By Yasmin Nasser
The Procedings of the 10 the Annual History of Medicine Days, edited by Dr. W. A. Whitelaw (Calgary, 2001)
Abstract: Ibn Tufayl was a well known 12th century Arab physician, who was born in Al-Andalus. Today the words Al-Andalus bring to mind the Spanish province of Andalucia, which lies in southern Spain, and contains the beautiful cities of Seville, Granada and Cordoba. In Ibn Tufayl’s time however, Al-Andalus was much larger – in fact, the name implied all Spain under the dominion of the Arabs. To understand Arab medicine, that is to say, this flowering of philosophy, learning, questioning and studying that occurred between the 9th and 15th centuries, we must first understand the history of these extraordinary times.
Extract: What is it that Ibn Tufayl tells us about asthma?
He says that: “Asthma occurs when it is hot, and on examination the lungs are distended, a pathognomonic sign.”
Overdistended lungs is a pathologic feature of asthma that is well recognised today. Celsus was the first to describe overdistention, so this statement is not an original thought by Ibn Tufayl.
Ibn Tufayl next tells us that: “The differential diagnosis is that of dyspnea. Cancer or ulcerations can produce the same symptoms, but must reach a considerable size before there is dyspnea.”
Ibn Tufayl’s statement about cancers and ulcerations is indeed true. Both of these must reach a significant size before they are able to block or occlude the airways.
“There is an obvious contrast between inspiration and expiration, a pair of opposites that correspond to contraction and relaxation of muscles.”
Here, Ibn Tufayl tells us about muscles that function during inspiration and expiration. Presumably, he is referring to muscle groups such as the intercostals. The use of musculature during breathing is not a new idea, as this was recognised previously by Galen. Ibn Tufayl’s next statement is surprising:
“Crisis occur mainly at night and are due to constrictions of the airways.”
This is a very intriguing statement. Ibn Tufayl tells us that crisis occur mainly at night, which we know to be true today. Asthmatics typically experience exacerbations of their symptoms at night, and this is considered as a bad prognostic sign. Even today, we cannot clearly explain this phenomenon. When Ibn Tufayl speaks of “constrictions of the airways”, does he mean bronchoconstriction? If so, it would mean that Ibn Tufayl is the first to recognise bronchoconstriction during an asthma attack. The symptoms that Ibn Tufayl describes may in fact be what we consider as asthma today.