GALLSTONES, KIDNEY STONES, HERNIA AND OB/GYN

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Aulus Cornelius Celsus (1st century), and the Hindu surgeon Susruta produced early descriptions of bladder stone treatment using perineal lithotomy.
Paulus Aegineta (7th-century Byzantine Greek physician) wrote “Medical Compendium in Seven Books” which gave a summary of medical knowledge and was unrivaled in its accuracy and completeness.

The procedure described by al-Zahrawi to remove kidney stones is almost word for word identical to the procedure he borrowed from the medical encyclopedia written by the Byzantine surgeon Paulus of Aegina except al-Zahrawi used a forceps instead of a scoop and chisel to break up the stones.

Al-Zahrawi was not the first to perform a cesarean section.

Al-Zahrawi was, however, the first to describe ectopic pregnancy.
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roman_catheters_bm_gr1968-6-26-1to39-1365x700

Roman catheters made of bronze
Al-Zahrawi’s catheter was the same as the Roman catheter except his catheters were always straight, but Romans used straight catheters for women and curved catheters for men.


GALLSTONES
Medical procedures of Al-Zahrawi for removing gallstones were the same as those used earlier in the Byzantine Empire.
Al-Zahrawi invented a suction syringe (that looked somewhat like a modern hypodermic needle) for emptying the contents of the bladder, but he borrowed the concept of a suction syringe from the physicians of the Byzantine Empire.


KIDNEY STONES
The procedure described by Al-Zahrawi to remove kidney stones is almost word for word identical to the procedure he borrowed from the medical encyclopedia written by the Byzantine surgeon Paulus of Aegina except al-Zahrawi used a forceps instead of a scoop and chisel to break up the stones.
Al-Zahrawi used either a catheter or a probe similar to a catheter, but solid rather than hollow, to probe the urethra by feel to locate obstructions and to push kidney stones blocking the urethra back up into the bladder.
Muslim writers sometimes refer to this tool as a “fine drill”, which is misleading because it did not drill holes. Both of these tools and the same procedure had been used by the Romans.  http://books.google.com/books?id=fHYuAAAAIAAJ&pg=PA145&lpg=PA145&dq=urethra+roman&source=bl&ots=YgWS38SbxD&sig=ekYtWUh7aC3L6kP6_41yTL33A2o&hl=en&sa=X&ei=AJ08U_uKL4eC2wXk7ICgAg&ved=0CCYQ6AEwATgK  —  
http://www.indiana.edu/~ancmed/instr1.html
Al Zahrawi’s catheter was depicted on a modern plaque awarded to a Muslim physician, but the plaque falsely claims al-Zahrawi invented the catheter.
http://rabieabdelhalim.com/blog/2014/01/19/the-millennium-anniversary-of-al-zahrawi-albucasis-commemorating-plaques-and-medals-2/
Wikipedia says “Lithotomy was a fairly common procedure in the past, and [Hippocrates wrote] there were specialized lithotomists …
Ammonius, who practiced lithotomy in Alexandria circa 200 BC, acquired the surname Lithotomus from the instrument he developed for fragmenting stones too large to pass through a small perineal incision. …
His lithotomy scalpel was straight with an upper blunt edge enabling the thumb to apply pressure on it, while the lower edge was sharp, which enabled the operator to make a semicircular incision.“
Aulus Cornelius Celsus (1st century), and the Hindu surgeon Susruta produced early descriptions of bladder stone treatment using perineal lithotomy.
Paulus Aegineta (7th-century Byzantine Greek physician) wrote “Medical Compendium in Seven Books” which gave a summary of medical knowledge and was unrivaled in its accuracy and completeness. Paulus’ description of lithotomy closely follows that of Celsus.
The writings of al-Zahrawi follow Paulus (the Byzantine surgeon Paul of Aegina) almost word for word but then describes a different sort of knife one that is “sharp on two sides“.
Albucasis also added using a forceps instead of the scoop and chisel of Ammonius to break up the stones.
http://en.wikipedia.org/wiki/Lithotomy   
The false claim that al-Zahrawi was the first to devote a chapter to the removal of kidney stones in women. Actually, book VII chapter XXVII in the Roman medical enyclopedia “De Medicina” by Celsus is devoted entirely to the removal of kidney stones from women, and portions of other chapters which precede it in that book are about the differences in removing kidney stones from women and from men http://books.google.com/books?id=p2kFAAAAQAAJ&pg=PA316&focus=viewport&output=html_text#c_top
Al-Zahrawi’s catheter was the same as the Roman catheter except his catheters were always straight, but Romans used straight catheters for women and curved catheters for men. The false claim that the catheter was a “fine drill” is an attempt to claim credit for a device invented many centuries later by Christian Europeans.
Straight and curved Roman catheters are illustrated at http://www.indiana.edu/~ancmed/instr1.html  
Al-Zahrawi’s straight catheter is illustrated at http://rabieabdelhalim.com/blog/2014/01/19/the-millennium-anniversary-of-al-zahrawi-albucasis-commemorating-plaques-and-medals-2/  along with a false claim that he invented the catheter.
Al-Zahrawi was not the first physician to examine the urine of patients. In ancient Greece, Hippocrates wrote about urine testing: “No other organ system or organ of the human body provides so much information by its excretion as does the urinary system,”

HERNIA
Al-Zahrawi’s writings on hernia surgery were mostly copied from Galen of Pergamon.

OB/GYN
In the year 963, al-Zahrawi was the first physician to describe an ectopic pregnancy.
Al-Zahrawi used a device with a mirror to look inside the cervix (the narrow outer end of the uterus), but similar devices were described many centuries earlier by Hindus in the Sushruta Samhita.
Al-Zahrawi may have positioned women differently during childbirth. He likely positioned women, in what is now called Walcher’s position of childbirth ,on her back with the back arched.
Childbirth position in ancient Rome was different than that of al-Zahrawi. According to Wikipedia, giving Donald Todman, “Childbirth in ancient Rome: from tradition folklore to obstetrics,” Australian & New Zealand Journal of Obstetrics and Gynecology, 2007, page 83 as their source, “During the labor process, the mother would lie on her back on a hard, low bed with support under her hips. Her thighs were parted with her feet drawn up . …. During the actual birth, the mother would be moved to the birthing stool where she was seated with a midwife in front of her and female aids standing at her sides. In a normal head first delivery, the cervical opening was stretched slightly, and the rest of the body was pulled out.”
Speculums were in use in the Roman Empire, and several were found at Pompeii.
Al-Zahrawi did not invent the forceps, but was the first to design a smaller forceps for removing a dead fetus. The Romans had used midwifery forceps for live births. http://www.forumromanum.org/milne/  but Celsus in book VII chapter XXIX in the Roman medical enyclopedia “De Medicina” describes using bare hands to remove a dead fetus. http://books.google.com/books?id=p2kFAAAAQAAJ&pg=PA316&focus=viewport&output=html_text#c_top
We know cesarean sections were performed by Jewish physicians many centuries before the time of al-Zahrawi, because the Jewish Talmud prohibits primogeniture when twins are born by cesarean section.

Image by unknown photographer of items in British Museum, via Wikimedia Commons
Image credit https://en.wikipedia.org/wiki/File:Roman_catheters_BM_GR1968.6-26.1to39.jpg

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