Avenzoar
Another of the distinguished Arabian physicians was Avenzoar--the
transformation of his Arabic family name, Ibn-Zohr. He was probably born
in Penaflor, not far from Seville. He died in Seville in 1162 at the
age, it is said, of ninety-two years. He was the son of a physician
descended from a family of scholars, jurists, physicians, and officials.
He received the best education of the time not only in internal
medicine,
greatest of the Spanish Arabian physicians. He was the teacher of
Averroes, who always speaks of him with great respect. He is interesting
as probably being the first to suggest nutrition per rectum. A few
words of his description show how well he knew the technique. His
apparatus for the purpose consisted of the bladder of a goat or some
similar animal structure, with a silver canula fastened into its neck,
to be used about as we use a fountain syringe. Having first carefully
washed out the rectum with cleansing and purifying clysters, he injected
the nutriment--eggs, milk, and gruels--into the gut. His idea was that
the intestine would take this, and, as he said, suck it up, carrying it
back to the stomach, where it would be digested. He was sure that he had
seen his patients benefited by it.
Some light on his studies of cases that would require such treatment may
be obtained from what he has to say about the handling of a case of
stricture of the esophagus. He says that this begins with some
discomfort, and then some difficulty of swallowing, which is gradually
and continuously increased until finally there comes complete
impossibility of swallowing. It was in these cases that he suggested
rectal alimentation, but he went farther than this, and treated the
stricture of the esophagus itself.
The first step in this treatment is that a canula of silver or tin
should be inserted through the mouth and pushed down the throat till its
head meets an obstruction, always being withdrawn when there is a
vomiting movement, until it becomes engaged in the stricture. Then
freshly milked milk, or gruel made from farina or barley, should be
poured through it. He says that in these cases the patient might be put
in a warm milk or gruel bath, since there are some physicians who
believe that through the lower parts of the body, and also through the
pores of the whole body, nutrition might be taken up. While he considers
that this latter method should be tried in suitable cases, he has not
very much faith in it, and says that the reasons urged for it are weak
and rather frivolous. It is easy to understand that a man who has
reached the place in medicine where he can recommend manipulative
treatments of this kind, and discuss nutritional modes so rationally,
knew his practical medicine well, and wrote of it judiciously.
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