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Reviving the art of medical poetry

Farid Alsabeh
Physician
May 7, 2023
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It’s often said that medicine is an art: that practicing it requires more than just a knowledge of theory, but a certain flair, intuition, and attention to style.

We might agree that medicine has the form of art. But what about medicine as the content of art: as the material and even the inspiration for artistic expression?

That isn’t as strange as it seems. In fact, in the Islamic tradition of medicine, a growing body of medical knowledge and discoveries was routinely expressed using the artistic mode of poetry.

Let’s plunge back in time, explore this lost art form, and see whether we can revive it for a modern audience.

The Islamic Golden Era, typically dated from 750 CE-1250 CE, led to a flourishing of intellectual activity across a diverse range of cultures and peoples. Combining them was Arabic, the language of Islamic scripture, which now served as the lingua franca of the new empire.

At the time, Arabic was already a language with an extensive poetic heritage. Nomadic bedouins, the keyholders of the tongue, had used it to defend their tribe’s honor, recount romantic meetups, and describe the haunting beauty of their desert landscape.

But now, taken up by the nascent Islamic civilization, the register of Arabic poetry was expanded beyond its original tribal context. The richness of scientific discovery combined with the eloquence of the Arabic tongue to create a unique genre: didactic poetry, the poetic expression of academic subjects.

Thus we find, for example, that a 9th-century astronomer named al-Fazari composed a work called “Poem on the Zodiac,” a poetic catalog of celestial knowledge intended as a transmission to the next generation of astrologers.

But the subject matter that inspired the most didactic poetry was medicine. In the centuries coinciding with the Islamic Golden Age, hundreds of didactic medical poems appear. And out of these, one of them would become so well-known that it would come to define the whole genre.

The medical poem of Ibn Sina, an Islamic polymath known as the “Prince of Physicians,” is the most famous Arabic didactic poem. Formally known as “Rajaz Poem on Medicine,” it numbers over 1300 lines and covers every medical topic known during its time, from the composition of the four humors to the treatment of ailments by herbal remedies.

The following line appears early in the poem and provides Ibn Sina’s definition of medicine:

“Medicine is the preservation of health and removal of disease / From causes in a body which has symptoms”

In this simple line, many aspects of medicine are exhibited: prophylaxis (preservation of health), treatment (removal of disease), etiology (from causes) and clinical medicine (has symptoms). And all of this is in a concise formulation, following a meter called “rajaz” that lends itself easily to memorization.

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In fact, so effective was the poem’s ability to convey medical knowledge that its Latin translation — which was devoid of its aesthetic qualities — was nonetheless studied for many centuries at medical schools in medieval Europe.

Is medical poetry an archaic genre, destined to be lost to time? Or are there opportunities to bring anew its relevance and application in modern times?

Of course, medical knowledge has expanded so much that a fully comprehensive work would be impossible. But what has been lost in comprehensiveness is gained in detail: Today, there are many information-rich topics that are open to the creativity of any poetically-inclined physician.

As for the formal aspects of Arabic medical poetry, the features of the “rajaz” meter are easily transferable into English. Each line is divided into halves called hemistiches, each of which conserves the same meter and rhyme scheme.

In my own practice as a psychotherapist, I have developed several “rajaz-like” verses in order to keep diagnostic criteria in mind. The following covers depression:

For depression at least one of two / loss of interest or a lowered mood

And then some of these symptoms combined / so in total they make at least five

Changes in appetite or in weight / sleeping too much or staying awake

Agitation or movements are slow / high fatigue or the energy’s low

Thoughts of guilt or of not having worth / trouble concentrating on their work

And the last one is thinking to die / either thoughts about it or to try

And the symptoms continue at least / a duration of time of two weeks

Like Ibn Sina’s “rajaz,” this short verse keeps a consistent meter (triplets) with doublet rhyming. It contains the necessary criteria for a major depressive episode, including its chronicity. Ultimately, it is intended as a shorthand: a catchy rule-of-thumb that I can use to arrive at a diagnosis.

As for medical diagnoses, here’s what a portion of a verse about hyponatremia might look like, taken from the clinical recommendations of Braun et al. (2015):

If the sodium level declines / so it’s lower than 135

Then you know right away when you’ve seen it / that the patient is hyponatremic

And the follow-up test has to be / for the serum osmolality

If the patient is measuring low / meaning 280 points or below

The condition is called hypotonic / and that means that it’s true and it’s honest

And the follow-up test you should do / is to check the TBW

If the patient is measuring high / but the total sodium is fine

Then the fluids may just have appeared / from an overabundance of beer

Or there aren’t appropriate rates / Of secretion of the ADH

Between mental and physical health diagnoses, health care providers can find many topics that lend themselves to the art form of medical poetry.

It takes art to practice medicine. But medicine itself, as a subject matter, can inspire art — and moreover, art that serves educational needs. The didactic poetry of medieval Islamic physicians, most notably that of Ibn Sina, give us a nice template to express medical knowledge through verses: for the enjoyment of the creator, the memorization of students, or purely aesthetic interests.

For poetically-inclined readers, I offer the following: Let’s work to revive the lost art of medical poetry, which reached its pinnacle in the Islamic tradition, and find catchy aesthetic expressions of medical knowledge.

Farid Alsabeh is a clinical psychologist.

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