Introduction: In Pursuit of an Unacknowledged Pioneer – Is the Historical Narrative Complete?

Ibn al-Nafis, the 13th-century Damascene physician, is widely recognized as the discoverer of pulmonary circulation. However, the question arises whether other Arab scholars anticipated this groundbreaking discovery, given the rich and enduring legacy of Arab medicine. Prior to and following Galen, prominent medical schools flourished in Baghdad, Cairo, and Cordoba, centers of medical excellence whose influence remains significant. Could it be that within these historical institutions, and within the pages of yet-to-be-deciphered manuscripts, lies evidence of a physician who, centuries before Ibn al-Nafis, understood the circulation of blood between the heart and lungs? The imperative to investigate this possibility stems from the need to accurately assess the contributions of Arab scholars to the history of medicine, contributions that may be more substantial than currently acknowledged.

The Enduring Influence of Galen

Before examining the question of precedence, it is essential to acknowledge the profound influence of Galen’s medical authority for centuries. Galen, the eminent Greek physician of the 2nd century AD, established foundational medical principles that served as primary references until the Renaissance. Galen’s insights were rooted in the theory of the four humors, which posited that health depended on the equilibrium of blood, phlegm, yellow bile, and black bile. He conceived of the circulatory system as a two-way system, wherein the liver transported nutrient-rich blood to the body’s periphery, while the heart pumped the vital spirit. Regarding the lungs, Galen did not recognize their role in blood purification and oxygenation, instead believing they served to cool the heart. This inaccurate understanding of blood circulation remained dominant, posing a significant obstacle to further advancements.

Ibn al-Nafis: A Pivotal Advancement

Galen’s conception prevailed for centuries, until the emergence of Ibn al-Nafis. In his “Commentary on Anatomy in Avicenna’s Canon,” Ibn al-Nafis presented a detailed description of pulmonary circulation: the passage of blood from the heart to the lungs, and its subsequent return enriched with oxygen. He explicitly refuted the existence of pores between the ventricles – a cornerstone of Galen’s theory. Instead, he elucidated that blood travels from the right ventricle to the lungs via the pulmonary artery, where it interacts with fresh air, and then returns to the left ventricle via the pulmonary vein. These precise observations, dating back to the 13th century AD, represent a pivotal advancement in medical understanding. Furthermore, he accurately described the function of the coronary arteries, the delicate blood vessels that supply the heart muscle – a detail absent from Galen’s work. Although his discovery did not gain widespread recognition in Europe until centuries later, his contribution remains a cornerstone of medical history, a testament to the intellectual prowess of the scholars of the Golden Age of Islam.

Searching for a Predecessor

Could an Arab physician have preceded Ibn al-Nafis in describing pulmonary circulation, yet remained unacknowledged by history? Our current objective is to delve into ancient texts, seeking any evidence to support this hypothesis. This is a formidable task, as historical narratives are often shaped by dominant perspectives, leaving untold stories behind.

Al-Razi (Rhazes) and Ali ibn al-Abbas al-Majusi (Haly Abbas)

Let us begin with Al-Razi (Rhazes), the Persian physician and philosopher, who left a significant medical legacy. His “Comprehensive Book” contains fleeting references to the movement of blood between the heart and lungs, but these are not sufficiently explicit to confirm a complete understanding of pulmonary circulation. Al-Razi states that blood travels from the heart to the lungs for purification and refinement, but he does not elaborate on the mechanism or the return of blood to the heart.

Next, we consider Ali ibn al-Abbas al-Majusi (Haly Abbas), who lived in the 10th century AD. His “Complete Book of the Medical Art,” also known as “The Royal Book,” offers a more detailed description that warrants further investigation. Al-Majusi mentions that blood travels from the right side of the heart to the lungs, and then returns to the left side, which closely resembles a description of pulmonary circulation. However, the critical question remains: did Al-Majusi fully comprehend that blood passes through the intricate blood vessels in the lungs, or did he simply believe it passed through invisible pores? This is the central challenge. Are these indications merely astute conjectures, or do they reflect a more profound understanding?

Challenges of Historical Documentation

Here, the inherent challenges of historical documentation become apparent. How many valuable texts have been lost to time? And how many innovative ideas have been obscured by bias or political conflict? Attributing scientific discoveries in history is a complex and precarious endeavor. Translation, for example, can be a double-edged sword. How many nuances were lost or distorted during the transfer of knowledge across languages? And how many cultural and political biases have subtly influenced these translations, reshaping history according to prevailing agendas?

We must also consider the role of power in shaping collective memory. How many brilliant scientists and thinkers have been marginalized due to views that contradicted prevailing ideologies? And how many pioneering discoveries have been falsely attributed to others, for reasons of prestige or influence? It is possible that this unknown physician is a victim of such circumstances.

Re-evaluating the Arab Medical Legacy

Re-evaluating the Arab medical legacy extends beyond simply identifying a predecessor to Ibn al-Nafis in describing pulmonary circulation. It is a call to recognize the significant advancements in medicine, encompassing both anatomy and surgery, that occurred during this golden age. We should remember Al-Zahrawi (Albucasis), who excelled in the use of sophisticated surgical instruments. This re-evaluation requires a meticulous examination of ancient Arabic manuscripts and a critical analysis of medical texts to uncover the unexplored facets of this legacy. Does this hidden treasure not merit discovery?

Conclusion: A Call to Action

This scientific investigation aims not only to revise historical narratives, but also to gain a deeper understanding of the evolution of medical thought and the profound influence of this civilization on the trajectory of modern medicine. The search for this unknown physician, who may have predated Ibn al-Nafis by centuries, presents a compelling challenge. Therefore, let us return to the ancient Arabic manuscripts, those treasures housed in libraries and museums, which hold within their pages undiscovered secrets. Let us reread the works of Al-Razi, Ibn Sina (Avicenna), and other luminaries of medicine, but this time, with greater discernment than ever before. Perhaps we will find subtle indications, or a surprisingly accurate description, that ultimately leads us to this forgotten pioneer.

In light of the challenges historians face in evaluating ancient scientific contributions, how can we ensure that historical errors are not repeated and that credit is given to those who truly deserve it for important medical discoveries? Share your opinions in the comments.