Before catgut, there were ants.
Think about that for a second. Really let it sink in, the
way cold water seeps through your shoes on a November morning. You’ve got a
wound—maybe a bad one, the kind that gapes open like a mouth trying to say
something terrible—and the solution, the only solution, was to grab a
big ant, press its mandibles to the edges of your torn flesh, and wait for the
little bastard to bite down. Then you’d snap the body off, leaving the head
there, doing its grim work. Holding you together with nothing but insect
stubbornness and the prayers of whoever loved you enough to stay in the room.
They did this in South America. Deep in Africa. Probably in
other dark, desperate corners of the world too, places where necessity didn’t
just mother invention—it tortured it into being.
There were also leaves. Chewed leaves, pressed into wounds
like a poultice from some fever dream. You can almost smell it, can’t you? That
green, vegetal smell mixing with copper blood, someone’s hands trembling as
they packed the injury shut and hoped.
Then came a man named Abul Qasim Khalaf ibn al-Abbas
az-Zahrawi.
The Europeans called him Abulcasis, because Europeans have
always had a talent for simplifying things they don’t fully understand. He was
born in 936 CE in Zahra, just outside Cordoba in what is now Spain, in a city
so wealthy and luminous and alive with knowledge that historians would
later call it the jewel of the tenth-century world. And that’s exactly what it
was—a jewel in the mud of a mostly dark and suffering Europe, shining.
Al-Zahrawi was, to put it plainly, a genius. The kind of
genius that comes along maybe once a century if you’re lucky, the kind that
looks at the world’s suffering and doesn’t flinch, doesn’t look away, but leans
in.
He invented catgut. Surgical suture. Thread made from the
intestines of sheep and cattle—animal tissue that a wounded human body would
accept instead of reject, would heal around instead of fighting off. He
understood, nine centuries before the germ theory of disease became fashionable
dinner conversation, that the body was a particular and temperamental thing,
that it had opinions about what you put inside it.
The ants became unnecessary. The chewed leaves were retired.
He invented 26 surgical instruments that had never existed
before. Scalpels. Bone saws. Retractors. Specula. Things that look, in old
illustrations, like the tools of some medieval nightmare but were in fact the
opposite—they were the instruments of salvation, of a man reaching into
the darkness of the human body and, with careful hands, pulling people back
toward the light.
His great work, Al-Tasrif, ran to thirty volumes and
fifteen hundred pages. Three hundred and twenty-five diseases, classified and
described with the cool, methodical precision of a man who had seen too much
suffering to be melodramatic about it. European surgeons carried that book the
way you might carry a Bible, or a compass, or a lucky charm against the
darkness. Guy de Chauliac, a French surgeon working three hundred years after
Al-Zahrawi died, quoted from it over two hundred times. Two hundred times.
Some Italian translator called him “the leader of all surgeons,” which sounds
like an epitaph, the kind you’d carve in stone if you wanted it to last.
It lasted.
Al-Zahrawi died in 1013 CE, at seventy-seven years old,
having served as personal physician to the Umayyad caliphs of Andalusia. Not
long after, the golden age he’d been a part of began its long, slow unraveling.
The Umayyad Caliphate in Cordoba crumbled. The jewel went dark, or at least
dimmer.
But the catgut remained. The instruments remained. The
knowledge—that careful, hard-won, blood-and-intestine knowledge—remained.
There’s something almost horrifying about that, in the best
possible way. The idea that a man born in the tenth century, in a city that no
longer exists as it was, could reach across a thousand years and still—still—have
his fingerprints on the sutures closing your wounds, on the tools in your
surgeon’s hands.
The ants are gone.
Al-Zahrawi is still here.
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