haec est condicio mortaliumâad has et eius modi occasiones fortunae gignimur, uti de homine ne morti quidem debeat credi
Pliny the Elder: Naturalis Historia VIIÂ 73 (ed. Mayhoff)
The text presented here to the public dates from the middle of the 11th century CE; its author is the Nestorian physician Ê¿UbaidallÄh Ibn BuḫtÄ«Å¡Å«Ê¿,1 who was born in Baghdad but spent most of his life in MaiyÄfÄriqÄ«n, Upper Mesopotamia, where he died sometime after the year 450/1058.2 The Arabic title of the text is KitÄb TaḥrÄ«m dafn al-aḥyÄʾ âBook on the Prohibition to Bury the Livingâ, behind which is hidden a most remarkable medical analysis of the intricate state known as apparent death. Ê¿UbaidallÄh Ibn BuḫtÄ«Å¡Å«Ê¿ framed his expositions as a commentary (tafsÄ«r) on a small treatise which he believed was composed by Galen, but which in fact is a pseudepigraph dating from presumably the 6th century CE; the Greek original of this treatise is lost, but it had been translated into Arabic around the year 800â¯CE, perhaps through a Syriac intermediate; much later, at the beginning of the 13th century CE and based upon the Arabic, a Hebrew translation was made, too. In the present book, Ê¿UbaidallÄh Ibn BuḫtÄ«Å¡Å«Ê¿âs Arabic commentary, which incorporates the pseudo-Galenic treatise, is critically edited from the sole surviving manuscript, translated into English with annotations, and made accessible through a variety of indices; moreover, two independent Arabic versions of the underlying treatise, as well as its Hebrew recension, are appended for comparative purposes.
As will become clear in the course of a detailed introductory study, Ê¿UbaidallÄh Ibn BuḫtÄ«Å¡Å«Ê¿âs commentary, with its sagacious and superior treatment of the subject, constitutes a unique piece of scientific writing: whilst the ritual and religious implications of apparent death have been recognized and raised as an issue by virtually all premodern civilizations, there is no other early example of a purely medicine-based approach to this complex conditionânot in Greek or Arabic literature, not in the rich medico-literary traditions of India or China, and not, for that matter, anywhere else.3 Another noteworthy feature of Ê¿UbaidallÄh Ibn BuḫtÄ«Å¡Å«Ê¿âs commentary is that it corroborates his psychological inclinations and aptitudes, which he displayed most impressively in an epistle on psychosomatics4 but which also pervade the work at hand: whilst (the real) Galen, even in those cases where he comes close to truly psychological interpretations of physical malaise,5 never actually crosses the barrier between body and soul reared by Plato, Ê¿UbaidallÄh Ibn BuḫtÄ«Å¡Å«Ê¿ categorically maintains that the body cannot remain healthy if the soul is ill, and vice versa, and that the body suffers if the soul does, and vice versaâin the context of an era when psychology as a clinical discipline was hardly conceived, and still less defined, Ê¿UbaidallÄh Ibn BuḫtÄ«Å¡Å«Ê¿âs stance, oscillating at times into the then equally nebulous realm of psychiatry, is an extraordinary intellectual achievement which should assure him a place in the annals of his profession.6
In pre-technological medicine, cases of apparent death7 (vita reducta) posed a major diagnostic problem, as it was well known that this condition is potentially reversible, that the signs of clinical death (coma, acrotism, cessation of ocular reflexes, apnoea, hypothermia) are therefore treacherous, and that even suggillation or rigidification do not always, and not necessarily, indicate the presence of a corpse rather than a living organism. Yet with registering the termination of these âvitalâ physical functions, doctors had reached their limits, and drew the still valid conclusion that a sharp boundary between life and death does simply not exist.8 The means to diagnose cerebral death or a breakdown of the central nervous system were not available to them; corneal turbidity, if it was recognized at all, is a rather late symptomatic feature; and whilst they knew the onset of decomposition to be extremely variable, religious and, ultimately, climatic factors, especially in hot countries, called for a clear message and, subsequently, a swift burial of the deceased. The medical profession, notably in the Islamic world, was obliged, when confronted with a seemingly inanimate patient, to weigh up the necessity for an expeditious funeral against the obligation to respect the sanctity of life, for burying a living human being would have amounted to homicide. The problem therefore did, and still does, go beyond the narrower realm of medicine to implicate ethics, theology and law, with the important difference that premodern societies were non-secular by default and scientific medicine far less advanced. On this background it is easy to see why a physician like Ê¿UbaidallÄh Ibn BuḫtÄ«Å¡Å«Ê¿, and before him the unknown author of the pseudo-Galenic treatise, would have felt the urge to take pen in hand and tackle the difficult subject from a clinical point of viewâperhaps in a gesture of self-defence, perhaps in an attempt to rationalize the issue, but no doubt driven by a profound sentiment of responsibility and compassion.
The rise of post-18th century European medicine, based on biochemical discoveries and techniques, brought rapid advances in pathology, diagnosis and therapy, and together with improvements in public health and nutrition also a radical decline in mortality; but even the most recent and most sophisticated tools to determine organic death are still subject to both legal discussions and medical interpretations.9 The 19th century, with its staggering growth of scientific knowledge and the development of increasingly rationalistic philosophies, is full of examples that testify to the simultaneous persistence of ingrained collective fears not just of death but of misdiagnosed death, and that are reflected in gothic literature as well as in occult scienceâsuffice it here to evoke Edgar Allan Poeâs famous tale The Premature Burial,10 or Franz Hartmannâs medico-theosophical effusions.11 It is not without wonder to be observed that Ê¿UbaidallÄh Ibn BuḫtÄ«Å¡Å«Ê¿âs study of apparent death, strictly medical in design but firmly embedded into a deeper layer of philosophical discourse, could have been conceived in a medieval society whose ideological substructure was set by the narratives of salvation history, and his ability to handle such precarious issues in a factual and pragmatic way is an all the more remarkable featâmay Ê¿UbaidallÄh Ibn BuḫtÄ«Å¡Å«Ê¿âs unusual commentary, through this publication, meet with the reception it deserves.
The system of transliteration used in this book is that of the Deutsche Morgenländische Gesellschaft.
Dates separated by a slash refer to the Islamic and Christian calendars respectively.
This observation is readily confirmed by perusing the relevant authoritative works of Jan Meulenbeld, Joseph Needham and George Sarton, for which see bibliography s.vv. HIML, SCC and IHS respectively; Ê¿UbaidallÄh Ibn BuḫtÄ«Å¡Å«Ê¿âs medical inquiries are, both in terms of scope and sophistication, a far cry from the extremely brief and merely descriptive prefigurations of death found in the Hippocratic ÏÏá½¹ÏÏÏον νεκÏá½½Î´Î·Ï or in SuÅrutaâs related declarations, see HippLi 2/112â119 and SuSaá¹ 1/225â228. On resurrection from apparent death as a topos in Arabic literature see BüTop passim, who explicitly notes (p. 177,2â¯ff.) that even in this form the subject has no Greek precedents.
Cf. p. 6 below (s.t. FÄ« Wuǧūb an-naáºar â¦).
See e.g. GalKü 14/632â¯f. with BuḫRis 29â¯f.
Standard histories of psychology have very little indeed to say about pre-Enlightenment forerunners in the field who were not primarily motivated, and constrained, by philosophical theories; for a representative example of the genre see bibliography s.v. IHP.
The German designation Scheintod has no other English equivalent.
On current medical definitions of death and death apparent see e.g. APGsP 11â¯ff.
See e.g. MaDBD 8â¯ff.
See WEAPÂ 236â250.
Thus, Hartmann wrote as late as 1895: âThere is much talk among scientists about the exactitude of their science; but a science that judges merely by appearances can never be exact except as to the mere appearance of things [â¦] Among the many occurrences of everyday life and of which as yet very little is generally known, are the phenomena of consciousness, of life and of death. As long as we do not know anything about their real nature, we have no right to say that a person is dead when the principle of life has ceased to manifest its activity in a human body; we can only say that such a person appears to be dead, and appearances are often delusive. This unfortunate circumstance, far more frequently than is commonly supposed, causes people to be buried alive, especially in countries in which no legal provision is made for public chambers for the dead or for the retention of the supposed corpses until the signs of putrefaction, the only true and infallible signs by which it may be known that the soul and the life have left forever the physical form, have made their appearanceâ, see HarBA 6â¯f.