Diet pills and other treatments for obesity first written about in approximately 930 C.E.

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Wednesday, July 20, 2005 4:59 am Email this article
A recent article stated that the word "obesity" first appeared in a medical context in a book published in 1620. This appears to be wrong by about 700 years. Obesity and its treatments discussed in “An Encyclopedia of Medicine” in approximately 930 C.E.

The first medical discussion of obesity goes back to about 930 C.E., or shortly thereafter, according to a letter published in The Lancet (Abdel-Halim, 2005).

A discussion of obesity and its treatments appeared in a book titled “Al-Hawi Fit-Tibb”, which translates to “An Encyclopedia of Medicine”, which appears to have been published in about 930 C.E., shortly after the death of its author, a great Muslim physican, alchemist and philosopher by the name of “Abu Bakr Muhammad ibn Zakariyya Al-Razi” or “Al-Razi” for short, also known as “Rhazes” in the West.

(Some websites list the data of his death as 930, while others say 925 or 926.)

Book contained all knowledge about obesity at the time (approximately 930 C.E.)

Among its numerous topics, the book contain “all the available knowledge on obesity at that time” according to the letter in The Lancet (Abdel-Halim, 2005).

Book discussed opinions of previous great physicians (approximately 930 C.E.)

“In the light of his own experience and practice, he discussed the opinions of scholars who preceded him, such as Hippocrates, Rufus of Ephesus, Galen, Oribasius, and Paul of Aegina, highlighting the points on which he had a different view, particularly in relation to the management of excessive obesity,” notes Abdel-Halim (2005).

(Hippocrates (460 BC – 380 BC) was an ancient Greek physician who has been called “the father of medicine”.)

(Rufus of Ephesus (98-117 C.E.) was a Greek-speaking physician who praticed during the time of Trajan.)

(Galen, who died in about 216 C.E., was the most important physician of the Roman Empire and arguably the most influential physician in medical history according to the U.S. National Library of Medicine’s “Islamic Medical Manuscripts” Website.)

(Oribasius (325-400 C.E.) was an encylopedist and healer from Pergamon (like Galen) according to the website Anotomist.co.uk. “He was a friend, physician and adviser to emperor Julian ‘the Apostate’ (332-363 C.E.). Julian was acclaimed Augustus by his troops, rebelling against Constantius, in February 360 C.E., but the idea that Oribasius headed a pagan cabal which organised this, or even that Julian himself was complicit, is not now widely accepted (see here for more background). Julian, in any case, encouraged Oribasius to compile his Medical Encyclopedia of 70 or so books, about a third of which survives, and in which he carefully and meticulously quotes earlier authors.”)

(Paul of Aegina was a Greek physician who lived in the mid-600’s C.E. who composed a comprehensive medical encyclopaedia that was translated into Arabic in the ninth century and widely used by Islamic physicians according to the U.S. National Library of Medicine’s “Islamic Medical Manuscripts” Website.)

In about 200 C.E., most famous physician from Roman Empire believed prolonged thinking would lead to weight loss

“Galen, for example, [the most famous physican in the Roman Empire, a Greek physician who lived from 129-216 C.E., 600 years after Hippocrates and crystallised all the best work of the Greek medical schools which had preceded him] believed that prolonged thinking and mental activity would slim the obese, but Al-Razi stated that ‘prolonged thinking that leads to sadness slims; otherwise prolonged thinking does not slim’,” the letter continues. (Abdel-Halim, 2005)

Al-Razi’s “An Encyclopedia of Medicine” discussed diet, diet pills, exercise, etc as treatment for obesity (approximately 930 C.E.)

“Al-Razi documented his discussion using clinical case reports of the patients with excessive obesity he successfully treated, describing in detail the treatments he used, including diet, drugs, exercises, massage, hydrotherapy, and lifestyle changes.”

Al-Razi’s “An Encyclopedia of Medicine” discussed all areas of medicine (approximately 930 C.E.)

“Ar-Razi’s last and largest medical encyclopedia is his ‘al-Hawi fit-Tibb’, which embraces all areas of medical knowledge of the time,” according to the International Muslim Association of Scientists and Engineers’ (IMASE) website.

(Note: Some spell it “Al Razi” while others spell it “Ar-Razi”.)

Al-Razi attacked fake doctors selling ‘cures’ (approximately 930 C.E.)

“He [Al Razi] also attacked charlatans and fake doctors who roamed the cities and the countryside selling their nostrums and ‘cures’,” notes Dr. Al-Ghazal (2003).

Al-Razi said that doctors could not cure all diseases (approximately 930 C.E.)

“At the same time, he [Al Razi] warned that even highly educated doctors did not have the answers for all medical problems and could not cure all sicknesses or heal every disease,” Dr. Al-Ghazal (2003) continues.

Al-Razi told doctors to keep up with new information (approximately 930 C.E.)

“Al-Razi exhorted practitioners to keep up with advanced knowledge by continually studying medical books and expose themselves to new information.” (Al-Ghazal, 2003)

Al-Razi wrote about breads, waters, dairy products, fruits, vegetables, spices, meats, and fishes (approximately 930 C.E.)

“Emphasizing specific matters and general regulations for healthy living, al-Razi [in another book he wrote] discussed breads, waters, dairy products, fruits, vegetables, spices, meats, and fishes.” (Al-Ghazal, 2003)

“He explained in detail their kinds, methods of preparation, physical properties, and therapeutic modes of action, and pointed out when they were useful and when not.” (Al-Ghazal, 2003)

Published after his death

“This huge compilation of sayings and interpretations by the ancients, Arabic physicians, and ar-Razi was gathered and edited after the author’s death by his students,” the website notes.

“Inevitably, it included sections related to ‘pharmacy in the healing art’, materia medica arranged in alphabetical order, compounded drugs, pharmaceutical dosage forms and toxicology,” according to another website.

Included prescriptions

“It also included numerous medical recipes and tested prescriptions that influenced ‘medical therapy’ in Islam and in the West during the Middle Ages,” they also note.

Al Razi first to write book of Home Remedies in early 900’s

Al Razi was also the first Muslim physican to write a book of Home Remedies called “Man la Yahduruhu Teb” for the general public according to paper by paper by Dr. Sharif Kaf Al-Ghazal (2003).

Al-Razi lived from 865 to 930 C.E.

Al-Razi was born in the Persian city of Ray, near present-day Tehran, Iran, in the year 865 C.E.

Patients flocked to Al-Razi from all over (early 900’s C.E.)

“At an early age he gained eminence as an expert in medicine and alchemy, so that patients and students flocked to him from distant parts of Asia,” Dr. Al-Ghazal (2003) states.

Al-Razi placed in-charge of the first Royal Hospital at Ray, then moved to head famous hospital in Baghdad (early 900’s C.E.)

“He was first placed in-charge of the first Royal Hospital at Ray, from where he soon moved to a similar position in Baghdad where he remained the head of its famous Muqtadari Hospital for along time,” Dr. Al-Ghazal (2003) continues.

“He moved from time to time to various cities, specially between Ray and Baghdad, but finally returned to Ray, where he died around 930 C.E.”

Al-Razi commemorated in the Razi Institute near Tehran

“His name is commemorated in the Razi Institute near Tehran, [Iran].”

1000 of Al Razi’s case histories preserved

“Over 1000 of his case histories are also preserved today, and they provide an important insight into the working life of the greatest medieval clinician,” according to the U.S. National Library of Medicine’s “Islamic Medical Manuscripts” Website.

“Drawbacks of excessive obesity” written about in the book ‘Canon of Medicine’ in about 1020-1030 C.E.

Later, Ibn Sina (known to Europeans as “Avicenna”), the foremost philosophers of the golden age of Islamic tradition who lived from 980 to 1037 C.E., was “known in the west he is also known as the ‘Prince of Physicians’ for his famous medical text al-Qanun ‘Canon’,” notes another website.

“In Latin translations, his works influenced many Christian philosophers, most notably Thomas Aquinas,” the website continues.

“Iban Sina “devoted a section of the 3rd volume of his ‘Canon in Medicine’ to the ‘drawbacks of excessive obesity’” according to the letter published in The Lancet (Abdel-Halim, 2005).

(I cannot find the date of publication, but I assume that this work was published in the neighborhood of 1020-1030 C.E. based on when Iban Sina lived.)

Medical book from the 1200’s says that hugely obese people are more likely to fall ill quickly

Another Muslim physician by the name of “Ibn Hubal Al-Baghdady (1121–1213 C.E.) also reported on the predisposition of “hugely obese persons” to fall ill quickly,” Dr. Al-Ghazal notes in his letter in The Lancet (2005).

Heavy exercise on an empty stomach recommended for excessively obese (1200’s)

“In their management, by heavy exercises on an empty stomach, he stressed the importance of a gradually increasing schedule because an excessively obese person may put himself at risk if he starts abruptly on heavy activities,” Dr. Al-Ghazal (2005) continues.

Obesity linked to heart attacks, strokes and breathing problems in the 1200’s

A Syrian physician by the name of “Ibn el Nefis (1207–1288 C.E.) [also written as “Ibn al-Nafis”] in his book Al Mujaz Fit-Tibb (which translates to ‘The Concise Book of Medicine’),” Dr. Al-Ghazal (2005) notes, “reported on the association between excessive obesity and cardiovascular and cerebrovascular accidents, and with respiratory and endocrine disorders:”

[Ibn el Nefis wrote] ‘Excessive obesity is a constraint on the human being limiting his freedom of actions and constricting his pneuma (vitality) which may vanish and may also become disordered as air may not be able to reach it.’

Obesity recognized to cause blood vessels to rupture (1200’s)

[Ibn el Nefis further wrote that] ‘They [excessively obese persons] run the risk of a fatal vessel rupture causing sudden death or bleeding into a body cavity.

Obesity recognized to cause death from ruptured blood vessel, breathing problems, or heart palpitations (1200’s)

[Ibn el Nefis continued by saying that] ‘But bleeding into the brain or the heart will lead to sudden death. And frequently they suffer from dyspnoea [labored breathing] or palpitation.’

Inherited obesity distinguished from diet-induced obesity (1200’s)

“Furthermore,” Dr. Al-Ghazal (2005) continues, “Ibn el Nefis (1207–1288 C.E.) distinguished a special type of excessive obesity in those who are “obese by birth” (congenitally obese).

People who inherited obesity recognized to have strong appetite, be cool-tempered, and may not respond to medicines (in the 1200’s C.E.)

“He recognised that ‘they are usually cool-tempered, slender-vesselled, subfertile, could not endure hunger or thirst, and medicaments hardly reach their organs except with difficulty and after a long time’.”

(Ibn el Nefis (1207–1288 C.E.) was originally from Damascus, but he spent much of his life in Cairo, where he became “Chief of Physicians” according to the U.S. National Library of Medicine’s “Islamic Medical Manuscripts” Website.

Arabic pharmacies in Baghdad the 9th Century

“Arabic pharmacy (Saydalah) as a profession with a seperate entity from medicine was recogined by the ninth century,” according to the paper by Dr. Al-Ghazal (2003).

REFERENCE

Abdel-Halim RE. Obesity: 1000 years ago. Lancet. 2005 Jul 16-22, 366(9481):204.

OTHER REFERENCES

Al-Ghazal SK. The valuable contribitions of Al-Razi (Rhazes) in the history of pharmacy during the Middle Ages. JISHIM, 2003, 2:9-11.

AUTHOR’S CORRESPONDENCE

Sharif Kaf Al-Ghazal, MD, MS, RCS, DM
1 Merlin Close
Morley, Leeds LS27 8TS
England
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