Work record
The Canon of Medicine, Book I
c. 1025 · Medieval · Essays · Arabic
Abstract
Background. Physician to several Persian princes and the foremost Aristotelian of his era, Ibn Sina sought to unite the Arabic translations of Greek medicine with natural philosophy in one ordered work. Book I gives the principles that the four later books on drugs, local diseases, general disorders and compounds apply.
Structure. Four parts cover, in turn, the foundations of physiology; disease with its causes and signs; hygiene from infancy to old age; and the kinds of treatment.
Key Concepts. Bodies are mixtures of elements whose temperament must be kept in balance. Food becomes four humours in the liver. Natural, vital and animal faculties work through organs and a subtle breath. Six classes of cause, including the passions, disturb health; pulse, urine and stools reveal it; regimen preserves it; diet, drugs and operation restore it.
Method. Ibn Sina argues by definition and numbered division, reports disagreements between philosophers and doctors, and gives practical rules, such as waiting on nature when a diagnosis is unclear and keeping narcotics within limits. Gruner's 1930 English edition interleaves the translated paragraphs with lengthy notes of his own.
Significance. Through the twelfth-century Latin version of Gerard of Cremona the Canon became the standard medical textbook of European universities until the seventeenth century, and it still shapes Unani practice.
Key figures
- Ibn Sina: Physician-philosopher of Bukhara and Hamadan, author of the Canon
- Galen: Greek physician whose system of humours and faculties underlies the book
- Aristotle: Philosopher whose view of the heart Ibn Sina prefers to the physicians'
- Hippocrates: Cited for rules on airs, seasons and evacuation
- O. Cameron Gruner: Physician who translated Book I and added a commentary (1930)
Summary
The Canon of Medicine (al-Qanun fi al-Tibb) is Ibn Sina's encyclopedia of medicine in five books, and Book I, the subject of this record, sets out the general principles on which the rest depends. It opens with a definition: medicine is the science of the states of the human body in health and when not in health, and of how health is lost and restored, with a theoretical part that gives knowledge and a practical part that guides the physician's judgment. The first part then lays out the foundations Ibn Sina took from Aristotle and Galen: the four elements; the temperaments, one balanced and eight unbalanced, varying with age, sex, region and each organ; the four humours, blood, serous humour (phlegm), yellow bile and black bile, and how they arise from digested food in the liver; the members, meaning the bones, muscles, nerves, arteries and veins; and the faculties, natural, vital and animal, with their seats in the liver, heart and brain. Here he notes that physicians place sensation in the brain while Aristotle placed the source of all faculties in the heart, and says the philosopher's view is deeper but the question belongs to natural philosophy rather than to the doctor. The second part treats disease: the kinds of disorder, the phases of illness, and the causes, including air and seasons, food and drink, movement and rest, sleep and waking, retention and evacuation, and the passions of the mind, whose effects he explains by the expansion and contraction of the vital breath. It then gives the signs of disease in the pulse, the urine and the stools. The third part is a manual of hygiene across the life span: care of the newborn, bathing, swaddling, breastfeeding and the choice of a wet-nurse, rocking and lullabies, the moral formation of children by guarding them from anger and fear, exercise, massage, bathing, food and sleep for adults, the regimen of the aged, and advice for travellers. The fourth part classifies treatment by diet, medicines and manual operation, with rules for evacuation by bloodletting, purging and emesis, for allaying pain, and for leaving an unclear disease to nature. The library text is O. Cameron Gruner's 1930 English translation, which interleaves Book I with Gruner's long commentary, sometimes abridges the text, and is an OCR transcription; the reprint front matter, appendix and index are omitted.
Virtues in this work
- Prudence: Part 4 tells the physician to leave a disease of unknown nature to nature rather than hasten treatment, and to fit each remedy to the organ and the stage of illness.
- Temperance: The regimen of Part 3 makes moderation in food, exercise, sleep and bathing, and in the emotions, the ordinary means of keeping health.
- Charity: Part 4 counsels the physician to please and calm the patient by anything that can reasonably gratify him, treating the sick person's joy as part of care.
Plot or Argument
- Part 1: Definition and foundations
Medicine defined and divided into theory and practice; the four elements; the nine temperaments and their variation by age and sex; the four humours and their generation; the members of the body; and the natural, vital and animal faculties.
- Part 2, Thesis 1: Disorders of health
States of the body between health and disease; disorders of temperament, of structure and of continuity; the stages of illness from onset through crisis.
- Part 2, Thesis 2: Causes of disease
Air, seasons, winds and localities; food and drink; exercise and rest; sleep and wakefulness; retention and evacuation; and the influence of the passions on the breath and the body.
- Part 2, Thesis 3: Signs of disease
Diagnosis by the pulse in its many qualities and rhythms, by the colour, density and sediment of the urine, and by the stools.
- Part 3: Preservation of health
Regimen from birth (the cord, bathing, binding, feeding, the wet-nurse, rocking and song) through childhood education, adult exercise, massage, bathing, diet and sleep, to the regimen of old age, of unbalanced temperaments, of the seasons and of travellers.
- Part 4: Classification of treatment
Treatment by regimen and diet, by medicines chosen for the member, the disease and its stage, and by manual measures; rules for evacuation, bloodletting, cupping, purging and emesis; the relief of pain; and the patient's joy as an aid to cure.
Lessons
Theory serves judgment
Ibn Sina insists that medical theory and practice are not two sciences but two aspects of one: theory gives knowledge, and practice is the knowledge that lets a physician form an opinion on which to base treatment. Learning principles is for the sake of sound judgment at the bedside.
- Why does Ibn Sina say practice is not the physician's handiwork but a branch of knowledge?
- Can a student become skilled in medicine without ever treating a patient, as Ibn Sina suggests?
Mind and body in one regimen
Book I treats the passions as causes of bodily change and calls for guarding children from anger, fear, despondency and sleeplessness, because habits of mind and states of the body shape each other. Ibn Sina makes emotional formation part of hygiene.
- Why would a physician write about the moral formation of children in a medical textbook?
- How does the doctrine of the vital breath explain blushing from shame in Part 2?
- What modern practices, if any, continue Ibn Sina's idea that joy aids healing?
Inheriting and ordering a tradition
The Canon gathers Hippocrates, Galen, Aristotle and later physicians into one ordered system, noting where they disagree, as on the heart and brain. Its strength is clear arrangement, which made it a textbook for six centuries.
- What is gained when a field's knowledge is organized into one canon, and what might be lost?
- How does Ibn Sina handle the disagreement between Aristotle and the physicians over the seat of the faculties?
Caution in treatment
Part 4 counsels leaving an unclear disease to nature, allaying pain first, using poppy no further than needed, and avoiding excessive evacuation. These rules show a measured therapeutics within the humoral framework.
- Why does Ibn Sina advise waiting when the nature of a disease is unknown?
- What does his warning about white poppy suggest about the risks he recognized in strong remedies?
Context
Ibn Sina worked in the eastern Islamic world in the late tenth and early eleventh centuries, when the Abbasid caliphate's authority had passed to regional dynasties such as the Samanids and Buyids. Greek medicine and philosophy had been translated into Arabic in ninth-century Baghdad by Hunayn ibn Ishaq and others, and physicians such as al-Razi and al-Majusi had already written large medical compendia. Ibn Sina combined this Galenic medicine with Aristotelian natural philosophy, in which he was also the leading thinker of his age.
Composition
Ibn Sina began the Canon at Jurjan around 1012 and continued it at Rayy and Hamadan; it was complete by the 1020s, and c. 1025 is the conventional date. It has five books: general principles (Book I), simple drugs (II), diseases of each part from head to foot (III), conditions affecting the whole body such as fevers, wounds and poisons (IV), and compound remedies (V). Book I is divided into four parts (fann), each subdivided into teachings and chapters.
Reception
Gerard of Cremona translated the Canon into Latin at Toledo in the twelfth century, and it became a core text of medical teaching at Montpellier, Bologna, Padua and elsewhere, printed in Latin from 1473 and in Arabic at Rome in 1593. It remained in university syllabuses into the seventeenth century, and in parts of the Islamic world Unani (Greco-Islamic) medicine continues to draw on it. Critics such as Paracelsus attacked its authority, and the anatomy and physiology of Vesalius and Harvey displaced its Galenic framework. Gruner, a British pathologist who later worked in Canada, published his translation of Book I with an extensive commentary in 1930; it was the first substantial English version.
Comparisons
- galen-selected-works
Ibn Sina takes Galen's faculties, temperaments and humours as his framework, but corrects Galen with Aristotle on points such as the seat of the faculties and on the role of the female seed.
- hippocratic-writings
The Canon's treatment of airs, seasons and localities, and its rules for purging and emesis, cite and systematize Hippocratic teaching.
- al-razi-treatise-on-smallpox-and-measles
Al-Razi's clinical monograph shows close bedside description of one disease; Ibn Sina's Book I shows the opposite strength, a systematic theory of all medicine.
- the-anatomy-of-melancholy
Burton cites Avicenna repeatedly, and his account of the passions, the non-natural causes and the regimen of melancholy rests on the framework Book I sets out.
- ghazali-deliverance-from-error
Al-Ghazali accepted the physicians' sciences while attacking parts of the philosophers' metaphysics, Ibn Sina's above all; reading the two shows how Avicenna's medicine and his philosophy were received differently.
- harvey-on-the-motion-of-the-heart-and-blood
Harvey's circulation overturned the Galenic physiology of blood made in the liver and ebbing through the veins that the Canon teaches in Part 1.
Quotes
Frequently cited
“Therefore in safeguarding the emotions the health of the mind and body are at the same time maintained.”
“When, in regard to medicine, we say that practice proceeds from theory, we do not mean that there is one division of medicine by which we know, and another, distinct therefrom, by which we act.”
“But physicians still keep to the opinion that the brain is the chief seat of sentient life, and that each sense has its own distinct member whereby it manifests function.”
“the movement is for the benefit of the body, and the music is for the benefit of the mind.”
“For just as bad habits of thought supervene on intemperament of the body, so also a physical intemperament may be traced to habits of mind which are contrary to the ideal.”
“When you do not know the nature of a malady, leave it to Nature ; do not strive to hasten matters.”
“If it is necessary to induce a stuporose state, do not go beyond the use of such as white poppy. Its anodyne action is well-known.”
“Remember, too, that among the advantageous contributory factors in treatment is the help afforded by anything which exalts the sensitive and vital faculties : for instance, joyfulness.”
For Students
A reading companion for classical Christian high school students. See the student guide.
Reading Guide
Watch for
- The opening definition of medicine and the claim that theory and practice are two aspects of one science (paras. 6-10).
- The way every topic, from organs to infants, is explained by the balance of hot, cold, wet and dry and by the four humours.
- Paragraph 141, where Ibn Sina sides with Aristotle against the physicians on the heart and brain and then says the matter belongs to the philosopher, not the doctor as doctor.
- The chapters on the passions and the breath in Part 2, which explain how fear, anger, joy and shame change the body.
- The regimen of children in Part 3, where rocking, song and the guarding of emotions belong to medicine.
Key terms and names
- Temperament (mizaj)
- The mixture of hot, cold, wet and dry in a body or organ. Ibn Sina counts one balanced and eight unbalanced kinds, and every person, age and organ has its own.
- Humours
- The four fluids made from digested food: blood, serous humour (phlegm), yellow bile and black bile. Health depends on their right quantity and quality.
- Faculties
- The powers of the body: the natural (nutrition and generation, seated in the liver), the vital (seated in the heart) and the animal or psychic (sensation and movement, seated in the brain).
- Vital breath (pneuma)
- A fine substance formed in the heart that carries the faculties through the body. Its expansion and contraction explain the bodily effects of emotion.
- Regimen
- The ordering of daily life (air, food, exercise, sleep, bathing, emotions) to keep or restore health. Part 3 is devoted to it.
- Evacuation
- Removing excess or corrupt humours by bloodletting, cupping, purging, emesis and similar means. Part 4 sets out when it is and is not indicated.
- Gruner
- O. Cameron Gruner, the physician who translated Book I in 1930 and added a long commentary. His notes are interleaved with the translation in the library text.
Seminar Questions
- Comprehension How does Ibn Sina define medicine in the opening paragraphs, and what does he mean by its theoretical and practical aspects?
- Comprehension What are the three faculties of the body, where does Ibn Sina locate each, and how does Aristotle's view in para. 141 differ from the physicians'?
- Comprehension What does Part 3 recommend for the care and emotional training of young children, and what reasons does Ibn Sina give?
- Interpretation Ibn Sina says the question of the heart and brain is for the philosopher, not the doctor as doctor. What does this suggest about how he saw the relation between medicine and philosophy?
- Interpretation Part 2 explains blushing from shame as the breath first contracting and then expanding when reason returns. How does this account join psychology and physiology?
- Interpretation Why might a medical textbook advise leaving an unknown disease to nature, and what does that rule assume about the body?
- Big Question Ibn Sina treats the emotions as a matter of health for body and mind. Is caring for the passions the work of physicians, of teachers and parents, of the church, or of all of them?
Faith Connections
- Proverbs 17:22 (Scripture)
A merry heart does good like a medicine, but a broken spirit dries the bones. Ibn Sina's claim that despondency is a desiccant and that joy aids treatment echoes the proverb's link between the heart and the body.
- Sirach 38:1-8 (Scripture)
Ben Sira honours the physician and says the Lord created medicines from the earth; Ibn Sina, writing as a Muslim, likewise speaks of the body formed by the decree of God and of medicine as knowledge of its natural powers.
- Basil of Caesarea, Longer Rules 55 (Church Fathers)
Basil asks whether Christians may use medicine and answers that the medical art is a gift of God to be used with thanks, without placing all hope in it, a view that helped Christian schools later receive works such as the Canon.
- Thomas Aquinas, Summa Theologiae I-II, q. 37, a. 4 (Great Conversation)
Aquinas asks whether sorrow harms the body more than other passions and answers yes, drawing on the medical view that passions change the body's motion, the same physiology of emotion Ibn Sina sets out.
Logic and Rhetoric
Central argument: Health is a balanced temperament of the body and its parts, maintained by the humours and the faculties; it is disturbed by causes such as air, food, movement, sleep, retention and evacuation, and the passions, which act through the vital breath; these disturbances show themselves in signs such as the pulse and the urine; therefore the physician who knows these principles can preserve health by regimen and restore it by diet, medicines and manual treatment, each chosen for the patient's temperament, the organ and the stage of disease.
Rhetorical device: division (diairesis). The whole of Book I proceeds by numbered division: medicine into theory and practice; health, disease and the third state; the six causes; treatment into diet, medicine and manual operation; and, in para. 905, three headings of treatment announced before each is taken in turn.
Debate: Resolved: Ibn Sina was right that the training of children's emotions belongs within medicine.
Memory Work
the movement is for the benefit of the body, and the music is for the benefit of the mind.
When you do not know the nature of a malady, leave it to Nature ; do not strive to hasten matters.
Writing Prompts
Essay: Ibn Sina writes that habits of mind and states of the body shape one another. Using the chapters on the passions in Part 2 and on children in Part 3, explain his reasoning and argue whether his advice about the emotions still holds when the humoral theory behind it is set aside.
Comparison with Galen: Selected Works: Ibn Sina built on Galen but disagreed with the Galenic physicians about the heart and the brain. Compare Galen's natural faculties with Ibn Sina's three faculties and argue what Ibn Sina's use of Aristotle adds to or changes in Galen's system.
Medical Lens
Book I is the most influential statement of Greco-Islamic humoral medicine and a key document for the history of psychiatry and pharmacology. It organizes health around temperament (the balance of hot, cold, wet and dry), the four humours, and the natural, vital and animal faculties, and it lists the causes later called the six non-naturals: air, food and drink, motion and rest, sleep and waking, evacuation and retention, and the passions of the soul. The passions are explained physiologically as sudden or gradual expansions and contractions of the vital breath (pneuma), so that anger, joy, fear and gloom have bodily effects up to syncope and death; this gave medieval and Renaissance physicians, including Burton, a framework for melancholy and for emotional causes of disease. The regimen of childhood treats emotional formation as hygiene, and Part 4 counts the patient's joy among aids to treatment. On drugs, Ibn Sina makes allaying pain the first step when pain accompanies disease and limits narcotic stupor to agents such as white poppy, an early statement of caution with opium. Evacuation by bloodletting, cupping, purging and emesis is regulated by detailed indications. Gruner's commentary often draws comparisons with modern physiology and with his own philosophical system; those views are his, not Ibn Sina's, and readers should separate the two. Present the humoral explanations as the period's medicine rather than as anticipations of modern findings.
- Part 1, paras. 6-10
The definition of medicine, the relation of theory and practice, and whether there is a third state between health and disease.
- Part 1, Theses III-IV
The temperaments and their variation by age and sex; the four humours, their normal and abnormal forms, and their generation in the liver.
- Part 1, paras. 138-141
The seats of the faculties in brain, liver and heart, and the disagreement between Aristotle and the Galenic physicians.
- Part 2, Thesis 2, paras. 336-345
Effects of sleep, wakefulness and insomnia; the passions as movements of the breath, with fear, anger, gloom and shame; the parents' imagination and the offspring.
- Part 2, Thesis 3
The pulse and the urine as signs of disease, with their classification by quality and rhythm.
- Part 3, Thesis 1, paras. 690-733
Care of the newborn, breastfeeding and the wet-nurse, infant disorders including night-terrors, and the emotional regimen of childhood.
- Part 4, paras. 920-922 and 934-975
General rules of treatment, the relief of pain with white poppy, joy as an aid to cure, and the indications for bloodletting, purging and emesis.
Creative Prompts
- Classroom
Have students build a chart of the six causes (air, food and drink, movement and rest, sleep and waking, retention and evacuation, states of mind) and, for each, write one piece of Ibn Sina's advice from Parts 2 and 3.
- Dialogue
Write a conversation between Ibn Sina and a Galenic physician of his day on whether the brain or the heart is the source of the faculties, using para. 141.
Further Reading
- The Life of Ibn Sina, Ibn Sina and Abu Ubayd al-Juzjani, trans. William E. Gohlman
Ibn Sina's autobiography, completed by his student.
- Medieval Islamic Medicine, Peter E. Pormann and Emilie Savage-Smith
- Avicenna, Jon McGinnis
An introduction to his philosophy and science.
- Medieval and Early Renaissance Medicine, Nancy G. Siraisi
Verification notes
All eight quotations were found by search in the stored Gruner text (content/texts/avicenna-canon-of-medicine-book-i.txt), an OCR transcription, and copied exactly including its spacing before colons and semicolons; only passages free of OCR damage were chosen, and none includes Gruner's bracketed insertions. Paragraph numbers are Gruner's running numbers for the translated text (his commentary uses separate section numbers marked §). Part and thesis assignments for paras. 141 and 336-345 follow the order of the file, where some headings are damaged by OCR. Gruner worked largely from the Latin tradition with reference to the Arabic, and notes in places that the text is abridged. Biographical dates (980-1037) and the Latin and Arabic printing dates (1473, 1593) are standard. Gruner's commentary contains his own speculative and comparative interpretations, which this record does not attribute to Ibn Sina.
- OCR text: check every quotation against the 1930 printed page or facsimile before publication.
- The Part and thesis of paras. 138-141 and 336-345, whose headings are damaged in the OCR.
- Ibn Sina's dates and places of composition for the Canon (Jurjan, Rayy, Hamadan) vary slightly in the sources.
- Gruner's later career and dates (often given as 1877-1972).