Introduction
Over the last few years, a multidisciplinary project dealing with the history of medieval medicine based upon the Cairo Genizah collectionsFootnote 1 has been carried out after more than a few publications of these manuscripts had hinted at its potential value.Footnote 2 A few phases of the research, mainly those dealing with medicinal substances,Footnote 3 practical medicine and its relation to the theoretical,Footnote 4 have already been successfully completed. The next phase of this research project is the reconstruction of the medical library of Eastern medieval Jewish medical practitioners centred upon the Cairo Genizah collections. The project, which made use of the Isaacs catalogue and the medical books he identified as a starting point,Footnote 5 has so far yielded only a few more identifications of unique early Arab medical books. Some of them have already been published,Footnote 6 while others are still in the process of publication.
In the course of the reconstruction project, an Arabic fragment of a unique tabular medical book was identified as Ibn Jazlah's tabulated manual Taqwīm al-abdān fī tadbīr al-insān (The Almanac of Bodily Parts for the Treatment of People). The uniqueness of this fragment is based on a few parameters, the main one being that it seems to be from one of the earliest known manuscript copies of this text. It should be noted that only five fragments, out of approximately 1550 fragments of medical books found in the T-S collectionFootnote 7 , are from medieval Arabic tabular medical books. Another parameter is that the setting of the tables in our fragment is different from most of the known manuscripts of the book. It seems that T-S Ar.41.137 was a draft that was never completed, giving us some indication of how the medieval copier worked.
a. The Author
Sharf al-Dīn Abū ʿAlī Yaḥyā Ibn ʿIsā Ibn Jazlah (d. 1100) was born and raised as a Nestorian Christian named Yūḥannā in Karkh, Baghdad, and later converted to Islam. His medical education was acquired under Sa`īd Ibn Hibat Allāh (1044–1101) at the ʿAḍuḍi hospital and under the influence of his teacher and patron, Muʿtazilī Abū ʿAlī ibn al-Walīd. According to Ibn Abī Uṣaybiʿa, Ibn Jazlah converted to Islam in 1074, and was appointed as a registrar at the court of ʿAbbāsid caliph in Baghdad where he also practiced medicine. His achievement as a medical practitioner brought him to the attention of Caliph al-Muqtadī (reigned 1075–1094) and he became his court physician. Footnote 8
Ibn Jazlah wrote several books on various subjects. The main ones are: (1) Taqwīm al-abdān fī tadbīr al-insān [a therapeutic hand-book]; (2) Minhāj al-bayān fī mā yastaʿmiluh al-insān [consists of an alphabetical list of plants and drugs, simple or compound]; (3) Faḍāʾil al-ṭibb; (4) al-Radd ʿala ‘l-naṣārā, [a work in praise of Islam and criticising Christianity]; (5) Mukhtār mukhtaṣar taʾrīkh Baghdādi [a summary of the work of al-Khṭīb al-Baghdādī].Footnote 9
The most well-known of his medical writings are al-Minhāj al-bayān and Taqwīm al-abdān, both treatises dedicated to the imperial library of Caliph al-Muqtadī. Ibn Jazlah was considered in his time as a one of the best physicians, mainly thanks to his knowledge of medical theory, wide experience and keen observation.Footnote 10 His gastronomical expertise in relation to medicine, which is mainly presented in al-Minhāj al-bayān, has been highly appreciated by scholars until the present day.Footnote 11 His writings were translated, widely circulated, and much quoted in the West with his name spelt as Ben Gesla, Byngezla, and Buhahylyha. Before he died he bequeathed his collection of books to the famous mosque and mausoleum library of al-Imām Abū Hanīfah in the city of Baghdad where he was buried. Footnote 12
b. The Book
Taqwīm al-abdān fī tadbīr al-insān (The Almanac of Bodily Parts for the Treatment of People) is a therapeutic handbook, or tabulated manual, one of the first books published in such form.Footnote 13 This type of tabulated medical book will be dealt with extensively in the discussion. No edition of it exists in a modern European language, but there is a rare Arabic edition.Footnote 14 The book was translated into Latin by the Sicilian Jewish physician, Faraj b. Sālim (Magister Farachi) in 1280, under the title of Tacuini aegritudinum (printed at Strasbourg in 1532), a German translation was published in 1533 in Strasbourg by Hans Schotte.
The book consists of 44 tables, divided into 12 columns each (similar to books of astronomical charts). In each column, data regarding one aspect or phase of the medical treatment is given: 1. Name of each disease mentioned in each class. 2. Temperament. 3. Age. 4. Season. 5. The country favourable to the genesis of the disease. 6. Prognosis, safe or grave. 7. Etiology. 8. Symptoms. 9. Emptying (bloodletting, vomiting, clyster). 10. Royal treatment. 11. Simple or easy treatment. 12. General treatment. Each page presents a category of diseases each consisting of eight of the principle species enumerated, all together describing 352 maladies and indicating the appropriate diets for them.Footnote 15
According to Vernet the author was apparently inspired by the Taḳwīm al-ṣiḥḥa of Ibn Buṭlān. This synoptic method was later imitated by other authors such as Ibn BiklārishFootnote 16 and by the anonymous author in Salerno of the mid-12th century, and may also have had an influence on the arrangement of the tables in the Taḳwīm al-buldān of Abu ‘l-Fidāʾ.Footnote 17
The book contains a general discussion of diseases their causes, symptoms, and medical treatments. Although the basic treatments listed in the book were not original, the tabulated form was of considerable advantage to physicians in emergency cases due to its utilisation of the synoptic method which simplified the location of the maladies and their treatment. The book was also useful for the teaching of medicine. The fifteen vertical sections of Ibn Buṭlān's tabulated book were reduced to eleven vertical columns by Ibn Jazlah in his Taqwīm. He also clarified terms and added more selective prescriptions and therapy in a new way that enabled both the simple practitioner and the layman reader to utilise it. Ibn Jazlah wrote that he consulted the works of the most important Classical and Arabic physicians, however, he used only the most important and necessary information, mainly from al-Majūsi. He knew Ibn Sina's work well, but it seems as though he deliberately did not mention it even once.Footnote 18
The main known manuscripts of Ibn Jazlah's Taqwīm al-abdān fī tadbīr al-insān are: Complete: 1. British Library Or. 12096. 2. British Library Or. 5862. 3. Browne OR MS P8 (13), University Library Cambridge. Incomplete: 1. Wellcome OR. 54. 2. Garrett Collection, Princeton University Library, No. 1099.
In the detailed introduction Ibn Jazlah stresses hygienic measures and strongly recommends using the means of preservation to promote good health. The spiritual and the physical aspects of life are both important for health and human life. He explains that: “one should labour for the present life as he is going to stay for ever on this earth, and for the life to come, as if this were his last days here”. He also wrote: “Prudent is the person who takes heed of this fact to make the best of both worlds. He should adorn himself with gaining useful knowledge and his daily living by good health either by its preservation or restoring it through medicine”.Footnote 19 The introduction ends with a discussion on poisons and their antidotes, explained and justified by the author: “to know about the danger of harmful substances helps one to avoid them”. According to Graziani, Ibn Buṭlān's book on Galen-Ḥunayn's six essentials (non-natural) for the preservation of good health became a model followed by Ibn Jazlah and other medical writers.Footnote 20
Illustration 1 T-S Ar.41.137 - recto
Illustration 2 T-S Ar.41.137 - verso
Findings
a. The Fragment - T-S Ar.41.137
T-S Ar.41.137 is written in the Arabic Naskhī script, on paper. It is a mutilated bifolium (2 leaves) measuring 25.2 × 33.6 cm. The content includes general management of fevers, hectic and septic fevers, cancer, erysipelas, soft and hard inflammatory swellings and elephantiasis. Simples mentioned include rose-water, pomegranate juice, wheat and barley-water, wine vinegar, violet and almond oil, verjuice-water, chamomile, spinach, endive, purslane and sweet marjoram. Verso contains part of a table (contents of the book). It was identified and described by Isaacs in his catalogue as: “part of a tabulated work on medicine”. Footnote 21
b. Transcription and Description
T-S Ar.41.137 – recto (left side) - transcription Footnote 22
T-S Ar.41.137 – recto (left side) – translation
T-S Ar.41.137 – recto (right side) - transcription Footnote 23
T-S Ar.41.137 – recto (right side) – translation
T-S Ar.41.137 – verso – transcription
T-S Ar.41.137 – verso - translation
Discussion
Historians of medicine use various types of documents, in most cases complete manuscripts or fragments of medical books. There is no doubt regarding their importance to the field of medical research. However, in this article, the discussion is on the value of a draft of a medical book which was probably made by the copier.
Original drafts of medical books have already been found in the Genizah, the most well known being the drafts of a few of Maimonides’ medical books.Footnote 24 Other fragments representing manuscripts of known medieval medical books,Footnote 25 some of which are unique early Arab medical books, were also identified.Footnote 26
In our case, T-S Ar.41.137 is not a draft of an original book, which means that it was not written by the author as part of a book he was in the process of writing. It rather seems to be the draft of a copier, written down in the process of copying Ibn Jazlah's tabulated manual “Taqwīm al-abdān”, in an attempt to reorganise the data or reformat the book. I suggest that our fragment is one of the earlier known drafts of this book, mainly due to the fact that the vast majority of the Genizah material is dated to the 10th–13th centuries and the known manuscripts of this book in libraries around the world are mainly of the 16th–17th centuries.
In order to analyze this fragment and its importance, the discussion will begin with a short introduction dealing with Arabic tabulated medical books and thereafter the fragment (contents) and its importance as presented below.
1. Arabic Tabulated Medical Books
According to Graziani, tabular books were first used by astronomers in formulating their astronomical tables.Footnote 27 Interestingly enough, five tabular fragments related to astrology and astronomy were discovered in the T-S Cairo Genizah collection: T-S AS 176.284; T-S AS 180.261; T-S AS 180.263; T-S AS 183.37; T-S AS 184.421.
The didactic tradition of presenting medical knowledge in synoptic tables was mainly used for the rules of dietetics, for the use and synonyms of medicinal substances, and for diseases and their treatment. It is a fascinating phenomenon in the history of Arabic medicine, mainly because tabular medical books are rare and unique. According to Savage-Smith, the origin of synoptic tables is unknown. The first occurrence, however, might be in an Arabic summary of Galen's book on simple drugs which may have been written in Alexandria, first in Greek and later translated into Arabic, and that survived.Footnote 28 The reason for inventing this system of book composition could have been, according to a note found in one early such manuscript: “. . .so that the book would be a better abridgement, more worthy of being taken seriously, more attractive to see, easier to read, and not so boring”.Footnote 29
According to Serri, the original book of Ibn Sina (d. 1039) included tables containing medicinal substances and their uses. However, it seems that, due to their enormous size (16 columns) and their complexity (use of many colours), these tables were not practical and were extracted from the book by the contemporary copier. Serri, in his doctoral dissertation, even reconstructed such a table and hopefully will publish it soon.Footnote 30 Haddad, while screening 11th century Arabic medical tabular works, mentioned four books (Ibn Jazla – Kitāb taqwīm al-ʾabdān; Ibn Buṭlān - Kitāb taqwīm al-ṣiḥḥa; Ibn al-ʿalāʾī – Taqwīm al-ʾadwiya al-mufrada; al-Tiflīsī – Taqwīm al-ʾadwiya).Footnote 31 According to Graziani, it appears that Abū al-Ḥasan al-Mukhtār Ibn Buṭlān, an important Christian Arab physician of Baghdad, was the originator of using and transferring this system into medical writings, while Ibn Jazlah developed this synoptic method of writing, and the Latin translation of his work later made it notorious.Footnote 32
Presented below are the most important Arabic-speaking authors of tabular books:
Ibn Buṭlān, a Christian physician of Baghdad (d. 1066) wrote Kitāb taqwīm al-ṣiḥḥa [fī quwā al-ʾaghdhiya wa-dafʿ maḍārrihā] (The Almanac of Health).Footnote 33 Ibn Buṭlān presented 210 plants and animals and 70 other items and procedures useful for maintaining good health in the course of 40 tables.Footnote 34
Sa`īd Ibn Hibat Allāh (d. 1101) wrote Kitāb al-mughnī fī tadbīr al-amrāḍ wa-maʿrifat al-ʿilāl wa-l-aʿrāḍ (al-Ṭibb) (The Ultimate Book on the Treatment of Diseases and the Knowledge of Afflictions and Affections).Footnote 35
Ismaʿil ibn al-Husayn al-Jurjani (d. 1136),Footnote 36 who lived in the province of Khwarazm in Persia, wrote a medical manual, Manāfiʻ tibbīyah va ikhlāt kā bayān Footnote 37 on the causes and symptoms of dieses (The Quintessence of Medicine).Footnote 38
ʿAdnan ibn Nasr al-ʿAynzarbi,Footnote 39 a court physician in Fatimid Egypt (d. 1153), wrote al-Kāfī fī ṣināʿat al-ṭibb (What is Sufficient for the Medical Art).Footnote 40
Ibn Biklārish al-Isra'ili (12th century) wrote Kitāb al-mustaʿīnī (The Book of Mustaʿīnī). He included 704 medicinal substances in his tabular treatise.Footnote 41
Hubaysh ibn Ibrahim al-Tiflīsī (12th century),Footnote 42 a prolific medical author, wrote Kitāb taqwīm al-ʾadwiya al-mufradawa-l-aghdhiya (Almanac of Simple Drugs and Foodstuffs). This work consists of two books, the first covering 730 commonly used medicaments and foodstuffs discussed in tables of 13 columns, and the second listing 880 rare drugs and foodstuffs with suggestions for substitute drugs mentioned in the first book.Footnote 43
Ibrahim ibn Abi Saʿd ibn Ibrahim al-ʿAla'i al-Maghribi (late 12th century) wrote a tabular materia medica for the Danishmendid dynasty in Anatolia, Kitāb taqwīm al-adwiya al-mufrada (Almanac of Simple Drugs) and presented 550 medicinal substances circulated under several titles in synoptic tables.Footnote 44
As mentioned above T-S Ar.41.137 is one of five fragments of medical tabulated books discovered in the T-S Cairo Genizah collection. The other four are:
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1. T-S Ar.11.29 (Medical book: Sa`īd Ibn Hibat Allāh's al-Mughnī fī al-ṭibb written in Judaeo-Arabic). This author was one of the teachers of Ibn Jazlah.Footnote 45
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2. T-S Ar.38.5 (Contents page of an unidentified medical textbook - tabulated and rubricated, written in Arabic).
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3. T-S Ar.44.12 (Unidentified medical book, Materia medica, tabulated and circular diagram, written in Arabic).
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4. T-S Ar.44.218 (Part of Ibn Biklārish's tabulated work, written in Judaeo-Arabic).Footnote 46
2. The Fragment
a. General Layout in Comparison with other Manuscripts (mainly WMS 418, Browne OR MS P8 (13), British Library Or. 5862 and the edition)Footnote 47
The first table in our fragment, T-S Ar.41.137 – verso (right side), consists of 11 rows, each one presenting a group of maladies and containing 8 diseases, totalling 88 maladies. The table is part of the contents page of the book, listing a quarter of the groups of maladies (eleven out of forty-four). It is in fact only half of a more detailed table (consisting of 22 rows) found for example in the WMS 418 (page 2b).
The first seven groups of maladies fully appear in the fragments; the rest were partly reconstructed using WMS 418. The first 11 groups are:
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1. Quotidian fever.
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2. Putrid fevers
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3. Tumours
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4. Skin diseases
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5. Skin diseases
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6. External diseases of the head and face
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7. External diseases of the hand and feet
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8. Wounds and ulcers
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9. Ulcers and burns
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10. Poisonous bites and stings
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11. Animal and vegetable poisons
The rows in the (WMS 418 2b) table are similar to other tables in the same manuscripts, and they are written in different colour inks (black and blue for the groups of maladies; and red for the extreme right column – the name of each group of maladies). This arrangement makes it easy to follow the information set in each row from the rows above and below.
It is important to note that the order of the diseases in T-S Ar.41.137 – verso (right side) is different from the setting in WMS 418 – for some unknown reason it is from left to right in each single row (see figure 1).
Figure 1 - Numeral Schematic Figure of (T-S Ar.41.137 – recto, right side) [bold figures are missing entries in the fragment]
The 8 diseases of each row are dealt with in detail on another page (for example in WMS 418 - 3b, 4b, 5b, . . .). In our fragment T-S Ar.41.137 there is only an early and unsuccessful attempt to start such a table.
In T-S Ar.41.137 – recto (left side) – there is another table of one column and 8 rows which includes practical matters, mainly relating to holistic medicine, e.g. diet (food and drinks), bath, massage etc. For comparison - in WMS 418 – such tables are found in pages - 4a, 5a, 6a . . . . . Diseases 1–8 (Fever in the Spirits) can be found in a table in WMS 418 page 3b and are discussed in detail in WMS 418 page 4a. The second group, diseases 9–16 (Putrid Fever and Hectic Fever) can be found in a table in WMS 418 page 4b and are discussed in detail in WMS 418 page 5a- and so on.
It turns out that the table in T-S Ar.41.137 (in relation to WMS 418) has less than half of the details in the table on page 2b, and the left side of the table is half of the table on page 4a.
The table in T-S Ar.41.137 – recto (left side) consists of 7 rows (4–5 written rows each): Row 1 – Theoretical general knowledge – continue at row 7. This information is written at the top of the page, above and below the table in WMS 418 (see for example 4a). Row 2 – does not exist in WMS 418 (page 4a) – it is a heading saying “general treatment”. Rows 3–6 describe the general administration for fevers, mainly “non drugs” treatment such as diet (food and drinks), bath, massage etc. Row 7 – is the continuation of the theoretical data from Row 1.
b. Main Medical Issues in the Fragments:
Fever and their Treatment in the Arabic Medieval Medicine
Fevers (ḥummayāt in Arabic), is a general name for a variety of heat diseases, mainly malaria. Malaria is an infection of the blood by a plasmodium parasite, and is clinically characterised by a periodic fever, anemia; enlargement of the spleen, and various syndromes of organs, such as: the brain, liver and kidneys. The severity of the disease depends upon the age, health, and degree of immunity of the patient and the particular species of the plasmodium parasite. Malaria is mainly transmitted by the Anopheles mosquito.Footnote 48 It seems to have originated in tropical Africa in prehistoric times, and extended its hold over most of the tropical world and much of the land in the temperate climates. It became endemic in Greece and Italy as early as the 5th century BC, had a deleterious effects on these civilisations, and its symptoms were recorded in the Hippocratic corpus and later medical works.Footnote 49 Malaria existed in most of the regions ruled by Islam and is widely mentioned in Arabic medical literature. However, it seems that the descriptions of fevers in Arabic medicine appear to be greatly dependent on Greco-Roman medical traditions.Footnote 50 Quite a few Arabic medical books were devoted to fevers.Footnote 51
Holistic Medicine
Modern holistic medicine is based on the idea of stimulating the natural self healing and self regulating abilities of the human body. It employs various techniques dealing with the soul and the body of patients and is called today alternative, complementary, unconventional, and mainly integrative medicine. It appears that holistic medical techniques were originally part of the medical culture and practice of ancient civilisations around the world, including the Greco-Roman and the Arabic.Footnote 52 Some of the medical techniques that were mentioned in our fragment (diet, massage, inhalation, bath), and presented below, are clear-cut evidence for the holistic medical perspective of Ibn Jazlah in the framework of Arabic medicine.
c. Two Versions of the Same Book?
After an examination of the existing manuscripts of Ibn Jazlah's Taqwīm al-abdān fī tadbīr al-insān in various libraries in England, it turns out that there are two different formats of the book:
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1. The First One is that of large-sized books with content pages consisting of 22 rows as found for example in the Wellcome OR. 54 (WMS 418) (17.8 × 28.5 cm – 53 folios); Browne OR MS P8 (13) (20.5 × 31 cm – 48 folios), University Library Cambridge, and in British Library Or. 5862 (23 × 31 cm - 50 folios). The average length of these books is 50 folios. The only published edition of the book has a similar number of pages (49 folios).Footnote 53
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2. The Second is characterised by a smaller size and the content page consists of 11 rows (in fact only half of more detailed table). This is the case of British Library Or. 12096 for example (16.5 × 27 cm – 99 folios). Interestingly enough, the title of this book in the manuscript is “Tadīr al-amrāḍ wa ma'rifat al-asbāb wal-a'rāḍ” and the author's name is “Muḥammad ibn Aṣad ibn Buraid al-Khuzā’zi al-Anṣāri” (1551 AD). However, the content is the same as Ibn Jazlah's Taqwīm al-abdān fī tadbīr al-insān. The length of these books is 90 folios. It seems as if this book was copied either from an older version or was even reorganised by a copier and was therefore given a “bookshelf title”, and named after the copier. According to Serikof, in the Arabic medical tradition books were arranged on shelves based on their titles. In many cases, books had “bookshelf titles” beside their original title,Footnote 54 and sometimes these “bookshelf” names could subsequently become a new title of the book.Footnote 55 British Library Or. 12096 might be an example for such an occurrence. According to this argument the book named “Tadīr al-amrāḍ wa ma'rifat al-asbāb wal-a'rāḍ” would be shelved under “diseases” in opposition to the original book written by Ibn Jazlah named “Taḳwīm al-abdān fī tadbīr al-insān” which would have been shelved under “body”.
It should be mentioned that all known manuscripts of the book are of the 16th-17th centuries. Our fragment (T-S Ar.41.137) is 25.2 × 33.6 cm (the folio) – however, the size of the book was (16.8 × 25.2 cm) and is more similar in its appearance and size to British Library Or. 12096. In any case, since the vast majority of fragments in the Cairo Genizah are from the 10th-13th centuries – we can argue that it is the earliest existing fragment.
When we try to analyze why the copier of our fragment changed the layout of the book from the original one, we can only speculate that the copier split the content of each original page into two parts that were written on two different pages in our fragment. This might have been done due to the size of the paper he had in his possession (too small to accommodate 44 rows each). Therefore, the book he copied or reshaped should have been twice as long. We should bear in mind that this is in total contradiction to the main idea of writing tabulated books – the summary of a large volume of information in a low number of pages! There is another rare option, that our fragment was copied from an already smaller sized manuscript of Ibn Jazlah's Taqwīm al-abdān fī tadbīr al-insān – the original master copy for manuscripts such as British Library Or. 12096.
Conclusion
T-S Ar.41.137 clearly shows that the medieval copier of this fragment tried to reorganise the setting of the book but quickly abandoned his work after using it as a model (perhaps unsuccessfully). In this regard, when comparing our fragment with WMS 418, a few differences come immediately to mind:
* The copier split the content of each original page into two parts that were written on two different pages in our fragment.
* It seems as if the copier failed in his mission and left off working in the middle of the third page – probably due to wrong planning of the setting and layout of the book, or to his lack of knowledge and experience in copying a tabulated book (which were very rare). Another option is that his attempt to make innovations in the style and the setting of the book had failed.
* The contents page - T-S Ar.41.137 – verso (right side) is written in a different way (opposite) – from left to right!
* In the first and last paragraphs (T-S Ar.41.137 – recto, left side), the copier deleted lines. The copier also added one heading (general treatment) separately in a different row.
* The copier changed the style of the book and shortened its contents. For example, he did not copy prefaces and simplified the contents of the book.
Can these remarks lead us to the assumption or conclusion that our fragment is a draft copy of the book?! We do not have a clue as to how successful he was with his new setting. The answer can only be made if we find another fragment of the book, written with the same hand!
As shown in the discussion, all the substances mentioned in T-S Ar.41.137 by Ibn Jazlah, such as food, drinks, bath liquids, massage oils, perfumes and salves for burns - have had many medical uses throughout history, including treatment for fevers. Some of these uses are practiced until present day by users of traditional medicine in the Middle East.
Appendix
Holistic healing techniques and medicinal substances mentioned in the fragment
All the medicinal substances mentioned in T-S Ar.41.137 are well known and were used for medical purposes since early times. However, in our fragment, they are not used as regular drugs taken internally or used externally, but are all part of a holistic system of healing and recovery. The active materials are inserted into the body through the mouth (food, drink, inhalation), or the skin (bath, massage, sousing).
I present here a short summary of the medicinal uses of these substances as found in the Genizah literary sources (theoreticalFootnote 56 as well as practical), other contemporary medical authorities, and traditional medicine. In many cases these sources mention the use of these substances for the treatment of fevers. It seems that in many cases the substances provided a cooling effect and were nutritious enough to fortify the body and help to overcome the disease. Each of these substances is presented according to the medical techniques in which it was used according to our fragments. A short historical introduction to each holistic technique is presented as well (all row numbers relate to T-S Ar.41.137 – recto, left side).
1. Massage
Massage was used as a preventive and practical holistic activity by the ancient Egyptians, Chinese, Greeks and Romans. It was adopted by the Arab physicians and widely practiced in the medieval period by medical practitioners.Footnote 57 A tender massage with the soft finger tips given in a heated place was recommended for a patient suffering from a fever (Row 12). A gentle massage with sweet violet oil and water lily was also recommended, after a bath in a basin of lukewarm water (Rows 23–24).
Massage Agents
Aromatic substances were used by Arab physicians for drugs, massages, baths and cosmetic agents.Footnote 58
Sweet Violet (Oil) (Viola odorata; Violaceae), in Arabic: banafsaj Footnote 59
A gentle massage with sweet violet oil after a bath in a basin with lukewarm water was recommended for the feverish patient “when the diseases leave” (Row 22). It was also used as a bath agent (Row 10). Different products of sweet violet figure in two Genizah lists of materia medica and in 13 prescriptions were used for swelling (oil), hallucination, diet (flowers), treating the face and the eyes, and as an aphrodisiac (flowers). Sweet violet is mentioned in medical books in recipes for fragrant drinks, for the treatment of headache, pain in the eyes, stomachache, the bites of scorpions and reptiles and haematuria, diarrhoea, abdominal pains, dysuria, and fevers, and also for palpitation, treatment of deafness, earache and throbbing headache, bathtub immersion for fever, and eye diseases.Footnote 60
Dioscorides reports the use of the plant Ion to treat epilepsy and throat inflammation.Footnote 61 Al-Kindī (9th century) states that the ‘banafsaj’ was used to treat the breathing tracts, intestinal disorders, mumps, toothache, haemorrhoids, and night blindness.Footnote 62 Maimonides (12th century) told the Ayyubid sultan that he recommended rubbing ‘banafsaj oil’ – purified violet oil – on the skin, and it is mentioned as a component in a sleeping drug.Footnote 63 Violet was said to be a cold and moist drug and a mild purgative. Violet oil was used as protection on “the lips of one who had sucked poison”.Footnote 64 Ibn al-Bayṭār (13th century) notes that the substance was used as a medication for the stomach, cough, eye diseases, pain, fever and to dispel gases.Footnote 65 He also describes violet oil and lists its medicinal uses.Footnote 66 Al-Qazwīnī (13th century) relates that the plant served as a medication for severe eye inflammation and to treat colds and various skin diseases.Footnote 67
From ethno-pharmacological surveys and research work we learn that Yemenite Jews used it medically as an eye dressing for inflammation and sores. It was used internally to treat fever and swellings in the body, to regulate the digestive tract, cleanse the stomach, cure jaundice and severe cough, to soothe, and to induce sleep.Footnote 68 Various types of violet, especially sweet violet, were used in Iran to reduce fever, and relieve headache, as a mild purgative, as a medication for constipation, as a soothing drug and to induce perspiration.Footnote 69 The use of this plant is widespread in the East to the present for treating cough.Footnote 70 Sweet violet is used to ease backache in traditional medicine in Israel.Footnote 71
Water Lily (Nymphaea alba, Nymphaeaceae), in Arabic: nīlūfar
A gentle massage with water lily after a bath in a basin with lukewarm water was recommended for the feverish patient “when the diseases leave” (Row 22). It was also used as a bath agent (Row 10). Different kinds of “lotus plants” appear in seven Genizah lists of materia medica and in a prescription. It was also mentioned in medical books: as an aphrodisiac, combating wet dreams, as well as eye and skin diseases.Footnote 72
In his entry ‘nymphaia’ Dioscorides describes Nymphaea alba and notes its uses, such as to treat dysentery, intestinal diseases, illnesses of the spleen, and problems of the urinary bladder.Footnote 73 According to Maimonides, the ‘nīlūfar’ is one of the plants that strengthens the appetite and the spirit, and is beneficial for skin diseases. The flower is used as a purgative drug, and the leaves serve as a component in an aphrodisiac preparation.Footnote 74 Al-Qazwīnī reports that the ‘nīlūfar’ was used as a soporific, to relieve headache, to treat leprosy and baldness, and to inhibit sexual desire.Footnote 75
A powder derived from the root stem of Nymphaea lotus serves as a medication for digestive or intestinal problems, and the powder of the crushed seeds is used in the Sudan to treat skin diseases.Footnote 76 Flowers of various types of the white water lily are sold in India where they are used as a medicinal drug, mainly as an astringent, to stop haemorrhages, and as a component in a preparation to reduce fever and cure lung diseases in children.Footnote 77
2. Bath
Bathing in hot, cold and mineral water was widely practiced for pleasure and as a preventive and practical holistic activity by the Greeks and the Romans.Footnote 78 Medical baths using aromatic substances was adopted by the Arabs and widely practiced in the medieval period by patients.Footnote 79 Baths were specifically prescribed by Arab physicians for recuperating from illness,Footnote 80 as demonstrated in our fragment four times. It was recommended as a treatment practiced when “the fever was gone”:
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1. “. . .. once the fever is gone, take a bath with water that were infused with sweet violet, water lily, chamomile. . ..” (Rows 9–10)
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2. “. . . . . . . In case the fever calmed down, enter a bath and then will be covered with a sheet. . .” (Rows 12–13)
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3. “. . . . . . . . .in case the fever is gone, later he enters the bath, rests an hour and then is fed. . .” (Rows 19–20)
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4. “. . . . . . . .when the disease leaves enter the bath and bathe in basin of lukewarm water. . .” (Rows 22)
Bath Agents
Three bath agents are mentioned in our fragment: sweet violet, water lily, chamomile (Row 10):
Chamomile (Matricaria aurea; Asteraceae), in Arabic: bābūnaj Footnote 81
Once a fever resulting from sunstroke or a hot wind is gone, a bath with water that was infused with chamomile and other agents was recommended (Row 10). Chamomile liquid features in one Genizah prescription. It is also mentioned in medical books found in the Genizah in recipes for skin lotions and poultices to heal pustules and remove scabs, to treat hair splitting and falling out, and eye complaints. Eating chicken soup with onion and chickpeas is given as advice to a patient, together with drinking wine and other simples and smearing himself with chamomile oil and nard. Footnote 82
Ancient Egyptians used the plant in cultic ceremonies and to cure malaria. For the Romans it was a protection against snakebites. Dioscorides describes the species of Anthemis and notes their medical uses: to accelerate menstruation, to abort foetuses, to dissolve stones in the urinary tract, to increase urination, to cure infections, and to reduce fever.Footnote 83 According to the physician Assaf (Assaf ha-Rofe), chamomile serves to cure eye diseases.Footnote 84 Al-Kindī describes the use of the plant in treating haemorrhoids, in settling the liver and stomach, strengthening the limbs, and soothing skin irritations.Footnote 85 According to Maimonides, ‘kamomil’ heats and dries, permeates the skin, and cures the limbs.Footnote 86 Ibn al-Bayṭār states that different varieties of the plant serve to eliminate stones in the urinary tract, treat the gall bladder, strengthen the womb, reduce swellings, accelerate menstruation, and increase urination and sweating.Footnote 87 Ibn al-Bayṭār also says that al-Tamīmī (10thcentury) noted that it was used to treat eye diseases.Footnote 88 According to the scholar al-Ghazzī (15th-16th century) the plant serves in the treatment of toothache and headaches, and causes vomiting.Footnote 89
The Arabs of Israel use the dried flowers to cure joint diseases and the digestive system, and to reduce high fever. Yemenite Jews used the inflorescence to rinse the mouth, to reduce swellings, to treat infections in the kidneys and liver, to soothe the nerves, to strengthen the mind, to treat headaches, dizziness, and chronic diseases. Moroccan Jews used the plant to reduce high fever, to treat cough and stomach aches, and to increase female fertility. Libyan Jews used it to increase sweating and to treat colds, while Persian Jews took it as a carminative. Tunisian and Algerian Jews, on the other hand, used it to treat stomach worms and stomach problems, spasms, and colds, and to accelerate menstruation. . .Footnote 90
Sweet Violet “Once a fever resulting from sunstroke or a hot wind is gone, take a bath with water that were infused with sweet violet and other bath agents” (Row 10). For more information regarding the plant and its medical uses - see above.
Water Lily “Once a fever resulting from sunstroke or a hot wind is gone, take a bath with water that were infused with water lily and other bath agents” (Row 10). For more information regarding the plant and its medical uses - see above.
3. Pouring on the Forehead
Rose [water] (Rosa canina; Rosaceae), in Arabic: nasrīn, ward Footnote 91
Pouring rose water on the forehead was used for “the weakening of the fever of the spirit by fighting the specific cause of the disease if it is the result of sunstroke or a hot wind” (Rows 7–8). It was also used, as in our fragment, as a drink in case a feverish patient “feels weakness” (Row 17).
Different products of rose, mainly water, figure in 14 Genizah lists of materia medica and in 57 prescriptions, mainly lincti and ointment. Many fragments of medical books attest to the medicinal uses of rose water, for the treatment of quartan fever, burning black bile and phlegm, headache and giddiness, cold, diarrhoea, melancholia, mania, pain in the eyes and stomach, skin complaints and to stop excess salivation. Flour mixed with rose water is considered a dietetic sweet dish, and are baked together as bread for the treatment of feverish patients.Footnote 92 Rose water is also used as a soft drink.Footnote 93
The medicinal use of the dog rose is also described by physicians of the classical period. Dioscorides, for example, describes the medicinal use of a variety of the dog rose to treat stomach disorders, headaches, gynaecological problems, skin diseases, wounds, and the eyes and gums.Footnote 94 Al-Kindī used rose water for neck pustules,Footnote 95 and Maimonides states that a cloth soaked in vinegar, henna, and rose water serves as a compress (dressing) to treat the stings of bees or wasps. Rose oil was used as a general strengthening and as an ingredient in the “great ʾiṭrīful” to fortify the heart, to delay old age, and to increase sexual potency.Footnote 96
4. Inhaling
The religious ceremonies of Eastern ancient civilisations such as Egypt, Babylon, India and China included the burning of incense. It seems that the smoke inhaled by the attendants induced calmness and a sense of comfort, and smoke inhalation was also used to treat various maladies including respiratory troubles. Inhalation therapy is the intake of medications (powder, smoke, the vapour of dry, burnt or boiled substances) through the nose or mouth for therapeutic purposes by natural respiration. It was an important therapeutic method in the past, and is still used as an effective treatment for variety of diseases in both modern medicine and traditional medicine. Inhalation of dried medicinal plants, boiled medications and the smoke of some burnt material as treatments of oral, pharyngeal and chest troubles is mentioned in the Ebers and Berlin medical papyri.Footnote 97 Evidence for similar uses were traced in Babylonian, Indian, Greek and Persian medical writings. The Romans constructed public baths in their cities that were supplied with cold and warm water. Steam inhalation was practiced there mainly for respiratory troubles. Galen for example, described the powdered snuff of many medicinal plants and the inhalation of their volatile vapour and smoke for the treatment of nasal and head troubles.Footnote 98 The Arab improved the technique of inhalation therapy with the addition of many medicinal plants and minerals. They also modified the use of public baths for therapeutic purposes by the addition of volatile medicinal plants to the warm water. Patients were submerged to the level of the neck in warm water and covered by a blanket to retain the vapours for inhalation.Footnote 99
Marjoram [sweet] (Origanum mayorana = Majorana hortensis; Lamiaceae), in Arabic: mardakūsh, marzanjūsh Footnote 100
Inhaling marjoram was recommended in case the fever “does not totally leave the body”, the patient took a bath, was covered with a sheet and ate pullet and camel meat (Rows 13–14). Sweet marjoram features in 3 Genizah lists of materia medica; a dried plant is mentioned in a prescription. Sweet marjoram is mentioned in medical books dealing with eye diseases, fevers, and as emmenagogues and abortifacients.Footnote 101
Dioscorides states that the plant is used as a cure for dropsy, oedema, inflammations, and excess urination, and to regulate menstruation.Footnote 102 He also praises ‘marjoram oil’ which was brought from Egypt.Footnote 103 The physician Assaf asserts that marjoram cures many illnesses, mainly gynaecological, kidney, and urinary tract disorders.Footnote 104 Maimonides cites al-Tamīmī in asserting that it was used to treat anaemia.Footnote 105 Al-Qazwīnī writes that sweet marjoram is used as a cure for migraines, headaches, constipation, and paralysis.Footnote 106
Marjoram is used by the Arabs of Israel to relieve headache, to cure gum inflammations, and to whiten and strengthen the teeth. It is also used to ease cough, strengthen the heart, cure dizziness, expel worms, and to treat internal inflammations of the stomach, lungs, and liver.Footnote 107 Yemenite and Babylonian Jews made a medicinal tea from marjoram leaves to ease labour pains, as a general sedative, to cure heart pains, and reduce body swellings, mainly in the legs. Marjoram was also used as a component in remedies to ease headaches, earache, and stomachache, and to disinfect the female sexual organs.Footnote 108
5. Burning
Humans have always admired fire and its power, and it became an ancient form of therapy. Burning or cauterising is a technique indigenous to the pre-Islamic Mediterranean e.g. ancient Egyptians, and ancient Greeks. The Arabs had great faith in the therapeutic values of fire as cauteriser, it was a basic tool in any Arab physician's armory, and is still one of the major components in Arab traditional medicine.Footnote 109 Cautery was dealt with in detail in Ibn Sina's al-Qanun (10th-11th century) and in the surgical book of the Andalusian physician Abu al-Qasim Khalaf ibn ’Abbas al-Zahrawi (10th-11th century), “al-Tasrif li-man ’Ajiza ’an al-Ta'alif”.Footnote 110
Cotton (Gossypium herbaceum; Malvaceae), in Arabic: quṭn Footnote 111
Cotton was burnt over the hot body of a feverish patient (Row 9). Seeds of cotton are mentioned in two Genizah prescriptions and one materia medica list. Cotton is also mentioned in medical books, including one that deals with fevers.Footnote 112
In the Levant cotton has been known since the Hellenistic period. Ibn al-Bayṭār describes the plant and cites al-Rāzī on the use of cottonseed in a preparation to arouse sexual desire, and the leaves to cure coughs in children.Footnote 113 Ghazzī notes that the leaves and seeds served for curative purposes.Footnote 114 According to Dāwud al-Anṭākī (16th century), the plant is a hot and dry drug with an intoxicating flower from which wine “that gladdens the heart” is made. The plant served to regulate the heartbeat, to cure insanity, to reduce swellings, to improve the memory, to prevent diarrhoea, and to treat burns, skin diseases, and haemorrhages.Footnote 115
In Iraq the roots of the cotton plant were used to accelerate menstruation, the cotton fibres were used for absorbing and for treating wounds, and the oil pressed out from the seeds served to soothe the skin and to produce hand creams and soaps.Footnote 116
6. Diet – Nutrition
Diet was an important part of medical treatment since early times. Arabic medicine used diet as a curative means, usually preferred over medication and external clinical activity.Footnote 117 It was a common practice among Arab physicians to try and restore the balance of the body through improving the patient's diet and lifestyle before using drugs. According to Martin and Waine, diet change was meant to maintain the balance of the body as part of preventive medicine.Footnote 118
A. Food
In our fragment, pullets were mentioned three times in the dietetic prescriptions that were part of the medical treatment:
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1. “In case the fever calmed down, enter a bath and then will be covered with a sheet and eat a pullet and roasted meat” (Row 13).
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2. “eat pullet cooked with verjuice (vinegar grapes) or pomegranate water” (Row 20).
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3. “eat pullet and thigh of young goat with lettuce and chicory and garden purslane and eat much” (Row 24).
Pullet, chicken (Gallus gallus domesticus; Phasianidae), in Arabic dajāj, dajāja
Pullets were mentioned in three dishes recommended for feverish patients in our fragment (Rows 13, 20, 24). Chicken figures in one Genizah list of materia medica and in two prescriptions including uses such as stopping bleedings. Chicken also served as invalid food for certain diets. Eating chicken soup is also given as advice to a patient.Footnote 119
In many medieval prescriptions, including a few found in the Cairo Genizah, nutritious instructions are given. For example, one prescription (TS Ar.30.305) recommends a dish of pullet cooked in sour grape-juice (verjuice) and pickled almonds.Footnote 120 Chicken was also mentioned in three recipes out of 12 that were found in a unique Genizah family prescription (T-S NS 223.82–83).Footnote 121
Moreover, chicken was an important part of the diet for the members of the Genizah society, as well as for medicine, including diet for the sick.Footnote 122 Maimonides reports that chicken meat and its products are good, healthy food. Chicken in lemon juice served as a purgative.Footnote 123
As we can see, other kinds of meat such as young goat and camel meat were recommended as well. The other foodstuffs that are mentioned as part of the medical diet are: lettuce, chicory, garden purslane, marrow concentrate, mongo bean and pomegranate water. All these substances are well-known drugs besides being foodstuffs, and some are even mentioned in the prescriptions found in our fragments.
Bread is mentioned in the dietetic instruction one time to be eaten “once the fever is gone” after a bath with chilled sweet drink (Row 10). In a medical book in the Genizah, bread baked with rose water was considered a dietetic sweet dish for the treatment of feverish patients.Footnote 124 Bread was the staple food of many societies in ancient times.Footnote 125 Since then bread-making has progressed to what we know today, but it basically utilises the same principles.
Bread was made in the Middle East and North Africa mainly of wheat and only rarely of barley. The grains where grounded and sifted in different ways, made into dough, leavened and then baked. Bread made out of wheat was more popular and a luxury, due to its ability to rise.Footnote 126 Bread-making in the medieval Arab world was still carried out in the home rather than being a commercial occupation.
Endive [Chicory] (Cichorium intybus; Asteraceae), in Arabic: hindabā Footnote 127
Endive was recommended to be eaten with “pullet and thigh of young goat” and other vegetables such as lettuce and garden purslane, when the fever left (Rows 24–25). Various parts of endive figure in 11 Genizah lists of materia medica and in 23 prescriptions: for an invalid's diet (root); plaster for swelling (seeds); aphrodisiac (seeds); fever (seeds); liver (root peel), weak eyesight and migraine (Maimonides; root peel, T-S Ar.30.286). It also appears in a family recipe (T-S NS 223.82–83, root, syrup and seeds). Endive is also mentioned in other fragments of medical books found in the Genizah to stop salivation. Endive water is an ingredient in a recipe for the treatment of eye complaints such as inversion, and lice of the eyelids and for the treatment of weakness of the liver and bile corruption.Footnote 128
Dioscorides distinguishes between the wild and the cultivated variety, which is called endive and was used as a remedy for the stomach, heart, and eyes and for scorpion stings.Footnote 129 According to al-Kindī, endive was used as an ointment for the nose and for treating skin rashes and the stings of scorpions and spiders.Footnote 130 Al-Bīrūnī (11thcentury) describes the use of ‘hindabā’: as a component in a drugged drink, of which an overdose could cause death.Footnote 131 Maimonides states that chicory seeds are a component in a preparation for foul breath,Footnote 132 and recommends ‘hindibāʾ’ as the best medicine for curing diseases of the liver and skin diseases.Footnote 133 Al-Qazwīnī cites Ibn Sīnā describing the use of the plant to treat rheumatism, eye inflammation, white spots in the eye, scorpion or wasp stings, and malaria.Footnote 134 Dāwud al-Anṭākī mentions uses such as curing malaria, fever, headache, jaundice, and problems of the liver, spleen, and kidneys. As a beverage, it strengthens the stomach, reduces swellings, and prevents inflammation of the eyes.Footnote 135
Lettuce ( Lactuca sativa; Asteraceae), in Arabic: khass Footnote 136
Lettuce was recommended to be eaten with “pullet and thigh of young goat” and other vegetables such as endive and garden purslane, when the fever left (Rows 24–25). Lettuce features in two Genizah prescriptions for linctus and ointment. Lettuce is also mentioned in medical books on dentistry, on sex, on dermatology, on poisons, on materia medica and pharmacopoeias (jaundice with acute fever and palpitation), in recipes for eye diseases.Footnote 137 Lettuce, together with lemon and milk, are mentioned as used to treat eye diseases in a 12thcentury Genizah letter.Footnote 138 Juice that was made out of lettuce and its seeds were used for medicine from early times. In traditional medicine, the plant was used to improve the production of mother's milk, to reduce sexual lust, and for the treatment of headache. Oil pressed out of lettuce seeds was used to strengthen the hair and treat hair ailments.Footnote 139
Mungo Bean (Phaseolus mungo radiatus; Fabaceae), in Arabic: mash Footnote 140
Mungo beans were recommended to be eaten with bread once a fever as a result of sunstroke or a hot wind was gone (Rows 10–11).
According to al-Baghdadi (13thcentury), the “mash” does not grow in Egypt, but it can be obtained from pharmacists who import it from the al-Sham region and sell it for curative purposes.Footnote 141 Al-Kindī relates that the “mash” was a component in an ointment to treat colour stains on the skin, lip swellings, and hemorrhoids.Footnote 142 The “mash” was a component in an ointment to remove freckles.Footnote 143 Maimonides also noted that it was considered a cold and dry drug.Footnote 144 Daud al-Antaki refers to its medical uses, such as to reduce fever, to stop blood hemorrhages, to cure malaria, sunstroke, and skin diseases, to regulate the kidneys, to strengthen the nerves, to reduce swellings, to stop sweating, to knit fractures, to dispel exhaustion and weakness (by external use).Footnote 145
B. Drinks
Almond Oil (Amygdalus communis; Rosaceae) lawz Footnote 146
Almond oil was recommended to be drunk in a cool place while lying down, in case a feverish patient felt weakness (Row 17). Different kinds of almond and its product, including oil, figure in 14 Genizah lists of materia medica found in the Genizah and in 27 prescriptions for the treatment of weak eyesight and migraine, for general eye treatment, diet, as an aphrodisiac and a laxative. Almond oil is mentioned as an immersion in the bathtub for the treatment of fever. Bitter almonds were used to treat stones in the bladder, urine retention, and for liver complaints, obstruction of the spleen, ear drops, warts, dysuria, dysmenorrhoea, and hard swelling; as a stomachic and abortifacient when the fetus is dead.Footnote 147
Dioscorides notes the amugdale and indicated its medicinal uses (seeds, oil and gum) as an emmenagogue, to relieve headaches, cure intestinal wounds, cough, inflammation, sunburn, and skin diseases, to soften the stomach, and eliminate stones.Footnote 148 The physician Assaf writes that almond oil fortifies the heart, relieves stress, kidney stones, liver ailments, renal obstructions, impotence, menstruation, and heals the intestines, headaches, general pains, cough, breathing and lungs problems.Footnote 149 Maimonides reports on the use of almonds in the context of the diet recommended to the Sultan. Elsewhere almonds and almond oil are mentioned as an emetic and a component in a medicine to purify the blood and to fortify the spirit, as well as being an ingredient of a medicine called the ‘greater ʾaṭrīfal’ which strengthened the organs and delayed old age.Footnote 150 Ibn al-Bayṭār attests that sweet almond oil is also mentioned as a cold and moist drug used as a remedy.Footnote 151
Yemenite Jews used almonds externally to treat haemorrhages, and internally to treat kidney stones, spleen, sore throat, and cough.Footnote 152 The Jews of Iraq make extensive use of almond products to treat eye diseases, dysentery, and earache; to relieve birth pains and to increase the production of mother's milk.Footnote 153 In Iran and Iraq ointment made of the nuts is used to treat carbuncles.Footnote 154 European traditional medicine uses almond oil as a softening drug, for pain relief, and for alleviating cough.Footnote 155
Barley Water (Hordeum sp.; Poaceae), in Arabic: shaʿīr, in Judaeo-Arabic: seʿurim.
Barley water was recommended to be drunk in case a feverish patient felt weakness, or as part of the recovery process (Row 10, 16, 18). Barley features in two Genizah prescriptions, for the treatment of the lips and to strengthen the gums. It is also mentioned in books found in the Genizah, such as in recipes for women's complaints, menorrhagia, liver diseases; for cosmetics and for topical uses. It was also found in medical books, mainly on fevers, skin diseases, paediatrics, dentistry and poisons.Footnote 156
The kernels were used since ancient times to produce beer. The plant was also used for healing, as a diuretic and as a base for ointments. Dioscorides notes that barley was used to treat inflation of the entrails, inflammation, leprosy, the joints, and the abdomen.Footnote 157 Al-Kindī writes that barley is used to treat deterioration of the memory, gum and teeth ailments, and slow growth of hair and beard.Footnote 158 Ibn al-Bayṭār, citing other sources, states that barley was used for the treatment of inflammation of the throat, fever and the stomach.Footnote 159 Yemenite Jews used barley to treat swellings, kidney stones, eye inflammations, headaches, and nerves.Footnote 160
Garden Purslane (Portulaca oleracea; Portulacaceae), in Arabic: rijla, baqala ḥamqāʾFootnote 161
Garden purslane was recommended to be drunk in a cool place while lying down, in case a feverish patient felt weakness (Rows 17–18). It was also recommended to be eaten with pullet and other vegetables such as lettuce and endive when the fever was gone (Row 24). Garden purslane figures in four Genizah lists of materia medica and in seven prescriptions, such as for dressing bites. It is also mentioned in a medical book in a prescription, including for the treatment of eye complaints as a dermatological potion and for the treatment of jaundice with acute fever and palpitation.Footnote 162
Dioscorides describes the use of the plant Andrachne to treat stomach problems.Footnote 163 Other classical physicians such as Hippocrates, Theophrastus, Pliny, and Galen report its use to treat diseases of the digestive tract as well as external wounds and burns.Footnote 164 According to al-Kindī, the plant was used to treat pustules on the lips, spitting blood, throat pains, and inflammation of the teeth and gums. The seeds are used for rinsing the mouth.Footnote 165 Maimonides, described ‘laglogot’ as a mild and safe medication,Footnote 166 as an external medication for erysipelas; he cites al-Tamīmī that the ‘laglogot’ stops the emission of blood from the intestines.Footnote 167 Garden purslane also serves as a component in an internal medication to treat the stings of bees and wasps, and as a medication against poisons.Footnote 168 Ibn al-Bayṭār describes its uses, such as for the treatment of stomach problems, stones in the kidney and urinary tract, and causing diarrhoea.Footnote 169
Grape (Vitis vinifera; Ampelidaceae = Vitaceae).
Various products made out of grapes were used as drugs since early times.
1. Vinegar, in Arabic: khall khamr;
Vinegar was recommended to be drunk as part of the effort to treat “fever of the spirit” as the result of “sunstroke or the hot wind” (Row 8). Vinegar figures in one of the Genizah lists of materia medica and in five prescriptions, such as for topical application, muscle pains, and swellings. In medical books, vinegar was used for the treatment of toothache and inflammatory swellings, diarrhoea and to strengthen the stomach muscles, to ease tooth extraction, and headache.Footnote 170
Vinegar was used as a basis for many remedies in ancient Babylonia.Footnote 171 Dioscorides notes the medicinal use of grapes to improve the appetite, to relieve stomach pains, and to treat dysentery; he also recommends wine to reduce fever.Footnote 172
Dioscorides used a drug named oxymel, which was made of vinegar, sea salt, honey, and water, for arthritis and epilepsy.Footnote 173 A similar kind of syrup, made of honey and vinegar, was called in Arabic: sikanjabīn.Footnote 174 According to Maimonides, vinegar was an important component in medications, including for treating attacks of poisonous creatures, in cathartic medicines, and for haemorrhoids. Oxymel was frequently used by Maimonides and physicians of his time.Footnote 175
2. Verjuice (vinegar of unripe grapes), in Arabic: ḥiṣrim
A syrup made of verjuice water was recommended to be drunk by a feverish patient while “resting in an open place with air supply” (Rows 18–19). Verjuice was also mentioned in a Genizah practical prescription (T-S Ar.30.305) as part of the nutritious instructions: “a dish of pullet cooked in sour grape-juice (verjuice) and pickled almonds”.Footnote 176 Both Maimonides and Ibn al-Bayṭār mentioned various medicinal uses of verjuice.Footnote 177
Lemon Syrup (Citrus limon; Rutaceae), in Arabic: līmūn, sharāb līmūn (lemon potion)
Drinking lemon syrup was recommended “if the fever calms down” (Row 16).
Lemon figures in eight Genizah lists of materia medica and in 12 prescriptions such as for fever, an invalid's diet, plaster, and lemon syrup.Footnote 178 Lettuce, together with lemon and milk, are mentioned as treatment for eye diseases in a 12thcentury Genizah letter.Footnote 179 Lemon, lemon juice, and lemon water were part of the diet of the Genizah society; and lemons were sold in the markets of Fustat.Footnote 180
Maimonides attests that lemon juice is used as a mild purgative,Footnote 181 the peel and the leaves serve as a medication against all poisons,Footnote 182 and chicken in lemon juice served as a purgative.Footnote 183
Al-Qazwīnī notes that lemon juice is a “wonderful” medicine against snake poison.Footnote 184 Daud al-Anṭākī wrote that the fruit served to treat, among other ailments, headaches and stomach upsets, to cure scars, to make a preparation to counteract poisons, and to stimulate the appetite, as well as to repress excessive appetite. Lemon vinegar is applied in the treatment of skin diseases.Footnote 185
In the past, sea travellers and pilgrims, mainly those from Europe, took lemons or lemon juice with them to prevent various diseases such as scurvy.Footnote 186 The effectiveness of the medical use of lemons in the past and present derives from the substances it contains such as abundant vitamin C, and its peel and leaves contain oils with disinfectant properties.Footnote 187 Yemenite Jews used lemon to reduce fever, to treat colds, and infections of the throat, ears, and eyes.Footnote 188 The Jews of Iraq made extensive use of lemon to dissolve kidney stones and to treat skin diseases, nausea, gases, colds, gonorrhoea, and fever.Footnote 189 In Iraq the oil of the lemon was used as a stimulating drug and an expectorant, and was designated as a cure for intestinal diseases, while lemon juice served to prevent and treat scurvy, to treat infected throats, joint infections, dysentery, diarrhoea, and urination problems.Footnote 190
Pomegranate Water (Punica grantum; Punicaceae), in Arabic: rummān, jullanār (flowers)Footnote 191
Pomegranate water was recommended to be drunk when the feverish patient felt weakness, while “lying down in a cool place” (Row 17). Different products of pomegranate figure in seven Genizah lists of materia medica and in nine prescriptions: for urinary complaints and in a medical diet. Pomegranate products are mentioned in medical books in a preparation of medical syrup. It also served as a simple in a gargling and rinsing solution for the treatment of inflammatory conditions of the tongue and gums and loss of teeth. Pomegranate juice is recommended for the treatment of diarrhoea. Sour pomegranate is recommended for the treatment of obstruction, wind, diarrhoea, pleurisy and trembling, and sweet pomegranate is recommended for phlegm, liver complaints, and nerves.Footnote 192
In ancient Babylonian culture, pomegranate flowers were used, among other things, to cure the stomach, ears, eyes, and chest, and to destroy worms.Footnote 193 Even Dioscorides maintained that Rhoa was beneficial for the stomach and cured diarrhoea, dysentery, mouth sores, vaginal sores, and earaches.Footnote 194 Al-Kindī describes pomegranate flowers used as bandages for the stomach and the liver, to ease spleen pains and scabies, to strengthen the limbs, to treat throat pains, ulcers, and decay in teeth and gums.Footnote 195 The Jewish physician Dāwud Ibn Abī al-Bayān, who lived in Cairo in the Ayyubid period, mentions the use of the ‘ḥabb rummān al-shāmī’ to slake thirst, to cure stomach aches, and to treat liver diseases.Footnote 196
The Palestinian Arabs used pomegranate juice to treat the sick, including children and even babies.Footnote 197 The Bedouins in Sinai use the pomegranate to stop diarrhoea.Footnote 198 Yemenite Jews made similar use of the fruit, and also used it to soothe stomach pains and to treat the eyes.Footnote 199 In Iran and Iraq pomegranate flowers and fruit were used to stop diarrhoea and to treat stomach problems and dysentery.Footnote 200
Spinach (Spinacia oleracea; Amaranthaceae = Chenopodiaceae), in Arabic: asfīnāj, isfānaj Footnote 201
Concentrate of spinach was recommended to be drunk when the feverish patient felt weakness, while “lying down in a cool place” (Row 17). Spinach figures in three Genizah prescriptions such as for an invalid's diet, for various uses, and was mentioned twice in a family prescription. Spinach is also mentioned in medical books on fevers.Footnote 202
Sugar (Saccharum officinarum; Poaceae), in Arabic: sukkar Footnote 203
Barley water chilled with pure sugar was recommended to be drunk with bread for a feverish patient once the fever is gone (Row 10). When the patient feels weakness, it was recommended to drink cold barley water and sugar (Row 18). Different kinds of sugar figure in 11 Genizah lists of materia medica and in 30 prescriptions such as for wind and colic, cleaning or treating the teeth, treating urinary complaints, hallucination, liver problems, fever, cough, swelling, weak eyesight and migraine, as an aphrodisiac and an ingredient and in an invalid's diet. Sugar was an important simple in the Middle Ages, mainly in the Islamic world, and this is attested by several Genizah fragments from medical books, for the treatment of colic and coughs.Footnote 204
Sugar is mentioned in classical sources. Strabo refers to the honey produced from Indian sugar cane, and Pliny writes about sugar produced in Arabia and India and used as a remedy. Among the medicinal uses of Sacharon, Dioscorides lists curing the stomach and intestines and relieving pains in the bladder.Footnote 205 Al-Kindī describes the use of red sugar in a mixture for a clysterFootnote 206 and of pure sugar for treating sore throat, in toothpaste, and in ointments and powders for the eyes to cure cataract.Footnote 207 Maimonides reports the wide use of sugar as a remedy.Footnote 208 Sugar served as an ingredient of purgatives and was recommended to be eaten with various foods such as almonds and raisins, and taken as a drink to strengthen the lungs.Footnote 209 In his medical letters to the Ayyubid sultan, Maimonides recommends dipping food in sugar.Footnote 210 Al-Qazwīnī describes medicinal uses such as treating cough and chest pains, improving urine flow and draining mucus in the chest, to improve eyesight, to reduce eye swellings, to strengthen the heart and to cure malaria.Footnote 211
Marrow (Cucurbita moschata; Cucurbitaceae), in Arabic: qar'a
Marrow concentrate was mentioned in two cases as a drink for a patient recovering from fever (Rows 10–11) or when he feels weak (Rows 17–18). From a medical book found in the Genizah we learn that marrow was used for sexual enhancement.Footnote 212
Snow is mentioned as cooling element (Rows 8, 17). It was very important especially for the treatment of various kinds of fever.Footnote 213
Acknowledgments
The author expresses his deepest thanks to Dr Yaron Serri, Zefat Academic College and Dr Ali Hussein, University of Haifa for helping with the Arabic text. I would also like to extend special thanks to my colleagues at the Taylor-Schechter Genizah Research Unit at the Cambridge University Library, who have always shared their enormous knowledge and experience with me and supported me with helpful remarks, in particular Dr Ben Outhwaite (head of the unit), and Prof. Stefan Reif (former head). The author is indebted to the Syndicate of Cambridge University Library for permission to publish the Cairo Genizah fragment presented in this article.
