of the other fngers (Table 4) (Figure 6)[57].
The Metatarsus & the Phalanges of the Foot
Regarding the number of the metatarsal bones and the bones of the toes, there is no diference between the information given by Galen[58], Avicenna[59], Vesalius[60], Valverde[61], ʿItāqī[62], and modern anatomical knowledge (Table 5) (Figure 7)[63].
The Optic Nerve, the Optic Chiasma, & the Oculomotor Nerve
ʿItāqī may have tried to support his explanations on the optic nerves, the optic chiasma, and the oculomotor nerves with the fgures copied from Vesalius and/or Valverde. However, these fgures actually show the cerebral fornix and lateral ventricles. The optic nerves, the optic chiasm, and the oculomotor nerves appear at the base of the brain, and Vesalius’s and Valverde’s works contain fgures depicting them. But it seems that ʿItāqī did not understand the structures correctly as seen in the fgures (Figure 8 and 9).
The Rete Mirabile
Andreas Vesalius[64] and Juan Valverde[65] declared that the rete mirabile or the reticular plexus, whose existence was accepted and mentioned by Galen[66] and Avicenna, was absent in human beings. Unfortunately, ʿItāqī’s book does not contain this important fnding, though it contains a chapter explaining the rete mirabile/shabaka dimāgh (Table 6)[67].
The Uterus
Vesalius said that though the fundus of the female uterus is bestowed with a single sinus[68], Galen assigned two sinuses to his uterus, as he often described it as his De usu partium[69]. Valverde also asserted that there are not many chambers in the uterus as some believed or found[70]. However, ʿItāqī repeats the information[71] given by Galen and Avicenna[72] (Table 7).
Discussion
This preliminary study reveals that ʿItāqī refected classical anatomical knowledge in the Islamic world of his era and Avicenna’s Canon of Medicine was the main source of his statements in the text. ʿItāqī’s book contains some fgures only from Vesalius and/or Valverde’s works, but there is no new explanation related to issues such as the mandible, the sacrum, the rete mirabile, and the uterus.
On the other hand, ʿItāqī seems to be unaware of ʿAbd al-Laṭīf al-Baghdādī’s work disclosing the mandible and the sacrum [with coccyx] as single bones. Although he put an explanation on the anatomy of the heart [the heart has two cavities] from Ibn al-Nafīs’s (d. 1288 AD) Sharh al-Tashrīḥ al-Qānūn, ʿItāqī preferred to give the classical anatomical knowledge on the heart [the heart has three cavities][73] mentioned in the Canon of Medicine[74]. Also, considering that Ibn al-Nafīs says there is no passage that appears in the interventricular septum of the heart or there is no invisible passage as Galen thought[75] and Vesalius also gives very similar statements[76], ʿItāqī’s explanations referring to Ibn al-Nafīs seem to be not in accordance with the statements of Ibn al-Nafīs, but are compatible with those of Galen[77]. And as Adıvar noted[78], ʿItāqī’s quotation from Ibn al-Nafīs disclosed that he unfortunately did not understand Ibn al-Nafīs’ statements on the pulmonary circulation (Table 8).
Who is ʿItāqī’s source for his fgures? Andreas Vesalius or Juan Valverde?
Many of the fgures that originated from the West in ʿItāqī’s Tashrīḥ al-Abdān wa Tarjamān Qibāla Faylasūfān also appear in Vesalius’s De humani corporis fabrica libri septem and in Juan Valverde’s Historia de la composicion del cuerpo humano. The similarities between the fgures of Vesalius and of Valverde caused Juan Valverde de Amusco to be accused of plagiarism. However, the fgures in Valverde’s Historia are reverse versions of the ones in Vesalius’s book and this is an expected result when someone copies a fgure on a plate and then prints it. When Western-originated fgures in ʿItāqī’s book are compared with those in both De humani corporis fabrica and Historia de la composicion del cuerpo humano, it is seen that most of them are very similar to those of Vesalius’s De humani corporis fabrica, except for the cervical vertebral fgure and female fgure which correspond to Tab. V. del Lib. I and Tab. VI. del Lib. III in Valverde’s book. On the other hand, the fgure of the man displaying body muscles among the fgures of ʿItāqī appears only in the Latin edition of Valverde’s work (Figure 10). This fact made us raise this question: Which one of these works did Shams al-Dīn ʿItāqī see? Or did Shams al-Dīn ʿItāqī see both of them?
All fgures, including the fgure depicting seven cervical vertebrae, the fgure showing body muscles, and the female fgure together reveal that the Western-originated fgures in ʿItāqī’s book are probably related to Valverde’s book of Latin edition in 1589. However, this assumption raises another question. The problem is that all the fgures in the manuscript Hüsrev Paşa, Nr. 464 are in a reverse position to those in Valverde’s book in Latin edition (1589) and in this respect, most of them correspond to those in Vesalius’s book except for the three fgures mentioned above. If someone draws a fgure looking at any object, he/she should draw what he/she sees! In this case, it comes to mind that there should be a copy of Valverde’s work that answers all these questions. Our comparisons between the fgures of all editions of Vesalius’s and Valverde’s works have made it clear that the Latin edition of Valverde’s book Anatome Corporis Humani published in 1607 was the source of the Western-originated illustrations in the manuscript Hüsrev Paşa, Nr. 464 (Figure 11).
However, while the fgures depicting the human skeleton, spine, and cervical vertebrae in the manuscript of Istanbul University, Turkish Manuscripts, TY 2662 are corresponding to those in Hüsrev Paşa, Nr. 464, the female fgure in the manuscript of Istanbul University, Turkish Manuscripts, TY 2662 seems to be drawn opposite to that in Hüsrev Paşa, Nr. 464. As such, how do we explain these pictures?
The Latin edition of Valverde’s book Anatome Corporis Humani published in 1607 probably was the source of all the Western-based illustrations, except for the female fgure in the manuscript of Istanbul University, Turkish Manuscripts, TY 2662. This fgure was probably copied from any of the Spanish, Italian, or Latin (1589) editions of Valverde’s book (Figure 12).
Spanish and/or Italian and/or Latin (1589) editions of Valverde’s book were the sources of most of the Western-originated illustrations, except the human skeleton fgure in the manuscript of Prof. Uzluk’s personal collection (Figure 13).
As conclusion #1
This limited study revealed that the information given by the works of Vesalius and Valverde has not infuenced the explanations of ʿItāqī. ʿItāqī wrote his book according to the classical anatomical knowledge in the Islamic world of his era and he added Eastern- and Western-originated anatomical fgures to his book to support/strengthen his statements. If it is accepted that ʿItāqī added fgures to his work and the copy of Hüsrev Paşa, Nr. 464 is the closest copy to the original, then his source for the Western-originated fgures in Tashrīḥ al-Abdān was Juan Valverde’s Anatome corporis humani published in 1607.
As conclusion #2
ʿItāqī wrote his book according to the classical anatomical knowledge in the Islamic world of his era. Also, his work Tasrīḥ al-Abdān originally contained no illustrations. However, later, scribes/copiers added Eastern- and Western-originated anatomical fgures to the book to support/strengthen statements at diferent times. The four copies of Tashrīḥ al-Abdān without illustrations and variations between the illustrated copies are in favor of this idea, and Prof. Uzluk’s copy of Tasrīḥ al Abdān directly supports it. It comprises many diferent illustrations in comparison to other illustrated copies.
Acknowledgement
Preparation for publication of this article is partly supported by the Turkish Neurosurgical Society
APPENDIXS