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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

but in all the specialties, and must be counted among the

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head meets an obstruction, always being withdrawn when there is a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.