ZEHRAVİ (936-1013)

Ebu’l Kasım Halef ibn Abbas ez-Zehravi  (batıda olarak bilinir Abulcasis – cerrahinin babası) MS 936’da mahalledeki Zahra’da doğdu, Cordoba. En tanınmış cerrahlardan biri oldu Müslümanların döneminde, İspanya Kralı Al-Hakam-II’nin doktoruydu. Uzun bir tıbbi kariyerin ardından, zengin ve orijinal katkılarıyla, MS 1013’te vefat etti.

Yaklaşık bin yıl önce, İspanya’nın (Andulesia) İslam imparatorluğunun bir parçası olduğu zamanda, başkent Cordoba yakınlarında yaşıyordu. Al Zahrawi o dönemde çok meşhur olan fakat şimdi büyük ölçüde unutulmaya yüz tutan, cerrahinin öncülerinden biriydi. El Zahrawi olarak bilinmesine rağmen, adı Avrupa dillerinde bir düzineden fazla farklı şekilde yazılmıştır: Abulcases, Albucasis, Bulcasis, Bulcasis, Bulcari,Alzahawi, Ezzahrawi, Zahravius, Alcarani, Alsarani, Aicaravi,Alcaravius, Alsahrawi vb.

El Zahrawi’nin, Cordoba’nın altı mil kuzeybatısındaki El-Zahra şehrinde,936 ile 940 yılları arasında doğduğuna inanılıyor. Burada yaşadığı, ölümünden kısa bir süre öncesine yani 1013’te El-Zahra şehrinin yağmalanmasından iki yıl sonrasına kadar burada tıp ve cerrahiyi okudu, öğretti ve uyguladı.

El-Zahra şehri yağmalanmış ve yok edilmiş olduğundan, onun meşhur evladı El Zahrawi hakkında çok az şey biliniyor. İlk olarak, Endülüslü alim Ebu Muhammed bin Hazm (993-1064) onu Mağrib İspanyası’nın büyük doktor-cerrahları arasında göstermiş ve bahsetmiştir. El Zahrawi’nin bilinen ilk biyografisi, El Zahrawi’nin ölümünden altmış yıl sonra tamamlanan Al-Humaydi’nin Jadhwat al-Muktabis (Endülüsün Bilginleri Üzerine) adlı eserinde ortaya çıktı.

El Zahrawi’nin yaşam öyküsünden ve yazılarından, tüm hayatını ve dehasını bir bütün olarak tıbbın ilerlemesine ve özellikle de cerrahiye adadığı açıktır. Cerrahi, tıp, ortopedi, oftalmoloji, farmakoloji, beslenme vb. bölümler içeren 30 ciltlik bir tıbbi ansiklopedi yazdı. Bu kitap At-Tasrif olarak biliniyordu ve El Zahrawi’nin neredeyse 50 yıllık bir kariyer boyunca biriktirdiği eğitim, öğretim ve uygulama verilerini içeriyordu. Görünüşe göre çok az seyahat etti fakat kazazedeler ve savaş yaralılarının tedavisinde geniş deneyime sahipti.

At-Tasrif’de El Zahrawi, “çocuklarım” dediği öğrencilerinin refahı konusundaki endişelerini dile getirdi. İyi bir doktor hasta ilişkisinin önemini vurguladı ve hastalarının sosyal statülerinden bağımsız olarak güvenlerini kazanmaya büyük özen gösterdi. El Zahrawi’nin klinik yöntemleri aşırı öngörü gösterirdi,  en doğru teşhisi ve mümkün olan en iyi tedaviyi oluşturmak için bireysel vakaların yakından gözlemlenmesini teşvik etti. Etik normlara uyum konusunda ısrar etti ve maddi kazanç amacıyla bazı hekimler tarafından kabul edilen belirsiz uygulamalara karşı uyarıda bulundu. Ayrıca cerrah olduklarını iddia eden fakat cerrahi becerilere sahip olmayan şarlatanlara karşı da uyarıda bulundu.

At-Tasrif, tarihsel açıdan ilgi çekici birçok orijinal gözlem içerir. El Zahrawi kitabında, hastalıkların nedenleri ve semptomları üzerine ayrıntılı bir çalışma yapıyor, çocukların ve gençlerin yetiştirilmesi ve yaşlı ve nekahet döneminde olanların bakımı üzerine teoriler ortaya koyuyor. Müslüman Alimler ve Bilim Adamları farmakolojisi ve terapötikleri ile ilgili bölümde kalp ilaçları, emetikler, laksatifler (müshiller), kozmetoloji, diyetetik, materia medica, ağırlıklar ve ölçüler ve ilaç ikamesi gibi alanları kapsamaktadır.

At-Tasrif, 12. yüzyılda Cremonalı Gerard tarafından Latince’ye çevrildi ve Avicenna’nın Kanununun yanı sıra, MS 12. yüzyıldan 17. yüzyıla kadar Avrupa üniversitelerinde tıbbi bir kaynak olarak önemli bir rol oynadı. El Zahrawi’nin iki eseri özel olarak anılmayı hak ediyor. İlk olarak Latince’de Liber servitoris de preeparatione medicinarum simplicium olarak bilinen onun 28. tezinde kimyasal preparatlar, tablet yapımı, ekstraktların filtrelenmesi ve ilgili farmasötik teknikler anlatılmaktadır. Bu inceleme, Nicolaus Jensen tarafından 1471’de Venedik’te basıldı.

Belki de en önemli tezi cerrahi ile ilgili olanıdır. Bu anıtsal eser, cerrahiyi bağımsız ve ayrıntılı olarak anlatan ilk Arapça eserdi. Çoğu El Zahrawi tarafından icat edilen birçok cerrahi alet resimleri ve bunların kullanımıyla ilgili açıklamalar içeriyordu. El Zahrawi, ameliyatta kullanılan aletlerin resimlerini sunan ilk tıbbi yazardı. Bir “dil bastırıcı” ve bir “diş çıkarıcı kateter” ve ayrıntılı bir “obstetrik cihaza” kadar değişen yaklaşık 200 adet bu tür çizim vardır.

Operasyon çeşitlerinin kapsam alanı inanılmaz. Bu incelemede El Zahrawi, koterizasyon, kan alma, ebelik ve doğum ile yaraların tedavisini tartıştı. Temporal arterin belirli tipteki baş ağrılarını hafifletmek için baskılanması ve bölünmesini, idrarın rektuma yönlendirilmesini, aşırı büyük göğüsler için meme küçültme ameliyatını ve kataraktların çıkarılmasını anlattı. Kemik ve eklem yaralanmaları hakkında kapsamlı yazılar yazdı, hatta burun kemikleri ve omurlardaki kırıklardan bahsetti. Aslında, çıkık bir omzu redükte etmek için uygulanan ‘Kocher’in yöntemi’, At-Tasrif eserinde Kocher doğmadan çok önce anlatılmıştı! El Zahrawi ameliyatta kostik(nitrikoksit) kullanımının ana hatlarını çizdi, ölü bir fetüs üzerinde gerçekleştirdiği tonsillektomi, trakeotomi ve kraniotomi operasyonlarını tam olarak tanımladı. Burundan polip çıkarmak için kancayı nasıl kullanacağını, çocuklara lavman vermek için icat ettiği ampul şırıngayı ve nasıl kullanacağını, mesane taşlarını çıkarmak için metal mesane şırıngası ve spekulumun nasıl kullanılacağını açıkladı.

El Zahrawi, obstetrikte sözde “Walcher’in pozisyonunu” tanımlayan ilk kişiydi; diş kemerlerini, dil bastırıcılarını, kılavuz kateterleri ilk gösteren ve hemofilinin kalıtsal koşullarını açıkça tanımlayan ilk kişiydi. Ayrıca Ambroise Pare’den çok önce kan damarlarının ligasyonunu anlattı. Cerrahide kullanılan 200 civarında aleti resimlerini çizerek detaylı şekilde anlatmıştır, nitekim bu aletlerden bir kısmı hala günümüzde kullanılmaktadır.

At-Tasrif, 12. yüzyılda Latince’ye çevrildiğinde, El Zahrawi’nin Batı’ya Cerrahi alanda muazzam bir etkisi oldu. Fransız cerrah Guy de Chauliac, 1363 yılında tamamladığı “Büyük Cerrahi”de At-Tasrif’den 200’den fazla alıntı yaptı. El Zahrawi, Pietro Argallata (1423’te öldü) tarafından “hiç şüphesiz tüm cerrahların şefi” olarak tanımlandı. Bir başka Fransız cerrah olan Jaques Delechamps (1513-1588), At Tasrifi kapsamlı bir şekilde kullanarak ayrıntılı bir şerhini kaleme aldı ve bu El Zahrawi’nin Orta Çağ boyunca ve Rönesans’a kadar olan büyük prestijini doğrular nitelikteydi

Kaynakça

Biography – Muslim Scholars and Scientists (W. Hazmy C.H.Zainurashid Z.Hussaini R.)  syf: 51-55

ZEHRAVİ KİMDİR?

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ZEHRAVİ KİMDİR?” için 369 yorum

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