The Royal Book by Haly Abbas From the 10th Century: One of the Earliest Illustrations of the Surgical Approach to Skull Fractures Haly Abbas was one of the pioneering physicians and surgeons of the Eastern world in the 10th century who influenced the Western world by his monumental work, The Royal Book. The book was first partly translated into Latin by Constantinus Africanus in the 11th century without citing the author’s name. Haly Abbas was recognized in Europe after full translation of The Royal Book by Stephen of Antioch in 1127. The Royal Book has been accepted as an early source of jerrah-names (surgical books) in the Eastern world. The chapters regarding cranial fractures in Haly Abbas’ work include unique management strategies for his period with essential quotations from Paul of Aegina’s work Epitome. Both authors preferred free bone flap craniotomy in cranial fractures. Although Paul of Aegina, a Byzantine physician and surgeon, was a connection between ancient traditions and Islamic interpretation, Haly Abbas seemed to play a bridging role between the Roman-Byzantine and the School of Salerno in Europe. KEY WORDS: Haly Abbas, Head trauma, History of medicine, Skull fracture, The Royal Book Neurosurgery 67:1466–1475, 2010 DOI: 10.1227/NEU.0b013e3181f8d392 www.neurosurgery-online.com A li bin Abbas Majusi Arrajani (?930-994) (Figure 1), known as Haly Abbas in the Western world, was the most influential physician and medical writer during the era between Rhazes (865-925) and Avicenna (980- 1037) when the Golden Age of Islam was still in its height. He was born in Iran and studied general sciences including the ancient masters’ works, and never left the country. 1 He was one of the early authors to refuse the classical knowledge introduced by Aristotle and Galen that implied an anatomic passage between ventricles of the heart. 2-4 Haly Abbas defined the concepts of the capillary system 4-6 and uterine movements during delivery. 4,6 He wrote on goiters and their surgical excisions 4,7,8 and recommended surgery for hy- drocele, imperforate hymen and anus, and arterial wounds when astringent or cauterization did not stop the bleeding. 7 The knowledge from Islamic geography provided by Haly Abbas had been relied on at the end of the 12th and early 13th centuries. Although Haly Abbas’ surgery was discerned in the 12th century, the spread of its Latin translation by Constantinus was probably before AD 1100. 9 Haly Abbas wrote an essential medical work: K amil al-Sin aÔat al-Tibbiya (The Perfect Book of the Art of Medicine), also known as Kit ab al-Malik  i (The Royal Book). 1,10,11 The Royal Book was a medical encyclopedia that quickly and greatly affected the Eastern and Western worlds. It was more systematic and concise than RhazesÕ Continens but more functional than Avicenna’s Canon, 6 by which it was displaced. 5,6,9 In the introduction to this encyclopedia, Haly Abbas criticized the works of Hippocrates (460-370 BC), Galen (AD 129-200), Oribasius (AD 325- 400), Paul of Aegina (AD 625-690), Ahron (sixth century ad), Serapion (second half of ninth century), Mas  ih (ninth century AD), and Rhazes and clarified that his aim was to write a medical book that would contain the whole medical knowledge. 11,12 He also wrote a chapter on medical ethics, 13,14 conveying Hippocrates’ ad- vice to physicians. 11,13 The first half of The Royal Book, consisting of 10 discourses, is related to theory and the second half of the book, con- taining the last ten discourses, is related to the practice of medicine. 1,6,7 The second and third discourses are related to anatomy 6,9 and the 19th discourse, containing 110 chapters, was dedi- cated to surgery. 7,9 Surgical discourse of The Royal Book contains the sections on spinal frac- tures and dislocations and their management, Ahmet Aciduman, MD, PhD Department of Medical History and Ethics, Ankara University School of Medicine, Ankara, Turkey Berna Arda, MD, PhD Department of Medical History and Ethics, Ankara University School of Medicine, Ankara, Turkey Esin Kahya, PhD Section of Science History, Department of Philosophy, Ankara University School of Letters, Ankara, Turkey Deniz Belen, MD Department of Neurosurgery, Ankara Numune Research and Educational Hospital, Ministry of Health, Ankara, Turkey Reprint requests: Ahmet Aciduman, MD, PhD, Do ¨ gol Caddesi, No. 27-14, Mebusevleri, 06580 Ankara, Turkey. E-mail: ahmetaciduman@yahoo.com Received, October 19, 2009. Accepted, June 25, 2010. Copyright ª 2010 by the Congress of Neurological Surgeons 1466 | VOLUME 67 | NUMBER 6 | DECEMBER 2010 www.neurosurgery-online.com LEGACY—INSTITUTIONS AND PEOPLE TOPIC Legacy—Institutions and People Copyright © Congress of Neurological Surgeons. Unauthorized reproduction of this article is prohibited.