Abū al-Qāsim Khalaf ibn al-'Abbās al-Zahrāwī al-Ansari, who lived from about 936 to 1013, was an Arab doctor, surgeon, and scientist from al-Andalus. He is widely regarded as one of the most important surgeons during the Middle Ages.

His most important work is the Kitab al-Tasrif, a 30-volume book that explains many medical practices. The part about surgery in this book was later translated into Latin and became a popular and widely used textbook in Europe for 500 years. Al-Zahrawi’s new ideas and inventions in surgery and tools had a big influence in both the East and West, even in modern times. Some of his discoveries are still used in medicine today. He was the first to use catgut for stitching inside the body, and some of his surgical tools are still used to treat patients.

He was the first doctor to recognize that haemophilia is passed down in families and to describe a type of pregnancy called abdominal pregnancy, which was deadly at the time. He also discovered the cause of paralysis. Additionally, he created tools used for surgeries such as Caesarean sections and cataract removal.

Biography

Al-Zahrawi was born in the city of Azahara, which is located 8 kilometers northwest of Cordoba, Andalusia. His exact birth date is unknown, but scholars believe he was born around 936, the same year the city of Azahara was founded. The part of his name, Al-Ansari, indicates he was from the Medinian tribe of Al-Ansar, linking his ancestry to Medina in the Arabian Peninsula.

He spent most of his life in Cordoba, where he studied, taught, and practiced medicine and surgery until shortly before his death in about 1013, two years after the destruction of Azahara. Limited details about his life remain, as much of the information was lost due to the later destruction of El-Zahra during conflicts between Castillian and Andalusian forces. His name first appears in the writings of Abu Muhammad bin Hazm (993–1064), who listed him among the greatest physicians of Moorish Spain. The first detailed account of al-Zahrawi’s life comes from al-Ḥumaydī’s Jadhwat al-Muqtabis (On Andalusian Savants), written six decades after his death.

Al-Zahrawi served as a court physician to the Andalusian caliph Al-Hakam II. He lived during the same time as other notable Andalusian chemists, such as Ibn al-Wafid, al-Majriti, and Artephius. He dedicated his life to improving medicine, especially surgery. As a court physician, he had access to the most advanced medical knowledge and resources of his time, which allowed him to create new surgical techniques and tools. His work as a physician and surgeon helped shape modern surgical practices and left a lasting influence on the field of medicine.

Surgical career

Al-Zahrawi focused on treating diseases using a method called cauterization, which involves burning to remove infected tissue. He created many tools used in surgery, such as instruments for examining the inside of the urethra and for removing objects stuck in the throat, ears, and other body parts. He was the first to draw detailed pictures of different types of tubes used in surgery and the first to treat a wart by using a metal tube and a strong chemical to remove it.

Although Al-Zahrawi never performed a procedure called tracheotomy, he treated a slave girl who had injured her own throat while trying to take her own life. He carefully stitched the wound, and the girl recovered, showing that a cut in the voice box could heal. In writing about this case, he shared important medical knowledge.

Al-Zahrawi also helped develop surgery for brain and nerve problems. He performed operations for head injuries, broken skulls, spinal injuries, hydrocephalus, subdural effusions, and headaches. He was the first to describe a surgical method for treating hydrocephalus, explaining how to safely remove fluid from the brains of children with the condition.

Kitab al-Tasrif

Al-Zahrawi's medical encyclopedia, Kitāb al-Taṣrīf, completed in the year 1000, covered many medical subjects, including surgery, medicine, orthopedics, eye care, drug use, nutrition, dentistry, childbirth, and disease study. The first volume explained general medical rules, the second focused on disease study, and many others discussed drugs and their uses. The final and most famous section described surgery. Al-Zahrawi explained that he placed surgery at the end because he believed it was the highest form of medicine and that a surgeon should know all other medical areas before practicing surgery.

The book included knowledge from nearly 50 years of learning, teaching, and medical work. Al-Zahrawi emphasized the importance of caring for patients and treating everyone fairly, regardless of their social position. He also stressed the need to carefully observe patients to make accurate diagnoses and provide the best treatments.

Modern studies of Kitāb al-Taṣrīf show that it described medical procedures later credited to other doctors. For example, it explained a method for treating a dislocated shoulder that became known as "Kocher's method" and a position used in childbirth called "Walcher position." It also described how to tie blood vessels nearly 600 years before a French doctor named Ambroise Paré did the same. The book was the first to explain that hemophilia, a bleeding disorder, can be passed down through families. It also described a surgical method for treating migraines by tying a blood vessel in the head, a technique that was rediscovered in the 21st century by a South African surgeon named Elliot Shevel.

The 30th and final volume of Kitāb al-Taṣrīf, titled On Surgery and Instruments, was the most important part of the book. It was the first illustrated guide to surgery and helped improve medical tools used in specific operations. Al-Zahrawi included drawings of tools used in surgeries to explain how to perform procedures step by step. The full text was divided into three books for medical students learning about surgery and its tools.

The book was translated into Latin in the 12th century by Gerard of Cremona. It became widely used in European medical schools, such as those in Salerno and Montpellier. For 500 years, it was the main source of surgical knowledge in Europe. A historian named Arturo Castiglioni said that Al-Zahrawi's work on surgery was as influential in its time as Avicenna's medical book, The Canon, was in medicine.

Al-Zahrawi claimed his knowledge came from studying ancient medical texts and his own experience. He wrote, "All my skills come from reading old medical books and learning from them. I also gained knowledge through years of practice." He wrote the book because he saw that surgery was underdeveloped in the Islamic world and not respected by many doctors. He believed this was due to poor understanding of the human body and its functions.

He stated that anyone studying surgery must learn about the body's structure. In urology, he described a tool called michaab, which helped remove kidney stones from the bladder without cutting the skin. His method improved a painful and dangerous procedure used in Europe at the time.

In dentistry, Al-Zahrawi made major contributions. His book included the earliest drawings of dental tools. He used gold and silver wires to fix loose teeth and was the first to replant a tooth in a patient. He also created tools to clean plaque from teeth, which helped prevent gum disease.

Al-Zahrawi invented over 200 surgical tools, including scalpels, retractors, and hooks. He also used catgut, a type of thread that dissolves in the body, for internal stitches. He discovered this after his monkey ate the strings of his oud (a musical instrument) and noticed the strings dissolved. He also designed tools to remove a dead fetus from the body.

Throughout the book, Al-Zahrawi spoke with confidence. He warned that certain procedures should only be done by experienced surgeons who understand the body's anatomy. He disagreed with old ideas, such as using gold for cauterization (burning to stop bleeding), and argued that iron worked better. He also warned that using a hot tool to treat an infection could cause serious harm or even death.

Pharmacology and cosmetics

In pharmacy and pharmacology, Al-Zahrawi helped develop methods to make medicines using sublimation and distillation. He wrote a chapter about pharmacy and drug-making techniques in his book. This chapter was later translated into Latin and called Liber Servitoris. It became an important resource for European herbalists. The book includes recipes and explains how to prepare "simples," which were used to make more complex medicines at the time.

Al-Zahrawi also wrote about cosmetics in his medical encyclopedia. A chapter on cosmetics was included in the Latin translation of his work and used in the West. He viewed cosmetics as part of medicine, calling it "Medicine of Beauty" (Adwiyat al-Zinah). He discussed perfumes, scented oils, and incense. He also created perfumed sticks shaped into molds, possibly the earliest versions of modern lipsticks and solid deodorants.

Legacy

Al-Zahrawi was the most often mentioned expert in surgery during the Middle Ages. Donald Campbell, a historian who studied Arabic medicine, described Al-Zahrawi's influence on Europe as follows:

In the 14th century, the French surgeon Guy de Chauliac referenced al-Tasrif over 200 times. Pietro Argallata (died 1453) called Al-Zahrawi "without doubt the best surgeon of all time." Al-Zahrawi's influence continued for at least five centuries, lasting into the Renaissance, as shown by the frequent use of al-Tasrif by French surgeon Jacques Daléchamps (1513–1588).

The street in Córdoba where he lived is named after him as "Calle Albucasis." He lived in house number 6 on this street, which is kept today by the Spanish Tourist Board with a bronze plaque (given in January 1977) that states: "This was the house where Al-Zahrawi lived."