Pericardial pathology 900 years ago. A study and translations from an Arabic medical textbook.

This is a study and translation of the section on pericarditis in Al Taisir book written by the Muslim physician Ibn Zuhr Avenzoar who lived and practiced in Eshbeelia nowadays Seville, Andalusia, Spain between 1091-1162 AD. Ibn Zuhr described the serous type of pericarditis as well as the pathological findings in fibrinous pericarditis. His description of the latter may also fit with the picture of chronic fibrous pericarditis. He also described acute purulent pericarditis and involvement of the pericardium in cases of acute carditis with hectic fever. Ibn Zuhr's description of the pericardial effusion in serous pericarditis as looking like urine indicates that he must have seen a sample of the fluid obtained either by pericardiocentesis or during a post-mortem examination. However, his description of solid substances accumulating on the inside of the hearts covering looking like layers upon layers of membranes could not have been made possible without post-mortem dissection.

Extraction of urinary bladder stone as described by Abul-Qasim Khalaf Ibn Abbas Alzahrawi (Albucasis) (325-404 H, 930-1013 AD). A translation of original text and a commentary.

This is a detailed study of the technique of cystolithotomy as practiced by the Muslim surgeon Alzahrawi (Albucasis) in Cordova more than 1000 years ago. In addition to translating the relevant chapter in his book Al-Tasreef, his technique is critically evaluated comparing it with that of his predecessors and his successors. The study confirmed the originality of Alzahrawi who described operative steps and invented operative instruments not known in the Greco-Roman era. He was also the first to describe, in details, the operative technique in women and to recommend the 2-stage operation in complicated cases. His modifications and innovations greatly influenced surgery in Middle Ages Europe up to the 18th century which witnessed the beginnings of the modern method using the suprapubic, instead of the perineal, approach. Alzahrawi's influence is vividly seen in the practice of the Italian lithotomist "Marianus Sanctus" (16th century), the French "Jack De Beaulieu" (17th century) and the English "Shelsden" (18th century). Alzahrawi is the founder of lithotripsy. He introduced Al-Kalaleeb forceps to crush large bladder stones and Al-Mishaab to drill and fragment an impacted urethral stone. Andreas a Cruce (18th century) only added screw action to Al-Kalaleeb lithotrite but Amussat managed in 1822 to apply it transurethrally. Similarly, by the notion of transurethrally getting at the stone while within the bladder, Alzahrawi's idea of drilling by Al-Mishaab was the foundation of the litholepte of Fournier de Lempdes (1812), the instrument of Gruithusien (1813), Civiale's trilabe (1818) and the brise coque of Rigal De Galliac (1829).