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 Applied Medical Statistics

ffirs.indd 1 30-03-2022 21:10:12

ffirs.indd 2 30-03-2022 21:10:12
 Applied Medical Statistics

Jingmei Jiang

Department of Epidemiology and Biostatistics,

Institute of Basic Medical Sciences,
Chinese Academy of Medical Sciences/School of Basic Medicine,
Peking Union Medical College,
Beijing, China

ffirs.indd 3 30-03-2022 21:10:13

 This edition first published 2022
© 2022 John Wiley and Sons, Inc.

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Library of Congress Cataloging-in-Publication Data

Names: Jiang, Jingmei, 1958- author.
Title: Applied medical statistics / Jingmei Jiang.
Description: Hoboken, NJ : John Wiley & Sons, Inc., 2022. | Includes
bibliographical references and index.
Identifiers: LCCN 2021021097 (print) | LCCN 2021021098 (ebook) | ISBN
9781119716709 (hardback) | ISBN 9781119716778 (pdf) | ISBN 9781119716792
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Subjects: LCSH: Medicine--Research--Statistical methods--Textbooks. |
Medical statistics--Textbooks. | Biometry--Textbooks.
Classification: LCC R853.S7 J53 2022 (print) | LCC R853.S7 (ebook) | DDC
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ffirs.indd 4 30-03-2022 21:10:13

 v

Contents

Preface xiii
Acknowledgments xv
About the Companion Website xvii

1 What is Biostatistics 1
1.1 Overview 1
1.2 Some Statistical Terminology 2
1.2.1 Population and Sample 2
1.2.2 Homogeneity and Variation 3
1.2.3 Parameter and Statistic 4
1.2.4 Types of Data 4
1.2.5 Error 5
1.3 Workflow of Applied Statistics 6
1.4 Statistics and Its Related Disciplines 6
1.5 Statistical Thinking 7
1.6 Summary 7
1.7 Exercises 8

2 Descriptive Statistics 11
2.1 Frequency Tables and Graphs 12
2.1.1 Frequency Distribution of Numerical Data 12
2.1.2 Frequency Distribution of Categorical Data 16
2.2 Descriptive Statistics of Numerical Data 17
2.2.1 Measures of Central Tendency 17
2.2.2 Measures of Dispersion 26
2.3 Descriptive Statistics of Categorical Data 31
2.3.1 Relative Numbers 31
2.3.2 Standardization of Rates 34
2.4 Constructing Statistical Tables and Graphs 38
2.4.1 Statistical Tables 38
2.4.2 Statistical Graphs 40
2.5 Summary 47
2.6 Exercises 48

3 Fundamentals of Probability 53
3.1 Sample Space and Random Events 54

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 vi Contents

3.1.1 Definitions of Sample Space and Random Events 54

3.1.2 Operation of Events 55
3.2 Relative Frequency and Probability 58
3.2.1 Definition of Probability 59
3.2.2 Basic Properties of Probability 59
3.3 Conditional Probability and Independence of Events 60
3.3.1 Conditional Probability 60
3.3.2 Independence of Events 60
3.4 Multiplication Law of Probability 61
3.5 Addition Law of Probability 62
3.5.1 General Addition Law 62
3.5.2 Addition Law of Mutually Exclusive Events 62
3.6 Total Probability Formula and Bayes’ Rule 63
3.6.1 Total Probability Formula 63
3.6.2 Bayes’ Rule 64
3.7 Summary 65
3.8 Exercises 65

4 Discrete Random Variable 69

4.1 Concept of the Random Variable 69
4.2 Probability Distribution of the Discrete Random Variable 70
4.2.1 Probability Mass Function 70
4.2.2 Cumulative Distribution Function 71
4.2.3 Association Between the Probability Distribution and Relative Frequency
Distribution 72
4.3 Numerical Characteristics 73
4.3.1 Expected Value 73
4.3.2 Variance and Standard Deviation 74
4.4 Commonly Used Discrete Probability Distributions 75
4.4.1 Binomial Distribution 75
4.4.2 Multinomial Distribution 80
4.4.3 Poisson Distribution 82
4.5 Summary 87
4.6 Exercises 87

5 Continuous Random Variable 91

5.1 Concept of Continuous Random Variable 92
5.2 Numerical Characteristics 93
5.3 Normal Distribution 94
5.3.1 Concept of the Normal Distribution 94
5.3.2 Standard Normal Distribution 96
5.3.3 Descriptive Methods for Assessing Normality 99
5.4 Application of the Normal Distribution 102
5.4.1 Normal Approximation to the Binomial Distribution 102
5.4.2 Normal Approximation to the Poisson Distribution 105
5.4.3 Determining the Medical Reference Interval 108
5.5 Summary 109
5.6 Exercises 110

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 Contents vii

6 Sampling Distribution and Parameter Estimation 113

6.1 Samples and Statistics 114
6.2 Sampling Distribution of a Statistic 114
6.2.1 Sampling Distribution of the Mean 115
6.2.2 Sampling Distribution of the Variance 120
6.2.3 Sampling Distribution of the Rate (Normal Approximation) 122
6.3 Estimation of One Population Parameter 124
6.3.1 Point Estimation and Its Quality Evaluation 124
6.3.2 Interval Estimation for the Mean 126
6.3.3 Interval Estimation for the Variance 130
6.3.4 Interval Estimation for the Rate (Normal Approximation Method) 131
6.4 Estimation of Two Population Parameters 132
6.4.1 Estimation of the Difference in Means 132
6.4.2 Estimation of the Ratio of Variances 136
6.4.3 Estimation of the Difference Between Rates (Normal Approximation
Method) 139
6.5 Summary 141
6.6 Exercises 141

7 Hypothesis Testing for One Parameter 145

7.1 Overview 145
7.1.1 Concepts and Procedures 146
7.1.2 Type I and Type II Errors 150
7.1.3 One-sided and Two-sided Hypothesis 152
7.1.4 Association Between Hypothesis Testing and Interval Estimation 153
7.2 Hypothesis Testing for One Parameter 155
7.2.1 Hypothesis Tests for the Mean 155
7.2.1.1 Power of the Test 156
7.2.1.2 Sample Size Determination 160
7.2.2 Hypothesis Tests for the Rate (Normal Approximation Methods) 162
7.2.2.1 Power of the Test 163
7.2.2.2 Sample Size Determination 164
7.3 Further Considerations on Hypothesis Testing 164
7.3.1 About the Significance Level 164
7.3.2 Statistical Significance and Clinical Significance 165
7.4 Summary 165
7.5 Exercises 166

8 Hypothesis Testing for Two Population Parameters 169

8.1 Testing the Difference Between Two Population Means: Paired
Samples 170
8.2 Testing the Difference Between Two Population Means: Independent
Samples 173
8.2.1 t-Test for Means with Equal Variances 173
8.2.2 F-Test for the Equality of Two Variances 176
8.2.3 Approximation t-Test for Means with Unequal Variances 178
8.2.4 Z-Test for Means with Large-Sample Sizes 181
8.2.5 Power for Comparing Two Means 182

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 viii Contents

8.2.6 Sample Size Determination 183

8.3 Testing the Difference Between Two Population Rates (Normal
Approximation Method) 185
8.3.1 Power for Comparing Two Rates 186
8.3.2 Sample Size Determination 187
8.4 Summary 188
8.5 Exercises 189

9 One-way Analysis of Variance 193

9.1 Overview 193
9.1.1 Concept of ANOVA 194
9.1.2 Data Layout and Modeling Assumption 195
9.2 Procedures of ANOVA 196
9.3 Multiple Comparisons of Means 204
9.3.1 Tukey’s Test 204
9.3.2 Dunnett’s Test 206
9.3.3 Least Significant Difference (LSD) Test 209
9.4 Checking ANOVA Assumptions 211
9.4.1 Check for Normality 211
9.4.2 Test for Homogeneity of Variances 213
9.4.2.1 Bartlett’s Test 213
9.4.2.2 Levene’s Test 215
9.5 Data Transformations 217
9.6 Summary 218
9.7 Exercises 218

10 Analysis of Variance in Different Experimental Designs 221

10.1 ANOVA for Randomized Block Design 221
10.1.1 Data Layout and Model Assumptions 223
10.1.2 Procedure of ANOVA 224
10.2 ANOVA for Two-factor Factorial Design 229
10.2.1 Concept of Factorial Design 230
10.2.2 Data Layout and Model Assumptions 233
10.2.3 Procedure of ANOVA 234
10.3 ANOVA for Repeated Measures Design 240
10.3.1 Characteristics of Repeated Measures Data 240
10.3.2 Data Layout and Model Assumptions 242
10.3.3 Procedure of ANOVA 243
10.3.4 Sphericity Test of Covariance Matrix 245
10.3.5 Multiple Comparisons of Means 248
10.4 ANOVA for 2 × 2 Crossover Design 251
10.4.1 Concept of a 2 × 2 Crossover Design 251
10.4.2 Data Layout and Model Assumptions 252
10.4.3 Procedure of ANOVA 254
10.5 Summary 256
10.6 Exercises 257

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 Contents ix

11 χ2 Test 261
11.1 Contingency Table 262
11.1.1 General Form of Contingency Table 263
11.1.2 Independence of Two Categorical Variables 264
11.1.3 Significance Testing Using the Contingency Table 265
11.2 χ2 Test for a 2 × 2 Contingency Table 266
11.2.1 Test of Independence 266
11.2.2 Yates’ Corrected χ2 test for a 2 × 2 Contingency Table 269
11.2.3 Paired Samples Design χ2 Test 269
11.2.4 Fisher’s Exact Tests for Completely Randomized Design 272
11.2.5 Exact McNemar’s Test for Paired Samples Design 275
11.3 χ2 Test for R × C Contingency Tables 276
11.3.1 Comparison of Multiple Independent Proportions 276
11.3.2 Multiple Comparisons of Proportions 278
11.4 χ2 Goodness-of-Fit Test 280
11.4.1 Normal Distribution Goodness-of-Fit Test 281
11.4.2 Poisson Distribution Goodness-of-Fit Test 283
11.5 Summary 284
11.6 Exercises 285

12 Nonparametric Tests Based on Rank 289

12.1 Concept of Order Statistics 289
12.2 Wilcoxon’s Signed-Rank Test for Paired Samples 290
12.3 Wilcoxon’s Rank-Sum Test for Two Independent Samples 295
12.4 Kruskal-Wallis Test for Multiple Independent Samples 299
12.4.1 Kruskal-Wallis Test 299
12.4.2 Multiple Comparisons 301
12.5 Friedman’s Test for Randomized Block Design 303
12.6 Further Considerations About Nonparametric Tests 306
12.7 Summary 306
12.8 Exercises 306

13 Simple Linear Regression 311

13.1 Concept of Simple Linear Regression 311
13.2 Establishment of Regression Model 314
13.2.1 Least Squares Estimation of a Regression Coefficient 314
13.2.2 Basic Properties of the Regression Model 316
13.2.3 Hypothesis Testing of Regression Model 317
13.3 Application of Regression Model 321
13.3.1 Confidence Interval Estimation of a Regression
Coefficient 321
13.3.2 Confidence Band Estimation of Regression Model 322
13.3.3 Prediction Band Estimation of Individual Response Values 323
13.4 Evaluation of Model Fitting 325
13.4.1 Coefficient of Determination 325
13.4.2 Residual Analysis 326

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 x Contents

13.5 Summary 327

13.6 Exercises 328

14 Simple Linear Correlation 331

14.1 Concept of Simple Linear Correlation 331
14.1.1 Definition of Correlation Coefficient 331
14.1.2 Interpretation of Correlation Coefficient 334
14.2 Hypothesis Testing of Correlation Coefficient 336
14.3 Confidence Interval Estimation for Correlation Coefficient 338
14.4 Spearman’s Rank Correlation 340
14.4.1 Concept of Spearman’s Rank Correlation Coefficient 340
14.4.2 Hypothesis Testing of Spearman’s Rank Correlation Coefficient 342
14.5 Summary 342
14.6 Exercises 343

15 Multiple Linear Regression 345

15.1 Multiple Linear Regression Model 346
15.1.1 Concept of the Multiple Linear Regression 346
15.1.2 Least Squares Estimation of Regression Coefficient 349
15.1.3 Properties of the Least Squares Estimators 351
15.1.4 Standardized Partial-Regression Coefficient 351
15.2 Hypothesis Testing 352
15.2.1 F-Test for Overall Regression Model 352
15.2.2 t-Test for Partial-Regression Coefficients 354
15.3 Evaluation of Model Fitting 356
15.3.1 Coefficient of Determination and Adjusted Coefficient of
Determination 356
15.3.2 Residual Analysis and Outliers 357
15.4 Other Aspects of Regression 359
15.4.1 Multicollinearity 359
15.4.2 Selection of Independent Variables 361
15.4.3 Sample Size 364
15.5 Summary 364
15.6 Exercises 364

16 Logistic Regression 369

16.1 Logistic Regression Model 370
16.1.1 Linear Probability Model 371
16.1.2 Probability, Odds, and Logit Transformation 371
16.1.3 Definition of Logistic Regression 373
16.1.4 Inference for Logistic Regression 375
16.1.4.1 Estimation of Model Coefficient 375
16.1.4.2 Interpretation of Model Coefficient 378
16.1.4.3 Hypothesis Testing of Model Coefficient 380
16.1.4.4 Interval Estimation of Model Coefficient 382
16.1.5 Evaluation of Model Fitting 385
16.2 Conditional Logistic Regression Model 388

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 Contents xi

16.2.1 Characteristics of Conditional Logistic Regression Model 390

16.2.2 Estimation of Regression Coefficient 390
16.2.3 Hypothesis Testing of Regression Coefficient 393
16.3 Additional Remarks 394
16.3.1 Sample Size 394
16.3.2 Types of Independent Variables 394
16.3.3 Selection of Independent Variables 395
16.3.4 Missing Data 395
16.4 Summary 395
16.5 Exercises 396

17 Survival Analysis 399

17.1 Overview 400
17.1.1 Concept of Survival Analysis 400
17.1.2 Basic Functions of Survival Time 402
17.2 Description of the Survival Process 405
17.2.1 Product Limit Method 405
17.2.2 Life Table Method 408
17.3 Comparison of Survival Processes 410
17.3.1 Log-Rank Test 410
17.3.2 Other Methods for Comparing Survival Processes 413
17.4 Cox’s Proportional Hazards Model 414
17.4.1 Concept and Model Assumptions 415
17.4.2 Estimation of Model Coefficient 417
17.4.3 Hypothesis Testing of Model Coefficient 419
17.4.4 Evaluation of Model Fitting 420
17.5 Other Aspects of Cox’s Proportional Hazard Model 421
17.5.1 Hazard Index 421
17.5.2 Sample Size 421
17.6 Summary 422
17.7 Exercises 423

18 Evaluation of Diagnostic Tests 431

18.1 Basic Characteristics of Diagnostic Tests 431
18.1.1 Sensitivity and Specificity 433
18.1.2 Composite Measures of Sensitivity and Specificity 435
18.1.3 Predictive Values 438
18.1.4 Sensitivity and Specificity Comparison of Two Diagnostic Tests 440
18.2 Agreement Between Diagnostic Tests 443
18.2.1 Agreement of Categorical Data 444
18.2.2 Agreement of Numerical Data 447
18.3 Receiver Operating Characteristic Curve Analysis 448
18.3.1 Concept of an ROC Curve 449
18.3.2 Area Under the ROC Curve 450
18.3.3 Comparison of Areas Under ROC Curves 453
18.4 Summary 456
18.5 Exercises 457

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 xii Contents

19 Observational Study Design 461

19.1 Cross-Sectional Studies 462
19.1.1 Types of Cross-Sectional Studies 462
19.1.2 Probability Sampling Methods 462
19.1.3 Sample Size for Surveys 466
19.1.4 Cross-Sectional Studies for Clues of Etiology 468
19.2 Cohort Studies 469
19.2.1 Measures of Association in Cohort Studies 469
19.2.2 Sample Size for Cohort Studies 470
19.3 Case-Control Studies 472
19.3.1 Measures of Association in Case-Control Studies 472
19.3.2 Sample Size for Case-Control Studies 473
19.4 Summary 474
19.5 Exercises 475

20 Experimental Study Design 477

20.1 Overview 478
20.1.1 Basic Components of an Experimental Study 478
20.1.2 Principles of Experimental Study Design 480
20.1.3 Blinding Procedures in Clinical Trials 482
20.2 Completely Randomized Design 483
20.2.1 Concept of Completely Randomized Design 483
20.2.2 Sample Size for Completely Randomized Design 485
20.3 Randomized Block Design 486
20.3.1 Concepts of Randomized Block Design 486
20.3.2 Sample Size for Randomized Block Design 488
20.4 Factorial Design 489
20.5 Crossover Design 491
20.5.1 Concepts of Crossover Design 491
20.5.2 Sample Size for 2 × 2 Crossover Design 492
20.6 Summary 493
20.7 Exercises 493

Appendix 495
References 549
Index 557

ftoc.indd 12 30-03-2022 21:10:37

 xiii

Preface

Over the past few decades, biomedical data have proliferated rapidly, and opportunities
have arisen to use this data to improve human health. Burgeoning methods, such as
machine learning techniques, have emerged to respond to the rapid growth of the
volume of data, and to exploit data in an effective and efficient manner. These methods
were founded on statistical learning theory, which is an expansion of traditional
statistics. Therefore, cultivating basic statistical thinking capability plays an important
and fundamental role in mastering these state-of-the-art methods and embracing the
upcoming big data era, which makes a course of introductory biostatistics an indispens-
able part of the curriculum for medical students. However, as a branch of mathematics,
statistics is characterized by hierarchically organized concepts, but a conceptual under-
standing of statistics is not always intuitive, which makes biostatistics an obstacle that
is regarded as a burden for most medical students. During almost 30 years of teaching
statistics at the Chinese Academy of Medical Sciences & Peking Union Medical College,
China, I have experienced too many occasions on which generations of students, both
undergraduate and postgraduate, have felt that they are struggling to grasp the essence
of statistical concepts and the implications of mathematical formulas, and to master
complex analytical methods. Moreover, their motivation to learn biostatistics has also
been dampened by abstruse formulas and derivation processes. Therefore, a reader-
friendly text that can provide sufficient help for developing statistical thinking and
building propositional knowledge, as well as understanding and mastering analytical
skills, is of great necessity, which was my motivation for writing this book.
Applied Medical Statistics is an introductory-level textbook written for postgraduate
students in the human life-science field, with most topics also being suitable for under-
graduate medical students. The ultimate objective of this book is to provide help in
developing “habits of mind” for statistical thinking, and to establish a trade-off bet-
ween mathematical derivation and know-how application among medical students.
The most distinctive features of this book are summarized as follows: First, emphasis
is placed on the most basic probability theory at the start of the book because, as the
theoretical pillar for almost all statistical methods, strengthening these fundamental
concepts is of great importance for laying a solid theoretical foundation for under-
standing sub­sequent chapters. However, for students to benefit from a practical and
intuitive understanding of principles, rather than presenting abstract concepts, I have
minimized the mathematical sophistication, and introduced content in a user-friendly
style to nurture interest and motivate learning. Second, I have based most of the

Applied Medical Statistics, First Edition. Jingmei Jiang.

© 2022 John Wiley & Sons, Inc. Published 2022 by John Wiley & Sons, Inc.
Companion website: www.wiley.com\go\jiang\appliedmedicalstatistics

fpref.indd 13 30-03-2022 21:10:59

 xiv Preface

working examples on research projects that I have conducted or participated in, and
such real-world settings, in my view, are more helpful for stimulating students’
interest, as well as helping them to learn how to use statistical procedures in practice.
Finally, although this is an elementary applied statistics textbook, it covers some com-
monly used advanced statistical techniques, such as survival analysis and logistic
regression. I also discuss fundamental issues in research design, and the inclusion of
this content will greatly enhance the applicability and benefit to students who need to
reference this book while performing day-to-day medical research.
I have organized the content of this book in a cohesive manner that links all the rel-
evant foundation concepts as building blocks. Chapter 1 starts with an introduction to
the basic concepts of biostatistics, and a section called “statis­tical thinking” strengthens
the importance of statistical thinking in solving real-world problems. Chapter 2 con-
tains an introduction to the basic concepts and application of some fundamental sum-
mary statistics. Moreover, it also covers how to organize data and display data using
graphical methods. Chapters 3 to 5 are compact, and provide background supporting
information to enable students to understand the basic rationale of biostatistics, in
addition to laying a theoretical foundation for subsequent chapters. Chapter 3 con-
tains the development of the basic principles of probability, with suitable examples.
Chapter 4 covers the fundamental concepts of random variables and discrete proba-
bility distribution, including binomial distribution, multinomial probability distribu-
tion, and Poisson distribution. Chapter 5 briefly introduces the most commonly used
continuous probability distributions: mainly normal and standard normal distributions.
Chapter 6 mainly focuses on an introduction to the sampling distribution, as well as
parameter estimation, and plays a unique role in linking descriptive statistics to infer-
ential statistics. This chapter starts the formal discussion of the theoretical background,
as well as the application of inferential statistics. Chapters 7 to 10 contain the basic
principles of hypothesis testing and the elementary parametric hypothesis testing
methods for normally distributed data in two-sample and multiple-sample scenarios,
such as the t-test and analysis of variance methods. The common requirement for
implementing these methods is the assumption that the underlying population should
be normally distributed. Chapter 11 contains an introduction to the fundamental con-
cepts of hypothesis testing methods for categorical data, the chi-square test, and
Fisher’s exact test, which are widely used in statistical analysis. Chapter 12 contains an
overview of some of the most well-known non-parametric tests suitable for scenarios
in which assumptions of normality can be relaxed. Chapters 13 and 15 contain intro-
ductions to extensively used models and techniques for exploring the association bet-
ween risk or predictor factors and continuous response variables. Chapter 13 mainly
focuses on the basic concepts and application of simple linear regression, and Chapter
15 covers its extension: multiple linear regression. Additionally, Chapter 14 contains
an introduction to simple correlation and rank correlation, which measure the strength
of the relationship between two variables. Chapters 16 and 17 contain an introduction
to some essential analysis techniques for modeling the binary and time-to-event
response variables, such as unconditional and conditional logistic regression, and the
Cox proportional hazards model used in processing time-to-event data. Chapter 18
then covers the most commonly used statistical evaluation indices and methods in
diagnostic tests. Chapters 19 and 20, as the concluding chapters of this textbook, con-
tain a discussion of methods for design and sample size estimation issues for observa-
tional and experimental studies.

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 xv

Acknowledgments

I am grateful for the support I received from many people and institutions during the
writing of this book. First and foremost, I express my deepest gratitude to an expert
and consultant team, which included professors Youshang Zhou, Songlin Yu, Konglai
Zhang, and Hui Li, all of whom are well-known Chinese statisticians and epidemiolo-
gists. Their unconditional support and encouragement at every stage of the writing of
this book made it possible for me to complete this work.
I am also grateful for the immense help that I received from my colleagues at the
School of Basic Medicine of Peking Union Medical College. Professor Tao Xu and Dr.
Fang Xue deserve special acknowledgement for providing assistance through conduct-
ing a professional review of my work, and their constructive comments greatly
improved the manuscript. I also want to acknowledge help from Doctors Wei Han,
Zixing Wang, Yaoda Hu, and Haiyu Pang, who provided assistance in the production
of this book through copyediting, reviewing, and correcting many subtle errors.
Fruitful discussions with them also improved how the manuscript treated certain
topics.
In particular, I appreciate the help of my post-graduate students in putting together
this book. Peng Wu help me in organizing much of the material and analyzing the data
in the examples; Ning Li and Cuihong Yang produced accurate figures and diagrams;
Yubing Shen and Luwen Zhang checked the accuracy of all the formulae; Yali Chen
and Lei Wang constructed the index and checked the accuracy of terminology and ref-
erence sources; Jin Du and Yujie Zhao checked the answers to exercises; and Wentao Gu
improved the quality of the mathematical formulas. Without their help, this work
would have been far more difficult to complete.
Much of the motivation of writing comes from teaching and supervising post-grad-
uate students at Peking Union Medical College. I am grateful for their inquisitive ques-
tions and useful feedback on a draft version of this manuscript, which allowed me to
improve the final version.
I express my gratitude to the research projects from which I obtained the data and
background for the examples and exercises; these projects were funded by the
National Natural Science Foundation of China, Ministry of Science and Technology
Fund, Chinese Academy of Medical Sciences Inno­vation Fund for Medical Sciences,
Cancer Research UK, UK Medical Research Council, and US National Institutes of
Health.

Applied Medical Statistics, First Edition. Jingmei Jiang.

© 2022 John Wiley & Sons, Inc. Published 2022 by John Wiley & Sons, Inc.
Companion website: www.wiley.com\go\jiang\appliedmedicalstatistics

flast.indd 15 30-03-2022 21:11:19

 xvi Acknowledgments

I would like express my deep and sincere gratitude to managing editor Kimberly
Monroe-Hill for the professional guidance, coordinating effort and continued support
during the entire drafting and publication process. I also wish to thank commissioning
editor James Watson for assisting us in many ways with this book. I would also like to
thank Arthi Kangeyan and Dilip Varma, the content refinement specialists, for the
professional help in getting the manuscript ready for production.
I thank the School of Basic Medicine of Peking Union Medical College for making
available all the support that I needed in the writing process.
Thanks are owed to Dr. Maxine Garcia, Dr. Jennifer Barrett, and the team at Edanz
Group China for their dedicated and professional language editing support.
Finally, I thank my family for their understanding and encouragement while I was
writing this book.

flast.indd 16 30-03-2022 21:11:19

 xvii

About the Companion Website

This book is accompanied by a companion website:

www.wiley.com\go\jiang\appliedmedicalstatistics
The website includes the solutions manual and data sets.

Applied Medical Statistics, First Edition. Jingmei Jiang.

© 2022 John Wiley & Sons, Inc. Published 2022 by John Wiley & Sons, Inc.
Companion website: www.wiley.com\go\jiang\appliedmedicalstatistics

flast.indd 17 30-03-2022 21:11:19

flast.indd 18 30-03-2022 21:11:19
 1

What is Biostatistics?

CONTENTS
1.1 Overview 1
1.2 Some Statistical Terminology 2
1.2.1 Population and Sample 2
1.2.2 Homogeneity and Variation 3
1.2.3 Parameter and Statistic 4
1.2.4 Types of Data 4
1.2.5 Error 5
1.3 Workflow of Applied Statistics 6
1.4 Statistics and Its Related Disciplines 6
1.5 Statistical Thinking 7
1.6 Summary 7
1.7 Exercises 8

1.1 Overview

Data are present everywhere in our lives, and almost all types of scientific research
have to deal with the collection, description, or analysis of data. This makes statistics
one of the most powerful methodologies across all disciplines for exploring the
unknown world. Statistics is a discipline on its own and has a wide spectrum of the-
ories, methods, and applications. A prerequisite for discussing the theory and applica-
tion of statistics is the definition and statement of its objectives. According to
Merriam–Webster’s Collegiate Dictionary, statistics is “a branch of mathematics dealing
with the collection, analysis, interpretation, and presentation of masses of numerical
data.” According to the Random House College Dictionary, it is “the science that deals
with the collection, classification, analysis, and interpretation of information or data.”
According to The New Oxford English–Chinese Dictionary, it is “the practice or science
of collecting and analyzing numerical data in large quantities, especially for the purpose
of inferring proportions in a whole from those in a representative sample.” Although
there are some differences among these definitions, each definition implies that
statistics is a science of data and uses the theory of mathematical statistics to make
inferences.

Applied Medical Statistics, First Edition. Jingmei Jiang.

© 2022 John Wiley & Sons, Inc. Published 2022 by John Wiley & Sons, Inc.
Companion website: www.wiley.com\go\jiang\appliedmedicalstatistics

c01.indd 1 30-03-2022 21:15:52

Visit https://ebookmass.com today to explore
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Exploring the Variety of Random
Documents with Different Content
 Intellectual Greatness of Moors and Jews Induced
by Their Material Prosperity.—Remarkable
Development of Agriculture.—New Discoveries in
Every Industry.—Mining a Specialty.—The Magnet,
Mariner's Compass Mechanical Apparatus.—Spread
of Commerce Leads to General Awakening of
Europe that Ends Middle Ages.

CHAPTER XV.
171-
The Inquisition.
188
Jewish and Moorish Intellectual Advance followed
by Physical Decline.—This Decline the Cause of
Their Downfall.—The Spaniard Again Ruler Over
Spain.—The Inquisition Established.—To Escape it,
Jews Become "New Christians".—Christianity no
Help to the Jews.—Thomas de Torquemada.—The
Tortures of the Inquisition.—A Public Burning.

CHAPTER XVI.
189-
The Expulsion of the Jews.
205
Torquemada Resolves Upon Immediate Expulsion of
all Unconverted Jews.—The Fatal Edict.—The
Spaniards Moved to Pity.—Don Isaac Abarbanel
Pleads with the Queen.—The Queen Hesitates.—
Torquemada, the Fiend, Conquers Again.—The Ill-
fated Jews Seek Among the Dead the Pity which
the Living Refuse.—The Departure.

CHAPTER XVII.
The Dispersion of the Jews. 206-
 224
Exiles Transported on Ships.—Heart-rending Scenes
on Board a Ship.—Set Ashore on Deserted Islands
to Starve.—Starving Jews Given the Choice
Between Death and Christianity.—Merciful Italy.—
Crafty Portugal.—Torquemada's Edict Eclipsed.—The
Expulsion of the Jews From Portugal.—A Condition.
—The King's Marriage.—Contract.—Final Expulsion.

CHAPTER XVIII.
225-
Effect of the Expulsion.
240
A Brief Review.—Curse of God Visited Upon Spain.—
The Church a False Prophet.—With Expulsion of the
Jews and Moors Spanish Prosperity Ceases.—
Spaniards Experience some of the Sufferings which
the Jews and Moors had Endured.—Spain Makes
Amends.—The Moors Lost.—The Jews Live.

The Jews and Moors in Spain.

 CHAPTER I.
A DAY IN CORDOVA.

SIX AND EIGHT AND TEN CENTURIES BACK IN THE WORLD'S

HISTORY.—OUR ENTRANCE INTO SPAIN.—A MIRACLE.—THE
BEAUTIFUL GUADALQUIVIR.—OUR BRONZE COMPLEXIONED
OARSMAN.—FAIR CORDOVA.—THE CITY OF THE ARTS AND
SCIENCES.—NIGHT.—A SERENADE.—OUR DEPARTURE.

It is with the past that we shall commune in these pages. Events

and scenes, beautiful and loathsome, joyous and tearful, ennobling
and degrading, will follow each other in rapid succession. There will
be much that, despite the very best of historic sources, and most
reliable and impartial authorities, will be accepted as fabulous or will
be rejected as incredible or impossible. Achievements will be
described, that will startle us for their peerless magnificence and
lead us to suppose that we are not dealing with facts, but with the
imaginations of some rich phantasy or with the fictitious colorings of
a mind enthusiastic for an ideal society; and miseries and sufferings
will be depicted that will strike terror into our very soul, and cause
our heart to rise in rebellion against the mind, when asked to believe
them as actual occurrences, and not as some distressing and
revolting and blood-stained work of fiction, written by some hellish
fiend for the amusement or for the schooling of the vicious
indwellers of the bottomless pit of Tophet. And yet, it will be history,
and true history, strange and incredible, marvelous and anomalous
though it may appear. Six and eight and ten centuries have since
passed by, and the most wonderful of all centuries they have been,
centuries that chronicle the birth and prodigious growth of the
sciences and inventions, the creation and successful continuance of
republican and constitutional governments, the breaking down of
castes and barriers between man and man, the suppression of
political and religious terrorism and these blessed results have so
tickled our conceit, have so raised our moral standard that it is
almost impossible for us to properly conceive—either in all its
grandeur or in all its baseness—that era of the past, which we are
about to traverse.
But know we must, and therefore, what the mind refuses to believe,
and what the heart refuses to credit, let the eye see. Let us think
ourselves back six and eight and ten centuries. Let us enter upon a
far and distant journey. Away we speed. Far, far across the wild
Atlantic. We have reached the sunny land of Spain. Here let us
pause for a hasty inspection. It will not take us long, for that
country, that is among the poorest of all European countries to-day,
whose reeking filth has recently made it a scene of revelry to the
ravishing plague, whose stupendous ignorance, and appalling
superstitions, have made it a by-word among the civilized people of
the earth, that country, so backward now, will certainly have no
attractiveness for us, ten centuries earlier in its history.
Lo! A miracle! The magic wand of some frolicksome fay must have
suddenly transformed the land of expected filth and wretchedness
into a beauteous fairyland. Amidst rapturous admiration of the
indescribable beauties, which meet our gaze everywhere, we glide
along upon the placid surface of the Guadalquivir, in which a
wondrously clear blue sky glasses itself, and splendrous palaces and
gorgeous parks are reflected. We have entered beautiful Andalusia.
We glide along the southern declivity of the Sierra Morena. Suddenly
there breaks upon our view a scene of beauty that mocks every
attempt at description. We ask our black eyed, bronze complexioned
and proud featured oarsman for the name of that magnificent city
that lies stretched for miles along the right bank. He understands us
not. We address him in French, in German, in Greek, in Latin. No
answer. We are at our wits' end. We must know, and so we seek
recourse, as a last resort, to our mother tongue, the language of the
Hebrews, and his face brightens, and his tongue is loosened, and in
accents as melodious and pure as it must have been spoken by
David himself, when he sang to his harp, the words of his own
heaven-inspired psalms he makes reply: "What ye behold, ye
strangers, is the city of Cordova, the government seat of the valiant
and chivalrous, and scholarly and liberal, and art-loving Caliph
Abderrahman III."
We are burning with a desire to see that city, whose simple outlines
display such bewildering elegance. With our courteous oarsman as
guide, we advance along the street that leads from the river bank.
We gaze and gaze in awe-stricken silence. Amazement is expressed
on every countenance. Our eyes are dazzled with the enchanting
magnificence that abounds. We have reached the palace of the
Caliph. Are we dreaming? Are we under the power of some magic
spell? Is this a whim of some sportive, mischief-loving fay? Have we
not thought ourselves some ten centuries back? Are we in the midst
of the Dark Ages; in European lands, and among the people of the
tenth century, concerning whose stupendous ignorance and
loathsome filth historians have had so much to say? Has history
deceived us in its teaching that the people of Europe, six and eight
centuries back had scarcely emerged from the savage state, that
they inhabited floorless, chimneyless, windowless huts, those of
princes and monarchs differing only in their having rushes on the
floor and straw mats against the walls, that they fed on roots and
vetches and bark of trees, clothed in garments of untanned skin
which remained on the body till they dropped in pieces, that there
existed scarcely a city, everywhere pathless forest and howling
wastes?
It is not a dream. Neither has history deceived us. We are in
European lands, but among Oriental people. We are in the midst of
the prime of the dark ages, but we are in the Southern part of
Spain, in Andalusia, in the city of Cordova, a city of 200,000 houses,
and 1,000,000 inhabitants, of hundreds of parks and public gardens,
of menageries of foreign animals, of aviaries of rare birds, of
factories in which skilled workmen display their art in textures of silk,
cotton, linen, and all the miracles of the loom, in jewelry and in
filigree works, in works of art, and in scientific instruments and
apparatus. We are in the city that, even then, could boast of a
college of music, of libraries, of public schools, of universities in
which instructions were given in the sciences and philosophies and
languages, and literatures and arts. We are in the city of art and
culture and learning, the city made famous and beautiful by the
literary and cultured Moors and Jews, whose prosperity continued as
long as the followers of Mohammed and the followers of Moses were
permitted to dwell in peace side by side, but whose glory vanished
as soon as Christianity banished the Jews and Moors from Spain. But
we must not indulge in any reflections now. Our raven locked guide,
whose beautiful form, and winning countenance, and melodious
voice involuntarily remind us of the beautiful lover of the love-
inflamed Shulamite in "Solomon's Song," beckons, and we must
follow. On we march, and with every step new and matchless
beauties unroll themselves before us. We know not what we shall
admire first, and most, whether the polished marble balconies that
overhang luscious orange gardens, or the courts with the cascades
of water beneath the shades of the cypress trees, or the artificial
lakes, supplied with water by hydraulic works, replete with fish;
whether the shady retreats with inlaid floors and walls of exquisite
mosaic, vaulted with stained glass and speckled with gold, over
which streams of water are continually gushing, or the fountains of
quicksilver, that shoot up in glittering globules and fall with a tranquil
sound like fairy bells; whether the apartments into which cool air is
drawn from the flower gardens, in summer by means of ventilating
towers and in winter through earthen pipes or caleducts imbedded in
the walls—the hypocaust, in the vaults below, or the walls adorned
with arabesque and paintings of agricultural scenes and views of
paradise, or the ceilings corniced with fretted gold, other great
chandeliers with their hundreds and hundreds of lamps; whether the
columns of Greek, Italian, Spanish and African marble, covered with
verd-antique and incrusted with lapis lazuli, or the furniture of sandal
and citron wood, inlaid with mother of pearl, ivory, silver, or relieved
with gold and precious malachite, or the costume of the ladies
woven in silk and gold, and decorated with gems of chrysolites,
hyacinths, emeralds and sapphires; whether the vases of rock
crystal, Chinese porcelains, the embroidered Persian carpets with
which the floors are covered, the rich tapestry that hangs along the
walls, or the beautiful gardens, profuse with rare and exotic flowers,
winding walks, bowers of roses, seats cut out of the rock, crypt-like
grottoes hewn into the stone; whether the baths of marble, with hot
and cold water, carried thither by pipes of metal, or the niches, with
their dripping alcarazzas, or the whispering galleries for the
amusement of the women, or the labyrinths and marble play-courts
for the children.
On and on we pass, and new beauties still. We pass mosques and
synagogues whose architectural finish is still the admiration and
model of the world, and our gentle guide informs us that a public
school is attached to each, in which the children of the poor are
taught to read and write. We pass academies and universities, and
our guide assures us that many a Hebrew presides over the Moorish
institutions of learning. He reads the expression of surprise on our
countenance, for we think of the striking contrast between his
Mohammedan liberality and the intolerance of the other European
countries, from which they are scarcely weaned as yet, and he
modestly informs us that the Mohammedan maxim is, that "the real
learning of a man is of more importance than any particular religious
opinions he may entertain." And as the famous scholars pass in and
out, our guide mentions them by name, and speaks of their brilliant
accomplishments, of professors of Arabic classical literature, of
professors of mathematics and astronomy, compilers of dictionaries
similar to those now in use, but of larger copiousness, one of these
covering sixty volumes, he points out the lexicographers of Greek
and Latin and Hebrew and Arabic, and the encyclopedists of the
"Historical Dictionary of Sciences," the poets of the satires, odes and
elegies, and the inventors of the rhyme, the writers of history, of
chronology, of numismatics, mathematics, astronomy, of pulpit
oratory, of agriculture, of topography, of statistics, of physics,
philosophy, medicines, dentistry, surgery, zoology, botany, pharmacy,
and of the numerous other branches of learning.
Night has set in. Men are gathering around their evening fires to
listen to the wandering literati, who exercise their wonderful powers
of tale telling, and edify the eager listeners by such narratives as
those that have descended to us in the "Arabian Nights'
Entertainments." The dulcet strains of the dreamy and love-awaking
mandolin, accompanying the rapturous love song of some chivalrous
knight to his lady fair, break on our ears. Soon all is silent. We fain
would stay, but our guide is weary from his day's task. Perchance
the sweet strains of the serenade have awakened within his bosom
tender longings for his fair Shulamite, "whose eyes are as the
dove's, and whose lips are like a thread of scarlet, and whose
speech is comely," (Song of Solomon, chap. iv.) to whom he would
eagerly speed. And so we retrace our steps. For miles we walk in a
straight line, by the light of public lamps; seven hundred years after
this time there was not so much as one public lamp in London. For
miles we walk along solidly paved streets. In Paris centuries
subsequently, whoever stepped over his threshold on a rainy day
stepped up to his ankles in mud. We have reached the bank of the
Guadalquivir, and we have parted with our guide.
We have seen in one day more than we ever dared to dream of;
enough to tempt us to visit it again and again, and not only Cordova,
but also Grenada, Toledo, Barcelona, Saragossa, Seville, and other
cities, to acquire a better acquaintanceship with their scholars and
institutions, and with the wondrous advance of their civilization.
Before we return, however, we shall visit France, Germany, England
and Northern Spain, during the same era of the world's history,
about ten centuries back, and the scenes that we shall meet there
will enable us to appreciate all the better the benefits which the
Moors and the Jews lavished upon Europe, and we shall become the
more painfully conscious of the unatonable crime Spain has
committed in expelling the Moors from Europe, and degrading the
Jews for centuries to the dregs of mankind.
 CHAPTER II.
EUROPE DURING THE DARK AGES.

UPON THE OCEAN.—DESOLATE EUROPE.—LONGING AFTER

CORDOVA.—SOUTHERN SPAIN CONTRASTED WITH THE REST OF
EUROPE.—REVOLTING UNCLEANLINESS.—ASCETIC MONKS
ESTABLISH THE BELIEF THAT CLEANLINESS OF BODY LEADS TO
POLLUTION OF SOUL.—INTELLECT FETTERED HAND AND FOOT.—
CLERGY RETARDING PROGRESS.—SECULAR KNOWLEDGE SPURNED.

On, on, we glide upon the smooth, broad bosom of the majestic
Guadalquivir, along graceful groves and parks and palaces, through
woods and meads, hills and dales, shades and sun. A last glance,
and beauteous Cordova hides her proud head behind the sun-kissed
horizon.

Fair Cordova, fair Andalusia, fair Southern lands of Spain, fare ye

well, take our brief adieu, till we visit you anew.
On, on, we sail, towards the Atlantic now we speed.

We have reached the shores of the interminable ocean. Its wild

waves dash fiercely against the rock-ribbed shores, as if impatient
for our return. Our goodly ship, staunch and strong, raises and
lowers its festooned bow upon the heaving billows of the waters
vast, and its pendant is playing in the wind, and its sails from the
foreroyal to the mizzenroyal, and up to the very top of the mainroyal
are furled to the full, in its hearty welcome to our return. We
embark, and—

"On, on the vessel flies, the land is gone.

Four days are sped, but with the fifth, anon,
New shores descried, make every bosom gay,"

For we are to visit beautiful France, and learned Germany, and busy
England, and Italy, of classic fame.
Once more we are on the continent. Once more our observations are
to be put to the task. Once more we think ourselves some six and
eight and ten centuries back in the world's history. Once more the
eye is to be made to see what the mind has refused to credit.
Dreary and chilling and appalling are the scenes that now break
upon our view. Longingly we think of thee, fair Cordova, thou pride
of beauteous Andalusia. We think of thy pavements of marble, of thy
fountains of jasper, of thy wondrous artistic skill, of thy exquisite
gardens, of thy famous poets and musicians, artists and writers,
philosophers and scientists, of thy chivalrous knights and enchanting
ladies. Longingly we think of thy wondrous beauty, that would,
indeed, in our present surroundings, have sounded fabulous had not
our own eyes seen it. Had we been suddenly transplanted from the
midst of blossoming and ripening summer, joyous because of its
balmy breath and the melodious song of its birds, and the fragrant
breath of its flowers, and the gladdening sight of its ripening fruit
into the midst of the barren winter, where nature is frozen dead, and
the storm rides on the gale, and the earth is bare and naked, and
the air is cold and dreary, and the sun shines gloomily through the
bleak and murky skies, that sudden change could not have been
more keenly nor more painfully felt than that which marked the
contrast between the southern lands of Spain and the countries of
France and Germany and England and Italy, during the same age of
the world's history. Scarcely a city anywhere, save those few that
had been erected along the Rhine and the Danube by the Romans.
Nothing that could, even with the broadest stretch of leniency, be
designated as agricultural. Everywhere pathless forests, howling
wastes, ill-boding wildernesses, death-exhaling swamps, pestiferous
fens. Prussia, and many more of to-day's proudest stars in the
galaxy of European provinces, we find still uncivilized, still roaming
about in the very costumes of native barbarians, in the spirits—and
vampires—and nixes—and gnomes—and kobolds—inhabited pathless
forests. Nowhere a street or highway, save those the Romans had
built. Everywhere we must make our way, amidst indescribable
difficulties, through almost impassable mud and clay. The people
crowded together in miserable hamlets, inhabit wretched
homesteads, crudely and bunglingly put together of undressed
timber, or of twigs wattled together and covered with clays or
thatched with straw or reeds, consisting seldom of more than one
room, which shelters alike man, woman, child, man servant, maid
servant, fowl and beast, a commingling of sex and species not
altogether conducive to modesty or morality. The floor, for the main
part is composed of the hard bare ground, or at best is covered with
dry leaves or with filthy rushes. Nowhere a window, nowhere a
chimney, the smoke of the ill-fed, cheerless fire escaping through a
hole in the roof. Straw pellets constitute the bed, and a round log
serves the place of bolster and pillow, one platter of treen stands in
the center of the table—if "table" it might be called—from which
man, woman and child, master and servant, maid and mistress, eat
with spoons of wood. Fingers serve the place of knives and forks,
and a wooden trencher makes the round to quench the thirst.
Everywhere we meet with men with squalid beards, and women with
hair unkempt and matted with filth, and both, clothed in garments of
untanned skin, or, at best, of leather or hair cloth, that are not
changed till they drop in pieces of themselves, a loathsome mass of
vermin, stench and rags. No attempt at drainage; the putrefying
slops and garbage and rubbish are unceremoniously thrown out of
the door.
The most revolting uncleanness abounds, and we cannot help
thinking of the scrupulous cleanliness that distinguished Cordova, for
cleanness is one of the most rigorous injunctions and requirements
with both the religion of Mohammed and the religion of Moses. Here,
on the contrary, personal uncleanliness, the renunciation of every
personal comfort, the branding of every effort for better
surroundings, we are told, upon inquiry, has the highest sanction of
the church. The sordid example set by the Ascetic monks has
established the belief that cleanliness of the body leads to the
pollution of the soul, that in the past those saints were most
admired who had become one hideous mass of clotted filth. With a
thrill of admiration a priest informs us that St. Jerome had seen a
monk who for thirty years had lived in a hole, and who never
washed his clothes, nor changed his tunic till it fell to pieces; that St.
Ammon had never seen himself naked; that the famous virgin,
named Silvia, had resolutely refused for sixty years, on religious
principles, to wash any part of her body, except her fingers; that St.
Euphraxia had joined a convent of 130 nuns, who shuddered at the
mention of a bath; that an anchorite had once imagined that he was
mocked by an illusion of the devil, as he saw gliding before him
through the desert a naked creature black with filth and years of
exposure; it was the once beautiful St. Mary of Egypt, who had thus
during forty-seven years been expiating her sins of Asceticism.
We have seen enough to lead us to the conclusion, that when we
enter into an examination of the mental and moral and religious
state of the people, whose personal and domestic life hold so low a
rank in the history of civilization, we must not place our expectations
too high. But low as we picture it to ourselves, the reality we find is
infinitly lower than even our most lenient imagination had pictured
it. Only a week ago we found Cordova proud, and distinguished, and
peerless in the realm of culture, and art, and philosophy, and
science, and now, during the same period of the world's history, we
find a deep black cloud of appalling ignorance overhanging France,
and Italy, and Germany and England, here and there only broken by
a few, a very few, glimmering lights. Intellect, fettered hand and
foot, lies bleeding at the feet of benighted barbarism, writhing in
pain beneath the lashes of degrading superstitions, and groveling
credulity. We search for the cause of this stupendous ignorance, and
we soon find that to the clergy, more than to all other causes
combined, belongs the very ignoble distinction of having ushered
into Europe this stolid ignorance, and for being responsible for the
unatonable crime of having retarded the advance of civilization by
many centuries.
To the all powerful and all controlling influence of the Church is to be
ascribed the universal paralysis of the mind during the very same
period, when art and science and independent research flourished in
Southern Spain under Moorish and Jewish influence. Whomsoever
we approach, be they dignitaries of the Church or Church menials,
distinguished luminaries or obscure parish priests, a conversation
with them soon proves to us the sad truth, that their stock of
knowledge exhausts itself with an enumeration of some monstrous
legends or with the practice and teaching of some degrading and
repulsive superstitions.
Secular knowledge is spurned. Physical science is held in avowed
contempt and persecuted upon the ground of its inconsistency with
revealed truth. Philosophical research is prohibited, under the
severest punishment, as pernicious to piety. Upon inquiry as to the
cause of this persecution of learning on the part of the church,
which, as we modestly dare to suggest, has nothing to lose, but
everything to gain from rational research and diligent pursuit of
knowledge, a bishop emphatically informs us that they did this with
the sanction and authority of the fourth council of Carthage, which
had prohibited the reading of secular books by bishops, and with the
authority of Jerome who had condemned the study of secular
subjects, except for pious ends, and as there was no lack of piety
(so they artlessly thought) they saw little use in preserving the
learning and literature of the accursed Jews and heathens, and
fearing lest they fall into the hands of others, not so pious as they,
and not so protected against their pernicious influence by the
knowledge of legends, or by the skillful use of magic spells, or
exorcising charms, as they were. Or perhaps secretly fearing, lest an
intimate knowledge of the learning of the ancients might open the
eyes of the people to the ignorance and extortions and crimes and
corruptions of the Church, they condemn that whole literature to the
flames. Hundreds and thousands of valuable manuscripts are thus
pitilessly destroyed. We fain would stay their cruel hand, but we fear
for our lives. We see them erase the writing from hundreds and
thousands of parchment copies of ancient priceless lore, and
substitute in its stead legends of saints, and ecclesiastical rubbish,
occasioning thus the loss of many an ancient author that is now so
painfully missed.
We turn away from this revolting stupidity, but nowhere a pleasing
sign to allay our anguish, or appease our grief-stricken heart.

"Oh, thou monstrous ignorance, how deformed dost thou look."

Nowhere freedom of humane thought. Everyone compelled to think

as ecclesiastical authority orders him to think. In Germany, France
and Northern Spain we find scarcely one priest out of a thousand
who can write his name. In Rome itself, once the city of art and
culture and learning, as late as 992, a reliable authority informs us,
there is not a priest to be found who knows the first elements of
letters. In England, King Alfred informs us that he cannot recollect a
single priest south of the Thames (then the most civilized part of
England) who at the time of his accession understood or could
translate the ordinary Latin prayer, and that the homilies which they
preached were compiled for their use by some bishop from former
works of the same kind, or from the early Patristic writings.
Throughout Christendom we find no restraint on the ordination of
persons absolutely illiterate, no rules to exclude the ignorant from
ecclesiastical preferment, no inclination and no power to make it
obligatory upon even the mitred dignitaries, to be able to read a line
from those Scriptures which they are to teach and preach as the rule
of right and the guide to moral conduct. Darkness, intense darkness,
stupendous ignorance everywhere. We shudder as we think of the
cruelties which this ignorance will bequeath as its curse upon
mankind. We shudder as we think of how this ignorance needs must
check the advance of civilization. We know that knowledge will not
be fettered forever, but before it shall be able to assert its right to
sway over the mind of men, countless giant minds will have to be
crushed and indescribable suffering will have to be endured. We
know that "ignorance seldom vaults into knowledge, but passes into
it through an intermediate state of obscurity, even as night into day
through twilight." We tremble for those independent spirits that shall
live during that transitory period. That twilight will be reddened by
the reflection of streams of human blood.
We fain would speed away from these European lands, for we
instinctively feel that we are in lands under the curse of God, and
smitten with darkness, because their people had laid cruel hands
upon the lands and the people of learning and culture and art.
But we must stay. We must note, distressing though the duty be, the
terrible influence which this ignorance exercised upon the morals of
the Church itself, and upon the mental and moral and political and
social and industrial state of the people.
 CHAPTER III.
EUROPE DURING THE DARK AGES.

(CONTINUED.)

GROSS SUPERSTITIONS.—A CRUCIFIX THAT SHED TEARS OF

BLOOD.—THE VIRGIN'S HOUSE CARRIED THROUGH THE AIR BY
ANGELS.—SATAN IN THE FORM OF A BEAUTIFUL WOMAN.—SCENES
IN HELL.—THE BURNING OF WITCHES.—A KING WHO CANNOT
WRITE HIS NAME.—FEUDAL LORDS AS HIGHWAY ROBBERS.—THE
SERFDOM OF THE PEASANTS.—RETURN TO CORDOVA.

We promised to make a careful examination into the influence which

the ignorance of the clergy exercised upon the aspect of religion,
upon the morals of the Church, and upon the social, industrial,
political, moral and mental state of the people at large. We fear we
made a rash promise. So heart-rending are the sights we see, if we
are to give a faithful report, those unacquainted with the state of
European civilization during the period which we are traversing, we
fear, may accuse us of exaggeration, or worse still, may think that
we, who belong to the race that suffered most during that period
from the corruption of the Church, are animated by a spirit of
revenge, and, therefore, find intense delight in holding so revolting a
picture before our readers. But, happily, our readers are not
composed of such. We are addressing intelligent people, men and
women who know that our people have suffered too terribly and too
unjustly from false accusations during many, many centuries, to
render ourselves guilty of the same crime; men and women who
know, that it is not from choice, but from historic necessity, that we
contrast the social, and moral and intellectual state of Christian
Europe during the Dark Ages, with the social and moral and
intellectual state of Moorish and Jewish Europe of the same period,
to appreciate the better the wonderful civilization of "The Jews and
Moors in Spain."
Our search discloses to us the sad and terrible truth that ignorance,
especially active ignorance, is the mother of superstition, and both
the parents of fanaticism, and the offspring of this trio is deliberate
imposture, extortion, corruption, crime, and these, in their turn,
beget the world's misfortunes. This sad truth stares us in the face
whatever church, cathedral, monastery or community we enter.
Everywhere miracles and relics and idolatry. Everywhere the
teaching and preaching of hell and Satan and witchcraft, and of the
necessity of blind credulity and unquestioning belief. Every cathedral
and monastery has its tutelar saint, and every saint his legend, and
wondrous accounts are spread concerning the saint's power, for
good or evil, often fabricated to enrich the church or monastery
under his protection.
In Dublin we see the crucifix that sheds tears of blood. In Loretto we
see the house once inhabited by the Virgin, and we were told, that
some angels, chancing to be at Nazareth when the Saracen
conquerors approached, fearing that the sacred relic might fall into
their possession, took the house bodily in their hands, and, carrying
it through the air, deposited it at its present place. In Bavaria they
show us the brazen android which Albertus Magnus had so cunningly
contrived as to serve him for a domestic, and whose garrulity had so
much annoyed the studious Thomas Aquinas. In Alsace the abbot
Martin shows us the following inestimable relics, which he had
obtained for his monastery: a spot of the blood of Jesus, a piece of
the true cross, the arm of the apostle James, part of the skeleton of
John the Baptist, a bottle of milk of the blessed Virgin, and, with an
ill-disguised envy, he told us that a finger of the Holy Ghost is
preserved in a monastery at Jerusalem.
Everywhere we are told that the arch fiend and his innumerable
legions of demons are forever hovering about us, seeking our
present unhappiness and the future ruin of mankind; that we are at
no time, and at no place, safe from them; that we cannot be
sufficiently on our guard against them, for sometimes they assume
the shape of a grotesque and hideous animal; sometimes they
appear in the shape of our nearest and dearest relatives and friends;
sometimes as a beautiful woman, alluring by more than human
charms, the unwary to their destruction, and laying plots, which
were but too often successful against the virtue of the saints;
sometimes the Evil One assumes the shape of a priest, and, in order
to bring discredit upon that priest's character, maliciously visits, in
this saintly disguise, some very questionable places and allows
himself to be caught in most disgraceful situations and
environments. Can we imagine an invention more ingenius to hide
the foul practices of the corrupt among the clergy?
Everywhere the clergy finds it a very profitable traffic to teach how
the people might protect themselves against the Evil One. The sign
of the cross, a few drops of Holy water, the name of the Virgin, the
Gospel of St. John around the neck, a rosary, a relic of Christ or of a
saint, suffice to baffle the utmost efforts of diabolic malice, and to
put the Spirits of Evil to an immediate and ignominious flight.
There is not a Church, not a monastery that we enter, but that our
blood is chilled at its fountain, as we gaze upon the ghastly
paintings, representing the horrible tortures of hell, placed
conspicuously for the contemplation of the faithful, or for the fear of
the wicked, or for the gain of the clergy—for the heavier the purse
the church receives, the surer the release. It is impossible to
conceive more ghastly conceptions of the future world than these
pictures evinced, or more hideous calumnies against that Being, who
was supposed to inflict upon His creatures such unspeakable misery.
On one picture the devil is represented bound by red-hot chains, on
a burning gridiron in the center of hell. His hands are free, and with
these he seizes the lost souls, crushes them like grapes against his
teeth, and then draws them by his breath down the fiery cavern of
his throat. Demons with hooks of red-hot iron, plunge souls
alternately into fire and ice. Some of the lost are hung by their
tongues, others are sawn asunder, others are gnawed by serpents,
others are beaten together on an anvil, and welded into a single
mass, others are boiled and strained through a cloth, others are
twined in the embraces of demons whose limbs are of flames. But
not only the guilty are represented suffering thus, but also the
innocent, who expiate amidst heart-rending tortures the guilt of their
fathers.[1] A little boy is represented in his suffering. His eyes are
burning like two burning coals. Two long flashes come out of his
ears. Blazing fire rolls out of his mouth. An infant is represented
roasting in a hot oven. It turns and twists, it beats its head against
the roof of the oven in agony of its suffering.
Unable to gaze upon the scene of innocent suffering any longer, we
turn from it, trembling with rage. We ask a priest, who chances to
be near, what fiend could calumniate thus the good God? And
smoothly he replies:
"God was very good to this child. Very likely God saw it would get
worse and worse and would never repent, and so it would have to
be punished much more in hell. So God, in his mercy, called it out of
the world in its early childhood."[2]
We no longer wonder at the stupidity of the people, at the enormous
wealth, and still greater power of the clergy, when we remember
that the people were inoculated with the belief that the clergy alone
could save them from such eternal tortures, and that money was the
safest and most potent redeemer, and the never failing mediator for
effacing the most monstrous crimes, and for securing ultimate
happiness.
We turn from these frightful sights only to encounter more terrible
scenes of misery. So far we had gazed upon purely imaginary
suffering, now we encounter the real, the intensely real. Everywhere
we see the sky lurid from the reflection of the autos da fe, on which
thousands of innocently accused victims, suffer the most agonizing
and protracted torments, without exciting the faintest compassion.
Everywhere we hear the prison walls re-echo the piercing shrieks of
women, suffering the tortures preceding their conviction as witches.
And once, it was in Scotland, we were the unfortunate spectators of
a sight which we never shall forget. While the act of burning witches
was being preformed amidst religious ceremonies, with a piercing
yell some of the women, half burnt, broke from the slow fire that
consumed them, struggled for a few moments with despairing
energy among the spectators, until, with wild protestations of
innocence, they sank writhing in agony, breathing their last.
And why are these women burnt by the thousands, everywhere, in
Germany, France, Spain, Italy, Flanders, Sweden, England, Scotland
and Ireland? Because they had entered into a deliberate compact
with Satan. They had been seen riding at midnight through the air
on a broomstick or on a goat. They had worked miracles thus
infringing upon the monopoly of the saints—or had afflicted the
country with comets, hailstorms, plagues, or their neighbors with
disease or barrenness. And who invents so malicious a falsehood?
Often the victims themselves, for, suspected or accused of witchcraft
they are at once subjected to tortures, to force a confession of their
guilt, and these are so terrible, that death is a release, and so they
confess, whatever the witch-courts want them to confess. Many a
husband cuts thus the marriage tie which his church had
pronounced indissoluble. Many a dexterous criminal directs a charge
of witchcraft against his accuser, and thus escapes with impunity.
Everywhere we find the whole body of the clergy, from pope to
priest, busy in the chase for gain; what escapes the bishop is
snapped up by the archdeacon, what escapes the archdeacon is
nosed and hunted down by the dean, while a host of minor officials
prowl hungrily around these great marauders. To give money to the
priest is everywhere regarded as the first article of the moral code.
In seasons of sickness, of danger, of sorrow, or of remorse,
whenever the fear or the conscience of the worshiper is awakened
he is taught to purchase the favor of the saint. St. Eligus gives us
this definition of a good Christian: "He who comes frequently to
church, who presents an oblation that it may be offered to God on
the altar, who does not taste the fruits of his land till he has
consecrated a part of them to God, who offers presents and tithes to
churches, that on the judgment day he may be able to say: "Give
unto us Lord for we have given unto Thee;" who redeems his soul
from punishment, and finally who can repeat the creeds or the
Lord's prayer."
Bad as we find their greed, we find their moral corruption
indescribably worse. Void of every sting of conscience, drunken, lost
in sensuality and open immorality. In Italy, a bishop informs us, that
were he to enforce the canons against unchaste people
administering ecclesiastical rites, no one would be left in the Church,
except the boys. Everywhere, clergymen, sworn to celibacy, take out
their "culagium," their license to keep concubines, and more than
one council, and more than one ecclesiastical writer we find
speaking of priestly corruption far greater than simple concubinage,
prominently among whom they mention, Pope John XXIII, abbot
elect of St. Augustine, at Canterbury, the abbot of St. Pelayo, in
Spain, Henry III Bishop of Liege, and they enumerate the countless
nunneries, that are degraded into brothels, and are flagrant for their
frequent infanticides.
There is scarcely a need for our reporting concerning the influence,
which this moral depravity of the Church has upon the masses. We
find that the ignorance and the corruption and the bigotry made the
people fully as ignorant and corrupt and vicious. The pernicious
doctrine already adopted in the fourth century, that it is an act of
virtue to deceive and lie, when by that means the interests of the
church might be promoted,[3] leads the people to the conclusion
that nothing can be possibly wrong, which leads to the promotion of
the Church's interests and finances. And so crimes are perpetrated,
wrongs committed, deceptions practiced, vice indulged without a
pang of conscience, or a throb of the gentler emotions. Ignorance
deadens every finer feeling, and religion, instead, of elevating man's
moral nature, crushes it by the opportunities it offers for canceling
crime with money, and for saving the soul from eternal torture and
damnation by increasing the clergy's opportunities for debauchery.
We next look for the intellectual accomplishments, but we look in
vain. The masses are intensely ignorant. The clergy can not instruct
them, neither would they, if they could. Knowledge among the
masses would have seriously interfered with their all-controlling
power, as it really did in later centuries. This ignorance is fully shared
by the secular chiefs of the land. Kings repudiate book-learning as
unworthy of the crown, and warlike nobles despise it as disgraceful
to the sword. It is a rare thing, and not considered an
accomplishment, to find a warrior who can read or write. To suppose
that he can write is to insult him by mistaking him for an ecclesiastic.
No less a personage than Philippe le Bel, the powerful monarch of
United France who conducts foreign wars and exterminates the
Templars, signs his name with the sign of the cross or a rude arrow
head, as late as the thirteenth century. Let us not forget, that nearly
three hundred years earlier in the world's history, we had found
public schools, academies, universities, libraries, poets, artists,
scientists and philosophers flourishing among the Moors and Jews of
Cordova—had seen Al Hakem the Caliph, writing a digest on the fly-
leaves of the contents of each of his books in his great library.
We next look for the Industries, and there is little to be found that
can be honored with that name. A belief prevails among the people
that the millenium, the end of the world, will set in, amidst terrible
sufferings at the year 1000. This belief stifles industry, and property
and wealth are turned over to the Church for the sake of the soul's
release. Next come the Crusades and these sap Europe of the flower
of its people, who leave by the thousands and hundreds of
thousands (and of which numbers but few return), to keep the
Moslems out of Jerusalem, while the aged and the infirm, the
women and children, eke out a miserable existence at home, feeding
on beans, vetches, roots, bark of trees—often horseflesh and mare's
milk furnish a delicious repast. During the intervals between the
various Crusades those few who return, are so accustomed to their
roving and plundering life that it is impossible for them to settle
down to mechanical or industrial pursuits.
The Jews devote themselves almost exclusively to the industries,
and for this they suffer much. Commerce is not safe. The feudal
lords descend from their fortresses to pillage the merchant's goods.
The highways are besieged by licensed robbers, who confiscate the
merchandise, murder the owners, or sell them as slaves, or exact
enormous ransoms. Might makes right, and the most powerful are
the most distinguished for their unscrupulous robberies. Their
castles, erected on almost inaccessible heights among the pathless
woods, become the secure receptacles of predatory bands, who
spread terror over the country and make traffic and enterprise
insecure and next to impossible. And as it is on land so it is at sea,
where a vessel is never secure from an attack of the pirates, and
where neither restitution nor punishment of the criminals is obtained
from governments, which sometimes fear the plunderer and
sometimes connive at the offense.
The political state of Europe we find still worse. The word liberty has
not yet found its way into the dictionaries of the people. By far the
greater part of society is everywhere bereaved of its personal liberty.
Everyone that is not Noble is a slave. Warfare is the rule of the day.
The Church tramples upon kings and nobles; these, in their turn,
such is the prestige of the feudal system, tyrannize over the next
lower order, the next lower order apes the example of its superior
upon its inferior, and so on from lower to lower caste, till the lowest,
the peasants, who have sunk into a qualified slavery called serfdom.
The fight for supremacy between Church and State, the dreadful
oppression of the several orders of feudalism, convulses society with
their perennial feuds, the pride of the countries are either cruelly
butchered or employed more frequently in laying waste the fields of
their rivals, or putting the destructive firebrand, or the ruthless
sword upon the prosperity of their foe, than improving their own.
Let this report, meager as it is, suffice. The ignorance and misery
and suffering and cruelties that abound everywhere are too revolting
to tempt a longer stay. Like Ajax, we pray for light. Away from the
jaws of darkness.
Ye sailors, ho! furl your sails, raise the anchor, clear the harbor. And
thou goodly vessel, staunch and strong, hie thee straight across the
foaming deep. And thou, O Aeolus, blow cheerily and lustily thy
southern winds upon us. And thou, O Neptune, speed thou our
course, haste us back again to fair Andalusia, to beauteous Cordova,
for there is no spot on earth like Cordova, "the city of the seven
gates," "the tent of Islam," "the abode of the learned," "the meeting
place of the eminent," the city of parks and palaces, aqueducts and
public baths, the city of chivalrous knights and enchanting ladies.
Aeolus and Neptune answer our prayer. The goodly ship she spins
along. "She walks the waters like a thing of life." Soon the lands we
eager seek will be descried, and, once again upon the sunny shore,
we shall continue our observations, and freely share them with our
friend upon Columbia's virgin soil.
 CHAPTER IV.
OUR RETURN TO CORDOVA.

CORDOVA AT DAY-BREAK.—THE MOHAMMEDAN SABBATH.—THE

YOUTH OF CORDOVA DISPORTS ITSELF UPON THE WATER.—SONG.
—CHALLENGE BETWEEN OARSMAN.—THE MUEZZIN'S CALL.—THE
GREAT MOSQUE.—A SERMON.—CHASDAI IBN SHAPRUT, THE
JEWISH MINISTER TO THE CALIPH.—DUNASH IBN LABRAT.—ON
THE WAY TO ABDALLAH IBN XAMRI, THE MOORISH POET.

Again our light-winged boat glides upon the broad and silvery bosom
of the majestic Guadalquiver, along parks filled with flowering
shrubs, along glittering palaces and song-resounding woods, along
palmy islets, and sweet scented and crimson-tinted hills.
It is an early spring morning, nearly 1,000 years back in the world's
history. Our boat makes a sudden turn, and Cordova, all glistening in
the morning dew, raises her head as if from a bath in the crystal
stream. Aurora, goddess of the dawn, blushes in the sky, and with
her rosy fingers she sports playfully with the golden tresses of
Andalusia's fairest daughter. It is morn,
 "When the magic of daylight awakes
A new wonder each moment, as slowly it breaks;
Hills, cupolas, fountains, called forth everyone
Out of darkness, as if but just born of the sun."

It is with difficulty that our agile oarsman, the raven-locked and

graceful featured Jewish youth, whose services as guide we have
again secured, makes his way among the countless pleasure boats
that ply to and fro. We marvel at this, for distinctly we remember
how the broad stream was furrowed during our first visit by boats of
traffic only. "It is Friday, the Mohammedan Sabbath," our guide
informs us, and we no longer wonder. The boats, some gilded, some
festooned, some decked with the richest tapestry, are peopled with
gay and happy pleasure seekers. The whole youth of Cordova seems
to disport itself upon the water. The air re-echoes their merry
laughters and their music:

"From psaltery, pipe and lutes of heavenly thrill,

Or there own youthful voices, heavenlier still."

The winged chorister of the woods and parks take up the refrain,
and warble their sweetest, as if in contest with voices human for
supremacy in song. But what is most strange and most charming is
the continual challenge between the oarsmen for repartee songs,
which are either extemporized at the moment, or quotations from
their numerous poets. A boat crosses our path, stays our course,
and its oarsman to test our guide's readiness to sing Cordova's
praise, thus begins in the sweet tones of the poetic Arabic tongue:
 "Do not talk of the court of Bagdad and its glittering magnificence.
Do not praise Persia and China, and their manifold advantages,
For there is no spot on earth like Cordova,
Nor in the whole world beauties like its beauties."

To which our guide instantly replies, with a sweet and pure tenor
voice:

"O, my beloved Cordova!

Where shall I behold thine equal.
Thou art like an enchanted spot,
Thy fields are luxuriant gardens,
Thy earth of various colors
Resembles a flock of rose colored amber."

The challenging oarsman had met his peer. He is pleased with the
reply and clears the path. Now our oarsman impedes the path of a
boat, and taking for his theme, "The Ladies," challenges its oarsman
thus:

"Bright is the gold and fair the pearl,

But brighter, fairer, thou, sweet girl.
Jacinths and emeralds of the mine,
Radiant as sun and moon may shine,
But what are all their charms to thine?"

To which the challenged replies:

 "The Maker's stores have beauties rare,
But none that can with thee compare,
O pearl, that God's own hand hath made;
Earth, sky and sea,
Compare with thee,
See all their splendors sink in shade."

We have reached the landing place. Again we tread in the streets of

Cordova, that had surprised and delighted us so much during our
first visit. We have not advanced far, when suddenly there breaks on
our ear a voice, loud and mighty, as never heard before. We look in
the direction whence the voice comes, and on the graceful balcony
around the "minaret"—the "muezzin," who calleth, with a solemn
power in his living voice, which neither flag, trumpet, bell nor fire
could simulate or rival, the Faithful thus to prayer:
"Come to prayer! Come to prayer! Come to the Temple of Salvation!
Great God! Great God! There is no God except God!"
At the sound of the muezzin's call, the throngs that crowd the
streets hasten their steps, while some few stop, and turning towards
the Kiblah—(point of the heaven in the direction of Mecca, which is
indicated by the position of the minarets,) either prostrate
themselves upon the ground, or, folding their arms across their
bosom, bow their turbaned head to the ground, and raise their heart
and voice to Allah. Five times, every day, our guide informs us, the
muezzin calls the faithful to prayer. Those who are thus worshiping
publicly upon the streets, are for some reasons prevented from
attending the mosque, and the Koran allows them to pray in any
clean place, and the streets of Cordova are clean indeed. Prayer is
great with the Moors, our guide continues. Mohammed has laid
great stress upon its efficacy and importance. "It is the pillar of
religion and the key to paradise," said he. "Angels come among you
both by night and day, when they ascend to heaven God asks them
how they left his creatures. We found them, say they, at their
prayers, and we left them at their prayers." Even the postures to be
observed in prayer he had prescribed. Females in prayer are not to
stretch forth their arms, but to hold them on their bosoms. They are
not to make as deep inflexions as the men. They are to pray in a low
and gentle tone of voice. They are not permitted to accompany the
men to the mosque, lest the mind of the worshipers should be
drawn from their devotions. Neither are they allowed to worship
together with the men. They have their gallery in the mosque fenced
in with latticework. No one is permitted to go to prayer decked with
costly ornaments or clothed in sumptuous apparel.
While listening to our guide, our feet unconsciously followed the
hastening throngs, and before we were aware of it we stood before
the "mezquita," the great mosque, the famous edifice which, with its
buildings and courts, covers more space than any place of worship in
existence, the rival of the Caaba at Mecca, and of the Alaksa of
Jerusalem. Like all Moorish architecture, its exterior is very plain. Our
guide gives us its dimensions; it is 642 feet long and 440 wide. The
height of the Alminar tower is 250 feet.
This is Friday, the "Yawn al Yoma" the great day of assembly for
worship, the Mohammedan Sabbath, sacred because on that day
man was created, because that day had already been consecrated
by the early Arabians to "Astarte," Venus, the most beautiful of the
planets and the brightest of the stars; and, also because from that
day, Friday (July 16, 622,) the day of the Hegira, begins the
Mohammedan calendar. Our guide assures us that there are special
services on Friday, that on this day the Mufti expounds some
chapters from the Koran, and the "Imaum" (preacher,) delivers a
"Khotbeh" (sermon).
We enter through one of the nineteen lofty and massive bronze
gates, and the beauties we now behold baffle description.
The "Kiblah" is reached by nineteen aisles, marked by columns of
jasper, beryl, verd-antique, porphyry, finely carved, supporting in two
directions double horseshoe arches, one above the other. These are
crossed by thirty-eight aisles, also composed of columns of different
marbles, making thus literally a forest of columns. The ceiling is filled
with ovals inscribed with appropriate inscriptions from the Koran, to
call the mind of the faithful to contemplation and devotion. From it
are suspended 280 chandeliers, which light the vast space with
upwards of 10,000 lights.
The "Al Mihrab" at the "Kiblah" end of the mosque is an octagonal
niche, the ceiling of which is formed like a shell out of a single block
of white marble. Within it is the Shrine of Shrines, containing one of
the original copies of the Koran, the one which lay upon the lap of
Othman, the third Caliph, our guide tells us, when he was
assassinated; it is stained with his life blood. It lies upon a lecturn of
aloe wood, put together with golden nails. The doors of the shrine
are pure gold, the floor solid silver, inlaid with gold and lapis lazuli.
In front of it is the pulpit made of costly woods, inlaid with ivory and
enriched with jewels; the nails joining its parts are also of gold and
silver. It is the gilt of the Caliph, and the cost exceeds $1,000,000.
The Caliph himself drew the plan of the entire edifice, and assisted
daily with his own hands in its erection.
Within the mosque there is a court 220 feet long, containing
promenades which invite to devout meditations, and reservoirs and
fountains for their ablution, for, as our guide informs us, ablution is
enjoined by the Koran, with great precision as preparative to prayer;
purity of body being considered emblematical of purity of soul.
There is not a seat in the entire edifice; the worshipers are either
prostrated upon the floor, which is artistically paved with marble
mosaics, or they stand profoundly bent in reverence.[4]
As the Mufti, his careful ablutions being completed, approaches the
"Al Mihrab," to take from its sacred Shrine the copy of the Koran, all
prostrate themselves on the ground. He opens the book, and with a
loud voice he reads the first "sura," chapter:
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